PS31 2014: Anaesthesia machine check

List:

· Introduction

· Level system

· Level 1 check

· Level 2 check

· Level 3 check

Introduction:

Premise	· Anaesthesia machines are complex · Many ways they can malfunction · Malfunction can cause injury and death · Frequent checks are required
Goals	· Power · Oxygen · Anaesthetic · Safe pressure

Level system:

	Occurrence	Responsibility	Training location
Level 1	After services and repair	Technician	Manufacturer’s course
Level 2	Before each list	Nurse delegate	Hospital
Level 3	Before each case	Anaesthetist	Hospital

Level 1 check:

· Electrical safety

· Gas delivery

· Inhaled anaesthetic delivery

· Ventilator

· (IV anaesthetic pump)

Level 2 check:

High pressure	· Wall: o Check screw connection o Check pressure · Oxygen cylinder: o Check yoke connection o Check pressure (= fullness) o Turn on and off
Low pressure	· Flowmeters: o Watch each bobbin move o Ensure 100% N2O is impossible · Vapourisers: o Check seating and interlock o Ensure tank full and port sealed o Test for leak · Breathing system: o Auto + manual – leak at 30cmH2O with 0.3L/min o Resistance and compliance o APL valve spill · Mechanical ventilator: o Test disconnection alarm o Test high pressure alarm · Scavenging system: o Check connections o Check flow rate o Ensure no blockage · Bag-mask ventilator and sucker
Monitoring	· Carrier gas analysis · Anaesthetic vapour analysis
Other	· Airway equipment · IV anaesthetic pump: power, connections, delivery
Final check	· Turn vaporisers off · Purge circuit with oxygen
Documentation	· Name · Date · Result

*Level 2 check is particularly to detect obstruction of the expiratory limb (= gas trapping)

Level 3 check:

· Vapouriser (if changed)

· Breathing system (if changed)

· IV anaesthetic pump

· Suction

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