Anaesthetic machine emergency equipment: an audit and completing the loop

Abstract

Introduction
Anaesthetists have a responsibility to check anaesthetic machines to ensure that all necessary and emergency equipment is available and functioning. The Association of Anaesthetists provide guidance on checking the anaesthetic machine prior to each operating list and before each case.
Methods
An initial audit of anaesthetic machines in anaesthetic rooms (AR) and operating theatres (OT) was completed in February 2022. The availability of equipment was recorded: oxygen and nitrous oxide cylinders; a spanner to open the oxygen cylinder; a self-inflating bag; equipment for front of neck access; a stethoscope; and a peripheral nerve stimulator (PNS). Following this, the interventions included ordering new equipment, as well as redistributing and labelling existing equipment. A repeat audit was performed in January 2023.
Results
The initial audit demonstrated that 100% of oxygen cylinders were within expiration date; however, only 75% of nitrous oxide cylinders were in date. Furthermore, merely 67% of anaesthetic machines included a spanner to open the oxygen cylinder in an emergency. 83% of theatres contained a self-inflating bag, stethoscope and PNS in either the OT or AR. Following the interventions described, the re-audit demonstrated 100% availability of in date oxygen and nitrous oxide cylinders, spanners, self-inflating bags and stethoscopes.
Conclusions
The initial audit demonstrated that all anaesthetic machines did not have the essential equipment for emergencies and suggested that anaesthetic machine checks were not being adequately performed or actioned. A number of interventions lead to an improvement in results, however, to maintain standards, anaesthetists must continue to monitor availability of equipment.