Engineering & the Physical Sciences

in Medicine Conference
2005

The Who, What, Where, Why and

When of Anaesthetic Machine
Maintenance

Presented by Terry Kirkman

 Introduction
† Anaesthetic machines are critical pieces of
biomedical equipment in theatre.

† Without them there is no surgery

† They are devices that do a large volume of work

† They require regular maintenance to keep them in

satisfactory condition

† Many forget the vital function the anaesthetist and

anaesthetic machine perform
 My anaesthetic machine is not
broken, why take it away?
† To optimise the safety, efficiency and economy of
diagnostic, therapeutic and supporting equipment
used for patient care

† To minimise the likelihood of equipment developing

faults

† To ensure equipment is able to perform

satisfactorily over its lifetime

† To replace parts susceptible to wear

 Who is taking my anaesthetic
machine away?
† Your friendly biomedical technician

† Typically, technicians have tertiary engineering

qualifications and biomedical experience and/or
training, often from equipment manufacturers

† This includes:
„ In-house biomedical engineering service
„ External contractors
„ Manufacturers, under service agreement or for
warranty issues
 What are the advantages of in-
house maintenance?
† On-call service for tech support (in & out of hours)

† Faster response time and less down time when machines

are out of service

† Equipment users are familiar with equipment

maintainers

† In-house personnel familiar with OTS environment,

layout and procedures
† May provide cost saving

† Extra value added services – eg IT support, other equip

† May be employed by BME or Anaesthetic Dept

 How often will my machine
be out of service?
† Every 12 months for fitting of service kits and
performance verification (takes a few hours, can be
done in theatre if available)

† Some machines may require 6 monthly

performance verification (1-2 hours)

† Some machines require major service at regular

intervals (eg yearly + 2 or 3 year maintenance kits)

† As faults arise if they pose a risk to patient safety -

will be removed from theatre
 What happens to the machine
during planned maintenance?
† Replace O-rings and gaskets, faulty or worn parts

† Replace batteries, if required

† Performance verification and any necessary

calibrations after repairs

† Any outstanding upgrades, modifications or recalls

† Clean equipment before returning to OTS

 What governs anaesthetic device
maintenance?
† Australian & New Zealand Standards
„ AS/NZS 3551 – Technical Management Programs for
Medical Devices
„ AS/NZS 3200.2.13 – Particular requirements for safety –
Anaesthetic Workstations

† ANZCA Professional Standards – attached to each

machine (who checks what and when)

† Manufacturers specifications

† ISO 9000 quality assurance standards if applicable

to the organisation
What tools are needed to conduct
maintenance?
† Hand tools

† Test equipment,
gauges and calibration
equipment

† Patient circuit tubing,

connectors, breathing
bags and sensors
Typical tools used for maintenance

† High and low flow

† High and low pressure

† Minute volume for

ventilator checking
Typical tools used for maintenance
† Low pressure for any
unit of measure

† High pressure (fitting

can fit all gas
connectors)
Typical tools used for maintenance
† Ancillary equipment
and calibration devices

† Patient circuits and

adaptors to suit test
equipment
Typical tools used for maintenance

† Calibrated gas
monitoring equipment
is as vital in
maintenance as it is
peri-operatively
 Summary - A useful toolkit …
† Selection of hand tools
„ Screwdrivers
„ Spanners
„ Dental picks for O rings
† Calibrated high and low flow meters
† Calibrated high and low pressure meters
† Calibration equipment
† Gas analyser
† Temperature sensor
† Assortment of patient tubes, connectors, bags etc.
† O ring lubricant (Teflon based)
† Store in a suitcase for convenience
Vaporiser maintenance
† Calibration should be done by NATA
accredited facility or equivalent

† Can be prohibitive to do in-house due to

cost and equipment

† To be done at regular intervals, as

stipulated as condition of a loan
agreement

† Performance verification should be done

annually with machine maintenance
 Vaporiser maintenance
Model Service Interval
Ohmeda Tec 5 Three years
Ohmeda Tec 4 One Year
Ohmeda Tec 3 One Year
Blease Datum & Datum ‘L’ 10 Years
(except Halothane models – 5 Years)
Penlon Sigma Delta 10 Years
(except Halothane models – 5 Years)
Penlon Sigma Elite Five Years
Penlon PPV Sigma Five years
MIE Vapamasta 5 & 6 One Year
Examples of what can go wrong
with anaesthesia machines …
† Indicators and remedies

„ Operator errors – procedural

errors or abuse
„ Failure of parts – agent
control
„ Externally induced faults –
water in medical breathing air
pipes
 Conclusion
† Anaesthesia machines are a vital component in the
OTS for surgery

† Good management of the maintenance plan will

allow more effective and efficient use of the
anaesthesia machine making it safer for the patient

† Maintenance can be conducted in-house, externally

or by manufactures and is governed by Standards

† A few general tools and some specific test

equipment is needed to conduct effective
maintenance to anaesthesia machines