Anesthesia Machines (Kane) Exam 3 Flashcards
When were the Anesthesia machine standards first established and reapproved?
a) 1969 and 2006
b) 1979 and 2005
c) 1989 and 2005
d) 1999 and 2010
b) standards
established in 1979
and
reapproved in 2005
Slide 2
Which organization is responsible for these standards?
a) American Society for Quality
b) American National Standards Institute
c) American Society for Testing and Materials
d) International Organization for Standardization
c) American Society for Testing and Materials
Slide 2
Which of the following is a function that it anesthesia machine should provide?
a) Accurate and safe gas delivery
b) Means for ventilating patients
c) Electrical outlets
d) All of the above
d) All of the above
Slide 3
Which of these is NOT mentioned as a function of the anesthesia machine?
a) Providing housing for monitoring devices
b) Providing a place to prop your feet
c) Providing patient transport
d) Providing storage/shelving
c) Providing patient transport
to prop your feet - HAHA, Dr. Kane!
Slide 3
What functions are enabled when the master switch is ON?
a) Only pneumatic functions
b) Only electrical functions
c) Both pneumatic and electrical functions
d) Neither pneumatic nor electrical functions
c) Both pneumatic and electrical functions
Slide 4
What happens to alarms and safety features when the master switch is ON?
a) They are disabled
b) They are activated
c) They remain unchanged
d) They are bypassed
b) They are activated
Slide 4
What can be bypassed when the master switch is ON?
a) Battery charger
b) Oxygen flush valve
c) Power-up protocol
d) Electrical outlets
c) Power-up protocol
Slide 4
True or False
Electronic functions are enabled when the master switch is OFF
FALSE!
Electronic functions are disabled when the master switch is OFF
Slide 4
When the master switch is OFF, which functions remain operational? (Select 4)
A) Pneumatic functions
B) Battery charger
C) Electrical outlets
D) Alarms and safety features
E) Oxygen flush valve
F) Auxilliary oxygen flowmeter
B) Battery charger
C) Electrical outlets
E) Oxygen flush valve
F) Auxilliary oxygen flowmeter
Big Elephants Often Amaze
Slide 4
What types of indicators can a power failure have?
a) Visual only
b) Audible only
c) Neither
d) Both
d) Both
*Kane: Something to tell you the machine is NOT ON should be visual or audible, preferably BOTH
*
Slide 5
Why should the machine be kept plugged in?
a) To ensure continuous operation
b) To maintain battery backup at the highest level
c) To prevent overheating
d) To reduce noise levels
b) To maintain battery backup at the highest level
Slide 5
The duration of the backup depends on which factor?
a) The type of power failure
b) The size of the machine
c) The power usage
d) The room temperature
c) The power usage
manual ventilation vs ventilation
Slide 5
In the context of the images, what is crucial to monitor on the Anesthesia machine? Select 2
a) Oxygen levels
b) Battery life
c) Patient monitor settings
d) Power failure
b) Battery life
d) Power failure
Slide 6
Anesthesia Machine should be plugged into the ____ outlets to ensure continuous operation during a power failure.
A. Red
B. White
C. Blue
D. Yellow
A. RED outlets
Slide 7
True or False
The electrical outlets on the machine are intended to power anesthesia monitors
True
Slide 8
Where should other appliances be plugged in?
a) Into the machine’s outlets
b) Into the hospital main
c) Into the backup generator
d) Into any available outlet
b) Into the hospital main
Slide 8
If requirements exceed the outlet capacity, the ____ breaker will activate
If requirements exceed the outlet capacity, the circuit breaker will activate
Slide 8
Which of the following is not a part of the pneumatic system?
a) High pressure
b) Intermediate pressure
c) Medium pressure
d) Low pressure
c) Medium pressure
Slide 9
The high-pressure system receives gases from cylinders at high, ____ pressure at ____ psi.
variable, 25-2200 psi
Slide 11
What are the functions of the first stage pressure regulator in the high-pressure system? Select two.
a) Increases the pressure to 50 psi
b) Reduces the pressure to a lower, more constant level
c) Maintains the high pressure
d) Reduces pressure to 45 psi
b) Reduces the pressure to a lower, more constant level
d) Reduces pressure to 45 psi
Slide 11
True or False
Without regulators, the flowmeters would have constant pressure.
FALSE
Without regulators would constantly change flowmeters
Slide 11
Which of the following are functions of the hanger yoke? (Select 3)
a) Orients and supports the cylinder
b) Measures gas flow
c) Provides a gas-tight seal
d) Ensures a unidirectional flow
e) Monitors patient gas flow
a) Orients and supports the cylinder
c) Provides a gas-tight seal
d) Ensures a unidirectional flow
Slide 13
How many yokes are at least required for oxygen and nitrous oxide?
a) One for each
b) Two for each
c) One for oxygen and two for nitrous oxide
d) Two for oxygen and one for nitrous oxide
a) a least 1 yoke for oxygen and 1 for nitrous
Slide 13
Match the parts of a Yoke to its corresponding definitions
A) Body - 1) Principal framework – (Square part)
B) Retaining screw - 2) Tightens cylinder (clamp)
C) Nipple - 6) Through which gas enters machine
D) Index pins - 5) Prevents attaching an incorrect cylinder
E) Washer - 4) Forms seal between cylinder and yoke – just one
F) Check valve assembly - 3) Ensures unidirectional flow
Slide 14
What is one of the primary functions of the check valve assembly?
a) Measure gas flow
b) Prevent gas from exiting the machine when there is no cylinder in the yoke
c) Allow gas to exiting the machine when there is no cylinder in the yoke
d) Vent excess gas pressure
b) Prevent gas from exiting the machine when there is no cylinder in the yoke
Slide 15
What does the check valve assembly prevent when two cylinders are in the yoke and ON?
a) Gas from exiting the machine
b) Gas from being transferred from a lower pressure cylinder to a higher pressure cylinder
c) Gas from being transferred from a higher pressure cylinder to a lower pressure cylinder
d) Gas from entering the machine
c) Gas from being transferred from a higher pressure cylinder to a lower pressure cylinder
Slide 15
What must be present for each gas supplied by cylinders?
a) Flowmeter
b) Regulator
c) Cylinder pressure indicator
d) Check valve
c) Cylinder pressure indicator
Slide 17
Which of the following statements about Bourdon tubes are correct? (Select 2)
a) Bourdon tubes are straight hollow tubes.
b) Bourdon tubes are curved hollow tubes.
c) Bourdon tubes are used in digital pressure devices.
d) Bourdon tubes are the working mechanism for analogue pressure devices.
e) Bourdon tubes keep a constant curve with pressure changes.
f) Bourdon tubes are filled with liquid.
b) Bourdon tubes are curved hollow tubes.
d) Bourdon tubes are the working mechanism for analogue pressure devices.
Slide 17
What functions do Bourdon tubes perform in a cylinder pressure indicator? (Select 2)
a) Measure temperature changes.
b) Transmit motion to the gauge.
c) Indicate the amount of gas remaining.
d) Increase or decrease their curve with pressure changes.
e) Provide a gas-tight seal.
b) Transmit motion to the gauge.
d) Increase or decrease their curve with pressure changes.
Slide 17
In what units is the gauge required to be calibrated? (select 2)
a) Pascals (Pa)
b) Kilopascals (kPa)
c) may also be in PSI
d) Millimeters of mercury (mmHg)
b) Kilopascals (kPa)
c) may also be in PSI
Slide 17
From where does the intermediate pressure system receive gases? (select 2)
a) Directly from the gas cylinders
b) From the pressure regulator
c) From the patient’s breathing circuit
d) From the pipeline
b) From the pressure regulator
d) From the pipeline
Slide 19
Which of the following statements are true about the 1st stage regulator and pipeline pressure affecting the intermediate pressure system? (Select 2)
a) The 1st stage regulator reduces gas pressure to 50-55 psi.
b) The 1st stage regulator reduces gas pressure to 45 psi.
c) The pipeline delivers gas at a pressure of 45 psi.
d) The pipeline delivers gas at a pressure of 50-55 psi.
b) The 1st stage regulator reduces gas pressure to 45 psi
d) The pipeline delivers gas at a pressure of 50-55 psi
Slide 19
What happens to the pressure in the intermediate pressure system if the master switch is OFF?
a) It remains the same
b) It increases slightly
c) It decreases slightly
d) It drops to 0
d) It drops to 0
Slide 19
Which components are included in the intermediate pressure system? (Select all that apply)
a) Pneumatic part of the master switch
b) Pipeline inlet connections and indicators
c) Piping
d) Oxygen pressure failure devices
e) Oxygen flush valve
f) Flow control valves
All of the above!
Kane: Lots of the front kind working stuff is in the Intermediate pressure system
“Proud People Practice Open Oxygen Flow”
Slide 19
What is the primary function of pipeline inlet connections?
a) To measure gas flow
b) To act as an entry point for gases from pipelines
c) To regulate gas pressure
d) To store medical gases
b) To act as an entry point for gases from pipelines
Slide 21
Which gases are required for pipeline inlet connections according to the lecture?
a) Oxygen and nitrous oxide
b) Oxygen and carbon dioxide
c) Air and nitrogen
d) Helium and oxygen
a) Oxygen and nitrous oxide
Require oxygen and nitrous; most have air
Slide 21
What type of fittings are used for pipeline inlet connections?
a) NPT fittings
b) Luer-lock fittings
c) DISS fittings
d) Barbed fittings
c) DISS fittings
Slide 21
Pipeline inlet connections must contain ____ check valve to prevent gas from returning to the pipeline.
unidirectional check valve
Slide 21
Which of the following statements about pipeline pressure indicators are correct? (Select 3)
a) They are required for each gas monitored.
b) They are usually found on the front of the anesthesia machine.
c) They can have LED displays in newer machines.
d) They are optional for some gases.
a) They are required for each gas monitored.
b) They are usually found on the front of the anesthesia machine.
c) They can have LED displays in newer machines.
Slide 23
Indicator must be on ____ side…if ____ and cylinder valve open, adequate pressure reading until cylinder is 0.
pipeline, downstream
Slide 23
What is the primary function of the piping inside the machine?
a) To regulate pressure
b) To measure gas flow
c) To connect components inside the machine
d) To monitor patient vitals
c) To connect components inside the machine
Kane - connects everything inside the machine to where it leave thru the common gas outlet
Sldie 25
The piping must be able to withstand how many times the intended pressure?
A. 2x
B. 3x
C. 4x
D. 5x
C. 4x
Kane - “shock worthy” if the pressure goes haywire, it shouldn’t damage the pipe-system inside the anesthesia machine
Slide 25
What is the maximum allowable leak rate for the piping inside the machine?
A. 15 ml/min
B. 20 ml/min
C. 25 ml/min
D. 30 ml/min
C. 25 ml/min
Flow meters to go to sleep 8L/min. If you lost 25ml/min, not a big difference or noticible leak
Slide 25
What happens if the oxygen pressure is reduced to 30 psi?
A. It increases or maxes out nitrous delivery
B. It decreases or discontinues nitrous delivery
C. It increases the oxygen flow in the ventilator
D. It triggers an immediate shutdown with one way valves.
B. It decreases or discontinues nitrous delivery
It tries to maximize the oxygen pressure to deliver O2 as a safety system, even if nitrous is used as anesthetic. The patient may wake up, so think of propofol or turn on back up tanks.
Continues until oxygen flow ceases
Slide 26
What is the minimum oxygen concentration maintained at the common gas outlet if oxygen pressure drops?
A. 21%
B. 18%
C. 19%
D. 20%
C. 19%
Slide 26
An alarm sounds within __________ seconds of detecting an oxygen pressure drop.
A. 5
B. 7
C. 10
D. 12
A. 5 seconds
Slide 26
During a machine check, the oxygen failure safety device is __________ to ensure it functions correctly.
A. Checked manually
B. Simulated
C. Bypassed
D. Disconnected
E. Tested electronically
B. Simulated
Slide 26
Where does the oxygen flush receive oxygen from?
A. Only from the cylinder pressure regulator
B. Only from the pipeline inlet
C. From both the pipeline inlet and cylinder pressure regulator
D. From the common gas outlet
C. From both the pipeline inlet and cylinder pressure regulator
Slide 27
What is the primary purpose of the oxygen flush?
A. To deliver air to the patient
B. To provide nitrous oxide
C. To regulate pressure within the machine
D. To send oxygen to the common gas outlet
D. To send oxygen to the common gas outlet
Kane - the oxygen flush can blow up the reservoir bag when we don’t have a good mask fit.. probably need to work on our seal on the mask..
slide 27
What is the flow rate range for the oxygen flush?
A. 10-25 L/min
B. 20-50 L/min
C. 35-75 L/min
D. 40-80 L/min
C. 35-75 L/min
slide 27
The standards that the oxygen flush button must have include:
Select 3
A. Operable with one hand
B. Ability to deliver nitrous oxide
C. Designed to minimize accidental use
D. Flow rate between 40-75L/min
E. Delivers only oxygen
F. Self - opening
Can be considered for emergency purposes
A. Operable with one hand
C. Designed to minimize accidental use - “submerged inside machine”
E. Delivers only oxygen - single purpose
Flow rate is 35-75L/min
It is Self-closing - push to turn on, release to turn off
Slide 27
Why might the oxygen flush cause patient awareness during anesthesia if it gets stuck on?
A. It increases the concentration of volatile gas
B. It dilutes out the volatile gas
C. It decreases the oxygen concentration
D. It increases the nitrous concentration
B. It dilutes out the volatile gas
Slide 28
What is one of the potential hazards of the oxygen flush if it gets stuck on?
A. It may cause tracheal fistulas
B. It may cause barotrauma
C. It may increase nitrous delivery
D. It may reduce oxygen flow
B. It may cause barotrauma
Slide 28
The flow adjustment control:
Select 2
A. Regulates gas flow for one gas
B. Must be below the flowmeter
C. Can have multiple controls per gas
D. Uses hydraulic mechanisms
E. Must be adjacent to its flowmeter
A. Regulates gas flow for one gas -one knob per gas, air, oxygen and nitrous
E. Must be adjacent to its flowmeter
The knobs or valves
Slide 30
What types of mechanisms can be used for flow adjustment control? Select 2
A. Manual only
B. Mechanical
C. Pneumatic only
D. Hydraulic only
E. Electronic
B. Mechanical
E. Electronic
slide 30
The oxygen flow knob must be ____ and ____ than the knobs for other gases.
A. Fluted, larger
B. Smooth, smaller
C. Textured, smaller
D. Smooth, larger
E. Fluted, smaller
A. Fluted, larger
Looks and feels different. Fluted (deep crevices)
Air and nitrous are smaller and smoother knobs
Slide 30
Where is the low pressure system located in relation to flow control devices?
A. Upstream
B. Parallel
C. At the same level
D. Downstream
E. Perpendicular
D. Downstream
Closer to the patient
slide 32
The pressure in the low pressure system is slightly above __________ and variable.
A. Atmospheric
B. Sea level
C. Normal
D. Standard
A. Atmospheric
Depends on flow from flow-meters and backpressure from breathing circuit
Slide 32
Which components are NOT included in the low pressure system?
A. Flowmeters
B. Hypoxia prevention devices
C. Unidirectional valves
D. Pressure relief devices
E. Oxygen flush valve
E. Oxygen flush valve
Flowmeters
Hypoxia prevention devices
Unidirectional valves - no backflow
Pressure relief devices
Common gas outlet - where the low pressure system stops
Friends Help Us Prevent Confusion:
Slide 32
What is the primary function of flowmeters?
A. To regulate gas pressure passing through
B. Indicates rate that gas is passing through
C. To mix different gases passing through
D. To store gases inside the machine
B. Indicates rate that gas is passing through
In Liters per min
Slide 34
Which features are true about the Thorpe tube in the flowmeter? Select 4
A. It is a vertical glass tube
B. It has the smallest diameter at the bottom
C. It has the smallest diameter at the top
D. It has a free-floating indicator
E. It has a stop at the top of the tube
F. It has a horizontal design
G. It a vertical plastic tube
A. It is a vertical glass tube
B. It has the smallest diameter at the bottom
D. It has a free-floating indicator - measures the level of flow, could be a ball or flat top
E. It has a stop at the top of the tube
Flow scale goes from low number to high number at the top of the tube
Slide 34
The flowmeter must be marked with appropriate ____ and ____ symbol.
A. color, chemical
B. size, weight
C. shape, number
D. color, numerical
E. texture, chemical
F. design, letter
A. color, chemical
slide 34
What does the 2nd stage regulator maintain?
A. 5-10 psi
B. 10-20 psi
C. 14-30 psi
D. 20-40 psi
C. 14-30 psi
Why is the 30psi imporant? At the oxygen failure alarm. If its <30 it will alarm
Slide 34
Where do the gases empty after passing through the flowmeter?
A. Into a separate compartment
B. Directly to the patient
C. Into a common manifold
D. Back into the cylinder
C. Into a common manifold and go to the vaporizer
Slide 34
What is the normal gas flow direction in a flowmeter?
A. Top-bottom and right-left
B. Bottom-top and left-right
C. Bottom-top and right-left
D. Top-bottom and left-right
B. Bottom-top and left-right
Slide 36
According to the standard, where should the oxygen flowmeter be placed?
A. On the left side
B. In the center
C. On the right side
D. At the bottom
C. On the right side
should be the closest thing to the patient for safety. less likely to get a hypoxic mixture
We care if oxygen leaks. If it were in the 1st or 2nd flow meter, the oxygen would be lost
Ohmeda is also known as Daytex
Slide 36
For hypoxia prevention, what is minimum oxygen flow setting when master switch is turned ON?
A. 10-50 ml/min
B. 50-250 ml/min
C. 100-300 ml/min
D. 200-400 ml/min
B. 50-250 ml/min
When turned ON
Slide 38
The minimum oxygen ratio uses mechanical linkage with ____ and the link engages when the oxygen concentration reaches ____%.
A. nitrous, 10
B. air, 15
C. nitrous, 25
D. carbon dioxide, 20
E. nitrous, 30
C. nitrous, 25%
If you are giving both O2 and nitrous as part of your anesthtic, it won’t allow you to just give ONLY nitrous. The machine forces you to have oxygen on at a certain ratio
Slide 38
Unidirectional valves are located between the ____ and common gas outlet.
A. vaporizer
B. oxygen flush valve
C. flowmeter
D. breathing circuit
E. gas cylinder
A. vaporizer
Slide 40
Which statements are true about unidirectional valves? Select 2
A. They are located between the vaporizer and flowmeter.
B. They are upstream from the oxygen flush valve.
C. They increase gas pressure from the flush or breathing circuit.
D. They lessen back pressure from flush or breathing circuit.
E. They are downstream from the oxygen flush valve
B. They are upstream from the oxygen flush valve.
D. They lessen back pressure from flush or breathing circuit. - Prevents pumping effect
Slide 40
Pressure relief devices are located near the ____.
A. flowmeter
B. vaporizer
C. oxygen flush valve
D. common gas outlet
E. breathing circuit
D. common gas outlet
Slide 41
What happens when the preset pressure is exceeded in the machine?
A. The device shuts down
B. The device opens to the atmosphere and vents
C. The device increases the pressure
D. The device activates an alarm
B. The pressure relief device opens to the atmosphere and vents
Lots of flow coming in, APL is closed and bypassed scavenging.. leaks going on in funny places. Last ditch effort to vent excess pressure..
Slide 41
Pressure relief devices limit the ability of the machine to provide adequate pressure for ____.
A. oxygen ventilation
B. nitrous oxide flow
C. jet ventilation
D. machine gas mixing
E. anesthesia ventilation
C. jet ventilation
Usually jet ventilate by plugging directly into the wall, or have its own tank and cable. Its a secondary system and don’t use the machine all the time
Kane - Manual process. Sending a jet of oxygen through a rigid bronchoscopy, keeps airway open to place a stent into a stenotic airway. Delivers 75L of O2 to patient and then pt has passive exhalation.. not good exhalation, breath stacking, barotrauma.
Slide 41
The common gas outlet receives all gases from the machine and delivers the ____ to the circuit.
A. mixture
B. oxygen
C. nitrous oxide
D. air
A. mixture
Delivers into the inspiratory limb of the circle system
Slide 42
Which statements are true about the common gas outlet? Select 2
A. It must be easy to disconnect
B. It delivers the gas mixture to the circuit
C. It should be used for supplemental oxygen
D. It must be difficult to disconnect
E. It should not be used for supplemental oxygen
F. It is primarily used for nitrous oxide delivery
D. It must be difficult to disconnect
E. It should not be used for supplemental oxygen -Can cause delays in emergencies
If you can’t get positive pressure during machine checks.. think about the common gas outlet being swtiched on
Slide 42
The common gas outlet should not be used for supplemental oxygen because:
A. It is quick in emergencies
B. It delivers inhalational agents
C. It is difficult to operate
D. It is prone to leaks
B. It delivers inhalational agents
Slide 42
When should the alternative oxygen control be activated?
A. When the gas flow is too low
B. When the oxygen concentration is too high
C. During regular maintenance
D. In case of electronic power failure
E. In case of hydrolic power failure
D. In case of electronic power failure
Independent of all other flow meters in the machine just prior to vaporizer
If you push the off button, everything on the machine turns off. You JUST get oxygen..this is for emergency purposes
Slide 44
