Anesthesia Machines Flashcards
1
Q
What Governing bodies regulate the Anesthesia machine usage
A
American National Standards Institute (ANSI)
Prior to 2000
American Society for Testing and Materials (ASTM)
Since 2000
International Electrochemical Commission (IEC)
Compressed Gas Association (CGA)
Institute of Electrical and Electronics Engineers (IEEE)
Federal Drug Administration (FDA)
2
Q
Components of the high-pressure system includes
A
- Auxiliary E – Cylinder
- Yoke assembly
- Burdon gauge
- High pressure regulator (HaBY)
3
Q
what is the range of oxygen cylinders
A
Size A-H
4
Q
Size A-E oxygen cylinder is used For?
A
Backup
5
Q
Whats the most common size of Cylinder used
A
E
6
Q
Size G-H oxygen cylinder is used for?
A
Banks,
Backup for oxygen hospital supply
7
Q
What is the Tank made up of?
A
Steel
8
Q
What is the tank for the MRI environment made up of?
A
Aluminum
9
Q
What does US Department of Transportation regulate?
A
Manufacture Marking/labeling Filling Handling Transport Storage Disposal of cylinders
10
Q
What agency sets the purity of medical gases
A
United States Pharmacopeia/National Formulary (USP/NF)
11
Q
Color For Oxygen
A
Green
12
Q
Color For Nitrous
A
Blue
13
Q
Color For Medical Air
A
Yellow
14
Q
West anesthesia Gas Color
A
Purple
15
Q
Vacuum(Suction) Color
A
White
16
Q
CO2 Color
A
Grey
17
Q
Nitrogen color
A
Black
18
Q
ISO Color code For Medical air
A
Black and White
19
Q
Iso color code for OXygen
A
White
20
Q
Iso Color code for Vacum
A
Yellow
21
Q
The PIN index safety system (PISS) is used in?
A
Yoke Assembly
22
Q
What is the function of the “Check Valve”in the yoke assembly
A
- Stop Transfer of Oxygen between tanks
2. Stop leaking Into ATmosphere
23
Q
Function of the yoke assembly
A
Orient tanks
Gas tight seal
Unidirectional flow of gases
Contains a filter
24
Q
Piss for Air
A
1,5
25
Piss for Oxygen
2,5
26
Piss for Nitrous
3,5
27
E cylinder Volume
660L
28
E Cylinder Pressure
1900 Psi
29
oxygen Full tank pressure
2200psi
30
Nitrous Full tank pressure
750psi
31
Oxygen's physical state at room air
Gas
32
Nitrous physical state at room air
Liquid and gas
33
Nitrous Full tank Liters of gas
1590L
34
When does pressure in the nitrous tank start to drop
When all the liquid has turned to gas at 75% usage of the full tank.
35
Name the 2 types of Cylinder safety systems
Frangible Disk and Fusible Plugs
36
What are the Characteristics of the Frangible Disk
Burst under pressure
37
What are the Characteristics of Fusible Plug
Melts at a predetermined Temperature(BLT with cheese)
| Bismuth,lead,tin,Cadmium
38
What is The Anesthesia Machine
Provides delivery of medical gases and vapors of volatile anesthetics in known concentrations to a common gas outlet
39
Standards of the Anesthesia machine are overseen by
American National Standards Institute (ANSI)
Prior to 2000
American Society for Testing and Materials (ASTM)
Since 2000
40
what is the function of the High Pressure Regulator
Reduces the high and variable pressure delivered from a cylinder to a lower and more constant pressure suitable for the anesthesia machine
41
pressure regulators are set at?
40-45 Psi
42
Between the pipeline gas and the cylinder gas.which source of delivery would the anesthesia machine use first
Pipeline gas will be used first
43
Intermediate Pressure system Receives gas from?
The pressure regulator or pipeline inlet
44
What are the components of the IPS
1. Hospital supply (pipeline inlet)
2. Oxygen flush valve
3. Pneumatic safety systems/electrical system (on switch)
Oxygen supply failure alarms
Oxygen failure protection devices
4. Auxiliary oxygen flowmeter
5. Second stage regulator
45
Is Oxygen Stored in liquid or Gas form(Hospital supple connection)
Liquid
46
what temp is oxygen stored in
-184 degress celcius
47
What cylinders do we store Nitrous in?
H cylinders
48
What is the function of the Diss(Diameter index safety System)
1.Ensures only the correct anasthesia can be connected
49
What pressure is oxygen supplied in to the hospital
50psi
50
What is the working pressure of the anesthesia machine
50psi
51
There are multiple shut off valves between the Hospital supply and the anesthesia machine,true or false?
True
52
The Diss system components are? (Hospital supply Connection)
Filter-Stop contaminants
Check valve-Ensures unidirectional flow
Pressure gauge-Pipeline pressure
Sized and threaded differently(body,nipple and nut combination
53
What are the characteristics of quick Connection(old)
Gas specific
| Wall outlet
54
Name the Characteristics of the oxygen Flush Valve
Provides 100% oxygen to the anesthesia circuit
Enters the circuit downstream from the vaporizers – directly to common gas outlet
Flow rate between 35 – 75 L/minute
Protected by rim to lessen the chance of accidental activation
55
What are the Hazards of using the oxygen flush valve
Barotrauma:Stuck valve If used during inspiratory phase of mechanical ventilation
Older - Ventilator relief valve closed & APL out of circuit
Newer - Fresh gas decoupling valve
Awareness:Dilute anesthetic gases
56
The Function of the Fresh Gas decoupling valve in the piston system is to ?
Prevent or limit Barotrauma
57
Anesthesia machine must have a battery back up of what time capacity
At least 30min battery backup for limited operation
58
What is the function of the Pneumatic Safety System
Prevent the delivery of hypoxic gas mixture ,where oxygen influences the flow of other gases.
59
What is the No Hypoxic gas mixture system requirement
“The anesthesia gas supply device shall be designed so that whenever oxygen supply pressure is reduced below the manufacturers specified minimum, the delivered oxygen concentration shall not decrease below 19% at the common gas outlet.”
60
It is Prudent to plug appliances on the back of the Anesthesia Machine.T/F
F
61
AT what pressure does the oxygen pressure Alarm sound
Oxygen pressure less than 38psi
62
What happens in the system when the oxygen pressure alarm sounds
The oxygen failure whistle valves opens
63
How long does the oxygen failure alarm sound
Whistle sounds until the oxygen pressure drops below 6psi
64
At what pressure after the oxygen fail alarm sounds does the supply of anesthesia gas stop.
at 30psi.
65
The Audible indications when pneumatic system is turned on will be oxygen filling whistle comes on.T/F
T
66
Name 3 functions of the fail safe valve.
1. Fail save valves are designed to prevent the delivery of Hypoxic gas mixtures from the machine in the event of failure of oxygen supply
2. Depends on the pressure of oxygen not flow
3. Protects against unrecognized exhaustion of oxygen delivery from either the pipeline or attached oxygen tank
4. Fail save devices either proportionally decreases the flow of all gases or shuts off (threshold) flow of all other gases except oxygen based on manufacture set pressures
67
What are the limits of the fail safe Valve
1. Does not prevent anesthesia gases from flowing
| 2. Works even if the wrong gas is supplied (pneumatic devices
68
In Datex Ohmeda if the what oxygen pressure limit needs to be reached for the device to activate and what will happen with the valve.?
<20psi of pressure. and valve will close
69
Function of auxillary oxygen flowmeter
1. Allows for the use of low flow oxygen without using the anesthesia circuit
2. Typically used for monitored anesthesia care
3. Can be used in Emergency without Machine power
4. Jet ventilation
70
What is the Function of The second stage pressure regulator
1. Supply constant pressure to the flow control valves and the proportioning system
2. Protects against fluctuations of pipeline pressure
3. Ensures that oxygen is the last flowing gas
71
What pressures does the 2nd stage pressure regulator lower the pressure to?
14-35psi
oxygen....14
Nitrous..26
72
Components of low pressure system
1. Flowmeters
2. Hypoxia prevention safety devices
3. Unidirectional valves (info only)
4. Pressure relief devices (info only)
5. Anesthesia vaporizers/vaporizer manifold (info only)
6. Common gas outlet
73
Pressure in the low pressure system is slightly above atmospheric.T/F
T
74
Where is the low Pressure system located
Between the flow control devices and common gas outlet
75
What are the flowmeters made up of
Flow control valves
| Flow Tube
76
What are the functions of the Flow meter
1. Regulates the flow of Gases entering the breathing circuit.
2. Directs the selected flows to the vaporizer.
77
Name 2 ways that the flowmeter control the flow of gases
1.Mechanically and electronically
78
Why are the oxygen and Nitrous flow linked mechanically-Mechanic and electronically
To prevent hypoxic gas mixture.
79
The Flow tubes are also known as the ?
Thorpe tubes.
80
2 types of Flow exist in the Thorpe Tubes
Lamina Flow-Bottom- low flow-Viscosity of gas
| Turbulent Flow-Top-High flow-Density of gas
81
What should be the position of the oxygen flowmeter.
It should be Farthest to the right.(Prevents hypoxic mixture)
82
What is the use of The LinK Proportioning system
Prevent Hypoxic gas mixture admin. by proportionally reducing the nitrous levels.
83
What is the Nitrous:oxygen ratio that is necessary to prevent hypoxic gas mixture.
75%n:25%0xy
84
What are Features of the Link -25 Proportion limiting device(Datex-Ohmeda)
oxygen and nitrous are mechanically linked.
N:O is in a 3:1 ratio
29 O teeth:15 N2O teeth
Balanced secondary regulator gives oxygen at 30PSIG
Nitrous pressure based on oxygen pressure.
Maintain oxygen concentration of at least 25%
85
Features of the Sensitive oxygen ratio controller system?
1. Pneumatic-mechanical interlock
2. openeing oxygen flow creates a back pressure in the chamber opening nitrous flow.
3. Maintains a ratio of 25% oxygen to 75% nitrous oxide flow into breathing circuit
4. Needs at least 200 mL/min to operate
86
What does the Common gas outlet do
Receives all the gases and vapors from the machine and delivers the mixture to the breathing circuit
87
Common gas outlet Features
15mm female slip Joint fitting
| Should not be used to administer supplemental oxygen to a patient
88
Name the 5 Pathway of oxygen
1. Flow to the fresh gas flowmeter
2. Powers the oxygen flush valve
3. Activates the fail-safe valve/mechanism
4. Activates the oxygen supply low pressure alarm
5. Compresses the bellows of the ventilator
89
What check do we perform on the anesthesia machine before each patient
Circuit Check(positive pressure check)
90
How often is the complete check done in the anesthesia circuit?
1 x a day
91
State the 9 steps of machine check
1. Emergency equipment
2. High pressure system check
3. Low pressure system check
4. Oxygen sensor
5. Scavenging system
6. Ventilator
7. Breathing system
8. Monitors
9. Final check
92
What components are included in the Emergency equipment check
1. Ambu bag
2. Back up oxygen cylinder (>1000 psig)
3. Functioning suction with yankauer
93
Describe High Pressure system check
```
1. Check O2 cylinder supply
Open cylinder and check PSI (>1000)
Close cylinder
Depress O2 flush
2.Disconnect pipeline supply from the wall
```
94
Describe Low pressure system check
```
1. Check vaporizers
Mounted, filled, and interlock works
2. Check low pressure system
Suction bulb to common gas outlet
Squeeze bulb until fully collapsed
Verify bulb stays deflated for 10 seconds
3. Turn on master switch
Listen for oxygen disconnect alarm
Reconnect pipeline pressure
Ensure pipeline pressure is > 50 psig
4. Test flowmeters
Adjust flow of all gases through their range
Attempt to create a hypoxic mixture
```
95
Describe Oxygen sensor check
1. Calibrate O2 sensor(Remove oxygen sensor to be exposed to room air)
Ensure reads 21% in room air
Verify low O2 alarm (set to 30%)
Re-install sensor and flush with O2 - now reads > 90%
2.Install breathing circuit
96
Describe the scavenging system check
1. Ensure proper connection of scavenging system
2. Adjust waste gas vacuum
3. Fully open APL valve
4. Occlude Y piece and ensure gauge reads < 10 cm H2O
5. With Y piece occluded, depress O2 flush ensure the reservoir bag distends, and the pressure gauge reads < 10 cm H2O
97
Describe the Vent check
Ventilation system
1. Place a second breathing bag on Y piece
2. Set appropriate ventilator setting for next patient
3. Set O2 @ 5 L
4. Turn ventilator on and fill bellow with flush valve
5. Verify bellows deliver adequate tidal volumes
6. Check function of unidirectional valve
7. Squeeze bag and check over pressure alarm
8. Set to manual ventilator mode
9. Ensure ability to manual ventilate
10 Turn off ventilator and remove breathing bag
98
Describe the positive pressure check(Breathing system) leak test
1. Set all gas flow to zero
2. Close APL valve an occlude the Y piece
3. Pressurize the breathing system to 30 cm H2O
4. Ensure pressure remains fixed for at least 10 seconds
5. Fully open APL valve and allow bag to self deflate and flows through the scavenger
99
Describe the final Check On the Machine check
1. Vaporizers off
2. APL valve open
3. Selector switch set to bag
4. All flowmeters set to zero
5. Suction available
6. Monitors set appropriately
7. Circuit on, CO2 sampling line connected, & correct mask on
100
Before the Final check on the Machine check what should you do
Set the Anesthesia monitors for the next patient.
101
What Do Hypoxia Prevention devices do
1.A proportioning system is to prevent the creation and delivery of hypoxic mixtures
2.Designed to prevent an operator selected delivery of oxygen concentration below 21%
3.The machine automatically limits the amount of nitrous oxide so a hypoxic mixture cannot be delivered
4Accomplished with a pneumatic-mechanical interface between the oxygen and nitrous oxide flows
