These guidelines were approved by the Diplomates of the ACVA in December of 1994, and published in the Journal of American Veterinary Medical Association on April 1, 1995. (JAVMA, Vol. 206, No. 7, 936-937.)
Objective: to ensure that blood flow to tissues is adequate.
Methods: (1) Palpation of peripheral pulse; (2) palpation of heartbeat through thoracic wall; (3) auscultation of heartbeat (stethoscope, esophageal stethoscope, or other audible heart monitor); (4) electrocardiogram (continuous display) (a, b); (5) noninvasive blood flow or blood pressure monitor (examples: Doppler ultrasonic flow detector, oscillometric flow detector) (a, b); and (6) invasive blood pressure monitor (arterial catheter connected to transducer/oscilloscope or to anaeroid manometer).(b)
Objective: to ensure adequate oxygen concentration in the patient's arterial blood.
Methods: (1) Observation of mucous membrane color; (2) pulse oximetry (noninvasive estimation of hemoglobin saturation); (3) oxygen analyzer in the inspiratory limb of the breathing circuit; (4) blood gas analysis (PaO2); and (5) hemoximetry (measurement of hemoglobin saturation in the blood).
Objective: to ensure that the patient's ventilation is adequately maintained.
Methods: (1) Observation of thoracic wall movement; (2) observation of breathing bag movement; (3) auscultation of breath sounds; (4) audible respiratory monitor; (5) respirometry (measurement of tidal volume +/- minute volume); (6) capnography (measurement of CO2 in end-expired gas); and (7) blood gas monitoring (PaCO2).
Objective: to maintain a legal record of significant events and to enhance recognition of trends in monitored variables.
Methods: (1) Record all drugs administered to each patient, noting the dose, time, and route of administration; and (2) record monitored variables (minimum: heart rate, respiratory rate) on a regular basis (minimum: every 10 minutes) during anesthesia.
Objective: to ensure that a responsible individual is aware of the patient's status at all times during anesthesia and recovery, and is prepared either to intervene, when indicated, or to alert the veterinarian in charge about changes in the patient's condition.
Methods: (1) If a veterinarian, technician, or other responsible person is unable to remain with the patient continuously, a responsible person should check the patient's status on a regular basis (at least every 5 minutes) during anesthesia and recovery; (2) a responsible person may be present in the same room, although not necessarily solely occupied with the anesthetized patient (for instance, the surgeon may also be responsible for overseeing anesthesia); (3) in either of the aforementioned situations, audible heart and respiratory monitors are suggested; and (4) a responsible person, solely dedicated to managing and caring for the anesthetized patient during anesthesia, remains with the patient continuously until the end of the anesthetic period.(a, b)