(仅供参考)麻醉机 协和
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conforms to current and relevant standards includes ：
an ascending bellows ventilator； the following monitors:
capnograph, pulse oximeter, oxygen analyzer, respiratory volume monitor, breathing system pressure monitor with high and low pressure alarms.
bag with O2 flush. 5. Set O2 flow to minimum, other gas flows to zero. 6. Verify that during inspiration bellows delivers
appropriate tidal volume and that during expiration bellows fills completely.
Monitors
Check, Calibrate and/or Set Alarm Limits of all Monitors
Capnograph - Pulse Oximeter -O2 Analyzer Respiratory Volume Monitor (Spirometer)Pressure Monitor with High and Low Airway Pressure Alarms
reservoir bag to collapse completely and verify that absorber pressure gauge reads about zero. e. With the O2 flush activated, allow the scavenger reservoir bag to distend fully, and then verify that absorber pressure gauge reads < 10 cm H2O.
4 Test Flowmeters
a. Adjust flow of all gases through their full range, checking for smooth operation of floats and undamaged flowtubes.
b. Attempt to create a hypoxic O2/N2O mixture and verify correct changes in flow and/or alarm.
Unidirectional valves & accessories
1. Exercise breathing circuit accessories to ensure proper function.
2. Turn ventilator OFF and switch to manual ventilation (Bag/APL) mode.
undamaged and unobstructed. c. Verify that CO2 absorbent is adequate. d. Install breathing circuit accessory equipment (eg,
humidifier, PEEP valve) to be used during the case.
将挥发性麻醉药的消耗量减少到最低
III. 提供呼吸（Breathing）
避免无意的重复吸入 病人能够自主呼吸
T管系统
缺点：需要较大的新鲜气流量（FGF） FGF≧2~3倍 MV
Mapleson系统
较T管系统相比 FGF得以一定 程度降低；
为了防止病人重 复吸收，仍需 要较高的FGF、 且不易确定
a. Close flow control valves and turn vaporizers off.
b. Check fill level and tighten vaporizers' filler caps.
Low Pressure System
2 Perform Leak Check of Machine Low Pressure System
3. Ventilate manually and assure inflation and deflation of artificial lungs and appropriate feel of system resistance and compliance.
4. Remove second breathing bag from Y-piece.
a. Verify that the machine master switch and flow control valves are OFF.
b. Attach "Suction Bulb" to common (fresh) gas outlet. c. Squeeze bulb repeatedly until fully collapsed. d. Verify bulb stays fully collapsed for at least 10 seconds. e. Open one vaporizer at a time and repeat "c" and "d"
呼吸机（from手控 to 机控）
挥发罐（from呼吸机 to 麻醉机）
麻醉呼吸环路
基本内容
1. 麻醉机基本原理（step by step）
2. 麻醉机使用
1) 使用前检查 2) 参数设定
3. 常见问题
FDA Anesthesia Apparatus Checkout Recommendations, 1993
1. Place a second breathing bag on Y-piece. 2. Set appropriate ventilator parameters for next
patient. 3. Switch to automatic ventilation mode. 4. Turn ventilator ON and fill bellows and breathing
as above.
f. Remove suction bulb, and reconnect fresh gas hose.
Low Pressure System
3 Turn On Machine Master Switchand all other necessary electrical equipment.
麻醉机
北京协和医院麻醉科 朱斌
基本内容
1. 麻醉机基本原理（step by step）
2. 麻醉机使用
1) 使用前检查 2) 参数设定
3. 常见问题
麻醉机的基本任务
I. 提供不同气体（ pipeline or cylinder）
建立一个人工的气体环境 提供一个气体的排除通路
II. 提供挥发性麻醉药 (vapors)
Breathing System
1 Calibrate O2 Monitor
a. Ensure monitor reads 21% in room air. b. Verify low O2 alarm is enabled and functioning. c. Reinstall sensor in circuit and flush breathing system
Close cylinder.
2 Check Central Pipeline Supplies
Check that hoses are connected and pipeline gauges read about 50psi.
Low Pressure System
1 Check Initial Status of Low Pressure System
Ventilation Systems
--check of ventilation relief valve
1. Set fresh gas flow to about 5 L/min.
2. Verify that the ventilator bellows and simulated lungs fill and empty appropriately without sustained pressure at end expiration.
Breathing system ready to use
the setting for Controlled Ventilation during Anesthesia
Final Position
Check Final Status of Machine
1. Vaporizers off 2. APL valve open 3. Selector switch to “Bag” 4. All flowmeters to zero (or minimum) 5. Patient suction level adequate
with O2 flush d. Ensure that pressure remains fixed for at least
10 seconds. e. Open APL (pop-off) valve and ensure that
pressurБайду номын сангаас decreases.
Ventilation Systems- Leak Check
Scavenging System
a. Ensure proper connections between the scavenging system and both APL valve and ventilator relief valve.
b. Adjust waste gas vacuum (if possible). c. Fully open APL valve and occlude Y-piece. d. With minimum O2 flow, allow scavenger
with O2. d. Verify that monitor now reads greater than 90%.
Breathing System
2 Check Initial Status of Breathing System
a. Set selector switch to "Bag" mode. b. Check that breathing circuit is complete,
Breathing System
3 Perform Leak Check of the Breathing System
a. Set all gas flows to zero (or minimum). b. Close APL (pop-off) valve and occlude Y-piece. c. Pressurize breathing system to about 30cmH2O
Emergency Ventilation Equipment
Verify Backup Ventilation Equipment is
Available
& Functioning
High Pressure System
1 Check O2 Cylinder Supply
Open O2 cylinder and verify at least half full (about 1000 psi).
麦氏系统改良型/Baraka双T管系统
两个单向活瓣
FGF≧MV 可自主呼吸； 也可控制呼吸
小结
I. FGF高且确定困难 II. 所呼出气体几乎全部排除
浪费、热量丢失、呼吸道干燥以及环境污 染
CO2吸收式通气系统
CO2吸收装置 处理呼出气体 以利于重复吸 收 APL阀可以为系 统（包括病人 呼吸系统）维 持一定的压力。
an ascending bellows ventilator； the following monitors:
capnograph, pulse oximeter, oxygen analyzer, respiratory volume monitor, breathing system pressure monitor with high and low pressure alarms.
bag with O2 flush. 5. Set O2 flow to minimum, other gas flows to zero. 6. Verify that during inspiration bellows delivers
appropriate tidal volume and that during expiration bellows fills completely.
Monitors
Check, Calibrate and/or Set Alarm Limits of all Monitors
Capnograph - Pulse Oximeter -O2 Analyzer Respiratory Volume Monitor (Spirometer)Pressure Monitor with High and Low Airway Pressure Alarms
reservoir bag to collapse completely and verify that absorber pressure gauge reads about zero. e. With the O2 flush activated, allow the scavenger reservoir bag to distend fully, and then verify that absorber pressure gauge reads < 10 cm H2O.
4 Test Flowmeters
a. Adjust flow of all gases through their full range, checking for smooth operation of floats and undamaged flowtubes.
b. Attempt to create a hypoxic O2/N2O mixture and verify correct changes in flow and/or alarm.
Unidirectional valves & accessories
1. Exercise breathing circuit accessories to ensure proper function.
2. Turn ventilator OFF and switch to manual ventilation (Bag/APL) mode.
undamaged and unobstructed. c. Verify that CO2 absorbent is adequate. d. Install breathing circuit accessory equipment (eg,
humidifier, PEEP valve) to be used during the case.
将挥发性麻醉药的消耗量减少到最低
III. 提供呼吸（Breathing）
避免无意的重复吸入 病人能够自主呼吸
T管系统
缺点：需要较大的新鲜气流量（FGF） FGF≧2~3倍 MV
Mapleson系统
较T管系统相比 FGF得以一定 程度降低；
为了防止病人重 复吸收，仍需 要较高的FGF、 且不易确定
a. Close flow control valves and turn vaporizers off.
b. Check fill level and tighten vaporizers' filler caps.
Low Pressure System
2 Perform Leak Check of Machine Low Pressure System
3. Ventilate manually and assure inflation and deflation of artificial lungs and appropriate feel of system resistance and compliance.
4. Remove second breathing bag from Y-piece.
a. Verify that the machine master switch and flow control valves are OFF.
b. Attach "Suction Bulb" to common (fresh) gas outlet. c. Squeeze bulb repeatedly until fully collapsed. d. Verify bulb stays fully collapsed for at least 10 seconds. e. Open one vaporizer at a time and repeat "c" and "d"
呼吸机（from手控 to 机控）
挥发罐（from呼吸机 to 麻醉机）
麻醉呼吸环路
基本内容
1. 麻醉机基本原理（step by step）
2. 麻醉机使用
1) 使用前检查 2) 参数设定
3. 常见问题
FDA Anesthesia Apparatus Checkout Recommendations, 1993
1. Place a second breathing bag on Y-piece. 2. Set appropriate ventilator parameters for next
patient. 3. Switch to automatic ventilation mode. 4. Turn ventilator ON and fill bellows and breathing
as above.
f. Remove suction bulb, and reconnect fresh gas hose.
Low Pressure System
3 Turn On Machine Master Switchand all other necessary electrical equipment.
麻醉机
北京协和医院麻醉科 朱斌
基本内容
1. 麻醉机基本原理（step by step）
2. 麻醉机使用
1) 使用前检查 2) 参数设定
3. 常见问题
麻醉机的基本任务
I. 提供不同气体（ pipeline or cylinder）
建立一个人工的气体环境 提供一个气体的排除通路
II. 提供挥发性麻醉药 (vapors)
Breathing System
1 Calibrate O2 Monitor
a. Ensure monitor reads 21% in room air. b. Verify low O2 alarm is enabled and functioning. c. Reinstall sensor in circuit and flush breathing system
Close cylinder.
2 Check Central Pipeline Supplies
Check that hoses are connected and pipeline gauges read about 50psi.
Low Pressure System
1 Check Initial Status of Low Pressure System
Ventilation Systems
--check of ventilation relief valve
1. Set fresh gas flow to about 5 L/min.
2. Verify that the ventilator bellows and simulated lungs fill and empty appropriately without sustained pressure at end expiration.
Breathing system ready to use
the setting for Controlled Ventilation during Anesthesia
Final Position
Check Final Status of Machine
1. Vaporizers off 2. APL valve open 3. Selector switch to “Bag” 4. All flowmeters to zero (or minimum) 5. Patient suction level adequate
with O2 flush d. Ensure that pressure remains fixed for at least
10 seconds. e. Open APL (pop-off) valve and ensure that
pressurБайду номын сангаас decreases.
Ventilation Systems- Leak Check
Scavenging System
a. Ensure proper connections between the scavenging system and both APL valve and ventilator relief valve.
b. Adjust waste gas vacuum (if possible). c. Fully open APL valve and occlude Y-piece. d. With minimum O2 flow, allow scavenger
with O2. d. Verify that monitor now reads greater than 90%.
Breathing System
2 Check Initial Status of Breathing System
a. Set selector switch to "Bag" mode. b. Check that breathing circuit is complete,
Breathing System
3 Perform Leak Check of the Breathing System
a. Set all gas flows to zero (or minimum). b. Close APL (pop-off) valve and occlude Y-piece. c. Pressurize breathing system to about 30cmH2O
Emergency Ventilation Equipment
Verify Backup Ventilation Equipment is
Available
& Functioning
High Pressure System
1 Check O2 Cylinder Supply
Open O2 cylinder and verify at least half full (about 1000 psi).
麦氏系统改良型/Baraka双T管系统
两个单向活瓣
FGF≧MV 可自主呼吸； 也可控制呼吸
小结
I. FGF高且确定困难 II. 所呼出气体几乎全部排除
浪费、热量丢失、呼吸道干燥以及环境污 染
CO2吸收式通气系统
CO2吸收装置 处理呼出气体 以利于重复吸 收 APL阀可以为系 统（包括病人 呼吸系统）维 持一定的压力。