E3 - Anesthesia Machine I Flashcards

1
Q

What must the anesthesia machine provide: Select 3
A. place to prop your feet during long cases
B. accurate and safe gas delivery
C. not a place to store anything
D. audible alarms
E. electrical outlets
F. housing for monitoring devices

A

B. Provide accurate and safe gas delivery
E. Provide electrical outlets
F. Provide a housing for monitoring devices
and:
* Provide a means for ventilating patients
* Provide storage/shelving

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2
Q

What features of the anesthesia still work if the Master Switch is OFF? select 2
A. alarms and safety features
B. battery charger
C. electrical outlets
D. power-up protocol
E. pneumatic functions

A

B. Battery charger
C. Electrical outlets
AND:
* Oxygen flush valve
* auxiliary oxygen flowmeter

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3
Q

What is the best way to save power on your ventilator if you lose power during an operation?
A. use the battery charger that is available
B. switch machine plug to a red electrical outlet
C. switch from control ventilator to manual ventilation
D. turn off the o2 flush valve mechanism

A

C. Switch from control ventilator to manual ventilation

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4
Q

What are the electrical outlets on the anesthesia machine used to power?
A. pneumatic system
B. anesthesia monitors only
C. other appliances
D. anesthesia monitors and other appliances

A

B. Anesthesia monitors only

Other appliances should be plugged into hospital’s main outlets

If requirements exceed outlet; circuit breaker will activate

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5
Q

What are the 3 parts of the pneumatic system?

A
  • High Pressure
  • Intermediate Pressure
  • Low Pressure
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6
Q

The high-pressure system receives gas from the ____ at high variable pressure.
A. rises
B. central supply
C. branch
D. cylinders

A

D. Cylinders (25 - 2200 PSI)

The pressure needs to be reduced to a lower, more constant pressure (like 45 psi) suitable for use in the anesthesia machine

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7
Q

What is the purpose of the pressure regulator (1st stage regulator) on the anesthesia machine?
A. reduce to lower pressure
B. increase to higher pressure
C. reduce or increase pressures depending on where the cylinder pressure is at
D. constantly change flowmeters

A

A. reduce to a lower, more constant pressure (45 psi)

Without regulators, we’d constantly be changing flowmeters

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8
Q

What is the purpose of the Hanger Yoke? Select 3
A. provide a gas-tight seal
B. reduce pressure to lower psi
C. allows bidirectional flow
D. ensures unidirectional flow
E. increase pressure to higher psi
F. orients and supports the cylinder

A

A. Provide a gas-tight seal
D. Ensures unidirectional flow
F. Orients and support the cylinder

It is REQUIRED to have at least 1 hanger yoke for oxygen and 1 hanger yoke for nitrous

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9
Q

What are the 6 parts of the 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!!!!

BRNIWC

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10
Q

The check valve assembly of the hanger yoke prevents: Select 2.
A. gas from entering machine when theres not cylinder in the yoke
B. gas from being transferred from a cylinder with lower pressure to one with higher pressure
C. gas from exiting the machine when there is no cylinder in the yoke
D. gas from being transferred from a cylinder with higher pressure to one with lower pressure

A

C. Prevent gas from exiting the machine when there is no cylinder in the yoke
D. Prevent gas from being transferred from a cylinder with higher pressure to one with lower pressure (IF both are in a yoke and ON) (so uses the oldest one first)

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11
Q

Cylinder pressure indicators work by using a __ gauge which consists of a tube bent into a coil or an arc.
A. thread
B. snap
C. bourdon
D. plug

A

C. Bourdon gauge consists of a tube bent into a coil or an arc.

Gauge required to be calibrated to kPa or psi

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12
Q

Describe the bourdon gauge inside of the cylinder pressure indicator:

As the pressure in the tube __ (increases or decreases) , the coil __ (winds up or straightens).

A

As the pressure in the tube increases, the coil unwinds/straightens.

  • A pointer connected to the end of the tube can be attached to a lever and a pointer calibrated to indicate pressure.

required to be calibrated in kilopascals (kPa)

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13
Q

What describes the intermediate pressure system? Select 2
A. receives pressure from the pressure regulator at 35 psi
B. receives pressure from the pipeline at 50-55 psi
C. it is downstream of flow control devices
D. pressure is slightly above atm
E. if master switch is OFF, pressure is zero

A

B. Receives pressure from the pressure regulator (45 psi) or from the pipeline (50-55 psi)
E. if master switch is OFF, pressure is zero

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14
Q

What is included in the intermediate pressure system? Select 3
A. Pneumatic part of the master switch
B. Pipeline inlet connections
C. Oxygen flush valve
D. Check valve assembly
E. Hanger Yoke
F. Flowmeters

A

A. Pneumatic part of the master switch
B. Pipeline inlet connections
C. Oxygen flush valve

also:
* Piping
* Oxygen pressure failure devices
* Flow control valves

D & E are part of high pressure system ; F is part of low pressure system

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15
Q

What is the pipeline inlet connection? What safety system accompanies this connection?
A. entry point for gases from pipelines; PISS
B. entry point for gases from pipelines; DISS
C. exit point for gases from pipelines; PISS
D. exit point for gases from pipelines; DISS

A

B. entry point for gases into anesthesia machine from pipelines; DISS

Pipeline inlet connects are fitted with a diameter index safety system (DISS)

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16
Q

The anesthesia machines are required to have pipeline inlets for what 2 gases?

A

Required: Oxygen and Nitrous

and most also have air

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17
Q

What part of the pipeline inlet connection prevents the anesthesia machine gas from returning to the pipeline?
A. washer
B. DISS
C. flow control valve
D. unidirectional check valve

A

D. Unidirectional check valve

18
Q

Where are the pipeline pressure indicators usually found?

And where should these pipeline pressure indicators be measuring pressure from?

A

On the front of the anesthesia machine!
digital or newer machines have LED

Should be measuring pressure on pipeline side!!
* if downstream and cylinder valve is open, then the indicator would display an adequte pressure reading until cylinder is 0 and fully empty…

Indicator must be on pipeline side…
19
Q

The piping connects the components inside the machine and must be able to withstand __ times the intended pressure. Select 2.

A. 4 times
B. 2 times
C. about 100 psi
D. about 200 psi

A

A. 4 times
D. about 200 psi

20
Q

Leaks must not exceed ____ ml/min inside the anesthesia machine.
A. 15
B. 20
C. 25
D. 20

A

C. 25 ml/min

21
Q

The O2 failure safety device: Select 2

A. kicks in if o2 pressure is reduced to 40 psi
B. kicks in if o2 pressure is reduced to 30 psi
C. increases nitrous
D. decreases or dc’s nitrous
E. maintains at least 18% o2 conc at common gas outlet

A

B. If O2 pressure is reduced to 30 psi,
D. nitrous will be decreased or discontinued

and it will maintain at least 19% O2 concentration at the common gas outlet.

Oxygen failure alarm will sound within 5 seconds

22
Q

Where does oxygen flush get its supply? Pick 2.
And where does it send O2? pick 1.
A. pipeline inlet
B. hanger yoke
C. flowmeter
D. cylinder pressure regulator
E. common gas outlet
F. risers

A

Receives oxygen from A. pipeline inlet
or from D. cylinder pressure regulator

and it sends O2 to E. common gas outlet

23
Q

What are the standards for the oxygen flush?
A. must be operable w/ 1 hand
B. multi purpose
C. self-closing
D. designed to minimize accidental use
E. have flow between 35-75 L/min
F. all but B
G. all but B and C
H. all of the above

A

F. ALL BUT B

Entire list:
* 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)

24
Q

What are the 2 hazards of using the oxygen flush?

A
  • Barotrauma
  • Awareness

awareness b/c we end up delivering a dilute concentration of gas

25
Q

What details must the flow adjustment control (knobs) have? Select 2.
A. can have 2 controls for each gas
B. only one control for each gas
C. must be on opposite side of flowmeter
D. must be adjacent to its flowmeter

A

B. only one control (knob) for each gas
D. must be adjacent to its flowmeter

can be mechanical or electronic

26
Q

What is unique about the oxygen flow knob?
A. smooth and larger than other gases
B. smooth smaller than other gases
C. fluted and smaller than other gases
D. fluted and larger than other gases

A

D. It must be fluted and larger than other gases (looks and feels different)

27
Q

What are 3 components of the low-pressure system?
A. hanger yoke
B. flowmeters
C. common gas outlet
D. unidirectional valves w/in the machine
E. O2 failure safety device
F. O2 flush

A

B. Flowmeters
C. Common gas outlet
D. Unidirectional valves (within the machine)
Also includes:
* Hypoxia prevention devices
* Pressure relief devices

total of 5 components..

28
Q

The low-pressure system is downstream of __.
A. O2 flush valve
B. common gas outlet
C. flow control devices
D. flowmeters

A

C. flow control devices (knobs)

pressure is slightly above atmospheric and variable but depends on flow from flowmeters and backpressure from breathing circuit

29
Q

The flowmeter indicates the rate that gas is passing through. Describe the design of a flowmeter: Select 2.
A. horizontal glass tube
B. smallest diameter at top
C. free floating indicator
D. a stop at top of tube
E. larger diameter at bottom

A

C. free floating indicator
D. with a stop at top of tube

It’s a Thorpe (vertical glass) tube with smallest diameter at the bottom and a flow scale

30
Q

Flowmeters have 2nd stage pressure regulators, so they maintain:
A. 14-30 psi
B. 30-40 psi
C. 45-55 psi
D. 50-60 psi

A

A. 14-30 psi

31
Q

What is the flowmeter sequence for normal gas flow?
A. left to right: top to bottom
B. right to right: top to bottom
C. bottom to top; left to right
D. bottom to top; right to left

A

C. Normal gas flow = bottom to top and left to right

we want either C (Drager) or D (Ohmeda) in the picture aka fail-safe bc O2 is on the far right!

32
Q

The standard requires ____ flowmeter to be placed on the right side.
A. air
B. nitrous
C. oxygen
D. volatile anesthetic

A

C. Oxygen

less chance of leaking and becoming hypoxic

33
Q

What are the 2 hypoxia prevention mechanisms found in low pressure system?

A
  • Mandatory Minimum Oxygen Flow (requires a minimum of 50-250mL/min)
  • Minimum Oxygen Ratio (requires minimum amount of o2 on if nitrous is on)
34
Q

The mandatory minimum oxygen flow is __ ml/min.

A
  • 50 to 250 ml/min

Master switch needs to be ON for mandatory minimum oxygen flow to work.

35
Q

The minimum oxygen ratio is a gas ratio between:
A. air and O2
B. O2 and nitrous
C. CO2 and O2
D. O2 and volatile anesthetic

A

B. Gas ratio between oxygen and nitrous

36
Q

Linkage between O2 and nitrous engages when oxygen concentration is ___.
A. 20%
B. 21%
C. 25%
D. 30%

A

Linkage engages when oxgyen concentration is C. 25%.

prevents delivery of a hypoxic mixture to the patient if using nitrous

37
Q

Where are the unidirectional valves located in the low-pressure system?
A. between the vaporizer and common gas outlet
B. between the vaporizer and flowmeter
C. between the flowmeter and common gas outlet

A

A. between the vaporizer and common gas outlet.

38
Q

The low-pressure unidirectional valves are __ (upstream or downstream) from oxygen flush valve.

A

upstream (before) the oxygen flush valve

lessen the back pressure from flush or breathing circuit

39
Q

In low pressure system:

What does the pressure relief valve do?
A. is far from common gas outlet
B. won’t vent if preset pressure is exceeded
C. limits the ability of the machine to provide adequate jet ventilation
D. doesn’t allow machine to increase O2 flows

A

C. Limits the ability of the machine to provide adequate jet ventilation

but functionally, it is near the common gas outlet and is open to the atmosphere to vent excess pressure above the preset

40
Q

T/F: The common gas outlet should not be used for supplemental oxygen.

A

True!!
This would cause delay in emergencies and could potentially delivery inhalation agents.

use axillary o2 flowmeter instead

41
Q

What component receives all gases from the machine and delivers the mixture to the circle system?
A. flowmeter
B. unidirectional valves
C. thorpe tubes
D. common gas outlet

A

D. Common gas outlet

it MUST be difficult to disconnect

42
Q

What can deliver oxygen in case of an electronic power failure?
A. common gas outlet
B. flow adjustment control
C. alternate o2 control
D. o2 flush

A

C. Alternate Oxygen Control

If you press this button, everything shuts off but this oxygen back up supply.