SCAVENGING SYSTEMS

CONTROL OF TRACE GAS LEVELS

MODERATOR – DR DEEPA
PRESENTOR-ANAMIKA .S
 CONTENTS
• PROBLEMS ATTRIBUTED TO TRACE GASES
• CONTROL MEASURES
• SCAVENGING SYSTEMS

1.GAS COLLECTING ASSEMBLY

2.TRANSFER TUBINGS
3.INTERFACE

4.GAS DISPOSAL TUBING

5.GAS DISPOSAL SYSTEM
• ALTERATIONS IN WORK PRACTICE
 INTRODUCTION

EXCESS OPERATING ROOM

ANESTHETIC PERSONNEL
GASES AND EXPOSED TO LOW
SIDE EFFECTS
VAPOURS WERE CONCENTRARION
DISCHARGED S OF THESE
INTO ROOM AIR DRUGS
 TRACE GAS LEVEL
• A TRACE LEVEL OF AN ANESTHETIC GAS IS A CONCENTRATION FAR BELOW
THAT NEEDED FOR CLINICAL ANESTHESIA OR THAT CAN BE DETECTED BY
SMELL .

• TRACE GAS LEVELS ARE USUALLY EXPRESSED IN PARTS PER MILLION (PPM),

• PARTS PER MILLION=[VOLUME OF SOLUTE/VOLUME OF SOLUTION] 1,000,000

 PROBLEMS ATTRIBUTED TO TRACE GAS
LEVELS

• 1.SPONTANEOUS ABORTION
• 2.INFERTILITY • 7.RENAL DISEASE

• 3.BIRTH DEFCTS • 8.AFFECTS HEMATOLOGIC FUNCTION

• 4.IMPAIRED PERFORMANCE • 9.NEUROLOGIC SYMPTOMS

• 5.CANCER • 10.ALTERATIONS IN IMMUNE RESPONSE

• 6.LIVER DISEASE • 11.CARDIAC DISEASE

 CONTROL MEASURES

• THE GOAL SHOULD BE TO • 1.SCAVENGING

REDUCE CONCENTRATIONS TO
• 2.EQUIPMENT LEAKS
THE LOWEST LEVEL
CONSISTENT WITH A • 3.WORK TECHNIQUES
REASONABLE EXPENDITURE OF • 4.ROOM VENTILATION SYSTEMS
EFFORT AND MONEY
 • SCAVENGING SYSTEMS
EVACUATION SYSTEMS/WASTE ANESTHETIC GAS DISPOSAL
SYSTEMS/ANESTHESIA WASTE EXHAUST/EXCESS ANESTHETIC GAS
SCAVENGING SYSTEMS

• SCAVENGING IS THE COLLECTION OF EXCESS GASES FROM

EQUIPMENT USED TO ADMINISTER ANESTHESIA OR EXHALED
BY THE PATIENT AND THE REMOVAL OF THESE GASES TO AN
APPROPRIATE PLACE OF DISCHARGE OUTSIDE THE WORK
ENVIRONMENT
• LOWERING AMBIENT CONCENTRATIONS BY UP TO 90%
PARTS OF SCAVENGING SYSTEM
THE INTERFACE-which
A GAS COLLECTING
provides positive[sometimes
ASSEMBLY-which captures
negative]pressure relief and
gas at the site of emission
reservoir capacity

THE GAS DISPOSAL

A TRANSFER TUBING-
TUBING-which conducts the
which conveys collected gas to
gases from the interface to the
the interface
gas disposal system

THE GAS DISPOSAL SYSTEM-

Which conveys gases to a point they
are discharged
COMPLETE SCAVENGING SYSTEM

• COMPLETE SCAVENGING SYSTEM

• THE GAS-COLLECTING ASSEMBLY MAY

BE AN INTEGRAL PART OF THE
BREATHING SYSTEM, VENTILATOR, GAS
MONITOR, OR EXTRACORPOREAL PUMP
OXYGENATOR.

• THE INTERFACE MAY BE AN INTEGRAL

PART OF THE GAS-COLLECTING
ASSEMBLY OR SOME OTHER PORTION
OF THE SCAVENGING SYSTEM.
 GAS COLLECTING ASSEMBLY
SCAVENGER ADAPTER; GAS CAPTURING ASSEMBLY, DEVICE, OR VALVE; SCAVENGING TRAP OR
VALVE; COLLECTING OR COLLECTION VALVE; SCAVENGING EXHALE VALVE; EVACUATOR;
ANTIPOLLUTION VALVE; DUCTED EXPIRATORY VALVE; COLLECTING SYSTEM EXHAUST VALVE;
SCAVENGING TRAP, COLLECTING SYSTEM

• COLLECTS EXCESS GASES AND DELIVER THEM

TO THE TRANSFER MEANS
Either attach to
(ASTM) STANDARD AND INTERNATIONAL the source
STANDARDS – Gas collecting
assembly Outlets of 2 or
1. SPECIFY THAT THE OUTLET Part of the
more sources are
source
CONNECTION MUST BE A 30-MM MALE FITTING joined together

(IT SHOULD NOT BE POSSIBLE TO

CONNECT COMPONENTS OF THE BREATHING
SYSTEM TO THE OUTLET.)
 GAS COLLECTING ASSEMBLY
CAPTURES GAS AT THE SITE OF EMISSION.
1.BREATHING SYSTEMS
2.RESUSCITATION EQUIPMENT
3.MASK OR NASAL CANNULAE
4.VENTILATORS
5.EXTRACORPOREAL PUMP OXYGENATORS
6.RESPIRATORY GAS MONITORS
7.CRYOSURGICAL UNITS
8.LEAK SITES
 TYPES OF GAS COLLECTING ASSEMBLY

• BREATHING SYSTEMS
1.SYSTEMS CONTAINING AN ADJUSTABLE PRESSURE RELEASING VALVE
APL VALVE IS FITTED WITH A SHROUD
INCLUDE THE CIRCLE SYSTEM AND MAPELSON A,B,C AND D SYSTEMS
2.T PIECE SYSTEMS WITHOUT AN APL VALVE
*CONTAINER ATTACHED TO SUCTION
*GAS COLLECTING ASSEMBLY BETWEEN BAG AND ITS ATTCHMENT TO TUBING
 TRANSFER TUBING
EXHAUST TUBING OR HOSE, TRANSFER MEANS,
TRANSFER SYSTEM

• CONVEYS GAS FROM THE COLLECTING

ASSEMBLY TO THE INTERFACE WHEN THE
INTERFACE IS NOT AN INTEGRAL PART OF THE
GAS-COLLECTING ASSEMBLY
 CHARECTERSTICS OF TRANSFER TUBING

1.THE TRANSFER TUBING IS MOST COMMONLY A LENGTH OF TUBING WITH A CONNECTOR AT EITHER END
2. THE INLET AND OUTLET FITTINGS SHOULD BE EITHER 19 OR 30 MM.

3.IT SHOULD BE AS SHORT AS POSSIBLE (THIS IS FACILITATED BY MOUNTING THE INTERFACE ON THE
ANESTHESIA MACHINE)

4.SHOULD BE WIDE ENOUGH TO CARRY A HIGH FLOW OF GAS WITHOUT A SIGNIFICANT INCREASE IN
PRESSURE.

5.IT SHOULD BE RESISTANT TO KINKING.

6.IT SHOULD NOT TOUCH THE FLOOR, BUT IF IT DOES, IT SHOULD BE DESIGNED TO PREVENT OCCLUSION.

7. IT SHOULD BE EASILY SEEN AND EASY TO DISCONNECT FROM THE GAS-COLLECTING ASSEMBLY IN THE
EVENT OF MALFUNCTION OR SCAVENGING SYSTEM OCCLUSION.

8.TO DISCOURAGE MISCONNECTIONS, IT IS RECOMMENDED THAT THE TRANSFER TUBING BE DIFFERENT

(BY COLOR AND/OR CONFIGURATION) FROM THE BREATHING SYSTEM TUBING .
 INTERFACE
BALANCING VALVE OR DEVICE, PRESSURE BALANCING VALVE OR DEVICE, INTERFACE
SYSTEM OR BLOCK, INTERMEDIATE SITE, SAFETY BLOCK, AIR BREAK RECEIVER, RECEIVER
UNIT, AIR BREAK, RECEIVING SYSTEM, INTERFACE VALVE, SCAVENGING VALVE, RESERVOIR

• SERVES TO PREVENT PRESSURE INCREASES OR DECREASES IN THE SCAVENGING SYSTEM FROM

BEING TRANSMITTED TO THE BREATHING SYSTEM, VENTILATOR, OR EXTRACORPOREAL
OXYGENATOR.
• THE U.S. AND INTERNATIONAL STANDARDS REQUIRE THAT THE PRESSURE IMMEDIATELY
DOWNSTREAM OF THE GAS-COLLECTING ASSEMBLY BE LIMITED TO BETWEEN –0.5 AND + 3.5 CM H2O
DURING NORMAL OPERATING CONDITIONS UP TO + 15 CM H2O WITH OBSTRUCTION OF THE
SCAVENGING SYSTEM
 CHARECTERSTICS OF AN INTERFACE
• THE INTERFACE INLET MUST HAVE A 19- OR 30-MM (PREFERRED)
MALE CONNECTOR
• .THE SIZE OF THE OUTLET IS OPTIONAL BUT SHOULD BE
DIFFERENT FROM BREATHING SYSTEM CONNECTORS AND FROM
THE INLET CONNECTOR IF THE DEVICE IS SENSITIVE TO THE
DIRECTION OF FLOW
• THE INTERFACE SHOULD BE SITUATED AS CLOSE TO THE
GASCOLLECTING ASSEMBLY AS POSSIBLE, WHERE IT CAN BE
READILY OBSERVED AND REACHED BY ANESTHESIA PERSONNEL
 BASIC ELEMENTS TO AN INTERFACE

POSITIVE PRESSURE RELIEF

Must be provided to protect the equipment and patient if occlusion of the scavenging system occurs.

NEGATIVE PRESSURE RELIEF

If an active disposal system is used,negative pressure relief is needed to limit subatmospheric pressure

RESERVOIR CAPACITY
Must be necessary to match the intermittent flow from the gas collecting assembly to the continuous flow of the disposal system

*Should be used only with active disposal systems

*should be different colour ,situated away from reservoir bag in the breathing system
 DEPENDING ON THE MEANS TO PROVIDE
POSITIVE AND NEGATIVE PRESSURE RELIEF
• INTERFACE
1.OPEN INTERFACE
2.CLOSED INTERFACE
*POSITIVE PRESSURE RELIEF ONLY(SHOULD BE USED
ONLY WITH A PASSIVE DISPOSAL SYSTEM, POSITIVE PRESSURE RELIEF VALVE REMAINS
CLOSED UNLESS THERE IS A PROBLEM DOWNSTREAM OF INTERFACE)

*POSITIVE AND NEGATIVE PRESSURE RELIEF(IN

AN ACTIVE SYSTEM-NEGATIVE PRESSURE RELIEF IS USED)
 OPEN INTERFACE
AIR BREAK RECEIVER UNIT
• HAS OPENINGS TO ATMOSPHERE (ALLOWING
POSITIVE AND NEGATIVE PRESSURE RELIEF)
• CONTAINS NO VALVES.
• TO BE USED ONLY WITH AN ACTIVE DISPOSAL
SYSTEM.
• THE INLET, THE DISPOSAL SYSTEM CONNECTION,
AND THE OPENING(S) TO ATMOSPHERE SHOULD BE
ARRANGED SO THAT WASTE GASES ARE REMOVED
BEFORE ROOM AIR IS ENTRAINED
 NEED OF RESERVOIR IN OPEN INTERFACE

• THE DISCHARGE OF WASTE GASES IS USUALLY INTERMITTENT AND FLOW

THROUGH AN ACTIVE DISPOSAL ASSEMBLY IS CONTINUOUS, A RESERVOIR IS
NEEDED TO HOLD THE SURGES OF GAS THAT ENTER THE INTERFACE UNTIL
THE DISPOSAL SYSTEM REMOVES THEM.

• THE RESERVOIR ALLOWS THE FLOW RATE IN THE DISPOSAL SYSTEM TO BE

KEPT JUST ABOVE THE AVERAGE FLOW RATE OF GASES FROM THE GAS-
COLLECTING ASSEMBLY.
 DISADVANTAGES OF OPEN INTERFACE

• THE OPEN INTERFACE IS SIMPLE, BUT IF RESERVOIR DOES NOT HAVE SUFFICIENT VOLUME LEADS TO
POLLUTION
• THE ACTIVE DISPOSAL SYSTEM MUST SUPPLY ADEQUATE FLOW
• TURBULENCE WILL INCREASE THE VOLUME OF AIR CONTAMINATED WITH ANESTHETIC GASES .
GREATEST-GAS FROM BREATHING SYSTEM FLOW AGAINST THE DISPOSAL SYSTEM
LEAST-WHEN FLOW IS IN THE SAME DIRECTION
 CLOSED INTERFACES

• MAKES CONNECTION TO ATMOSPHERE THROUGH VALVES

• A POSITIVE PRESSURE RELIEF VALVE IS ALWAYS REQUIRED TO ALLOW

GASES TO BE RELEASED INTO THE ROOM IF THERE IS OBSTRUCTION OF
THE SCAVENGING SYSTEM DOWNSTREAM OF THE INTERFACE.
• WITH ACTIVE DISPOSAL SYSTEM -A NEGATIVE PRESSURE RELIEF (POP-IN,
INLET RELIEF) VALVE IS NECESSARY
• A RESERVOIR - NOT REQUIRED

(EXCEPTION-USED WHEN AN ACTIVE DISPOSAL SYSTEM IS USED)

 CLOSED INTERFACES

• THEY MUST BE DESIGNED SO THAT THEY DO NOT STICK OR LEAK

• IF THE BAG IS CONTINUALLY COLLAPSED OR THE NEGATIVE PRESSURE RELIEF VALVE
OPENS FREQUENTLY, THE FLOW SHOULD BE LOWERED.
• IF THE BAG BECOMES DISTENDED OR THE POSITIVE PRESSURE RELIEF VALVE OPENS
FREQUENTLY, FLOW SHOULD BE INCREASED
 GAS DISPOSAL TUBING
RECEIVING HOSE, DISPOSAL TUBING
• CONNECTS THE INTERFACE
TO THE DISPOSAL SYSTEM
CHARECTERISTICS
1. TO AVOID MISCONNECTIONS, IT SHOULD BE DIFFERENT IN SIZE
AND APPEARANCE FROM THE BREATHING SYSTEM HOSES.
2. RESISTANT TO COLLAPSE AND FREE OF LEAKS.
3. WITH A PASSIVE GAS-DISPOSAL SYSTEM -THE HOSE BE AS
SHORT AND WIDE TO MINIMIZE RESISTANCE.
4. IF THE TUBING MUST BE RUN ACROSS THE FLOOR-AVOID
OCCLUSION
 GAS DISPOSAL SYSTEM
ELIMINATION SYSTEM OR ROUTE, DISPOSAL-
EXHAUST ROUTE, DISPOSAL ASSEMBLY
• REMOVES WASTE GASES FROM THE
ANESTHETIZING LOCATION.
• THE GASES MUST BE VENTED AT A
POINT THAT IS ISOLATED FROM
PERSONNEL AND ANY AIR INTAKES.
 GAS DISPOSAL
SYSTEM

PASSIVE SYSTEMS
Pressure is raised above the
ACTIVE SYSTEM atmosphere by patient
A flow inducting device exhaling,by manually
move the gases squeezing the reservoir bag
or by the ventilator

ACTIVE DUCT ROOM

SYSTEM Piping direct to ADSORPTION
VENTILATION
PIPED VACUM atmosphere DEVICE
Evacuation system SYSTEMS
Cental vacuum(most that leads to outside
popular) and employes flow
inducing device that
move large volume of
gases at low pressures
 ALTERATIONS IN WORK PRACTICES

• WITHOUT COMPROMISING SAFETY,

AND THEY ARE ARE BENEFICIAL TO
THE PATIENT.
 • 2.USING SCAVENGING EQUIPMENT
• 1.CHECKING EQUIPMENT BEFORE USE
• ALL COMPONENTS OF THE SCAVENGING SYSTEM
SHOULD BE SECURLEY CONNECTED AND PATENT
• IF AN ACTIVE GAS DISPOSAL ASSEMBLY –FLOW
TURNED ON
• THE PREUSE CHECKOUT SHOULD REVEAL
LEAKS
• NITROUS OXIDE SHOULD BE TURNED ON ONLY MOMENTARILY
DURING THE PREUSE EQUIPMENT CHECKOUT. MOST TESTS
SHOULD BE CONDUCTED BY USING OXYGEN OR AIR
• 3.PROPER MASK FIT • 4.WASHOUT OF ANESTHETIC GASES
AT THE END OF A CASE
(ANESTHESIA BY THE FASK CAUSES THE HIGHEST
LEVEL OF POLLUTION WHEN USED IN ASSISTED OR • 100%OXYGEN SHOULD BE
CONTROLLED VENTILATION) ADMINISTERED BEFORE EXTUBATION
• THE FACE MASK OR SUPRAGLOTTIC
METHODS
DEVICE IS REMOVED TO FLUSH MOST
AN ACTIVE SCAVENGING DEVICE NEAR OF THE ANESTHETIC GASES INTO THE
THE MASK SCAVENGING SYSTEM
THE USE OF A DOUBLE MASK CAN
REDUCE ROOM POLLUTION FROM A
POOR MASK FIT
• 5.PREVENTING ANESTHETIC GAS FLOW DIRECTLY
INTO THE ROOM

• .

• NITROUS OXIDE-SHOULD BE TURNED ON ONLY AFTER • PREVENTION

ENSURING PROPER SEAL OF FACE MASK • RELEASE OF ANESTHETIC GASES INTO THE ROOM
• DURING INTUBATION-GAS FLOW CAN BE TURNED OFF CAN BE MINIMIZED IF THE RESERVOIR BAG IS
FIRST GRADUALLY EMPTIED INTO THE
• PATIENT CONNECTION PORT ON BREATHING SYSTEM – SCAVENGING SYSTEM AND THE FRESH GAS FLOW
BLOCKED DURING TUBATION IS TURNED OFF.
• FRESH GAS FLOW TURNED OFF/APL VALVE OPENED – • ALTERNATELY, THE PATIENT PORT CAN BE
TO PREVENT REFILLING OCCLUDED AND THE APL VALVE OPENED SO THAT
THE GASES WILL ENTER THE SCAVENGING
• PREVENT DISCONNECTIONS
SYSTEMS
1.DISCONNECTIONS FOR ACTIVITES LIKE
TAPING TRACHEAL TUBE/POSITIONG OF PATIENT-
SHOULD BE REDUCED TO MINIMUM
• 6.PREVENTING LIQUID AGENT • 7.AVOIDING CERTAIN TECHNIQUES
• INSUFFLATION TECHNIQUES IN WHICH AN
ANESTHETIC MIXTURE IS INTRODUCED INTO THE
PATIENT’S RESPIRATORY SYSTEM DURING
• THE USE OF AN AGENT-SPECIFIC
INHALATION ARE USED FOR LARYNGOSCOPY
FILLING DEVICE AND BRONCHOSCOPY.

• USING LOCAL SCAVENGING DISADVANTAGES

• RESULT IN FLOODING THE AIR AROUND THE
• A PORTABLE VAPORIZER MAY BE FACE WITH ANESTHETIC AGENTS.
FILLED IN A HOOD WITH GAS PREVENTION
EXTRACTION. • HIGH FLOW RATES ARE REQUIRED TO AVOID
DILUTION WITH ROOM AIR AND RESULT IN A
• THE CONNECTIONS FOR FILLING AND
CLOUD OF ANESTHETIC GASES ESCAPING INTO
DRAINING A VAPORIZER SHOULD BE THE ROOM AIR.
KEPT TIGHT. • LOCAL SCAVENGING SHOULD BE USED
• 8.PROPER USE OF AIRWAY DEVICES
• THE USE OF CUFFED TRACHEAL TUBES - REDUCE ENVIRONMENTAL
CONTAMINATION
• UNCUFFED TUBES

1.ONLY SMALL LEAKS SHOULD BE PERMITTED AROUND UNCUFFED TUBES IN

PEDIATRIC PATIENTS.
2.WHEN USING AN UNCUFFED TUBE- PLACEA SUCTION CATHETER IN THE
MOUTH ,USE A THROAT PACK .
• FACE MASK>SUPRAGLOTTIC AIRWAY DEVICES>CUFFED TRACHEAL TUBES
WHERE IT IS NOT POSSIBLE TO USE A LEAK-TIGHT DEVICE, A HOOD CAN BE
PLACED AROUND THE HEAD AND SUCTION USED TO REMOVE THE TRACE GASES
• 9.DISCONNECTING NITROUS OXIDE SOURCES. • 10.USING LOW FRESH GAS FLOWS
1. NITROUS OXIDE AND OXYGEN • 11.USING INTRAVENOUS AND
PIPELINE HOSES LEADING TO THE MACHINE REGIONAL ANESTHESIA
SHOULD BE DISCONNECTED(AS CLOSE AS
TERMINAL UNIT) • 12.KEEPING SCAVENGING HOSES OFF
2.WHEN CYLINDERS ARE USED, THE
THE FLOOR
CYLINDER VALVE SHOULD BE CLOSED
GAS REMAINING IN THE MACHINE SHOULD BE
“BLED OUT” AND EVACUATED THROUGH THE
SCAVENGING SYSTEM
THANK YOU
REFERENCE
• UNDERSTANDING ANESTHESIA
EQUIPMENTS DORSCH AND DORSCH