Question

At the end of a long operation, a new anesthetist calls you into the operating room. The anesthetist tells you that he is trying to switch volatile anesthetic agents from isoflurane to desflurane but is unable to turn the dial on the desflurane vaporizer to turn it on. He currently has the isoflurane vaporizer on. Both vaporizers are noted to be full of medication. The anesthetist wants to know if he needs a new vaporizer. What should you tell the anesthetist?

A) Yes, the anesthetist needs a new vaporizer. You should be able to turn on both vaporizers at the same time to switch medications.
B) Yes, the anesthetist needs a new vaporizer. There must be a leak in the vaporizer as the anesthesia machine has a safety mechanism that prevents the vaporizer from turning on if there is a leak.
C) No, the vaporizer does not need to be replaced. You explain that there is a safety feature on the anesthesia machine that will not let him switch volatile anesthetics during an operation.
D) No, the vaporizer does not need to be replaced. You explain that there is a safety feature on the anesthesia machine that will not let more than one vaporizer open at a time.
E) No, the vaporizer does not need to be replaced. You tell the anesthetist that if he wants to switch medications, he should just add some desflurane to the sevoflurane vaporizer rather than use a different vaporizer.

Answer 1

The anesthetist is experiencing difficulty due to a safety feature that prevents more than one inhalation anesthetic vaporizer from being used at the same time. No new vaporizer is needed; the issue will resolve by first turning off the isoflurane before turning on the desflurane vaporizer.

Step-by-step explanation:

The issue the new anesthetist is facing is not due to a malfunctioning vaporizer but to a safety feature present in modern anesthesia machines. This safety feature is designed to prevent the accidental administration of more than one volatile anesthetic agent at a time. Hence, the dial on the desflurane vaporizer cannot be turned on while the isoflurane vaporizer is active. The correct response to the anesthetist would be:

No, the vaporizer does not need to be replaced. You explain that there is a safety feature on the anesthesia machine that will not let more than one vaporizer be open at a time (Option D).

Furthermore, it is crucial to note that adding desflurane to the sevoflurane vaporizer, or vice versa, is not appropriate as each agent requires specific vaporizer calibration for accurate dosing, and the agents should not be co-administered due to risk of overdosing or underdosing, as well as potential interactions between different anesthetics.