Exam 1: Lecture 3: Anesthesia Machine Flashcards by Matthew Irvin

What is letter A

Oxygen cylinder

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What is letter B

Cylinder Valve

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What is letter C

Cylinder Pressure gauge

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What is letter D

Regulator (or reduction valve)

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What does letters A,B,C,D make up on the machine?

High pressure system

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What is letter G

Oxygen flush / bypass valve

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What system is made up by letter G on the machine

Intermediate pressure system

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What is letter E

Flow meter

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What is letter F

Vaporizer

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What is letter H

Common gas outlet

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What is letter I

common gas inlet

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What is letter J

one way valves
- inspiratory
- expiratory

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What is letter K

pop-off valve

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What letters do E, F, H, I, J , and K make up on the machine

Low pressure system

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What type of oxygen source is defined?

E, G and H cylinder
Usually 2 banks are connected to a common manifold that converts them into one continuous supply

Compressed gas in cylinders

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What type of oxygen source is defined?

Large liquid oxygen container installed at facilities that have fairly constant demand

Cryogenic liquid source

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What type of oxygen source is defined?

When oxygen is needed the O2 is drawn as required and passed through the heater to increase temperature and raise the pressure

Cryogenic liquid supply

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What type of machine increases O2 concentration by absorbing nitrogen onto a molecular sieve and allows O2 and trace gasses to pass through = resulting in an O2 concentration of 90-96%

Oxygen concentrator

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What type of oxygen source is this?
- compact, lightweight, reliable units and easy to transport
- can save money
- Maintenance required
- takes a few min to reach 96% concentration
- produces gas flow that would be acceptable for small animal anesthesia patients

Oxygen concentrator

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What part of the oxygen cylinder is labeled by the arrow on the top left corner?

neck

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What part of the oxygen cylinder is labeled by the arrow on the top right corner?

tapered screw threads, attached to valve

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What part of the oxygen cylinder is labeled at the bottom?

base

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What type of oxygen source can be made of steel, steel carbon fibers or aluminum
- filled and discharged through a value, the port is the point of exit
(protect port during transport, use seal washer(gasket) over nipple prior to attaching cylinder to yoke)
- handle or cylinder wrench used to open / close the cylinder valve

Oxygen cylinder

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What consequence could occur on a oxygen cylinder if you open the valve quickly (rapid compression of gas generates heat) = adiabatic process + dust, grease, etc.

flash fire or explosion
- Always open the valve slowly to avoid these

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In a Oxygen Cylinder labeled E, what is the capacity for storage?

660

In a Oxygen Cylinder labeled E, what is the pressure for storage?

2200

In a Oxygen Cylinder labeled H, what is the capacity for storage?

6900

In a Oxygen Cylinder labeled H, what is the pressure for storage?

2200

When should oxygen cylinder be inspected or tested

every 5 years - safety mechanisms to prevent connection of wrong gas

What color are oxygen tanks in the US?

Green

What color are oxygen tanks outside of the US?

white

What color is N2O gas tanks?

blue

What is this?

Pin Index Safety System (PISS)

What is this?

Diameter Index Safety System (DISS)

What is this?

Manufacturer-specific quick connector

What is labeled by the red arrow?

regulator

What is labeled by the green arrow?

cylinder pressure gauge

What is the role of the regulator on an anesthesia machine?

- reduces the gas pressure from the cylinder (or other sources) to a usable level of a constant 50 psi - specific for gas and tank size (E or H) - terminates in a gas specific male DISS fitting

What is the role of the Cylinder pressure gauge on an anesthesia machine?

- Must be installed downstream of each pressure regulator - Calibrated in psi - allows user to calculate remaining liters in tank or pipeline pressure

At what PSI should you replace the oxygen cylinder?

less than 500 PSI

How many liters of oxygen are left in this E tank?

1500 PSI

How many L are left in the following cylinder

2200 PSI / 660 PSI = 1500 PSI / XL = 2200 X = 1500 (660) = X = 990,000 / 2200 = X = 450 L

What part of the oxygen machine receives O2 from the pipeline inlet or cylinder pressure regulator and directs a high unmetered flow directly to the common gas outlet?

35 to 75 L/min activated = possible barotrauma, so NEVER use when connected to a non-rebreathing system

T/F: It is ok to open the oxygen flush valve when the patient is hooked up as long as the tank is being exchanged

FALSE!!! never open the flush valve when the patient is hooked up

What is this?

Oxygen flush valve

What is this?

Flow meter

What part of the oxygen machine - indicates rate of flow of gas passing through them - turn control knob counterclockwise to increase flow and clockwise to decrease flow

Flow meter

What direction do you turn the control knob on a flow meter to decrease output?

clockwise

What direction do you turn the control knob on a flow meter to increase output?

Counter clockwise

What should the flow meter be set to for reliable output?

500 - 2000 mL/min

Dont set the flow meter lower than _______ with a rebreathing system

0.5 L/min

What is the variable orifice flow indicator

tube is internally tapered (smallest diameter at bottom), so hight increases = more gas flow

How many L/min of oxygen is being delivered with this flow meter setting?

1.5 L/min

Where is the only place unidirectional valves are located and what is the purpose of these valves?

Only present on a rebreathing system - allows gases to only travel in one direction - inspiratory valve - expiratory valve

What are the disadvatages of unidirectional valves

increase resistance to breathing - if one of both valves are leaky the patient will rebreathe CO2

What device changes a liquid anesthetic agent into its vapor and adds a controlled amount of that vapor to the fresh gas flow going into the patient breathing system

vaporizer

Modern vaporizers share what following designs?

gas specific concentration calibrated variable bypass flow over vaporization method temperature controlled

What is this?

Unidirectional valves

What is this?

Vaporizer

Where are concentration calibrated vaporizers located on the oxygen machine?

Between the flowmeter and common gas outlet

How is vaporizer output controlled

dial / knob that is calibrated in volumes percent

how does the vaporizer dilutes the saturated vapor pressure by splitting the gas flow?

- bypass to the vaporizer outlet - vaporizing chamber

What is this?

Vaporizer

What will prevent the two vaporizers on machine turning on at the same time

interlock systems

If the vaporizer is tipped it should be flushed with high ______, flow rate for the max time recommended by manufacture

Ideally, vaporizer should be emptied prior to transport, left in upright position, and dial is set to what position

What color is a bottle of isoflurane anesthetic

purple

What color is sevoflurane anesthetic

yellow

What part of the machine receives all gasses and vapors from the machine and delivers the mixture to the breathing system

common / fresh gas inlet and outlet

What is this?

Common / fresh gas inlet

What is the reservoir bag used for in surgery

used to monitor the frequency of respiratory rate and compliance of patient's pulmonary system during assisted ventilation

What size reservior bag would you select for a 35 lb dog

B 35 lb =15.9 kg 16 kg x 10 mL/kg X 5 800 mL = 0.8 L

What part of the anesthesia machine is used to control the pressure in a breathing system - transiently close APL to deliver manual ventilation to patient - Otherwise must be kept open at all times

Adjustable pressure limiting (pop-off) valve

What must you remember about an adjustable pressure limiting (pop-off) valve

must be kept open at all times

What is this?

Adjustable pressure limiting (pop-off) valve

What are the top 3 killers for anesthesia machine

closed pop-off valve too little O2 too high vaporizer setting

What are some common safety concerns of a anesthesia machine

improper cylinder storage tipping over vaporizer wrong inhalent in vaporizer overfilling vaporizer O2 and N2O are flammable

Describe proper cylinder storage

- never in contact with the oils, grease, organic lubercants and rubber - valve kept close to prevent bleeding - store away from a heating duct - never drag, drop, slide or roll

What are the 7 steps to machine pressure check

- O2 on flow meter is off - Close pop off valve - Occlude the patient end of the Y piece - Press the O2 flush - Observe pressure gauge for 30 seconds - Release the APL valve - Remove occlusion from Y piece

What is labeled by the orange arrow?