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Without reference, identify principles about Anesthesia Units with at least 70 percent accuracy. Anesthesia unit. Purpose of Anesthesia Units Supplies a set mixture of gases and anesthetic vapors to the patient Helps the clinician control patient breath rates, volumes, and pressures
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Without reference, identify principles about Anesthesia Units with at least 70 percent accuracy.
Anesthesia unit • Purpose of Anesthesia Units • Supplies a set mixture of gases and anesthetic vapors to the patient • Helps the clinician control patient breath rates, volumes, and pressures • Monitors gas concentrations from the anesthesia machine • Provides patient monitoring • Includes safety features to help protect the patient • Removes excess gases from the breathing system and out of the anesthetizing location
Anesthesia unit • Anesthetizing Locations • An area used to administer any flammable or nonflammable anesthetic agent such as the operating room, delivery room, emergency room and anesthetizing room • Requirements for a nonflammable anesthetizing area • Areas must be clearly labeled “RESTRICTED TO NONFLAMMABLE ANESTHETICS”
Anesthesia unit • Environments factors • Humidity must be maintained at a minimum of 35% • Ventilation requirements • Used to remove bacteria, anesthetic gases, and maintain proper humidity • A positive pressure is maintained within the anesthetizing area • Temperature • Decreases metabolic rate of the patient • Decreases blood loss • Decreases infection by minimizing bacteria growth
Anesthesia unit • Clinical Aspects of Anesthesia • Definitions • Anesthesia – the loss of the normal perception of pain • Anesthetic – a substance which produces anesthesia • Purpose of anesthesia – to remove the patient’s sensitivity to pain during surgical procedures
Anesthesia unit • Types of anesthesia • Local anesthesia • Applied only to the area of treatment • Patient remains conscious • General anesthesia • Applied to the entire body • Usually results in loss of consciousness • Administered one of two ways • Intravenous – the anesthetic is injected into the blood stream • Inhalation – the patient breathes a gas mixture containing the anesthetic agent
Anesthesia unit • Inhalation Anesthetics • Delivered by inhalation • May be gases or volatile liquids • All common anesthetics in use today are non-explosive and nonflammable • Minimum alveolar concentration level (MAC) • Concentration of any anesthetic agent in which 50% of the population will be anesthetized • The MAC level must be exceeded to ensure proper anesthesia
Anesthesia unit • Nitruous • It is colorless and odorless • Nitrous oxide is a gas at ambient temperature and pressure • Kept as a liquid under pressure • Does not provide significant muscle relaxation • MAC = 105% • Frequently used in combination with the more potent volatile agents
Anesthesia unit • Halogenated anesthetic agents • Causes rapid, shallow breathing • Relaxes skeletal muscles • Halothane • Detrimental effect on rubber goods and some metals • MAC = 0.77% • Isoflurane • Several side effects and is not popular • MAC = 1.77%
Anesthesia unit • Enflurane • Few side effects • MAC = 1.3% • Deslurane • Will not evaporate at room temperature • Requires a special heated vaporizer • Low solubility in blood and body tissues causes a very rapid wash-in and wash-out • MAC = 7.25% • Aevoflurane • Low solubility in blood and body tissues • MAC = 1.7%
Anesthesia unit • Stages of General Anesthesia • Induction – start of administration of the anesthesia agents (during induction it is very important to remain as calm as possible) • Excitement – the patient is delirious and physiologically unstable • Surgical Plane – the patient is insensible to pain. Breathing is steady and automatic • Danger – the patient is in danger of cardiopulmonary arrest
General Calibration Procedures for an Anesthesia unit • Guidelines set by the manufacturer must be strictly followed • Recommendations before attempting maintenance of this type of equipment • All test equipment and ventilators are not the same • Ventilator Operation is Usually Unsupervised • The calibrations are extremely critical to the support of the patient's health and/or life
General Calibration Procedures for an Anesthesia unit • Anesthesia Unit Operation is Usually Supervised • The calibrations are extremely critical to the support of the patients health and/or life • Tolerances • Are not as narrow as the ventilator due to the constant supervision of the patient • Still very real because of the drugs that are used • A unit’s reaction to the changes in the patient’s condition • Can cause under or over anesthetic dosage • Can lead to damage or death
General Calibration Procedures for an Anesthesia unit • Tolerances • Are narrower than most other devices in the hospital (ex. +/- 1% instead of +/-3%) • A units reaction to the changes in the patient's condition • Can cause under or over ventilation • Can lead to injury or death
General Calibration Procedures for an Anesthesia unit • Test Equipment • Calibrations are only as accurate as the calibration of the test equipment • Calibration Items • Pressure delivery • Pressure sensing • Peak • Mean • Peep
General Calibration Procedures for an Anesthesia unit • Overpressure • Volume delivered • Volume sensing • Breath rate • Oxygen blending • Assist sensitivity • Safety devices • Alarm limits
General Calibration Procedures for an Anesthesia unit • Anesthesia unit special items of concern • Safety devices • Proportioning system • Monitors the nitrous oxide flow to the oxygen flow to maintain <3:1 ratio • Designed to prevent oxygen concentration from falling below 25% • The kick-in point will • limit nitrous oxide flow from increasing if nitrous oxide is increased above 3:1 • increase oxygen flow if nitrous oxide is increased above 3:1 • Below 25% oxygen is considered hypoxic • decrease nitrous oxide flow if oxygen is decreased above 3:1
General Calibration Procedures for an Anesthesia unit • Secondary gas shutoff • Monitors the oxygen source pressure • Controls nitrous oxide and air flows (secondary gases) • Will either • Decrease flow of secondary gases in proportion to oxygen pressure • Shutoff flow instantly at a preset pressure • Either way the secondary gases will be completely cut-off before oxygen is depleted • Vaporizerinterlocks • Used on multiple vaporizer systems • Prevents more than one vaporizer from being turned on at a time
General Calibration Procedures for an Anesthesia unit • Alarm limits • Common/fresh gas concentrations • Ensure minimum oxygen content cannot be adjusted to hypoxic levels • Vaporizer • Calibration verification can only be performed • Use a Rankin gas analyzer • If verification falls outside of limits then vaporizer will be sent to manufacturer for repair or replacement