Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Basics TL > Week 3 Handout > Flashcards

Week 3 Handout Flashcards

(90 cards)

Start Studying
1
Q

What is a Galvanic Fuel Cell – Oxygen Analyzer?

A

It is the last time the gas mixture gets checked before reaching the patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does a Galvanic Fuel Cell operate?

A

It functions via a chemical reaction between oxygen and an electrolyte within the cell, generating an electrical current proportional to the oxygen concentration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the advantages of a Galvanic Fuel Cell?

A

Long life (up to 2 years) and self-powered (does not require an external power source).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the disadvantages of a Galvanic Fuel Cell?

A

Slower response time compared to paramagnetic analyzers and requires regular calibration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is the Galvanic Fuel Cell commonly used?

A

In portable monitors and cost-sensitive settings, such as transport ventilators and backup anesthesia systems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a Paramagnetic Oxygen Analyzer?

A

It is based on the attraction of oxygen to a magnetic field, creating a detectable magnetic imbalance correlated to oxygen concentration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the advantages of a Paramagnetic Oxygen Analyzer?

A

Rapid response time and high accuracy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the disadvantages of a Paramagnetic Oxygen Analyzer?

A

Higher cost and requires external power.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is the Paramagnetic Oxygen Analyzer commonly used?

A

In high-end anesthesia workstations and ICU ventilators.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is an open circuit in anesthesia?

A

A non-rebreathing system where the patient breathes fresh gas directly from the source, and exhaled gases are vented into the atmosphere.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the advantages of open circuits in anesthesia?

A

Simplicity, rapid onset and offset, and low resistance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the disadvantages of open circuits in anesthesia?

A

Gas waste, poor control of gas concentrations, and OR pollution.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the four stages of anesthesia?

A

Stage I: Induction, Stage II: Excitement, Stage III: Surgical Anesthesia, Stage IV: Overdose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What occurs during Stage I of anesthesia?

A

Begins with initial administration of the anesthetic and ends at loss of consciousness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What occurs during Stage II of anesthesia?

A

Begins after loss of consciousness and ends at the onset of regular, automatic breathing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What occurs during Stage III of anesthesia?

A

Begins with the onset of regular respirations and is the target stage for surgical procedures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What occurs during Stage IV of anesthesia?

A

Begins with excessive anesthetic concentration beyond therapeutic range, leading to severe CNS depression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are Mapleson Circuits?

A

Non-rebreathing systems without CO₂ absorbers, categorized A–F based on component arrangement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the core mechanism of Fresh Gas Flow (FGF) in Mapleson Circuits?

A

High FGF flushes out CO₂ before the next breath, preventing rebreathing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the function of the reservoir bag in Mapleson Circuits?

A

Acts as a reservoir of gas during expiration, allowing the patient to draw in the next breath.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the key characteristics of Mapleson Circuits?

A

No CO₂ absorption, minimal resistance, and classified as semi-open.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Mapleson A (Magill’s Circuit) best for?

A

Spontaneous ventilation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Mapleson D (Bain Circuit) best for?

A

Controlled ventilation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the Pethick Test?

A

A test to check for leaks or disconnection in a Bain Circuit before use.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is Mapleson E (Ayres T-Piece)?
A very simple circuit with straight tubing, no reservoir bag or APL valve.
26
What is Mapleson F (Jackson-Rees Modification)?
A modified T-piece with an added reservoir bag, used for both spontaneous and assisted ventilation.
27
What is the purpose of a gas sample line?
Continuously samples gas from the patient’s breathing circuit for real-time feedback.
28
What is Fresh Gas Coupling (FGC)?
A feature where fresh gas flow contributes to the delivered tidal volume during mechanical ventilation.
29
What is the impact of FGF during inspiration?
If FGF enters the circuit during inspiration, it adds to the set VT, leading to potential over-ventilation.
30
How does the timing of FGF delivery affect ventilation?
The amount of volume added by FGF depends on when during the respiratory cycle the fresh gas is delivered. If delivered during inspiration, the patient receives more gas; if delivered during expiration, the impact is minimal.
31
What is a clinical implication of increased FGF?
Increased FGF leads to higher anesthetic agent delivery, potentially deepening anesthesia, especially relevant with volatile agents like sevoflurane or desflurane in non-decoupled machines.
32
What can happen if FGC is not accounted for?
The actual tidal volume (VT) delivered may exceed what was set, leading to hyperventilation, barotrauma, and inaccurate anesthetic delivery.
33
What is the formula for actual tidal volume?
Actual Tidal Volume = Set Tidal Volume + FGC Effect
34
How is FGC Effect calculated?
FGC Effect = FGF × Duration of Inspiration
35
What is an example calculation for FGC Effect?
Set VT = 500 mL, FGF = 2 L/min = 2000 mL/min, I:E ratio = 1:2, RR = 12 → total cycle = 5 sec → I-time = 1.67 sec = 0.028 min. ## Footnote FGC Effect = 2000 mL/min × 0.028 min = 56 mL
36
What are ascending bellows?
Ascending bellows fill from the bottom, moving upward during expiration, making it easy to visually monitor.
37
What is a clinical advantage of ascending bellows?
Preferred design due to its reliable leak detection and clear visual feedback.
38
What are descending bellows?
Descending bellows fill from the top, relying on gas weight and gravity, making leak detection unreliable.
39
What is a clinical risk associated with descending bellows?
Delayed recognition of disconnection, which could result in hypoventilation or apnea.
40
What are piston ventilators?
Piston ventilators are electrically powered, using a motor to drive a piston for precise control of breath delivery.
41
What are the advantages of piston ventilators?
They provide excellent control of small tidal volumes, reduce oxygen consumption, adjust based on lung compliance, and operate quietly.
42
What monitoring and safety features do piston ventilators have?
Built-in sensors track patient lung mechanics in real time, triggering alarms for disconnects, pressure issues, or ventilation mismatch.
43
What are piston ventilators ideal for?
Piston ventilators are ideal for pediatric cases needing small, accurate tidal volumes, low-flow or closed circuit anesthesia, and cases where driving gas conservation is important.
44
Why are piston ventilators considered highly reliable and safe?
They are highly reliable and safe due to electronic control and real-time feedback.
45
What is the positive pressure in piston ventilators?
Positive Pressure is approximately +75 cm H₂O, which indicates peak inspiratory support or flush valve activation.
46
What is the negative pressure in piston ventilators?
Negative Pressure is approximately -8 cm H₂O, which poses a risk of entraining room air, leading to gas dilution and potential patient awareness or inadequate anesthesia.
47
What characterizes the ventilator mode (Controlled Mode) for pistons?
In Controlled Mode, the piston delivers breaths, bypassing the reservoir bag, which may appear still or slightly inflated.
48
What happens in the spontaneous mode for pistons?
In spontaneous mode, the patient initiates their own breaths, and the bag fills with fresh gas and deflates with patient inspiration.
49
What are the five tasks of oxygen in the anesthesia machine?
1. Proceeds to the fresh gas flowmeter. 2. Powers the oxygen flush valve. 3. Activates the fail-safe mechanism. 4. Activates the low-pressure alarm. 5. Compresses the bellows of mechanical ventilators.
50
What is PIP (Peak Inspiratory Pressure)?
PIP is the maximum pressure during inhalation, with a goal to keep it under 35 cm H₂O, indicating airway resistance.
51
What is Pplat (Plateau Pressure)?
Pplat is the pressure in the alveoli after a pause with no airflow, with a goal to keep it under 30 cm H₂O, reflecting lung compliance.
52
What is PEEP (Positive End-Expiratory Pressure)?
PEEP maintains alveolar openness at end-exhalation, typically set between 5–15 cm H₂O, improving oxygenation and reducing atelectasis.
53
What is the driving pressure in ventilation?
Driving Pressure is calculated as PIP - PEEP or Pplat - PEEP, representing the pressure needed to inflate the lungs, with a goal to keep it under 15 cm H₂O to minimize lung injury.
54
What is a special note for unsecured airway during anesthesia?
Under anesthesia, the lower esophageal sphincter (LES) tone drops to ~12 cm H₂O. If PIP exceeds 12, there is a risk of gastric insufflation and aspiration.
55
What is spontaneous breathing?
Spontaneous breathing is when the patient initiates and completes the breath without assistance, reflecting intact respiratory drive.
56
What is assisted breathing?
Assisted breathing occurs when the patient initiates the breath, and the ventilator assists with added volume or pressure.
57
What is controlled breathing?
Controlled breathing is when the ventilator delivers all breaths with no input from the patient, necessary in deep anesthesia or critical illness.
58
What is Controlled Mandatory Ventilation (CMV)?
CMV maintains stable ventilation during deep anesthesia or respiratory failure, where the patient cannot initiate breaths.
59
What are the considerations for CMV?
CMV requires close monitoring to avoid hypo-/hyperventilation and barotrauma, and sedation or paralysis may be needed.
60
What is Assist Control Ventilation (ACV)?
ACV provides partial respiratory support, delivering full tidal volume for every breath initiated by the patient or machine.
61
What are the risks associated with ACV?
ACV carries a risk of hyperventilation if the patient breathes rapidly, requiring careful monitoring.
62
What is Synchronized Intermittent Mandatory Ventilation (SIMV)?
SIMV allows the patient to gradually take over their breathing effort by combining mandatory breaths with spontaneous breathing.
63
What are the considerations for SIMV?
Proper synchronization between mandatory breaths and patient effort is critical to avoid dyssynchrony and discomfort.
64
What is PCV-VG (Pressure Control Ventilation – Volume Guaranteed)?
PCV-VG is used for lung-protective ventilation, ensuring a set tidal volume while limiting peak airway pressure.
65
What are the considerations for PCV-VG?
Monitoring is essential to prevent over- or under-ventilation, and patient comfort may require fine-tuning.
66
What is Pressure Support Ventilation (PSV)?
PSV helps patients transition off full ventilator support by encouraging patient-initiated breathing with ventilator assistance.
67
What are the risks associated with PSV?
PSV poses a risk of hypoventilation if pressure support is too low, necessitating careful adjustment.
68
What is PSV-Pro (Proportional Assist Ventilation)?
PSV-Pro is designed for awake patients needing mild to moderate support, adjusting assistance based on patient effort.
69
What are the considerations for PSV-Pro?
Monitoring and adjustment are crucial to ensure synchronization with the patient's inspiratory effort.
70
What is CPAP (Continuous Positive Airway Pressure)?
CPAP is used to prevent airway collapse in obstructive sleep apnea and helps maintain alveolar recruitment post-op.
71
What are the considerations for CPAP?
CPAP requires spontaneous breathing and carries a risk of barotrauma, necessitating close monitoring.
72
What is BiPAP (Bilevel Positive Airway Pressure)?
BiPAP provides ventilatory support for spontaneously breathing patients, reducing work of breathing.
73
What are the considerations for BiPAP?
BiPAP requires monitoring for synchrony and is not suitable for apneic patients.
74
What is APRV (Airway Pressure Release Ventilation)?
APRV is used in ARDS to keep alveoli open while allowing spontaneous breathing, improving oxygenation.
75
What are the considerations for APRV?
APRV requires frequent monitoring and adjustment to balance oxygenation and ventilation.
76
What is Inverse Ratio Ventilation (IRV)?
IRV is used in severe respiratory failure to prolong inspiratory time, improving oxygen exchange.
77
What is the transition process for lengthening T-high?
Lengthening T-high to slowly shift to conventional modes (e.g., PSV or SIMV) is guided by lung recovery and gas exchange stability.
78
What is Inverse Ratio Ventilation (IRV) used for?
IRV is used in severe respiratory failure (e.g., ARDS) when conventional ventilation fails to maintain adequate oxygenation.
79
What is the key concept of IRV?
The I:E ratio is inverted (e.g., 2:1 or 3:1 instead of normal 1:2), meaning inspiration lasts longer than expiration.
80
What are the risks associated with IRV?
Risks include Barotrauma/Volutrauma, Hemodynamic Compromise, and the need for vigilant monitoring of oxygenation, EtCO₂, blood pressure, and signs of auto-PEEP.
81
How should one transition from IRV?
Gradually return to a conventional ratio by decreasing inspiratory time and transitioning to a more normal I:E ratio (e.g., 1:2).
82
What is High-Frequency Ventilation (HFV)?
HFV is a lung-protective strategy ideal for patients with ARDS or at risk for ventilator-induced lung injury, delivering very small tidal volumes at rapid rates.
83
What are the considerations for HFV?
Considerations include ventilation/oxygenation monitoring, hemodynamic effects, and the need for specialized equipment.
84
How should one transition from HFV?
Gradually shift to conventional ventilation as lung compliance and gas exchange improve, considering patient stability.
85
What is the Venturi Effect in jet ventilation?
The Venturi Effect is based on the principle that when gas flows through a narrow passage, pressure drops, allowing entrainment of surrounding gas or air.
86
What are Airway Exchange Catheters (AECs) used for?
AECs are used to maintain airway access during ETT exchange and difficult extubation or reintubation scenarios.
87
What is Transtracheal Jet Ventilation (TTJV)?
TTJV is indicated in emergency 'cannot intubate, cannot oxygenate' (CICO) situations, involving inserting a large-bore catheter through the cricothyroid membrane.
88
What are the typical settings for TTJV?
Typical settings include RR: ~8–10 breaths per minute and an I:E Ratio of 1:3 or 1:4 (e.g., 1 sec inspiration, 3 sec expiration).
89
What are the risks associated with TTJV?
Risks include barotrauma, subcutaneous emphysema, pneumothorax, catheter obstruction, and air trapping (auto-PEEP).
90
What are safety tips for TTJV?
Use lower inspiratory pressures (25–50 psi), ensure a patent upper airway for exhalation, and use short inspiratory times with prolonged expiratory phases.

Basics TL (57 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions