Ex2 Anesthesia Gas Machine 2

Question 1

Ultimate destination of gases

Answer 1

Patient

*not scavenging system

Question 2

DISS (diameter index safety system)

Answer 2

Coupling mechanism: connects end of hose + appropriate gas outlet

• color coded
• to prevent incorrect hose to hospital gas pipeline

Question 3

PISS (pin index safety system)

Answer 3

2 holes in cylinder valve (E-cylinder) that correspond to pins in yoke (anesthesia machine)

Question 4

O2 Pin index position

Answer 4

2+5

Green

Question 5

Air Pin Index Position

Answer 5

1+5

Yellow

Question 6

NO2 Pin Index Position

Answer 6

3+5

Blue

Question 7

If complete loss of pressure occurs, what should you do?

Answer 7

Open O2 E cylinder
Manually ventilate
Disconnect pipeline (prevent retrograde flow)

Question 8

What is the first thing you should look at if machine goes out?

Answer 8

Circuit breaker (back on machine)

Question 9

Hanger yoke

Answer 9

Orients cylinders, prevents gastight seal

Ensures unidirectional flow

Question 10

Minimizes likelihood of transfilling/leaking to atmosphere in cylinders

Answer 10

Check valve (within hanger yoke)

Question 11

Cylinder regulator

Answer 11

Converts E-cylinder pressure to 45 psi

Distal to hanger yoke

Question 12

Bourdon-type pressure gauges are ______

Answer 12

Aneroid gauges - compare pressure to barometric pressure

Question 13

All gases (except O2) flow through what before proceeding through flowmeters?

Answer 13

Fail-safe valve

Question 14

Location at which gases join for first time

Answer 14

Common manifold

Question 15

After gases pass thru vaporizer where do they go?

Answer 15

Common gas outlet

Question 16

Circle system is a _____

Answer 16

Semi closed

Low FLOW

Question 17

How many grooves on oxygen knob?

Answer 17

8

45*

Question 18

If using oxygen flush valve to fill bellows, how should you use it

Answer 18

Short burst during expiratory phase

Question 19

Pt receives .25 mL/min flowmeter, how much FiO2?

Answer 19

100%

Question 20

Low pressure alarm

Answer 20

Pressure is lost in O2 circuitry
Datex = <28psi
Drager = <37 psi

Question 21

Modern vaporizers

Answer 21

Variable-bypass

Question 22

Function of concentration control valve

Answer 22

Regulate amount of flow thru the bypass/vaporizing chambers

Question 23

Splitting ratio

Answer 23

Flow thru vaporizing chamber/flow thru bypass chamber

Question 24

Unique aspect of Desflurane vaporizer

Answer 24

Heated - dual circuit
“Datex ohmeda Ted 6”
(Near boiling temp at room temp)

Question 25

Interlock system ensures

Answer 25

Only one vaporizer can be on at a time

Question 26

What if vaporizer says “tipping”?

Answer 26

Don’t use it - tipped > 45*

Question 27

Factors that influence vaporizer output

Answer 27

1. Flow rate (O2 flush bypasses vaporizer, so dilutes gas) 2. Temperature 3. Back pressure (high PEEP=higher vaporizer output) 4. Atmospheric pressure (changes volume%)*** 5. Carrier gas

Question 28

Vaporizers and carrier gas

Answer 28

Calibrated for 100% oxygen

Question 29

Addition of N2O will result in _____ MAC

Answer 29

Lowered

Question 30

Dead space ends at

Answer 30

Y-piece of circuit (where inspiratory/expiratory gases diverge)

Question 31

APL valve

Answer 31

Releases gases to scavenging system | Provide control of pressure in breathing system

Question 32

Bag mask ventilation - APL valve should be

Answer 32

Left partially open

Question 33

Mechanical ventilation - APL valve should be

Answer 33

Excluded (selector switch on ‘automatic’)

Question 34

Main reason for APL valve

Answer 34

Positive pressure during manual ventilation

Question 35

Advantage of circle system

Answer 35

Prevents rebreathing of CO2 while allowing rebreathing of all other gases

Question 36

If increased inspired/exp CO2

Answer 36

Increase FGF to 5-8L/min (semi-open)

Question 37

ETCO2 waveform: prolonged plateau, slanting inspiratory downstroke

Answer 37

Incompetent inspiratory valve

Question 38

What makes rebreathing of gases possible?

Answer 38

Carbon dioxide absorption

Question 39

Which absorbant must be used with FiCO2 monitoring?

Answer 39

Spiralith (no color indicator)

Question 40

Which absorbant stays indicator color permanently?

Answer 40

Litholyme

Question 41

Which absorbent does not have a color indicator?

Answer 41

Spiralith

Question 42

How do you prevent wall effect/channeling in absorbent?

Answer 42

Shaking canister

Question 43

Cons to barolyme

Answer 43

Burning skin/contacts

Question 44

Water content of most absorbents

Answer 44

15%

Question 45

Which absorbent does not have water content?

Answer 45

Spiralith

Question 46

Importance of water content in absorbent

Answer 46

Produces compound A, carbon monoxide, all negative effects

Question 47

Mesh size of most absorbents

Answer 47

1/4-1/8”

Question 48

Significant indicator of CO2 absorbent exhaustion

Answer 48

Dysrhthmias or increased bleeding

Question 49

End stage renal failure pt should not receive

Answer 49

Sevo — d/t risk of Compound A

Question 50

Risk of Desflurane

Answer 50

Carbon monoxide

Question 51

Exposure max of halogenated agents

Answer 51

2 ppm (0.5 ppm if+N20)

Question 52

Exposure max N2O

Answer 52

25 ppm (based on 8hrs)

Question 53

Closed interface system

Answer 53

Scavenger system - communicate to atmosphere only thru valves * used w/ passive disposal system (no suction) * can be used w/ active - change interface

Question 54

Open interface

Answer 54

Scavenging system No valves Active (suction)

Question 55

Difference between closed and open scavenging systems

Answer 55

``` Closed = valve Open = no valves (+active) ```