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Workstation
Hazards
Objectives
Anesthesia Machine
Ventilators
Scavenging Systems
System Checkout
ventilator
Flow
meter
bellow
Corrugate
d tube
Soda lime
vaporizer
APL valve
Scavengin
g system
High
Intermediate
Low Pressure
Circuit
Oxyge
n
Color
Nitrous
Oxide
Carbon
Dioxide
Air
White
Blue
(green)
Gray
Black/Whi
te (yellow)
State
Gas
Liquid and
gas
Liquid and
gas
Gas
Contents (L)
625
1590
1590
625
Empty Weight
(kg)
5.90
5.90
5.90
5.90
Full Weight
(kg)
6.76
8.80
8.90
Pressure Full
(psig)
2000
750
838
1800
Cylinders Tank
Pressure gauge
Hanger Yolk
Pressure Reducing
Device
Pressure Reducing
Device
Intermediate Pressure
System
Pipeline
Pipeline Inlet
Connections
Oxygen Pressure
Failure Devices
Oxygen Pressure
Failure Devices
Oxygen supply
pressure opens the
valve as long as it is
above a pre-set
minimum value (e.g..
20 psig).
If the oxygen supply
pressure falls below
the threshold value
the valve closes and
the gas in that limb
(e.g.. N2O), does not
advance to its flowcontrol valve.
Oxygen Failure
Protection Device
(OFPD)
Based on a proportioning principle rather
Limitations of Fail-Safe
Devices/Alarms
Limitations of Fail-Safe
Devices/Alarms
Receives O2 from
pipeline inlet or cylinder
reducing device and
directs high, unmetered
flow directly to the
common gas outlet
(downstream of the
vaporizer)
Machine standard
requires that the flow be
between 35 and 75 L/min
The ability to provide jet
ventilation
Hazards
May cause barotrauma
Dilution of inhaled
anesthetic
Second-Stage
Reducing Device
Flow meters
Vaporizer mounting device
Check valve
Common gas outlet
Flowmeter assembly
Arrangement of the
Flow-Indicator Tubes
Proportioning Systems
Mechanical
integration of the
N2O and O2 flowcontrol valves
Automatically
intercedes to
maintain a
minimum 25%
concentration of
oxygen with a
maximum N2O:O2
ratio of 3:1
Limitations of
Proportioning Systems
Vaporizers
A vaporizer is an
instrument designed
to change a liquid
anesthetic agent into
its vapor and add a
controlled amount of
this vapor to the fresh
gas flow
Classification of
Vaporizers
Flow-over
Bubble through
Injection
Temperature compensation
Thermocompensation
Generic Bypass
Vaporizer
VARIABLE BYPASS
Patient
Flowmeter
Patient
Flowmeter
Patient
Flowmeter
Hazard
Breathing System
Maplesons
fresh gas inlet, breathing tube, APL valve,
reservoir bag
Circle system
add features: unidirectional valve, CO2 arsobent
and CO2 absorber
Non Rebreathing
Circuit
Advantages
Less resistance to breathing
Less mechanical dead space
They are simple devices, with less potential for
malfunction, and they are inexpensive
The light weight and less bulk
Disadvantages
deliver a high flow of dry cool gas which causes
significant heat and humidity loss. (Hypothermic)
higher requirement of carrier gas and anesthetic
results inincreased cost.
Arrangement is variable,
but to prevent rebreathing of CO2, the
following rules must be
followed:
Unidirectional valves
between the patient
and the reservoir bag
Fresh-gas-flow cannot
enter the circuit
between the
expiratory valve and
the patient
Adjustable pressurelimiting valve (APL)
cannot be located
between the patient
and the inspiratory
valve
Circle System
Advantages:
Disadvantages:
Complex design = potential for malfunction
High resistance (multiple one-way valves) =
higher work of breathing
Scavenging Systems
Protects the
breathing circuit
or ventilator from
excessive positive
or negative
pressure.
Scavenging Systems
Ventilators
Inspiratory phase
Triggered by
Preset limit of time (fixed
duration)
Set inspiratory pressure
Predetermined tidal volume
Expiratory Phase
pressure
Controlled ventilation
Checking Anesthesia
Machines
8 Categories of check:
Emergency ventilation equipment
High-Pressure system
Low-Pressure system
Scavenging system
Breathing system
Manual and automatic ventilation
system
Monitors
Final Position
The end
Case Discussion:
Unexplained Light
Anesthesia
An extremely obese but otherwise healthy 5-yearold girl presents for inguinal hernia repair. After
uneventful induction of general anesthesia and
tracheal intubation, the patient is placed on a
ventilator set to deliver a tidal volume of 7 mL/kg at
a rate of 16 breaths/min. Despite delivery of
2%halothane in 50%nitrous oxide, tachycardia (145
beats/min) and mild hypertension (144/94 mm Hg)
are noted. To increase anesthetic depth, fentanyl (3
g/kg) is administered. Heart rate and blood
pressure continue to rise and are accompanied by
frequent premature ventricular contractions.
Case Discussion:
Detection of a Leak
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