Becoming familiar with the anesthesia apparatus for the anesthesiologist is one of its basic tasks, for which it requires not only knowing its operation, but the basic characteristics of its components being in accordance with safety standards, being the main work area of the anesthesiologist and at the same time allows you to choose and combine measured gases, vaporize exact amounts of anesthetic gases and therefore administer controlled concentrations of anesthetic mixture through the airways. Despite the diversity of anesthesia devices that are manufactured in the world, their functional aspects are practically similar; It can serve as a table for equipment, accessories and medicines, it has drawers to store whatever is necessary, as well as conservation and operation manuals.
Being the work area most frequented by the anesthesiologist, some characteristics must be observed such as construction materials, their resistance, placement of monitors, flow meters, their characteristics, oximeters, spirometers, pressure gauges, and lighting that should be indirect and diffuse so that indicators and alarms are easily located without large displacements of the anesthesiologist's head or eyes.
A little history
Initially the first devices for administering anesthesia were metal or glass vessels partially filled with diethyl ether or chloroform where the patient inhaled the vapors, increasing their evaporation surface by means of sponges, gauze, copper ducts or wide-surface containers. The chloroform was applied in known volumes in airbags, pumping air through the liquid without taking into account the patient's ventilation. The less potent nitrous oxide was inhaled directly from gasometers or oiled silk bags.
In 1903 Harcourt used unidirectional valves for the application of chloroform and applying heat could increase the vaporization of the liquid. The N2O was available in compressed form since 1880 by the dentist White of New England but its clinical application despite the advantages of compressed gases, was not used due to lack of reduction valves. Between 1910 and 1930 the inventions, research and scientific studies of several anesthesiologists revolutionized the design of anesthesia machines. Since 1930 the design and basic function of anesthesia devices is very similar to those used today, being its main characteristics, patient safety, built with increasingly better quality materials, development of vaporizers from the copper pot (1940) to those currently used.
How do these devices work?
Anesthesia machines are precision equipment with details of mechanics, engineering and electronics to ensure an exact amount of a gas that is predictable for patient safety. Anesthesia equipment consists of four important characteristics: a source of O2 and a form of CO2 removal, a source of anesthetic liquids or gases, and an inhalation system for what cylinders and their yokes require, adjustment valves, flow meters, pressure gauges and inhalation system to administer the anesthetic mixture to the patient's airways.
What gases do they use?
The gases currently used in anesthesia are O2, air and N2O; the hospital usually distributes them to the operating room through pipes; these may fail or the devices must be used in areas that do not have piping. Anesthesia devices have compressed gas cylinders of size E reserve; in some places that there is no source of central O2, the so-called godmother tank is used, which are of size G with pressures of 750 to 2000 psi (pounds per square inch) and by means of reducing valves are adjusted from 35 to 50 Psi, thus allowing use. They pass through safety self-control pipes, to suppress anesthetic gases if the O2 pressure is reduced, with audible alarms; then they pass through needle valves and flow meters to enter the vaporizers and pass to the patient. All equipment has O2 manual fast flow valves to quickly fill the circuit.
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