Anaesthetic Machine

Anatomy

Year Group: BVSc3 +

Document Number: CSL_A00
 Equipment list:
Anaesthetic Machine Anatomy
Equipment for this station:
• Anaesthetic machine
• Name labels
• Function labels

Considerations for this station:

• Do not attempt to attach cylinders or connect the
oxygen pipeline, this machine is for reference only and
is NOT a working machine.
• The first time you try to complete this task it may be
worth refreshing your memory of the anaesthetic
machine by reading the section of this booklet marked
‘Answers’.

Anyone working in the Clinical Skills Lab must read the ‘CSL_I01 Induction’ and
agree to abide by the ‘CSL_I00 House Rules’ & ‘CSL_I02 Lab Area Rules’
Please inform a member of staff if equipment is damaged or about to run out.
 Clinical Skills:
Anaesthetic Machine Anatomy

1 2 3

Using the name labels On the bottom of the name On some of the function
provided, name each part of label, place a function label labels there are additional
the anaesthetic machine (match the circular tabs). questions.
(match/stick the white square Place the correct answers in
velcro tab to the yellow the space provided (match
square tab). the semi-circular tabs).

4 5

You will need to lift the lid Once you have placed all of
to find all of the the labels, use the
components! information on the following
pages of this booklet to
check your answers.

Here are some online resources and tutorials that you may find useful:
1. http://mhra.gov.uk/learningcentre/AnaestheticMachines/player.html

2. https://www.youtube.com/watch?v=1LY0eAzrIrE
 ANSWERS:
Anaesthetic Machine Anatomy

ANSWERS

The following pages contain the answers i.e. the name

and function of each part of an anaesthetic machine
 Clinical Skills:
Anaesthetic Machine Anatomy

Schematic Diagram of an Anaesthetic Machine

Pipeline
Pressure regulator oxygen (O2)
O2 flush
Pressure gauge
O2 failure alarm
Check valve and reservoir

Common
Oxygen gas outlet
(O2)
Flowmeter Vaporiser
N2O cut-off
Nitrous
oxide
(N2O)

Pipeline
nitrous oxide
(N2O)

N.B. This diagram is simplified to aid in the understanding of the components.

Anaesthetic machines have additional regulators and check valves to those shown
above. Ensure you know the functions of each of the components named in the diagram.
 Clinical Skills:
Anaesthetic Machine Anatomy

1 2 3

Gas source: Cylinders attach via a yoke. The yoke contains a Bodok
• Cylinders The yoke: seal. The Bodok seal consists
(not included on this • Supports the cylinder of a non-combustible
machine - do NOT attach) • Provides a gas-tight seal neoprene washer with a
(Bodok seal) copper ring.
• Allows unidirectional flow It ensures a gas-tight seal
from the cylinder to the between the yoke and the
machine gas cylinder.
• Prevents the cylinder being
attached to the wrong inlet
(pin index system)

4 5 6

The yoke also prevents a Yoke pin positions for an

cylinder being attached to oxygen cylinder.
the wrong inlet via the Pin
Index Safety System.
Example pins on gas
The yoke for each gas type cylinders:
has 2 protruding pins that
• Oxygen (O2) has a pin index
match 2 holes on the
of 2 & 5
respective gas cylinders.
• Nitrous oxide (N2O) has a
The placement of the pins
pin index of 3 & 5
(and holes) vary for each
gas, with a potential 6 pin
positions, shown above.
 Clinical Skills:
Anaesthetic Machine Anatomy

7 8 9
Schrader sockets

Gas source: Some practices use a Flexible pipelines connect

• Pipeline pipeline system. the terminal outlet to the
(do NOT attach the oxygen Piped gas is drawn from a anaesthetic machine.
pipeline included on this central source and fed into a
machine to the wall outlet) labelled and colour-coded
pipeline distribution
network which terminates in
self-closing Schrader sockets
at the wall.

10 11 12

Flexible pipelines have three 2. Flexible hosepipe 3. Non-Interchangeable

components: Modern hoses are colour Screw Thread (NIST)
1. Schrader probe coded for each gas: This comprises of a nut and
probe with a unique profile
This prevents misconnection • Oxygen – white for each type of gas.
to the wrong gas service. • Nitrous oxide – blue It includes a one-way valve to
Each gas probe has a • Medical air – black & white ensure unidirectional flow.
protruding index collar with
a unique diameter - this only When a pipeline is used, it is
fits the Schrader socket for good practice to have reserve
the same gas type. cylinders available as a back-
up.
 Clinical Skills:
Anaesthetic Machine Anatomy

13 14

Spring

Diaphragm The pressure regulator:

Pressure regulator:
Gas from cylinders is at • Reduces the cylinder
pressure to a suitable
very high pressure supply pressure
(>10,000 kPa)
Valve • Compensates as the
This pressure needs to be cylinder content decreases
reduced to a safe level This ensures a safe delivery
that will not damage the Inlet from Outlet to of gas at a manageable
anaesthetic machine cylinder machine pressure, whilst smoothing
(approximately 400 kPa) HIGH LOW any fluctuations of pressure
PRESSURE PRESSURE from the gas supply.

15 16 17

Pressure gauges: Oxygen (O2) is stored as a gas in On this machine the pressure
The pressure gauges the cylinder. The pressure is gauges can be identified for
proportional to the volume of gas both the cylinders and the
indicate the pressure of in the cylinder. As the cylinder
gas in kPa. pipeline supply.
empties, the pressure gauge
If using cylinders, use the drops in a linear fashion.
pressure gauge to Nitrous oxide (N2O) is both liquid
determine when the and gas in the cylinder. As N2O is
cylinder is nearly empty used, liquid vapourises into the
(low pressure on gauge) gaseous form and the pressure
remains constant. Once the liquid
and needs changing. is used up, the pressure falls
quickly. As soon as the pressure
gauge decreases, be aware that
the cylinder is nearly empty.
 Clinical Skills:
Anaesthetic Machine Anatomy
Inlet
18 19 Alarm

Valve

Reservoir
Outlet
Check valve: O2 failure alarm:
The check valve is a one way An alarm sounds when the
valve that prevents backflow pressure in the oxygen
of gas to the atmosphere or supply falls below 200 kPa.
between cylinders on one In this machine there is a
machine. reservoir of air used to
supply the whistle alarm.

20 O2
O2

N2O input
N2O input
N2O output
N2O output
Nitrous oxide cut off:
The flow of N2O is dependent on
oxygen pressure. When the O2
pressure falls past a certain
threshold, the nitrous oxide supply
is cut off. This threshold is between
130 kPa to 70 kPa, depending on
the machine.
This prevents the administration of
a hypoxic gas mixture.
 Clinical Skills:
Anaesthetic Machine Anatomy

21 22 23

Flowmeter: 1. Flow control valves 2. A tapered tube

Flowmeters measure the • Reduce gas pressure from • Gas enters the tube when
flow rate of a gas passing 420 kPa to just above the valve is open.
through them. They consist atmospheric pressure 3. A bobbin or ball
of: (1 atm or 100 kPa). • The bobbin floats within
1. A flow control valve • Allow fine adjustment of the tube as the gas flow
2. A tapered transparent gas flow through the passes around it.
tube flowmeters by manual • The higher the flow, the
3. A lightweight rotating adjustment. higher the bobbin rises.
bobbin or ball

24 25 26
N2O flow- O2 flow-
meter meter

Link

Gas flow rate: Read the gas flow rate from: Some flowmeters have a built in
To adjust the gas flow rate of • The TOP of the bobbin hypoxic guard: The O2 and N2O
control valves are linked
a particular gas, rotate the (not the dot) mechanically. Either valve can be
respective flow control • The MIDDLE of the ball (if adjusted independently but the
valve. a spherical ball is used in link maintains a minimal ratio of
Take care when adjusting place of a bobbin) O2 : N2O.
these valves, the mechanism If you turned on the N2O alone,
is delicate and can be broken the O2 flowmeter is also
by using too much force or operated so that 100% N2O is
closing the valve too firmly. not delivered. If you turn the O2
off, the N2O is also turned off. In
this way O2 can never be
administered at less than 20-25%
 Clinical Skills:
Anaesthetic Machine Anatomy

27 Occasionally old anaesthetic machines have

an uncalibrated vaporiser. These are simple
and inexpensive but have been replaced by
calibrated vaporisers as the vapour produced
varies depending on temperature, gas flow
rate and back pressure from a ventilator.
Gas enters the chamber, picks up vapour and
then exits the vaporiser. It is difficult to
control the concentration of agent that is
delivered. As the agent vaporises it will cool.
Vaporisers: The saturated vapour pressure will fall and
so less agent is delivered.
This is situated on the back bar of
Gas in Gas out
the anaesthetic machine
downstream of the flowmeter It
contains the volatile liquid
anaesthetic agent (e.g. isoflurane, Agent
sevoflurane). Gas is passed from vapour

the flowmeter through the Agent liquid

vaporiser. The gas picks up
“vapour” from the vaporiser to
deliver to the patient. Most
vaporisers are calibrated (see 28).

Control Valve
28 Gas in Bypass Gas out

Brass Chamber
container
Agent
vapour
Calibrated vaporiser: Agent liquid
• Designed to overcome flaws of simple model
• Gas entering vaporiser is split into two streams
- Bypass channel (does not contact anaesthetic) Bi-metallic Strip
- Chamber above liquid anaesthetic
• A control valve adjusts the ratio of gas that bypasses the vapour chamber to the gas that passes through
the chamber. The concentration of the vapour being “entrained” (picked up) by the gas can be increased
by adjusting this ratio. This valve is controlled by the large dial on the front of the vaporiser.
• The vaporiser is housed in a large block of brass to minimise the effect of temperature cooling.
• A bi-metallic strip is a secondary control point that adjusts the gas flow through the vaporiser. As the agent
cools, the bimetallic strip moves, allowing a greater ratio of the gas to pass through the vapour chamber,
entraining a greater concentration of volatile agent and mitigating the effect of temperature.
 Clinical Skills:
Anaesthetic Machine Anatomy

29 30 31

Common
gas outlet

Back bar: Common gas outlet: O2 flush:

This is where the This connects to the This supplies O2 in an emergency
vaporiser(s) can be anaesthetic breathing directly from the high pressure
connected to the circuit to deliver the circuit (bypassing the flowmeters
anaesthetic machine.
combined product of gases and vaporiser). This is pure O2 at
Some anaesthetic machines and anaesthetic agent to 35-60 L/min and does not contain
have positions for more than
one vaporiser, on these the patient. It is also used anaesthetic agent.
machines there are safety by the oxygen flush, in the On this old machine it is possible
interlocks to prevent case of an emergency. to ‘hold’ the O2 flush - a dangerous
administration of 2 volatile function that is no longer possible
agents simultaneously. on newer machines due to the risk
of causing barotrauma (injury
caused by pressure).
Wall outlet
32 33 34
Activated
charcoal
canister

Scavenging: 1. Active Scavenging 2. Passive Scavenging

Waste anaesthetic gases and • Waste gases are drawn • No fan
volatile agents are subject to the outside of the building via a • Exhaled gas propelled by patient’s
Control of Substances Hazardous fan and vent system. expiratory effort into tubing:
to Health and the Health and • An air break is necessary to i. Waste gas carried via tubing to
Safety at Work Act. prevent negative pressure outside of building (N.B. creates
“Scavenging” describes the being applied to the patient high resistance making it more
removal of environmental breathing system. difficult for patient to exhale).
contaminants to ensure that • On this machine the top of the ii. Or waste gas absorbed in canister
exposure limits are not exceeded scavenger would attach to the of activated charcoal (N.B. N2O is
(Isoflurane 50 ppm, N2O 50 ppm) breathing circuit, the bottom NOT absorbed by this method).
There are 2 types of scavenging: would connect to the wall • The canister should be weighed
1. Active outlet. regularly to monitor lifespan and
2. Passive replaced when it reaches a
particular weight.
 Resetting the station:
Anaesthetic Machine Anatomy

1. Ensure all the name and function labels have

been removed from the machine
2. Return the labels to their containers
3. Replace the lid on the anaesthetic machine

Station ready for the next person:

Please inform a member of staff if equipment is damaged or

about to run out.
 I wish I’d known:
Anaesthetic Machine Anatomy

• It is essential that you know how an anaesthetic machine

works – if something goes wrong during a general
anaesthetic, you won’t have much time to figure it out!
• Different machines will have slight differences, make sure
that you are familiar with the machine you are using,
before starting the anaesthetic.