Anesthesia Machine Flashcards by Grace Prinsell

what AANA - Standards for Nurse Anesthesia Practice is used?

standard VIII (8)

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gas supplies connected to the machine

High pressure system

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blending of gases and volatile agent based on control settings; regulated down to a level to deliver to patients

Low pressure system

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fresh gas mixture passes from machine to patient

Breathing system

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collects and disposes of excess gases; contaminated air

Scavenging system

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what is the “back-up system”

e cylinder

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what do check-valves do?

ensure no retrograde flow, prevent leakage

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what colors are the pipe lines?

oxygen=green
air=yellow
nitrous=blue

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what is the pressure gauge for hospital pipeline?

50 to 55 psig

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what utilizes the diameter of the connection is different between the 3 on both ends (so that you cant take the nitrous hose to connect into the oxygen inlet, etc.)

DISS (diameter indexed safety system)

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what is the pressure gauge for cylinder gas inlet?

45 psig

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what can high pressure cause in patient?

barotrauma (pneumo)

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how full should the cylinder be?

at least 1000! (greater than half full, 1900)

if less than that, change out the cylinder

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position of OXYGEN pins?

2-5 (think “25” is the ideal age)

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position of NITROUS pins?

3-5 (think “35” is starting to get a little old and loopy)

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position of AIR pins?

1-5 (think “15” is the age when your brain is full of air)

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how do you allow gauge to read 0?

bleed it

if 0 is not the baseline, gauge will only read accurately pressures that are higher than the baseline

(think like zeroing a scale before using it)

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how do the bellows move down?

oxygen “powering”; compressing them down

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do you hit the o2 flush valve button when patient is on ventilator?

NO
this would cause barotrauma during the inspiratory phase (35 to 75L/min of o2)

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low o2 supply pressure alarm alarms within how many seconds?*

Reservoir-reed device is used within 5 seconds; if it drops below 30 psig

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o2 pressure failure safety mechanism (fail-safe) occurs if o2 pressure falls below what?*

25 psig

shuts off the nitrous so patient does not become hypoxic

the machine just looks at the pressure, not looking at the type of gas!*

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which type of gas should be closet to the vaporizers? downstream? on the right?

oxygen

To minimize risk of hypoxic mixture being delivered if leak occurs in the flowmeters

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what is coated with conductive subtance to minimize static electricity?

flow/thorpe tubes

tapered
higher the flow, the more turbulent probably

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where do you read the number for a tapered float?

at the very top

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where do you read the number for a sphere float?

center

how big is a small thorpe tube?

1 liter

Should you turn your flows off before you turn machine off?

YES to prevent damaging the float stop

4 things associated with the Touch-Index O2 flow control knob

1) fluted 2) size difference 3) protrudes further 4) most right

chain that connects oxygen flow meter to nitrous flow meter?

Link-25

what does the proportioning system help deliver oxygen at?

at least 25% + 4% O2

what are basal metabolic needs for oxygen? minimal oxygen flow when machine is on for the flow meter?

150ml/min

where gases from different flowmeters mix together and have opportunity to enter into a vaporizer which is attached here?

Manifold

what prevents using more than one vaporizer at a time

Interlock-exclusion system

what are 3 places leaks could occur in low pressure system?

flow reader vaporizer manifolds

Compress bulb, then plug into machine, make sure it stays compressed (so that there is no leak) ?

common/fresh gas outlet

how long should bulb be compressed?

10 seconds

what 3 places does electricity flow from the system switch?

ventilator monitors desflurane vaporizer (to heat it up)

what does turning off the electricty do?

it releases the pressure to atmosphere and lets the valves rest

what does NOT rely on electrical power?

spontaneous or manually assisted ventilation mechanical flowmeters scavenging laryngoscope, flashlights intravenous bolus or infusion battery operated peripheral nerve stimulators or intravenous infusion pumps monitoring using the anesthetist's five senses **typically fresh gas flow, vaporizers, and manual ventilation function (know specifics in operator’s manual) are maintained

what color does co2 absorber turn when old?

purple due to the acid

if APL valve was all the way closed, what would we generate?

70 cmh20 (CHECK this number!)

Safety features of the breathing system

Antidisconnect fresh gas hose connector Antidisconnect pressure sampling line connection Ventilator low airway pressure alarm Ventilator pressure-limiting adjustment knob Ventilator pressure relief valve

which is preferred, active or passive scavenging system?

active passive is used in medical missions with evacuation hose

what allows the waste gases which enter the system in uneven delivery to be handled in a constant, continuous manner?

reservoir (gray bag)

what is from APL valve and ventilator pressure relief valve

collecting hoses

adjust the amount of vacuum from the hospital disposal influencing the scavenging system

vacuum control (active system)

if vacuum in scavenging system is not high enough, pressure will NOT back up into breathing system (should be <10*)

Positive pressure relief mechanism

if vacuum is too strong, the gases to be delivered to the patient will NOT be affected (should be >0*)

Negative pressure relief mechanism

Scavenging system: gas enters the scavenging system when the peak pressure exceeds the opening pressure of the APL valve

Manual ventilation

Scavenging system: during late exhalation and the expiratory pause after the ventilator bellows have returned to full position

Mechanical ventilation

Scavenging system: during late exhalation and the expiratory pause after the reservoir bag is full

Spontaneous ventilation

5 functions/paths of Oxygen?**

1) Go to oxygen flowmeter 2) Go to O2 flush 3) Activate oxygen pressure failure safety mechanism (fail-safe) 4) Activate oxygen low-pressure alarm 5) Powers the mechanical ventilator bellows

does the o2 flush skip the vaporizers?

YES, goes straight to the common gas outlet

does the o2 driving bellows skip the vaporizers?

YES, goes straight to the breathing circuit

is an oxygen analyzer essential?

YES Irreversible hypoxic brain injury after 4 minutes of arterial desaturation!

3 Primary purposes of the machine?

1) provide oxygen 2) blend anesthetic gas mixture 3) To allow ventilation of patient’s lungs, whether spontaneous, assisted, or controlled

what is patient ready mode?

APL open bag/vent switch in bag mode all flows off mask in place vaporizers off

decreases O2 pressure to 16-20 psig ( N2O reduced to 32 psig)***

Second-stage regulator

connected to the mechanical ventilator and O2 flush valve

o2 power outlet

what is an example of the proportioning system

link-25

what is the ratio for the proportioning system

Ratio of N2O to O2 is not more than 3:1

what is the purpose of the proportioning system**

to not allow a hypoxic mixture (o2 of less than 21%***)

add vaporized anesthetic agent to gas flow

Calibrated Vaporizers

interfaces between the machine and the disposal system

manifold of the scavenging system

what does the second stage regulator decrease N20 down to

32 psig

what does the second stage regulator decrease O2 down to

16-20 psig

KNOW FOR EXAM if vacuum of SCAVENGING system is not high enough, pressure will not back up into breathing system (should be <10*)

* APL OPEN * Bag mode * Y piece occluded * Hit O2 button POSITIVE pressure relief mechanism (scavenging)

KNOW FOR EXAM if vacuum of SCAVENGING system is too strong, the gases to be delivered to the patient will not be affected (should be >0*)

NEGATIVE pressure relief mechanism (scavenging) * APL OPEN * Bag mode * Y piece occluded

KNOW FOR EXAM Machine should be off, compress bulb then plug it in, it should stay compressed for 10 seconds Turn on each vaporizer, repeat step

LOW-Pressure Circuit Leak Test

KNOW FOR EXAM * Occlude Y-piece * All flows off * APL valve CLOSED * Bag mode * Hit O2 flush up to 30 Ensure 30 on gauge holds for 10 seconds, release pressure with APL valve

POSITIVE Pressure Leak Test

Delivers gas from CGO to patient

breathing system

pipeline and cylinder

high pressure system

flowmeters and vaporizers

low pressure system