Anesthesia Machine Checkout Flashcards
Step 1
Verify backup ventilation equipment is funtioning
Purpose of verifying backup equipment
If the machine fails, the AMBU bag is the only way to provide positive pressure ventilation
Step 2
Check Oxygen cylinder supply (at least 1000 psi)
Purpose of checking Oxygen cylinder supply
It is your backup 02 supply if the pipeline fails
Step 3
Check central pipeline supplies (About 50 psi)
Purpose of checking central pipeline supplies
To ensure adequate gas supply
Step 4
Check initial status of low pressure system (everything off)
Purpose of checking low pressure system
To get the machine ready for the next steps
Step 5
Perform a leak check of low pressure system
Purpose of performing a leak check on the low pressure system
It checks for leaks in the flow meter tubes and vaporizers
Step 6
Turn the machine ON
Purpose of turning the machine on
The flow meters don’t work when the machine is off
Step 7
Test the flow meters
Purpose of testing the flow meters
To make sure the floats don’t get stuck and give false readings and to make sure that the hypoxic guard mechanism prevents FiO2 setting less than 25%
Step 8
Adjust and check the scavenging system
Purpose of checking the scavenging system
A loose of improperly adjusted vacuum will release waste gases into the OR
A broken negative pressure valve will allow excessive vacuum and create sub-atmospheric pressure
A broken positive pressure valve will cause buildup of waste gases
Step 9
Calibrate the O2 monitor (21% - >90%)
Purpose of calibrating the O2 monitor
To prevent delivering a hypoxic gas mixture to the patient and to know when a hypoxic gas mixture is being delivered (via alarm)
Step 10
Check the initial status of the breathing system
Purpose of checking the initial status of the breathing system
An improperly attached circuit can cause ventilation problems
Exhausted CO2 absorbent causes rebreathing
Changing the absorbent can cause a circuit leak
Step 11
Perform a breathing system leak check
Purpose of checking the breathing system for a leak
To see if closing the APL valve or using the O2 flush creates a leak (high pressure situations)
Use the fresh gas flows to measure the amount of the leak
Step 12
Test ventilation systems and unidirectional valves
Purpose of testing the ventilation systems and unidirectional valves
Ensure the ventilator works properly
High gas flows will hide a leak
Stuck inspiratory valve will increase pressure in the machine
Stuck expiratory valve will increase the pressure inside the patient’s lungs
Step 13
Check capnometer
Purpose of checking the capnometer
to ensure that it works properly
Step 14
Check the final status of the machine
Purpose of checking the final status of the machine
to ensure that you are ready to start the case once the patient is in the room
Three tips for troubleshooting leaks
- Start from the patient end and move backward
- Check connections
- Adjust CO2 absorber
What to do when the CO2 waveform is distorted or nonexistent
- Check to make sure the sample line is tight and functioning by breathing into it
- Make sure line is not occluded or bent
What to do if the suction is not working/weak
- Check the wall suction
- Make sure the canister top is not loose
- Make sure all ports are closed
- Tighten suction tubing
Which steps need not be repeated after initial checkout?
Steps 1-9
Which four steps are often skipped?
Steps 5 (low pressure leak check), 8 (checking the scavenging system), 9 (calibrating the O2 monitor), and 13 (checking and calibrating alarms)
