Indian journal of anaesthesia
-
Anaesthesia is one of the few sub-specialties of medicine, which has quickly adapted technology to improve patient safety. This application of technology can be seen in patient monitoring, advances in anaesthesia machines, intubating devices, ultrasound for visualisation of nerves and vessels, etc., Anaesthesia machines have come a long way in the last 100 years, the improvements being driven both by patient safety as well as functionality and economy of use. Incorporation of safety features in anaesthesia machines and ensuring that a proper check of the machine is done before use on a patient ensures patient safety. This review will trace all the present safety features in the machine and their evolution.
-
The main purpose of this review article is to bring up what has been known (practiced) about decontamination, disinfection, and sterilisation of anaesthetic equipment. It also discusses how this evidence-based information on infection prevention and control impacts care of patient in routine anaesthesia practice. This review underscores the role played by us, anaesthetists in formulating guidelines, implementing the same, monitoring the outcome and training post-graduate trainees and coworkers in this regard. ⋯ For this review, we conducted literature searches in Medline (PubMed) and also searched for relevant abstracts and full texts of related articles that we came across. There is much to be learned from the western world where, health care organisations now have legal responsibility to implement changes in accordance with the newer technology to reduce health care associated infection. There is a need to develop evidence-based infection prevention and control programs and set national guidelines for disinfection and sterilisation of anaesthesia equipment which all the institutions should comply with.
-
Invention of oxygen cylinder was one of the most important developments in the field of medical practice. Oxygen and other gases were compressed and stored at high pressure in seamless containers constructed from hand-forged steel in1880. Materials technology has continued to evolve and now medical gas cylinders are generally made of steel alloys or aluminum. ⋯ The type of valve varies with cylinder size. Small cylinders have a pin index valve while large have a bull nose type. Safety features in the cylinder are: Color coding, pin index, pressure relief device, Bodok seal, and label attached etc., Safety rules and guidelines must be followed during storage, installation and use of cylinders to ensure safety of patients, hospital personnel and the environment.
-
The technical advancement in the anaesthesia workstations has made the peri-operative anaesthesia more safer. Apart from other monitoring options, respiratory gas analysis has become an integral part of the modern anaesthesia workstations. Monitoring devices, such as an oxygen analyser with an audible alarm, carbon dioxide analyser, a vapour analyser, whenever a volatile anaesthetic is delivered have also been recommended by various anaesthesia societies. This review article discusses various techniques for analysis of flow, volumes and concentration of various anaesthetic agents including oxygen, nitrous oxide and volatile anaesthetic agents.
-
Mapleson breathing systems are used for delivering oxygen and anaesthetic agents and to eliminate carbon dioxide during anaesthesia. They consist of different components: Fresh gas flow, reservoir bag, breathing tubes, expiratory valve, and patient connection. There are five basic types of Mapleson system: A, B, C, D and E depending upon the different arrangements of these components. ⋯ For adults, Mapleson A is the circuit of choice for spontaneous respiration where as Mapleson D and its Bains modifications are best available circuits for controlled ventilation. For neonates and paediatric patients Mapleson E and F (Jackson Rees modification) are the best circuits. In this review article, we will discuss the structure of the circuits and functional analysis of various types of Mapleson systems and their advantages and disadvantages.