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Anesthesiology > Breathing Systems > Flashcards

Breathing Systems Flashcards

1
Q

Two types of breathing systems

A

Rebreathing

Non-rebreathing

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2
Q

Rebreathing tube types

A
  1. Circle/Y piece

2. Universal F

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3
Q

Non-rebreathing tube types

A
  1. Mapleson D
  2. Mapleson F
  3. Bain
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4
Q

Components of the Rebreathing system

A
  1. Fresh gas and O2 flush
  2. Unidirectional valves (inspiratory and expiratory)
  3. Breathing hoses
  4. CO2 absorber
  5. Adjustable pressure limiting valve aka pop-off valve
  6. Reservoir bag
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5
Q

Rebreathing system advantages

A
  1. Lower fresh gas flow rate
  2. Saves money
  3. Decreases pollution
  4. Patient breathes warm humidified air
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6
Q

Rebreathing system disadvantages

A
  1. More components and potential for leaks

2. Increased resistance for smaller patients (

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7
Q

Pop-off valve

A

Limits pressure buildup in the system

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8
Q

Position of the pop-off valve

A

ALWAYS OPEN

Unless checking for leaks or administering positive pressure ventilation

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9
Q

Consequences of leaving the pop-off valve closed

A

Increases pressure in breathing system

Results in possible cardiopulmonary injury

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10
Q

Breathing system pressure gauge

A

SHOULD ALWAYS BE ZERO

Except: performing leak checks or providing positive pressure ventilation

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11
Q

Most common CO2 absorber medium

A

Soda lime

Calcium hydroxide with small amounts of sodium hydroxide and crystal violet (colour indicator)

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12
Q

Colour change in soda lime

A

White- fresh

Violet- exhausted

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13
Q

Signs of exhaustion

A
  1. Increase in tidal CO2
  2. Increased ventilation, HR/BP (then drop) if light enough
  3. Rebreathing capnograph
  4. Respiratory acidosis
  5. Red mucous membranes due to carbon monoxide production/inhalation
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14
Q

Reservoir bag function

A

Observe ventilation, inspiratory reserve, administer manual positive pressure ventilation

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15
Q

Calculation for reservoir bag size

A

Tidal volume = 10-20mL/kg x 6

Round UP if between sizes

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16
Q

Oxygen flow rate-

Rebreathing Small animal

A

Induction/ Recovery= 50-100 mL/kg/min O2

Maintenance= 20-50mL/kg/min O2

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17
Q

Oxygen flow rate

Rebreathing Large animal

A

Induction/ Recovery= 20-50 mL/kg/min O2

Maintenance= 10-20mL/kg/min O2

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18
Q

Non-rebreathing system components

A
  1. Fresh gas
  2. Non-rebreathing tubes
  3. APL (mapleson D) or open/close (mapleson F) valve
  4. Reservoir bag
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19
Q

Non-rebreathing Advantages

A
  1. Very light with minimal dead space

2. Minimal resistance to ventilation (better for

20
Q

Non-rebreathing Disadvantages

A
  1. High Gas flow rate
  2. More expensive to run larger patients
  3. Increased environmental pollution
  4. Gas cold and dry
21
Q

Non-rebreathing Oxygen flow rates

A

2-3x tidal volume in most cases

200-300mL/kg/min O2

22
Q

Indications for endotracheal intubation

A
  1. Maintain patent airway
  2. Protect airway from foreign material
  3. Provide intermittent positive pressure ventilation (IPPV)
  4. Apply tracheal or bronchial suction
  5. Administer oxygen
  6. Deliver inhalant anesthesia
23
Q

Benefits of intubation

A
  1. Reduced anatomical deadspace

2. Maintain inhalant anesthesia with minimal environmental contamination (with properly inflated cuff)

24
Q

Routes of Intubation

A
  1. Oral
  2. Nasal
  3. External pharyngotomy
  4. Tracheostomy
25
Q

E-tube materials

A

PVC, rubber, or silicone

26
Q

Purpose of cuff

A

Protects airway and environment from contamination

27
Q

Types of e-tubes

A
  1. Murphy- most common
  2. McGill
  3. Wire reinforced (do not use with MRI)
  4. Cole- avian
  5. Tracheostomy
28
Q

What type of tube provides the least air resistance

A

Larger radium and shorter length (Poiseuille’s law)

29
Q

Cat e-tube sizing

A

3.5-4.5mm generally

30
Q

Dog e-tube sizing

A

8.0-12mm depending on size of dog

14-16mm for giant breed dogs

31
Q

Sheep e-tube sizing

A

10-12mm

32
Q

Horse e-tube sizing

A

26-30mm

33
Q

Safe e-tube inflation

A

No audible release of gas around e-tube when pop-off is closed and reservoir bag is squeezed to 20cmH2O

Air should be escaping at 30cmH2O- prevents over inflation

34
Q

Potential complications of intubation

A
  1. Laryneal damage- small animal espeically
  2. Tracheal damage
    • over inflated cuff
    • moving/twisting of inflated cuff
  3. Tube obstruction
  4. Endobronchial intubation (hypoxemia, tachypnea, cynosis)
  5. ETT inhalation/ingestion
35
Q

Purpose of scavenging

A

Collection and transport of waste gasses from the anesthetic machine to a safe disposal area

36
Q

Types of scavengers

A

Active and passive

37
Q

Elements of a scavenger

A
  1. Collecting system (APL valve)
  2. Transfer system/interface
  3. Receiving system
  4. Disposal system
38
Q

Olfacotry ppm of gasses

A

> = 125ppm

39
Q

Exposure limits to anesthetic gasses

A
40
Q

Scavenging principles

A
  1. Scavenge everything

2. No leak technique (

41
Q

Passive scavenging system medium

A

Charcoal

F-air canisters; does not scavenge nitrous oxide

42
Q

Passive scavenging piping

A

Atmosphere (window etc)

43
Q

Active scavenging system

A

Piped vacuum (WHITE drop and tubing)

44
Q

Charcoal scavenging advantages

A
  1. Absorbs hydrocarbons
  2. Does not release to ozone
  3. Portable
45
Q

Charcoal Scavenging disadvantages

A
  1. Does not absorb N2O
  2. Limited flow
  3. Added resistance
  4. Weigh before use and record weight
  5. Discard with 50grams+ or after 8-12 hours continuous use
46
Q

Active scavenging system flow rate capacity

A

30L/min

Anesthesiology (27 decks)

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