ANESTHESIA GUIDELINES / REPAIRS
All certification includes preventative maintenance and repairs to give the best long-term sustainability out of your anesthesia equipment. Variable factors such as cleanliness, frequency of use, quality of equipment, age, temperature, and altitude affect the machine's performance. Annual service is mandated by OSHA, State Veterinary Boards, and AAHA to monitor these conditions as they change over time. This is critical for both your patients and staff as undiagnosed problems with equipment will yield complications during surgery. Anesthesia machines can often run for years without preventive maintenance giving the appearance of 'functionality' but leaks will become unsafe for the staff, cleanliness can cause health issues for the patients and damage the machine, and overall performance will vary giving inconsistency between patient-to-patient procedures with no regard for safety.
The most common issues during anesthesia typically are not even a result of the 'anesthesia complications with the patient' but rather due to poor 'anesthesia machine maintenance.' You can perform 'anesthesia' with 'leaky' equipment but get mixed results. With a hole in a rebreathing bag, cracked patient circuit, and leaky o-rings/gaskets, you can compensate for this leak by adding more 'oxygen' and 'anesthetic agent.' This however, gives you a faulty sense of 'functionality' that your patient is receiving appropriate dosages and may cause them to 'wake-up' or 'crash' due to these complications in over compensation. Even more alarming, as a staff member working with the 'anesthetic gas' having a leak, you are also now exposed to the drug itself. This can cause fatigue, confusion, and a loss of coordination which is obviously not good during surgery. Beyond the immediate effects, OSHA has instructed, "Moreover, there is biological plausibility that adds to the concern that high levels of unscavenged waste anesthetic gases present a potential for adverse neurological effects or reproductive risk to exposed workers or developmental anomalies in their offspring." These problems can also come from other sources like: faulty scavenging systems, incorrect fittings, improper procedure, and equipment malfunctions. Anesthesia is not just a procedure for your patient but also a safety mechanism for you as a staff member.
In continuation of poor practice, neglected maintenance will not only cause 'leaks' with questionable anesthesia delivery, but also present an issue with 'infections.' Without proper cleaning, a transfer of bacterial growth can occur and spread throughout the practice with relative ease. The warmth and condensation in our patients breath when exhaling applied on a rebreathing circuit can cause 'moisture' to fill under the 'domes, patient circuits, tracheal tubes, and bags' which will slowly cause a 'mold' growth to begin developing at a microscopic level inside the anesthesia machine and related components. If not cleaned, this growth will begin to spread more visibly from the machine, to the patient circuits and bags, and ultimately infecting patients with an upper respiratory infection because one piece of equipment was contaminated. Older patient circuits will lose its 'clear' coat and begin to have a 'blue/green/yellow tint' that never really is 'disinfected' and then when it is transferred to another machine for use, it begins spreading the 'mold' to the next machine, the related bags/circuits, and eventually through the hospital and all patients sharing the equipment, because the source of the problem was never fixed. While it is still possible to perform 'anesthesia' with dirty equipment, any attempt at sterility with an immunocompromised patient is null and potentially exacerbating a problem later on. For something as simple as cleaning, it is one of the greatest things you can do to help your patient before, during, and after anesthesia.
'Anesthesia machines' have also been around for almost a hundred years. Over time, there have been a multitude of enhancements, regulatory compliances, and innovations that have completely remodeled 'veterinary anesthesia machines' and the tools that are used today. Like cars, regulatory agencies have mandated changes in vehicles that have truly enhanced safety, environmental pollution, and user friendliness. Back in the 60's and 70's, cars were not required to have seat belts until laws changed. It is impossible to argue that the seat belt was not for the benefit of everyone on the road. During this time, there was a switch from 'leaded' to 'unleaded' gasoline along with stricter 'emissions' requirements that helped the environment with smog and pollution. More recently, as of 2018 all cars sold in the U.S. must have 'back-up cameras.' Not only do those screens give you a greater sense of safety, but they now have 'Bluetooth' and 'G.P.S.' integrated which makes it a more pleasant experience for the driver. Henry Ford once said "If I had asked people what they wanted, they would have said faster horses.” Henry Ford invented the 'Ford Motor Vehicle' because people couldn't make a faster horse, what they really wanted was a car. Just like the cars, anesthesia machines do have modern features available now that were never available or thought of before. For many doctors and older techs, these tools may have never even been seen or used before in their clinic. A small example would be a 'pressure gauge.' With an easy 'retro-fit,' you can now accurately and empirically measure your patients 'lung pressure' and check your machine for leaks as opposed to 'eye-balling a bag' on both 'rebreathing' and 'non-rebreathing' machines. While you may feel experienced to perform without a gauge, it is like driving without an 'odometer (speed gauge),' it is a hazard just waiting for an inexperienced technician to injure a patient. 'Occlusion valves' can be added to a 'Pop-Off Valve or A.P.L. (Adjustable Pressure Limiting)' to prevent the user from ever needing to 'close a pop-off' and forget to open it. It also allows for a 'quick resuscitation' which gives you more reliable control in an emergency situations. 'Non-Rebreathers' can be adapted to the machine for 'smaller patients' for an easier, direct, and quicker anesthetic 'dosage' to a patient. 'Human medical machines' far outpace 'veterinary machines' with technology and features making them incompatible in the veterinary industry, impossible to train the staff with, or get certification for. However, STASIS has dozens of unique and exclusive proprietary devices only for the 'veterinary industry' that meet and exceed compliance requirements and can bring your 'older' anesthesia machine to the modern age. These enhancements are not a complete redesign like 'humane anesthesia machines' but rather a practical and integrated system designed specifically for your machine. Unless you call STASIS, you will still be 'riding a horse' when STASIS has the 'car.' The surgery and patient should be your only focus, not having these features will only lead to unnecessary distractions.
Lastly, your vaporizer is a 'medically calibrated' device. Under the assumption your anesthesia machine is 'cleaned' and 'holding pressure,' your vaporizer is the true delivery mechanism that you can control 'by the books.' STASIS CAN NOT endorse or recommend medical practices, however, STASIS CAN verify that these practices/techniques are safe to perform with the equipment presented. So 'by the books' may say that 'For a 50 lbs. healthy dog @ 2 L./Min. oxygen flow rate on a rebreather using a 2 L. bag @ ISO 2% concentration is normal,' the book is assuming your 'medically calibrated device' is identical to the one they are using. Vaporizers are typically calibrated 'at sea level at 75 degrees Fahrenheit,' however we know our temperature and altitude is NOT the same in our surgical suite and therefore we have different anesthetic outputs because of these factors. This would be equivalent to why a 'cookbook' will recommend different settings for your stove for boiling/baking based on your current 'altitude.' This is especially critical in Arizona as temperatures will swing from '0-120 degrees' throughout the state during the seasons and having altitudes from '1500 feet in Phoenix to 7000+ feet in Flagstaff.' An easy comparison would be like 'filling a balloon with helium and letting it go.' As the balloon rises, the pressure inside gets greater, the balloon gets bigger, and eventually pops when it gets so high because of atmospheric pressure differences. If a balloon is a 'pressurized chamber of gas,' so is a vaporizer also like a 'pressurized chamber of gas.' The higher in altitude, the greater the baromic pressure, the greater the anesthetic delivery. STASIS can verify the calibration at the location to see how it may differ from what what the 'vaporizer dial' is saying versus what the 'actually concentration' is being delivered. The same is also true in temperature which is why a 'hot air balloon' rises with more heat. As our temperature changes, so does the anesthetic delivery concentration. The greater the temperature, the greater the anesthetic delivery. However above all else, your patients vitals are the only thing that matters during surgery, not what a book 'says' is normal. STASIS can provide you with 'working' and 'validated' equipment but it is up to the doctors and technicians to use STASIS's diagnosis of equipment on how best to proceed given what your patients vitals are presenting.
Beyond the basic 'Anesthesia Certification' if your equipment can not perform some of these critical functions or lacks certification, repairs will be necessary to restore full utility. There are many different anesthesia machines and veterinary equipment systems that are uniquely adapted to the clinic and often require some universal compatibility. STASIS often sees 'antique' but still certified compliant machines that require these specific adaptations and calibrations to become contemporary and functionable. Even today, research teams are still enhancing equipment with truly innovative designs that continually evolve and improve anesthesia capabilities . As repairs become specific, we carry many parts in stock but will also use some outside sales partners to find exactly what's right for you as many items require customization over years of obsoletion and 'wear and tear.'
The most common issues during anesthesia typically are not even a result of the 'anesthesia complications with the patient' but rather due to poor 'anesthesia machine maintenance.' You can perform 'anesthesia' with 'leaky' equipment but get mixed results. With a hole in a rebreathing bag, cracked patient circuit, and leaky o-rings/gaskets, you can compensate for this leak by adding more 'oxygen' and 'anesthetic agent.' This however, gives you a faulty sense of 'functionality' that your patient is receiving appropriate dosages and may cause them to 'wake-up' or 'crash' due to these complications in over compensation. Even more alarming, as a staff member working with the 'anesthetic gas' having a leak, you are also now exposed to the drug itself. This can cause fatigue, confusion, and a loss of coordination which is obviously not good during surgery. Beyond the immediate effects, OSHA has instructed, "Moreover, there is biological plausibility that adds to the concern that high levels of unscavenged waste anesthetic gases present a potential for adverse neurological effects or reproductive risk to exposed workers or developmental anomalies in their offspring." These problems can also come from other sources like: faulty scavenging systems, incorrect fittings, improper procedure, and equipment malfunctions. Anesthesia is not just a procedure for your patient but also a safety mechanism for you as a staff member.
In continuation of poor practice, neglected maintenance will not only cause 'leaks' with questionable anesthesia delivery, but also present an issue with 'infections.' Without proper cleaning, a transfer of bacterial growth can occur and spread throughout the practice with relative ease. The warmth and condensation in our patients breath when exhaling applied on a rebreathing circuit can cause 'moisture' to fill under the 'domes, patient circuits, tracheal tubes, and bags' which will slowly cause a 'mold' growth to begin developing at a microscopic level inside the anesthesia machine and related components. If not cleaned, this growth will begin to spread more visibly from the machine, to the patient circuits and bags, and ultimately infecting patients with an upper respiratory infection because one piece of equipment was contaminated. Older patient circuits will lose its 'clear' coat and begin to have a 'blue/green/yellow tint' that never really is 'disinfected' and then when it is transferred to another machine for use, it begins spreading the 'mold' to the next machine, the related bags/circuits, and eventually through the hospital and all patients sharing the equipment, because the source of the problem was never fixed. While it is still possible to perform 'anesthesia' with dirty equipment, any attempt at sterility with an immunocompromised patient is null and potentially exacerbating a problem later on. For something as simple as cleaning, it is one of the greatest things you can do to help your patient before, during, and after anesthesia.
'Anesthesia machines' have also been around for almost a hundred years. Over time, there have been a multitude of enhancements, regulatory compliances, and innovations that have completely remodeled 'veterinary anesthesia machines' and the tools that are used today. Like cars, regulatory agencies have mandated changes in vehicles that have truly enhanced safety, environmental pollution, and user friendliness. Back in the 60's and 70's, cars were not required to have seat belts until laws changed. It is impossible to argue that the seat belt was not for the benefit of everyone on the road. During this time, there was a switch from 'leaded' to 'unleaded' gasoline along with stricter 'emissions' requirements that helped the environment with smog and pollution. More recently, as of 2018 all cars sold in the U.S. must have 'back-up cameras.' Not only do those screens give you a greater sense of safety, but they now have 'Bluetooth' and 'G.P.S.' integrated which makes it a more pleasant experience for the driver. Henry Ford once said "If I had asked people what they wanted, they would have said faster horses.” Henry Ford invented the 'Ford Motor Vehicle' because people couldn't make a faster horse, what they really wanted was a car. Just like the cars, anesthesia machines do have modern features available now that were never available or thought of before. For many doctors and older techs, these tools may have never even been seen or used before in their clinic. A small example would be a 'pressure gauge.' With an easy 'retro-fit,' you can now accurately and empirically measure your patients 'lung pressure' and check your machine for leaks as opposed to 'eye-balling a bag' on both 'rebreathing' and 'non-rebreathing' machines. While you may feel experienced to perform without a gauge, it is like driving without an 'odometer (speed gauge),' it is a hazard just waiting for an inexperienced technician to injure a patient. 'Occlusion valves' can be added to a 'Pop-Off Valve or A.P.L. (Adjustable Pressure Limiting)' to prevent the user from ever needing to 'close a pop-off' and forget to open it. It also allows for a 'quick resuscitation' which gives you more reliable control in an emergency situations. 'Non-Rebreathers' can be adapted to the machine for 'smaller patients' for an easier, direct, and quicker anesthetic 'dosage' to a patient. 'Human medical machines' far outpace 'veterinary machines' with technology and features making them incompatible in the veterinary industry, impossible to train the staff with, or get certification for. However, STASIS has dozens of unique and exclusive proprietary devices only for the 'veterinary industry' that meet and exceed compliance requirements and can bring your 'older' anesthesia machine to the modern age. These enhancements are not a complete redesign like 'humane anesthesia machines' but rather a practical and integrated system designed specifically for your machine. Unless you call STASIS, you will still be 'riding a horse' when STASIS has the 'car.' The surgery and patient should be your only focus, not having these features will only lead to unnecessary distractions.
Lastly, your vaporizer is a 'medically calibrated' device. Under the assumption your anesthesia machine is 'cleaned' and 'holding pressure,' your vaporizer is the true delivery mechanism that you can control 'by the books.' STASIS CAN NOT endorse or recommend medical practices, however, STASIS CAN verify that these practices/techniques are safe to perform with the equipment presented. So 'by the books' may say that 'For a 50 lbs. healthy dog @ 2 L./Min. oxygen flow rate on a rebreather using a 2 L. bag @ ISO 2% concentration is normal,' the book is assuming your 'medically calibrated device' is identical to the one they are using. Vaporizers are typically calibrated 'at sea level at 75 degrees Fahrenheit,' however we know our temperature and altitude is NOT the same in our surgical suite and therefore we have different anesthetic outputs because of these factors. This would be equivalent to why a 'cookbook' will recommend different settings for your stove for boiling/baking based on your current 'altitude.' This is especially critical in Arizona as temperatures will swing from '0-120 degrees' throughout the state during the seasons and having altitudes from '1500 feet in Phoenix to 7000+ feet in Flagstaff.' An easy comparison would be like 'filling a balloon with helium and letting it go.' As the balloon rises, the pressure inside gets greater, the balloon gets bigger, and eventually pops when it gets so high because of atmospheric pressure differences. If a balloon is a 'pressurized chamber of gas,' so is a vaporizer also like a 'pressurized chamber of gas.' The higher in altitude, the greater the baromic pressure, the greater the anesthetic delivery. STASIS can verify the calibration at the location to see how it may differ from what what the 'vaporizer dial' is saying versus what the 'actually concentration' is being delivered. The same is also true in temperature which is why a 'hot air balloon' rises with more heat. As our temperature changes, so does the anesthetic delivery concentration. The greater the temperature, the greater the anesthetic delivery. However above all else, your patients vitals are the only thing that matters during surgery, not what a book 'says' is normal. STASIS can provide you with 'working' and 'validated' equipment but it is up to the doctors and technicians to use STASIS's diagnosis of equipment on how best to proceed given what your patients vitals are presenting.
Beyond the basic 'Anesthesia Certification' if your equipment can not perform some of these critical functions or lacks certification, repairs will be necessary to restore full utility. There are many different anesthesia machines and veterinary equipment systems that are uniquely adapted to the clinic and often require some universal compatibility. STASIS often sees 'antique' but still certified compliant machines that require these specific adaptations and calibrations to become contemporary and functionable. Even today, research teams are still enhancing equipment with truly innovative designs that continually evolve and improve anesthesia capabilities . As repairs become specific, we carry many parts in stock but will also use some outside sales partners to find exactly what's right for you as many items require customization over years of obsoletion and 'wear and tear.'
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