You are on page 1of 31

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : For ...

Page 1 of 31

Anesthesia Equipment and Physics made easy and explained !

[ Go to Home Page ] [ please leave your comments ] [ read this disclaimer ] [ about me ]

Vaporisers

Menu

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : For ... Page 2 of 31

What is a vapor ? Basic vaporiser Flow and Vaporisers Temperature and Vaporisers Pumping Effect Desflurane Vaporiser Inter lock mechanisms Agent specific vaporiser fillers

[ Go to Home Page ]

What is a vapour ?
A "vaporiser", as it name suggests, has something to do with producing "vapour". So before going onto discussing vaporisers, we need to have some idea as to what a vapour is. And, unfortunately, to understand what a vapour is, we need to know about something called critical temperature. If you take a gas, and compress it really hard, the particles that compose it are brought ever so close to each other. As you keep compressing , the particles will at some point coalesce and convert the gas into liquid. However, if the gas is above a certain temperature, called a "critical temperature", whatever amount of pressure you apply, that gas will not become a liquid. This temperature is called "critical temperature" and every gas has its particular critical temperature. For Isoflurane, it is about 200 degrees Celsius. Now to what a vapour is: A gas that is currently below its critical temperature is called a vapour. If compressed with enough pressure, it will condense into a liquid. A gas that is currently above its critical temperature remains a gas. However hard you compress it, it will not condense into a liquid.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : For ... Page 3 of 31

Click on button to get a way of remembering the difference between a gas and vapour

Click on button to find out what happens to Isoflurane on Venus

[ Go to Top of Page ] [ Go to Home Page ]

Basic Vaporiser
The purpose of a vaporiser is to add anaesthetic vapor into the fresh gas flow in a way that the output of the vaporiser delivers the set concentration of anaesthetic agent accurately. Fresh gas enters the inlet of the vaporiser and is divided into two flow pathways. The splitting valve, depending on the setting of the control dial, adjusts how much goes through each of the pathways. The fresh gas that is sent along the "by pass" pathway doesn't get into contact with any vapor. On the other hand, the fresh gas that is sent to the vaporising chamber becomes fully saturated with vapor. At the exit end of the vaporiser, the by pass gas (vaporless) meets the chamber gas (fully

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : For ... Page 4 of 31

saturated with vapor) and the two mix. The resultant output depends on how much of fresh gas went though each of the pathways.

The image below shows you that if you dial a high anaesthetic concentration requirement, the splitting valve sends more fresh gas via the vaporising chamber and less through the by pass pathway.

Similarly, the image below shows you that if you dial a low anaesthetic concentration requirement, the splitting valve sends less fresh gas via the vaporising chamber and more through the by pass pathway.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : For ... Page 5 of 31

Click on button to learn about splitting ratios

The image below shows that if you set the dial to zero to make vaporiser deliver no anaesthetic vapor, the splitting valve sends all the fresh gas via the by pass pathway and nothing through the vaporising chamber.

The basic vaporiser discussed above has a very simple design. Unfortunately, this simple design has some problems and these will be explained in more detail in later sections.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : For ... Page 6 of 31

Problems of the Basic Design


The basic vaporiser discussed previously has a very simple design. Unfortunately, this simple design has some problems:

The flow rate of fresh gas going through the vaporiser can affect its output. The temperature of the vaporiser drops with use and this can affect its output. Some ventilators transmit a "positive pressure" back into vaporiser which can affect its output.

[ Go to Top of Page ] [ Go to Home Page ]

Problem of High Flow


As discussed before, part of the fresh gas flow enters the vaporisation chamber and picks up vapor.

However, this vaporisation is not very efficient. If one uses a high fresh gas flow, the vaporisation process can't keep up with so much gas arriving into the vaporisation chamber. The result is that, relative to the high flow of fresh gas flow, the amount of anaesthetic vaporised is inadequate. So this means that at high flows, the vaporiser delivers less anaesthetic concentration than is set on the dial.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : For ... Page 7 of 31

The solution employed by modern vaporisers to solve this problem is to make the vaporisation much more efficient by increasing the surface area of contact between the fresh gas and anesthetic agent. So even when there are high flows, the efficient vaporisation means that all gas going through the vaporisation chamber is fully saturated. Because of this ability to saturate fresh gas at all flow rates, the output concentration remains accurate to the setting on the dial over a wide range of flows. I.e. The output concentration is independent of flow. One method that vaporisers use to increase the efficiency of vaporisation is to dip wicks into the anaesthetic agent. Due to capillary action, the anaesthetic agent rises into the wicks. This dramatically increases the surface area of anaesthetic agent exposed to the fresh gas entering the vaporisation chamber and thereby improves the efficiency of vaporisation.

Certain vaporisers (e.g. "Copper Kettle") use bubbles to increase the surface area for vaporisation. In these, some of the fresh gas flow is bubbled through a disk made out of a special material (sintered disk) that is very porous. The disk is submerged into the anaesthetic agent and when fresh gas is sent through it, a large number of tiny bubbles form. The tiny bubbles of fresh gas have a very large

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : For ... Page 8 of 31

total surface and thus become fully saturated with vapor efficiently.

[ Go to Top of Page ] [ Go to Home Page ]

Problem of Temperature
For vaporisation to occur, the anaesthetic molecules have to "escape" from the liquid state and become vapor. To escape, the molecules need energy and they take it from the liquid that they escape from. As more and more molecules escape, more and more energy is lost from the liquid. It is the "energy" in a liquid that causes it to have a temperature. Hot liquids have more energy than cold fluids. Therefore, as the escaping molecules take energy, the temperature of the liquid falls (see latent heat of vaporisation). The lower temperature of liquid means that it has less energy and this makes it more difficult for the remaining molecules to escape and become vapor. Thus at lower temperatures, there is less vaporisation.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : For ... Page 9 of 31

The less vaporisation then will decrease the concentration of anaesthetic delivered by the vaporiser. I.e. It will deliver an anaesthetic concentration below the setting you dialled. There are two common solutions to this problem. One is that we can give heat to the liquid to minimise the temperature drop. The other is to increase the flow of fresh gas into the vaporising chamber to compensate for the reduced vaporisation efficiency of the cold fluid.

GIVING HEAT In most vaporisers, we don't actually give heat "actively". That is, we don't electrically heat it (complicated and needs a power supply) and we don't light a fire under it (absolutely dangerous). Instead, we make it easy for the vaporiser to use heat from the surrounding air. We do this by making the vaporiser out of metal which is a good conductor of heat and will help transfer heat from the surrounds into the liquid.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 10 of 31

In addition, the metal casing is made very thick. Metal has a high specific heat capacity. That is, metal has a high ability to "store" energy and give it up when necessary. When the liquid anaesthetic vaporises, its temperature drops below that of the thick surrounding metal casing. The metal casing then donates the heat it has to the liquid, minimising the temperature drop of the liquid. The thicker the metal, the more energy that it can store. However, the metal casing cannot give up heat indefinitely and after sometime, it also has a significant temperature drop. But because it has a high ability to store heat, the drop is slow. In between your anaesthetic, when you turn the vaporiser off and have coffee before your next case, the metal will continue to "absorb" heat from the surroundings and its temperature will rise, ready to donate heat when you turn the vaporiser on again. To summarise, the metal casing is a good conductor, so allows heat to be easily transferred from the surroundings to the fluid, and is also a good "heat reservoir", so is able to donate heat and help resist the temperature drop.

GIVING MORE FLOW When the temperature of the liquid drops, we have seen that the output concentration of the vaporiser drops. A way of compensating for that problem is to increase the flow of gas via the vaporising chamber (altering the splitting ratio). One could manually do this by measuring the temperature of the liquid with a thermometer and increasing the dial setting according to some kind of reference chart. This would be quite tedious as you would have to do it all the time. Modern vaporisers have removed the hard work. When the liquid drops its temperature, the flow of gas through the vaporising chamber is automatically increased without you having to turn the dial. This is accomplished by an automatic temperature compensating valve that influences how much flow occurs into the vaporising chamber. So, the splitting of gas between the by pass pathway and the vaporising chamber is controlled by two valves: the dial you set (splitting valve) and the temperature compensating valve which operates automatically according to the liquid temperature.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 11 of 31

The automatic temperature compensating valve uses the physical property that substances (e.g. metals and liquids ) become smaller when the temperature lowers. A metal rod (shown in black below) shortens as the temperature drops. Similarly, a liquid filled in collapsing bellows (shown in green below) becomes smaller in volume when cooled to a lower temperature.

This property is used in the design of temperature compensating valves in vaporisers. In the design that uses a metal rod, the rod offers some resistance to flow into the vaporising chamber. As the vaporiser cools, the rod becomes shorter, making the valve move away from the opening. This reduces the resistance to flow and thus more flow occurs into the vaporising chamber.

Some vaporisers use liquid instead of the metal rod. The liquid is filled inside collapsible bellows. As the temperature falls, the liquid in the bellows contracts into a smaller volume. This makes the bellows shrink, pulling the valve away and thereby increase flow.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 12 of 31

Another method uses a "bi metallic" strip. Different metals expand and contract to differing extents when exposed to temperature changes. In the example below, the "green" metal expands and contracts less than the "red" metal.

In a bimetallic strip, two metals with very different degrees of thermal expansion ( "different coefficients of thermal expansion" ) are fixed together. In the example below, when the temperature drops, the "green" metal contracts much more than the "red" metal. Because they are fixed together, they cannot contract independently, like in the diagram above. Instead, the "green" metal "tries" to drag the "red" metal and causes the bimetallic strip to bend.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 13 of 31

In the vaporiser, the bimetallic strip is fixed in such a way that it offers a resistance to flow entering the vaporising chamber. When the temperature of the vaporising chamber drops, the bimetallic bends and moves away. This reduces the resistance to flow and thus more flow occurs into the vaporising chamber.

[ Go to Top of Page ] [ Go to Home Page ]

THE "PUMPING EFFECT"


Positive pressure ventilation result in intermittent pressure changes. During the positive pressure, there is a pressure rise and during expiration, there is a sharp drop in pressure. These pressure

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 14 of 31

changes can be transmitted back into the vaporiser and can affect the concentration of anaesthetic agent delivered. The effect of changing pressure affecting the output of the vaporiser is called the "pumping effect". In this section, this effect and the methods used by vaporiser designers to prevent it from happening are explained. Below is shown a basic vaporiser and beyond it a bag to represent positive pressure ventilation.

When the bag is squeezed (positive pressure ventilation), pressure is transmitted back into the vaporiser as shown below. This "back pressure" is transmitted to both, the "by pass" channel and also to the vaporising chamber. This "back pressure" opposes the flow of the fresh gas in both the "by pass" channel and the vaporising chamber. The fresh gas tries to move forward and gets compressed both in the 'by pass' channel and the vaporising chamber. However, the vaporising chamber volume is much larger than the 'by pass' channel volume, and thus, more fresh gas gets compressed into it than into the 'by pass' channel.

This extra fresh gas that enters the vaporising chamber collects anaesthetic vapor as shown below.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 15 of 31

Now see what happens when the positive pressure is suddenly released (expiration). The previously compressed gases now suddenly expands in all directions.

Some of the rapidly expanding gas (containing vapor) enter the inlet of the vaporiser and cross over into the 'by pass' channel as shown below.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 16 of 31

Normally, a vaporiser 'by pass' channel does not have vapor. So this vapor due the 'pumping effect' is additional. When this 'by pass' vapor flows across to the exit of the vaporiser, it meets the vapor from the vaporising chamber. The addition of the 'by pass' vapor to the vapor from the vaporising chamber raises the final concentration of anaesthetic delivered. i.e. The 'pumping effect' increases the delivered concentration of anaesthetic agent.

Vaporiser designers have various tricks to reduce the 'pumping effect' and some of these are discussed below:

LARGE 'BY PASS CHANNEL The 'by pass' channel can be made larger, ideally equal to the volume of the empty space of the

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 17 of 31

vaporising chamber. Therefore, when there is 'back pressure', the effects will be equal in both; in the vaporising chamber and the 'by pass' channel. Therefore, when there is 'back pressure', no longer will extra fresh gas go into the vaporising chamber.

LONG INLET TUBE The vaporiser inlet tube can be made longer. When the 'back pressure' is suddenly released during expiration, as discussed before, the extra gas in the vaporising chamber will suddenly expand. However, thanks to the long inlet tubing, the extra gas containing vapor expands into the long inlet tube and doesn't reach the 'by pass' channel.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 18 of 31

INCREASED RESISTANCE The vaporiser can be designed to have a high internal resistance to flow. This high resistance "resists" changes to flow caused by the intermittent 'back pressure' of positive pressure ventilation.

ONE WAY VALVE A 'one way' valve (also called unidirectional valve) can be put between the vaporiser outlet and the ventilator / breathing system. On way valves allow flow in one direction, but not in the other. In the diagram below, the one way valve is allowing gases to flow forwards.

However, this valve prevents flow from occurring in the reverse direction. This prevents the transmission of 'back pressure' to the vaporiser.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 19 of 31

[ Go to Top of Page ] [ Go to Home Page ]

Desflurane Vaporizer
Desflurane has a very low boiling point (about 23 degrees Centigrade) and even at room temperature, has an high vapor pressure. Also, for small changes in temperature, the vapor pressure of desflurane changes quite dramatically. I.e. desflurane is said to have a very steep "Vapor Pressure versus Temperature curve".

These physical properties of desflurane created a big headache for vaporiser designers.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 20 of 31

An operating room temperature is not perfectly constant. It keeps changing slightly depending on various factors including the number of medical students (young body heat) watching the surgery. These changes in operating room temperature then change the temperature of vaporisers present in that room. As discussed elsewhere, the standard vaporisers try to resist changes in temperature (e.g. by having thick metal construction). However, these mechanisms are not perfect and in practice small changes in vaporiser temperature still occur. This is not a big problem with anaesthetic agents such as Isoflurane or Sevoflurane which have a relatively less steep "Vapor Pressure versus Temperature curves". In them, small temperature changes will lead to only small changes in vapor pressure and this can be compensated by mechanisms such a the bimetallic strip. With Desflurane, with its steep "Vapor Pressure versus Temperature curve", even these small temperature changes can cause large changes in vapor pressure which cannot be compensated for with simple devices such a bimetallic strip. So a whole new vaporiser design had to be made. The solution chosen for the problem is to have a vaporiser that heats the Desflurane to a very precisely controlled temperature that is not affected by changes in room temperature. The heated vapor is then "injected" into the fresh gas flow. Before discussing the desflurane vaporiser in detail, let us first understand the concept of vaporisers "injecting anaesthetic" ( No, I am not referring to you "injecting" propofol into a patient! ). You will recall that "standard" vaporisers work by splitting the fresh gas flow into two pathways, one going through the vaporising chamber and picking up anaesthetic agent and the other "by passes" the chamber and thus has no anaesthetic. The two streams then mix at the end of the vaporiser to give the final concentration of anaesthetic.

Another option is to "inject" the anesthetic agent directly into the fresh gas flow. In this method, the fresh gas flow coming from the flow meters does not split into two streams. There is only one stream for the fresh gas flow, and into this stream, the anaesthetic agent is directly injected.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 21 of 31

The desflurane vaporiser works in a similar way. There is a tank (sump) which contains desflurane which is electrically heated to a highly controlled constant temperature (approximately 40 degrees C). Because of the heat, above the liquid Desflurane is gaseous Desflurane at a pressure of about two atmospheres (about 1500 mmHg or 200 kPa). This Desflurane gas is injected into the fresh gas flow.

The amount of Desflurane concentration in the fresh gas is controlled by the dial setting set by you. The dial moves a valve which varies the resistance to Desflurane flow from the tank to the fresh gas. If you want a higher concentration of desflurane, the valve attached to the dial reduces the resistance to flow of desflurane and more of it gets injected into the fresh gas. Conversely, if you want a lower concentration of desflurane, the valve attached to the dial increases the resistance to flow of desflurane and less of it gets injected into the fresh gas.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 22 of 31

THE PROBLEM of FLOW You may recall that the "standard" vaporiser is flow dependant. That is, at higher flows, the vaporisation is inadequate and the concentration of anaesthetic delivered will fall unless special modifications are made to the basic design.

The Desflurane vaporiser discussed so far will also be affected by the flow rate of fresh gas going through it. However, it is very important to note that the mechanism of how flow can affect a "normal" vaporiser and a Desflurane vaporiser are very different. In an "ordinary vaporiser", the high flow rates cause the vaporiser output concentration to drop because of inadequate vaporisation. In the Desflurane vaporiser, this is not the reason for drop in concentration at high flows, as there is no problem with vaporisation. In fact, because of its low boiling point, Desflurane very easily becomes vapor. In the desflurane vaporiser, the reason for a drop in concentration of anaesthetic at high flows is that the anaesthetic becomes more diluted by that high flow. If you keep the rate of injection of Desflurane constant, and increase the fresh gas flow, the injected Desflurane will be diluted more and the delivered concentration will drop. Conversely, if you keep the rate of injection of Desflurane constant, and decrease the fresh gas flow, the injected Desflurane will be less diluted and the delivered concentration will increase.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 23 of 31

One solution would be for you to manually adjust the dial setting to match the fresh gas flow. For low flows, you will have to reduce the dial setting to reduce the rate of Desflurane injection, and for high fresh gas flows, you will need to do the opposite. This would be really tedious in our modern times. Fortunately, the Desflurane vaporiser automatically adjusts the rate of injection of desflurane to match the flow rate, and thus keeps the delivered concentration constant. We are now ready to discuss the workings of the Desflurane vaporiser. You will need to refer to the numbers on the diagram below:

Your flow meters deliver the fresh gas flow [1]. The fresh gas travels through pipe [2]. Note that, unlike other vaporisers, none of the fresh gas goes to the vaporising chamber [4]. The vaporising chamber is electrically heated [3]. Using sensors for feedback, the temperature is kept very constant. The heating causes the Desflurane to become a gas under pressure [4] and this travels down pipe [5]. The dial you control is fixed to a valve [6] that changes the resistance to Desflurane flow. When you increase the concentration setting, the valve opens a bit and lowers the resistance, allowing more Desflurane to flow through. The Desflurane then goes via pipe [7] and meets the fresh

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 24 of 31

gas at [8]. The Desflurane mixes with the fresh gas and a final concentration emerges from the exit of the vaporiser [9]. Now we can discuss how the vaporiser, to keep the output concentration accurate, adjusts the Desflurane flow when the fresh gas flow changes. Here is the same diagram again:

The fresh gas flows in pipe [2]. This pipe has a fixed resistance [10] in its path. For the fresh gas flow to overcome this resistance [10], the pressure in pipe [2] rises. Higher the fresh gas flow in pipe [2], higher will be the pressure rise in pipe [2] since more flow has to occur through the same fixed resistance [10]. Similarly, when the fresh gas flow is decreased, the lesser flow will find it easier to go through the fixed resistance and the pressure in pipe [2] drops. It is important to remember that the pressure in pipe [2] is proportional to the fresh gas flow going through it. Higher the flow, higher is the pressure. Pipe [5] carries desflurane under pressure from the vaporising chamber [4] to the fresh gas flow at [8]. The flow of Desflurane is resisted by two valves [6,13]. Valve [6] is the valve that you control when you set the dial to a particular concentration. Valve [13] is an electronically controlled valve. Computer [12], the vaporiser's "brain", is able to alter the flow of Desflurane by controlling valve [13]. Device [11] is called a "differential pressure transducer". It has a diaphragm that on one side is exposed to the pressure in pipe [2] carrying fresh gas and the other side of the diaphragm is exposed to the pressure in pipe [5] carrying Desflurane. When the pressure is equal on both sides of the diaphragm, it lies in a neutral position. If one side of the diaphragm is at a higher pressure than the other side, the pressure difference makes the diaphragm move. In this way, the differential pressure transducer [11] is able to measure the pressure difference between the fresh gas pipe [2] and the Desflurane pipe [5]. It continuously keeps computer [12] informed about pressure difference information. Now let us see how the vaporiser copes when the fresh gas flow is increased.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 25 of 31

The fresh gas flow has been increased by you [1]. Increased flow fresh gas flows through pipe [2] and meets fixed resistance[10]. The increased flow through the fixed resistance [10] makes the pressure in pipe [2] to rise and this pressure is experienced by differential pressure transducer [11]. Since the desflurane pressure in pipe [5] is now lower than the fresh gas pressure in pipe [2], the diaphragm in the differential pressure transducer [11] moves and a signal about the pressure difference is sent to the computer [12].

The computer [12], acts on the information provided by the differential pressure transducer. It proceeds to increase the flow of desflurane to inject into the increased fresh gas flow. It commands the electronically controlled valve [13] to reduce the resistance to flow. As the valve [13] opens up and lowers the resistance, the Desflurane flow increases.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 26 of 31

The increased flow of Desflurane causes the pressure in pipe [5] to rise and this rise pushes the diaphragm of the differential transducer back to its neutral position and it sends a signal to the computer [12] that the desflurane pressure has increased sufficiently and the computer stops telling the valve to open further. The increased pressure [5] increases the Desflurane flow which mixes with the increased fresh gas flow and maintains the output concentration [9]. If the fresh gas flow changes the system will again alter the rate of injection of Desflurane.

Click on button for more details about the Desflurane vaporiser

[ Go to Top of Page ] [ Go to Home Page ]

Interlock Mechanism
Many anesthetic machines have more than one vaporiser attached so that one has a choice of inhalational agents to use. However, it is important that only one vaporiser be used at a given time to avoid overdose with different vapors going into the patient simultaneously. There are many different safety mechanisms available which prevents more than one vaporiser to be used simultaneously. I describe one such system below. Please note that your anesthesia machine may use a different

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 27 of 31

system. In this system, each vaporiser has two pins protruding out. When the vaporiser is in use, the pins protrude outwards. When the vaporiser is turned off, the pins retract back to where they were.

On the other hand, if any of the pins are pushed in (i.e. by another vaporiser) this locks the vaporiser dial in the OFF position. When the pin is no longer pushed in, the dial once again becomes unlocked and can be turned.

When you put two vaporisers together, their pins touch. When one vaporiser is turned on, it protrudes its pins which then pushes in the pins of adjacent vaporisers and locks them. When this vaporiser is turned off, its pins retract and releases the pins on the adjacent vaporisers and thereby unlocks them. In this way, only one dial can be turned on at a given time.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 28 of 31

Click on button to see photos of an interlock mechanism

[ Go to Top of Page ] [ Go to Home Page ]

It is important to fill the correct agent into the correct vaporiser. If a wrong agent is filled into a vaporiser, you will be giving the wrong drug, and worse, since vaporiser designs for different agents vary, you may seriously overdose your patient. Early vaporisers had simply a funnel into which you could pour virtually anything by mistake (including coffee).

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 29 of 31

Modern vaporisers have special filling systems specific for each anaesthetic agent to prevent inadvertent filling with an wrong agent. Think of it as a "lock and key" system, i.e. a particular key will fit only a specific lock.

The joke about the three beautiful women at The Pearly Gates .....

There are various systems in use. In the system below, the Isoflurane filler (key) has a notch in a corner. This fits perfectly with the filling hole in the Isoflurane vaporiser. The filling hole has pin at the corner over which the notch of the Isoflurane filler key can pass over.

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 30 of 31

A different anaesthetic agent such as Halothane (not commonly used anymore) has a different filling key. In this case, the key has a notch at the side instead of at the corner. So the Halothane filler key will not fit into the Isoflurane vaporiser filling hole.

The system described above is only one type of agent specific filling system. There are others that are there and depend on the manufacturers and the country you work in. In addition to the physical shapes being different, the key fillers are also color coded (purple for

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

Anaesthesia vaporisers explained ! Anesthesia Equipment simplified and explained : F...

Page 31 of 31

Isoflurane, yellow for Sevoflurane, blue for desflurane).

Click on button to see photos of some filling systems

[ Go to Top of Page ] [ Go to Home Page ]


Anesthesia Secrets James Duke MD MBA... New $35.02 Best $31.01 CURRENT Diagnosis and Treatment Surg... Gerard Doherty New $62.50 Best $36.95 Clinical Anesthesiology, 4th Edition... G. Morgan, Maged M... New $51.71 Best $38.99 Oxford Handbook of Anaesthesia Keith Allman, Iain... New 23.90 Best 23.90

Basic Physics & Measurement in Anaes... Paul D. Davis BSc ... New 42.68 Best 39.65

Drugs in Anaesthesia and Intensive C... Susan Smith, Edwar... New 21.55 Best 21.55

[ Go to Top of Page ] [ Go to Home Page ]

http://www.equipmentexplained.com/physics/agent_delivery/vaporizer/vaporizers.html

9/18/2011

You might also like