ANESTHESIA MACHINE

By Dr. Shikha Shah

• An anesthesia workstation integrates most of the
components necessary for administration of
anesthesia into one unit.
• It consists of the
• anesthesia machine,
• vaporizers,
• ventilator,
• breathing system,
• scavenging system, and
• monitors.
• Added to this may be drug delivery systems,
suction equipment, and a data management
system.
 System components
• Electrical
• 1.Master Switch
• 2.Power Failure Indicator
• 3.Reserve Power
• 4.Electrical Outlet
• 5.Circuit Breakers
• 6.Data Communication Port
• Pneumatic
• High pressure system
• Intermediate system
• Low pressure system
 Electrical system
• Master Switch
Master (main power) switch activates both the pneumatic and electrical
functions . On most machines, when the master switch is in the OFF position,
the only electrical components that are active are the battery charger and the
electrical outlets.

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.
 Power Failure Indicator

• Most machines are equipped with a visual

and/or audible indicator to alert the
anesthesia provider to the loss of mains
power .
• The machine will usually give an indication
when mains power is lost.
 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.
 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.
 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
 Pneumatic system
• the pneumatic part of the machine can be
conveniently divided into three parts-
• high ,intermediate and low pressure systems
 The High-pressure System

• The high-pressure system receives gases from

cylinders at high, variable pressures and
reduces those pressures to lower, more
constant pressure suitable for use in the
machine
 Hanger Yoke

• The hanger yoke orients and supports the cylinder,

provides a gas-tight seal, and ensures a
unidirectional gas flow
 The hanger yoke is composed of several parts: The body,
which is the principal framework and supporting structure;
• the retaining screw, which tightens the cylinder in the yoke;
• the nipple, through which gas enters the machine;
• the index pins, which prevent attaching an incorrect cylinder;
• the washer, which helps to form a seal between the cylinder
and the yoke;
• a filter to remove particulate matter; and
• the check valve assembly, which ensures a unidirectional flow
of gas through the yoke
Hanger yoke assembly
 Body
• The body of the yoke is threaded into the frame of the
machine. It provides support for the cylinder.
 Commonly the swinging gate type is used.

 When a cylinder is mounted onto or removed from a yoke,

the hinged part can be swung to side.
 Retaining Screw

• The retaining screw (clamping device, retaining bar)

is threaded into the distal end of the yoke.
• Tightening the screw presses the cylinder valve
outlet against the washer and nipple so that a gas-
tight seal is achieved.
• The conical point of the retaining screw is shaped to
fit the conical depression on the cylinder valve .
Nipple

 It is a part of the yoke through which

the gas enters the machine.

 It fits into the port of the cylinder valve.

 If it is damaged, it may be impossible to

obtain a tight seal with the cylinder
valve
 Index Pins
• These are situated below the nipple.

• These help to prevent mounting of incorrect cylinder to yoke.

• The holes into which the pins are fitted must be of a specific
depth.

• If they extend too far into the body of the yoke, it may be
possible to mount a incorrect cylinder.
 Washer
• A washer (gasket) is placed around the nipple to
produce a seal between the cylinder valve and the
yoke. A washer is usually supplied with each full
cylinder.
• When a cylinder is fitted to a yoke, care should be
taken to ensure that the washer is present and in
good condition. A broken or curled washer should
not be used.
 Filter
• The anesthesia workstation standard requires that a
filter be installed between the cylinder and pressure
regulator or flow control valve to prevent particulate
matter from entering the machine.
 Placing a Cylinder in a Yoke
1.Cylinder valves and yokes not be
contaminated with oil or grease
2. Persons placing a cylinder in a yoke
should always wash their hands first
3. Pin Index Safety System pins are
present.
4.Retract the retaining screw.
5. The washer is placed over the nipple.
6.The cylinder is supported by the foot
and guided into place manually.

7. The port on the cylinder valve is guided over the nipple and the index
pins engaged in the appropriate holes.
8. The retaining screw is tightened .
9. Do not insert the screw in the safety relief device.
10. Make certain that the cylinder is full and that there is no leak.
 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.

• It allows an empty cylinder to be replaced with a full one

without having to turn off the `in–use` cylinder.

• 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 consists of a plunger that slides away from the side where
the pressure is greater. When cylinder pressure exceeds the
pressure on the machine side, the plunger is pushed to the
right, and gas passes around it and into the machine. When
machine pressure exceeds cylinder pressure, the plunger
moves to the left, blocking the gas flow.
• These check valves are not designed to act as permanent
seals for empty yokes and may allow a small amount of gas to
escape. To minimize such losses, a yoke should not be left
vacant. As soon as a cylinder is exhausted, it should be
replaced by a full one. If a full cylinder is not available, a yoke
plug (dummy cylinder block or plug, blanking cap or plug)
should be placed in the empty yoke
 Cylinder Pressure Indicator (Gauge)

• Displays the cylinder pressure for each gas supplied by

cylinders .
• The indicator may be located near the cylinders or on a panel
on the front of the machine.
• The scale must be at least 33% greater than the maximum
filling pressure of the cylinder or the full indication position.
• Many indicators are of the Bourdon tube (Bourdon spring,
elastic element) type.
• A hollow metal tube is bent into a curve, then sealed and
linked to a clocklike mechanism. The other end is connected
to the gas source.
• An increase in gas pressure inside the tube causes it
to straighten.
• As the pressure falls, the tube resumes its curved
shape. Because the open end is fixed, the sealed end
moves. These motions are transmitted to the
indicator, which moves over a calibrated scale.
• Gauges are required to be calibrated in kilopascals
(kPa) but pounds per square inch (psi) may also be
used.
 Safety features in Cylinder Pressure
Indicator
• Gauge is usually color coded.
• Name and symbol of gas are written over dial.
• If bourdon tube ruptures gas is vented from back side
• Gauges are angled and placed in such a way that it can be easily read by
anesthetist.
• Instructions like “use no oil’’
“open the valve slowly’’
are written on the gauge
 Pressure Regulators

 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.

 Physical Principle- A large pressure acting over a small area is

balanced by a small pressure over a larger area
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)
 Intermediate Pressure System

• The intermediate pressure system receives gases

from the pressure regulator or the pipeline inlet to
the anesthesia machine.
• Oxygen may enter the pneumatic components by
way of the master switch.
• When the master switch is turned OFF, the pressure
in the intermediate pressure system will drop to zero.
• The intermediate pressure system pneumatic components include
• the pneumatic part of
the master switch,
• pipeline inlet connections,
• pipeline pressure indicators,
• piping,
• the gas power outlet,
• oxygen pressure failure devices,
• the oxygen flush,
• additional pressure regulators (if so
equipped),
• and the flow control valves.
 MASTER SWITCH (PNEUMATIC
COMPONENT )
 The pneumatic portion of the master switch is located in the intermediate
pressure system downstream of the inlets for the cylinder and pipeline supplies

 The oxygen flush is usually independent of this switch.

 The master switch may be a totally electronic switch that when activated controls
the various pneumatic components in the anesthesia machine.

 When the master switch is turned off ,the pressure in the intermediate system will
drop to zero.
 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
 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 for the gases that they
monitor

• 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 the indicator were on the machine (downstream) side of the check
valve, it would not give a true indication of the pipeline supply pressure
unless the cylinder valves were closed. 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.
 Piping
• 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
• If the yoke and pressure reducing system are
included, the leakage may not exceed 150
mL/minute.
 GAS SELECTOR SWITCH
• Some machines have a gas selector switch that
prevents air and nitrous oxide from being used
together.
 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.
 Oxygen Pressure Failure Devices
• One of the most serious mishaps that occurred with early
machines was depletion of the oxygen supply (usually from a
cylinder) without the user awareness.
• The result was delivery of 100% anesthetic gas.
• Numerous inventions have been devised to prevent this
 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.
• 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 .
Delivers oxygen at 60 psig.
 Reported hazards associated with the oxygen flush include
• Accidental activation – causing oxygen-enriched gas mixture,
anaesthetic dilution
• The flush valve stuck in the ON position
• Barotrauma and awareness during anesthesia
• Internal leakage

• The anesthesia workstation standard requires that the

connection of the flush valve delivery line to the common gas
outlet be designed so that activation does not increase or
decrease the pressure at the vaporizer outlet by more than 10
kPa or increase the vapor output by more than 20%.
 FLOW ADJUSTMENT CONTROL
• Controls flow of gas through it’s associated indicator
by manual adjustment of a variable orifice
• Current standard requires that there be only one
flow control for each gas. It must be adjusted or
identifiable with its flow indicator
• Flow adjustment control,
shown in the closed position.
• Turning the stem creates a leak
between the pin and seat so that
gas flows to the outlet.
• The stop collar prevents
overtightening of the pin in
the seat
 Components
• Body
• The flow control valve body screws into the anesthesia
machine.
• Stem and Seat
• The stem and seat are shown in . The stem and seat have fine
threads so that the stem moves only a short distance when a
complete turn is made. When the valve is closed, the pin at
the end of the stem fits into the seat, occluding the orifice so
that no gas can pass through the valve.
 CONTROL KNOB
• Touch and colour coded

• Joined to stem

• Large enough to be turned easily

 ROTATORY STYLE KNOBS
• Oxygen knob- Fluted Profile, as large/ larger than any
other gas knob
• Knobs turned counter clockwise- increase flow
• Knobs turned clockwise- decrease flow
• All other knobs should be round
• Oxygen knobs must look and feel different than other
knobs
• They should operate smoothly
• Knob should not be over turned during closure because
further tightening may damage the pin/seat
• Problems with Flow Control Valves
• If the flow control valve knob is loose or worn, it may
respond to a light touch or even accidental brushing.
• Flow control valves should be closed when not in use.
If there is no yoke plug or cylinder in the yoke or the
one-way valve in the pipeline inlet does not work well,
gas from an unused gas system could flow retrograde
through a flowmeter with an open flow control valve
and leak to atmosphere.
• The stem or seat can block the flow
THANK YOU