Anesthesia Systems Flashcards by Hailey Haas

Requirements of breathing system 4

deliver gas to alveoli in same concentration as set at shortest time possible
eliminate co2
minimal apparatus dead space
low resistance

How well did you know this?

Not at all

Perfectly

Desirable for breathing system to: 8

Economy of fresh gas, conserve heat, humidify inspired air, light weight, convenient, efficient in spontaneous and controllent vent, adapt to adults and peds, reduce pollution

How well did you know this?

Not at all

Perfectly

How machines minimize resistance

Short tubing, large diameter, avoid sharp bends, caution w valves, minimize connections

How well did you know this?

Not at all

Perfectly

Rebreathing

Why its good and bad

Reduces cost, adds humidification

Bad to rebreath co2

How well did you know this?

Not at all

Perfectly

Higher fresh gas flow associated with what

Less rebreathing of any circuit

How well did you know this?

Not at all

Perfectly

Dead space- increases chance of what

Where it is

Rebreathing co2. Where inspiratory and expiratory gas streams diverge

How well did you know this?

Not at all

Perfectly

How to minimize dead space in system

Separate ins and exp limbs as close to pt as possible

How well did you know this?

Not at all

Perfectly

Open systems characterized by 3

2 types

No: gas reservoir bag, valves, or rebreathing of exhaled gas

Insufflation/blow by, open drop

How well did you know this?

Not at all

Perfectly

Ex of insufflation

Nasal cannula, head drape, steal induction (mask), bronchoscope port

How well did you know this?

Not at all

Perfectly

Advantages of insufflation 4

Simple, avoids direct pt contact, no co2 rebreathing, no reservoir bags or valves

How well did you know this?

Not at all

Perfectly

Disadvantages of insufflation 4

No ability to assist/control ventilation, may have co2/o2 accumulation under drapes, no control of anesthetic depth or fio2, environmental pollution

How well did you know this?

Not at all

Perfectly

Schimmelbusch mask
What it is
Problems

Open circuit, cloth saturated with anesthetic over mask

Can cause hypoxia or too much drug

How well did you know this?

Not at all

Perfectly

Open drop method
Example
Advantages 3

Ether mask

Simple, low cost, portable

How well did you know this?

Not at all

Perfectly

Open drop method

Disadvantages 5

Poor control of inspired anesthetics, accumulate co2 under mask, hypoxia risk, spontaneous vent only, OR pollution and HCP risk

How well did you know this?

Not at all

Perfectly

Semi open systems: 5 components

Face mask or ETT
Pop off valve (APL) 
Reservoir tubing 
Fresh gas inlet 
Reservoir bag

How well did you know this?

Not at all

Perfectly

Examples of semi open systems

Mapleson A-F
Bain
Circle

How well did you know this?

Not at all

Perfectly

Group 1 maplesons
Which letters
Where stuff located

Pop off valve near face mask, FGF at opposite end

How well did you know this?

Not at all

Perfectly

Group 2 maplesons
Which
Where stuff is

B and C

Pop off valve and FGF near face mask

How well did you know this?

Not at all

Perfectly

Group 3 maplesons
Letters
Where stuff is
Opposite of what

D, E, F
FGF near face mask, pop off valve at opposite end
Mapleson A

How well did you know this?

Not at all

Perfectly

Co2 rebreathing depends on 3

Fresh gas inflow rate
Minute ventilation of pt
Type of ventilation (spontaneous or controlled)

How well did you know this?

Not at all

Perfectly

APL ___ to exhale w less resistance. ___ APL for positive end pressure

All the way open

Somewhat closed

How well did you know this?

Not at all

Perfectly

Mapleson A best for what

Study These Flashcards

Spontaneously breathing pts, dont need as much fresh gas flow, only need 1-2x minute ventilation of gas flow
`

Mapleson d best for what

Study These Flashcards

Controlled ventilation

Mapleson D
Can be used for
FGF x mv what
Most __ mapleson during ___ ventilation

Study These Flashcards

Spontaneous and controlled ventilation
2-3 spont, 1-2 controlled
Efficient, controlled

Mapleson E (__ __) Most commonly used where No __ __ and no __ __ __ If spontaneous, fgf what

T piece Icu and pack No reservoir back or apl valve 2-3

Mapleson f (__ __) Modification of mapleson __ Difference Popular for who

Jackson reese E Pop off valve and reservoir bag Peds

Bain circuit Modification of which mapleson FGF tubing is where and allows what

D Fgf inside of large corrugated tubing Exhaled gas warms inspired gas, preserves heat and humidity

Bain circuit Used for 2 FGF reqs Disadvantage

Controlled or spontaneous vent Same as mapleson d Potential for tube leaks, kinking, disconnection

``` Ambu bag Modified mapleson __ which what Capable of delivering what Reservoir is __ __ Requires __ fresh gas flow Depends on __ __ ```

``` A, non rebreathing valve High fio2 Self filling High Minute ventilation ```

Advantages of maplesons | 6

Simple, lightweight, can provide positive pressure, low resistance, portable, more predictable and less room pollution w anesthetics

``` Disadvantages mapleson Requires: Control of what is variable: Possibility of what if fgf not maintained: Poor conservation of what 2 ```

``` Calculation of fgf which varies with type of circuit and vent mode Anesthetic depth Co2 build up Heat and humidity Costly, special assembly ```

Circle system Can be used as: depends on what, what varies for each Prevents what Allows what

Semi open, semi closed, or closed. Apl valve adjustment and fgf Rebreathing of co2 Rebreathing of other exhaled gases

Circle system components: 7

Fresh gas flow source Ins and exp unidirectional valves Ins and exp limbs/corrugated tubing Y piece, Apl, reservoir bag, co2 absorber

Order of circle system path 7

Y piece, ins limb, inhalation check valve Fresh gas inlet, co2 canister, apl valve Reservoir bag

Reservoir bag Made of what Neck is what Tail is what

Neoprene or rubber 22 mm female fitting into male system End opposite neck

Reservoir bag | Functions 4

Accumulation of gas during exhalation Assist/control vent Visual/tactile monitor to see breathing Protects against excessive pressure

Breathing tubes Material 2 Size, what fits to machine Pt end is what

Plastic or rubber 22 mm female fits w machine T piece 22 mm male 15 mm female coaxial fit

Breathing tubes | Functions 4

Reservoir, flexible, lightweight connection, low resistance

APL valve Releases gas where Clockwise does what Provides control of what in system, where gauge is

Scavenge or atmosphere exhaust port Closes valve and increases pressure Pressure, on absorber

Apl valve: spontaneous resp- Valve should be what What for assist vent Mechanical vent

Spont: fully open, partially closed only if reservoir bag collapses Assist: partially open, bag squeeze on ins Mech: valve closed

Peak airway inspiratory pressure

15-20 mmhg

If unidirectional valve working properly only dead space in circle system is where

Between y piece and patient

Adding extensions where increases dead space

Beyond y piece near pt

Circle system must follow rules: Unidirectional valves between what on what FGF cant enter system where APL cant be located where

Pt and reservoir bag on ins and exp limbs Between exp valve and pt Pt and ins valve

``` Semi open circle system When used What doesnt occur What it requires No conservation of what APL is ```

``` Not often, for sedation Rebreathing High flow of gas, 10-15 to eliminate re breathing Gases and heat All the way open ```

``` Semi closed circle system __ __ breathing system Requires what kind of flow rate ___ heat and gas Some __ __ of agents Apl valve what ```

``` Most common Low flow rate, 1-3 lpm Conserves Re breathing Partially closed, can be adjusted ```

``` Closed circle system Where its used Inflow gas matches what Rebreathing is what Conservation is what Apl valve is ```

``` 3rd world countries Metabolic needs of pt Total rebreathing after co2 absorbed Total of exhaled gases Closed ```

O2 consumption how to calculate

10 x kg ^3/4

Advantages circle system

Stability of inspired gases, conserves moisture and heat, prevents or pollution, can be used for closed system anesthesia, can be used w low flows w no rebreathing co2, economy of anesthetics and gases, can scavenge waste gases

Disadvantages circle system

Complex, 10 connections (leak potential), malpractice claims, potential malfunctioning valves, increased resistance of breathing, less portable than mapleson

Circle system leak test, how to

Set gas flows to zero, occlude y piece, close apl, pressurize circuit to 30 cm h20 using flush valve, make sure p holds 10 seconds, listen for sustained pressure alarm, open apple valve and make sure pressure decreases

Circle leak test doesnt do what

Assess integrity of unidirectional valves

Circle system test: flow test

Attach breathing bag to y piece, turn on vent, assess integrity of unidirectional valves

Do which circle system check every case

Flow test

Anesthesia Systems Flashcards

(54 cards)