The Anesthesia Gas Machine
Michael P. Dosch CRNA MS
University of Detroit Mercy Graduate Program in Nurse Anesthesiology.
The url for this site is http://www.udmercy.edu/crna/agm/. Copyright. Last revised Feb 2006.
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DRE is a professional supplier of new, preowned, and refurbished anesthesia machines, surgical tables, patient monitors, surgery lights, and a wide variety of used medical equipment.
History of site, Author's Disclosure statement, Acknowledgments, How to contact author, Other resources for learning.
Introduction, Numbers to remember, General features of all anesthesia gas machines, Path of gases within the machine, Five tasks of oxygen, Supply Processing Delivery & Disposal (SPDD) model, Manufacturers.
Gas sources- Pipeline, Cylinders (Standards, Capacity of cylinders, Component parts, Storage handling and installation, Compressed gases), Electrical power supply, Failures and faults (What happens when pipeline oxygen pressure lost? What happens when electrical power is lost?).
Fail-safe system, Flowmeters (Glass, Electronic, Using flowmeters, Flowmeters for auxiliary oxygen, scavenging, and common gas outlet), Proportioning systems (Hypoxic guard).
Physical principles, Classification, Vaporizer interlock, Operating principles, How to fill vaporizers, How much liquid agent does a vaporizer use per hour?, Hazards and safety features of contemporary vaporizers, Current models.
Breathing circuits- Classification, Non rebreathing circuits (How do they work?, Fresh gas flow requirements, Pethick Test for the Bain Circuit), Circle System (and King). Advantages and disadvantages
General characteristics, Chemistry (soda lime, barium hydroxide lime, Medisorb and other new formulations), Changing canisters, Clinical signs of exhaustion.
Classification, Bellows classification, Choosing ventilator modes and settings, Typical ventilator alarms, New features (Piston ventilators, Flexibility (New modes), Accuracy at lower tidal volumes, Compliance and leak testing, Fresh gas decoupling versus compensation, Suitability for low flows ), Current models (Dräger Divan, Julian, Fabius GS, AV-E and AV-2; Datex-Ohmeda 7000, 7100, 7800, 7900 SmartVent, S/5 ADU, Kion )
Humidification, Choosing the best fresh gas flow, Low flows, How to denitrogenate ("preoxygenate"), Malignant hyperthermia implications for equipment, Ventilator and Breathing circuit problems and hazards, Increased inspired carbon dioxide (troubleshooting and treatment).
Scavenging Systems (Purpose, Types, Practice guidelines, Components, Hazards), Controlling waste anesthetic gas exposure.
Anesthesia gas machine check (Negative pressure leak check, Minimum test under life-threatening conditions, Electronic checklists, FDA anesthesia gas machine checklist 1993, Modified Anesthesia Gas Machine Checklist), Medicolegal (Risk management, Quality assurance, Monitoring standards, Manufacturing standards), Cleaning and sterilization (Sterilization-Moist heat, liquid and gas sterilization methods, Care of specific equipment).
Current models from Dräger, Datex-Ohmeda, Siemens.
Question and answer format.