Ali intro Final- Things I Can't Remember Flashcards
Desired breathing circuit features
Economy of FGF
Conservation of heat/humidity
Light weight
Convenient
Effective in SV and CV
Adaptability for kids/adults/mechanical ventilation
Little environmental pollution — safe disposal waste system
Considerations of breathing circuit
Resistance Rebreathing Dead space Dry gases/humidification Manipulation of inspired content Bacterial colonization
Advantages of Bain
Warm/humidify
Light weight, easily sterilized, reusable
Good for cases with little access to pt head
Ease of scavenge waste gas
Advantages of Mapleson E
Less resistance
Minimal dead space
No valves (decr resistance)
Good for peds/neonatal (due to less resistance)
Parts of Ambu Bag (5)
Gas inlet One way flap valve Reservoir Non rebreathing valve Small bore nipple to allow for O2 addition/attachment
Ambu bag safety features
Elasticity of outer cover to limit pressure to 7 kPa
Peds have pressure limiting valve (4 kPa)
Similarities of Mapleson and Circle System
Both have FGF
Both supply volume/flow to patient
Both eliminate CO2 in some way
Difference between Mapleson and Circle System
Mapleson: bidirectional valve, no rebreathing (FGF high enough to eliminate CO2)
Circle: uni valves, rebreathing occurs, CO2 scrubber, vaporizer, scavenger
Benefits of Circle System
Stability of concentration of gases Conservation of heat/moisture Low resistance Can do closed system anesthesia Low FGF Economy of gases Ability to scavenge Prevent OR pollution
Hallmark component of Circle System
Unidirectional gas flow via unidirectional valves
Primary source of resistance in circle system
Tracheal tube (ETT) (larger if possible) Valves (keep dry) CO2 scrubber (short and wide help)
Closed circle system
APL closed
Concentration of gases - if want to change them happens SLOWLY
FGF low
Rebreathing occurs
Advantages of Circle System
Retained heat/humidity Stability of gas concentration Low resistance Closed system anesthesia Low FGF with no rebreathing of CO2 Recycles gas Scavenge waste
Disadvantages of Circle System
Increase resistance from uni valves Complex Malfunction of valves can occur Less portable Increases dead space
2 tests of circle systems
Leak test- occlude y piece, o2 flush to 30 cm h2o for 10 seconds, ensure holds, listen for sustained pressure alarm
Flow test- breathing bag on y piece, ventilator on, check unidirectional valves
Safe handling of cylinders (NEVER DO THIS…..)
- Stand alone upright w/o support
- Leave empty cylinder on back of machine
- Leave plastic tape on port while installing cylinder
- Rely on cylinders for color identification
- Oil valves
- Open towards you (SHOULD OPEN AWAY DUE TO ADIABETIC PROCESS-fire, dust)
- Have valve half open (SHOULD BE FULLY OPEN WHEN CYLINDER IN USE due to result in delivering inadequate amounts of gas)
Vapor pressure depends on…
- Temperature
- Vapor pressures
- Amount of carrier gas (carrier gas flow)
Latent Heat of Vaporization
calories needed to change 1g liquid into vapor WITHOUT a temp change
Specific Heat
calories to increase temp of 1g of substance by 1 degree Celsius
Vaporizer desired features (with regards to specific heat and thermal conductivity)
Want a HIGH specific heat
Want a HIGH thermal conductivity
What happens to temp/vaporization rate as liquids start vaporizing
(In absence of outside source of energy)…
Temp of liquid itself will DECREASE during vaporization so rate of vaporization will further DECREASE (heat released to environment, out of liquid itself)
If rate of vaporization decreases, less will turn into vapor (not good)
We need a system where temp of liquid remains constant——specific heat/thermal conductivity comes into play
Thermal Conductivity
Measure of speed with which heat flows through a substance
Higher conductivity—> better a substance conducts heat (allows heat to flow through)
Vaporizers constructed of metals—high thermal conductivity—helps them maintain uniform internal temp during evaporation
Vaporizers: absorb the environmental heat that is given off during vaporization process to prevent the temp of liquid from decreasing
Keeps rate of vaporization more constant
Vaporizers: (temp compensating valve)
COLD vs HOT situations
Cold: bends to the LEFT, more FGF goes INTO vaporizer
(Helps overcome decr vaporization rate from decr temp)
Hot: bends to RIGHT, more FGF through BYPASS chamber, less through vaporizer
(Helps overcome increase in vaporization rate that occurs from incr temp)
Vaporizers: Concentration Control Vial
Controls how much saturated FGF with anesthetic leaves the vaporizer to join FGF to go to pt
Dial turned down (goes into system, less vaporized saturated FGF let out to patient)
Dial turned up (dial comes out of system, less blocked, more vaporized saturated FGF let out to patient)