Veterinary Anesthetic and Monitoring Equipment

The Editors Kristen G. Cooley, BA, CVT, VTS (Anesthesia/Analgesia), is an Instructional Specialist in the School of Veterinary Medicine at the University of Wisconsin, Madison, Wisconsin, USA. Rebecca A. Johnson, DVM, PhD, DACVAA, is a Clinical Associate Professor of Anesthesia and Pain Management in the Department of Surgical Sciences, School of Veterinary Medicine at the University of Wisconsin, Madison, Wisconsin, USA.

• List of Contributors xviiPreface xxi1 Medical Gas Cylinders and Pipeline Systems 1Carl Bradbrook1.1 Medical Gas Cylinders 11.2 Liquid Oxygen Tanks 81.3 Oxygen Concentrators 91.4 Medical Gas Pipeline Systems 9References 152 Oxygen Concentrators 17Allan Williamson2.1 Introduction 172.2 Function 172.3 Product Gas 172.4 Clinical Use 182.5 Advantages 202.6 Disadvantages 202.7 Hazards 202.8 Summary 21References 213 Small Animal Anesthetic Machines and Equipment 23Craig Mosley and Amanda Shelby3.1 Introduction 233.2 Safety and Design 233.3 The Basic Veterinary Anesthetic Machine 233.4 Breathing Systems 333.5 Waste Gas Scavenge Systems 333.6 Routine Anesthesia Machine Checkout Procedures 33References 344 Large Animal Anesthesia Machines and Equipment 35Amanda Shelby4.1 History of the Large Animal Anesthesia Machine 354.2 Purpose 354.3 Standards 354.4 Similarity to Small Animal Machines 354.5 Components of the Anesthesia Machine 364.6 Large Animal Anesthesia Workstations 414.7 Common Commercially Available Machines 414.8 General Cautions 514.9 Miscellaneous Equipment for Large Animal Anesthesia 51References 535 Anesthetic Vaporizers 55Sharon Fornes, Kristen G. Cooley, and Rebecca A. Johnson 5.1 Introduction 555.2 Vaporizer Physics 555.3 Vaporizer Classification 565.4 Other Factors Affecting Vaporizers 625.5 Maintenance and Repair 645.6 Current Vaporizer Standards 655.7 The Modern Vaporizer 655.8 Specific Vaporizers 665.9 Summary 71References 716 Anesthetic Ventilators 73Katrina Lafferty 6.1 Introduction 736.2 Ventilator Function in the Breathing Circuit 736.3 Tidal Volume Delivery 736.4 Driving Gas 746.5 Bellows Construction 756.6 Pressure Limiting Controls 766.7 Gas Pressure Alarm 776.8 Exhaust Valve 776.9 Spill Valve 776.10 Ventilator Hose Connection or Ventilator Hose Switch 776.11 Ventilation Modes 786.12 Cleaning and Sterilization 796.13 Pressure Checking 796.14 General Concerns and Troubleshooting 806.15 Pediatric Ventilation 816.16 Basic Ventilator‐Patient Set‐up 826.17 Small Animal Mechanical Ventilators 826.18 Large Animal Mechanical Ventilators 856.19 Conclusion 89References 897 Humidification and Positive Pressure Equipment 91Stephanie Keating and Stuart Clark‐Price 7.1 Humidification 917.2 Positive Pressure Equipment 96References 988 Waste Anesthetic Gas Collection and Consequences 101Heidi Reuss‐Lamky 8.1 Introduction 1018.2 Occupational WAG Exposure 1018.3 Physical Properties and Elimination 1028.4 Pharmacodynamics 1028.5 History of Governmental Regulations and Trace (Waste) Gas Exposure 1048.6 WAG Exposure Level Recommendations 1048.7 Reducing Environmental WAG Exposure 1048.8 The Anesthetist’s Responsibility 1078.9 Monitoring WAG Exposure 1128.10 Summary 112References 1139 Hazards of the Anesthetic Delivery System and Operating Room Fires 115Odette O9.1 Hazards of the Anesthetic Delivery System 1159.2 Operating Room Fires 123References 12510 Components of the Breathing System 127Craig Mosley and Amanda Shelby10.1 Breathing Systems 12710.2 Summary 139References 13911 Mapleson Breathing Systems 141Tatiana Ferreira11.1 Introduction 14111.2 Fresh Gas Flows (FGFs) 14111.3 Advantages and Disadvantages 14111.4 Choice of System 14311.5 Specific System Types 14311.6 Combined Systems 15011.7 Respiratory Gas Monitoring 15011.8 Potential Hazards 151References 15212 The Circle System 155Geoffrey Truchetti and Trish Anne Farry12.1 Introduction 15512.2 Components 15512.3 Component Arrangement 16212.4 Gas Flow 16412.5 Resistance and Work of Breathing in the Circle System 16612.6 Dead Space 16612.7 Heat and Moisture 16712.8 Maintenance 16712.9 Advantages/Disadvantages 168References 16813 Laryngoscopes 171Erin Wendt‐Hornickle13.1 History 17113.2 Laryngoscope Use 17113.3 Description 17113.4 Fiber Optic Endoscopes 17413.5 Veterinary‐Specific Laryngoscopes 17513.6 Summary 175References 17614 Supraglottic Airway Devices and Tracheal Tubes and Stylets 177Jennifer Sager14.1 Introduction 17714.2 Laryngeal Mask Airway (LMA) 17714.3 Veterinary‐gel (v‐gel®) Airway Device 17814.4 Endotracheal Tubes 17914.5 Large Animal Endotracheal Tubes 18414.6 Reinforced Tubes 18514.7 Laser Safe Tubes 18514.8 Single Lung Intubation 18614.9 Stylets 18714.10 Cuff Pressure Manometers 18814.11 Summary 190References 19015 Oxygen Delivery Systems 193Jonathan Bach15.1 Introduction 19315.2 Oxygen Supplementation Techniques 19315.3 Hyperbaric Oxygen 197References 19716 Gas Monitoring 199Louise O’Dwyer16.1 Introduction 19916.2 Capnometry/Capnography 19916.3 Oxygen Measurement 20716.4 Nitrous Oxide and Inhalation Agent Analyzers 20816.5 Blood Gas Analysis: Partial Pressures of Oxygen and CO2 21016.6 Conclusion 210References 21017 Airway Volumes, Flows and Pressures 213Andrew Claude and Alanna Johnson17.1 Introduction 21317.2 Definitions 21317.3 Volume and Flow Measurement Devices 21417.4 The Ventilatory (Respiratory) Cycle 21817.5 Airway Pressure Monitoring 21917.6 Spirometry Loops 219References 22218 Pulse Oximetry 223Odette O18.1 Introduction 22318.2 History 22318.3 Importance of Pulse Oximetry 22318.4 Function 22418.5 Pulse Oximeter Probes 22418.6 Uses 22518.7 Oxyhemoglobin Dissociation Curves in Different Species 22518.8 Patient Factors 22618.9 Abnormal Hemoglobin 22718.10 Sources of Error 22718.11 Perfusion Index (PI) and Plethysmograph Variability Index (PVI) 22818.12 Other Pulse Oximeter Models 22918.13 Low Saturation Alarms 23118.14 Pulse Oximetry Use in the Recovery Period 23118.15 Summary 231References 23219 Cardiovascular Monitoring 235Anderson Favaro da Cunha and Rebecca A. Johnson19.1 Introduction 23519.2 Definitions 23519.3 Measurement Techniques 23519.4 Patient Point of View 24419.5 Central Venous Pressure (CVP) 24519.6 Cardiac Output Monitoring 24619.7 Conclusion 248References 24820 Electrocardiography 253Tracey Lawrence20.1 Overview 25320.2 The ECG Machine 25320.3 Lead Systems 25420.4 Mean Electrical Axis (MEA) 25720.5 ECG Cycle 25820.6 Electrode Placement 26020.7 ECG Filters 26320.8 Evaluating the ECG 26420.9 Equipment Maintenance 26820.10 Summary 268References 26921 Neuromuscular Transmission Monitoring 271Molly Allen and Rebecca A. Johnson21.1 Introduction 27121.2 Neuromuscular Transmission 27121.3 Peripheral Nerve Stimulation 27121.4 Monitoring Techniques 27521.5 Other Equipment 279References 28022 Temperature Regulation and Monitoring 285Caroline Baldo and Darci Palmer22.1 Introduction 28522.2 Heat and Thermodynamics 28522.3 Thermoregulation 28522.4 Types of Heat Loss 28622.5 Heat Loss During Anesthesia 28722.6 Effects of Hypothermia and Hyperthermia 28822.7 Re‐Warming 28922.8 Temperature Monitoring Devices 29022.9 Sites of Temperature Monitoring 29122.10 Warming Devices 29322.11 Active Warming Devices 29322.12 Other Techniques to Minimize Heat Loss 29822.13 High‐Risk Heating Methods 299References 30023 Fluid Regulation and Monitoring 303Julie Walker23.1 Overview of Fluid Physiology 30323.2 Assessment of Fluid Balance 30423.3 Advanced Fluid Balance Monitoring Techniques 30723.4 Fluid Therapy 31123.5 Equipment for Fluid Therapy 31223.6 Summary 319References 31924 Anesthetic Records 323Thomas Riebold24.1 Introduction 32324.2 Maintaining Anesthetic Records 32324.3 Monitoring Recommendations 32324.4 Paper Anesthetic Records 32424.5 Electronic Anesthetic Records 32424.6 Transitioning from Paper to Electronic Medical Records 32724.7 Specific Types of Anesthetic Monitoring Software 32824.8 Patient Management and Digital Records 33024.9 Automated Dispensing Systems and Record Keeping 333References 33325 Equipment for the Magnetic Resonance Imaging System 335Kris Kruse‐Elliott25.1 Basic Principles of Magnetic Resonance Imaging 33525.2 Regulations 33725.3 MRI Hazard Classification 33725.4 Types of Metal 33825.5 Gauss Lines and Safety Zones 33825.6 Specific Hazards 33925.7 Compatible MRI Equipment 34025.8 Anesthetic Machines 34025.9 Vaporizers 34125.10 Ventilators 34225.11 Laryngoscopes 34225.12 Endotracheal Tubes and Airway Devices 34225.13 Monitors 34225.14 Miscellaneous Items 34525.15 Summary 346References 34626 Equipment for Environmental Extremes and Field Techniques 349David Brunson and Kristen G. Cooley26.1 Environmental Extremes 34926.2 Temperature 34926.3 Atmospheric Pressure 35126.4 Drug Delivery Systems 35226.5 Monitoring Equipment 35626.6 Field Techniques 35826.7 Anesthesia for Situations with Limited Means 35826.8 Stress 36226.9 Summary 363References 36327 Equipment Checkout and Maintenance 365Molly Allen and Lesley Smith27.1 Introduction 36527.2 Daily Checks 36527.3 Other Equipment 37327.4 End of Case 37327.5 Preventative Maintenance 374References 37428 Equipment Cleaning and Sterilization 377Cristina de Miguel Garcia and Kristen G. Cooley28.1 Introduction 37728.2 The Decontamination Process 37828.3 Recommendations for Cleaning and Disinfecting Specific Items 384References 38829 Unique Species Considerations: Dogs and Cats 391Turi Aarnes29.1 Introduction 39129.2 Intubation 39129.3 Breathing System 39229.4 Monitoring 39229.3 Recovery 39329.6 Anesthetic Risk 393References 39430 Unique Species Considerations: Ruminants and Swine 395Denise Radkey, Lindsey Snyder, and Rebecca A. JohnsonPart I: Ruminants 39530.1 Introduction 39530.2 Handling and Restraint 39530.3 IV Catheterization 39630.4 Induction Equipment 39730.5 Tracheal Insufflation and Demand Valves 40330.6 Padding and Positioning 40430.7 Monitoring Equipment 40630.8 Commercial Anesthetic Machines 40830.9 Anesthetic Circuit 40830.10 Anesthetic Recovery 40930.11 Summary 410Part II: Swine 41030.12 Introduction 41030.13 Handling and Restraint 41030.14 Intravenous Catheter Placement 41130.15 Induction Equipment 41230.16 Monitoring Equipment 41430.17 Anesthetic Circuit 41530.18 Anesthetic Recovery 41630.19 Summary 416References 41631 Unique Species Considerations: Equine 419Carolyn Kerr31.1 Introduction 41931.2 Sedation and Pre‐Anesthetic Period Considerations 41931.3 General Anesthesia 42631.4 Recovery Period 43731.5 Medical Records 437References 43832 Unique Species Considerations: Avian 441Carrie Schroeder32.1 Introduction 44132.2 Anesthetic Considerations 44332.3 Venous Access 44532.4 Anesthetic Monitors 44632.5 Anesthetic Circuits 44732.6 Maintenance of Body Temperature 44832.7 Anesthetic Recovery 448References 44933 Unique Species Considerations: Rabbits 451Katrina Lafferty33.1 Introduction 45133.2 Intubation 45133.3 Breathing Circuits 45433.4 Monitors 45433.5 Thermal Support 45833.6 Summary 458References 45834 Unique Species Considerations: Rodents 461Mario Arenillas Baquero and Rebecca A. Johnson34.1 Introduction 46134.2 Anesthetic Machines 46134.3 Anesthetic Induction Chambers 46234.4 Masks 46434.5 Endotracheal Intubation and Intubation Devices 46634.6 Ventilators 46934.7 Monitoring Equipment 46934.8 Warming Devices 47334.9 Summary 474References 47435 Unique Species Considerations: Fish and Amphibians 477Kurt Sladky35.1 Introduction 47735.2 Fish and Amphibian Anesthesia: Induction and Maintenance 47735.3 Anesthetic Monitoring 483References 48636 Unique Species Considerations: Reptiles 489Christoph Mans36.1 Introduction 48936.2 Anesthetic Induction 48936.3 Airway Intubation 48936.4 Anesthetic Monitoring 49136.5 Summary 495References 49537 Unique Species Considerations: Non‐Human Primates 497Stephen Cital37.1 General Anatomy 49737.2 Taxonomy 49737.3 Immobilizing Equipment 49737.4 Anesthetic Machines 49737.5 Monitors 49837.6 Summary 501References 502Index 503

"Veterinary Anesthetic and Monitoring Equipment is a very nice compilation of anesthetic equipment–related topics.  The text is very easy to read and contains good explanations of concepts....complemented with good-quality photographs and diagrams accompanied by explanations…. I recommend this book for anyone who is learning about veterinary anesthesia or intends to perform anesthesia." JAVMA, MAR 15, 2019, VOL 254, NO. 6