[accordion open=”1″] [accordion-item title=”Tipping “]
  • If tipped more than 45 degrees from the vertical, liquid agent can obstruct valves.
  • Treatment: Flush for 20-30 minutes at high flow rates with high concentration set on dial. Please note that this is the recommended treatment for the TEC 4 vaporizer. The correct approach for other models differs, so their individual operating manuals must be consulted.
[/accordion-item] [accordion-item title=”Simultaneous inhaled agent administration”]
  • If removing the central vaporizer from a group of three on Ohmeda Modulus machine, move the remaining two so that they are adjacent. On models which were manufactured prior to 1995, removing the center vaporizer of three defeats the interlock, and allows the outer two vaporizers to be turned on simultaneously.
[/accordion-item] [accordion-item title=”Reliance on breath by breath gas analysis rather than preventative maintenance”]
  • Problem: failure of temperature compensation device may result in a rapid onset, high output failure on the vaporizer.
  • Failure of renewable components such as seals and O-rings may have the same effect.
[/accordion-item] [accordion-item title=”Overfilling”]
  • May be prevented by following the manufacturer’s guidelines for filling: fill only to the top etched line on the liquid level indicator glass, and fill only when the vaporizer is off (Anaesthesia 2002;57:288).
[/accordion-item] [accordion-item title=”Leaks”]
  • Leaks are relatively common, often due to malposition of vaporizers on the back bar (Anaesthesia 2002:57:229-300), or loss of gaskets, and these leaks may not be detected with the standard checklist unless the negative pressure check is performed.
  • TEC 6 vaporizers can also leak liquid while being filled, if the desflurane bottle is missing the white rubber ring near its tip. This can be mistaken for a defective vaporizer (Anesth Analg 2003; 96:1534-5).
[/accordion-item] [accordion-item title=”Electronic failure “]
  • As vaporizers incorporate electronics, they are susceptible to electronic failure. Two case reports detail ADU vaporizers failing due to “fresh gas unit failure,” and from copious emesis soaking the machine (Anaesthesia 2000;55:1214-5, Anaesthesia 2000;55:1215).
[/accordion-item] [accordion-item title=”Liability”]
  • If a third party is guaranteeing your vaporizers deemed perfect for surgeries after doing a routine efficacy test always ask, “Is your company carrying the product liability on this vaporizer?”
  • G.A.S. carries the product liability for three years from the date of installation.
  • What happens if there is a patient incident and the vaporizer is not under warranty with an anesthetic vaporizer service center? Whose liability is it, the person doing the efficacy testing on site or the hospital or purchasing group?
[/accordion-item] [accordion-item title=”Cost”]
  • Most of G.A.S.’ vaporizer service exchange is approximately $390.00. With this you get a three-year warranty, meaning G.A.S covers the product liability for the three years. After three years the vaporizer would need to be exchanged.
[/accordion-item] [accordion-item title=”How does vaporizer service/exchange work”]
  • The customer calls specifying the model, the agent, and the type of filler.
  • G.A.S. receives a P.O.
  • The vaporizer is shipped with the calibration certificate and a prepaid label to send the exchange back.
[/accordion-item] [accordion-item title=”Consequences of not maintaining vaporizers”]
  • Patient death.
  • Patient awareness (of surgery going on even though they cannot move or speak).
  • Regaining consciousness.
  • The vaporizer jams up and the surgery has to come to a halt.
  • The patient is injured – there is a mental or physical trauma.
[/accordion-item] [accordion-item title=”Safety features”]
  • Keyed vaporizers.
  • Low filling port.
  • Secured vaporizers.
  • Interlocks.
  • Concentration dial increases output when rotated clockwise.
[/accordion-item] [accordion-item title=”Vaporizer types”]
  • TEC 3, TEC 4, TEC 5, TEC 7, Draeger 19.1, Draeger 19.3 & Draeger 2000, Aladin Cassette – vaporizers are classified as variable bypass vaporizers.
  • Variable bypass is the fresh gas flow from the flowmeters, entering the inlet of a vaporizer that is “on”. The dial splits the gas flow into bypass gas which does not enter the vaporizing chamber and the carrier gas which flows over the liquid agent.
  • Carrier gas flows over the surface of the agent in the vaporizing chamber.
  • Therm – the therm is automatic and ensures steady vaporizer output over a wide range of temperature.
  • Variable bypass vaporizers are agent specific.
[/accordion-item] [accordion-item title=”Vaporizer preventative maintenance”]
  • This does not ensure that the vaporizer will not fail due to contaminated rotary valves or consumable parts cracking and drying up.
  • A full service and calibration takes hours.
  • Vaporizers are drained and dried up on drying out banks.
  • The dial is removed and the vaporizer screw is taken apart.
  • The wicks are changed.
  • All the O-rings are changed.
  • The therm is tested to make sure it is working properly.
  • The rotary valve is cleaned with new lubricant between the valves.
  • The vaporizer is put back together.
  • New dial strips and labeling is applied if needed.
  • The vaporizer is filled with agent and again leak tested.
  • The vaporizer is sent to the calibration room where it is attached to the laser refractometer and a computer to get the Calibration Report.
  • The vaporizer then goes to QA (Quality Assurance) before it is bagged and boxed and ready for shipment.
  • The warranty on a fully serviced and calibrated vaporizer is three years.
  • An efficacy test can check the tolerances onsite but this is a “ preventative maintenance.”
[/accordion-item] [/accordion]