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610 Anesthesia Concepts > Anesthesia Machine Overview > Flashcards

Anesthesia Machine Overview Flashcards

1
Q

What do the components of the anesthesia workstation function to do?

A

deliver known concentrations of inhaled anesthetics to the patient

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2
Q

What does the anesthesia work station consist of?

A

anesthesia machine, vaporizers, ventilator, breathing system, scavenging system, respiratory and physiological monitors

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3
Q

What are the benefits and disadvantages of having everything in one workstation?

A

benefits: reduces chances of disconnections
disadvantages: variety of machines; learning curve for each one

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4
Q

What is something you have to do with a computerized AW?

A

power it down q24h

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5
Q

What is the common gas outlet?

A

where the AW provides delivery of medical gases and vapors of volatile anesthetics

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6
Q

What is the common place for disconnect at the AW? Where do gases mix prior to going to the patient?

A

common gas outlet

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7
Q

After the common gas outlet, where do the gases go?

A

they enter the anesthetic breathing system

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8
Q

How are the gases delivered to the patient?

A

via spontaneous or mechanical ventilation

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9
Q

How are exhaled gases removed?

A

scavenger; from the breathing system

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10
Q

What groups set the standards for AWs? What standards do they specifically set?

A

American Society for Testing and Materials (ASTM)= year 2000 and newer
American National Standards Institute (ANSI)= earlier than 2000

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11
Q

What are 5 pathways for O2 in the anesthesia machine?

A
  1. flow to fresh gas flowmeters
  2. powers the O2 flush valve
  3. activates the failsafe mechanisms
  4. activates the O2 low pressure alarm
  5. compresses the bellows of the vent
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12
Q

The pneumatic system is a _________pressure system. It has 3 levels, what are they?

A

air
high
intermediate
low

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13
Q

What does the high pressure system do?

A

reduces pressure from cylinder pressure to pressure suitable for use in the machine

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14
Q

What is the DISS? What does it provide?

A

Diameter Index Safety System; provides noninterchangable connections for the medical gas lines

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15
Q

What does the DISS consist of? Why is this important?

A

body, nipple and nut connection; only properly mated parts will fit together and allow the threads to engage

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16
Q

Is a DISS required or optional part of the anesthesia workstation?

A

required

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17
Q

What is involved in the intermediate pressure system?

A 
pipeline sources of O2, N2O, air
pressure regulators (2nd stage)
Oxygen pressure failure device
flow meter control valves
flush valve
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18
Q

What is part of the low pressure system?

A 
flow meter tubes
hypoxia prevention safety device
unidirectional valves (outlet check valve)
pressure relief devices
common gas outlet
vaporizers/manifold
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19
Q

What is the pressure level of the low pressure system?

A

slightly higher than atmospheric

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20
Q

What is the O2 pressure sensor shut off valve?

A

safety valve downstream from the N2O supply source

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21
Q

What is the purpose of having the O2 pressure sensor shut off valve?

A

shuts off N2O or proportionally decreases the supply of N2O allowed into the machine if O2 supply pressure decreases to a predetermined threshold value (ie 25psi)

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22
Q

What are 2 different types of O2 pressure sensor shut off valves?

A

threshold: either on or off

proportioning type: OFPD responds proportionally to changes in O2 supply pressure

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23
Q

What types of cylinders are typically used for the AW?

A

E

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24
Q

What system allows only the correct tank to be attached to the correct hose on the AW? How does it work?

A

PISS: Pin Index Safety System

holes on the tank only allow specifically placed pins to fit in; #ed from left to right 1 to 6

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25
Q

What are the PISS settings for O2, N2O and air?

A

O2: 2 & 5
N2O: 3 & 5
air: 1 & 5

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26
Q

When is an E cylinder of oxygen considered full?

A

at 2000psi or approximately 625-650 liters of O2

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27
Q

What happens to the pressure of the O2 tank as O2 is used up?

A

pressure falls in proportion to amount of O2 left in tank

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28
Q

If a tank starts out at 2000psi and 625L of O2, then drops to 1000psi, how much O2 is left?

A

312.5L

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29
Q

If your O2 tank is half full and you are running O2 at 2L/min, how many hours do you have left before the O2 runs out?

A

2.6 hours (156minutes)

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30
Q

What does the number on the O2 pressure gauge on the cylinder reflect?

A

the volume of O2 stored as a gas

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31
Q

What is the volume of O2 in a cylinder if the psi is 2200, 1100, 550, 225, and O?

A 
2200psi=625L
1100psi=312.5L
550psi=156.25
225psi=78L
0psi=0L
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32
Q

What is the psi of a full N2O tank?

A

745psi

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33
Q

What does a pressure regulator do?

A

reduces the pressure to a constant 45psi

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34
Q

What is a type of pressure regulator not in all machines?

A

second stage

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35
Q

What does a second stage regulator do? Where is it found?

A

reduces the pressure even more (14psi for O2, 26psi for N2O)
found downstream from pressure regulator

36
Q

What is the purpose of a flow meter?

A

to measure gas flow to the common gas outlet

37
Q

What are 2 types of flow meters?

A

Thorpe tubes; electronic flow sensors

38
Q

What are some safety features of flow meters?

A

color coded; O2 flow knob is distinct; location of O2 flow knob

39
Q

What are the color codes of the gases?

A

O2=green N2O=blue air=yellow

40
Q

How is the O2 flow knob distinct?

A

distinctively fluted; projects beyond control knobs of the other gases; larger in diameter

41
Q

Why is the O2 flow meter positioned downstream?

A

downstream from N2O prevents hypoxic mxture if leak is present: NOT FAILSAFE

42
Q

What can happen if there is a leak in the O2 flow meter?

A

hypoxic mixture

43
Q

What is the flow rate of the O2 flush?

A

35-75L/min

44
Q

Where does the O2 flush go to?

A

directly to machine outlet–>patient circuit

45
Q

What is a potential adverse effect of using the O2 flush?

A

potential for barotrauma

46
Q

What is the only reasonable use for using the O2 flush?

A

aid in machine check; fill bellows on expiratory phase of respiration

47
Q

What is a safer way to fill the bellows?

A

turn up O2 flow meter

48
Q

What does using the O2 flush not replace?

A

a good mask fit

49
Q

When is the anesthesia machine checked?

A
  1. complete and thorough daily check

2. circuit check before each new case

50
Q

What is the best monitor at your disposal?

A

VIGILANCE

51
Q

What are monitors effective in doing?

A

detecting problems with or adequacy of ventilation and oxygenation

52
Q

What are common monitors you will see?

A

EKG, SBP, temp, O2 sats, CO2, anesthetic gases and vapors, alarm systems

53
Q

What monitor is the best for detecting a disconnect? What else may show this?

A

ETCO2

low pressure alarms

54
Q

What is the most important monitor on the machine? What does it do?

A

Oxygen analyzer

detects if machine is getting correct FIO2

55
Q

What do you want to calibrate the O2 analyzer to?

A

21% O2; room air

56
Q

What monitor provides ongoing monitoring of exchange?

A

SpO2

57
Q

What are you checking in a machine check?

A

gas line connections; vent check; flow meter controls; vaporizer levels; O2 analyzer; low pressure circuit leak check; circle system test; work station self tests

58
Q

What is the only monitor that detects problems downstream from the flow control valves?

A

oxygen analyzer

59
Q

What is the process of checking the O2 analyzer?

A

expose O2 sensor to room air for given amount of time

60
Q

What is the purpose of checking the low pressure circuit test?

A

checks the integrity of the machine from flow control valves to the common gas outlet

61
Q

What parts of the machine are most vulnerable to breakage?

A

components in the low pressure circuit

62
Q

Is there 1 specific way to check the low pressure circuit?

A

no; differs w/ machine depending on whether or not the machine has a check valve

63
Q

For a 1993 FDA negative pressure leak test, what switches must be turned off or on?

A

machine master switch, flow control valves, and vaporizers: all must be in OFF position

64
Q

What is the suction bulb attached to for a leak test?

A

common gas outlet

65
Q

Why is the suction bulb squeezed several times in a leak test? How do you know if the machine is leak free?

A

squeeze until it is fully collapsed: this creates a vacuum in the low pressure circuit

bulb remains collapsed for at least 10 seconds

66
Q

What is the purpose of a circle system check?

A

evaluate the integrity of the circle breathing system

67
Q

Where does the circle breathing system extend from?

A

the common gas outlet to the Y piece

68
Q

How do you perform a leak test of the circle system?

A

occlude the Y piece, close off APL valve, pressurized the circuit to 30 cm H2O using the O2 flush valve

69
Q

What are you looking for on the leak test of the circle system?

A

sustained positive pressure reading on the airway pressure gauge

70
Q

What does a leak test of the circle system not test?

A

the integrity of unidirectional valves

71
Q

What does test the unidirectional valves?

A

flow test

72
Q

How do you perform a flow test of the circle system?

A

attach breathing bag to Y piece, turn on ventilator and assess integrity of unidirectional valves

73
Q

What will dilute the anesthetic if you use it on the patient?

A

O2 flush valve

74
Q

What prevents backflow of gas?

A

outflow check valve

75
Q

What is the main component of the high pressure system?

A

tanks

76
Q

What is the psi that the gas in the tanks is reduced to?

A

45psi

77
Q

What is the psi that the gas from the pipeline is reduced to?

A

50psi

78
Q

What is the main component of the intermediate pressure system?

A

pipeline

79
Q

What is the symbol for the Oxygen flush valve?

A

O2+

80
Q

The flow meters are part of the _________pressure system but the knobs are part of the __________ pressure system.

A

low

intermediate

81
Q

Describe the hypoxic prevention device.

A

oxygen is always downstream from N2O (O2 is closest to vaporizer)
this way if there is a crack in the system, O2 will still be pumped to patient
If you turn on N2O before O2, O2 will turn up to 30% before N2O turns on
Also, if you turn O2 down, N2O will decrease as well

82
Q

If the O2 pressure shut off alarm goes off, what will the workstation do?
What will it not do?

A

it will turn off N2O and air and only give patient O2

It won’t turn off the anesthetic

83
Q

What does the O2 pressure shut off valve not respond to?

A

FiO2

84
Q

If the O2 fail safe alarm goes off, what should you do?

A

disconnect the pipeline and use the cylinder

85
Q

If your patient is on O2 and you want to decrease your FiO2 from 100% at 10L/min to 50% @ 10L/min, how do you adjust your gases if you are using O2 and N2O?

A

give 5L/min of both O2 and N2O

610 Anesthesia Concepts (6 decks)

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