Circle System Flashcards

1
Q

Work of breathing is _____ and ____.

A

resistance

compliance

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2
Q

Circle System Components

A
  • Carbon Dioxide Absorbent
  • Carbon Dioxide Absorbers
  • Unidirectional Valves
  • Inspiratory/Expiratory Ports
  • Breathing Tubes
  • Y-Piece
  • Fresh Gas Inlet
  • APL Valve
  • Reservoir Bag
  • Bag/Ventilator Switch
  • Ventilator
  • Pressure Gauge
  • Respiratory Gas Monitor Sensor
  • Airway Pressure Monitor Sensor
  • Respirometer
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3
Q

Carbon Dioxide Absorbant types (2)

A
  • soda lime
  • barium hydroxide lime
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4
Q

How is carbon dioxide absorbed?

A

carbonic acid neutralization

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5
Q

When you should change absorbent? (3)

A

CO2 in inspired gases
Color change
Heat in canisters

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6
Q

Tube length does affect dead space because of unidirectional gas flow. True or false?

A

false

does not

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7
Q

Breathing Tubes—colored end is inspiratory. True or false?

A

true

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8
Q

What is the connector between breathing tubes & endotracheal tube or supraglottic airway device?

A

Y-piece

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9
Q

_________ is where fresh gases with/without anesthetics enter the breathing circuit

A

fresh gas inlet

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10
Q

APL Valve functions: (2)

A
  • Controls pressure in breathing system
  • Releases gases to scavenging system
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11
Q

Reservoir bag function (4)

A
  • Allows gas to accumulate during exhalation (reservoir of gas for next inspiration)
  • Method of generating positive-pressure ventilation
  • Way to monitor spontaneous respiration
  • Protects patient from excessive pressure in breathing system
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12
Q

What will warn clinicians of high or low-pressure conditions in breathing system?

A

Airway Pressure Monitor Sensor

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13
Q

What are the objectives of a circle system design?

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
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14
Q

In CO2 absorbant, smaller granules have high absorptive surface area & high resistance to gas flow. True or false?

A

true

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15
Q

Drier absorbent will absorb & degrade volatile anesthetics more. True or false?

A

true

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16
Q

Do not change absorbent during the case. True or false?

17
Q

The inspiratory and expiratory port diameters are:

A

22–mm and male

18
Q

What gases are found inside the bellows? (3)

A
  • FGF
  • agent
  • patient exhaled gases
19
Q

Most common fresh gas inlet location

A

Upstream of the inspiratory valve and downstream from the absorber

20
Q

Most common location for the APL valve:

A
  • Near the reservoir bag downstream of the expiratory valve & upstream of the absorber
  • In this position, fresh gas will be vented only if the fresh gas flow is high.
21
Q

Most common reservoir bag location:

A
  • Between the expiratory unidirectional valve & the absorber
  • With manually assisted/controlled ventilation, more efficient absorbent use occurs with the bag upstream of the absorber.
  • A disadvantage of placing the bag upstream of the absorber is that a sudden increase in pressure from squeezing the bag may force dust from the absorber into the inspiratory tubing.
22
Q

Most common ventilator location:

A
  • Upstream of the absorber, near the APL valve
23
Q

During spontaneous inspiration, gas flows from the reservoir bag thru the absorber where it joins with the fresh gas & flows to the patient. True or false?

24
Q

During exhalation, exhaled gases pass into the reservoir bag until it is full then excess gases are vented thru the APL valve. True or false?

25
Excess gases are released thru the APL valve. True or false?
true
26
For the Drager machines (Fabius & Apollo), the ventilator is between the\_\_\_\_\_\_\_ & the \_\_\_\_\_\_\_\_\_. The reservoir bag is between the ________ & the absorber. ## Footnote During spontaneous inspiration, gases will flow from the reservoir bag & fresh gas inlet thru the inspiratory valve to the patient.
fresh gas decoupling valve inspiratory valve expiratory valve
27
In the Drager system,during manual inspiration, the bag is compressed causing exhaled gas to pass thru the absorber after which it is joined by fresh gas. True or false?
true
28
In the Drager system, with mechanical ventilation during inspiration, the fresh gas decoupling valve closes which isolates the fresh gas from the inspired gas. True or false?
true
29
Drager system during exhalation during ventilation, exhaled gases will pass thru the expiratory valve & the absorber & on to the ventilator. True or false?
true
30
Low flows fresh gas requirement: (3)
* Require CO2 absorber * Vary O2 & anesthetic concentrations * Prolong induction & recovery
31
Requirement for high fresh gas flows: (4)
* \> 5 L/min don’t require CO2 absorber * Accelerate induction & recovery * Compensate for circuit leaks * Decrease unanticipated gas mixture risk
32
The area distal to point of inspiratory & expiratory gas mixing at the Y-piece is defined as:
dead space
33
Resistance in circuit is increased by (3):
Unidirectional valves CO2 absorber Coaxial tubings
34
Circle System Advantages (7)
* 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
35
Circle System Disadvantages
* 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