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Surgical Anesthesia

Surgical Anesthesia. Jose D. Chinchilla, LVT, RLATG Training Coordinator Priority One Services. A Components Introduction. Anesthesia Components. Anesthesia Machine. Frame Regulator Flowmeter Oxygen Flush Assembly Vaporizer Anesthetic Supply System Scavenging System.

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Surgical Anesthesia

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  1. Surgical Anesthesia Jose D. Chinchilla, LVT, RLATG Training Coordinator Priority One Services A Components Introduction

  2. Anesthesia Components • Anesthesia Machine • Frame • Regulator • Flowmeter • Oxygen Flush Assembly • Vaporizer • Anesthetic Supply System • Scavenging System

  3. Anesthesia Components • Anesthesia Machine • Frame • Supports the components of the anesthetic machine • Several styles available

  4. Anesthesia Components • Anesthesia Machine • Frame • Regulator • Placed on O2 tanks to decrease pressure from tank • 2 types of tanks • “E” Tanks • 650L @ 1800PSI • “H” Tanks • 7100L @ 2200PSI • Output pressureadjusted with knob

  5. Anesthesia Components • Anesthesia Machine • Frame • Regulator • Flowmeter • Controls the amount of air released into the anesthetic circuit • Calculation:(Tidal volume - mL) x (Breathes per minute) /(1000mL/Liter)=Liters Resp. per Minute

  6. Anesthesia Components • Anesthesia Machine • Frame • Regulator • Flowmeter • Oxygen Flush Assembly • High flow oxygen straight from O2 supply • 45-50psi • Do not use while connected to patient through tracheal tube • Use to flush anesthetic gases from circuit and minimize exposure

  7. Anesthesia Components • Anesthesia Machine • Flowmeter • Oxygen Flush Assembly • Vaporizer • Changes liquid agent toa vapor • Delivers the vapor into the movingsteam of oxygen in controlled amounts • Must b e serviced to maintain accuracyof delivery and safety • Caution with refurbished models

  8. Anesthesia Components • Anesthesia Machine • Oxygen Flush Assembly • Vaporizer • Anesthetic Supply System • a.k.a Breathing circuits • Rebreathing • Exhaled air is cleaned and reused with the patient • Non-rebreathing • Exhaled air is taken by scavenging system

  9. Anesthetic Supply Systems Rebreathing Circuit Non-Rebreathing Circuit Modified from Nakae Y et al. Anesthesia and Analgesia 1996;83:488-492

  10. Anesthesia Components • Anesthesia Machine • Vaporizer • Anesthetic Supply System • Scavenging Systems • Containing Anesthetic Gas • Evacuating Gases • Filtering Gases • Passive vs. Active Evacuation • In-facility Vacuum • Fume Hoods & Down Draft Tables

  11. Scavenging Systems • Scavenging Systems • Containing Anesthetic Gas • NIOSH • National Institute for Occupational Safety and Health • Permissible Exposure Limits (PEL's) • 2 parts per million (PPM) • Must make every attempt to limit leaks • Where can leaks come from?

  12. Scavenging Systems • Scavenging Systems • Containing Anesthetic Gas • Evacuating Gases • Waste gas is contained until it can be released to the outside atmosphere • Ensure connections are leak free • No resistance of gas flow • Evacuation lines checked to assure they are clear of obstructions • Passive Systems • Active Systems

  13. Scavenging Systems • Scavenging Systems • Containing Anesthetic Gas • Evacuating Gases • In-facility Vacuum • Connects the in-house vacuum lines to the exhaust portion of the anesthetic machine • Caution: Negative pressure in exhaust line possible • Caution: Positive pressure build up in circuit possible

  14. Scavenging Systems • Scavenging Systems • Containing Anesthetic Gas • Evacuating Gases • Filtering Gases • Fume Hoods & Down Draft Tables • Applies negative pressure to procedure area not just exhaust. • Less possibility of incorrect use • Must keep patient and exhaustwithin cabinet or 30” from table

  15. Scavenging Systems • Scavenging Systems • Containing Anesthetic Gas • Evacuating Gases • Filtering Gases • Activated Charcoal • Adsorbent Material • Management of Canisters • 25% of Original Canister Weight • Documentation

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