SimpleGallery: Latest Photos for Anesthesia Safety

Monthly PowerPoint “In-House” review

Ralph Williams — Wed, 14 Jul 2010 16:46:46 GMT

Monthly PowerPoint “In-House” review of anesthesia/endodontic/general procedures and staff discussion.

Practice CPR sessions

Ralph Williams — Wed, 14 Jul 2010 16:46:48 GMT

Practice sessions with CPR and Advanced Cardiac Life Support using in office CPARLENE® simulators, monthly.

CPR practice "anywhere"

Ralph Williams — Wed, 14 Jul 2010 16:46:49 GMT

Emergencies can happen anywhere. We are prepared and our equipment is mobile and able to be wheeled anywhere including the parking lot.

CPARLENE® simulations

Ralph Williams — Wed, 14 Jul 2010 16:46:51 GMT

CPARLENE® simulations monthly… the doctor picks a “surprise spot”.

Criticare ECG monitors

Ralph Williams — Wed, 14 Jul 2010 16:46:53 GMT

CPR/ACLS practice sessions monitored by CPARLENE® and Criticare ECG monitors to maintain 100 beats per minute/CPR rhythm.

ER Manuals in all treatment rooms

Ralph Williams — Wed, 14 Jul 2010 16:46:54 GMT

ER manuals used in treatment rooms

Ralph Williams — Wed, 14 Jul 2010 16:46:55 GMT

ER manuals used in treatment rooms

Ralph Williams — Wed, 14 Jul 2010 16:46:55 GMT

ER manuals used in treatment rooms – Adult and Pediatric

Ralph Williams — Wed, 14 Jul 2010 16:46:56 GMT

Backup oxygen and bag-mouth-ventilators

Ralph Williams — Wed, 14 Jul 2010 16:46:58 GMT

Backup oxygen and bag-mouth-ventilators in each treatment room. Note pediatric drug/dose measuring strip on wall.

Minimal floor foot controls

Ralph Williams — Wed, 14 Jul 2010 16:46:59 GMT

Minimal floor foot controls of equipment to allow for open free floor space/no tripping. L – Foot switch controls all equipment on shelves in background and is switched to control each device. R – Foot switch controls air powered hand pieces.

Simple, clutter, trip free foot pedals.

Ralph Williams — Wed, 14 Jul 2010 16:47:00 GMT

All wiring and hoses under flooring in conduits.

Chair Cushion

Ralph Williams — Wed, 14 Jul 2010 16:47:00 GMT

Anesthesia patients and chronic neck/back pain patients utilize chair cushion (“memory foam”)

Chair cushion

Ralph Williams — Wed, 14 Jul 2010 16:47:01 GMT

Chair cushion also allows for good neck tip-back and chin lift of patient’s head for good airway maintenance.

N2O mask on patient

Ralph Williams — Wed, 14 Jul 2010 16:47:02 GMT

Great airway position of patient – safe, no obstruction.

N2O mask (close-up)

Ralph Williams — Wed, 14 Jul 2010 16:47:04 GMT

Close-up view of nitrous oxide-O2 mask – clear, non-obtrusive, non-claustrophobic, comfortable.

N2O mask will not block X-Rays

Ralph Williams — Wed, 14 Jul 2010 16:47:05 GMT

Nitrous Oxide-O2 mask without cheek hoses that could block e-ray detail of images. Elastic strap is “invisible” on x-ray images.

02 Cannula with C02 monitor

Ralph Williams — Wed, 14 Jul 2010 16:47:05 GMT

Oxygen nasal cannula with CO2 capnography (to monitor exhaled carbon dioxide – verifies good breathing of patient in monitors)

Wide hallways

Ralph Williams — Wed, 14 Jul 2010 16:47:06 GMT

Wide obtrusive, clear, well lit access to treatment rooms if 911 call from all for doors.

Separate 2nd front door for entry/exit of sedation patients

Ralph Williams — Wed, 14 Jul 2010 16:47:07 GMT

Separate 2nd front door for entry/exit of sedation patients or special needs/handicapped patients. Note remote controlled electrical lock on top of door frame and slip-proof floor mats.

Easy wheelchair access

Ralph Williams — Wed, 14 Jul 2010 16:47:08 GMT

Easy wheelchair access through any entrance/exit door. Minimal threshold height/wide doors.

Adjacent Hillsborough County fire station

Ralph Williams — Wed, 14 Jul 2010 16:47:10 GMT

Looking out of our anesthesia treatment room, you can see the antennae of our adjacent Hillsborough County fire station with full Advanced Cardiac Life Support and Emergency Services.

Open/easy rear access

Ralph Williams — Wed, 14 Jul 2010 16:47:12 GMT

Open/easy rear access in case of 911 call. Ground floor/no steps.

Open, free access

Ralph Williams — Wed, 14 Jul 2010 16:47:13 GMT

Open, free access if 911 call, wide sidewalks.

Open/free street access

Ralph Williams — Wed, 14 Jul 2010 16:47:15 GMT

Open/free street access if 911 call.

Double locked keyed drug/N2O closet

Ralph Williams — Wed, 14 Jul 2010 16:47:16 GMT

Double locked/separately keyed (top-staff, bottom-Dr.) drug/N2O closet to prevent theft/abuse of contents.

Locking drug/anesthetic gases closet

Ralph Williams — Wed, 14 Jul 2010 16:47:17 GMT

Locking drug/anesthetic gases closet by staff members.

Inside view of drug/Rx closet

Ralph Williams — Wed, 14 Jul 2010 16:47:20 GMT

Inside view of drug/Rx closet housing anesthetic gases and 2-door locked drug cabinet (outside door-staff, inside door-Dr.).

Inner door of locking drug cabinet.

Ralph Williams — Wed, 14 Jul 2010 16:47:21 GMT

All drugs are logged in/out in notebook including discards as per Federal Law.

Airgas “tear-offs” around necks of tanks

Ralph Williams — Wed, 14 Jul 2010 16:47:22 GMT

Airgas “tear-offs” around necks of tanks display easy visual status of tanks: 1 – full, 2 – in-use, 3 – empty.

Porter Remote Sentinel System®

Ralph Williams — Wed, 14 Jul 2010 16:47:23 GMT

Porter Remote Sentinel System® to provide a loud audible warning of low oxygen or nitrous oxide in supply tanks. A backup tank would then be turned on to finish an anesthetic case.

Porter Remote Sentinel System®

Ralph Williams — Wed, 14 Jul 2010 16:47:25 GMT

Porter Remote Sentinel System® sensing low oxygen in tank (note: bottom R light is lit, unit would be buzzing).

Porter Navicom® Communication System

Ralph Williams — Wed, 14 Jul 2010 16:47:27 GMT

Porter Navicom® Communication System – in each operation, front desk, break area, Dr.’s office – provides 2-way audible and text messaging between staff/doctors in case of emergency, requests for assistance or equipment, and schedule updates. The units are programmable for custom commands.

Porter Navicom® Stystem

Ralph Williams — Wed, 14 Jul 2010 16:47:29 GMT

Porter Navicom® communicator in action

Ralph Williams — Wed, 14 Jul 2010 16:47:32 GMT

Flourescent bulbs (battery backup)

Ralph Williams — Wed, 14 Jul 2010 16:47:33 GMT

Flourescent bulbs in operatory ceilings/hallways/restrooms have both battery and generator backup.

“Hospital grade” outlets

Ralph Williams — Wed, 14 Jul 2010 16:47:34 GMT

Treatment rooms electrical outlets are “hospital grade”, ground-faulted for safety and ID-coded as per building code.

Roll around vitals monitor.

Ralph Williams — Wed, 14 Jul 2010 16:47:35 GMT

Note “pigtail” wire recharging power supply for use anywhere.

Close-up view of vitals monitor.

Ralph Williams — Wed, 14 Jul 2010 16:47:38 GMT

Measures blood pressure, heart rate, and % of oxygen saturation and prints out a paper strip of results.

ECG (“EKG”) monitor

Ralph Williams — Wed, 14 Jul 2010 16:47:39 GMT

Battery and AC powered. Note: tip-proof roll stand, also prints out data results.

View of anesthesia monitor

Ralph Williams — Wed, 14 Jul 2010 16:47:40 GMT

View of anesthesia monitor to observe ECG, BP, heart rate, SPO2 (oxygen saturation), CO2 capnography (exhaled carbon dioxide), respiration rate and temperature of the patient.

“Atomic” clocks used in operatories

Ralph Williams — Wed, 14 Jul 2010 16:47:41 GMT

“Atomic” clocks used in operatories to synchronize anesthesia monitors to correct time. Check at end of day prior to next treatment day.

Wall mounted automated external defibrillators

Ralph Williams — Wed, 14 Jul 2010 16:47:43 GMT

Wall mounted automated external defibrillators with attached Ziploc bag containing extra chest pads (adult and pediatric), electric razor, and clothing scissors. Note: adjacent fluorescent backup lighting lanterns.

Extra (redundant) defibrillator and lantern

Ralph Williams — Wed, 14 Jul 2010 16:47:44 GMT

“Crash Cart”

Ralph Williams — Wed, 14 Jul 2010 16:47:46 GMT

Contains all resuscitative drugs and supplies, IV access and solutions, airway supplies, CPR board and is full mobile.

“Fish-eye” view of prepared anesthesia treatment room.

Ralph Williams — Wed, 14 Jul 2010 16:47:48 GMT

Note clipboard at lower left where dedicated anesthesia monitor assistant sits to independently observe the patient, monitors, listen to the patient’s airway via wireless precordial stethoscope, and record anesthesia data for patient safety.

Sedation case in progress.

Ralph Williams — Wed, 14 Jul 2010 16:47:51 GMT

Note wireless precordial stethoscope worn by the doctor in the right ear.

ECG monitor in shared view by doctor and anesthesia assistant sitting behind the doctor.

Ralph Williams — Wed, 14 Jul 2010 16:47:54 GMT

Close-up view of treatment in progress.

Ralph Williams — Wed, 14 Jul 2010 16:47:55 GMT

Note “third” tube in nitrous oxide-O2 mask (bottom middle of mask) that monitors CO2 capnography (exhaled carbon dioxide – verifies patient ventilation).

Sedation Case

Ralph Williams — Wed, 14 Jul 2010 16:47:58 GMT

Note nitrous oxide-O2 mixer head easily seen by doctor to his left

Sedation Case

Ralph Williams — Wed, 14 Jul 2010 16:48:00 GMT

At quick glance to the right, the doctor can see the ECG monitor. All “vitals” have audible warnings to alert the doctor and attending assistants of “out of range” patient data immediately. All patient data is recorded and printed out every 5 minutes.

Close up view of sedated patient

Ralph Williams — Wed, 14 Jul 2010 16:48:03 GMT

Note precordial stethoscope and ECG lead placement, CO2 capnography tube in the N2O-O2 mask and rubber dam replacement (to prevent aspiration).

Dental Chair Special IV arms

Ralph Williams — Wed, 14 Jul 2010 16:48:05 GMT

The dental chair has special IV-arms and Velcro straps for secure IV access near height of the patient’s heart. The IV arm is fully adjustable and can be attached to the left for right of the dental chair.

Airway – Airway – Airway

Ralph Williams — Wed, 14 Jul 2010 16:48:06 GMT

Safe anesthesia is all about good airway, head/neck position, back/chair support. Note taped tubing to Nitrous Oxide O2 head, convenient visualization of digital/analog x-rays and electronic apex locator.

Pediatric Anesthesia Case (Dr. Vila)

Ralph Williams — Wed, 14 Jul 2010 16:48:08 GMT

Note: proportioned chair “bed”, headrest, “kid’s blanket”, full monitoring.

Pediatric Anesthesia Case

Ralph Williams — Wed, 14 Jul 2010 16:48:09 GMT

Note his monitor cart, min as a backup – everything’s on wheels and fully adjustable to special needs cases.

“Two man operator” pediatric anesthesia case with assistant and Dr. Vila

Ralph Williams — Wed, 14 Jul 2010 16:48:10 GMT

In deeper sedation/special needs, etc., Dr. Russin is focused only on endodontics. Dr. Vila is focused only on anesthesia.