Anesthesia with the UAM

1. ANESTHESIA WITH THE UAM
Gradian Health Systems
Simulation-Based Product Training
Version 2.0

2. Agenda
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UAM Simulation-based Training I Lecture Content | Anesthesia with the UAM
I. Anesthesia with the UAM
a. Induction
b. Manual Bellows
c. Controlled Ventilation & Spontaneous Breathing
d. Assessment
e. Ayre’s T-Piece

3. Anesthesia with the UAM: Induction
• Select 6-10 liters/minute
• Pre-oxygenate with mask
• Ensure the mask has a tight
seal
• Give intravenous or
inhalation induction
• During spontaneous
breathing, observe up and
down movement of bellows
• Operate bellows for
controlled ventilation
INDUCTION OF ANESTHESIA
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UAM Simulation-based Training I Lecture Content | Anesthesia with the UAM

4. Anesthesia with the UAM: Manual Bellows
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• Use flat of hand and thumb
o Use small pleats for children
o Use big pleats for adults
• Pull up to draw gas from
system
• Push down briskly to ventilate
• Operate only one side
• Give adequate tidal volumes
OPERATING THE BELLOWS

5. Anesthesia with the UAM
• Operate bellows
• Give adequate tidal volumes
• Match gas flow with IPPV
• Manage ventilation as normal
• Observe chest movement or
monitor carbon dioxide
CONTROLLED VENTILATION
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UAM Simulation-based Training I Lecture Content | Anesthesia with the UAM
• Match gas flow with
patient’s minute volume
• Keep reservoir bag half
full and observe bellows
movement
• Assist ventilation if
necessary
SPONTANEOUS BREATHING

6. Anesthesia with the UAM: Assessment
Gas flow equals patient
breathing (MV):
• Bag stays half full
• Bellows rises and falls
• No air enters system
BALANCING GAS SUPPLY
& PATIENT DEMAND
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UAM Simulation-based Training I Lecture Content | Anesthesia with the UAM

7. Anesthesia with the UAM: Assessment
BALANCING GAS SUPPLY
& PATIENT DEMAND
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UAM Simulation-based Training I Lecture Content | Anesthesia with the UAM
Gas flow less than patient's
breathing:
• Bag and bellows empty
• Air enters system and
oxygen concentration
falls
• Look at the patient
before adjusting flows
Use this to deliver < 95% O2

8. Anesthesia with the UAM: Assessment
Gas flow greater than patient is
breathing
• Bag fills
• Bellows rises
• Apnea alarm sounds: patient
not breathing enough
• Look at the patient before
adjusting flows
BALANCING GAS SUPPLY
& PATIENT DEMAND
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UAM Simulation-based Training I Lecture Content | Anesthesia with the UAM

9. Anesthesia with the UAM: Ayre’s T-Piece
• Attach to inspiratory outlet
• Pressurize circuit at start of use
• Select 6 L/min oxygen
• Bellows should be 2/3 inflated
• Up and down movement shows correct
forward flow of gas into ATP
• Give IPPV or allow spontaneous
breathing
• Do not cover hole at end of the green
bag as it releases the carbon dioxide
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UAM Simulation-based Training I Lecture Content | Anesthesia with the UAM
USING THE AYRE’S T-PIECE (ATP)