Without reference, identify principles about Anesthesia Units with at least 70 percent accuracy

Without reference, identify principles about Anesthesia Units with at least 70 percent

accuracy.

Purpose of Anesthesia Units ◦ Supplies a set mixture of gases and anesthetic

vapors to the patient ◦ Helps the clinician control patient breath rates,

volumes, and pressures ◦ Monitors gas concentrations from the anesthesia

machine ◦ Provides patient monitoring ◦ Includes safety features to help protect the

patient ◦ Removes excess gases from the breathing system

and out of the anesthetizing location

Anesthesia unit

Anesthetizing Locations ◦ An area used to administer any flammable or

nonflammable anesthetic agent such as the operating room, delivery room, emergency room and anesthetizing room

◦ Requirements for a nonflammable anesthetizing area

◦ Areas must be clearly labeled “RESTRICTED TO NONFLAMMABLE ANESTHETICS”

Anesthesia unit

◦ Environments factors Humidity must be maintained at a minimum of

35% Ventilation requirements

Used to remove bacteria, anesthetic gases, and maintain proper humidity

A positive pressure is maintained within the anesthetizing area

Temperature Decreases metabolic rate of the patient Decreases blood loss Decreases infection by minimizing bacteria growth

Anesthesia unit

Clinical Aspects of Anesthesia ◦ Definitions

Anesthesia – the loss of the normal perception of pain

Anesthetic – a substance which produces anesthesia

◦ Purpose of anesthesia – to remove the patient’s sensitivity to pain during surgical procedures

Anesthesia unit

◦ Types of anesthesia Local anesthesia

Applied only to the area of treatment Patient remains conscious

General anesthesia Applied to the entire body Usually results in loss of consciousness Administered one of two ways o Intravenous – the anesthetic is injected into the blood

stream o Inhalation – the patient breathes a gas mixture containing

the anesthetic agent

Anesthesia unit

Inhalation Anesthetics ◦ Delivered by inhalation ◦ May be gases or volatile liquids ◦ All common anesthetics in use today are non-

explosive and nonflammable ◦ Minimum alveolar concentration level (MAC)

Concentration of any anesthetic agent in which 50% of the population will be anesthetized

The MAC level must be exceeded to ensure proper anesthesia

Anesthesia unit

Nitruous It is colorless and odorless Nitrous oxide is a gas at ambient temperature and

pressure Kept as a liquid under pressure Does not provide significant muscle relaxation MAC = 105% Frequently used in combination with the more potent

volatile agents

Anesthesia unit

◦ Halogenated anesthetic agents Causes rapid, shallow breathing Relaxes skeletal muscles Halothane

Detrimental effect on rubber goods and some metals MAC = 0.77%

Isoflurane Several side effects and is not popular MAC = 1.77%

Anesthesia unit

Enflurane Few side effects MAC = 1.3%

Deslurane Will not evaporate at room temperature Requires a special heated vaporizer Low solubility in blood and body tissues causes a very

rapid wash-in and wash-out MAC = 7.25%

Aevoflurane Low solubility in blood and body tissues MAC = 1.7%

Anesthesia unit

Stages of General Anesthesia ◦ Induction – start of administration of the

anesthesia agents (during induction it is very important to remain as calm as possible)

◦ Excitement – the patient is delirious and physiologically unstable

◦ Surgical Plane – the patient is insensible to pain. Breathing is steady and automatic

◦ Danger – the patient is in danger of cardiopulmonary arrest

Anesthesia unit

Guidelines set by the manufacturer must be strictly followed ◦ Recommendations before attempting

maintenance of this type of equipment All test equipment and ventilators are not the

same Ventilator Operation is Usually

Unsupervised ◦ The calibrations are extremely critical to the

support of the patient's health and/or life

General Calibration Procedures for an Anesthesia unit

Anesthesia Unit Operation is Usually Supervised ◦ The calibrations are extremely critical to the

support of the patients health and/or life◦ Tolerances

Are not as narrow as the ventilator due to the constant supervision of the patient

Still very real because of the drugs that are used A unit’s reaction to the changes in the patient’s

condition Can cause under or over anesthetic dosage Can lead to damage or death


◦ Tolerances Are narrower than most other devices in the

hospital (ex. +/- 1% instead of +/-3%) A units reaction to the changes in the patient's

condition Can cause under or over ventilation Can lead to injury or death


Test Equipment ◦ Calibrations are only as accurate as the

calibration of the test equipment Calibration Items

◦ Pressure delivery ◦ Pressure sensing

Peak Mean Peep


◦ Overpressure ◦ Volume delivered ◦ Volume sensing ◦ Breath rate ◦ Oxygen blending◦ Assist sensitivity ◦ Safety devices ◦ Alarm limits


Anesthesia unit special items of concern◦ Safety devices

Proportioning system Monitors the nitrous oxide flow to the oxygen flow to

maintain <3:1 ratio Designed to prevent oxygen concentration from falling

below 25% The kick-in point will o limit nitrous oxide flow from increasing if nitrous oxide is

increased above 3:1 o increase oxygen flow if nitrous oxide is increased above 3:1

Below 25% oxygen is considered hypoxic decrease nitrous oxide flow if oxygen is decreased above

3:1


◦ Secondary gas shutoff Monitors the oxygen source pressure Controls nitrous oxide and air flows (secondary gases) Will either o Decrease flow of secondary gases in proportion to oxygen

pressure o Shutoff flow instantly at a preset pressure

Either way the secondary gases will be completely cut-off before oxygen is depleted

Vaporizer interlocksUsed on multiple vaporizer systems Prevents more than one vaporizer from being turned

on at a time


◦ Alarm limits◦ Common/fresh gas concentrations

Ensure minimum oxygen content cannot be adjusted to hypoxic levels

VaporizerCalibration verification can only be performed Use a Rankin gas analyzer If verification falls outside of limits then vaporizer will

be sent to manufacturer for repair or replacement


Documents

Without reference, identify principles about Anesthesia Units with at least 70 percent accuracy