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Anaes VivasThe anaesthetic machine

Anaes Vivas · The anaesthetic machine

Equipment viva — the anaesthetic machine and its safety devices

The classic equipment viva on the anaesthetic machine — the four-stage pressure path from the pipeline and cylinder supply to the common gas outlet, with the cylinder regulator, the Thorpe-tube flowmeters, the Link-25 hypoxic guard, the O2-last arrangement, the oxygen supply failure device with its weekly alarm test, the emergency oxygen bypass, and the oxygen analyser as the final defence. The discriminating details are the exact pressures (pipeline gauges 400 to 500 kPa, O2 cylinder 137 bar, N2O above 5000 kPa with liquid present), the distinction between the fail-safe and the analyser, and the closed-claims toll of gas-delivery error.

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Prompt
A modern anaesthetic machine (the anaesthesia workstation) with its pipeline inlets, cylinder yokes, flowmeters, vaporiser back bar, common gas outlet and breathing circuit, on the viva table. Describe the machine as a gas-flow path and explain each of its safety devices.

Stimulus

A modern anaesthetic machine on the viva table, with the pipeline inlets, the cylinder yokes (with the cylinders fitted), the flowmeter bank, the vaporiser back bar, the common gas outlet and the circle breathing circuit. Walk the examiner along the gas-flow path from the supply to the patient, and at each stage name the component, state the pressure, and explain the safety device.

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References8ShowHide
  1. [1]Hartle A, Anderson E, Bythell V, et al. Checking anaesthetic equipment 2012. Anaesthesia, 2012.PMID 22563957
  2. [2]Das S, Chattopadhyay S. The anaesthesia gas supply system. Indian Journal of Anaesthesia, 2013.PMID 24249882
  3. [3]Srivastava U. Anaesthesia gas supply: gas cylinders. Indian Journal of Anaesthesia, 2013.PMID 24249883
  4. [4]Goneppanavar U, Prabhu M. Anaesthesia machine: checklist, hazards, scavenging. Indian Journal of Anaesthesia, 2013.PMID 24249887
  5. [5]Mehta SP, Eisenkraft JB, Posner KL, Domino KB. Patient injuries from anesthesia gas delivery equipment: a closed claims update. Anesthesiology, 2013.PMID 23835591
  6. [6]De Cooman S, Schollaert C, et al. Hypoxic guard systems do not prevent rapid hypoxic inspired mixture formation. J Clin Monit Comput, 2015.PMID 25270987
  7. [7]Garg R, Gupta RC. Analysis of oxygen, anaesthesia agent and flows in anaesthesia machine. Indian Journal of Anaesthesia, 2013.PMID 24249881
  8. [8]Pauling M, Ball CM. Delivery of anoxic gas mixtures in anaesthesia. Anaesth Intensive Care, 2017.PMID 28675797
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