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Principles of Anesthesia 1 (Summer 25') > 24 June 25 Key Concepts and Circuit Types > Flashcards

24 June 25 Key Concepts and Circuit Types Flashcards

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1
Q

What is a key component to identify in anesthesia circuits?

A

Reservoir bag, insertion point for fresh gas flow, APL valve

These components are crucial for understanding the functionality of the circuit.

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2
Q

What is the function of the APL valve in anesthesia circuits?

A

Regulates pressure during ventilation

The APL valve can be adjusted to generate pressure when assisting ventilation.

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3
Q

What does corrugated tubing refer to in anesthesia circuits?

A

Large diameter tube used for gas flow

Corrugated tubing is important for maintaining gas flow and preventing kinks.

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4
Q

What is a characteristic of the Mapleton circuit?

A

No CO2 absorber or separate inspiratory/expiratory limbs

Mapleton circuits are unilimb, meaning they have a single tube for gas flow.

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5
Q

Fill in the blank: In a Mapleton circuit, the fresh gas flow must exceed the patient’s _______ to prevent rebreathing.

A

minute ventilation

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6
Q

True or False: The Mapleton D circuit is commonly used for controlled ventilation.

A

False

The Mapleton D circuit is more efficient for spontaneous respiration.

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7
Q

What is the minimum fresh gas flow required for the Mapleton D circuit?

A

2 to 2.5 times the minute ventilation

This ensures adequate gas exchange and prevents rebreathing.

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8
Q

What is a disadvantage of the Bane circuit?

A

Loss of gas volume during exhalation

Fresh gas flow can escape through the APL during exhalation, making it less efficient.

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9
Q

What is the purpose of the pettics test in anesthesia circuits?

A

To check for disconnection of the inner tubing

This test ensures that the fresh gas flow tubing is properly connected.

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10
Q

How does the Bane circuit differ from traditional circle systems?

A

Tube within a tube design for warming and humidification

The Bane circuit helps to retain moisture and heat during ventilation.

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11
Q

What are the two variations of the Bane circuit?

A
  • True tube inside a tube
  • Split in half design
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12
Q

What should be done if a sterile adapter is needed for a circuit?

A

Use a metal coupling or wrap with IO band

IO band can help maintain sterility, but care must be taken when removing it.

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13
Q

Fill in the blank: The fresh gas flow in a Bane circuit needs to be at least _______ times the exhaled tidal volume.

A

two

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14
Q

What is a common use for Mapleton circuits?

A

Transportation of patients

Mapleton circuits are designed for efficiency during patient transport.

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15
Q

What is the main advantage of using the main circuit?

A

Warming and humidification of gases

This feature improves patient comfort and gas exchange.

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16
Q

What happens to the fresh gas flow during spontaneous respiration in Mapleton circuits?

A

It enters near the reservoir bag and flows into the corrugated tubing

This design enhances gas delivery efficiency.

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17
Q

True or False: The APL valve in Mapleton circuits is located away from the patient.

A

False

In Mapleton circuits, the APL valve is positioned close to the patient for better efficiency.

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18
Q

What is the purpose of the pettics test?

A

To determine if the inner fresh gas flow tubing is patent

The test involves including the patient into the circuit and checking for the Venturi effect.

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19
Q

What happens during the pettics test when the occlusion is released?

A

A Venturi effect occurs, creating a vacuum that flattens the reservoir bag

This indicates that the inner tube is patent.

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20
Q

What is the role of the APL valve in gas circuits?

A

To prevent rebreathing and allow excess gas to escape

APL stands for adjustable pressure limiting valve.

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21
Q

What is a Jackson Reese setup primarily used for?

A

To allow pediatric patients to breathe spontaneously and be ventilated

It has the ability to turn the reservoir bag on and off.

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22
Q

True or False: The Jackson Reese setup is commonly used for adult patients.

A

False

It is primarily used for pediatric patients.

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23
Q

What is a key disadvantage of using the Jackson Reese setup?

A

It can restrict a patient’s ability to exhale when the reservoir bag is turned off

This can lead to complications in ventilation.

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24
Q

What does a true circle system in anesthesia rely on?

A

One-way valves to control the direction of gas flow

These valves help prevent rebreathing of exhaled gases.

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25
Fill in the blank: In a semi-open system, rebreathing is dependent on _______.
Fresh gas flow ## Footnote Higher fresh gas flow leads to less rebreathing.
26
What is a significant advantage of low flow anesthesia?
Cost savings by using less volatile agents ## Footnote It also reduces environmental waste.
27
What is a disadvantage of low flow anesthesia?
It makes rapid changes in anesthetic concentration difficult ## Footnote Adjustments require increasing fresh gas flow or anesthetic concentration.
28
What happens when fresh gas flow is less than a patient's minute ventilation?
Rebreathing occurs ## Footnote This can lead to inadequate ventilation and buildup of carbon dioxide.
29
What is the Venturi effect in the context of anesthesia circuits?
A phenomenon where gas flow creates a vacuum effect ## Footnote This effect is used to indicate patency in gas flow tubing.
30
What is the consequence of using black rubber tubing in older anesthesia systems?
It may break down due to volatile anesthetics, releasing harmful chemicals ## Footnote Care should be taken when using such materials.
31
What is a characteristic of the Mapleson A system?
It has increased efficiency with rebreathing due to pop-off valve placement ## Footnote This design contrasts with other systems that may vent more gas.
32
What type of flow is generally observed in anesthesia systems?
Laminar flow ## Footnote This results in less resistance to gas flow.
33
What is the primary function of one-way valves in anesthesia systems?
To prevent the backflow of gases during respiration ## Footnote They ensure that exhaled gases do not re-enter the patient's lungs.
34
What is a potential issue with high fresh gas flow settings?
Rapid changes in humidity and temperature can occur ## Footnote This can affect patient stability and comfort.
35
What is the primary use of scavenging systems in anesthesia?
To remove waste gases from the operating room environment ## Footnote This minimizes exposure to anesthetic agents for healthcare personnel.
36
Fill in the blank: A closed circle system matches oxygen flow to _______.
Metabolic demand ## Footnote This prevents waste gases from being vented.
37
What happens to blood pressure when vasodilation occurs?
Blood pressure decreases ## Footnote Vasodilation leads to rapid changes in human physiology, affecting blood pressure.
38
What is a potential consequence of decreased gas exchange due to vasodilation?
Accumulation of unwanted waste products ## Footnote Reduced gas exchange may lead to the build-up of compounds like CO.
39
What are the advantages of a circle anesthesia system?
* Low fresh gas flows * CO2 removal * Stable inspired gas concentration ## Footnote Circle systems maintain a constant flow and conserve heat, moisture, and gas.
40
What are the disadvantages of a circle anesthesia system?
* Logistically complex * Increased incidence of disconnections * Fragile tubes ## Footnote The complexity arises from managing two tubes, which are more prone to issues.
41
How can a disconnect in the anesthesia circuit be identified before an alarm goes off?
Flat bellows ## Footnote Observing the bellows can indicate a disconnect before other signs, such as loss of CO2.
42
What common factors can lead to disconnections in the anesthesia circuit?
* Patient movement * Equipment interference * Improperly secured connections ## Footnote Most disconnections occur at the patient interface or machine end.
43
What is a self-inflating bag?
A manual resuscitator that expands on its own ## Footnote These bags are common in emergency settings and are used for manual ventilation.
44
Fill in the blank: If there is no fresh gas, a self-inflating bag can provide _______.
21% oxygen ## Footnote Self-inflating bags can deliver ambient air, which contains approximately 21% oxygen.
45
What is a significant risk associated with using self-inflating bags?
Gastric inflation and barotrauma ## Footnote The risk increases if patients are not intubated or if excessive pressure is applied.
46
What type of filters became significant during the COVID pandemic?
Bacterial filters ## Footnote These filters are used to prevent contamination of anesthesia machines and the spread of infections.
47
Where are bacterial filters typically placed in an anesthesia circuit?
* On the expiratory limb * At the patient interface ## Footnote Some facilities use two filters to enhance safety and reduce contamination risks.
48
What is a complication of using bacterial filters?
Increased resistance in the circuit ## Footnote High resistance can complicate ventilation, especially in patients with pulmonary issues.
49
True or False: Bacterial filters can have permanent electrical charges to attract bacteria.
True ## Footnote Many filters are designed with this feature to enhance their effectiveness.
50
What can happen to the anesthesia circuit during long cases?
Condensation may build up ## Footnote Condensation can obstruct airflow, necessitating drainage during lengthy procedures.
51
What should be monitored when using drugs that may get trapped in filters?
Patient's ventilation and drug delivery ## Footnote Drugs may not be effectively delivered to the patient if they are trapped in the filter.
52
What is the purpose of draining the circuit during long OMF cases?
To prevent issues from trapped substances in the filter ## Footnote Long cases can lead to buildup that affects ventilation
53
Where should medications be placed in the circuit when using an MDI or nebulizer?
On the patient side of the HME ## Footnote This ensures effective delivery of medications
54
What can cause increased airway pressures during ventilation?
Factors such as: * Secretions in the filter * Patient positioning * Mechanical constrictions * Under sedation
55
How can you identify if secretions are causing ventilation issues?
By observing peak airway pressures and changes in airflow ## Footnote A gradual increase in pressures can indicate blockage
56
What is absolute humidity?
The mass of water vapor present in a gas ## Footnote It is measured in grams per cubic meter
57
What is relative humidity?
The amount of water vapor at a particular temperature relative to the maximum amount it can hold ## Footnote It is expressed as a percentage
58
What is the effect of low temperatures on humidity?
Cold temperatures tend to have low humidity levels ## Footnote This can lead to dehydrated patients if not managed properly
59
What happens when a patient is intubated regarding humidification?
The patient loses their body's ability to warm and humidify air ## Footnote This can lead to evaporative fluid loss
60
What are potential complications of under-humidifying patients during ventilation?
Thickened secretions and decreased ciliary function ## Footnote This can lead to difficulty in mobilizing secretions
61
What is the role of HMEs in patient circuits?
To warm and humidify inhaled gases ## Footnote They help prevent dehydration and maintain airway moisture
62
What are hygroscopic filters?
Filters made of treated fibers or papers that retain moisture ## Footnote They provide moisture exchange during ventilation
63
What are hydrophobic filters used for in anesthesia?
To filter bacteria and serve as HMEs ## Footnote They are more common in anesthesia than hygroscopic filters
64
What is a common method to amplify humidification for patients?
Using a bubble humidifier connected to the oxygen manifold ## Footnote This is often used for patients on long-term oxygen therapy
65
What can cause bronchospasm in patients under anesthesia?
Cool, dry gases can irritate the airway ## Footnote Humidification helps mitigate this risk
66
What is water vapor pressure?
The pressure exerted by water vapor in a gas mixture ## Footnote It is a critical factor in understanding humidity effects
67
What can excessive fluid in the airway lead to?
Inability to ventilate and monitor gas effectively ## Footnote This includes issues with CO2 and volatile agent monitoring
68
What can be observed when secretions begin to obstruct the airway?
Inconsistent flow and fluttering in peak airway pressures ## Footnote This may indicate the need for suctioning
69
What are the consequences of secretions thickening in the lungs?
Difficulty in mobilizing secretions and increased risk of infection ## Footnote Treatment often involves medications to thin secretions
70
What is the significance of monitoring airway pressures?
It helps detect issues with secretions or mechanical obstructions ## Footnote Consistent monitoring is essential for patient safety
71
What type of ventilators commonly have more than one humidification device?
ICU ventilators
72
What is a common function of a humidifier in a medical setting?
To amplify humidification to patients
73
What type of humidification system is most commonly used with long-term oxygen patients?
Bubble type system connected to the oxygen manifold
74
Why is it important to provide humidification to patients on oxygen?
To prevent drying out nasal passages
75
Who are typically the patients that need long-term oxygen?
Older adults
76
What risk is increased when nasal passages dry out in older patients on anticoagulants?
Increased risk of bleeding
77
What is the requirement for inpatient orders regarding oxygen use for over two hours?
Humidification device must be applied
78
What is the primary function of the humidifier in an ICU ventilator?
Heating and providing moisture for the patient
79
What can humidifiers adjust in relation to the gas provided to patients?
Temperature
80
What pulmonary complication can occur when cooling the airway?
Bronchospasm
81
What happens to tissues when the airway is cooled?
Tissue constricts
82
What is one disadvantage of using humidifiers?
They can be bulky and require electrical sources
83
What is a risk associated with using humidifiers in ventilator circuits?
Entraining air
84
Fill in the blank: Humidifiers can _______ the gas or air for patients.
warm
85
Fill in the blank: Older patients on oxygen may experience increased risk of _______ due to dry nasal passages.
bleeding
86
True or False: Humidifiers are always electronically controlled.
False
87
What is one reason why HMEs are not as efficient as other humidifiers?
They are less effective at retaining moisture

Principles of Anesthesia 1 (Summer 25') (14 decks)

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