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Technology > Intro to Anesthesia machines, Gas supply, cylinders and pipelines ppt > Flashcards

Intro to Anesthesia machines, Gas supply, cylinders and pipelines ppt Flashcards

1
Q

the Main integrated anesthesia delivery system includes what?

A

gas supply

control system

breathing and ventilation system

a scavenging system

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2
Q

What is does the APL valve stand for

A

Aveolar pressure limiting valve

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3
Q

who are the 3 main anesthesia machine manufactors in the US?

A

Daxtex-Ohmeda (GE)

North American Draegar (mainly up north)

Datascope

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4
Q

*******the Hospital pipeline is the primary gas source, what is the psig (normal working pressure of most machines)?

A

50 psig

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5
Q

******Cylinders-O2 is supplied at around 2000 psig. it is regulated to approximately ___ psig after it passes through the downstage regulator into the machine)

A

45 psig

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6
Q

*******Cylinders are regulated by whom?

A

The Department of Transportation

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7
Q

**** oxygen flush is a “straight shot” from supply to delivery point at ___ to ___ L/min

A

35 to 75 L/min

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8
Q

*********************According to the OSHA fact sheet of 1991 on Waste Anesthestic Gasses (WAGs) occupational exposure should be limited to an 8 hour time-weighted average of not more than _______ ppm for halogenated agents such as (Halothane, Enflurane, Isoflurane, Sevoflurane, desflurane)

A

2 ppm

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9
Q

*********************According to the OSHA fact sheet of 1991 on Waste Anesthestic Gasses (WAGs) occupational exposure should be limited to an 8 hour time-weighted average of not more than_____ppm of halogenated agent is allowed when the halogenated agent is COMBINED with N2O

A

0.5 ppm

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10
Q

*********************According to the OSHA fact sheet of 1991 on Waste Anesthestic Gasses (WAGs) occupational exposure should be limited to an 8 hour time-weighted average of not more than_______ppm of N2O can be used at all times (with or without halogenated Agent)

A

25 ppm

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11
Q

******* 5 functions of O2

A

Powers the ventilators “drive gas”

O2 Flush

Activates low pressure alarms

Activates fail safe mechanisms

Tumbles through the flowmeter

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12
Q

N2O is useful for what?

A

Assisting with anesthetizing

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13
Q

Air is useful for what?

A

When N2O won’t do (the few instances when N2O is contraindicated)

this was per his slide I am sure there are other uses since we basically us it for every case as fresh “gas” flows

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14
Q

ORMC stands for what?

A

Oxygen Ratio Monitor Controller

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15
Q

Can you recite the 4 parts of the path all the way to the pt. (it seems incomplete but this is in his slide)

A

Hospital medical gas delivery system (large outdoor tanks)

Cylinders

Downstage pressure regulation

intermediate pressure system

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16
Q

Medical gas from the hospital connects to machine using the _________ system??

A

D.I.S.S.

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17
Q

Cylinders are the ______ pressure source of the medical gasses?

A

High

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18
Q

The hang in yoke assemblies with the _______ system?

A

PISS

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19
Q

with the gas inlets and pressure regulators the pressured is measured by the ________ ________ gauges

A

Bourdon Pressure

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20
Q

What do pressure regulators do? and this is where the what pressure system begins?

A

reduce the high cylinder pressure to a more manageable 50 psig

This is where the intermediate pressure system begins

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21
Q

*****************

P.I.S.S

what does it stand for?

what is it’s purpose?

A

Pin-index safety system

it prevents misconnection of a cylinder to the wrong yoke.

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22
Q

you should keep cylinders closed except for what 2 incidences

A

checking the machine

and In use(if the O2 from the pipeline is unavailable)

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23
Q

The only place you can have high pressure is in the what?

A

cylinder

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24
Q

*********

since you can only have high pressure in the cylinder it would make sense that all things connected to the system are part of what?

A

The high pressure system!!

(this will go until something can down regulate it)

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25
Q

since you can only have high pressure in the cylinder it would make sense that all things connected to the system are part of the high pressure system, this system continues until it hits the what?

A

downstage pressure regulator

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26
Q

4 main parts to the high pressure system

A

hanger yoke(including filter and unidirectional valve)

Yoke block (with check valves)

cylinder pressure gauge

cylinder pressure regulators

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27
Q

3 Functions of the hanger Yoke

A

orients cylinders

provides UNIdirectional flow

ensures tight seal at interface

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28
Q

What 3 things does the check valve do?

A

Minimizes transfilling

allows change of cylinders during use

Minimizes leaks to atm is a yoke is empty

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29
Q

The __________ __________ __________ converts high, variable cylinder pressure to a constant pressure of approximately 45 psig down stream the regulator

A

cylinder pressure regulator

30
Q

the cylinder pressure regulator converts high, variable cylinder pressure to 45 psig downstream of the regulator. this is intentionally slightly less than pipeline pressure why?

A

to prevent silent depletion of cylinder contents if a cylinder is inadvertently left open after checking the pressure

31
Q

*******

what is special about measuring the amt of N2O in a cylinder

A

you have to weigh it b/c you can be almost 25% empty and still read 745 psig, there is no way you calculate how much N2O is left in a cylinder without a weight

(so if on a test he gives a formula, and there is no weight, it can’t be done)

32
Q

*************************

name the Color of the cylinder (US/international), PSIG, Capacity (L), and PISS for

O2

N2O

Air

A

GAS Color (US/INT) PSIG Capacity (L) PISS

O2 Green (white) 2000 660L 2-5

N2O Blue (blue) 745 1590L 3-5

Air Yellow (B&W) 1900 625L 1-5

a way to remember the PISS

1st they breath air (1-5)

2nd they breathe O2 (2-5)

3rd they breathe N2O (3-5)

(thanks Dwayne)

33
Q

What 4 things are involved in the Intermediate pressure system

A

Hospital pipeline outlets

Machine piping

Machine pipeline inlets

Pipeline gauges

34
Q

the intermediate pressure system receives gasses at a constant pressure of what?

A

37-55psig

35
Q

do fail-safe systems pevent hypoxic mixtures???

A

NO

36
Q

What does the fail safe device ensure?

the loss of oxygen pressure results in alarms at ____ psig pipeline pressure

A
  • ensures that whenever oxygen pressure reduced and untill flow ceases the set oxygen concentration shall not decrease at the common gas outlet
  • 30 psig
37
Q

As long as there is pressure in the O2 line. nothing in the fail safe system prevents you from turning on a gas mixture of 100% N2O, however this should be prevented by the ________ _______ system

A

Hypoxic guard

38
Q

What can cause problems in pipline pressure?

A
  • Contamination (particles, bacteria, viral, moisture)
  • inadequate pressure
  • excessive pressure
  • accidental crossover ( switch b/t oxygen and another gas)
39
Q

What is you lose pipeline pressure?

A
  • the alarm will sound
  • open the O2 cylinder
  • Disconect from the wall
40
Q

*************

How long before a given O2 tank is exhausted

general rules??/

A

2200psi= 660L

psi * 0.3= L remaining

41
Q

******************************

The O2 cylinder reads 1000 psi

TFGF is 0.5L/min O2 and 1.5 L/min N2O, RR 10, TV 700

How long till the cylinder is exhausted

A
42
Q

Are hypoxic mixtures possiable?

A

yes

43
Q

The hypoxic guard system can fail and permit hypoxic breathing mixyures if what occurs

(4)

A
  • wrong suppy gas in O2 pipline or cylinder
  • defective pneumatic or mechanical components
  • leaks that exist down stream of flow control valves
  • if third inert gas is used (helium)
44
Q

****************

What makes up the low pressure sytem?

(4)

A

*** everything distal to flowmeter needle valve

  • flowmeter tubes
  • vaporizers
  • check valves (if pressent
  • common gas outlet
45
Q

what is an older term for flowmeters

A

thorpe tube

46
Q

what are the components of the flowmeter?

(4)

A

needle valve

indicator float

knobs

valve stops

47
Q

Flow increases via the flowmeter when the valve is turned what direction (same as vaporizers)

A

counterclockwise

48
Q

At low flows the annular-shaped orfice around the float has what type of flow (according to poiseuille’s law?

what about at high flows?

A

Low- laminar flow

High- turbulent flow

49
Q

A hyperbaric chamber produces a ______ than indicated flow on the flowmeter, and anesthesia delivery at higher altitudes produces __________ flows than indicated

A
  • lower
  • higher
50
Q

on the flow meter what is always the last gas in the chain?

A

O2

51
Q

why is the O2 always the last gas in the chain (on the flowmeter?

A

diminishes the chance of hypoxic mixture

decreased chance of O2 dilution

52
Q

The needle valve of the flowmeter can be damaged if what occure?

A

it is closed under force

53
Q

The flow tube (thorpe tube) is shaped how? and specific to what?

A

Tapered (norrower at bottom)

gas specific

54
Q

If a valve needle on the flowmeter has 2 tubes, how are they controlled?

A

a single control

55
Q

what is the link-25 system? for?

A
  • chain system that connects 2 gasses like O2 and N2O
  • the purpose is to decrease the risk of hypoxic mixture delivery-
56
Q

What are teh restrictions the link 25 system employs?

(4)

A
  • Minimum O2 flow when the machine is on
  • minimum O2 / N2O ration (1:3)
  • Device or proportioning system that does not allow O2 level < 25%
  • hypoxic guard
57
Q

What is the minimum ration of flow the link 25 system allows b/t O2 and N2O?

A

1:3

58
Q

What is Vapor pressure?

A

when the molecules escape from the volatile liquid to the vapor phase, creating a “saturated vapor pressur” at equilibrium

59
Q

VP is __________ of Atm pressure

A

independent

60
Q

VP __________ with temp increase

A

Increases

61
Q

VP depends only on what 2 things

A
  • Physical Characteristics of teh liquid
  • it’s temp
62
Q

how many vaporizers at a given time may be open to the carrier gas?

A

one

63
Q

What is included in the circle system?

A

CO2 absorber housing and absorber

unidirectional valves (AKA fluter Valves)

inspiratory and expiratory ports

fresh gas outlet

APL valve

Pressure Gauge

Breathing tubes

Y-peice

Reservoir bag

Bag/vent switch

Respiratory gas monitor sensor

64
Q

The CO2 System consist of what? (4)

A

housing

absorbent

Baffles

Side tube

65
Q

The CO2 canister consist of

_____% air space

_______% Void Space

________% pore space

A

50%

42%

8%

66
Q

All VAA are degraded by absorbents with _____________ exhibiting the highest degradations

A

Sevoflurane (Ultane)

67
Q

VAA’s have increased degradations in the CO2 absorber with what 5 things

A

Baralyme

increased temp

Dry absorber

Duration of exposure

increased anesthetic concentration

68
Q

*************************

of the 5 things that can increase degradations within the CO2 absorbers what is teh most INFLUENTAL cause? what cause it to occur?

A
  • dry absorbers
  • Caused by prolonged high flows
69
Q

With the bellow assembly the ascending bellows compress _______ during inspiration, and the descending bellows compress _____ during inspiration. this results in a slight negative during exhalation until bellow is refilled

A

down

up

70
Q

Teh bellow pressure is always what?

A

Positive

71
Q

The bellows cause a PEEP of what

A

2-4 cmH2O

72
Q

****************************

The Ascending bellows will collapse in the presence of what?

A

A leak (disconnect)

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