Vital signs monitoring for anesthesiologists, explained
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- Опубликовано: 1 авг 2024
- What monitors does an anesthesiologist use during surgery? In this video, I explain - and demonstrate - the standard vital sign equipment that I monitor anytime I'm providing anesthesia.
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0:00 Start
00:24 Why monitor vital signs
02:14 ECG
04:31 Pulse oximetry
07:36 Capnography (CO2)
10:11 Blood pressure
13:54 Temperature
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Find Max Feinstein, MD online:
Instagram: @MaxMFeinstein
Twitter: @MaxMFeinstein
Website: www.MaxFeinsteinMD.com
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The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
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#Anesthesiology #Residency #MedicalSchool 
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You should be a Professor of Anesthesiology.... you teach this subject very well. Your students would love you!
Professors need to have crazy high research outputs, nothing to do with teaching ability.
@@harveypraz7962 I would also guess they have to be very well established as well with research and work and stuff, probably makes it were mostly only older people get hired as professors
@@harveypraz7962 not entirely true. Depends on the institution
@@harveypraz7962 Not necessary true!!! Research is being done somewhere in this world every second. A professor educates you and it's your job to take in what you've learned and also continue educating yourself.. From your comment I take it your in the medical profession so you should know this is why we always have "Conferences often in multiple states" ",Meet the standards of continuing education yearly" etc. I've seen many Anesthesiologist and others who teach within a year of graduation. As you know there's levels to education. Honestly Max is doing an awesome job at what he's doing. He's educating on levels that many can not do no matter how much "Research" they do. Some are phenomenal at their profession however they can not delivery information to others.. Kudos to all of us in the medical profession!!
An important aspect of all medical practice is teaching! Starting even in medical school, students that are further along instruct/tutor/mentor younger students. Doctors are always teaching other doctors and medical professionals (for example, attendings supervising residents and interns), as well as their patients.
I used to work in an OR as a young man at 20 years old, as an orderly. When I had some free time moving patients back and forth to the OR, I used to stand and watch the anesthesia and the surgeons working. On my first day on the job. Dr. McNamara was doing a lung resection. He called me over to the surgery table and had me take a look into the chest cavity at the heart beating inside the patients chest. I was just so amazed I knew right then that I wanted to become a surgeon, though I did not become a surgeon it was an outstanding experience that will stay with me for the rest of my life.
Last year, I had two surgeries in 24 hours. So thankful for the skilled doctors during this scary time. You are so smart . . . much respect.
Love your videos! I don’t understand why some people are like Max is just staring at a screen thinking about vacation while the surgeons do all of the work. You’re labeled as the “guardian angel”. I think they don’t get enough credit like the surgeons do. Without them, the patient wouldn’t be alive.
I’d rather have a great anesthesiologist and an average surgeon than an average anesthesiologist and a great surgeon. They bring you near death and bring you back.
Literally, they don't receive their due credits instead receive some kind of inferior behaviour in some parts of world.
Anesthesiologist is working all the time, not getting distracted despite of having a live surgery in front of him he keeps monitioring all the things. Little bit of negligience and person is gone, anesthesia is like controlling all the vitals of person and giving the surgeon a ready field to just work, but the great field is made by anesthesiologist, maintained by anesthesiologist and no batsman can success if the field only is bad.
Each staff member in the surgicAL suite is a TEAM member. Always keep that in mind.-
No :231:
/7
I watched a bunch of your videos before my surgery, and when the anesthesiologist brought me in he was extremely impressed when I basically narrated all the prep he was doing. Made my surgery much less stressful!
Spent some weeks in an icu after a bike crash and for the part i was off sedation i got the chance to observe doctors and crna's in action for about 72 hours, before i was discharged to the trauma block. I cant find words to explain how impressed i am with what you guys are doing, its just amazing. Plus everyone was super friendly and talking to me, which really helped me with recovery.
I had major surgery months ago, and had so many questions after I woke up. I’m just in utter awe of science and all that you and surgeons do. It’s been so much fun learning from your channel!
Max, you’re also a great teacher. I hope the hospital appreciates what you’re doing. Your videos not only inform the patient, but lessen the fear of a surgical procedure by understanding the different steps and why they’re used. Thank you.
Absolutely love your humbleness...
Are you talking to me? Well I am humble... Perhaps the most humble man in the World! (Stolen from the movie, "Camelot", Lancelot to Guinevere.) BTW That is one of my favorite movies...
This was amazing, gave me a good reminder as to why I’m even studying for the MCAT to begin with. You’re a godsend Dr. Max, in the future can we get more day in the life content and maybe in feature a few cases?
My wife of 21 years is a surgeon and I like to watch things about her job so I can understand better when talking with her about how her day was or at a table with her doc friends at home or at conferences. Your videos are funny and very informative, some of the best I have seen. Keep up the great work!
Thanks Robert I appreciate that!
@MaxFeinsteinMD your videos are very informative. I've never known about the EKG and all of the things that go on but always wanted to understand. Now I know something about how you anesthesiologists keep your patients alive in surgery. Thank you for all you do. ❤
Your videos really helped me to get over my fear of general anesthesia. Thank you so much!
I'm really glad to know that!
Your videos are awesome. My 13 year old son is interested in a career in medicine and we've been watching all your videos. Very informative and my son loves to see and hear about it all.
This is so wonderful to know! Wishing your son all the best, hope to see him in the ORs down the road.
Thank you for making such wonderful and detailed videos. I have a surgery in 2 weeks, first time I'll ever be under general anesthetic, and watching through what the preparation is, what devices will be used and how my doctors will be sure I'm OK has greatly reduced my anxiety over it all
When I started working in the OR 50 years ago, I remember charting under anesthesia used “PANIS”
Pentothal, Atropine, Nitrous, Inovar, Sublimaze. Anesthesia machines had N20,O2, with their bottles hanging off the side, Cyclopropane ( highly flammable), Flouthane. Ethane and Penthrane for the halagenous gasses.
Monitor equipment was no more than a manual BP cuff and sphygmomanometer, Bird PR-1 ( old green ) respirator. non disposable rubber masks, breathing circuits, Datascope EKG monitoring. Even the old Puritan Bennett suctions were reusable glass bottles, rubber tubing and metal Yankauer suction tips. ET tubes and airways all reusable. Anesthesia techs would decontaminate them using Cidex.
You make everything so understandable! I'm not going to be a Dr but I always feel a little smarter after watching your videos!
I was on the core team from the beginning that developed the patient monitor used in this OR. My role was the user interface design. The team in Milwaukee that did the development on this was spectacular without exception. I’ve never worked with a group as talented as this before or after. It’s gratifying to see this in use!
Excellent video. A mature, friendly, common-sense delivery. A credit to yourself and your hospital. Keep up the good work.
Your humor is so natural and effortless. MORE MORE MORE!!!!!!
You really rock! If I’m having surgery in my future, I’ll review these videos to grill and impress my anesthesiologist, lol
Nice let me know if that ever happens haha but hopefully you won't have a reason to meet an anesthesiologist
I enjoy your videos! Great sense of humor and professionalism and great explanations! As a stroke survivor, I would be very comfortable with you monitoring my anesthesia. You represent your profession with honor!
I love your videos. I am in nursing school studying perioperative nursing for lecture. I enjoy getting a chance to see it from an anesthesiologist's point of view.
I'm not sure why but you starting this video wearing all the monitoring equipment was the funniest thing I have seen in a long time!
I've learned a lot in just watching a few of your videos. Had no idea so much was going on, and the number of drugs that can be administered! Thanks for doing these informative videos and talking at just the right level of technical speak so that the average person can understand what you're saying. I've subscribed and forwarded links to my friends. Fascinating stuff!
When I was 13 my GP and ENT ended up determining that I needed a tonsillectomy based on the threat to my breathing at night, my tonsils were frequently so enlarged that they caused sleep apnea.
I swear this is a true story. I remember it vividly. The anesthesiologist picked up quickly on how inquisitive and hungry for knowledge I was and my effort to understand what was happening. The last thing I remember before going under is that she asked if I wanted to knock myself out. I said that sounds cool! She held my hand and guided my thumb as I pressed the plunger on the syringe. I only made it about 1/3 of the way into the dose before my next memory which was talking to someone that definitely wasn't in the recovery room and they were wiping tears from my face. They said everything went well and that I would be moved into recovery soon. From then I don't remember anything until I was coming to again in the recovery room and the nurse offered me to sip some sprite.
Sounds like good medicine..the staff treating you as a 'grown-up' and offering you some real warmth!
Retired OR RN. I really enjoyed your presentation. Your manner is calm and reassuring for patients. Very matter of fact. You could put me down any time!
Great video with helpful information. Never thought of a persons Oxogen rate decreasing when the Blood Pressure is being taken on the same arm. It is very interesting to watch these videos and find out all the Anesthesiologist does while you are knocked out cold for surgery.
I think you got a great employer that allows you to make your videos i their facillities. 😊
It is a win win for the hospital, great teaching video and also a great resource for patients to get informed.
Yes, the anesthesiology department at Mt. Sinai has been extremely supportive of these videos, including letting me use equipment (which costs money) to film.
Thanx for a great quick education. The true art in your job is establishing every individual baseline which can rapidly change with every surgery. With so many different ages, races, general health status only experience can teach. Thanks.
I'm glad you mentioned Malignant hyperthermia. I have to explain it to so many Dr's when they ask about allergies.
These are so good. I am having a series of small procedures that require general anesthesia, and I love understanding the setup a bit better because I'm (besides really scared!) also very curious about what happens during surgery and the waking up phase before you make proper memories again.
Thank you so much for another video. Love the way you teach and explain the procedure. Great Doctor
Your channel is awesome! As an incoming M1 interested in anesthesia, these videos are everything to me. How about a vid about anesthesia's role/plan of action during intraoperative emergencies like patients crashing, MH, code hemorrhage, difficult airways, etc. Keep it up!
This is such a great video, I’ve had several surgeries so I’ve been under anesthesia quite a lot.
I was drinking ice tea when you said some strange place like Florida or something I practically blew all of the tea out of my mouth and onto my laptop screen. hilarious
LOL I was trying to think of an exotic place and Florida is the first one that came to mind.
Kool video Dr Max. Very informative! Keep them coming! Good to see you!
Anesthesiologists; not just the pre-game show :D I had no idea the depth of what anesthesiologists do, thanks for the entertaining and very informative vids!
I’m having surgery in two weeks and a bit nervous about the idea of general anesthesia. Thanks for these videos - they are a huge help!
amazing video, really hope you continue this throughout your residency and beyond
Thanks Lisa, I appreciate that!
This is amazing! Your explanations are very clear - thank you so much!!😄
Very well explained takes a away some of the anxiety of surgery great job !!!
Hello from Chilliwack Canada. Cancer will soon result in my bladder and prostate removal. Hope my Anesthesiologist is as fantastic as you. You rock
Love your videos, educational and sound like easy though I know in reality it could be overwhelming! Good job and thanks for your service!
Dr. Max, Just seen your video for the first time. Learned sooo much. Thank you. Looking forward to seeing your other videos. Btw, love your sense of humor!
Thank you very much for the video with kindness and respect
Thanks for the video. Helps me understand my surgery.
Thank you for your vids man, I've taken an interest in anesthesia and your videos are great for getting to know the specialty better
Glad you like them!
Your presentation is very interesting and readily understood. Things have come a long way since the days of ether on a folded piece of cloth (the only thing I remember about my tonsillectomy in ca. 1945). Keep up the good work!
Love these videos! Keep them coming! Thank you for sharing!
I've been enjoying your videos. One thing I really like is which finger you choose for the oximeter. It makes sense but I noticed some other people don't do that. I love learning little tricks that stick with me.
Wonderfully clear, cogent explanations. Well done.
Very interesting. Never knew all this. Always wanted to know. Thank you doc
Excellent teaching skills
Very informative. Thank you for explaining in laymen’s words.
Love your videos. As a Board-certified Ob/Gyn I diagnose and care for many breast cancer patients. It would be informational for a lot of us as Ob/Gyn attendings as to how you adapt anesthesia procedures for mastectomy and reconstruction patients. For example, where do you place BP, temperature, and ECG monitors given the surgical site would preclude the usual placement of these monitors. Also how do you keep the patients warm given the exposure of the surgical field. In Ob/Gyn, a Pair Hugger device is placed on the upper body and keeps the patient warm while we operate in the abdomen or vaginally.
Hi Dr. Collins, thanks for your feedback! There's always a place to attach monitors, sometimes we just have to get a little creative. For breast surgery, EKG leads go on the back. If we can't use a patient's arms, BP cuff can go on the leg (or we can place an arterial line). Temperature probes can go basically anywhere-- nares, esophagus, axilla, temperature probe on a Foley, etc. In addition to upper body Bair, we can either do lower body or underbody.
So glad when you post a new video! Keep going! :)
I'm an Assistant Physician Anesthetist in Kenya and I find your teachings good
Super cool and informative video! Thank you.
You are highly intelligent. I love your videos. Amazing information.
Thank you for these great videos. I love the info on the variety of vitals monitoring, within the surgical procedure. Would you consider discussing vitals and responses in the recovery room? I had hand surgery during which, everything was fine during the surgery but a little different in recovery. Once I was more "awake", the nurse kept asking me to take deep breaths and not fall back asleep. Then came o2 via nasal. They ended up calling anaesthesia because come to find out I kept desating, even with o2 support. A few minutes later I had a whole lot of bedside visitors including my surgeon, anesthesiologist, and just a mess of people. Things get a little muddled at that point but obviously I came out just fine! I woke up again in a different part of recovery, nrb,and a nurse who wouldn't leave the monitors. Hours later I was much better and begrudgingly sent home but with a warning to tell any future anesthesiologists that this happened. Though I'm not Sure what 'this' is. I'd love to hear about some post op scenarios where this could happen. Thanks!
I'm a veterinary nurse, and our anesthesiologists at the teaching hospital taught us that monitors are great tools, but nothing is better than your own senses. We were encouraged to use our ears by inserting esophageal stethoscopes, our eyes by looking at the patient- eye position, color of mucus membranes, is the chest rising and falling. We should touch the patient- how tight or slack is the jaw, are they warm, cold, hot? At the teaching hospital we had all sorts of monitors. In some private practices, they may not have anything!
Love the content!
Yes you're absolutely right. Even in an academic setting at a big hospital where we have an amazing amount of equipment at our disposal, sometimes issues come up and we can't use the equipment so have to rely on foundational physical exam skills.
One of the most important people in the room.
Wow your amazing ...and hold everyone's attention..
Your great
Max, you are a jack of all trades 👍😀
Hey Max, love your thoughtful, informative videos. As an M1 interested in anesthesia, I was just wondering if you'd be able to make a video of tips and advice for med students interested in going into anesthesiology and what we can do at each stage of training to help prepare(e.g. pre-clinical years, clinical years, research, etc.). Would love to see it!
Hi ALdawg this is a great idea, I'm adding it to my list. Thanks!
Just love your videos, extremely helpful content #keepitup Greetings from Cape Verde 🇨🇻 Obrigada 🙏🏽
1:39 "THE MATRIX" - That was a really nice touch, max :D .
Love your scrub cap!
Would appreciate it if you could do a video on the anesthesia machine with regards to the vent and vent settings!
When I had surgery to fix a distal radius fracture the trainee (not sure exactly what they were) put the pulse oximeter on my operating hand. The surgical nurse politely called it into question, and the trainee quizzically stated that it needed to go on the opposite arm as the blood pressure cuff. The nurse gently got them to realize that a pulse oximeter on an extremity that had a tourniquet cuff on it wasn't going to work during surgery...
Hey max, love the videos, I have a weird side interest in anaesthesia because I'm MH susceptible. It'd be great to see a video on the different ways you prep and precautions you take for MH susceptible or risky patients some day. Keep up the great work! ❤️🇦🇺
Great idea for a video! Thanks for following along.
Superb video!! Great details 🙏🙏🙏
I agree. U should be a professor at least part time as iits obvious u love your field. I love your videos. Not sure how I missed this one.your so awesome.
Love that you're explaining the monitors! Thank you! So would you give fluids, depending, if the CO2 levels go down since capnography corresponds with Cardiac Output? Lower the capnography, lower cardiac output...
Thanks a lot. I really enjoyed this
Good information ! I will have a Thyroidectomy on June 15 , Thank you for the information! 🙂
I love your videos!! Keep up the great work!!
All your video are wonderfull...thank you very much.
Woah this is so cool, thanks for the great video!
Thanks for continuing to follow along, Ryan!
great videos, thanks Doc
It’s a great video for non-medical people. I thought about anaesthesia as a specialty until actually acting as the anaesthetist (as a senior med student under supervision of course). It was a cycle of constant checking, relief, increasing anxiety leading to checking, relief continue ad finitum.
The surgery went well, patient was fine… me, hmmm it was an experience 😂
Thank you for the video by the way
Thank you Dr Feinstein!
Thanks for watching!
Hello Dr. Feinstein, I just came across your channel and enjoyed watching and listening. I am 74 years old and retired from a 42 year career as a nurse anesthetist. Since retiring in 2016, I truly missed the operating room activities and anesthesia. I have been truly blessed to have had that career and miss it to this day. So I live in one of those exotic far away places named Florida.. Retirement communities abound here and are affectionally known as cataract farms. I'm wondering if it was ever your department's policy to include BIS monitoring ? We went through a phase here where it was required on all GA cases. Thanks for making these videos as I read in the comment section, many have expressed appreciation for an inside look at anesthesia monitoring. Well done! Ted in Sebastian, Fl.
do more of these for all the monitors
I may do a video like this for cardiac anesthesia, which includes several extra monitors not shown in here. Thanks for the suggestion!
@@MaxFeinsteinMD I’m a paramedic but also an anesthesia groupie. Love your vids
Dude, might want to check that bp. Seriously though, i stumbled into here after finding a video about anesthesia and Myasthenia Gravis. Thanks for doing what you do. 😊
Great video! Thanks! You are awesome!
Thanks for your effort. Also, could you please make an video about ETCO2 reading?
Brilliant video, thank you :)
love the intro. All hooked up to the good stuff. lol Still haven't forgotten that CT Scanner that had a donut facade in an earlier video. Actually had my first donut in over a year the other day. Yum.
lol yes never forget the donut.
Hey ! Another great video ! Hope all is well ! Stay safe ! 🗽🚑👍
Would love to have some ACLS and ALS based videos please. Thank you for much informative vids. Well done!
Thank you for the info
I love your dry humor!
Doctor, could you make a video about the plethysmographic wave of the monitor? Thanks!
I'm just a EMT but I love your channel
Freelancer...do not forget.,..each team member is important to pt. care. Starting out, I did numerous hours as a student EMT in the ER. Asked a bazillion questions, learned to closely observe and report s/s, saw some very interesting surgeries (most plastic surg) the staff didn't want me to leave. Be proud and be the BEST EMT ever...frequently leads onto higher level spots in the medical career path. (Paramedic?, nursing, etc......) Best wishes to you, Meg
Great vid doctor.
Great man love his clips
OMG! You use the Celsius/centrigate scale on body temperature instead of Farenheit. Makes a Norwegian happy. ☺️
Great video man!! I learned a lot! I love your videos! Keep it up
Thanks Darrion I appreciate that!
@@MaxFeinsteinMD you welcome