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SEE NCE Boards CoreConcepts > SEE EQUIPMENTS/TECH : Delivery and Airway Equipment > Flashcards

SEE EQUIPMENTS/TECH : Delivery and Airway Equipment Flashcards

1
Q

What is the volume of the gases that cannot be accurately estimated from the cylinder pressure gauge?

A

Nitrous

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2
Q

With nitrous the pressure will remain constant until

A

constant until the LIQUID portion of the gas is depleted.

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3
Q

If you’re doing a case and you suspect a pipeline cross over ,2 corrective actions that must be undertaken are?

A

Open the backup oxygen cylinder

Disconnect the pipeline gas

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4
Q

When you suspect a pipeline crossover, you disconnect the pipeline gas from the wall why?

A

Because the anesthesia machine will continue to draw from the higher pressure system even if the lower pressure O2 cylinder is open

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5
Q

If the flow of O2 is 2L/min , and the cylinder’s gauge pressure is 500 psi, how long will it last?

A

87 minutes

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6
Q

Molecular weight of N2O is

A

44g/mol , one mole at STP is 22.4 L

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7
Q

Names 3 components of the low pressure system

A

Common gas outlet
Flow meters
Vaporizer

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8
Q

Flush valve is part of which system?

A

Intermediate pressure system

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9
Q

Hanger yoke and cylinder pressure gauge is part of what system?

A

High pressure system

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10
Q

What is the purpose of the Diameter index safety system (DISS)

A

Prevents incorrect hose attachment.

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11
Q

The DISS Is required by the

A

American Society for TESTING and MATERIALS for an anesthesia workstation

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12
Q

What is the purpose of the pressure regulator on the gas machine?

A

Reduces cylinder pressure to a lower pressure before it enters the flow valve.

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13
Q

The pressure regulator decrease the variable cylinder pressure to

A

45-47 psig, to prevent dangerous levels to enter the flow valve.

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14
Q

What device reduces the pressure of gas from an E-cylinder to a usable pressure?

A

Regulator

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15
Q

A dula hanger yoke system hold 2 oxygen e-cylinder. If both cylinders are open , where will the gauge indicate the pressure?

A

The cylinder that has the highest pressure.

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16
Q

The HANGER Yoke functions?

A

Orients cylinders
provides a gas tight seal
Ensures unidirectional low.

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17
Q

The hanger yoke has a _____system

A

PIN index systme, in order to prevent the connection of a cylinder of one gas to a yoke intended for another.

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18
Q

What type of valve is an oxygen regulator?

A

DIAPHRAGM

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19
Q

Describe the design of the THORPE TUBE.

A

Gas specific
Tapered
Narrowest part of the bottom
Largest part on top

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20
Q

What is the minimum oxygen flow rate through the oxygen flow valve when the anesthesia machine is turned on?

A

150 ml/min

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21
Q

Oxygen flow valves are designed to deliver a minimum flow of

A

150ml/min when the anesthesia machine is on

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22
Q

Flow meter knobs are ____coded and _____coded

A

Color and touch

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23
Q

Ball types floats are read in the

A

Center of the float

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24
Q

Plumb types floats are read

A

At the top of the float

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25
Q

Changing the inspired gas composition from 100% O2 to 70% nitrous oxide may have what transient effect through the vaporizer?

A

A decrease volatile anesthetic concentration due to the higher solubility of nitrous in volatile agents. [

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26
Q

2 things that may occur from filling a VARIABLE BYPASS vaporizer with DESFLURANE?

A

The patient may receive a hypoxic mixture

The patient may receive a overdose of desflurane.

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27
Q

Desflurane has a _____boiling point and a ______VP

A

Low; high

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28
Q

At normal flow rate, changing the inspired gas composition from 100% O2 to 70% nitrous oxide will cause which of the following to happen to a vaporizing chamber output?

A

Increase until a new steady state is achieved.

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29
Q

The quantity of inhalational agent delivered from a vaporizer is dependent on the

A

Flow rate of the carrier gas through the vaporizer.

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30
Q

Effect of altering the carrier gas

A

Causes a temporary decrease in the vaporizer output followed quickly by an increase in output until a new steady state is achieved.

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31
Q

What are factors that affect the steady state of convential vaporizers ?

A

Viscosity of the Carrier gas
Density of the carrier gas
solubility of the carrier gas in the anesthetic liquids
Flow splitting characteristic of the specific vaporizer.
Concentration set on the vaporizer dial

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32
Q

Filling an enflurane-specific vaporizer with halothane will have what effect on anesthetic gas delivery?

A

40% increase in the anesthetic gas delivery, leading to anesthetic overdose.

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33
Q

Desflurane vaporizers have which of the following features?

A

Temperature regulation

separation of fresh gas flow from liquid agent

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34
Q

Desflurane vapor is added to

A

the fresh gas mixture before exiting

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35
Q

The Vaporizer for desflurane is called a

A

TEC 6 (tec ,4, 5, 7) and they are temperature compensated.

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36
Q

What are factors that influence variable bypass vaporizer output ?

A

High fresh gas flowrate through the vaporizer
intermittent back pressure for the use of PPV
Carrier gas composition

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37
Q

Vaporizer output is influenced by the _______. What is the significance of that ?

A

Carrier gas composition ; Changes the carrier gas to a one more soluble than oxygen changes vaporizer output.

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38
Q

2 things that can create higher than expected vaporizer output?

A

Using the flush valve

Positive pressure ventilation

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39
Q

Why are certain metals chosen for vaporizer construction?

A

Metal with HIGH THERMAL CONDUCTIVITY are chosen to maintain a uniform internal temperature/

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40
Q

What is thermal conductivity?

A

It is a measure of the speed with which heat flow through a substance.

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41
Q

What is the purpose of gas machine proportioning system?

A

Prevent the delivery of a hypoxic gas mixture to the patient.

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42
Q

What does the proportioning system do?/

A

Decrease the pressure of nitrous when oxygen pressure decreases proportionately to prevent a hypoxic gas mixture.

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43
Q

Nitrous oxide gas flow is regulated to maintain a minimum oxygen concentration of _____ by linking it with which gas?

A

21-25% Oxygen

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44
Q

Which of the following gases carries the greatest risk of creating a hypoxic mixture when delivered to the patient via a nitrous oxide-oxygen (3:1) FGF? why?

A

Desflurane. Because high concentration of a less-potent volatile, such as desflurane, can result in a vapor mixture that contains less than 21% oxygen even with a fully functioning proportioning system. This high concentration may become a higher percentage of total gas flows, lowering the inspired oxygen levels.

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45
Q

Oxygen supply pressure safety devices are

A

Oxygen failure cut-off valve
Pneumatic alarm
Second stage oxygen pressure regulator
Electronic alarm

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46
Q

Electronic flowmeters do what?

A

Allow the anesthetist to estimate total gas flow quantity in the event of a total electrical power outage but does not prevent a hypoxic mixture.

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47
Q

The oxygen supply pressure safety devices function

A

Ensure the delivered oxygen concentration will not fall below 19% at the common gas outlet if there is an oxygen pressure failure.

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48
Q

The Datex-Ohmeda 2nd stage oxygen pressure regulator is set to which of the following pressure ranges

A

12-19 psi

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49
Q

Oxygen supply low pressure sensors are designed to activate a gas whistle or electronic alarm when inlet gas pressure drops below the usual threshold?

A

20-35 psi

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50
Q

The 2000 ATSM F1850-00 standard states:

A

The anesthesia gas supply device shall be designed so that whenever oxygen supply pressure is reduced to below the manufacturer specified minimum, the delivered Oxygen concentration shall not decrease below 19% at the common gas outlet

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51
Q

Systems that warn of troubles with the oxygen supply or less the chances of hypoxemia are based on monitoring which of the following?

A

The pressure within the oxygen circuitry of the gas machine

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52
Q

Does the warning system of a oxygen supply problem ensure that oxygen is present?

A

NO . It is based solely on OXYGEN PRESSURE

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53
Q

What is the only MONITOR that can verify that oxygen is present?

A

Inspired oxygen analysis sensor.

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54
Q

Older gas machines, the pressure sensor shutoff valves operate under which of the following principles

A

Oxygen pressure > 20 psi is needed to maintain the nitrous oxide valve in the open position. If the oxygen supply pressure drops below 20psi the valve will shut and nitrous flow stops

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55
Q

Most modern gas use a proportioning safety device which

A

reduces the pressure of all gases, except air in the event of a loss of O2 pressure

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56
Q

At what pressure is the FAIL-SAFE VALVE ACTIVATED?

A

< 30 Psi

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57
Q

What is the purpose of the fail-safe device ensures that

A

When the oxygen pressure is lowered, the oxygen concentration will not decrease at the common gas outlet.

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58
Q

The loss of the oxygen pressure will result in an

A

Alarm at or below 30 psi of pipeline pressure.

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59
Q

Which gas is shut off by modern fail-safe valve?

A

Nitrous oxide

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60
Q

What literally hold open the gate so that nitrous oxide can flow through the gas machine?

A

Pressure in the oxygen line

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61
Q

What is the purpose of the fail-safe system?

A

Prevents delivery of a hypoxic gas mixture.

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62
Q

The fail-safe allows the flow of other gases only if there is

A

Sufficient oxygen pressure in the supply pipeline. If the oxygen pipeline pressure falls, gases such as nitrous oxide are stopped, thus preventing accidental delivery of a hypoxic mixture.

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63
Q

Because of the design of the ventilator spill valve, bellows ventilators have what level of intrinsic PEEP?

A

2-3 cm H2O

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64
Q

Standing bellows ventilator shave a mandatory PEEP of

A

2-3 cm H2O

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65
Q

When the bag/vent selector switch is set to vent which of the following component is taken out of line from a circle anesthetic system?

A

APL valve

bag

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66
Q

Machine prep for a patient with known or suspected MH?

A

Change breathing circuit
Change CO2 absorbent
Remove vaporizers
Flush machine at a rate of 10L/min for 20 minutes

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67
Q

During maintenance this is required?

A

Increased fresh gas flows.

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68
Q

Features of a DESCENDING bellows ventilator

A

Bellows continue to move upward and downward despite a patient disconnnection.
The driving gas pushes the bellow upward during inspiratory phase.

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69
Q

Features of a ASCENDING bellows ventilator

A

A ball type valve in the base of the ventilator relief valve produces 2-3 cm H2O of PEEP During ventilator use in all ascending-bellows ventilators.

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70
Q

In ascending bellows ventilator, scavenging ONLY OCCURS DURING

A

Expiratory phase.

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71
Q

In ascending bellows ventilator, a weighted ball produces 2-3 cm H2O of pressure when the

A

Patient exhales

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72
Q

Use of the flush valve inappropriately?

A

Inaprappropriate use of the flush valve delivers oxygen at a rate 25-75L/min directly into the circuit, can cause BAROTRAUMA of the lungs.

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73
Q

Leaks in the bellows assembly of an ascending-bellows ventilator may cause what with ventilation?

A

Inadequate ventilation because the driving gas is vented to the atmosphere.

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74
Q

Leaks in the bellows assembly of an ascending-bellows ventilator may cause what with alveolar ventilation?

A

Alveolar hyperinflation due to high pressure driving gas entering the patient circuit.

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75
Q

Leaks in the bellows assembly of an ascending-bellows ventilator may cause what with oxygen concentration?

A

A possible increase of the O2 concentration of the patient gas to 100% if the driving gas is oxygen .

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76
Q

Leaks in the bellows assembly of an ascending-bellows ventilator may cause what with Volatile concentration?

A

A lower than anticipated delivered volatile concentration.

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77
Q

A hole in the bellows can lead to

A

Alveolar hyperinflation

Possible barotrauma

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78
Q

High pressure circuits parts are

A

Hanger yoke
Yoke Block
Cylinder pressure gauge
Cylinder pressure regulators

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79
Q

Pipeline inlets and pressure gauges: H/I/L

A

Intermediate pressure circuits parts

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80
Q

ventilator power inlet H/I/L

A

Intermediate

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81
Q

Oxygen pressure failure device (fail-safe) and alarm H/I/L

A

Intermediate

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82
Q

Flowmeters valves part of H/I/L

A

Intermediate

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83
Q

Oxygen and nitrous oxide second stage regulators H/I/L

A

Intermediate

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84
Q

Oxygen flush valve H/I/L

A

Intermediate

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85
Q

The low pressure circuit includes components distal to the flowmeter needle

A

Valve
Flowmeters
Vaporizers
CGO

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86
Q

Commercial soda lime has a water content of

A

14-19%

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87
Q

Which of the following indicators is sued in CO2 absorbent?

A

Ethyl violet

88
Q

Commercial soda lime is capable of absorbing up to _______of carbon dioxide per 100g of absorbent

A

23-26L / 100g of granules

89
Q

Barium hydroxide lime is capable of absorbing

A

9-18 L / 100g of granules.

90
Q

Dry soda lime can produce which of the following problem degradation products from volatile anesthetics?

A

Compound A

Carbon monoxide.

91
Q

Desflurane, Can interact with dry soda lime or barium hydroxide lime to produce

A

Carbon monoxide (CO)

92
Q

Increase produces of carbon monoxide can cause

A

elevated carboxyhemoglobin levels.

93
Q

At a given MAC fractions, absorbents will produce carbon monoxide from the degradation of volatile agents at which relative proportion?

A

Desflurane >/equal Enflurane > Isoflurane

94
Q

The magnitude of CO production from GREATEST to LEAST is

A

Desflurane > Enflurane > Isoflurane&raquo_space;Halothane = Sevoflurane.

95
Q

How much CO2 can be absorbed by a standard soda lime CO2 absorbent?

A

14-23 L CO2/ 100 grams absorbent granules

96
Q

Key advantage of calcium hydroxide lime absorbents?

A

Absence of strong bases eliminates the production of Compound A
Calcium Hydroxide lime will not produce carbon monoxide as a byproduct

97
Q

AMSORB is a

A

Calcium Hydroxide lime

98
Q

Advantage of Amsorb

A

Shows less degradation of sevo into compound A and Desflurane into carbon monoxide.

99
Q

Disadvantage of Amsorb

A

HIGHER cost

LESS CO2 absorptive capacity

100
Q

What are factors that affect CO2 absorbent function

A

Type of absorbent
Size of the granules
Channeling of gas through larger, low-resistance pathways
Amount of water in the absorbent.

101
Q

What is the role of the ethyl violet as a pH indicator?

A

Indicate when granules are becoming exhausted.

102
Q

The effective ilife or a canister of soda lime?

A

Channeling will shorten the life of a cannister.

103
Q

What is channeling?

A

When the ventilator gas flows creates a small passageway through the absorbent granules, causing gases to travel down the path of least resistance, limiting the life of the CO2 absorbent.

104
Q

In the absence of the absorber color change, CLINICAL SIGNS OF CO2 ABSORBENT is exhausted may include?
Respiration? ABG?

A

Increased spontaneous RR
Resp acidosis of ABG
Increase SNS drive (skin flushing, tachycardia, sweating)
Failure of ETCO2, to return to zero during inspiration

105
Q

With CO2 absorbent exhaustion clinical signs include an initial

A

increase in hemodynamics f/B DECREASE in BP and HR

106
Q

Factors leading to an increased concentration of compound A

A 
Fresh carbon dioxide absorbent
Low total flow
Baralyme, soda lime
Higher absorbent temperature
HIGH LEVELS of SEVOFLURANE
107
Q

When are higher levels of CO production more likely

A

INcrease anesthestic concentration

Absorbent dehydrated, absorbent temp is increased.

108
Q

Recommended ways to reduce the incidence of CO exposure in humans?

A

Rehydrate dessicated absorbents by adding to the absorbents

Use calcium hydroxide instead of soda lime

109
Q

In a review of the ASA closed claims which of the following is the most common malfunction of the medical gas delivery system?

A

The BREATHING CIRCUIT

110
Q

Most common/ popular anesthetic breathing system in the United states?

A

Circle

111
Q

2 most common reasons for increases in inspired CO2 are

A

Faulty unidirectional valves

Exhaustion of absorbent granules.

112
Q

Which of the following utilizes a NRB valve?

A

Resuscitation breathing system

113
Q

A mapleson system is considered______

A

valveless

114
Q

What circuit is referred to as a modified mapleson D circuit

A

Bain circuit

115
Q

Which of the following will trigger a low-pressure alarm?

A

Disconnection of the ETT from the circuit

116
Q

Disconnection of the ETT from the circuit will trigger which alarm?

A

Low pressure alarm

117
Q

Nitrous oxide in the oxygen pipeline gas supply will trigger which alarm?

A

NO ALARM will be triggered.

118
Q

Minimum disconnect alarms that should be found on anesthesia workstations?

A

Low peak inspiratory pressure
Low exhaled TV
Low exhale CO2

119
Q

3 things that may trigger a HIGH PEAK INSPIRATORY PRESSURE Alarm?

A

Increased TV
Peritoneal gas insufflation
Inadvertent ENDOBRONCHIAL intubation

120
Q

Disconnection of the expiratory limb will cause which alarm?

A

Low peak inspiratory pressure alarm

121
Q

Esophageal intubation will trigger no alarm, T/F

A

True

122
Q

High pipeline gas pressure will trigger

A

NO ALARM because it is expected and is mediated by the anesthesia macing itself.

123
Q

The Peak inspiratoyr pressure is the

A

HIGHEST CIRCUIT PRESSURE generated during the INSPIRATORY cycle

124
Q

The peak inspiratory pressure is the highest circuit pressure generated during the inspiratory cycle and gives an IDEA of the

A

DYNAMIC COMPLIANCE OF THE LUNG

125
Q

Ventilators with both ascending and descending bellows are available, but the ascending beloowes are preferred why?

A

Ascending bellow draw attention to a disconnected circuit by collapsing and hanging bellows are rarely used, because a disconnect from the circuit is not indicated in the bellows.

126
Q

What can occur if the ventilator pressure relief valve (spill valve) is stuck closed?

A

Pulmonary barotrauma

127
Q

Fully closed pressure relief valve could cause rise in _________

A

rise in lung pressure, resulting in pulmonary barotrauma, and hemodynamic compromise.

128
Q

Oxygen flush valve delivers 35-75L/min to______and bypasses the ______and ______

A

Common gas outlet; flowmeters and vaporizers.

129
Q

An empty bellows alarm suggests a _____ or ______

A

circuit disconnection or an occult leak.

130
Q

Most frequent site of disconnection

A

Y-piece disconnection

131
Q

Smallest and largest cylinder

A

with “A” being the smallest and “H” being the largest (most commonly).

132
Q

Full E-cylinder O2 L and PSIG

A

660L and 1900 psi

133
Q

E cylinder pin position for
Oxygen
Air
NItrous

A

2-5
1-5
3-5

134
Q

Color for O2, nitrous and air respectively

A

Green, blue, yellow

135
Q

Full E-cylinder nitrous L and PSIG

A

1590L and 745 PSIG

136
Q

At what volume will the pressure gauge of nitrous oxide e-cylinder fall bellow its maximal pressure

A

400L

137
Q

When does the service pressure of Nitrous begin to decrease?

A

ONce the liquid nitrous in the cylinder is vaporized.

138
Q

Hanger yoke is part of what system

A

High pressure

139
Q

Cylinder pressure gauge is part of what system

A

High pressure

140
Q

Common gas outlet required by the ATSM is _____and _______why?

A

Inner diameter 15mm and outer 20 mm; to prevent accidental disconnection

141
Q

What is the path of fresh gases through an anesthesia gas machine?

A

Oxygen is added last to the fresh gas manifold to reduce the risk of hypoxic mixture in the event a flow tube is cracked.

142
Q

To prevent a hypoxic mixture in the event of a leak, what is the preferred means of compressing the bellows?

A

Oxygen

143
Q

5 tasks of Oxygen

A 
Compress the bellow
fail-safe mechanism
providing fresh gas flow to the flowmeter
driving oxygen flush valve
activate low oxygen pressure alarm
144
Q

O2 pipeline gas supply should be regulated to what pressure

A

50 Psi

145
Q

Cylinder pressure is set at _____psi and pipeline is set at ______why?

A

45; 50 ; To ensure that the flow of gas preferentially comes from the pipeline supply, rather than the cylinder. This prevents the unnecessary utilization of the limited gas supply within a cylinder when pipeline supplies are available, such as when a cylinder is inadvertently left open.

146
Q

Causes of flowmeter malfunction include?

A

Sticking of the float at the top of the tube

vertical tube misalignment

147
Q

O2 flush valve delivers oxygen at ____psi and _____L/min

A

50; 35-75L/min

148
Q

The high flow rate of the O2 flush valve bypasses

A

Flowmeters and vaporizers

149
Q

Some flowmeters have 2 glass tubes

A

ONe for high flows and one for low flows

150
Q

Flowtubes are coated with a conductive or nonconductive

A

COnductive substance

151
Q

Variable bypass vaporizers have which of the following features?

A

Temperature compensated

Flow-meter methodology for vaporization

152
Q

Injector vaporizes utilize a

A

Gas/Vapor blender

153
Q

Risks of vaporizers including

A

Overfilling the vaporizer
Tipping the vaporizer
incorrectly administering the wrong agent
Vaporizer leaks or electronic failures and failure to perform regular preventative maintenance.

154
Q

When will the hypoxic guard systems not work?

A

If there is a pipeline crossover

155
Q

If pneumatic /mechanics are defective would the hypoxic guard work

A

No

156
Q

Nitrous oxide administration is controlled to limit to what ratio with oxygen?

A

3:1

157
Q

Hypoxic prevention measures between O2 and N2O are present

A

on all curent anesthesia gas machines, they limit the ration of nitrous oxide To oXYGEN to 3:1, ensuring that a minimum of 21-23% is ALWAYS PRESENT

158
Q

The link 25 proportion system is present on what type of machine

A

Datex-Ohmeda

159
Q

The datex ohmeda link 25 proportion system does what?

A

It will automatically iNCREASES THE FLOW of OXYGEN TO maintain a ratio of N2O to oxygen of no less 3:1

160
Q

Dual circuit vaporizers do not prevent

A

hypoxic concentration of oxygen

161
Q

Datex Ohmeda second stage oxygen pressure gradient is set to ______psig

A

12-19 psig

162
Q

The Datex ohmeda pressure sensor shutoff valve on these machines is set at ____psig

A

20-30 psig

163
Q

The anesthesia gas supply device shall be designed so that whenever oxygen supply pressure is reduce to below

A

the manufacturer specified minimum, the delivered oxygen concentration will not decrease below 19% of the common gas outlet

164
Q

Oxygen supplly low pressure sensors are designed to activate a gas whistle or electronic alarm when inlet gas pressure drops below

A

20-35 psig

165
Q

Systems that warn that troubles with the oxygen supply or lessen the chances of hypoxemia, are based on

A

the pressure within the oxygen circuitry of the gas machine

166
Q

Which is the only systme that ensures oxygen is present in the pipeline or cylinder?

A

Inspired oxygen analysis

167
Q

Older gas machines the pressure sensor shut off valves operate under the principle that oxygen pressure _____Psi is needed to maintain the nitrous oxide valve in the open position

A

> 20

168
Q

Most modern anesthesia machine use a proportioning safety decide that

A

Proportionately reduce the pressure of ALL GASES, EXCEPT air, in the event of a loss of oxygen pressure.

169
Q

A leak downstream of the flow control valves may lead to

A

Formation of a hypoxic mixture

170
Q

What is the NIOSH recommended limitation of the room concentration of nitrous oxide? ____ppm

A

25ppm

171
Q

What is the NIOSH recommended limitation of the room concentration of Halogenated agent? ____ppm? if nitrous being use

A

2 ppm ; 0.5

172
Q

Descending bellow ventilator design can continue to

A

Move upward and downward despite a patient disconnnection

173
Q

Descending bellow, what happens during inspiration>?

A

Push bellows upward during inspiration

174
Q

With ascending bellows when is the expired gases scavenged?

A

During the Expiratory phase

175
Q

Commercial soda lime has a water content of

A

14-19%

176
Q

How much CO2 can be absorbed by a standard lime CO2 absorbent?

A

14-23L / 100 g of absorbent

177
Q

What outcome of sevoflurane can occurs with interaction with the dessicated Baralyme?

A

Fire withing the breathing system

178
Q

Key advantages of calcium hydroxide lime absorbents include?

A

Absence of strong bases eliminates production of compound A

Calcium hydroxide will not procuce CO as a by product

179
Q

When are high levels of CO production less likely?

A

When the anesthetic concentration is reduced.

180
Q

2 components of the circle systme

A 
APL 
Reservoir bag
Fresh gas flow source
Both insp and exp valve 
y connector
CO2 absorber
181
Q

What is the potential cause of system obstruction and failure

A

Manufacturing defects

182
Q

Which of the following will lead to an increase in INSPIRED CO2?

A

Faulty unidirectional valves

Exhausted CO2 absorbent

183
Q

To troubleshoot an elevated inspired Co2

A

Increase FGF to 5-8 L/min

184
Q

Does non rebreathing system have unidirectional valves?

A

NO; *pay attention

185
Q

Disadvantage of NRB system

A

Hard to detect disconnection or kinking in fresh gas hose

Higher flows may increase the cost of anesthesia delivery

186
Q

What is the minimum fresh gas flow to prevent rebreathing in Mapleson D circuit?

A

2-3 times the MV

187
Q

Potential complication associated with the malfunction of a Bain breathing system?

A

Respiratory acidosis due to unrecognized kinking of the fresh gas hose.

188
Q

Per ASTM standards, a high priority alarm may not be silence longer than

A

2 minutes

189
Q

What will initiate a priority high alarm

A

Continuing high pressure
Negative pressure
Oxygen faillling below 18%

190
Q

The oxygen supply low pressure sensor will activate when the inlet gas pressure decrease below a theshold of

A

20-35 psig

191
Q

Gas composition in the breathing circuit can be significantly affected by

A

Anesthetic uptake into the patient’s lungs
Presense of gas leaks
MV
Volume of the breathing circuit itself

192
Q

During bag mask ventilation, continued deflation of the breathing bag when the pressure relief valve is closed usually indicates

A

A substantial leak around the mask

193
Q

During bag mask ventilation, the generation of high breathing circuit pressure with minimal chest movement and breath sound suggests/

A

An obstructed airway

194
Q

The use of a flexible fiber optic bronchoscope is preffered over direct laryngoscope with a rigid scope for which types of patients

A

Patients with unstable cervical spines

Patients with congenital upper airway anomalies

195
Q

According to the laryngeal view scoring system developed by comack and lehande, a grade 3 visualization would indicated that the laryngoscope could visualize

A

The epiglottis but no part of the glottis can be seen

196
Q

An ETT tube marked with “I.T.” or “Z-79” indicateds

A

The ETT has been tested to ensure nontoxicity

197
Q

The resistance of airflow through an ETT tube depends on 2 factors

A

Length of the ETT

Curvature of the ETT

198
Q

The resistance of airflow through an ETT is primarily a function of the tube

A

Diameter

199
Q

ETT tube cuff pressure depends on the

A

Intrathoracic pressure
Tracheal and cuff compliance
Diameter of the cuff in relation to the trachea
Volume of air used to inflate the cuff

200
Q

Which of the following is the equation to determine the appropriate internal diameter in mm of an ETT tube for a child?

A

4 + (age/4)

201
Q

A full term infant requiring intubation would most likely require what size of ETT

A

3.5 ID and 12 cm length

202
Q

All double lumen tubes are

A

longer bronchial lumen and another shorter tracheal lumen
Preformed curve that allows preferential entry into either bronchus
A bronchial cuff

203
Q

Most double lumen tube easily accommodate bronchoscopes with outer diameters between

A

3.6-4.2 mm

204
Q

Major complications specific to double lumen bronchial tubes inclde

A

Hypoxemia due to tube misplacement or occlusion
Tracehaobronchial rupture resulting from overinflation of the bronchial cuff
Inadvertent suturing of the tube to a bronchus during surgery

205
Q

Which of the following is a an examples of a right double lumen bronchial tube?

A

Gordon-Green tube

206
Q

What is A robert shaw tube?

A

A double lumen bronchial tube that can intubate either the right or left bronchus

207
Q

What is a carlens tube?

A

Double lumen bronchial tube that is intended to intubate the left bronchus.

208
Q

What is a forgathy catheter

A

Type of bronchial blocker

209
Q

During one lung ventilation, the mixing of unoxygenated blood from the collapse, operative lung with oxygenated blood from the dependent lung

A

Increases the PA-a oxygen gradient which can lead to hypoxemia

210
Q

What limit the increase of the PA-a oxygen gradient?

A

Hypoxic pulmonary vasoconstriction

211
Q

Which of the following is the preferred laryngoscope blade for insertion of a double lumen bronchial tube./

A

Macintosh (improve visualization)

212
Q

The length of an appropriately sized nasal airway can be dtermined by

A

Distance from nares to meatus of the ear

213
Q

Nasal airways should not be used in which of the follwoing

A

Anticoagulants patients

Patients with a basilar skull fracture

214
Q

Where is a standart tacheosteomy performed

A

At the level of the 4-6th tracheal ring

Below the isthmus of the thyroid gland

215
Q

Contraindications to the use of LMA include

A

Bronchospasm

216
Q

LMA and compliance of lung

A

Contraindicated in decrease pulmonary compliance. such as fibrosis, sarcoidism

217
Q

LMA vs ETT bronchospasm

A

Less bronchospasm compared to ETT

SEE NCE Boards CoreConcepts (44 decks)

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