Key Features and Considerations for Selecting an Anesthesia Workstation
When selecting an anesthesia workstation, prioritize safety features, ergonomic design, and reliable monitoring capabilities to ensure optimal patient outcomes and minimize morbidity and mortality risks.
Essential Safety Features
- Reliable oxygen supply system with hypoxic mixture protection and backup oxygen sources to prevent delivery of hypoxic gas mixtures 1
- Functional oxygen failure alarm that sounds for at least 7 seconds when oxygen pressure drops, with clear understanding of which gases continue to flow during oxygen failure 1
- Backup power supply that provides at least 30 minutes of operation during mains failure, with appropriate alarm systems to indicate power source status 1
- Continued oxygen supply capability even during complete power failure 1
- Self-inflating ventilation bag immediately available as an alternative means of ventilation in emergency situations 1
- Automated machine check functionality with clear indication of which checks are performed automatically 1
Monitoring Capabilities
- Essential monitoring devices including pulse oximeter with plethysmograph, non-invasive blood pressure, ECG, and temperature monitoring 1
- Waveform capnography for continuous monitoring of ventilation and early detection of breathing circuit issues 1
- Inspired and expired oxygen concentration monitoring 1
- Airway pressure, tidal volume, and respiratory rate monitoring during mechanical ventilation 1
- Quantitative neuromuscular monitoring when using neuromuscular blocking drugs 1
- Processed EEG monitoring when administering total intravenous anesthesia with neuromuscular blockade 1
- Appropriate alarm systems with clear distinction between high, medium, and low priority alarms 1
Ventilation Features
- Multiple ventilation modes including volume control, pressure control, pressure support, and synchronized intermittent mandatory ventilation to accommodate different clinical scenarios 2
- Fresh gas decoupling to reduce the risk of ventilator-induced volutrauma 2
- Accurate tidal volume delivery system 2, 3
- Ability to deliver lung-protective ventilation strategies 4
Ergonomic Considerations
- Appropriate machine configuration (left-handed or right-handed) based on the anaesthetist's position and dominant hand 1
- Light, compact, and easy to maneuver design 1
- Proper positioning to allow the anaesthetist to simultaneously reach the reservoir bag, controls, and monitoring while maintaining contact with the patient 1
- Adjustable screen brightness and contrast to suit operating room lighting conditions 1
- Appropriate illumination of controls and displays (minimum 200 lx for work requiring perception of detail) 1
Electrical Safety
- Direct connection to mains electrical supply without using multisocket extension leads 1
- Automatic switching to emergency generator during mains failure 1
- Uninterruptible power supply for critical components 1
- Emergency lighting for evacuation routes 1
- Compliance with electrical safety regulations 1
Common Pitfalls and Caveats
- Failure to perform proper pre-use checks: Always follow the manufacturer's recommended checks and the Association of Anaesthetists' checklist before each session and between patients 1
- Inadequate training: Ensure thorough training and formal induction on specific workstation models; a quick "run-through" is not acceptable 1
- Alarm fatigue: Inappropriate setting of alarm trigger levels can lead to desensitization and neglect of important alarms 1
- Distractions during critical phases: Maintain a "sterile cockpit" environment during induction and emergence to minimize errors 1
- Failure to check backup systems: Regularly verify backup power sources and alternative ventilation equipment 1
- Incompatibility between machine configuration and anaesthetist positioning: Ensure proper positioning of left-handed or right-handed machines relative to the anaesthetist 1
By carefully considering these features and avoiding common pitfalls, clinicians can select an anesthesia workstation that maximizes patient safety and optimizes workflow in the operating room.