Contemporary Anaesthetic Equipments.An Aid for Healthcare Professionals. (1, #1) ebook

CONTEMPORARY

ANAESTHETIC EQUIPMENTS.

AN AID FOR HEALTHCARE PROFESSIONALS.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the copyright holder.

Copyright © Joshua  Jataunamo OSCAR

(RN, RM, RNAS, RNE, BNSc, PDGE, MSc, FWACN PhD)

First Published, 2023

ISBN: 978-1-304-99639-8

Noogul Digital Publishing

Table of Contents

ALL RIGHTS RESERVED

SECTION ONE:

EQUIPMENT’S USED IN ANAESTHESIOLOGY

Introduction

Medical Gas Supply

Cylinders

Pin index system

Pressure in the cylinders

Cylinder valve

Piped gas supply

Liquid oxygen

Oxygen Concentrator

Compressed Air

Pressure Gauge

Pressure regulator (Reducing valve)

Flow restrictor

Flowmeters

Vapourizers

Ideal vapourizers characteristics

Boyle's bottle/glass-ether vapourizers

Trichloroethylene vapourizer bottle

Goldman halothane vapourizer

Back bar

Oxygen supply failure alarm

Plenum vapourizers

Common gas outlet

Bag mount

Rebreathing bag

Corrugated Rubber Tube

Adjustable pressure limiting valve (Expiratory valve)

Face mask and angle piece

Anaesthetic Breathing System

Advantages:

Disadvantages:

Soda Lime

Conical neutralization of CO2

Baralyme

Absorbers

Water's 'to-and-fro' system

Circle breathing system

Vapourizer outside the circle breathing system

Vapourizer inside the circle breathing system

Mapleson Classification

Criteria for an Ideal Breathing System

Mapleson A System

Mapleson B System

Mapleson C System

Mapleson D System

Mapleson E System

Mapleson F System

Bain Circuit

Endotracheal Tubes and Airways

Endotracheal tubes

Length of the tube:

Type of cuff:

Oxford endotracheal tube

Armoured endotracheal tube

RAE (Ring, Adair and Elwyn) endotracheal tube

Laser resistant endotracheal tube

Micro laryngeal endotracheal tube

Tracheostomy tubes

Metal Tracheostomy Tubes

Double Lumen Endobronchial Tubes

Oropharyngeal Airway

Nasopharyngeal Airway

Laryngeal Mask Airway

Advantages:

Disadvantages:

Laryngoscopes

Endotracheal Tube Connections

Catheter Mount

Intubating Forceps (Magill)

Laryngeal Spray

Gum Elastic Bougie

Stylet

Ventilators

Options:

Summary

Bibliography

SECTION TWO:

ANAESTHETIC MACHINE

Components of Anaesthetic Machine:

Safety Devices incorporated in the anaesthetic machine

Explain uses of O2 in the Anaesthetic machine

Temperature Compensated Vaporizer

Temperature uncompensated vapourizer (Not temperature compensated)

Modern – Plenum Vapourizer Temperature compensated.

Signs of Electrolyte Imbalance

Peri Operative Embolism

Management: - Vasopressors, inotopes

Isoflurane

Side effect – Respiratory depression, low blood pressure

Uses:

Adverse Effect

Physical Properties: Molecular weight 184.5glmol

Mechanism of Action:

Premedication

Specific Indications:

Factors that Reduces Sedative Premedication

Summary

References

List of Figures

Figure 1: Cylinder Valve Flush Type

Figure 2: Pressure Gauge

Figure 3: Rotameter Unit

Figure 4: Boyles Ether  / Isofluorane Vaporiser

Figure 5: Goldman Vaporizer

Figure 6: Trilene Interlock Unit

Figure 7: A Bag Mount

Figure 8: Rebreathing / Reservoir Bag

Figure 9: Corrugated Rubber Tube

Figure 10: Expiratory Valve

Figure 11: Anaesthesia Face Masks

Figure 12: Face Mask Angle Piece Adaptor

Figure 13: Schimmelbusch Mask

Figure 14: Dr. Ralph Waters  To and Fro System Canister

Figure 15: Circle Carbon dioxide Absorber

Figure 16: Mapleson A Circuit

Figure 17: Mapleson B Circuit

Figure 18: Mapleson C Circuit

Figure 19: Mapleson D Circuit

Figure 20: Mapleson E Circuit

Figure 21: Mapleson F Circuit

Figure 22: Bain Circuit

Figure 23: Plain and Curved Endotracheal Tube

Figure 24: Oxford Non-kinking Endotracheal Tube

Figure 25: Latex Armoured Endotracheal Tube

Figure 26: Tracheostomy Tubes Cuffed and Uncuffed

Figure 27: Metal Tracheostomy Tubes

Figure 28: Double Lumen Endobronchial Tube

Figure 29: Phillips Airway

Figure 30: Water's Airway

Figure 31: Guedel Airway

Figure 32: Nasopharyngeal Airway

Figure 33: Laryngeal Mask Airway

Figure 34: Laryngoscope

Figure 35: Straight Bladed Magill Laryngoscope

Figure 36: Macintosh Laryngoscope Blades

Figure 37: Magill Connection Nasal and Oral

Figure 38: Cobb's Suction Union and Nosworthy Endotracheal Connection

Figure 39: Catheter Mount

Figure 40: Magill Forceps

Figure 41: Anaesthesia Gas Machine Ventilator

The anaesthetic machine enables to deliver gas and vapour mixtures to the patient accurately and continuously. The Boyle anaesthetic machine is designed by HEG. Boyle in 1915. Modern machine differs greatly in detail and modified time-to-time, but the basic principles remain the same. It consists of:

i.  Oxygen and anaesthetic gas supply

ii.  Pressure gauges

iii.  Reducing valves

iv.  Flow meters

v.  Vapourizers

vi.  Common gas outlet

vii.  Certain other features:

High flow oxygen flush, pressure relief valve, oxygen supply failure alarm, suction apparatus! Monitoring devices.

  Made of molybdenum steel to withstand high pressures

  Made of different sizes (A to J). Size E cylinders are used in the anaesthetic machine

  Oxygen is stored as gas at about 2000 lb/inch2 and nitrous oxide is stored in a liquid phase with vapour on the top at a pressure of 760 lb/inch2. It is 75% filled with liquid nitrous oxide Note: Filling ratio is the weight of fluid in the cylinder divided by the weight of water need to fill the cylinder.

  Cylinders are colour coded.

-  Oxygen: Black with white shoulders, green in some countries.

-  Nitrous oxide: Blue

-  Carbon dioxide: Grey

-  Entonox: Blue with white /bluequarters shoulder

-  Air: Grey with white/black quarters shoulder.

  Some markings engraved on the cylinders:  Test pressure, chemical formula, Tare weight,  dates of test performed, etc.

  Checking and testing by manufacturers at regular intervals:

-  Flattening test

-  Bending test

-  Impact test

-  Pressure test

-  Tensile test.

  Gases and vapour must be free from water vapour as it may freeze and block the exit port at a decreased temperature particularly when opening

  Cylinder valve provides pin index- system as a safety feature to make it almost impossible to connect a cylinder to a wrong yoke

  Should be stored in a dry, well-ventilated and fire proof room. Avoid dampness, corrosives and fumes nearby. No oil or grease or any other flammable materials or any source of heat ; should be allowed

  Full cylinders should be kept separately and should not be mixed with empty ones

  Avoid over pressurized full cylinders..

A specific pin configuration