Given below is a brief description of the scan. While the text may appear long, in reality the scan can be accomplished quite quickly ( e.g. less than two minutes ). The purpose of this section is to "talk you through" a scan. More details of individual components are available elsewhere in this website. When you read through, don't get disheartened if you cannot remember it all. Any scan will take a little practice before one becomes fluent in it !
The scan begins with the "Airway". In this scan, the "Airway" includes all the tubing from the common gas outlet up to the patient end. You start at the common gas outlet. Is it connected and secure? Then assess the breathing system. See for secure connections and valve positions. Then check the specific airway such as laryngeal mask or endotracheal tube. Is it secure?
From the airway , move onto the chest to assess "Breathing". Look for equal chest expansion. If not done recently , you might also want to auscultate.
Now assess gas exchange. Assess Oxygenation. Since your eyes are at the patient , check the surgical field. Is the blood red? You can also , at the same time , judge oozing / bleeding. Then move to your monitor. Look at FiO2 and Oxygen saturation. Then assess CO2. Look at the trace and end tidal CO2.
Now that you have an idea of the gas exchange, you can optimise the mechanics of ventilation. Remember Flow -- Pressure -- Volume -- Rate -- Muscle (diaphragm). "Flow" is to remind you to check the flow meters. Are they set correctly? Regarding ventilation, is the Pressure , Volume , and Rate appropriate. "Muscle" reminds you to check muscle relaxation. (You can think of the diaphram to help remember muscle relaxation). This completes "Breathing".
Now assess "Circulation".
Look at the output of the heart. Is the BP appropriate? You might want to palpate pulse volume ( you have already seen the pulse oximeter plethysmograph under "oxygenation" ).
Now look at the heart itself. Is the electrocardiogram okay?
Then assess the input to the heart. Asses the Fluid IN Vs. Fluid OUT. Assess CVP.
This completes "Circulation"
Now asses "Depth". Use clinical, MAC and other means to assess depth of anesthesia and analgesia. Check vaporizer level.
Then look at "Exposure". Look at position and pressure points. Check on anti DVT measures. Check temperature and warmers.
The scan is now complete.
Hopefully you now have a rough idea of the Rapid Anesthesia Scan. Of course you can modify the scan to suit your preferences and to add additional monitoring such as esophageal doppler, etc. Please visit the other sections of this website to get more details.