Scavenging System Flashcards

1
Q

What is scavenging?

A
  • collection of excess gases from equipment used in administering anesthesia, or exhaled by patients
  • removal of these excess gases to an appropriate place of discharge outside the working environment
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2
Q

How does a scavenger decide what remove?

A
  • the scavenger maintains constant pressure in breathing circuit
  • removed FGF - volume lost in patient’s O2 consumption
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3
Q

What is the OSHA recommended Level for volatile halogenated anesthetic alone?

A

2ppm

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4
Q

What is the OSHA recommended Level for nitrous oxide alone?

A

25 ppm

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5
Q

What is the OSHA recommended Level for volatile halogenated anesthetic with nitrous oxide?

A

Less than or equal to 0.5 ppm and 25ppm respectively

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6
Q

How does nitrous oxide affect the concentration of an anesthetic in the blood stream?

A
  • second gas effect
  • small molecule
  • increase soluability coeffient
  • higher saturation
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7
Q

What are determinants of exposure to waste gases

A
  • amount of OR ventilation and air turnover
  • functional status of anesthesia equipment (machine check/circuit check)
  • good fitting mask
  • present FGF from entering atmosphere
  • turn off anesthetic gas before suctioning patient
  • evacuate anesthetic gases into scavenger at end of case
  • cuffed/uncuffed ETT (uncuffed lets air escape up)
  • integrity of equipment (leaks present)
  • TIVA
  • avoid N2O
  • high FGF can flush more volume into air
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8
Q

What are the five basic components of a scavenging system

A
  • gas collection assembly
  • transfer means
  • scavenging interface
  • gas disposal tubing
  • gas disposal assembly
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9
Q

Describe the Gas collection Assembly

A
  • output usually 30mm male-fitting connection
  • captures excess gases at the site of emission (breathing)
  • site include: APL valve during spontaneous ventilation, spill valve in mechanical ventilation
  • delivers the gas to the transfer means tubing
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10
Q

Describe the Transfer Means tubing

A
  • aka exhaust tubing or hose and transfer system
  • conveys ga to collection assembly to interface
  • usually a made of short, fat (large diameter) tubing with female connector
  • designed to carry high flow without increase in pressure
  • yellow color; stiffer plastic than breathing tube
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11
Q

Describe the Scavenging Interface

A
  • aka balancing device and balancing valve
  • most critical component of the scavenging system
  • 30mm male connector
  • should be situated as close as possible to the gas-collecting assembly
  • 2 types (open/closed)
  • 3 elements (positive pressure relief, negative pressure relief, and reservoir capacity)
  • prevents pressure increases and decreases to be transmitted to breathing system
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12
Q

What happens when the scavenger removes too much gas from the system?

A
  • creates a negative pressure system or a vacuum in the circuit
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13
Q

What happens when the scavenger does not remove enough gas from the system

A
  • there is too much pressure in the system and could lead to barotrauma
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14
Q

What is an open scavenging interface

A
  • this means it is “open” to the atmosphere via “relief ports” in reservoir, avoiding buildup of positive or negative pressure
  • removes risk of barotrauma or vacuum creation in breathing circuit
  • utilizes reservoir (open canister) and central vacuum (literally vacuum)
  • gas enters the system at the top of the canister and travels through a narrow inner tube to the base
  • vacuum control valve can be adjusted to the level of suction on the canister/reservoir (must be equal to or greater than the excess gas flow rate to prevent OR pollution)
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15
Q

In an open system too much suction from the vacuum results in what?

A

Entrains room air into scavenger

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16
Q

In an open system too little suction from the vacuum results in what?

A

Scavenged gas into the OR

17
Q

What is a closed system interface?

A

-
Two types:
- positive pressure relief only
-negative pressure relief and positive pressure relief

18
Q

Closed System with positive pressure relief only

A
  • single positive: pressure relief valve opens when a max pressure is reached
  • passive disposal: no vacuum used; no reservoir bag needed
19
Q

Closed System with positive and negative pressure relief

A
  • has positive pressure relief valve, and negative pressure relief valve and a reservoir bag
  • used with an active disposal system (vacuum control valve adjusted two that the reservoir bag is not over distended or completely deflated)
  • gas is vented to the atmosphere if the system pressure exceeds 5cm H2O
  • room air is entrained if the system pressure is less than -0.5cm H2O
  • a backup negative pressure relief valve opens at -1.8cm H2O if the primary negative pressure relief valve becomes occluded
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Q

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