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Anaesthesia and Pain Management > Anaesthetic circuits > Flashcards

Anaesthetic circuits Flashcards

1
Q

What should be considered when choosing an anaesthetic system?

A
  • Patient size
  • Type of ventilation
  • Cost
  • Inhalation agent
  • Length of procedure
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2
Q

What are non-rebreathing systems?

A
  • Semi-closed systems
  • High fresh gas flows wash-out expired gases to prevent rebreathing; removed via adjustable pressure limiting valve (APL) which must remain open
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3
Q

What is the mapleson classification?

A
  • Used to categorise non-rebreathing circuits based on appearance and whether you can perform IPPV
  • Class A = Magill
  • Class A = Parallel/Mini lack
  • Class D = Bain
  • Class E = Ayre’s T piece
  • Class F = Jackson Rees Modified
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4
Q

What is a Magill?

A
  • Non-rebreathing system
  • Not suitable for IPPV
  • 200ml/kg/min
  • For patients 5-80 kg
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5
Q

What is a Lack?

A
  • Non-rebreathing system
  • Not suitable for IPPV
  • 200ml/kg/min
  • For patients over 10kg
  • Mini lacks can used for patients under 10kg
  • Have lower oxygen and volatile agent requirements than T-piece
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6
Q

What is a Co-axial Bain?

A
  • Non-rebreathing system
  • Suitable for IPPV
  • 200-400ml/kg/min
  • For patients 8-70kg
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7
Q

What is the Ayre’s T-piece and Jackson Rees modified?

A
  • Non-rebreathing system
  • Suitable for IPPV
  • 500-600ml/kg/min
  • For patients under 10kg
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8
Q

What do rebreathing systems consist of?

A
  • Exhalation unidirectional valve
  • Pop-off valve
  • Inhalation unidirectional valve
  • Pressure manometer
  • Reservoir bag
  • CO2 absorbent canister
  • Breathing tubes
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9
Q

What is the carbon dioxide absorber canister?

A
  • Incorporate a chemical soda-lime
  • Absorbs the CO2 content of expired gases
  • Contains calcium hydroxide 90%, sodium hydroxide 5%, silicates 5% and pH indicator
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10
Q

What is a unidirectional valve?

A
  • Controls the direction of gas flow
  • Enables anaesthesist observation for proper placement of ET tube and monitor rate and depth of breathing
    Flutter valves can become stuck
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11
Q

What is a humphrey ade system with soda lime?

A
  • Rebreathing system
  • Ideal for IPPV
  • Initially 3 litres/min to fill up system then 10mls/kg/min
  • For patients 7-100kg
  • Lever should be up
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12
Q

What is the humphrey ade without soda lime?

A
  • Non-rebreathing system
  • Ideal for IPPV
  • Initially 2 litres/min to fill up system and then 70-100mls/kg/min
  • For patients under 7kg
  • Lever should be down
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13
Q

What is the circle?

A
  • Rebreathing system
  • Ideal for IPPV
  • Initially 100mls/kg/min to de-nitonise the system then 10mls/kg/min
  • For patients over 10kg
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14
Q

How is IPPV given?

A
  • Close APL valve
  • Squeeze bag
  • Open valve
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15
Q

What is the reservoir bag?

A
  • Flexible storage reservoir
  • Can observe patient respiration and confirm proper ETT placement
  • Allows delivery of anaesthetic gases to patient and can perform IPPV
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16
Q

What are the advantages of non-rebreathing systems?

A
  • Reliable concentrations delivered
  • Range of sizes available
  • Decreased resistance to breathing
  • Disposable
17
Q

What are the disadvantages of non-rebreathing systems?

A
  • Gases are dry and cold
  • Increases oxygen use
  • The increased cost of volatile agent
  • Increased environment pollution
18
Q

What are the advantages of rebreathing systems?

A
  • Warms and humidifies gases
  • Two breathing system sizes
  • Decreased use and cost of gases
  • Decreased volatile agent use and cost
  • Decreased environmental pollution
19
Q

What are the disadvantages of rebreathing systems?

A
  • Slow changes of volatile agent to patient
  • Increases resistance to breathing
  • Has many parts
  • Requires monitoring of parts and CO2 absorber
20
Q

What is the fresh gas flow calculation?

A
  • Kg x circuit calculation = answer/1000 litres
  • If the circuit calculation is a range, must do both ranges and leave answer as a range
21
Q

What is capnography?

A
  • When a sample of gas is taken away for monitoring
  • When calculating an extra 200 mls/min must be added

Anaesthesia and Pain Management (5 decks)

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