9. Equipment Flashcards

1
Q

LASERS
Stands for
How are they varied

Carbon dioxide lasers are used to

Argon or krypton Use & spectrum

Nd YAG

A

Light Amplification by Stimulated Emission of Radiation

Differing mediums are used in order to vary the depth of penetration, wavelength of light and power of the beam

CO2 cut tissues and coagulation precisely.
needs He laser - aiming guide
cornea risk > retina

Argon - blue-green - maximally absorbed by red
Ophthalmology, photocoagulation and dermatology.
400-700

Neodymium yttrium-aluminium-garnet (Nd YAG)
near infra-red lasers,
debulk tumours photocoagulation.
1064nm laser -

waves are
Parellel
monochrotmatic
in phase
non divergent
high energy intesinty w/ low power source
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2
Q
Trachy
where inserted
size connector
tip cut
fenestrated
metal LT properties
A
Where - stoma trach rings 2-4
15mm connector as standard
Tip cut square reduce obstruction v wall
Great curve - air directed vocal cord
Metal - long term, bactericidal, uncuff, inner - removed clean
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3
Q

Lasers safety

LSO

A

Laser safey officer
Trained + aware precautions

Eye safety & approp for wavelength
Entry controlled + signs
Reflective surfaces avoided (not necc matt black)
Good ventilation for fumes

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4
Q
Manley MP3
How work
number bellows & valves
TV max
How adjust
Mapleson?
A

FLOW GENERATED MIN VOL DIVIDER

Minute volume divider pneumatic driven
Entire FGF delivered to pt - diveded into set volume
FGF drives - rapid detect failure
2 sets bellows & 3 unidirectional valve
TV 1000
Inflation pressure adjust weight on a rail
Like mapleson D during spontaneous vent
Not suit poor complinace

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5
Q

The relationship between frequency (f), wavelength (λ) and velocity (v) is as follows:

A

λ = v/f

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6
Q

Straight blade laryngoscopes

Name 4
how are they used

A

Miller, Soper, Wisconsin and Seward.
advanced over the epiglottis which is then lifted in order to view the larynx. Straight blades are commonly used for intubating neonates and infants but can be just as easily be used in adults.

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7
Q

What side is the macintosh

A

Right sided as standard (left for facial deform)

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8
Q

Polio - angle

A

20-135 degrees to the handle

Irong lung ventilators during the polio epidem

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9
Q

McCoy

A

Based on the standard Macintosh blade

(not Robertshaw’s), with a lever operated hinged tip, which can improve the view at laryngoscopy.

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10
Q

PA catheter
Number of lumens
Calculate temp
Baloon

meaures LAP

A
4 lumens
 (blue=right atrial, yellow=pulmonary artery, white=proximal infusion port, red=balloon air inflation). A further channel contains a wire connecting to a thermistor.

thermistor at its distal end can measure core temperature and cardiac output using a thermodilution technique
The balloon is filled with air to enable catheter migration in the direction of blood flow.

The left atrial pressure is measured indirectly as the catheter wedges in a pulmonary artery, the tip measuring the pressure in the pulmonary capillaries which are in continuity with pulmonary veins and hence the left atrium.

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11
Q

LMA - weight + cuff volume

A
Size	Weight	Maximum Air in Cuff
1	<5 kg	4 ml
1.5	5 to 10 kg	7 ml
2	10 to 20 kg	10 ml
2.5	20 to 30 kg	14 ml
3	30 kg to small adult	20 ml
4	Adult 50-70 kg	30 ml
5	Big adult 70-100 kg	40 ml
6	Adult >100 kg	50 ml
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12
Q

High frequency ventilation (HFV)
What is it
Rate+ volumes

A

small tidal volumes delivered at high frequencies, maintaining gas exchange without barotrauma or other deleterious effects of intermittent positive pressure ventilation (IPPV).
s ventilation at four times the normal rate (not ten times), and uses tidal volumes of 1-3 ml per kg (not per hour).
can use conventional ett

three modes used (not two):

High frequency positive pressure ventilation (HFPPV)
High frequency jet ventilation (HFJV) and
High frequency oscillation (HFO).

vasive form of ventilation that uses high frequency oscillation within a cuirass.
to a cuirass, so that it covers them from the axilla to the lower abdomen. It is not connected directly to an endotracheal tube. The Hayek oscillator works by decreasing and increasing the pressure within the cuirass, causing inspiration and expiration respectively.

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13
Q

Doppler effect

A

Apparent change in frequency -

movement object in relation to the source.

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14
Q

Human hearing frequency

Medical ultrasound

A

15Hz - 20000hz

  • 2.5 MHz to 15 MHz
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15
Q

LMA Size

Prox end size

A

Size 2 is 7 mm
Size 3 is 10 mm
Size 4 is 10 mm
Size 5 is 11.5 mm.

Proximal end is a standard 15 mm (not 22 mm).

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16
Q
Wrights respirometer
What is it
What does it measure
Where should it sit
how accurate
Vane revolutions per l gas
Min flow
Accuracy @ high &amp; low flow
A

one way system exhaled TV & MV

Expiratory size (trachea )
- lower pressure  v inspiratory side inaccuracy from gas leaks expansion  tubing.

accuracy of +/- 5 to 10%.

The vane does 150 revolutions (not 250) when one litre of gas

A minimum flow of 2 litres per minute is required for the respirometer to function accurately, but it tends to over-read at high flow rates and under-read at low flows.

17
Q

HAFOE

A

Work
on Bernoulli principle
Venturi effect - entertainment air

100ax21b = 30 x req fio2
a = oxygen flow
b entrained airlow rate

Rely Peak inspiratry flow <30lmin

Highest Fio2 60%
15lmin flow
8l min = 35% Fio2
10l = 40%

18
Q

Waters circuit

A

Resevor bag
fgf
apl
patient

19
Q

NIBP

A

MAP most accurate - osscillomtery - max oscillations occur at mean

DBP = least acc
incc pinpoint when disappear

mean = diastolic + 1/3 systolic - diastolic

20
Q

wavelengths of laser

birthmarks

Pulsed dye

Argon

NDyag

A

488 - pulsed dye laser - birthmark vascular skin lesion

515 - argon - destroy cancer

532 ndyag - diabetic retinop -

660 - visble spec - barcodes hair remove

1064 nd yag - debulk tumor

21
Q

Servo ventilators

A

Minute volume divieres

Bag - filled gas from FGF

Spring compresses bag = push gas into insp limb

Flow measure pneumotachogrph

Divide vol deliver - inspirtory limb clamp =- exp limb opens

22
Q

Diathermy

current

cutting pattern

A

Uses AC 0.5-1 MHz

Sine wave pattern - cutting + damped / pulsed sine - coa

23
Q

filter for blood

A

200 microns

24
Q

filter for epidural and hme size

A

.2

25
Q

fibreoptic cables

A

Propagated light will remain within the core material which will have a higher refractive index than the cladding

core surrounded by cladding

light propagated by total internal relection
- light incideent on boundray completely reflect back to the core

26
Q

DLT

derived

A

Derived from Carlens tube

Robertshaw - classic red rubber
designed avoid RUL collapse vs bronchocath
ex small sml large med

broncocath fr gauge 35-41 + 28L

left side tube best Right sided surgery - decomp r lung left lung ent

27
Q

Drip counter

reliant on

drop size vary how much
what varies

where imporntant

A

Reliant LED + Photo detection

Drop size vary 20% vary 
density
surface tenson
temperature
composition fluid

acurrat - important in paeds

liq in drip counter - occupy 1/3 of space

28
Q

If a ray of light in an optical fibre post refraction emerges from the side of the fibre

A

angle of incidence of the ray of light < critical angle of the fibre

29
Q

Maggil

A

Mapleson A

Fxn sim to lack

suit kids >25kg

Inneficcient IPPV

effective for spont vent

FGF req = al min vent 70/kg

. If some rebreathing of this dead space gas is accepted, a flow approximating to around 70% of the minute volume can be used:

Vent x3 alveolar min vent

30
Q

Where would expect high pressure airway alarm to be positioned

A

Patient side inpsiratory and expiratory valves

31
Q

Min FGF on mapleson E

if scavengin good on an F
What vol should be in corrugated tubing
bag moving on bain = FGF deliver

Manley set to SV
example of a

A

3-4l/min
lower - inhling air end insp = if tv> volume tube

No
volume greater than tv in the F

No - confirmed movement gas
no warning inner tube disconnect

Vol currgated tubing attach bain - important
Small = ventilator dribing gas diltuing fgf
Rec Vol <500

manley - sv = non coacil mapleson D

32
Q

Piezoelectric effect

A

Mechanical distortion electrical potential produced depend on thickness of crystal (frequency_

inverse also applies
field applies - realigment creates electric energy

33
Q

Velocity =

sound frequency in air

short wl have a higer or lower freq

Sounds with low freqency sound low or high pitched

radiowaves lower freq / higher vs cray

A

frequency x wavelength

v constant = wavelenght decrase frequency increases

343 m/s

Short w/l = higer freq

Sound LOW frequency = LOW pitched

lower

34
Q

Sterilisation

what does it do

whats the prefered method

what other methods
how long do these take

A

all types micro ogranism incl spore killed

Steam - efficient safe + preferred method if can withstand

others
Chem - glutaraldehyde 2%,
>10h

Ethylene oxide
2-12h
alkylisation proteins

gas plasma
Highly ion gas
75m

Gamma irrad - commercial use - expensive + not prefered method hosp use

35
Q

Pacemaker

Letter positioning

A
1 Paced
2 Sensed
3 Response sense
4 Porgram + rate modulating
5 antiarrhy fxn

Hypercapnia can increase thereshold excitation

newer pacemakers are bipolar
anode + cathode closer = reduced risk artefact interupting

36
Q

LASERS waves properties

A
waves are
Parallel
monochromatic
in phase
non divergent
high energy intensity w/ low power source