Outpatient Surgery Magazine

Manager's Guide to Surgery's Ambulatory Anesthesia - July 2015

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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4 4 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E J U LY 2 0 1 5 1. Flow meters Flow meters set the levels of nitrous oxide, oxygen and air, as well as the per- centage of inspired oxygen and total gas flow for the patient. In older models, this was regulated with manual flow control valves that set gas distribution based on a provider's manual calculations. New machines, though, do all of this electronically. The latest models include a system that acts like a computer to automatically determine relative gas flows. You use a digital screen to select the amount and mixture of gas you want and let the machine do the heavy lifting. For example, if you want to achieve 50% inspired oxygen in the fresh gas mixture, you input that into the system. The machine then determines how much of the second gas (either air or nitrous oxide) must be mixed in to reach that 50% concentration. There are other benefits to electronic flow meters. Compared to mechanical valves, new electronic machines require less maintenance or calibration, and can be integrated into your EHR system. Importantly, new machines have mechanical backup valves that can continue the delivery of oxygen to patients if power is lost. 2. Vaporizer The machine's vaporizer adds exact amounts of volatile anesthetic to the fresh gas flow. Fresh gas is divided as it enters the machine. Part of it enters the vaporizer, which mixes the gas with the anesthetic vapor. This mixture then joins back with the other part of the fresh gas flow before entering the patient's breathing circuit. Previously, anesthesia providers manually controlled this split- ting ratio using a dial to adjust the amount of anesthetic a patient would get. Now, sensors inside the electronic vaporizer determine the splitting ratio auto- matically based on the provider's desired amount and report that electronically. Some of the latest vaporizers can even precisely inject liquid volatile anesthetic into the fresh gas flow, much like the fuel injection system in your car. Compared to older models, these electronic vaporizers are extremely accurate

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