E3- Anesthesia Machine I Flashcards
- What group oversees the standards of the anesthesia machine?
- When did standard begin + last reapproved?
- American Society for Testing and Materials
- 1979 + 2005
What should the anesthesia machine do?
- Provide accurate and safe gas delivery
- Provide a means for ventilating patients
- Provide electrical outlets
- Provide a housing for monitoring devices
- Provide storage/shelving
What features of the anesthesia works if the Master Switch is ON?
o Pneumatic + electrical functions properly
o Activates alarms + safety features
o Power-up protocol can be bypassed
What features of the anesthesia works if the Master Switch is OFF?
- Battery charger
- Electrical outlets
- Oxygen flush valve is active
- Auxillary Oxygen flowmeter
*Electronic functions disabled *
Power Failure Indicator
- Visual or _______ alarm
- How do you keep battery back up at highest level?
- audible
- keep machine plugged in
Power Failure Indicator
- The duration of back up power depends on _______ _______
- What is the best way to save power on your ventilator if you lose power during an operation?
- What are the hospital’s back-up?
- power usage
- Switch from control ventilator to manual ventilation
- Red outlets
What are the electrical outlets on back of the anesthesia machine used to power?
- Anesthesia monitors ONLY
- Other appliances should be plugged into hospital’s main outlets
- If requirements exceed outlet; circuit breaker will activate - cause whole machine to go out
What are the 3 parts of the pneumatic system?
- High Pressure
- Intermediate Pressure
- Low Pressure
- The high-pressure system receives gas from the _______
- At a _____ + _____ pressure
- The presssure is _____ psi
- Cylinders
- high + variable
- 2200
What is 4 purpose of the Hanger Yoke?
- Orients and support the cylinder
- Provide a gas-tight seal
- Ensures unidirectional flow
- Required to have a least 1 yoke for oxygen and 1 for nitrous
o Not required for air
- High pressure system uses a ______ _______ that lowers + makes pressure more constant.
- How much PSI?
- What would happen without these?
- pressure regulator
- 45 PSI
- constantly change flowmeter
What are 6 parts of Hanger Yoke?
- Body- principal framework
- Retaining screw- tightens cylinder (clamp)
- Nipple- thru which gas enters the machine
- Index pins- prevents attaching an incorrect cylinder (PISS)
- Washer- forms seal between cylinder and yoke
- Check valve assembly- ensure unidirectional flow
Body Rub Nipple Intense Washing Cream
What is the purpose of the check valve assembly of the hanger yoke?
- Ensures unidirectional flow
- Prevent gas from exiting the machine when there is no cylinder in the yoke
- Prevent gas from being transferred from a cylinder with higher pressure to one with lower pressure
- How do cylinder pressure indicators (gauges) work?
- What is the gauge required to be calibrated in?
- Must be present for each gas!
-
Bourdon Tubes – curved hollow tubes
o Working mechanism for analogue pressure devices
o Pressure changes increase/decrease curve
o Motion is transmitted to indicator needle on front of pressure gauge - gauge required in kilopascals (kPa) or psi
%%%%%
What is the purpose of pressure regulators?
- Reduce high, variable pressure in cylinders to lower constant pressure for the machine.
- One pressure regulator must be present for each cylinder
Pressure regulators are also called reducing valves
What are the components of the high-pressure system?
- Cylinder
- Hanger Yoke
- Check Valve Assembly
- Cylinder Pressure Indicator - bourdan tubes
- Where 2 places intermediate system get its pressure from?
- PSI of each?
- Receives pressure from the cylinder, specifically the pressure regulator (45 psi)
- Receives pressure from the pipeline (50-55 psi)
What is the intermediate pressure system pressure if the master switch is OFF?
- 0 mmHg
What 6 included in the intermediate pressure system?
- Pneumatic part of the master switch
- Pipeline inlet connections
- Piping
- Oxygen pressure failure devices
- Oxygen flush valve
- Flow control valves
What is the pipeline inlet connection?
What are the inlets fitted with?
- The entry point for gases from the pipelines.
- fitted with a diameter index safety system (DISS)
The anesthesia machines are required to have pipeline inlets for what gases?
- Required: Oxygen and Nitrous
- Most also have air
What is required and will prevent the anesthesia machine gas from returning to the pipeline?
- Unidirectional check valve
Where is the pipeline pressure indicator located?
Newer machines may have _____ number display
- Found on front of the anesthesia machine
- LED
- Required for each gas monitored
Picture next to the pressure indicator signifies whether gas is from the pipeline or cylinder.
The piping connects the components inside the machine and must be able to withstand ______ times the intended pressure.
- 4 times (about 200 psi)
Leaks must not exceed __________ ml/min inside the anesthesia machine.
- 25 ml/min
How does the oxygen failure safety device work?
What does it do?
When will the oxgen failure alarm sound within?
- If O2 pressure is reduced to 30 psi,
nitrous will decrease or discontinue to
maintain at least 19% O2 concentration at the common gas outlet. - Continues until oxygen flow ceases
- Simulated in machine check
- 5 seconds
What two places does the oxygen flush get its supply?
- Receives oxygen from pipeline inlet
- Receives oxygen from cylinder pressure regulator
What are the 5 standards for the oxygen flush?
- Must be operable with 1 hand
- Single purpose
- Self-closing
- Designed to minimize accidental use
- Have flow between **35-75 L/min **(can cause barotrauma)
What are the hazards of using the oxygen flush?
- Barotrauma
- Awareness - diluting vapor
What is the function of the flow adjustment control?
2 requirements?
- Regulate the flow of oxygen, air, and other gases
- knobs on flowmeters lol
^^ - Mechanical (knob) or electronic (arrow buttons)
- Must be only one control for each gas
o must be adjacent to its flowmeter
What is unique about the oxygen flow knob?
- It must be fluted + larger than other gases (looks and feels different)
What are the 5 components of the low-pressure system?
- Flowmeters
- Hypoxia prevention devices
- Unidirectional valves (within the machine)
- Pressure relief devices
- Common gas outlet
- The low-pressure system is downstream of ___________.
- pressure is slightly above atmospheric + ________.
- pressure depends on ?
- flow control devices (knobs)
- variable
- flow from flowmeters + back pressure from circuit
What indicates the rate that gas passes through?
- Flowmeter
Thorpe tube design, small diameter at the bottom, wider at the top
- Flowmeters are also known as ________ tubes.
- smallest diameter at the _______ with free floating indicator
- must be marked with apropriate _______ and _______
- a 2nd stage regulator maintains what psi?
- gas empties into a __________________-
- Thorpe
- bottom
- color + symbol
- 14-30 psi
- common manifold
- What is the flowmeter sequence or normal gas flow pattern?
- Drager vs. Ohmeda sequence?
- Normal gas flow bottom to top + Left to right
- Drager = nitrous, air, o2 … ohmeda = air nitrous o2
Drager = similar to dragon – has an N – Nitrous first
The standard requires oxygen flowmeter to be placed on the _______ side.
- right
least chance of leaking and being hypoxic.
What are the hypoxia prevention devices?
- Mandatory Minimum Oxygen Flow
- Minimum Oxygen Ratio
The mandatory minimum oxygen flow is _______ ml/min.
- 50 to 250 ml/min
- activated when master switch is ON
What is the minimum oxygen ratio?
How does it work?
- Gas ratio between oxygen and nitrous
- uses mechanical linkage with nitrous
- Link engages when oxgyen concentration is** 25%.`**
Where are the unidirectional valves located in the low-pressure system?
- Located between the vaporizer and common gas outlet.
- The low-pressure unidirectional valves are upstream (before) from the _________ valve.
- They lessen the __________________ from flush or breathing circuit
- Oxygen Flush
- back pressure (pumping effct)
- What are pressure relief valves located near?
- They are open to atmosphere + _______ excess pressure
- what do these valves prevent?
- common gas outlet
- vents
- barotrauma
What is the drawback to the pressure relief valve of the low-pressure system?
- Limits the ability of the machine to provide adequate jet ventilation
The common gas outlet should not be used for __________.
What could it cause?
- Supplemental oxygen
- This can cause delay in emergencies and cause potential delivery of inhalation agents.
- What component receives all gases from the machine and delivers the mixture to the circle system?
- What must it be?
- Common gas outlet
- difficult to disconnect
What can deliver oxygen in case of an electronic power failure?
- Alternate (auxillary) Oxygen Control
If you press this button, everything shuts off but this oxygen back up supply.
