Equipment and monitors

Question 1

What components make up the high pressure system

Answer 1

Hanger yoke
yoke block with check valves
cylinder pressure gauge
cylinder pressure regulators

Question 2

What components make up the intermediate pressure system

Answer 2

pipeline inlets
pressure gauges
oxygen pressure failure device
oxygen second stage regulator
oxygen flush valve
ventilator power inlet
flowmeter valves

Question 3

Where does the high pressure system begin and end?

Answer 3

begins at the cylinder and ends at the cylinder regulators

Question 4

Where does the intermediate pressure system begin and end

Answer 4

Begins at the pipeline and ends at the flowmeter valves

Question 5

What components make up the low pressure system?

Answer 5

Flowmeter tubes (thorpe tubes)
vaporizers
Check valve
Common gas outlet

Question 6

Where does the low pressure system begin and end?

Answer 6

Begins at the flowmeter tubes and ends at the common gas outlet

Question 7

How is a low-pressure leak test performed and what pressure must be generated to perform this test? What needs to be off?

Answer 7

Attatch a bulb to the common gas outlet and create a negative pressure of -65cmH20
Ventilator, vaporizers, and FGF must be off. Machines with minimum FGF must also be turned off

Question 8

How long is the cutoff for the low-pressure test to fail?

Answer 8

If the bulb refills in less than 10 seconds the machine failed the test

Question 9

Low-pressure leak test should be repeated with what components turned “on”

Answer 9

Test is performed with vaporizers off first, then repeated with each vaporizer turned on

Question 10

What pressure should be achieved for the high-pressure leak test?

Answer 10

30 cmH20

Question 11

During a high-pressure leak test on a machine WITH a check valve, what components of the low pressure system are assessed?

Answer 11

WITH check valve the test assesses the breathing circuit and low-pressure system up to the check valve

Would include common gas outlet

Question 12

If the machine does NOT have a check valve what does the high-pressure leak test assess?

Answer 12

The entire low pressure system and the breathing circuit

Question 13

Low-pressure leak test assesses what components of the machine?

Answer 13

integrity of the low-pressure circuit from the flowmeter valves to the common gas outlet

Question 14

What are the 5 tasks of oxygen according to the SPDD model?

Answer 14

1. O2 pressure failure alarm
2. O2 pressure failure device
3. O2 flowmeter
4. O2 flush valve
5. Ventilator drive gas

Question 15

What makes up the supply of the anesthesia machine

Answer 15

Pipeline to back of anesthesia machine

Question 16

What component(s) is the processing part of anesthesia machine

Answer 16

Inside machine up to the common gas outlet

vaporizers, flowmeters, o2 flush, flowmeters,

Question 17

What makes up the delivery components

Answer 17

Breathing circuit

Question 18

Disposal system

Answer 18

scavenger

Question 19

Name the PISS configuration for O2, air, and N2O

Answer 19

O2 = 2,5
Air= 1,5
N20= 3,5

Question 20

O2 cylinder pressure drops to what pressure if it enters the intermediate system? what is the purpose of this?

Answer 20

Drops from 1900 to 45psi, helps ensure preferential pulling of pipeline gases if a cylinder is left open

Question 21

How could PISS be bypassed?

Answer 21

More than one washer between the hanger yoke and stem of the tank

Question 22

Diss system prevents misconnections of

Answer 22

gas hoses

Question 23

What is the ONLY way to know what contents are inside a cylinder

Answer 23

Its LABEL!!! NOT its color

Question 24

WHO colors for air, O2 and nitrous oxide

Answer 24

Air = black and white
O2 = white
Nitrous oxide= blue

Question 25

What is the critical temperature of O2

Answer 25

-119C

Question 26

What pressure is an oxygen tank full and how many liters does this mean are in the tank?

Answer 26

1900psi 660L

Question 27

Why is nitrous oxide liquid inside a cylinder

Answer 27

Its critical temperature is 36.5 and is above room temperature

Question 28

What is critical temperature of a gas?

Answer 28

the highest temperature that a gas can exist as a liquid. In other words, any temperature above which a gas cannot be liquified regardless of the pressure applied to it.

Question 29

CO2 is similar to nitrous oxide. What is its maximum volume and what is its service pressure

Answer 29

1590L and 838psi

Question 30

At what pressure should Nitrous oxide be changed

Answer 30

As soon as it falls below 745

Question 31

what is the maximum volume of a nitrous cylinder? What is the volume when the pressure falls to 400 and how much nitrous is remaining?

Answer 31

max volume= 1590 At 400psi no liquid is left and the volume remaining is only 136L

Question 32

What is the most delicate part of a cylinder?

Answer 32

Cylinder valve

Question 33

What do you do if you open a cylinder and hear a hissing sound?

Answer 33

First- tighten connection second- replace washer (gasket) between cylinder and hanger yoke assembly third- use a different cylinder

Question 34

If you lack a replacement cylinder for a gas what must you do?

Answer 34

insert a yoke plug. This is a backup plan in case the check valve fails. If the check valve fails and there is no yoke plug the gas will exit the anesthesia machine instead of going to the patient

Question 35

How can you identify an MRI safe cylinder?

Answer 35

Two colors, most of the tank will be silver. The top of the color signifies the gas it cntains. But you also must read the label

Question 36

What makes up the fire triad?

Answer 36

Oxidizer, fuel, igniter

Question 37

What temps increase risk of fire/explosion

Answer 37

130F or 57C

Question 38

Examples of safety relief valves that prevent explosion in the event of a fire. These valves allow the cylinder to release contents in a slow and controlled way

Answer 38

-Fusible plug that melts at elevated temps (Bismuth, lead, tin, cadmium -BLT w/Cheese) -A valve that opens at elevated pressures -A frangible disk that ruptures under pressure

Question 39

Sets the standards for the required components of the anesthesia machine. standards document ends in F1850.

Answer 39

American society for Testing and Materials (ASTM)

Question 40

This organization created the macine pre-use checkout procedures

Answer 40

FDA 1993

Question 41

Set the occupational exposure standards for volatile anesthetics

Answer 41

OSHA

Question 42

set standards for compressed gas cylinders

Answer 42

United states department of Transportation

Question 43

What pressure (above service pressure) is tested on cylinders?

Answer 43

1.66x | 1900 x 1.66 =3,154

Question 44

how often must cylinders be tested?

Answer 44

every 5 years

Question 45

What 7 things must be included on a cylinder label according to the USDOT

Answer 45

1. Govt agency 2. type of metal used to make cylinder 3. maximum filling pressure 4. serial number 5. manufacturer 6. owner 7. date of last inspection

Question 46

What are the two components of the oxygen pressure failure device

Answer 46

1. a threshold alarm that sounds when the O2 pipeline pressure falls below 28-30psi 2. a pneumatic device that reduces or stops the flow of nitrous when the pressure in the oxygen pipline falls below 20psi

Question 47

The o2 pressure failure device will warn you of the following:

Answer 47

depleted O2 tank, a drop in pipeline pressure, or a disconnected O2 hose

Question 48

What is the only gas that passes directly from its source to its flow valve at the flowmeter?

Answer 48

Oxygen

Question 49

Some mahines do not require air to pass through a failsafe valve, what does this allow?

Answer 49

patient to be ventilated with air if O2 is not available

Question 50

# Oxygen pressure failure devices This machine proportionately decreases nitrous flow as O2 pressure decreases and only stops nitrous when O2 pressure is extremely low

Answer 50

Drager

Question 51

# Oxygen pressure failure devices This machine will completely stop Nitrous oxide if O2 pressure is <20psi

Answer 51

GE Datex-Ohmeda "all or nothing response"

Question 52

How can you tell if the O2 pressure failure device is working ?

Answer 52

1. O2 and N2O on 2. turn off O2 cylinder and disconnect O2 pipeline 3. Observe meters, the Nitrous oxide flow should stop jsut before the O2 flow stops 4. re-introducing O2 supply to the machine should restore both gases to their previous flow rates

Question 53

What are two circumstances where a machine could still deliver a hypoxic mixture?

Answer 53

1. pipeline crossover (its the pressure NOT the concentration 2. flowmeter leak (upstream of the failure device)

Question 54

The hypoxia prevention safety device will limit nitrous oxide flow to ____ times oxygen flow

Answer 54

3

Question 55

GE Datex-Ohmeda utilizes what type of hypoxic prevention device?

Answer 55

Link 25 system

Question 57

This hypoxia prevention safety device incorporates a second-stage regulator for oxygen and nitrous oxide. If you adjust the nitrous too high a gear will engage that will automatically increase O2 flow. O2 and Nitrous are connected mechanically.

Answer 57

Link 25 system

Question 58

Oxygen ration monitor controller is utilized by what type of machine?

Answer 58

Drager

Question 59

This hypoxia prevention safety device connects O2 and and nitrous pneumatically. If O2 is adjusted in a way that would create a hypoxic mixture, the supply of nitrous will be reduced to maintain a 3:1 ratio.

Answer 59

Oxygen ratio monitor controller

Question 60

what circumstances prevent a hypoxia prevention safety device from preventing a hypoxic mixture ?

Answer 60

1. oxygen pipeline crossover 2. Leaks distal to flowmeter valves 3. administration of 3rd gas (helium) 4. Defective pneumatic or mechanical components

Question 61

What flowmeter is read at the middle?

Answer 61

Ball

Question 62

What types of flowmeter are read at the top of the float?

Answer 62

Skirted, plumb bob and nonrotating floats

Question 63

Oxygen flowmeters are always _ in the sequence of flowmeters. In the US this is furthest to the ___.

Answer 63

Last ; Right

Question 64

What type of flow corresponds to the following Reynold's number and what law applies to the flow * Re <2000 * Re >4000 * Re 2000-4000

Answer 64

* Re <2000: laminar (viscosity) Poiseuille law * Re >4000 Turbulent flow (density) Graham's law * Re 2000-4000 transitional

Question 65

At high flow annular space is ____

Answer 65

Orificial

Question 66

At low-flow annular space is ____

Answer 66

laminar

Question 67

What is the most delicate part of an anesthesia machine?

Answer 67

Flowmeter (made of glass)

Question 68

Air flow at 1L/min and O2 at 3L/min calculate the FiO2 in %

Answer 68

80%

Question 69

What is the max FiO2 delivered by a NC and at what flow rate is this achieved?

Answer 69

6L and 44%

Question 70

1L/min of O2 by NC delivers what FiO2

Answer 70

24%

Question 71

Starting at 1L and 24% you can add ____ % FiO2 for every 1L increase in flow when calculating FiO2 by nasal cannula

Answer 71

4

Question 72

In machines with coupled FGF and Vt what will happen if you increase FGF

Answer 72

Vt, minute ventilation, PiP would all increase and EtCO2 would decrease | Decreasing FGF will do the oposite

Question 73

In machines with coupled FGF what vent changes will increase delivered Vt?

Answer 73

Decreased RR, Increased IE ratio (from 1:2 to 1:1), Increased FGF, Increased bellows height | Changes that decrease delivered Vt are the opposite of above

Question 74

Compliance =

Answer 74

Change in Volume Divided by Change in pressure

Question 74

turning the dial on the vaporizer determines the ____ ratio

Answer 74

splitting

Question 75

What are inside the vaporizer to ensure the air entering the vaporizer becomes 100% saturated

Answer 75

Wicks and baffles

Question 76

1 ml of anesthetic liquid can produce how much anesthetic vapor?

Answer 76

200ml

Question 77

Flows less than ____ ml/min or greater than ____ L/min can reduce vaporizer output

Answer 77

200ml/min and 15L/min

Question 78

This term refers to the number of calories needed to convert 1g of liquid into vapor without a change in temperature

Answer 78

latent heat of vaporization

Question 79

what component of a vaporizer ensures consistent output across a wide range of temperatures?

Answer 79

Temperature compensating valve

Question 80

What two scenarios are likely to cause the pumping effect?

Answer 80

PPV and O2 flush valve

Question 81

Most common cause of a vaporizer leak

Answer 81

Loose filler cap

Question 82

Most common cause of a leak in the low-pressure system

Answer 82

internal leak in the vaporizer

Question 83

What is the formula to determine how long your agent will last based on ml/hr

Answer 83

vol% x FGF (L/min) x 3

Question 84

What do you do if you tip a vaporizer

Answer 84

Run high FGF for 20-30min with dial turned to the highest setting

Question 85

What is the pressure and temp of a tec 6 Des vaporizer?

Answer 85

39C and 2 atm