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FCP > Breathing Systems > Flashcards

Breathing Systems Flashcards

1
Q

FGF

A

Fresh gas flow: the total volume of gas that flows from the anaesthetic machine into the breathing system per minute.
This includes oxygen, nitrous oxide and any other gases employed.

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2
Q

TV

A

Tidal volume

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3
Q

MV

A

Minute volume

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4
Q

SF

A

System factor

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5
Q

IPPV

A

Intermittent positive pressure ventilation. Might be required if the patient stops breathing due to reaction, cardiopulmonary arrest etc.

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6
Q

APL valve

A

Adjustable pressure limiting valve

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7
Q

RR

A

respiratory rate

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8
Q

Give some examples of non-rebreathing systems

A
  • T-piece
  • Lack or Mini Lack
  • Bain
  • (Humphrey ADE in smaller patients)
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9
Q

Give some examples of rebreathing circuits

A
  • Circle
  • Humphrey ADE (for larger patients)
  • Induction chamber
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10
Q

What are some characteristics of a Bain breathing system?

A
  • Tube within a tube
  • Non-rebreathing
  • Can be used for IPPV
  • Suitable for 10-30kg patients
  • Relies on high FGF
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11
Q

What are some characteristics of the T-piece breathing system?

A
  • One long tube and one short tube. The expiratory limb (short) has the reservoir bag on.
  • Non-rebreathing
  • Can be used for IPPV
  • Good for small patients <10kg and fine for tiny patients (500g)
  • Relies on high FGF
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12
Q

What are some characteristics of the Lack or Mini Lack breathing system?

A
  • 2 parallel tubes. Can recycle dead space gas for the patient.
  • Non-rebreathing.
  • Cannot be used for IPPV.
    • Can potentially give the odd breath, but not prolonged IPPV as the patient would be breathing in CO2.
  • Lack = patients >10kg
  • Mini Lack = patients 2-10kg
  • More oxygen efficient than T-piece and Bain due to lower SF
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13
Q

What are some characteristics of the Circle breathing system?

A
  • Soda lime used to absorb CO2 (must be changed regularly)
  • Rebreathing
  • Can be used for IPPV, but not at the low flow rates used for maintenance
  • Standard circle = patients 10-150kg
  • Pediatric tubing = patients 2-10kg
  • Common in practice and very oxygen efficient (after initial high FGF)
  • Warms and humidifies the gas entering the patient
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14
Q

What are some characteristics of the Humphrey ADE breathing system?

A
  • Designed for use out in the field where one system does all.
  • Rare.
  • Rebreathing for larger patients or can be non-rebreathing for smaller patients.
  • Can be used in an MRI.
  • Low FGF rates so economical with oxygen.
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15
Q

Give some characteristics of an induction chamber as a breathing system?

A
  • Rebreathing
  • Can reduce stress of handling, but can cause stress if used inappropriately
  • Can dry out patient’s eyes.
  • Health and safety concern when opening lid.
  • Cannot be used for IPPV.
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16
Q

Which breathing system is shown here?

A

Circle

17
Q

Which breathing system is shown here?

A

Humphrey ADE

18
Q

Which breathing system is shown here?

A

Bain

19
Q

Which breathing system is shown here?

A

Lack or Mini Lack

20
Q

Which breathing system is shown here?

A

T-piece

21
Q

How do you calculate the FGF required for a patient on a non-rebreathing system?

A

FGF = MV x SF

MV = TV x RR

TV = 10mls/kg

22
Q

How do you calculate the FGF required for a patient on a rebreathing system?

A

First 10-15 mins = 100mls/kg/min

Maintenance = 10ml/kg/min

23
Q

How do you calculate patient TV?

A

TV = 10mls/kg

24
Q

How do you calculate the size of the reservoir bag needed for a patient on a rebreathing system?

A

Reservoir bag = TV x 4

25
Q

Why do we need a high FGF initially on a rebreathing system?

A
  • To cause denitrogenation
  • To flood them with anaesthetic agent so this can take over the job of the induction agent
26
Q

Should your APL valve be open or closed when you connect the patient to the breathing system?

A

Open

The image shows what happens if it is closed - there is not way for exhaled gas/fresh gas to leave the breathing system when pressure gets too high

The reservoir bag mimics what is happening to the patient’s lungs

27
Q

Should the APL valve be open or closed when you give a breath via IPPV?

A

Closed.

Close the valve → squeeze the bag (be mindful of patient size) → open the valve

FCP (34 decks)

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