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Anaesthetic machine
Process type
physical change
Industrial sector(s)
anesthesia (medicine)
Main technologies or
vaporization
sub-processes
Feedstock
Product(s)
Leading companies
Main facilities
Inventor
Year of invention
16 October 1846
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 original concept of Boyle's machine was invented by the British anaesthetist Henry
Boyle (18751941) in 1917. Prior to this time, anaesthetists often carried all their equipment with
them, but the development of heavy, bulky cylinder storage and increasingly elaborate airway
equipment meant that this was no longer practical for most circumstances. The anaesthetic machine
is usually mounted on anti-static wheels for convenient transportation.
Simpler anaesthetic apparatus may be used in special circumstances, such as the TriService
Apparatus, a simplified anaesthesia delivery system invented for the British armed forces, which is
light and portable and may be used effectively even when no medical gases are available. This
device has unidirectional valves which suck in ambient air which can be enriched with oxygen from a
cylinder, with the help of a set of bellows. A large number of draw-over type of anaesthesia devices
are still in use in India for administering an air-ether mixture to the patient, which can be enriched
with oxygen. But the advent of the cautery has sounded the death knell to this device, due to the
explosion hazard.
Many of the early innovations in U.S. anaesthetic equipment, including the closed circuit carbondioxide absorber (aka: the Guedel-Foregger Midget) and diffusion of such equipment to
anaesthetists within the United States can be attributed to Richard von Foregger and The Foregger
Company.
In dentistry a simplified version of the anaesthetic machine, without a ventilator or anaesthetic
vaporiser, is referred to as a relative analgesia machine. By using this machine, the dentist can
administer a mild inhalation sedation with nitrous oxide and oxygen, in order to keep his patient in a
conscious state while depressing the feeling of pain.
Contents
[hide]
4 See also
5 References
6 External links
Pressure gauges, regulators and 'pop-off' valves, to protect the machine components and
patient from high-pressure gases
Flow meters (rotameters) for oxygen, air, and nitrous oxide, low Flow meters oxygen nitrous
oxide
Updated vaporizers to provide accurate dosage control when using volatile anaesthetics
such as isoflurane and sevoflurane
A manual ventilation bag in combination with an Adjustable Pressure Limiting (APL) valve
Systems for monitoring the gases being administered to, and exhaled by the patient
Systems for monitoring the patient's heart rate, ECG, blood pressure and oxygen saturation,
in some cases with additional options for monitoring end-tidal carbon dioxide andtemperature
an oxygen failure alarm (aka 'Oxygen Failure Warning Device' or OFWD). In older machines
this was a pneumatic device called a Ritchie whistle which sounds when oxygen pressure is 38
psi descending. Newer machines have an electronic sensor.
Nitrous cut-off or oxygen failure protection device, OFPD: the flow of medical nitrous-oxide is
dependent on oxygen pressure. This is done at the regulator level. In essence, the nitrous-oxide
regulator is a 'slave' of the oxygen regulator. i.e., if oxygen pressure is lost then the other gases
can not flow past their regulators.
hypoxic-mixture alarms (hypoxy guards or ratio controllers) to prevent gas mixtures which
contain less than 21-25% oxygen being delivered to the patient. In modern machines it is
impossible to deliver 100% nitrous oxide (or any hypoxic mixture) to the patient to breathe.
Oxygen is automatically added to the fresh gas flow even if the anaesthetist should attempt to
deliver 100% nitrous oxide. Ratio controllers usually operate on the pneumatic principle or are
chain linked (link 25 system). Both are located on the rotameter assembly, unless electronically
controlled.
the Pin Index Safety System prevents cylinders being accidentally connected to the wrong
yoke
the NIST (Non-Interchangeable Screw Thread) or Diameter Index Safety System, DISS
system for pipeline gases, which prevents piped gases from the wall being accidentally
connected to the wrong inlet on the machine
pipeline gas hoses have non-interchangeable Schrader valve connectors, which prevents
hoses being accidentally plugged into the wrong wall socket
The functions of the machine should be checked at the beginning of every operating list in a
"cockpit-drill". Machines and associated equipment must be maintained and serviced regularly.
Older machines may lack some of the safety features and refinements present on newer machines.
However, they were designed to be operated without mains electricity, using compressed gas power
for the ventilator and suction apparatus. Modern machines often have battery backup, but may fail
when this becomes depleted.
The modern anaesthetic machine still retains all the key working principles of the Boyle's machine
(a British Oxygen Company trade name) in honour of the British anaesthetist Henry Boyle. In India,
however, the trade name 'Boyle' is registered with Boyle HealthCare Pvt. Ltd., Indore MP.
[2]
[3]
An anaesthetic machine
The Anesthesia machine contains mechanical respiratory support (ventilator) and O2 support as well
as being a means for administering anesthetic gases which may be used for sedation as well as total
anesthesia. An anesthesia cart holds extra IV push meds for anesthesia, sedation and reversal,
extra equipment that the person giving anesthesia/sedation might need, and the hardware for
respiratory support and resuscitation.
See also[edit]
Ether Dome
References[edit]
1.
2.
3.
Jump up^ Baillie, JK; P. Sultan; E. Graveling; C. Forrest; C. Lafong (2007). "Contamination of anaesthetic machines with
pathogenic organisms".Anaesthesia 62 (12): 125761. doi:10.1111/j.1365-2044.2007.05261.x. PMID 17991263.
External links[edit]
Wikimedia Commons has
media related
to Anaesthetic machines.
History of Richard von Foregger and the Foregger Company written by his son, R.
Foregger, this website chronicles one of the leading manufacturers and developers of
anesthesiology equipment in the early 20th century.
Checking Anaesthetic machines
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