Safety measures

in anaesthesia
machine

Presenter – Dr Tanya
Moderator – Dr Badri Prasad Das
Why safety features?

 To safeguard human life from unknown human errors.

 Safety devices are to prevent delivery of hypoxic mixture
 Regulation to prevent excessive pressure which is traumatic to patient.
Machine has two components

Electrical Component Pneumatic component

Master switch High pressure system
Power failure indicator Intermediate pressure system
Reserve power Low pressure system
Electrical outlets
Circuit breakers
Data Communication ports
Master switch

 turning the master switch to

the ON position activates both
pneumatic and electrical
functions of the machine as
well as certain alarms and
safety features.
Power failure
indicator
 The machine will give audio-
visual indication when when
main power is lost.
Reserve power

 The anaesthesia provider should check the battery status during the pre use
checkout procedure.
Electrical outlets

 Convenient electrical outlets on

the back of the anaesthesia
machine . These should be used
only for anaesthesia monitors
and not for general operating
room use.
Pneumatic component
• Cylinders
High • Hanger yoke assembly

pressure •
•
Pressure gauge
Pressure reducing device

• Pipelines and
Intermediat their pressure
gauges
e pressure • O2 flush
• O2 failure alarms

• Flowmeters
Low • Vapourisers
pressure
High Pressure
system
SAFETY FEATURES OF CYLINDERS

 • Molybdenum steel alloy construction. This is

stronger and lighter than its carbon steel
predecessor
 • Color-coding for each gas or vapor
 • Bodok seals (bonded disk): These are
noncombustible small metal and neoprene seal
(neoprene washers with aluminum or brass
edges) to ensure a gas-tight fit between the
cylinder and anesthetic machine yoke
 Cylinder labels [Name,Chemical
symbol,Physical state, Maximum pressureand
amount(in L), size code,Product license
number,Warning of the principal hazards]
Colour coding of cylinders

 Oxygen black body ,white shoulders

 Nitrous blue
 Air white and black
 Carbon dioxide gray
 Helium brown
 Entonox black with blue/white shoulders
Pin Index
safety system
 This prevents the
accidental connection of
a cylinder/yoke block of
one gas to the hanger
yoke of another gas on
the anesthesia machine
or work station
 It uses geometric features on yoke to ensure that pneumatic connections
between cylinder and AM are not connected to wrong gas yoke.
Pressure relief devices

The safetly relief device is composed of

 - Frangible disc [ bursts under extreme pressure]

 Fusible plug [ wood’s metal which becomes soft so

that cylinder contents are discharged

 Safetly relief valve [reclosing device, opens at

extreme pressure]
Safetly feature in cylinder pressure
indicator
 Bourdon pressure gauges are fitted
adjacent to each yoke and pipeline
connection on the machine.
 Gauge is usually color coded
 Name and symbol of gas are written
over dial.
 If bourdon tube ruptures , gas Is vented
from back side.
 Gauges are angled and placed in such a
way that it can be easily read by
anaesthetist.
 Instructions like “use no oil” ”open
valve slowly”are written on the gauge.
Intermediate
pressure system
Intermediate system

 Pipeline
 Wall outlet : labelled and color coded
 Manual shutoff valves (visible and accessible at all times)
 Service shutoff valves (designed to be used only by authorized personnel)
 Schraeders probes, quick connectors or diameter index safety system to
prevent interchangibility
 Pipeline hoses are color coded
Diameter Index Safety system

 Schraeders probes, quick connectors or diameter index safety system to

prevent interchangibility
Oxygen flush

 oldest safety features on the machine,

 directly to the patient’s breathing circuit bypasses the anesthetic vaporizers
 remains closed until the operator opens it. The feature is
 usually available even when the machine is not turned on
Oxygen failure safety device
Oxygen whistle alarm

 When o2 pressure falls< 38 psig (260kPa), the gas in the reservoir will pass
through a clarinet like reed , which produces a sound.
 At 30 psig (200kPa), it cuts off the supply of anaesthetic gases to the
patient.
Flow control valves

 All knobs are color coded for the appropriate gas,

 chemical formula or name of the gas
 protected with a shield or barrier to minimize inadvertent change from a
preset position
 Oxygen flow control knob is the largest and fluted for easy identification
LOW PRESSURE
SYSTEM
Flowmeters

 Bobbin rotates on flow which prevents it sticking.

 bobbin is antistatic to prevent sticking to the wall of the flowmeter
 If a single gas has two flow tubes, the tubes are arranged in series and are
controlled by a single flow control valve
 Dust filter at the base
Sequence of flowmeters
Datex-ohmeda link-25 proportion
limiting control system
Vaporizer

 Clear color-coding indicator on the vaporizer and agent bottle

 Agent specific filling systems with sealed bottles [Fraser sweatman pin safety
system]
 Agent level indicators
 Mounting systems with interlock to prevent simultaneous use of two
vaporizers [Selectatec mechanism]
 Filling port is low to avoid overfilling
 Electronic vaporizers have audiovisual alarm systems which
detect malfunction—tilting, low agent and low temperature
 Agent monitoring allows detection of misfilling, overdose and low output
Alternative oxygen control
Scavenging system

 Scavenging system is distinctly different from the airway accessories making

misconnections improbable.
 Scavenging systems also incorporate negative and positive pressure relief
valves to make sure no dangerous pressures are transmitted into the
breathing system in the event of malfunction of the system
Breathing system

 All breathing systems have an adjustable pressure limiting (APL) valve which
opens the system to the atmosphere. The opening pressure of this valve is
adjusted normally according to the breathing system used and its
applications. Occasionally, this valve may get stuck and allow development of
high pressure. If such an event were to occur, the system should be
immediately disconnected from the patient to avoid barotrauma.
 Some of the APL valves manufactured nowadays vent gases to the atmosphere
when the pressure exceeds 60 cm H2O, even when they are fully closed.
 Another safety feature in the breathing system is the reservoir bag. Most of
these bags give way when the pressure builds up above 50 cm H2O.
Monitoring

 General anaesthesia should never be administered without an oxygen analyser

in the breathing circuit.

 Oxygen analysers have to be calibrated at regular intervals, most often as

part of the machine start-up check procedure.
Summary
Reference

 Understanding anaesthesia equipment 5th edition ; Jerry A Dorsch

 Miller’ anaesthesia 7th edition
 Understanding anaesthesia equipment ; Dwarkadas K Baheti
Thank you