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CM Anesthaesia Machine PP

The document discusses the principles and components of an anaesthesia machine. It describes the machine's functions which include providing oxygen to patients and blending gas mixtures. It also discusses maintaining safe and controlled ventilation. The summary provides an overview of the key topics covered in the document related to anaesthesia machines, including their purpose, components, and how they work.

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Mohamed Ali
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0% found this document useful (0 votes)
93 views34 pages

CM Anesthaesia Machine PP

The document discusses the principles and components of an anaesthesia machine. It describes the machine's functions which include providing oxygen to patients and blending gas mixtures. It also discusses maintaining safe and controlled ventilation. The summary provides an overview of the key topics covered in the document related to anaesthesia machines, including their purpose, components, and how they work.

Uploaded by

Mohamed Ali
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Anaesthesia Machine

o Principles of operation
o construction
o troubleshooting
o preventive maintenance
o safety considerations
o performance monitoring

13.7.1 Maintain an Anaesthesia Machine


Unit B 13.7 Maintaining Ventilation and Anaesthesia equipment
Module 279 18 B Medical Instrumentation I

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Function
What is a the purpose of Anaesthesia units dispense a mixture of gases and vapours/drugs and vary the
an proportions to control a patient’s level of consciousness and/or analgesia during
Anaesthesia machine surgical procedures
(or Boyle machine) ?
Why is it During most surgical procedures, some form of anaesthesia is used. General anaesthesia
important ? is a state of unconsciousness, with an absence of pain sensation over the entire body,
produced by anaesthetic agents, often with muscle relaxants. By using anaesthesia
patients can be operated without feeling pain.

Functions of an • Provide oxygen (O2) to the patient.


anaesthesia machine • Blend gas mixtures that can include (besides O2) an anaesthetic vapor, nitrous oxide
(N2O), other medical gases, and air.
• Facilitate spontaneous, controlled, or assisted ventilation with these gas mixtures.
• Reduce/eliminate anaesthesia-related risks to the patient and clinical staff.

The anaesthesia machine is used by anaesthesiologists, nurse anaesthetists, and


anaesthesiologist assistants to support the administration of anaesthesia.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Use: operational room or theatre
There are at least four different types of anaesthesia
1. General anaesthesia is a state of unconsciousness, with an absence of pain
sensation over the entire body, produced by anaesthetic agents, often with
muscle relaxants. General anaesthesia is administered by inhalation,
intravenously, intramuscularly, rectally or via the stomach.
2. Local anaesthesia is where a specific area is “numbed” such as in a
dentist’s office. The patient is awake and may feel some limited pain.
3. Saddle block anaesthesia is where the patient is conscious and the area of
the body that would touch a saddle is affected. This is accomplished by
injecting an anaesthetic agent low in the dural sac and is common for
childbirth.
4. Spinal anaesthesia is where an anaesthetic agent is injected beneath the
membrane of the spinal cord. There is no sensation below that point until
the agent wears off.

In this presentation we focus on 1. general anaesthesia, through the use of an anaesthesia machine

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Science: Sleep and Anaesthesia

• Sleep is an active process generated in the brain.


• Memory and Consciousness also reside in the brain. Research is progressing
on how exactly the different parts of the brain contribute to these processes.
• Anaesthesia has an impact on some brain structures and results in
• unconsciousness, which is a similar state to sleep.
• amnesia, so that the patient does not store the events in his memory.
• Consciousness and subsequent recall of intraoperative events—known as
“awareness during general anaesthesia”—occur in 1 to 2 cases per 1000.

Electroencephalographi
c (EEG) methods, can
be used to monitor
anaesthetic depth

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Stages of Depth of Anaesthesia

The stages of Depth of Anaesthesia (DoA) defined by Guedel in 1937 are generally
accepted:

Stage I (stage of analgesia or disorientation): from beginning of induction of general


anaesthesia to loss of consciousness.
Stage II (stage of excitement or delirium): from loss of consciousness to onset of
automatic breathing. Eyelash reflex disappears but other reflexes remain intact and
coughing, vomiting and struggling may occur; respiration can be irregular with breath-
holding.

Stage III (stage of surgical anaesthesia): from onset of automatic respiration to Arthur Guedel
respiratory paralysis.

Stage IV: from stoppage of respiration till death, Anaesthetic overdose causes
paralysis wit respiratory arrest and vasomotor collapse. Pupils are widely dilated and
muscles are relaxed.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Agents, gases and drugs

Drugs given to induce or general anaesthetic can be either as gases or vapours (inhalational anaesthetics), or as
injections (intravenous anaesthetics or intramuscular). It is possible to deliver anaesthesia solely by inhalation or
injection, but most commonly the two forms are combined, with an injection given to induce anaesthesia and a gas used
to maintain it.
Inhalational anaesthetic substances are either volatile liquids or gases and are usually
delivered using an anaesthesia machine. An anaesthesia machine allows composing a mixture
of oxygen, anaesthetics and ambient air, delivering it to the patient and monitoring patient
and machine parameters. Liquid anaesthetics are vaporised in the machine. All of these agents
share the property of being quite hydrophobic (i.e., as liquids, they are not freely mixable in
water).

Desflurane, isoflurane and sevoflurane are the most widely used volatile anaesthetics today.
They are often combined with Nitrous Oxide.

Injectable anaesthetics are used for the induction and maintenance


of a state of unconsciousness, examples are propofol and etomidate.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Continuous Flow and Draw-Over systems
During anaesthesia using a Boyles machine or continuous flow system (figure 1),
compressed gases (oxygen and nitrous oxide or air) pass from cylinders mounted on
the machine to rotameters (flow meter) and then through the vaporizer where a
volatile agent such as halothane is added to the gas mixture. The resulting mixture is
delivered to the patient via a breathing circuit. This type of anaesthesia system is
dependent on a supply of compressed gases. If these run out during an operation, so
does the anaesthetic!

classic
Magill
breathing
circuit

A Draw-over system (fig.2) is designed to provide anaesthesia without


requiring a supply of compressed gases. Atmospheric air is used as the main
carrier gas and is drawn by the patient's inspiratory effort through the
vaporizer, where the volatile agent, normally ether or halothane, is added.
The mixture is then inhaled by the patient via a non-rebreathing valve.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Combined gas law
To understand the functioning of anaesthesia machines and bottled
gases it’s important understand some gas physics. Boyle’s law,
Charles’s law and Gay-Lussac’s law form the combined gas law:

“The ratio between the pressure-volume product


and the temperature of a system remains constant”

• When the pressure of a closed gas system is increased – at


constant temperature - the volume goes down in the same
proportion
• When the temperature is increased – with constant volume –
the pressure will increase in the same proportion

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Anaesthesia system
The basic anaesthetic delivery system consists of During delivery of gas anaesthesia to the patient, O2
• sources of gases (O2, N2O, air) (N2O, air) flows through the vaporizer and picks up
• flowmeters the anaesthetic vapours. The O2-anaesthetic mix then
• precision vaporizers, which produce a vapour from a flows through the breathing circuit and into the
volatile liquid anaesthetic patient's lungs, usually by spontaneous ventilation
• a patient breathing circuit (tubing, connectors and valves) (respiration). Occasionally, it is necessary to use
• a scavenging device that removes any excess anaesthetic assisted ventilation, especially when opening the chest
gases. This is critical, since room pollution with (thoracic) cavity. Assisted ventilation is accomplished
anaesthetic gases may cause health problems. by use of a ventilator.

Maintain an anaesthesia machine


Ventilation is part of the Anaesthesia system
Because normal breathing is depressed by anaesthetic agents and by muscle relaxants administered in
conjunction with them, respiratory assistance — either with an automatic ventilator or by manual
compression of the reservoir bag — may be necessary to deliver the breathing gas to the patient.

Manual compression
Bellows piston based ventilator
of a reservoir bag

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Construction, components
Vaporisers

Monitor
Mixing board,
traditionally with with rotameters 

Breathing circuit
Emergency bag
Soda lime CO2 Absorption Bellows 

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Gas supply & Flowmeters
Since cylinders store gas at very high pressure (2,000 PSI~=150bar), a
pressure- reducing valve or regulator is required to reduce the pressure to
about 50 PSI~=3.5bar, a level that can be handled by the anaesthesia system.

As O2 is consumed during use, the pressure within the cylinders declines.


The regulator adjusts automatically when the pressure inside the cylinder
falls as the gas is used. When the pressure reaches 500 PSI~=35bar, an
"E(mpty)" tank contains approximately 175 L of O2 and should be replaced.

Further reduction in pressure can be achieved by adjusting the flow meter


control knob for safe delivery of gas to the patient. The flowmeter uses an
adjustable needle valve to deliver the desired flow in ml or litres per minute
to the patient circuit.

Most anaesthesia machines have an O2 range up to 10 litres of O2 per minute. Flowmeters are individually calibrated for a
specific gas, e.g., oxygen or nitrous oxide.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Mixing board with rotameters
• A mixing board on the anaesthesia machine allows the anaesthetist to mix
oxygen, anaesthetic gases and the patients expired air to the desired ratios
for delivery to the patient.
• The ratio of the fresh gasses is continuously measured by their flow rates.

• A typical mixing board will contain several rotameters for measuring


gas flow.
• Rotameters are calibrated in cubic centimetres (cc) or millilitres (ml)
of gas per minute. The amount of each gas entering the mixing board
is controlled by needle valves at the base of each rotameter.

The walls of the rotameters are slightly “V” shaped (‘tapered’) so that as the ball rises, more of the gas is diverted
around the ball lowering the force upwards on the ball/bobbin. When the force of gravity is just balanced by the
force upwards of the gas, the ball will stop moving. As the flow rate increases, the ball moves up and as the flow
rate decreases, the ball moves down. Thus, the height of the ball can be used to determine the flow rate of the gas in
the rotameter. Flow is read from the indicator/bobbin on the graduated scale.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Vaporiser
• As air enters the vaporiser, it is directed into either
the vaporising chambers or a bypass chamber.

• The anaesthesiologist will control the bypass


valve to allow more or less of the incoming
gases to flow through the vaporising chamber
usually via a large knob on top of the vaporiser.

• The liquid anaesthetic agent resides in the


lower part of the unit. As the gas moves
across the top of the liquid, the anaesthetic
agent vaporises and is carried by the gas
towards the outlet, where it is blended with
the gas that has bypassed the chamber

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Breathing Circuit
The goals of the breathing circuit are to:
• Deliver oxygen to the patient
Anaesthetic gas is delivered • Deliver anaesthetic to the patient
to the patient via the • Remove carbon dioxide that is produced by the patient
breathing circuit. • Provide a method for assisting or controlling
ventilation, if needed

The breathing system


contains an adjustable
pressure limiting valve
to limit accidental
pressure in the system
(safety)
Examples of breathing circuits

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Scavenging system
Since the expired gases of the patient contain anaesthetic agents,
they must not be allowed to enter the operating room.

In addition to potentially placing the operating staff under the


anaesthetics effects, certain agents are flammable, and chronic
exposure can cause high fevers and severe liver damage.

To remove this danger, anaesthesia machines contain a scavenger (or


scrubber or trap) before venting the expired gas into the room.

In the developing world, the activated carbon filter (consumable !)


may not be regularly exchanged forcing the staff to vent the expired
gas outside.
passive scavenger system with replaceable filter
cartridges to absorb waste gases. Activated
charcoal filter absorbs 125% of its own weight .

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Further components
CO2 Absorber If (part of) the expired air is to be rebreathed - that is:
returned to the patient - then a CO2 absorber is used. A CO2 absorber
contains a soda-lime (or barium hydroxide lime) filter that strips the
expired gases of CO2.

Bellows Self-inflating bellows are mechanical devices that allow the


anaesthetist to measure the patient’s ventilation. By its movement in a
calibrated chamber, a bellows indicates the volume of air that the patient is
breathing. The bellows will rise when the patient exhales and will fall when
the patient inhales.
Bellows may be part of the ventilator system when pressure applied to the
outside of the bellows will force air into the patient lungs at a prescribed rate
and volume.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Further components
Reservoir Bag The reservoir bag (0.5-2.0 liter) is made of latex,
rubber of plastic. It serves to convert a continuous supply of gas flow
into a intermittent breathing/ventilation pattern of the patient. During
spontaneous breathing It acts as a breathing monitor (pattern, tidal
volume). It may also be used as emergency bag.

Emergency Bag When intermittent ventilation is required, the


doctor can use an emergency bag (usually 0.5 liter). The bag allows
the doctor to manually push air into the patient’s lungs. reservoir bag

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Anaesthesia Monitoring

To meet the minimum standard of care in the United


States, the American Society of Anaesthesiologists (ASA)
states that anaesthesia systems must continually monitor
the patient's
• oxygenation
• ventilation
• circulation
• expired CO2 levels
• temperature

Integrated or stand-alone monitors may be used.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Construction: Gas system diagram

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Construction: System diagram

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Trouble shooting: Common faults
As with other pieces of complex medical equipment, power supply and user error problems account for most of the
problems in anaesthesia machines. Drawover machines have fewer problems than other anaesthesia machines, but all
machines suffer from leaks and sticky valves.

Leaks: Tubes tend to deteriorate in hot and humid environments. Also, re-using disposable materials causes
deterioration. An expiration-side leak occurring before the scavenger is most critical to check, but also the easiest because
anaesthetic gases have a distinctive smell which is easily detected. If a leak occurs in the OR, doors to the room should be
opened to allow air to flow through the room. A second danger with gas leaks is that some anaesthetic gases are
flammable. Halothane and ether are two explosive anaesthetic gases.

The tubing often develops leaks in between the corrugations (‘wrinkles’).


You can check for leaks by placing the tubing in a bucket of water, blocking
one end, blowing in the other, and looking for bubbles to escape.
Repair tubing leaks with epoxy or a silicon sealant. However, this is a
temporary repair. It is better to replace the tubing. In some cases, the tubing
can be shortened to remove the leaking section. Consult with the anaesthetist
before shortening a section of the circuit.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Trouble shooting: Common faults
Other problems
• The needle valves controlling the flow into the rotameters can be sticky or blocked
• The floats in a rotameter can be stuck.
Rotameters and needle valves can be dismounted and flushed with alcohol. Make sure they are completely dry
before using again. When taking apart multiple rotameters, floats and needle valves, be sure to put them back
together in a set. The float from one gas may not work in the glass tube from another. One simple solution is to
disassemble only one rotameter at a time.

If there are valves which appear to be sticky in the circuit, the circuit needs to be
replaced. Other sticky valves may be cleaned with water and dried thoroughly
before reuse.
If the problem is in the ventilator, CO2 absorber or vaporizer, and the problem is not
a leak, the problem is typically very difficult to repair in the field. It is generally
necessary to replace the entire sub-unit with one from another anaesthesia machine.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Preventive Maintenance
In the case of anaesthesia machines, the preventive maintenance and inspection is a detailed examination of the
device’s mechanical condition and a safety inspection to insure that the device functions reliably and safely.

There is a single preventive maintenance procedure which is performed four times per year. This procedure is a
thorough inspection and operational test which is to be performed on each unit. It is designed to identify major and
minor deficiencies in a unit which must be corrected for efficient, reliable operation.

Look up the service manual of your anaesthesia machine to find


instructions for preventive maintenance. An example of this is
presented in the following sheets.

There are 3 elements of inspection:


1. Visual inspection
2. Performance testing
3. Environmental inspection

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Preventive Maintenance: Visual Inspection
1. Mounting brackets, wheels, supports, and frames are securely attached, operate correctly and are adequate in
strength to support the components mounted on them
2. Nuts, bolts, screws and other hardware will be tight and in good condition
3. Flow meters will be clean, free if all defects and mounted securely
4. Pressure gauges will be clean, free of all defects and mounted securely
5. Controls, mechanical locks and levers will be securely attached to the driven element, properly indexed, free of
defects, and functional
6. Cabling, conductors tubing and accessories will be clean, free of cracks or splices, and functional
7. Face masks, rubber tubing and bladder bags will be clean, free of defects and functional
8. Flow check valves will be clean, free of defects and functional, with adequate spares available
9. Vaporisers will be securely mounted and free of visible defects
10. Absorber canister shall be changed when necessary, free of defects and functional
11. Electrical connectors on instruments mounted on the machine will be free of cracks, breaks, and properly attached
to the chassis, line cord or cabling.
12. Ground cables, line cords, and transducer leads will be free of splices or frayed insulation.
13. Where applicable cables, clips, studs, and terminals will be free of dirt, dust, corrosion, and will not be worn.
14. The grounding system (both external and internal) will be of an approved type, properly installed and functional

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Preventive Maintenance: Performance testing
The performance test for anaesthesia machines combines tests for
functional operation and safety. Specifications for each instrument
must be based upon the manufacturer's published specifications for
that particular model and serial number.

In all cases, performance tests must be performed by qualified


biomedical engineering technicians or medical equipment repairmen.
The performance tests, as set forth in the preventive maintenance and
inspection procedures, are minimum-acceptable standards.

Devices failing to meet either the prescribed standard or the


manufacturer’s specifications must be reworked until they meet the
standard. If a particular unit or component cannot be brought up to
standard without excessive expenditure of time/capital, it is to be
scheduled for replacement.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Preventive Maintenance: Performance testing
Qualitative tests: Quantitative tests:
– Chassis/Housing – Mount/Fasteners – Casters/Brakes – AC – Grounding resistance [≤0.5 Ω]
Plug – Leakage current [≤300 μA chassis]
– Fittings/Connectors – Filters – Modes and settings [±10% accuracy] – Monitors and Alarms
– Controls/Switches – Fan [±10% accuracy]
– Line Cord – Alarms tested:
– Strain Reliefs • Airway pressure • Tidal volume
– Circuit Breaker/ – Tubes/Hoses • FIO2
– Cables • Others
– Battery/Charger
– Indicators/Displays – Alarms/Interlocks – Labeling Test apparatus and supplies:
– Accessories & Bellows – Lung simulator with adjustable compliance or ventilator tester
Other checks: – Pressure gauge or meter with 2 cm H2O resolution, from -20 to
– Gas Supply +120 cm H2O
– Pneumatic lines (including air filters) – Various breathing circuit adapters
– Gas cylinders (and gauges and regulators, if so equipped) – Leakage current meter or electrical safety analyzer
– Patient Circuit – Ground resistance ohmmeter
– Breathing circuit (including filters) – Humidifiers – Additional items as required for specific manufacturers’
– Pressure-relief mechanism procedures
– Absorber

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Preventive Maintenance: Environmental inspection
Due to the mobility of the anaesthesia machine, it is difficult to examine every possible
location of use. Its point of maximum use, however, can be visually inspected and electrically
tested; this is generally one operating room. The following inspection and test factors will be
included in this inspection.

1. The electrical distribution will be inspected and tested to insure that:


a. Voltage level is adequate;
b. Receptacle polarity is correct;
c. Receptacle ground is present
d. Receptacle has mechanical integrity

2. Mechanical clearance between the anaesthesia machine and instruments, apparatus, and
other devices.

3. Shelves, cabinets or storage space are clean, mechanically secure and free of obstructions.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Safety Considerations
The major hazard associated with anaesthesia machine is the delivery of an inappropriate oxygen/anaesthesia gas
mixture to the patient. There are several modalities where the function of the anaesthesia machine can be lost. These
range from incorrect gas in a marked cylinder to defective or impaired flow meters.

Incorrect gasses in a particular cylinder sounds like an impossible situation. The only problem is that it happens.
Two factors may cause this basic error. The first factor has been hospital staff members who have used an “empty"
bottle to store an excess of a particular gas. To prevent this, no technician or anaesthesiologist is to transfer gasses
from one full tank to an empty tank unless specifically trained for and assigned to the task of transferring from bulk
storage to small cylinders.

The second factor has been errors by commercial suppliers where their personnel accidentally filled cylinders from
an inappropriate source. To prevent this from affecting patients, each tank must have a filling tag which is filled out
and replaced when the cylinder is charged. If the cylinder colour code does not agree with the cylinder filling tag
(either one incorrect), the cylinder is not to be used. It is to be returned to its source, emptied of its contents, and
recharged with the appropriate medical gas.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Safety Considerations
Defective or impaired flow meters can only be detected by routine operational tests using appropriate test flow
meters. The test flow meters should have an accuracy at least twice that of the anaesthesia machine’s flow meters.
Defective or impaired vaporisers should be prevented if they are removed from service once a year and returned
to the manufacturer for cleaning, repair, calibration and test.
Leaky check valves can also degrade the performance of the anaesthesia machine. They must be cleaned regularly
and functionally testes quarterly to prevent deterioration.
Cracked, torn or split rubber anaesthetic tubing and/or face masks can also reduce the effectiveness of the
anaesthesia machine. When detected, they must be replaced.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Safety Considerations
Needle valves used to adjust pressures and flows can become
damaged, resulting in a reduction of adjustment range.
Damaged needle valves must also be replaced.

Most anaesthesia machines utilise wheels to provide mobility.


When they are moved, they can be tipped over or strike another
device and suffer damage. If a unit has been damaged, it must
be removed from service and subjected to a preventive
maintenance inspection.

An Anaesthesia machine may appear to be operating correctly


after being subjected to stress and yet have sustained sufficient
damage to create a serious patient hazard.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Safety Considerations
Explosive gasses are used with most anaesthesia machines. This means that the anaesthesia cart must be constructed
of conductive materials including all metal, plastic and rubber parts. Furthermore, a ground lead should be carried out
from the cart to the operating room’s ground-equalisation system. When other devices are used with the anaesthesia
machine, they should also be grounded to the ground-equalisation buss with a separate ground lead. In some
instances, it is convenient to mount a ground junction box on the anaesthesia machine's frame and carry the other
grounds to the junction box. A single lead from the junction box to the ground-equalisation buss system effectively
grounds all the devices.

It must be remembered that an anaesthesia-gas explosion during a


surgical procedure always kills the patient (ruptures the lungs) and
usually severely injures the anaesthetist (propels facemask and
fitting into the gut or face). They must be avoided at all cost in
terms of both $$ and effort.

If monitors or other electronic instruments are mounted on the


anaesthesia machine, they must share a common chassis ground
with the frame of the anaesthesia cart.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


Safety Considerations
The machine is mobile enough so that, even though it’s supposed to be used in a particular area, it can, with little
notice, be moved to another area. The resulting electrical and explosion hazard condition is undefined.

To mitigate this situation, the normal handlers of the anaesthesia


machines should be show how to:
1. Ground the unit when no standard ground outlet is present
2. Check to see that other devices in contact with the patient are
also grounded
3. Operate the instrument with minimum exposure of the patient
to hazards
4. Transport the anaesthesia machine by pulling it through
doorways, onto and off of elevators and up and down
hallways.

© dr. Chris R. Mol, BME, NORTEC, 2016 Maintain an anaesthesia machine


EN
D
The creation of this presentation was supported by a grant from THET:
see https://www.thet.org/

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