Critical thinking and anesthetic monitoring

Drawing on more than 20 years of experience, Amanda Shelby, RVT, VTS (Anesthesia; Analgesia), talks about the importance of considering patient history, comorbidities, and anticipated complications alongside monitoring equipment readings to achieve optimal anesthetic management and patient safety.

Transcript

Amanda Shelby, RVT, VTS (Anesthesia; Analgesia): Hi, I'm Amanda Shelby. Super excited to be speaking at Fetch. If you couldn't catch it live, of course, we hope to have an on-demand viewing of this outstanding lecture. This, again, is in live person. In person will be interactive, and the key feature to this presentation, what is happening, reading between the lines, is to put the whole clinical picture in front of you in a controlled setting, obviously in a classroom-esque setting, but case-based anesthetic, real-life monitoring situations that I've accumulated over the 20-plus years in the field of anesthesia, of unique things and sometimes common things that we see. I'll share with you a video or a clip with a little bit of background about a patient, and you get to see if you can figure out with the clinical information I provide you what you think is happening by reading between the lines. So the key points here to drive home critical thinking, taking into consideration your patient's history, any comorbidities, what anesthetics they have, what anticipated complications associated with the comorbidities and procedure they're undergoing, looking at those monitors, taking in that information that I provide you, and coming to a conclusion on what you think is happening, and even better, what you think the treatment should be to turn that case around. So that's what you hope to achieve, or what I hope you can enjoy and achieve from this presentation of reading between the lines.

Yeah, so in a clinical situation under anesthesia, or in a patient that's sedated, or one I'm getting prepared to put under anesthesia, as soon as we induce a patient, or even when we give a medication, the three key things that, you know, we don't need to make this super complicated, the three key things: does it have a pulse? Is it breathing? And what is its level of anesthetic depth? And that probably relates more to already being unconscious. But is it going to jump up and leave the table, or are we on a pathway towards undesirable outcomes from there? It's attaching monitoring equipment and learning about what that monitoring equipment tells you and perhaps what it doesn't tell you, and then always being able to reach under there and look at your patient. Now I realize some procedures make it a little more challenging than others to see your patient, but comparing what does your patient show you with what does your monitor show you, and what did you anticipate to happen is really what I find to be key in getting those key foundations in place, those foundational bricks in place to being a true, outstanding anesthetist. So I do hope that you can take away some of those nuggets from this "Reading Between the Lines" presentation to build that foundation.