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Anesthesia Machine

  • Chapter
Basic Clinical Anesthesia

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Abstract

The anesthesia machine has evolved from simple Boyle’s apparatus to a complex integrated anesthesia workstation (Fig. 5.1), which includes the anesthesia machine, vaporizers, ventilator, breathing system, scavenging system, monitors, drug delivering system, data management system, and suction equipment.

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Further Reading

  1. Armstrong RJ, Kershaw EJ, Bourne SP, Strunin L. Anaesthetic waste gas scavenging systems. Br Med J. 1977;1(6066):941–3.

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  2. Baum JA, Nunn G. Low flow anaesthesia: the theory and practice of low flow, minimal flow and closed system anaesthesia. 2nd ed. Oxford: Butterworth-Heinemann; 2001.

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  3. Conway CM. Anaesthetic breathing systems. Br J Anaesth. 1985;57:649–57.

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  4. Dorsch JA, Dorsch SE. Understanding anesthesia equipment. 4th ed. Williams & Wilkins, Philadelphia: Lippincott; 1999.

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  5. Eichhorn JH. Medical gas delivery systems. Int Anesthesiol Clin. 1981;19(2):1–26.

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  6. Food and Drug Administration, Anesthesia apparatus checkout recommendations. Rockville, MD: Food and Drug Administration; 1993.

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  9. Mapleson WW. The elimination of rebreathing in various semiclosed anaesthetic systems. Br J Anaesth. 1954;26:323–32.

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  10. Miller DM. Breathing systems reclassified. Anaesth Intensive Care. 1995;23:281–3.

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  11. Ritz RH, Previtera JE. Oxygen supplies during a mass casualty situation. Respir Care. 2008;53(2):215–24. discussion 224–5.

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  12. Westwood M-M, Rieley W. Medical gases, their storage and delivery. Anaesth Intensive Care Med. 2012;13(11):533–8.

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Author information

Authors and Affiliations

  1. All India Institute of Medical Sciences, New Delhi, India

    Preet Mohinder Singh M.D. & Dipal Shah

  2. Department of Anesthesiology and Perioperative Medicine, Drexel University College of Medicine, 245 N. 15th Street, MS 310, Philadelphia, PA, 19102, USA

    Ashish Sinha M.D., Ph.D.

Authors
  1. Preet Mohinder Singh M.D.
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  2. Dipal Shah
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  3. Ashish Sinha M.D., Ph.D.
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Corresponding author

Correspondence to Ashish Sinha M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Perioperative Medicine, Emerson Hospital (former faculty Brigham and Women’s Hospital, Harvard Medical School), Concord, Massachusetts, USA

    Paul K. Sikka

  2. Associate Professor, Associate Residency Program Director, Director of Trauma Anesthesiology, Department of Anesthesiology-Presbyterian Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Shawn T. Beaman

  3. Chair, Department of Anesthesia and Perioperative Medicine, Emerson Hospital; Associate Professor, Northeastern University, Boston, MA (former faculty Brigham and Women’s Hospital, Harvard Medical School), Concord, Massachusetts, USA

    James A. Street

Appendices

Clinical Review

  1. 1.

    All of the following are components of the low-pressure system of the anesthesia machine, except:

    1. A.

      Flowmeters

    2. B.

      Vaporizers

    3. C.

      Fail-safe valve

    4. D.

      Common gas outlet

  2. 2.

    The pressure gauge of an oxygen “E” cylinder shows 1,000 psi. How long will it take for the tank to get empty if using flows of 10 L/min?

    1. A.

      15 min

    2. B.

      30 min

    3. C.

      1 h

    4. D.

      1.5 h

  3. 3.

    The fail-safe valve:

    1. A.

      Senses pressure

    2. B.

      Senses flow

    3. C.

      Senses both pressure and flow

    4. D.

      Prevents delivery of a hypoxic gas mixture

  4. 4.

    If the fresh gas flow is 2 L/min, the volume of gas exiting via the scavenging system should be (L/min):

    1. A.

      0.5

    2. B.

      1

    3. C.

      1.5

    4. D.

      2

  5. 5.

    Characteristic of a circle system is that:

    1. A.

      It is light weight.

    2. B.

      It conserves heat and humidity.

    3. C.

      Disconnections are rare.

    4. D.

      It is not environmental friendly.

  6. 6.

    End products of the reaction in a CO2 absorbent are:

    1. A.

      Carbonates

    2. B.

      Water and heat

    3. C.

      Sodium hydroxide

    4. D.

      All of the above

  7. 7.

    Hazards of vaporizer include:

    1. A.

      Tipping

    2. B.

      Pumping effect

    3. C.

      Incorrect agent

    4. D.

      All of the above

  8. 8.

    If the volume of gas is 500 L at 1,520 mmHg pressure, what would be the volume of gas at 760 mmHg, temperature being constant?

    1. A.

      250 L

    2. B.

      500 L

    3. C.

      1,000 L

    4. D.

      2,000 L

  9. 9.

    During manual ventilation, with the APL valve fully open, on squeezing the reservoir bag:

    1. A.

      All the gas is delivered to the patient.

    2. B.

      All the gas is leaked to the atmosphere.

    3. C.

      All the gas is collected by the scavenging system.

    4. D.

      The pressure in the reservoir bag increases.

  10. 10.

    On the anesthesia machine, the oxygen flowmeter should be arranged:

    1. A.

      Last in the sequence, on the right.

    2. B.

      First in the sequence, on the left.

    3. C.

      In the middle, between the other flowmeters.

    4. D.

      The order of arrangement is of insignificant consequence.

Answers: 1. C, 2. B, 3. A, 4. D, 5. B, 6. D, 7. D, 8. C, 9. C, 10. A

Appendix 1: Anesthesia Machine Checkout Recommendations

To be accomplished daily

Item 1: Verify that an auxiliary oxygen cylinder and self-inflating manual ventilation device are available and functioning

Item 2: Verify that patient suction is adequate to clear the airway

Item 3: Turn on the anesthesia delivery system and confirm that AC power is available

Item 4: Verify the availability of required monitors, including alarms

Item 5: Verify that pressure is adequate on the spare oxygen cylinder mounted on the anesthesia machine

Item 6: Verify that piped gas pressures are ≥50 psi

Item 7: Verify that vaporizers are adequately filled and, if applicable, that filler ports are tightly closed

Item 8: Verify that there are no leaks in the gas supply lines between the flowmeters and the common gas outlet

Item 9: Test the scavenging system function

Item 10: Calibrate or verify calibration of the oxygen monitor and check the low-oxygen alarm

Item 11: Verify that the carbon dioxide absorbent is not exhausted

Item 12: Check for proper breathing system pressure and leaks

Item 13: Verify that gas flows properly through the breathing circuit during both inspiration and expiration

Item 14: Document completion of checkout procedures

Item 15: Confirm ventilator settings and evaluate readiness to deliver anesthesia care (anesthesia time-out)

Appendix 2: Anesthesia Machine Checkout Recommendations

To be completed before each procedure

Item 2: Verify that patient suction is adequate to clear the airway

Item 4: Verify the availability of required monitors, including alarms

Item 7: Verify that vaporizers are adequately filled and, if applicable, that filler ports are tightly closed

Item 11: Verify that the carbon dioxide absorbent is not exhausted

Item 12: Check for proper breathing system pressure and leaks

Item 13: Verify that gas flows properly through the breathing circuit during both inspiration and expiration

Item 14: Document completion of checkout procedures

Item 15: Confirm ventilator settings and evaluate readiness to deliver anesthesia care (anesthesia time-out)

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Singh, P.M., Shah, D., Sinha, A. (2015). Anesthesia Machine. In: Sikka, P., Beaman, S., Street, J. (eds) Basic Clinical Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1737-2_5

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  • DOI: https://doi.org/10.1007/978-1-4939-1737-2_5

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1736-5

  • Online ISBN: 978-1-4939-1737-2

  • eBook Packages: MedicineMedicine (R0)

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