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N928 Basic Principles of Anesthesia > AGM Need to Know > Flashcards

AGM Need to Know Flashcards

1
Q

What AACN standard is pertinent to the anesthesia gas machine?

A

Standard 6

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2
Q

When does the anesthesia gas machine check need to be completed?

A

every morning without fail, abbreviated check between cases

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3
Q

What does SPDD stand for?

A

Supply, Processing, Delivery, Disposal

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4
Q

Why are some gases stored as liquids instead of gases?

A

1 liter of liquid O2 is equal to 860 liters of gas so it also us to optimize space

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5
Q

What is a floating valve?

A

a floating valve is a unidirectional valve in the circle system
it opens and closes with pressure and moves in direction of gas flow

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6
Q

The critical temperature of gas determines

A

how it will be stored as a liquid or as a gas

O2 & air are stored as gases; nitrous oxide is stored as a liquid

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7
Q

The pressure gauges on the front of the machine are also known as

A

Bourdon pressure gauges

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8
Q

Describe the pin location for air, nitrous oxide, and oxygen for the pin index safety system

A

air: 1 & 5
Nitrous oxide: 3 & 5
Oxygen: 2 & 5

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9
Q

What makes up Wood’s Metal?

A

Bismuth, lead, Tin, Cadmium
Wood’s metal is a safety mechanism where when certain temperatures are experienced in the OR, it will melt to prevent a tank from exploding

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10
Q

The markings on the tank indicate (green, yellow & red)

A

green diamond- indicates its a non-flammable gas
yellow- oxidizer
red- flammable gas

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11
Q

The federal food, drug, and cosmetic act is responsible for

A

regulating medical gases contained in cylinders

sets standard for potency/purity

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12
Q

The Department of Transportation is responsible for

A

cylinder design, construction, testing, marking, handling, filling, transportation

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13
Q

The Compressed Gas Association is responsible for

A

sets standards on safe practice

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14
Q

The National Fire Protection Association is responsible for

A

location, construction, installation of bulk systems

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15
Q

The critical temperature of nitrous oxide is

A

36.5 degrees C

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16
Q

Name the color, pressure, capacity & pin position for oxygen

A

green, 1900 PSI, 660 L, pin position 2,5

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17
Q

Name the color, pressure, capacity & pin position for nitrous oxide

A

blue, 745 PSI, 1590 L, pin position 3 & 5

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18
Q

Name the color, pressure, capacity & pin position for air

A

yellow, 1900 PSI, 625 L, pin position 1 & 5

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19
Q

Oxygen has critical temperature of

A

-118.8 degrees Celsius (below room temp.)

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20
Q

Utilize Boyle’s Law to calculate how much time you have before having to change your tank

A

set up a proportion using P1V1=P2V2

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21
Q

What is part of the high pressure system?

A

Exposed to cylinder pressure; hanger yoke, yoke block with check valves, cylinder pressure gauge and cylinder pressure regulators

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22
Q

What is part of the intermediate pressure system?

A

exposed to pipeline pressure ~50 psi; includes pipeline inlets, check valves, pressure gauges, ventilator power inlet, oxygen pressure-failure devices, flowmeter valve, oxygen second stage regulator; flush valve

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23
Q

What is part of the low pressure system?

A

distal to flowmeter needle valve; flowmeter tubes, vaporizers, check valves, common gas outlet

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24
Q

Describe the purpose of the failsafe valve

A

The system is designed to prevent unintentional delivery of a single gas other than oxygen to the flow control valves but if adequate pressure remains in the system then the valve will remain open; if there’s a malalignment and it is not really oxygen, then it will allow the valve to remain open and deliver a gas that is not O2… fail safe, not fail proof

25
Q

Safety mechanisms in relation to the flowmeters include:

A

color and touch coded (oxygen is fluted)

26
Q

What laws are pertinent to the Thorpe tube?

A

Bernoulli, Pouiselle’s, and Ohm’s law

27
Q

Vapor pressure increases

A

with temperature

28
Q

List the vapor pressure of isoflurane

A

239 mmHg

29
Q

List the vapor pressure of halothane

A

243 mmHg

30
Q

List the vapor pressure of Enflurane

A

175 mmHg

31
Q

List the vapor pressure of sevoflurane

A

170 mmHg

32
Q

List the vapor pressure of desflurane

A

669 mmHg

33
Q

When you add vaporized anesthetic agent

A

the total volume exiting the chamber is greater than the volume entering the chamber

34
Q

When a certain volume of carrier gas flows from machine into vaporizing chamber over a certain period of time

A

that same volume of carrier gas exits the chamber over the same period of time

35
Q

If a higher VP agent is placed in a vaporizer of a lower VP agent,

A

concentration of agent delivered will be HIGHER than dialed setting and vice versa

36
Q

The Tec 6 vaporizer is

A

a gas/vapor blender; not variable bypass

37
Q

The issue with desflurane is

A

it is boiling at room temperature; the Tec 6 vaporizer avoids the problem by heating desflurane above its boiling point

38
Q

On the Tec 6 vaporizer, the internal battery is

A

alarm only; it has to be electrically powered in order to use; internal battery is for alarms only and will not support the heating element so if you lose power you have to change your volatile anesthetic

39
Q

The warm-up (amber) light on the Tec 6 means

A

the machine is in warm-up mode and we cannot turn the control dial

40
Q

The operational (green) light on the Tec 6 means

A

the vaporizer is functional

41
Q

The no output (red) light on the Tec 6 means

A

the vaporizer can’t add agent vapor to gas flow due to lack of agent, tilting, or malfunction

42
Q

The low agent light on the Tec 6 means

A

<250 mL of agent in sump

43
Q

The alarm battery low (amber) on the tec 6 means

A

low battery voltage- battery only powers alarms, not vaporizers

44
Q

The five tasks that oxygen is responsible for includes

A

proceeds through flowmeter, supplies O2 flush valve, activates fail-safe mechanism, activates low oxygen pressure alarm, drives the ventilator

45
Q

Describe an open circuit

A

An open circuit does not have a reservoir bag, does not permit rebreathing and examples include open drop, nasal cannula, or face masks

46
Q

Describe a semi-open circuit.

A

A semi-open circuit includes a reservoir bag, does not allow rebreathing, and examples include nonrebreathing circle or circle at high FGF (>VE)

47
Q

Describe a semi-closed circuit

A

A semi closed circuit includes a reservoir bag, allows for partial rebreathing, and an example is circle at low FGF (

48
Q

Describe a closed circuit.

A

A closed circuit includes a reservoir bag, has complete rebreathing, and an example is circle (with pop-off valve [APL] closed)

49
Q

What is the purpose of the APL valve?

A

The APL valve is used to regulate the pressure in the circuit during MANUAL ventilation; it is bypassed in mechanical ventilation mode
(adjustable pressure limiting valve)

50
Q

A ventilator hazard is the failure of

A

emergency O2 supply or the E-cylinder

51
Q

Granule sizes includ

A

4 to 8 mesh which means there are 4 quarter inch openings per linear inch
must compromise between resistance to airflow and surface area for absorptive capacity

52
Q

In a nonrebreathing system or semi-open system,

A

we have to make sure fresh gas flow is high enough or you’ll have rebreathing

53
Q

Describe the Mapleson A circuit.

A

The Mapleson A circuit is a nonrebreathing if FGF> alveolar ventilation; the overflow valve opens during expiration when maximum pressure is reached
Order as follows: FGF, bag, tubing, expiratory valve & mask

54
Q

Describe the Mapleson B circuit.

A

The Mapleson B circuit includes fresh gas inlet and overflow valve closer together to the patient to decrease rebreathing; requires FGF 2-2.5x’s minute ventilation
bag, tubing, FGF, expiratory valve, bag mask

55
Q

Describe the Mapleson C circuit.

A

Shorter expiratory limb than Mapleson B; requires FGF 2-2.5 x’s minute ventilation
Bag, tubing, FGF, expiratory valve, bag mask

56
Q

Describe the Mapleson D circuit.

A

Fresh gas inlet and overflow valve opposite Mapleson A; requires FGF 2-3 x’s minute ventilation
bag, tubing, FGF, expiration valve, mask

57
Q

Describe the Mapleson E circuit.

A

Valveless and bagless (basically a T-piece); expiratory limb must be > patient’s tidal volume to prevent entrainment of room air; FGF 3x’s minute ventilation to prevent hypercarbia
No expiratory valve, NO bag
Tubing, FGF, mask

58
Q

Describe the Mapleson F circuit

A

Jackson-Rees modification of the Mapleson D; requires FGF 2-3x’s minute ventilation; minimal dead space/low resistance
when using controlled ventilation know the different characteristics of Mapleson A, B, C, D, & E
expiratory valve, bag, tubing, FGF, mask

N928 Basic Principles of Anesthesia (16 decks)

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