To do or not to do a preinduction check-up of the anesthesia machine

The anesthesia machine check is an integral part of the anesthesiologist's daily routine. It is standard operating procedure to check the high- and low-pressure systems of the machine as well as other integral parts that are accessible. Many new anesthesia machines offer a self-testing capability, but older ones with fewer electronics on board are still widely used. Whether the machines self test or not, each machine contains a CO2 absorber and a circuit that may be prone to problems. In our case we encountered an open CO2 absorber after a service of the machine had been performed between the cases without our knowledge. We were unable to ventilate the patient during induction. The presence of a backup self-filling manual ventilation bag was invaluable in preventing an otherwise inevitable emergency.