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PMI > 14. Adv Anesthesia Machine > Flashcards

14. Adv Anesthesia Machine Flashcards

1
Q

vaporizer dial percentage

A

the percent of agent in the fresh gas flow

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2
Q

3% vaporizer dial

A

3% of the FGF will be VA

97% O2
3% agent

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3
Q

vaporizer chambers for volatile agents will produce

A

vapor pressure

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4
Q

which volatile agent has the highest vapor pressure

A

Des

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5
Q

which volatile agent has a lower poiling point

A

Des

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6
Q

rank the inhalational agent vapor pressure from highest to lowest

A

HIGHEST
Nitrous
Des
Iso
Sevo
LOWEST

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7
Q

latent heat of vaporization

A

heat released as the liquid turns into vapor

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8
Q

what is unique about Des’ vaporizer

A

it is pressurized
and heated

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9
Q

prolong usage of Nitrous from a tank can cause

A

ice crystallization on the cylinder

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10
Q

Sevo/Iso vaporizer type

A

variable bypass vaporizer

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11
Q

variable bypass vaproizer

A

some FGF goes into the vaporizer while most of it bypasses the vaporizer

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12
Q

condensation

A

converting gas to liquid

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13
Q

what makes condensation easier

A

cooling
pressurizing

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14
Q

critical temperature

A

the temp at which a gas becomes cold enough to liquify

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15
Q

below critical temp

A

gas CAN be liquified by pressure

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16
Q

above critical temp

A

gas CANNOT be liquified by pressure

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17
Q

O2 critical temp

A

-119C

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18
Q

Air critical temp

A

-140.6C

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19
Q

Nitrous Oxide critical temp

A

36.5C

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20
Q

gasses with lower critical temps are ________ to liquify

A

gasses with lower critical temps are harder to liquify

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21
Q

ideal gas laws

A

P/V = P/V

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22
Q

ideal gases

A

O2
N2

Air is a mix of N2 and O2

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23
Q

what temp do hospitals store bulk O2 in?

A

-183C
typically liquid

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24
Q

air

A

21% O2
79% N2

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25
Q

is nitrous oxide an ideal gas

A

No

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26
Q

what state is nitrous found in the E cyclinder?

A

liquid and gas

has vapor pressure

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27
Q

full tank of O2

A

2000 psi
660 L

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28
Q

full tank of N2O

A

750 psi
1590 L

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29
Q

the N2O tank will have liquid in it as long as it is ______ % full

A

the N2O tank will have liquid in it as long as it is 25% full

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30
Q

once the N2O tank is ______% depleted, it will exist entirely in ______ form

A

once the N2O tank is 75% depleted, it will exist entirely in the gas form

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31
Q

when does the pressure in the N2O tank begin to drop

A

once all the liquid is depleted (75% depleted)

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32
Q

at what volume will the N2O tank begin to drop pressure?

A

<400L left in tank

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33
Q

O2 gas tank color: USA

A

Green

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34
Q

O2 gas tank color: ISO

A

White

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35
Q

N2O gas tank color: USA and ISO

A

light blue

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36
Q

Air tank color: USA

A

yellow

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37
Q

Air tank color: ISO

A

black and white

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38
Q

suction color: USA

A

white

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39
Q

suction color: ISO

A

yello

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40
Q

N2 tank color: USA/ISO

A

black

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41
Q

CO2 tank color: USA/ISO

A

grey

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42
Q

Helium tank color: USA/ISO

A

brown

43
Q

safety features of VA

A
  1. color coded
  2. safety interlock
  3. keyed adapters
44
Q

sevo color

A

yello

45
Q

iso color

A

purpple

46
Q

des color

A

blue

47
Q

safety interlock system

A

one vaporizer can be turned on at a time

48
Q

what would happen if you put Des in Sevo vaporizer?

A

overdose

Des has 4x vapor pressure of sevo

49
Q

what would happen if you put Sevo in Des vaporizer?

A

underdose

Sevo has 4x less vapor pressure than des

50
Q

max limit of N2O allowed in OR

A

25 PPM

51
Q

max limit of VA allowed in OR: alone

A

2 PPM

52
Q

max limit of VA allowed in OR: w/25 PPM nitrous

A

0.5 PPM

53
Q

thorpe tube flowmeter

A

bobbin
tapered tube

54
Q

which side of the thorpe tube is wider

A

top of tube is wide
bottom of tube is narrow

55
Q

why is O2 furthest downstream from N2O and air?

A

prevents hypoxic mixture of gas from being delivered to pt in case of leak

56
Q

compliance

A

ability of container to expand when pressure is added to it

57
Q

low compliance

A

will not expand easily

58
Q

high compliance

A

will expand easily

59
Q

compliance def

A

how much the volume of a container changes per unit of pressure added

60
Q

pulmonary compliance eq

A

pulm compliance = change in volume (mL) / change in pressure (cmH2O)

61
Q

higher volume change

A

higher compliance

62
Q

lower volume change

A

lower compliance

63
Q

elastic recoil

A

ability of container to return to original volume after the pressure inside the container is released

64
Q

low elasticity

A

deflate slowly

65
Q

high elasticity

A

deflate quickly

66
Q

elasticity and compliance relationship

A

inversely proportional

67
Q

compliant lung

A

expand well
deflate slowly

air trapping

COPD/smoking

68
Q

non-compliant (restrictive) lung

A

hard to get air in
easy to exhale

acute respiratory disress syndrom

69
Q

PIP is aka

A

dynamic compliance

70
Q

plateau pressure aka

A

static compliance

71
Q

spirometer location

A

in front of expiratory valve

72
Q

spirometer measures

A

exhaled tidal volumes

73
Q

spectrometer analyzes

A

which gases
In tidal
en tidal

74
Q

O2 analyzer

A

FiO2 (in tidal O2)

75
Q

fail safe valve

A

prevents accidental overdose of N2O

76
Q

fail safe valve sense

A

decrease in O2 wall pressure

77
Q

when does the fail safe valve close?

A

if O2 supply falls below 25 psi

78
Q

check valve location

A

before common gas outlet

79
Q

check valve

A

prevents PPV from backing up into the vaporizers and flowmeters

80
Q

PPV backflow could

A

change inhaled anesthetic concentration

cause inaccurate flowmeter readings

81
Q

false positive

A

indicates presence of problem even though no problem exists

82
Q

high false positive rate

A

higher chance of alarm being incorrect

83
Q

false negative

A

no alarm
indicates no problem even though a problem exists

84
Q

false negative examples

A

pulseless electrical activity (PEA)

CO poisoning (pulse ox)

85
Q

high sensitivity

A

high false positive rate
low false negative rate

86
Q

high specificity

A

low false positive rate
high false negative rate

87
Q

sensitivity and specificity relationship

A

inversely proportional

88
Q

O2 supply failure alarm triggers at

A

<30psi

indicates fail safe valve is close to closing

89
Q

low inspire O2 alarm triggered by

A

low FiO2

90
Q

high circuit pressure alarm triggers

A

kinked ETT
weight against diaphragm (obese, Tberg, lap)
light anesthesia (bronchospasm, coughing)

91
Q

sustained airway pressure alarm triggers

A

continuous increase in circuit pressure

APL valve is too closed
scavenging is blocked

92
Q

low circuit pressure alarm triggers

A

large circuit leak
(disconnected circuit)

93
Q

older machine differences

A

visible ventilator bellows
ventilator powered by high pressure O2 pathway (no electrical power needed)
in vent mode, breathing bag independent of circuit
fresh gas coupling

94
Q

leak in older machine bellows could cause

A

higher than expected PIP
higher than expected FiO2

95
Q

descending bellows

A

descend when filling with FGF
ascend when giving breath

hard to diagnose circuit leak

96
Q

ascending bellows

A

ascend when filling w/FGF
descend when giving breath

easier to diagnose circuit leak

97
Q

fresh gas coupling

A

FGF from flowmeters adds extra volume to tidal volume being delivered by vent

tidal volumes increase as FGF increases

98
Q

ventilator decoupling

A

FGF rate does not affect tidal volume

feature on newer machines

99
Q

increase dead space

A

increases airway resistance

100
Q

decreasing radius/diameter of circuit

A

increases circuit resistance

101
Q

what has a greater impact on resistance?

A

diameter/radius > length

102
Q

how do you decr circuit resistance

A

shorten circuit volume
incr diameter of circuit/breathing tube

103
Q

tidal volume is lost to the ______ of the circuit

A

tidal volume is lost to the compliance of the circuit

PMI (18 decks)

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