Item to be completed | Responsible party |
To be completed daily | |
Item #1: Verify that auxiliary oxygen cylinder and self-inflating manual ventilation device are available and functioning | Provider and technician |
Item #2: Verify that patient suction is adequate to clear the airway | Provider and technician |
Item #3: Turn on anesthesia delivery system and confirm that AC power is available | Provider or technician |
Item #4: Verify availability of required monitors, including alarms | Provider or technician |
Item #5: Verify that pressure is adequate on the spare oxygen cylinder mounted on the anesthesia machine | Provider and technician |
Item #6: Verify that the piped gas pressures are ≥50 psig | Provider and technician |
Item #7: Verify that vaporizers are adequately filled and, if applicable, that the filler ports are tightly closed | Provider or technician |
Item #8: Verify that there are no leaks in the gas supply lines between the flowmeters and the common gas outlet | Provider or technician |
Item #9: Test scavenging system function | Provider or technician |
Item #10: Calibrate, or verify calibration of, the oxygen monitor, and check the low oxygen alarm | Provider or technician |
Item #11: Verify that carbon dioxide absorbent is not exhausted | Provider or technician |
Item #12: Breathing system pressure and leak testing | Provider and technician |
Item #13: Verify that gas flows properly through the breathing circuit during both inspiration and exhalation | Provider and technician |
Item #14: Document completion of checkout procedures | Provider and technician |
Item #15: Confirm ventilator settings and evaluate readiness to deliver anesthesia care (anesthesia time out) | Provider |
To be completed prior to each procedure | |
Item #2: Verify that patient suction is adequate to clear the airway | Provider and technician |
Item #4: Verify availability of required monitors, including alarms | Provider or technician |
Item #7: Verify that vaporizers are adequately filled and, if applicable, that the filler ports are tightly closed | Provider |
Item #11: Verify that carbon dioxide absorbent is not exhausted | Provider or technician |
Item #12: Breathing system pressure and leak testing | Provider and technician |
Item #13: Verify that gas flows properly through the breathing circuit during both inspiration and exhalation | Provider and technician |
Item #14: Document completion of checkout procedures | Provider and technician |
Item #15: Confirm ventilator settings and evaluate readiness to deliver anesthesia care (anesthesia time out) | Provider |
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