Anesthesia Machine Check Off Flashcards
Basic Anesthesia Machine Principles
Anesthesia provider running it as ultimately responsible
When machine is moved must recheck
If ever turned off, need a full check
Safe Anesthesia Care Requirements
Reliable O2 delivery
Positive Pressure
Gas delivery (anesthetic)
Suction
Machine Check Off: Step 1
Emergency Ventilation Equipment
Ambu Bag w/ O2 tubing
Know auxiliary O2 source!!!
Be able to deliver O2 if other things fail
Machine Check Off: Step 2
High Pressure System - Oxygen Cylinders
Cylinders on back of machine
E-Cylinder
45 Psi
For back up emergency if wall is goes out
Should always be off, just turning on to check, then turn off, must be at least half full (1000psi)
Gauges on front of machine
with tank = tanks on back
no tanks = from the wall
Machine Check Off: Step 3
High Pressure System - Wall Supply
Comes from:
Wall
Coming from hospital supply, H-Cylinder
50 Psi
Checking to make sure coming from wall at 50 psi
Machine Check Off: Step 4
Low Pressure System - Initial Status of System
Check Initial Status of Low Pressure System
a. Close flow control valves and turn vaporizers off.
b. Check fill level and tighten vaporizers’ filler caps.
Machine Check Off: Step 5
Low Pressure System - Leak Check
Perform Leak Check of Machine Low Pressure System
a. Verify that the machine master switch and flow control valves are OFF.
b. Attach “Suction Bulb” to common Fresh gas outlet.
c. Squeeze bulb repeatedly until fully collapsed.
d. Verify bulb stays fully collapsed for at least 10 seconds.
e. Open one vaporizer at a time and repeat ‘c’ and ‘d’ as above.
f. Remove suction bulb, and reconnect fresh gas hose.
Machine Check Off: Step 6
Turn Machine On
Turn on all electrical
Machine Check Off: Step 7
Test Flowmeters
Test Flowmeters
a. Adjust flow of all gases through their full range, checking for smooth operation of
floats and undamaged flowtubes.
b. Attempt to create a hypoxic /N 0 mixture and verify correct changes in flow 02 2 and/or alarm.
Left is low flow, right is high flow
Machine Check Off: Step 8
Scavenging System - Adjust and Check Scavenging System
Adjust and Check Scavenging System
a. Ensure proper connections between the scavenging system and both APL (pop-oft)
valve and ventilator relief valve.
b. Adjust waste gas vacuum (if possible). (black knob on back)
c. Fully open APL valve and occlude Y-piece. MEASURED IN PRESSURE OF WATER cm H20
Open all the way to left, Closed all the way to right
d. With minimum 02 flow, allow scavenger reservoir bag to collapse completely and 2
verify that absorber pressure gauge reads about zero.
e. With the 02 flush activated allow the scavenger reservoir bag to distend fully, and 2 then verify that absorber pressure gauge reads < 10 cm H20
Purple tubing - Scavenger
White tubing - Vacuum
Machine Check Off: Step 9
Breathing System - Calibrate O2 Monitor
Calibrate 02 Monitor
a. Ensure monitor reads 21% in room air.
b. Verify low 02 alarm is enabled and functioning
c. Reinstall sensor in circuit and flush breathing system with 0 . 2
d. Verify that monitor now reads greater than 90%.
Machine Check Off: Step 10
Breathing System - Check Initial Status of Breathing System
Check Initial Status of Breathing System
a. Set selector switch to “Bag” mode.
b. Check that breathing circuit is complete, undamaged and unobstructed.
c. Verify that C absorbent is adequate. 02
d. Install breathing circuit accessory equipment (e.g. humidifier, PEEP valve) to be used
during the case.
Machine Check Off: Step 11
Breathing System - Perform Leak Check of the Breathing System
Perform Leak Check of the Breathing System
a. Set all gas flows to zero (or minimum).
b. Close APL (pop-off) valve and occlude Y-piece.
c. Pressurize breathing system to about 30 cm H 0 with 02 flush. 2 2
d. Ensure that pressure remains fixed for at least 10 seconds.
e. Open APL (Pop-off) valve and ensure that pressure decreases
Machine Check Off: Step 12
Manual and Automatic Ventilation Systems - Test Ventilation Systems and Unidirectional Valves
Test Ventilation Systems and Unidirectional Valves
a. Place a second breathing bag on Y-piece.
b. Set appropriate ventilator parameters for next patient.
c. Switch to automatic ventilation (Ventilator) mode.
d. Fill bellows and breathing bag with 0 flush and then turn ventilator ON. 2
e. Set 0 flow to minimum, other gas flows to zero. 2
f. Verify that during inspiration bellows deilvers appropriate tidal volume and that during
expiration bellows fills completely.
g. Set fresh gas flow to about 5 L/min.
h. Verify that the ventilator bellows and simulated lungs fill and empty appropriately
without sustained pressure at end expiration.
i. Check for proper action of unidirectional valves.
j. Exercise breathing circuit accessories to ensure proper function.
k. Turn ventilator OFF and switch to manual ventilation (Bag/APL) mode.
I. Ventilate manually and assure inflation and deflation of artificial lungs and appropriate
feel of system resistance and compliance.
m. Remove second breathing bag from Y-piece.
Machine Check Off: Step 13
Monitors - Check, Calibrate and/or Set Alarm Limits of all Monitors
Check, Calibrate and/or Set Alarm Limits of all Monitors
Capnometer Pulse Oximeter
Oxygen Analyzer Respiratory Volume Monitor (Spirometer)
Pressure Monitor with High and Low Airway Alarms
