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Anesthesiology
Lecture 2 - Anesthetic Equipment
105
Veterinary Medicine
Professional
11/28/2011

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Cards

Term
What is the anesthetic machine?
Definition
A piece of equipment employed when inhalational anesthesia is performed
Term
What are the essential functions of an anesthetic machine?
Definition
Deliver inhalational anesthetics (anesthetic gases) safely and accurately; Deliver O2; Allow elimination of expired CO2 from breathing system; Provide a means for controlled ventilation
Term
What are the essential parts of an anesthetic machine?
Definition
Carrier gas source/inlet (hanger yoke/pipeline); Pressure regulator; Flow meter; O2 flush valve (emergency O2 control); Vaporizer mounting bracket; Common gas outlet
Term
What are the optional/additional parts of an anesthetic machine?
Definition
Check valves; Low oxygen alarm; Overpressure valves; Emergency air-intake valves; Nitrous Oxide cut-out devices
Term
What is the function of a check valve?
Definition
Prevent back-flow of gas
Term
What pressure is delivered to the anesthetic machine once the gas passes through the pressure regulator?
Definition
50-55PSI
Term
What is the pipeline connected to?
Definition
Larger cylinders stored in gas central supply room
Term
What is a hanger yoke? Do all anesthetic machines have one?
Definition
Gas-specific mounting bracket; No
Term
Which part of the flow meter bob should be read if it is spherical? Cylindrical?
Definition
S: middle
C: top
Term
What is the flow level of the O2 flush valve, and what does it bypass?
Definition
35-75L/min; vaporizer
Term
What is the O2 flush valve used for?
Definition
Flush anesthetic out of breathing systems
Term
The O2 flush valve should be avoided when _____.
Definition
The pt is connected
Term
What attaches to the common gas outlet?
Definition
Breathing system
Term
What is the function of the common gas outlet?
Definition
Lets out the mixture of carrier & anesthetic gas at the preset concentration
Term
What is the final exit point of carrier gas & inhalational anesthetic mixture from the machine?
Definition
Common gas outlet
Term
VIC is positioned _____ to CGO; VOC is positioned _____ to CGO.
Definition
downstream; upstream
Term
What do carrier gases do?
Definition
Dilute the anesthetic gas in the vaporizer to a safe []; provide a way to physically deliver the volatile agent to the pt
Term
Carrier gases must be approved for _____.
Definition
Medical use
Term
Name 3 carrier gases.
Definition
Oxygen (100% O2); O2 + N2O mix (Entonox); Medical Air
Term
Environmental air has ____% N and ____% O2
Definition
79; 21
Term
N2O is never given without _____.
Definition
O2
Term
What is medical air?
Definition
A carrier gas; purified, dehumidified environmental air; usually mixed w/ O2; approved for medical use
Term
What is the [O2] of medical air compared to room air?
Definition
Greater
Term
What phases are contained in N2O cylinders?
Definition
Liquid & Gas
Term
The N2O cylinder gauge does not indicate _____
Definition
volume left
Term
_____ to know N2O volume left in the cylinder
Definition
Weigh
Term
O2 is a _____ under pressure.
Definition
Gas
Term
O2 cylinders contain _____ phase(s).
Definition
Gas
Term
O2 cylinder gauge indicates _____.
Definition
Volume left
Term
What is the location of a size E cylinder?
Definition
Anesthetic Machine
Term
What is the location of a size G cylinder?
Definition
Cylinder bank
Term
What is the location of a size H cylinder?
Definition
Cylinder bank
Term
What is the N2O psig of a size E cylinder? G? H?
Definition
All 745
Term
psig
Definition
pounds per square inch gauge
Term
What is the rank of size for the 3 cylinders?
Definition
E<G<H
Term
What is the N2O volume of an E cylinder?
Definition
1590 L
Term
What is the N2O volume of a G cylinder?
Definition
13800 L
Term
What is the N2O volume of an H cylinder?
Definition
15800 L
Term
What is the O2 volume of an E cylinder?
Definition
660L
Term
What is the O2 volume of an H cylinder?
Definition
6900L
Term
What is the O2 psig of an E cylinder?
Definition
1900
Term
What is the O2 psig of an H cylinder?
Definition
2200
Term
Where can the pipelines be located?
Definition
Ceiling, Column, Wall
Term
What is the purpose of anesthetic machine safety features?
Definition
Avoid accidental delivery of the wrong gas; Avoid pressure excess/fluctuations
Term
Name the safety features that avoid accidental delivery of the wrong gas & where they are located.
Definition
Color coding & labeling (cylinders/pipelines)
PISS (cylinder/hanger yoke)
NIST (pipeline)
DISS & Quick connect (pipeline)
Term
Name the safety feature(s) that avoid(s) pressure excess/fluctuations
Definition
Pressure regulator
Term
Which safety feature prevents the wrong cylinder from being hung on the wrong HY?
Definition
PISS
Term
In the US, what gas is represented by green? Blue? Yellow? Grey?
Definition
Green: O2
Blue: N2O
Yellow: Air
Grey: CO2
Term
In the UK, what gas is represented by black body/white shoulders?
Definition
O2
Term
What is labeled on the cylinder & pipelines?
Definition
Content, Pressure, Warnings, Owner, Date
Term
PISS is primarily for _____ cylinders.
Definition
Small (e.g. E) on anes. machine
Term
What are some cylinder safety precautions?
Definition
Don't drop or expose to heat (explosive)
Store & secure upright
Never lubricate or use grease or oil
No access to unauthorized persons
Store in clean, dry, well-ventilated area
"No naked flames" & "No Smoking" signs
Term
Are O2 & N2O flammable?
Definition
No; they support combustion
Term
High pressure system is from _____ to _____.
Definition
Cylinder (2000psi) to Pressure regulator (50psi)
Term
Intermediate pressure system is from _____ to _____.
Definition
Pressure regulator (50psi) to Flowmeter
Term
Low pressure system is from _____ to _____.
Definition
Downstream of flowmeter needle to CGO
Term
What is the pressure of the low pressure system/circuit?
Definition
Near atmospheric
Term
The pressure regulators in the large cylinder bank & inside the anesthetic machine are part of the _____ pressure circuit.
Definition
High
Term
What does a vaporizer do?
Definition
Allows controlled evaporation of liquid anesthetic; Allows dilution of the anesthetic vapor in a carrier gas; Allows delivery of a range of [vapor]s
Term
What are the key parts of the vaporizer?
Definition
Filling port, Sight glass, Dial or control knob, Bypass channel, Vaporization chamber
Term
A plenum vaporizer is _____ resistance.
Definition
High
Term
What are some bases for vaporization classification?
Definition
Location (VIC/VOC)
R to carrier g flow (high/low)
g flows through (plenum/draw-over)
precision (y/n)
T compensation (y/n)
agent specificity (y/n)
Term
Modern anesthetic machines have _____ vaporizers.
Definition
Calibrated/Precision
Term
Characteristics of Calibrated/Precision Vaporizers:
Definition
Efficient & accurate; T compensation; Plenum gas flow; High R to flow (VOC); Agent-specific; Safety key filler
Term
On a vaporizer, yellow represents _____ and purple represents _____.
Definition
Sevoflurane; Isoflurane
Term
What is the purpose of a key filler?
Definition
Avoids accidental filling w/ the wrong agent
Term
Precision vaporizer use (4 steps)
Definition
Check level of liquid anesthetic, Check filling port is closed, Check dial turns easily, Check if properly mounted
Term
4 precautions for precision vaporizer use:
Definition
Never tip on side; Turn off after use; Turn off if refilling while in use; Remember to turn back on
Term
What affects vaporizer performance?
Definition
Extremes of T; FGF; Barometric P; Filling level; Mvmt/tilting; Thymol preservative
Term
_____ vaporizers perform better than _____ over a range of flows
Definition
Plenum; Draw-over
Term
Thymol preservative is used with _____ only.
Definition
Halothane
Term
In VSL, when is the low O2 alarm triggered?
Definition
≤35psi
Term
For SA, many practices use _____ anesthesia equipment.
Definition
Human
Term
Specifically designed vet anesthesia equipment is available for _____.
Definition
LA
Term
Custom-built SA machines are suitable for:
Definition
Companion animals, sheep, goats, birds, smaller pigs
Term
Custom-built SA machines often lack _____.
Definition
Safety features of human machines
Term
Custom-built LA machines usually have _____ & _____ specially attached.
Definition
Circle breathing systems; Ventilators
Term
Give 2 examples of machines w/ in-circuit vaporizers.
Definition
Stephens & Komesaroff
Term
The oxygen cylinder has a gas pressure of up to _____ d/o size.
Definition
2200 psi
Term
What specific parts are included in the high pressure circuit?
Definition
Cylinder P gauge, Pipeline to P regulator, Cylinder P regulators, HY (including filter & unidirectional or check valve), yoke block
Term
What specific parts are included in the intermediate pressure circuit?
Definition
pipeline inlets & P gauges, ventilator power inlet, O2 P-failure device (fail-safe) & alarm, flowmeter valves, O2 & N2O 2nd-stage regulators, O2 flush valve
Term
What specific parts are included in the low pressure circuit?
Definition
Valves, flowmeter glass tube, vaporizers, check valves, CGO
Term
What is 50-55 psi in kPa?
Definition
345-380
Term
_____ are always present on machines carrying 2 or more gases.
Definition
Check valves
Term
Can you see check valves?
Definition
No
Term
What indicates that a check valve is missing or absent?
Definition
A hissing sound at the yoke
Term
What is the lowest ration of N2O to O2?
Definition
2:1
Term
What can occur with accidental delivery of N2O w/o O2?
Definition
Death from hypoxia
Term
What is the last gas to flow into the flowmeter manifold?
Definition
O2
Term
O2 flowmeter should be located to the ____ of all other flowmeters.
Definition
Right
Term
What are anesthetic gases?
Definition
Substances in a gaseous state at room T & atmospheric P w/ gen anesthetic properties
Term
Give an example of an anesthetic gas.
Definition
N2O
Term
What is an inhalation anesthetic? Give 3 examples.
Definition
Liquid at room T & atmospheric P w/ general anesthetic properties; Extremely volatile; Quickly evaporate & pass to gas state (vapor) when in contact w/ atmosphere; Isoflurane, Sevoflurane, Halothane
Term
What N2O concentration must be delivered to appreciate its anesthetic & analgesic properties?
Definition
50%
Term
What is the bonded seal of pin index cylinders?
Definition
Bodock washer
Term
What is the isoflurane vapor concentration at room T? What is the MAC?
Definition
31.5%; ~1.3%
Term
Which are the internal features of a vaporizer?
Definition
Bypass channel & vaporization chamber
Term
VIC R to flow:
Definition
Low
Term
VOC R to flow:
Definition
High
Term
VIC precision:
Definition
uncalibrated
Term
VOC precision:
Definition
calibrated
Term
VIC gas flow:
Definition
Draw-over
Term
VOC gas flow:
Definition
Plenum
Term
When using closed circle systems, carrier gas flow greater than or equal to ____ is recommended.
Definition
200-300mL/min
Term
With precision vaporizers, does IPPV alter output?
Definition
No
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