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Oxygensaturation(SpO2) pulseoxymetry
Drh.Deni Noviana,PhD Bloodpressure,HR,RR,SpO2
sphygmomanometers+pulseoxymetry
Drh.R.HarryS,MAppSc,PhD
Esophagealsthetoscope
Bagian Bedah dan Radiologi Apneamonitor
Departemen Klinik,Reproduksi
Klinik Reprod ksi dan Patologi
Fakultas Kedokteran Hewan IPB

Drh.Deni Noviana,PhD
http://deni.staff.ipb.ac.id/

1. Patientmonitoringsystem Oxygensaturationisa
measurementoftheamountof
2.
2 Peralatan resusitasi oksigen oxygenattachedtothe
h d h
3. Peralatan heatingtherapy haemoglobin cellinthecirculatory
system.
4. Peralatan fluidtherapy
AlsocalledSaO2,SpO2,pulseox,
5. Monitorlistrik jantung andsatorsats (shortfor
6. Peralatan cardiacarrest saturation)
7
7. Peralatan penanganan perdarahan Putsimpleritistheamountof
Put simpler it is the amount of
oxygenbeingcarriedbythered
8. Peralatan aspirator bloodcellintheblood.
9. Peralatan anaestesi inhalasi Normalrange:9699%

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Pulseoximetry isanoninvasive
methodallowingthe
monitoringoftheoxygenation
ofapatient'shemoglobin.
SpO2Isgiveninasa
percentage,forexample96%.
Sensorsconnectedtothe
d h
patientscontaintwoparts
LEDsandphotodetectors.

Sensorisplacedonathinpartofthepatient'sbody(fingertip,earlobe,acrossafoot)
Animalsneedtoclipthehairwhenthesensorisapplied
Between9699%
Lightwithredwavelengthsandlightwithinfraredwavelengthsissequentiallypassedfromoneside
i h ih d l h d li h i h i f d l h i i ll df id
g
Onehaemoglobin y
moleculecancarrya
toaphotodetector ontheotherside. maximumoffourmoleculesofoxygen
Onehundredhaemoglobin molecules
couldtogethercarryamaximumof
Differenceincolorbetweenoxygenbound(brightred)andoxygenunbound(darkredorblue,in 400(100x4)oxygenmolecules
severecases)bloodhemoglobin causeddifferentratioofabsorbance
Ifthese100haemoglobin molecules
werecarrying380oxygenmolecules
y y g( / )
theywouldbecarrying(380/400)x
Changingabsorbanceofeachofthetwowavelengthsismeasured
100=95%ofthemaximumnumberof
oxygenmoleculesthatcouldcarryand
sotogetherwouldbe95%saturated.
Thepercentofhemoglobinmoleculesboundwithoxygenmolecules(oxyhemoglobin)canbemade
SpO2

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Pulseoximetry isasimple,
noninvasivemethodof Bloodpressureisalwaysgivenas
monitoringthepercentageof thesetwonumbers,thesystolicand
diastolic pressures
diastolicpressures.
hemoglobin(Hb)intheblood Bothareimportant.Usuallythey
thatissaturatedwithoxygen. arewrittenoneaboveorbeforethe
Completesystempulse other,suchas120/80mmHg.
Systolicpressureisthehighest
oxymetry pressureintheheartandis
Description:SpO2,ECG,Pulse measuredwhentheheartis
contracting.
, p
rate,respirationrate.
Diastolicpressure,the
Di t li th lowest
l t
Waveforms:ECG pressureintheheart,occurswhen
Plethysmogram. theheartisfilling.
Blood pressuretypicallyisreported
Graphicstrends:SpO2,Pulse asatwonumberratio,systolic
rate,Pulsesignalstrengthand over diastolicpressure.
respiration

Themostcommonnoninvasiveblood
Bloodiscarriedfromthehearttoallpartsofyour pressure(NIBP)measurementmethod
body in vessels called arteries. involvesabloodpressurecuffanda
involves a blood pressure cuff and a
Bloodpressureistheforceofthebloodpushing stethoscope
againstthewallsofthearteries. Thecuffisconnectedtoagaugethat
Oneoftheprincipalvitalsigns. displays pressureinthecuff.
Thecuffandgaugetogetherare
Systolicpressure measuresthemaximum termeda sphygmomanometer.
pressureinthearteriesduringthecardiaccycle,
whichoccurswhentheheartcontracts,orbeats,
hi h h th h t t t b t Thebloodpressurecuffisusually
The blood pressure cuff is usually
placed aroundthearmandinflatedto
topumpblood.
pressuresdisplayedonthegauge.
Diastolicpressure whentheheartisatrest,
betweenbeats,yourbloodpressurefalls.

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Average canine blood pressure: 133/75


Breed SystolicPressure(mmHg) DiastolicPressure(mmHg) PulseRate
Themanualtechnique LabradorRetriever 11817 66 13 99 19
p
involvesapersonwho GoldenRetriever 12214 7011 95 15
listensusingthe GreatPyrenees 120 16 66 6 95 15
YorkshireTerrier 121 12 69 13 120 14
stethoscopetoKorotkoff WestHighland 126 6 83 7 112 13
sounds. BorderCollie 131 14 75 12 101 21
Sphygmomanometers KingCharlesSpaniel 131 16 7214 124 24
canuseairormercury GermanShepherd 132 13 7510 108 23
(Hg)withinthe gaugeto Terrier 136 16 7612 104 16
determinethepressure. Bullterrier 134 12 7717 122 6
Chihuahua 134 9
134 84 12
84 109 12
109
Thepressuresare MiniatureBreeds 136 13 74 17 117 13
reportedin millimeters Pomeranian 136 12 76 13 131 14
ofmercury(mmHg), Beagle 140 15 79 13 104 16
Dachshound 142 10 85 15 98 17
Saluki 143+16 88 10 98 22
Greyhound 14920 87 16 114 28
Pointer 145 17 83 15 102 14

Cat
Thebloodpressurevaluesforcatsarenotbreedspecific.
Normalfelinebloodpressure:124/84
118/84 Kobayashi,1990
12511/89 9 Brownetal.,1997
123 14/88+15
14/88 15 Curtet,2001
125 12/86 15 Weberetal.,2002

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PulseOxymetry withBloodPressure
OESOPHAGEALSTHETOSCOPE
measurement Magnatek 1400
Thismonitorcanfunctionasa standalone
NoninvasiveBloodPressure Transmitheartandlung
Monitors/NIPB monitor
Monitors/NIPBmonitor soundstothe
d t th
(Systolic/Diastolic/MeanArterialPressure)
Completesystempulseoxymetry anesthesiologists
Description:SpO2,ECG,Pulserate,
respiration. earpiece
Waveforms:ECGPlethysmogram.
Graphicstrends:SpO2,Pulserate,Pulse
Smooth,heatbonded
signalstrengthandrespiration
g g p cufftotubetransition
NIBPMONITOR)orcanbeconfiguredwith
SpO2,TEMPandprinterasanindependent minimizespotentialfor
vitalsignsmonitor.Combinewiththe esophagealirritation.
magnaTek 1300or1500toadd
parameters.

Aninstrumentpassedintotheesophagus Definitionisamedicalequipmentthatrecords
withthetippositionedatthelevelofthe
ith th ti iti d t th l l f th ananimal
an animalssheartrateandbreathingpattern,
heart rate and breathing pattern
heart. andalarmsifananimalsheartrateslows
down(bradycardia)orifheorshestops
Itprovidesanexcellentmeansof breathingforaperiodoftime(apnea).
monitoringheartsoundsandrespiration Alsocalledacardiorespiratory monitor.
( g)
(lung)whiletheanimalisanesthetized.
Theapneamonitorwillbeturnedonfora
Th it ill b t d f
Usuallyusethebatteryaspowersupply certainamountoftime,usuallywhileanimals
inconcious/anaesthetized.

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Aboxwithknobs,wires,TV
likescreens(dependon
( p Tracheostomy:A
y
type),andapowercord tracheostomy isahole
Theymaysticktotheskin,
orbeheldonwitha
createdinthenecktohelp
lightweightbelt. animalsbreathemore
Theremayalsobeother easily.
attachmentsthatmeasure
airflowthroughthenoseor D ring operation
Duringoperation
mouth. anaesthetizedanimals
Theelectrodeshavewires
comingfromthemwhichare
attachedtothedevice.

Airflow:Thisshowshowmuchairflowsfromnoseormouthtothelungs.

Apnea:Thisshowshowmanytimesanimalhadapnea,andhowlongthey
Apnea: This shows how many times animal had apnea and how long they
stoppedbreathingeachtime.

Breathingpattern:Thisshowsifanimalbreatheevenlyandregularly.

Breathingrate:Thisshowshowmanytimesyoubreatheinoneminute.

Chestmovement:Thisshowshowoftenyourchestrisesandfalls*

Electrocardiogram:Thismeasurestheelectricalactivityinyourheart
Electrocardiogram: This measures the electrical activity in your heart*

Oxygenlevel:Thisshowshowmuchoxygenisinyourblood*

*Dependonthetypeofapnoe monitor

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Adeviceusingpositivepressuretoinflatethelungsofan
unconsciousanimalwhoisnotbreathing,inordertokeep
Resusitasi merupakan sebuah upaya themoxygenatedandalive.
menyediakan
di k oksigen
ki k otak,jantung
ke t k j t d
dan Therearethreebasictypes:
There are three basic types:
1. Manualversion(bagvalvemask)consistingofamaskanda
organorganvitallainnya melalui sebuah largehandsqueezedplasticbulbusingambientair,orwith
tindakan medis supplementaloxygenfromahighpressuretank.
Mechanicalventilation Resucitator
OxygenChamber/tank
Oxygen Chamber/tank
Otherrespiratoryequipment Nebulizer

Mechanicalventilationdevices airispushed
i t th l
intothelungs
Thisdoesnotmimicactualbreathing.In
normalbreathing,airis suckedintothelungs
bymovingthediaphragm.

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2. Thesecondtypeisapulmonaryorbreathpoweredresuscitator. Oxygentherapypurpose
3. Thethirdtypeisanoxygenpoweredresuscitator.Thesearedrivenby
pressurizedgasdeliveredbyaregulator,andcaneitherbeautomaticor
Equippedwiththermoandhygrometer
manuallycontrolled.

Resuscitator:
Adeviceusingpositivepressuretoinflatethelungsofanunconsciousanimalwhois
notbreathing,inordertokeepthemoxygenatedandalive.

Infantmanualresuscitator Adultmanualresuscitator
Mask Mask Nebulizer Thisdeviceisabletocreatea
O
Oxygenreservoirbag(1700
i b (1700 Oxygen reservoir bag (2500
Oxygenreservoirbag(2500 medicationmist
di ti i t thatcanbeaddedtoairtobe
th t b dd d t i t b
ml) ml)
inhaledbyapatient.
Oxygentubing6080mm Oxygentubing200cm

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Principleforallnebulizersisto ACpowersupply
eitheruseoxygen,compressed p
Powerconsumption60
airorultrasonicpowertobreak
i l i b k
upmedical watt
solutions/suspensionsintosmall Ultrasonicfrequency:1.7
aerosoldroplets,fordirect
inhalationfromthemouthpiece Mhz
ofthedevice. Max.Atomizingflowrate:
Importanttonotethatinhaled
aerosol droplets can only
aerosoldropletscanonly pp /
Approx.4mL/min
penetrateintothenarrow Aerosol particle size:1~5
branchesofthelowerairwaysif
theyhaveasmalldiameterof1
5micrometers. Solutionbottlecapacity:
150mL

useapistonstyleaircompressor usehighfrequencyvibrationsto
turnthemedicineintoamist

p
Infraredlamp
thisairpressurespraysthe theanimalinhalesmistthrougha
devicethatinsertsintothemouth
Heatingpad
medicationoutintoamistform
ormask

theanimalinhalesmistthrougha themisttheyproducehasmore
devicethatinsertsintothemouth consistent,uniformandsmaller
ormaskk particlesize

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Infraredlampspecifications
Infraredlampshave Hasbeenproventoeffectively
relieveachesanpainscausedby
many uses but are
manyuses,butare muscularpainsandstiffjoins
l i d iff j i
mostcommonlyused Output:100150Wattinfrared
incommunication warmth
andheating. Penetratesdeepintoskin,
improvingbloodcirculation
Infraredheatinguses therebygivingreliefforone
p
infraredlampsto areas
transmitinfrared Concentricringshelptofocus
onspecificspots
radiationtothebody
Adjustableangle
thatisbeingheated.

Hasbeenproventoeffectively
relieveachesanpainscaused Heatingpadsareusefulfor
bymuscularpainsandstiff
providing warmth for young
providingwarmthforyoung
joins
puppies/kittens,fordogs/cats
Comfortablewarmth
penetratesdeepintotheskin,
duringcoldweather,post
stimulatesbloodcirculation parturation orforolderdogs
andwarmsthemuscles. witharthritisandjoint
Themusclesautomaticallyy problems.
loosenupandrelax Aheatingpadisasafewayto
Thetissuebecamemore increaseyourdog'scomfort
pliable warmsalsoreduces whenusedproperly.
stiffnessandmakesjoinsmore
flexible

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Infusioncuff Introduction
Bottlesoffluidsusedgravityflow
g y
Infusionpump to dripfluidsintoapatient.
Astechnologyexpandedinto
Syringepump health care,thebottleswere
replacedwithplasticbagsand
gravitywas nolongermedically
adequate.
Electromechnical pumpsare
p p
more reliableandprovide
constantmonitoringoffluid
delivery.

Alat yangdigunakan untuk Also calledintravenouspump,IVAC,


andIV pump
membantu
b t mendorong
d Delivers medication,blood,orfluid
cairan di dalam botal infus intothepatientovera specific
periodoftimeataparticularrate.
akan keluar lebih cepat Thepumpensuresanaccuraterate
diperlukan untuk and,therefore,anexactdose.
IVbags,filledwithfluid,are
melakukan flushingdalam g g
connectedthroughtubingtothe
jumlah banyak dan periode pump,andthenthroughthepump
totheveinsofthepatient.
waktu yangsingkat

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Syringepumpsdeliver Electrocardiograph/Elektrokardiogra
medicationfromasyringeby mm (Germany) Atransthoracic
usinga
i pistontodrivetheback
i di h b k i
interpretationoftheelectrical
i f h l i l
ofastandardsyringe. activityoftheheartovertime
Thisdeviceis usuallyusedfor capturedandexternallyrecordedby
verysmallamountsof skinelectrodes.
medicationdeliveredvery Itisanoninvasiverecording
accurately. producedbyanelectrocardiographic
AswithIVpumps,the device.
medicationisusuallydelivered
di i i ll d li d Worksmostlybydetectingand
W k l b d i d
topatientsthroughtheirveins. amplifyingthetinyelectrical
Dosinginstructions(timeand changesontheskinthatarecaused
amount)areprogrammedbythe whentheheartmuscle
clinicalstaff. "depolarizesrepolarizes"during
eachheartbeat.

Electrocardiography Fibrillation theflutteringof


theheart,whichisessentially
randomizedelectricalsignals
thatresultinchaoticand
ineffectivecontractions.
Asystole noelectrical
activityoftheheart,flat
line. Patientsinthis
condition are clinically dead.
conditionareclinicallydead.
Conductionabnormalities
disruptionoftheelectrical
pathwaysoftheheart.

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Onlytwoconnectionsarerequiredtomeasure Eachleadgraphicallyshowsthevoltage
the electrical activity of the heart
theelectricalactivityoftheheart. ( t ti l diff
(potentialdifference)betweentwoofthe
)b t t f th
Forexample,averybasicECGcanreadilybe electrodes.
seenbyholdingaleadineachhandandusing AthreeleadECGillustratestheelectrical
somesimplesignalprocessingamplifiers.
activityoftheheartinthreedifferentways
Therearethreeconnectionstothepatientina g
usingthethreeelectricalwiresconnectedto
th
threeleadECG.
l d ECG
thepatient.
TheconnectionsaremostoftenlabeledRA
(rightarm),LA(leftarm),andLL(leftleg).

LeadI LA
(positive)and
(positive) and
RA(negative)
LeadII LL
(positive)and
RA(negative)
LeadIII
L d III LLLL
(positive)and
LA(negative)

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Fairlysimpledevicethatdeliversalarge
amount of energy across a patientsschest
amountofenergyacrossapatient chest
whentheheartisnotbeatingproperly.
Whentheheartisnotbeatingwithapattern,
allcellsarecontractingatdifferenttimes;this
isknownasfibrillation.
Defibs
D fib (astheyareoftencalled)inusetoday
( th ft ll d) i t d
sendabout3,000volts(V) upto20amperes
(A) acrossapatientschest.

Defibrilator

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Thislargeamountofenergy Electrocauter
causes all cells in the heart
causesallcellsintheheart
todepolarizeatonce.
Thisactionmayallowthe
SAnodetoresumefunction
andgenerateanormal
p
electricalpattern.
SometimestheSAnodecan
recover,butsometimesit
cannot.

Cauterizationisanancientmedicalpracticeby
Onepaddleisplacedonthe
p p
rightsideofthepatient,near creatingburnsonthetissuetoeitherclose
ti b th ti t ith l
theclavicle.Thispaddleis woundsorstopbleeding,ortoremovepartof
oftenlabeledsternum. thebody.
Theotherpaddleisplacedon Thispracticewouldclosewoundsandstop
theleftsideofthepatient g
bleedingbecausetheheatwouldmakethe
neartheribs,belowthe bloodclot.
breast.Thispaddleisoften
labeledapex. Cauterizationisusedwithgreatfrequency

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Burningofthetissueisusuallyaccomplished
viaoneoftworoutes,eitherbytheuseof
i ft t ith b th f
electricityorwithchemicals.
Whenelectricalpulsesareused,thisiscalled
electrocauterization,anditsoftenusedto
y
destroytissuesandmakesurethatsmall
arteriesorveinsdontbleedexcessivelyfrom
removaloftissues.

Inmonopolar electrosurgery thecurrent


flowsfromthegeneratortotheactive
electrode,inthehandofthesurgeon,at
thesurgicalsite.Thecurrentpasses
throughthepatientsbodytoadispersive
pad,whichisthegroundelectrode,and
backtothegenerator.

Inbipolarelectrosurgery currentflows
fromthegeneratortotheinstrument,
typicallyforceps.Onetineoftheforceps
actsastheactiveelectrodeanddirects
t th ti l t d d di t
thecurrentthroughthepatienttissueto
theothertine,whichactsasthereturn
electrodeandenablestheflowtoreturn
tothegeneratortocompletethecircuit.

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Electrocauterization(Bipolar)

Unipolar Electrosurgery

Aspiratorsurgery

Bipolar
Bipolar
Electrosurgery

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ForFirstAidEmergency Masker
Suctionpumpforpost
Suction pump for post
tracheotomyandminor Laryngoscope
surgery
Lightandeasytoclean.
EndotrachealTube(ETT)
Onejartype flowrate
15lt/min 25lt/min
Powersource:ACand/DC
/
(Battery)
Antibacterial&hidrofobic
filter(opt)

Ukuran bervariasi
Disambungkan dengan
mesin anesthesi inhalasi
untuk mengirimkan
oksigen dan inhalan
Disambungkan dengan
resuscitatoruntuk
membantu pengiriman
oksigen
Disambungkan dengan
nebulizeruntuk
membantu pengiriman
misttertentu

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Ventilatorsaremostcommonlyconnectedtothe
patientvia anendotracheal tubethroughthemouth.
Thetubeiscurvedto
The tube is curved to matchanimals/humananatomy.
match animals/human anatomy.
Manyendotracheal tubescontainan inflatablecuffat
theendtomakeasealagainstthesidesofthe trachea.
Thecuffisinflatedwithairfrom asyringe.

Alaryngoscopeisusedtoguidetheinsertion Berfungsi untuk mengalirkan gasinhalan dan


ofthe
f th endotracheal
d t h l tube.
t b oksigen
Thesedevicesareverycommoninhospitals. Intubasi dilakukan segera setelah induksi
anestesi oleh preparat yangbersifat
menghilangkan reflek menelan (ketamine,
tiletamine/zaolazepam)
Singleuseatau
Si l t reuseETT
ETT
Perhatikan ukuran ETT

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Hewan Berat (kg) Diameter ETT


(mm)
Anjing 3-7 3.0-
3.0-5.0
7-15 5.0-
5.0-7.5
15--30
15 7.5-
7.5-9.5
>30 9.5
9.5--12
Kucing 2.5-
2.5-4.0

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Endotracheal Intubation

References
BarbaraL.Christe.2009.Introductionto
Bi
BiomedicalInstrumentation(TheTechnology
di l I t t ti (Th T h l
ofPatientCare).IndianaUniversityPurdue
University Indianapolis.CambridgeUniversity
Press.

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