Friday, 27 January 2017

Scavenging System in anesthesia workstation

What is scavenging in OT? what are five basic parts of a scavenging system? What are the hazards of a scavenging system?

Scavenging is the collection and the subsequent removal of waste anesthetic gases from the operating room 
Scavenging systems generally have five components  (1) the gas-collecting assembly, (2) the transfer means, (3) the scavenging interface, (4) the gas-disposal assembly tubing, and (5) an active or passive gas-disposal assembly An “active system” uses a central evacuation system to eliminate waste gases. The “weight” or pressure of the waste gas itself produces flow through a “passive system.

Gas-Collecting Assembly
The gas-collecting assembly captures excess anesthetic gas and delivers it to the transfer tubing. Waste anesthetic gases are vented from the anesthesia system either through the APL valve or through the ventilator relief valve which  accumulates in the gas-collecting assembly and is directed to the transfer means. 
Transfer Means
The transfer means carries excess gas from the gas-collecting assembly to the scavenging interface. The tubing must be either 19 or 30 mm, and should be sufficiently rigid to prevent kinking, and as short as possible to minimize the chance of occlusion.and is sometimes  color code with yellow  to distinguish it from 22-mm breathing system tubing.. The two tubes frequently merge into a single hose before they enter the scavenging interface.
Scavenging Interface
The scavenging interface is the most important component of the system because it protects the breathing circuit or ventilator from excessive positive or negative pressure. The interface should limit the pressures immediately downstream from the gas-collecting assembly to between -0.5 and +10 cm water with normal working conditions. Interfaces can be open or closed, depending on the method used to provide positive and negative pressure relief.
Open Interfaces
An open interface contains no valves and is open to the atmosphere, allowing both positive and negative pressure relief. Open interfaces is used  with active disposal systems that use a central evacuation system. Open interfaces require a reservoir because waste gases are intermittently discharged in surges, whereas flow from the evacuation system is continuous.
 An open canister provides reservoir capacity which should be large enough to accommodate a variety of waste gas flow rates. Gas enters the system at the top of the canister and travels through a narrow inner tube to the canister base. Gases are stored in the reservoir between breaths. Positive and negative pressure relief is provided by holes in the top of the canister 
Closed Interfaces
A closed interface communicates with the atmosphere through valves. All closed interfaces must have a positive-pressure relief valve to vent excess system pressure if obstruction occurs downstream from the interface. A negative-pressure relief valve is mandatory to protect the breathing system from subatmospheric pressure if an active disposal system is used. Two types of closed interfaces are commercially available. One has positive pressure relief only; the other has both positive and negative pressure relief.
Gas-Disposal Assembly Conduit
The gas-disposal assembly conduit  conducts waste gas from the scavenging interface to the gas-disposal assembly. It should be collapse-proof and should run overhead, if possible, to minimize the chances of accidental occlusion
Gas-Disposal Assembly
The gas-disposal assembly ultimately eliminates excess waste gas  There are two types of disposal systems: active and passive.
The most common method of gas disposal is the active assembly, which uses a central evacuation system. A vacuum pump serves as the mechanical flow-inducing device that removes the waste gases usually to the outside of the building.
interface with a negative-pressure relief valve is mandatory because the pressure within the system is negative. A reservoir is very desirable, and the larger the reservoir, the lower the suction flow rate needed.
Hazards
Scavenging systems add complexity to the anesthesia system.
 A scavenging system extends the anesthesia circuit all the way from the anesthesia machine to the ultimate disposal site. 
Obstruction of scavenging pathways cause excessive positive pressure in the breathing circuit, resulting in  barotrauma . 
Excessive vacuum  to a scavenging system can cause  undesirable negative pressures within the breathing system. 
Scavenging system catching  fires in engineering equipment rooms that house the vacuum pumps used for waste anesthetic gas evacuation. due to oxygen enrichment 

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