Basic knowledge and instrument introduction of hospital anesthesia
一、The work of an anesthesiologist
The anesthesiologist is also called the physician in the operating room. The anesthesiologist wants to relieve the patient's pain and manage important vital signs of the patient, including breathing, heart rate, blood pressure, heart, nervous system, liver and kidney functions, etc. Not only is proficient in various anesthesia operation techniques to ensure that the patient's surgery is painless and the operation is carried out smoothly, but also uses advanced instruments to monitor the patient's life function at any time. Take various treatment measures to maintain the stability of the patient’s life function and ensure the safety of the patient.
Generally speaking, clinical anesthesiologists are responsible for:
1. Jointly decide with the patient's doctor in charge whether the patient can withstand surgical anesthesia;
2. Decide which anesthesia and monitoring measures to use;
3. Anesthetize the patient;
4. Make every effort to ensure the safety of patients throughout the operation;
5. After the operation, the patient can recover safely and steadily;
6. Postoperative pain treatment;
7. Treatment of chronic pain.
Clinical anesthesia is divided into general anesthesia and local anesthesia. General anesthesia (intravenous general anesthesia, inhalation general anesthesia, combined intravenous inhalation):, intraspinal anesthesia (epidural, spinal, combined spinal and epidural anesthesia, sacral anesthesia), nerve block (cervical plexus, brachial plexus, sciatic nerve) . Local anesthesia: superficial anesthesia, basic anesthesia, controlled blood pressure reduction, invasive monitoring, deep vein puncture, blood gas analysis, etc.
The pain treatment work of anesthesiologists is mainly postoperative analgesia, painless abortion, painless childbirth, treatment of painful diseases, treatment of nerve paralysis and spasm, and various acute and chronic pains such as head and neck pain, frozen shoulder, waist and leg pain band Herpes pain, etc.
Anesthesiologists have 4 main procedures for anesthesia surgery:
(1) Preoperative preparation: Within a period of time after deciding to undergo the operation, that is, before anesthesia, the anesthesiologist needs to prepare the patient in all aspects according to the patient's physical condition and condition. Part of the work also depends on the patient. The overall purpose of the cooperation is to improve the patient’s anesthesia tolerance and safety, ensure the smooth progress of the operation, and strive to stabilize the patient’s vital signs during the operation, and also help promote the recovery of the patient’s physical condition after the operation.
(2) Implement anesthesia (induction phase): The doctor decides which anesthesia method to implement: general anesthesia, spinal anesthesia, surface anesthesia, and nerve anesthesia after observing and analyzing the patient's condition according to the preoperative preparation phase.
General anesthesia is a relatively common method of anesthesia. After induction of anesthesia, an intubation laryngoscope is used to assist the intubation, and the anesthesia machine can be operated to pass the anesthetic gas into the patient's respiratory tract.
(3) Intraoperative anesthesia (anaesthesia stage): After the patient enters a state that can be operated on, the anesthesia state and vital signs need to be maintained. The anesthesiologist needs to follow up the whole process to avoid the patient's consciousness and pain during the operation.
(4) Postoperative resuscitation: After the operation is completed, the patient needs to be pushed to the resuscitation room next to the operating room, inhale oxygen, monitor blood pressure and electrocardiogram, and transfer to the general ward after the patient’s vital signs stabilize after resuscitation. If the patient’s condition is abnormal, Quickly return to the operating room for rescue.
二、Introduction to the main medical equipment of the anesthesia department
1.Anesthesia machine
The anesthesia machine is mainly used for general anesthesia. It delivers anesthetics into the patient's alveoli through a mechanical circuit to form a partial pressure of the anesthetic gas. After it is diffused into the blood, it directly inhibits the central nervous system and produces the effect of general anesthesia. The anesthesia machine is a semi-open anesthesia device. It is mainly composed of liquid medicine tank (evaporation tank), ether adjustment switch, folding bellows, suction and breathing circuits, exhalation one-way valve and bellows.
2. Patient monitor
A Patient monitor is a device or system that measures and controls the physiological parameters of a patient, and can compare with the known set value, and if it exceeds the standard, it can send out an alarm device or system. The monitor must continuously monitor the physiological parameters of the patient for 24 hours, detect the trend of change, point out the critical situation, and provide the basis for emergency treatment and treatment by the doctor, so as to minimize the complications and achieve the purpose of alleviating and eliminating the condition. In addition to measuring and monitoring physiological parameters, the purpose of the monitor also includes monitoring and processing the conditions before and after medication and surgery.
3. Visual laryngoscope (tube mirror)
A tool for clinically provoking patients to expose the glottis in the pharynx. The visual laryngoscope effectively solves the routine and difficult endotracheal intubation treatments during anesthesia and emergency rescue. The doctor can complete the endotracheal intubation clearly, intuitively and gently through the laryngoscope screen, ensuring the safe and effective operation of the surgical patients and reducing the trachea Complications of intubation.
