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Principles 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

Cylinder - primary vs emergency source

A

o Primary – used for transport
o Emergency – if pipeline fails + use tanks on back of machine

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3
Q

What are the colors of each gas?

A

o Oxygen = green
o Air = yellow
o Nitrous = blue
o Vacuum = white

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4
Q
  • Define Non-Liquified gas.
  • What were examples?
A
  • gases that do not liquefy at ordinary ambient temperatures regardless of the pressure applied
  • Oxygen
  • Air
  • Helium
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5
Q

A liquified gas can become a liquid at _________ temperature and at pressures from ____- _____psi

A
  • ambient
  • 25 to 1500 psi
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6
Q

What were examples of liquified gases?

A
  • Nitrous oxide
  • Carbon dioxide
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7
Q

What government agencies are involved with compressed gases used in the OR?

A
  • FDA (purity of substance)
  • DOT (marking, labeling, storage, handling)
  • OSHA (employee safety)
  • National Fire Protection Association
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8
Q

Name 4 components of the cylinder:

A
  • Body
  • Check Valve
  • Handle
  • Pressure Relief Device
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9
Q

What is the body of the cylinder made out of?

A
  • Steel
  • Steel Carbon Fiber
  • Aluminum - for MRI
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10
Q

What kind of bases do the cylinders have?

A
  • Flat Base
  • Concave Base
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11
Q

What is the check valve of the cylinder made out of?

A
  • Bronze
  • Brass
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12
Q

What is the function of the valve on the cylinder?

A
  • The valve is attached to neck of the cylinder
  • allows refilling and discharge of gas
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13
Q

What is used to open/close the cylinder?

A
  • Handle
  • Handles should be attached to EVERY cylinder*
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14
Q

What component vents cylinder contents to the atmosphere if pressure increases to a dangerous level (overheating or filling)?

A
  • Pressure relief device
  • (Safety relief)
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15
Q

What is the Pin Index Safety System?

A
    • Prevents crossover of the wrong tank into the wrong fitting
    • Holes on cylinder valve positioned in an arc below outlet port
    • Pins on the yoke or pressure regulator are positioned to fit into these holes

Oxygen = 2, 5 … Nitrous = 3, 5

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16
Q

What are 3 methods a pressure relief device works?

A
  1. Disc that bursts
  2. Fusible plug melts
  3. Valve opens + raises to let gas out or compresses a spring
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17
Q

How are cylinder sizes labeled?

What is the most common cylinder size on anesthesia machines?

A
  • Letter code :: A-H
  • A = smallest
  • H = largest - for refilling smaller tanks
  • E = most commonly on back of anesthesia machines
  • D = for transport
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18
Q

What size cylinders are used for transport?

A
  • Cylinder size D are used for transport
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19
Q

Pressure decreases as volume decreases .. with what type of gas ?

A

Non-Liquified
oxygen, air, helium

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20
Q
  • what is the approx psi of cylinder?
  • must remain ______. why?
A
  • 45 psi
  • closed - audible alarm that signals changing from wall to tank
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21
Q

Non-Liquified Gas

Pressure and volume when full?
Half full?
Quarter full?
Empty?

A
  • 600 L @ 1900 psi
  • 330 L @ 950 psi
  • 165 L @ 475 psi
  • 0 L @ 0 psi
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22
Q
  • With liquified gas, pressure depends on what?
  • the ___________ is not an indication of remaining ________________
A
  • vapor pressure
  • pressure ,, volume
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23
Q

Liquified Gas

What are the weight, volume, + pressure of nitrous oxide at….
* Full?
* Half Full?
* No liquid remaining (vapor only)?
* Nearly empty (no vapor either)?

A
  • 20.7 lb ,, 1590 L ,, 745 psi
  • 17.3 lb ,, 745 psi
  • 14.2 lb ,, 250 L ,, 745 psi
  • 14.1 lb ,, 125 L ,, 350 psi

PSI doesnt fall until nearly empty

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24
Q

What are the Department of Transportation (DOT) regulations for cylinders?

A
  • 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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25
Q

Cylinder Standards: Valves, regulators, gauges never come into contact with what?

A
  • Oil
  • Grease
  • Lubricants
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26
Q

Cylinder Standards: Never subject cylinder to temps above ______

A
  • 54 C (130 F)
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27
Q

Cylinder Standards: Never cross use what?

A
  • Hoses
  • Regulators
  • Gauges
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28
Q

Cylinder Standards: What must not be altered?

A
  • Original Markings on Cylinder
  • Original Labels
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29
Q

Cylinder Standards

  • connections always ______
  • cannot be ________
  • valve kept ______ at all times
  • properly ________ to revent fall
A
  • tight
  • dropped, drug, slid
  • closed
  • secured
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30
Q

Associate the color with gas:
Green
Blue
Yellow
White

A
  • Green = Oxygen
  • Blue = Nitrous
  • Yellow = Air
  • White = Suction
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31
Q

Describe the 6 conditions of storage rooms for cylinder tanks.

A
  • Adequate ventilation
  • “No smoking,” or “No Combustibles” signs
  • Cylinders are not exposed to corrosive chemicals, fumes
  • Stored upright in bins
  • Full tanks separated from empty tanks
  • Do not wrap or drape cylinders
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32
Q

8 things to consider prior to using gas cylinders.

A
  • Inspect label, pin index holes, regulator, valve outlet
  • Check if tamper seal is removed
  • Check if washer is in place
  • Open the valve to relieve excess pressure before bringing cylinder to pt
  • Face valve outlet away from people
  • open slowly
  • Check service pressure
  • Correct leaks
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33
Q

Pipeline systems are used to deliver what kind fo gas?

A

Non-flammable gases
nitrous, oxygen, air

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34
Q

What are the 3 components of pipeline systems?

A
  1. central supply
  2. piping - receiving at 50 psi
  3. terminal units - maintains approx 50 psi
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35
Q

Where are possible locations for the Central Supply?

A
  • Outdoors in an enclosure
  • Indoors in secure area
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36
Q

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

A
  • 2 days
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37
Q

What cylinder size would an oxygen bank be?

A
  • G and H cylinders
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38
Q

Differentiate between a gaseous and liquid oxygen supply source.

A
  • Gaseous supply = contained in large G/H cylinders + refilled on-site or transported
  • Liquid supply = less expensive and more convenient to store, refilled by supply trucks, service not be interrupted
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39
Q

What are the 3 classes of piping?

A
  • Main lines = connect gas source to risers
  • Risers = vertical pipes connecting main line with branch lines on each level of the facility
  • Branch = sections supplying a room or group of rooms on one level of the facility (horizontal)
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40
Q

Permit specific areas of the piping system to be isolated for problems /maintenance.

A
  • Shut-off Valves
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41
Q

The area alarm system must be in at least how many places?

What places will have the gas alarm system?

A
  • 2 places
  • The affected unit, critical life support area, maintenance, engineering
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42
Q

The area alarm system will be triggered if pressure increases/decreases ____ % from normal.

A
  • 20%
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43
Q

Area system alarm must be ________ AND ________.

A
  • audible
  • visible
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44
Q

What are terminal units?

A
  • Point in piped gas distribution where user connects and disconnects by hose
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45
Q

What safety system does the terminal unit use?

A
  • Diameter Index Safety System (DISS)
  • “quick connects”

DISS = Nipple and nut vary in bore and diameter

46
Q

differentiate bw PISS + DISS

A

PISS = cylinders :: hanger yoke pins + holes
DISS = terminal wall units :: nipple + not vary in bore + diameter

47
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
48
Q

Where are possible locations for Quick Connects?

A
  • Wall
  • Ceiling -mounted
  • Ceiling column
49
Q

Define Vaporizer.

A
  • A device that
  • changes a liquid anesthetic agent to a vapor
  • adds controlled amt of vapor to FGF breathing system
50
Q

Volatile anesthetics exist in a liquid state below what temperature?

A
  • 20C (68F)
51
Q
  • In a closed container, molecules escape liquid to __________ phase.
  • These molecules borbard container walls + create _____________________
A
  • Vapor
  • vapor pressure
52
Q

What is saturated vapor pressure (SVP)?

A
  • When equillibrium is achieved bw liquie + vapor phase @ constant temp … from molecules hitting walls of container
  • Gas phase above liquid contains all the vapor it can hold
  • highest amt of vapor pressure
53
Q

Saturated Vapor Pressure

What is SVP dependent on?
What is SVP independent of?

A
  • characteristics + temperature of liquid
  • atmospheric pressure - altitude does not change vapor pressure
54
Q

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

A

Partial pressure

55
Q

State Dalton’s Law

A
  • Sum of Partial Pressure = Total Pressure
  • Part of the total pressure of any one gas in a mixture
56
Q

Partial pressure is dependent on _______.
NOT dependent on ___________

A
  • Temperature
  • atmospheritc pressure
57
Q

The concentration of a gas in a mixture expressed as a percentage

A
  • Volume percent
58
Q

Formula for volumes percent

A

Partial Pressure / Total Pressure = vol percent

59
Q

Vapor pressure is independent of _______

A
  • Atmospheric Pressure (Barometric Pressure)
60
Q

Vapor pressure is dependent on ________

A
  • Characteristics of liquid
  • Temperature of liquid
61
Q

Vapor Pressure of Fluothane

A
  • 243 mmHg

Halothane

62
Q

Vapor Pressure of Forane

A
  • 238 mmHg

Isoflurane

63
Q

Vapor Pressure of Suprane

A
  • 669 mmHg

Desflurane

64
Q

Vapor Pressure of Ultane

A
  • 157 mmHg

Sevoflurane

65
Q

What are the trade names for Halo, Iso, Des, + Sevo?

A
  • halo = fluothane
  • iso = forane
  • des = suprane
  • sevo = ultane
66
Q

%%%

The temperature at which vapor pressure equals to atmospheric pressure.

A
  • Boiling point
67
Q

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

A
  • Desflurane (Suprane)
  • Boiling point of Desflurane 22.8C (73F)
68
Q

Define Heat of Vaporization

A

The number of calories necessary to convert 1 gram of liquid into vapor (or 1 mL of liquid to vapor).

69
Q

What happens to the liquid temperature and vapor pressure as carrier gas flows through the vaporizer, causing the vapor molecules to leave?

A
  • Liquid temperature drops&raquo_space; vapor pressure drop
  • > > equilibrium shift - more molecules in a liquid state
  • > > Output vapor decrease

More heat needed to increase vapor out - Vapor p dependent on temp

70
Q

Define specific heat

A

Number of calories required to raise the temperature of 1 g of a substance 1 degree C

71
Q

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

A

more

72
Q

Specific Heat of Water

A

1 cal/g

The Standard

73
Q
  • Specific heat is considred when choosing ________ for vaporizer.
  • Material with higher specific heat minimizes _________.
A
  • material
  • Temperature Variation
74
Q

Define thermal conductivity

A

The ‘speed’ at which heat flows through a substance

75
Q

The _________ the thermal conductivity, the better the substance conducts heat

A

higher

76
Q

Metals with high thermal conductivity minimize ____________ during vaporization.
Examples??

A
  • temperature swings
  • Copper + aluminum

  • Copper and Aluminum have the best thermal conductivity
77
Q

A device that changes a liquid anesthetic agent to a vapor and adds a controlled amount of that vapor to fresh gas flow in the breathing system.

A
  • Vaporizer
78
Q

Modern vaporizers are
_________-calibrated and _______ bypass.

A
  • Concentration
  • variable
79
Q

Where is the vaporizer located?

A
  • Between flow meter and common gas outlet
80
Q

Where can a caporizer NOT be placed? Why?

A

after common gas outlet ,
bc not calibrated for high flows of oxygen flush

81
Q

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
82
Q

What regulates the concentration of the volatile in the vaporizer (variable bypass)?

A
  • The concentration dial
83
Q

What is the splitting ratio?

A

ratio depends on size of adjustable orfice (hole)
* determines how much FGF bypaasses or goes into vaporizer chamber

84
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.

85
Q

What are the two types of vaporizers?

A
  • Flow-over (modern) - wicks
  • Bubble through (older)
86
Q

%%%%%%%%%%

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.
87
Q
  • in modern vaporizers, there are electronic temperature _______.
  • what changes as temperature changes?
  • ____________ temperature leads to more vapor amt
A
  • sensor
  • splitting ratio nchanges as temperature changes
  • high
88
Q

What are 8 vaporizer hazards?

A
  • Placing incorrect agent in the vaporizer
  • FGF Flow Rate
  • Pumping Effect
  • Effects of Rebreathing
  • Barometric Pressure
  • Tipping
  • Overfilling
  • Leaks
89
Q

Why is placing the incorrect volatile agent in the vaporizer unlikely?

A
  • Filling systems are agent-specific
  • each type has different “key” hole for each gas type
  • monitor will show 2 different vapors
90
Q

How do you fix this issue if you somehow get the wrong agent in the vaporizer?

A
  • Vaporizer must be completely drained, and all liquid discarded
  • Run FGF at 8-10 L/min until no vapor is detected

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

91
Q

What does FGF have to be between to have no vaporizer problems?

A

250 mL/min – 15 L/min

92
Q

What happens to the vaporizer output if the flow rate is less than 250 ml/min?

A
  • vaporizer Output < setting
  • High density of volatile prevents upward movement of molecules
93
Q

What happens to the vaporizer output if the flow rate is greater than 15 L/min?

A
  • vaporizer Output < setting
  • Failure to saturate carrier gas
94
Q

What are two common causes of the anesthesia machine’s intermittent back pressure (pumping effect)?

A
  • Positive Pressure Ventilation
  • Oxygen Flush Valve
95
Q

The pumping effect is more pronounced with:

A
  • Low flow rates
  • Low dial settings
  • Low levels of liquid in the vaporizing chamber
96
Q

What problem does the pumping effect have on vaporizer output?

A
  • Inconsistency in maintaining alveolar pressure of anesthetic vapors

Negate the pumping effect by maintain adequate flow rate and dial setting

97
Q

What object in the anesthesia machine fixes/inhibits the pumping effect?

A
  • Machine Outlet Check Valve
98
Q

What are 4 measures to attenuate the pumping effect besides the machine outlet check valve?

A
  • Smaller vaporizing chamber
  • Baffle system
  • Longer tube for the inlet of the vaporizing chamber
  • addition of check valve
99
Q

Effects of rebreathing with high FGF?

Effects of rebreathing with low FGF/high Vm?

A
  • Little exhaled gas rebreathed
  • Significant rebreathing with low FGF
100
Q

Remember :: vapor pressure is _________ of barometric/atm pressure

A

independent

101
Q

Vaporizers are ALWAYS calculated at __________

A
  • sea level (760 mmHg)

Unless requesed to be another level - denver

102
Q

%%%

Why will an increase in altitude not affect the delivery of Isoflurane or Sevoflurane?

A
  • Isoflurane and Sevoflurane are not pressurized. They operate as a function of atmospheric pressure.
  • At sea level, atm = 760 mmHg. This pressure keeps molecules down in the liquid phase.
  • So, in higher elevations, there will be less atmospheric pressure. Which means more molecules can escape as a gas.
  • The decrease in atmospheric pressure and the increase in the volume percent of gas will equal the partial pressure of gas delivered at sea level.
  • Refer to the math below or watch the YouTube link.
  • https://www.youtube.com/watch?v=UgViWCNVgOA&ab_channel=CountBackwardsFrom10
103
Q

Why is altitude increase controversial?

A
  • volumes % increase significtnly
  • partial pressure changes lesser
  • anesthetic dpeth is partial pressure in brain
104
Q

How does tipping affect vaporizer output?
Fix?
what type of vaporizer isolates vaporizer + bypass chamber with transport dial?

A
  • There will be an excessively high output due to liquid entering the bypass chamber
  • hook up to FGF + dry it up
  • drager
105
Q

What problem is seen when liquid enters bypass chamber + excess dose delivered to pt? Now fixed with preventative design.

A

Overfilling

106
Q

Vaporizer leaks can be caused by:

A
  • Loose filler caps
  • Drain valves
  • Vaporizer/mounting bracket interface
107
Q

What would be indicators of vaporizer leaks?

A
  • Odor of gas
  • Lower than expected inhaled concentration (Fi)
108
Q

What will be the patient consequence of a vaporizer leak?

A
  • Patient awareness
109
Q

What are 5 vaporizer safety standards?

A
  • Average concentrations +/- 20% of setting
  • Gas may not pass through more than 1 vaporizer - INTERLOCK
  • Output of vaporizer <0.05% in OFF
  • All control knobs counterclockwise
  • Filling levels displayed
110
Q

What are 4 mounting standards of the vaporizer?

A
  • Detachable
  • Weight of vaporizer and “O” ring creates seal
  • Locking lever on the back
  • Easily removed and replaced (especially for MH)
111
Q

What prevents more than 1 vaporizer from being turned on at a time?

A
  • Interlock Device

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