Common Equipment Problems

Question 1

What is a common problem with the laryngoscope

Answer 1

Unreliable and inconsistent illumination

Question 2

Common problems with ETT

Answer 2

Hole at the attachment of the pilot tube

Question 3

Name three common O2 cylinder sizes, their capacity and how long they will flow for at 10L/min

Answer 3

C - 170L - 17 minutes
D - 340L - 34 minutes
E - 680L - 68 minutes

Question 4

What should be done if the reservoir bag fails to stay full or the ventilator bellows fail?

Answer 4

Close APL –> switch to manual bag ventilation –> if this works then the fault lies within the ventilator or the anaesthetic machine. If lungs cannot be ventilated then assess patient immediately.

INSUFFICIENT GAS FLOW?

1. Check Pipeline/cylinder pressure,
2. Increase FGF,
3. Check vaporizer seal and seating,
4. Check ACGO.

LEAK within the circuit

1. Gas sampling port left open
2. Gas sampling return not connected to circle circuit
3. Damaged reservoir bag
4. Cuff leak, movement of ETT, poor connections
5. APL open

OCCLUSION

1. Breathing circuit kinked
2. Filter blocked

Question 5

Where should the circuit be disconnected when moving a patient to minimize risk of inadvertant extubation?

Answer 5

As near to the ETT as possible

Question 6

Why is an inappropriately long circuit hazardous

Answer 6

1. Trip hazard
2. Increased volume of the system –> change in dialled fresh gas composition takes longer to equilibrate with the gases in the circle

Question 7

How can soda lime exhaustion be diagnosed on the capnograph

Answer 7

Capnograph does not return to 0 during rebreathing

Question 8

What is the problem with leaving a syringe attached to an intravenous port?

Answer 8

Reflux of contents and delivery of incorrect doses.

Question 9

What is the risk with tangled intravascular access lines?

Answer 9

Inadvertant arterial administration of harmful drugs leading to tissue necrosis or permanent limb damage

Question 10

How can the BP cuff be correctly positioned and sized practically

Answer 10

1. Inappropriate cuff size

(best way to size is to measure and go by manufacturer guidance table)

• Width should be 2/3rd of upper arm length
• Bladder length should envelop 80% of the upper arm circumference
• Bladder width should be 40% of upper arm circumference
• The midline of the bladder should overlie the branchial artery
• Firmly wrap and secure the cuff

2. Patient position
   - Lateral positionwith dependent arm
3. Other
   - O-ring damage
   - Movement artefact
   - Atrial fibrillation

Question 11

What causes over-damped or attenuated IABP trace?

Answer 11

Wrist flexion with kinked tubing

Small clot in lumen (flushing system inadequately pressurised)

Question 12

What causes an underdamped tracing

Answer 12

If the pressure transducer changes altitude relative to the level of the operating table (the point at which it was zeroed. The Pressure transducer should be kept at the same level relative to the patient throughout the procedure.