There is another potential problem with using Boyle's machines or their
likes in the emergency department. Patients who are ventilated on them
usually have their post intubation/ventilation ABGs and physiology checked.
However it is not uncommon for patients to be changed to a portable oxylog
or 'equivalent' to transfer the patient to CT, ITU, Neuro or interhospital
transfer. ABGs and physiology are sometimes un-checked following the change
of ventilators, a potential for critical incidents.
Dr John Ryan
----- Original Message -----
From: Paul Bailey <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, October 29, 2001 06:24
Subject: Re: anaesthetic machines in A&E
> Hi everyone,
>
> > Of course you need anaesthetic machines.
>
> Well, to take a contrary opinion.... no, they are not required.... I
> guess that it depends on what we mean by 'anaesthetic machines'. I take
> it we are talking about a Boyles machine with Nitrous / Inhaled
> anaesthetic / O2 / Ventilator.....
>
>
> >As you know, I have equipped each bay in the new Emergency Unit with its
> own to ensure best quality care throughout. There are many occasions where
> patients need emergency intubation and ventilation, and must be
> anaesthetised to facilitate this.
>
> Agree
>
> > They then need to be kept anaesthetised, and this can only safely be
> done with an interlinked modern anaesthetic provision.
>
> This is where the majority of EM Docs in Australia would disagree. It is
> perfectly safe to 'anaesthetise' patients without access to a Boyles
> machine. All that is required is a Morph + Midaz infusion to keep them
> asleep, and an Oxylog, and an appropriate monitoring environment. The
> sole purpose, as far as I can see, of a Boyles machine is to make the
> Anaesthetists feel at home if / when they enter the department to take
> care of someone's airway. This, and the fact that they take a lot of
> maintenance to keep fully operational.
>
> Interested to hear alternative viewpoints.
>
> Paul
>
> Dr Paul Bailey MB BS FACEM
> Western Australia
> >
> > Best wishes,
> >
> >
> > Rowley Cottingham
> >
> > [log in to unmask]
> > http://www.emergencyunit.com
> >
>
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