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目的掌握调压限制阀(APL阀)的正确设置,减少气压伤。方法调查日常麻醉机使用及维护过程中APL阀的设定;调查APL阀不当设定在麻醉诱导期及麻醉机意外断电时的安全隐患;调查麻醉机断电试验和呼吸回路意外充氧情况。结果术中麻醉机APL阀设置正确率仅20.6%,APL阀处于关闭状态高达41.2%;半年间,麻醉机意外断电事件5例,发生手控呼吸皮囊膨胀与呼吸回路高压状态2例;10台麻醉机断电试验,4台麻醉机手控—机控切换开关自动转换至手控模式,导致呼吸皮囊持续充氧。结论麻醉前APL压力限制阀档位的正确设定、麻醉机电源检查与呼吸回路检查同样必不可少。带有“自充氧”气袋的简易呼吸囊能确保足够的通气,是应对任何麻醉机功能失灵的有效办法。
Objective To understand the correct setting of the pressure limiting valve (APL valve) to reduce barotrauma. Methods Investigate the setting of APL valve during routine anesthesia use and maintenance; Investigate the improper setting of APL valve in the induction period of anesthesia and accidental power failure of anesthesia machine; Investigate the anesthetic machine power failure test and accidental oxygenation of breathing circuit . Results The APL valve setting accuracy was only 20.6% and the APL valve was 41.2% during the anesthesia. During the first half of the year, there were 5 cases of accidental disconnection of the anesthesia machine, 2 cases of hand-controlled breathing bladder expansion and high pressure of breathing circuit. Taiwan anesthesia machine power-off test, 4 anesthesia machine manual-machine switch automatically switches to manual mode, resulting in sustained oxygenation of the respiratory skin. Conclusion APL pressure before anesthesia limit the correct setting of the valve position, anesthesia machine power check and breathing circuit check is also essential. A simple resuscitation bag with a “self-inflating” air bag ensures adequate ventilation and is an effective solution to any malfunction of the anesthesia machine.