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Board Study > Anesthesia Machine > Flashcards

Anesthesia Machine Flashcards

1
Q

What is the best way to detect a vaporizer leak?

A
  • Negative pressure test (low pressure leak test)

- assesses the integrity of the low pressure system

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2
Q

What does the high pressure leak test assess for?

A
  • if the machine does NOT have a check valve: breathing circuit and entire low pressure system
  • if the machine has a check valve: breathing circuit and low pressure system up to the check valve
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3
Q

What are the PISS configurations for air, O2 and N2O?

A
  • Air: 1, 5
  • O2: 2, 5
  • N2O: 3, 5
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4
Q

What is the max pressure and volume for air?

A
  • 1900 (or 2000) psi

- 625 L

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5
Q

What is the max pressure and volume for O2?

A
  • 1900 (or 2000) psi

- 660 L

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6
Q

What is the max pressure and volume for N20?

A
  • 745 psi
  • 1590 L
  • only reliable method to determine the volume that remains is to weigh it
  • N2O is a liquid and will read 745 psi until the liquid is gone and only gas remains - at this point the cylinder is about 3/4 empty
  • wise to change the tank anytime it falls below 745 psi
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7
Q

What is the main purpose of the oxygen pressure failure device?

A
  • monitor for and protect against low O2 pressure in the anesthesia machine
  • it is the pressure in the supply line (not O2 concentration) that maintains fail-safe in the open position
  • resides in the intermediate pressure system
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8
Q

How does the Hypoxia Prevention Safety Device work?

A
  • prevents you from setting a hypoxic mixture with the control valves
  • Limits N2O flow to 3 times O2 flow (N2O max ~ 75%)
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9
Q

When are instances when proportioning devices CANNOT prevent a hypoxic mixture?

A
  • O2 pipeline crossover
  • leaks distal to the flowmeter valves
  • administration of a third gas (helium)
  • defective mechanic or pneumatic components
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10
Q

There are 4 types of floats in flowmeters. Where is the measurement taken at each?

A
  • the widest part of the float
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11
Q

Where should the O2 flowmeter be positioned to prevent a flowmeter leak from creating a hypoxic mixture?

A
  • all the way to the Right (closest to the common gas outlet)
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12
Q

What are concepts that come to mind about a Variable Bypass Vaporizer?

A
  • variable bypass
  • flow-over
  • temperature compensated
  • out-of-circuit
  • agent specific
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13
Q

Does the pumping effect increase or decrease vaporizer output?

A
  • increases
  • usually d/t positive pressure ventilation or use of flush valve
  • it is enhanced by low FGF, low dial setting, and low levels of anesthetic gas
  • this effect is minimized by the modern vaporizer
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14
Q

Does tipping the vaporizer over cause an increase or decrease in output?

A
  • increase

- run FGF through the vaporizer for 20-30 min before connecting to the pt

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15
Q

What are concepts that come to mind about the Tec6 vaporizer?

A
  • it heats and pressurizes to 39 C & 2 atms
  • uses an injector
  • doesn’t compensate for changes in elevation
  • at Higher elevation the partial pressure in the breathing circuit is Lower than expected
  • at Lower elevation or hyperbaric chamber the partial pressure in the breathing circuit will be Higher than expected
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16
Q

What are key points about the oxygen analyzer?

A
  • it monitors O2 concentration (not pressure)
  • can detect O2 pipeline crossover
  • can detect leak in breathing circuit (most common is circuit disconnect and 2nd is CO2 canister)
17
Q

Which type of pneumatic bellows will not fill if there is a disconnect, ascending or descending?

A
  • Ascending - regarded as safer b/c of this
18
Q

What happens when there is a leak in the pneumatic bellows?

A
  • may transmit high gas pressure to the breathing circuit
  • increased breathing circuit pressure may cause barotrauma
  • if there is a bellows leak and O2 is used as the ventilator drive gas, FiO2 in breathing circuit may increase
  • if there is a bellows leak and air is used as the ventilator drive gas, FiO2 in breathing circuit may decrease
19
Q

What is the mechanism of a piston ventilator?

A
  • use an electric motor to compress piston to generate positive pressure
  • won’t consume O2 tank w/pipeline failure
20
Q

How many pressure relief valves are on the piston ventilator?

A
  • there are 2 pressure relief valves: + and -
  • Positive pressure relief: opens @ 75+/-5 cm H2O (prevents excessive build up in anesthesia circuit)
  • Negative pressure relief: opens @ -8 cmH2O (when circuit pressure galls below this value, the valve opens and entrains air) - protects against negative end-exp. pressure
21
Q

How do piston ventilators deliver constant tidal volume?

A
  • Fresh gas decoupling
22
Q

What happens to the breathing bag on the piston ventilator during mechanical ventilation?

A
  • the bag is incorporated into the vent during mechanical ventilation
  • bag inflates during inspiration and deflates during expiration
  • if the bag rapidly deflates suspect circuit disconnect
  • piston won’t move when the pt initiates spontaneous breath on the ventilator
23
Q

What are the fixed and variable components of Volume Control Ventilation?

A
  • Fixed: TV, Insp. Flow Rate, Insp. Time

- Variable: Peak insp. pressure

24
Q

What are the fixed and variable components of Pressure Control Ventilation?

A
  • Fixed: Peak Insp. Pressure, Insp. Time

- Variable: TV, Insp. Flow

25
Q

What are advantages of PCV?

A
  • delivers larger TV for given insp. airway pressure
  • insp. flow pattern improves gas exchange
  • dec. risk of vent associated lung injury (VALI)
  • useful if pt has low compliance (high PIP is dangerous) or to compensate for leaks
26
Q

What are disadvantages of PCV?

A
  • inc. airway resistance and/or dec. lung compliance dec’s TV
  • requires extra attention w/circumstances that can alter pulmonary resistance or compliance will cause TV to change
27
Q

What is the final product of the soda lime reaction?

A
  • Calcium carbonate + 2 Sodium Hydroxide
28
Q

At what pH does the indicator ethyl violet change from clear to purple?

A
  • 10.3
  • it may revert to a colorless stage when the machine is not in use, but will change back as soon as it comes in contact with CO2
29
Q

If unable to change exhausted soda lime, what should you do?

A
  • increase FGF to convert a circle system to a semi-open system
  • this will prevent rebreathing and capnograph should return to zero
30
Q

What are benefits of using Calcium Hydroxide Lime (Amsorb Plus)?

A
  • no carbon monoxide
  • very little or no compound A
  • may be lower risk of fire
31
Q

What are drawbacks of using Calcium Hydroxide Lime (Amsorb Plus)?

A
  • absorbs less CO2 than soda lime and requires more frequent changing
  • more expensive

Board Study (29 decks)

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