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Amachine

pieces n parts-BARRY

QuestionAnswer
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 on 2010-04-06



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