The Anesthesia Machine

By: Tasew (BSc, MSc in

Anesthesia)

Department of Anesthesia
Nov , 2022
 Objectives
 At the end of this cession, students are able to:
 List the components of anaesthetic machines

 Understand the routes of gas delivery through the machine

with its system of pressure reduction.
 Perform routine anaesthesia machine check
 Aware Safety features of anaesthetic machine

 Explain types vaporizers with their advantage.

 Understand how the ventilators work & their advantages
 Discuss on the different AM
12/19/2022 types of filters and their 2
 Introduction

12/19/2022 AM 3
 Cont.…

12/19/2022 AM 4
 Why do we need an anaesthesia machine?

 Received compressed gases from their supplies

 To measure flow of gases
 Add vapours in known concentrations

 To deliver vapours and gases to patient via a breathing

system
 Scavenge waste gases
 To monitor patients

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 Cont.…

12/19/2022 AM 6
 Classification of Anesthesia machine:
 Intermittent flow machine: Gas flow only during inspiration
E.g. - Drawover machine
 Continuous flow machine: Gas flow both during inspiration
and expiration
E.g.- Boyle’s machine
- Anaesthesia Workstation

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 Draw over Anesthesia Machine:

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 Continuous flow machine:
• Original Continuous-flow Anaesthetic Machine designed by
Boyle a century ago.
• Most current anaesthetic machines derived from Boyles
Machine.

12/19/2022 AM 9
 Parts of anaesthesia machine

12/19/2022 AM 10
 Parts cont’d…

12/19/2022 AM 11
12/19/2022 AM 12
Measurement of pressure= Important Units
1 atm=14.7psi=1030cmh2O=1000mBar
=100kpa=760mmhg

12/19/2022 AM 13
 Pneumatic System:
 The Pneumatic part of the machine can be
conveniently divided into three parts: depending on the
pressure with in the machine
1. High-pressure system
2. Intermediate-pressure system, and
3. Low-pressure systems
 Cont.…

12/19/2022 AM 15
 Cont.…

12/19/2022 AM 16
 Note: the
The anaesthetic machine: a “circuit diagram” pressure of the
O2 flush is 4
O2 failure Bar
Wall alarm
supply

Oxygen
Pressure
! flush
Oxygen
cylinder regulator Rotameter
with needle
valve

13700 kPA (=137 Bar) FGF

or
50-60Psi (=4 Bar) CGO
16 Psi (=1Bar) Pressure
Vaporiser relief valve
12/19/2022 AM 17
 Cont.…

12/19/2022 AM 18
 Cont.…
o The pressure in the cylinder is 137 Bar; too high for the
anesthetic machine.
o The pressure is reduced to 4 Bar (Usually around 50 psig
-60psig) to protect the machine (it would still harm or
kill a patient).
o After the rotameters, the pressure is reduced to slightly
above atmospheric pressure (16psig or < 1/3 Bar) to
protect the PATIENT.
o This requires pressure regulators or pressure release
valves.
 I. The High-pressure System

1. Hanger Yoke
2. Cylinder Pressure Indicator (Gauge)
3. Pressure Regulators
 Hanger yoke: parts

Cylinder valve
washer
Pin index
safety system
Retaining screw

Anesthesia
machine
hanger-yoke
assembly
Gas cylinder
12/19/2022 AM 21
 Cylinder Pressure Indicator
(Gauge)

o Bourdon tube type indicators

(Commonest).
o The lowest pressure
indication is between the 6
o'clock and 9 o'clock
positions
Bourdon pressure gauge
 Cont.…

12/19/2022 AM 23
 Cont.…

12/19/2022 AM 24
 Pressure Regulators

o Pressure regulators and pressure release valves maintain a

constant pressure.
o Different regulators may protect the anesthetic machine
(providing 4 Bar) or the patient (by providing 1 Bar).
o These regulators do NOT limit flow; the pressure should
be the same whether the anesthetic machine is providing
15 L/min or is off.
o The pressure down-stream of a pressure regulator is NOT
dependent on the pressure up-stream (within wide limits)
i.e. the cylinder pressure can vary, but the down-stream
 Cont..

12/19/2022 AM 26
 Pressure

Spring (force F)
Diaphragm (area A)

High pressure Cont’d Constant low

in to regulator pressure ‘down-
stream’

Valve

-Gas enters the high pressure chamber and passes to the low pressure
chamber via the valve

-The pressure in the low pressure chamber exerts a force on the

diaphragm which is balanced by the spring (P = F / A)

-If the pressure is too low, the valve opens; if it is too high, it closes
II. Intermediate Pressure System
1. Master Switch (Pneumatic Component)
2. Pipeline Inlet Connections
3. Pipeline Pressure Indicators
4. Oxygen Pressure Failure Devices
5. Oxygen Failure Safety Device
6. Oxygen Supply Failure Alarm
7. Second-stage Pressure Regulator
8. Oxygen Flush
9. Flow Adjustment Control
10.Control Knob
12/19/2022 AM 29
Pipeline Inlet Connections

o Entry point for gases

from the pipelines.
o Inlet must contain a
unidirectional (check)
valve .
o Have a filter with a pore
size of 100 µm or less.
 Pipeline Pressure Indicators

o Should always be checked before the machine is

used (+ve tug test).
o Adequate pressure on the pipeline indicator
does not guarantee that gas is not being drawn
from a cylinder.
o Should be between 50 and 55 psig (345 and 380
kPa).
 Oxygen Pressure Failure Devices
o Depletion of the oxygen supply (usually from a
cylinder) results in delivery of 100% anesthetic gas.
o Machine standard requires that an anesthesia machine
be designed so that whenever the oxygen supply
pressure is reduced below normal, the oxygen
concentration at the common gas outlet does not fall
below 19%.
 Oxygen Pressure Failure Devices
• A Fail-Safe valve is present in the gas line supplying each of
the flow-meters except O2. This valve is controlled by the O2
supply pressure and proportionately decreases the supply
pressure of all other gasses as the O2 supply pressure
decreases.
• Historically there are 2 kinds of fail-safe valves:

1. Pressure sensor shut-off valve (Ohmeda)

2. Oxygen failure protection device (Drager)

12/19/2022 AM 33
 1. Pressure Sensor Shut-Off Valve
• Oxygen supply pressure opens
the valve as long as it is above
a pre-set minimum value (e.g..
20 psig).
• If the oxygen supply pressure
falls below the threshold
value, the valve closes and the
gas in that limb (e.g.. N2O),
does not advance to its flow-
12/19/2022 AM 34
 2. Oxygen Failure Protection Device (OFPD)

• Based on a proportioning
principle rather than a
shut-off principle.
• The pressure of all gases
controlled by the OFPD
will decrease
proportionately with the
oxygen pressure
12/19/2022 AM 35
 Limitations of Fail-Safe
Devices/Alarms
• These devices do not prevent hypoxia from accidents such
as pipeline crossovers or a cylinder containing the wrong
gas.
• These devices prevent hypoxia from some problems
occurring upstream in the machine circuitry (disconnected
oxygen hose, low oxygen pressure in the pipeline and
depletion of the oxygen cylinder).

12/19/2022 AM 36
 Limitations of Fail-Safe
Devices/Alarms:
• Equipment problems that occur downstream (for example
leaks or partial closure of the oxygen flow control valve) are
not prevented by these devices.

12/19/2022 AM 37
 Oxygen Supply Failure Alarm

 Usually 30 psig (205 kPa)

 At least a medium priority alarm shall be initiated within

5 seconds.
 It shall not be possible to disable this alarm.

 Oxygen failure safety device and alarm depend on

pressure and not flow, they have limitations.
 These devices do not offer total protection against a
hypoxic mixture being delivered.
 Second-stage Pressure Regulator

 Some machines have;

 Just upstream of the flow indicators.

 Reduce it further to around 26 psi (177 kPa) for nitrous

oxide and 14 psi (95 kPa) for oxygen.
 The purpose of this pressure regulator is to eliminate
fluctuations 2o to fluctuations in pipeline pressure.
 Cont.…

12/19/2022 AM 40
 Oxygen Flush
 Named as flush or emergency oxygen or by other numerous
names, this switch directs a high pressure flow of oxygen
direct to the CGO from the source, either pipeline or cylinder,
bypassing all intermediate meters and vaporizers. 
 Flush valves for gases other than oxygen are not permitted.
 Oxygen Flush can be activated regardless of weather machine
is turned on or off.
 Pressure delivered is 60 psig

12/19/2022 AM 41
Oxygen Flush……

o Commonly labeled “O2+.”

o A flow between 35 and 75
L/minute delivered.
o Hazards
1. Accidental activation
2. stick in the ON position
3. sticking and obstructing
4. Barotrauma and
5. Awareness=due to dilution
of Inhaled anesthetics
 Oxygen Flush……

12/19/2022 AM 43
 The oxygen flush:
=> This allows rapid filling of the circuit with oxygen
However caution is required:
=> The flush pressure is 4 Bar; it would cause severe
barotrauma (damage to lungs due to high pressure) – though
it is generally not transferred to the patient

=> It dilutes volatile agents in a circle circuit (since the O 2

does not go through the vaporiser)

Be CAUTIOUS if you use the oxygen flush, or

you may harm the patient
12/19/2022 AM 44
 Look where the flush is !!!
O2 failure
Wall alarm
supply

Oxygen
Pressure
! flush
Oxygen
cylinder regulator Rotameter
with needle
valve

13700 kPA (=137 Bar) FGF

or
50-60Psi (=4 Bar) CGO
16 Psi (=1Bar)
Pressure
Vaporiser relief valve
12/19/2022 AM 45
 Flow Adjustment Control

12/19/2022 AM 46
Components….

o Turning the stem creates a

leak between the pin and seat
so that gas flows to the outlet.
o The stop collar prevents over-
tightening of the pin in the
seat.
o Now on closed position.
 Control Knob
o Joined to the stem.
o The oxygen flow control knob must have a fluted profile
and be as large as or larger than that for any other gas.
o The flow control valves should be opened until the gas
pressure is reduced to zero and then closed.
o If the gas source is not disconnected, the flow control
valve should be turned OFF.
 Cont.…

12/19/2022 AM 49
 III. Low-pressure System

1. Flow-meters
2. Hypoxia Prevention Safety Devices
3. Pressure Relief Device

4. Common (Fresh) Gas Outlet

5. Vaporizer
6. Unidirectional valves
Flow-meters
o A: No gas flow.
o B: Gas enters at the base and
flows through the tube, causing
the indicator to rise.
o The gas passes through the
annular opening around the float.
o The area of this annular space
increases with the height of the
indicator.
o Thus, the height of the indicator
is a measure of gas flow.
Indicator

o The plumb bob and skirted

floats are kept centered in the
tube by constant rotation. The
reading is taken at the top.
o The ball indicator is kept
centered by rib guides. The
reading is taken at the center.
o The non-rotating float does
not rotate and is kept centered
by gas flow.
Cont’d

o Flow indicator sequence-

o A, B: Potentially
dangerous arrangements,
with the oxygen flow
indicator upstream. If a
leak occurs, oxygen will
be selectively lost.
 Cont…
o C, D: Oxygen is downstream from other gases, which is a
safer situation because anesthetic gas rather than oxygen will
be lost.

 Oxygen is the last gas to be added to circuit

 This reduce risk of only non oxygen gas reaching to patient.

12/19/2022 AM 54
 Flow indicators sequence (which is best?)

12/19/2022 AM 55
Hypoxia Prevention Safety Devices
o Sprockets are secured to the
stems of the oxygen and
nitrous oxide flow control
valves ( anti- hypoxic
device).
o A chain linking the
sprockets limits the
minimum oxygen
concentration that can be
set.
 Mechanism of working…

12/19/2022 AM 57
 Cont.…
 Links nitrous oxide and oxygen flows (mechanically,
pneumatically, or electronically) to prevent final inspired
oxygen concentration of less than 25% .

Ohmeda Link 25:

 A chain links nitrous oxide and oxygen flow control knobs,
allows either to be adjusted independently, yet automatically
intercedes to maintain a minimum 1:3 ratio of oxygen to
nitrous oxide.

12/19/2022 AM 58
 Pressure Relief Device:
o Device near the common gas outlet to protect the machine and
patient from high pressures.
o This valve opens to atmosphere and vents gas to atmosphere if
a preset pressure is exceeded.
o May limit the ability of an anesthesia machine to provide
adequate pressure for jet ventilation.
o Not recommend that the common gas outlet be used to
provide jet ventilation.
o Some machines offer a connection from the pipeline or
intermediate pressure system for a jet ventilation device.
 Common (Fresh) Gas Outlet:

o Receives all of the gases and vapors from the machine

and delivers the mixture to the breathing system.
o Will accept a tracheal tube connector.
o Some new anesthesia machines provide two common gas
outlets.
 Cont.…
o A hazard with this arrangement is that the fresh gas may be
directed to the wrong outlet.
o Standard states that there shall be only one functional common
gas outlet at a time.
o An interlock prevents both outlets from being inadvertently
operative at the same time.
o The common gas outlet should not be used to administer
supplemental oxygen to a patient.

12/19/2022 AM 61
Reading Assignment
Oxygen Analyzers???

General anesthesia should not be administered without

an oxygen analyzer in the breathing circuit.
Three types of oxygen analyzers are available:
- polarographic
-Clark electrode,
-galvanic (fuel cell), and
-paramagnetic

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Vaporizers:
 Vaporizers

12/19/2022 AM 64
 Vaporizer
• -Is an instrument designed to:-
o Used at ambient temperatures between 18- 30 ⁰c.

The role of vaporizers

 To add a clinically useful concentration of anaesthetic
vapour to a carrier gas.
 To produce a controlled and predictable concentration
of anaesthetic vapour.
 Ideally independent of carrier gas flow rate.
 Ideally independent of AM
12/19/2022 temperature . 65
 Basic concepts
Latent heat of vaporisation:
 Energy is needed to convert a substance from a liquid state into vapour or
gas
Vapour pressure
 Partial pressure exerted by molecules escaping from the surface of a
liquid to form a vapour
 Raising the temperature of a liquid  increased molecular energy 
increased tendency for molecules to escape the liquid  increased
vapour pressure
Saturated vapour pressure (SVP)
 The vapour pressure exerted by the vapour phase of a substance
in equilibrium with the liquid phase.
 It is determined by the temperature.

12/19/2022 AM 66
 SVP indicates the volatility of the liquid anaesthetic in
the carrier gas.
 After equilibration, the concentration of highly volatile
anaesthetics gas will be higher than that of poorly
Cont’d
volatile anaesthetics.
 An anaesthetics with a higher SVP requires a smaller
proportion of the total gas to pass through the
vaporising chamber to produce a given concentration.
 This explains why different volatile agents need
different vaporisers.
Rate of vaporization

Depends on:-

1. The volatility of the liquid

2. The temperature of the liquid.
3. The temperature of gas flowing over the
liquid.
4. The flow rate of gas.
5. The area of contact b/n the gas and liquid.
6. The shape and vol. of the space above the
liquid.
 Factors affecting vaporiser output:
Gas flow rates: - By varying the ‘splitting ratio’, the vaporiser output
is controlled
For example, at high flow rates, the gas leaving the vaporising
chamber will tend to be less saturated (since the gas spends less
time in the chamber), so the output of the vaporiser will tend to fall
Temperature:
-As SVP increases, vaporiser output will tend to increase

Ambient pressure:
-SVP is solely a function of temperature

 Therefore, if ambient pressure is reduced, the (constant) SVP

becomes a greater proportion of the total pressure, and the
output concentration rises
12/19/2022 AM 69
 Cont.…
Carrier gas composition
 The composition of the carrier gas may affect vaporiser
output by: 

- Changes in the viscosity and density of the gas mixture

affecting the proportion of the total flow that passes
through the vaporising chamber 
- Nitrous oxide dissolving in the anaesthetic, thus altering
the effective volume that passes through the vaporising
chamber.

12/19/2022 AM 70
 Classification
 Historic ( old design) Vs Modern design vaporizer

 Variable bypass vaporiser Vs measured flow vaporizer

 Vaporiser in circle (VIC) Vs out of circle (VOC)

 Calibrated or uncalibrated

 Plenum vaporisers Vs draw-over vaporisers

12/19/2022 AM 71
 Cont...
Modern=Dragger and Ohmeda
Old=Copper Kettle and Vernitrol
Vaporizer:
-Variable bypass -Measured flow
-Temperature compensated -Non temperature compensated
-Agent specific -Multiple agent
-Out of circuit -Out of circuit

Vaporizer Interlock System

-Only 1 vaporizer can be turned on

-Gas enters only the “on” vaporizer
-Leak of trace gas is minimized
-Vaporizers are locked into the circuit
12/19/2022 AM 72
 Variable bypass vaporiser

 There are two main types of variable bypass vaporiser,

1. Plenum vaporizer
2. Draw-over vaporizer
 Cont.…

o A: In the OFF position, all of

the inflowing gas is directed
through the bypass.
o B: In the ON position, gas
flow is divided between the
bypass and the vaporizing
chamber.

12/19/2022 AM 74
 Measured flow vaporiser

– This vaporiser has a chamber in which the VA is heated by

an electrical element to produce pure vapour under
pressure.
– This type of device is used for desflurane
 Vaporiser in circle (VIC) Vs out of circle (VOC)

 Vaporiser in circle (VIC):

 Vaporiser is placed within the circle
 Oxygen enters the breathing circuit from the flow meter
 Either in circle or at CGO
 Low resistance vaporiser required
 High concentrations are possible →safer in spontaneous ventilation
(because respiration will decrease with excess agent and draw less
agent in)
 Vaporiser out of circle(VOC)
 Localized between flow meter and CGO
 Oxygen from the flow meter enters the vaporizers prior to entering the
breathing circuit
 Generally uses plenum vaporiser, but draw-over vaporisers can be used
 Concentration of volatile agent within the circle is less than that dialled on
the vaporiser output, due to dilution with exhaled gas
 Concentration Calibration
 Nearly all the vaporizers in use today.
 Also called direct-reading, dial-controlled, automatic plenum,
percentage-type, and tec-type vaporizers.
 Vaporizer output is controlled by a single knob or dial that is
calibrated in volumes percent.
 Designed to be located between the flowmeters and the
common gas outlet on the anesthesia machine.
 They are not designed to be used between the common gas
outlet and the breathing system or in the breathing system,
because they are not calibrated for the high gas flows that
occur with the oxygen flush.
12/19/2022 AM 77
Plenum vaporisers Vs draw-over vaporisers

Drawover vaporiser:
 gas is pulled through the vaporizer by negative or low
positive pressure.
 low resistance.

Plenum vaporiser:

 gas pass through vaporiser under pressure at the back bar.

 high resistance ; must be outside circuit.

12/19/2022 AM 78
 Cont...

Plenum vaporisers
• Gas passes through vaporiser under pressure at the back bar
• High resistance; must be outside-circuit
• Generally two types:
– Simple plenum vaporizer
– Precision plenum vaporisers
 Simple plenum vaporisers

 They consist of a glass vaporising chamber holding the

volatile agent
 A tap controls the proportion of gas passing through the
chamber
 The major advantage is their relatively low cost
 The vaporising chamber may contain a wick to improve
vaporisation
 Cont.…
 Disadvantages of simple plenum vaporisers
 No compensation is made for changes in temperature:
 The concentration leaving the vaporising chamber is usually
unknown
 Also, higher gas flow rates will tend to lower the
concentration further,
 The variable output means these are generally not calibrated
 Adjustments are made according to the response of the patient
 The delivered concentration will also be reduced over time,
 Cont.…

12/19/2022 AM 82
 Precision plenum vaporisers

 Channels and wicks inside ensure the gas is fully saturated

with volatile (at SVP)
 Compensatory mechanisms for temperature and gas flow
 The proportion of the total gas flow passing through the
vaporising chamber is controlled by a dial which accurately
indicates the concentration of the anaesthetic delivered by the
vaporiser

• Precision plenum vaporisers

• Precision plenum vaporisers
  Precision plenum vaporisers: temperature compensation
(1) A heavy copper construction acts as heat sink  minimises

temperature fluctuations.
(2)Compensation for temperature changes: a valve varies the
proportion of the gas that flows through the vaporising
chamber.

12/19/2022 AM 84
  Precision plenum vaporisers……..

 Other design and safety features:

 Stable mechanical mounting

 Clear liquid level gauge
 Safeguards against leakage if
tilted
 Interlock system
 Agent specific filling ports

12/19/2022 AM 85
 Advantages of precision plenum vaporizer:
 Highly accurate
 independent of time, gas flow rate
and temperature
Disadvantage:

 expensive
 built for use with specific agent
 high internal resistance prevents them from being
used in the breathing circuit.

12/19/2022 AM 86
 Briefly about Desflurane vaporisers
o Desflurane is extremely volatile (the boiling point of 22.8°C is only
slightly above room temperature)
o A desflurane vaporiser is totally different from others

o The desflurane is heated and then “injected” into the carrier gas as a
spray
12/19/2022 AM 87
 Fillers

• Vaporisers may be filled by a conventional funnel-fill mechanism or with a

key-filler system

• Isotec 4 vaporiser with funnel-filler

• Isotec 4 vaporiser with key-filler

• Key-filler vaporiser inlet Key-filler vaporiser bottles
 Hazards
 Incorrect agent

 Tipping

 Over/under filling

 Reversed flow

 Control dial in wrong position

 Cont.…

 Leaks

 Contamination

 Physical damage

 No vapor output

12/19/2022 AM 91
 Ventilators (reading Assighement)
Function:
 provide mechanical ventilation of lungs during
anesthesia by creating a positive pressure gradient
between the upper airway and the alveoli.

Ventilation cycle consists of 4 phases:

-Inspiration- active phase - positive pressure
-Transitional phase => between inspiration and
expiration
-Expiration => passive phase
-Transitional phase -between expiration and
inspiration
12/19/2022 AM 92
 Classification:
=> How the tidal volume is delivered by producing gas
flow along a pressure gradient.
Either by ;
-Constant flow: Constant flow generator or
-Constant pressure: Constant pressure generator
Power source:
- compressed gas, electrical or both (bellows ventilators require
both);
- piston ventilators do not require driving gas.
Drive mechanism :
– Bellow ventilators are classified as double-circuit,
pneumatically driven.

-Double-circuit means that a pneumatic force compresses a

bellows, which empties its contents (gas from flow meters
and vaporizer) into the patient.
-Driving gas is oxygen
12/19/2022 AM 93
 Bellow Ventilators

12/19/2022 AM 94
 Humidification and filtration

12/19/2022 AM 95
 Humidifiers

Humidity: basic concepts

 Absolute humidity:
 Absolute humidity is defined as the weight of water
vapor in 1 L of gas (ie , mg/L).or mmHg (partial
pressure)
 Relative humidity:
 Relative humidity is the ratio of the actual mass of
water present in a volume of gas to the maximum
amount of water possible at a particular temperature

12/19/2022 AM 96
12/19/2022 AM 97
12/19/2022 AM 98
Cont.…

Normal physiological humidification:

Normal humidity in the airways

Mouth breathing
At carina;36 °C
=> 60% - 70% saturated with water

Nasal breathing
At nose; 30 °C

At carina;36 ° C
=> 80% - 90% saturated with water
largely due to nasal transfer

-If totally dry gases were inspired and fully saturated gases exhaled, the total water loss
from ventilation at rest would be about 300 ml/day in the average adult.
12/19/2022 AM 99
Cont.…

Why humidify?

 For prevention of cilial damage and reduced drying of secretions

 Cilia paralysis and reduced rates of mucus flow occur below 50%
relative humidity at 37 °C.

 For microbial filtration

-Some heat moisture exchangers incorporate

viral/bacterial filters

12/19/2022 AM 100
Cont.…

Disadvantages of humidification?

 Disconnection - Increase the component count

 Circuit resistance increases

 Dead-space increases

12/19/2022 AM 101
Humidification and filtration
Types of humidifier:
(1) Anaesthetic circuits:
-There is some heat and water transfer in breathing circuits

(2) Nebulisers:
• Results in an inhaled aerosol of 100% relative humidity
• Lower than room temperature => increases heat loss rather than reducing it.
• Water uptake may be excessive

(3) Active heated humidifiers:

-Container with a thermostatically controlled heating element and tubing
with water traps;
-Expensive and complex to use
-Infection hazard
-Potential for burns and drowning

(4) HMEFs: -Heat & moisture exchange filter

12/19/2022 AM 102
Humidification and filtration
 Heat and moisture exchange filters (HMEFs:)

 Cheap
 Disposable
 Modified hygroscopic paper filters encased in a plastic case
 50% to 80% moisture efficiency at best (depending on inspired humidity)
 Almost as effective as the human nose
 Provide enough humidification to maintain ciliary action and mucus flow and
to reduce heat and moisture losses during anaesthesia to insignificant levels
 Also act a microbiological filters

12/19/2022 AM 103
Cont.…
Filters: function:
 Minimise transmission of bacteria or viruses
Note: 86% bleeding of after intubation; site of transmission

 They protect:
-patient
-breathing circuit
-anaesthetic machine
-ventilator

 Can also have a humidification role

12/19/2022 AM 104
Cont.…
Filters: ideal characteristics:

-Efficient (99.99% removal or better)

-Minimal dead-space
-Minimum resistance to gas flow
-Unaffected by anaesthetic agents
-Effective if wet or dry
-Light weight
-Disposable
-Humidifies as well
-Transparent
-Cheap

12/19/2022 AM 105
Safety Features of a Modern Anesthetic Machine
Color-coded pressure gauges

Color-coded flowmeters

An oxygen flowmeter controlled by a single touch-

coded knob

Oxygen is the last gas to be added to the mixture

Oxygen concentration monitor or analyzer

Nitrous oxide is cut off when the oxygen pressure is low

email: tadaelz3@gmail.com
12/19/2022 phone: +251904932767 106
 Cont.…
 O2: N2O ratio monitor and controller

 Pin index safety system for cylinders and

noninterchangeable screw thread (NIST) for pipelines
 Alarm for failure of O2 supply

 Ventilator disconnection alarm

 At least one reserve O2 cylinder should be available

on machines that use pipeline supply
email: tadaelz3@gmail.com
12/19/2022 phone: +251904932767 107
 TAKE-A HOME MESSAGE
 Check all equipment before use
 Never use less than 30% oxygen
 Always use oxygen analyzer
 Know your specific equipment
 Never leave the theatre while your patient is under
anesthesia

12/19/2022 AM 108
 THANK U!

12/19/2022 AM 109