Anesthesia machine vs cart

[heathersue]

I have a very basic question...pardon my ignorance. I work in an outpatient facility where we provide moderate sedation for our procedure patients. I've been asked to figure out what we need (besides the anesthesiologist), anesthesia machine, cart, etc. My first thought was, why don't I ask the anesthesiologist? I guess that's frowned upon.

My question, are the anesthesia machine and the anesthesia cart two different things? Or are the terms interchangable? I'm trying to find out if I'm looking for one or both.

Thanks so much for your help!

[TakeOne]

In my experience, an anesthesia machine contains mechanical respiratory support (ventilator) and O2 support as well as being a means for administering anesthetic gases which may be used for sedation as well as total anesthesia. An anesthesia cart holds extra IV push meds for anesthesia, sedation and reversal, extra equipment that the person giving anesthesia/sedation might need, and the hardware for respiratory support and resuscitation.

[Spode]

The Machine and the cart are two different things. The cart is provides a space for storage of supplies, a surface for drawing up and labeling drugs, etc. It is the workspace for the anesthetist. The machine usually has a few drawers and a writing surface but the cart is a must. Not a dumb question. If it helps, I can tell you common items for the cart if you are in charge of the ordering. Airway supplies, IV stuff, syringes, needles, tape, drug labels, etc. Hope this helps

[heathersue]

Thanks for your help. I am the one who will be making purchasing decisions. I just learned that an anesthesia tech will come over from a partner hospital to help get this set up, but I appreciate having additional information in advance.

I have a list for the cart from another organization, but I would be interested in seeing what you have. I forgot to mention in my previous post that we will be using propofol (once we have an anesthesiologist).

Thanks again for your help.

[Spode]

the anesthesia tech should be very helpful. If you can, find out what types of airway stuff this doc likes. A difficult airway cart should be considered as well as making sure you have dantrolene in stock. It is very expensive with a short shelf life and is a JCHAO requirement. Also ask about IVF, in most healthy adults, they usually start cases with LR. You may need Fluid warmers with walrus tubing, and bair huggers with blankets.

[aracelih]

Anesthesia carts are hospital devices used to store tools that are necessary for aid during procedures that require administration of anesthesia. Anesthesia refers to the use of drugs to subdue a patient's mind and prevent him or her from feeling any pain during a surgical operation. It is very important for anesthesia tools to be well organized and maintained so that patients receive proper anesthesia care.

[GHGoonette, BSN, RN]

If you're setting this up from scratch, you need to plan a waiting area, the procedure room and a recovery area.

The waiting area should have subdued lighting, pastel-colored walls, comfortable chairs for patients and family members and soft background music. Try to design it to look as little "institutional" as possible.

The procedure room needs both anaesthetic machine and cart, as previously pointed out, and don't forget the emergency trolley and defibrillator. The room must be well lit and if it is not fitted with the maneauverable lights such as are used in an OT, you may need to look at a mobile lamp (you don't specify what types of procedures are to be carried out.) You may also need additional wall-mounted shelves and storage areas to keep instruments and sterile packs close at hand.

The recovery area can be an adjacent bay, screened from the procedure room, and will need suction equipment, oxygen supply and at least a dynamap and pulse oximeter. Bed with side rails and a couple of chairs for family members.

You will need a fridge for keeping certain drugs and possibly a fluid warmer. A bair hugger is a nice thing to have, but for short, minimally invasive procedures it should not be necessary.

The anaesthetic tech will be able to advise you on the type of airway maintenance and intubation equipment you will need, and the anaesthetist will tell you if there are any specific drugs, eg short-acting opioids, which he/she wants you to stock.

Sounds like an exciting assignment! Enjoy yourself, and I hope they give you a blank cheque!

[remifentanil]

If you are looking to purchase an anesthesia machine... and you do not have an anesthesia provider yet...I would suggest you have someone who actually gives anesthesia come over and give some input... and anesthesia tech is not the person who should be consulted. Both the anesthesia cart, and to a greater extent the machine are CRITICAL to a patients SURVIVAL... period. A person will die a lot faster due to an anesthesia problem than a surgical one in the vast majority of cases.

The machine you chose should be one with the features needed for your cohort of patients. Machines have basic common features... but differ in the bells and whistles.

Something this critical should have the input of someone who actually knows how to give anesthesia.

I am kind of amazed your hospital is giving you the responsibility of buying survival critical equipment with, what appears to be no knowledge of its function.