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SRNAProfessionalGuide > Anesthesia Machine Parts > Flashcards

Anesthesia Machine Parts Flashcards

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1
Q

What are the 3 types of valves

A

1.Free floating : one way 2.Ball and Spring valve : All or none valve 3.Diaphragm: Pressure Reducer Valve

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2
Q

Pressure

A

one 1L of oxygen , 1000psi may be

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3
Q

All anesthesia machines have about the

A

same parts

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4
Q

Endoskeleton of the machine

A

1st stage vs 2nd stage regulator.

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5
Q

one way valve

A

Free floating inhale : expiratory valve (close) exhale: inspiratory valve (open) expiratory valve open when you exhale E-Cylinder APRV or Pop Off valve (manually operated) Gas flow pushes gas to valve seat

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6
Q

Function of floating Valve

A

prevent gases from escaping the closed circuit system.

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7
Q

Radicals , macrophages, and eosinophils are mobilized

A

when the patient is given 100% oxygen

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8
Q

Pop off valve : turned to the right? what happens? Turn to the left –> ?

A

turned to the right (tighten , all the gas goes to the bag and the patient. Lefty loosy, more of the gas goes out the scavenging system

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9
Q

Pop off valve (APRV)

A

The more difficult, close more The less difficult, open a little more

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10
Q

One way free floating

A

from tank to patient, (one way out)

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11
Q

If you have 2 oxygen cylinders 1100 psi vs 1000 which one will deliver the pressure

A

1100 then both The cylinder with the higher pressure will deliver more oxygen.

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12
Q

DISS wall valve

A

Diameter Index Safety System (DISS) Idiot proof

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13
Q

Green yellow blue

A

Oxygen, air, nitrous oxide.

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14
Q

PISS

A

Pin Index Safety System (E-Cylinder) Different pin for each (Oxygen, nitrous)

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15
Q

Bourdon gauge

A

it measures pressure generated from its sources (bag, e-cylinder, ventilator or wall) Importance lies when bagging the patient with a mask: STAY below 20cmH2…(adjust pop off valve) Why? Barotrauma, ESOPHAGEAL SPHINCTER will open with 15cmH2O. IF you need to ventilated can go UP , (Smoking, obesity, OSA)

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16
Q

Inhale Know pressure and lung volume End Tidal is the opposite of

A

peak, plateau , exhale Inspiratory pressure.

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17
Q

Tidal volume x RR

A

minute ventilation

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18
Q

Ultrasonic flow meter

A

back of machine, light blue Tall blue dark (The WRIGHT SPIROMETER) measures TV and RR (which is minute ventilation)

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19
Q

Ultrasonic flow meter vs Wright spirometer

A

Highly accurate not affected by flow situations= Ultrasonic flow meter The wright spirometer= Does not measure volume directly

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20
Q

One way valve All of them measure

A

Bourdon gauge , ultrasonic flow meter EXHALATION

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21
Q

Expiration vs inhalation

A

Expiration is longer (passive) normal require passive

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22
Q

Fast ambu bag delivery

A

it will cause barotrauma.

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23
Q

How long to wait for sats

A

30 seconds

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24
Q

Alveolar recruitment maneuver (ARM)

A

Read

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25
Ball & Spring (All or none) Valve
O2 wall connector think of when you applying valve to a wall, (push it in) REQUIRES ENERGY TO ACTIVATE
26
Flush valve generates \_\_\_to \_\_\_\_L/min and can cause \_\_\_\_\_\_\_\_\_\_if pressed too much or can also dilute out the volatile anesthetic being administered.
generates 35 to 75 L/min --\> Barotrauma
27
Diaphragm Function Pressure \_\_\_\_\_and \_\_\_\_\_pressure first stage? 2nd stage?
Reduce pressure throughout the system pressure regulator/Reduce pressure First stage: reduce for both O2 and N2O to 40-55psig 2nd stage: Reduces internal intermediate pressure to 15psig (low pressure)
28
Diaphragm (pressure \_\_\_\_\_and \_\_\_\_\_Pressure)
pressure regulator/Reduce pressure First stage: reduce for both O2 and N2O to 40-55psig (intermediate pressure) 2nd stage: Reduces internal intermediate pressure to 15psig (low pressure)
29
Intermediate (normal)
40-55
30
Back up pressure
cylinders
31
Oxygen Fail Safe Mechanisms
Oxygen failure protection device: Flow dependent If oxygen is lower then 25 psig, N2O will shut off
32
Datex Ohmeda
PROPORTION LIMITING SYSTEM Drager: Limits flow of N2O according to O2 flow.
33
Thorpe tube:
Tapered and largest at top
34
From low flow to high flow
Laminar to turbulent AS the diameter increases, you allow for more lamia
35
For Flowmeters for Ball float
read at middle
36
For Flowmeters for arrow float
read on top
37
TEC 6 Desflurane Vaporizer • Heated up to ___________ • Pressurized up to\_\_\_\_\_\_\_\_\_\_
39 degrees Celsius 2 atmospheres.
38
Soda Lime composition, what are the 3 ingredients
Calcium Hydroxide Sodium Hydroxide Potassium Hydroxide
39
What is the percentage of calcium hydroxide in the soda lime?
80%
40
What is the percentage of sodium hydroxide in the soda lime?
4%
41
What is the percentage of Potassium hydroxide in the soda lime?
1%
42
Soda lime mesh size ?
4-8
43
Ethyl violet absorbers are \_\_\_\_\_\_\_when fresh and \_\_\_\_\_\_\_colored when exhausted
white; Purple
44
What kind of valve in the absorber
Inspiratory or Expiratory Unidirectional valve APL
45
How many liters of CO2 can the CO2 absorber absorb?
26L
46
With \_\_\_\_\_FIRES can occur at \_\_\_\_\_\_\_\_F
Sevoflurane 400
47
What do you do if the Soda Lime turns purple and you don’t have time to change it?
Use fresh ga
48
What do you do if the Soda Lime turns purple and you don’t have time to change it? EX:
Increase the inspiratory flow 3 TIMES the minute ventilation If minute ventilation is 3L/min increase to 9L/min
49
What is the purpose of increase the respiratory flow
Gas flow out to the scavenging system ; you lose gas bu the patient is SAFE
50
2 types of ventilators
Ascending Descending Safer is ascending because descending is affected my gravity and may not be reliable
51
Advantages and disadvantages of Piston ventilators? How is it powered? advantages: is there PEEP, comment on TV, and compliance loss Disadvantages: can generated \_\_\_\_\_\_\_\_\_
Piston Ventilators (electric powered) adv: quiet, no peep, greater precision with TV, less compliance losses disadv: less familiarity with standing bellows, quiet operation, cannot use Mapleson circuits; can generate Negative End Expiratory Pressure (NEEP).
52
The mushroom valve is an
EPRV: expiratory pressure release valve. ▪ One-way (free floating) valve.
53
Ventilator disconnect alarm 2 types of alarm: ▪ Volume alarms  Spirometer  Reverse flow  Low flow
- pressure alarm - volume alarm
54
Pressure alarm detect
by a drop in pressure of the system Threshold number
55
Volume alarm
 Spirometer  Reverse flow  Low flow
56
CC think compliance is
Chest
57
Lungs think
Elasticity
58
Pressure =
Flow x resistance
59
Compliance = change in volume
change in pressure
60
Normal Tidal volume is
5ml/kg lowest
61
Tidal Volume is dependent ?q
1. Set tidal volume 2. Flow rate of all gases -Increased flow rates lead to increase TV 3. The set I:E time  The longer the inspiratory time the more TV is delivered. Watch for overdistension. 4. Inspiratory flow speed  Increasing the flow speed increases the plateau phase leading to increased TV
62
Increase flow rate increase/decrease TV
Increase
63
The longer the inspiratory time the (more/less) TV is delivered
More
64
What increases the plateau phase\_\_\_\_\_\_leading to \_\_\_\_\_\_TV
Increasing the flow speed ; increase TV
65
What are we trying to achieve? MAD SPM
▪ Safe delivery of minute ventilation ▪ Maintain ETCO2 around 32-36mm Hg ▪ Adequate inspiratory time  Maintain alveoli open  Do not overdistend alveoli ▪ Prevention of lung injury
66
Set these 2 parameters together
Rate and I: E time
67
For respiratory rate of 10 , set I: E at \_\_\_\_\_\_\_so expiratory time is \_\_\_\_\_\_seconds
1:2; two
68
For respiratory rate of 8 , set I: E at \_\_\_\_\_\_\_so expiratory time is \_\_\_\_\_\_seconds
1:3 ; 1.88 seconds
69
For respiratory rate of 6 , set I: E at \_\_\_\_\_\_\_so expiratory time is \_\_\_\_\_\_seconds
1:4 ; 2 seconds
70
How do we go about prevent lung injury ?
- Set rate and I:E time ▪ Set tidal volume ▪ Look at the pressure monitor ▪ Fine tune by changing the flow control ▪ Make sure inspiratory relief valve is above PIP
71
2 knobs
1. Inspiratory flow control dial 2. RR frequency & I:E ratio
72
What is the Flow Control Dial? what is the function?
Controls the speed of injection of gas around the bellows ▪ Gas is combination of Oxygen and Air ▪ Faster flows increase the PIP ▪ Lower flows will lead to inadequate alveolar ventilation
73
Open Reservoir Scavenging system: FLow indicator? Relief ports at side does what?
Flow Indicator = ball is at middle portion is 25 L per minute. ▪ Relief Ports at side = suctions room air if there is too much vacuum.
74
Open Reservoir Scavenging system: receives gas from?
Receives gas from machine through APL and the ventilator.
75
NIOSH 1977 Recommended Exposure Limits When halogenated only? Halogenated agent and N2O N2O only
\*\*\* Halogenated agents only = \<2 ppm ▪ \*\*\* Halogenated Agent + N20 = 0.5 ppm ▪ \*\*\* N20 only = 25 ppm N20
76
ETCO2 graph b b to c c-d d d to e
(b) Zero: Begin expiration. ▪ (b to c) Ascending: Combination of dead space and alveolar gases. ▪ (c-d) Plateau: Alveolar gases. ▪ (d) End of plateau: ETC02, @ FRC, @end expiration. ▪ (d to e)Descending: Inspiration
77
Draw this multiple times
CIRCUIT CIRCLE
78
Describe the circle system
Circle System -\> -\> -\>flow meters --\> vaporizer --\>Common gas outlet (CGO) --\> soda lime --\> inspiratory valve --\> inspiratory limb of the circuit --\> ETT --\> patient --\> expiratory limb of the circuit --\>expiratory valve --\> ultrasonic flow meter or Wright spirometer --\> bag vs. ventilator lever
79
Happens simultaneously--\>
--\> bag --\> pop off/ IPRV --\> soda lime…etc.---\> scavenger. --\>ventilator --\> soda lime …. Etc. --\> mushroom valve --\> scavenger.
80
Circle system function (5)
minimize rebreathing ▪ need for soda lime ▪ dead space ▪ direction of gas flow ▪ required gas flow
81
02 PATHWAY THROUGH THE MACHINE FROM E CYLINDER
E cylinder --\> PISS valve ---\> bourdon gauge (pressure closes other free floating E cylinder valves) --\> First Stage Diaphragm Valve (E cylinder pressure to intermediate pressures) ---\>
82
Simultaneously……
▪ oxygen pressure sensor valve ▪ flush valve (bypasses flowmeters and vaporizers ---\> CGO: common gas outlet) ▪ DISS (closes) ▪ Second Stage Diaphragm Valve (intermediate to low pressure

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