Korean J Anesthesiol.  2010 Oct;59(4):270-274. 10.4097/kjae.2010.59.4.270.

Interruption in the supply of breathing gas during general anesthesia due to malposition of the vaporizer: A case report

• Kim HJ
• Kim MW

• KMID: 1766448
• DOI: http://doi.org/10.4097/kjae.2010.59.4.270

Abstract

We report a case of interruption in the supply of breathing gas during general anesthesia caused by malposition of the Drager Vapor 2000(R) vaporizer, which was accidentally tilted and lifted off the Selectatec manifold of the anesthesia machine. Because the patient was an 1-month-old infant, we couldn't check if he had experienced awareness with recall. We emphasize the importance of checking the anesthetic vaporizer after mounting it on the back bar of the anesthesia machine.

Keyword

Gas leak; Selectatec; Vaporizer

MeSH Terms

Anesthesia
Anesthesia, General
Humans
Infant
Infant, Newborn
Nebulizers and Vaporizers
Respiration