11 No disposable breathing circuit is available
Use reusable breathing hose systems, whenever possible with water traps.
12 Reduce the fresh gas flow
Fresh gas flow > 20% of the minute volume, at least 1 L/min. For patients with increased CO
2
production
(e.g. high fever), the fresh gas flow should be set significantly higher (e.g. >50% of the minute volume).
more humidity in the breathing system (circle system) and the piston ventilator
higher consumption of soda lime due to more rebreathing, please refer to the following website
https://www.draeger.com/en_corp/Corporate/Coronavirus-COVID-19 for a calculation tool.
Deviation between set O
2
concentration in the fresh gas flow and measured FiO2 increases
The system reacts slower to changes of the fresh gas O
2
settings
Check also chapter 4.1
To be considered
Adjust the filter set-up: no filter at the inspiration port, use mechanical filter (if possible with HME)
at the Y-piece (TwinStar HEPA or SafeStar)
Set narrow alarm limits for FiO2, MV low, Paw high and insp. CO2 high
Use the longest possible hoses with water traps in the inspiration and expiration limb
Perform a system test of the anesthesia devices every 24 h. For devices of the Apollo and
Fabius famliy, remove condensate out of the piston diaphragm before starting the system test.
During the process of draining the patient must be ventilated differently.
Check the accessories frequently, at least every 4 hours
Check the water traps of the breathing hose system and drain them if they contain condensate
Check the water trap of the gas measurement (Waterlock2) and drain it if it is half full with
condensate
Check the filter and change it if there is an increased amount of condensate present
Change the CO
2
in time if 2/3 of its content has turned purple
Permanent presence of an experienced user with detailed knowledge of rebreathing systems
is necessary
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