Veterinary Anesthetic and Monitoring Equipment

List of Contributors xvii Preface xxi 1 Medical Gas Cylinders and Pipeline Systems 1 Carl Bradbrook 1.1 Medical Gas Cylinders 1 1.2 Liquid Oxygen Tanks 8 1.3 Oxygen Concentrators 9 1.4 Medical Gas Pipeline Systems 9 References 15 2 Oxygen Concentrators 17 Allan Williamson 2.1 Introduction 17 2.2 Function 17 2.3 Product Gas 17 2.4 Clinical Use 18 2.5 Advantages 20 2.6 Disadvantages 20 2.7 Hazards 20 2.8 Summary 21 References 21 3 Small Animal Anesthetic Machines and Equipment 23 Craig Mosley and Amanda Shelby 3.1 Introduction 23 3.2 Safety and Design 23 3.3 The Basic Veterinary Anesthetic Machine 23 3.4 Breathing Systems 33 3.5 Waste Gas Scavenge Systems 33 3.6 Routine Anesthesia Machine Checkout Procedures 33 References 34 4 Large Animal Anesthesia Machines and Equipment 35 Amanda Shelby 4.1 History of the Large Animal Anesthesia Machine 35 4.2 Purpose 35 4.3 Standards 35 4.4 Similarity to Small Animal Machines 35 4.5 Components of the Anesthesia Machine 36 4.6 Large Animal Anesthesia Workstations 41 4.7 Common Commercially Available Machines 41 4.8 General Cautions 51 4.9 Miscellaneous Equipment for Large Animal Anesthesia 51  References 53 5 Anesthetic Vaporizers 55 Sharon Fornes, Kristen G. Cooley, and Rebecca A. Johnson 5.1 Introduction 55 5.2 Vaporizer Physics 55 5.3 Vaporizer Classification 56 5.4 Other Factors Affecting Vaporizers 62 5.5 Maintenance and Repair 64 5.6 Current Vaporizer Standards 65 5.7 The Modern Vaporizer 65 5.8 Specific Vaporizers 66 5.9 Summary 71  References 71 6 Anesthetic Ventilators 73 Katrina Lafferty 6.1 Introduction 73 6.2 Ventilator Function in the Breathing Circuit 73 6.3 Tidal Volume Delivery 73 6.4 Driving Gas 74 6.5 Bellows Construction 75 6.6 Pressure Limiting Controls 76 6.7 Gas Pressure Alarm 77 6.8 Exhaust Valve 77 6.9 Spill Valve 77 6.10 Ventilator Hose Connection or Ventilator Hose Switch 77 6.11 Ventilation Modes 78 6.12 Cleaning and Sterilization 79 6.13 Pressure Checking 79 6.14 General Concerns and Troubleshooting 80 6.15 Pediatric Ventilation 81 6.16 Basic Ventilator‐Patient Set‐up 82 6.17 Small Animal Mechanical Ventilators 82 6.18 Large Animal Mechanical Ventilators 85 6.19 Conclusion 89  References 89 7 Humidification and Positive Pressure Equipment 91 Stephanie Keating and Stuart Clark‐Price 7.1 Humidification 91 7.2 Positive Pressure Equipment 96  References 98 8 Waste Anesthetic Gas Collection and Consequences 101 Heidi Reuss‐Lamky 8.1 Introduction 101 8.2 Occupational WAG Exposure 101 8.3 Physical Properties and Elimination 102 8.4 Pharmacodynamics 102 8.5 History of Governmental Regulations and Trace (Waste) Gas Exposure 104 8.6 WAG Exposure Level Recommendations 104 8.7 Reducing Environmental WAG Exposure 104 8.8 The Anesthetist’s Responsibility 107 8.9 Monitoring WAG Exposure 112 8.10 Summary 112 References 113 9 Hazards of the Anesthetic Delivery System and Operating Room Fires 115 Odette O 9.1 Hazards of the Anesthetic Delivery System 115 9.2 Operating Room Fires 123 References 125 10 Components of the Breathing System 127 Craig Mosley and Amanda Shelby 10.1 Breathing Systems 127 10.2 Summary 139 References 139 11 Mapleson Breathing Systems 141 Tatiana Ferreira 11.1 Introduction 141 11.2 Fresh Gas Flows (FGFs) 141 11.3 Advantages and Disadvantages 141 11.4 Choice of System 143 11.5 Specific System Types 143 11.6 Combined Systems 150 11.7 Respiratory Gas Monitoring 150 11.8 Potential Hazards 151 References 152 12 The Circle System 155 Geoffrey Truchetti and Trish Anne Farry 12.1 Introduction 155 12.2 Components 155 12.3 Component Arrangement 162 12.4 Gas Flow 164 12.5 Resistance and Work of Breathing in the Circle System 166 12.6 Dead Space 166 12.7 Heat and Moisture 167 12.8 Maintenance 167 12.9 Advantages/Disadvantages 168 References 168 13 Laryngoscopes 171 Erin Wendt‐Hornickle 13.1 History 171 13.2 Laryngoscope Use 171 13.3 Description 171 13.4 Fiber Optic Endoscopes 174 13.5 Veterinary‐Specific Laryngoscopes 175 13.6 Summary 175 References 176 14 Supraglottic Airway Devices and Tracheal Tubes and Stylets 177 Jennifer Sager 14.1 Introduction 177 14.2 Laryngeal Mask Airway (LMA) 177 14.3 Veterinary‐gel (v‐gel®) Airway Device 178 14.4 Endotracheal Tubes 179 14.5 Large Animal Endotracheal Tubes 184 14.6 Reinforced Tubes 185 14.7 Laser Safe Tubes 185 14.8 Single Lung Intubation 186 14.9 Stylets 187 14.10 Cuff Pressure Manometers 188 14.11 Summary 190 References 190 15 Oxygen Delivery Systems 193 Jonathan Bach 15.1 Introduction 193 15.2 Oxygen Supplementation Techniques 193 15.3 Hyperbaric Oxygen 197 References 197 16 Gas Monitoring 199 Louise O’Dwyer 16.1 Introduction 199 16.2 Capnometry/Capnography 199 16.3 Oxygen Measurement 207 16.4 Nitrous Oxide and Inhalation Agent Analyzers 208 16.5 Blood Gas Analysis: Partial Pressures of Oxygen and CO2 210 16.6 Conclusion 210 References 210 17 Airway Volumes, Flows and Pressures 213 Andrew Claude and Alanna Johnson 17.1 Introduction 213 17.2 Definitions 213 17.3 Volume and Flow Measurement Devices 214 17.4 The Ventilatory (Respiratory) Cycle 218 17.5 Airway Pressure Monitoring 219 17.6 Spirometry Loops 219 References 222 18 Pulse Oximetry 223 Odette O 18.1 Introduction 223 18.2 History 223 18.3 Importance of Pulse Oximetry 223 18.4 Function 224 18.5 Pulse Oximeter Probes 224 18.6 Uses 225 18.7 Oxyhemoglobin Dissociation Curves in Different Species 225 18.8 Patient Factors 226 18.9 Abnormal Hemoglobin 227 18.10 Sources of Error 227 18.11 Perfusion Index (PI) and Plethysmograph Variability Index (PVI) 228 18.12 Other Pulse Oximeter Models 229 18.13 Low Saturation Alarms 231 18.14 Pulse Oximetry Use in the Recovery Period 231 18.15 Summary 231 References 232 19 Cardiovascular Monitoring 235 Anderson Favaro da Cunha and Rebecca A. Johnson 19.1 Introduction 235 19.2 Definitions 235 19.3 Measurement Techniques 235 19.4 Patient Point of View 244 19.5 Central Venous Pressure (CVP) 245 19.6 Cardiac Output Monitoring 246 19.7 Conclusion 248 References 248 20 Electrocardiography 253 Tracey Lawrence 20.1 Overview 253 20.2 The ECG Machine 253 20.3 Lead Systems 254 20.4 Mean Electrical Axis (MEA) 257 20.5 ECG Cycle 258 20.6 Electrode Placement 260 20.7 ECG Filters 263 20.8 Evaluating the ECG 264 20.9 Equipment Maintenance 268 20.10 Summary 268 References 269 21 Neuromuscular Transmission Monitoring 271 Molly Allen and Rebecca A. Johnson 21.1 Introduction 271 21.2 Neuromuscular Transmission 271 21.3 Peripheral Nerve Stimulation 271 21.4 Monitoring Techniques 275 21.5 Other Equipment 279 References 280 22 Temperature Regulation and Monitoring 285 Caroline Baldo and Darci Palmer 22.1 Introduction 285 22.2 Heat and Thermodynamics 285 22.3 Thermoregulation 285 22.4 Types of Heat Loss 286 22.5 Heat Loss During Anesthesia 287 22.6 Effects of Hypothermia and Hyperthermia 288 22.7 Re‐Warming 289 22.8 Temperature Monitoring Devices 290 22.9 Sites of Temperature Monitoring 291 22.10 Warming Devices 293 22.11 Active Warming Devices 293 22.12 Other Techniques to Minimize Heat Loss 298 22.13 High‐Risk Heating Methods 299 References 300 23 Fluid Regulation and Monitoring 303 Julie Walker 23.1 Overview of Fluid Physiology 303 23.2 Assessment of Fluid Balance 304 23.3 Advanced Fluid Balance Monitoring Techniques 307 23.4 Fluid Therapy 311 23.5 Equipment for Fluid Therapy 312 23.6 Summary 319 References 319 24 Anesthetic Records 323 Thomas Riebold 24.1 Introduction 323 24.2 Maintaining Anesthetic Records 323 24.3 Monitoring Recommendations 323 24.4 Paper Anesthetic Records 324 24.5 Electronic Anesthetic Records 324 24.6 Transitioning from Paper to Electronic Medical Records 327 24.7 Specific Types of Anesthetic Monitoring Software 328 24.8 Patient Management and Digital Records 330 24.9 Automated Dispensing Systems and Record Keeping 333 References 333 25 Equipment for the Magnetic Resonance Imaging System 335 Kris Kruse‐Elliott 25.1 Basic Principles of Magnetic Resonance Imaging 335 25.2 Regulations 337 25.3 MRI Hazard Classification 337 25.4 Types of Metal 338 25.5 Gauss Lines and Safety Zones 338 25.6 Specific Hazards 339 25.7 Compatible MRI Equipment 340 25.8 Anesthetic Machines 340 25.9 Vaporizers 341 25.10 Ventilators 342 25.11 Laryngoscopes 342 25.12 Endotracheal Tubes and Airway Devices 342 25.13 Monitors 342 25.14 Miscellaneous Items 345 25.15 Summary 346 References 346 26 Equipment for Environmental Extremes and Field Techniques 349 David Brunson and Kristen G. Cooley 26.1 Environmental Extremes 349 26.2 Temperature 349 26.3 Atmospheric Pressure 351 26.4 Drug Delivery Systems 352 26.5 Monitoring Equipment 356 26.6 Field Techniques 358 26.7 Anesthesia for Situations with Limited Means 358 26.8 Stress 362 26.9 Summary 363 References 363 27 Equipment Checkout and Maintenance 365 Molly Allen and Lesley Smith 27.1 Introduction 365 27.2 Daily Checks 365 27.3 Other Equipment 373 27.4 End of Case 373 27.5 Preventative Maintenance 374 References 374 28 Equipment Cleaning and Sterilization 377 Cristina de Miguel Garcia and Kristen G. Cooley 28.1 Introduction 377 28.2 The Decontamination Process 378 28.3 Recommendations for Cleaning and Disinfecting Specific Items 384 References 388 29 Unique Species Considerations: Dogs and Cats 391 Turi Aarnes 29.1 Introduction 391 29.2 Intubation 391 29.3 Breathing System 392 29.4 Monitoring 392 29.3 Recovery 393 29.6 Anesthetic Risk 393 References 394 30 Unique Species Considerations: Ruminants and Swine 395 Denise Radkey, Lindsey Snyder, and Rebecca A. Johnson Part I: Ruminants 395 30.1 Introduction 395 30.2 Handling and Restraint 395 30.3 IV Catheterization 396 30.4 Induction Equipment 397 30.5 Tracheal Insufflation and Demand Valves 403 30.6 Padding and Positioning 404 30.7 Monitoring Equipment 406 30.8 Commercial Anesthetic Machines 408 30.9 Anesthetic Circuit 408 30.10 Anesthetic Recovery 409 30.11 Summary 410 Part II: Swine 410 30.12 Introduction 410 30.13 Handling and Restraint 410 30.14 Intravenous Catheter Placement 411 30.15 Induction Equipment 412 30.16 Monitoring Equipment 414 30.17 Anesthetic Circuit 415 30.18 Anesthetic Recovery 416 30.19 Summary 416 References 416 31 Unique Species Considerations: Equine 419 Carolyn Kerr 31.1 Introduction 419 31.2 Sedation and Pre‐Anesthetic Period Considerations 419 31.3 General Anesthesia 426 31.4 Recovery Period 437 31.5 Medical Records 437 References 438 32 Unique Species Considerations: Avian 441 Carrie Schroeder 32.1 Introduction 441 32.2 Anesthetic Considerations 443 32.3 Venous Access 445 32.4 Anesthetic Monitors 446 32.5 Anesthetic Circuits 447 32.6 Maintenance of Body Temperature 448 32.7 Anesthetic Recovery 448 References 449 33 Unique Species Considerations: Rabbits 451 Katrina Lafferty 33.1 Introduction 451 33.2 Intubation 451 33.3 Breathing Circuits 454 33.4 Monitors 454 33.5 Thermal Support 458 33.6 Summary 458 References 458 34 Unique Species Considerations: Rodents 461 Mario Arenillas Baquero and Rebecca A. Johnson 34.1 Introduction 461 34.2 Anesthetic Machines 461 34.3 Anesthetic Induction Chambers 462 34.4 Masks 464 34.5 Endotracheal Intubation and Intubation Devices 466 34.6 Ventilators 469 34.7 Monitoring Equipment 469 34.8 Warming Devices 473 34.9 Summary 474 References 474 35 Unique Species Considerations: Fish and Amphibians 477 Kurt Sladky 35.1 Introduction 477 35.2 Fish and Amphibian Anesthesia: Induction and Maintenance 477 35.3 Anesthetic Monitoring 483 References 486 36 Unique Species Considerations: Reptiles 489 Christoph Mans 36.1 Introduction 489 36.2 Anesthetic Induction 489 36.3 Airway Intubation 489 36.4 Anesthetic Monitoring 491 36.5 Summary 495 References 495 37 Unique Species Considerations: Non‐Human Primates 497 Stephen Cital 37.1 General Anatomy 497 37.2 Taxonomy 497 37.3 Immobilizing Equipment 497 37.4 Anesthetic Machines 497 37.5 Monitors 498 37.6 Summary 501 References 502 Index 503