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RUSVM Anesthesiology > The Anesthesia Machine > Flashcards

The Anesthesia Machine Flashcards

1
Q

why should you not deliver anesthestic gas in air (21% O2)

A

would lead to hypoxemia due to hypoventilationa and V/Q mismatch by anesthetic itself

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2
Q

minimal acceptible range of O2

A

30-35% O2 (FiO2= 0.30-0.35)

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3
Q

what is the metabolic requirement for oxygen?

A

5-10 mL/kg/min

this would be the minimun O2 flow required

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4
Q

what are other medical gases

A

nitrous oxide

medical air

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5
Q

types of oxygen sources

A

cylinders

liquid (cryogenic oxygen)

oxygen concentrator

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6
Q

E- cylinders

A

usually single, attached directly to anesthesia machine via yoke

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7
Q

H-cylinders

A

often in banks, supply central O2

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8
Q

T/F clyniders are color coded

A

True

oxygen= green

nitrous oxide (N2O) = blue

medical air = yellow

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9
Q

T/F unsecured tanks may explode if dropped or falls over and can become a projectile

A

True!!

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10
Q

what can you do to avoid fire with tanks

A

clean oils from hands and tank

open cylinder valves slowly

open & close walve briefly before attaching to machine to remove dust from connecting port

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11
Q

T/F pressure in the breathing system is meansure in psi

A

False

measured in cmH2O, the cylinder is measured in psi

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12
Q

what are pressure gauges used to measure

A

cylinder pressures

pipeline pressures

anesthetic machine working pressures

pressure within the breathing system

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13
Q

what part of the system is in low pressure

A

between flowmeter output and common gas outlet

breathing system (= pressre in patient’s lungs)

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14
Q

what is the capacity of an E-cylinder

A

660L (know this!!)

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15
Q

both E and H cylinders are filled to:

A

2200 psi (know this!!)

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16
Q

how can you calculate remaining O2 in the tank

A
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17
Q

how can you gifure out how many minutes of O2 are left

A
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18
Q

T/F N20 exisits in both a gaseous an dliquid form in the tank

A

True

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19
Q

T/F it is NOT possible to calculate amount of N2O gas remaining based on pressure

A

True

gauge only reads the gas pressure

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20
Q

what are some of the safety systems in place

A

color-coded tanks

labelling

diameter index safety system

pin index safety system

quick connectors

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21
Q

what is the diameter index safety system

A

non-interchangeable, gas specific threaded connection system

used universally by all equipment and cylinder manufacturers

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22
Q

what is the pin index safety system

A

gas-specific pin patterns that only allow connections bewteen the appropriate cylinder yokes and e tanks

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23
Q

characteristics of quick connectors

A

manufacturer-specific

facilitate rapid connecting and disconnecting of gas hoses

useful for multipurpose work areas

24
Q

what does the regulator/pressure-reducing valve

A

decreases tank pressure to a safe working pressure (≈50 psi) which is supplied to flowmeter

prevents pressure fluctuations as the tank empties

25
Q

flowmeter

A

controls rate of gas flow through the vaporizer (L/min)

gas enters at bottom at 50 psi and exits the top at 15 psi

26
Q

the single/double taper flowmeter is more accurate at lower gas flows

A

Double-taper

27
Q

T/F flowmeters are calibrated for 760 mmHg and 20ºC

A

True

28
Q

where do you read the flow?

A

middle of the ball

top of the bobbin

29
Q

T/F flowmeters are gas-specific

A

True

O2 flowmeter is NOT accurate if used for N2O or medical air

30
Q

if there are multiple flowmeters where would the O2 be located

A

the far right (downstream of all other gases)

prevent delivery of a hypoxic gas mixture

31
Q

in a mixed gas set up the N2O is set to 6L and the O2 set to 1L, is there sufficient O2 flow going the patient

A

No!!!

1L O2 + 6L N2O

02 = 1/7 = 14% (minimum is 35%)

This would be a hypoxic mixture = fatal

32
Q

T/F the quick flush bypasses the vaporizer and delivers O2 with no anesthetic gas

A

True

dilutes gas in the circuit

33
Q

when should the quick flush be used

A

quickly decrease anesthic gas % in the circuit (emergency, recovery)

Remember: disconnect patient from cicuit before using quick flush→ can resulti n dangerous increases in breathing circuit pressures

34
Q

what is a possible complication of the quick flush

A

pneumothorax

small circuit, high pressure, small patient

35
Q

what do anesthetic vaporizers do

A

change liquid anesthetic into vapor

deliver selected % of anesthetic vapor to fresh (common) gas outlet

36
Q

vapor

A

gasesous state of substance that is liquid at ambient temp and pressure

halothane, isoflurane, sevoflurane, desflurane

37
Q

gas

A

exists in gaseous state at ambent T and P

N20, Xenon

38
Q

vapor pressure

A

pressure exerted by vapor molecules when liquid and vapor phases are in equilibrium

39
Q

T/F vapor pressure is dependent on temperature

A

True

increases with increases temperature, inversely related to boiling point

40
Q

saturated vapor pressue

A

maximum administration percentage

vapor pressure/barometric pressure

41
Q

characteristics of modern vaporizers

A

agent-specific

concentration-calibrated

variable-bypass

flow-over

out-of circuit

high resistance

compensated for temp, flow and back-pressure

42
Q

variable-bypass system

A

fresh gas flows over a reservoir of liquid anesthetic and mixes wit carrier gas

43
Q

vaporizers out of circuit (VOC)

A

carrier gas is from flowmeter

anesthetic % is known - percision vaporizer

44
Q

vaporizers in circuit (VIC)

A

not currently recommended

cannot produce known anesthetic gas %

not temperature compensated

non-precision

45
Q

modern vaporizers compensate for:

A

temperature bewteen 15-35º C

flow rate between 0.5 and 10 L/min

back pressure associated with positve pressure ventilation and ise of flush valve

46
Q

how is temperature compensation achieved

A

using materials that are efficient heat conductors

mechanical thermocompensation systems: has thermal element mode of heat sensitive metal that reliably expands and contracts based on temp

47
Q

how is flow rate compensation achieved by

A

saturation of gas moving through vaporizing chamber

use of wicks, baffles, and spiral tracks that facilitate vaporization

48
Q

back pressure

A

can occur during positive pressure ventilation or use of the flush valve

may increase vaporizer output of compensation mechanisms not present

vaporizers have mechanism to prevent

49
Q

how are vaporizers filled

A

using screw-cap port or agent-specific keyed filler port

50
Q

characteristics of vaporizers

A

require no external power (except desflurane)

routine maintenance is required and must be performed by a qualified technician

mounted on a “back bar” on the machine

cannot be tipped-must be emptied before transporting

51
Q

what can happen if vaporizer is filled with wrong agent

A

depends on vapor pressure and petency of each agent

iso in sevo vaporizer could produce a leathal concentration

52
Q

what should you do if you put the wrong agent on the vaporizer

A

drain and run 1 L/min O2 until completely dry

53
Q

what would happen if vaporizer was tipped

A

anesthetic may enter the bypass channel and deliver a high concentration

run 1 L/min O2 through machine with vaporizer off to fix

54
Q

what is the common gas out

A

where gas exits the vaporizer

55
Q

where is the common gas outlet connected

A

by a hose to the fresh gas inlet - must be connected so fresh gas flows to the breathing circuit

connects to either rebreathing or non-rebreathing system

RUSVM Anesthesiology (39 decks)

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