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Sarah's Physics > Equipment > Flashcards

Equipment Flashcards

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1
Q

How does a VIE work

A

Liquid O2 stored at -150 to -170 and 5-10 atms.
O2 vapour heated and passed through pressure regulator to pipelines at 400kPa

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2
Q

What happens in a VIE at times of increased use

A

Control valve allows liquid O2 to pass through pressure raising vaporiser and super heater to enter pipelines.

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3
Q

What happens in a VIE at times of decreased use

A

Pressure within system increases and a safety valve blows up if goes over 1700kPa

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4
Q

How do oxygen concentrators work

A

O2 extracted from air via differential adsorption through a zeolite medium.

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5
Q

Safety features of gas outlets

A

Schrader sockets, colour coded
O2 black, N2O blue, Air black and white, Suction yellow

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6
Q

Safety features of anaesthetic machine gas outlet

A

Colour coded hoses, NISTs

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7
Q

Safety features of gas cylinders

A

Bodok seal
Pin index system

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8
Q

Gas cylinder sizes

A

D 340L
E 680L
F 1360L

CD 460L

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9
Q

Pin index of air

Pin index of O2

Pin index of N2O

A

1 and 5

2 and 5

3 and 5

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10
Q

Pin index of air

Pin index of CO2

A

1 and 5

1 and 6

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11
Q

Pin index of entonox

A

7

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12
Q

Effect of altitude on concentration of anaesthetic gas

A

Concentration different ie (2x100/100 ) = 2% at 100kPa vs (2x100/50) = 4% at 50kPa therefore partial pressure is the same.

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13
Q

Ideal scavenging system (5)

A
  1. Simple and cheap
  2. Doesn’t affect oxygenation or ventilation
  3. Doesn’t affect breathing dynamics
  4. Can’t be connected to patient (30mm tube)
  5. Doesn’t pollute other parts of hospital
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14
Q

Components of active scavenging system

A

Collection and transfer (between APL and receiver), receiving unit (guards against excessive pressures), disposal through vacuum and copper pipe.

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15
Q

How does a Cardiff aldsorber work

A

Filters volatiles, doesn’t filter N2O, increases weight with use, heating releases gases

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16
Q

Limits of sevoflurane

A

60 ppm

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17
Q

Limits of N2O

A

100 ppm

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18
Q

Limits of isoflurane/ enflurane

A

50 ppm

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19
Q

Limits of halothane

A

10 ppm

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20
Q

Classify breathing systems

A

Open - ether mask

Semi open - Hudson, VM

Semi-closed - Mapleson

Closed - circle (with exp valve closed)

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21
Q

Advantages (4) of circle system

A
  1. Economical - can use low flows
  2. HME gases
  3. Suitable for SV and IPPV
  4. Scavenging
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22
Q

Disadvantages (3) of circle system

A
  1. Complex and risks of disconnection
  2. Rebreathing metabolised products (theoretical)
  3. Requires monitoring (volatiles and O2)
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23
Q

Components of soda lime

Mesh size

A

94% CaOH
5% NaOH/ KOH
0.2% silica and zeolite

4-8

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24
Q

Titan yellow colour change

Ethyl violet colour change

A

Pink –> white

White –> purple

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25
Q

Effect of granule size on CO2 absorption

A

Increased - decreased SA for absorption
Decreased - increased resistance to flow

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26
Q

Features of HME

A

Passive, exhaled gases fully saturated with water pass over mesh and causes water to condense on its surface allowing warmth and humidification of fresh gas.
15 and 22mm fittings
Side port analysis

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27
Q

How do nebulisers add humidification

Risks of ultrasonic nebs

A

Add water particles, not vapour

Risk of over saturation of airway

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28
Q

Types of oxygen analysers

A
  1. Electrochemical
    a) Galvanic fuel cell
    b) Polarographic cell
  2. Physical
    a) paramagnetic
    b) mass spectrometer
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29
Q

How does galvanic fuel cell work

A

Gold cathode and lead anode
Lead anode acts as battery
In KOH solution

Measures voltage generated in proportion to concentration of oxygen.

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30
Q

How does paramagnetic oxygen analyser work

A

Nitrogen dumbbells between two magnets with mirror in the middle.
Oxygen attracted to magnetic field displaces dumbbells. The mirror reflects light which is detected by photocell. Current prop to O2 conc.

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31
Q

Disadvantages of galvanic fuel cell (4)

A

Slow
Temp sensitive
Drifts
Expires

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32
Q

Features of IR spectroscopy

A

Molecules of 2 or more elements can absorb IR radiation.
Ionised and charged particle goes through accelerator. Particles deflected based on mass:charge ratio and detected.

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33
Q

IR peaks of
CO2
N2O
Volatiles

A

4.3 micrometres
4.6 micrometres
3.3 and 8-9 micrometres

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34
Q

Describe graph of current of charging circuit of defibrillator at point of switch closure

A

Time x axis
Current y axis
Exponential decline

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35
Q

Describe graph of voltage of charging circuit of defibrillator at point of switch closure

A

Exponential increase

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36
Q

Sterilisation definition

A

Eliminates all microbes (assurance 1x10^6)

37
Q

Disinfection definition

A

Removes all but bacterial spores

38
Q

Cleaning

A

Removes visible soil

39
Q

Methods of sterilisation (4)

A

Steam
Ethylene Oxide
Ozone
Hydrogen Peroxide

40
Q

Methods of disinfection (3)

A

Thermal wash
Chemical
Pasteurisation

41
Q

What does a pulse oximeter measure

A

Proportion of Hb saturated O2 in pulsatile blood

42
Q

What is the Beer-Lambert law

A

Beer’s law = absorption is directly proportional to the concentration
Lambert’s law = absorption is directly proportional to the length

43
Q

How does a pulse ox work

A

2x light emitting diodes, one red one infrared light, sequence of on/off and off cycle.
Photodetector produces current proportional to ratio of light and compared to reference table

44
Q

What is the isobestic point

A

Point both wavelengths absorptions is the same, 590 and 810 nm

45
Q

What wavelength and type does deoxyHb absorb more

A

Red
660nm

46
Q

What wavelength and type does oxyHb absorb more

A

IR
940nm

47
Q

Sources of pulse ox error

A
  1. Pulsatile
    Poor perfusion
    Dyes
    CO poisoning
    Methhaemagolbinaemia
  2. Non pulsatile
    Movement
    Ambient light
    Nail varnish
    Diathermy
48
Q

Wavelengths of light absorbed by COHb and Met Hb

A

CO Hb 660nm

MetHb both 660 and 940nm

49
Q

How does CO2 monitoring work

A

IR absorption spectrophotometry
Sapphire lens, 4.3nm, detector compares reference and sample chamber

50
Q

Other methods of CO2 monitoring

A

Raman spectrometry (argon laser)
Mass spectrometry
Photoacoustic spectrometry
Chemical colourmetry

51
Q

What is resonance

A

Tendency to oscillate at bigger amplitude

52
Q

How does BP change in the periphery

A

Higher systolic and lower diastolic

53
Q

Non electric methods of temperature monitoring

A

Mercury (to -39)
ETOH (to -70)
Dial

54
Q

Electrical methods of temperature monitoring

A

Theromocouple
Thermistor
Resistance wire

55
Q

How does thermocouple work

Graphical relationship

A

Seebeck effect
Cu/ constantan metals. Voltage generated at junction of metals depending on temperature.

Positive linear

56
Q

Advantages of thermocouple

A

Simple, cheap, tough, small

57
Q

How does thermistor work

A

Semiconductor beads made of chromium or manganese oxides
Resistance decreases as temp increases (expo)

58
Q

Advantages (3)
Disadvantages (2) of thermistor

A
  1. Accurate, cheap, quick, can be used in intravascular devices
  2. Ages, hysteresis
59
Q

How does a resistance wire temperature monitor work

Graphical relationship

A

Platinum wire, resistance increases and temperature increases
Linear

60
Q

Advantages (3)
Disadvantages (2) of resistance wire

A
  1. Accurate, precise, wide temp range
  2. Slow, hysteresis
61
Q

Single twitch NMB monitor character

A

0.1-0.2ms at 1Hz

62
Q

TOF character

A

4 stimuli at 2Hz

63
Q

DBS character

A

2 bursts of 3 stimuli at 50Hz separated by 750ms
Can repeat after 20 secs

64
Q

Tetanic stimulation character

A

5 seconds at 50Hz
3 second pause then can check PTC at 1Hz x 20

65
Q

Correlation of PTC and TOF

A

> 15 = 2 TOF

66
Q

What does a co-oximeter measure

A

OxyHb, DeoxyHb, MetHb, COHb

67
Q

Cathode and anode of a polarographic clark electrode

A

Platinum cathode
Silver/ silver chloride anode

68
Q

Solution of polarographic electrode

A

KOH/ KCl

69
Q

What process occurs at cathode/ anode in Clark electrode

A

Cathode - reduction (gain electrodes)
Anode - oxidation (loss electrodes)

70
Q

Equation at anode at cathode in Clark electrode

A

Anode - Ag + Cl = AgCl + e
Cathode - O2 + 2H2O + 4e = 4OH-

71
Q

How does Serveringhaus (CO2) electrode work

A

Silver/ silver chloride electrode in pH sensitive glass surrounded by HCO3 buffer. CO2 moves through teflon/ rubber membrane. Moves equation to the right which increases H+ ions therefore decreases pH

72
Q

Pros (2) and cons (2) of Severinghaus electrode

A

Pro - accurate, stable
Cons - rate governed by permeability of membrane and rate of reaction

73
Q

Equation of H2O/ CO2

A

H2O + CO2 <–> H2CO3 <–> H+ + HCO3-

74
Q

Components of pH electrode

A

Calibrated with 2x solutions of known pH.
Silver silver chloride measuring electrode in HCl
Mercury/ mercury chloride reference electrode in KCl with porous plug

75
Q

How does a pH electrode work?

A

Electrode is a metal conductor in electron solution enclosed in a membrane with selective ion permeability.
Pourous plug minimises KCl diffusion into sample on reference electrode.
Metal conducts electrons, solution conducts ions. Difference between H+ in sample and HCl at generates EMF/ voltage.

76
Q

How does an oesophageal doppler work

A

Measures velocity of blood flow via the change in frequency of reflected US waves. Velocity can be converted to flow by knowing diameter of aorta. Then can be X HR = CO.

77
Q

Assumptions for use of doppler (4)

A
  1. 70% SV in descending aorta
  2. Diameter same throughout cycle
  3. Blood moving at the same velocity
  4. No blood flow in diastole
78
Q

Measurements doppler gives

A

Peak velocity (contractility)
SV (area of peak)
FTc
CO
Increase in SV by 10% = fluid responsive

79
Q

Explain dye dilution and thermodilution measurement of CO

A

Dye dilution (indocyanine green)(lithium) injected at known amount. Change in conc downstream proportional to flow. CO inversely proportional to AUC

Thermodilution injects known amount cold saline and thermistor detects temperature difference

80
Q

Mechanism of electrical injury (3)

A
  1. Shock (macro and micro)
  2. Burns (direct/ fire)
  3. Interference (acting upon incorrect monitoring)
81
Q

Limits of type 1 electrical equipment

A

B/BF - 0.1 mA –> 0.5 mA SFC
CF - < 0.05mA

82
Q

Limits of type 2 electrical equipment

A

B/BF - 0.1mA –> 0.5mA SFC
CF - <0.01mA

83
Q

Effect of increasing frequency of US waves

A

Increased resolution
Decreased penetrating capacity

84
Q

What is the piezoelectric effect

A

Mechanical stress induced in crystalline substance when potential difference applied across it (or vice versa)

85
Q

How does USS work?

A

Probe generates pulsed sound wave at desired frequency.
Sound waves penetrates to a depth determined by frequency.
Sound waves reflected back to transducer when reaches a barrier between media.
Sound energy converted to electrical energy to display image.

86
Q

What is the doppler effect

A

Frequency of transmitted sound alters as it is reflected from moving object.

87
Q

What is the doppler equation

A

Velocity = (F reflected - F origin) x speed of sound / 2Fo x cos angle between sound and object

88
Q

Use of doppler effect

A

Doppler equation measures velocity.
If cross sectional area of vessel known can measure flow in CO monitoring

89
Q

How does wet dry hygrometer work

A

2 mercury thermometers. One in bulb in water.
Latent heat of vaporisation causes bulb wet bulb to cool.
Amount of evaporation dependent on humidity of air.
(More evaporation = greater cooling).
Difference in temp correlates to humidity. (Bigger difference = less humid).
Relative humidity referenced against calibrated reference table.

Sarah's Physics (6 decks)

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