AGM Flashcards
Check valves
Prevent backflow of gas
Gas can only flow in one direction
Found all over AGM
Pressure regulator
Drops pressure
Drops pressure from tanks (2000psi) to intermediate pressure (50psi)
2nd stage pressure regulator drops pressure from intermediate to low pressure (16psi)
High pressure system
750-22200psi
Cylinders
Cylinder pressure gauge
Cylinder pressure regulator
Hanger yoke
Yoke block with check valve
Intermediate pressure
40-50psi
Ventilator power inlet
Check valves
Pressure gauges
Flow meter valves
Oxygen pressure failure devices
Oxygen second stage regulator
Flush valve
Low pressure system
16psi
Flow meter tube
Vaporizers
Check valves
Common gas outlet
Low pressure leak test
Fail if suction bulb inflates within 10 seconds
Needs to be done everyday before 1st case
Should be repeated with vaporizers off and on
High pressure leak test
Fail if circuit does not remain pressurized at 30cm h2o
Close APL valve to pressurize circuit
Should be done between every patient and when circuit is changed
SPDD
Supply
Processing
Delivery
Disposal
Supply (SPDD)
Gases from cylinders and wall
Electricity from power cord
Processing (SPDD)
How AGM prepares gases before delivery
Delivery (SPDD)
Circuit brings gases to the patient
Disposal (SPDD)
Scavenger system removes gases from the breathing circuit
Can only remove an amount equal to FGF minus volume lost to 02 consumption
Too much removal - negative pressure in circuit
Too little removal- risk of barotrauma
APL (spontaneous breathing) and ventilator spill valve control gas going to scavenger
Parts of the scavenger
Gas collection assembly
Gas disposal tubing
Gas disposal system (gets gas from scavenger to earths atmosphere, active uses suction, passive relies on positive pressure and no suction)
Transfer tube
Interface (open vs closed)
Convenience receptacles
Found on back of AGM
Protected by circuit breakers or fuses
In theory, blowing a fuse should not affect operating of the AGM
Devices not requiring electricity
Spontaneous ventilation
Mechanical flow meters
Scavenging
Laryngoscope
IV bolus or infusion
Peripheral nerve stimulators
Five senses
Bypass vaporizers
Devices requiring electricity
Ventilators
Monitors
Lights
Digital flow meters
Bypass pumps and oxygenators
Warming blankets
Gas vapor blenders (Tec-6) or vaporizers with electronic controls (Aladin, Aisys)
Open interface
No mask on face
Open to atmosphere
Only used with active systems (suction)
Risk of healthcare team exposure
Contains reservoir
Too much suction- room air entrained
Too little suction- waste gas goes to healthcare team
No positive or negative pressure valves
No risk of barotrauma
Closed interface
Mask on face
Uses pressure valves
Doesn’t remove fresh gas from circuit
If passive- needs positive pressure relief
If active- needs both positive and negative pressure relief
Contains reservoir
5 tasks of oxygen in AGM
O2 flush valve (25-75 LPM)
O2 supply failure (less than 30 psi)
O2 pressure failure (fail safe, prevents hypoxic mixture)
Ventilator drive gas (to bellow, jet devices, auxiliary flow meter)
Flow meters (circle system-> patient)
PISS
Pin index safety system
Prevents cylinder from misconnection to AGM
Defeated if more than one washer used, or pins are removed or missing
PISS for air, O2, and Nitrous oxide
1,5
2,5
3,5
DISS
Diameter index safety system
Prevents gas hose from misconnection
Cylinder sizes
E- 2x4 (travel size, what we mostly see)
H- 4x9 (bedside when no pipeline available, in OR as N2 compressed gas)
Capacity and PSI of O2
660L, 1900-2200psi