E3- Anesthesia Machine I Flashcards
1
Q
- What group oversees the standards of the anesthesia machine?
- When did standard begin + last reapproved?
A
- American Society for Testing and Materials
- 1979 + 2005
2
Q
What should the anesthesia machine do?
A
- Provide accurate and safe gas delivery
- Provide a means for ventilating patients
- Provide electrical outlets
- Provide a housing for monitoring devices
- Provide storage/shelving
3
Q
What features of the anesthesia works if the Master Switch is ON?
A
o Pneumatic + electrical functions properly
o Activates alarms + safety features
o Power-up protocol can be bypassed
4
Q
What features of the anesthesia works if the Master Switch is OFF?
A
- Battery charger
- Electrical outlets
- Oxygen flush valve is active
- Auxillary Oxygen flowmeter
*Electronic functions disabled *
5
Q
Power Failure Indicator
- Visual or _______ alarm
- How do you keep battery back up at highest level?
A
- audible
- keep machine plugged in
6
Q
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?
A
- power usage
- Switch from control ventilator to manual ventilation
- Red outlets
7
Q
What are the electrical outlets on back of the anesthesia machine used to power?
A
- 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
8
Q
What are the 3 parts of the pneumatic system?
A
- High Pressure
- Intermediate Pressure
- Low Pressure
9
Q
- The high-pressure system receives gas from the _______
- At a _____ + _____ pressure
- The presssure is _____ psi
A
- Cylinders
- high + variable
- 2200
10
Q
What is 4 purpose of the Hanger Yoke?
A
- 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
11
Q
- High pressure system uses a ______ _______ that lowers + makes pressure more constant.
- How much PSI?
- What would happen without these?
A
- pressure regulator
- 45 PSI
- constantly change flowmeter
12
Q
What are 6 parts of Hanger Yoke?
A
- 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
13
Q
What is the purpose of the check valve assembly of the hanger yoke?
A
- 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
14
Q
- How do cylinder pressure indicators (gauges) work?
- What is the gauge required to be calibrated in?
A
- 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
15
Q
%%%%%
What is the purpose of pressure regulators?
A
- 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
16
Q
What are the components of the high-pressure system?
A
- Cylinder
- Hanger Yoke
- Check Valve Assembly
- Cylinder Pressure Indicator - bourdan tubes
17
Q
- Where 2 places intermediate system get its pressure from?
- PSI of each?
A
- Receives pressure from the cylinder, specifically the pressure regulator (45 psi)
- Receives pressure from the pipeline (50-55 psi)
18
Q
What is the intermediate pressure system pressure if the master switch is OFF?
A
- 0 mmHg
19
Q
What 6 included in the intermediate pressure system?
A
- Pneumatic part of the master switch
- Pipeline inlet connections
- Piping
- Oxygen pressure failure devices
- Oxygen flush valve
- Flow control valves
20
Q
What is the pipeline inlet connection?
What are the inlets fitted with?
A
- The entry point for gases from the pipelines.
- fitted with a diameter index safety system (DISS)
21
Q
The anesthesia machines are required to have pipeline inlets for what gases?
A
- Required: Oxygen and Nitrous
- Most also have air
22
Q
What is required and will prevent the anesthesia machine gas from returning to the pipeline?
A
- Unidirectional check valve
23
Q
Where is the pipeline pressure indicator located?
Newer machines may have _____ number display
A
- 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.
24
Q
The piping connects the components inside the machine and must be able to withstand ______ times the intended pressure.
A
- 4 times (about 200 psi)
25
Leaks must not exceed __________ ml/min inside the anesthesia machine.
* 25 ml/min
26
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
27
What two places does the oxygen flush get its supply?
* Receives oxygen from **pipeline inlet**
* Receives oxygen from **cylinder pressure regulator**
28
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)
29
What are the hazards of using the oxygen flush?
* Barotrauma
* Awareness - diluting vapor
30
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
31
What is unique about the oxygen flow knob?
* It must be **fluted + larger** than other gases (looks and feels different)
32
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
33
* 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
34
What indicates the rate that gas passes through?
* Flowmeter
## Footnote
Thorpe tube design, small diameter at the bottom, wider at the top
35
* 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
36
* 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
## Footnote
*Drager = similar to dragon -- has an N -- Nitrous first*
37
The standard requires oxygen flowmeter to be placed on the _______ side.
* right
## Footnote
least chance of leaking and being hypoxic.
38
What are the hypoxia prevention devices?
* Mandatory Minimum Oxygen Flow
* Minimum Oxygen Ratio
39
The mandatory minimum oxygen flow is _______ ml/min.
* 50 to 250 ml/min
* activated when master switch is ON
40
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%.`**
41
Where are the unidirectional valves located in the low-pressure system?
* Located between the vaporizer and common gas outlet.
42
* 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)
43
* What are pressure relief valves located near?
* They are open to atmosphere + _______ excess pressure
* what do these valves prevent?
* common gas outlet
* vents
* barotrauma
44
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
45
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.
46
* 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
47
What can deliver oxygen in case of an electronic power failure?
* Alternate (auxillary) Oxygen Control
## Footnote
If you press this button, everything shuts off but this oxygen back up supply.
