Anybody still scavenge?

Started by Ahmad Menari, January 20, 2005, 04:53:18 AM

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Ahmad Menari

Modern operating rooms have standards for aiconditioning that state that the total air content within the OR be replaced once every 10 minutes with filtered sterile fresh air. To me, this makes scavenging a T-piece circuit for use in kids unnecessary. While you may get a faint whiff of sevo every now and then, the dilution is so rapid from the airconditioning that it becomes trivial.

Any thoughts?

Geri Hill

I think that it is still worth scavenging. You will have a higher flow rate with a T-piece compared to a circle and, while during early mask induction there may be escape of gases around the mask, once it is firmay applied it can be mostly scavenged. I prefer not to have several litres per minute of 8% sevo floating round my head or even 3-4%. Once on the ventilator, all gases are automatically scavenged, except for an unavoidable leak around the tube.
I still remember halothane in the days before scavenging and am a convert. Even when I go to Nepal to do cleft palate surgery, we passively scavenge.

Matthew Parsons

I disagree. The high concentrations during induction are unavoidable and unscavengable.

Once maintenance is achieved, the concentrations are lower, although the flow rates are still high. As long as you allow the bag to vent away from the surgeons and scrub staff's faces, the airconditioning will so rapidly dilute the gas that it cannot be smelled. And sevo is so pungent that we can smell minute quantities of it (try it - even 0.2% is easiliy detectable).

Unless you are of the belief that trace amounts of volatile is dangerous (for which there is no evidence), then scavenging is unnecessary.