Anesthetic Pollution-Filling a Vaporizer in Use during Ventilation

Vaporization results in equilibration of liquid anesthetic in expanded space by transfer to gas phase. Amount of gas produced is related to the vapor pressure of the anesthetic.

Pour (top) and key types of filling devices.

Recommendations for filling vaporizers, machine assessment, patient connection, scavenging, and more.

Reasons and recommendations for training, service and monitoring practices to avoid pollution.

Concerns related to filling vaporizers and video of proper technique.

Review of vaporizer filling ports. Concerns noted related to improper identification.

Determination of inhalant level with suggestion for calculating remaining anesthetic time.

Circumstances when staff should consider wearing a filter mask to avoid anesthetic pollution exposure.

Recommendation for preferred locations in hospital to fill vaporizers.

Consideration of time of day and potential exposure of staff to inhalant during vaporizer filling.

Storage of filling devices (after used to pour inhalant). Use of a sealed container to avoid pollution.

Filling a vaporizer while in use (O2 flow on) requires special attention to avoid pollution.

Filling a vaporizer while using a ventilator requires special attention to avoid pollution.

Technical details on filling vaporizers. Videos of proper technique and dangerous spills.

Leaks in machines and circuits. Pressure testing and techniques for locating.

Intubation concerns - proper tube location, cuff inflation and timing of inhalant use.

Inhalant induction or mask maintenance concerns. Scavenge use. Hospital ventilation role.

POLLUTION-FREE ANESTHETIC MANAGEMENT

Home

Part I- Sources of Anesthetic Pollution

Part II- Awareness/Assessment

Vaporizers

Machine

Intubation

Other

Filling Technique

Basics

Vaporizer

Design

Need to fill

Safety Issues

Filters

Location

Timing

Sealing devices

Filling During Use

02 flow

Ventilation

Filling During Use | Ventilation

Place mouse over each step:

Put on mask
Turn vaporizer OFF
Attach filling device to bottle
Open filling port
Fill to FULL mark
Close port
Turn vaporizer back ON
Cap bottle
Seal filling device for storage

When the filling port is opened during positive pressure ventilation, a major spill will occur if the vaporizer is ON.

Inhalant is under greater pressure during positive pressure ventilation, than exerted by the O2 flow alone and this can result in a spray of liquid anesthetic from the vaporizer filling port if it is opened without turning off the vaporizer.

A dramatic spill has been staged to demonstrate the potential disaster when filling a vaporizer improperly during positive pressure ventilation.

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