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It is the first day of operation of the hospital’s new outpatient surgery wing. The anesthesiologist reports to work looking forward to a day of easy cases consisting of healthy American Society of Anesthesiologists class I outpatients. During the first case, however, a tiny chirp is heard, accompanied by an advisory stating that the oxygen (O 2 ) supply is low. Several seconds later, the anesthesiologist notices that the ventilator bellows is not filling, the comforting sound of the cycling ventilator is absent, and a cacophony of alarms is sounding, including apnea pressure and volume alarms and minute volume alarms.
A pipeline failure can be one of two types: a quantitative problem, with too little or too much pressure, or a qualitative error, indicating that a contaminant is present ( Box 116.1 ). In the extreme case of switched pipelines, the contamination consists of 100% undesired gas. The pipeline is made up of a large number of components ( Fig. 116.1 ), any of which can fail.
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