SIUE-Nicole's Scavenger systems
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| An anesthesia machine has what types of components working together? | Vaporizers, anesthesia circuit, ventilator, scavenger system.
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| What is a scavenger system used for? | Collection and removal of excess gas in the OR.
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| The volume of gas flow which enters the circuit, must have equal volumes leaving for what reason? | Unequal volumes can result in barotrauma to your patient, or gases leaking into the OR.
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| What are the 5 components to a scavenger system? | 1)Gas collecting assembly 2)transfer means 3)scavenging interface 4)gas disposal assembly tubing 5)active or passive gas disposal assembly
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| The APL valve, and ventilator relief valve are what component of the scavenger system and what is their purpose? | Components of the Gas collecting assembly- collects excess gas and delivers to transfer tubing.
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| What is the purpose of the transfer means? | Carries gas to scavenger interface usually from two separate tubes, one from APL, and one from relief valve.
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| The transfer means has what kinds of safety standards? | 19 or 30 mm ID rigid tubing-difficult to rollover, or bend it and it only fits into one spot.
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| What component is considered the most important part of the system? | Scavenger interface. Can be open or closed.
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| Where is the interface located and what is mandatory on this component? | Interface is b/t the patient circuit and hospital suction system. Positive pressure relief valve is mandatory.
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| Why is the positive pressure relief valve mandatory? | Because it protects the circuit from excessive + or - pressures.
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| In a closed interface system under what pressure does the pressure pop-off valve open? What else causes this valve to open? | +5 cm H2O. If excess suction is applied the valve opens at -0.25 to -1.8 cm H2O.
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| If you see a bag what type of system are you working with? | Closed system
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| When there is an open system, there is an open relief port and gas is directed where? | Gas is directed to bottom of reservoir canister. Since gas is heavier than air it remains at bottom where it is then pulled out by the hospital sx.
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| What is the purpose of the bag in a closed system? | The bag can determine if the suction is too high or too low, by the bag being flat or over-distended.
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| If the bag in a closed system is over-distended what should be your next action? | The being over-distended is meaning that not enough sx. is able to pull the gases from the circuit and can result in barotrauma.
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| If the bag is flat in a closed system what should you do to your sx? | You should turn it down because it is pulling so hard that patient can't exhale anything.
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| If there is a soft, intermittent hiss with a closed system what is happening and what should you do? | The soft hiss is from the positive pressure relief valve releasing gas into to OR. The suction should be turned up.
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| Closed systems are safer for the OR staff, but not the patient, why is this? | In a closed system the relief valves could fail resulting in barotrauma to the patient or could expose the patient to too much suction.
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| An open system are safer for the patient but not for OR staff why is this? | Open systems do not have the risk of interface relief valve failure, but if suction is not properly used risk of gas in OR is possible.
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| If you are using an open interface scavenger system and you hear a continuous hiss what should you do? | Nothing, this is what we want to hear to know that our suction is on and has been properly adjusted.
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| What are the two types of gas disposal assembly? | Active and Passive
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| Where does the gas disposal assembly tubing conduct waste gas from? | Conducts waste gas from interface to gas disposal assembly where ever the hospital suction goes. Usually runs from overhead to prevent accidental occlusion.
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| In an active gas disposal assembly what is needed for it's operation? | A negative central vacuum that generates negative pressure (suction) and a negative pressure relief valve that draws air into system if there is too much negative pressure.
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| In a passive gas disposal assembly what is needed for it's operation? | A positive pressure relief valve that opens and lets excess gas out into the OR if suction is not high enough, and a positive pressure of the waste gas itself, meaning the higher pressure overrides the low sx. pressure.
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| With an open system, what is responsible for removing the waste gas? | The OR air circulation. Must be sufficient enough to keep N2O concentrations less than 22 ppm.
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| What type of system is needed if there is a passive gas disposable assembly and the suction system stops working? | Need a closed system b/c we do not need suction with a closed system. Turn up O2 to generate flow. Positive pressure would build up and either go out via the positive pressure valve or by the positive pressure of the waste gas & ^ O2 pushing out.
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| If you are using an open system and the suction stops working what should we do? | I.V. anesthesia will have to be used and we will still have to ventilate with O2, b/c that can go out into the room.
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| At the end of your case you turn up the O2 to decrease the concentration of Sevo. What else should be done? | Increase suction with increase in gas flows to prevent barotrauma.
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| If you were to increase the T.V. on your ventilator, what would you see with your bag in a closed system and what else would you have to adjust? | The bag would increase b/c a greater volume is being exhaled, which means that the suction would also have to be increased.
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| Halogenated agent__ppm. Nitrous Oxide__ppm. Halogenated agent + Nitrous Oxide__ppm. Dental Facilites Nitrous Oxide__ppm. | 1)2ppm 2)25ppm 3)Halogenated-0.5ppm, Nitrous Oxide 25ppm 4)50ppm
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| When is most appropriate time to turn on gas agent? | When the mask is properly secured to patient or attached to ET tube.
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| Some things we can do to prevent the leakage of gas into the OR? | 1)washout anesthetics at end of case 2)Insure ETT cuff is properly inflated 3)No spillage when filling vaporizers 4)Disconnect N2O line at end of day 5)Turn off N2O tanks at end of day
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