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VT Surgical Nursing > Anesthetic Machines > Flashcards

Anesthetic Machines Flashcards

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1
Q

What are the purposes of endotracheal tubes?

A

They are to:
Maintain an open airway
Minimize risk of pulmonary aspiration of blood, stomach contents, etc.
Ease supplemental oxygen flow
Allow anesthetist to ventilate patient

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2
Q

What are the 2 types of endotracheal tubes?
What differentiates one from the other?

A

Murphy tube - an endotracheal tube that has a murphy eye.
Cole tube - an uncuffed tube that has an abrupt decrease in diameter near the patient end. Used in species with no flexibility in their trachea. The narrow tip sits in the trachea and the transition to the wider portion of the tube acts as a seal at the tracheal opening.

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3
Q

What are the advantages and disadvantages of PVC endotracheal tubes?

A

They have reduced chance of kinking but more chance of causing tissue trauma.

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4
Q

What are the advantages and disadvantages of red rubber endotracheal tubes?

A

They have a reduced chance of traumatizing tissue but dry and crack as they age.

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5
Q

What are the advantages and disadvantages of silicone endotracheal tubes?

A

They have a reduced chance of traumatizing tissue and of kinking. The chance of them kinking can be further reduced by embedding them with spirals of metal or vinyl.

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6
Q

What is the Murphy eye in an endotracheal tube?

A

It is a hole in the side of the end of the endotracheal tube that prevents asphyxiation if the end of the tube is blocked with mucus.

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7
Q

What is the cuff on an endotracheal tube?

A

It is an inflatable sac near the end of the tube that creates a seal between the tube and the trachea.

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8
Q

What are the two types of cuff on endotracheal tubes? Which is preferred?

A

High volume low pressure and low volume high pressure. High volume low pressure because with careful use this type is less likely to damage the trachea.

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9
Q

What are the 4 general systems in an anesthesia machine?

A

Carrier gas supply
Anesthetic vaporizer
Breathing circuit
Scavenging system

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10
Q

What are the 2 most common sizes of compressed gas cylinders used to store oxygen in veterinary medicine? What are their capacities?

A

E- tank - 660 L capacity
H- tank - 6900 L capacity

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11
Q

How should a technicians work day start an end with respect to anesthetic machines?

A

The day should start with turning on the oxygen supply and checking the supply in the primary and backup tanks.

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12
Q

True or false. Oxygen can be exposed to sources of ignition such as flame or sparks.

A

False

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13
Q

True or False. the oxygen supply should only be turned on when it is attached to the yoke or a pressure regulator?

A

True

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14
Q

True or False. It is ok to have tanks of compressed gases unsecured in the hospital.

A

False

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15
Q

What does the acronym PISS stand for?

A

Pin Index Safety System. It is a system to ensure that only appropriate gas tanks are attached to anesthetic machines. It is used with E- tanks.

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16
Q

What does the acronym DISS stand for?

A

Diameter Index Safety System. It is a system to ensure that only appropriate gas tanks are attached to anesthetic machines. It is used with H- tanks.

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17
Q

What is the purpose of the tank pressure gauge?

A

It tells you how much compressed gas is in the tank.

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18
Q

True or False. If the tank pressure gauge reads zero it always means that it is empty.

A

False. The tank pressure gauge should only be read once the oxygen supply has been turned on.

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19
Q

True or False. It is not possible to calculate how long your oxygen supply will last based on the tank pressure gauge reading.

A

False. The pressure in the tank can be converted to Liters of oxygen. Oxygen is delivered to patients in Liters per minute so the length of time an oxygen supply will last can be calculated.

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20
Q

What is the purpose of the pressure reducing valve.

A

It reduces the pressure of the oxygen coming from the tank from 1900-2200psi /13,000-15,000 kPa to 40 to 50 psi (about 275 to 345 kPa)

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21
Q

What is the purpose of the line pressure gauge?

A

It measures the pressure of the gas in the line between the pressure reducing valve and the flow meters.

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22
Q

What is the purpose of the oxygen flow meter?

A

It allows a controlled volume of oxygen to be delivered to the patient at a safe pressure for the patients’ lungs.

23
Q

What is the oxygen flush valve

A

It is device that allows the operator to deliver pure oxygen at a rate of 35-70L/minute bypassing the vaporizer and the oxygen flow valve. It delivers oxygen into the common gas outlet or into the breathing circuit of a rebreathing system.

24
Q

What is the function of the anesthetic vaporizer?

A

The function of the vaporizer is to convert a liquid anesthetic (eg. isoflurane, sevoflurane) to a gaseous state and to add controlled amounts of this vaporized anesthetic to the carrier gases to be delivered to the patient.

25
Q

What types of anesthetic gases require a precision vaporizer?

A

High vapor pressure gases that evaporate readily.

26
Q

Why can’t precision vaporizers be used in the anesthetic circuit?

A

Vaporizers within the circuit rely on the respiratory drive of the patient to move the gases through the breathing circuit. Precision vaporizers create too much resistance to the flow of gas for this to be possible.

27
Q

What are the factors that can affect vaporizer output and list those that have been compensated for in modern precision vaporizers.

A

1.temperature, 2.carrier gas flow rate
3.respiratory rate and depth & 4.back pressure
1, 2 & 4 have been compensated for in modern precision vaporizers. 3. do not affect the function of precision vaporizers because they are located outside the anesthetic circuit.

28
Q

What factor, despite being compensated for in the vaporizer can affect anesthetic gas concentration in the breathing circuit

A

Carrier gas flow rate.

29
Q

What are the features that identify which vaporizer is meant to deliver which inhalant anesthetic

A

Colour coding. Additionally the appropriate inhalant anesthetic is generally written on the vaporizer.

30
Q

What component of the vaporizer is used to control the quantity of inhalant anesthetic being delivered to the patient?

A

The control dial

31
Q

How does the operator knows whether the vaporizer needs to be refilled?

A

This is done by looking at the indicator window and ensuring that the liquid is between the upper and lower lines.

32
Q

What is the vaporizer inlet port?

A

This is the port that connects the oxygen flowmeters to the vaporizer.

33
Q

What is the vaporizer outlet port?

A

It is the port where Oxygen and inhalant anesthetic gases exit the vaporizer on their way to the breathing circuit.

34
Q

What is the common gas (Fresh Gas) outlet

A

In some anesthetic machines the vaporizer outlet port leads to connecting tube to which the breathing circuits (non-rebreathing and rebreathing) are attached. This is the common gas outlet.

35
Q

What is the function of the breathing circuit in an anesthetic machine?

A

It circulates fresh gases (carrier and inhalant anesthetic) to patient and conveys waste gases to scavenging system.

36
Q

What are the 3 types of breathing circuits?

A

Closed/total rebreathing system, semi-closed/partial rebreathing system and non-rebreathing system

37
Q

List the parts of a rebreathing circuit

A

Fresh gas inlet, unidirectional flow valves (inhalation, exhalation), reservoir (rebreathing) bag, pop-off (pressure relief) valve, CO2 absorbent canister, pressure manometer, negative pressure relief valve &
Corrugated breathing tubes

38
Q

What are the 2 types of unidirectional valves?

A

The inspiratory and expiratory valves.

39
Q

What are the functions of the unidirectional valves?

A

They ensure that the flow of gas in the breathing circuit is in one direction.

40
Q

Where are the unidirectional valves located?

A

The inspiratory (inhalation) unidirectional valve is located at the attachment point for the inspiratory breathing tube.
Expiratory (exhalation) unidirectional valve is located at the attachment point for the expiratory breathing tube

41
Q

Describe the pop off valve

A

It is the point of exit of anesthetic gases from the breathing circuit.

42
Q

What dangers are associated with the pop off valve?

A

If the pop off valve is left closed, pressure rapidly builds up in the breathing circuit causing trauma to the lungs of the patient and decreased cardiac output. If not corrected rapidly it is fatal.

43
Q

What is the function of the CO2 absorbent cannister?

A

When a rebreathing system is being used It removes CO2 from the exhaled gases from the patient before the gases are returned to the patient.

44
Q

What factors would indicate to a technician that the CO2 absorbent granules should be changed?

A

They become hard and brittle, the develop an off white color. If there is a color indicator 1/3 - 1/2 of the granules change color. During anesthesia if the capnometer reads >0 at peak inspiration. After 6-8 hours of use or every 30 days.

45
Q

What is the function of the positive pressure manometer?

A

To measure the pressure of gases in the breathing circuit

46
Q

Why is it important to know the pressure of gases in the breathing circuit?

A

The airways and lungs are part of the breathing circuit. It is important to know what pressure they are being subjected to because certain pressures can be damaging.

47
Q

What is the maximum acceptable pressure in the breathing circuit when a small animal is receiving positive pressure ventilation?

A

20cm H20

48
Q

What is the function of the negative pressure relief valve?

A

It is a safety feature that if a partial vacuum develops in the breathing circuit the patient receives some oxygen in the form of room air.

49
Q

What is the function of the corrugated breathing tubes?

A

The carry anesthetic gases to and from the patient.

50
Q

What size corrugated breathing tube should be used with a small animal weighting 9kg

A

22mm diameter tubes

51
Q

What is the benefit of a universal F-circuit?

A

It conserves patient heat because the inspiratory tube is located inside the expiratory tube.

52
Q

What is the equation that tells us the minimum volume of a reservoir bag for a particular size of patient?

A

At least 50ml/kg of body weight

53
Q

What are the functions of the reservoir bag?

A

It is a flexible storage reservoir for anesthetic gases, a visual indicator of anesthetic rate and depth, a tool to confirm ET tube placement, a means of delivering anesthetic gases to the patient & an indicator that the pop off valve is closed

VT Surgical Nursing (3 decks)

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