Anesthesia Machine I Flashcards
The ASA closed claims database project showed only a small number (Approx 2%) of cliams were related to gas delivery equipment. Tho small in number, these cases carried a: (name 3)
high severity of injury
high cost
prominent role for equipment MISUSE
misuse of equipment is ____ x more likely than an actual equipment malfunction due to these two things:
3x
lack of familiarity and failure to perform a machine check
what is the single highest source of error involved in gas delivery claims?
the breathing circuit
3 things you need in ANY emergency or malfunction
ambu bag, o2 tank, and propofol
what are the four types of anesthesia machine manufacturers
draeger medical inc
GE Healthcare
maquet geting group
penlon america
what are the 3 purposes of the anesthesia machine?
deliver gases to the patient
create an artifical breathing environment for patient during anesthesia
removal of excess gases from patienta nd breathing circut
what are the two absolute pressures of a compressed gas
absolute pressure exceeding 40 psi at 70 degrees OR
absolute pressure exceeding 104 psi at 130 degrees
what can a compressed gas be supplied in?
cylinder or the pipeline
name the 3 ways O2 is manufactured:
fractional distillation of liquified air
electrolysis of water
thermal decompensation of NA Chlorates
what is the most common method of manufacturing O2 that accounts for 80%
fractional distillation of liquified air
liquid occupies ______ of the space a gas would occupy
1/860
how can oxygen be stored?
cyllinder tank or liquid
what is manufactured by the thermal decompensation of ammonium nitrate?
N2O
how is nitrous oxide classified?
nonflammable but supports combustion
name the 4 gases that do not liquify at ordinary temperature and ambient pressure:
oxygen
nitrogen
air
helium
2000 PSI = how many liters of oxygen
660
1000 PSI = how mnay liters of oxygen
330
what PSI and liters does a high pressure cylinder contain?
3000 PSI and 1000 liter O2
what two gases can become liquid in containers at ordinary temperatures and pressures ranging from 25-1500 PSI
nitrous oxide
carbon dioxide
the cylinder pressure of N20 remains nearly constant if the temperature remains constant Until:
almost all of the liquid has evaporated
what PSI is liquified N20 at until all the liquid has evaporated?
745
a nonprofit organization that promotes, develops, represents, and coordinates technical and standardization activities in the compressed gas industries including end uses of products
compressed gas association of 1913
are you forced to join the compressed gas association?
no legal force
what agency uses the force of law to ensure purity in compressed gas regulation?
FDA
what team is used in the marking. labeling, qualifications, transport, maintenance, and disposition of cyllinders containing compressed gas?
the department of transportation (DOT)
inspection and internal hydrostatis pressure test occurs every ___ years for cyllinders?
5 years, but with special permit testing is permissable to every 10
cylinders are tested to ____ of their service pressure
1.66
what are the advantages of pipeline systems?
cheaper
less danger than cylinders
convenient
gas is delivered at reduced pressure
what is the reduced pressure that the pipeline system delivers gas at?
50-55 PSI
what kind of tubing is the pipeline system made of?
copper tubing approved by the national fire protection agency
what are the problems with pipeline systems?
contamination can occur (particles, bacteria, viral, moisture)
inadequate pressure
excessive pressure
accidental crossover
what is a pipeline crossover
an anesthetic emergency
when the oxygen and nitrous oxide lines are switched
how will you know if theres a pipeline crossover?
low o2 sensor, low fio2 noted
what do you do in the event of a hospital pipeline crossover?
turn on backup oxygen cylinder
disconnect oxygen pipeline supply hose from the wall
ventilate manually
what is a manual shut off lever of a pipeline system?
a section of the pipeline used for maintenance repair, testing, or problems distal to the valve
what side of the anesthesia machine consists of those parts which reveive gas at cylinder pressure?
the high pressure circuit
what are the components of the high pressure side?
hanger yoke
yoke block
cylinder pressure gauge
cylinder pressure regulator
what is the safety feature of the hanger yoke?
the PISS - pin index safety system
go piss girl
what is the purpose of the pin index safety system?
to prevent interchanging of cylinders on the cylinder yoke
what are the combinations of these three gases’ cylinder valve pins
oxygen
air
n2O
2-5
1-5
3-5
what are the two styles of hanger yokes
the ohmeda- swing gate
draeger- screw type
how many times can you use a gasket?
ONCE, single use only
what is the purpose of the check valve?
minimizes trans-filling of cylinders
allows change of cylinders
minimizes leaks to atmosphere if a yoke is empty
what does the cylinder pressure gauge reflect:
cylinder pressure
the cylinder pressure gauge is located on which side of the anesthesia machine:
high pressure side
what are the names of the two types of pressure gauge readings?
bourdon gauge, digital readout
connects a gas from a variable prssure within the gas cylinder to a lower more constant working pressure suitable for use in the anesthesia machine:
the first stage regulator OR the pressure reducing valve or reducing regulator or regular valve
1 million names for the same shit
what pressure does the first stage regulator reduce to?
45-50PSI
what kind of valve is inside the first stage regulator?
a diaphragm type valve
name all the components of the intermediate pressure side of the anesthesia machine:
good luck
pipeline inlets
check valves
pressure gauges
ventilator power outlet
oxygen pressure failure devices
oxygen second stage regulator
flush valve
what is the primary source for the anesthesia gas machine?
the hospital medical gas pipeline
what PSI is the hospital medical gas pipeline?
50-55 PSI
what is the PSI of the anesthesia machine gas cylinder pressure?
45-50 PSI
cylinder pressure operates at a constant prssure of approx ___ PSI
45
why is the pressure slightly less in cylinder pressure than pipeline pressure?
to prevent silent cylinder depletion in the event a cylinder is accidentally left open after checking its pressure (during a machine check)
what protects the anesthesia machine from accepting the wrong pipeline gas?
the DISS- diameter index safety system
why did the compressed gas association develop the diameter index safety system?
to establish a standard for non-interchangeable, removable connections for use with medical gases, vacuum, and evacuation service
what does the master switch do?
turns power on to the machine
all pneumatic and electrical features turn on at once
all alrms and safety features must be activate when master switch is turned on
what PSIG and PSI does the second stage regulator reduce nitrous oxide and oxygen to?
26, 14
what is the purpose of the second stage regulator?
elimninates fluctuations in pressure supplied to the flow indicator caused by fluctuations in pipeline pressure
by reducing the pressures below the normal fluctuation range, the flow remains more constant
what are the other names for the oxygen flush valve?
oxygen bypass or emergency oxygen
the oxygen flush valve directs a high flow of _____ L/min of O2 to the machine outlet
35-75 L/min
the low pressure side of the machine is ____ to get to the patient
safe
components of the low pressure system: (4)
flowmeter tubes, vaporizers, check valves, common gas outlet
gas flows of the flowmeters are required through a range of ___ mL to __L
200 ml to 15 L
the flowmeters contain a combination of …. (6)
oxygen
nitrous oxide
air
helium
nitrogen
carbon dioxide
what kind of design principle is the variable orifice flowmeters?
thorpe tube design
smaller at the bottom, wider at the top
minimal oxygen flow is provided by an adjustable stop on the oxygen flowmeter control knob (___to___ML)
200-300mL
flowmeter features:
knobs are color coded
oxygen knob has design color and larger shape
spacing betwen knobs is a minimium of 25mm
delicate instruments, some of which are pin indexed to prevent interchangability
examples of laminar flow:
low flow
viscosity of gas
poisellue’s law
examples of turublent flow:
high flow
density of gas
graham’s law
traditional flowmeters are calibrated within ____to___% accuracy at atmospheric pressure and room temperature
2-10% accuracy
what is atmospheric and room temperature
760 Torr
20 degrees Celsius
true of false: temperature changes do not significantly induce changes in flowmeter accuracy
true
when flowtubes are used at high altitudes, actual flow is ____ than indicated on the flowmeter scale because atmospheric pressure ___ with altitude
higher
decreases
when flowtubes are used at low altitudes, actual flow is ___ than indicated on the flowmeter scale bc atmospheric pressure ___ below sea level
lower
increases
what side is oxygen flowmeter located on?
right
where do you read the ball vs the nonrotating float?
ball- middle
float- top
electronic flowmeters are _____x more accurate than glass flowtubes
5-10x
how many minutes does the battery back up have on anesthesia machine?
30 min
what is the point of exit for gas from the anesthesia machine?
common gas outlet
How is N20 manufactured?
Thermal decompensation of ammonium nitrate
