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Machine Final > circle system > Flashcards

circle system Flashcards

1
Q

what is the benefit of rebreathing alveolar gas

A

conserves heat & humidity

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2
Q

what is the purpose of the carbon dioxide absorbent?

A

elimination of CO2 to prevent hypercarbia

CO2 absorbents contain hydroxide salts that are capable of neutralizing carbonic ac

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3
Q

Name one common absorbent material used for CO2 absorbers ?

A

soda lime

capable of absorbing up to 23 L of CO2/100 g of absorbent.

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4
Q

what acid is produced produced when CO2 combines with water?

A

carbonic acid

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5
Q

what are the end products of the neutralizing reaction provided by the CO2 absorber?

A

heat
water
calcium carbonate

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6
Q

In regards to soda lime, what minimizes the risk of inhalation of sodium hydroxide dust

A

adding silica to increase hardness

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7
Q

what prevents dust formation in the CO2 absorbers?

A

hardness of the lime agent

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8
Q

In regards to the CO2 absorber, how could it delay the induction or emergence?

A

Absorbent granules can absorb & later release significant amounts of volatile anesthetic. The drier the soda lime, the more likely it will absorb & degrade volatile anesthetics.

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9
Q

you’re checking your machine in the a.m., the CO2 absorbent looks to be a new canister, but after 2 hours into your first case you notice rebreathing on the monitor and notice the canister is now 75% puprle. what is this phenomenon

A

peaking or regeneration

seen with absorbents that contain strong bases, absorbent appears to be reactivated with rest

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10
Q

what are indications to change absorbent?

A

CO2 in inspired gases (FiCO2)
Color change
Heat in canisters

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11
Q

True or false. Double CO2 canisters lower gas flow resistance.

A

True

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12
Q

which canister goes on top when loading a new CO2 absorbent canister in a double canister system?

A

the new one goes on bottom, the older bottom canister is moved to the top

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13
Q

what should be done after changing out the CO2 canisters?

A

circuit leak check

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14
Q

what is the puprose of the unidirectional valves?

A

check valves that prevent flow in opposite directions, make the circle circuit possible

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15
Q

which valve is exposed to humidity of alveolar gas?

A

expiratory

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16
Q

discuss the valves at inspiration

A

Inhalation opens the inspiratory valve allowing the patient to breath a mixture of fresh & exhaled gas that has passed thru the CO2 absorber. Simultaneously, the expiratory valve closes to prevent rebreathing of exhaled gas that still contains CO2.

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17
Q

discuss the valves at expiration

A

exhalation opens the expiratory valve. This gas is vented thru the APL valve or rebreathed by the patient after passing thru the absorber. Closure of the inspiratory valve during exhalation prevents expiratory gas from mixing with fresh gas in the inspiratory limb.

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18
Q

What are some problems that could come about due to damaged valves?

A

rebreating CO2 – related to both

a stuck inspiratory valve- pressure build up in machine

a stuck expiratory valve - pressure build up in patient

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19
Q

what is true of deadspace in the breathing circuit.

A
  1. occurs where there is bi-directional flow
  2. occurs from y piece to patient
  3. The length of the tubes does not affect the amount of dead space
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20
Q

what is an advantage of concentric patient circuit? Disadvantage?

A

a. outer corrugated tube carrries exhaled gas that can moderately warm inspired tube gases
b. disadvantage - increased resistance, hypercapnea due to inner tube leak

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21
Q

what is true of the Y piece

A
  1. contains deadspace
  2. has (2) male ports at 22 mm
  3. has (1) female port at 15 mm
22
Q

what size is the facemask orifice?

A

22 mm

23
Q

what is function of APL (adjustable pressure limit) valve ?

A

Controls pressure in breathing system

Releases gases to scavenging system

24
Q

what happens when the pressure has reached APL valve setting?

A

the valve opens & excess gas is vented to the scavenging system during inspiration.

25
Q

what is function of reservoir bag?

A
  1. gas storage
  2. Method of generating positive-pressure ventilation
  3. Way to monitor spontaneous respiration
  4. Protects patient from excessive pressure in breathing system
26
Q

what type of switch is the bag/ventilator selector switch?

A

3 way (stop cock like)

27
Q

what is bypassed when switch is set to ventilator?

A

APL valve

28
Q

where is drive gas in relation to the bellows?

A

inside the plastic canister, surrounding bellows (not actually in the bellows)

29
Q

which gas makes the bellows go down?

A

drive gas — from pipeline (oxygen or air)

30
Q

which gas makes the bellows go up?

A

with patient exhalation —- in the bellows is pt. exhaled gas, agent, and fresh gas flows

31
Q

true or false. Drive gas can be delivered to the patient?

A

False. drive gas is never delivered to the patient. only to atmosphere

32
Q

what is an indication via the bellows that the patient is fighting the vent?

A

bellows will dip down slightly with an inspiration when you expect an exhalation

33
Q

what is the pressure gauge associated with the circle circuit?

A

displays the airway pressure

34
Q

what is the respiratory gas monitor sensor?

A

Analyzes concentrations of gases in breathing system

35
Q

what is the function of the airway Pressure Monitor Sensor

A

alarm that Warns clinicians of high or low-pressure conditions in breathing system

36
Q

what Measures ventilatory volumes

A

Respirometer

37
Q

ojectives of the circle system

A 
Maximum inclusion of fresh gas in inspired mixture & maximum venting of alveolar gas
Minimize absorbent dessication
Minimal absorbent consumption
Accurate respirometer readings 
Maximal inspired gas humidification
Minimal dead space
Low resistance
Minimal pull on mask, ETT, or LMA
Convenience
38
Q

why is inclusion of fresh gas in inspired mixture important?

A

will result in faster inductions & emergences

39
Q

what is the most common location of the fresh gas inlet?

A

upstream of the inspiratory valve and downstream of the absorber

40
Q

what is the most common location of the APL valve?

A

near reservoir bag downstream of the expiratory valve & upstream of the absorber

41
Q

what is most common location of reservoir bag?

A

between the expiratory valve & the absorber

42
Q

what is most common location of ventilator?

A

upstream of the absorber, near APL valve

43
Q

during spontaneous exhalation, where do exhaled gases go?

A

into the reservoir bag until it is full then excess gases are vented thru the APL valve

44
Q

where does fresh gas flow enter in the datex-ohmeda circle system?

A

fresh gas enters the system between the inspiratory valve & the Y-piece

45
Q

what is true of low flows of fresh gases in a circle circuit?

A

Require CO2 absorber
Vary O2 & anesthetic concentrations
Prolong induction & recovery

46
Q

What is true of high flows of fresh gases in a circle circuit

A

> 5 L/min don’t require CO2 absorber
Accelerate induction & recovery
Compensate for circuit leaks
Decrease unanticipated gas mixture risk

47
Q

what is Tidal volume that is not part of alveolar ventilation

A

dead space

48
Q

what increases resistance in a circle system?

A

Unidirectional valves
CO2 absorber
Coaxial tubings

49
Q

what are the advantages of a circle system?

A

Economy
Reduced operating room pollution
Reduced environmental pollution
Estimation of anesthetic agent uptake & oxygen consumption
Buffered changes in inspired concentrations
Heat & humidity conservation
Reduced barotrauma risk

50
Q

what are the disadvantages of a circle system?

A 
Larger overall size
Less portability
Increased complexity
Increased resistance
Difficult to predict inspired gas concentrations with low fresh gas flows
Hypercarbia risk
Faster absorbent exhaustion

Machine Final (9 decks)

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