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Basic Principles of Anesthesia - CP > Anesthesia Gas Machine > Flashcards

Anesthesia Gas Machine Flashcards

1
Q

Who developed the first anesthesia gas machine?

A

Dr. Jay Heidbink developed the Heidbrink Anesthetizer Model T

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2
Q

Why do we do the anesthesia gas machine check?

A

Standard 6: equipment, patient safety

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3
Q

What does critical temperature mean?

A

temperature below which a gas is converted to liquid form by pressure

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4
Q

what is the critical temperature of oxygen?

A

-118 degrees C

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5
Q

1 L of oxygen = how many liters of oxygen gas

A

860 L oxygen gas

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6
Q

intermediate pressure includes

A

pipeline source to wall outlet
connecting supply hoses
filters and check valves
pressure gauges

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7
Q

high pressure includes

A 
cylinder sources
pressure regulator (decreases pressure to 50 PSI)
hanger yoke
filter and check valves
pressure gauge
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8
Q

what should our pipeline bourdon pressure gauges read?

A

each gauge should read about 50 psi

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9
Q

what does psi stand for?

A

pounds per square inch

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10
Q

What is the KISS safety feature?

A

key index safety sytem
connects gas hose to wall outlet
unique key for each gas
color coded

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11
Q

What is the DISS safety feature?

A

diameter index safety system
connects hose to back of the machine
each fitting has a different diameter and internal key unique for each gas

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12
Q

describe floating valves

A 
opens and closes with pressure
moves in direction gas flow pushes it
prevents rebreathing of CO2
also known as check valve - interface between pipeline and gas machine
unidirectional valves in circle system
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13
Q

what kind of valve does the O2 flush button have?

A

ball and spring

all or none

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14
Q

what does the diaphragm valve do?

A

reduces pressure

1st and 2nd stage regulators

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15
Q

what does psiA stand for?

A

pounds per square inch ABSOLUTE

psia = Pgauge + Patm

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16
Q

what does psiG stand for?

A

pounds per square inch GAUGE

psig = Patm - Pabsolute

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17
Q

what does 760 mmHg equal in psiA and psiG?

A 
psia = 14.7
psig = 0
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18
Q

what does the bourdon pressure gauge measure?

A

high pressures (Cylinder) relative to atmospheric pressure

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19
Q

when the gauge reads 0 what does that mean?

A

pressure = atmospheric

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20
Q

what is the purpose of the hanger yoke?

A

connects cylinder to gas machine
orients the cylinder
provides unidirectional flow
ensures gas tight seal

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21
Q

what is the pin position of oxygen, nitrous oxide, and air?

A

oxygen = 2 & 5
nitrous oxide = 3 & 5
air = 1 & 5

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22
Q

what is wood’s metal and what is comprised of?

A

fusible plug that melts at high temps (155-250 degrees F) to release gas from cylinder to prevent gas from exploding

composed of bismuth (50%), lead (25%), tin (12.5%), cadmium (12.5%)

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23
Q

what is the construction of the cylinder based on?

A

DOT specifications

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24
Q

what are the 7 required markings on a cylinder?

A

regulatory body type and material of the cylinder
serial number
purchase, use, and manufacturer
manufacturer’s manual
manufacturer’s identifying symbol
retest date, retester, id symbol, 110% filling, ten year test interval
neck ring owners id

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25
Q

what does green color marking indicate?
yellow?
red?

A

green - nonflammable
yellow - oxidizer
red - flammable

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26
Q

what are cylinders made from?

A

steel, walls are 3/8 inch thick

some are chrome molybdenum alloy

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27
Q

what kind of cylinders are needed for MRI?

A

aluminum

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28
Q

what does the federal food, drug, and cosmetic act regulate?

A

medical gases contained in cylinders

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29
Q

what does the united states pharmacopoiea regulate?

A

the cylinder potency and purity

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30
Q

what does the department of transportation regulate?

A

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

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31
Q

what does the compressed gas association regulate?

A

sets standards on safe practice

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32
Q

what does the national fire protection association regulate?

A

location, construction, installation of bulk systems

33
Q

safe handling of a cylinder includes

A

never stand upright without support
never leave empty cylinders on machine
never leave plastic cover on the port when installing
never rely on color for ID of contents - read label
never oil the valves
never remove a cylinder from a yoke without filling the space with a yoke plug

34
Q

what is the critical temperature of nitrous oxide?

A

36.5 degrees celcius

35
Q

what does a pressure reducing valve do?

A

reduces the high, variable pressure to a lower constant pressure
maintains constant gas flow without changing the supply pressure

36
Q

what is oxygen’s pressure and capacity?

A

1900 psi, 660 L

37
Q

what is nitrous oxide’s pressure and capacity?

A

745 psi, 1590 L

38
Q

what is air’s pressure and capacity?

A

1900 psi, 625 L

39
Q

which law do we utilize when calculating our cylinder supply?

A

boyle’s law - P1V1 = P2V2

40
Q

where does the high pressure system end?

A

at the regulators

which will reduce pressures to lower, more constant pressures

41
Q

what is the purpose of the fail safe system?

A

prevent unintentional delivery of hypoxic mixture to the flow control valves
but doesn’t prevent hypoxic mixture (if cross connection)

42
Q

what does the low pressure alarm indicate?

A

signals low o2 pressure delivery to the machine

it is pressure driven

43
Q

describe flowmeters

A

receive gas at low pressure
two flowmeters for each gas but one knob so that there is an accurate measurement at high and low flows
low flowmeter - up to 1 LPM
high flowmeter - up to 12 LPM

44
Q

where is the o2 flowmeter positioned and why?

A

downstream closest to the common gas outlet to reduce chance of hypoxic mixture

45
Q

what are the components of a flowmeter?

A

knob, needle valve, valve stops, flow tube, indicator float

46
Q

what is the minimum o2 flow?

A

250 mL/min

47
Q

what are other names for flowmeters? what law(s) relate to them?

A

thorpe tubes, rotameters, variable orifice
poiseulle’s law - laminar flow below the bobbin, deals with viscosity
graham’s law - turbulent flow as diameter gets bigger, deals with density
as flow rate increases, diameter increases, so pressure doesn’t change

48
Q

how many notches are on the o2 flowmeter knob?

A

8

49
Q

flow through a tube depends on

A

the pressure drop across the constriction
the size of the annular opening
the physical properties of the gas

50
Q

what is another name for the proportioning system?

A

hypoxic guard system

link 25

51
Q

what do vaporizers do?

A

blend fresh gases from flowmeters with sufficient vapor to form a concentration to be delivered to the patient

52
Q

an increase in temperature = a ____ rate of evaporation

A

increase

53
Q

what does evaporation mean?

A

liquid and container cool, heat energy carried from liquid with evaporating molecules, cooling effect

54
Q

an increase in temperature = ___ in vapor pressure

A

increase

55
Q

what law explains vapor concentration?

A

dalton’s law - relationship between volume % in the anesthetic agents partial pressure

56
Q

what is the vapor pressure of isoflurane?

A

239 mmHg

57
Q

what is the vapor pressure of halothane?

A

243 mmHg

58
Q

what is the vapor pressure of enflurane?

A

175 mmHg

59
Q

what is the vapor pressure of sevoflurane?

A

170 mmHg

60
Q

what is the vapor pressure of desflurane?

A

669 mmHg

61
Q

describe latent heat of vaporization

A

the number of calories needed to convert 1 g of liquid to vapor, without temperature change in the remaining liquid

62
Q

describe specific heat

A

the number of calories needed to increase the temperature of 1 g of a substance by 1 degree C

63
Q

why do manufacturers select materials for vaporizer construction with high specific heats?

A

to minimize temperature changes associated with vaporization

64
Q

describe thermal conductivity

A

measure of how fast a substance transmits heat

high thermal conductivity is desirable in vaporizer construction (copper)

65
Q

describe variable bypass vaporizer

A

determines gas split, flow over, automatic temperature compensation, agent specific calibration

66
Q

describe measured flow vaporizer

A

operator determines carrier gas split, bubble through, changes in carrier gas flow for temperature compensation
multiple agent calibration

67
Q

what factors influence agent output?

A
  • flow rate
  • temperature (as temp increases, greater gas flow)
  • intermittent back pressure (positive pressure ventilation or oxygen flush valve = increased concentration; minimized with baffles and check valve)
  • carrier gas composition (n2o more soluble than oxygen)
68
Q

when temperature increases, the bimetallic strip ___- flow through the vaporizer chamber

A

decreases

69
Q

what does the vaporizer interlock system check?

A

ensures that only one vaporizer is turned on

70
Q

what are some hazards and safety features with the vaporizers?

A

tipping (>45 degrees agent can get into bypass chamber and increase concentration)
overfilling
leaks (loose filler caps, o ring junction, malposition)
simultaneous inhaled agent administration (if center vaporizer is removed)
incorrect agent in the vaporizer

71
Q

if a higher vapor pressure agent is put into a lower vapor pressure agent’s vaporizer what happens?

A

the concentration of the agent delivered will be HIGHER than the dialed setting

72
Q

describe the tech 6 vaporizer

A

vaporizer for desflurane
gas/vapor blender
electrically heated

73
Q

what is desflurane heated to?

A

39 degrees C

74
Q

What does the amber, green, and red lights indicate on the tech 6 vaporizer?

A

amber- in warm up mode, alarm battery low
green - vaporizer functional
red - no output (lack of agent, tilting, malfunction)

75
Q

how do you do the checkout of the tech 6 vaporizer?

A
  1. press and hold the mute button until all lights are activated
  2. turn on to >1%
  3. unplug the electrical connection
  4. no output alarm should sound
76
Q

standard delivery of the oxygen flush valve

A

35-75 L/min at 50 PSI

bypasses directly to common gas outlet

77
Q

the internal battery of the tech 6 vaporizer is for….

A

alarms only!

78
Q

the electrical outlet for the tech 6 vaporizer is for..

A

the heating element.. if lose power will need to switch to another agent

79
Q

5 tasks/directions of oxygen

A
  1. proceeds through flowmeter
  2. supplies o2 flush valve
  3. activates fail safe mechanism
  4. activates low oxygen pressure alarm
  5. drives the ventilator

Basic Principles of Anesthesia - CP (7 decks)

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