i Essentials of Anaesthetic Equipment FOURTH EDITION
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iii Essentials of Anaesthetic Equipment FOURTH EDITION Baha Al-Shaikh FCARCSI, FRCA Consultant Anaesthetist, William Harvey Hospital, Ashford, Kent, UK Honorary Senior Lecturer, King s College London, University of London, UK Visiting Professor, Canterbury Christ Church University, UK Simon Stacey FRCA Consultant Anaesthetist, Barts and The London NHS Trust, London, UK Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2013
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Contents Preface Acknowledgements vii ix Chapter 1 MEDICAL GAS SUPPLY 1 Chapter 2 THE ANAESTHETIC MACHINE 19 Chapter 3 POLLUTION IN THEATRE AND SCAVENGING 45 Chapter 4 BREATHING SYSTEMS 55 Chapter 5 TRACHEAL AND TRACHEOSTOMY TUBES AND AIRWAYS 75 Chapter 6 MASKS AND OXYGEN DELIVERY DEVICES 99 Chapter 7 LARYNGOSCOPES AND TRACHEAL INTUBATION EQUIPMENT 111 Chapter 8 VENTILATORS 121 Chapter 9 HUMIDIFICATION AND FILTRATION 135 Chapter 10 NON-INVASIVE MONITORING 145 Chapter 11 INVASIVE MONITORING 177 Chapter 12 PAIN MANAGEMENT AND REGIONAL ANAESTHESIA 201 Chapter 13 ADDITIONAL EQUIPMENT USED IN ANAESTHESIA AND INTENSIVE CARE 219 Chapter 14 ELECTRICAL SAFETY 241 Appendix A CHECKING ANAESTHETIC EQUIPMENT 256 Appendix B RECOMMENDATIONS FOR STANDARDS OF MONITORING DURING ANAESTHESIA AND RECOVERY 258 Appendix C GRAPHICAL SYMBOLS FOR USE IN LABELLING MEDICAL DEVICES 263 Appendix D DECONTAMINATION OF MEDICAL EQUIPMENT 265 Appendix E LATEX ALLERGY 269 Appendix F DIRECTORY OF MANUFACTURERS 271 Glossary 275 Index 279
Preface Over 20 years ago, we conspired to write our colour equipment textbook Essentials of Anaesthetic Equipment. It is now in its fourth edition and hopefully as relevant to anaesthetic practice as ever. We have tried to keep the book concise, however due to the sheer number of new anaesthetic equipment products used in the clinical practice today, the size of the book has increased slightly. We have tried to freshen up the photography/diagrams wherever possible. The text has been updated too and single best answer questions have been included. We hope this book will continue to be the equipment book of choice for both the trainees sitting FRCA exams and their trainers and a useful reference tool for our Nursing and Operating Department Practitioner colleagues. BA-S Ashford, Kent SGS London 2013
Acknowledgements We are extremely grateful to the many manufacturers and others who have supplied the necessary information and images for this edition. Without their help, this fourth edition could not have gone ahead in its current format. Special mention goes to Andy Coughlan of Smiths Medical for his unflagging help with all things photographic. Below is a list of the people and their companies who helped us by providing images during the preparation of the book. We are also grateful to the association of Anaesthetists of Great Britain and Ireland for granting permission to reproduce their equipment checklist and monitoring recommendations. Molly Bruton (Vygon) Tony Calvo (Olympus) Emma Christmas (Gambro) Andy Coughlan (Smith s Medical) Inga Dolezar (Chart BioMedical) Bjrake Frank-Duab (Radiometer) Andrew Garnham (Penlon) John Jones (MAQUET) John van Kessel (B Braun) Vanessa Light (Philips Health Care) Sharon Maris (Teleflex) Lucy Martin-Davis (Verathon Medical) Anne Pattinson (Draeger) Mark Pedley (Blue Box Medical) Lee Pettitt (Rimer Alco) Ciska Proos (B Braun) Malcolm Pyke (Philips Heath Care) Siama Rafiq (BD Medical) Emma Richardson (Argon Medical) Rachel Stein (I-Flow) Frank Toal (B Braun) Jill Garratt (Zoll Medical)