Skill 10 (1)

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Mechanical Engineering

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Jan 9, 2024

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Kathryn Fleming Externship 2 Student # 23306038 Skill 10 The anesthesia machine is a very important piece to any veterinary clinic/hospital, especially being able to maintain it. There can be daily, weekly, monthly and even yearly maintenance services that will need to be done. Some of these include but are not limited to checking for leaks, changing out the soda lime, filling the vaporizer, cleaning the machine, and basic routine checks. Doing these tasks will help keep the anesthesia machine working at its best, and lasting longer with less issues or concerns. Most anesthetic machines have a direct connection to an oxygen line. This should be checked at the beginning of each day to make sure the H tank is secured to the wall, and the E tank is secured to the anesthesia machine. At the end of the day make sure the oxygen tank is closed, or turned off to not waste any. You should change the oxygen tanks when they reach 500 psi or less. Some weekly maintenance steps that can also be daily, depending on how much you use the machine, are filling the isoflurane or sevoflurane as needed, identify when the soda lime is exhausted, and refill as needed, and also check the valves for any moisture; clean as needed. Look for tears or leaks, especially any dry rot or debris. All machines should have a scavenging system to help reduce waste and anesthetic gas exposure. Also make sure all lines, canisters, and containers are secured tightly and appropriately. Besides cleaning and refilling, you should also run pressure checks as maintenance. To start this, “Close the pop-off valve and occlude the patient end of the circuit with your thumb or palm.” (Firstline, 2019) Next step you will need to turn on the flowmeter to start airflow through the machine. Watch the pressure gauge and once it reads 20 centimeters, turn off the flowmeter. Proceed to wait a few seconds and if the system is set appropriately, the needle will stay in place. “If no leaks are present in the breathing system, the pressure should remain constant for at least 15 seconds.” (Firstline, 2019) If the needle starts to drop, then there is a leak somewhere in the system. Before rechecking the pressure system again, make sure all seals are cleaned from debris so you don’t have any inadequate seals. Also check the vaporizer; if it needs services/calibrated, this will be performed off-site by a separate service. Also if you used your thumb to cover the patient end of the breathing tube, maybe try using a rubber stopper or another rebreathing bag to make sure there is a tight seal and no leaks. Once you have a successful pressure check, the anesthetic machine will be ready after you set up the correct breathing system for your patient.

Depending on the patient you will either use a rebreathing (CBS) or non-rebreathing system (NRBS). Non-rebreathing systems are most commonly used in small patients, weighing less than 5-10kgs. Whereas rebreathing systems are used mainly on larger patients. With this system, gas will flow into the gas inlet on the breathing tube through the the inner tube, to the patient, then the patient exhales the waste gas through the outer tube to the reviver bag, from the reviver back the waste gas goes to the scavenger or f/air canister. “Non-rebreathing systems have no CO2 absorbent so all the exhaled gas must be eliminated. These circuits have minimal resistance or dead space.” (Dunlop, 2014) Because of this, the non-rebreathing system requires higher O2 flow which then increases the consumption and causes more waste of the anesthetic, which can be seen as a negative to using this system. With the rebreathing system, gas flows into the gas inlet on the machine itself, then flows through the inspiratory value, to the breathing tube, through the inner tube to the patient, then the patient exhales the waste gas through the outer tube to the inspiratory valve. The waste gas will go through the reviver bag to the CO2 absorber, then back to the fresh air intake to be recycled through. One benefit of this system is that it requires less of an oxygen flow rate, which will cause less anesthetic gas, meaning producing less waste gas. “Rebreathing circuits help keep patients warmer and help to retain moisture.” (Crump, 2017) Both have their pros and cons, but you should always do what is best for your patient. And always make sure your anesthetic machine is properly handled and maintained. Work Cited Crump, K. (2017, April 21). Rebreathing or non-rebreathing? . Making Anesthesia Easier. https://advancedanesthesiaspecialists.wordpress.com/2017/04/21/rebreathing-or-non- rebreathing/ Dunlop, C. (2014). Circuits for inhalation anaesthesia - WSAVA 2014 Congress - Vin . Powered By VIN. https://www.vin.com/apputil/content/defaultadv1.aspx? id=7054800&pid=12886 Firstline. (2019, December 16). Leaky anesthesia machine? how to check the breathing system . DVM 360. https://www.dvm360.com/view/leaky-anesthesia-machine-how-check- breathing-system

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