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103 Cards in this Set
- Front
- Back
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What are the 5 types of anesthesia equipment?
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1) Anesthesia machines
2) Mechanical ventilators 3) Monitors 4) Infusion pumps/syringe pumps 5) Patient warming devices |
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What are the 2 components of an anesthesia machine?
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1) Gas supply component
-Regulate oxygen delivery -Vaporize anesthetic agent -Deliver gases to patient component 2) Patient component -Absorber and patient circuit -Administer oxygen/anesthetic agent -Removes CO2 from expired gas -Allows manual or mechanical ventilation |
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What are the 4 types of anesthesia systems? Which ones require a gas supply component?
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1) Open
2) Semi-open 3) Circle 4) To and fro -Last 3 require gas supply component |
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Does rebreathing occur with an open anesthesia system?
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No
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What is an open anesthetic system?
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Mask & gauze
-No reservoir -Outmoded |
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What types of anesthetic agents are used with an open system?
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Agents w/ low vapor pressure
-Don't want to vaporize excessively |
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What is another name for a semi-open circuit?
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Non-rebreathing circuit
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Does a semi-open anesthesia system have an absorber? Directional valves?
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No, no
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When do you use a semi-open anesthesia system?
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Patients weighing <7kg
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Do semi-open anesthesia machines have a flow meter & vaporizer?
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Yes
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What are the 4 components of the manifold that is optional when using a semi-open anesthesia machine?
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1) Bag mount
2) Manometer -Feels airway pressure 3) Pop-off valve 4) Occlusion device |
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Does the semi-open anesthesia system have a scavenging device?
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Yes
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What are the 2 types of circuits used with semi-open anesthesia machines?
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1) Coaxial circuit
2) Bain circuit |
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What type of an anesthesia system uses a norman elbow?
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Semi-open circuit
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What type of an anesthesia machine is an Ayres T-piece used on?
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Semi-open
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What is the purpose of using an occluder?
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Helps pop open pop off valve so don't have to worry about high pressures as much
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Does a to and fro anesthetic system allow rebreathing? Does it have a rebreathing bag?
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Yes, yes
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Does a to and fro anesthetic system have an absorber? Direction valves
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Absorbent-yes
Directional valves-no |
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Are to and fro anesthetic systems common?
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No, uncommon
-not currently used in small animal medicine but has some use in large animal anesthesia |
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What anesthetic systems have a sodalime canister?
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To and fro system
Circle system |
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Which anesthetic systems have directional valves?
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Circle system
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Which anesthetic systems have absorbers?
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Semi-open
To and Fro Circle |
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What anesthetic systems have pressure relief valves?
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To and fro
Circle |
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Which anesthetic systems have pressure manometers?
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Semi-open
To and fro Circle |
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Which anesthetic systems have a fresh gas inlet?
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To and fro
Circle |
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Which anesthetic systems have a scavenging device?
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Semi-open
To and fro Circle |
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What anesthetic systems allow rebreathing?
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To and fro
Circle |
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Are circle anesthetic systems commonly used?
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Yes very common
-All currently used in small animal medicine -Almost all used in large animal medicine |
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What's the benefit of a bain circuit?
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Allows animal to maintain body temperature better
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What anesthetic systems have a vaporizer and flow meter?
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Semi-open
To and fro Circle |
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What anesthetic systems have an oxygen flush valve?
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To and fro
Circle |
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What MUST occur to allow rebreathing?
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Carbon dioxide removal
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Why is it so important for an absorber canister to be sized correctly?
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Need a large enough volume of canister for exhaled volume to sit in the canister for one respiratory cycle
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What type of a reaction occurs to remove carbon dioxide?
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Exothermic reaction
-also gets color change |
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What are the 5 types of absorbents?
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1) Baralym
2) Sodasorb, sodalime USP 3) Sodasorb LF 4) Amsorb 5) Amsorb plus |
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What color change occurs w/ baralyme? What's the reaction?
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Colorless/pink--> blue/grey
-Reacts w/ sevoflurane to produce compound A -Currently unavailable |
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What color change occurs with sodasorb and sodalime?
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White--> purple
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What absorbent will lose its color during nonuse bc the ethyl violet is inactivated by light?
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Sodasorb, sodalime
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What absorbent is a permanent color change?
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Amsorb, amsorb plus
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What 2 absorbents exhibit a white--> violet color change?
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Amsorb, amsorb plus
Sodasorb LF |
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What are the 3 mechanisms of action of amsorb and amsorb plus?
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1) Inhibit compound A production
2) Inhibit carbon monoxide production 3) Inhibit degradation of anesthetic agents |
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What are the 3 mechanisms of action of Sodasorb LF?
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1) Inhibit compound A production
2) Inhibit CO production 3) Inhibit degradation of anesthetic agents |
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What is the tubing diameter of a small animal anesthesia machine? Canister?
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22mm tubing diameter
Single absorber canister |
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What is the tubing diameter of a large animal anesthesia machine? Canister?
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55 mm tubing diameter
Large absorber canister |
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What is the tubing diameter of a human medicine anesthesia machine?
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22 mm diameter
Dual absorber canisters |
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What are the 3 safety systems for medical gas?
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1) Color
2) Pin index safety system 3) Diameter index safety system |
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What color are oxygen tanks?
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Green
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What color are nitrous oxide tanks?
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Blue
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What color are medical air tanks?
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Yellow
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What color are waste anesthetic gas disposal tanks?
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Violet
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What color are medical vacuum tanks?
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White
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What color are nitrogen tanks?
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Black
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What color are carbon dioxide tanks?
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Grey
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What are Ohmeda style DISS?
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Quick snap ons
-Part of diameter index safety system |
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What are the 3 oxygen sources?
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1) Cylinder (compressed)
2) Cylinder (liquid) 3) Generator |
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How is oxygen produced by a generator?
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At varying rates, and pressure excess is stored in reserve cylinder
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What is the decision to purchase an oxygen generator based on?
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Oxygen use and cost
|
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What are the 3 types of compressed cylinders?
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D-400 L (cheapest)
E-660 L H-6900 L (most expensive) |
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A cylinder with 100 L of liquid oxygen is equivalent to _______.
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18 H cylinders
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What is the downfall of liquid oxygen?
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If you don't use it you lose it- because the oxygen keeps vaporizing
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What is a big difference b/w the gages for nitrous oxide and oxygen?
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Oxygen can calculate exactly how much is in the tank, but can't do this with nitrous oxide- NO will remain at the same level then once starts to drop depletes very quickly
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What are the 3 Nitrous oxide tanks?
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D: 940 L $19
E: 1590 L $20.03 H: 15,800 L $65.06 |
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Nitrous oxide exists as a _____ in a cylinder when compressed.
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Liquid- so liquid sits at bottom and gas on top
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Where does gas flow after going through the regulator?
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enters distribution system
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What are the 2 types of regulators?
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Preset OR single stage (50 psi)
Adjustable or two stage -Usually 50-60 Psi for O2 Usually < 200 psi for nitrogen |
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What are 2 tyeps of distribution systems?
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1) Copper pipe
-In ceiling or wall, conducts from storage area to where being used - Then use Upper hose assembly in room 2) Tanks |
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How do you read flow meters?
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At the top of float or middle of ball
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What are the 3 sizes/types of flow meters?
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1) 0-4 L/min
2) 0-8L /min 3) 0-12 L/min (large animal) |
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What are the 2 classifications of anesthesia machine use (based on oxygen flow) ?
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1) Semi-closed
2) Closed |
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What description of oxygen flow (classification of use) is most commonly used?
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Semi- closed
(>99.9% of time) |
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What patients is a closed oxygen flow usually used on? What is another name for this system?
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Also called low flow
Used more commonly in large animals -Supplies metabolic needs and nothing more |
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The flow meter for nitrous oxide machines is linked to ______.
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Oxygen flow
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Nitrous oxide can be used at ___-____% of total flow.
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25-66% of total flow
-Calculate oxygen, then add nitrous oxide |
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What do vaporizers do?
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Converts liquid anesthetic to vapor in a precise manner
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What are the 2 types of vaporizers?
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Measured flow
Variable bypass |
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What are the two types of variable bypass vaporizers?
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Temperature compensated
Flow compensated |
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What type of anesthetic agent(s) is used with measured flow vaporizers?
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Any agent
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What type of vaporizer has an extra flow meter on the anesthesia machine for the vaporizer?
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Measured flow
|
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What type of vaporizer is no longer in production?
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Measured flow
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What are the 2 chambers of a flow compensated vaporizer?
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Vaporizing chamber down low and mixing chamber up top- can't spill these bc chambers will mix
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What is the purpose of having wicks in a flow compensated variable bypass vaporizer?
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Increases surface area for liquid to vaporize off of
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How is 3.2% isoflurane established?
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Isoflurane vaporizes to saturation (32%) so 10% of air goes into vaporizer and then mixes with oxygen producing a 32%
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What are 4 brands of flow compensated variable bypass vaporizers?
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1) Tec series
2) Vapor 19x series 3) Penlon series 4) Ohio calibrated vaporizer series |
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Why can't the wrong anesthetic agent be used in a specific type of vaporizer?
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Because vaporizer keys and pour spouts are specific for each anesthetic agent so the slot of one type won't match with others
|
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What agents can be used with non-precision vaporizers?
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Can only be used with agents of low volatility or low potency
|
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What is an example of a non-precision vaporizer?
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Ohio #8
-Has crank that just goes 0-10 so not sensitive to amount used |
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How can you modify non-precision vaporizers (uncommonly done)?
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By removing wick for use with isoflurane or sevoflurane
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Waste anesthetic gases were linked epidemiologically to what 2 health problems?
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1) Decreased fertility
2) Increased spontaneous abortion and congenital malformation -Also increased overall mortality -Increased in neoplasia and hepatic, neural and hematopoietic diseases Psychomotor and behavior changes |
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How serious do we think the health problems are related to waste anesthetic gases?
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It becomes an issue of perception:
-Overwhelming evidence indicates no carcinogenic risk -Effect on fertility is equivocal |
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What is the purpose of scavenging?
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To remove waste anesthetic gases
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What mandates the levels of chronic exposure to gases that are acceptable? What are they?
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NIOSH
-Nitrous oxide: 24 ppm -Halogenated agents: 2 ppm |
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What are 3 passive scavenging systems?
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1) Charcoal canisters
2) Exhaust through exterior wall 3) Exhaust through existing HVAC if nonrecirculating |
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How do you know when an activated charcoal canister should be disposed of?
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Weight before use, then when weight 50 g more than originally all the charcoal has expanded
-Have to use if moving around |
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What is required for an active scavenging system? What's the advantage?
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Vacuum pump or fan
Scavenger interface -Advantage: allows multiple users |
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Why can't suction be applied directly to the anesthesia machine?
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Will suck air out of rebreathing bag
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If you have the flow rate set at 2 L /min and the suction is at 4- 8 L/min then, how is this possible?
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Room air can be aspirated through the positive pressure relief valve and allows vacuum pump to pull at 6 L/min
|
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A _____ flow technique should be used for anesthesia.
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Low flow
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Relatively ____ agents should be used for anesthesia.
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Insoluble agents
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When should vaporizers be filled?
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At the end of the day
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What are 3 types of ancillary equipment used during anesthesia?
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1) Infusion pumps
2) Syringe pump 3) Thermal support |
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Why should infusion pumps be used? Syringe pumps?
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Infusion pumps: add convenience/ precision to fluid administration
Syringe pumps: add convenience/ precision to low volume medication administration |
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What are 4 types of thermal support that can be used for anesthetized patients?
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1) Circulating warm water blankets
2) Convective warming 3) Insulation (bubble wrap/ foil) 4) Hydrocolloidal gell |
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Where do you get hydrocolloidal gel from? How do you prepare them for thermal support?
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Transfer gel from freeze packs
Use incubator or microwave -must allow heat to equilibrate if using microwave to avoid burns |
