Equipment and Monitoring Flashcards
How long does the backup battery on AM’s last?
30 minutes
What pressure is hospital pipeline?
50 psi (344 kPa)
What makes up the pipeline connection at the back of the AM?
DISS, pipeline inlet, filter, check valve, pressure gauge
What are the events that occur if the pipeline pressure fails?
oxygen low pressure alarm sounds, fail-safe valve halts delivery of all gases except O2
What steps are taken if complete loss of O2 pipeline pressure occurs?
Open the O2 cylinder, disconnect the pipeline, switch to low FGF, manually ventilate to conserve O2.
Why is it so important to disconnect the pipeline in the event of cross-connection of gases or pipeline pressure issues?
Cylinder pressure is 45 psi, Pipeline is 50 psi. The AM will preferentially draw gas from the higher pressure source.
What are the only instances backup cylinders should be open? (2)
when they are being checked, when the pipeline fails
What is the E-cylinder color, PSI, capacity, and PISS position for Air?
yellow, 1900, 625L, 1-5
What is the E-cylinder color, PSI, capacity, and PISS position for O2?
green, 1900, 660L 2-5
What is the E-cylinder color, PSI, capacity, and PISS position for NO2?
yellow, 745psi, 1590L, 3-5
What is the most fragile part of a E-cylinder?
cylinder valve
What are the 3 safety relief devices on the E-cylinders?
frangible disk bursts under pressure, valve that opens at high pressure, fusible plug that melts
What are the three functions of a hanger yolk?
orients cylinders, gas tight seal, ensures unidirectional flow
What is transfilling of E-cylinders and how is it prevented?
2 tanks of the same gas with different pressures. The higher psi tank will empty into the lower psi tank instead of proceeding towards the flowmeters. Prevented with a unidirectional valve.
Who sets purity standards for medical gases?
USP and FDA
What gases pass through a fail safe valve before proceeding to their flowmeters?
All but O2
Which direction do flowmeters turn to increase the gas flow?
counterclockwise
What is the best alternative to the flush valve to rapidly fill the bellows?
increase FGF to 8-10L
Describe the relationship of temperature and rate of vaporization?
direct. Increased temp, increased vaporization
What three factors determine rate of vaporization?
temperature, vapor pressure of liquid, partial pressure of the vapor above the liquid
What components of a vaporizer ensure carrier gas fully saturated with anesthetic vapor?
wicks and baffles
What is a Tec 6 vaporizer heated and pressurized to?
39 degrees, and 2 atmospheres (520mmHg)
Vaporizers should be drained and fresh gas ran through them if they are tipped to what degree?
45 degrees
Explain the four breathing circuits?
Open- no reservoir, no rebreathing
semi-open- reservoir, no rebreathing. Circle with FGF > ME
semi-closed- reservoir, partial rebreathing. Circle with FGF < ME
closed- reservoir, complete rebreathing. Circle with APL closed and low flows
How much FGF is required to prevent rebreathing in nonrebreathing circuits?
2-3x ME, typically 5L/min
What is the major disadvantage of the Bain circuit?
if the inner FGF tubing becomes kinked, the entire circuit becomes dead space.
What is the minimum weight of a child for a pediatric circle system?
10-20kg
What are the only two common reasons for an increase in inspired CO2?
exhausted CO2 absorbent, faulty unidirectional valves
If inspired CO2 reaches more than 1-3 mmHg what should FGF be increased to?
5-8L/min
In what two patient populations is low flow anesthesia absolutely contraindicated?
smoke inhalation injury and MH
Which CO2 absorbent activator (NaOH, KOH) is implicated with producing more carbon monoxide, and Compound A?
KOH
At what pH does ethyl violet change from colorless to blue-purple?
10.3
Which volatiles are degraded the most and least by soda lime?
Sevo the most, Desflurane the least
What is capnometry?
all means of measuring CO2
What is capnography?
recording the CO2 measurement
What is the continuous display of CO2?
capnogram
How is CO2 monitoring accomplished?
infrared analysis
