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Various Anesthesia Machine and Related Troubleshooting Notes

Reason Offending Resolution Notes Called Machine Sample line I always check the connection at the connections first. water trap loose. Many times these are CO2 trace on the Tightened 2 turns - loose or cross monitor does not look problem solved. threaded. However, I correct, possibly Agilent gas analyzer. have seen several the sucking air from Change Aquaknot on water traps with outside of the circuit. Sam Module, Change cracked threads, ETCO2 Line and causing a similar Check Sodasorb for leak. saturation All connections were tight, there was mist in the tube, chest rise, CO2 Trace - non- 100% sPO2, but no existent: The CO2 CO2 return.... When Replace the sample trace was visible on carefully examined, Agilent gas analyzer line the monitor, but was the Sample line had or Phillips MP90 "Flat line" even been pinched and monitor Replace Aquaknot though the patient almost fused together and change sodasorb was properly during shipping. intubated. There was a long flat section of the sample tube that could not pass air of any sort. Always check the Receding the gas connections and have CO2 Trace is flat- Agilent gas analyzer bench on the a good rapport to the line. Anesthesia Machine. Anesthesiologists on duty. CO2 sample line is Gas bench sample replaced sample line, some techs, an Dr's occluded line on GE it was kinked feed the sample line Carestation through the swivel arm that carries the the monitor cables on 2

the anesthesia machine to a central organizer, there isn't a lot of room in the channel and the sample line gets smashed flat. We have been asked not to do this. Many times the outlet has not been working and the anesthesia If a blank screen is machines internal present, change the back-up power only power cord outlet. If powers the machine only the Date/Time and not the monitors. Phillips Monitor not stamp is on the The docs raise and displaying screen, re-seat the lower the monitors information other Phillips cable leading from arm on the side of the than the time or is off the data module into machine continuously completely. the housing. throughout the day and eventually, the Reboot monitor and connective cable check all power connection works its connections way loose but appears to be connected. At this facility, the anesthesia technical service providers do not turn-over rooms. A new pst Fabius Anesthesia All of the control (perioperative machine not lines for the services tech) had working!! A very Drager Fabius pneumatic valves in disconnected the panicked call from the manifold had lines and did not tell the room been disconnected. anybody, and the anesthesia provider did not do a vent check before the case started. Reason Offending Resolution Notes Called Machine Bis Monitor is not BIS Monitor Replace the entire The cables become 3

damaged where they enter the patient interface box from constant bending back and forth. Since these cables are accessories, they have to be purchased. cable. Order A refurbished cable replacement cables to cost $1800 with a attach to the box trade-in. The because the cables replacement cables reading that the are damaged. without the box cost: sensor is attached between $120.00- Check power $200.00, depending connections and BIS on which portion of cable and strips the cable you need. They are easy to change out. Just open the box and unclip the plug from the board; clip the new cable in and close the box by screwing the screws back in. Changed the CO2 tubing and the defend cartridge. Did not help. Replaced Gas CO2 not reading Drager Gas bench broken bench with another one and CO2 worked fine. Sent bad gas bench to Bio-med for repair Take off the bench, collector and sodasorb drain every Gas bench, sodasorb piece and let air dry Machine wont pass Daytex Anesthesia and condensation then reassemble. If morning check Machine collector look dry on you have an extra set the outside. of these parts (like we do :) then you can put them on and get rolling right away. Scavenger bag is Daytex Anesthesia While patient is First I would check 4

the hose it may not be connected all the way. Then I would intubated doc calls look down by the you to the room scavenger bag and because his filling up and alarms twist the little black Machine scavenger back looks sounding knob ever so slightly like a model good in the direction that year blimp!!!! allows the bag to What’s happening? drain the waste gas and the bag flattens out again. After checking blood pressure hose which inflates the cuff and assuring there was no split or crack. Went to side of machine and discovered that Called to room the opposite end of Blood pressure cuff tonight because the B.P. hose was not G.E. Aisys monitor not cycling blood pressure cuff connected to the wouldn't cycle. monitor. therefore it could not inflate the cuff. Removed hose completely and reattached to monitor. Dr. was satisfied and there were no more problems. Easy fix! checked the connections and all Called to room were fine. Called because monitor quit Bio-med and they working. Monitor went black G.E. Aisys monitor replaced with a temporary monitor. 2 Check all power weeks later the connections monitor was back repaired. Called to room GE care station Aisys Checked CO2 sample when the anesthesia because pt fico2 was monitor line, then noticed co2 machines get moved over 9 and rising, pt scavenging reservoir to different locations co2 high bag was full, checked it is imperative to the scavenge check and make sure pipeline-it was the machine is 5

disconnected. plugged in and all connected the pipe components are line and readings working before went back to normal starting a new case the soda lime canister I had turned that appeared to have room over prior to been dropped as it case and had done a had a large crack in leak test so I knew it. I'm not a fan of the circuit was good, keeping extra I ask the Dr if she disposable canisters had changed the soda in the rooms because Called to room lime, she stated she if they get dropped or because had, I replaced the knocked over they GE care station anesthesiologist had a disabled canister, and crack and no one anesthesia machine large leak during the leak went away. I notices till its too New Daytex case. Air was to have had this late. Anesthesia Machine escaping for problem and I've anesthesia machine. been working with I make it a point to the store room in check the canister for making sure that cracks when I am when the shipment of putting a new one in. canisters come in. Also, sometimes the That the case or box drain valve is open that it comes in is not below the canisters damaged. which can create a very large leak. Reason Offending Resolution Notes Called Machine Checked CO2 When pushed back sampling line, in, it began working checked defend trap. after a few minutes. CO2 not reading Defend trap had Sometimes you have when machine GE Aestiva/5 popped out ever so to turn the machine checked. slightly preventing off and then back on the machine from again, in order for the checking the gas machine to recheck sampling line. the gas sampling line. Problems with the GE Aestiva/5 Dismantle the I do not know when APL valve sticking working portions of these machines had during a general the anesthesia last been taken down anesthesia case using machine according to and thoroughly an LMA. the maintenance cleaned. My thought instructions for was that it needed to 6

cleaning. Clean and sterilize/disinfect as be cleaned. The recommended. In CRNA's thought it between terminal was something wrong cleaning times, with the valve itself. change out parts that The GE service rep. are excessively wet thought it was just that you can if the moisture. As it turned problem reoccurs. out it was excessive Remove the manifold moisture and mold if necessary and dry growth in the thoroughly. Retest machine. Once it was for leaks when you cleaned and the reassemble the excess moisture machine. removed, the machine functioned Check valve filter for without problems. excessive condensation No CO2 end-tidal Daytex Anesthesia I will check the CO2 If the problem is not reading on the Machine sampling line to fixed, with the patient anesthesia machine at make sure there are in the room, I would all no kinks as well as bring a new the defend trap. Also anesthesia machine discuss with the and will prepare to anesthesiologist connect the circuit to about any solution to the patient -- push the problem. back the dysfunctional machine and bring the new one closer to the patient and hoping that there is a CO2 end-tidal reading.

If your anesthesia machines have modules for the ETCO2, BP, etc.; it is easier to change the module out first, than the whole machine. I have had this occur before and when the module was switched 7

the problem was corrected. The faulty module was sent to Bio-Med who sent it off to be repaired. I will check the I thought I tried circuits to the everything, except machine are one thing that I connected properly. I haven't thought of - is will check also the the sodasorb - there sampling line is are no indications of connected to the color change but The circuit check Datex Anesthesia circuit and to the there is a small crack failed. Machine machine because under the canister. So sometimes it is changing the loosely attached. If sodasorb then the circuit check fails rechecking the circuit again, I will put will result to a passed brand new circuits on circuit for the next the anesthesia new patient case. machine. I checked the plastic I'm surprise how it Call to the room tube that sits over the would get bumped because the bellows Datex-Ohmeda bellows and made enough that would were not filling up sure it was seated in cause a leak. place. it was time to replace checked the d-fend the d-fend trap so i trap and it did have call to room for d- put in a new one and Datex-Ohmeda water in it and it was fend alert pop it in place and pop out enough for everything worked the alert find put the part back on the right way and ran circuit leak test keeps another test and failing found that the everything worked machine had been circuit leak Datex-Ohmeda taken apart for It is very important to cleaning and not put perform a leak test back on right after cleaning the machine. Prevents headaches later. Problem with bellows Excel exel210 stated doing a talk to my co-worker pressure test found never change nothing the night before they if you are in rush to 8

change the sodalime they didn`t do a go home (the patient pressure check and it was in room and was not adjust almost was put properly . realigned sleep ) to pressure test back in service. got in the room check sample line it look go then I check the filter talk to all the it was change two anesthesia tech days ago it was good everytime they too . Them I check change the filter on a when was the last Bad CO2 RGM RGM to calibrated time that it was with calibrated gas calibrated and is was .And to too regular about two weeks calibration twice a when it was day. calibrated . Took some calibrating gas re-calibrated . Reason Offending Resolution Notes Called Machine Audible Leak issuing Excel 210 I called our Service This machine had from under table top rep who thought it been tampered with of Excel Anesthesia might be the vacuum and when I turned the machine that I was hearing. machine on to Disconnected the perform a machine vacuum/scavenger check after replacing hoses, leak the circuit, sampling continued. The line and such, I heard machine was taken an audible leak. It did out of service until not affect the the rep came to repair machine check or it. The leak was leak test. coming from the machine on/off When the rep switch. The switch removed the table was replaced and the top, we noticed that leak was corrected. one screw that holds the switch stable was completely out and off to the side. The other was halfway 9

out. He stated that in 17 years of working on these machines he had never seen the screws work loose on a machine. Checked all Bellows cover had connections and come untwisted and discovered loosened Bellows won't drive G.E. Aisys didn't have a seal. I bellows cap. ventilator Carestation always check the Tightened bellows bellows cap between cap and achieved a each case now. proper seal Could not Anesthesiologist duplicate---Called O2 flush valve stuck stated this was GE Carestation Bio Med---Bio med in or in the on dangerous and could anesthesia Machine cleaned debris from position have given pt a inside machine pneumothorax. around valve. Called to room GE Carestation Switched the Anesthesia was very because the "Do machine during the upset as the case was anesthesia check out" case. When the case underway. There was display was on. was done a complete nothing I could do calibration check out aside from switching was done, and the out the machine. As machine passed. the machine seemed to be fine we left the machine. We checked the log on the , and it had been more than 24 hours since the last test.The Dr. had me write an incident report, as if something had happened during the case and the pre- check hadn't been done he and the anesthesia tech working am would have been in trouble as neither noticed the machine had not been calibrated before 10

starting the case. Reason Offending Resolution Notes Called Machine If you change the user from adult to pediatric or neonatal, the label changes to pediatric or neonatal but the alarm pediatric patient parameters are the blood pressure and same unless you change the patient heart rates are giving change the patient Phillips Monitor Profile to pediatric or alarms on normal Profile to pediatric or neonatal values for pediatric neonatal. The screen pts. goes black for a half a second then shows the patient’s profile and alarm parameters are for the appropriate age group. Flow sensor failure Drager Apollo We had to devise a The only other mid case Anesthesia Machine way to ventilate the alternative would patient while have been to bag the removing the flow patient and switch sensors which machines mid-case. requires taking the We were not patient off the comfortable with that ventilator. We plan of action unless hooked an Ambu bag we had to in order to to the side O2 port minimize infection and let the anesthetist chances. bag the patient. Then, two of us had practiced on a different machine in a downed room. We then used the Red- Handled Allen Wrench to unlock the chamber and remove the top housing. We unscrewed the valve covers and replaced 11

both the inspiratory and expiratory sensors at the same time. Reseated the top housing and attached the housing to the circuit and finished in all of Fifty-Three seconds. The patient was reattached to the machine and within 2 minutes the alarms stopped and gave accurate readings. The Sodasorb Changed the circuit canister had a small twice. Changed the crack on the back water trap to ensure side of the housing no leak. We could not which couldn’t be hear any leak at the seen from the front patient’s airway and Circuit leak Mid-case but when I knelt the cuff held down I could hear a pressure. The crack faint whisper of air was only a millimeter during breaths. or two in length but Replaced canister was enough of a and of course, the crack to create a leak disappeared. considerable leak. sometimes, you may The CO2 tubing can reverse the sometimes cross Circuit leak during connections to the thread if forced onto leak test water trap and circuit the water trap. and obtain the same Switched out tubing. result. Reason Offending Resolution Notes Called Machine Called to room I had the CRNA bag Finish the case and because the left the patient and I then I called the screen went blank Datex-Ohmeda rebooted the machine service rep to check and machine failure and the screen came out the machine appeared on the back normal further. screen Called to the room Datex-Ohmeda I had the CRNA bag I called the service because of vaporizer the patient as I switch rep to fix the machine 12 failure out the machine The machine air hose was connected into a Y connector so OR could their I was in the room equipment up to air when the CRNA had Datex-Ohmeda and it was drawing Air supply pressure too much air pressure lost from the Anesthesia machine. So I switch to Air reserve gas cylinder. I would check the tracheal tube for any Called to the room leaks then I would because there wasn't change the sampling Datex-Ohmeda a CO2 tidal volume line then if I'm still reading not getting a reading then I would change the module. There is an assumable, hard to Called to the room If you reach to move recognize button on because the patient the monitor from the Datex-Ohmeda the side of the monitoring display side. You will turn monitor. I rebooted went blank. the monitor off. the monitor and continued the case. Air Alarm was going There was something off when I was Belmont Rapid on the sensor so I priming the Rapid Infuser cleaned it with a Infuser damp cloth. We do not use the Jet Vent very often so when I was called for this alarm I had to get Biomed right away. Acutronic Jet Power Fail Alarm We had to bring them Ventilator a new Jet Vent because the other one needed a new battery and it could not be changed in the room Cell Saver Centrifuge Cell Saver 5+ The bowl was not error properly seated and 13

therefore was not allowing the centrifuge to spin. Took bowl out and reseated, error message gone. Reason Offending Resolution Notes Called Machine The Reservoir tubing that attaches to the machine was too I always double The Rapid Infuser tight and was causing check the reservoir was not priming Belmont the roller to not work level prior to priming properly. correctly. I moved the pump. the reservoir down and restarted the prime, it worked fine. The Machine had not been QC correctly. This should only The Cell Saver was Therefore, the tubes been done in non tripping before it had to be clamped off emergency cases. If reached the volume Cell Saver 5+ and the machine had you cannot do it then needed to wash a to be turned off. I ran you can run the bowl. a QC a second time machine in manual and it worked as it mode should. When the Air Tank was put on it had been tightened too I was called into the much and there was room because the air GE Datex - Ohmeda causing and error. It tank was reading Aisys could have also empty. The tank had caused damaged the just been changed. pin system if they continued to tighten them too much. During the case the Called to the room machine had been because the Cerebral moved and the Oximetry was Somanetics - connection to the PC alarming a yellow Cerebral Oximetry had been pulled out. code. Output device After reconnection not connected. the alarm went away. 14

The Waste bag was too full and was not Fluid Detected in the allowing the waste to Cell Saver 5+ centrifuge go anywhere. Once we emptied the bag the alarm went away. Reason Offending Resolution Notes Called Machine Could not get the flush to stick. Called Biomed to check out. O2 flush button stuck GE Aisys Biomed took the open machine apart and cleaned all parts. Could not duplicate Checked all connections of the CO2 tubing, elbow, hoses, sodasorb canister, breathing bag. Checked for moisture in the flow sensor, and condenser. Set APL circuit leak test failed GE Aisys valve between 30 and 70. Filled breathing bag with O2. Released using the drain valve on the condenser. Lots of moisture was released. Did this several times. Circuit leak test passed. Circuit leak test GE Aisys Checked all failure connections on circuit and CO2 tubing. Reset defend cartridge. Still would not pass. Changed out the CO2 canister and test passed. Found a small crack in the housing of the 15

CO2 canister Sevo vaporizer won't seat. Keeps popping out. Changed to a Vaporizer won't seat GE Aisys new vaporizer and sent offending vaporizer to Biomed for repair. FICO2 reading above Changed sodasorb GE Aisys 7 canister. easy fix While checking the Draeger machine in OB, The pressure was not steady. Leaking. I reset the Pressure test not absorbers and Draeger steady checked the Spiromed. This fixed the problem. I think the sodasorb canisters were not seated tightly. The placement of the tubing in the valves Cell Saver Error, Air was not seated Cell Saver Detected in Fill Cycle correctly, removed and reseated. Quick fix The Cable had been Called to room for damaged and had to blank screen on Glidescope be sent to Biomed to Glidescope be fixed The tubing next to the roller pump had not been inserted correctly and was Pump Error Cell Saver 5+ keeping the pump from rolling. Adjusted the tubing and problem solved. The Patient was Belmont Rapid High Pressure Alarm checked and the rate Infuser had to be lowered. 16

Reason Offending Resolution Notes Called Machine Some of the Fibers Very important to had been broken and hold scope properly Black Spots on Storz Fiberoptic scope had to be sent or it will break the Screen Bronchoscope to Biomed to be fibers and it is very fixed. expensive to fix! Sometimes the cables Art Line Cable not Replaced the cable GE Aisys can be worn down working with a new one. and become cracked. need to check the batteries before each Replaced the case. batteries It makes it easier if Try replacing all you check your No light in the weak batteries batteries on a weekly Laryngoscope laryngoscope weekly or twice a or biweekly basis and week if necessary. replace any that are Check batteries on not bright. I do this Tuesdays and on my laryngoscope Fridays. handles and intubating bronchoscopes. I got lucky, discovering this cord Checked all circuit wasn't functioning. I breaker pop out took a cord from buttons. All were another room and fine. Checked power replaced the bad one. Draeger monitor went blank, cord and discovered Had Biomed replace Narkomed(our old during case it had no power cord in the other anesthesia machines) supply. Replaced room the next day. power cord and No more problems. If monitor came back something similar online. were to happen I would check the power cord first. Laryngoscope handle Heine handles .replaced batteries our laryngoscope light flickering and the problem handles get wiped persisted. Took the down with 17

handle apart and discovered moisture had accumulated inside the handle. Took handle completely apart and dried all pieces. Also, disinfectant between took sandpaper and each case. So cleaned the occasionally they get connection between moisture inside. the batteries and the bulb, where slight corrosion had accumulated. put it all back together, and no more problems w/that handle. You can touch any When hooking up the button on the screen Bair hugger make to turn off the alarm sure that nothing is but you should also blocking the airflow. Over temp Light unplug the machine If the flow of air is flashing and alarm Bair Hugger and call your Bio blocked or impeded sounding Med Tech to service in anyway; it will the machine. cause the machine to Replaced with a read "Over Temp" different Bair Hugger and alarm. Tried to increase the volume on the screen but no sound still. Changed the batteries GE Dash 300 No sound and there was still no Monitor sound. Had to get a new monitor and take the other one to Biomed. During intubation Storz Fiberoptic Doctors had turned Check to make sure screen went black Bronchoscope the screen really hard the cord to the towards them in monitor is secure in panic to see better the back before and when they did so giving machine to they pulled the cord doctors. out of the back of the monitor. Just had to plug it back in and 18

we were up and running. Turned up the suction rate as high as I could with out damaging If you need a second the RBC but not set of tubing you change. Then i found should either get that someone taken a another Cell Saver or Suction not working Cell Saver 5+ second set of tubing attach another correctly from the surgeon and reservoir to IV pole placed it on the and give the surgeons reservoir. This was another set of sterile causing the main tubing tubing to not have proper suction.

Reason Offending Resolution Notes Called Machine Checked the monitor to see if the parameters were set to the appropriate Pressure Transducer scale they were so No waveform (ART, CVP, PA) then I made sure that the parameters were turned on…which, they were not. Problem fixed. The locking this problem has just mechanism was worn started happening Vaporization cassette and the cassette GE Carestation, with a few of the keeps popping out of would not stay Aladin2 cassette machines our machine, wont stay in latched. Replaced the machines are about 3 cassette with a new and a half years old one, problem solved. Called to room there GE Carestation The machine had this happens alot is a "large leak" you anesthesia machine passed the circuit when the anesthesia could here it leak test prior to case provider changes the starting, but the soda lime cannister, anesthesia doc had because they are busy replace the multitasking, I wish disposable co2 they would just call canister during us to do it. current case, and had 19

not seated the canister cradle firmly enough, I released the canister and reseated it into the cradle, problem solved The touch sensitive buttons on the side of the monitor were cracked (I believe I've asked if we Called to room this is caused by the should use different because the cleaning wipes we GE Carestation cleaning wipes, but resolution buttons on use) and flaking off. I patient monitor have been told by the the side of the patient called bio med and display. GE reps that the ones monitor would not they replaced the we use are the work interface key pad recomended ones with a new one, as we don’t stock those parts, problem solved. Always when turning over a room the i check the hose suction should be could not see check and also before anything wrong then the case the i check the anesthesiologist connections to the should also check. canister and could see that the lid was It is the ultimate not put on tight this responsibility of the was a easy fix. anesthesia provider to Called to room for Datex-Ohmeda check their machine suction not working When setting up a before each case to new suction canister, ensure there are no always apply suction problems with the until you hear a small machine and that pop. This lets you there is working know that the top is suction available; but sealed. Also check we all know who will your gauge to make get yelled at if sure you have something is wrong working suction. or there is not suction. Intubation Fiberoptic When the dr. went to The scope should be 20

use the light was out check before going in Bronchoscope on scope i replace the the room. battery. Talk to supply Check machine is support to very good change circuit careful when opening and it work take old Bellows not raising Draeger-Apollo boxes with knife circuit test in other because of what machine it had knife happen and I show cut. them the circuit. The transducer that I Check monitor pass change took the lot pressure no problems change number and made Bad waveform transducer( ART) transducer and go it report to see if we working. will get some more defectives transducer. Talk to my co-worker to be careful when turning over a room Would not pick up and always set the and I when check out machine for proper the machine it was cases from adult to Pressure cuff peds size set for an adult. I peds. went change setting This does not happen everything back to on the Aestiva/5: it normal. will read the BP regardless of what it is set on. Usually these machines do not work properly if the battery is weak. If it is the wires that Replace battery first. are the problem, If it still doesn't work replacing them Nerve Stimulator is Micro-Stim Nerve replace the wires (if usually resolves the not working Stimulator they are being used). issue. Rarely is it the If all else fails, send actual machine. it to Bio-Med. I always keep an extra 9 volt battery on each anesthesia cart because you never know when it will be needed. Battery safety issue Infus O. R. syringe Use Duracell "C" cell Received a safety 21

alert from the company stating that Energizer batteries pumps batteries can cause the pump to malfunction or fail and to stop using them.

Pt arms were tucked During long cases at sides during open especially ones where heart surgery, unable arms are tucked it’s a to get under drapes to good idea to place the check probe or probe sensor on an Monitor reading "no connections. I got the area that’s not probe" on sp02 GE Care station spare trunk cable out confined. When the monitor. of the anesthesia case was over and we machine and placed a removed the arm forehead probe on pt. sleds, I noticed the Immediately got a finger probe was tracing and a o2 sat smashed and moved reading of 100% off the finger. fluid level was low Called to room Baxter Hot line fluid refilled with because fluid warmer warmer hydrogen peroxide/ was alarming sterile water solution

The screen was not Some anesthesia docs Called to room configured to show change screen set ups because they had set Art line. I went to for their cases and up the art line and Carestation GE monitor set up, went don’t switch them they could not get to screen one set up back, its a good idea "Art Line" to show and added Art line to to check this after up when connecting the wave form screen each case the cable The interface module that allows information to be shared from main Machine was still Could not get Fico2 monitor to the slave usable and there is a reading on top GE Carestation monitor in a more fico2 reading on the monitor prominent form on main monitor its just top of the machine not as easy to see was broke, called bio med and they brought up a new module. 22

Reason Offending Resolution Notes Called Machine Checked the hose system on the Airway Pressure Fabius Tiro machine and found High there was a kink in the hose. The APL bypass valve connection and Error message Fabius Tiro become "Check APL Valve" disconnected. Easy Fix Tanks were all full so next I checked the Error message "Fresh breathing circuit and Fabius Tiro Gas Low" found there was a leak. Replaced circuit and problem solved. The anesthesiologist The monitor went not happy about this black during case I but I made sure that check all the when biomed was connections coming he also made everything looked Called to room for sure he had a monitor Daytex Ohmeda good to me. I called monitor not working with him so we could biomed and we save time. All of our pulled the monitor rooms were going so and put a new one on I could not get a and everything monitor from another worked out fine. room I checked the blood pressure hose and found a split in the Called to room for hose. I went and got blood pressure cuff Datex Ohmeda a new hose and not working replace it and everything worked out Called to room for 02 Datex Ohmeda I change the oxygen sensor not working sensor on her finger and still wasn’t working. I took the O2 sensor box from 23

the anesthesia machine and replace it with another o2 sensor box and it worked out. i then sent the bad box to biomed to be checked out Found monitor cord unattached from gas CO2 gas bench not bench. Screws to registering on Draeger hold in place monitor stripped. called biomed and had cord replaced Turned off Baer Hugger, turned back on. Changed temp Baer Hugger not settings, still not Baer Hugger heating heating. Sent to biomed for repair and replaced with another one Upon inspection of the EKG leads found EKG not working one crushed from the EKG, Aisys after case started arm board. Got new EKG leads and problem solved Write up a work Moved the anesthesia One of the cylinders order so maintenance machine to the other does not connect to Cylinder can fix the damage hook up on the other the ceiling hose hanging from side of the room the ceiling I would taped the drawer on the side so The drawer of the Write up a work Datex Anesthesia the drawer doesn't anesthesia machine is order so Biomed can Machine slide back and hit the broken fix the loose drawer anesthesiologist in the leg Went switch out with The alarm went off Fluid warmer was another fluid warmer Ranger because it was alarming and then had Bio- getting to warm. med check it out. 24

I notice that the tank was closed but it was empty. I changed the tank with a new one. I then disconnected the air hose from the Called to the room GE service rep came pipe line and from because the air tank out and replace the Datex the back of the was empty on the one way valve in the machine. I turn the back of the machine. back of the machine. air tank on and heard it leaking from the machine. I reconnected the air hose to the machine and the pipe line. Not reading change After the case was PC and still not over I try the old PC reading change cable Called pressure cuff on me (the one that Draeger Apollo from machine and not working didn`t work on the still not reading, got patient) and it worked PC for the thigh and on me. work. Not getting the right waves and tried a Checked the lot couple of time we number to see if we Call in to help with a change swan and GE Aestiva /5 got some more swan work it was a defective ones, but defective one I spent none so far. in that room to one hour before I got out. The patient was on mechanical ventilation, i asked the Dr. if we could turn off the machine to re-boot. He bagged Machine had two the patient while we That spare housing alarms going off all Aespire did this; 12 hour test for the flow sensors at once: 12 hour test alarm was cleared. is invaluable. and Insp. rev flow. Next, I swapped out the flow sensors with a spare housing containing new sensors. Insp. rev flow alarm cleared. 25

Checked all cables were connected. Got a portable monitor so the Dr. could maintain the patient. Monitors went black, Aespire called service but still had sound provider, they suggested a cord failure. had biomed bring up spare cord. problem resolved. In an emergency one may use a 3 lead ECG set attached to a 5 lead cable and it This always occurs may work correctly Complaints about when the 3 lead set is but most often it ECG wave being too GE Aestiva 5 and plugged into the 5 produces a wide wide and the Datex Ohmeda Excel lead cable. Changed wave form. I had anesthetist cannot 210 the cable to a 3 lead troubleshot this correct it on the one and the problem previously to the monitor. was corrected. extent of changing the module, ECG leads and 5 lead cables and still had the problem. ...I always dbl check connections first and This happens over then quickly scanned time but the cuff can Called to room: BP and found culprit to be restored...Biomed Draeger Narkomed cuff not inflating be the "Y" in the cuts hose beyond GS properly hose was split further split and reattaches than normal...I the metal tips…back grabbed b/u hose all on track you go..voila was good

Reason Offending Resolution Notes Called Machine I, too, get called Draeger, Narkomed I have found that I try not to keep because the EKG sometimes it is merely excessive clutter wave is reading interference...Something items or cords wide but my source as simple as unplugging around. (Safety 1st) is different the OR table, contingent …like Bair 26

huggers...fluid upon the fact the bed is warmers... "not in "charged", and often use" or other items times it solves it that may encourage interference

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