Have you found yourself getting lazy with your machine checks?

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well.

I caught myself yesterday not checking the machine. I have to say, i was annoyed with myself for being so complacent.

Have you all been finding you skip it or parts of it?

anyone ever have something happen due to this?

To me its like flying a plane, you miss your pre-flight, someone may die.... bad bad.
 
The machine only needs to do 2 things...like a good woman.

blow

and

suck...

it only takes 2 seconds to check that.
 
Suction...airway, scope, tube.....seal....done.

Our anesthesia techs spoil us too much. They have never let me down...
 
BLADEMDA said:
Dude, I can't believe you actually posted that on the public side.

Blade
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You should read some of my other Non-PC posts.
waveusa.gif
FLIPA.gif
 
militarymd said:
You should read some of my other Non-PC posts.
waveusa.gif
FLIPA.gif
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because that makes you a real man--being all non-PC and putting down women. ooooh. wow. impressive. 🙄

Have you told your wife/mother/sister/daughter that that's all they really need to do to be a good woman? How'd that go over with them?
 
At the private hosp where I rotated for anesthesia, I have seen ONE attending check the bellows. No one else did a thing.
How common is this outside residency?

Noyac said:
Umh, I'm a little confused.



What's a machine check?😉
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DrDre' said:
At the private hosp where I rotated for anesthesia, I have seen ONE attending check the bellows. No one else did a thing.
How common is this outside residency?
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Thats what the techs are for.
 
pillowhead said:
because that makes you a real man--being all non-PC and putting down women. ooooh. wow. impressive. 🙄

Have you told your wife/mother/sister/daughter that that's all they really need to do to be a good woman? How'd that go over with them?
Click to expand...

You're obviously one of those uppity women.
 
we have the new Drager's that do their own machine check. All we do is turn it on, press a button and voila - it's done! Only thing I've had to do to make the check happy is change an oxygen cylinder once or twice.
 
pillowhead said:
because that makes you a real man--being all non-PC and putting down women. ooooh. wow. impressive. 🙄

Have you told your wife/mother/sister/daughter that that's all they really need to do to be a good woman? How'd that go over with them?
Click to expand...

Relax and pick another cause, dude.....
 
militarymd said:
You're obviously one of those uppity women.
Click to expand...

If not brushing off and laughing at incredibly sexist "jokes" on a public forum that's supposed to be about health care of all things makes me an uppity woman, then yes, and damn proud of it, too.

If someone said something like that about black or hispanic people, it would never fly. Well, guess what? It shouldn't fly when you say it about women either.

When you post all over another thread about implying that women trying to "have it all" (e.g. working moms) are ruining anesthesiology and then you post something like this, you come across as an incredibly mysogonistic person. So pardon me if I'm not just going to relax and ignore someone saying women need to get out of the workplace and all they're really good for is sex anyway.
 
ummmmm...anyways,

Our new Dragers do the test for us.

Otherwise I check pipeline, tank pressure, co2 canister is there, test the patency of the circuit. I haven't done a neg pressure test (which is the only thing that actually tests the machine itself for leaks...the positive pressure test wont. It only tests the circuit) since CA-1 year.

Machine check takes me about 15-20 seconds. It used to take me, during my first week, friggen 20 minutes! WTF man!
 
pillowhead said:
If not brushing off and laughing at incredibly sexist "jokes" on a public forum that's supposed to be about health care of all things makes me an uppity woman, then yes, and damn proud of it, too.

If someone said something like that about black or hispanic people, it would never fly. Well, guess what? It shouldn't fly when you say it about women either.

When you post all over another thread about implying that women trying to "have it all" (e.g. working moms) are ruining anesthesiology and then you post something like this, you come across as an incredibly mysogonistic person. So pardon me if I'm not just going to relax and ignore someone saying women need to get out of the workplace and all they're really good for is sex anyway.
Click to expand...


Forgive me......






you must be one those uppity BLACK women.
 
militarymd said:
Forgive me......






you must be one those uppity BLACK women.
Click to expand...


As a true Southerner would say......."Day-um".


Some of you may razz da military man, but I find it quite refreshing to meet, even if on an online forum, ESPECIALLY in this often nauseating current-day PC-esque atmosphere.......someone that calls it like he sees it.

Makes me laugh.

You go Mil.
 
pillowhead said:
If not brushing off and laughing at incredibly sexist "jokes" on a public forum that's supposed to be about health care of all things makes me an uppity woman, then yes, and damn proud of it, too.

If someone said something like that about black or hispanic people, it would never fly. Well, guess what? It shouldn't fly when you say it about women either.

When you post all over another thread about implying that women trying to "have it all" (e.g. working moms) are ruining anesthesiology and then you post something like this, you come across as an incredibly mysogonistic person. So pardon me if I'm not just going to relax and ignore someone saying women need to get out of the workplace and all they're really good for is sex anyway.
Click to expand...

Does your husband know you left the kitchen to use the computer?
 
rmh149 said:
Thats what the techs are for.
Click to expand...

Our techs suck. So lazy. It is not uncommon for there to be no suction, no back-up O2 cylinder, little agent in the vaporizers. I always check it myself. Takes less than a minute.
 
pillowhead said:
because that makes you a real man--being all non-PC and putting down women. ooooh. wow. impressive. 🙄

Have you told your wife/mother/sister/daughter that that's all they really need to do to be a good woman? How'd that go over with them?
Click to expand...

Being the good ignorant trailer trash redneck that NaziMD is, he just very well might tell all of the above that they need to keep blowing and sucking. I haven't even seen surgeons come off so full of blowhard bullcrap and be so in love with themselves as this clown.
 
Ouch. A sense of humor (even a small one) goes along way.

Lets keep it civil peeps and get back to the EXCITING TOPIC OF MACHINE CHECKS!
 
rmh149 said:
Thats what the techs are for.
Click to expand...

Techs can be helpful but they can also screw you...

On my cardiac rotation the cardiac anesthesia fellow and myself had just finished our first round case, brought the patient to ICU and came back for the second round. We line up all of our patients in an induction room on an OR table so we simply wheel them down the hall into the OR and start induction. For some reason our tech had the brilliance during turnover to remove one of the sodasorb canisters and the rubber seal. He closed the system so you couldn't really tell that anything was missing (older Ohmeda machine).

Three anesthesiologists (attending/fellow/resident) did not notice that this had occurred during turnover (normally they don't touch the machines during turnover, this was truly a freak thing). We induced the patient, tried to put him on the vent and noticed a huge leak in the system. Long story short we had to put the patient on ambu bag until we could find the tech who had taken the canister/rubber seal. Turns out he had gotten "busy" and set it down in the utility room and was going to come back...he did not notice that we had a second round in our room so he thought he had all the time in the world to put it back.

Lucky for myself and the fellow that our attending was cool about the situation and actually took responsibility with us because he is a stand-up guy. Needless to say it was somewhat embarassing having everyone in the OR watch us ambu the patient while waiting for the tech to return. Other attendings would have tried to make us look like fools and maybe even tried to write us up for this.

With that being said do I ALWAYS do a leak test in between cases? No, but if I have time I do. If I don't have time I at least perform a quick visual inspection.

anyone else have similar stories?
 
Stimulate said:
Techs can be helpful but they can also screw you...

On my cardiac rotation the cardiac anesthesia fellow and myself had just finished our first round case, brought the patient to ICU and came back for the second round. We line up all of our patients in an induction room on an OR table so we simply wheel them down the hall into the OR and start induction. For some reason our tech had the brilliance during turnover to remove one of the sodasorb canisters and the rubber seal. He closed the system so you couldn't really tell that anything was missing (older Ohmeda machine).

Three anesthesiologists (attending/fellow/resident) did not notice that this had occurred during turnover (normally they don't touch the machines during turnover, this was truly a freak thing). We induced the patient, tried to put him on the vent and noticed a huge leak in the system. Long story short we had to put the patient on ambu bag until we could find the tech who had taken the canister/rubber seal. Turns out he had gotten "busy" and set it down in the utility room and was going to come back...he did not notice that we had a second round in our room so he thought he had all the time in the world to put it back.

Lucky for myself and the fellow that our attending was cool about the situation and actually took responsibility with us because he is a stand-up guy. Needless to say it was somewhat embarassing having everyone in the OR watch us ambu the patient while waiting for the tech to return. Other attendings would have tried to make us look like fools and maybe even tried to write us up for this.

With that being said do I ALWAYS do a leak test in between cases? No, but if I have time I do. If I don't have time I at least perform a quick visual inspection.

anyone else have similar stories?
Click to expand...


Totally.

Similar thing here.

Had something just like this during a simulation where I didn't check the machine.

Nothing worse than breaking out the ambu after induction.
 
Always check the circuit. Its not uncommon at all for something to be a little loose, or the sodasorb sabotage situation or something else that gives you a big leak. Takes 5 seconds. I do right before I start preoxygenating. MAke sure you pressurize it, then release the popoff (don't just take your thumb off the y-piece) and make sure it depressurizes, otherwise, you still might bne screwed. Then if there's a leak, its because you suck at masking, not because of the circuit.
 
VentdependenT said:
ummmmm...anyways,

Our new Dragers do the test for us.
Click to expand...


I love these things! I rotated at a hospital with them. What I liked most is the screen that that had a timer and a calculator in the utility menu.

I have no idea about piston-driven machines though - they are completely different than machines with bellows. It freaked me out that the bag was moving in and out when the vent was on. I hope the board exam has no questions about them. :scared:
 
Actually, it is pretty amazing how reliable our systems are provided no human interference disables function. Leak test absolute minimum and will keep you safe for all but one in thousand.
 
Another interesting situation at my institution (not my case this time though!!):

From what I heard about the case:

There was a complete membrane in the inspiratory limb of the disposable circuit that totally occluded the lumen of the tubing but was not visible by inspection.

After induction they were unable to ventilate the patient (felt like severe bronchospasm, i.e. no air movement with manual ventilation). After some initial anxiety (they though they had "can't ventilate" situation) I think the team went straight for intubation and were successful. Once they knew they had an airway they again had no ventilation so they switched to ambu bag and figured it out. I think they are writing that case up.
 
Stimulate said:
Long story short we had to put the patient on ambu bag until we could find the tech who had taken the canister/rubber seal.
Click to expand...

Do most places use AMBU? We use jackson-reese (Mapelson F) or Mapelson D. I like them much better than the AMBU for several reasons.
 
intubator said:
Do most places use AMBU? We use jackson-reese (Mapelson F) or Mapelson D. I like them much better than the AMBU for several reasons.
Click to expand...

We don't stock JR circuits in each O.R. but there is always an ambu bag for emergencies.
 
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