Equipment

Adequate blood pressure is essential to maintain the blood supply and function of vital organs. Measurement of blood pressure is therefore a key part of the monitoring of patients during anaesthesia and critical care.Blood Pressure Measurement – June 1, 2000

This article focuses on the breathing systems used with plenum anaesthetic machines (those with a supply of pressurized gas); drawover apparatus will be described in a future article.Breathing Systems – December 1, 2008

Continuous flow anaesthetic machines date back to the first availability of compressed gases, and despite numerous modifications the modern apparatus retains many of the features of the original Boyle’s machine, a British Oxygen Company trade name in honour of the British anaesthetist H E G Boyle (1875- 1941). This article describes the basic principles of continuous flow apparatusContinuous Flow Anaesthetic Apparatus – The Boyle’s Machine – June 1, 1996

Decontamination of medical equipment involves the destruction or removal of any organisms present in order to prevent them infecting other patients or hospital staff. Decontamination reduces the risks of cross infection, helps to maintain the useful life of equipment and is important in the overall control of hospital acquired infection.Decontamination Procedures for Medical Equipment – December 1, 2008

This article describes the ways in which draw-over apparatus can be used to provide safe, high quality anaesthesia.Drawover anaesthesia Parts 2 and 3 (Update 3) – December 1, 1993

This paper discusses the equipment and role of drawover anaesthesia for the uninitiated ‘plenum anaesthetist’ while also delving into some of the finer aspects for experienced users.Drawover Anaesthesia Review (Update 15) – December 1, 2002

Cardiac arrhythmias during anaesthesia and surgery occur in up to 86% of patients. Many are of clinical significance and therefore their detection is of considerable importance. This article will discuss the basic principles of using the ECG monitor in the operating theatre. It will describe the main rhythm abnormalities and give practical guidance on how to recognise and treat them.ECG Monitoring in Theatre – June 1, 2000

An endotracheal tube introducer made of thick copper wire can be used to stiffen the tube during intubation. This may be of help during difficult intubations. An introducer can be easily made as described in this article.
Endotracheal Tube Introducer – Make Your Own – June 1, 1995

Oxygen supports combustion. Any flammable substance may become dangerous when exposed to an atmosphere of 100% oxygen and this effect is worsened either in the presence of high pressure or in the presence of heat. The following short report describes a life threatening incident that occurred during the handling of oxygen. It is written with the intention of demonstrating the danger we face when dealing with oxygen in the operating theatre.Explosion of an Oxygen Regulator – December 1, 2004

This article describes the principles behind and the clinical use of the fibreoptic intubating laryngoscope.Fibreoptic Intubating Laryngoscope – December 1, 2004

This article explains how fires and explosions develop and the precautions which, when acted upon, help to avoid this serious and sometimes disastrous event. Fires and Explosions in the Operating Room – December 1, 2008

The use of anaesthetic gases, such as nitrous oxide and volatile agents, within the closed environment of the operating theatre may lead to the chronic exposure of staff with potential adverse consequences on health. Certain agents, notably ether are potentially flammable and should not be allowed to accumulate. This article describes the component features of anaesthetic gas scavenging systems.Gas Scavenging in Anaesthesia – December 1, 2008

An anaesthetic machine suitable for use in poor-resource settings should be reliable, easy to understand and operate, economical to run, require minimal servicing which can be carried out locally and be versatile, so that the same machine can be used in all patients both as an anaesthetic machine in the operating room and as a ventilator in a recovery room or ICU. The Glostavent anaesthetic machine has been designed to fulfill these requirements.Glostavent Anaesthetic Machine – June 1, 2003

The HemoCue B-Haemoglobin analyser is a portable, rapid and accurate method of measuring haemoglobin at the bedside. It is particularly useful in acute clinical situations and as a guide for blood transfusion requirements. It is easily used by any healthcare workers after a short period of training.Hemocue Analyser – June 1, 2001

Few advances in anaesthesia have had such a dramatic impact as the introduction of the classic Laryngeal Mask Airway (cLMA) to anaesthesia in 1988. This was the first really effective alternative to facemask or tracheal intubation for airway maintenance during anaesthesia. The cLMA rapidly became the standard alternative to tracheal intubation and is the first of the modern supraglottic airway devices (SADs).Laryngeal Mask Airway – June 1, 2005

If laryngoscopes are looked after they will last for many years. this article descibes simple maintenance procedures to get the most out of your laryngoscope.Laryngoscope Maintenance – June 1, 1994

This is the first of two articles describing the maintenance of sphygmomanometers. The first deals with mercury type machines, and the second aneroid gaugesMaintenance of a Mercury Sphygmomanometer – June 1, 1993

The first article in this series (below) described the maintenance of a mercury sphygmomanometer, this article describes the maintenance of an aneroid blood pressure apparatus.Maintenance of an Aneroid Sphygmomanometer – December 1, 1993

Mechanical ventilation is the major invasive intervention offered in the ICU. In low income countries, where the facilities exist, it is appropriate that this therapy is only offered to patients suffering reversible critical illness. Mechanical ventilation (Update 28, 2012) – December 21, 2012

Compressed air is required in hospitals to operate surgical instruments such as pneumatic drills and saws. Air is also used to run ventilators and may be used as a carrier gas in anaesthesia. Medical Grade Compressed Air – June 1, 2001

One of the simplest and most reliable methods of detecting oesophageal intubation involves the use of an oesophageal detector device (ODD), the best alternative to capnography in differentiating oesophageal from tracheal intubation.Oesophageal Intubation Detector Devices – June 1, 1997

Oxygen concentrators provide an invaluable alternative to piped or cylinder oxygen and are reliable, relatively cheap and easy to maintain and service.Oxygen Concentrators – June 1, 1992

Oxygen is one of the most basic drugs we have. In many acute illnesses such as acute respiratory infections, asthma, fetal asphyxia, and shock the availability of an oxygen supply can save a patient’s life. Many small or remote hospitals have difficulty obtaining a reliable oxygen supply in cylinders because of logistical and cost factors. The advent of oxygen concentrators has contributing considerably to overcoming this deficiency.
Oxygen Concentrators for District Hospitals – June 1, 1999

Pulse oximetry is a simple non-invasive method of monitoring patients which can be used in a wide variety of circumstances, and in the face of limited resources. The pulse oximeter represents a wise choice of monitor since, with appropriate training, it allows assessment of several different patient parameters. The basic science principles, pitfalls and clinical use of pulse oximeters are discussed.Pulse Oximetry – Practical Applications – December 1, 2008

This article described the techniques available for monitoring gas and vapour levels in anaesthetic gas mixtures. The clinical implications of this are discussed.Respiratory Gas Analysis – December 1, 2008

This article deals with the problem of accumulation of materials inside the Oxford Miniature Vaporiser, which make it increasingly difficult to move the control pointer.Servicing a Seized Oxford Miniature Vaporiser – June 1, 2005

The Oxford Miniature Vaporiser is designed for drawover anaesthesia and rarely give problems. Occasionally the pointer becomes stiff to rotate due to deposits of thymol left behind by halothane.Sticking Oxford Miniature Vaporiser – Practical Tips – June 1, 1996

Using an endotracheal tube to secure a patient’s airway is still the gold standard. Most routine orotracheal or nasotracheal intubations are performed with the help of a laryngoscope that has a curved or straight blade. Other adjuncts such as external laryngeal pressure, a bougie, a stylet or a pair of Magill’s forceps may also be used.Tracheal Intubation Aids – December 1, 2003

This article should be read in conjunction with ‘Gases and vapours’. Several areas and concepts are duplicated but are retained for the benefit of an alternative explanation. Full coverage of the features of all vaporisers is clearly not possible, however the common underlying principles of their function are demonstrated using examples of widelyused devices. A clear understanding of the uses and pitfalls of vaporisers is essential for their safe clinical use.Vaporisers – December 1, 2008

This article is based on WHO information regarding the Haemoglobin Colour Scale which is a simple, reliable and inexpensive tool developed by the WHO to screen for anaemia in the absence of laboratory-based haemoglobin measurement.WHO Haemoglobin Colour Scale – December 1, 2002