SIM Lab - 2

Question 1

This receives waste from gas from the AGM (APL) and the ventilator

Answer 1

Scavenging / Disposal system

Question 2

____ _____ vent has built in positive and negative pressure release valves

Answer 2

piston driven

Question 3

How to respond to sustained high pressure breathing circuit?

Answer 3

switch to bag mode or manual ventilation, try manyally ventilating the patient, assess and treat patient related causes

Question 4

The ventilator relief valve is ____ during expiratory phase

Answer 4

Open

Question 5

SOAP ME

Answer 5

Suction, oxygen, airway, Pressure, Medications, Extra Equipment

Question 6

Leaks in bellows may dilute gas with driving gas and cause what two things

Answer 6

Hypoxia and loss of agent

Question 7

This mode of ventilation DETECTS inspiration and augments spontaneous breath by adding preset pressure during inspiration, can also provide PEEP, good for patients breathing spontaneously during anesthesia

Answer 7

PSV Pressure support Ventilation

Question 8

Advantages of Piston Driven Vent

Answer 8

Quiet, no extra peep, precision of tidal volume, compliance testing completed on closed circuit and calibrates to how much additional volume must be added to eah breath to deliver set volume, fresh gas decoupling

Question 9

This mode of ventilation is good for patients capable of spontaneous ventilation who are at risk for apnea or inadequate spontaneous efforts

Answer 9

SIMV

Question 10

Surge of oxygen of 600-1200 ml/s is administered by pressing what?

Answer 10

02 Flush valve (panic button)

Question 11

This kind of bellows is rises during the expiratory phase, safer, will not fill if a total disconnection occurs

Answer 11

Ascending (standing)

Question 12

Study notes

Answer 12

on basic anesthesia design

Question 13

Ventilator relief valve has a little inherent PEEP of __to ___ cmh20

Answer 13

2 to 3

Question 14

Delivers a constant tidal volume with each breath, pressure will vary with changes in lung compliance and resistance

Answer 14

Volume controlled Ventilation

Question 15

How to avoid waste gas exposure

Answer 15

Good mask fit, avoid unscavengable techniques (insufflation), prevent flow from breathing system into room air, only turn on agent and nitrous oxide after mask is on face, turn the gas off before suctioning, washout anesthetic at the end of the case, don’t spill the liquid agent, use low flows, use cuffed ETT when possible, check the machine regularly for leaks, disconnect mitrous oxide pipeline connection at wall at the day’s end, or use total intravenous IV anesthesia

Question 16

Excessive or high pressure mauy arise from what two things?

Answer 16

Incorrect ventilator setting OR ventilator malfunction

Question 17

VCV or PCV ventilation breaths are provided at the present respiratory rate. Spontaneous efforts can trigger these breaths and spontaneous breaths that exceed the preset trigger PSV breaths

Answer 17

SIMV

Question 18

Does a piston driven machine require a drive gas?

Answer 18

NO

Question 19

If pressure is relieved after removing ventilator from system what is the conclusion?

Answer 19

Ventilator relief valve is malfunctioning and the vent must be removed from service and repaired

Question 20

What prevents buildup up of volume and pressure within the breathing circuit?

Answer 20

Ventilator Relief Valve

Question 21

Delivers a constant inspiratroy pressure with each breath, volume will vary with changes in lung compliance and resistance, and would be used for patients with respiratory distress syndrome requiring increased inspiratroy pressures

Answer 21

Pressure controlled ventilatioin

Question 22

Ventilator fresh gas relief valve is _______ during inspiration

Answer 22

closed

Question 23

Fresh gas flow from the ____ _____ outlet will contribute to the tidal volume delivered to the tpatient

Answer 23

common gas

Question 24

PALMS

Answer 24

Positive pressure, Airway, Laryngospasm medications, monitors, suction

Question 25

critical incident related to ventilators

Answer 25

Fire in breathing circuit and would be treated same as for airway fire

Question 26

Bellows machine are ______ or _______ limited

Answer 26

volume or pressure

Question 27

This kind of bellows falls during expiration phase, weighted, will continue upward and downward despite patient disconnect, MUST have CO2/apnea alarm

Answer 27

Descending (hanging)

Question 28

What kind of vent uses electric motor to compress the gas in a rigid piston during the inspiratory phase or respiration?

Answer 28

Piston Driven Ventilator

Question 29

This valve directs gas flow during inspiration to the manual breathing bag, which remains in circuit during mechanical ventiliation and is not added to the delivered tidal volume

Answer 29

Fresh Gas Decoupler

Question 30

breathing circuit compliance, compression losses, gas sampling are all sources of _____ _____

Answer 30

system leaks

Question 31

If PIP is 20 cm H20 about _____ ml of set tidal volume is lost to the expanding circuit

Answer 31

100

Question 32

What kind of vent has a multi-mode, manual/spontaneous, VCV, PCV, SIMV (with or without PSV)

Answer 32

Modern Gas Driven Bellows Vent

Question 33

If apnea occurs during _______ ventilation, conisder changing to controlled or mixed mode of ventilation

Answer 33

PSV Pressure support Ventilation

Question 34

Force of compressed gas (air or 02) as driving mechanism to compress what?

Answer 34

Bellows

Question 35

During early expiration, a _____ within the ventilator relief valve holds the pathway _______ until the bellows have filled

Answer 35

Weight and closed

Question 36

Disadvantages of piston driven vent

Answer 36

loss of visibility (no bellows), quiet, does not easily accommodate non-rebreathing systems, potential for NEEP, potential to dilute patietn's inspired gas concentration with room air

Question 37

When you have sustained high pressure during manual ventilation you would check what?

Answer 37

Is the scavenger obstructed, scavenger relief valves have failed, disconnect scavenging system if possible, use ambu bag to ventilate

Question 38

During _______ phase, driving gas closes the ventilator relief valve, preventing gas within the bellow exiting to the scavenger

Answer 38

Inspiratory

Question 39

Modern gas driven bellows have a _____ _______

Answer 39

Double circuit

Question 40

Do piston drive machines have inherent PEEP?

Answer 40

NO

Question 41

Use 02 flush valve (panic button) during _________ cycle fo ventilation

Answer 41

expiratory