EBME Forums Forums Management Medical Equipment Management Draeger Primus

We occasionally find varying amounts of fluid inside the bellows of the Draeger Primus anaesthetic machine during service.

Just wondering if anyone else has experienced any issues with fluid in the bellows.

Also, what cleaning schedules/methods are being used for your breathing systems?


Any views/experiences are much appreciated.

Thanks

This is normal if your users are running low flows in relatively cold theatres
This is the condensation of the humidity generated from the reaction of CO with sodalime
Not a problem - just remove when you do the PM

Thanks for the reply, we have since begun to routinely check for fluid during each service and on some occasions it has been quite a large amount, (140ml in one case) as well as our 6 monthly checks we have asked theatre staff to check each machine on a more regular basis (daily). This should hopefully avoid any subsequent issues.

Thanks again.

Do the machines have cosy heaters fitted, we had a similiar issue with our Drager Fabius machines and since we have fitted heaters the problem seems to have died a death.

Thanks, The breathing system allready has a heater built in. It appears that it is partially the design (intended or otherwise) of the breathing system which causes the formation and collection of fluid in the bellows. The bellows is the lowest and coolest point in the system so inevitably there will allways be some fluid appearing here. I am assured this is normal and that our daily routines should identify abnormal levels. It is recommened that the whole breathing system is decontaminated on a weelkly basis, we have aprox 90 machines so this is not really an option. We are subsequently trying to encourage theatres to be more vigilant with their daily inspections. (it seems to be working, for now!)

Hello Robert,
Does the Drager Apollo have a similar issue of condensation in the belows? Or is this just only related to Drager Primus.

Have you addressed your concern with Drager about the accumulation of condensation with Primus?

Have they provided a solution to resolve the condensation? Is this a manufacturing flaw?
Did Drager provide a proper explanation in regards to the condensation?
What precautions have you provided to resolve this issue?

Does the condensation accumulate any bacteria?

Thanks
Tim

Hi Tim,

As far as I can see from google images, the apollo and Primus ustilise the same breathing system/ventilator so I assume the condensation issues are the same.

We have spoken with drager regarding any potential problems and they assure us that condensation in the bellows is normal and will not affect the operation of the machine.
They do however refer to the user maintenance guidance which states that the bellows should be inspected and 'cleaned' on a daily basis. Our theatre departments are currently updating our 'daily procedures' to include checking for fluid.

We have had a number of instances when, during maintenance we have seen quite a lot of fluid which, it appears has been neglected for some unkown period of time.

Our infection control/microbiology team have been consulted and they didn't think it was worth taking samples to test.

As its is logistically difficult to carry out the recommedned weekly decontamination procedures we are trying to minimise the risk of fluid build up by vigourous checks. As I mentioned previously, we have not had any cases since, and this problem has not caused any actual operational problems....yet!

Rob

We are at present changing our water trap holders to the new type so I dont know if everyone has changed theirs and whether it has any bearing on the problem.

Will have a look at ours today as we are about to service it.

Cheers for the info

Hello Robert,
Thanks for your reply. The operation of the machine is not a concern but the condensation accumulating in the belows is a major concern from the patient health and safety perspective.

Especially in the US where liability is a major and serious issue. It just takes one incident for a major disaster to occur. Hospitals might be heading for litigation which could cost them millions of dollars.

I think Drager is being complacent about this issue. They should take this problem seriously and provide a permanent solution asap.

The reason is that there is a high risk factor involved which entails cross contamination from one patient to another. i.e if patient vented has TB, how can you be certain that another patient is not infected infected? i.e. particles may enter into the airway of a healthy patient via the anesthesia machine.

Does the intubation has sub micron filters to ensure no microbes enter into the patient's lungs?

Please advise..what are your thoughts and suggestions..

Thank you,


However in the meantime I will ask the Drager rep in USA to provide us an answer.