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I & M II > Respiratory Gas Analysis > Flashcards

Respiratory Gas Analysis Flashcards

1
Q

What gases use INFRARED analysis on the multigas analyzer?

A
  • CO2
  • N20
  • Anesthetic agents
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2
Q

What gases use PARAMAGNETIC analysis on the multigas analyzer?

A

O2

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3
Q

Why do we monitor respiratory gases?

A

Capnography
Breathing circuit problems
End tidal AA – estimate alveolar concentration
Adequacy of pre-oxygenation
Anesthesia machine failures/malfunctions
Physiologic events - bronchospasm, etc.
Gas supply problems
Gas uptake and production

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4
Q

What is the SIDE STREAM gas sampling technique?

A

Gas withdrawn from the airway and diverted to the analyzer.

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5
Q

What are the characteristics of the SIDE STREAM technique? (2)

A

diverting analyzer

withdrawal sampling

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6
Q

What is the rate and the response time for the side stream technique?

A

50 - 250 ml/min

300 ms

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7
Q

What is the MAIN STREAM gas sampling technique?

A

Infrared light beam is passed through the airway.

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8
Q

There is more dead space when the sample line is (before/after) the HME.

A

after

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9
Q

What does the circle depict?

A

The sensor has been separated from the cuvette, which contains the window through which infrared light passes.

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10
Q

What changes in monitoring will occur when the sample line is behind the HME?

A

decreased Et CO2

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11
Q

What is a disadvantage of attaching the sample line on the patient side of the HME?

A

water and bacterial/viral contamination of the sample line and then the monitor

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12
Q

What can occur if the water trap is located under the vaporizer?

A

Plastic that makes the trap can be damaged if contacted by a liquid anesthetic agent

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13
Q

What can occur if the gas sampling line is attached to the breathing circuit near the Y-piece?

A

Fresh gas entering the inspiratory limb will dilute readings, thus place the gas sample nearest to ETT

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14
Q

What is the volume of gas that is sampled?

A

2 - 5 ml

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15
Q

It is not useful to measure EtCO2 with loose fitting masks or nasal cannulae. T or F?

A

False

The presence of exhaled CO2 provides info that the pt is breathing even though the values will be diluted with oxygen and air.

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16
Q

There are automatic and manual agent detectors.

If an agent is erroneously detected, what should you do to correct the error?

A

Turn the machine off then back on.

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17
Q

What is the benefit of an automatic agent identifier over a manual one other than the obvious answer?

A

Automatics can detect contaminated vaporizers.

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18
Q

What are the techniques used to analyze oxygen?

What is the fastest?

A

Polarographic

Fuel cell

Paramagnetic (is the fastest that we need to know)

Mass spectrometry–technically the fastest

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19
Q

What is the lifespan of a fuel cell? (2)

What is the response time?

A

200,000% hours –> 2000 hrs

~15 months in RA

5-35 sec

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20
Q

The paramagnetic technique has what response time?

A

150 msec

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21
Q

Identify:

A
22
Q

Identify:

A
23
Q

Name the distinctions between the polarographic Clark electrode and an oxygen fuel cell.

A
  1. The entire fuel cell device has to be replaced.
  2. Increased O2 consumes more of the electrolyte found within the cell→shorter cell life
  3. Polarographic has a battery source
  4. Have different cathode/anodes
24
Q

The magnetic susceptibility of oxygen is _____ times greater than other gases used in anesthesia.

A

200

25
Q

Name the 2 paramagnetic oxygen analyzing techniques.

A
  • Dumbbell (magnetodynamic) (Linus Pauling)
    • Direct Reading
    • Null Deflection
  • Differential Pressure
26
Q

What type of oxygen analyzer is this?

How does it work?

A

Null deflection

Dumbbells are N2 filled which are pushed out of field by paramagnetic oxygen. The magnitude of the torque determines pO2.

27
Q

What type of analyzer is this?

A

Direct reading dumbbell

28
Q

What is the modern oxygen analyzer used now?

What generally used as the reference gas?

A

Differential pressure (magnetpneumatic)

RA

29
Q

Know the FiO2 equation.

Why would calculated FiO2 differ from FiO2(inspired)?

A

0.21 * Air (L) + O2 (L)
Air (L) + O2 (L)

The excess O2 and expired gases are in the reservoir bag.

30
Q

If the skin is heated locally to ___-____ºC, the peripheral blood vessels dilate and the oxygen used in the skin is negligible compared with the total oxygen present in the capillaries.

A

43 - 44

31
Q

What type O2 analyzer does the transcutaneous oxygen measurement method use?

A

polarographic electrode

32
Q

At what temperature do skin burns occur?

A

45ºC

33
Q

To avoid damage to the skin and to maintain accurate operation of the transcutaneous oxygen analyzer, what should you do?

A

The electrode position should be changed every 3-6 hours.

34
Q

Identify the paO2 and paCO2 curves

What do points A,B and C,D indicate?

A

A,B is O2 decrease due to cuff occlusion.

C,D is due to hyperventilation.

35
Q

What type of monitoring is being used to measure tcpO2 and CO2? (tcp = transcutaneous pressure)

What are the black probes?

A

Laser Doppler

heated doppler probes

Used to monitor perfusion of extremities.

36
Q

What is:

The absorption of infrared radiation that results in excitation of vibrational, rotational and bending modes (molecule remains in electronic ground state)?

A

infrared spectroscopy

37
Q

What gases can be measured using infrared spectroscopy?

A

asymmetric polyatomic molecules

Note: Not O2, N2, or He

38
Q

Name the gases that can be measured by infrared spectroscopy.

A

Carbon Dioxide
Nitrous Oxide
Halothane
Enflurane
Isoflurane
Desflurane
Sevoflurane
Nitric Oxide
Water Vapor

39
Q

Label the gases in this infrared spec:

A
40
Q

The measurement of O2 consumption of a pt who inspires dry gas but expires humidified gas will result in reduced and inaccurate readings because of the partial pressure of water vapor.

This is significant in measuring oxygen consumption. True or false?

A

True

41
Q

In order to correct altered readings from water vapor in gas analysis, what can be implemented?

A

Nafion tubing can be used to remove water vapor by passing gases through silica gel before analysis.

42
Q

You can get obscured O2 gas analyzer reading when albuterol is given. True or false?

A

True, the analyzer cannot dstinguish propellent gases.

43
Q

Because the amount of radiation absorbed is a function of the number of molecules present, it is therefore a function of _______.

A

partial pressure

44
Q

When a pt coughs, what changes occur on the gas analyzer?

A

Higher readings due to increased absolute pressures.

45
Q

How do you calculate partial pressure?

A
46
Q

In an NDIR (non-dispersive IR) analyzer, how is the IR beam interrupted?

A

mechanically by a “chopper” wheel or electronically

47
Q

In most cases, the balance gas in multigas analyzers is what?

A

Any gas that can not be detected, but it will probably be nitrogen. However if heliox is being analyzed, then helium would be read as the balance gas.

48
Q

What is balance gas?

A

The result of partial pressures of unmeasured gases

49
Q

What is the fragmentation of the molecule by an electron beam?

A

mass spectrometry

50
Q

Mass spectrometry gas analysis produces a positive ion whose path is determined by the _________.

A

mass to charge ratio (m/e)

51
Q

What gases can be measured by mass spectrometry?

A

Oxygen
Nitrogen
Carbon Dioxide
Helium(?)–monoatomized, makes it difficult to ionize
Nitrous Oxide
Halothane
Enflurane
Isoflurane
Desflurane
Sevoflurane
Nitric Oxide
Xenon

Basically, all our gases can be measured.

52
Q

A mass spectrometer relies on what to produce results?

A

magnetic sector

quadrapole

I & M II (21 decks)

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