Week 1 Handout Flashcards
What is a key responsibility of a CRNA?
Administering anesthesia and ensuring patient safety
When was anesthesia first publicly demonstrated?
1846 at Massachusetts General Hospital
What were the early anesthetic agents mentioned?
- Ether
- Chloroform
What role did nurses take on in the 19th century concerning anesthesia?
They became anesthetists due to a lack of interest from physicians
What advancements have been made in modern anesthesia practice?
Advancements in drugs, techniques, and safety protocols
In what settings do nurse anesthetists work?
- Hospitals
- Surgical centers
- Military contexts
Who was Catherine S. Lawrence?
A nurse who played a crucial role in administering anesthesia during the Civil War
What significant organization was founded by Agatha Hodgins?
National Association of Nurse Anesthetists (NANA)
What is Alice Magaw known for?
Being referred to as the ‘Mother of Anesthesia’ and her meticulous documentation of techniques
What contributions did Helen Lamb make to nurse anesthesia?
Developing and enhancing educational standards and curricula
What is the significance of the American Association of Nurse Anesthetists (AANA)?
It represents the professional organization for nurse anesthetists established in 1931
Fill in the blank: Medical gases used in operating rooms include oxygen, nitrous oxide, air, and _______.
Nitrogen
What is critical for patient safety regarding medical gas systems?
Correct configuration and functionality
What determines the medical gas supply system design in hospitals?
Peak demand estimates
How is medical grade oxygen produced?
By fractional distillation of liquefied air
What type of cylinder do small hospitals typically use for oxygen storage?
High-pressure cylinders (H-cylinders)
What safety feature do oxygen E-cylinders have?
A plug made from Wood’s metal that ruptures at 3300 psig
What is the critical temperature of nitrous oxide?
36.5°C
What is a notable safety feature of nitrous oxide E-cylinders?
They are equipped with a Wood’s metal plug to prevent explosion
True or False: The transition of nitrous oxide to a gaseous phase causes a significant rise in tank pressure.
False
What is the primary function of woods metal in anesthesia machines?
To prevent explosion under high gas pressure conditions.
This includes unintentional overfilling or during a fire.
What is the constant pressure in reserve nitrous oxide E-cylinders at 20°C?
745 psig
This pressure remains constant until the liquid nitrous oxide is exhausted.
How is the residual volume of nitrous oxide in a cylinder best determined?
By weighing it.
The tare weight (TW) is often stamped on the cylinder.
What is the growing trend in anesthesiology regarding gas usage?
Increasing use of medical air.
This is due to the decline in nitrous oxide popularity and reduction in high concentrations of oxygen use.
What is the composition of medical-grade cylinder air?
A blend of oxygen and nitrogen.
What is the critical temperature of air?
-140.6°C.
What is the purpose of nitrogen in hospitals?
To power operating room equipment like saws, drills, and surgical handpieces.
What is the function of the central vacuum system in hospitals?
To prevent contamination and may be used for waste anesthetic gas disposal (WAGD).
What color coding is used for medical vacuum receptacles?
Typically black with white lettering.
What is carbon dioxide used for in surgeries?
Insufflation of body cavities during laparoscopic or robotic-assisted surgeries.
What are the characteristics of carbon dioxide?
Odorless, colorless, nonflammable, and slightly acidic.
What is a risk associated with carbon dioxide cylinders?
They share the same size orifice and thread with oxygen cylinders.
What are the three main anesthesia gas sources?
- Oxygen
- Nitrous oxide
- Air
What are the wall outlet color codes in the operating room for gas delivery?
- Green for oxygen
- Blue for nitrous oxide
- Yellow for air
What is the purpose of the Diameter Index Safety System (DISS)?
To prevent misconnections in gas delivery systems.
What is the approximate pipeline pressure for gases delivered to the anesthesia machine?
50 psig.
What is the role of safety devices in gas delivery systems?
To ensure that other gases can only flow if there is sufficient oxygen pressure.
What does the high-pressure system in anesthesia machines manage?
High-pressure gas from the anesthesia machine’s cylinders.
What is the pressure range typically found in the high-pressure system?
2000 to 2200 psi.
What is the function of the intermediate pressure system?
To ensure a constant and safe pressure for gas delivery.
What pressure range is typical for the low-pressure system?
Close to atmospheric pressure, typically between - psi.
What is the purpose of the low-pressure system?
To accurately deliver and regulate the anesthetic agent to the patient.
What is the method for determining nitrous oxide cylinder depletion?
Assumed when the pressure gauge begins to decrease.
What does a full E size nitrous oxide cylinder contain in liters?
1590 L.
What is the function of the Pin Index Safety System (PISS)?
To prevent misconnections in gas cylinders.
What color is the oxygen tank in the USA?
Green.
What is the pressure gauge reading for a full E size oxygen tank?
2000 psi.
What is the function of the pressure gauges on anesthesia machines?
To indicate the pressure of the gas in the corresponding cylinder.
What is the storage requirement for air in hospitals?
Dehumidified but unsterile air through pipeline systems powered by compression pumps.
What must be avoided with the inlets for compression pumps?
Contamination from vacuum exhaust vents and machinery.
What is the relationship between pressure and volume in an oxygen cylinder?
Directly proportional.
What is the assumption about remaining gas when the pressure gauge for nitrous oxide decreases?
About 75% of the contents are exhausted.
What is the purpose of the high-pressure leak test on an anesthesia machine?
To ensure the integrity and safety of the high-pressure components of the machine
Leaks in the high-pressure system can lead to failure in gas delivery, compromising patient safety.
What should be done during the preparation phase of a high-pressure leak test?
Turn off the anesthesia machine, disconnect from power, close flow control valves, turn off vaporizers, and remove the breathing circuit
Proper preparation is crucial for an effective leak test.
How is the high-pressure system pressurized during the leak test?
By opening the valve of one gas cylinder at a time
Typically, the pressure level corresponds to a full cylinder, around 2000 to 2200 psi for oxygen.
What indicates a leak in the high-pressure system during testing?
A drop in pressure on the gauge after closing the cylinder valve
The rate of pressure drop can help determine the severity of the leak.
Where should common leak points be checked in the high-pressure system?
- Cylinder valve
- Connection between the cylinder and the yoke
- High-pressure hoses
- Regulators
A soap solution can be used to visually identify leaks.
What is the purpose of the low-pressure leak test on an anesthesia machine?
To ensure the integrity and safety of the anesthesia delivery system, particularly in the low-pressure circuit
This test checks for leaks that could lead to inadequate anesthesia delivery.
What components are checked during the low-pressure leak test?
- Vaporizers
- Flowmeters
- Common gas outlet
- O-ring seals
- Breathing circuit connections
- CO2 absorber canister
- Ventilator bellows and hoses
- Pressure relief devices
- Check valves
Each component plays a crucial role in preventing leaks.
What should be done during the preparation phase of a low-pressure leak test?
Connect the machine to the gas supply, ensure gas cylinders are turned off, close flowmeters, turn off vaporizers, and attach a test lung or occlusion device
Proper setup is essential for accurate leak detection.
How is the low-pressure system pressurized during the leak test?
By squeezing the reservoir bag or using the oxygen flush until a pressure of about 30 cm H2O is achieved
This pressure should remain stable if the system is intact.
What indicates a leak in the low-pressure system during testing?
A drop in pressure
The rate of pressure drop can indicate the severity of the leak.
What should be done if a leak is detected in the system?
Check each component systematically to identify the source of the leak and repair or replace the faulty component
Repeating the test after repairs is necessary to ensure all leaks have been addressed.
