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Anesthesia Concepts > Vaporizers/Medical Gas - EXAM 2 > Flashcards

Vaporizers/Medical Gas - EXAM 2 Flashcards

0
Q

How are the flow control knobs for O2 and N2O different?

A

oxygen is green and a little smoother

nitrous oxide is blue and has deeper grooves

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1
Q

What is the apportioning system?

A

a safety feature that will automatically turn on the O2 if you only start to turn on the N2O.

*doesn’t work in the opposite direction

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2
Q

What are the characteristics of E size cylinders?

A

pressure is 2200 psi
can hold approximately 625-700 L O2

pressure will fall proportional to volume because the oxygen is in a gaseous state

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3
Q

What are the characteristics of air cylinders?

A

pressure is 1900-2000 psi
can hold about 625L

pressure in the tank will fall proportionate to the volume

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4
Q

what are the characteristics of nitrous cylinders?

A

pressure of 745 psi
volume of 1590L

pressure will not decrease as volume decreases, because the nitrous is in liquid state

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5
Q

When will the pressure drop in the nitrous oxide cylinder?

A

once the last drop has vaporized the pressure will precipitously drop

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6
Q

Who regulates the purity of medical gases?

A

US Pharmacopeia and the FDA

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7
Q

How is the DOT responsible for medical gases?

A

regulates manufacturing, transporting, storage, handling and maintenance, disposition, etc. for medical gases

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8
Q

What are the ways that medical gas cylinders are identified?

A

labels - decal/sticker that cannot cover any permanent markings
tags - Full/In Use/Empty
permanent markings - required by DOT

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9
Q

As volume in a cylinder increases, pressure will

A

increase

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10
Q

What happens to the gas as it leaves the cylinder?

A

pressure drastically decreases and the gas will expand in the atmosphere

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11
Q

What will a STAR on the cylinder indicate?

A

that the cylinder can be restested in 10 years instead of the standard 5 years.

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12
Q

What does the + sign mean on a cylinder?

A

that it can be overfilled by 10% of the marked service pressure

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13
Q

What kind of information does the cylinder label have on it?

A

flammability status, hazards that need to be considered, name of the gas, manufacturer, etc.

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14
Q

How should gas cylinders be stored?

A

in an upright rack, free of dust and other clutter, labels visible.

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15
Q

What is the Pin Index Safety System?

A

safety check so that you won’t put the wrong gas cylinder onto the wrong yoke. A series of 7 pins are arranged uniquely for each type of gas so that it will only hook up to one yoke

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16
Q

What are the sizes of the pins?

A

4 mm wide and 6mm long

*pin #7 is slightly wider

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17
Q

What is the Diameter Index Safety System?

A

provides non-interchangeable connections for the pipeline gases. system contains a body, nipple and nut.

*requirement on every anesthesia machine.

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18
Q

What are some important safety tips for handling gas cylinders?

A

never oil the valves
always open the valve all the way
don’t leave empty cylinders on the machine
always position them standing up
always remove the plastic covering before attaching to the machine
never rely on color alone to hook up a tank
clear any foreign particles or dust from the cylinder before attaching it

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19
Q

What is vaporization?

A

conversion of a liquid to a gas

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20
Q

Why do anesthetic agents need to even go through a vaporizer?

A

because they are extremely potent in their original containers and need to be diluted before they can be administered to a patient.

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21
Q

Vaporization is dependent on what 3 factors?

A

vapor pressure
temperature
amount of carrier gas used

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22
Q

What is vapor pressure?

A

the constant flux between molecules in a gaseous state and liquid state puts pressure on the surface of the container and generates a certain VAPOR PRESSURE which is compared to atmospheric air.

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23
Q

vapor pressure of ENFLURANE

A

172 mmHg

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24
Q

vapor pressure of DESFLURANE?

A

669 mmHg

25
Q

vapor pressure of ISOFLURANE?

A

240 mmHg

26
Q

vapor pressure of HALOTHANE?

A

244 mmHg

27
Q

vapor pressure of SEVOFLURANE?

A

160 mmHg

28
Q

When temperature increases, rate of vaporization will …

A

increase

29
Q

when temperature decreases, rate of vaporization will…

A

decrease

30
Q

what is “latent heat”?

A

of calories require to change 1 gram of liquid into vapor without a change in temperature

31
Q

Where does the energy for vaporization come from in most circumstances?

A

from the liquid itself

*can be an outside heater

32
Q

What is specific heat?

A

of calories required to increase the temperature of 1 gram of substance by 1 degree C

33
Q

What is thermal conductivity?

A

a measure of how quickly heat can flow through a substance

*the higher the conductivity the better it will transmit heat

34
Q

How does altitude affect barometric pressure?

A

as altitude increases, barometric pressure decreases

as altitude decreases, barometric pressure increases

35
Q

What is boiling point?

A

when vapor pressure equals atmospheric pressure

*at higher elevations the gases will boil faster

36
Q

What are the 3 main components of vaporizers?

A

they’re agent specific, temperature controlled and have variable bypass

37
Q

What components make up your total gas flow and how is this controlled?

A

oxygen, air, nitrous, etc.

controlled by the flowmeters

38
Q

What is the lowest % of O2 delivery that you can give a healthy patient?

A

25%

39
Q

What is the variable bypass system?

A

pulls a portion of the gas flow down through the vaporizer to dilute the anesthetic

*dependent on the settings put into the flowmeter

40
Q

What is the concentration control dial?

A

what you turn to determine the concentration that the vaporizer should use.

41
Q

How can you determine the concentration that should be delivered to the patient?

A

will depend on the patient’s health history, use of other drugs, the MAC of the anesthetic

42
Q

What does MAC stand for?

A

minimum alveolar concentration

*related to the ED50 of a drug

43
Q

How does the temperature compensating valve work?

A

it is a bimetallic strip that will move left or right depending on the temperature to control changes in the gas flow through the vaporizer

44
Q

If the temperature is higher, the temperature compensating bypass will allow ***** gas to go through

A

more

45
Q

if the temperature is cooler, the temperature compensating bypass will allow ** gas to flow through the vaporizer

A

less

46
Q

What will happen to the temperature of the cylinder as vaporization is occurring?

A

It will start to get really cold because the gas is drawing energy from itself to vaporize

47
Q

How should you take care of your vaporizer if you move to an area of higher altitude?

A

the vaporizer will need to be recalibrated

48
Q

The % of anesthetic gas delivered is relative to the agent’s vapor pressure as compared to **?

A

barometric pressure

49
Q

If barometric pressure goes down, the concentration of the anesthetic delivered will…

A

also go up

50
Q

If you’re not going to recalibrate your vaporizer at a higher altitude, what is an important safety condition that the practitioner must consider?

A

the patient will be getting more than what you’ve dialed in, so you may want to consider setting the concentration lower

51
Q

What is a TEC 6 vaporizer?

A

a vaporizer specifically designed for DESFLURANE because it has such a high vapor pressure.

Exerts 2 atms of pressure around the anesthetic through the generation of heath so that it lowers the boiling point and the anesthetic can remain as a liquid for longer time

52
Q

How did copper kettles work?

A

you could place any anesthetic gas into the copper kettle and dictate your flowmeter through “measured flow”. The gases would then “bubble through” towards the liquid. The highly concentrated vapors would then be dilute with the fresh gas flow

53
Q

Why is the oxygen flowmeter closest to the patient in modern day systems?

A

so that if there is a leak in the system, other gases might escape but not oxygen.

54
Q

What modern component replaced the “bubble through” function of the copper kettles?

A

variable bypass

55
Q

What are some ways that you’ll know you’ve used the right cassette with the right anesthetic?

A

they are color coded, they use a PISS and a spectrometry system might be able to analyze the vapors

56
Q

How might you know that you’d given too high a concentration of the wrong gas before your machine even started alarming? What should you do?

A

the patient would quickly become bradycardic and hypotensive.

TURN DOWN THE GASES

57
Q

What are some components that are required on all anesthesia machines?

A

oxygen analyzer, oxygen, pressure sensors, alarm system

58
Q

What is the problem with tipping a vaporizer?

A

liquids can flow into the wrong chamber and mess up the system

59
Q

How does the machine prevent simultaneous administration of more than one anesthetic?

A

you can now usually only run 1 vaporizer at a time

there is even a special button that you have to push down to use the vaporizer on the back of the cassette

60
Q

What is the pumping effect?

A

When high flows of oxygen are used in multiple sources from the same pipeline, a backflow in the system can occur and the gases won’t flow into the vaporizer correctly

*usually occurs in the morning when all the cases are starting

Anesthesia Concepts (8 decks)

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