Anesthesia Machine Checkout

Question 1

Step 1

Answer 1

Verify backup ventilation equipment is funtioning

Question 2

Purpose of verifying backup equipment

Answer 2

If the machine fails, the AMBU bag is the only way to provide positive pressure ventilation

Question 3

Step 2

Answer 3

Check Oxygen cylinder supply (at least 1000 psi)

Question 4

Purpose of checking Oxygen cylinder supply

Answer 4

It is your backup 02 supply if the pipeline fails

Question 5

Step 3

Answer 5

Check central pipeline supplies (About 50 psi)

Question 6

Purpose of checking central pipeline supplies

Answer 6

To ensure adequate gas supply

Question 7

Step 4

Answer 7

Check initial status of low pressure system (everything off)

Question 8

Purpose of checking low pressure system

Answer 8

To get the machine ready for the next steps

Question 9

Step 5

Answer 9

Perform a leak check of low pressure system

Question 10

Purpose of performing a leak check on the low pressure system

Answer 10

It checks for leaks in the flow meter tubes and vaporizers

Question 11

Step 6

Answer 11

Turn the machine ON

Question 12

Purpose of turning the machine on

Answer 12

The flow meters don’t work when the machine is off

Question 13

Step 7

Answer 13

Test the flow meters

Question 14

Purpose of testing the flow meters

Answer 14

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%

Question 15

Step 8

Answer 15

Adjust and check the scavenging system

Question 16

Purpose of checking the scavenging system

Answer 16

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

Question 17

Step 9

Answer 17

Calibrate the O2 monitor (21% - >90%)

Question 18

Purpose of calibrating the O2 monitor

Answer 18

To prevent delivering a hypoxic gas mixture to the patient and to know when a hypoxic gas mixture is being delivered (via alarm)

Question 19

Step 10

Answer 19

Check the initial status of the breathing system

Question 20

Purpose of checking the initial status of the breathing system

Answer 20

An improperly attached circuit can cause ventilation problems
Exhausted CO2 absorbent causes rebreathing
Changing the absorbent can cause a circuit leak

Question 21

Step 11

Answer 21

Perform a breathing system leak check

Question 22

Purpose of checking the breathing system for a leak

Answer 22

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

Question 23

Step 12

Answer 23

Test ventilation systems and unidirectional valves

Question 24

Purpose of testing the ventilation systems and unidirectional valves

Answer 24

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

Question 25

Step 13

Answer 25

Check capnometer

Question 26

Purpose of checking the capnometer

Answer 26

to ensure that it works properly

Question 27

Step 14

Answer 27

Check the final status of the machine

Question 28

Purpose of checking the final status of the machine

Answer 28

to ensure that you are ready to start the case once the patient is in the room

Question 29

Three tips for troubleshooting leaks

Answer 29

• Start from the patient end and move backward
• Check connections
• Adjust CO2 absorber

Question 30

What to do when the CO2 waveform is distorted or nonexistent

Answer 30

• Check to make sure the sample line is tight and functioning by breathing into it
• Make sure line is not occluded or bent

Question 31

What to do if the suction is not working/weak

Answer 31

• Check the wall suction
• Make sure the canister top is not loose
• Make sure all ports are closed
• Tighten suction tubing

Question 32

Which steps need not be repeated after initial checkout?

Answer 32

Steps 1-9

Question 33

Which four steps are often skipped?

Answer 33

Steps 5 (low pressure leak check), 8 (checking the scavenging system), 9 (calibrating the O2 monitor), and 13 (checking and calibrating alarms)