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What is the pressure, temperature, and capacity of an OXYGEN E cylinder? 1800-2200 psi; 20*C with capacity of 625-700 liters
oxygen pipeline pressure 2000 +/- 5 psi
Oxygen is manufactured by? fractional distillation of liquefied air
Nitrous Oxide is manufactured by? heating ammonium nitrate (thermal decomposition)
Critical temperature of nitrous oxide 36.5*C
What is the pressure, temperature, and capacity of a NITROUS OXIDE E cylinder? 745 psi; 20*C with capacity of 1590 liters
What is the only reliable way to measure nitrous oxide in an E cylinder? weigh it
By the time you see a decrease in pressure of nitrous oxide, how many liters do you have left in an E cylinder? 400 Liters
Nitrous is stored in what state? liquid
what is the critical temperature of air? Thus, what state does it exist in? 140.6*C, gas state
What is the pressure, temperature, and capacity of an AIR E cylinder? 1800-2200 psi; 20*C with capacity of 625-700 liters
Cylinders that have a marking of “3AA” are manufactured by using what metal? Steel
The marking “3AL” or “3ALM” indicates that the cylinder is made from? aluminum alloys
Where can you not go in with anything steel? MRI
An E cylinder should have at least _______ psi or should be replaced or refilled. 1000 psi
Coupling mechanism that connects end of hose with appropriate gas outlet (color coded); Made to prevent incorrect hose attachment to hospital gas pipeline DISS (diameter index safety system)
E cylinders have 2 holes in cylinder valve that mate with corresponding pins in yoke in anesthesia machine PISS (pin index safety system)
Oxygen Pin Index Position 2 + 5
Air Pin Index Position 1 + 5
Nitrous Oxide Pin Index Position 3 + 5
Which patients require warmer OR rooms? pediatrics/burn patients
Recommended relative humidity in OR should be? >50%
If relative humidity is lower than recommended what can occur? microshock secondary to static sparks can occur
If working with orthopedic prosthesis implants what must you do upon entering the OR? and why? must enter through inner laminar flow door; must not break air seal on outer door
High flow ventilation in OR is useful because? decreases contamination of surgical site
Who regulates purity of cylinders (how they are being filled)? Pharmocopeia of the United States or National Formulary
Who regulates storage and transportation of compressed gases? U.S. Department of Transportation
How often are cylinders inspected? every 10 years
Who publishes standards for use of only nonflammable agents in OR? National Fire Prevention Association
standard for health care facilities for pipeline gas sources and electrical supply to OR (Voluntary but enforceable by law) NFPA 99
Who creates standards for manufacture and delivery of compressed gases Compressed Gas Association
Legislation which requires you to notify the FDA if death or injury occurs with equipment? Safe Medical Devices Act of 1990
Private organization that publishes minimum safety and performance standards for anesthesia machine American National Standards Institute (ANSI)
Publishes standards for anesthesia machine and equipment (i.e. ETT may have Z-79 (or IT) marking; identifies passed tissue toxicity test) American Society for Testing and Materials (ASTM)
Committee that monitors outcomes, analyzes problems and offers solutions and also requires a safety program Joint Council on Accreditation of Hospital Organizations (JCAHO)
Type of electricity that causes electrons to flow back and forth AC (alternating current)
Impendence is? sum of forces that oppose electron movement when AC is used
Impendence only applies to which type of current? AC (alternating current)
Type of electricity that is nonoscillating; electrons only flow in one direction (i.e: battery) DC (direct current)
Resistance is? measure of its opposition to the passage of a steady electric current
Resistance only applies to which type of current? DC (direct current)
Heart is most susceptible to how many Hertz? (Hz = # of cycles per second) 40-150 Hz
How does a patient recieve an electrical shock? Body contact with two conductive materials at different voltage potentials may complete a circuit
Ohm's Law E = I x R
Voltage (E) is? unit of electromotive force that propels electrons thru circuit (volts)
Current (I) is? unit of electron flow (amps)
Resistance (R) is? force that opposes electron flow; everything provides some resistance to electron flow (ohms)
Electric Power (W) is? electromotive force (watts)
Equation for Joules? Joules (watts per second) W= E x I
What is a conductor? any substance that permits the flow of electrons (AC or DC)
What is inductance? ability of electrons flowing in a wire or wire coil to create a magnetic field around the wire which can induce an opposing electromotive force in adjacent conductors
As AC frequency increases (greater electron movement), inductance & impendance __________. increase
What is capacitance? ability to store an electrical charge (defibrillator)
A capacitor is? consists of two parallel conductors separated by an insulator
This type of electricity has no circuit loop current and does not flow unless plates are connected; this occurs only when the capacitor is discharged DC (direct current)
This type of electricity has no possibility of leakage current... and why? DC (direct current); since battery operated devices use 1/10th voltage
This type of electricity continually reverses itself and will permit current to flow even when a circuit is not completed. This property results in presence of leakage current from? AC (alternating current); "stray capacitance"
Leakage current is present in? all electrical equipment as a result of capacitance coupling, induction between internal electrical components or defective insulation
What is macroshock, and when does it occur? when electricity enters and exists thru skin (lightening bolt); gross amount of current applied to dry intact skin that can cause harm or death
Macroschock is first sensed at? 1 milliamp (mamp- mA)
Pain sensed with microshock at? > 5 mA
Current of ________ produces “let go” condition; unable to let go of source 10-20 mA
Macroschock that can induce Vfib but respiratory center remains intact? 100-300 mA
Macroshock that is a threat to heart and respiratory centers? >6000 mA
What is a microshock? Current that enters thru portal into patient (pacing wires, central line, etc)
Vfib can be induced with how many microamps of microshock electrical current applied directly to the myocardium? 100 microamps (0.1 mA)
Microshock of ______________ recommended with maximal 60 Hz leakage current for pacer wires, PA catheters, etc. 10 microamps (0.01 mA)
An electrosurgical unit (ESU) does what? provides hemostasis during surgery; Current passes from tip of cautery thru tissue and back to machine via grounding pad and wire
What is the current that flows through an ESU? Usually 300-3000 KHz
Bipolar cautery is preferred in which patients? patients with pacemakers
Most common source of thermal injury to patient ESU (electrosurgical unit)
How does bipolar cautery work? Current flows from each tip of cautery so doesn’t flow thru body
Where should you never place a grounding pad? between heart and surgical area
What does "grounded" mean? there is a connection between the electrical circuit and earth ground
What is a safety feature of OR outlets and equipment? All outlets and equipment are grounded
An isolation transformer is used to? isolate the electrical system in the OR and a safety feature to protect against macroshock
How does an isolation transformer work? Uses electromagnetic induction to induce a current in a secondary ungrounded system; voltage potential between live and neutral lines but no voltage difference between two working lines and ground; if working properly, a circuit cannot be completed
What is a first fault? If a short circuit develops b/t two working lines, potential develops b/t the lines and ground, creating a potential for shock
What is a line isolation monitor? detects current leakage caused by first fault and sounds an alarm
If line alarm monitor sounds what should you do? the fault must be found; equipment should be unplugged in reverse order that it was plugged in
Created by: gen76