This document provides information about the basic components and functioning of an anaesthesia machine. It discusses the key components of the machine's pneumatic and electrical systems. The pneumatic system includes the high pressure, intermediate pressure and low pressure systems which are responsible for delivering precisely controlled gas mixtures from pressurized cylinders or central pipelines. The electrical components power and monitor the machine. The document also provides details on cylinders, pressure regulators and other individual parts that make up the overall anaesthesia machine.
The anaesthetic machine (UK English) or anesthesia machine (US English) or Boyle's machine is used by anaesthesiologists, nurse anaesthetists, and anaesthesiologist assistants to support the administration of anaesthesia. The most common type of anaesthetic machine in use in the developed world is the continuous-flow anaesthetic machine, which is designed to provide an accurate and continuous supply of medical gases (such as oxygen and nitrous oxide), mixed with an accurate concentration of anaesthetic vapour (such as isoflurane), and deliver this to the patient at a safe pressure and flow. Modern machines incorporate a ventilator, suction unit, and patient monitoring devices.
The anaesthetic machine (UK English) or anesthesia machine (US English) or Boyle's machine is used by anaesthesiologists, nurse anaesthetists, and anaesthesiologist assistants to support the administration of anaesthesia. The most common type of anaesthetic machine in use in the developed world is the continuous-flow anaesthetic machine, which is designed to provide an accurate and continuous supply of medical gases (such as oxygen and nitrous oxide), mixed with an accurate concentration of anaesthetic vapour (such as isoflurane), and deliver this to the patient at a safe pressure and flow. Modern machines incorporate a ventilator, suction unit, and patient monitoring devices.
mapleson circuits used in anesthesia practice, are in their way out but it is as important to know the mechanism with which the gases flow to and fro through them.
The most common type of anaesthetic machine in use in the developed world is the continuous flow anaesthetic machine, which is designed to provide an accurate & continuous supply of medical gases(such as O2 & NO2)mixed with an accurate concentration of anaesthetic vapour(such as halothane,isoflurane)& deliver this to the patient at a safe pressure & flow.
Modern machine incorporate a ventilator,suction unit & patient monitoring devices.
mapleson circuits used in anesthesia practice, are in their way out but it is as important to know the mechanism with which the gases flow to and fro through them.
The most common type of anaesthetic machine in use in the developed world is the continuous flow anaesthetic machine, which is designed to provide an accurate & continuous supply of medical gases(such as O2 & NO2)mixed with an accurate concentration of anaesthetic vapour(such as halothane,isoflurane)& deliver this to the patient at a safe pressure & flow.
Modern machine incorporate a ventilator,suction unit & patient monitoring devices.
The anaesthesia gas machine is a device which delivers a preciselyknown but variable gas mixture, including anesthetizing and lifesustaining gases.
• Original Boyle was made by the firm COXTERS.
• There are several differences between newer and older anesthesia
machines.
• Advanced ventilators are the biggest difference between newer and
older gas machines.
Types Of Anaesthesia Machine
• Intermittent Anaesthesia Machine
-Gas flows only during inspiration
• Ex:-
• Entonox apparatus ,
• Mackessons apparatus
• Continuous Anaesthesia Machine
-Gas flows both during inspiration
and expiration.
• Ex:-
• Boyle Machine
• Forregar
• Dragger
• Medical gas supply system in hospitals and
other healthcare facilities are utilized to supply
specialized gases and gas mixtures to various
parts of the facility .
Supply of Medical Gases:
• From:
• Cylinders (Manifold)
• PIPED gas system
• Medical gases commonly
used:
• Oxygen
• Nitrous oxide
• Air
• Nitrogen
• Carbon Dioxide
Anaesthesia Workstation for Residents.
With High pressure, Mid and low pressure workstation.
Explaining the Gas delivery with respect to safety features of the machine.
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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The basic anaesthesia machine
1. THE BASIC ANAESTHESIA
MACHINE
Moderated by-
Dr.Dipika Choudhury
Prof. & Head
Presented by-
Dr.Hrishikesh Bharali,PGT
Deptt. of Anaesthesiology and Critical Care, GMCH
2. ANAESTHESIA MACHINE
• Anaesthesia machine is a device which delivers
precisely known but variable gas mixture, including
anaesthetizing and life sustaining gases.
• Standard guidelines have been given to
manufacturers for minimum performance, design,
characteristics and safety requirements of machine.
• The current standard for anesthesia workstation as
promulgated by American society for testing and
materials (ASTM) is F1850. European standard is
EN740
3. 3
Types of anesthesia machine
• Intermittent-Gas flows only during
inspiration
• E.g: Entonox apparatus
• Continuous-Gas flows both during inspiration
and expiration. E.g : Boyle Machine, Forregar
Dragger
4. History
• The original concept of Boyle's
machine was invented by the
British anaesthetist H.E.G.
Boyle in 1917
• 1920 – A vapourizing bottle
isincorporated to the machine.
• 1930 – Circle absorption system
was introduced by Brian Sword
• 1933 – A dry-bobbin type of
flowmeter is introduced.
• 1937 – Rotameters replaced dry-
bobbin type of flowmeters
• 1952-Pin index safety system
(PISS) by Woodbridge
5.
6. System components
Electrical Pneumatic
1.Master Switch
2.Power Failure Indicator
3.Reserve Power
4.Electrical Outlet
5.Circuit Breakers
6.Data Communication Port
1.High Pressure System
2.Intermediate System
3.Low Pressure System
7. Electrical Components
• Master Switch
Master (main power) switch activates both the
pneumatic and electrical functions .
•Standby position - allows
the system to be powered up
quickly
•Computer-driven machines should
be turned OFF and restarted with a
full checkout at least every 24
hours.
•STANDBY mode is not used for an
extended period.
9. Reserve Power
• Backup source of power for the occasional outage
is necessary.
• The anesthesia provider should check the battery
status during the preuse checkout procedure.
• While some older anesthesia machines used
replaceable batteries, most new machines use
rechargeable batteries.
• It usually takes a number of hours to fully
recharge a battery after it has completely
discharged.
10. Electrical Outlets
Most modern anesthesia machines have electrical
outlets.
These are intended to power monitors and other
devices.
As a general rule, these outlets should only be
used for anesthesia monitors.
Other appliances should be connected directly to
mains power.
Fig: Next to each outlet is a circuit breaker.
11. Circuit Breakers
• There are circuit breakers for both the anesthesia
machine and the outlets .
• When a circuit breaker is activated, the
electrical load should be reduced and the circuit
breaker reset
Data Communication Ports
Most modern anesthesia machines have
data communications ports.
These are used to communicate between
the anesthesia machine, monitors, and
the data management system
15. Pressure units to remember
100 kPa = 1000 mbar = 760 mm Hg =
1030 cm H2O = 14.7 psi = 1 atm
1 psi = 6.8 kpa
Psig = pounds per square inch gauge
16. BRIEF NOTE ON CYLINDERS
• Components:
Body
Valve – Port, stem
Handle
Pressure relief
device
Conical depression
Pin index safety
system
17. Body:
• Most medical gas cylinders are made of steel
with various alloys added
Molybdenum (0.15-0.25%)
Chromium (If + 0.8-1.1%)
used to increase strength and to minimise
weight and wall thickness
▫ MRI compatible cylinders are made of aluminium
18. • Walls of the cylinder vary from 5/64 to ¼ inch
thickness on an average
• Cylinders that have a marking 3AA are made
from steel. The marking 3AL or 3ALM indicates
that the cylinder is made from aluminium
• Cylinder have a flat or a concave base. The other
end may taper into a neck that is fitted with
tapered screw threads that attach to the cylinder
valve
19. Cylinder valves are of 2 types –
packed type and diaphragm type
Packed type:
•Capable of withstanding
high pressures
•A.k.a direct acting valve
•Stem is sealed by resilient
packing such as TEFLON
which prevents leaks
around the threads
•It is opened by 2-3 turns
•Used in most of the
cylinders
20. Diaphragm valve
• This valve uses a two piece stem separated by
non-perforated diaphragms. These diaphragms
prevent leakage along the valve stem.
• The lower part of the stem is encased in a
spring, which forces the stem away from the
seat when the valve is opened. The upper stem
is threaded into the diaphragm retainer nut.
• When the handwheel is rotated to the closed
position, the upper stem pushes on the
diaphragms, which deflect downward, forcing
the lower stem against the valve seat.
• Can be opened fully by ½ to ¾ turns
• Generally preferred when pressures are
relatively low and no leaks can be allowed
21. Port:
•It is the point of exit for the gas
It fits into the nipple on the hanger yoke of the
anesthesia machine
•When installing a cylinder on anesthesia
machine, it is important for the user not to
mistake the port for the conical depression
Stem:
Closes the valve by sealing against the seat.
When the valve is opened, the stem moves
upward,allowing the gas to flow to the port
22. Conical depression
▫ Conical depression is situated on the
opposite side of the port on the cylinder
valve and is situated above the safety relief
device
▫ It is present on those cylinders which are
designed to fit on anesthesia machine
▫ Conical depression is designed to receive
the retaining screw on the yoke of the
anesthesia machine
Screwing the retaining screw into the
port may damage the port
23. Pressure Relief Devices:
▫ Every cylinder is fitted with pressure relief devices
whose purpose is to vent the cylinder’s contents to
the atmosphere
if the pressure of enclosed gas increases
to dangerous levels
▫ Types:
Rupture Disc
Fusible Plug
Combination of Both
Pressure Relief valve (spring loaded)
24. Rupture Disc:
When pre-determined pressure is reached the disc
ruptures and allows the gas contents to be
discharged
It is a non- reclosing device held against an orifice
It protects against excess pressure as a result of high
temperature/overfilling
25. Fusible Plug:
It is thermally operated
It is a non-reclosing pressure relief device where the plug
is held against the discharge channel
It provides protection against excess pressure due to high
temperature but not overfilling
Woods metal alloy is most commonly used
YIELD TEMPERATURE: Temperature at which fusible
material becomes sufficiently soft to extrude from its
holder- so that cylinder contents are discharged
26. Spring loaded pressure relief device:
It is a reclosing device
When set pressure is
exceeded, the pressure
in the cylinder forced
the spring to open the
channel for letting out
the gases
27. Handle/ Handwheel:
▫ It is used to open or close a cylinder valve
▫ It is turned counter-clockwise to open and clock-
wise to close
this causes the stem to turn
▫ A good practice is to attach a handle to each
anesthesia machine or other apparatus for which
it may be needed
28. Color coding
GAS SHOULDER BODY
OXYGEN WHITE BLACK
NITROUS OXIDE BLUE BLUE
CYCLOPROPANE ORANGE ORANGE
CARBON DI OXIDE GREY GREY
AIR WHITE GREY
NITROGEN BLACK BLACK
ENTONOX WHITE BLUE
29. Pin Index Safety System
• It consists of holes on the cylinder
valve positioned in an arc below the
outlet port
A series of pins on the hanger yoke
is made to fit into the
corresponding indentations
• The seven hole positions are on the
circumference of a circle of 9/16
inch (14.3mm) radius centered on
the port
30. GAS PIN INDEX
AIR 1,5
OXYGEN 2,5
NITROUS OXIDE 3,5
NITROGEN 1,4
O2-CO2 (CO2 <7.5%) 2,6
O2-CO2 (CO2 >7.5%) 1,6
ENTONOX 7
31. Contents and Pressure
• In a cylinder containing a non-liquefied gas
Pressure declines as the contents are withdrawn
Hence pressure can be used to measure cylinder
volume(approximately)
32.
33. In a cylinder containing a liquified gas, the pressure
depends on VAPOUR PRESSURE of the liquid and is not
an indication of the amount of gas remaining in the
cylinder as long as the contents are partly in the liquid
state
Pressure remains nearly constant till all liquid has
evaporated
After which pressure declines till cylinder is
exhausted
34.
35. • Consists of:
– Hanger Yolk
– Check valve
– Cylinder
Pressure
Indicator
(Gauge)
– Pressure
Reducing
Device
(Regulator)
• Usually not
used, unless
pipeline gas
supply is off
36. Hanger Yoke Assembly
1) Orients and supports the cylinder
2) Provides a gas-tight seal
3) Ensures uni-directional gas flow
The workstation standard recommends that
there be at least one yoke each for
oxygen and nitrous oxide.
If the machine is likely to be used in
locations that do not have piped gases,
it is advisable to have a double yoke,
especially for oxygen.
37. • BODY:
Threaded into frame of
machine
Supports cylinder
Hinged Swinging gate
• RETAINING SCREW:
Threaded into the distal end
of yoke
Tightening the screw – gas
tight seal
Conical point fits into conical
depression on cylinder
• NIPPLE:
Projects from yoke and fits
into cylinder port
Entrance of gas into machine
38. • INDEX PINS
Component of pin
index safety system
4mm in diameter and
6mm long (except pin
7 which is slightly
thicker) .
Fit into the
corresponding holes
on the cylinder
39. • Bodok seal
• -cylinders are fitted with yoke with a sealing
washer called BODOK SEAL
• -it is made up of non combustible material and
has a metal periphery which make it long lasting.
• -it should be less than 2.4mm thick prior to
compression.
• -only one seal should be use between the valve &
yoke
Filter
It is used to prevent particulate matter from
entering the machine.
It is to be placed between the cylinder and
the pressure reducing device.
40. Bourdon Pressure gauge
• Displays cylinder pressure for each gas
• The gauge is usually colour coded and name and
symbol of gas are written over the dial. Blue colour for
nitrous oxide and white for oxygen.
• The scale must be at least 33% greater than the
maximum filling pressure of the cylinders or the full
indication position.
• Gauge is calibrated in (kilopascal)kPa or (pound per
square inch)psi or Kg/cm2 .
40
41. Check valve assembly
It allows gas from a cylinder to enter the machine
but prevents gas from exiting the machine when there
is no cylinder in the yoke.
Prevents transfer of gas from one cylinder to the
other with a lower pressure in a double yoke.
It consists of a plunger that slides away from the
side of the greater pressure.
It is not designed to act as a permanent seal for
empty yoke and may allow small amount of gas to
escape.
As soon as a cylinder is exhausted it should be
replaced by a full one or a dummy plug.
42. Pressure reducing device
The pressure in a cylinder varies. The anesthesia machine is fitted
with devices (reducing valves, regulators, reducing regulators,
reduction valves, regulator valves) to maintain constant flow with
changing supply pressure.
These reduce the high and variable pressure found in a cylinder to a
lower (40 to 48 psig, 272 to 336 kPa) and more constant pressure
suitable for use in an anesthesia machine.
The machine standard requires reducing devices for each gas
supplied to the machine from cylinders.
43. • BASIC PRINCIPLE
A larger pressure acting over a small area is
balanced by a smaller pressure acting over a
large area.
A1 x P1=A2 x P2
46. 46
Safety features on pressure
regulator
• Pressure regulators have safety relief valves
• If due to any reason there is build up of pressure
in pressure regulator then the safety valve blow
off at a set pressure of 525 k pa(70psi)
47. INTERMEDIATE
PRESSURE
SYSTEM
Begins at the regulated
cylinder supply source
at 45 psig includes the
pipeline sources at 50
to 55 psig and extends
to the flow control
valve.
48. INTERMEDIATE PRESSURE SYSTEM
• COMPONENTS
Pipeline inlet connections
Pipeline pressure indicators
Piping
Gas power outlet
Oxygen pressure failure devices
Oxygen flush
Additional pressure regulators
Flow control valves
49. PIPELINE INLET CONNECTIONS
It is the entry point for gases from the pipelines.
The anesthesia workstation standard requires pipeline inlet connections for
oxygen and nitrous oxide.Most machines also have an inlet connector for air.
These inlets are fitted with threaded non interchangeable Diameter Index Safety
System (DISS) fittings
A unidirectional (check) valve prevents reversed gas flow from the machine into
the piping system
Each pipeline inlet is required to have a filter with a pore size of 100μm or less.
The filter may become clogged, resulting in a reduction in gas flow.
50. PIPELINE PRESSURE INDICATORS
Indicators to monitor the pipeline pressure of each gas are required by
the anesthesia workstation standard.
They are usually found on a panel on the front of the machine and may
be color coded
The workstation standard requires that the indicator be on the pipeline
side of the check valve in the pipeline inlet.
If the indicator is on the pipeline side of the check valve, it will monitor
pipeline pressure only. If the hose is disconnected or improperly
connected, it will read “0” even if a cylinder valve is open
If a cylinder valve is open and the pipeline supply fails, there will be no
change in the pressure on the indicator until the cylinder is nearly
empty.
Pipeline pressure indicators should always be checked before the
machine is used. The pressure should be between 50 and 55 psig (345
and 380 kPa). The indicators should be scanned repeatedly during use.
51. • Piping is used to connect components inside the
machine
• It must be able to withstand four times the
intended service pressure
• Leaks between the pipeline inlet or cylinder
pressure reducing system and the flow control
valve not exceed 25 mL/minute
PIPING
52. GAS POWER OUTLET
• One or more gas power (auxiliary gas) outlets may
be present on an anesthesia machine. It may serve
as the source of driving gas for the anesthesia
ventilator or to supply gas for a jet ventilator.
Either oxygen or air may be used.
• The ventilator is an integral part of the modern
machine and the breathing system and is connected
to the ventilator with internal piping. Therefore,
the power outlet is not found in many anesthesia
machines today.
53. Oxygen Pressure Failure devices-
These includes-
• 1.Oxygen Failure safety devices- (Oxygen Failure
safety valve,low pressure guardian system, Oxygen
Failure protection devices, pressure sensor shutoff
system,fail safe,nitrous oxide shutoff valve)
• This valve shuts off or proportionally decreases and
ultimately interrupts the supply of nitrous oxide if
the oxygen supply pressure decreases.
• The anaesthesia workstation standard requires that
whenever the oxygen supply pressure reduced below
the manufacturer-specified minimum,the delivered
oxygen concentration shall not decrease below 19%
at the common gas outlet.
57. OXYGEN FLUSH
The oxygen flush (oxygen bypass, emergency oxygen
bypass) receives oxygen from the pipeline inlet or
cylinder pressure regulator and directs a high
unmetered flow directly to the common gas outlet.
It is commonly labeled “02+.”
On most anesthesia machines, the oxygen flush can
be activated regardless of whether the master
switch is turned ON or OFF.
A flow between 35 and 75 L/minute must be
delivered.
The button is commonly recessed or placed in a
collar to prevent accidental activation.
58. OXYGEN FLUSH
It consists of a button and stem
connected to a spring loaded ball .The
ball is in contact with the seat .When
the button is depressed, the ball is
forced away from the seat , allowing
the oxygen to flow to the outlet. A
spring opposing the ball will close the
valve when the button is not
depressed .
Hazards:
•May cause barotrauma
•Dilution of inhaled anaesthetic
•Accidental activation
•Flush may stick and obstruct flow of
gases from flowmeter
59. Second-stage Pressure Regulator
• Some machines have pressure regulators in the
intermediate pressure system just upstream of the flow
indicators
• Reduce the pressure further to around 26 psi (177 kPa)
for nitrous oxide and 14 psi (95 kPa) for oxygen
• The purpose of this pressure regulator is to eliminate
fluctuations in pressure supplied to the flow indicators
• By reducing the pressures below the normal fluctuation
range, the flow will remain more constant.
• Not all anesthesia machines are equipped with this
device.
62. Contd.
• It is advantageous to have stops for the OFF and
MAXIMUM flow positions. A stop for the OFF
position avoids damage to the valve seat. A stop for
the MAXIMUM flow position prevents the stem from
becoming disengaged from the body.
Control Knob :
• The control knob is joined to the stem. If it is a
rotary style knob, the oxygen flow control knob must
have a fluted profile and be as large as or larger than
that for any other gas. All other flow control knobs
must be round.
• The knob is turned counterclockwise to increase
flow. If other types of flow control valves are present,
the oxygen control must look and feel different from
the other controls.
63. Contd…..
When a machine is not being used, the gas
source (cylinder or pipeline) should be closed or
disconnected.
The flow control valves should be opened until
the gas pressure is reduced to zero and then
closed.
If the gas source is not disconnected, the flow
control valve should be turned OFF to avoid the
fresh gas desiccating the carbon dioxide
absorbent and to conserve gas.
Before machine use is resumed, the control
valves should be checked to make certain that
they are closed.