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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
monitoringthepercentageof
hemoglobin(Hb)intheblood
thatissaturatedwithoxygen.
Completesystempulse
oxymetry
Description:SpO2,ECG,Pulse
, p
rate,respirationrate.
Waveforms:ECG
Plethysmogram.
Graphicstrends:SpO2,Pulse
rate,Pulsesignalstrengthand
respiration
Bloodiscarriedfromthehearttoallpartsofyour
body in vessels called arteries.
Bloodpressureistheforceofthebloodpushing
againstthewallsofthearteries.
Oneoftheprincipalvitalsigns.
Systolicpressure measuresthemaximum
pressureinthearteriesduringthecardiaccycle,
whichoccurswhentheheartcontracts,orbeats,
hi h h th h t t t
topumpblood.
Diastolicpressure whentheheartisatrest,
betweenbeats,yourbloodpressurefalls.
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Bloodpressureisalwaysgivenas
thesetwonumbers,thesystolicand
diastolic pressures
diastolicpressures.
Bothareimportant.Usuallythey
arewrittenoneaboveorbeforethe
other,suchas120/80mmHg.
Systolicpressureisthehighest
pressureintheheartandis
measuredwhentheheartis
contracting.
Diastolicpressure,the
Di t li th lowest
l t
pressureintheheart,occurswhen
theheartisfilling.
Blood pressuretypicallyisreported
asatwonumberratio,systolic
over diastolicpressure.
Themostcommonnoninvasiveblood
pressure(NIBP)measurementmethod
involvesabloodpressurecuffanda
involves a blood pressure cuff and a
stethoscope
Thecuffisconnectedtoagaugethat
displays pressureinthecuff.
Thecuffandgaugetogetherare
termeda sphygmomanometer.
b t Thebloodpressurecuffisusually
The blood pressure cuff is usually
placed aroundthearmandinflatedto
pressuresdisplayedonthegauge.
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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
withthetippositionedatthelevelofthe
ith th ti iti d t th l l f th
heart.
Itprovidesanexcellentmeansof
monitoringheartsoundsandrespiration
( g)
(lung)whiletheanimalisanesthetized.
Usuallyusethebatteryaspowersupply
Definitionisamedicalequipmentthatrecords
ananimal
an animalssheartrateandbreathingpattern,
heart rate and breathing pattern
andalarmsifananimalsheartrateslows
down(bradycardia)orifheorshestops
breathingforaperiodoftime(apnea).
Alsocalledacardiorespiratory monitor.
Theapneamonitorwillbeturnedonfora
Th it ill b t d f
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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Infraredlampshave
many uses but are
manyuses,butare
mostcommonlyused
incommunication
andheating.
Infraredheatinguses
p
infraredlampsto
transmitinfrared
radiationtothebody
thatisbeingheated.
Hasbeenproventoeffectively
relieveachesanpainscaused
bymuscularpainsandstiff
joins
Comfortablewarmth
penetratesdeepintotheskin,
stimulatesbloodcirculation
andwarmsthemuscles.
Themusclesautomaticallyy
loosenupandrelax
Thetissuebecamemore
pliable warmsalsoreduces
stiffnessandmakesjoinsmore
flexible
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Infraredlampspecifications
Hasbeenproventoeffectively
relieveachesanpainscausedby
muscularpainsandstiffjoins
l i d iff j i
Output:100150Wattinfrared
warmth
Penetratesdeepintoskin,
improvingbloodcirculation
therebygivingreliefforone
areas
Concentricringshelptofocus
onspecificspots
Adjustableangle
Heatingpadsareusefulfor
providing warmth for young
providingwarmthforyoung
puppies/kittens,fordogs/cats
duringcoldweather,post
parturation orforolderdogs
witharthritisandjoint
problems.
Aheatingpadisasafewayto
increaseyourdog'scomfort
whenusedproperly.
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Infusioncuff
Infusionpump
Syringepump
Alat yangdigunakan untuk
membantu
b t mendorong
d Delivers medication,blood,orfluid
cairan di dalam botal infus
akan keluar lebih cepat
diperlukan untuk
melakukan flushingdalam
jumlah banyak dan periode
waktu yangsingkat
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Introduction
Bottlesoffluidsusedgravityflow
g y
to dripfluidsintoapatient.
Astechnologyexpandedinto
health care,thebottleswere
replacedwithplasticbagsand
gravitywas nolongermedically
adequate.
Electromechnical pumpsare
p p
more reliableandprovide
constantmonitoringoffluid
delivery.
Also calledintravenouspump,IVAC,
andIV pump
intothepatientovera specific
periodoftimeataparticularrate.
Thepumpensuresanaccuraterate
and,therefore,anexactdose.
IVbags,filledwithfluid,are
g g
connectedthroughtubingtothe
pump,andthenthroughthepump
totheveinsofthepatient.
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Syringepumpsdeliver
medicationfromasyringeby
usinga
i pistontodrivetheback
i di h b k
ofastandardsyringe.
Thisdeviceis usuallyusedfor
verysmallamountsof
medicationdeliveredvery
accurately.
AswithIVpumps,the
medicationisusuallydelivered
di i i ll d li
topatientsthroughtheirveins.
Dosinginstructions(timeand
amount)areprogrammedbythe
clinicalstaff.
Electrocardiography
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Electrocardiograph/Elektrokardiogra
mm (Germany) Atransthoracic
i
interpretationoftheelectrical
i f h l i l
activityoftheheartovertime
capturedandexternallyrecordedby
skinelectrodes.
Itisanoninvasiverecording
producedbyanelectrocardiographic
device.
d Worksmostlybydetectingand
W k l b d i d
amplifyingthetinyelectrical
changesontheskinthatarecaused
whentheheartmuscle
"depolarizesrepolarizes"during
eachheartbeat.
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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