Week 2 Handout Flashcards
What is the primary function of the Pipeline Check Valve?
Automatically switch between the pipeline supply and the E-cylinder based on pressure levels.
When does the Pipeline Check Valve engage the E-cylinder?
When the pipeline pressure drops below a certain threshold.
What is the importance of the Pipeline Check Valve in anesthesia?
Ensures a continuous supply of oxygen critical for patient safety.
What does the Hanger Yoke Valve provide?
A physical interface for attaching gas cylinders to the anesthesia machine.
What is the purpose of the Pin Index Safety System (PISS)?
Prevents the attachment of a cylinder with the wrong gas by matching specific pin configurations.
What does the Bourdon Gauge measure?
The pressure in a gas cylinder.
What happens to the Bourdon tube when pressure is applied?
It straightens out, causing a dial or needle movement on the gauge face.
What is a critical limitation of the Bourdon Gauge?
It only indicates pressure, not the exact amount of gas remaining.
What does the first stage oxygen pressure regulator do?
Reduces high pressure from the cylinder to a more manageable intermediate pressure.
What is the typical pressure output from the first stage regulator?
Around 45-50 psi.
What is the function of the second stage oxygen pressure regulator?
Reduces intermediate pressure to a low, constant working pressure.
What is the typical working pressure output from the second stage regulator for oxygen?
Around 16 psi.
What does the oxygen flush valve do?
Delivers oxygen directly to the breathing circuit at a high flow rate.
What is the typical flow rate provided by the oxygen flush valve?
Around 35-75 liters per minute.
What is the function of the oxygen failure cutoff valve?
Automatically cuts off or reduces the flow of other gases when oxygen pressure falls below a threshold.
What does the inspiratory one-way valve prevent?
Prevents exhaled gases from re-entering the inspiratory limb of the circuit.
What does the expiratory one-way valve allow?
Allows the flow of gases away from the patient during exhalation.
Fill in the blank: The oxygen flush valve is used for _______.
[rapidly increasing oxygen concentration in the patient’s breathing circuit]
True or False: The Bourdon gauge requires a power source to operate.
False
What is the safety implication of the inspiratory one-way valve?
Ensures patients breathe fresh gas with each inhalation.
What is the function of the expiratory one-way valve?
Allows the flow of gases away from the patient during exhalation
It opens during exhalation to let exhaled gases exit the lungs.
How does the expiratory one-way valve prevent inhalation of exhaled gases?
The valve closes on inhalation
This prevents the patient from inhaling their exhaled gases.
What are the safety implications of the expiratory one-way valve?
- Avoids rebreathing of exhaled gases
- Maintains circuit integrity
Crucial for adequate oxygenation and carbon dioxide removal.
What is the purpose of the Adjustable Pressure Limiting (APL) valve?
Controls pressure within the breathing circuit
It adjusts resistance to gas flow out of the circuit.
What does the APL valve do during manual ventilation?
Vents excess gases to the scavenging system
This is especially important when bagging.
What is barotrauma, and how does the APL valve prevent it?
Injury caused by increased air pressure
The APL valve controls circuit pressure to avoid this injury.
What is the function of flowmeters in anesthesia?
Measure and display the flow rate of gases
They are crucial for delivering the correct concentration of gases.
How do flow control valves operate?
Adjust the flow of gas into the flowmeters
They are typically located below the flowmeters and adjusted manually.
What is the significance of the sequential layout of flowmeters?
Minimizes the risk of diluting oxygen
Oxygen is placed downstream to avoid significant dilution from other gases.
What is the primary purpose of the Link-25 proportioning system?
Prevents a hypoxic mixture of gases
It mechanically links flow control valves of oxygen and nitrous oxide.
How does the Oxygen Ratio Monitor Control (ORMC) function?
Monitors the ratio of oxygen to other gases
It makes automatic adjustments to maintain safe oxygen levels.
What is the oxygen volume fraction of room air?
Approximately 0.21
Room air is composed of about 21% oxygen.
What is the significance of adjusting flow rates of gases?
Fine-tunes the FiO2 to meet patient needs
The flow rate affects the overall oxygen concentration delivered.
What is the function of a variable bypass vaporizer?
Turns liquid anesthetic agents into vapor
It allows control over the concentration of anesthetic agent delivered.
What does the vaporizer allow the CRNA to set?
The desired concentration of anesthetic agent.
How does the vaporizer work?
By diverting a portion of the fresh gas flow through the liquid agent, mixing it with gas bypassing the agent.
What is the safety implication of vaporizers?
They deliver a consistent concentration of anesthetic vapor regardless of changes in temperature, flow rate, or pressure.
What is an agent-specific design in vaporizers?
Each vaporizer is calibrated for a specific anesthetic agent to ensure accurate dosing.
What is unique about the Tec-6 vaporizer?
It is designed exclusively for desflurane, which has different physical properties compared to other anesthetic agents.
What temperature does the Tec-6 vaporizer heat desflurane to?
39°C.
What pressure does the Tec-6 operate under?
1500 mmHg.
What is the purpose of the bypass chamber in vaporizers?
One fraction of gas bypasses anesthetic.
What does the vaporizing chamber do?
It passes a second fraction through, becoming saturated with anesthetic vapor.
What is the function of the pressure compensation in vaporizers?
It adjusts for atmospheric pressure changes to maintain constant anesthetic gas partial pressure.
What is the effect of lower ambient pressure at high altitudes on desflurane?
It leads to lower partial pressure of desflurane, risking underdosing.
Fill in the blank: The required vaporizer setting at high altitude is calculated using the equation: Required vaporizer setting = (Desired sea level setting x 760 mmHg) / Local barometric pressure (in _______).
mmHg.
What is the function of the fresh gas inlet in the circle system?
It introduces fresh anesthetic gases and oxygen into the system.
What role do the inspiratory and expiratory valves play?
They ensure unidirectional flow of gases.
What is the purpose of the Y-Piece in the circle system?
It connects to the patient’s endotracheal tube or mask.
What does the reservoir bag allow for?
Manual ventilation of the patient and provides a visual indication of the patient’s breathing.
What does the CO2 absorber canister do?
It absorbs carbon dioxide from the exhaled gases before they are recirculated back to the patient.
What is the function of the pressure relief valve (APL Valve)?
It helps control the pressure within the breathing system by venting excess gas.
What does the scavenging system do?
It removes excess gases and anesthetic agents from the operating room.
What is one advantage of the circle system related to heat and moisture?
It conserves heat and moisture by allowing rebreathing of exhaled gases after CO2 removal.
How does the circle system contribute to the economy of anesthetic gases?
It allows the patient to rebreathe some of the exhaled gases, reducing overall consumption.
What is a disadvantage of the circle system regarding complexity?
It is more complex than non-rebreathing systems, making setup and maintenance challenging.
What can occur if the CO2 absorbent in the circle system is exhausted?
There is a risk of CO2 rebreathing, leading to hypercapnia.
Fill in the blank: The circle system is bulkier and heavier compared to _______ systems.
simpler.
What is a characteristic of a semi-open system in anesthesia?
The patient breathes fresh gas from the source, and all exhaled gases are released into the atmosphere.
What is required in a semi-closed system to ensure adequate removal of CO2?
A moderate flow of fresh gases.
What defines a closed system in anesthesia?
Part of the exhaled gases is rebreathed after CO2 removal, with the rest vented out.
What is a key advantage of a closed system?
Highly efficient in gas usage; requires minimal fresh gas flow.
What is a closed system in anesthesia?
In a closed system, all exhaled gases are rebreathed after CO2 is removed. There’s minimal or no release of gases into the environment.
What are the characteristics of the Circle System?
- Highly efficient in gas usage
- Requires minimal fresh gas flow once the desired anesthetic depth is achieved
- Requires precise monitoring and control of gas concentrations
- Can be complex to manage due to the need for tight control of ventilation and anesthetic depth
What is the primary usage of closed systems in anesthesia?
Closed systems are used in longer surgeries where conservation of gases and maintaining patient temperature and humidity are crucial.
What is the Fresh Gas Inlet (FGI)?
The FGI is the point in the anesthesia delivery system where fresh anesthetic gases and oxygen are introduced into the breathing circuit.
What is the primary role of the Fresh Gas Inlet?
The FGI is responsible for delivering a controlled mixture of oxygen, air, nitrous oxide, and volatile anesthetic agents to the patient.
Fill in the blank: The rate at which gases are delivered through the FGI is known as the _______.
fresh gas flow rate
What are the two types of valves in the anesthesia circle system?
- Inspiratory Valve
- Expiratory Valve
What is the function of the inspiratory valve?
The inspiratory valve opens during inhalation, allowing fresh gas and reconditioned exhaled gas to flow towards the patient.
What is the function of the expiratory valve?
The expiratory valve opens during exhalation, allowing the patient’s exhaled gases to leave the breathing circuit.
True or False: Both valves in the circle system ensure a unidirectional flow of gases.
True
What could result from a malfunctioning inspiratory valve?
If the inspiratory valve fails to open, the patient cannot receive the fresh gas mixture, leading to hypoxia.
What are the components of breathing tubes in the anesthesia circle system?
- Inspiratory Limb
- Expiratory Limb
What does the inspiratory limb do?
The inspiratory limb carries the fresh gas mixture from the anesthesia machine to the patient.
What is a critical consideration regarding the length and diameter of breathing tubes?
The length and diameter can affect resistance to gas flow, which is especially important in pediatric anesthesia.
What materials are typically used for breathing tubes in anesthesia?
Breathing tubes are typically made from corrugated plastic or rubber.
What should be regularly checked to ensure the safety of the FGI?
Regular checks for leaks and proper functioning of the FGI and its connections.
What is the risk associated with breathing tubes in anesthesia?
Breathing tubes can harbor contaminants and require thorough cleaning or replacement to reduce the risk of cross-contamination.
Fill in the blank: Malfunctioning valves can lead to the rebreathing of _______ before they are processed through the CO2 absorber.
CO2
What is a practical tip for ensuring correct valve function?
Conducting a leak test during machine setup can help detect issues with valve integrity.
What is the primary function of the Y-Piece in the anesthesia circle system?
It serves as the junction between the patient and the anesthesia breathing circuit.
What direction does the Y-Piece direct inhaled anesthetic gases?
From the inspiratory limb to the patient.
How is gas flow affected at the Y-Piece during the respiratory cycle?
Gas flow changes during inhalation and exhalation.
True or False: A disconnection or leak at the Y-Piece can compromise patient safety.
True
What should be regularly inspected before using the anesthesia tubing?
The tubes for cracks, leaks, or any sign of wear and tear.
What is the purpose of the Pressure Relief Valve (PRV) in the anesthesia circle system?
To control the pressure within the breathing circuit.
Where is the Pressure Relief Valve typically located?
Near the reservoir bag or in the expiratory limb of the circle system.
What is one of the main risks of excessive pressure in the breathing circuit?
Barotrauma in the patient’s lungs.
Fill in the blank: The Pressure Relief Valve allows excess gases to escape into the _______.
scavenging system.
What is the function of the Reservoir Bag in the anesthesia system?
To provide a volume of gas that is available for the patient to inhale.
What materials are typically used to make the Reservoir Bag?
Flexible materials like rubber or silicone.
True or False: The Reservoir Bag helps in monitoring the adequacy of ventilation.
True
What does the CO2 Absorber Canister do in the anesthesia circle system?
Removes carbon dioxide from exhaled gases.
Where is the CO2 Absorber Canister positioned within the circle system?
After the expiratory limb and before the inspiratory limb.
Fill in the blank: The CO2 absorbent typically changes color when it is _______.
exhausted.
What is a critical indicator to monitor in the CO2 Absorber Canister?
The color change of the absorbent material.
What type of material is commonly used in CO2 absorbent canisters?
Soda lime or Amsorb.
What is a practical tip for anesthesia providers regarding the CO2 Absorber Canister?
Conduct regular inspections to ensure its integrity and proper function.
What should be done if the Reservoir Bag does not inflate properly?
Check for a leak or disconnection in the system.
What is the importance of familiarity with different Y-Piece designs?
It is important for understanding the type used in your clinical setting.
What are the risks of desiccation of the CO2 absorbent?
It can reduce the efficiency of CO2 removal.
What should anesthesia providers practice regarding manual ventilation?
Practice using the reservoir bag to ensure proficiency.
What is the primary function of the Y-Piece during exhalation?
To channel exhaled gases from the patient into the expiratory limb.
What is the composition of soda lime?
A mixture of calcium hydroxide, water, and a small amount of sodium or potassium hydroxide
It may also contain a color indicator that changes color when the absorbent is exhausted.
What is the function of soda lime in anesthesia?
It chemically reacts with CO2 to form calcium carbonate, effectively removing CO2 from the circuit.
What is the most commonly used CO2 absorbent in anesthesia practice?
Soda lime
What distinguishes Amsorb® Plus from traditional CO2 absorbents?
It is a newer, non-toxic CO2 absorbent that does not contain strong bases like sodium or potassium hydroxide.
What are the advantages of Amsorb® Plus?
Safer, produces less heat, and avoids toxic byproducts like Compound A or carbon monoxide.
What is the composition of Baralyme?
It consists of barium hydroxide lime and calcium hydroxide.
What is a notable issue with Baralyme?
It can produce high levels of carbon monoxide when used with volatile anesthetics.
Where are lithium hydroxide absorbers typically found?
In portable or military-grade units.
What is the primary function of the scavenging system in anesthesia?
To collect and remove excess anesthetic gases and vapors from the operating room.
What are the two main types of scavenging systems?
- Active systems
- Passive systems
How do active scavenging systems operate?
They use a vacuum source to actively draw gases out of the circle system.
What is the role of proper connection in scavenging systems?
To prevent accidental leakage of anesthetic gases into the OR.
What must be regularly monitored in scavenging systems?
The system’s functioning to ensure efficient removal of waste gases.
What is the Fresh Gas Inlet in the circle system?
The entry point for fresh gas flow from the anesthesia machine.
What does the Y-piece in the anesthesia system do?
It connects to the patient’s endotracheal tube or mask for inhalation.
What is the purpose of unidirectional valves in the circle system?
To ensure gas flows in one direction only.
What happens to exhaled gas in the circle system?
It flows through the Y-piece into the expiratory limb and then past the expiratory valve.
What is the role of the carbon dioxide absorber in the anesthesia circuit?
To chemically remove carbon dioxide from the exhaled gas.
What is the function of the Adjustable Pressure-Limiting (APL) valve?
To control the pressure within the system by releasing excess gas into the scavenging system.
What does the reservoir bag do in the circle system?
Acts as a buffer for gas volume fluctuations during the breathing cycle.
Fill in the blank: The scavenging system is designed to collect and remove _______ from the operating room.
excess anesthetic gases and vapors
True or False: Baralyme is currently favored as a CO2 absorbent in modern anesthesia practice.
False
