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Sophie Young
Supply compressed gases Measure flow of gases Add vapours in known concentrations
Deliver vapours and gases to patient via a breathing system Scavenge waste Monitor machine and patient
Anaesthetic Machines
Pressurised gases are supplied by cylinders or pipelines to the anaesthetic machine which controls the flow of gases before passing them through a vaporiser and delivering the resulting mixture to the patient via the breathing circuit
History
Original Continuous-flow Anaesthetic Machine designed by Boyle in 1917 Most current anaesthetic machines derived from Boyles Machine Simpler anaesthetic machines draw over used by Armed Forces (no need for fresh gas supply)
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Gas supplies Pressure gauges Pressure reducing valves Rotameters Vapourisers Common gas outlet High flow oxygen flush Pressure relief valve Oxygen supply failure alarm
Fundamentals of Anaesthesia
Central supply point O2, N2O, air, medical vacuum supplied Pipelines throughout hospital Outlets colour and shape coded Flexible colour coded pipelines run to anaesthetic machine Pipelines permanently fixed to machine (NonInterchangable Screw Thread NIST) Pressure 400kPa (4 bar)
Molybdenum steel Size E Filling pressures Colour coded Pin Index System Bodok seal Valve (open + close prior to attaching) key and keyless
Essentials of Anaesthetic Equipment
Pressure Gauges
Pressure gauges to measure pipeline and cylinder pressures O2, N2O and air gauges on front of machine Gas colour coded and calibrated
Bourdon Gauge
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Pressure Regulators
Function: Reduce pressure to protect machine Maintain constant supply to compensate for changing cylinder pressures + demand
Rotameters
Measure flow rate of gas passing through them Calibration (accuracy +/- 2.5%)
Components: flow control (needle) valve, tapered tube, bobbin (slits + dot)
Low flow rates: flow laminar + function of gas viscosity (Poiseuilles Law) High flow rates: flow turbulent + function of gas density
Non-vertical tubes Tube damage/leakage (O2 enters back bar downstream from other rotameter outlets) Back pressure from common gas outlet drop in bobbin level Bobbin sticking: Static electricity Dirt
Back Bar
Horizontal part of machine between rotameters and common gas outlet Vapourisers mounted here so volatiles can be added to fresh gases
Vapourisers
Add controlled amount inhalational agent, after changing it from liquid to gas, to fresh gas flow Design depends on SVP, boiling point and MAC of volatile being used variable bypass or measured flow vapouriser Accurate delivery of anaesthetic agent regardless of time, gas flow and temperature
Antispill mechanism Colour coded keyed filling devices Safety interlock device
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Non interchangable pipeline outlets Colour coded pipelines and cylinders Pin index system Pressure gauges for gases Colour coded rotameters Oxygen rotameter on left, protrudes, ridged
Oxygen/nitrous oxide interlink device Emergency oxygen flush Oxygen failure warning device Keyed vapouriser fillers Pressure relief valve Anaesthetist to check the machine
Upstream of rotameters
Specifications (British Safety Standard): Audible alarm >60db, 1m from machine, >7 seconds Activated when O2 supply falls to 200kPa Power supply from O2 supply pressure Alarm cant be switched off/reset until O2 supply restored Coupled to gas cut off valve opens machine circuitry to air
Fundamentals of Anaesthesia
Non-locking button Bypass rotameter block and back bar Delivers flow > 30 l/min Pressure ~400 kPa
Summary
Any Questions?
References