Having trouble remembering the components of a basic (manual) machine check? A song to help you remember!

The Lyrics:
ANESTHESIA MACHINE CHECK
To the tune- “I’m Gonna Be (500 Miles)” by The Proclaimers

When I come in, the first thing I’m gonna do is turn on the anesthesia machine.
While it’s loading, check the suction for full power, if it’s broken it’s turned off where you don’t see.
Take off pipeline, open the O2 tank and be sure it’s at least 1000 PSI.
Bleed the system, get it all back down to zero and don’t forget you’ve got to close that O2 tank!

CHORUS
Well keep an ambu bag nearby,
And make sure your O2 tank is full -
Just in case, don’t freak out. Sing this song in the morning when you do your machine check!

For the Vent - make a fake lung, O2 at 4, turn on the vent and check that there’s no leak.
With each breath, the one-way valves open and close according to the timing of the breath we seek.
Let’s calibrate (calibrate!), the oxygen to air so open it and wait until it’s 21%
All these steps, are checked automatically in new machines, so follow the instructions and don’t fret!

CHORUS
DA DA DA! DA DA DA! DA DADUM DUM DUM DUM DA DA
DA DA DA! DA DA DA! DA DADUM DUM DUM DUM DA DA

Don’t forget, close the APL then O2 flush, if pressure maintains circuit’s clear to continue.
Low-pressure check, switch to CGO, turn gas on low, squeeze the bulb and watch the shape hold true.
Fill the vapes (fill the vapes!), with the matching key and med in hand, fill it till you reach the top line.
Clear CO2? (CO2!) The more you know your machine, the safer you are in your practice, bottom line.
And the sooner you go home, and drink wine!

CHORUS
DA DA DA! DA DA DA! DA DADUM DUM DUM DUM DA DA
DA DA DA! DA DA DA! DA DADUM DUM DUM DUM DA DA
CHORUS

----------------------------------------------------------Detailed Explanation-----------------------------------------------------------------------
Checking pipeline gases and cylinder supply – Remove oxygen pipeline (only necessary if there is only one gauge to read both oxygen wall and cylinder pressures), open oxygen tank briefly and then close it (this way you won’t forget later). Check the pressure of the tank to make sure it is full (at least 1000, full = 2200). While the machine is disconnected from pipeline (or else it will just flush gas from wall), you want to press the O2 flush to bring the reading back down to 0. Why? You’re removing gases from the system, but may also be good mindset to have. If the gauge is showing a reading for the cylinder, you may not be confident that the O2 tank is closed and so IF the pipeline was to fail, it could start pulling from the tank without your knowledge.
Check ventilator and unidirectional valves – Attach second reservoir bag to Y-piece to simulate lungs, turn on fresh gas flow (Oxygen at 4 L/min) and turn on the ventilator. You are checking for leaks, proper valve movements on inspiration and expiration, and proper tidal volumes.
Check circuit and APL- Occlude the Y-piece, turn switch to bag, close the APL (turn it to 50-70), press O2 flush until gauge reads 35-50 (doesn’t matter, as long as you watch that the pressure maintains for 30 seconds). Slowly open the APL (gradually to 0) and make sure the pressure drops accordingly. You are observing for leaks in the system as well as ensuring APL is working properly. THIS CAN BE TESTED BETWEEN EACH CASE.
O2 Analyzer- If it is manual, you want to remove the oxygen analyzer and place it on the table exposed to room air until it reads 21%. Then you hit “calibrate”. This can be tested during a case, but you have to plug the circuit where the O2 analyzer was removed to keep the system closed.
Low Pressure System Check- Connect bulb (like for a BP reading) to auxiliary CGO, and turn it to CGO from circle. Turn on the vaporizers to 1%, compress bulb and make sure it stays compressed for 10-30 seconds. If it doesn’t, there is a leak.
Check hypoxic-guard backup- Turn flows of oxygen on very low, increase nitrous and watch that oxygen also increases. Now turn down oxygen flows and observe nitrous levels also fall. (Not always required- internal backup system)
Check that CO2 absorbent is clear, suction works properly, vaporizers are full….and of course, that you have an ambu bag and full oxygen tank nearby!!!