VAPORIZER

Dr.K.M.LAKSHMANARAJAN . MD.

REFERENCES

DORSCH AND DORSCH WARDS MILLER

 WHAT IS VAPOR ?
Vapor is the gaseous phase of a substance which is normally a liquid at room temp. and atm. pressure. Eg. water vapor is the vapor form of water

Gas is substance which exists only in the gaseous state at room temp. and amt. pressure.

WHAT IS A VAPORIZER ?
A vaporizer is an instrument designed to facilitate the change of a liquid anaesthetic agent into a vapor And Add a controlled amount of this vapor to the FGF
The SVP of most inhalation agents is MUCH more that is required to produce anesthesia i.e. 32% vs 0.75 or 243 mm Hg vs 5.7 mm Hg for halothane Need to dilute this vapor with the carrier gas and deliver a controlled amount of this vapor to the patient

DISCUSSION
EVALUATION OF VAPORIZER PHYSICS APPLIED TO VAPORIZER HOW IT WORKS? CLASSIFICATION INDIVIDUAL VAPORIZER HAZARDS & SAFETY FEATURES IDEAL VAPORIZER

EVOLUTION.

Schimmelbusch's Inhaler

Wilson and Pinson's Ether "Bomb

MORTON INHALER

EMO VAPORIZER

Foregger Model of Morris' Copper Kettle Vaporizer

FLAGGS CAN

EVOLUTION OF VAPORIZERS
MORTONS ETHER INHALER 1846, OCT 16

SNOW MARCH 1847

10

CLOVER PORTABLE REGULATING ETHER INHALER 1877

VERNON HARCOURT CHLOROFORM INHALER 1903

OMBREDANNE ETHER INHALER 1908

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SOMNOFORM INHALER 1908

Mixture of ethyl chloride, methyl chloride & ethyl bromide

Free Template from www.brainybetty.com

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OPEN DROP MASK

OPEN DROP MASK

OGSTON INHALER

EPSTEIN MACINTOSH OXFORD VAPORIZER 1952 (EMO)

EPSTEIN MACINTOSH OXFORD VAPORIZER 1952 (EMO)

GOLDMAN VAPORIZER

ROWBOTHOM VAPORIZER
Modification of Goldman vaporizer

POCKET TRILENE INHALER

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APPLIED TO VAPORIZER

PHYSICS

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WHAT IS CRITICAL TEMPERATURE ?

For any substance there is a max. temp. at which it can be compressed so as to convert it from a gas to a liquid. This is known as the critical temp. and above this temp. no amount of compression will liquefy it. Under this condition the substance is a gas. Below that critical temp it is a vapor.

 A gas that is currently below its critical temperature is called a vapour. If compressed with enough pressure, it will condense into a liquid.

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Critical temperature of Oxygen 1180C

Nitrogen
Air

147oC
141oC

Carbon dioxide 31oC Nitrous oxide Entonox 36.4oC - 5 to -7 (psuedocrit-temp)

ISOFLURANE ON VENUS
The critical temperature of Isoflurane is about The temperature on the planet Venus is about 200 C 500 C

So if you lived on Venus, Isoflurane would exist as a gas. On earth, since The temperature where you live is hopefully below the critical temperature of Isoflurane, it exists as a vapour / liquid.

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VP & SVP

Vapor exerts a pressure on its surroundings Vapor pressure . Vapor pressure depends only on the temp. and liquid. Vapor pressure of an agent determines how much of vapor will be formed from 1 ml of the liquid. Since different anaesthetic agents have different vapor pressures the need separate vaporizers.

SVP ?

For a particular liquid at a particular temp. there occurs an equilibrium at which the number of molecules leaving the liquid equals the number reentering It is the maximum VP at a particular temp. Increases rapidly as boiling point approaches.

HOW DO YOU DEFINE BOILING POINT? -Is the temperature at which the vapor pressure reaches the atmp - decrease the atmp dec the BP -increase the atmp incre the BP IF THE B.P OF ETHER IS 36.5 C , WILL IT BE BOILING ALWAYS IN THE ROOM TEMP IN THE SUMMER IN MADURAI WHEN THE TEMP IS 40 C? SVP MAY BE > ATMP ATMP MAY BE > SVP ---- its not BP To get boiling point SVP to reach ATMP

BOILING POINT ?

BOILING POINT
S.NO 1 2 3 LIQUID ANESTHETIC ETHYL CHLORIDE DESFLURANE ISOFLURANE B.P in C 12.4 22.8 48.5

4
5 7 8 9

HALTHANE
ENFLURANE SEVOFLURANE ETHER METHOXY FLURANE

50.2
56.5 58.6 34.6 105

GAS CONCENTRATION:
Partial pressure: Molecular agitation Bombardment on the walls of container Creation of a pressure Daltons law of partial pressure: total pressure of the mixture is the sum of the partial pressures of the constituent gases Volume percent: partial pressure/ total pressure x 100

HEAT of VAPORIZATION
In a liquid, molecules are in a state of continuous motion because of mutual attraction by Van-der Waals forces. Some molecules may develop velocities sufficient to escape from these forces and may enter the vapour phase. The amount of heat required to convert a unit mass of liquid into a vapour without a change in temperature of the liquid is termed the heat of vaporization.

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HEAT OF VAPORISATION:

No of calories necessary to convert 1 G of liquid into vapour Effect of heat loss on continuous vaporisation Gradient of temp. between liquid and surrounding Ways of Supplied heat

SPECIFIC HEAT CAPACITY

Quantitiy of heat required to raise the temp of 1 G of the Substance by 1 C Material used to construct the vaporiser should have High sp.heat capacity THERMAL CONDUCTIVITY: Measure of the speed with which heat flows through a substance Cu > Al > brass > steel >> glass

Agent Halothan e

Boiling Vapor Density of Point (C, Pressure Liquid 760 mm Hg) (torr, 20C) (g/mL)

Heat of Vaporization cal/g 35 (20C) cal/mL 65 (20C)

Specific Heat of Liquid cal/mL 0.35 cal/g 0.19

MACa in O2 (%)

50.2

243

1.86 (20C)

0.75

Enflurane

56.5

175

1.517 (25C)

42 (25C)

63 (25C)

1.68

Isoflurane

48.5

238

1.496 (25C)

41 (25C)

62 (25C)

1.15

Desfluran e

22.8

669

1.45 (20C)

6.4

Sevoflura ne

58.6

157

2.0

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VOLATILE AGENTS
Boiling point SVP at 20c MAC BG coefficient

Desflurane
Ether Isoflurane Halothane Enflurane Sevoflurane

22.8 c
34.6 c 48.5 c 50.2 c 56.5 c 58.5 c

669 mmhg
425 mmhg 175 mmhg 243 mmhg 175 mmhg 157 mmhg 20 mmhg 4000 mmhg

6.4
1.92 1.15 0.75 1.68 2.0 0.2 104 60-70

0.45

1.4 2.5 1.8 0.65 12-15 0.47 0.115

Methoxyflurane 105 c Nitrous oxide Xenon 21.2 c -108.1c

HOW IT WORKS ?

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VAPORIZATION

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VAPORIZATION

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VAPORIZATION AT HIGH FLOW

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,, the vaporiser delivers less anaesthetic concentration than is set on the dial
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VAPORIZER IN HIGH FLOW

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VAPORIZATION AT HIGH FLOW

The solution employed by modern vaporisers to solve this problem is to increase the surface area of contact between the fresh gas and anesthetic agent. The output concentration remains accurate to the setting on the dial over a wide range of flows. One method that vaporisers use to increase the efficiency of vaporisation is to dip wicks into the anaesthetic agent

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WICKS

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BUBBLE THROUGH

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BUBBLE THROUGH

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SPECIFIC HEAT

50

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This property is used in the design of temperature compensating valves in vaporizers.

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THERMAL STRIP

53

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Another method uses a "bi metallic" strip. Different metals expand and contract to differing extents when exposed to temperature changes

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EFFECT OF TEMPERATURE ON THE PERFORMANCE OF VAPORISERS

As liquid is vaporised, energy is lost in the form of heat As the temp. decreases, so does the vapour pressure vaporisation decreases, so does the vaporiser output

Effect of heat loss on the performance of Boyles bottle:

METHODS OF TEMPERATURE COMPENSATION:

1. Supplied heat Large mass of copper high specific heat and thermal conductivity water jacket electric heater
2. Flow compensation Increase the % of carrier gas flow that is directed through the vaporizing chamber

EFFECT OF INTERMITTENT BACK PRESSURE:

Positive pressure from breathing system, O2 flush 1.PUMPING EFFECT 2. PRESSURISING EFFECT

PUMPING EFFECT:
Increased pressure fluctuation - increased gas flow into vaporising chamber picking up more vapour which enters into the bypass chamber diluent containing vapour increased vaporiser output

Pumping effect
Common in plenum ( high resistant vaporizers) Seen in low flow anesthesia, low dial settings, low level of liquid agent Seen in when high RR used, high PIP, rapid drops in airway pressure during expiration When use O2 flush also ( during intraop)

Pumping effect
(Think traffic signal, starting from signal )
During IPPV gas flow to pt & to back bar also
Pressure rises in the back bar

Pressure transmitted to bypass channel (only FGF coming ) & to vaporizer chamber

Vapor molecules compressed inside the vapor chamber Compressed FGF again will diverted more into vaporizer
Now SVP raised More molecules of concentrated vapor produced

On expiration pressure drops at common gas outlet High concentrated vapor than the dial setting delivered to the pt Pumping effect

PUMPING EFFECT:

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Modifications to minimise the pumping effect: 1. Increasing the size of bypass chamber
2. Decreasing the size of the vaporising chamber

3. Long inlet tube

4. Avoiding wicks in the inlet area

5. Increase resistance to gas flow through vaporiser

6. Unidirectional / pressurising valve at the outlet of the vaporiser

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PRESSURISING EFFECT:

Will vaporisation increase as the pressure in the vaporising chamber increase? SVP depends on temperature , not on pressure This effect leads to a decrease in the vaporiser output

Pressurizing effect
According to the second concept Common in high flow anesthesia

Common in VIC vaporizer SVP of vapor not increased Less common effect and less danger than pumping effect

Ippv back flow/pressure transmitted back to vaporizer / bypass Vaporized molecules are compressed without altering SVP Same no molecules but diluted (density reduced) Vapor concentration decreased & delivered on expiration
Pressurizing effect

PRESSURISING EFFECT:

Which effect is important?

Pumping effect is more dangerous

Pressurising effect occurs in high gas flows

Pumping effect in low flows..

EFFECT OF ALTERED BAROMETRIC PRESSURE ON THE PERFORMANCE OF VAPORISERS:

Vaporisers in high altitude and hyperbaric chambers Vaporiser output concentration differs Partial pressure remains the same, so does depth of anesthesia C = C x P/ P

PLACING THE VAPORISER IN THE BREATHING CIRCUIT

1. VAPORISER OUTSIDE THE CIRCLE ( VOC ) 2. VAPORISER INSIDE THE CIRCLE ( VIC )

VOC
IN THE BACK BAR.
Between the flow meter and common gas outlet Or between common gas outlet and breathing system Vaporisers in a row.. Selectatec mechanism Difficult to equalise the vaporiser concentration with alveolar concentration

VOC VAPORISER IN A ROW IN THE BACK BAR Two consideratons: Parallel / serials Cross contamination should be minimum If it occurs, it should be least dangerous With agents equal potency the agent with the lower vapor pressure should be upstream With agents of equal vapour pressure, the less potent should be upstream Explosive agents, trilene should be downstream..

VAPORIZER ARRANGEMENT
In the order of SVP and potency( less SVP , less potent first)

Thymol added vaporizer in the downstream

ORDER OF VAPORIZERS
Less potent More potent If equipotent Low VP High VP upstream downstream upstream downstream

If explosive Trilene Easy to clean -

downstream downstream downstream

UP STREAM

DOWNSTREA M

SEVOFLURAN E VP157

ENFLURANE ISOFLURAN E 175 238

HALOTHAN E 243

DESFLURANE

669

VAPORISERS IN A ROW

VAPORISER INSIDE THE CIRCLE:

Low resistance vaporiser incorporated in the circle system
Economical Faster induction Vaporiser output and concentration are not same Easy to achieve alveolar concentration similar to vaporiser concentration Dangerous concentration may build up 2 positions: Expiratory side, Inspiratory limb

VIC - IN THE EXPIRATORY LIMB: Safe Moisture condensation Wastage through relief valve

VIC - IN THE INSPIRATORY LIMB:

Faster induction Danger of liquid anesthetic aspiration

VAPORIZER
Vapour output depends on Temperature of liquid Volatility Surface area of liquid FGF rate Ippv Carrier gas composition Barometric temperature ( eg high altitude)

FACTORS AFFECTING VAPORIZER OUTPUT

1. FLOW THROUGH THE VAPORIZING CHAMBER: Varying the proportion of gas passing through the vaporizing chamber and bypass chamber 2. SURFACE AREA OF THE LIQUID GAS INTERFACE: Greater the surface area, more will be the vaporization. Bubble through > flow over

 3. TEMPERATURE: as temperature increase, output increase 4. TIME: Output concentration tend to fall over time 5. GAS FLOW RATE: (A) At high flowrates, the gas leaving vaporization chamber is less saturated (B) Alters the total flow that passes through the vaporization chamber

 6. CARRIER GAS COMPOSITION: (a) Changes in viscosity & density may affect the proportion of the total flow passing through the vaporization chamber (b) N2O dissolves in the flow, thus altering the effective volume passing through the vaporization chamber 7. BOILING POINT: Higher the boiling point, less will be the vapor output

 8. AMBIENT PRESSURE: - SVP is solely a function of temp. so if ambient pressure is reduced, the constant SVP becomes a greater proportion of the total pressure -> output increases. - Agents with low boiling points are more susceptible to the influence of ambient pressure

EFFECT OF LOW ATMOSPHERIC PRESSURE

CONCENTRATION CALIBRATED High resistance pathway through the vaporizing chamber offers less resistance, under hypobaric conditions and so a slight increase in vapor output occurs. Deliver higher conc. if measured in vol. % but deliver same PP so clinicall effect unchanged CP =CP or C=CP/P At 0.5 atm. C=Cx1/.5=2%

EFFECT OF LOW ATMOSPHERIC PRESSURE

MEASURED FLOW Here the delivered partial pressure & volume percent increases. Amount of increase depends on the barometric pressure & the vapor pressure of the agent. Closer the vapor pressure is to barometric pressure, greater the effect.

EFFECT OF HIGH ATMOSPHERIC PRESSURE

CONCENTRATION CALIBRATED ATM PRESSURE INCREASES -> Density of gas CHANGES -> More resistance to flow of gas through the vaporizing chamber -> Decreased vapor O/P (Partial Pressure & Volume Percent) Effect on partial pressure is less dramatic

EFFECT OF HIGH ATMOSPHERIC PRESSURE

MEASURED FLOW Lower concentration in terms of PP/Volume percent

1988 ASTM MACHINE STANDARDS FOR VAPORIZERS 1. The effects of variations in ambient temperature and pressure, tilting, back pressure, and input flow rate and gas mixture composition on vaporizer performance must be stated in the accompanying documents. 2. The average delivered concentration from the vaporizer shall not deviated from the set value by more than 20% or 5% of the maximum setting whichever is greater without back pressure.

3. The average delivered concentration from the vaporizer shall not deviate from the set value by more that + 30% or 20% or by more than + 7.5% or 5% of the max. setting whichever is greater, with pressure fluctuations at the common gas outlet of 2 kPa with a total gas flow of 2 L/minute or 5 kPa with a total gas flow of 8 L/minute 4. A system that prevents gas from passing through the vaporizing chamber or reservoir of one vaporizer and the through that of another must be provided 5. The output of the vaporizer shall be less than 0.05% in the OFF or zero position if the zero position is also the OFF position.

6. All vaporizer control knobs must open counterclockwise 7. Either the max. and min. filling levels or the actual usable volume and capacity shall be displayed 8. The vaporizer must be designed so that it cannot be overfilled when in the normal operating position. 9. Vaporizer unsuitable for use in the breathing system must have noninterchangeable proprietary or 23 mm fittings. Conical fittings of 15 mm and 22 mm cannot be used. When 23 mm fittings are used the inlet must be male and the outlet female. The direction of gas flow must be marked.

10. Vaporizers suitable for use in the breathing system must have standard 22-mm fittings or screwthreaded, weightbearing fittings with the inlet female and the outlet male. The direction of gas flow must be indicated by arrows and the vaporizer marked for use in the breathing system.

CLASSIFICATION
1-Regulation of output concentration A. measured outflow B. Concentrations calibrated 2-Method of vaporization A. Flow over ( over surface of liquid) B. Bubble thro ( ether bottle) C. Draw over ( cyprane inhaler,EMO ) D. Injector ( TEC6) 3- Location A. VOC ( in back bar) B. VIC ( in closed circuit )

4.Plenum or not A occupied / closed room, in which the pressure of the air is greater than that of the outside atmosphere Here the air is forced in to the chamber Eg ether , copper kettle, tec 5.Compensations A. Temperature (bimetallic strip,heater) B. Back pressure (tec 3- 7) C. Tilt D. Ambient pressure ( high altitude ) 6. Agent specific or not 7.Electronically controlled or not ( TEC 6, aladin casette) 8. Measured output flow rate compensation ( TEC 6 plus)

 Plenum types have high resistance

Draw over low resistance

VARIABLE BYPASS VAPORISERS Vaporiser has to dilute the saturated vapor as vapour pressure of most volatile anesthetics are much greater than the partial pressure required to produce anesthesia Accomplished by splitting the gas flow that passes through the vaporiser Some of the gas flows through the vaporising chamber and remainder gas through a bypass to the vaporiser outlet Both flows join downstream to give the desired concentration Splitting ratio

VARIABLE BYPASS
Patient

Flowmeter

VARIABLE BYPASS
Patient

Flowmeter

FLOW OVER

Carrier gas flows OVER liquid picking up vapor. Efficiency improved by increasing area that carrier gas flows over gas-liquid interface. ie. Baffles or wicks

FLOW OVER VAPORISERS

Performance depends on
1. Vapour pressure of the liquid

2. Efficiency of vaporisation
3. Area of the gas-liquid interface

4. Velocity of carrier gas flow

5. Height of gas flow above the liquid

BUBBLE THROUGH VAPORISERS:

Performance depends on: Size of the bubbles

Depth of the liquid

Velocity of gas flow

DRAW-OVER VAPORIZER

Principle of the draw-over vaporizer

PLENUM VAPORIZER

INDIVIDUAL VAPORISERS BOYLES ETHER BOTTLE:

Variable bypass flow over or bubble through out of system -No temperature compensation -U inlet tube ,plunger with hood ( cowl )

-Cork with an attached chain

BOYLES BOTTLE
Parts: (1) vaporizing bottle 300 mL (2) Metal top incorporating controls (3) Lever, plunger which is chrome plated (4) Stopper & Retaining chain Concentration calibrated Flowover or bubble through Not temperature compensated Multiple agents Vaporizer outside circuit

BOYLE BOTTLE

BOYLES ETHER BOTTLE:

EVALUATION OF ETHER BOTTLE:

Factors influencing the vaporiser output: Temperature of the liquid in the vaporiser

Plunger level
Position of the control lever

Volume flow of the gas through the vaporiser

Level of liquid in the vaporiser

Agitation of the vaporiser

BOYLES BOTTLE:
ETHER BOTTLE: Vaporising chamber is large Copper inlet tube and hood HALOTHANE BOTTLE: No hood or plunger Chromium plated inlet tube Inlet tube is plugged at the tip and a side hole 1 cm above Control lever scale is larger Vaporising chamber is smaller than ethers

OXFORD MINIATURE VAPORIZER (OMV)

Variables bypass Flowover with steel wicks Temperature compensated For use by multiple agents Vaporizer outside circuit Halothane trilene methoxyflurane ether isoflurane

OMV

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MEASURED FLOW (COPPER KETTLE & VERNITROL)

Also known as bubble through or Vernitrol. Flow meter-measured. Manually calculated bypassed carrier flow. Temperature compensated by construction materials with high specific heat and thermal conductivity to offset cooling from vaporization induced heat loss. ie. Copper Amount of carrier gas (CG) O2 bubbled through is determined by a dedicated Thorpe tube flowmeter A valve separates the vaporizer circuit from the standard O2 & N2O flowmeters

METAMATIC VAPORIZER

122

FOREGGER COPPER KETTLE 1952

FOREGGER COPPER KETTLE 1952

GOLDMAN VAPORISER

Variable bypass flow over without wick in or out of system No temperature compensation
Designed for intermittent flow machine When vaporising chamber is full, 2% halothane concentration can be achieved at a lever position of 3.

VIC concentration may reach 3.5 % - 4.5%

Problem of the preservative - Thymol

GOLDMAN VAPORIZER

 Youngs modification of goldman Placing wicks 34%

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EPSTEIN-MACINTOSH-OXFORD VAPORISER

Variable bypass flow over with wick in system temperature Compensation by supplied heat and flow alteration Designed for field condition
Can be used for both spontaneous and controlled ventilation

A ventilating bellows has to be added in the circuit for controlled ventilation

EMO vaporizer 1953

Variable bypass Incomplete vapourizatio Low resistance Agent-specific for ether or may not be Temperature compensated by bellows, Temperature stabilized by water jacket, Transportable but heavy (10kg). .

EPSTEIN MACINTOSH OXFORD VAPORIZER 1952 (EMO)

EPSTEIN MACINTOSH OXFORD VAPORIZER 1952 (EMO)

E.M.O VAPORISER

FLUTEC
All TEC
Variable bypass Plenum Temperature compensated Concentrations calibrated Flow compensated by using wicks ( except TEC 2)

 TEC 2- 4 not agent specific Backpressure (pumping effect) compensation starts from TEC 3 Anti spill proof starts from TEC 4 Agent specific starts from TEC 4 Selectatec starts from TEC 4 Color coding starts from TEC 5 ( but our TEC 3 having color coding) Tilt compensation from TEC 6 Barometric pressure compensation TEC 7 But TEC 2 used only for HALOTHANE

 Bimetallic strip(temp compensating device ) may be in inside the vaporizer chamber or in bypass channel TEC 5 PUMPING EFFECT> TEC 4 INTERNAL BAFFLES TEC5

FLUTEC Mk-III
Variable bypass flow over with wick out of system Temp. compensation by flow alteration agent specific ( Halothane ) Bypass is located concentrically within the vaporising chamber Flow alteration is by a bimettalic strip Volume of vaporising chamber is 270 ml, wick retains 35 ml Maximum 5% Accuracy is good up to 3% with all flows

FLUTEC Mk - III

TEC 5 VAPORISERS Meant for isoflurane, sevoflurane

Improvised to check the pumping effect

Accuracy is assured in clinically used flow rates

Liquid anesthetic cant enter the bypass channel

Fitted with coded filling system

TEC Mk 5 VAPORISERS:

TEC Mk 5 VAPORISER

TEC 6- why
Desflurane BP 22.8 c So at room temperature will be in vapor or as gas form ( u wont able to see even drops of desflurane) So we may not know how much it is delivered to the patient if u give it by scimmelbusch mask like ether Suppose if u use desflurane by other Tec - high output will be delivered Suppose if u are reducing desflurane output by diluting its vapor molecules in other Tec u need to keep FGF of 73 L/min to have 1% vapor

 If u supply desflurane in ordinary Tec all desflurane vapoured in room tem This leads to excessive cooling of vaporizer-lead on to low output So Desflurane needs special (controlled vaporization) vaporizer

TEC 6
Parts 1. It has 2 independent gas circuits in parallel
1.FGF inlet circuit passes thro R1(fixed 2.Vapor circuit passes thro R2 (variable ie the dial setting) 2.Differential pressure transducers 3.Control electronics 4.Pressure regulating valve 5.Desflurane resorvoir(heating sump) 6.Shut off valve restrictor) restrictor,

TEC 6

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TEC 6

Tec 6 how it works

Sump (electrically heated) is heated up 39c Vapor pressure in sump reaches 2atm absolute Shutt of valve opened ( dial setting on) Pass thro R2 R2 reduces pressure to 1.1atm absolute

After R2 vapor joins with FGF

When FGF rate constant Back pressure to the diaphragm of differential pressure transducer(dpt) DPT conveys pressure diff between fgf circuit & vapor circuit Now control electronics act on pressure regulative valve

Pressure in vapor circuit = pressure in FGF circuit Now this is the working pressure of vaporizer If FGF rate constant working pressure constant If u increase the FGF rate working pressure is also increased But change in FGF rate or dial setting will not change vapor pressure ( vapor output is constant)

Special operating features of TEC 6

Once vaporizer connected to power supply the vaporizer starts to heat the sump automatically No separate switch to on heaters
Warm up time 5-10 mins Front panel has 5 LED lights

Tec 6 LEDs top to bottom

Operational LED (ready to use) - green No output LED - red Low agent LED(refilling is required) amber Warm up LED - amber Alarm Low battery LED amber

Amber LED
Amber color LED - Emits light during Warm up Agent <50ml Muted the alarm for >120 secs Low battery If press the mute button continuosly vaporizer will go for self testing

RED LED
If fluid level < 20ml Tilting >105 ( > 15 deg from vertical axis) Power failure Internal malfunction

There is 10 seconds delay from the time detected malfunction to time alarm activated

TEC 6 - LCD
Battery 9 volt comes for 1 year LCD bars (20 small bars, instead of fluid column in others)- receives signal from sump If heaters switched off or Low agent LCD bars also will drop Upper most LCD bar = 390 ml in sump Middle bar = 240 ml Lowest = only 60 ml

TEC 6
Beginning of warm up all LED s flash for 1 sec with alarm Tec 6 tilt proff - when tilt > 105 - shutts of vaporizer Up to 90 u can use the vaporizer Filling speciality SAF T-FIT specific filler nozzle in desflurane bottle Nozzle is attached with filler port in vaporizer then turned upward and invert the bottle

 Now the vaporiser is filled If u fill the vaporiser when LCD bar showing < 240 ml ( below middle bar)- port will accept the whole bottle Once bottle emptied bottle turned to starting (upward) position Now the filler port ejecting nozzle of bottle You can fill when vaporizer on flow Overfilling prevented Dial setting 1 18%

TEC 6 CHECK OUT

1-Press and hold the mute button until all lights and alarms activated. 2-Turn on to at least 1% and unplug the electrical connection. A "No Output" alarm should ring within seconds. This tests battery power for the alarms. This step is crucial in relation to the quick emergence characteristics of this agentany interruption in its supply must be noted and responded to at once
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TEC 6
Tell me one disadvantage of Tec 6 ?

Not barometric pressure compensated so dial settings to be adjusted I tell u why ?

High altitude & vaporizer

For classical plenum vaporizers, the percentage output increases roughly in proportion to the fall in barometric pressure, But a smaller partial pressure increase. Depth of anesthesia depends on partial pressure The changes in partial pressure are relatively small, So normal vaporizer settings work as expected at altitude

TEC & barometric compensation

At 20 c SVP of isoflurane 238 mmhg At high altitude temperature rises to 35 c SVP rised to 450mmhg Increase pressure in vaporizing chamber bend the bimetallic strip So the bimetallic strip decrease FGF to the vaporizing chamber reduce the vapor output so same concentration is delivered = same anesthetic potency

High altitude & Tec 6

The percentage delivered is essentially held constant so partial pressure FALLS in proportion to the fall in atmospheric pressure. The dial setting should be turned up to compensate Required dial setting = normal dial setting * 760 mmhg/ ambient pressure (mmhg) I mean the vapor pressure of deslurane at outlet to the pt is always constant becoz 2 pressure resistors

VAPORIZER

SAFETY FEATURES

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INTERLOCK SYSTEM

167

INTERLOCK DEVICES
Selector valve Selectatec system Back bar devices Ohio switch Drager lock

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BACK BAR
Safety Selectatec system Opening more than 2 vaporizer not possitbe at a time

SELECTA TEC

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Fillers
Types Funnel fillers simple funnel there (most of our vaporisers) Keyed filler specific attached to vapor bottle and vaporiser ( not in our institute) Quick filler sevoflurane vaporizer is (eg our theatre sevo) SAF-T-FIT special for desflurane ( we r having) Easy filler Tec 7 ( bottle adapter)

FILLING FUNNEL

173

KEYED FILLING

174

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EASY FILL

178

SAFE T-FIT

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AGENT SPECIFIC FILLING SYSTEMS PROBLEMS

1. 2. 3. 4. 5. 6. 7. 8. Difficulty in filling Misalignment of adaptor in filler receptacle Adaptor not sealing at the bottle end Leak in the bottle adaptor Air bubbles. Lost bottle adaptor Failure of keyed system Liquid leaks

AGENT SPECIFIC FILLING SYSTEMS PROBLEMS

9. VAPORIZER TIPPING If filler receptacle on vaporizer extends beyond the base it cannot be set upright on a flat surface this can cause tipping prevented by setting the vaporizer receptacle at the edge of the surface or a ring can be fitted at the base that extends below the projection of the filler reeptacle 10.POOR DRAINAGE 11. BROKEN INNER TUBE

ADU ALADIN CASSETTE

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ALADIN CASSETTE
Cassettes color & magnetic coded Handle Filler 10% fluid only messages in machine& alarm Vaporizer oultet flow-controlled by CPU Cassette temp<18C fan activated Over fill protection ( air deactivate it) Temperature maintenance- brass shell around the cassette
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DRAGER VAPORIZER
VAPOR 19.1 Calibration with air Over fill protection even the vaporizer in on position VAPOR 2000 ( DRAGER) Air calibration DRAGER D For desflurane
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PENLAN DELTA
O2 CALIBRATION TEMP COMPENSATION- 1- 2HRS PENLON ALPHA FOR DES FAST WARM UP SLOWER POWER CONSUMPTION CALCULATE THE AMOUNT OF DES USED FOR EACH CASE CPU CAUTERY MAY AFFECT

186

HAZARDS
Wrong agent Tipping Overfilling Reversed flow Control dial in wrong position Leaks Vapor leak Cross contamination
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HAZARDS
TIPPING Liquid from vaporizing Chamberbypass/outlethigh output Drained before moving OVERFILLING In majority, the design of the filling port and agent specific filling systems prevent this During filling do not: Turn the dail ON/Unscrew the bottle adaptor

HAZARDS
Reversed flow Inlet male & outlet female Increased output Physical damage Obstruction to fresh gas flow Interlock malfunction

VAPOURISER check
Check for the required vaporizer Check for the fluid level Filler caps and draining port should be tight Check for the correct seating and locking of the a detachable vaporizer Ensure power supply if electrically operated.

Vapor output
VO: Vapor Output (mL/min) CG: Carrier Gas Flow (mL/min) VP: Vapor Pressure (mmHg) BP: Barometric Pressure (760mmHg) VAA%: Volatile Anesthetic Agent Concentration
VO = CG x VP BP VP VO = Total Gas Flow VAA%

Examples
Halothane: VP 243 mmHg CG: 100 mL/min
VO = (100 mL/min)(243mL/min) = 24300 = 47mL/min (760mmHg 243mmHg) 517 If 1% of Halothane is desired: 47mL/min = 4700mL/min Total gas flow needed 0.01

HALOTHANE
If 100mL/min of O2 enters , 147ml of gas will exit (100mL of O2 picked up 47mL of Halothane) % Halothane exiting is 32% (243/760=0.32) at 1 atm If Only 1% Halothane needed for anesthesia, the 32% needs to be diluted with 4553mL/min 4700mL/min 147mL/min = 4553mL/min

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Isoflurane
Avagadro law 1.5% iso 5 litre/min flow Total /hr = 300l 1.5% = 300* 1.5% = 4.5l 184.5 mol wt iso 22.4l 4.5 37 gms Sp gravity 1.496 37/1.496 = 24.7 ml
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IDEAL VAPORISER CHARACTERISTICS:

Performance should not get affected by changes in fresh gas flow, volume of the liquid, ambient temp and pressure, decrease in liquid temp, pressure fluctuation due to mode of respiration Low resistance to flow

Lightweight with small liquid requirement

Economy and safety in use with minimal servicing requirements

Corrosion and solvent resistant construction

Are we having such type of a vaporiser?

Concluding

Inhalational anesthesia is the most important part of modern balanced anesthesia To efficiently and safely conduct an inhalational anesthesia, a proper knowledge of a vaporiser is a must. THANK YOU