AMERICAN MONITORING - STANDARDS AND STATE-OF-THE-ART

Monitoring of the anesthetized patient, the anesthesia machine, and th e patient-machine interface is an essential component of anesthetic pr actice in order to prevent anesthetic-related injuries resulting from equipment failure or human error. While the optimal monitor to detect anesthetic problems (hypoxia, esophageal intubation, hemodynamic compr omise, for example) is unclear at present, American standards require continuous presence of qualified personnel who evaluate patient oxygen ation, ventilation, circulation, and temperature. A common monitoring array includes electrocardiogram, autosphygmomanometer, pulse plethysm ography/oximetry, stethoscope, anesthetic gas analyzer, thermistor, an d nerve stimulator. The role of emerging technologies, including trans esophageal echocardiography, automated electrocardiographic analysis o f ST segments, transcranial Doppler, and transcranial near infrared sp ectroscopy are discussed.