Who fixes anesthesia equipment during surgery?

On rare occasion, anesthesia equipment like the ventilator may malfunction in the middle of surgery. Who fixes this equipment, and how do they learn to do it? In this video, I spend a day with anesthesia technician Nilson Flores to understand a vital aspect of the anesthesia team.
0:00 Start
0:45 Anesthesia tech overview
3:55 OR coverage
5:46 Machine checkout
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.

[@michaelsanchez7235]

As an anesthesia tech here at Baptist Hospital in Miami, it’s nice to shed some light on our end. Everything he explained is spot on and it’s a vital role that I’m glad that we’re a part of 👍🏽

[@acloudshapedcloud7785]

I'm also an anesthesia tech! At my hospital we are also responsible for priming fluid set ups (free flows, A-lines, blood warmers, alaris, and Belmonts) and setting up scopes so the provider can obtain an airway. I'm curious if this varies from hospital to hospital or if the state decides who is in charge of these.

[@michaelsanchez7235]

@@acloudshapedcloud7785 we do the same thing in my hospital and in some of the many different departments we work in, we can be more involved with patient care and assisting the anesthesiologist as well. It can vary from hospital to hospital and that’s how we pretty much do things at the hospital j work in

[@soniass2978]

​@@michaelsanchez7235😊

[@jeffreybellantoni8758]

Shut your mouth

[@kneeyul]

As a Biomedical Equipment Technician, whenever I get a call from an anesthesia tech I know things are B A D and I need to get over there ASAP. The amount of work and troubleshooting they accomplish is very impressive and an experienced tech knows the machines better than the BMETs that went to the manufacturer's training! In short, anesthesia techs are a BMET's best friend in the OR and arguably the whole hospital.

[@johnsadang3845]

We love our Biomed guys!

[@DudeWhoSaysDeez]

I'd love to see more videos about the support staff required to keep the whole surgery center functioning

[@rf159a]

I had no idea these people existed. It's great you highlighted the people us patients never get to meet. They are indeed the backbone to the whole surgical staff!!

[@surgeon1016]

As a med student and a frequent flyer as a patient in the operating rooms I just want to your videos are some of the most informative and educational videos so thanks for always providing excellent content

[@hunterG60k]

I love that you took the time to credit the people working behind the scenes to enable you to do your job. A lot of the spotlight goes on surgeons but there are hundreds of people involved in each surgery 👏

[@lisalaunius7389]

I worked (as an RN) PACU at a major Dallas hospital for 15 yrs. I knew anesthesia techs existed but not the extent of their duties. Thanks so much for recognizing them.

[@r.d.9399]

They definitely don't get paid enough for all they do

[@bettysmith4527]

What a nice young man, I wish him the best in his career and future endeavors! As usual, thanks for the video!

[@infopubs]

Nilson does a very important job! Thanks for highlighting this role.

[@bookkeepingsmes2089]

Thank you to all those behind the scenes who basically ensure success 💜

[@bgilbert95]

I’m an anesthesia technician in the Tampa Bay Area! It’s very rewarding knowing that we helped save a life or many.

[@loloali9776]

Really appreciate what anesthesia team ( nurses, physicians and technicians) and all peoples behind the scenes are doing to keep us safe during surgery ❤🥰

[@elizabethkuchta5097]

❤

[@blip_bloop]

This is one of my favorite videos, there are so many overlooked people in hospitals that help make care possible, I appreciate all your videos that bring light to the less known about corners of medicine. Thank you Doctor Feinstein

[@coryl5142]

Thank you to Nilson and everyone behind the scenes for the work they do.

[@Love-ql7rd]

This interview highlighting the support staff was excellent. These gentlemen take their jobs very seriously and the love they have for their work shows. This is one of my favorite videos of yours. Thank you Nilson for allowing Dr. Feinstein to do this interview!

[@AvalonCN]

Love that you showed this aspect of healthcare. Also interesting to see that the anesthesia techs at Mount Sinai are trained in anesthesia machine repairs. Since I work in BIOMED, I usually see that BIOMED handles this, but I think it’s very efficient for the anesthesia techs to have this skill. Do the anesthesia techs also perform the preventive maintenance on the machines? Great video!

[@shaikhmehboob8781]

Proud to be an anaesthesia tech from India 🇮🇳

[@andycraddock7677]

Dr. Feinstein: Thank you for sharing such a fascinating video showing just how many people “behind the scenes” (including you - to an extent- as you stated) play a vital and important role in ensuring a patient has a safe and hopefully trouble-free surgery. I don’t recall you stating this, but in the rare event that your computer-controlled, $100,000 Philips vent simply crashes during surgery, as an emergency measure you can whip out the Ambu Bag and hand ventilate your patient. But this is very quickly exhausting for the care provider. Like you, I’ve done it. Definitely come a long way from 1931, the year my grandfather graduated Hahnemann University School of Medicine (now merged with Drexel U). I recall my grandfather describing anesthesiologists of that era using Either Masks and slowly dripping Either onto the thick cotton on the mask. If I recall, Either, Nitrous and Curare were about it in the anesthesia tool bag c. 1931. Fascinating stuff. Perhaps you could do a future presentation on the history of Anesthesia, with the story of the moment a certain physician was heard to exclaim in 1846, “Gentlemen, this is no humbug!”

[@starfishgurl1984]

Great video! Before she went to work for Phillips my sister was in charge of equipment installations at Mass General (and some of the smaller subsidiary hospitals in the system), and I remember her talking about having to borrow equipment from some of the smaller hospitals at the height of the pandemic when they were creating specific Covid units/wards and it really opened my eyes to sides of healthcare that I never really gave much thought to before that. After her grad school program at the VA hospital in LA she got her start as a clinical engineer at Kaiser Health System prior to working at Mass General and now she works on specific Phillips installations at multiple hospitals but she deals with a lot of the behind the scenes people similar to the people you featured in this video and I find it totally fascinating! Go team of silent heroes go!!!

[@queenbunnyfoofoo6112]

This was very interesting! Thank you for spotlighting the techs....they deserve recognition.

[@tayzonday]

Whatever an anesthesia tech is paid, I have a feeling I’d want mine to be paid more.

[@isaacdmanful]

Agreed. While the Dr seems like a big part, it's these quiet professionals that really make things work

[@Eman1900O]

@@isaacdmanful some are lazy and hide basically. I’m a CRNA and we don’t have techs at my current hospital but I can tell he’s good at his job

[@DudeWhoSaysDeez]

I didn't expect Tay to be watching these videos. But hi!

[@chrisdee9620]

@@isaacdmanful hi😅 I

[@talpa6969]

80k :sob:

[@SmileBro12]

I was an anesthesia tech for over a year. My favorite job I’ve ever had. I had to come in at 4 am to make sure the machines were good to go and rooms were fully stocked. Making A lines, setting up IVs

[@JulietNovember]

Thank you so much for making this video ❤ Shout out to all people who work behind the scenes 👏

[@ilovetotri23]

Great points! I could not agree more! I never even knew of this incredibly life saving position until now. Great video!

[@413smr]

It's really nice that you thought to highlight in a video the work that goes on behind the scenes by technical support staff. Thank you.

[@pattineedham9094]

I am just a patient and want you to know how grateful I have always been to you doctors who make sure I miss the party of surgery. I do remember you!

[@sandyseibelhager7131]

Wow! So much more advanced than the anesthesia machine that I used as a veterinary technician ten years ago. (The machine is from the 70s)

[@johnsadang3845]

Thank you for this video. Nothing beats the feeling of you worked side by side with your provider in a big emergency case. You walked out of the room knowing you provided everything your provider needed in a room all in a fly! Proud anesthesia tech here.

[@patspencer5649]

It takes a village! Great teamwork.

[@SD45-ET44AC]

Susie was one of the 1st Anes.Techs I worked with & she set the bar very high. My two all time favorites were Jamie and Brian, although Jamie was the best. Jamie would quietly be there just in case something was required or a pt.’s status were to change. She was very organized & she would help the entire surgical team and routinely go above what her job description was.

[@joemygawd]

Very interesting and it’s great to know you value the little guy.

[@DheerajMasapu]

lot of respect for Anesthesia techs with out them it would be impossible to operate in countries like India where the number of cases done per day in hospitals is very high in number . They help us in getting things ready and also lend a helping hand in managing crisis situations.

[@lilbatz]

I LOVED this. So many people support the doctors that you never hear about.

[@darriontunstall3708]

Wow, that was awesome and amazing! The Anastasia tech is awesome and very important!! I learned a lot!! I really look up to anesthesiologist! I have had 14 surgeries because of my cerebral palsy, I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college to be a anesthesiologist physician because of my cerebral palsy! I think it takes a special person and skills to be a anesthesiologist and you’re one of those special people! I’m 33 ! You rock man! I’m from Memphis

[@shelleyrhodes6231]

8:15 ❤ everyone on the team who does a surgery is extremely important! I do remember my anesthesiologist name, it was Dr. Johnson. keep doing what you’re doing! You do make things and explain things very helpful.

[@peggymartin7681]

Wow!! I’m so impressed with this tech. I don’t know why it never occurred to me that these machines malfunction on occasion.

[@prydin]

What a lovely tribute to all the heroes working behind the scenes to make modern medicine possible! Thank you Nelson!

[@richardwroy14]

Unique and very informative channel! And thank you for putting the spotlight on these very important people in the anesthesia team. 💯👏🏽

[@paulcreedon1375]

This was a great episode Max. They are really the unsung heroes of the OR!

[@IAm-NotHear]

I love this channel. Thank you Max you answer and ASK questions.

[@vidad3820]

This is fantastic! Kudos to anesthesia techs! 🙌

[@jillthompson4280]

Awesome behind the scene! 😍

[@joeantinora8396]

Great stuff!! I'm a Anesthesia tech at SIUH Northwell. I love it when guys/Gals do these videos ❤

[@goskaes5468]

my son in law is anestesiology doctor. watching this channel makes me to respect him much more...its just WOW

[@connormarston8311]

Healthcare is a team sport. Love to see videos like this.

[@leodikinis7390]

Verry cool Dr. Max! Keep up the great content!

[@sarelgonzalez1271]

Thanks a lot for the shared info! Not sure if I will match in Anesthesia in future but even if I ended up working in Mc Donalds in Japan i love these videos! Here is my thumb up!

[@sherrydawson6253]

Wow this was awesome 👌 I've never heard of a anesthesiologist tech before. They have alot to learn. Omg can't imagine the feeling if your not able to fix a problem. He seems like u, stays calm. How long do they go to school? I just love ❤️ your videos. Idk why sometimes it takes so long to show up in my feed. Thank u for shareing so much !

[@kristinchong629]

This is so fun. ( of course I hope people dont have to have surgery.) Like its so much better than watching influencers, like you can have a life where you learn and help people. So cool.

[@hpd6119]

Dr. Feinstein, thanks for excellent videos on a topic I never though I'd be so interested in! Episode suggestion, and I'm sorry if I missed you covering this already, but it would be interesting to hear about your use, or potential use of Naloxone in your treatment of patients, along with the other drugs that may reverse the effect of other drugs. When a cop brain becomes interested in Anesthesiology.... Yikes! Take care and best wishes from Montana!

[@maebellinekang]

Wow .. how I wish I work in American Hospitals.. where you guys have specialised techs for the anaes machines. Here in Aus the anaes nurses do most of the trouble shooting and cleaning of the block in their shift time 💀

[@ameowingbird]

i love the tech's anesthesia med lanyard!

[@molu10591]

Hey Max, do you have the "et Control" option in your Aisys CS2? Its basically a cruise control for you anesthesia machine. GE Healthcare recently got the FDA approval for it. People in other countries have been using for almost a decade now. You might have to upgrade few things on your machine though, for example your anesthesia gas analyzer.

[@The.Challenged.Gardener]

Would love to know more about what roll anesthesia plays with your system after surgery and to get our systems moving again and why it effects some people more than others..

[@muntacamil1463]

Gold

[@AnElt999]

Immediately Dr. Glaucomflecken's sketch about surgeon floats in my mind. "Why isn't my equipment working? Than find someone who can tell me why isn't it working! ***five minutes later*** What are you doing here? Why what doesn't work? I don't care"

[@Velianna]

In my country nurses make machine checks everyday and if something is malfunctioning during surgery anesthesiologists with nurse have to do minor repairs, and if that is not possible then we switch to tiva, use ambu masks and get spare respirator. Such things show why US healthcare is much more expensive, we don't have techs...

[@paulpoppenfuse7071]

Love

[@pantherinae_art]

I just found your channel, so forgive me if any of these have been answered, but I have a couple of questions you might be able to answer 😊 Firstly, my brother had a 15+ hour brain surgery once (he's had more than 25 in total, but I think only the one was quite that long!) and I always wondered how on earth the team operating cope with that?! How do you maintain the anaesthetic for that long? Are there special considerations for both patient and staff? Do you do a shift change in a really really long surgery? I mean surely you've got to go to the bathroom or something at some point!? Is the medication you use different for something really long, and is it more complex to reverse a long sedation? Secondly on another line entirely, I'm a chronic pain patient and I take slow release codeine every day as well as occasional NSAIDs for flare ups. How do you manage pain in someone who already takes daily opiates? Would I need to go without my usual meds (for a planned surgery) and in the case of an emergency, can you add other opiates into my system on top of those?? I nearly needed urgent surgery in 2021, and I was kept without ALL my meds or food for a day (which was horrible. I could cope without food but without meds!) but luckily the IV antibiotics I had worked and I didn't need surgery :). I worry about these things because I need some surgery in the future (they're trying to wait as many years as they can) and that time without my meds was horrible!

[@BrentDrinnen]

Can you do a video on Sterile Processing. Its another forgotten piece in surgery that patients never see

[@elizabethkuchta5097]

❤

[@MrA1Sauce]

I think I talk to the anesthesiologist longer than the doctor. So don’t think you are behind the scenes. For most people you are the person they are talking to during the most important part of their surgery (for them anyway).

[@wp2727]

In Australia most hospitals have nurses instead of techs. But they are responsible for one theatre not multiple.

[@chris2746]

I'd be interested in learning what the difference is between anesthesia and a medically induced coma. I'm finding very little information that provides any real detail. Might be a good episode topic. I couldn't find one about it by you with a basic search

[@jordanking7711]

I wouldn't go as far Max to say that patients don't remember anesthetists. I can't tell you how many surgeries I have had, where I have had several anesthetists, and I remember each and every one of them. And there were quite a few that REALLY looked after me when I've been there and I've acknowledged them in emails to the relevant patient reps. Don't sell yourself short Max is all I'm trying to say.

[@SE45CX]

Hi Max, I'd assume it is a pleasure to work with these high quality medical grade systems. This in contrast to consumer grade stuff, like computer and smartphone software/apps and car infotainment systems for example. What is your take on this?

[@tyw7205]

Hey, Im getting wisdom teeth surgery with IV sedation. Im nervous, and can anyone tell me what it's like?

[@loganmacgyver2625]

when I started electronics highschool (I have a matura which is like a highschool diploma and a profession in electronics) I had the option to choose to continue in telecomms, medical machinery maintenance/repair, manufacturing and I don't know what the fourth option was. by the time I graduated all those courses dissolved, I was thinking telecom or as a plan B "meditronics", only thing holding me back from meditronics being plan A is the fact that I get quesy easily if I see anything medical that is real (as in, not Hollywood), I have no issues watching Goran Vjnic crack a chest on ER but I fainted in a biology class about the heart and circulatory system. Imagine the technician fainting while fixing the machine mid surgery 🤣

[@johngolden7517]

what happens patient wise if machine fails during surgery?

[@soniass2978]

How can apply overses anesthesia technician to USA?

[@reddbendd]

I can imagine this guy running through the hallways carrying an ifixit kit for hospital equipment

[@caseyslifewithcp3727]

I don't think I've ever been on the ventilator during surgery obviously I don't remember

[@TheFarrierguy]

How much does a tech make??

[@LeGenDxKaOtiK]

100 attendings and 100 residents just for anesthesia??? How massive is that hospital? 😨

[@davidciaffa4711]

It's huge - Mt. Sinai Medical Center proper in NYC has over 1100 beds. If you count all its affiliate centers, it encompasses almost 4000 beds. Max can probably provide more detailed info.

[@conrad6598]

this kinda reminds me of truckers who does a complete check before he/she starts, a once over after stopping for anything, and a post trip check before ending the day.

[@seraphina985]

Same is true for pilots also, then again I would be surprised if there are not similar rules for bus and train drivers, and other roles which involve operating safety critical equipment.

[@jimmydandy9364]

Corners are cut even with medical equipment - with such high cost of these equipment they should not break down or extremely rarely - there needs to be a very high level of quality control and testing under very high stress and load - and these machines need to periodically be maintained and checked - Unfortunately medical equipment is not immune from shoddy components, poor QC and QA testing.

[@gunsnrosesforever100]

I had a trimalleolar fracture of the left ankle and all I remember is my anesthetic guy showing up and saying time for " milk " and I was out like a light lmao

[@deanvrabl]

I've just had surgery. Since I'm still alive , all went well. ( I guess ) 😅

[@mikeschulte4271]

Glad all went well wishing u a speedy recovery ❤‍🩹 😎

[@mainlymusicman]

make sure to pick the one who's black to interview. correction: make sure to pick the TWO who are black to interview. correction # 2: make sure to pick the THREE who are black to interview.

[@PURPLESPARKLESFASHION4]

You do agree that all so called brain and cardiac dead organ donors should always be fully anesithitized with full general anesthesia in the exact same way the rescupients are?

[@bettysmith4527]

Stop giving the patients Versed, they'll remember you! 😁

[@gigitonsvajv]

Why is there not a spare one in the room? I’m no expert but I think there’s no such thing having to trouble shoot a ventilator. 😳

[@Coffeeisnecessarynowpepper]

You need to be continued education which means you have to pay for two years of school every two years and it's expensive

[@JenJen0582]

Why doesn’t the tech just replace the ventilator and take the broken one back to fix it? Wouldn’t that save time?

[@MaxFeinsteinMD]

Replacing the entire ventilator would take a significant amount of time.

[@teleman07]

Don't you need to cover that chest hair during surgery?

[@Twinsen764]

I would hate that cleaning job. No matter if it paid 6 figures.

[@bobd.4967]

The Bio-Engineering Department might be useful also when the s*+T hits the fan.

[@SD45-ET44AC]

Our Bio-Med staff were all very valuable and knowledgeable people and would come in on call at 0300 if we just asked (even though we were discouraged from asking them to come in because they were highly paid+call pay+ a minimum charge as they were independently employed.)

[@smitvirani5791]

That vent broke message goes to an engineer simply

[@MrYashasviVerma]

04:24 I want to know how Indians like Ravi can work as anesthesia technician in US

[@astrostar4181]

Hidden Figures.