Machine Check

Question 1

Emergency equipment check

Answer 1

1. Ambu bag
2. Back up oxygen cylinder (>1000 psig)
3. Functioning suction with yankauer

Question 2

High pressure system check

Answer 2

1.  Check O2 cylinder supply
Open cylinder and check PSI (>1000)
Close cylinder
Depress O2 flush
2.  Disconnect pipeline supply from the wall

Question 3

Low pressure system check

Answer 3

1.  Check vaporizers
Mounted, filled, and interlock works
2.  Check low pressure system
Suction bulb to common gas outlet 
Squeeze bulb until fully collapsed
Verify bulb stays deflated for 10 seconds
3. Turn on master switch
Listen for oxygen disconnect alarm
Reconnect pipeline pressure
Ensure pipeline pressure is > 50 psig
4.  Test flowmeters
Adjust flow of all gases through their range
Attempt to create a hypoxic mixture

Question 4

4. Oxygen sensor and Breathing circuit

Answer 4

1. Calibrate O2 sensor
   Ensure reads 21% in room air
   Verify low O2 alarm (set to 30%)
   Re-install sensor and flush with O2 - now reads > 90%
2. Install breathing circuit

Question 5

Scavenging System

Answer 5

1. Ensure proper connection of scavenging system
2. Adjust waste gas vacuum
3. Fully open APL valve
4. Occlude Y piece and ensure gauge reads < 10 cm H2O
5. With Y piece occluded, depress O2 flush ensure the reservoir bag distends, and the pressure gauge reads < 10 cm H2O

Question 6

Ventilation system

Answer 6

1. Place a second breathing bag on Y piece
2. Set appropriate ventilator setting for next patient
3. Set O2 @ 5 L
4. Turn ventilator on and fill bellow with flush valve
5. Verify bellows deliver adequate tidal volumes
6. Check function of unidirectional valve
7. Squeeze bag and check over pressure alarm
8. Set to manual ventilator mode
9. Ensure ability to manual ventilate
   10 Turn off ventilator and remove breathing bag

Question 7

Check breathing system (Positive pressure check)

Answer 7

1. Set all gas flow to zero
2. Close APL valve and occlude the Y piece
3. Pressurize the breathing system to 30 cm H2O
4. Ensure pressure remains fixed for at least 10 seconds
5. Fully open APL valve and allow bag to self deflate and flows through the scavenger

Question 8

Monitors

Answer 8

1. Set anesthesia monitors for next patient

Question 9

Final Check

Answer 9

1. Vaporizers off
2. APL valve open
3. Selector switch set to bag
4. All flowmeters set to zero
5. Suction available
6. Monitors set appropriately
7. Circuit on, CO2 sampling line connected & correct mask on