Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

671A - Anesthesia I > Week 5 - Anesthesia Equipment Part 1 > Flashcards

Week 5 - Anesthesia Equipment Part 1 Flashcards

1
Q

What does SPDD stand for?

A

Supply, processing, delivery, and disposal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anesthesia equipment malfunction is _______ while human error is ________ _________

A

Rare, more common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is the ultimate destination of anesthetic gases?

A

To enter the scavenging system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How would you describe delivery in the SPDD model?

A

How is the interaction of gases with the patient controlled and monitored?

Ex –> Breathing circuits, ventilators, monitors, PEEP, gas delivery hose, CO2 absorber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Components of the low pressure system?

A

Flowmeter tubes, vaporizers, check valves, common gas outlet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Components of the high pressure system?

A

Hanger yoke, yoke block with check valve, cylinder pressure gauge, cylinder pressure regulator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pipeline psi for gases such as O2 and N20

A

50 psi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cylinder psi enters the intermediate pressure system at ______ psi

A

45 psi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the normal working pressure of the anesthesia machine?

A

50 psi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is DISS utilized?

A

When using pipeline pressure.
Supply hoses are attached directly to the anesthesia machine (in the back). These hoses each have a specific diameter attached to the correct gas inlet on the anesthesia machine. This prevents cross contamination of gases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the purpose of the check valve?

A

Ensures unidirectional forward flow of gases.
Helps prevent back flow and filling of cylinders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

While preforming your anesthesia machine check, you accidentally leave the backup O2 cylinder on. You know that doing this won’t drain your O2 cylinder if everything is functioning correctly and pipeline pressure is maintained. If the pipeline pressure does fail, what will happen

A

You won’t be notified of the failure because the machine will pull O2 directly from the cylinder. You will be notified when this cylinder is about empty which isn’t ideal since this was your backup supply.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the purpose of the oxygen analyzer?

A

To prevent a hypoxemic mixture from being delivered to the patient. Detects O2 concentration and alarms if its too low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the proper procedure when the oxygen low pressure alarm sounds?

A

The anesthetist should fully open the E cylinder oxygen, disconnect the pipeline.
Consider the use of low fresh gas flows and manual ventilation to conserve O2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is disconnecting the pipeline hose recommended during oxygen pressure loss? 2 reasons

A

This WILL NOT deplete the O2 cylinder.
1. Can prevent cross contamination of gases
2. Can protect the patient from exposure to contaminants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should you trust the oxygen analyzer?

A

ALWAYS! Unless you have specific reason to believe it is due to something else.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Your oxygen analyzer alarms, reporting a hypoxemic mixture being delivered to your patient. What should you do?

A

Suspect a pipeline crossover
Open the emergency O2 cylinder, disconnect the pipeline, and use low fresh gas flows and manual ventilation (unless using a piston operated anesthesia machine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Your oxygen analyzer alarms, reporting a hypoxemic mixture being delivered to your patient. Why must the pipeline be disconnected in order to use your emergency O2 cylinder?

A

Pipeline pressure is 50 psi, whereas cylinder pressure is 45 psi. Because the pipeline has a higher pressure, the anesthesia machine will continue to pull from this source.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When should cylinder gases be opened?

A

Only when checked and if pipeline supply is unavailable (due to low pressure or pipeline crossover)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

N2O E cylinder service pressure

A

745 psi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How many liters of O2 are in a full E cylinder?

A

660 L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How many liters of gas does a full E cylinder of air store?

A

625 L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which full E cylinder has the greatest capacity in L? Air, O2 or N2O?

A

N2O, 1590 L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When is PISS utilized?

A

When using E cylinders.
Each cylinder valve has a unique arrangement of holes that correspond to its intended contents. These holes will fit with pins in the corresponding yoke.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How does the oxygen flush system work?

A

O2 path which bypasses the low pressure system. It travels from the intermediate pressure system to the breathing circuit.
- It allows an O2 flow of 35-75 L per min
- O2 pipeline pressure of 50 psi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the most fragile part on a gas cylinder?

A

Cylinder valve, this must be protected!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 3 different safety release mechanisms a gas cylinder may be equipped with in case of a fire/increased pressure?

A
  • Frangible disk that bursts under pressure
  • A valve that opens under increased amounts of pressure
  • A fusible plug made of Wood’s metal (melts in elevated temperatures)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the 3 functions of the hanger yoke?

A

Orients the cylinder, provides a gas tight seal, and ensures unidirectional flow into the machine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is transfilling?

A

If two cylinders of the same gas are open, transfilling occurs when a gas flows from the cylinder with higher pressure to the cylinder with lower pressure, opposed to following the normal gas flow to the flowmeters.
- Fire hazard because transfilling generates heat!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why is cylinder pressure 45 psi opposed to 50 psi like pipeline pressure?

A

Prevents silent depletion of cylinder contents if valve remains open.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What regulatory body oversees manufacturing, handling, transport, storage, and disposal of gas cylinders?

A

Department of Transportation (DOT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What cylinders are safe in the MRI suite?

A

Non-ferrous (aluminum) cylinders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do you remove dirt or debris from the port of a cylinder?

A

“Crack” the valve. Open the valve briefly and carefully before attaching to the anesthesia machine. Hold the cylinder securely while doing this and do not point the port towards yourself or anyone else.
This dirt can cause barotrauma to the patient if not removed.

34
Q

How do you calculate the remaining L in an O2 cylinder? (besides N2O)

A

Only determines requirements of the flowmeter.

35
Q

True or false
It is okay to briefly lay a gas cylinder on it side?

A

True

36
Q

Why are Bellow (non-piston) ventilators not ideal during a time when pipeline O2 pressure is lost?

A

The bellow operates by O2 as a driving gas (newer ones can switch to air). This means that on top of your flowmeter volume you are delivering you patient, you are losing O2 cylinder pressure to the bellow. You should hand ventilate.

37
Q

What happens if there is a tear in the bellow to the patient?

A

You can see an increase in FiO2 as the patient is receiving more O2, and the anesthetic will become more diluted. This can lead to awareness.

38
Q

What does the USP (United States Pharmacopeia) regulate?

A

The gas cylinder contents. Must meet their purity requirements.

39
Q

What can happen if you are delivering more that 4 L per min of N2O?

A

Formation of frost on the walls of the cylinder or freezing of the valve.

40
Q

N2O _______ non-flammable and _________ support combustion

A

is, DOES

41
Q

What will happen if the anesthesia machine’s power cord becomes disconnected during a case? Or a loss of power?

A

At least a 30 minute backup battery will keep the anesthesia machine powered, however there will be limited function (typically without patient monitors)

42
Q

Who are the two main manufacturers of anesthesia machines in the United States?

A

Drager medical and GE healthcare

43
Q

What would you expect with a power outage when using a piston operated anesthesia machine?

A

Once backup battery depletes, patient will need to be hand ventilated. Piston ventilators use electricity for ventilation, opposed to pneumatic pressure in Bellow ventilators

44
Q

Apollo and Fabius GS anesthesia machines key points

A

Manufactured by Drager Medical
Piston driven ventilators
Piston driven ventilators are more accurate with tidal volume

45
Q

Aisys, Aestiva, Aespire, Avance, and ADU anesthesia machine key points

A

Manufactured by GE Healthcare
These are standing bellows anesthesia machines

46
Q

Which gas doesn’t pass through the fail safe valve?

A

Oxygen (in newer models, air doesn’t pass through this either)

47
Q

Each gas (N20, O2, and air) flow from its supply point to a _____________

A

flowmeter

48
Q

How does the fail safe valve work?

A

The O2 pipeline pressure holds open this valve, which will open up the N2O and Air pathways. (Some newer machines don’t make air pass through a fail safe valve)

49
Q

How much pressure is required to keep the failsafe valve open?

A

At least 20 psi

50
Q

After passing out of the flowmeters, the gases ____________

A

Mix together in the common manifold

51
Q

What occurs after gas mixture in the common manifold?

A

The gases pass through any vaporizer that is turned on to pick up the inhaled anesthetic. From here they enter the CGO (common gas outlet)

52
Q

Why is O2 always located on the very right of the flowmeters, and enters the common manifold downstream from the other two gases (N2O and air)

A

So the chance of hypoxic breathing mixtures is lessened.

53
Q

What are the 5 tasks of O2 in the anesthesia machine?

A
  1. Proceeds to a fresh gas flowmeter
  2. Powers the oxygen flush
  3. Activates the failsafe mechanism (needs 20 psi to remain open)
  4. Activates oxygen low pressure alarms (around 28 psi)
  5. Used as a drive gas (compresses the bellows)
54
Q

On the anesthesia machine, flows increase when the knob on the flowmeter is turned _____________

A

Counter clockwise

55
Q

What are the five components of the flowmeter?

A

Knob, needle valve, valve stops (not present on all machines), flow tube, and indicator float.

56
Q

Can a flowmeter tube (thorpe tube) be interchanged with other gases?

A

No, these are specific for each gas

57
Q

What is the most fragile part of the anesthesia machine?

A

Flowmeter tubes (thorpe tubes, glass flowtubes)

58
Q

When should flowmeters be turned off?

A

Before pipelines are connected, cylinders are opened, the anesthesia machine is turned on, and after each case.
This prevents float from shooting to the top and damaging the tube.

59
Q

Why should flowmeters be turned off after each case?

A

Prevents premature drying of the carbon dioxide absorbent.
This premature drying can lead to increased degradation of inhaled anesthetics, generation of carbon monoxide in the canisters, and canister fires.

60
Q

What is the purpose of auxiliary flowmeters?

A

Serves as an additional site for oxygenation in situations when the patient doesn’t require mechanical ventilation. Can be used for nasal cannulas or oxygen masks.
Can also be used for manual ventilation via an Ambu bag

61
Q

2 disadvantages of an auxiliary flowmeter

A
  1. If pipeline pressure is lost, it can’t be used.
  2. FiO2 cannot be varied when using auxiliary flowmeters.
62
Q

When are common gas outlet flowmeters used?

A

Generally as a backup on newer gas machines that have electronic capture and display flows. This would be used during power outages or when the computer screen display fails.

63
Q

What is a disadvantage of the common gas outlet flowmeter?

A

Shows the flow of all the gases combined, not individual. Only used as a backup when other methods fail

64
Q

What does a scavenging flowmeter indicate?

A

That suction is adequate and that it is removing the waste anesthesia gases correctly.

65
Q

How much oxygen does the oxygen flush provide in L per min?

A

35 - 75 L per min

66
Q

What is the purpose of the oxygen flush valve?

A

To quickly fill the breathing circuit with oxygen

67
Q

What can happen to the patient if the flush valve is accidentally pushed during inspiration?

A

Barotrauma

68
Q

How can you fill a ventilator bellow if it becomes disconnected and deflates?

A
  1. You can push the oxygen flush valve in short bursts during EXPIRATION.
  2. You can increase fresh gas flow to 8-10 L per min for a few breaths. This will fill the bellow without the need to use the oxygen flush system.
69
Q

What can happen within the patient when using the oxygen flush system?

A
  1. Awareness due to dilution of the inhaled anesthetic gases
  2. Barotrauma
70
Q

What is a fail safe system?

A

This is a valve within the anesthesia machine that will close off the pathway of other gases (mainly N2O) if the pressure of O2 drops too low (20 psi is required to keep it open). This prevents the possibility of a hypoxic mixture to be formed if you suddenly lose O2 pressure.

71
Q

True or false
Fail safe systems analyze oxygen pipeline contents?

A

False, this fail safe system ONLY responds to decreased pressure (closes at less than 20 psi). This would NOT protect a patient from a pipeline crossover.

72
Q

True or false
Newer machines are switching to only make N2O go through the fail safe valve?

A

True, the rational behind this is you can’t create a hypoxic mixture from too much air.

73
Q

At what pressure will the low pressure alarm sound?

A

28 psi or less

74
Q

What is the purpose of the low pressure alarm?

A

Alerts you that the pipeline pressure has decreased to or below 28 psi.
You need to
1. Turn on backup E cylinder
2. Disconnect pipeline hose

Can also tell you if you’re using cylinder pressure already that your cylinder is about empty

75
Q

When is O2 used as a ventilator drive gas?

A

Only in bellows operated anesthesia machines. Piston operated anesthesia machines don’t use O2 as a drive gas to compress the bellows, they use electricity.

76
Q

What is the purpose of the proportioning system (hypoxic guard)?

A

It prevents a hypoxic mixture from being formed between N2O and O2. No more than a 3:1 ratio of N2O:O2. This ensures the 02 concentration is at least 23-25%

77
Q

At what ratio does the proportioning system prevent N2O to O2 from exceeding?

A

This system doesn’t allow N2O to O2 exceed a 3:1 ratio, thus final breathing mixtures via the common gas outlet contain at least 23-25% O2.

78
Q

How does the proportioning system work?

A

Via a chain connected to O2 and N2O within the flowmeters. (Link-25)

79
Q

When does the proportioning system fail?

A
80
Q

What alarm system alerts you that the concentration of O2 within the anesthesia machine is too low?

A

Oxygen analyzer

81
Q

What are the two types of oxygen analyzers?

A

Electrochemical (galvanic fuel cells) and Paramagnetic

82
Q

Which oxygen analyzer is used most frequently and why?

A

Paramagnetic. This is due to its fast response, low cost, and extremely low maintenance requirements.
Electrochemical must be calibrated each morning and the fuel cells need to be changed periodically.

671A - Anesthesia I (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions