Technology Topics 2005

CA1 - CA40 focus

BWH Anesthesia Clinical ConferenceAugust 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

Fresh Gas Flow decoupling

Exhaled tidal volume feedback

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Compensation for Compliance

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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

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Sample Gas Return (SGR) and LeaksOlder 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

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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

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ALTITUDE EFFECTS ON VAPORIZERS

Concentration Delivery Vaporizers and Flowmeters

Partial Pressure Delivery Vaporizers

Approximate Partial Pressure Delivery Vaporizers

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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

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

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Negative Pressure Leak Test (NPLT)

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Draeger Fabius Alarms can be confusing

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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

Just say “no” to 100% O2 Cal

21% is necessary and sufficient

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Fabius has a Water Trap

Between Ventilator and Breathing Circuit

Water condenses here

Keep it empty

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Anesthesia Department Web Site

http://etherweb.bwh.harvard.eduAnd navigate to Education / Educational Resources / Technology Matters

Or go directly tohttp://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

All this pre-use check and use info is on

Thank you