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SRNAProfessionalGuide > Anesthesia Machine Parts > Flashcards

Anesthesia Machine Parts Flashcards

1
Q

What are the 3 types of valves

A

1.Free floating : one way 2.Ball and Spring valve : All or none valve 3.Diaphragm: Pressure Reducer Valve

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2
Q

Pressure

A

one 1L of oxygen , 1000psi may be

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3
Q

All anesthesia machines have about the

A

same parts

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4
Q

Endoskeleton of the machine

A

1st stage vs 2nd stage regulator.

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5
Q

one way valve

A

Free floating inhale : expiratory valve (close) exhale: inspiratory valve (open) expiratory valve open when you exhale E-Cylinder APRV or Pop Off valve (manually operated) Gas flow pushes gas to valve seat

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6
Q

Function of floating Valve

A

prevent gases from escaping the closed circuit system.

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7
Q

Radicals , macrophages, and eosinophils are mobilized

A

when the patient is given 100% oxygen

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8
Q

Pop off valve : turned to the right? what happens? Turn to the left –> ?

A

turned to the right (tighten , all the gas goes to the bag and the patient. Lefty loosy, more of the gas goes out the scavenging system

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9
Q

Pop off valve (APRV)

A

The more difficult, close more The less difficult, open a little more

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10
Q

One way free floating

A

from tank to patient, (one way out)

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11
Q

If you have 2 oxygen cylinders 1100 psi vs 1000 which one will deliver the pressure

A

1100 then both The cylinder with the higher pressure will deliver more oxygen.

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12
Q

DISS wall valve

A

Diameter Index Safety System (DISS) Idiot proof

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13
Q

Green yellow blue

A

Oxygen, air, nitrous oxide.

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14
Q

PISS

A

Pin Index Safety System (E-Cylinder) Different pin for each (Oxygen, nitrous)

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15
Q

Bourdon gauge

A

it measures pressure generated from its sources (bag, e-cylinder, ventilator or wall) Importance lies when bagging the patient with a mask: STAY below 20cmH2…(adjust pop off valve) Why? Barotrauma, ESOPHAGEAL SPHINCTER will open with 15cmH2O. IF you need to ventilated can go UP , (Smoking, obesity, OSA)

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16
Q

Inhale Know pressure and lung volume End Tidal is the opposite of

A

peak, plateau , exhale Inspiratory pressure.

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17
Q

Tidal volume x RR

A

minute ventilation

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18
Q

Ultrasonic flow meter

A

back of machine, light blue Tall blue dark (The WRIGHT SPIROMETER) measures TV and RR (which is minute ventilation)

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19
Q

Ultrasonic flow meter vs Wright spirometer

A

Highly accurate not affected by flow situations= Ultrasonic flow meter The wright spirometer= Does not measure volume directly

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20
Q

One way valve All of them measure

A

Bourdon gauge , ultrasonic flow meter EXHALATION

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21
Q

Expiration vs inhalation

A

Expiration is longer (passive) normal require passive

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22
Q

Fast ambu bag delivery

A

it will cause barotrauma.

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23
Q

How long to wait for sats

A

30 seconds

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24
Q

Alveolar recruitment maneuver (ARM)

A

Read

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25
Q

Ball & Spring (All or none) Valve

A

O2 wall connector think of when you applying valve to a wall, (push it in) REQUIRES ENERGY TO ACTIVATE

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26
Q

Flush valve generates ___to ____L/min and can cause __________if pressed too much or can also dilute out the volatile anesthetic being administered.

A

generates 35 to 75 L/min –> Barotrauma

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27
Q

Diaphragm Function Pressure _____and _____pressure first stage? 2nd stage?

A

Reduce pressure throughout the system pressure regulator/Reduce pressure First stage: reduce for both O2 and N2O to 40-55psig 2nd stage: Reduces internal intermediate pressure to 15psig (low pressure)

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28
Q

Diaphragm (pressure _____and _____Pressure)

A

pressure regulator/Reduce pressure First stage: reduce for both O2 and N2O to 40-55psig (intermediate pressure) 2nd stage: Reduces internal intermediate pressure to 15psig (low pressure)

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29
Q

Intermediate (normal)

A

40-55

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30
Q

Back up pressure

A

cylinders

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31
Q

Oxygen Fail Safe Mechanisms

A

Oxygen failure protection device: Flow dependent If oxygen is lower then 25 psig, N2O will shut off

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32
Q

Datex Ohmeda

A

PROPORTION LIMITING SYSTEM Drager: Limits flow of N2O according to O2 flow.

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33
Q

Thorpe tube:

A

Tapered and largest at top

34
Q

From low flow to high flow

A

Laminar to turbulent AS the diameter increases, you allow for more lamia

35
Q

For Flowmeters for Ball float

A

read at middle

36
Q

For Flowmeters for arrow float

A

read on top

37
Q

TEC 6 Desflurane Vaporizer • Heated up to ___________ • Pressurized up to__________

A

39 degrees Celsius 2 atmospheres.

38
Q

Soda Lime composition, what are the 3 ingredients

A

Calcium Hydroxide Sodium Hydroxide Potassium Hydroxide

39
Q

What is the percentage of calcium hydroxide in the soda lime?

A

80%

40
Q

What is the percentage of sodium hydroxide in the soda lime?

A

4%

41
Q

What is the percentage of Potassium hydroxide in the soda lime?

A

1%

42
Q

Soda lime mesh size ?

A

4-8

43
Q

Ethyl violet absorbers are _______when fresh and _______colored when exhausted

A

white; Purple

44
Q

What kind of valve in the absorber

A

Inspiratory or Expiratory Unidirectional valve APL

45
Q

How many liters of CO2 can the CO2 absorber absorb?

A

26L

46
Q

With _____FIRES can occur at ________F

A

Sevoflurane 400

47
Q

What do you do if the Soda Lime turns purple and you don’t have time to change it?

A

Use fresh ga

48
Q

What do you do if the Soda Lime turns purple and you don’t have time to change it? EX:

A

Increase the inspiratory flow 3 TIMES the minute ventilation If minute ventilation is 3L/min increase to 9L/min

49
Q

What is the purpose of increase the respiratory flow

A

Gas flow out to the scavenging system ; you lose gas bu the patient is SAFE

50
Q

2 types of ventilators

A

Ascending Descending Safer is ascending because descending is affected my gravity and may not be reliable

51
Q

Advantages and disadvantages of Piston ventilators? How is it powered? advantages: is there PEEP, comment on TV, and compliance loss Disadvantages: can generated _________

A

Piston Ventilators (electric powered) adv: quiet, no peep, greater precision with TV, less compliance losses disadv: less familiarity with standing bellows, quiet operation, cannot use Mapleson circuits; can generate Negative End Expiratory Pressure (NEEP).

52
Q

The mushroom valve is an

A

EPRV: expiratory pressure release valve. ▪ One-way (free floating) valve.

53
Q

Ventilator disconnect alarm 2 types of alarm: ▪ Volume alarms  Spirometer  Reverse flow  Low flow

A
  • pressure alarm - volume alarm
54
Q

Pressure alarm detect

A

by a drop in pressure of the system Threshold number

55
Q

Volume alarm

A

 Spirometer  Reverse flow  Low flow

56
Q

CC think compliance is

A

Chest

57
Q

Lungs think

A

Elasticity

58
Q

Pressure =

A

Flow x resistance

59
Q

Compliance = change in volume

A

change in pressure

60
Q

Normal Tidal volume is

A

5ml/kg lowest

61
Q

Tidal Volume is dependent ?q

A
  1. Set tidal volume 2. Flow rate of all gases -Increased flow rates lead to increase TV 3. The set I:E time  The longer the inspiratory time the more TV is delivered. Watch for overdistension. 4. Inspiratory flow speed  Increasing the flow speed increases the plateau phase leading to increased TV
62
Q

Increase flow rate increase/decrease TV

A

Increase

63
Q

The longer the inspiratory time the (more/less) TV is delivered

A

More

64
Q

What increases the plateau phase______leading to ______TV

A

Increasing the flow speed ; increase TV

65
Q

What are we trying to achieve? MAD SPM

A

▪ Safe delivery of minute ventilation ▪ Maintain ETCO2 around 32-36mm Hg ▪ Adequate inspiratory time  Maintain alveoli open  Do not overdistend alveoli ▪ Prevention of lung injury

66
Q

Set these 2 parameters together

A

Rate and I: E time

67
Q

For respiratory rate of 10 , set I: E at _______so expiratory time is ______seconds

A

1:2; two

68
Q

For respiratory rate of 8 , set I: E at _______so expiratory time is ______seconds

A

1:3 ; 1.88 seconds

69
Q

For respiratory rate of 6 , set I: E at _______so expiratory time is ______seconds

A

1:4 ; 2 seconds

70
Q

How do we go about prevent lung injury ?

A
  • Set rate and I:E time ▪ Set tidal volume ▪ Look at the pressure monitor ▪ Fine tune by changing the flow control ▪ Make sure inspiratory relief valve is above PIP
71
Q

2 knobs

A
  1. Inspiratory flow control dial 2. RR frequency & I:E ratio
72
Q

What is the Flow Control Dial? what is the function?

A

Controls the speed of injection of gas around the bellows ▪ Gas is combination of Oxygen and Air ▪ Faster flows increase the PIP ▪ Lower flows will lead to inadequate alveolar ventilation

73
Q

Open Reservoir Scavenging system: FLow indicator? Relief ports at side does what?

A

Flow Indicator = ball is at middle portion is 25 L per minute. ▪ Relief Ports at side = suctions room air if there is too much vacuum.

74
Q

Open Reservoir Scavenging system: receives gas from?

A

Receives gas from machine through APL and the ventilator.

75
Q

NIOSH 1977 Recommended Exposure Limits When halogenated only? Halogenated agent and N2O N2O only

A

*** Halogenated agents only = <2 ppm ▪ *** Halogenated Agent + N20 = 0.5 ppm ▪ *** N20 only = 25 ppm N20

76
Q

ETCO2 graph b b to c c-d d d to e

A

(b) Zero: Begin expiration. ▪ (b to c) Ascending: Combination of dead space and alveolar gases. ▪ (c-d) Plateau: Alveolar gases. ▪ (d) End of plateau: ETC02, @ FRC, @end expiration. ▪ (d to e)Descending: Inspiration

77
Q

Draw this multiple times

A

CIRCUIT CIRCLE

78
Q

Describe the circle system

A

Circle System -> -> ->flow meters –> vaporizer –>Common gas outlet (CGO) –> soda lime –> inspiratory valve –> inspiratory limb of the circuit –> ETT –> patient –> expiratory limb of the circuit –>expiratory valve –> ultrasonic flow meter or Wright spirometer –> bag vs. ventilator lever

79
Q

Happens simultaneously–>

A

–> bag –> pop off/ IPRV –> soda lime…etc.—> scavenger. –>ventilator –> soda lime …. Etc. –> mushroom valve –> scavenger.

80
Q

Circle system function (5)

A

minimize rebreathing ▪ need for soda lime ▪ dead space ▪ direction of gas flow ▪ required gas flow

81
Q

02 PATHWAY THROUGH THE MACHINE FROM E CYLINDER

A

E cylinder –> PISS valve —> bourdon gauge (pressure closes other free floating E cylinder valves) –> First Stage Diaphragm Valve (E cylinder pressure to intermediate pressures) —>

82
Q

Simultaneously……

A

▪ oxygen pressure sensor valve ▪ flush valve (bypasses flowmeters and vaporizers —> CGO: common gas outlet) ▪ DISS (closes) ▪ Second Stage Diaphragm Valve (intermediate to low pressure

SRNAProfessionalGuide (8 decks)

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