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october exam > anesthesia machine > Flashcards

anesthesia machine Flashcards

1
Q

what is the pipeline pressure

A

50 psi

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2
Q

what is the tank pressure

A

45 psi

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3
Q

how to test low pressure system

A

attach bulb to CGO- create negative pressure- test fails if bulb reinflates within 10 sec

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4
Q

high pressure leak test

A

close APL, pressurize circuit to 30- observe pressure gauge- pressure should remain constant

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5
Q

what is the SPDD model

A

supply: how gas enters the machine

processing: how the anesthesia machine prepares the gas (up to CGO)

delivery: how prepared gases are brought to the patient

disposal: how gases are removed from the circuit (scavenging)

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6
Q

5 tasks of oxygen

A

o2 pressure alarm
o2 pressure failure device
o2 flowmeter
o2 flush
ventilator drive gas

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7
Q

what is the pin index safety system

A

-prevents inadvertant misconnection of gas cylinders
-pin configuration on each hanger yoke- diff for each gas
-o2 pressure drops to 45 psi when it enters entry into intermediate system

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8
Q

how can the PISS be bypassed

A

the prescence of more than one washer between hanger yoke assembly and tank allows PISS to be bypassed

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9
Q

diameter index safety system

A

prevents inadvertent misconnections of gas hoses. each gas hose and connector are sized and threaded for each gas

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10
Q

what is the pipeline pressure

A

50 psi (same as intermediate)

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11
Q

how do you tell cylinder content

A

by LABEL not color

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12
Q

how many L and psi are in oxygen

A

660 L , 1900 psi

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13
Q

how many L and psi are in air

A

625 L and 1900 psi

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14
Q

how many L and psi are in n2o

A

1590 L and 745 psi

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15
Q

what law is used to calculate cylinders content

A

boyles

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16
Q

how does n2o exist in the tank

A

as a liquid unless it is almost empty

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17
Q

what is the pressure of the gas n2o above liquid

A

remains constant at 745 psi regardless of how much liquid is in the tank

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17
Q

what is the critical temp of n2o

A

36.5 (above room temp 20 degrees c)

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17
Q

what is the most sensitive part of the gas cylinder

A

cylinder valve

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18
Q

what to do if you suspect a leak in the cylinder

A

-tighten the connection
-replace washer between cylinder and hanger yoke
-change cylinder
-if you dont have replacement cylinder: insert yoke plug- if valve fails and there is no cylinder/ yoke plug- gas should be going to pt will exit here

19
Q

what cylinders are MRI safe

A

aluminum. 2 colors: silver tank and color on top

20
Q

what is the oxygen pressure failure device (failsafe)

A

-monitors for low o2 pressure in the anesthesia machine
-alarms in the event of depleted o2 tank, drop in pipeline pressure or disconnected o2 hose
-does NOT alarm in the setting of pipeline crossover (measures pressure, not o2 concentration!!!)

is in intermediate pressure system: alarms when pressure is below 28-30 psi

will stop n2o when pressure is below 20

21
Q

hypoxic prevention safety device

A

-prevents a hypoxic pressure
-fio2 should never drop below 25% (3:1 ratio)

22
Q

when will the hypoxic prevention safety device alarm

A

-o2 pipeline crossover
-leaks distal to flowmeter valves
-administration of a 3rd gas
-defective mechanic/ pneumatic components

23
Q

what begins the low pressure system

A

flow meters

24
Q

where should the o2 flowmeter be positioned

A

CLOSEST to CGO

25
Q

reynolds number

A

laminar <2000
turbulent >4000
transitional 2-4000

26
Q

when is laminar flow favored

A

low FGF

higher FGF annular space acts like an orfice creating turbulent flow pattern

27
Q

what is fresh gas coupling

A

coupling of FGF to the tidal volume set on the ventilator may lead to errors in predicted Vt and MV (really only seen with older anesthesia machines)

28
Q

what is the tidal volume given to the patient during fresh gas coupling

A

tidal volume delivered to patient= Vt set on the ventilator + FGF during inspiatrion- volume lost to circuit compliance

in flow coupled anesthesia machines, changes in RR, I:E ratio, FGF and height of the bellows impact total Vt given to pt

if machine does not couple FGF to Vt, then what is set on ventilator is what gets delivered to patient

29
Q

what is circuit compliance

A

a chance in volume for a given change in pressure- measure of distensibility

30
Q

do modern ventilators compensate for fresh gas lost to circuit compliance

A

yes- when ventilator produces positibe pressure inside breathing circuit some of the gas causes circuit to expand. the quality of gas does not reach the patient and does not contribute to vt pateint recieeves. not an issue now

31
Q

what is variable bypass

A

when FG enters vaporizer- some encounters liquid anesthetic- the rest bypasses the anesthetic.

the concentration set on the dial determines the splitting ratio.

before leaving the vaporizer the 2 fractions mix- determines final anesthetic concentration to the patient

32
Q

what is flow over?

A

as fresh gas enters the vaporizing chamber (liquid anesthetic is here)- it flows over a series of baffles and wicks.

33
Q

what do you do if a vaporizer tipped over

A

run on high FGF for 20-30 mins before using on pt. some liquid anesthetic may enter bypass chamber

34
Q

temp compensated

A

the valve adjusts ratio of vaporizing chamber flow to bypass flow and guarantees a constant vaporizer output a wide range of temps

35
Q

what does out of circuit mean

A

the variable bypass vaporizer is positioned outside the breathing circuit

36
Q

what does agent specific mean

A

each vaporizer is calibrated to one anesthetic agent

37
Q

how does tec 6 vaporizer work

A

injects a precise amount of des directly into FGF

38
Q

what temp does des heat up to

A

39 c and presurizes it to 2 atm

39
Q

what is des vaport pressure

A

3-4 x higher than those of the other agents

40
Q

why cant you use a normal vaporizer with des

A

boils just above room temp (22 C)

41
Q

tec 6 and changes in elevation

A

does NOT compensate- important b/c depth of anesthesia is determined by partial pressure NOT concentration

42
Q

higher altitude with tec 6->

A

higher setting on dial

43
Q

hyperbarbaric oxygen tank and tec 6->

A

lower setting on dial

44
Q

what is the oxygen analyzer

A

-typically resides in the inspiratory limb
-final defense against hypoxic mixture!!!!

45
Q

what is the only safety device that measures o2 concentration

A

oxygen analyzer

can detect pipeline crossover and hypoxic mixture due to a leak in flowmeter

46
Q
A

october exam (12 decks)

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