Clinical Equipment
Tools of the Perioperative Medicine Clinician
UC Irvine department of perioperative medicine is dedicated to providing anesthesia in the safest possible manner and environment. This is accomplished through a dedicated team of professionals trained in all aspects of delivering anesthesia using the latest, state of the art tools and technology. Within the past year alone, the University Of California Medical Center, under the leadership of our Chairman Dr. Zeev Kain; has procured over three million dollars worth of new equipment and technology to ensure that all the tools are available to support all levels of this care. Below you will find descriptions of some of this equipment and technology that available for our patients.
Anesthesia Delivery Systems
Most of the operating rooms at the UC Irvine Medical Center are now equipped with the Aisys® Carestation® This perioperative carestation is designed to integrate devices, therapies and information systems at the point of need. It combines one of the most sophisticated ventilators currently available for intraoperative use that provides modes of ventilation suitable for virtually any patient, with precision anesthetic gas delivery. Integrated with this is a suite of physiologic monitoring devices based on the Solar 8000 system from General Electric that itself incorporates the latest technologies from Aspect medical Systems (BIS) as well as Massimo (Pulse Oximetry). Data from the ventilator and monitors is presented in an integrated and ergonomically designed manner to provide the clinician with all the information necessary to manage the patient, the workload and fatigue of the clinician.
Pulse Oximetry
In addition to standard pulseoximetry on all Aisys Carestations all anesthetizing locations are equipped with stand-alone Masimo SET® pulse oximeters. This is a breakthrough noninvasive blood constituent monitoring platform that can measure many blood constituents that previously required invasive procedures. They can continuously and noninvasively measure carboxyhemoglobin (SpCO™) methemoglobin (SpMet™), and pleth variability index (PVI™), in addition to oxyhemoglobin (SpO2), perfusion index (PI) and pulse rate. These units potentially have the capability to additionally monitor total hemoglobin (SpHb™), oxygen content (SpOC™) and are currently awaiting FDA approval. Once that approval is attained, UC Irvine’s department of perioperative medicine will be ready to take advantage of this exciting technology allowing early detection and treatment of potentially life-threatening conditions.
INVOS® Cerebral Oximeters
Some disease states and some surgical procedures, e.g. carotid artery endarterectomy put patients at risk for developing brain injury caused by insufficient blood and oxygen to the brain. It has long been a challenge for anesthesia providers to monitor blood flow and oxygen delivery to this vital organ. The INVOS® System is the first and only patient monitoring system commercially available in the U.S. that noninvasively and continuously monitors changes in the regional oxygen saturation of the blood in the brain.
UC Irvine Medical Center has dedicated operating rooms for both cardiac and neuro surgery. These facilities have been equipped with INVOS® Cerebral Oximeters which monitor changes in regional saturation of oxygen, or rSO2, within a sample of blood in the cerebral cortex. Changes in INVOS (In Vivo Optical Spectroscopy) values monitor the critical balance between oxygen delivery and cerebral consumption. The measurement are made by noninvasively transmitting and detecting harmless, low intensity and near infrared light through SomaSensors that are placed on both sides of a patient's forehead. Use of this monitoring system allows the anesthesiologist to monitor changes in cortical blood oxygen saturation and take immediate corrective action. Research and clinical experience indicates that such action can prevent or reduce neurological injuries associated with surgery and other critical cares situations, and therefore, reduce the cost of care.
Airway Management Equipment
The practice of anesthesiology requires that the practitioner be highly skilled in the management of a patient’s airway. The UC Irvine department of Perioperative Medicine prides itself not only of its own skills in this area but on passing them on to our medical students and residents. In addition to all the standard methods of managing airways we have also been actively procuring many of the recently developed tools that provide video assisted laryngoscopy. The use of these tools not only has increased overall safety to the patient but has provided a new and exciting method of teaching those same medical students and residents under the guidance of the clinical anesthesiologists.
The GlideScope® was one of the first video laryngoscopes commercially available and we are proud to have been amongst some of the early adopters of this equipment. This equipment is now available throughout all areas where anesthesia care is delivered and their portability has allowed extending this care throughout the hospital. A recent addition to this armory has been the McGrath® Series 5 Portable Video Laryngoscopes shown to the left.
All visiting medical students to our department will be offered an opportunity to practice their skills with these and other such devices.
Ultrasound Technology for Regional Anesthesia
Regional aesthesia differs from general anesthesia in that only the specific areas that are subject to pain are anesthetized. This is achieved by injecting medicines that block the nerves that conduct pain messages to the brain. Adverse affects that are common with general anesthesia such as nausea, vomiting, sore throat and sleepiness can be avoided using a regional technique. Certain disease states may also compromise a patient’s ability to tolerate a general anesthetic and then a regional anesthetic becomes a preferred option.
Traditional techniques of regional anesthesia have relied on the practitioner placing the tip if a hypodermic needle at the site of a nerve which couldn’t be directly visualized. These blind techniques now belong in the past. The development of high quality portable ultrasound equipment now enables the clinician to accurately place the anesthetic medicine at the exact location to block the nerve that can be clearly seen on a screen during the procedure. The UC Irvine Department of Perioperative Medicine had acquired the latest tools including the LOGIQ® i from General Electric healthcare that facilitate all of our regional anesthetics. All residents are trained in the use of these techniques with this technology.
Links
Aisys Carestation from GE Healthcare
Radical 7 Pulseoximeter from Masimo
McGrath® Series 5 Portable Video Laryngoscope
LOGIQ® i Portable Ultrasound equipment from GE Healthcare
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