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103 Cards in this Set

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What are the 5 types of anesthesia equipment?
1) Anesthesia machines
2) Mechanical ventilators
3) Monitors
4) Infusion pumps/syringe pumps
5) Patient warming devices
What are the 2 components of an anesthesia machine?
1) Gas supply component
-Regulate oxygen delivery
-Vaporize anesthetic agent
-Deliver gases to patient component
2) Patient component
-Absorber and patient circuit
-Administer oxygen/anesthetic agent
-Removes CO2 from expired gas
-Allows manual or mechanical ventilation
What are the 4 types of anesthesia systems? Which ones require a gas supply component?
1) Open
2) Semi-open
3) Circle
4) To and fro
-Last 3 require gas supply component
Does rebreathing occur with an open anesthesia system?
No
What is an open anesthetic system?
Mask & gauze
-No reservoir
-Outmoded
What types of anesthetic agents are used with an open system?
Agents w/ low vapor pressure
-Don't want to vaporize excessively
What is another name for a semi-open circuit?
Non-rebreathing circuit
Does a semi-open anesthesia system have an absorber? Directional valves?
No, no
When do you use a semi-open anesthesia system?
Patients weighing <7kg
Do semi-open anesthesia machines have a flow meter & vaporizer?
Yes
What are the 4 components of the manifold that is optional when using a semi-open anesthesia machine?
1) Bag mount
2) Manometer
-Feels airway pressure
3) Pop-off valve
4) Occlusion device
Does the semi-open anesthesia system have a scavenging device?
Yes
What are the 2 types of circuits used with semi-open anesthesia machines?
1) Coaxial circuit
2) Bain circuit
What type of an anesthesia system uses a norman elbow?
Semi-open circuit
What type of an anesthesia machine is an Ayres T-piece used on?
Semi-open
What is the purpose of using an occluder?
Helps pop open pop off valve so don't have to worry about high pressures as much
Does a to and fro anesthetic system allow rebreathing? Does it have a rebreathing bag?
Yes, yes
Does a to and fro anesthetic system have an absorber? Direction valves
Absorbent-yes
Directional valves-no
Are to and fro anesthetic systems common?
No, uncommon
-not currently used in small animal medicine but has some use in large animal anesthesia
What anesthetic systems have a sodalime canister?
To and fro system
Circle system
Which anesthetic systems have directional valves?
Circle system
Which anesthetic systems have absorbers?
Semi-open
To and Fro
Circle
What anesthetic systems have pressure relief valves?
To and fro
Circle
Which anesthetic systems have pressure manometers?
Semi-open
To and fro
Circle
Which anesthetic systems have a fresh gas inlet?
To and fro
Circle
Which anesthetic systems have a scavenging device?
Semi-open
To and fro
Circle
What anesthetic systems allow rebreathing?
To and fro
Circle
Are circle anesthetic systems commonly used?
Yes very common
-All currently used in small animal medicine
-Almost all used in large animal medicine
What's the benefit of a bain circuit?
Allows animal to maintain body temperature better
What anesthetic systems have a vaporizer and flow meter?
Semi-open
To and fro
Circle
What anesthetic systems have an oxygen flush valve?
To and fro
Circle
What MUST occur to allow rebreathing?
Carbon dioxide removal
Why is it so important for an absorber canister to be sized correctly?
Need a large enough volume of canister for exhaled volume to sit in the canister for one respiratory cycle
What type of a reaction occurs to remove carbon dioxide?
Exothermic reaction
-also gets color change
What are the 5 types of absorbents?
1) Baralym
2) Sodasorb, sodalime USP
3) Sodasorb LF
4) Amsorb
5) Amsorb plus
What color change occurs w/ baralyme? What's the reaction?
Colorless/pink--> blue/grey
-Reacts w/ sevoflurane to produce compound A
-Currently unavailable
What color change occurs with sodasorb and sodalime?
White--> purple
What absorbent will lose its color during nonuse bc the ethyl violet is inactivated by light?
Sodasorb, sodalime
What absorbent is a permanent color change?
Amsorb, amsorb plus
What 2 absorbents exhibit a white--> violet color change?
Amsorb, amsorb plus
Sodasorb LF
What are the 3 mechanisms of action of amsorb and amsorb plus?
1) Inhibit compound A production
2) Inhibit carbon monoxide production
3) Inhibit degradation of anesthetic agents
What are the 3 mechanisms of action of Sodasorb LF?
1) Inhibit compound A production
2) Inhibit CO production
3) Inhibit degradation of anesthetic agents
What is the tubing diameter of a small animal anesthesia machine? Canister?
22mm tubing diameter
Single absorber canister
What is the tubing diameter of a large animal anesthesia machine? Canister?
55 mm tubing diameter
Large absorber canister
What is the tubing diameter of a human medicine anesthesia machine?
22 mm diameter
Dual absorber canisters
What are the 3 safety systems for medical gas?
1) Color
2) Pin index safety system
3) Diameter index safety system
What color are oxygen tanks?
Green
What color are nitrous oxide tanks?
Blue
What color are medical air tanks?
Yellow
What color are waste anesthetic gas disposal tanks?
Violet
What color are medical vacuum tanks?
White
What color are nitrogen tanks?
Black
What color are carbon dioxide tanks?
Grey
What are Ohmeda style DISS?
Quick snap ons
-Part of diameter index safety system
What are the 3 oxygen sources?
1) Cylinder (compressed)
2) Cylinder (liquid)
3) Generator
How is oxygen produced by a generator?
At varying rates, and pressure excess is stored in reserve cylinder
What is the decision to purchase an oxygen generator based on?
Oxygen use and cost
What are the 3 types of compressed cylinders?
D-400 L (cheapest)
E-660 L
H-6900 L (most expensive)
A cylinder with 100 L of liquid oxygen is equivalent to _______.
18 H cylinders
What is the downfall of liquid oxygen?
If you don't use it you lose it- because the oxygen keeps vaporizing
What is a big difference b/w the gages for nitrous oxide and oxygen?
Oxygen can calculate exactly how much is in the tank, but can't do this with nitrous oxide- NO will remain at the same level then once starts to drop depletes very quickly
What are the 3 Nitrous oxide tanks?
D: 940 L $19
E: 1590 L $20.03
H: 15,800 L $65.06
Nitrous oxide exists as a _____ in a cylinder when compressed.
Liquid- so liquid sits at bottom and gas on top
Where does gas flow after going through the regulator?
enters distribution system
What are the 2 types of regulators?
Preset OR single stage (50 psi)
Adjustable or two stage
-Usually 50-60 Psi for O2
Usually < 200 psi for nitrogen
What are 2 tyeps of distribution systems?
1) Copper pipe
-In ceiling or wall, conducts from storage area to where being used
- Then use Upper hose assembly in room
2) Tanks
How do you read flow meters?
At the top of float or middle of ball
What are the 3 sizes/types of flow meters?
1) 0-4 L/min
2) 0-8L /min
3) 0-12 L/min (large animal)
What are the 2 classifications of anesthesia machine use (based on oxygen flow) ?
1) Semi-closed
2) Closed
What description of oxygen flow (classification of use) is most commonly used?
Semi- closed
(>99.9% of time)
What patients is a closed oxygen flow usually used on? What is another name for this system?
Also called low flow
Used more commonly in large animals
-Supplies metabolic needs and nothing more
The flow meter for nitrous oxide machines is linked to ______.
Oxygen flow
Nitrous oxide can be used at ___-____% of total flow.
25-66% of total flow
-Calculate oxygen, then add nitrous oxide
What do vaporizers do?
Converts liquid anesthetic to vapor in a precise manner
What are the 2 types of vaporizers?
Measured flow
Variable bypass
What are the two types of variable bypass vaporizers?
Temperature compensated
Flow compensated
What type of anesthetic agent(s) is used with measured flow vaporizers?
Any agent
What type of vaporizer has an extra flow meter on the anesthesia machine for the vaporizer?
Measured flow
What type of vaporizer is no longer in production?
Measured flow
What are the 2 chambers of a flow compensated vaporizer?
Vaporizing chamber down low and mixing chamber up top- can't spill these bc chambers will mix
What is the purpose of having wicks in a flow compensated variable bypass vaporizer?
Increases surface area for liquid to vaporize off of
How is 3.2% isoflurane established?
Isoflurane vaporizes to saturation (32%) so 10% of air goes into vaporizer and then mixes with oxygen producing a 32%
What are 4 brands of flow compensated variable bypass vaporizers?
1) Tec series
2) Vapor 19x series
3) Penlon series
4) Ohio calibrated vaporizer series
Why can't the wrong anesthetic agent be used in a specific type of vaporizer?
Because vaporizer keys and pour spouts are specific for each anesthetic agent so the slot of one type won't match with others
What agents can be used with non-precision vaporizers?
Can only be used with agents of low volatility or low potency
What is an example of a non-precision vaporizer?
Ohio #8
-Has crank that just goes 0-10 so not sensitive to amount used
How can you modify non-precision vaporizers (uncommonly done)?
By removing wick for use with isoflurane or sevoflurane
Waste anesthetic gases were linked epidemiologically to what 2 health problems?
1) Decreased fertility
2) Increased spontaneous abortion and congenital malformation
-Also increased overall mortality
-Increased in neoplasia and hepatic, neural and hematopoietic diseases
Psychomotor and behavior changes
How serious do we think the health problems are related to waste anesthetic gases?
It becomes an issue of perception:
-Overwhelming evidence indicates no carcinogenic risk
-Effect on fertility is equivocal
What is the purpose of scavenging?
To remove waste anesthetic gases
What mandates the levels of chronic exposure to gases that are acceptable? What are they?
NIOSH
-Nitrous oxide: 24 ppm
-Halogenated agents: 2 ppm
What are 3 passive scavenging systems?
1) Charcoal canisters
2) Exhaust through exterior wall
3) Exhaust through existing HVAC if nonrecirculating
How do you know when an activated charcoal canister should be disposed of?
Weight before use, then when weight 50 g more than originally all the charcoal has expanded
-Have to use if moving around
What is required for an active scavenging system? What's the advantage?
Vacuum pump or fan
Scavenger interface
-Advantage: allows multiple users
Why can't suction be applied directly to the anesthesia machine?
Will suck air out of rebreathing bag
If you have the flow rate set at 2 L /min and the suction is at 4- 8 L/min then, how is this possible?
Room air can be aspirated through the positive pressure relief valve and allows vacuum pump to pull at 6 L/min
A _____ flow technique should be used for anesthesia.
Low flow
Relatively ____ agents should be used for anesthesia.
Insoluble agents
When should vaporizers be filled?
At the end of the day
What are 3 types of ancillary equipment used during anesthesia?
1) Infusion pumps
2) Syringe pump
3) Thermal support
Why should infusion pumps be used? Syringe pumps?
Infusion pumps: add convenience/ precision to fluid administration
Syringe pumps: add convenience/ precision to low volume medication administration
What are 4 types of thermal support that can be used for anesthetized patients?
1) Circulating warm water blankets
2) Convective warming
3) Insulation (bubble wrap/ foil)
4) Hydrocolloidal gell
Where do you get hydrocolloidal gel from? How do you prepare them for thermal support?
Transfer gel from freeze packs
Use incubator or microwave
-must allow heat to equilibrate if using microwave to avoid burns