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AP 1 > Test 1 part VI (Anesthesia Machine) > Flashcards

Test 1 part VI (Anesthesia Machine) Flashcards

1
Q

What is the SPDD Schematic?

A

Supply, Processing, Delivery, and Disposal

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2
Q

Refers to how gases get to the anesthesia machine. Involves pipeline and cylinders.

A

Supply

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3
Q

Oxygen is a stored as a ______ at a temperature of _____ deg C.

A

Liquid; -160 degrees C

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4
Q

Refers to how the anesthesia machine prepares the gases before they are delivered to the patient.

A

Processing

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5
Q

Refers to how the prepared gases are brought to the patient.

A

Delivery

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6
Q

Refers to how the gases are removed from the OR

A

Disposal

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7
Q

What are the 5 tasks of O2?

A
  1. Proceeds to the fresh gas flow meter
  2. Powers the O2 flush (35-75 L/min)
  3. Activates the fail-safe valve (occludes N2O if low O2 pressure is present)
  4. Activates the O2 low pressure alarm
  5. Compresses the bellows of mechanical ventilation
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8
Q

What is the minimum FGF required to prevent rebreathing?

A

2-3 x minute ventilation (or a minimum fresh gas flow of 5L/min)

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9
Q

Occurs when there is no rebreathing of any exhaled gases.
-Lack unidirectional valves
-Lack soda lime CO2 absorption
-FGF determines the amount of rebreathing
-Resistance and WOB is low

A

Non-Rebreathing Systems (rare)

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10
Q

-NO Reservoir or Unidirectional Valves
-NO rebreathing (must have FGF >6 L/min)
-Ex: Open drop/NC/Face Mask
-Patients have access to the atmosphere

A

Open

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11
Q

-Has a Reservoir
-NO Rebreathing
-CO2 is eliminated by dilution and exclusion
-Ex: Circle system at high FGF (must be > Minute Ventilation) or non-rebreathing system
-Ex: Mapleson and Bain System
-Good for peds patients due to low resistance to flow

A

Semi-Open

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12
Q

-Has a reservoir
-Partial rebreathing
-CO2 is absorbed (soda lime) and excluded (unidirectional valves)
-Ex: Circle System at low FGF (less than Minute Ventilation)

A

Semi-Closed

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13
Q

-Has a reservoir
-Complete rebreathing
-Ex: Circle system at extremely low FGF with APL Valve closed

A

Closed

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14
Q

Defines breathing circuits by the presence or absence of a reservoir bag and the degree to which rebreathing occurs.

A

Mapleson Classification of Breathing Circuits

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15
Q

_____ and ____ systems are not capable of being semi-closed or closed because they do not have a way to eliminate CO2 by chemical absorption and lack valves to eliminate CO2 rebreathing by exclusion.

A

Mapleson and Bain

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16
Q

A system that prevents the rebreathing of CO2, while allowing the rebreathing of other gases.
-Can be Semi-open, Semi-closed, or Closed
-Inspiratory & expiratory unidirectional valves enforce flow pattern, all exhaled gasses are directed through CO2 absorbent, low FGF technique

A

Circle System

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17
Q

Allows venting of excess gas from breathing system into the waste gas scavenging system – adjusted to provide controlled ventilation – fully open (min) during spontaneous ventilation

<30 to prevent barotrauma

A

Adjustable Pressure Limiting (APL) Valve

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18
Q

Maintains a reserve volume of gasses from the anesthesia machine – serves as a safety device bc of its distensibility

A

Reservoir Bag

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19
Q

What are the advantages to using the Circle System?

A
  1. Constant inspired concentrations
  2. Conservation of respiratory tract heat/humidity
  3. Minimal OR pollution
  4. Useful for closed/low flow/semi-open configurations
  5. Low resistance
20
Q

What are the disadvantages of the Circle System?

A
  1. Relatively complex
  2. potential for disconnections
  3. malfunction of unidirectional valves (open rebreathing; closed occlusion)
  4. less portable
  5. increased dead space
21
Q

Prevent the circle system from contributing to apparatus dead space. Failure of these to seal converts a large volume of the circuit into apparatus dead space, resulting in rebreathing!!

A

Unidirectional Valves

22
Q

The only apparatus dead space in the Circle System is:

A

The distal limb of the Y-connector and any tube or mask between it and the patient’s airway!!

23
Q

What components make up the High Pressure System?

A

Cylinder to the first stage regulator.
-Hanger yoke, yoke block with check valves, cylinder pressure gauge, cylinder pressure regulators
-Cylinder Regulator = 45 psi

24
Q

What are the components of the Intermediate Pressure System?

A

Exposed to pipeline pressure.
-Pipeline inlets, check valves, pressure gauges, ventilator power inlet, oxygen pressure-failure devices, flow meter valve, oxygen second-stage regulator, flush valve
-Pipeline = 50 psi

25
Q

What are the components of the Low Pressure System?

A

Distal to flow meter needle valves.
-Flow meter tubes, vaporizers, check valves, common gas outlet
-Pressures are slightly greater than atm pressure

26
Q

How to calculate minutes of O2 remaining in the cylinder?

A

Tank capacity (L)/Full tank pressure (psi) = Contents Remaining (L)/Gauge pressure

Contents Remaining/Flow rate (L/min) = Minutes left before tank expires

27
Q

What is the color, service pressure (psi), capacity (L), and Pin Position of Oxygen?

A

Green; 1900; 660; 2-5

28
Q

What is the color, service pressure (psi), capacity (L), and Pin Position of Nitrous Oxide?

A

Blue; 745; 1590; 3-5

29
Q

What is the color, service pressure (psi), capacity (L), and Pin Position of Air?

A

Yellow; 1900; 625; 1-5

30
Q

Prevents inadvertent misconnection of gas hoses. Each gas hose & connector are sized & threaded for each individual gas by a series of increasing & decreasing diameters —not fail-proof system

A

Diameter Index Safety System (DISS)

31
Q

Prevents inadvertent misplacement of gas cylinders –not fail-proof. Pin configuration on each hanger yoke assembly is unique for each gas. Hanger yoke orients cylinder, provides gas-tight seal, ensures unidirectional flow in the machine

A

Pin Index Safety System (PISS)

32
Q

What can cause the PISS to fail?

A

If pins are missing/removed, or if more than 1 washer is used.

33
Q

Where is the oxygen flow meter always positioned?

A

Furthest to the right

34
Q

How does the O2 pressure fail-safe system work?

A

Proportionally reduces N2O flow if O2 pressure drops below 20 psi. Limited if pipeline crossover occurs (can still create a hypoxic mixture)

35
Q

How does the hypoxic proportioning system (link system) work?

A

Prevents the delivery of a hypoxic mixture with the flow control valves by requiring a 3:1 N20:O2 mixture. Tested by turning on N2O without O2. Final breathing mixtures at the CGO are at least 23-25% O2.

36
Q

Hypoxia prevention devices and the Fail Safe system only respond to changes in O2 ______, NOT the O2 ______. This is why proper use of a calibrate O2 analyzer in each GA case is of vital importance.

A

Only respond to changes in O2 pressure or flow, NOT the O2 concentration. Could have pipeline crossover and would only be detected by O2 analyzer.

37
Q

What are the limitations of the hypoxic proportioning system (Link system)

A
  1. O2 pipeline crossover
  2. Administration of a 3rd gas
  3. Defective mechanic or pneumatic components
38
Q

What is the only system that would detect a pipeline crossover?

A

A calibrated O2 analyzer

39
Q

A type of O2 analyzer that works via a current generated across 2 electrodes as the O2 tension increases. Must be calibrated daily and replaced over time.

A

Galvanic Fuel Cell

40
Q

A type of O2 analyzer that works via increasing O2 tension creating increased magnetic attraction. Self calibrating and faster, lower cost, and low maintenance.

A

Paramagnetic Analyzer

41
Q

The tendency of a liquid to evaporate. The more volatile the agent, the faster it will evaporate

A

Volatility

42
Q

Inhalational agents are volatile liquids at _____ deg C

A

20 degrees C (room temp)

43
Q

The molecules in gas phase of a substance that is liquid at room temp & at 1 atm

A

Vapor

44
Q

The conversion of a liquid to a vapor in a closed container. Rate depends on temp, vapor pressure of liquid, and the partial pressure of vapor above evaporating liquid.

A

Vaporization

45
Q

Modern vaporizers are made out of what materials?

A

Metals with high thermal conductivity & capacity (copper)

46
Q

The energy required to transform molecules from the liquid phase to the gas phase; remaining liquid in container is cooled.

A

Latent Heat of Vaporization

47
Q

What are some of the safety features regarding volatile agents and vaporizers?

A
  1. Vaporizers are agent-specific and color coded
  2. Filling connectors are specific to each agent
  3. Vaporizers are “out of circuit” - they are isolated outside of the breathing system
  4. Safety interlock system

AP 1 (32 decks)

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