Full tour of the anesthesia machine

The anesthesia machine is the centerpiece of all the anesthesia equipment, and yet it doesn't actually get much attention. In this video, I show you some of the key functionality of the machine and explain how it facilitates safe patient care.
0:00 Start
0:44 Overview
3:40 Gas delivery
4:56 Breathing circuit
7:59 Waste handling
8:28 Ventilator function
11:44 Other screens
Music:
Subtle Swagger by Ron Gelinas: / atmospheric-music-portal
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
#Anesthesiology #Residency #MedicalSchool

[@christineheadley]

Thanks Doc, If I had 25 years remaining, I'd become an Anesthesiologist. It's the most fascinating medical field; a lot of the other fields are carpentry. At 84 I'm running out of time so I'll stick with learning as much as I can. This has served me well in that I have caught doctors either lying or being ill informed. Christine, 18 May 2024, 1131 hrs MST

[@VintageteaCher56]

I have a new found respect for anesthesiologists. Thank you for your videos. Up to watching your videos I thought that your only job was to put us to sleep and wake us up. Thank you for opening my eyes. Puppy hugs to your fur baby..

[@qwerty112311]

Did you think they make 500K plus to just push a plunger or two on a syringe into the IV line?

[@MxCartney_Lou]

Anesthesiologists are the nicest doctors I’ve ever known in my life, I was born with congenital heart disease…..I’ve been getting surgeries for heart problems and other medical problems since I was 4 months old

[@Nunofurdambiznez]

DR. Feinstein, of all your hundreds of videos, honestly, I think is absolutely one of your best!! It's very informative and you made it all very easy to understand the equipment.

[@dancenutcracker7502]

I’m an ICU nurse and this is a very interesting look at how anesthesia works in the OR.

[@southaussiegarbo2054]

"We better leave that off so i dont accidentally anethatize myself" - max 2024 😂😂😂

[@PaulLoveless-Cincinnati]

So if I see a maintenance man with a very large smile on top of the exhaust stack on the roof - I will know it's time for a urine analysis for him lol. "Terry! I need to change the light on top of the stack! " "You just changed it two hours ago!"

[@ShaunPuzon]

YES! It's always a great day when Dr. Feinstein uploads a video! Thanks for the video, Max! Your content is incredible, and your editing skills are excellent! Thank you!

[@mhenderson9311]

Interesting video! So it's not just all about the drugs and the chemicals. Anesthesiologists also need to be concerned about gas pressures and volumes. So much concern goes into planning these surgeries. Thank you for sharing!

[@sandybeasley2286]

Great explanation. Was just operated on last Monday and always I am googling and watch and procedures and what’s behind the scenes. Thank you

[@paulkoza8652]

Well done, Max. I appreciate the effort you put into your videos.

[@darriontunstall3708]

That was so cool and amazing! I learned a lot about the anesthesia machine!! I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college because of my cerebral palsy! I really wanted to be an anesthesiologist physician!! You rock man

[@johnmartin4650]

You’re back ! …….good to see you again .

[@uTube486]

Having a daughter finishing med school, your work is helpful. Thanx Dr. Max.

[@macking104]

Is she going into easy specialty like pediatric cardio anesthesiology or complex like family doctor in a small town.

[@uTube486]

@@macking104 She's starting residency at a children's hos in Philly. She wants to be into pedo oncology.

[@dogsarefun2]

Excellent information on the GE Anesthesia Machine.

[@RobinHood70]

Story time: Back in 2010, I had an anaesthesiologist (possibly the resident) who forgot that all-important "Gas Delivery" checkbox. I got the anaesthetic, but no airflow apart from that. I tried to indicate that there was a problem, and at first, they took the mask off and set it near enough that I was still getting the anaesthetic, probably thinking that I just didn't like breathing through a mask. They never actually checked the airflow, though. Later, they put the mask back on without so much as a "by your leave". I tried again to indicate that there was a problem but the two nurses standing near me were both blabbing away and I was so out of it that I couldn't get their attention. My last conscious thought was that I knew I was hooked up to an O2 monitor, so they were bound to notice that dropping at some point and fix the problem. (Yay for anxiolitics making that a very calm thought.) They must have clued in at some point cuz I was distantly aware of air suddenly starting to flow before I lost consciousness completely. I never followed up, but I wouldn't be surprised if I had a spot in the next M&M.

[@dominiccorbo9979]

Loved this video! Working in a surgery center I have helped change the circuit yet always wanted to know what every part of the machine does. Appreciate it Dr.Feinstein!

[@jo1e-de-v1vre]

Great video Max!

[@squigglesquaggle6553]

These videos help It’s a daunting unfamiliar environment for the patient Thank you

[@Gsavega2803]

Ive learned SO much about anesthesia from your videos that I was able to name everything in the operating room to the anesthesiologist during a recent procedure. He and staff got a kick out of it and it really put me much more at ease knowing what was happening. Thank you very much for your content.

[@loribach534]

This is well beyond my level of understanding and my first time seeing an anesthesia machine. Although I'm unable to grasp the technical aspects, your presentation is outstanding!

[@sherrydawson6253]

Dang I'm so amazed at what all u guys need to know. I love your videos! You are one awesome Doctor. I worry once your all done are u going to just drop all of us? Kobe is adorable. ❤❤❤❤

[@brianmenear4458]

Well done video. easy to understand. Im not a MD, Medical Simulation Tech. We do a lot of training for the Anes. residents

[@ianmalcolm9395]

This guy is a beast at what he does I’m amazed

[@ZeroStatic]

Max, Thanks so much for another informative and interesting video. 👍

[@kenzulian2007]

Very informative video, Max. I really like your vids.

[@rothsleep4039]

Very good basic information. Well organized and presented. Thanks!

[@thebenandfridayshow]

Max, can you please tour the anesthesia cart next keep pumping out good content.

[@kevinshannon9917]

He has done a tour of the medicines he pulls and more generally how he prepares for a procedure, using the MS MAIDS mnemonic.

[@michaelwillis9449]

Great explanation thanks I've had 13 different surgeries and i have always told my doctors I don't care what you are doing I want you to explain EVERYTHING to me as we go for a few reasons 1 it makes me feel better if I know exactly what you are doing and why. 2 its just interesting stuff 😊

[@JMcdon1627]

Excellent Sir.

[@TomLeg]

Ecellent description! Thank you!

[@sandyseibelhager7131]

Very cool. Way more fancy than the very old system I used in the veterinary clinic. Ours had a knob for flow rate, a bag and co2 absorber. No monitoring or anything else. It didn’t even get plugged in(totally manual). No power, no problem. I believe the machine was from the late 60s or early 70s. Reworked to run isoflurane

[@christopherleubner6633]

Used to repair the laser anesthesia gas monitoring units. They had either argon ion lasers or helium neon lasers. The argon laser ones had a low powered laser in them that would cause the various gases to glow at raman frequencies. The HeNe units were similar. The oxygen was measured using a servomex magnetic oxygen sensor. The newer ones like yours use a near infrared spectral absorption sensor as those cover a lot of gas choices as well as monitor the CO2. The sensor unit is very small compared to the laser based ones. ❤

[@musicbeachdance]

Thank you for this ! I always am wondering how every aspect of the OR works. Love your videos so helpful !

[@crispychipfriezz]

Going in for a MPFL Reconstruction this Friday.

[@sheagoff6009]

Love it when Kobe makes a cameo

[@GreggBB]

Thanks for a look at that machine. Really interesting! I can't imagine what it takes to become familiar and proficient with using them all

[@sajnasaju487]

Thank you sir ❤well Explained 👍

[@HobbesBaxter]

Thank you!

[@mcrchickenluvr]

I’m having a hysterectomy a week from Thursday. This isn’t my first surgery as I’ve had several. It is however the first one where I’ve had an organ removed. While I’m no stranger to anesthesia, it actually helps calm my nerves a bit knowing what all goes into keeping us alive when we’re so close to death.

[@Beef3D]

If you read this.... Coincidentially I'm currently busy on a detailed 3D model of a mechanical bellow driven ventilator (from scratch). not for any professional and/or medical purposes, but purely out of my own interest as a portfolio project. this video surely will help better understand the inner workings.

[@quinn2014]

Taking medicine is science to a whole 'nother level! 🎉

[@molu10591]

You should get the Et Control upgrade option for your Aisys CS2, it will make your like so much easier. Also, its better to monitor FiCO2 rather than EtCO2 to find if the absorbent has exhausted. EtCO2 can take a while to build up to be noticeable or triggers an alarm.

[@Scott-ff2oe]

Thank you.

[@Scott-ff2oe]

@gaswork

[@DamonJohnCollins]

As someone who budgets/orders/deploys this equipment, I'd love to know more about the accessories that are likely (or possible) for different specialties to be sure we include everything needed. My last project, we didn't know we needed to purchase the vaporizers and we, in fact, needed 2 types for every machine. Thanks Max!

[@zachmcpherson97]

Love your content! Do you work with any CRNAs? Would love to see an interview with one and their role at your practice! Also, maybe a scrub hat tour with links? You have some awesome ones

[@sarahvlach2767]

I ditto this - I'm considering becoming a CRNA and would love to see a their perspective.

[@sarahvlach2767]

Dr Max, thank you for your videos. I'm considering becoming a CRNA because of your calm demeanor, nerdy details in your videos and truly seeing how possible it is to learn anesthesia. However, CRNAs lean anesthesia in 3 years during their DNP days, they perform anesthesia the exact same way an anesthesiologists does. Could you include content with a CRNA? I'd like to explore CRNAs further. I almost quit my hopes of becoming a CRNA after leaning they insert central lines snd arterial lines. Have you posted a video about this? I also appreciated your cideo about blood product transfusions. I'm shadowing a CRNA next month and because of you, I will actually have something of depth to talk about and explore further with the CRNA. Many thanks for sharing your knowledge. 🎉

[@JohansenHosein]

Hi I love this

[@elizabethmcglothlin5406]

This is like a space launch.

[@ReclusiveMountainMan]

That's the most important machine in the room! :) Would be amazing to see the central storage tank/area for O2/air/NO2 if you can find them/or if it's allowed.

[@m.k.8158]

N2O, NOT NO2!

[@ReclusiveMountainMan]

@@m.k.8158 typo...;p

[@m.k.8158]

@@ReclusiveMountainMan It happens!

[@rachelreid8621]

Hi Dr.Feinstein! I admire your job I really do. I'm wondering if you have ever experienced a malfunction with the machine? If you did what would you do in a case like that and what would rhat mean for the patient?

[@trirail812productions8]

can you do a video of the or hallway like i saw you in this video i saw the sink and stuff what gos on in the rest of the flour

[@janismcgovern5067]

After my general anesthesia I had a large swollen gland on the right side of my neck that lasted a couple weeks and eventually went away. Was this due to intubation?

[@nickymoony1304]

I volunteer in a children’s hospital and sometimes just before they are anaesthetised they sometimes get the wiggles and start rolling and moving. So I was wondering what this phenomenon is called and if you could please do a video on it. Also this was a great and interesting video.

[@joshbritton]

In terms of making your videos, do you write a script first and then get all of the shots you need? Or a bit of both? Or solely shots first based on what you know/want to say and then write a script after?

[@MaxFeinsteinMD]

I always make an outline, but I don't write a full script!

[@ncooper8438]

I saw the title and watched the video but there was no description of the anaesthetic gasses used or how they were delivered. This video is mainly about ventilation.

[@MaxFeinsteinMD]

Correct, this video is about the machine, not the medications administered

[@jasonryan378]

Hey Max is there any way the next time I have surgery you can put me under? Last time I had anesthesia they had to put me under twice

[@caydenprescott]

Do you think I will start walking again I had a stroke during surgery in October 2022 during a spinal fusion and now I can't walk right now

[@joshbritton]

11:52 I wasn’t able to find the linked video in the corner, but if you’re able to add it that would be great! 🙏🏼

[@MaxFeinsteinMD]

Should be there now, thank you!

[@Andrei26888]

Is it possible to have general anesthesia without curers? Because I suffer from sleep paralysis and going into surgery knowing that my body is so paralyzed which is similar to sleep paralysis.

[@bradzeigler]

@maxfeinsteinmd I’m curious, as a Pediatric Anesthesiologist, would you be interested in doing a video breaking down how the 2018 Thai Cave Rescue team used a cave diving anesthesiologist to sedate the boys using Ketamine and other drugs to facilitate a safe rescue? It’s an amazing story but I’d love to hear more on the medical side of how they pulled it off.

[@MaxFeinsteinMD]

Yes!!! I watched one of the documentaries and it blew my mind. One of these days I will make a video about that. Truly incredible.

[@bradzeigler]

⁠​⁠​⁠@@MaxFeinsteinMDI did the same and thought that would be right in your wheelhouse. Hard to believe it will be 6 years ago in July. I look forward to it!

[@danieldaniel4375]

I have a question. I had a surgery awhile ago. I have several problems that I told the staff about. I asked them to make a note and let everyone that would be there know my simple directives stemming from my issues. I was reassured that my request would be fulfilled and that the messages were taken and would be shared. My request were ignored and when I got the records from my surgery there were no notes about my issues or request. Is there other records that staff share? Or was I just lied to about them being accommodating so that they could get me into the room?

[@Rs90sR]

Oh, nice, I wonder, do you have an anesthesiologist's assistant? I saw a lot of them helping with anaesthesia carts, are there some of them with you?

[@robertobryk4989]

What's the typical fraction of gas that's recirculated (i.e. the ratio between respiratory_rate*tidal_volume and gas inflow)? I'm surprised that recirculation is worth it, given that (a) the temperature/humidity/... could be ensured with heaters/evaporators/... (b) it adds a scrubber breakthrough failure mode that has to be distinguished from problems that have their cause inside the patient. Am I very wrong in one of these assumptions, am I missing something, or is this just a question of somewhat different weighing of tradeoffs?

[@rockroll7649]

I had surgery for kidney cancer last Sept. All I can say is that God for anesthesiologists. You don't even know it happened (aside from the obvious discomfort during the following couple of weeks.)

[@balzoemg8415]

I recently had a colonoscopy & endoscopy. They told me they were using propofol, but when I looked at my paperwork, they added fentanyl with propofol. Do you know why this could be?

[@MaxFeinsteinMD]

For these types of procedures, propofol is very commonly the main medication for the anesthetic and a bit of fentanyl is added on top of that for pain control (propofol doesn’t help with pain).

[@jeromedavis8575]

I want to see and hear it in action.

[@altavaer]

how you know what the values are suppose to bee on to each difference persons? values u telling about on 10:21 ?

[@karupaiyapaiya3335]

Good morning sir

[@nikhot1000]

What kind of anesthesia is used for gallbladder surgery? Do they give me fentanyl morphine versed dilaudid (probably spelled wrong) I don’t like any of that I hate feeling high except from my medical marijuana

[@karupaiyapaiya3335]

Hello sir I am from india tamil nadu sir

[@JimFromMarietta]

Do surgeons pick the anesthesiologist, or are anesthesiologists assigned arbitrarily to surgeons

[@PatrickDKing]

Please tell me that the software was not written by Microsoft.

[@MaxFeinsteinMD]

It was not

[@kriskass2670]

Did the puppy help with editing 😊?

[@MaxFeinsteinMD]

Yes, couldn’t do it without him!

[@kriskass2670]

Lol

[@poly021]

Have you thought about saying “Go under” instead of “Dive in” when you do your intros to videos? I think it would be hilarious!

[@vancouveropenbsd985]

Is it true that part of the anesthesia curriculum is anesthesitizing your classmates/being anesthes'd by classmates?

[@MaxFeinsteinMD]

No, that is false

[@vancouveropenbsd985]

@@MaxFeinsteinMD wait what? I read on the internet that it was. LOLOLOLOL On a slightly more serious note, thank you for this channel and for everything that you do.

[@TeslaTales59]

Why is intubation required on some surgeries and not others?

[@Joel-zc3xl]

Intubation is required for any surgical procedure that requires the patient put under GENERAL ANESTHESIA which one part of it is muscle relaxation and cessation of breathing. So an endotracheal tube will be inserted and the machine will breathe for the patient for the duration of the general anesthesia. The other is REGIONAL ANESTHESIA which only certain part of the body is anesthetized through various methods such as nerve block but no relaxation of breathing muscle. Thus it will not be necessary to intubate the patient. In short Intubation is only required when the machine needs to breathe for the patient.

[@jessicas2379]

Can someone explain what medical air is

[@MaxFeinsteinMD]

Medical air is purified air at a specific humidity, notably with an oxygen concentration of approximately 21%.

[@jessicas2379]

@@MaxFeinsteinMD ahhhhh I see thanks!

[@bd03]

Still in the Stone Age of med cabinets lol. Tell them to get the Pyxis or Omnicell anesthesia carts.

[@dodofabregas4]

Thank you for sharing this. Just for everyone to remember that there are people in Gaza who are killed by bombs and undergo surgeries everyday without the privilege of appropriate anesthesia. Keep them in your thoughts and speak about them.

[@Megg23456]

It’s a step up from ether dripping, eh? Lol

[@ianshelton6662]

My machine has a third blue gas (N20, silly gas)

[@TheScapegoat420]

Do anesthesiologists take bets on who can stay awake the longest?

[@mikeearls126]

Were you one of those guys that kicked a** all the way through hs and college? seems like getting to where you are requires a huge brain!!

[@JimAllen-Persona]

Do you get offended when people refer to you as a "gas passer"? (It's an old term used to describe anesthesiologts (by doctors))

[@MaxFeinsteinMD]

I've never been called that, but I wouldn't be offended

[@jeremylowe2309]

All the machines in this video will have to be cleaned. Do you pay for that or is the hospital? I’m curious. You are showing people how things work and the hospital is letting you use their property. Who pays for the cleaning after your videos?

[@MaxFeinsteinMD]

I clean everything I use after filming 👍🏽 And when I open equipment such as an endotracheal tube, I ask for departmental permission to do so.

[@tluton64]

seems pretty complicated🤣🤣🤣

[@rosacuore15]

Love your assistant 🦮🥰🙂 I always have respect for the complexities of the work a great anesthesiologist does in most situations. Thank you 🙏 for the video!