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Anesthesia Machines Flashcards

1
Q

What Governing bodies regulate the Anesthesia machine usage

A

American National Standards Institute (ANSI)
Prior to 2000
American Society for Testing and Materials (ASTM)
Since 2000
International Electrochemical Commission (IEC)
Compressed Gas Association (CGA)
Institute of Electrical and Electronics Engineers (IEEE)
Federal Drug Administration (FDA)

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2
Q

Components of the high-pressure system includes

A
  1. Auxiliary E – Cylinder
  2. Yoke assembly
  3. Burdon gauge
  4. High pressure regulator (HaBY)
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3
Q

what is the range of oxygen cylinders

A

Size A-H

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4
Q

Size A-E oxygen cylinder is used For?

A

Backup

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5
Q

Whats the most common size of Cylinder used

A

E

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6
Q

Size G-H oxygen cylinder is used for?

A

Banks,

Backup for oxygen hospital supply

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7
Q

What is the Tank made up of?

A

Steel

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8
Q

What is the tank for the MRI environment made up of?

A

Aluminum

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9
Q

What does US Department of Transportation regulate?

A 
Manufacture
Marking/labeling
Filling
Handling
Transport
Storage
Disposal of cylinders
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10
Q

What agency sets the purity of medical gases

A

United States Pharmacopeia/National Formulary (USP/NF)

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11
Q

Color For Oxygen

A

Green

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12
Q

Color For Nitrous

A

Blue

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13
Q

Color For Medical Air

A

Yellow

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14
Q

West anesthesia Gas Color

A

Purple

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15
Q

Vacuum(Suction) Color

A

White

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16
Q

CO2 Color

A

Grey

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17
Q

Nitrogen color

A

Black

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18
Q

ISO Color code For Medical air

A

Black and White

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19
Q

Iso color code for OXygen

A

White

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20
Q

Iso Color code for Vacum

A

Yellow

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21
Q

The PIN index safety system (PISS) is used in?

A

Yoke Assembly

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22
Q

What is the function of the “Check Valve”in the yoke assembly

A
  1. Stop Transfer of Oxygen between tanks

2. Stop leaking Into ATmosphere

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23
Q

Function of the yoke assembly

A

Orient tanks
Gas tight seal
Unidirectional flow of gases
Contains a filter

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24
Q

Piss for Air

A

1,5

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25
Q

Piss for Oxygen

A

2,5

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26
Q

Piss for Nitrous

A

3,5

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27
Q

E cylinder Volume

A

660L

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28
Q

E Cylinder Pressure

A

1900 Psi

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29
Q

oxygen Full tank pressure

A

2200psi

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30
Q

Nitrous Full tank pressure

A

750psi

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31
Q

Oxygen’s physical state at room air

A

Gas

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32
Q

Nitrous physical state at room air

A

Liquid and gas

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33
Q

Nitrous Full tank Liters of gas

A

1590L

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34
Q

When does pressure in the nitrous tank start to drop

A

When all the liquid has turned to gas at 75% usage of the full tank.

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35
Q

Name the 2 types of Cylinder safety systems

A

Frangible Disk and Fusible Plugs

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36
Q

What are the Characteristics of the Frangible Disk

A

Burst under pressure

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37
Q

What are the Characteristics of Fusible Plug

A

Melts at a predetermined Temperature(BLT with cheese)

Bismuth,lead,tin,Cadmium

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38
Q

What is The Anesthesia Machine

A

Provides delivery of medical gases and vapors of volatile anesthetics in known concentrations to a common gas outlet

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39
Q

Standards of the Anesthesia machine are overseen by

A

American National Standards Institute (ANSI)
Prior to 2000
American Society for Testing and Materials (ASTM)
Since 2000

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40
Q

what is the function of the High Pressure Regulator

A

Reduces the high and variable pressure delivered from a cylinder to a lower and more constant pressure suitable for the anesthesia machine

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41
Q

pressure regulators are set at?

42
Q

Between the pipeline gas and the cylinder gas.which source of delivery would the anesthesia machine use first

A

Pipeline gas will be used first

43
Q

Intermediate Pressure system Receives gas from?

A

The pressure regulator or pipeline inlet

44
Q

What are the components of the IPS

A
  1. Hospital supply (pipeline inlet)
  2. Oxygen flush valve
  3. Pneumatic safety systems/electrical system (on switch)
    Oxygen supply failure alarms
    Oxygen failure protection devices
  4. Auxiliary oxygen flowmeter
  5. Second stage regulator
45
Q

Is Oxygen Stored in liquid or Gas form(Hospital supple connection)

46
Q

what temp is oxygen stored in

A

-184 degress celcius

47
Q

What cylinders do we store Nitrous in?

A

H cylinders

48
Q

What is the function of the Diss(Diameter index safety System)

A

1.Ensures only the correct anasthesia can be connected

49
Q

What pressure is oxygen supplied in to the hospital

50
Q

What is the working pressure of the anesthesia machine

51
Q

There are multiple shut off valves between the Hospital supply and the anesthesia machine,true or false?

52
Q

The Diss system components are? (Hospital supply Connection)

A

Filter-Stop contaminants
Check valve-Ensures unidirectional flow
Pressure gauge-Pipeline pressure
Sized and threaded differently(body,nipple and nut combination

53
Q

What are the characteristics of quick Connection(old)

A

Gas specific

Wall outlet

54
Q

Name the Characteristics of the oxygen Flush Valve

A

Provides 100% oxygen to the anesthesia circuit
Enters the circuit downstream from the vaporizers – directly to common gas outlet
Flow rate between 35 – 75 L/minute
Protected by rim to lessen the chance of accidental activation

55
Q

What are the Hazards of using the oxygen flush valve

A

Barotrauma:Stuck valve If used during inspiratory phase of mechanical ventilation
Older - Ventilator relief valve closed & APL out of circuit
Newer - Fresh gas decoupling valve
Awareness:Dilute anesthetic gases

56
Q

The Function of the Fresh Gas decoupling valve in the piston system is to ?

A

Prevent or limit Barotrauma

57
Q

Anesthesia machine must have a battery back up of what time capacity

A

At least 30min battery backup for limited operation

58
Q

What is the function of the Pneumatic Safety System

A

Prevent the delivery of hypoxic gas mixture ,where oxygen influences the flow of other gases.

59
Q

What is the No Hypoxic gas mixture system requirement

A

“The anesthesia gas supply device shall be designed so that whenever oxygen supply pressure is reduced below the manufacturers specified minimum, the delivered oxygen concentration shall not decrease below 19% at the common gas outlet.”

60
Q

It is Prudent to plug appliances on the back of the Anesthesia Machine.T/F

61
Q

AT what pressure does the oxygen pressure Alarm sound

A

Oxygen pressure less than 38psi

62
Q

What happens in the system when the oxygen pressure alarm sounds

A

The oxygen failure whistle valves opens

63
Q

How long does the oxygen failure alarm sound

A

Whistle sounds until the oxygen pressure drops below 6psi

64
Q

At what pressure after the oxygen fail alarm sounds does the supply of anesthesia gas stop.

65
Q

The Audible indications when pneumatic system is turned on will be oxygen filling whistle comes on.T/F

66
Q

Name 3 functions of the fail safe valve.

A
  1. Fail save valves are designed to prevent the delivery of Hypoxic gas mixtures from the machine in the event of failure of oxygen supply
  2. Depends on the pressure of oxygen not flow
  3. Protects against unrecognized exhaustion of oxygen delivery from either the pipeline or attached oxygen tank
  4. Fail save devices either proportionally decreases the flow of all gases or shuts off (threshold) flow of all other gases except oxygen based on manufacture set pressures
67
Q

What are the limits of the fail safe Valve

A
  1. Does not prevent anesthesia gases from flowing

2. Works even if the wrong gas is supplied (pneumatic devices

68
Q

In Datex Ohmeda if the what oxygen pressure limit needs to be reached for the device to activate and what will happen with the valve.?

A

<20psi of pressure. and valve will close

69
Q

Function of auxillary oxygen flowmeter

A
  1. Allows for the use of low flow oxygen without using the anesthesia circuit
  2. Typically used for monitored anesthesia care
  3. Can be used in Emergency without Machine power
  4. Jet ventilation
70
Q

What is the Function of The second stage pressure regulator

A
  1. Supply constant pressure to the flow control valves and the proportioning system
  2. Protects against fluctuations of pipeline pressure
  3. Ensures that oxygen is the last flowing gas
71
Q

What pressures does the 2nd stage pressure regulator lower the pressure to?

A

14-35psi
oxygen….14
Nitrous..26

72
Q

Components of low pressure system

A
  1. Flowmeters
  2. Hypoxia prevention safety devices
  3. Unidirectional valves (info only)
  4. Pressure relief devices (info only)
  5. Anesthesia vaporizers/vaporizer manifold (info only)
  6. Common gas outlet
73
Q

Pressure in the low pressure system is slightly above atmospheric.T/F

74
Q

Where is the low Pressure system located

A

Between the flow control devices and common gas outlet

75
Q

What are the flowmeters made up of

A

Flow control valves

Flow Tube

76
Q

What are the functions of the Flow meter

A
  1. Regulates the flow of Gases entering the breathing circuit.
  2. Directs the selected flows to the vaporizer.
77
Q

Name 2 ways that the flowmeter control the flow of gases

A

1.Mechanically and electronically

78
Q

Why are the oxygen and Nitrous flow linked mechanically-Mechanic and electronically

A

To prevent hypoxic gas mixture.

79
Q

The Flow tubes are also known as the ?

A

Thorpe tubes.

80
Q

2 types of Flow exist in the Thorpe Tubes

A

Lamina Flow-Bottom- low flow-Viscosity of gas

Turbulent Flow-Top-High flow-Density of gas

81
Q

What should be the position of the oxygen flowmeter.

A

It should be Farthest to the right.(Prevents hypoxic mixture)

82
Q

What is the use of The LinK Proportioning system

A

Prevent Hypoxic gas mixture admin. by proportionally reducing the nitrous levels.

83
Q

What is the Nitrous:oxygen ratio that is necessary to prevent hypoxic gas mixture.

A

75%n:25%0xy

84
Q

What are Features of the Link -25 Proportion limiting device(Datex-Ohmeda)

A

oxygen and nitrous are mechanically linked.
N:O is in a 3:1 ratio
29 O teeth:15 N2O teeth
Balanced secondary regulator gives oxygen at 30PSIG
Nitrous pressure based on oxygen pressure.
Maintain oxygen concentration of at least 25%

85
Q

Features of the Sensitive oxygen ratio controller system?

A
  1. Pneumatic-mechanical interlock
  2. openeing oxygen flow creates a back pressure in the chamber opening nitrous flow.
  3. Maintains a ratio of 25% oxygen to 75% nitrous oxide flow into breathing circuit
  4. Needs at least 200 mL/min to operate
86
Q

What does the Common gas outlet do

A

Receives all the gases and vapors from the machine and delivers the mixture to the breathing circuit

87
Q

Common gas outlet Features

A

15mm female slip Joint fitting

Should not be used to administer supplemental oxygen to a patient

88
Q

Name the 5 Pathway of oxygen

A
  1. Flow to the fresh gas flowmeter
  2. Powers the oxygen flush valve
  3. Activates the fail-safe valve/mechanism
  4. Activates the oxygen supply low pressure alarm
  5. Compresses the bellows of the ventilator
89
Q

What check do we perform on the anesthesia machine before each patient

A

Circuit Check(positive pressure check)

90
Q

How often is the complete check done in the anesthesia circuit?

91
Q

State the 9 steps of machine check

A
  1. Emergency equipment
  2. High pressure system check
  3. Low pressure system check
  4. Oxygen sensor
  5. Scavenging system
  6. Ventilator
  7. Breathing system
  8. Monitors
  9. Final check
92
Q

What components are included in the Emergency equipment check

A
  1. Ambu bag
  2. Back up oxygen cylinder (>1000 psig)
  3. Functioning suction with yankauer
93
Q

Describe High Pressure system check

A 
1.  Check O2 cylinder supply
Open cylinder and check PSI (>1000)
Close cylinder
Depress O2 flush
2.Disconnect pipeline supply from the wall
94
Q

Describe Low pressure system check

A 
1.  Check vaporizers
Mounted, filled, and interlock works
2.  Check low pressure system
Suction bulb to common gas outlet 
Squeeze bulb until fully collapsed
Verify bulb stays deflated for 10 seconds
3. Turn on master switch
Listen for oxygen disconnect alarm
Reconnect pipeline pressure
Ensure pipeline pressure is > 50 psig
4.  Test flowmeters
Adjust flow of all gases through their range
Attempt to create a hypoxic mixture
95
Q

Describe Oxygen sensor check

A
  1. Calibrate O2 sensor(Remove oxygen sensor to be exposed to room air)
    Ensure reads 21% in room air
    Verify low O2 alarm (set to 30%)
    Re-install sensor and flush with O2 - now reads > 90%
    2.Install breathing circuit
96
Q

Describe the scavenging system check

A
  1. Ensure proper connection of scavenging system
  2. Adjust waste gas vacuum
  3. Fully open APL valve
  4. Occlude Y piece and ensure gauge reads < 10 cm H2O
  5. With Y piece occluded, depress O2 flush ensure the reservoir bag distends, and the pressure gauge reads < 10 cm H2O
97
Q

Describe the Vent check

A

Ventilation system
1. Place a second breathing bag on Y piece
2. Set appropriate ventilator setting for next patient
3. Set O2 @ 5 L
4. Turn ventilator on and fill bellow with flush valve
5. Verify bellows deliver adequate tidal volumes
6. Check function of unidirectional valve
7. Squeeze bag and check over pressure alarm
8. Set to manual ventilator mode
9. Ensure ability to manual ventilate
10 Turn off ventilator and remove breathing bag

98
Q

Describe the positive pressure check(Breathing system) leak test

A
  1. Set all gas flow to zero
  2. Close APL valve an occlude the Y piece
  3. Pressurize the breathing system to 30 cm H2O
  4. Ensure pressure remains fixed for at least 10 seconds
  5. Fully open APL valve and allow bag to self deflate and flows through the scavenger
99
Q

Describe the final Check On the Machine check

A
  1. Vaporizers off
  2. APL valve open
  3. Selector switch set to bag
  4. All flowmeters set to zero
  5. Suction available
  6. Monitors set appropriately
  7. Circuit on, CO2 sampling line connected, & correct mask on
100
Q

Before the Final check on the Machine check what should you do

A

Set the Anesthesia monitors for the next patient.

101
Q

What Do Hypoxia Prevention devices do

A

1.A proportioning system is to prevent the creation and delivery of hypoxic mixtures
2.Designed to prevent an operator selected delivery of oxygen concentration below 21%
3.The machine automatically limits the amount of nitrous oxide so a hypoxic mixture cannot be delivered
4Accomplished with a pneumatic-mechanical interface between the oxygen and nitrous oxide flows

Anesthesia Machines (2 decks)

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