Basics Exam 1 Anesthesia Delivery System Flashcards by Krista Walls

What is more common: misuse or equipment failure?

Misuse is 3x more common than equipment failure

Misuse occurs due to lack of familiarity, errors in preparation, maintenance, or deployment.

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What does the anesthesia machine control regarding gas?

The machine controls flow and reduces pressure of supplied gases to a safe level

It vaporizes volatile anesthetics into a final gas mixture.

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What is the primary function of an anesthesia machine?

Deliver O2, deliver inhalation anesthetics, and remove CO2

This process is essential for maintaining patient safety during anesthesia.

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What are the two main manufacturers of anesthesia machines?

Datex and Drager

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What type of anesthesia machine is compatible with MRI?

MRI compatible anesthesia machine has no ferrous (iron) components

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What are the components of an anesthesia machine?

Vaporizers
Anesthetic breathing circuit
Ventilator
Scavenging system
Suction regulator

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What does the monitoring system of an anesthesia machine include?

Vitals
Inhaled concentrations of gases
Exhaled concentrations of gases

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What is the pressure range for high pressure in gas cylinders?

Up to 2200 psi for O2 and 750 psi for nitrous oxide

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What is the intermediate pressure for cylinder regulators?

45 psi

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What happens if pipeline O2 pressure is lost?

The delivery will begin from the cylinder without warning of low O2 supply pressure

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What should always be done after a machine check?

Always turn off the cylinder

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What do pressure regulators do?

Reduce high and variable pressures

They ensure optimal use of cylinders.

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What is the purpose of a fail-safe valve?

Stops other gas flow if O2 supply pressure fails

This prevents hypoxic gas mixtures.

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What is the role of the oxygen analyzer in an anesthesia machine?

It is the most important monitor on the machine

It measures oxygen levels downstream from flowmeters.

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What is the primary function of a free floating/check valve?

Promote unidirectional flow

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What does the Bourdon pressure gauge measure?

Measures pipeline and cylinder pressures

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What color coding system is used in central gas supply pipelines?

Color coded for air, nitrous oxide, and oxygen

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What is the purpose of the DISS?

Noninterchangeable gas-specific threaded connections

Prevents misconnections at wall outlet and machine inlet.

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What is the pressure from central gas supply necessary for flowmeters to function properly?

50 – 55 psi

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What must be marked on gas cylinders?

7 markings must be on cylinders

They must meet ICC specs and potency/purity is determined by US Pharmacopeia.

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What is the function of the pin index safety system (PISS)?

Prevents retrograde flow using unique pin arrangements for each gas

What happens to nitrous oxide pressure as liquid remains in the tank?

Stays at 745 – 750 psi until all liquid has vaporized

What is the function of flowmeters?

Allow precise control of flow to vaporizers/common gas outlet

What design feature allows flowmeters to function properly?

Variable orifice

What is the minimum oxygen flow usually set when an anesthesia machine is turned on?

150 mL/min

What does the oxygen flush valve do?

Bypasses flowmeters, manifold, and vaporizers ## Footnote It provides a large volume of oxygen for emergency purposes.

What is the historical significance of the copper kettle vaporizer?

Copper has high specific heat and enhances ability to maintain constant temperature

What is the maximum concentration that can be delivered through a modern vaporizer?

Volatile anesthetics must be vaporized and diluted before delivery

What is the purpose of modern variable bypass vaporizers?

Divert a fraction of fresh gas flow to flow over the anesthetic agent

What is a TEC 6 vaporizer used for?

Specifically designed for desflurane due to its high volatility

What is the pumping effect in early vaporizers?

Downstream pressure caused back pressure transmitted to low-pressure system ## Footnote This led to higher concentrations of anesthetic.

What is the common gas outlet's role in the anesthesia machine?

Supplies the patient circuit with an oxygen/medical gas/anesthetic agent mixture

What is the most important part of the pre-check for anesthesia machines?

Ambu bag and oxygen

What is the primary function of the anesthesia breathing circuit?

Deliver O2 & agent to patient while eliminating CO2 to prevent rebreathing ## Footnote Achieved through washout via fresh gas flow (FGF) or chemical reaction

What does the AMBU bag deliver?

Almost 100% oxygen ## Footnote It can be used for spontaneous or controlled ventilation

What are the components of the AMBU bag?

* Non-rebreathing valve * Self-refilling bag * Oxygen/air inlet ## Footnote These components are essential for its function in ventilation

What is the difference between open and semi-closed anesthesia breathing systems?

Open systems allow non-contained exchange with atmosphere; semi-closed systems involve rebreathing of gases with valves ## Footnote Semi-closed systems are more popular due to their efficiency in conserving gases

What is the significance of fresh gas flow (FGF) in the breathing circuit?

FGF is a major factor in preventing rebreathing ## Footnote Rebreathing varies inversely with FGF

Fill in the blank: The _______ system is the most popular anesthesia breathing circuit.

Semi-closed (circle) ## Footnote It delivers oxygen/anesthetic gases and eliminates CO2 while conserving airway moisture and body heat

What are the advantages of a closed anesthesia breathing system?

* Maximal humidification/warming * Less pollution * Economic efficiency ## Footnote However, it has disadvantages such as inability to rapidly change anesthetic concentrations

What type of ventilator is powered by compressed gas and electricity?

Mechanical anesthesia ventilator ## Footnote This ventilator must have disconnect alarms to detect leaks in the system

What is the purpose of the APL valve in anesthesia?

Allows venting of gas from the breathing system into the scavenging system ## Footnote It is also known as the pop-off valve and is crucial for managing pressure within the circuit

True or False: The Mapleson A system is most efficient for controlled ventilation.

False ## Footnote Mapleson D is considered the best for controlled ventilation

What are the three types of oxygen analyzers used in anesthesia?

* Polarographic (Clark) * Galvanic (fuel cell) * Paramagnetic ## Footnote Each type has its own features regarding calibration and response time

What are the disadvantages of the circle system?

* Increased resistance to breathing * Bulkiness * Enhanced opportunity for malfunction ## Footnote These factors can complicate the use of the circle system in practice

What is the role of scavenging systems in anesthesia?

Dispose of excess gases vented from the breathing circuit ## Footnote Scavenging systems can be passive or active and are vital for patient safety

How does soda lime absorb CO2?

Initial reaction: CO2 + H2O yields H2CO3 (carbonic acid) ## Footnote Soda lime can absorb 23-26 liters of CO2 per 100g of absorbent

What is the importance of the spirometer or respirometer in anesthesia?

Measures exhaled and inhaled tidal volumes ## Footnote It can provide crucial data on patient ventilation during procedures

What happens if the spill valve sticks during mechanical ventilation?

You can see abnormally high airway pressure during exhalation ## Footnote This can indicate a malfunction in the ventilation system

What should be done if the oxygen analyzer indicates levels below 18%?

An alarm should activate within 30 seconds ## Footnote This is crucial for ensuring patient safety during anesthesia

Fill in the blank: The _______ system is useful for pediatric anesthesia and transporting intubated patients.

Mapleson F (Jackson-Rees) ## Footnote This system is ideal for both spontaneous and controlled ventilation