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Our New Anes Machines

Technology Topics 2005 CA1 - CA40 focus BWH Anesthesia Clinical Conference August 31, 2005 James H. Philip, MEE, MD, CCE © Copyright 2005, James H Philip, all rights reserved. Our New Anes Machines. Three Ventilator types at BWH. Old fashioned Bellows movement control

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Our New Anes Machines

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  1. Technology Topics 2005 CA1 - CA40 focus BWH Anesthesia Clinical ConferenceAugust 31, 2005James H. Philip, MEE, MD, CCE© Copyright 2005, James H Philip, all rights reserved

  2. Our New Anes Machines

  3. Three Ventilator types at BWH • Old fashioned Bellows movement control • Fresh Gas Flow decoupling • Exhaled tidal volume feedback More

  4. Compensation for Compliance More

  5. Four Gas Sensor Technologies at BWH • Turbine Flow Sensor • Hot wire Anemometer Flow Sensor • Differential pressure across an orifice Flow Sensor • Ultrasonic Flow Sensor - MR-compatible More

  6. Sample Gas Return (SGR) and Leaks • Older Ohmeda Anes Machines (Ohmeda Modulus 2 and SE) have • SGR connected to CO2 Absorber port • specific port is on Absorber but functionally in Expired Ckt Limb • connection is marked Expiratory Airway Pressure • Ohmeda Aestiva and Draeger Fabius have added adapters for SGR • SGR connector is chrome and connected to CO2 Absorber Exp limb • SGR can sometimes be connected to Scavenger Interface More

  7. CHARCOAL ANESTHETIC AGENT ABSORBERS • Charcoal Absorbers can remove volatile agents from effluent gas • Outlying Anesthetizing Locations need innovative scavenging • Charcoal Absorbers absorb 50 g anesthetic • Charcoal Absorbers absorb almost same amount that vaporizer delivered More

  8. ALTITUDE EFFECTS ON VAPORIZERS • Concentration Delivery Vaporizers and Flowmeters • Partial Pressure Delivery Vaporizers • Approximate Partial Pressure Delivery Vaporizers More

  9. FABIUS REQUIRES PRESS ROTARY KNOB TO CONFIRM - be careful! • Draeger Fabius requires you press Rotary Knob to confirm vent settings • Ohmeda Smart-Vent allows you to confirm Rotary Knob or original Select button • Beware, Beware, Beware • This is a challenge to all of us

  10. OXYGEN RATIO CONTROL DIFFERES AMONG MACHINES • Ohmeda Anes Machines (Ohmeda Modulus 2 and SE) • Hidden Chain links O2 and N2O needle valves • Draeger Anes Machines (Fabius, Tiro, Narkomed, Future) • Flow changes by itself when other flow is adjusted More

  11. Negative Pressure Leak Test (NPLT) More

  12. Draeger Fabius Alarms can be confusing More

  13. Pre-Use Check Documents are available • Every machine has its machine-specific pre-use check list attached • Pre-Use Check is usually on chain at right back corner of Anes Machine • Pre-Use Checks vary slightly from model to model • Draeger Fabius is very different and included automatic ventilator calibration • Documents (Microsoft Word) are available several places

  14. Just say “no” to 100% O2 Cal • 21% is necessary and sufficient More

  15. Fabius has a Water Trap • Between Ventilator and Breathing Circuit • Water condenses here • Keep it empty More

  16. All this pre-use check and use info is on Anesthesia Department Web Site http://etherweb.bwh.harvard.edu And navigate to Education / Educational Resources / Technology Matters Or go directly to http://etherweb.bwh.harvard.edu/education/resources/anes_tech.php Special thanks to Anes IS TeamJamie Bell, Dan Holtzman, Fred Donovan, Athena Dimas, and new Director, Bob Gimlich

  17. Thank you

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