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Journal of Case Reports
Pre-anesthesia Check of Breathing Circuit - Is it infallible?

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Madhu Gupta, Shalini Subramaniam, Deepika Govil, Iti Shri
From the Department of Anaesthesia, ESI Post Graduate Institute of Medical Sciences & Research, Basaidarapur, Ring Road, New Delhi 110015, India.
Corresponding Author:
Dr. Madhu Gupta
Email: madhugupta2602@gmail.com
Received: 30-NOV-2013 Accepted: 24-DEC-2013 Published Online: 30-DEC-2013
DOI: http://dx.doi.org/10.17659/01.2013.0108
Abstract
It is a case of equipment failure in the form of leak in the breathing circuit which remained undetected during the pre-anaesthesia leak test done before the start of two different cases. The peri-operative course of the first case was uneventful. The second patient developed intra-operative bronchospasm. But suddenly the ventilator bellows collapsed and manual ventilation was possible only with intermittent oxygen flushes. Presence of a hissing sound prompted a check of the breathing system and revealed a hole 2.5 mm size in the expiratory limb of the silicone breathing hose. It probably got resulted when the circuit was stretched while trying to ventilate against an increased airway resistance and could be found. We recommend extending our breathing circuit to its the full length while checking to avoid such misses as a standard practice.
Keywords : Anesthesia, Bronchial Spasm, Ventilators, Equipment Failure, Oxygen.
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