Anaesthesia Equipment

In each location where general anaesthesia is to be performed, there must be;

1. An Anaesthesia Delivery System:
   • Each anaesthesia machine must comply with minimum safety requirements as specified in KSA recommendation on anaesthetic machine a user manuals should be readily available .
   • The machine must be in good working condition.
   • Breathing systems and accessories suitable for paediatric use when necessary.
   • A range of suitable breathing systems with appropriate measures to ensure the sterility of breathing gases supplied to each patient.
2. A manual bag valve/self inflating resuscitation bag must be provided. The size of the bag and its attachments must be appropriate for patients being anaesthetized at that location. Its oxygen supply must be independent of the anaesthesia delivery system.
3. Suction apparatus must be available for the use of the anaesthetist at all times together with appropriate suction catheters. Provision must be made for an alternative suction system in the event of primary suction failure.
4. Appropriate protection for the anaesthesia team against biological contaminants. This must include gowns, disposable gloves, masks and eye shields.
5. A stethoscope.
6. A sphygmomanometer.
7. Monitoring equipment complying with Recommendations on Monitoring During Anaesthesia. These must include; pulse oximeter, non invasive blood pressure monitor (with appropriately sized cuffs), electrocardiograph and temperature.
8. Appropriate airway management instruments and accessories, these include:
   • An appropriate range of face masks.
   • An appropriate range of oropharyngeal airways. where necessary, nasopharyngeal, laryngeal mask and other artificial airways should be available.
   • One laryngoscopes set per theater with a range of suitable blades.
   • An appropriate range of endotracheal tubes and connectors.
   • Endotracheal cuff inflating syringe.
   • Magill’s forceps and throat packs.
   • A suitable range of adhesive and other tapes for securing the tubes.
   • Scissors.
   • Sterile lubricant suitable for use with airway devices.
   • Accessories to warm and/or humidify respiratory gases during anaesthesia (HME).
9. Appropriate accessories for circulation management, these include;
   • Tourniquets for use during IV insertion.
   • Intravenous infusion supplies with an appropriate range of cannulae and solutions.
   • A suitable range of adhesive and other tapes for securing the IV line.
10. Means for the safe disposal of items contaminated with biological fluids, “sharps” and waste glass.
11. Appropriate lighting for the clinical observation of patients
12. Emergency lighting and alternative electric power supply.
13. Mechanisms for Routines for Checking, Cleaning and Servicing Equipment. This should include;
    • Regular sterilizing, cleaning and housekeeping routines for the care of equipment should be established.
    • Documented servicing of the anaesthesia delivery system and medical gas equipment by an appropriate organization must be carried out at intervals recommended by the manufacturer. In the absence of a manufacturer’s recommendation on servicing intervals, servicing must be carried out atleast once a year. After any maintenance or modification to the gas distribution system, tests of gas flow, pressure and identification must be carried out and documented according to current national standards prior to use.
14. An operating table with Trendelenburg position control at the head of the table.
15. Intravenous fluid infusion pole.
16. A copy of Protocol for Checking the Anaesthesia Machine or a similar document should be available on each anaesthesia delivery system.

Level 5 and 6 should also have

• Infusion devices designed for controlled delivery of intravenous drugs when required
• Capnography
• Volatile agents / gas analyzer

In every anaesthetizing location there must be readily available:

1. Equipment for managing difficult intubations in all locations where endotracheal intubation is electively performed. – A range of endotracheal tube introducers and bougies.
2. Equipment for the rapid infusion of fluids.
3. A cardiac defibrillator with capacity for synchronized cardioversion.
4. Interpleural drainage sets including appropriate underwater seal drainage equipment or one way valves.
5. Equipment to cool patients in the event of inappropriate increases in body temperature.
6. When appropriate, having regard to the procedures being undertaken, equipment to minimise patient heat loss including insulating sheets, forced air warming devices, mattress warmers and intravenous fluid warmers.
7. Instruments required for sub-arachnoid, epidural or regional nerve blocks, when appropriate.
8. Equipment to ensure safe positioning for patients during procedures.
9. Telephone/Intercom to communicate with persons outside the anaesthetizing location including an “anaesthesia emergency” call system.
10. Refrigeration facilities for the storage of fluids, drugs and biological products.
11. The means to maintain room temperature at range of 18- 28 degrees celsius in the anaesthetizing room.
12. Patient transfer trolleys/beds.
13. Devices such as rollers or patient slides to assist with transfer of patients in a manner safe for patients and staff.
14. A minimum of three people to assist with transfer of the patient when required, with the anaesthetist having prime responsibility for the patient’s airway, head and neck.
15. Guidelines for the management of rare emergencies associated with anaesthesia e.g Malignant Hyperthermia, Anaphylaxis, Peri-arrest arrhythmias must be displayed prominently in the anaesthetizing locations.