Breathing systems

Question 1

FGF

Answer 1

= fresh gas flow

Question 2

TV

Answer 2

= tidal volume

Question 3

MV

Answer 3

= minute volume

Question 4

SF

Answer 4

= system factor

Question 5

IPPV

Answer 5

= intermittent positive pressure ventilation

Question 6

APL Valve

Answer 6

= adjustable pressure limiting valve

Question 7

What are the available non-rebreathing systems?

Answer 7

• T-piece
• Lack or mini lack
• bain

Question 8

What is the available rebreathing system?

Answer 8

• circle

Question 9

Which breathing systems can you use for IPPV?

Answer 9

• t-piece
• bain
• circle

Question 10

Which breathing systems are not suitable for IPPV?

Answer 10

• lack or mini lack

Question 11

T-piece: pt size

Answer 11

• <10kg

Question 12

T-piece: SF

Answer 12

• 2.5

Question 13

What does T-piece look like?

Answer 13

• reservoir bag on expiratory limb, 1 long tube and a short tube

Question 14

Why is lack/mini lack more oxygen efficient that t-piece or Bain?

Answer 14

• lower SF

Question 15

Standard lack: pt size

Answer 15

• > 10kg

Question 16

Mini lack: pt size

Answer 16

• 2-10kg

Question 17

Lack/mini lack: SF

Answer 17

• 1

Question 18

What does a lack/mini-lack look like?

Answer 18

• 2 parallel tubes

Question 19

What does a Bain look like?

Answer 19

• tube within a tube
  – internal tube supplies gas

Question 20

Bain: pt size

Answer 20

• 10-30kg

Question 21

Bain: SF

Answer 21

• 2.5

Question 22

What does a Bain rely on?

Answer 22

• high FGF

Question 23

Formula for FGF for non-rebreathing systems

Answer 23

• MV x SF

Question 24

Formula for MV

Answer 24

• TV x RR (20bpm)

Question 25

TV

Answer 25

- 10ml/kg

Question 26

Circle: pt size

Answer 26

- standard circle: 10-150kg - paediatric tubing: 2-10kg

Question 27

What has to be checked and changed regularly with a circle?

Answer 27

- the soda lime -- it absorbs the CO2

Question 28

Calculations for rebreathing systems: first 10-15mins

Answer 28

- 100ml/kg/min -- flood the pt with anaesthetic agent to take over job of induction agent -- de-nitrogenation

Question 29

Calculations for rebreathing systems: maintenance

Answer 29

- 10ml.kg.min -- only when have a low flow flowmeter

Question 30

Calculations for rebreathing systems: reservoir bags

Answer 30

- TV x 4

Question 31

Use of Humphrey ADE circle

Answer 31

- can be non-rebreathing for smaller pts (similar to lack) - rebreathing for larger pts - designed for out in field - able to use for MRI - low FGF rates - rate

Question 32

Use of induction chambers

Answer 32

- can reduce stress of handling -- but can be stressful if used incorrectly - can dry out eyes - H&S concern when opening lid