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Nurse Anesthesia Summer 19 > C02 absorption > Flashcards

C02 absorption Flashcards

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1
Q

C02 absorber

A
  • chemically neutralizes C02
  • C02 + H20 = carbonic acid
  • Base neutralizes acid
  • end product = carbonate H20 & heat
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2
Q

4 types of absorbers

A
  1. Soda Lime
  2. Calcium hydroxide lime (amsorb plus)
  3. Litholyme (lithium hydroxide)
  4. Baralyme
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3
Q 
Soda Lime components 
sodium hydroxide (NaOH) lime
A

4% NaOH sodium hydroxide

1% KOH potassium hydroxide

80% CaOH calcium hydroxide

15% water

0.2% silica

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4
Q

Soda Lime equation

A

C02 + H20 = H2C03

H2C03 + 2Na0H (K0H) = Na2C03 (K2C03 + 2H20 + HEAT

Na2C03 (K2C03) + Ca0H = CaC03 + 2Na0H (K0H) + HEAT
*quicker Rex

OR

C02 + Ca0H2 =CaC03 + H20 + HEAT
*slower rxn

C02 combines with H20 to form carbonic acid which reacts with. hydroxides to form Na or K carbonate heat and H20

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5
Q

Soda Lime absorption

A

26L of C02/ 100g of absorbent granules

1lb of CaOH absorbs 0.59lb of C02

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6
Q

Calcium Hydroxide Lime

Amsorb plus components

A

80% CaOH

1-4% calcium chloride CaCl

16% water

calcium sulfate and poly-vinyl-pyrrolidine

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7
Q

Calcium Hydroxide (CaOH)Lime rxn

A

C02 +H20 = H2C03

H2C03 + Ca0H2 = CaC03 +2H20 + HEAT

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8
Q

CaOH absorption

A

absorbs 10L/ 100g of absorbent granules

1lb of CaOH absorbs 0.59lb of C02

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9
Q 
Lithium Hydroxide (Li0H)
Litholyme components
A

75% lithium hydroxide (Li0H)

<3% lithium chloride (LiCl)

12-19% H20

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10
Q

Litholyme rxn

A

2Li0H x H20 + C02 = Li2C02 + 3H20 - HEAT

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11
Q

Litholyme absorption

A

almost 1:1 ratio

1lb of Li0H absorbs 0.91lb of C02

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12
Q

Baralyme components

A

20% Ba0H

80% Ca0H

small amounts of Na0H and K0h

*no water or hardening agent

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13
Q

Baralyme rxn

A

Ba0H + 2(8H20) + C02 = BaC03 + 9H20 + HEAT

9H20 + 9C02= 9H2C03

9H2C03 + 9Ca(0H) = 9CaC03 + 18H20 + HEAT

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14
Q

Baralyme risks

A
  • more likely to dry out ( risk of C0)
  • risk of fire
  • contain some Na0H and K0H (risk of compound A)
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15
Q

Baralyme absorption

A

26L/ 100g of absorbent granules

*same as soda lime but slightly less efficient

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16
Q

Absorbent granule size

A

granule size = mesh size

4-8 mesh

mesh size = # of openings per inch in a sieve through which granular particles can pass

size and shape are intended to maximize absorption and minimize resistance

*smaller size greater surface area for absorption but more resistance

17
Q

Granule Hardness

A

hardness needed to prevent excess powder creating resistance and caking

Silica (soda Lime)
calcium sulfate and poly-vinyl-pyrrolidine (CaOH lime)
*used for hardness

-granules tested with steel ball & screen pan
% of original remaining = hardness #

Hardness # >75

18
Q

Channeling

A

preferred passage of exhaled gases through absorber (path of least resistance)

caused by loosely packed granules

absorbents along channel may exhaust quicker and C02 can filter through (increased C02 seen on monitor)
*if cant change right away increase FGF

air space occupied 48-55% of canister volume

some manufactures use polymer to bind granules in preformed channels to prevent channeling

19
Q

Indicators

A

acid or base whose color depends on pH

*ethly violet pH 10.3
(what we use)

color change = absorber exhaustion

color can revert back with rest (especially in Na0H containing formula)

replace with 50-70% color change

20
Q

Compound A

A

K0H and Na0H (in C02 absorber granules) can break down anesthetic agents (especially servo)

when servo is broken down by these chemicals it created a concentration of compound A (nephrotoxic in rats)

21
Q

Sevoflurane

A

160 mmHg

to minimize risk of compound A formation it is recommended servo use should not exceed 2 MAC hours at flows of 1-2L/min

22
Q

Carbon Monoxide

A

-can accumulate in dry Na0H and K0H absorbent granules

  • dried out absorbent granules cause a slow rxn with volatile agents that produce C0
  • if patient exposed = critically high levels of carboxyhgb (false high 02 sat)
  • dryness can be cause from by high flow through system for long period of time (24-48hrs)
  • increased temp can increase production of C0
  • higher anesthetic concentration produce mire C0
  • lower FGF rates
23
Q

Desflurane

A

669 mmHG

highest accumulation of C0

24
Q

Anesthesia Safety Foundation Recommendations for safe use of C02 absorber

A
  1. Turn of all gas flows when machine not in use
  2. Change absorber regularly
  3. Change whenever color change indicated exhaustion
  4. Change all absorbent not just one canister
  5. change when uncertain of hydration state (dry)

Nurse Anesthesia Summer 19 (11 decks)

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