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Amachine
pieces n parts-BARRY
| Question | Answer |
|---|---|
| high pressure system includes | hanger yoke,cylinder pressure gauge, yoke block w/valves,cylinder pressure regulator,PISS |
| what are the high pressures | 2000psi, 725psi |
| what are pipeline pressures | 45-55 psi |
| what is in intermediate pressure area | pipeline inlets, vent power inlet, O2 pressure failure, flowmeter valve, O2 second stage,O2 flush, DISS |
| PISS consists of | specific location for pins and holes for @ gas |
| Placing cylinder on yoke | first retract screw next mate cylinderPISS |
| Pressure regulator | can be direct or indirect |
| Low pressure includes | flow tubes, vaporizers, Common Gas Outlet, Check valve |
| Bourbon Gauge is for | comparing one pressure to barometric |
| The minimum O2 flow used with N2O is | 28% |
| Halothane(fluothane) has a vapor pressure of and a MAC of | 243 and 0.74 |
| Isoflurane(forane) has a MAC of | 1.2 |
| Pipeline pressures delivered from H cylinders is | 50psi |
| low pressure alarm and N2O failsafe alarms will sound when | pipeline pressure has failed*****disconnect pipeline and open E cylinder |
| Desflurane (Suprane has a vapor pressure and MAC of | 669, 6% |
| Most resistance is at A.nonrebreathing valve B.CO2 canister C.Tracheal tube D.Y-piece | D |
| Resevoir bag can | provide positive pressure, allow low gas flow,serve as monitor for spontaneous respirations, can cause excessive pressure if APL is closed |
| Effects of rebreathing are | decreased loss of heat and water, reduced inspired O2, less fluctuation in inspired anesthetic tensions |
| which mapleson is fresh gas farthest from pt | mapleson A |
| Which mapleson most efficient for spontaneous breathing | mapleson A, 2* to position of APL valve and FGF |
| which mapleson most efficient for controlled ventilation | mapleson D |
| most common location for resevoir bag in circle system is | between exhale valve and absorber |
| best location for fresh gas inlet in circle system is | Upstream of inspiratory valve |
| physiologic effect of lowered body temp in post op include | shivering and increased cardiac demand |
| O2 Analyzer is the ONLY Monitor to | Detect Hypoxic Mixture |
| name 3 cylinder safety valves that prevent cylinder from exploding with extreme temp change | frangible disc-copper that burst, wood metal plug that melts, and spring loaded- opens under pressure |
| which safety mechanisms are used to prevent hypoxic mixtures being delivered when flowmeters are incorrectly set | O2 analyzer and proportioning system |
| PISS # 's are | O2 2-5 Air 1-5N2O 3-5 |
| O2 E cylinder tank in US is | green |
| Which gases will support combustion | O2, N2), Air |
| Complications associated with use of face mask include what | movement of C-Spine, Facial nerve injury, Chemical irritation to eyes |
| What maneuvers can be used to secure an airway | Jaw thrust and chin lift |
| contraindications to nasal airways include | basilar skull fxr, sepsis, Hemmorrhagic disorder |
| External meas for nasal airway is | tip of earlobe to cricoid cartlidge |
| Fresh gas flow minus patient uptake equals | amt of flow to scavenger |
| Anesthetic travels from vaporizer thru flowmeter where it mixes for first time in common manifold T/F | True- O2 always added downstream to lessen chance of hypoxic mixture |
| five tasks for O2 with ventilator | Flow meters, O2 Flush, Activate Fail Safe(O2/N2O), Low Pressure alarms, Ventilator |
| How many groves on larger fluted O2 valve | 360/45= 8 |
| The most fragile part of the machine is | Flow tube = Thorpe tube //Variable Flow indicator gas enters bottom read floats |
| O2 flush at 50psi should be flushed to fill resevoir bag on a regular basis T/F | False direct flow will cause barotrauma |
| Fail Safe- cut off gas with no O2 for mixwhat are two types | Ohmeda- 20psi pressure sensor shut offDrager- 12psi OFPD decrease proportionally |
| best way to detect an esophageal intubation | monitor carbon dioxide in exhaled gases |
| T/F Ascending bellow fill when they drop. | false |
| Hypoxic guard O2/N2O what is the % | give at least room air usually set at 25% Teeth system 14teeth N2O /28 teeth O2 |
| O2 Analyzer only monitor to detect hypoxic mixture 4 ways..what are they | Inert gas administration,wrong supply gas(cross contamination), defective pneumatics, leak low pressure |
| The reason for elevated end-tidal CO2 with good alveolar plateau is | Hypoventilation |
| T/F The curare cleft is seen with spontaneous respirations | True Inadequate muscle relax reversal could be one cause |
| What is difference between fail safe and proportioning devices? | Fail Safe device relies on O2 Pressure/// Proportioning relies on O2 FLOW |
| In which wavelength does reduced hemoglobin absorb more light? | The red band |
| Effects on pulse oximeter readings of a methemoglobin level higher than 1% include | false low<85% |
| Twitch frequency for TOF | 2Hz for 2sec |
| Which equipment can provide an alternate ventilation method for the patient with difficult airway? | LMA,Combitube, Transtracheal Ventilation, MASK |
| With loss of pipeline O2 what would conserve O2 from cylinder? | Discontinue using ventilator, Use low O2 flow |
| OR temp range is | 20-24 degree celsius/ 24 degrees for peds, burns, trauma |
| waste anesthetic exposure #s | 25ppm for N20, 2 ppm for Halogenated agents, 0.5ppm for combo |
| Usually between 2mA and 5mA this alarms with high current flow to ground | What is LIM Line Isolation Monitor |
| Located at the dorsal motor function of spinal cord- stimulate peripheral nerve with this potential | What is SSEP Somatosensory Evoked Potential |
| BIS EEG data for GA and deep hypnosis is | 65-40, <40 cortical suppression; 85-65 sedation; 100-85 awake |
| What does anesthesia cause on EEG | decreased amplitude and increased latency |
| What four EEG waves do we monitor | Alpha-eyes closed but awake, Beta-normal awake, delta-deep sleep, theta-sleep state |
| What is the pressure ans capacity of an E cylinder at 20*C | 1800-2200psi, 625-700 liters |
| What is the only reliable way to measure N2O in cylinder? | Weigh it-- |
| what government agency regulates compressed gas | US Dept of Transportation |
| Where is the most resistance in intubated patient? | Connection between ETT and Y piece |
| Where is most resistance in unintubated patient? | At expiratory valve in semi-closed system. |
| What does Reynolds number measure? | Viscosity of Gases |
| How do you classify Non-Rebreathing System? | 1.Open-Insufflation 2.Semi-Open-Mapleson |
| How do you classify Circle Systems? | 1.Semi-closed:partial rebreathing 2.Closed:rebreathing |
| Mapleson Circuit Efficiency for Control Ventilation is | D>B>C>A |
| Mapleson Circuit Efficiency for Spontaneous Ventilation is | A>D>C>B |
| What is most common breathing system used today | Semi-closed circle |
| What is ventilation? | Removal of CO2 |
| What is Minute Ventilation? | TVxRR=MV Normal 5-10 l/min |
| What is PEEP? | Airway pressure at end of expiration prevents alveoli collapse can be used to recruit |
| What are 3 severe side effects from excessive PEEP? | Barotrauma, Decresed CO and BP, and Increased ICP with fluid retention |
| T/F Flow tubes show gas mixtures? | False- Flowtubes/Thorpe tubes are specific for each gas,tapered if has two tubes has SINGLE control and low flow MOST FRAGILE |
| How much O2 is delivered with flush valve? | 35-75L/min |
| Most ventilators use ascending bellows why? | Can detect and alert loss of pressure in circuit |
| What does fail safe rely on for reading? | Oxygen Pressure |
| What does proportioning system rely on? | Oxygen flow |
| 2 common reasons for increased in inspired CO2 | Exhausted Absorbent, faulty unidirectional flow valves |
| What alarm are based on pressure in breathing system? | High pressure , disconnect |
| Another name for Mapleson D | Bain Circuit |
| What are FGF requirements for Bain circuit for CV and SV? | CV-70ml/kg to prevent hypercarbiaSV-100-300 to prevent hypercarbia |
| Whats a disadvantage of Bain circuit? | Rebreath exhaled with unrecognized kinking of inner tube |
| Which Mapleson is the modified Ayers T? | Mapleson F=Jackson-Reese good for peds minimal dead space but 2xFGF to prevent hypercarbia |
| What is CMV? | Controlled Mechanical Ventilation; preset TV, RR no effort by patient |
| What is ACV? | Assist control ventilation; preset TV allows trigger respiration with full TV if apneic funtions in "control mode" |
| What is IMV? | Patient own TV and RR, in addition preset TV and RR intermitten |
| What is SIMV? | Synchronized IMV- prevents patient fighting ventilator patient with TV and RR |
| What causes O2 toxicity? | Prolonged exposure to O2>60-70% |
| What are 4 phases of ventilation? | Inspiration, Inspiration to Expiration, Expiration, Expiration to Inspiration; Ventilator function differs based on role during above phases |
| What is mechanical Ventilation? | Allows artificial work of respiratory muscles (oxygentation) followed by ventilation (removal of CO2) |
| What is macroshock? | gross current enters and exits skin, first sensed at 1mA, Pain >5mA, Letgo 10-20Ma, Vfib 100-300mA (resp.intact), >6000mA Threat to heart and respiratory |
| What is Microshock? | Electric current direct to myocardium Eg.Thru central line Vfib with 0.1mA |
| What is AC? | Alternating current:back and forth Impediance applies to AC |
| What is DC? | Direct current:one directionResistance only applies to DC |
| What is recommended Humidity level for OR? | 50% |
| What is the only monitor to detect Hypoxic Mixture? | O2 Analyzer |
Created by:
margbauer
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