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ANAESTHESIA MACHINE
High Pressure
Cylinder - O2: 2000 PSI, N20: 750 PSI
Pressure reducing device
Intermediate Pressure
Cylinder 35 50 PSI
Pipe line 45-60 PSI
Low Pressure
14 20 PSI
Pipeline Connections
Pipe / Cylinder Pressure Gauge
Gas power outlet
Master Switch
Oxygen Pressure alarms
Oxygen flush
Flow Control Valves
flow meter
Flow meters
Vapourizer circuit central valves
Back pressure safety devices
Low pressure pipe line
Common gas outlet
Capacity of Cylinder
BODY
SCREW
O2: 2 & 5
INDEX
PINS
CO2: 1 & 6
Pressure Gauge
Components:
Pressure Regulator
38 mm
1. Diameter 38 mm
2. A robust flexible coiled tube in
cross section
3. Tube sealed at inner end and
connected to needle pointer
4. Other end open to gas supply
Safety features:
N2O: 3 & 5
NIPPLE
WASHER
Purpose:
To deliver gases at constant pressure to patient and
maintain constant flow
Types:
1. Pneumatic balance
2. Demand valve
a. fixed pressure
b. adjustable spring pressure
RESTING
POSITION
Mode of working:
Analogy two children of different weight on a teeter
totter balancing each other
Pressure Regulator
Pressure Regulator
O2
AIR
N20
VACUUM
ensures that:
"Whenever oxygen pressure reduces and until flow ceases,
the set oxygen concentration shall not decrease
at the common gas outlet"
In addition, the loss of oxygen pressure results in
alarms, audible and visible
Fail-safe systems don't prevent hypoxic mixtures,
Which is a function of Hypoxic Guards
Objective:
To supply 100% oxygen
at high flow rates (35 75 lt / min) & at intermediate pressure
Standards:
Hazards:
Baro trauma
Altered anaesthetic gas concentration
Standards:
Flow meters
Principle of working:
Float is buoyed by flowing gas that
passes between the float and walls of
the tube
Narrowing of cross sectional area at the
float creates resistance to flow and
causes pressure drop
Float will settle where the force
represented by pressure difference
multiplied by cross section area equals
to gravity
Flow meters
Hypoxic Guard
Dual taper
Dual floats
In series
In parallel
Flow meter with 25 : 75
design
DUAL TAPER
DUAL FLOATS
IN SERIES
Other Components
Back bar (Selectatec)
Back pressure safety devices
Cylinders:
Miscellaneous
Antistatic wheels
Flow meters
Placement of knobs at distance
Down stream placement of knob
Back light display
Link devices
Back pressure check valves
Audible alarms etc
Critical Incidents
1980
HENCE
WE MUST ALWAYS REMAIN
EDUCATED
PREPARED
AND
VIGILANT
TO AVOID CRITICAL INCIDENTS
90
80
70
60
50
40
30
20
10
0
81
TOTAL
MISADVENTURES
53
HUMAN ERROR
27
FAILURE TO
CHECK
ANAESTHESIA
MISADVENTURES
1980
Critical Incidents
1980
1200
1089
1000
TOTAL
MISADVENTURES
800
600
400
223
200
1.
2.
3.
FAILURE TO
CHECK
0
ANAESTHESIA
MISADVENTURES
4.
Cooper et al (1984)
5.
1980
200
180
160
140
120
100
80
60
40
20
0
190
1980
100%
TOTAL
PARTICIPANTS
SUCCESSFUL
PARTICIPANTS
UNSUCESSFUL
PARTICIPANTS
6
13
PARTICIPANTS
80%
56
60%
NOT DETECTED
45
40%
DETECTED
40
20%
44
35
30
PERSONAL
CHECKLIST
FDA 1986
CHECKLIST
29.9
25.8
25
0%
FAULT DETECTION
20
15
10
FAULT DETECTION
Pre-use Training
1990
81%
62%
PRE-TRAINING
POST-TRAINING
RESIDENTS
2000
This
Performance Improvement
Underlines The Need For
Training
Required For
Anaesthesioloists On A
Continuous Basis
To
Enhance
Patient Safety
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
100%
80%
29%
50
60%
POOR
EXCELLENT
12%
DONE
NOT DONE
40%
20%
50
0%
TRAINING
RESPONDERS
Anaesthesia Machine
Pre-use checklists
&
Monitors (5)
Capnograph
Pulse Oximeter
Oxygen Analyzer
Spirometer
Breathing System Pressure Monitor
If Not So Equipped, The Checklist Must Be Modified suitably
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.