Lachgasbedingte Todesfälle

Herff, Holger; Paal, Peter; Kh, Lindner; Goedecke, Achim von; Keller, Christian; Wenzel, Volker

doi:10.1007/s00101-008-1434-7

Cited by 14 publications

(4 citation statements)

References 24 publications

(11 reference statements)

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“…in the European Union (EN 740). 2 3 However, these devices obviously failed in our studies in the last decade, and therefore we propose that any additional strategy to increase safety should be used even in the industrialized world. Further, many of our old anesthesia machines have been sold or donated to hospitals in lower income countries and will be on duty for many further years.…”

Section: Discussionmentioning

confidence: 87%

“…All fatal cases related to ventilation with pure nitrous oxide were due to misconnection of supply lines prior to the flow meters in the anesthesia machine. 2 3 When nitrous oxide flows out of the pipelines instead of oxygen, this can only be discovered by oxygen meters that are now mandatory in modern anesthesia machines e.g . in the European Union (EN 740).…”

Section: Discussionmentioning

confidence: 99%

“… 1 However, in an analysis of media sources in the last decade, several fatal nitrous oxide-related cases caused by a misconnection of gas pipelines were discovered in Germany, Austria and Switzerland, the UK, the U.S. and Italy. 2 3 …”

Section: Introductionmentioning

confidence: 99%

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Safer employment of nitrous oxide in anesthesia machines—a technical simulation

et al. 2018

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Several incidents of anesthesia-attributed mortality in the past were caused by misconnection of gas pipelines resulting in ventilation with pure nitrous oxide. A simple safety feature may be to “mark” nitrous oxide with a lower pressure than oxygen and room air within the hospital's gas pipeline system. Then, any misconnection of gas pipelines could be detected by pressure differences with a manometer in the anesthesia machine. To check technical suitability, we tested maximum achievable nitrous oxide flows of an anesthesia machine at different pressures in the nitrous oxide supply line. Using decreased pressures for nitrous oxide compared to oxygen did not result in decreased nitrous oxide flows, as long as pressure in the nitrous oxide supply line was >1500 hPa. A concept of different pressures for nitrous oxide and oxygen could be used to technically differentiate between those two gases, and to avoid potentially fatal misconnections.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Safer employment of nitrous oxide in anesthesia machines—a technical simulation

et al. 2018

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“…[78] Misconnection of O 2 pipeline hose to N 2 O cylinder in the manifold room by technical personnel has resulted in hypoxic gas delivery. [910] Insertion of the Equanox (50% each of O 2 and N 2 O) probe accidentally into the N 2 O wall outlet resulted in 100% N 2 O delivery. [11] These problems were compounded by either lack of oxygen analyser or failure to recognise the hypoxia early and changing over to an alternate plan by the concerned anaesthesiologist.…”

Section: Hazards Of Anaesthesia Machinesmentioning

confidence: 99%

Anaesthesia machine: Checklist, hazards, scavenging

Umesh

Prabhu

2013

Indian J Anaesth

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From a simple pneumatic device of the early 20th century, the anaesthesia machine has evolved to incorporate various mechanical, electrical and electronic components to be more appropriately called anaesthesia workstation. Modern machines have overcome many drawbacks associated with the older machines. However, addition of several mechanical, electronic and electric components has contributed to recurrence of some of the older problems such as leak or obstruction attributable to newer gadgets and development of newer problems. No single checklist can satisfactorily test the integrity and safety of all existing anaesthesia machines due to their complex nature as well as variations in design among manufacturers. Human factors have contributed to greater complications than machine faults. Therefore, better understanding of the basics of anaesthesia machine and checking each component of the machine for proper functioning prior to use is essential to minimise these hazards. Clear documentation of regular and appropriate servicing of the anaesthesia machine, its components and their satisfactory functioning following servicing and repair is also equally important. Trace anaesthetic gases polluting the theatre atmosphere can have several adverse effects on the health of theatre personnel. Therefore, safe disposal of these gases away from the workplace with efficiently functioning scavenging system is necessary. Other ways of minimising atmospheric pollution such as gas delivery equipment with negligible leaks, low flow anaesthesia, minimal leak around the airway equipment (facemask, tracheal tube, laryngeal mask airway, etc.) more than 15 air changes/hour and total intravenous anaesthesia should also be considered.

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Medicinal Gases and Volatile Anesthetics

Bohrer

2012

Sources of Contamination in Medicinal Products and Medical Devices

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Lachgasbedingte Todesfälle

Cited by 14 publications

References 24 publications

Safer employment of nitrous oxide in anesthesia machines—a technical simulation

Safer employment of nitrous oxide in anesthesia machines—a technical simulation

Anaesthesia machine: Checklist, hazards, scavenging

Medicinal Gases and Volatile Anesthetics

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