American Society of Anesthesiologists Recommendations for Preanesthesia Checkout Procedures

To Be Completed Daily.

Item 1: Verify that auxiliary oxygen cylinder and self-inflating manual ventilation device are available and functioning.

Item 2: Verify that patient suction is adequate to clear the airway.


Item 3: Turn on anesthesia delivery system and confirm that AC power is available.

Item 4: Verify availability of required monitors, including alarms.

Item 5: Verify that pressure is adequate on the spare oxygen cylinder mounted on the anesthesia machine.

Item 6: Verify that the piped gas pressures are ≥50 psig.

Item 7: Verify that vaporizers are adequately filled and, if applicable, that the filler ports are tightly closed.

Item 8: Verify that there are no leaks in the gas supply lines between the flowmeters and the common gas outlet.

Item 9: Test scavenging system function.

Item 10: Calibrate, or verify calibration of, the oxygen monitor and check the low oxygen alarm.

Item 11: Verify that carbon dioxide absorbent is not exhausted.

Item 12: Perform breathing system pressure and leak testing.

Item 13: Verify that gas flows properly through the breathing circuit during both inspiration and exhalation.

Item 14: Document completion of checkout procedures.

Item 15: Confirm ventilator settings and evaluate readiness to deliver anesthesia care. (anesthesia time out)

To Be Completed Before Each Procedure.

Item 2: Verify that patient suction is adequate to clear the airway.

Item 4: Verify availability of required monitors, including alarms.

Item 7: Verify that vaporizers are adequately filled and, if applicable, that the filler ports are tightly closed.

Item 11: Verify that carbon dioxide absorbent is not exhausted.

Item 12: Perform breathing system pressure and leak testing.

Item 13: Verify that gas flows properly through the breathing circuit during both inspiration and exhalation.

Item 14: Document completion of checkout procedures.

Item 15: Confirm ventilator settings and evaluate readiness to deliver anesthesia care. (anesthesia time out)

Some of these steps may be part of an automated checkout process on many machines. Following these checklists will typically require < 5 minutes at the beginning of the day, and < 2 minutes between cases, but will provide you with the confidence that the machine will be able to provide all essential life support functions before you begin a case.