Anesthesia Machine Flashcards
1
Q
what kind of power back up is required of an anesthesia machine
A
back up battery lasts 30 min
2
Q
what are the three kinds of anesthesia alarms
A
high, medium, low priority
3
Q
how long can a high-priority alarm be silenced for
A
no more than 2 minutes
4
Q
what alarms and monitors must be automatically enabled
A
breathing circuit pressure
oxygen concentration
exhaled volume or carbon dioxide
5
Q
what must disconnect alarms be based on
A
low pressure
exhaled volume
carbon dioxide
6
Q
a high-priority pressure alarm must sound for what 4 reasons
A
user-adjusted limits are exceeded
continuing high pressure is sensed
negative pressure
low inspired O2
7
Q
what are the required monitors for anesthesia machine
A
-exhaled volume
-inspired O2 with a high priority alarm with 30 seconds of oxygen falling below 18% (or set limit)
-oxygen supply failure alarm
-a hypoxic guard for less than 21% O2 if NO is used
-anesthetic vapor concentrator monitor
- pulse ox, blood pressure, ECG
-pressure in breathing circuit set to 125 cm water
-nondetachable or resistant to detachment electrical supply cord
8
Q
what is the max pressure in the breathing circuit for alarm
A
12.5 kPa / 125 cm water
9
Q
what vital monitors must be present on the anesthesia machine
A
pulse ox
blood pressure
ECG
10
Q
what are required cylinder supplies of the anesthesia machine
A
-at least one O2 cylinder attached
-hanger yoke must be pin-indexed, have a leak resistant clamping device, filter, check valve, cylinder pressure gauge
-cylinder pressure regulators, must use pipeline gas as long as pipeline pressure is greater than 345 kPa (50 psi)
11
Q
what must pipeline gas pressure be above for cylinders to not be used
A
345kPa (50 psi)
12
Q
what are required components of an anesthesia machine related to flowmeters
A
-single control for each gas
-each flow control must be next to a flow indicator
-must be a uniquely shaped oxygen control knob
-valve stops to no damage to flowmeter
-O2 flow indicator is the right side of a flowmeter bank
-O2 enters the common manifold downstream of other gases
-an auxilliary O2 flowmeter is strongly recommended
-an oxygen flush is present capable of 35-75 L/min that does not proceed through any vaporizers
13
Q
what flow must an oxygen flush be capable of
A
35-75 L/min
14
Q
what are required components of an anesthesia machine related to vaporizers
A
-they must be concentration calibrated
-an interlock must be present (only one can turn on)
-liquid level must be indicated and designed to prevent overfilling
-keyed filler devices(recommendednotrequired)
-no discharge of liquid anesthetic occurs from the vaporizer, even at the maximum fresh gas flow
15
Q
what are required components of an anesthesia machine related to the pipeline gas supply
A
-pipeline pressure gauge
-inlets for at least O2 and NO
-Diameter index safety system (DISS) protected
-in line filter
-check valve
16
Q
what are the components of the electrical system of the anesthesia machine
A
master switch
power failure indicator
backup (battery) power
electrical outlets
17
Q
what are components of the pneumatic system of the anesthesia machine
A
high-pressure system
intermediate pressure system
low pressure system
18
Q
what does the master switch activate
A
pneumatic and electric functions
19
Q
what components of the anesthesia machine run without power
A
O2 flush
suction
auxillary O2
20
Q
what alerts the anesthesia provider of loss of power to the machine
A
power failure indicator
21
Q
should high frequency surgical devices be connected to electrical outlets of the anesthesia machine
A
no
22
Q
what are the boundaries of the high pressure system
A
received gases from cylinder till first stage pressure system
23
Q
what does the first stage pressure system lower the pressure to
A
40-50 psi 40-60, multiple answers
24
Q
what are the boundaries of the intermediate pressure system
A
from first stage regulator or pipeline system to flow controls or O2 flush valves
25
what is the pressure in the intermediate system
40-60 PSI or 40-50 or 16-55 so who knows
26
what are the boundaries of the low pressure system
from control valves to common gas outlet, vaporizers, flowmeters, and check valves
27
what part of the anesthesia system is the O2 flush valve part of
intermediate pressure system
28
where does gas of the high pressure system come from
cylinder
29
what is included in the high-pressure system
hanger yoke,
yoke block,
check valves
micron filter
cylinder pressure indicator (gauge)
pressure-reducing device (regulator)
30
what device prevents backflow
check valves
31
what device do you double check on a cylinder when you notice a leak
o ring/cylinder gasket
32
each hanger yoke must have a ______________ that displays the pressure of the cylinder supplied gas
pressure indicator/gauge
33
what is the role of a cylinder pressure regulator (aka first stage regulator)
-maintain constant flow with a change of supply pressure
-reduce the high and variable pressure of a cylinder to intermediate pressure
34
what is the pressure of the intermediate system
40-50 psi
35
if both pipeline and cylinder gases are being used which will the machine use
the higher pressure, so the pipeline, because the first stage regulator changes the tank pressure to 45 and the pipeline pressure should be 50
36
what is the pin index safety system (PISS) for oxygen
2,5
37
what is the pin index system system (PISS) for N2O
3,5
38
what is the pin index system system (PISS) for Air
1,5
39
what is the pin index system system (PISS) for CO2
1,6
40
what is the volume and pressure of an oxygen E-cylinder
2000 psi
660 L
41
what is the volume and pressure of an N2O E-cylinder
745 psi
1590 L
42
what is the weight of a full N2O cylinder
8.8 kg
43
what is the weight of an empty N2O cylinder
5.9 kg
44
when the pressure of an N2O E-cylinder starts to drop how many L are left
400L
45
what is the weight of N2O inside a full E-cylinder
2.9 kg (8.8 kg-5.9kg)
46
when do we replace an O2 cylinder on an anesthesia machine
1000 psi, 330 L
47
know how to do cylinder math ie if an O2 cylinder is half full and running at 3L/min how long will it last
110 minutes
48
what is included in the intermediate pressure system
-pipeline inlet connections
-pipeline pressure gauges (on the front of machine)
-pipleline pressure gauge/micron filter
-ventilator power inlet
-O2 pressure-failure devices
-second stage pressure regulators
-flush valve (O2)
-auxillary O2 flowmeter
-master switch
49
what is the specialized fitting system for the pipeline inlet connections
DISS diameter index safety system
50
what does each pipeline inlet connection contain to prevent backflow
check valve
51
what is present in each pipeline inlet connection to keep dirt and stuff out
100 micrometer filters
52
what happens when pipeline inlet filters become clogged
decreased gas flow
53
what is the color of oxygen
green
54
what is the color of air
yellow
55
what is the color of N2O
blue
56
how much pressure must the internal piping of an anesthesia machine be able to uphold
4x
57
what prevents the depletion of O2 supply from a cylinder so you dont deliver 100% anesthetic gases
oxygen pressure failure devices
58
what do oxygen failure safety devices (fail safe) do
shuts off/decreases/stops the flow of N2O and other gases if O2 supply decreases to below 25 psi
59
where is the fail safe located
upstream of flow control valves
60
what alarm sounds if oxygen falls below threshold (30psi)
oxygen supply failure alarm
61
what is the flow of the oxygen flush valve
35-75 L/min
62
what is the pressure system of the oxygen flush valve
intermediate
63
what are risks of the oxygen flush valve
accidental activation
internal leakage
sticking in ON position
**Barotrauma**
**anesthesia awareness (dilutes anesthetics)**
if activated during inspiration may cause very high pressures
64
where does the intermediate pressure system end
needle valves of the flowmeters (includes the valves)
65
where is the second stage reducing device in relation to N2O and O2 flow valves
upstream
66
what pressure does the second stage reducing device lower N2O to
26psi
67
what pressure does the second stage reducing device lower O2 to
14 psi (or 16 in book...)
68
what controls the rate of flow of gas through a flow indicator (flowmeter) by manual adjustment
flow control valve
69
what is the profile of the O2 flow control valve
fluted profile (for safety it must look and feel different from others)
70
what rotation of the flow control valves increases flow
counterclockwise
71
what rotation of the flow control valves decrease flow
clockwise
72
what is the boundaries of the low pressure system
downstream of flow control valves (flowmeters) to common gas outlet though circuit
73
what is included in the low pressure system
flowmeter tubes
vaporizers
outlet check valve
common gas outlet
74
flow meters are tapered with the smallest diameter at the
bottom
75
where does gas enter the flow meter
from the bottom
76
what are flow indicators made from
glass
77
where do you read a ball float in a flow meter
in the middle
78
where do we read a bobbin flow meter
top of float
79
what does the float stop prevent
indicator plugging the outlet for gas
80
why is the sequence of flow indicators important
improper flow indicator order can cause hypoxia (oxygen must be last ie far right)
81
where should oxygen be in the sequence of flow indicators
the most downstream (right)
82
what are the flow safety features for minimum O2 flow
minimum flow of O2 before other gases will flow
50-250 ml/min preset at factory
activated when master switch is turned on
83
what does the O2 ratio and proportion system keep oxygen % at
minium 25% flow
84
what causes O2 and N2O to turn together or disables the N2O until more O2 is dialed in
the O2 ratio and proportioning system
-may have mechanical or pneumatic linkages between N2O and O2
85
what is the mechanical link between the N2O and O2 flow meters called
link-25 proportion limiting control system (increased N2O increased O2)
86
what is the function of the auxiliary O2 flowmeter
-allows for connection of nasal cannula, face mask, ambubag when master switch is off
-used when machine malfunctions
87
what state does the flowmeter have the most innaccuracy
low flows
88
what causes float sticking in flowmeters
static electricity, dirt, debris
89
where is the vaporizer mounting device located
in the low pressure system between flowmeters and common gas outlet
90
do you tip a vaporizer
no
91
what receives all gases and vapors from machine and delivers them to patient through fresh gas supply
common gas outlet
92
what is a location of possible leak or disconnect
common gas outlet
93
what ensures that gas flows towards the patient in one breathing tube and away from the patient in another
unidirectional valves
94
what permits gas flow to patient during inspiration
inspiratory check valve
95
what permits gas flow from patient to rebreathing bag/scavenging system/and CO2 absorber
expiratory check valve
96
can the expiratory and inspiratory valve be open at the same time
no, only one valve open at a time
97
what does the APL valve do
located on the expiratory side of the circuit
-adjusted to provide varying pressure to patients resp efforts
-alters amount of common gas within breathing bag
98
what is another name for the pop-off valve
APL valve (adjustable pressure limiting valve)
99
during spontaneous respiration the APL valve is
fully open
100
during manual ventilation the APL valve is
partially open
101
during mechanical ventilation the APL valve is
isolated from the system
102
during manual ventilation, what determines the pressure at which you are bagging the patient
APL valve
103
what pressure does the APL valve determine
relief pressure
104
what measures the tidal volume delivered to the patient
spirometer
105
where is the spirometer located in the breathing circuit
expiratory limb
106
what measures the tidal volume intermittently delivered to patient from breathing circuit
spirometer
107
what principle measures minute and tidal volumes in the spirometer
turbine principle
108
what causes errors in spirometery
friction, water, condensation, debris
109
what is measured by the breathing circuit pressure gauge
the pressure between inspiratory and expiratory unidirectional valves,
measures airway pressure
110
what can causes changes in spirometry
usually changes in ventilator settings and changes in spontaneous breathing patterns
-can reflect circuit disconnect or equipment malfunction
111
what is the highest pressure read by the breathing circuit pressure gauge
PIP
112
what does PIP indicate about the lungs
compliance
113
what does an increased airway pressure from the breathing circuit pressure gauge tell us
worsened pulm compliance
increaced TV
obstruction in circuit
114
what does a decreased airway pressure from the breathing circuit pressure gauge tell us
improvement in pulm compliance
decreased TV
leak in circuit
115
what is the breathing bag of the anesthesia circuit
ventilator bellows
116
what are the two types of ventilator bellows
standing
hanging
117
where does ventilator bellows receive gases
ventilator power inlet
pressurized O2 from machine,
reservoir for gases
118
in standing bellows, where does the bellows move during expiration
upward
119
in standing bellows, where does the bellows move during inspiration
downward
120
in hanging bellows, where does the bellows move during inspiration
upward
121
in hanging bellows, where does the bellows move during expiration
downward
122
what alarm detects a drop in peak circuit pressure
disconnect alarm
123
what percent is the O2 sensor calibrated to
21
124
what disposes of gases that have been vented from breathing circuit
waste gas scavenging system
125
what can happen if the waste gas scavenging system indicator is outside of the green
gas could be vented into OR
126
what are the 4 components of the scavenging system
relief valve
tubing
interface
disposal line
127
how much alveolar gas does the circle system allow you to rebreathe
<1 L/min
128
what is wet soda lime composed of
80% calcium hydroxide Ca(OH)2
5% potassium hydroxide KOH
15% water
trace amounts of silica and clay
129
what does the silica and clay do in the soda lime
increases hardness and decreases dust formation
130
exhaled CO2 combine with H2O to create
carbonic acid
CO2 + H2O -> H2CO3
131
what is the fast reaction formula for soda lime
H2CO3 + 2NaOH -> Na2CO3 + 2H2O + heat
132
what is the slow reaction formula for soda lime
Na2CO3 + Ca(OH)2 -> CaCO3 + 2NaOH
133
what are the reactant products of CO2 absorbent
heat, water, calcium carbonate
134
how much CO2 is absorbed by absorbant
14-23 L CO2/100 g absorbant
135
what is the mesh size of CO2 absorbant
4-8 mesh
136
what percent of absorbant is used before color change occurs
50-70%
137
does a mesh size of 1-2 have more or less surface area
less
138
the larger the granules the __________ the resistance
less
139
the smaller the granules the ___________ the surface area
greater
140
an open circuit system has _______ reservoir and ______ rebreathing
no
no
141
a semi open circuit system has ______ reservoir and _______ rebreathing
a
no
142
an semi closed circuit system has _______ reservoir and ______ rebreathing
a
partial
143
an closed circuit system has _______ reservoir and ______ rebreathing
a
complete
144
at what flow do you not need a CO2 absorber in a circle system
>5/L minute
145
where is dead space located in a circle system
distal to the y piece
146
what kind of resistance does the circle system have, what contributes to it
minimal
valves and absorber
147
how does high flow affect moisture
low moisture, will dry out CO2 reabsorber
148
what is the color for sevoflurane
yellow
149
what is the color for isoflurane
purple
150
what is the color for desflurane
blue
151
what is the area after the flowmeters where different gases first mix
common manifold
152
what mapleson classification of breathing circuits are semi closed
ABCDF (if flow is low)
153
how long must the O2 sensor be left to room air before calibration
2 min
154
what is the definition of a closed system
inflow matches exactly loss from the system
155
semi open systems are also known as
non-rebreathing systems
156
what rate does fresh gas need to be supplied at for a semi open system
greater than the minute ventilation of the patient (>5L minute usually)
157
in a semi open system what is in the reservoir
fresh gas
158
in semi closed system what gases are in reservoir
fresh gas and alveolar gas
159
what are examples of open system
nasal cannula, simple mask, mapleson E, venturi
160
what are examples of semi open system
circle system with a high fresh gas flow over mv
or a nonrebreathing circuit
mapleson D
161
what are examples of semi closed systems
circle system with a fresh gas flow less than mv
mapleson ABC
bain
jackson reece
162
what are the coaxial circuits
tube within a tube
bain (D)
jackson reece (F)
lack
mera G
Humphrey ADE
163
what systems rely on the CO2 absorber
semi closed
closed
164
what determines if a system is semi open or semi closed
fresh gas flow
165
what mapleson circuit is open
E
166
what mapleson circuit do you use for pediatrics
F
167
at what flow is the circle system a closed system
flows less than 0.5 L/min
168
in the link-25 system, how many teeth are on the N2O knob? how many on the O2?
14
29
169
how do you calculate FiO2 from machine flows
(air flow rate x21) + (oxygen flow rate x 100) / total flow rate
170
what kind of alarm does low O2 pressure set off
medium priority
171
what are the 5 functions of O2
O2 flowmeter supply
O2 flush valve
O2 pressure alarm low
O2 pressure device (fail safe)
compress bellows
172
what are causes of pipeline pressure drop
clogged filter
bad check valve
hospital supply problem
173
what could cause the hypoxic gaurd not to work
wrong gas in pipeline/cylinder
third gas
leak past flow control valve
defective mechanics
174
what effects the vaporizer rate of vaporization
temp
vapor pressure
pp of vapor above liquid
175
what decreases breathing circuit resistance
decrease tube length
increased diameter
straighten tube
eliminate valves
promote laminar flow
176
what are the steps is you lose O2 pipeline supply
fully open O2 tank
D/C pipeline O2
low flows
manually ventilate
177
when does gas go through scavenging system in mechanical ventilation
exhalation
178
when does gas go through scavenging system in manual ventilation
inhalation
179
what is A
flowmeter
180
what is B
flush button
181
what is C
vent bellows
182
what is D
common gas outlet
183
what is E
absorber
184
what is F
brake
185
what is G
system switch
186
what is H
vaporizors
187
what is i
ventilator
188
what is A
gas supply modules
189
what is B
sensor interface panel
190
what is C
waste scavenging interface valve
191
what is D
absorber
192
what is A
right angle connector
193
what is B
Y connector
194
what is C
expiratory unidirectional valve
195
what is D
APL valve
196
what is E
reservoir
197
what is F
CO2 absorber
198
what is G
fresh gas inlet
199
what is structure H
inspiratory unidirectional valve
200
what is i
flexible breathing tube
201
what goes through this
oxygen 2,5
202
what goes through this
nitrous 3,5
203
what goes through this
air 1,5
204
what goes through this
CO2 1,6
205
what goes through this
oxygen 2,5
206
what goes through this
N2O 3,5
207
what goes through this
air 1,5
208
what goes through this
CO2 1,6
209
what is 1
check valve
210
what is 2
N2O pipeline supply
211
what is structure 3
pressure regulator (decreases from high to intermediate pressure)
212
what is 4
fail safe valve (only open when oxygen is flowing at 25 psi or greater)
213
what is 5
second stage pressure regulator (decreases intermediate pressure, maintains constant flow, no fluctuations)
214
what is 6
vaporizers (only one at a time)
215
what is 7
rotameter flowmeter
216
what is 8
needle valve for flowmeter
217
what is 9
pressure relief valve
218
what is 10
outlet check valve
219
what is 11
common gas outlet
220
what is 12
breathing circuit to patient
221
what is area highlighted by 13
low pressure
222
what is 14
O2 flush valve
223
what is 15
second stage O2 pressure regulator
224
what is 16
O2 supply low pressure alarm
225
what is 17
auxiliary O2 flowmeter
226
what is 18
auxiliary O2 DISS connector
227
what is 19
anesthesia ventilator driving gas circuit
228
what is 20
line pressure gauge
229
what is 21
O2 pipeline supply
230
what system is N2O molecule A in
high pressure
231
what system is N2O molecule B in
intermediate
232
what system is N2O molecule C in
low
233
what system is oxygen molecule E in
intermediate
234
what system is oxygen molecule D in
low
235
what system is oxygen molecule F in
intermediate
236
what system is oxygen molecule J in
intermediate
237
what system is oxygen molecule G in
intermediate
238
what system is oxygen molecule H in
intermediate
239
what system is oxygen molecule I in
high
240
pressure system breakdown
241
what goes in structure 5
to machine
242
what goes in 1
wall supply
243
what is structure 2
DISS fitting
244
what is structure 3
valve seat
245
what is 4
check valve
246
what is A
Cylinder gasket/ O ring
247
what is B
T handle
248
what is C
pipeline inlet
249
what is D
cylinder wrench
250
what is 1
N2O flow of O2 failsafe valve
251
what is 2
valve return spring of O2 failsafe valve
252
what is 3
valve of O2 failsafe valve
253
what is 4
valve seat of O2 failsafe valve
254
what is 5
thrust pin of O2 failsafe valve
255
what is 6
piston of O2 failsafe valve
256
what is 7
diaphragm of O2 failsafe valve
257
what is 8
O2 pressure at 25 psig or higher for O2 failsafe valve
258
what is A
T handle
259
what is B
valve stem
260
what is C
cylinder valve
261
what is D
gasket
262
what is E
to machine
263
what is F
hanger yoke check valve
264
what is G
PISS System
265
what is H
gas outlet
266
what is 14
inspiratory check valve
267
what is 10
CO2 absorber
268
what is 2
sevo vaporizor
269
what is 12
auxiliary common gas outlet
270
what is 4
oxygen inlet
271
what is 7
air inlet
272
what is 1
N2O pressure gauge
273
what is 2
N20 pressure regulator
274
what is 3
closed circuit outlet
275
what is 4
ventilator outlet
276
what is 5
O2 flush
277
what is 6
fresh gas outlet
278
what is 7
O2 pressure regulator
279
what is 8
O2 pressure gauge
280
what is 9
for low pressure alarm system
281
what is 1
gas outlet to manifold
282
what is 2
float stop
283
what is 3
tapered flow tube
284
what is 4
float
285
what is 5
float stop
286
what is 6
valve seal
287
what is 7
O2 inlet (14/16 psi for O2)
288
what is 8
needle
289
what is 9
valve stops
290
what is 10
flow control knob (fluted for O2)
291
what is this system
Link 25 Proportioning System
292
what is 1
N2O gear
293
what is 2
kick-in tab on gear
294
what is 3
O2 gear
295
what is 4
O2 knob and collar
296
what is 5
stop screw on collar
297
what is 6
chain
298
what is A
vaporizer A
299
what is B
to common gas outlet
300
what is C
manifold bypass
301
what is D
from flowmeters
302
what is E
vaporizer B
303
what is A
stationary vane (channels gas into spiral motion)
304
what is B
rotating vane of spirometer
305
what is included in the high pressure circuit
cylinders
cylinder pressure regulators
306
what is included in the intermediate pressure circuit
the regulated cylinder supply
pipeline sources
gas flow
control valves
307
what is in the low pressure circuit
flow control valves to common gas outlet
(includes flow tubes, vaporizers)
308
what system helps ensure that wall gases are not mixed
DISS
309
what system helps ensure that cylinder gases are not mixed
PISS
310
calculate time remaining for oxygen cylinder
cylinder pressure/(200x flow rate)
311
how much N2O is in a cylinder
1600L
312
T/F oxygen failure cutoff valves prevent a hypoxic gas mixture
False
313
what is a thorpe tube
flowmeter
314
what does the link 25 system regulate
N20 and O2 to prevent hypoxic mixutre (ratio 3:1 O2, N2O)
315
what is temperature at which the vapor pressure equals atmospheric pressure
boiling point
316
what gas has the lowest boiling point
des
317
what are examples of variable bypass flow over temperature compensated agent specific out of breathing circuit vaporizers
The GE Tec 5, Tec 7, and 850 vaporizers,
the Dräger Vapor 2000 and 3000 series vaporizers
318
if sevo is put in an iso vaporizeer, the concentration of delivered sevo will be (higher/normal)
lower
319
if iso is put into a sevo vaporizer the concentration delivered will be (higher/lower)
higher
320
what kind of vaporizer is required for des
TEC 6
321
what is the the pressure exuded by vapor phase molecules of a volatile liquid above the liquid against the container it is being held in
saturated vapor pressure
322
as temperature increases, SVP (increases, decreases)
increases
323
what is The amount of energy that is consumed by a given liquid as it is converted to a vapor or the number of calories required to change 1 g of liquid into vapor without a temperature change
latent heat of vaporization
324
what is the number of calories required to increase the temperature of 1 g of a substance (a solid, liquid, or gas) by 1°C
specific heat
325
what is a measure of the rate at which heat flows through a substance
thermal conductivity
326
calculate the vapor concentration of sevo
For example, the SVP of sevoflurane is 160 mmHg at 20°C, at sea level. This corresponds to a vapor concentration of 160 mmHg/760 mmHg × 100 = 21%,
327
what effects the output of vaporizers
FGF
Temp
intermittent back pressure (PPV, flush valve)
fresh gas composition
328
what circle system has no rebreathing and requires a very high FGF
semi open
329
what circle system is associated with some rebreathing and is the most common used in the US
semi closed
330
what circle system does the FGF exactly match what is consumed by the patient and has complete rebreathing of exhaled gases
closed
331
what are the components of circle system
(1) a fresh gas inflow source;
(2) inspiratory and expiratory unidirectional valves;
(3) inspiratory and expiratory corrugated tubes;
(4) a Y-piece connector;
(5) an overflow or pop-off valve, referred to as the adjustable pressure-limiting valve (APL) valve;
(6) a reservoir bag; and
(7) a canister containing CO2 absorbent.
332
what is composition of soda lime
80% calcium hydroxide
15% water
4% sodium hydroxide
1% potassium hydroxide
silica (to make calcium and sodium silicate)
333
what is the benefit of calcium hydroxide over other agents
decreased production of carbon monoxide and compound A
334
how much CO2 can 100g soda lime absorb
26L
335
what turns the soda lime purple
ethyl violet (triggered by decrease in ph 10.3 ish)
336
what factors increase risk of compound A with SEVO
(1) low flow or closed circuit anesthetic techniques;
(2) the use of Baralyme (now no longer available);
(3) higher concentrations of sevoflurane in the anesthetic circuit;
(4) higher absorbent temperatures; and
(5) fresh absorbent
337
what is the order in which volatile create carbon monoxide
desflurane ≥
enflurane >
isoflurane >>
halothane = sevoflurane)
338
T/F dry absorbent makes more CO than wet absorbant
true
339
T/F baralyme creates more CO than soda lime
true
340
what factors increase CO production
(1) the inhaled anesthetic used (for a given MAC multiple, the magnitude of CO production from greatest to least is desflurane ≥ enflurane > isoflurane >> halothane = sevoflurane);
(2) the absorbent dryness (completely dry absorbent produces more CO than hydrated absorbent);
(3) the type of absorbent (at a given water content, Baralyme produced more CO than does soda lime);
(4) the temperature (increased temperature increases CO production);
(5) the anesthetic concentration (more CO is produced from higher anesthetic concentrations)92;
(6) low FGF rates; and
(7) reduced experimental animal (patient) size per 100 g of absorbent.
341
how much peep is part of the ascending bellows
2-3 cmH2O
342
what are two critical components of setting up the anesthesia workstation
AMBU bag
full tank of O2
343
what does the low pressure leak test assess
the integrity of the low pressure circuit from the flowmeter valves to the common gas outlet
344
how do you perform a low pressure leak test
attach a bulb to the common gas outlet and creating negative pressure (-65 cmH2O)
the test fails if the bulb reinflates within 10 seconds
345
the high pressure leak test is conducted by
closing the APL valve,
pressurizing the circuit to 30 cm H20
observing the airway pressure gauge (should remain constant)
346
what are the 5 tasks of O2 in the SPDD model
O2 pressure alarm
O2 pressure failure device
O2 flowmeter
O2 flush valve
ventilator drive gas
347
what is the supply part of the SPDD
how the gases enter the anesthesia machin
location- pipeline to the back of the anesthesia machine
348
what is the processing part of the SPDD model
how the anesthesia machine prepares the gases before they are delivered
location- inside the machine up to the common gas outlet
349
what is the delivery part of the SPDD
how the prepared gases are brought to the patient
location- breathing circuit
350
What are the three rules to prevent rebreathing of CO2 in a traditional circle system
-unidirectional valve must be located between the patient and the reservoir bag on both insp and expir limbs of circuit
-fresh gas flow cannot enter the circuit between the expir valve and the patient
-the over flow (pop off) valve cannot be located between the patient and the inspiratory valve
