Advanced Monitoring and Cardiac Resuscitation Techniques ,Instrumentations,co2 angiography,ACT equiment, in Interventional Radiology

Advanced Monitoring and Cardiac Resuscitation Techniques ,Instrumentations,co2 angiography,ACT equiment, in Interventional Radiology

• 2.
  content • Pulse oximetry •Cardiac resuscitation measures - ECG • Pressure injector • Catheters, needles and other tools • 3-D rotational angiography • Image processing • Patient monitor • ACT equipment • CO2 angiography
• 3.
  PULSE OXIMETRY • pulseoximetry is a non‑invasive optical technique that estimates arterial oxygen saturation (SpO₂) and pulse rate using red and infrared light transmitted or reflected through pulsatile tissue, most commonly a fingertip or earlobe.
• 4.
  Basic principle • Bluepulse oximeter probe applied to a person's finger. • A pulse oximeter uses two LEDs, typically around 660 nm (red) and 940 nm (infrared), and a photodetector positioned opposite (transmission type) or adjacent (reflectance type) to the tissue. • Oxyhemoglobin and deoxyhemoglobin have different absorption characteristics at these wavelengths; by measuring the change in absorbance with each arterial pulse (AC component) over the non‑pulsatile background (venous blood, tissue; DC component), the device calculates a ratio that is converted to SpO₂ via empirically derived calibration curves. • Measurement and output • Pulse oximeter diagram • The sensor detects the pulsatile increase in arterial blood volume with each heartbeat and extracts this signal to provide heart rate and the corresponding oxygen saturation value, usually displayed as a percentage (e.g., SpO₂ 97%). • In routine clinical practice, readings 94–95% in a patient with a normal oxyhemoglobin ≥ dissociation curve are generally considered adequate, while persistent values below this range may suggest hypoxemia and trigger further assessment or oxygen therapy.
• 5.
  Clinical uses • Pulseoximetry is widely used as a continuous monitoring tool in anesthesia, critical care, emergency departments, and during procedural sedation, and is often described as the “fifth vital sign.” • It is also employed for screening and monitoring in chronic respiratory or cardiac conditions, assessing response to supplemental oxygen, and in portable/wearable devices for home or ambulatory monitoring. • Pulse oximetry provides continuous, non‑invasive monitoring of SpO₂ and pulse during IR procedures. • It helps detect early hypoxia and respiratory depression in sedated patients in the angio suite. • SpO₂ and pulse trends guide safe titration of sedatives and analgesics, especially in high‑risk patients. • A probe on the ipsilateral limb monitors distal perfusion during transradial or femoral arterial access. • Loss of waveform or drop in saturation can indicate arterial spasm, thrombosis, or embolism requiring urgent action. • During long, complex IR (e.g., embolization, EVAR), oximetry complements BP and ECG for global hemodynamic assessment. • Continuous SpO₂ monitoring in recovery helps detect delayed respiratory compromise after procedures. • Limitations include motion artefact, poor perfusion, and dyshemoglobinemias, so readings must be interpreted in clinical context.
• 6.
  Types of pulseoximeters • Bedside and transport monitors use cabled sensors (finger, ear, toe, or forehead) as part of multiparameter systems in hospitals, while compact clip‑on fingertip devices are common for spot checks in clinics and home use. • Newer wearable designs integrate reflective sensors into watches or patches, enabling long‑term trend monitoring but often with performance characteristics that differ from medical‑grade, regulated devices.
• 7.
  Cardiac resuscitation • Cardiacresuscitation measures involving ECG focus on using continuous rhythm monitoring to diagnose arrest rhythm, guide interventions, and assess response to CPR and advanced life support. • Core roles of ECG in resuscitation • Identify initial rhythm: ventricular fibrillation (VF), pulseless VT, asystole, or pulseless electrical activity (PEA). • Decide immediate action: defibrillation for shockable rhythms (VF/pulseless VT) vs high‑quality CPR and drugs for non‑shockable rhythms (PEA/asystole). • Confirm rhythm changes during CPR (e.g., VF organized rhythm → with pulse = ROSC, or VF asystole). →
• 8.
  Cardiac resuscitation measures– ECG • Continuous ECG monitoring is essential during cardiac arrest to identify the rhythm and guide resuscitation. • Shockable rhythms (VF/pulseless VT) on ECG require prompt defibrillation plus ongoing high‑quality CPR. • Non‑shockable rhythms (PEA/asystole) on ECG require immediate CPR, adrenaline, and correction of reversible causes (4 Hs, 4 Ts). • ECG helps detect arrhythmias precipitating arrest (e.g., STEMI with VF, long‑QT torsades, severe bradyarrhythmias). • During resuscitation, progressive ECG changes (e.g., narrowing QRS, increasing rate in PEA) may indicate improving myocardial perfusion and likelihood of ROSC. • After ROSC, a 12‑lead ECG is mandatory to look for ischemia (ST elevation, new LBBB) and decide on urgent coronary angiography. • Serial ECGs in the post‑arrest phase help monitor for reinfarction, ongoing ischemia, or new arrhythmias while optimizing hemodynamics. • Quantitative ECG waveform analysis (e.g., VF waveform characteristics) is an emerging tool to assess CPR effectiveness and predict defibrillation success in research settings.
• 9.
  Cardiac resuscitation measures- ECG • ECG in Cardiac Arrest: Core Role • ECG is the primary tool to identify cardiac arrest rhythm and direct ACLS interventions (shock vs non‑shock algorithms). • Classifies rhythms into shockable (VF, pulseless VT) and non‑shockable (PEA, asystole), determining defibrillation or immediate CPR • Guides moment‑to‑moment decisions during resuscitation: rhythm checks every 2 minutes, recognition of ROSC vs persistent arrest. • Helps identify precipitating pathology (e.g., STEMI, long‑QT, severe bradyarrhythmias) that must be treated alongside resuscitation.
• 10.
  ECG Before, Duringand After Resuscitation • Pre‑arrest / early phase: ECG detects high‑risk patterns (ischemia, electrolyte‑related changes, conduction blocks) allowing preventive therapy before arrest. • During resuscitation: quantitative ECG features (VF waveform, QRS rate and width in PEA) act as physiologic feedback and correlate with likelihood of ROSC. • Post‑ROSC: 12‑lead ECG is mandatory to look for ischemia and guide urgent coronary angiography and ongoing anti‑arrhythmic/anti‑ischemic management. • Ongoing monitoring: continuous ECG in ICU detects recurrent VT/VF, bradyarrhythmias, and drug‑induced changes, and supports prognostication and long‑term planning.
• 12.
  Pressure injector
• 16.
  Catheters, needles andother tools