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AS - N928 Basic Principles of Anesthesia > Anesthesia Gas Machine > Flashcards

Anesthesia Gas Machine Flashcards

1
Q

Pipeline Supply

A

Bulk gases delivered to back AGM
Intermediate pressure
50psi
DISS/KISS

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2
Q

Cylinder Supply

A

High pressure
Requires pressure regulator to ↓45-50psi
PISS

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3
Q

Floating Valve

A 
Unidirectional or check valves (FUCk)
Interface b/w pipeline supply & AGM
Opens & closes w/ pressure
Allows gas to enter machine
Promotes one-way flow & prevents backward flow into tank or pipeline
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4
Q

Ball & Spring

A

All or nothing
O2 flush 35-75L/min @ 50psi directly from gas supply to CGO (bypasses vaporizers ↓volatile agent delivered to patient → recall risk)

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5
Q

Diaphragm Valve

A

Pressure reducing ↓pressure to lower, constant
1st & 2nd stage regulators
Maintains constant gas flow w/o changing supply pressure

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6
Q

AANA Standard 6

A

Equipment

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7
Q

American Society for Testing & Materials

A

ASTM

Specifies minimum performance & safety requirements used in AGM design for human use to enhance patient/operator safety

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8
Q

FDA

A

Federal food, drug, & cosmetic act

Regulates medical gases contained in cylinders

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9
Q

US Pharmacopeia

A

FDA

Sets potency & purity standards

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10
Q

Department of Transportation

A

DOT

Cylinder design, construction, testing, marking, handling, filling, & transportation

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11
Q

Compressed Gas Association

A

CGA

Sets standards on safe practice

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12
Q

National Fire Protection Association

A

NFPA

Location, construction, & bulk systems installation

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13
Q

Critical Temperature

A

Temperature below which gas converted to liquid form by pressure
Oxygen -118°C

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14
Q

Safety Systems

A
  • Color coding
  • Key filler caps & ports
  • DISS/KISS/PISS
  • Interlock system
  • Link 25 or hypoxic guard
  • CO2 absorber
  • Unidirectional valves
    Safety relief devices to prevent rupture
  • Frangible copper disc
  • Spring-loaded valve
  • Fusible plug (Wood’s metal)
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15
Q

Pin Index Safety System

A

PISS
Holes in cylinder valve that corresponds w/ 2 pins in the hanger yoke
6 numbered positions

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16
Q

Hanger Yoke

A

Connects cylinder to AGM
Orients the cylinder
Provides unidirectional flow (floating valve)
Ensures gas-tight seal

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17
Q

Oxygen PISS

A

2 + 5

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18
Q

Air PISS

A

1 + 5

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19
Q

N2O PISS

A

3 + 5

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20
Q

Wood’s Metal

A

Safety pressure relief device
Fusible plug that melts at predetermined temperature to release gas from cylinder
Alloy w/ bismuth, lead, tin, & cadmium

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21
Q

Cylinder Labeling & Markings

A

Regulatory body DOT cylinder type & material
Serial number
Purchase, user, & manufacturer
Manufacturer’s number
Manufacturer’s identifying symbol
Re-test date, re-tester, ID symbol, 110% filling, 10yr test interval
Neck ring owners ID

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22
Q

Cylinder Construction

A

Walls 3/8” thick
Tested at 1.66x the service pressure
Interior hydrostatic pressure test at least 1x every 5yr

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23
Q

Adiabatic Compression/Expansion

A

Rapid compression (exothermic) heat liberation does not have time to dissipate
Things in vicinity or in contact w/ gas will heat up
Rapid expansion (endothermic) surrounding area will feel cold
OR insulated area where compression/expansion occurs ჻ heat trapped and unable to dissipate

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24
Q

Oxygen Cylinder

A

660L/1900psi
Ensure at least 1000psi
2 & 5
Green

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25
N2O Cylinder
1590L/745psi Critical temperature 36.5°C 3 & 5 Blue
26
Air Cylinder
625L/1900psi 1 & 5 Yellow
27
E-Cylinder Calculation
Available psi x 0.347 = L | Total L / L/min flow = min remaining
28
Boyle's Law
P1V1= P2V2
29
Low Pressure System
Flowmeters Vaporizers Fresh gas outlet (CGO) Check valves
30
Intermediate Pressure System
``` 45-55psig Receives gases from pipeline Unidirectional check valve DISS/KISS Pipeline inlets Check valves Pressure gauges Flowmeter valve ```
31
High Pressure System
``` Receives gases from cylinders at high variable pressures → regulators → lower, more constant pressures Pipeline supply 50psi E-Cylinders (745-1900psi) Hanger yoke & PISS O2 flush 35-75L/min @ 50psi Ends at regulator ```
32
Failsafe Valve
Designed to prevent unintentional hypoxic mixture delivery | Stops N2O delivery when O2 supply pressure falls below threshold setting
33
Low O2 Pressure Alarm
Low O2 pipeline or cylinder delivery | <30psi
34
Low Flow L/min
< 1Lpm
35
High Flow L/min
10-12Lpm
36
O2 Flowmeter
Fluted knob w/ 8 flutes Positioned closest to the CGO to prevent hypoxic mixture (less likely to mix when downstream - closest to patient) O2 always added to the gas mixture last (prior to vaporizers)
37
Flowmeter Components
Rotameters - Knob - Needle valve controls gas flow - Valve stops prevent damage to needle valve from excessive force - Flow tube - Indicator float (ball or bobbin)
38
Minimum AGM Flow
O2 flow 200-300mL/min
39
Flowmeters
Thorpe tube Tapered glass tube Constant-pressure, variable orifice R = P/ Q
40
Link 25
Hypoxic guard system Proportioning system N2O:O2 3:1 ratio
41
Dalton's Law
Volume % = partial pressure / total ambient pressure x 100 | P1 + P2 + P3 + PN = Total pressure
42
Vapor Pressure
Molecules escape from volatile liquid into vapor phase creating saturated vapor pressure at equilibrium Pressure exerted by vaporized molecules ↑temperature ↑vapor pressure
43
Variable Bypass Vaporizers
Flow over vaporization method Concentration dial splits stream into bypass & carrier Flow over gas picks up liquid volatile agent Calibrated specific to each volatile anesthetic agent DO NOT TIP >45°
44
Vaporizer Complications
Vaporizer tipped >45° ↑concentration → overdose Overfilling → volatile anesthetic liquid able to enter bypass chamber Leaks - loose filler cap, O-ring junction, or malposition Simultaneous inhaled agent administration - vaporizers not side-by-side interlock system possible to override Higher VP agent place in lower VP agent vaporizer ↑concentration delivered
45
Gas-Vapor Blender
Tec 6 Measured flow Bubble through vaporization Heated to 39°C
46
Desflurane Tec 6
Gas-vapor blender VP 669mmHg BP 24°C Electrically heated 39°C
47
Tec 6 Alarms
``` Warm-up mode = amber Operational = green No output = red Alarm battery low = amber - Lack agent, tilting, or malfunction - Low agent <250mL Internal battery only powers alarms NOT vaporizer ```
48
Circle System Components
``` FGF inflow source Overflow valve APL Gas reservoir bag Unidirectional valves Corrugated 22mm diameter tubes x2 Y-piece connector CO2 absorber ```
49
Semi-Closed System
Low FGF < minute ventilation | Some rebreathing
50
Semi-Open System
High FGF > minute ventilation | No rebreathing
51
Closed System
FGF = patient uptake Complete rebreathing Requires functional CO2 absorber APL valve closed
52
CO2 Absorption
Soda lime & baralyme Colorless when fresh Exhausted pH 10.3 → purple (soda lime) & blue-grey (baralyme) 4 to 8 mesh
53
Soda Lime
``` Ca(OH)2 NaOH KOH Silica H2O ```
54
Mapleson
Semi-open (non-breathing) | A-F
55
Mapleson A
APL on patient side
56
Mapleson B
Both APL & FGF on patient side w/ corrugation
57
Mapleson C
No corrugation
58
Mapleson D
Distant APL
59
Mapleson E
Easy (no bag or valve)
60
Mapleson F
Jackson-Rees modification to Mapleson D | No APL valve on FGF
61
Bain Circuit
FGF warmed by exhaled gases (improved humidification) 100-300mL/kg to prevent hypercarbia ↑resistance Pethick test to check inner gas hose integrity Rebreathing d/t unrecognized inner tube disconnect or kink
62
Ascending Bellows
Standing bellows Ascend on expiration Descend on inspiration Unable to fill when disconnected or leak present
63
Descending Bellows
Hanging bellows Fall/lower on expiration Fill even when disconnected
64
WAGs
Waste anesthesia gases
65
Scavenger Systems
Active (suction) Passive Open Closed

AS - N928 Basic Principles of Anesthesia (18 decks)

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