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# Medical Gas Systems

### Basics of Anesthesia quiz 4

Who is responsible for the handling, transportation, storage, and disposal of cylinders ? USDOT (US Department of Transportation)
What other 2 associations contribute to the handling, transportation, storage, and disposal of cylinders? CGA (Compressed Gas Association), NFP (National Fire and Protection Association)
At room temperature, what is oxygen stored as? Compressed Gas
What is the critical temp of oxygen? -119 degrees C
Manifolds reduce to pressure in cylinders of oxygen from what to what? 2000psi to 50psi
Reducing the pressure in the cylinder promotes what? Safe delivery of the gas
What is room temperature? 20 degrees C/68 degrees F
Oxygen is stored as what below critical temp? A liquid
True/False - liquid oxygen must be stored well below its critical temperature of -119 degrees C True
Can gas be liquified by pressure? Yes, but only if stored below critical temperature (-119 C)
Regarding storage of liquid oxygen, why do hospitals prefer this method of storage? More economical
True/False - Anesthesia providers should always have a backup of oxygen in case of pipeline failure. True
What is the maximum capacity of oxygen in liters? 660L
What is the service pressure of oxygen? 2000psi
How much pressure should be in a cylinder of oxygen to be considered adequate? 1000psi
If you have a service pressure of 1000psi in a cylinder of oxygen, how many liters of oxygen are available? 330L
What should an anesthesia provider do in the event of loss of pipeline pressure? 1. Fully open up the E cylinder 2. Disconnect the pipeline 3. Consider using low fresh gas flow as to not deplete your cylinder too quickly
Why might the flow of oxygen end before a cylinder is completely empty? If the E cylinder is not fully open
Where are hoses to the pipeline disconnected from? Quick Connection Fitting
True/False - As oxygen is expended from a cylinder, the cylinder pressure falls with its content True
In an E cylinder of nitrous oxide, what is the capacity in liters? 1600L
What is the working pressure of a cylinder of nitrous oxide? 745mmHg
Nitrous oxide is stored as a what? A liquid
What is the critical temperature of nitrous oxide? 36.5 degrees C (above room temp)
How is nitrous oxide achieved? By the process of thermal decomposition of ammonium nitrate
Nitrous oxide is stored in what type of cylinder? Large H cylinder
True/False - Bulk storage of nitrous oxide is NOT available. False - bulk storage of nitrous oxide is available
True/false - Nitrous oxide is easily compressed without a large increase in tank pressure True
What is a rupture disc? All gas cylinders are equipped with a ruptured disc which is an emergency pressure relief valve which prevents explosion under conditions of high pressure?
What is a condition that might result in high pressure of an E cylinder? Overfilling
At what PSI will the pressure relief valve rupture? 3300psi
E cylinders can withstand up to how much pressure? 5000psi
What is a low temperature metal located between the valve block and the cylinder body and melts at a low temperature of 158 degees F? Wood's Metal
What is the purpose of Woods Metal? Allows the contents in the cylinder to escape in a controlled fashion, lessening the risk of explosion.
Define a small burst disc. A small metal gasket engineered to rupture at a pre-determined pressure
True/False - Some burst discs are backed with a low melting point and the valve must be exposed to excessive heat before the disc can rupture. True
True/False - The volume remainging in the nitrous oxide cylinder is proportional to the cylinder pressure False - The volume remaining in the nitrous cylinder is not proportional to the cylinder pressure. The pressure will remain at 745psi till approximately 400L are left in the tank.
When should a nitrous oxide tank be changed? When the tank pressure falls below 745psi
What does a nitrous oxide cylinder reading higher than 745psi imply? 1. Gauge Malfunction 2. Overfilling 3. A gas other than nitrous oxide was mistakenly filled
What is your action as an anesthesia provider if you have a nitrous tank with a service pressure reading higher than 745psi? Take the tank out of service
When energy is consumed in the conversion of liquid to gas, what is this phenomenon called? Latent Heat Vaporization
What is nitrous oxide stored as? A liquid at room temperature
What happens when you are running 4L/min or greater of nitrous oxide? Rapid removal of nitrous oxide from a cylinder can cause the formationof frost on its walls or feeze the valve because of the loss of latent heat of vaporization from the liquid nitrous oxide.
Liquid oxygen must be stored at or below what temperature? -119 degrees C
What is the meaning of "tare weight" and where can it be found? Tare weight means empty and can be found on the shoulder of the cylinder
What is the tare weight of an E cylinder? 9.8lbs
Describe the proper way to "crack" a cylinder Open the valve to release some gas
What is the purpose of cracking a cylinder? To remove debris/particles that could possibly interfere with flow
What color is the nitrous tank? Blue
What color is the oxygen tank? Green
What is the only reliable way to determine the residual volume of a nitrous oxide cylinder? To weigh the tank
When will a cylinder of nitrous begin to lose its pressure? When approximately 400L remain
What color is medical air? Yellow
How is medical air obtained? By blending oxygen and nitrogen together or it can be provided by air compressors
What is the critical temperature of air? -140.6 degrees C
True/False - Medical gas is stored as a gas in cylinders whose pressures fall in proportion to the tank content True
What 2 items help to provide the filtered but unsterile air to the anesthesia system? In-line filters and water traps
How many liters can an H cylinder hold? 7000L
What are the major constituents of compressed air? 1. Nitrogen-78% 2. Oxygen-21% 3. Argon-1%
What does the pneumonic WAGD stand for? Waste, Anesthesia, Gas, Disposal
What does DISS stand for? Diameter Index Safety System
What is the purpose of DISS? Makes cross connection more difficult by using different size and shape connectors for N2O and O2. This makes cross connection difficult but not impossible.
What does PISS stand for? Pin Index Safety System
What is the purpose of PISS? Another means of preventing misconnection. pin arrangement matches holes in the yoke, where the cylinder attaches to the machine
What are the PISS numbers for Air? 1 and 5
What are the PISS numbers for oxygen? 2 and 5
What are the PISS numbers for Nitrous oxide? 3 and 5
What are the PISS numbers for CO2? 1 and 6
What are the PISS numbers for Helium? No pins for Helium
What provides for uninterrupted gas supply to the OR? Auto Switching Manifolds
What is another term for emergency shut off valves? Zone Valves
Where are zone valves located? Outside of the OR's
True/False - Compressed Nitrogen is administered to patients False - Compressed Nitrogen is used to power OR equipment
What kind of cylinder is compressed nitrogen stored in? H cylinders and they are wheeled around on a dolly
True/False - Nitrogen tanks are generally regulator controlled True
What is compressed carbon dioxide used for in the OR? Insufflation of the abdomen during laparoscopic procedures
What is the insufflation pressure of the abdomen? 15
What color tank is the insufflation gas carbon dioxide? Gray
What 2 items should be checked to ensure the proper gas for the proer application? Label and PISS
Who recommends color coding? CGA (Compressed Gas Association)
True/False - Color coding is mandatory False - Color coding is not mandatory. It is recommended but not all manufacturers follow the recommendation
Who published the standards on professional qualifications for inspectors and verifiers of medical gas systems? The AmericanSociety of Sanitary and Engineering (ASSE)
True/False - Anesthesia providers have and obligation to ensure the system is properly designed and functioning and should participate in the final inspection process True
True/False - Most problems with cross connections occur due to human error False - Most problems with cross connections occur with new systems or following repairs
What are gas pipes constructed of? Seamless copper tubing
What is avoided at all costs in terms of the pipeline? Internal contamination with oils, dust, and water
Anesthesia equipment interface with the pipeline systems how? By color coded hoses
True/False - Quick connect couplers are noted on the wall and the DISS fittings that help prevent connection errors are found on the anesthesia machine True
What are 4 ways to test the anesthesia gas circuits prior to patient use? 1. Pressure Test 2. Test for Cross Connections 3. Pipeline Purge Test using a cheesecloth 4. Standing Pressure Test after the wall are close up
In accordance with the ASSE 6000 requirements, what is another name for the tests? System Verification Tests
True/FAlse - Each gas outlet is tested individually to ensure it is connected to the proper source True
What is generally used to blow the pipeline free of debris? Humidity and contaminate free nitrogen
What is the purpose of the pressure test? Increase the pressure for 48 hours while monitoring for leaks
Created by: Lmc145