1. Non-Rebreathing System
Used for patients weighing: <15 pounds
Some clinics may use a rebreather for patients as small as 6 pounds
Less than 6 pounds: non-rebreather is a MUST
There are many types: we will be discussing the Jackson-Rees (in detail) and the Bain coaxial

2. Non-Rebreathing System
1. Attach a clear, long, plastic hose to the fresh
gas outlet
This tube comes from the ______________ _________ _______
Flow of gas differs from rebreathing circuit now!!
2. Fresh gas goes directly to the patient
Not through the unidirectional valves!
The same gas exchange happens
in the patient…

3. Non-Rebreathing System
3. Exhaled gas comes directly out through a separate hose.
This plastic hose is ____________, short, and much wider.
4. Gas now flows through the pop-off and then either into a reservoir bag OR scavenging hose.
5. a. PPV is administered the same
b. WAG are scavenged the same

4. What’s Missing Here??
What parts on the rebreathing system are missing from the non-rebreathing system? 1. 2. 3.
How do we compensate for this?

5. Non-Rebreathing System
Benefits:
1. Less parts = less ________________
Smaller animals need this feature!
2. _________ changes in anesthetic depth
Disadvantages:
1. Higher amount of oxygen used due to patient not-rebreathing any gases
2. Patient is only breathing ____, dry fresh gas
What can we do about this?

6. Non-Rebreathing Systems
Jackson-Rees
Norman Mask Elbow

7. Non-rebreathing Systems
Bain coaxial

8. Universal Bain Block

9. Intubated Oxygen Flow Rate
Non-rebreathing system:
High b/c removal of CO2 is dependent on gas flow in the system
Can go up to 600 ml/kg/min!
Note: An inadequate fresh gas supply will result in your patient re-breathing gases…remember, there is no CO2 absorber!

10. Non-rebreathing Oxygen Flow Rate
Practice problem: Patient weighs 4.65 kg
How many ml/min of oxygen does the patient need?
Flow rates need to be in L/min:

11. Leak Testing (Both Breathing Circuits)
Performed before every anesthesia to check the system for leaks
The last thing you do on your anesthetic machine
If you make any changes to the machine, this must be done AGAIN!
If this step is not performed:
WAG will escape into the room
Patient will not receive enough fresh gas

12. Leak Testing – Low Pressure Test
Steps: close pop-off valve AND cover end of breathing tube with something
Turn on the flow meter and let oxygen fill reservoir bag until 30 cmH2O is reached
Once full, turn off the flow meter
Listen/feel for leaks within the circuit
If none, maintain a full bag for: __________ at _______________.
*If the bag doesn’t hold pressure (remain full), you have a leak!

13. Troubleshooting
Where to look for leaky parts: 1. 2. 3.

14. Practice Question #1
Which breathing circuits may help keep a patient from becoming hypothermic?
Jackson-Rees
Universal-F
Circle with Y-piece
Bain coaxial

15. Practice Question #2
Which rebreathing circuit provides the least resistance to the patient?
Jackson-Rees
Universal-F
Circle with Y-piece
Bain coaxial

16. Practice Question #3 Which breathing circuit is most costly to use?
Jackson-Rees
Universal-F
Circle with Y-piece

17. Practice Question #4
Which breathing circuit allows for the quickest change in anesthetic depth?
Jackson-Rees
Universal-F
Circle with Y-piece