Our staff has noticed that in the operating rooms, when the procedure is finished, they take the patient to the recovery area and frequently leave the oxygen running at maximum on the anesthesia machine. Some of these machines are left running all night (as evidenced by finding them going on weekends when no cases were done). Not only does this waste gas, but creates a potential fire safety problem if the oxygen accumulates around anything combustible.
A call to Facilities gave me the actual cost for our piped oxygen, which was $0.6124/liter liquid on our last delivery. Oxygen expands by a factor of about 861 turning from liquid to gas.
If an average of 5 machines were left running for 1 year, the oxygen wasted would cost $28,000.
We have over 60 of these machines.
If the clinicians would simply press the "End Case" button on the anesthesia machine when the patient was disconnected, it automatically turns off the O2 flow. This takes like one second to do. The anesthsia technicians are also supposed to make sure the flow is off.
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Posted on behalf of Errol
Posted on behalf of Errol Lobo, MD, PhD, Professor and Vice Chair, Chief Anesthesia for Vascular Surgery, Department of Anesthesia and Perioperative Care, Medical Director, Perioperative Services:
Anesthesia machines deliver oxygen to patients in the Operating Theater. The oxygen source for these machines comes from wall outlets that are connected to Oxygen Tanks within the physical plant of the Hospital Building or from “e” cylinders, which are located on the posterior aspect of the anesthesia machine. The “e” cylinders are only used when there is a disruption to oxygen from the wall outlet. In other words they are a safety reservoir. The flow of oxygen from the anesthesia machine is controlled by the anesthesia provider. Flow of oxygen to the patient is turned “on” right before the induction of anesthesia. Oxygen is usually run at low flows, about 2 liters per minute. At the conclusion of a case the flow of oxygen may be increased to “washout” anesthetic gases. When the patient wakes up from anesthesia and is transferred out of the operating theater, the flow of oxygen from the machine is turned off. Oxygen for transport, from the operating theater to either the recovery room or intensive care unit comes from an “e” cylinder on the transport gurneys.
After a procedure is completed and the patient leaves the Operating Theater, the Operating Theater is cleaned, as is the anesthesia machine. During cleaning, the anesthesia technicians insure that the oxygen flow is turned off, as well as remove and discard the contaminated anesthesia circuits. A new circuit is then placed and the room is prepared for the next case. This sequence of events occurs after every case as Operating Theaters have to be prepared for the future cases or emergencies. Hence oxygen is NOT left flowing after the patient has left the Operating Theater. This is monitored by anesthesia technicians and anesthesia providers alike.
Finally, at the end of the day, machines are checked and calibrated. This insures that there is oxygen flow in the absence of patient care.
Our direct observation is the
Our direct observation is the oxygen is left flowing at night on some machines. We can try to survey to see how often this actually happens. Sometimes the Auxiliary oxygen is observed to be flowing as well.