Gas Machine Flashcards
(88 cards)
1
Q
Two Types of Gas Machines are
A
GE - Datex
North American Drager
2
Q
Two forces (2 factors) necessary to operate AGM
A
Gas -> Pressure {The entire machine is is pressurized with 100% O2}
Electricity -> Power
Battery will only last 2-3 hours
3
Q
Why do we pressurize the machine with O2
A
We use O2 instead of any other gas in case of any malfunction, the parent doesn’t become too hypoxic (all the other gases depend on the flow of O2 for delivery, if O2 supply stops (the main driving source), all the delivery of the other gases stop.
4
Q
High Pressure system range is
A
750-2000 PSI
5
Q
PSI
A
Pounds per square inch
6
Q
what is the size of cylinder used on AGM?
A
e-cylinder
7
Q
when do you turn on your cylinders?
A
EMERGENCY
8
Q
pressure in a full O2 tank
A
2000 PSI
9
Q
half tank of O2
A
1000 PSI
10
Q
full tank of Nitrous Oxide
A
750 PSI
11
Q
half full tank of Nitrous Oxide
A
750 PSI
12
Q
Intermediate pressure system
A
50 PSI
Hospital System
13
Q
Why do we use low pressures for patients?
A
decrease risk of barotrauma
decrease risk of equipment damage
14
Q
Low pressure is at what level?
A
<40 psi
15
Q
Pressure is measured how (3 types)
A
PSI
cmH20
torr
16
Q
volume is measured how (2 types)
A
L/min
mL/min
17
Q
Body of the tank
A
colored portion of tank tells what is in the tank
Except for aluminum tanks (can go the MRI)
made of heavy metals and allows to withstand high pressures
18
Q
Valve
A
top of the tank
two parts the port and the stem
19
Q
Port (part of the valve)
A
Larger hole where gas exits tank to machine
20
Q
Stem (part of the valve)
A
the extension that opens and closes the valve
Turn 1/4 turn to open or close
21
Q
Pressure relief valve
A
smaller hole on the opposite side of the port
Relieves excess pressure if overfilled or when overheated
22
Q
Conical depression
A
located above pressure relief device
A depression where the retaining screw of the AGM secures the tank to machine
ENSURES TIGHT SEAL TO PREVENT LEAKS
23
Q
NISS
A
noninterchangeable safety system (NISS)
fail safe devices
prevents delivery of a hypoxic gas mixture
24
Q
PISS
A
pin index safety system (PISS)
*used ONLY for E-cylinders
Holes located on the cylinder valve below the outlet port
- unique configuration for each type of gas tank
- prevents the wrong type of tank from engaging with the wrong yoke
25
Coloring system
Different colored tanks indicates what type of gas is in each tank
26
Color of each gas O2, Nitrous Oxide, Air
O2- Green
Nitrous Oxide - Blue
Air - Yellow
27
How to store O2 tanks
upright in the cart
dont place in the bed on the side rail
place under the transportation cart
28
Yoke
Where all high pressure gases ENTER the AGM
***HIGH PRESSURE***
Houses the cylinders
Forms tight seal
Promotes unidirectional flow of gas
3 ports on each AGM
29
Nipple
part of the yoke
***High Pressure***
Engages with PORT of E-cylinder
Make sure you pale the plastic asher on the nipple to minimize leaks
30
Filter
INSIDE the Nipple
Filters out the particles
31
Parts of the HIGH PRESSURE SYSTEM
yoke, nipple, filter, cylinder gage
32
Intermediate pressure supply
50 PSI
33
Central Supply System
Intermediate
Small facilities utilize this system
Cost effective
Utilizes large cylinders (H-type) in several banks
34
Bulk Supply
utilized in large facilities
higher yield
O2 is gas at room temperature, must be cooled to -297 F to turn to liquid
**small volume of liquid yields large amount of gas
35
Air compressors
located on roof
filters out water - dry air is given to prevent mechanical/machine damage
filters ***Water**Smog**CO2**Dirt Particles***
36
Piping
coper pipes in facility walls
37
size of copper pipes
O2- (smaller) 1/4 diameter
N02 - larger- 1/2 diameter
***SAFTY SYSTEM***
38
Shut of safety valve on pipes
located in every OR
| Turn valve 1/4 turn clockwise
39
Terminal Units
phrase used to when talking about the pipelines and the end point for each gas
Each OR is a Terminal Unit
Every Terminal unit has a shut off valve
40
DISS
Diameter Index System (Diss)
Connections to wall or ceiling supply have different diameters to prevent improper connections of gases
41
How to calcite how long your cylinder will last
PSIG x 0.3
---------------
L/min x 60
42
How to make you cylinder last longer
decrease the the O2 flow to little as possible
AND
Hand ventilate (O2 is the driving gas in the ventilator)
43
Gas Flow in a HIGH PRESSURE
Cylinder -> Nipple/filter-> cylinder gauge -> cylinder regulator
44
What changes the high pressure to a low pressure
Cylinder Regulator
45
What to check in the AM
Cylinder gage pressure, wall pressure, oxygen sensory, suction on your scalage,
46
Cylinder check
prevents the back flow of gases
| gas should go to the patient
47
Fas flow of the Intermediate Pressure supply
piperine -> pipeline gage -> pipline relief valve -> NO2 pressure shut off valve -> secondary regulator ->
48
Why not leave the cylinders pressure on?
If the pressure in the hospital ever drops than the extra pressure form the cylinder will fill in for the pipeline and deplete the tank leaving you in trouble if their is an emergency
49
Where can pressure go even if the power is turned off? (3 places)
```
#1 Side arm flowmeter
#2 Oxygen Flush Button
#3 The power button
```
50
What switches the pressure from a intermediate to low pressure
Secondary Regulator pressure goes from 50 psi to a 30 psi
51
What is the N2O circuit valve
when O2 pressure drops the N20 valve turns off.
***FAIL SAFETY SYSTEM***
Prevents hypoxia
There must be pressure in the O2 circuit to keep the N20 shut off valve open and enable flow of N20.
52
What kind of tube is a flowmeter?
Thorpe Tube
53
What is a Thorpe Tube
Tapered, lower at the bottom, and larger at the top
The diameter of the Thorpe tube is called the ANNULAR
{Higher gas flow at higher liter demands}
The diameter increases at higher flow rates
54
O2 Knob is different how
* Fluted
* Color
* Diameter (larger)
* ALWAYS ON the RIGHT
55
N2) knob details
* Knurled
* Color - Blue
* Smaller than O2
* not on the right
56
Link-25 ??
GE has a failsafe system.
The O2 and N2O knobs are linked together physically.
Prevents hypoxic gas mixture, keeps N2O to O2 at a 3:1 ratio
57
Where do all the gasses mix together
Common gas manifold (LOW PRESSURE SYSTEM)
58
What is a vapor pressure
The pressure a volatile agent generate when it vaporizes in a closed container/system
59
If a more volatile agent has a higher or lower vapor pressure
HIGHER vapor pressure
60
If the agent is volatile than it needs a higher or lower temp.
higher temp
61
What agent is the most volatile
Des
62
What is the most important component of vaporization?
TEMPERATURE
63
carrier gas properties
passing a carrier gas over the liquid decreases the vapor pressure, cooling the liquid
64
What do we have the biggest control over when talking about the gasses
We control the flow rate of carrier gas
65
an increased carrier gas temperature will carry more or less gas??? AND how can you compensate?
MORE…. you can decrease the flow of the carrier gas
66
a decreased carrier gas temperature will carry more or less gas??? AND how can you compensate?
Less…. you can increase the flow of the carrier gas
67
Vaporizer has what kind of safety device in it
Bi-metallic strip
68
In high temperature what will the bimetallic strip do?
Reduced the flow of carrier gas to maintain set concentration by EXPANDING
69
In low temperature what will the bimetallic strip do?
Increases flow of the carrier gas to maintain set concentration by CONTRACTING
70
Does the Des have a bi-metalic strip?
NO.. it has an exterior heater
71
What gas can be filed during surgery?
DES
72
What is the last part of the machine before entering the breathing system
Common Gas Outlet
73
anything downstream from the ________ is in direct contact with the patient
Common gas outlet
74
Inspiratory Limb
The common gas outlet enter the patient circuit, also known as a circle breathing system via the fresh gas outlet
75
Where doest the gas enter the breathing system?
Fresh gas inlet
76
The inspiratory Valve opens when?
Inspiration
Opens when you squeeze the bag to deliver a breath
Opens when the ventilator delivers a mechanical breath (bellow pushes down)
CLOSES ON EXPIRATION
77
What is on the inspiration limb?
Humidifier -> Oxygen senor (check prior to case) -> Mass spectrometry
78
Gas passes what on the expiratory limb?
airway pressure valve -> expiratory valve->
79
Expiratory Limb opens when
opens upon patient expiration
opens when you release pressure on the bag
open when the ventilator bellow go up
Closes on Inspiration
80
Mechanical unidirectional valves
ensure that the gasses only flow one-way through circuit
81
highest point of resistant on the breathing system is
the unidirectional valve
82
Absober does what
the gas enters from the top of the canister to the bottom.
When the ventilator bellow or piston delivers a breath (pushes down) OR you manually squeeze the bag,
*****you are delivering exhaled CO2 gases through the absorber and to the inspiratory limb of the patient******
83
Absorber system
pulls CO2 out of exhaled gas mixture
Flow enters from the top and flows through absorbent, exiting from the bottom
84
Wall effect
There is more space in between the canister walls and the granules vs. the space in between the granules
*GOOD THING* Allows you to visualize whether the absorber is exhausted or not because the granules on the outside
85
Absorbent compensation...
BASE
| NaOH, KOH, CaOH (Hydroxides)
86
Chemical reaction in the absorbents
CO2 + H20 =H2CO3 (carbonic acid)
H2CO3 + NaOH, CaOH, KOH (hydroxides)
CaCO3 (carbonates) + HEAT + H20
87
What makes the granules purple?
CO2 reacts with hydroxides and water in absorbent to produce HEAT, WATER, and CARBONATES, with resulting color change from WHITE to PURPLE
88
Issue with absorbent (Soda Lime & Sodasorb)
If canister is not changed at end of case and sits there overnight, it can change back to WHITE!
Increasing CO2 in body (looks like MH)
* Increase ETCO2
* flushed
* tachycardia
* sweating
* vasodilation
