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NUNA 690 - Principles > Vaporizers > Flashcards

Vaporizers Flashcards

1
Q

Sevoflurane is known for ________ induction and awakening

A

Rapid

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2
Q

Sevoflurane can react with _____ absorbents to form nephrotoxic _______

A

CO2; compound A

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3
Q

Sevoflurane is often used for what population?

A

Peds

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4
Q

Sevoflurane is the only inhalation agent that can be used for what?

A

Inhalation induction

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5
Q

______ elimination of Sevoflurane results in ______ awakening

A

Rapid; quick

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6
Q

Signature color of Sevoflurane?

A

Lemon yellow

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7
Q

Desflurane requires ____________?

A

An electrically heated vaporizer

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8
Q

Desflurane is an airway ______, therefore combine with __ agents during ________.

A

Irritant; IV; induction

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9
Q

Desflurane can cause _________, therefore use with caution in patients with ___.

A

tachycardia; CAD

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10
Q

_______ elimination of Desflurane results in _______ awakening

A

Rapid; quick

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11
Q

Isoflurane was once considered the “____ _______” for _____surgery

A

gold standard; neuro

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12
Q

Isoflurane can cause _____ ______ ____ ________ through ________ _________ __________/_________.

A

Coronary artery steal syndrome; significant peripheral vasodilation; hypotension

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13
Q

Isoflurane’s signature color is?

A

Medium purple

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14
Q

Halothane, once the agent of choice for inhalation induction, has now been replaced by ________.

A

Sevoflurane

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15
Q

Halothane is a potent _________, therefore good for ________ patients

A

bronchodilator; reactive airway

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16
Q

Halothane’s effect on what organ causing ________ _______ is a major disadvantage?

A

Liver; halothane hepatitis

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17
Q

Halothane causes an increased risk of ________ along with __________ or __ use with local anesthetics.

A

dysrhythmias; catecholamines (DL stimulation); epi

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18
Q

Emergence is significantly _________ with Halothane compared to other inhaled agents. How long?

A

slower; 30-40 minutes

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19
Q

Nitrous oxide is NOT a ________ _________.

A

volatile agent

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20
Q

Nitrous oxide is used to ________ inhalation agents

A

supplement

21
Q

Nitrous oxide is the only inhalation agent with ________________ activity

A

sympathomimetic

22
Q

Nitrous oxide use should not exceed __% (with __% O2)

A

70; 30

23
Q

What are two major safety issues with nitrous oxide due to its fast diffusion? How can the latter be prevented?

A

Diffusion into air-filled spaces and diffusion hypoxia; don’t extubate on nitrous and give high FiO2.

24
Q

What is a vaporizer?

A

A device for converting a liquid volatile anesthetic agent into breathable vapor

25
Q

Components of vaporizers?

A

Concentration-calibrated dials; sit between flow meters and CGO; agent-specificity; interlocking safety mechanisms

26
Q

Vapor

A

gaseous at room temperature at 1 atm (760 mmHg)

27
Q

What happens to the temperature of remaining liquid in a vaporizer as vaporization increases?

A

It decreases if heat is not added, causing vaporization to decrease

28
Q

What is saturated vapor pressure?

A

The equilibrium pressure of a vapor above its liquid or solid (in a closed container) at a certain temperature; dependent on specific agent and temperature (NOT atmospheric pressure)

29
Q

Boiling point is…

A

The temperature at which the vapor pressure equals atmospheric pressure

30
Q

Latent heat of vaporization

A

The calories needed to convert 1 gram of liquid to vapor without changing the temperature in the remaining liquid

31
Q

Specific heat

A

Calories needed to increase the temperature of 1 gram of a substance by 1 degree Celsius

Vaporizers materials must have a high specific heat in order to minimize temperature change with vaporization (ex., copper kettle)

32
Q

What are the characteristics of a copper kettle vaporizer (Vernitrol)?

A

Old school; uses MEASURED-FLOW (oxygen bubbles THROUGH agent; outside of breathing circuit; manual temperature compensation

Copper has a high specific heat and high thermal conductivity

33
Q

Characteristics of Variable Bypass vaporizer?

A

Most common contemporary vaporizer; gas is split into CARRIER GAS (enters vaporizing chamber to pick up agent) and gas which bypasses the chamber; wicks/baffles ensure full saturation of carrying gas.

34
Q

What determines the splitting ratio in a variable bypass vaporizer?

A

The internal resistance to flow (dial) and the temperature compensating mechanism

35
Q

In a variable-bypass vaporizer, saturated gas combines with fresh gas at _______ ________ to consistently produce final desired concentration regardless of _____ _____ ____ _____.

A

vaporizer outlet; total fresh gas flow

36
Q

Characteristics of TEC 6 vaporizer

A

Electronic (heated); for desflurane; since des nearly boils at room temperature and would excessively cool liquid des due to volatility (VP 681 @ 1 atm), TEC 6 heats des and injects it into the system to maintain an appropriate concentration controlled by dial internal transducer.

37
Q

Desflurane vaporizers compensate for ____ and ___; they cannot compensate for ___________.

A

flow; atm; temperature

38
Q

TEC 6 requres __ ______ warm-up if left cold and can be _____ during ________.

A

10 minute; filled; delivery

39
Q

___________ can cause “No Output” with shutdown in a TEC 6 vaporizer.

A

Tilting

40
Q

Aladin Cassette vaporizer characteristics

A

Once central electronic control mechanism into which different agent cassettes are inserted; when not in use, cassettes are stored in non-electronic ports; no tilt risk; hold less agent; variable bypass for all agents including desflurane (does not require additional heat).

41
Q

If a sevoflurane (VP: 157) vaporizer was filled with isoflurane (VP: 240), what would happen upon administration? With the reverse scenario?

A

Overdose; underdose

42
Q

Six safety mechanisms of vaporizers

A

Color coding; keyed fillers; low filling port; secured vaporizers; all dials adjust in the same direction (counterclockwise for increase); interlocks

43
Q

What is a vaporizer interlock?

A

Safety mechanism that ensures only one vaporizer can be turned on at a time; gas can only enter the vaporizer in the on position, minimizing trace vapor output when off; locked into gas circuit and seated correctly.

44
Q

What risks are imposed by tipping a vaporizer?

A

Tilt of >45 degrees can result in overdose if vaporizer is not flushed before use

45
Q

What safety mechanism can help the CRNA to know if the vaporizer is out of calibration?

A

Breath to breath analysis

46
Q

What safety check can show the CRNA circuit leaks?

A

Negative pressure check

47
Q

What is pumping, and what mechanism prevents this in newer anesthesia machines?

A

Back pressure into the vaporizer causing increased concentration of agent in the circuit; one-way valves

48
Q

What vaporizer models can suffer from electronic dysfunction?

A

TEC 6 and Aladin

NUNA 690 - Principles (5 decks)

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