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Setting Up the Anaesthetic Equipment: Avoiding Disaster
E. Leece
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Many of the problems commonly encountered during equine anaesthesia can be prevented by simple equipment checks before starting the anaesthetic. In veterinary anaesthesia it appears that any emergency procedures, regardless of the patient’s health status, carries a higher risk of mortality than elective anaesthesia and perhaps one cause is a lack of thorough preparation.
At the beginning of each day it is worthwhile to check the oxygen cylinders and also the anaesthetic machine, including the breathing system. Flowmeters should be turned on and off and should have free movement. If a leak is present then it is difficult to maintain a stable plane of anaesthesia whilst causing pollution to the theatre environment. This is done by closing the APL valve and occluding the patient end. The fresh gas flow is increased to inflate the bag until a pressure of 20 cmH2O and then the fresh gas flow is turned off. The pressure within the circuit should be maintained if no leaks are present. If the pressure falls then a leak is present and needs to be identified before starting the anaesthetic. Various recommendations have been made for acceptable leaks (a fresh gas flow rate less than 0.25 l/min to maintain a pressure of 30 cmH2O or a pressure drop of less than 5 cmH2O in 30 s). The system can be pressurised higher by squeezing the reservoir bag and this is useful for identifying where any leaks are coming from (usually the soda lime canister or the bag). The APL valve can then be opened and the bag should deflate easily. [...]
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