References · October 2026
References and verification
The clinical numbers and definitions on this site were checked against the sources below. Each entry notes what it supports on the site. All sources were reviewed one by one in October 2026.
Notes
- The "at least half full" criterion for the back-up O₂ cylinder comes from ASA 2008 (≈ 1000 psi in an E cylinder). For a 150-bar cylinder this is ≈ 75 bar, and the site uses this 75-bar threshold.
- Timelines in the simulations (desaturation, arrest) are simplified models derived from these sources and must not be used for clinical decisions.
Content verification · 8 October 2026
- ASA. Standards for Basic Anesthetic Monitoring (2025).On this site Monitoring frequency and temperature measurement
- Young PJ et al. A low-volume, low-pressure tracheal tube cuff reduces pulmonary aspiration. Crit Care Med. 2006;34:632–639.On this site Residual microaspiration risk with cuffed tubes
- APSF. Strategy Outlined to Avoid Hypoventilation (1989).On this site Bellows movement does not exclude disconnection
- Getinge. SERVO-air Ventilator System v2.2: User’s Manual.On this site PRVC target volume and pressure limits
- IUPAC Gold Book. Beer–Lambert law.On this site Decadic absorbance and light transmission
- DailyMed. Sevoflurane: prescribing information.On this site Olive oil/gas partition coefficient
- Goff MJ et al. Absence of bronchodilation during desflurane anesthesia: a comparison to sevoflurane and thiopental. Anesthesiology. 2000.On this site Effects of desflurane on airway resistance
- Szypula KA et al. Detection of inner tube defects in co-axial circle and Bain breathing systems: a comparison of occlusion and Pethick tests. Anaesthesia. 2008;63:1092–1095.On this site Limitations of the Pethick test
- Baska Mask. Product information.On this site Membrane cuff and manufacturer generation terminology
- BTS. Guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017;72(Suppl 1).On this site Total flow and inspiratory demand with Venturi masks
- Eakin Respiratory. AMSORB Plus: product information.On this site Limitations of absorbent color and the role of capnometry
Core textbooks
- Dorsch JA, Dorsch SE. Understanding Anesthesia Equipment. 5th ed. Lippincott Williams & Wilkins.On the site Machine components, Thorpe tube, vaporisers, bellows, safety systems
- Ehrenwerth J, Eisenkraft JB, Berry JM. Anesthesia Equipment: Principles and Applications. Elsevier.On the site Liquid agent consumption (3 × FGF × %), vaporiser physics, equipment faults
- Gropper MA et al. Miller's Anesthesia. "Inhaled Anesthetic Delivery Systems" and "Inhaled Anesthetics: Uptake and Distribution".On the site Partition coefficients, MAC, uptake model
- Davis PD, Kenny GNC. Basic Physics and Measurement in Anaesthesia. Butterworth-Heinemann.On the site Gas laws, fluids, Beer–Lambert, Bernoulli
Machine, gas analysis and checkout
- ASA. Recommendations for Pre-Anesthesia Checkout Procedures (2008). APSF announcement.On the site Checklist and hands-on machine checkout (15 items; suction bulb, 30 cmH₂O circuit test)
- Subrahmanyam M, Mohan S. Anaesthesia machine: checklist, hazards, scavenging. Indian J Anaesth 2013.On the site Checkout steps, fault types, scavenging
- The Anesthesia Workstation and Delivery Systems for Inhaled Anesthetics (Aneskey).On the site Low-pressure leak test criteria, oxygen failure alarm
- The Anesthesia Machine and Workstation (Aneskey).On the site O₂ supply alarm: medium-priority alarm within 5 s; ≥ 7 s on older systems
- University of Detroit Mercy. Anesthesia Gas Machine: Checkout.On the site Details of checkout tests
- ISO 5362:2006. Anaesthetic reservoir bags.On the site Reservoir bag: 30–60 cmH₂O at 4× volume
- Functions of anesthesia reservoir bag in a breathing system. Zdrav Vestn.On the site Pressure-limiting function of the reservoir bag (Laplace)
- Langton JA, Hutton A. Respiratory gas analysis. Contin Educ Anaesth Crit Care Pain (BJA Education).On the site Capnometry and agent analysis (infrared, paramagnetic O₂)
- Mortier E et al. Methane influences infrared technique anesthetic agent monitors. J Clin Monit Comput 1998.On the site Agent measurement at 3.3 µm and 8–9 µm; methane interference
- Can modern infrared analyzers replace gas chromatography to measure anesthetic vapor concentrations? BMC Anesthesiol 2008.On the site Accuracy of infrared agent analysers
Pharmacokinetics and low flow
- Yasuda N et al. Solubility of desflurane, sevoflurane, isoflurane, and halothane in human blood. Masui 1991.On the site Blood/gas partition coefficients
- Blood-gas partition coefficient (ScienceDirect Topics; Miller / Eger tables).On the site Tissue/blood coefficients (wash-in model)
- da Silva JM et al. Quantitative study of Lowe's square-root-of-time method of closed-system anaesthesia. Br J Anaesth 1997.On the site Agent uptake at low flow (square-root-of-time)
- Closed-circuit anesthesia (Clinical Tree).On the site Closed circuit and O₂ consumption (≈ 250 mL/min)
- FDA. ULTANE (sevoflurane) prescribing information, 2017.On the site Compound A: FGF < 1 L/min not recommended; 1 ≤ FGF < 2 L/min for ≤ 2 MAC·h. The site does not calculate compound A levels; it only shows labelling guidance
- APSF. Patient safety and low-flow anesthesia.On the site Safety and monitoring at low flow
Ventilation and asynchrony
- Thille AW et al. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med 2006;32:1515–22.On the site Asynchrony index (> 10% high), ineffective and double triggering
- Asynchronies during invasive mechanical ventilation: narrative review and update. Acute Crit Care 2022.On the site Asynchrony definitions and waveform patterns
- Hamilton Medical. Double triggering: diagnosis, differentiation, and resolution.On the site Recognising and correcting double triggering
- Cycling of the mechanical ventilator breath (Respir Care).On the site PSV cycle criterion (25% default; 40–60% in COPD), trigger 1–2 L/min
- Respiratory mechanics: to balance the mechanical breaths. Indian J Crit Care Med 2021.On the site Equation of motion, resistance and compliance
- Emeriaud G et al. PALICC-2 executive summary. Pediatr Crit Care Med 2023.On the site For paediatric ARDS (PARDS): Pplat ≤ 28, ΔP ≤ 15 cmH₂O, Vt 6–8 mL/kg (lower of actual and predicted weight). These limits do not automatically guarantee safety for every child
- Neonatal respiratory physiology (Deranged Physiology).On the site Neonatal compliance and resistance
Clinical event management
- MHAUS. Managing a crisis (Malignant Hyperthermia Association of the United States).On the site Malignant hyperthermia: dantrolene 2.5 mg/kg IV rapidly, repeat according to response; cool if core temperature > 39 °C, stop below 38 °C
Paediatric physiology
- Patel R et al. Age and the onset of desaturation in apnoeic children. Can J Anaesth 1994;41:771–4.On the site Age-related shortening of time to desaturation in apnoea
- Benumof JL et al. Critical hemoglobin desaturation will occur before return to an unparalyzed state following succinylcholine. Anesthesiology 1997 (and 2005 follow-up).On the site Safe apnoea time estimates in adults, children and infants
- Society for Pediatric Anesthesia. Neonatal emergencies (2007).On the site Neonatal O₂ consumption ≈ 6 mL/kg/min, bradycardic response to hypoxia
- Pediatric anesthesia (Aneskey).On the site Paediatric vital signs and FRC
Airway equipment, breathing systems and scavenging
- Medscape. Pediatric endotracheal tube size calculator.On the site ETT size: uncuffed age/4 + 4, cuffed age/4 + 3.5
- EMCrit. Endotracheal tube depth.On the site ETT depth (3 × ID; 21/23 cm in adults)
- University of Washington. Pediatric airway: LMA sizes.On the site LMA size by weight
- Sengupta P et al. Endotracheal tube cuff pressure in three hospitals. BMC Anesthesiol 2004.On the site Cuff pressure target 20–30 cmH₂O, mucosal perfusion
- ProSeal LMA: oropharyngeal leak and mucosal pressure (Br J Anaesth).On the site LMA seal pressures and mucosal pressure
- WFSA. Anaesthetic breathing systems (Update in Anaesthesia).On the site Mapleson D: spontaneous ≈ 150 mL/kg/min, controlled 70 (normocapnia)–100 (mild hypocapnia) mL/kg/min; Mapleson F (< 20 kg): spontaneous 2–3 × MV (≥ 3 L/min), controlled 1000 mL + 100 mL/kg
- University of Detroit Mercy. Anesthesia Gas Machine: breathing circuits.On the site Mapleson circuits
- Jouan ZT et al. Hypercarbia induced by detachment of inner fresh gas delivery tube of the Bain circuit. Acta Anaesthesiol Sin 1995.On the site Bain inner-tube disconnection and Pethick test
- OSHA. Anesthetic gases: guidelines for workplace exposures.On the site NIOSH recommendations (1977): N₂O 25 ppm as a time-weighted average during anaesthetic administration; halogenated agents 2 ppm ceiling (60 min), 0.5 ppm with N₂O. Not legal limits; local regulations may differ
- NIOSH Pocket Guide to Chemical Hazards: Nitrous oxide.On the site N₂O recommended exposure limit (REL): 25 ppm, time-weighted average over the exposure period
- NIOSH. Engineering controls for post-operative waste anesthetic gases (2022).On the site Current confirmation of the 1977 NIOSH exposure limits
- Virginia Commonwealth University. Waste anesthetic gas.On the site Waste gas exposure and control
- University of Detroit Mercy. Anesthesia Gas Machine: scavenging.On the site Open/closed interface, −0.5 to +5 cmH₂O relief valves