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Anaesthesiology
Additional equipment used in anaesthesia and intensive car
Built from Al-Shaikh — Essentials of Equipment in Anaesthesia, Critical Care and Peri-operative Medicine, 6e
What’s inside
11 sections · 106 slides
Overview
- What this deck covers
Continuous Positive Airway Pressure
Holding the lungs open in a breathing patient
- What CPAP is, in plain terms
- Why it improves oxygen levels
- CPAP breathing system set-up
- The parts of a CPAP system
- How CPAP works
- Adding a second pressure level: BiPAP
- Problems and safety points
Haemofiltration
Bedside kidney support for the critically ill
- The core idea: ultrafiltration
- Why intensive care loves it
- Continuous haemofiltration machine
- The components
- Haemofilter set: filter, tubing and collecting bag
- How it works: driving the fluid across
- Venovenous haemofiltration circuit
- Flows, filtrate and replacement fluid
- What the filter is like
- Anticoagulation and safety
Blood Gas Analysis
Measuring oxygen, carbon dioxide and pH with electrodes
- Getting the sample right
- Blood gas analyser
- Measured versus calculated values
- Blood gas electrode reactions
- pH relationship expression
- Clark (polarographic) oxygen electrode: parts
- How the oxygen electrode works
- Oxygen electrode mechanism
- The pH electrode
- pH electrode mechanism
- pH definition equation
- Key learning-point marker
- Carbon dioxide (Severinghaus) electrode
- Carbon dioxide electrode mechanism
Cardiac Support Devices
The intra-aortic balloon pump and the defibrillator
- Intra-aortic balloon pump: the idea
- Intra-aortic balloon pump in the aorta
- Components of the balloon pump
- Balloon pump console
- Inflation and deflation timing
- Balloon pump effect on the arterial waveform
- What the pump achieves, and why helium
- When to use the balloon pump
- When not to use it, and its risks
- Defibrillator: what it does
- Automated external defibrillator
- Manual defibrillator
- Why direct current, and how it is made
- Defibrillator electric circuit
- Delivering the shock to the heart
- Monophasic versus biphasic shocks
- Defibrillator waveforms
- Monophasic versus biphasic performance
- Implantable cardioverter defibrillator (ICD)
- Implantable cardioverter defibrillator
IV Access, Fluids and Warming
Giving sets, cannulae and fluid warmers
- Intravenous giving sets
- Intravenous giving sets
- Paediatric giving sets
- Intravenous cannulae
- Cannula gauge and flow rate
- Range of intravenous cannulae
- Safety cannula with needle guard
- Closed-system integrated cannula
- Blood and fluid warmers
- Coaxial fluid warmer
- Rapid fluid warmer
- Forced-air warmers
- Forced-air warming blanket system
Chest Drain
Draining air and fluid from the pleural space
- What a chest drain does
- Seldinger chest drainage kit
- Inserting the drain
- Chest drain underwater seal
- Reading the underwater seal
- Safety points
The Ultrasound Machine
Seeing beneath the skin with sound
- What ultrasound is
- Ultrasound machine
- How the image is made: the piezoelectric effect
- Display modes and getting a good picture
- Ultrasound probes
- Gain, and telling vein from artery
Cell Saver (Red Cell Salvage)
Giving the patient back their own blood
- What the cell saver does
- Cell salvage machine
- Components and collection
- How the cells are washed and returned
- Cell saver schematic
- What is lost, and cautions
ECMO
Extracorporeal membrane oxygenation: a bedside heart-lung machine
- What ECMO is
- When ECMO is used
- Two types of ECMO
- Components and how it runs
- Problems and safety features
Summary and Key Points
Pulling the equipment together
- The big picture
- High-yield exam facts
- References
- Why is direct current (DC), not alternating current (AC), used for defibrillation?
- How does an air bubble in an arterial blood gas sample distort the result?
- Why must a chest drain never be clamped when there is a continuing air leak?
- Essentials of Equipment in Anaesthesia, Critical Care, and Perioperative Medicine