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Ga Machine Draft-3

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KHAIRUL REDZUAN
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29 views41 pages

Ga Machine Draft-3

Uploaded by

KHAIRUL REDZUAN
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Understanding GA

machine
Presenter : Yeong Chee June
Moderator : Dr Farah Syaza
Contents
• Introduction
• Safety features
• Gas supply
• Cylinder inlets
• Flow valves and meters
• Vaporizers
• The breathing circuit
• Adjustable pressure-limiting valve
• Waste gas scavengers
GA machine
• An electronic mechanical device for:
1. Administration of inhalation anesthetic gases and volatile
anesthetic agents.
2. Controlling ventilation
Safety measures of GA machine
Functional schematic of GA machine
Gas supply
• Most machines have gas inlets for oxygen, nitrous oxide, and
air

• Pipelines inlet – DISS


• Oxygen and nitrous oxide (and oft en air) are delivered from
their central supply source to the operating room through a
piping network.
• The tubing is color coded and connects to the anesthesia
machine through a noninterchangeable diameter-index safety
system (DISS)

What is DISS??
• fitting that prevents incorrect hose attachment.
• The noninterchangeability is achieved by making the bore
diameter of the body and that of the connection nipple
specific for each supplied gas.
• The approximate pipeline pressure of gases delivered to the
anesthesia machine is 50 psig.
Medical gases colour coding
Cylinder inlets
• Cylinders attach to the machine via hanger-yoke assemblies
that utilize a pin index safety system – PISS
• to prevent accidental connection of a wrong gas cylinder.
• The yoke assembly includes index pins, a washer, a gas filter,
and a check valve that prevents retrograde gas flow.
Gas cylinders

YOKES

Mechanical system for fitting cylinders


securely to the machine. Components
usually include:

1.Pins for the indexing system


2.Bodok seal - neoprene disk with
aluminium or brass ring - generates airtight
seal
3.Check valve to prevent retrograde loss of
gas on cylinder disconnection
4.Filter - 34 micron - to prevent dust
entering and blocking needle valves etc
Pin Index Safety System (PISS)
Oxygen Supply Failure Protection Devices

• These devices permit the flow of other gases only if there is


sufficient oxygen pressure in the safety device
• Prevent accidental delivery of a hypoxic mixture in the event
of oxygen supply failure
• These devices, called an oxygen failure protection device
(Dräger)
• or a balance regulator (Datex-Ohmeda)
• Proportionately reduce the pressure of nitrous oxide and
other gases except for air
• Another safety features of GA mchine is
A. Minimum Oxygen Flow –
-The oxygen flow valves are usually designed to deliver a
minimum flow of 150 mL/min when the anesthesia machine is
turned on
-This safety feature helps ensure that some oxygen enters
the breathing circuit even if the operator forgets to turn on the
oxygen flow.
-some machine has minimum oxygen flows as low as 50 mL/min.
B. Oxygen/Nitrous Oxide Ratio Controller
-linkage of the nitrous oxide gas flow to the oxygen gas flow
-this arrangement helps ensure a minimum oxygen
concentration of 25%.
Flow Valves & Meters
• Once the pressure has been reduced to a safe level,each gas
must pass through flow control valves and is measured by
flowmeters before mixing with other gases, entering the active
vaporizer, and exiting the machine’s common gas outlet.
• Flowmeters are calibrated for specific gases, as the flow rate
across a constriction depends on the gas’s viscosity at low
laminar flows
• Some flowmeters have two glass tubes, one for low flows and
another for high flows
• the two tubes are in series and are still controlled by one
valve.
Flowmeter malfunction causes
• debris in the flow tube
• vertical tube misalignment
• and sticking or concealment of a float at the top of a tube.
Vaporizers
• A mechanical devices attached to the GA machine back
bar to produce a controlled and predictable
concentration of anesthetic vapor in the carrier gas
passing through the vaporizer
• Sevoflurane and halotane can be used for inhalational
induction
• Desflurane and Isofurane can not be used for inhalational
induction
Vaporizers
• Colour coded:
• Isoflurane: purple
• Sevoflurane: Yellow
• Desflurane: Blue
• Halotane: Red
• Inhalational anaesthetic agents need to be delivered to the
lungs for them to work.
• One way is to convert the liquid inhalational agent into a
vapour that can be delivered by the inhalational route to the
patient. A device which converts liquid to vapour is called a
vaporiser.
• A gas that is currently below its critical temperature is called a
“vapour “. If compressed with enough pressure, it will
condense into a liquid.
• A gas that is currently above its critical temperature remains a
gas. However hard you compress it, it will not condense into a
liquid.
• E.g critical temperature of isoflurane is about 200 C. Therefore,
at room temperature (e.g. 21 C), isoflurane exists as a vapour
THE BREATHING CIRCUIT
• The breathing system most commonly used is the circle system
• The functions of the breathing circuit are to deliver oxygen
and other gases to the patient and to eliminate carbon
dioxide.

• One can then further categorize the circuits as those that use
an absorber to eliminate carbon dioxide (the circle system)
and those that do not (the Mapleson circuits).
• Circle breathing system is so named because it allows circular,
unidirectional gas flow, which is facilitated by unidirectional
valves
APL
• The adjustable pressure-limiting (APL) valve, sometimes
referred to as the pressure relief or pop-off valve, is usually
fully open during spontaneous ventilation but must be
partially closed during manual or assisted bag ventilation
• not closed sufficiently excessive loss of circuit volume due to
leaks - prevents manual ventilation.
• if closed too much a progressive rise in pressure could result in
pulmonary barotrauma (eg, pneumothorax) or hemodynamic
compromise
Added safety features of APL
• the APL valves on modern machines act as true pressure-
limiting devices that can never be completely closed; the
upper limit is usually 70–80 cm H 2 O.
WASTE GAS SCAVENGERS
• Pollution of the operating room environment with anesthetic
gases may pose a health hazard
• scavengers dispose of gases that have been vented from the
breathing circuit by the APL valve and ventilator spill valve.
• To avoid the buildup of pressure, excess gas volume is vented
through the APL valve in the breathing circuit and the
ventilator spill valve.
• Both valves are connected to hoses leading to the scavenging
interface
• The scavenging interface may be described as either open or
closed.
• An open interface is open to the outside atmosphere and
usually requires no pressure relief valves.
• In contrast, a closed interface is closed to the outside
atmosphere and requires negative and positive-pressure relief
valves that protect the patient from the negative pressure of
the vacuum system and positive pressure from an obstruction
in the disposal tubing
• The outlet of the scavenging system may be a direct line to the
outside via a ventilation duct (passive scavenging) or a
connection to the hospital’s vacuum system (active
scavenging).
• A chamber or reservoir bag accepts waste-gas overflow when
the capacity of the vacuum is exceeded. The vacuum control
valve on an active system should be adjusted to allow the
evacuation of 10–15 L of waste gas per minute
Reference
• Morgan, G. E., Mikhail, M. S., & Murray, M. J. (2006). Clinical
anesthesiology. New York: Lange Medical Books/McGraw Hill
Medical Pub. Division.

• http://www.anaesthesia.med.usyd.edu.au/resources/
lectures/gas_supplies_clt/regulator.html
Thank you

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