Anaesthesia machine-1

High pressure system

Presenter Dr. Aswathy M S
Moderator Dr. Mathew
Classification

The pneumatic part of the machine can be divided into

three parts:
High, intermediate, and low-pressure systems.
Classification based on pressure
High pressure system – receives gas at cylinder pressure.
Intermediate pressure system -receive gases at reduced
pressures.
Begins at the pipeline inlet pressures of 60 psig (50–55
psig in the US) and regulated cylinder pressures of 45
psig to the flow control valves where the pressures
would be 14–26 psig.
Low pressure system: takes the gases from the flow
meters to the machine outlet. Pressure is slightly above
atmospheric.
The high-pressure system
receives gases from cylinders at high, variable
pressures and reduces those pressures to lower, more
constant pressure suitable for use in the machine.
Classification
The High-pressure System

 Hanger yoke assembly

 Cylinder pressure gauge
 Pressure regulator
MEDICAL GAS CYLINDERS
Modern cylinders - lightweight strong chrome-molybdenum steels
can be filled to pressures of up to 300 bar g .

Cylinders were previously made of the much heavier low-carbon

steels

Portable cylinders- lighter weight composite (hoop wrap) cylinders

These are constructed from either lightweight steel or, more
commonly, an aluminium liner.
 strengthened by wrapping a filament material, such as Kevlar or
carbon-fibre, coated in epoxy resin circumferentially along the
parallel length of the cylinder.
can be filled to pressures up to 300 bar g.
COMPONENTS OF CYLINDER
1. Body
2. Valve
3. Handle or hand wheel
4. Pressure relief device
5. Non- interchangeable safety system
 VALVE

 Filled and discharged through spindle valve

 Made of bronze or brass

 Removed only by cylinder owner

 CATEGORIES OF VALVES
A. Integral valve (built – in regulator and
flow meter)

B. Non- integral valve (require manual

attachment of external pressure regulator)

i. Small pin index and side spindle pin

index outlet valve
ii. Bull nose outlet valve
iii. Handwheel actuated valve
PIN INDEX SYSTEMS
A) SMALL PIN INDEX SYSTEM
Fitted to small cylinders (<5 L) on
anaesthesia machine.
PIN INDEX SYSTEMS
B) SIDE SPINDLE PIN INDEX VALVES
Fitted to large cylinders
BULL NOSE OUTLET VALVE
 Fitted to F and G cylinders

 Has Residual Pressure Device – ensures a positive

pressure of 3 bar retained in the cylinder – prevent
ingress of moisture if valve left open after cylinder
is empty
BULL NOSE CYLINDER VALVE
HAND WHEELS

 In F and G size CO2 cylinders

and N2O cylinders.
 Has protective guard.
 Has gas specific, male thread ,
side outlet.
 INTEGRAL VALVES
 Has built- in regulator and flow
meter
 ADVANTAGES :-
a. Less prone to particulate
contamination (manufactured in
clean environment).
b. Eliminate risk of incorrect
regulator attachment
c. Easier to handle ; has live
pressure gauges to check
cylinder contents.
HANDLE OR HAND WHEEL
Handles :- ( in small cylinders)
i. Hexagonal opening
ii. Rachet type

Handwheel :- in large cylinders .

HANDLES
PRESSURE RELIEF DEVICE
a) Rupture disc.
b) Fusible plug.
c) Combination Rupture disc\Fusible plug.
d) Pressure relief valve- Reclosing
FRANGIBLE DISC/BURST DISC
 BURST PRESSURE
FUSIBLE PLUG
 Yield temperature – Temperature →fusible
material become soft to extrude from its holder and
release cylinder contents.
PRESSURE RELIEF VALVE
Cylinder sizes
Technically, cylinders are defined by their water
capacity and range between 1.2 L and 47.2 L
 Identified by a size code ranging from A to H
Type –A,B,C .portable.
D & E have pin index safety system
Can be mounted on to the yoke assembly
F to H bulk cylinders
do not have PISS
CYLINDER SIZES
CONTENTS AND PRESSURES
A) Non liquefied gas:-
pressure -cylinder contents.
 B) Liquefied Gas :-
Weight -amount of liquid .
Cylinder identification
The correct method of identifying the contents of a
cylinder is to read the collar identification label
 product name, chemical symbol and pharmaceutical form
of the product
 product specification
 hazard warning diamond(s)
 product licence number
 cylinder contents in litres
 maximum cylinder pressure
 cylinder size code
 directions for use and information for storage and
handling
The cylinder label also has a unique batch label ,
which contains:
The batch number
 Fill and expiry date
 The size and type of gas.
 The label is changed every time the cylinder is filled
and serves two important functions:
 (a) it provides vital information for a batch recall
should the cylinder be involved in an incident
 (b) it provides information for proper cylinder rotation
MARKINGS
 Permanently stamped onto shoulder of cylinder.
 Arranged as :-
• DOT- 3A2015
• 8625
• XYZ
• JCN
MARKINGS
LABELLING
TAGS
 COLOR
International colour code –Medical Gas
Industry in 1949
New international color coding 2010
Cylinder testing
All cylinders must undergo hydraulic testing and
internal inspection at regular intervals, to ensure they
remain safe to use.
The test is carried out every 10 years for steel
cylinders
 Every 5 years for composite cylinders.
 A colour-coded plastic ring between the valve and the
cylinder neck indicates when the next test date is due
 Service pressure – Maximum pressure to which cylinder
may be filled at 70°F.
Hanger yoke assembly
The hanger yoke orients
and supports the cylinder,
provides a gas-tight seal,
and ensures a unidirectional
gas flow.
 BODY

Swinging
gate
Parts
Parts of hanger yoke.

Body
Retaining screw
Nipple
Index pins
Washer
Filter
Check valve assembly
Hanger yoke assembly
Body
Principal framework and supporting structure
Threaded -> frame of the machine
Support for the cylinder(s)
swinging gate (toggle handle, swivel gate)–type yoke
the distal part is hinged.
When a cylinder is being mounted onto or removed
from a yoke, the hinged part can be swung to the side
Hanger yoke assembly
Retaining Screw
clamping device/retaining bar
Threaded into the distal end
of the yoke
 Tightening the screw presses
the cylinder valve outlet
against the washer and nipple
 gas-tight seal is achieved
The conical point of the
retaining screw is shaped to
fit the conical depression on
the cylinder valve
Hanger yoke assembly
Nipple
gas enters the machine
Projects from the yoke
and fits into the port on
the cylinder valve
Damaged- no tight seal
Hanger yoke assembly
Index Pins
 Below the nipple
 holes must be of a
specific depth

If extend too far into the

body of the yoke
↓
possible to insert an
incorrect cylinder
• INDEX PINS
✓4mm in diameter and
6mm long (except pin
7 which is slightly
thicker)
✓Fit into the
corresponding holes
on the cylinder
✓Holes are on the
circumference of a
circle of 9/16th inch
radius centered on
the port of a cylinder
1, 3 Ethylene
1, 4 Nitrogen
1, 5 Air
1, 6 CO2 or O2 (CO2 >7%)
2, 4 Helium & O2 (He <80%)
2, 5 Oxygen
2, 6 CO2 or O2 (CO2 <7%)
3, 5 Nitrous oxide
3, 6 Cyclopropane
4, 6 He & O2 (He >80%)
7 Entonox
Hanger yoke assembly
 Washer (gasket/ Bodox seal)
 it is made up of non
combustible material
and has a metal periphery
which make it long lasting.

 placed around the nipple

 seal between the cylinder
valve and the yoke
Don’ t use- broken or curled
washer
More than 1 washer
↓
 Prevent tight seal
 Over-ride pin index safety
system
Hanger yoke assembly
Filter
 installed between the cylinder and pressure regulator
or flow control valve
to prevent particulate matter from entering the
machine
Hanger yoke assembly
Check Valve Assembly
Allows gas from a cylinder to enter the machine but
prevents gas from exiting the machine when there is no
cylinder in the yoke.
Uses
Allows an empty cylinder to be replaced with a full one
without losing gas.
prevents gas transferred from a cylinder with a higher
pressure to another one with lower pressure when both
are connected to a double yoke and turned ON at the
same time.
Check Valve Assembly
Hanger yoke assembly
Check Valve Assembly
To minimize air losses, a yoke should not be left
vacant.
cylinder -> exhausted
 replaced by a full one
 a yoke plug (dummy cylinder block or plug, blanking
cap or plug)
 Yoke plug
 Solid piece of metal or other
material
 conical depression -retaining
screw
 hollowed area- nipple
The plug forms a seal to prevent
the gas from escaping from the
machine.
Often chain yoke plugs to the
machine.
To prevent transfilling between paired cylinders as a
result of a defectivr check valve ,only one cylinder of a
gas should be open at a time.
How to place a cylinder in a yoke.
Valves, yokes free of oil or grease (fire hazard)
 Persons should always wash their hands first.
Check whether the two Pin Index Safety System pins
are present.
A missing pin could allow the safety system to be
bypassed.
How to place a cylinder in a yoke.
Steps:
1. Retract the retaining screw
2. Gate is swung open
3. Washer placed over the nipple.
4. Cylinder supported with foot and raised into yoke
5. Port on cylinder valve is guided over nipple, pin ,holes
6. Gate closed
7. Retaining screw tightened
8. Cylinder opened to make certain that it is full and that there is no
leak
9. The valve should be closed unless it is to be the primary gas
supply
The most common cause of a leak ?
Is due to a defective or missing washer.
Cylinder Pressure Indicator (Gauge)

Displays the cylinder

pressure

Location: near the

cylinders or on a panel
on the front of the
machine
Types
 Bourdons tube
 Digital
 LED
 40

Bourdon Pressure gauge

• Displays cylinder pressure for each gas

• The gauge is usually color coded and name and symbol
of gas are written over the dial.
• The scale must be at least 33% greater than the
maximum filling pressure of the cylinders or the full
indication position.
• calibrated in (kilopascal)kPa or (pound per square inch)psi
or Kg/cm2
 1.Bourdon tube (Bourdon spring, elastic
element)
A hollow metal tube is bent
into a curve, then sealed and
linked to a clocklike
mechanism.
The other end connected= gas
source
An increase in gas pressure
inside the tube
->straighten
pressure falls, the tube resumes
its curved shape
Bourdon tube
 open end is fixed, the
sealed end moves.
These motions are
transmitted to the
indicator, which moves
over a calibrated scale.
Gauges - calibrated in
(kPa) but (psi) may also
be used
2.Digital pressure indicators
Used on some modern
electronic anesthesia
machines.
3.LED type
light-emitting diodes (LEDs) to indicate cylinder
pressure .
LED is green – open valve and the pressure is
adequate.
LED is red - open valve but the inadequate
pressure.
Dark - the cylinder valve is not open.
Pressure Regulators

The pressure in a cylinder varies

It reduces the high and variable pressure found in a
cylinder to a lower, more constant pressure suitable for
use in an anesthesia machine
Other names : Reducing valves, reducing regulators,
reduction valves, regulator valves, gas pressure
reducing device/system.
Pressure regulator for each gas supplied from cylinders
 Pressure Regulators

Physical Principles
Pressure = force acting against
an area.
Force - increased either by
increasing the pressure or by
increasing the area over which
the pressure acts.
Pr × A2 = Pc × A1
Pr = A1/A2 × Pc
Pressure Regulators

Has a high pressure

chamber with an inlet
that has a filter
high pressure chamber
has a valve which leads
to a low pressure
chamber with an outlet
The low-pressure
chamber has a
diaphragm attached to a
spring
Pressure Regulators

If the outlet is closed the pressure again builds up and

the valve closes.
 Thus the force exerted by the high pressure gases tries
to close the valve while the opposing force of the
diaphragm and spring tries to open the valve.
The balance between the two opposing forces helps to
maintain a constant gas flow
GENERAL RULES FOR SAFETY

 Never exposed to temperature of >54°C or <-7°C.

 Valves to be kept closed at all times except when in use.
 Repainted only by supplier.
 Markings , labels or tags not to be altered or removed.
 Transported - cart /carrier made for this purpose (not
dragged or rolled).
 STORAGE

 Protected from extremes of temperature & from

ground beneath.
 Flammable gases not to be stored in enclosure
containing oxidising gases( N2O , O2 ,
compressed air).
CRACKING OF CYLINDER
 Slowly & briefly opening valve with port pointed
away from user or any other persons.
 Rapid recompression -produce large amount of
heat – flash fire or explosion.
AFTER USE
 Cylinder valve closed completely and all pressure
vented from the system
 Empty /near empty cylinder not to be left on
anaesthesia machine.
 TRANSFILLING

 Transferring medical gas from one cylinder to another.

 Best performed by gas manufacturer or distributor.
HAZARDS
1. Ignition of combustible substances.
2. Overfilling of small cylinder.
3. Wrong filling
References
Dorsch Anaesthesia equipments 5th edition

Ward’s Anaesthesia equipment 5th edition

Thankyou