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Principles of Anesthesia I > E3 - Compressed Gases and Vaporizers > Flashcards

E3 - Compressed Gases and Vaporizers Flashcards

1
Q

PSI stands for:

A

pounds per square inch

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2
Q

What are the gases that do not liquify at ordinary ambient temperatures regardless of the pressure applied? Select 3
A. O2
B. air
C. nitrous
D. CO2
E. CO
F. helium

A

A. Oxygen
B. Air
F. Helium

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3
Q

A liquified gas can become a liquid at ambient temperature and at pressures from ____- _____psi
A. 15 to 1000 psi
B. 20 to 1000 psi
C. 25 to 1500 psi
D. 30 to 1250 psi

A

C. 25 to 1500 psi

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4
Q

What are 2 examples of liquified gases?
A. air
B. N2O
C. CO
D. CO2
E. O2

A

B. Nitrous oxide
D. Carbon dioxide

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5
Q

What government agencies are involved with compressed gases used in the OR and how are they involved? Select 3
A. FDA… labeling
B. DOT… purity
C. Dept of Labor/OSHA… employee safety
D. FDA… purity
E. DOT…. storage, handling
F. Dept of Labor/OSHA… marking

A

C. OSHA (employee safety)
D. FDA (purity of substance)
E. DOT (marking, labeling, storage, handling)
And:
National Fire Protection Association

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6
Q

What are components of the cylinder? Select 3.
A. pressure relief device
B. PEEP
C. neck with no handle
D. PISS
E. check valve
F. cap

A

A. Pressure Relief Device
D. Pin Index Safety System (PISS)
E. Check Valve
And: body & Handle (to open and close cylinder)

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7
Q

What is the body of the cylinder made out of? What kind of bases do they have?
A. steel; concave
B. aluminum; round
C. plastic; concave
D. steel carbon fiber; convex

A

A. Steel , Steel Carbon Fiber , or Aluminum ; Flat or concave bases

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8
Q

What is the valve of the cylinder made out of? Where on the cylinder is it attached?
A. silver; to the neck
B. bronze or brass; to the handle
C. silver; to the body
D. bronze or brass; to the neck

A

D. Bronze or Brass; attached to the neck

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9
Q

What is the function of the valve on the cylinder?
A. prevents discharge of gas
B. allows refilling and discharge of gas
C. allows removal of gas
D. prevents escape of gas

A

B. The valve is attached to the neck of the cylinder and allows refilling and discharge of gas

O2 tanks are now refilled away from the facility.

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10
Q

What is used to open/close the cylinder?

A

Handle

duh

Handles should be attached to EVERY cylinder

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11
Q

What component vents cylinder contents to the atmosphere if pressure increases to a dangerous level (overheating or filling)?
A. Valve closes
B. Non-fusible plug
C. Pressure relief device
D. Disc that sticks

A

C. Pressure relief device

can be a disc that opens, a fusible plug that melts, or a valve opens

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12
Q

What is the Pin Index Safety System?
A. pins that click cylinder in
B. pins numbered but do not fit specific hole
C. pins that fit corresponding holes in the cylinder valves
D. pins that could correspond to multiple cylinders

A

C. Pins protrude from yokes and fit corresponding holes in the cylinder valves, providing a mostly “fool-proof” way of connecting the appropriate gas to the appropriate valve.

oxygen tank is 2&5 ; nitrous tank is 3&6

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13
Q

What is the most common cylinder size on anesthesia machines?
A. A
B. B
C. C
D. D
E. E

A

E. Cylinder size E on anesthesia machines

D for transport, A is smallest

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14
Q

What size cylinders are used for transport?
A. A
B. E
C. D
D. C

A

C. Cylinder size D are used for transport

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15
Q

What is the smallest size cylinder?
A. A
B. F
C. E
D. D

A

A. Cylinder size A is the smallest

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16
Q

What is the O2 tank PSI? wall PSI?
A. approx 45 psi; wall - 35-40 psi
B. approx 30 psi; wall - 50-55 psi
C. approx 45 psi; wall - 50-55 psi
D. approx 30 psi; wall - 35-40 psi

A

C. approx 45 psi; wall - 50-55 psi

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17
Q

T/F: O2 tank must remain closed.

A

True.
Per Dr Kane: if left open and wall pressure fails, no audible alarm to let us know that we’re switching from wall pressure to tank pressure…so it won’t to let us know that we only have mins left before the pt is just breathing room air lol

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18
Q

What is the pressure and content of a full non-liquified (o2, air, helium) gas tank on an anesthesia machine?
Half?
Quarter full?
empty?

A

Full: 1900; 600 L
Half: 950 psi; 330 L
Quarter full: 475 psi; 165 L
empty: 0 psi; 0 L

Non-liquified gases: Pressure decreases as volume decreases. Half the volume, Half the psi.

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19
Q

For liquified gases (N2O, CO2), the pressure depends on ______.
A. volume
B. vapor pressure
C. content
D. liquid remaining

A

B. Vapor Pressure
This makes the pressure in tank NOT an indication of remaining volume.

Note: the full and half tank of Nitrous have different volumes remaining, but both have a pressure of 745 psi. Pressure is not an indicator of volume for liquified gas.

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20
Q

What are some of the Department of Transportation (DOT) regulations for cylinders? Select 3
A. next service date
B. test date
C. name and address of manufacturer
D. hectagon shaped label
E. expiration date of contents
F. name and address of hospital

A

B. test date
C. name and address of manufacturer
E. expiration date of contents

Entire List:
* Service pressure
* Test date
* Diamond shaped label indicating hazard of gas…danger, warning, or caution
* Name and address of manufacturer
* Expiration date of contents

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21
Q

Cylinder Standards:

Valves, regulators, gauges should never come into contact with what? Select 2

A. hand sanitizer
B. oil, lube
C. perfume
D. grease
E. hairspray

A

B. Oil, Lubricants
D. Grease

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22
Q

Cylinder Standards:

Should never subject cylinder to temps above ______
A. 50 deg C
B. 52 deg C
C. 54 deg C
D. 56 deg C

A

C. 54 deg C (130 F)

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23
Q

Cylinder Standards:

You should NEVER cross use what 3 things:
A. hoses
B. regulators
C. knobs
D. gauges
E. outlets
F. valves

A

A. Hoses
B. Regulators
D. Gauges

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24
Q

Cylinder Standards:

What must not be altered?
A. original gauges
B. original valves
C. original hoses that connect to cylinders
D. original markings and labels on cylinder

A

D. Original Markings on Cylinder and Original Labels

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25
Q

Associate the color with gas:
Green
Blue
Yellow

A
  • Green = Oxygen
  • Blue = Nitrous
  • Yellow = Air
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26
Q

Describe the conditions of storage rooms for cylinder tanks: Select 2
A. adequate ventilation
B. exposed to fumes
C. stored horizontal in bins
D. full seperated from empty

A

A. Adequate ventilation
D. Full tanks separated from empty tanks

and:
* “No smoking,” or “No Combustibles” signs
* Cylinders are not exposed to corrosive chemicals, fumes
* Stored upright in bins
* Do not wrap or drape cylinders

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27
Q

Things to consider when using gas cylinders. Select 3.
A. Check if tamper seal is removed
B. Inspect label, pin index holes, regulator, valve outlet
C. Check to make sure there are 2 washers in place
D. Open the valve (slowly) to relieve excess pressure before bringing the cylinder to pt
E. Face the valve outlet toward people
F. Allow leaks to ensure the pressure isn’t too high

A

A. Check if tamper seal is removed
B. Inspect label, pin index holes, regulator, valve outlet
D. Open the valve (slowly) to relieve excess pressure before bringing the cylinder to pt

ALSO:
* Check if (ONE) washer is in place
* Face valve outlet away from people
* Check service pressure
* Correct leaks

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28
Q

How do oxygen, nitrous, and air get delivered throughout the hospital?
A. tank trucks outside
B. from other hospitals
C. only tanks
D. pipeline systems

A

D. Pipeline Systems

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29
Q

Where are the 2 possible locations for the Central Supply?
A. Outdoors in open field
B. Indoors in secure area
C. Indoors in non-secured area
D. Outdoors in an enclosure

A

B. Indoors in secure area
D. Outdoors in an enclosure

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30
Q

A Central Supply “bank” must contain gas for at least how many days?

A
  • 2 days
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31
Q

What cylinder size would be stored in a bank with gaseous oxygen supply?
A. A and D
B. B and C
C. D and E
D. G and H

A

D. G and H cylinders

Refilled on site or transported

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32
Q

What is the difference between a gaseous o2 supply and a liquid o2 supply?
A. Gaseous oxygen supply is less expensive and more convenient to store.
B. Gaseous oxygen supply is refilled by supply trucks.
C. Liquid oxygen supply is less expensive and more convenient to store.
D. Liquid oxygen supply is refilled on site or transported.

A

C. Liquid oxygen supply is less expensive and more convenient to store, refilled by supply trucks, and service can not be interrupted

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33
Q

Class of Piping:

What is a main line?
A. connect supply trucks to gas source
B. connect gas source to risers
C. connect risers to branch
D. connect bank to branch

A

B. Main lines: connect gas source (central supply) to risers

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34
Q

Risers are vertical pipes connecting:
A. supply truck to branch lines on each level of the facility
B. central supply to branch lines on each level of the facility
C. main line with branch lines on each level of the facility
D. central supply with a section supplying a group of rooms on each level of the facility

A

C. Risers are vertical pipes connecting main line with branch lines on each level of the facility

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35
Q

What is a branch class of piping?
A. sections supplying a room or group of rooms on multiple levels of the facility
B. sections supplying a room or group of rooms on one level of the facility
C. vertical piping connecting central supply to one level of the facility
D. vertical piping connecting central supply to multiple levels of the facility

A

B. Branch - sections supplying a room or group of rooms on one level of the facility

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36
Q

What permit specific areas of the piping system to be isolated for problems/maintenance?
A. risers valves
B. turn on valves
C. shut off valves
D. main line valves

A

C. Shut-off Valves

37
Q

The area alarm system must be in at least which 2 places?
A. maintenance
B. house supervisor
C. the unaffected unit
D. engineering
E. OR main desk

A

A. maintenance
D. engineering
Also should be in: affected unit and/or critical life support area

bottom line: system MUST alarm in at least 2 places!!

38
Q

The area alarm system will be triggered if pressure increases/decreases ____ % from normal.
A. 5
B. 10
C. 15
D. 20

A
  • 20% from normal
39
Q

Area system alarm must be ________ AND ________.
A. inaudible and invisible
B. inaudible and visible
C. audible and invisible
D. audible and visible

A

D. audible AND visible

cmon now

40
Q

What are terminal units?
A. the point in piped gas distribution where user connects and disconnects by hose
B. user is not able to connect and disconnect by hose
C. the point in risers where user connects and disconnects by hose
D. the point in main branch where user connects and disconnects by hose

A

A. Point in piped gas distribution where user connects and disconnects by hose

41
Q

What safety system does the terminal unit use for wall units?
A. NISS
B. SISS
C. DISS
D. PISS

A

C. Diameter Index Safety System (DISS)
PISS for cylinders ; DISS for wall units

Nipple and nut vary in bore and diameter

42
Q

What allows convenient connection with one/both hands to terminal units?
What is the drawback to this?

A
  • Quick Connectors
  • Drawback: Quick Connectors leak more
43
Q

Where are 3 possible locations for Quick Connects?
A. wall
B. floor
C. ceiling-mounted
D. storage room
E. ceiling column

A

A. Wall
C. Ceiling - mounted
E. Ceiling column

cmon now

44
Q

Volatile anesthetics exist in a liquid state below what temperature?
A. 18 deg C
B. 20 deg C
C. 30 deg C
D. 68 deg C

A

B. 20 C (68 F)

45
Q

In a closed container, molecules escape liquid to __________ phase.
A. solid
B. vapor
C. slush
D. slime

A

B. Vapor

46
Q

Saturated vapor pressure (SVP) is when equilibrium is achieved between:
A. the vapor and solid phases at a opposite temperature
B. the liquid and vapor phases at a constant temperature
C. the liquid and vapor phases at a opposite temperature
D. the vapor and gas phases at a constant temperature

A

B. the liquid and vapor phases at a constant temperature

Basically, when vapor molecules hit walls of a container until it has reached an equilibrium of the liquid’s surface!

Gas phase above liquid contains all the vapor it can hold

47
Q

Saturated vapor pressure is dependent on:
A. atmospheric pressure and temperature of liquid
B. characteristics and atm pressure of liquid
C. characteristics and temperature of liquid
D. temperature of liquid and barometric pressure

A

C. characteristics and temperature of liquid

saturated vapor pressure is INDEPENDENT of atmospheric pressure

48
Q

State Dalton’s Law

A
  • Sum of all the Partial Pressures (P1 + P2 + P3…) = Total Pressure
49
Q

Define Partial pressure

A

Part of the total pressure of any one gas in a mixture

make schmidt (daddy) proud

50
Q

What is the concentration of a gas in a mixture expressed as a percentage?

A

Volumes percent

51
Q

Partial Pressure / Total Pressure =

A

Volume percent

52
Q

Vapor pressure is independent of _______
A. temperature
B. liquid state
C. barometric pressure
D. subatmospheric pressure

A

C. Atmospheric Pressure (Barometric Pressure)

53
Q

Vapor pressure is dependent on what 2 things?
A. Characteristics of vapor
B. temperature of vapor
C. Characteristics of liquid
D. temperature of liquid

A

C. Characteristics of liquid
D. Temperature of liquid

54
Q

Vapor Pressure of Halothane (Fluothane)

A

243 mmHg

55
Q

Vapor Pressure of Isoflurane (Forane)

A

238 mmHg

56
Q

Vapor Pressure of Desflurane (Suprane)

A

669 mmHg

57
Q

Vapor Pressure of Sevoflurane (Ultane)

A

157 mmHg

58
Q

The temperature at which vapor pressure equals atmospheric pressure is called:

left this from last years class

A
  • Boiling point
59
Q

Which volatile anesthetic has a vapor pressure almost equal to atmospheric pressure?

A

Desflurane (Suprane) = 669 mmHg
rmbr: atm is 760 mmHg

And boiling point of Desflurane 22.8C (73F)

60
Q

What is the number of calories necessary to convert 1 gram of liquid into vapor (or 1 mL of liquid to vapor)?
A. boiling point
B. vapor point
C. specific heat
D. heat of vaporization

A

D. Heat of Vaporization

heat is energy (aka calories) transferred from one source to another causing a change in temp

61
Q

Describe equilibrium shifts that occur in the vaporizer.

  • As carrier gas flows through vaporizer, vapor molecules leave.
  • Then, liquid temperature ____ (rises or drops), causing vapor pressure to ____ (rise or drop).
  • There will be an equilibrium shift; more molecules in a ____ (liquid or vapor) state.
  • So, output of vapor will ____ (decrease or increase).
A
  • As carrier gas flows through vaporizer, vapor molecules leave.
  • Liquid temperature drops, causing vapor pressure to drop.
  • There will be an equilibrium shift, more molecules in a liquid state.
  • Output of vapor will decrease.

More heat will be needed to increase vapor output.
Vapor pressure is dependent on heat (temperature).

62
Q

What is the number of calories required to raise the temperature of 1 g of a substance 1 degree C?
A. specific heat
B. heat of vaporization
C. thermal conductivity
D. boiling point

A

A. Specific Heat

The higher the specific heat, the more heat required to raise the temp of the substance

63
Q

Specific Heat of Water

A

1 cal/g

water is the standard!

64
Q

Material with higher specific heat minimize _________.
A. vapor pressure
B. temperature variation
C. conductivity
D. equilibrium

A

B. Temperature Variation

65
Q

The ‘speed’ at which heat flows through a substance is called:
A. evaporization
B. specific heat
C. vapor pressure
D. thermal conductivity

A

D. Thermal Conductivity

The higher the thermal conductivity, the better the substance conducts heat (coffee mug has high thermal conductivity)

66
Q

Metals with high thermal conductivity minimize ____ during vaporization.
A. carrier gas flow
B. calories burned
C. temperature swings
D. specific heat

A

C. temperature swings

COPPER and ALUMINUM = high thermal conductivity

67
Q

Modern vaporizers are ____-calibrated and ____ bypass.
A. high flow ; variable
B. concentration ; variable
C. concentration ; set
D. high flow ; set

A

C. Modern vaporizers are concentration-calibrated and variable bypass.

and are NOT calibrated for high flows of o2 flush

68
Q

Where is the vaporizer located on anesthesia machine?
A. between flow meter and common gas outlet
B. between flow meter and inspiratory limb
C. between common gas outlet and inspiratory limb
D. between common gas outlet and O2 flush

A

A. between flow meter and common gas outlet

may NOT be past common gas outlet!!

69
Q

left from last year’s class

What happens if the vaporizer is before the flow meter?

What happens if the vaporizer is after the common gas outlet?

A
  • Carrier gas will be on the wrong side and will not be able to pick up adequate vapor molecules
  • There will be less stability and flow of vapor molecules delivered to the patient
70
Q

What makes up the splitting ratio?

A

Vaporizing chamber flow rate: Bypass pathway flow rate

Higher splitting ratio means more flow will go through vaporizing chamber, higher anesthetic gas delivery.

71
Q

What are the two types of variable-bypass vaporizers?

hint: modern one and an old one

A
  • Flow-over (modern)
  • Bubble through (older)
72
Q

left from last year’s class

Why is desflurane heated in the vaporizer when its boiling point is at room temperature?

A
  • There is a lot of variability at room temperature.
  • Desflurane is heated to a precisely controlled temperature and stable vapor phase.
  • The heated vapor is then “injected” into the fresh gas flow to deliver a precise anesthetic concentration.
73
Q

What factors can influence vaporizer output and potentially be hazardous? Select 3
A. pumping effect
B. FGF rate
C. room temperature
D. underfilling
E. leaks

A

A. Pumping Effect
B. FGF Rate
E. Leaks
and:
* Placing incorrect agent in the vaporizer
* Effects of Rebreathing
* Barometric Pressure
* Tipping
* Overfilling

74
Q

Why is placing the incorrect volatile agent in the vaporizer unlikely?
A. vaporizer would alarm
B. CO2 absorber would change color right away
C. FGF would not increase w/ wrong agent
D. filling systems are agent-specific

A

D. Filling systems are agent-specific

75
Q

What should the monitor show if incorrect agent is added to vaporizer?
A. would detect 2 vapors (incorrect + correct)
B. higher ETCO2
C. lower ETCO2
D. higher ET O2

A

A. the monitor will detect 2 vapors if incrorect agent is added to the vaporizer

76
Q

What happens to the vaporizer output if the flow rate is less than 250 ml/min?
A. output will be more than setting
B. output will be less than setting
C. output will be unchanged

A

B. Output will be less than setting
High density of volatile prevents upward movement of molecules

77
Q

What happens to the vaporizer output if the flow rate is greater than 15 L/min?
A. output will be more than setting
B. output will be less than setting
C. output will be unchanged

A

B. Output will be less than setting
Failure to saturate carrier gas because the carrier gas is too fast.

78
Q

What are two common causes of the anesthesia machine’s intermittent back pressure (pumping effect)?
A. CO2 absorbent exhausted
B. NPV
C. PPV
D. O2 flush valve
E. Scavenging system blocked

A

C. Positive Pressure Ventilation
D. Oxygen Flush Valve

79
Q

The pumping effect is more pronounced with: Select 2
A. high flow rates
B. low flow rates
C. high dial settings
D. low levels of liquid in vaporizing chamber

A

B. Low flow rates
D. Low levels of liquid in the vaporizing chamber
AND: Low dial settings

80
Q

What problem does the pumping effect have on vaporizer output?
A. inconsistency in maintaining alveolar pressure of anesthetic vapors
B. can’t maintain inspiratory pressure of anesthetic vapors
C. causes more rebreathing
D. causes low levels of liquid in chamber

A

A. Inconsistency in maintaining alveolar pressure of anesthetic vapors

Negate the pumping effect by maintaining adequate flow rate and dial setting!

81
Q

What object in the anesthesia machine counters the pumping effect?
A. shorter tube for inlet of vaporizing chamber
B. vaporizer interlock
C. larger vaporizer chambers
D. check valve

A

D. Machine Outlet Check Valve
and:
* Smaller vaporizing chambers
* Baffle systems
* Longer tube for the inlet of vaporizing chamber

82
Q

Vaporizers are calculated at ____ mmHg.

A
  • 760 mmHg (sea level)
83
Q

How does tipping affect vaporizer output? select 2
A. excessively high output
B. moderate output
C. extremely low output
D. due to liquid entering bypass chamber
E. due to liquid leaving bypass chamber

A
  • There will be an A. excessively high output due to liquid D. entering bypass chamber
84
Q

Vaporizer leaks can be caused by:
A. opened gas tank
B. tight caps
C. drain valves
D. broken dial

A

C. Drain valves
and:
* Loose filler caps
* Vaporizer/mounting bracket interface

85
Q

What would be 2 indicators of vaporizer leaks?
A. patient too deep
B. co2 canister used faster
C. higher than expected inhaled concentration
D. odor of gas
E. lower than expected inhaled concentration

A

D. Odor of gas
E. Lower than expected inhaled concentration

86
Q

What will be the patient consequence of a vaporizer leak?
A. pt too deep
B. more N/V
C. patient movement
D. patient awareness

A

D. Patient awareness

87
Q

What are some vaporizer safety standards? select 2
A. average concentrations +/- 10% of setting
B. Gas may not pass through more than 1 vaporizer
C. All control knobs counterclockwise
D. output of vaporizer <1.0% in OFF

A

B. Gas may not pass through more than 1 vaporizer
C. All control knobs counterclockwise

And:
* Average concentrations +/- 20% of setting
* Output of vaporizer <0.05% in OFF
* Filling levels displayed

88
Q

What are the mounting standards of the vaporizer? Select 3.
A. permanent
B. locking lever on back
C. easily removed and replaced
D. low weight of vaporizer
E. detachable
F. does not create a seal so it can be removed easier

A

B. Locking lever on the back
C. Easily removed and replaced (especially for MH)
E. Detachable

and:
* Weight of vaporizer and “O” ring creates seal

89
Q

What prevents more than 1 vaporizer from being turned on at a time?
A. DISS
B. PISS
C. interlock device
D. valve system

A

C. Interlock Device

Principles of Anesthesia I (27 decks)

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