麻醉机APL减压阀不当设置的安全隐患  

The safety hazard of adjustable pressure-limiting valve in anesthesia machine

作　　者：李蓉[1] 费建平[1] 

机构地区：[1]江苏省昆山市中医医院,215300

出　　处：《临床合理用药杂志》2017年第4期40-42,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的掌握调压限制阀(APL阀)的正确设置,减少气压伤。方法调查日常麻醉机使用及维护过程中APL阀的设定;调查APL阀不当设定在麻醉诱导期及麻醉机意外断电时的安全隐患;调查麻醉机断电试验和呼吸回路意外充氧情况。结果术中麻醉机APL阀设置正确率仅20.6%,APL阀处于关闭状态高达41.2%;半年间,麻醉机意外断电事件5例,发生手控呼吸皮囊膨胀与呼吸回路高压状态2例;10台麻醉机断电试验,4台麻醉机手控—机控切换开关自动转换至手控模式,导致呼吸皮囊持续充氧。结论麻醉前APL压力限制阀档位的正确设定、麻醉机电源检查与呼吸回路检查同样必不可少。带有"自充氧"气袋的简易呼吸囊能确保足够的通气,是应对任何麻醉机功能失灵的有效办法。Objective To master the correct method of setting adjustable pressure-limiting（APL） valve,then reduce airway pressure damagement. Methods To investigate APL＇s setting in using and maintenance of anesthesia machine;to in- vestigate the safety hazard of APL during the induction period or accidental power failure of the anesthesia; to investigate the test of anesthesia machine＇s power failure and the accident of oxygen filling in respiratory circuit. Results The rate of correct setting of APL was only 20.6% ,and the APL was in the closed state as high as 41.2%. In half a year,there were 5 cases of accidental due to power failure of the anesthesia machine,2 cases of hand controlled breathing bladder expansion and breathing circuit pressure. 10 sets of anesthesia machine＇s power cut-off test,4 sets of anesthesia machine hand Bag/Ventilator switch conversion to hand control mode, Final result to excessive oxygen supply in the respiratory circuit. Conclusion The correct setting of the APL valve and the inspection of the power supply of the anesthesia machine are as important as the detection of the respiratory circuit of the anesthesia machine. In any emergency of malfunctioning of anesthesia machine ,the best option is to disconnect the anesthesia machine altogether and to use the self-inflating bag to ensure adequate ventilation.

关 键 词：麻醉机故障 APL阀 气道压力 

分 类 号：R197.39[医药卫生—卫生事业管理]