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What This Guide Helps With
This guide addresses situations where the GE Avance anesthesia machine:
- Triggers low agent or low gas delivery alarms
- Shows inconsistent or insufficient delivery of anesthetic gases
- May cause a reduction in flow despite normal setup
The focus is on logical, external checks before considering internal failures, ensuring patient safety and proper escalation.
Step-by-Step Troubleshooting
Check the Gas Supply Connections
- Verify that oxygen, nitrous oxide, and air supply lines are properly connected to the machine and fully open.
- Ensure pressure gauges read within normal ranges.
Why: Low or disconnected supply lines can trigger delivery alarms immediately.
Inspect the Vaporizers
- Confirm that vaporizers are correctly seated and locked in place.
- Check that the anesthetic agent levels are adequate.
- Look for any leaks around the vaporizer ports.
Why: Improperly seated vaporizers or low agent can cause low delivery alarms.
Verify Circuit Connections
- Ensure the patient circuit is properly connected and free of kinks or occlusions.
- Check the CO₂ absorber and breathing bag for proper installation.
Why: Leaks or disconnections in the circuit can cause false low delivery alarms.
Examine Flow Settings and Monitoring
- Confirm that flowmeters are set correctly and functional.
- Ensure the machine is not in a mode that limits agent delivery (e.g., standby).
Why: Misconfigured flows can mimic delivery problems even when gas supply is adequate.
Check Alarms and Sensors
- Inspect oxygen and agent concentration sensors for proper connection and cleanliness.
- Reset alarms and observe if they recur.
Why: Faulty sensors may trigger alarms without an actual delivery issue.
Power Cycle the Machine
- Safely power down, wait 30 seconds, and power back on.
- Observe self-test results and verify if alarms persist.
Why: Software glitches or transient errors can sometimes cause false alarms.
If the Problem Persists
- Common external causes have been ruled out.
- Remove the machine from service.
- Label as Out of Service.
- Escalate to vendor service or Biomedical Engineering bench evaluation.
Remember: Knowing when to stop is proper troubleshooting—patient safety is the priority.
Clinical Use Tip
- Never troubleshoot on an active patient.
- Move the patient to another functional anesthesia machine first.
- Only perform checks when the patient is safe and monitored.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“Low agent delivery alarm triggered during case; insufficient anesthetic observed.”
Cause
What was observed during troubleshooting.
Example:
“Vaporizer improperly seated; agent level low; patient circuit connections verified and flowmeters functional.”
Resolution
What action was taken.
Example:
“Reseated vaporizer, refilled agent, verified all connections; alarms cleared; machine returned to service after self-test.”
Helpful Details to Include
- Gas supply pressures checked
- Vaporizer agent levels noted
- Flowmeter settings verified
- Sensor calibration or connection checks
- Circuit and CO₂ absorber verified
- Alarms observed and cleared
- Machine self-test results
Final Thought
Troubleshooting anesthesia machines requires a methodical approach prioritizing patient safety. Start with the simplest external checks, escalate appropriately, and document all steps clearly using the CCR method. Proper escalation avoids risk to patients and ensures regulatory compliance.
That is successful troubleshooting.