Anesthesia machine checkout procedure

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Anesthesia machine checkout procedure : 

Anesthesia machine checkout procedure New machine checkout procedure

The new machine is a piston and not a bellow apparatus technology : 

The new machine is a piston and not a bellow apparatus technology Piston Bellow

Comparison in technologies : 

Comparison in technologies A piston ventilator is able to deliver higher inspiratory flows and tidal volumes than bellows technology1 “Under conditions of high respiratory rates and high inflating pressures, the bellows delivered lower tidal volumes than did the piston ventilator. The primary reason was that it delivered less than 50% of the inspiratory flow of the other machines.“ 1 This means that the piston ventilator technology is able to deliver larger tidal volumes and higher airway pressures than a bellows 1.Anesth Analg. 2000 Nov;91(5):1145-50. Pressure control ventilation: three anesthesia ventilators compared using an infant lung model. Stayer SA, Bent ST, Skjonsby BS, Frolov A, Andropoulos DB. Department of Anesthesiology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA

Slide 4: 

Power Failure Differences

Machine Preparation : 

Make sure: The built in uninterruptible supply is fully charged for 10 hours before first use of machine The machine is connected to main AC power Pipeline and cylinder supplies are correctly installed and connected to the machine Breathing system is correctly installed Anesthetic gas scavenging system is properly installed and connected Absorber canister is filled, connected, and ready for use Vaporizers are correctly installed and filled for usage Gas analyzing equipment properly installed; gas sample line, water trap, and breathing circuit adapters Machine Preparation

Machine component locations : 

Machine component locations Breathing Circuit, APL valve, bag with breathing arm Vaporizer locking and control area O2, N2O, Air flow meter control areas Auxiliary and total flow control lever Touch screen interface with ventilator and on-screen display and control knob for checkout procedures Soda lime CO2 absorber canister Rear of machine O2 tank, network input, and gas pressure line input area 2 1 3 4 5 6

Machine checkout and Self test : 

Machine checkout and Self test A preuse checkout procedure must be preformed every 24 hours to ensure immediate machine use. One manual checkout and one automated checkout per 24 hours is required The manual procedure is displayed and summarized after the machine is powered on The automatic procedure begins after the manual checks have been completed and confirmed

Manual Checkout : 

Manual Checkout Ensure pipeline and cylinder pressures are within manufacturer and institutional guidelines (psi) Make sure O2 flush is functional by pushing O2 flush valve Turn on auxiliary O2 flow meter and make sure functional Are vaporizers set and locked in the zero position and filled Is the breathing circuit assembled and correctly connected Test the suction to make sure you get appropriate suction seal and vacuum Is there an emergency breathing bag present and functional and immediately available Occlude Y-piece and turn APL valve to 30cmH2O and press O2 flush valve until gauge reads 45cmH2O and make sure it is stable at that pressure Release O2 flush valve and pressure should not fall below 15 cmH2O Automatic self test will continue if all parameters passed If any parameter fails contact biomed, replace appropriate equipment, or contact company for further assistance

Automated checklist : 

Automated checklist Follow on-screen steps and prompts and implement on-screen cues During the automated checkout there is no user interaction necessary A detailed list of the tested components are displayed during the checkout Exclamation points will be visible to any test interruption and then a system message will display for help in remedying errors The test duration is 3 minutes

Emergency : 

Emergency In the event an emergency patient needs to be attended to during a checkout, press the “cancel test” key. The machine then runs through a minimal patient safety check that last 10 seconds and then the machine is ready for use. Note: this bypass minimal test, or pressing the “cancel test” key can only be bypassed ten consecutive times and then a complete test (manual and automatic) is required. Cancelling the self test may lead to limited functionality, you can always manually ventilate but automatic functions will be limited It is recommended after every emergency procedure to perform a full checkout and a daily test so that limited functionality will never occur

Tolerance levels : 

Tolerance levels This new machine self determines the current leakage of the breathing system and breathing circuit Any leakages over 150 mL/min will signal an exclamation point and display area of integrity issue For any leaks over 150 mL/min, check the components of the breathing system, repair or replace any parts, and repeat leak test If the leak can not be found contact vendor and biomed

Potential causes of leaks : 

Potential causes of leaks Damaged or defective breathing hose Gas sampling line not connected to breathing hose or water trap Breathing bag defective Vaporizer not connect or filling aperture open Absorber canister not firmly mounted-reclick in place Flow sensor not installed properly Breathing system not assembled correctly Microbial filters not connected securely

Successful completion of test : 

Successful completion of test After successful completion of manual test, the automatic test is available, after successful completion of the automatic test the machine places itself in Standby mode and is available for immediate patient use The test results also will display and display the time and date of the last successful self test. Practitioners should keep the last date in mind as the checkout need to be performed every 24 hours A “self test result” button can be pressed to display results for review at any time

Final : 

Final You have now successfully reviewed and participated in a required manual and automatic checkout A test will follow for competency of checkout procedure and location of vital machine components

When manually checking out the machine, what is the acceptable limit of a leak test? : 

When manually checking out the machine, what is the acceptable limit of a leak test?

An automatic test takes 10 minutes so you can go have coffee and come back? : 

An automatic test takes 10 minutes so you can go have coffee and come back?

When setting the APL valve for the leak test, you should set it at 70 cmH2O : 

When setting the APL valve for the leak test, you should set it at 70 cmH2O

The bellow apparatus can produce more tidal volumes and higher airway pressures than a piston ventilator. : 

The bellow apparatus can produce more tidal volumes and higher airway pressures than a piston ventilator.

After biomed has assembled the new machine and labeled it for use, you can use it right away for patient care. : 

After biomed has assembled the new machine and labeled it for use, you can use it right away for patient care.

Quiz : 

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