Duties Anesthesia Assistant check lists and musts

INSTRUCTIONS FOR OPERATION ROOM ASSISTANTS (ORA)

Check-list I for Continuous Flow (Boyle’s Anesthetic Apparatus or any Anesthesia Machine) (see Fig. AIII.1)

•       All anesthetic apparatus must be checked before beginning of anesthesia.

•       A suitable resuscitation device (for example a self-inflating bag or bellows) to ventilate the lungs of the patient in case the gas supply fails should be available at all times.

Oxygen Supplies

For Machines Fitted with Cylinder Supply 

•       Turn on the oxygen supply from the cylinder in use and check the pressure (Full 2000 lb/in2)

•       Turn on the supply from the reserve cylinder, check the pressure and turn it off again

•       Check that a third cylinder is available to replace the cylinder in use when it is exhausted

•       Keep marker slip on the cylinders as ‘Full’, ‘empty’ or ‘inuse’.

For Machine Fitted with a Piped Gas Supply

•       Check the source of piped gas whether supply is on or not

•       Check that there is a full cylinder of oxygen fitted to your machine in case the pipeline supply fails.

Turn off All Machine Gas Supplies Except One Oxygen Cylinder or Pipeline Supply

•       Open all rotameters. Only oxygen should flow through oxygen rotameter tube

•       If this does not happen, do not use the machine.

If the Machine has an Oxygen-failure Warning Device

Test it as follows:

•       Turn on the gas supply from one oxygen cylinder (pipeline disconnected if fitted) and one nitrous oxide cylinder (if fitted)

•       Open rotameter taps to give a flow of oxygen and nitrous oxide of 5 litres/min

•       Turn off the oxygen supply at the cylinder. If a functioning warning device is fitted, an alarm should sound, and automatically nitrous oxide supply cuts off

•       After the test remember to open the oxygen cylinder valve again

•       Avoid using a machine that does not have a functioning oxygen-failure alarm

•       If there is no alternative, one must record the oxygen cylinder pressure every 5 min throughout anesthesia and change cylinders when the cylinder pressure drops below 220 psic

•       Never begin anesthesia with a machine that has only a single source of oxygen, i.e. only one cylinder or the pipeline.

Nitrous Oxide

•       Check the labels, keep reserve cylinder

•       The amount present in the cylinder can only be ascertained by weighing as the gas is in liquid form and the gas pressure above the liquid level remains reasonably constant as long as any liquid remains

•       Till the exhaustion of the cylinder, the pressure will show high. Only when all the liquid is vaporized, there will be drop in pressure

•       So keep a watch on the fall in pressure and the approxi­mate time a cylinder lasts

•       Cylinders should be labelled as “full”, “in use”, “empty.”

Rotameters

•       Inspect visually for cracks

•       Make sure that the bobbins do not stick in the tubes.

Emergency Oxygen

•       Turn on the emergency oxygen (bypass) button or tap

•       A high flow of oxygen should be delivered from the gas outlet

•       Note that this supply does not pass through the oxygen rotameter.

Vaporizer

•       Check that all vaporizers are firmly connected and filled with the correct anesthetic agent

•       Check that all filling ports are firmly closed and con­centration dials are set to zero

•       A Boyle’s bottle should have the lever in off position and the plunger pulled up.

Leaks

•       Check machine once a month for leaks or when you suspect. Apply suspected area with soapy water and watch for bubbles from suspected site

•       Possible site for leak are the joints, in the bag and breathing circuit.

Breathing System

•       Check for correct assembly.

•       Check the inner tube of bain circuit before each use.

Make Sure that You have

•       Face mask of suitable size

•       Oropharyngeal or nasopharyngeal airway of suitable size

•       Tested laryngoscope

•       Endotracheal tube of suitable size (test cuff by inflating)

•       Tested suction apparatus and suction catheters

•       Table or trolley that can be tilted head-down

•       All emergency and routine drugs

•           All electrical points to ventilator, monitors and suction apparatus to be checked for any loose contact

Any questions be sent to drmmkapur@gmail.com
All older posts arestored in archives for accrss and review.
Visitors thAt follow may post contributions to the site.
To create consumer/provider engagemrnt visit www.surgseminar.blogspot.com
www.drmmkaput.blogspot.com