Machines--Humidification, Cleaning, Hazards

Front 1

Upper airways heat and humidfy inhlaed gases to __C and ___% humidity

Back 1

37C
95% Humidity

Front 2

Purpose of mucous?

Back 2

Traps foreign particles and soluble irritant gases

Front 3

T/F:
Mucociliary transport works best at 80-90% RH and 32-33C

Back 3

True

Front 4

Absolute Humidity=

Back 4

ACTUAL mass of water in a given vol of gas at a given temp (mg/L)

Front 5

Maximum (Saturated) Humidity=

Back 5

Maximum mass of water vapor that a given volume of gas can hold at a given temp (saturated water content)

Front 6

What is the water content at 37C?

Back 6

44mg/L water

Front 7

Relative humidity=

Back 7

Absolute Humidity / Maximum Humidity x 100

Front 8

Insensible water loss of ____-___ ml/day from respiratory tract

Back 8

250-350ml/day

Front 9

We inspire air at 50% humidity that has 9mg water/L, must increase it to ___mg/L

Back 9

Must increase it from 9 to 44mg/L (35 mg/L difference or water loss of 13gm/hr)

Front 10

Warming of inspired gas to 37C burns ___cal/min

Back 10

40

Front 11

___-___% body heat lost humidifying inspired air

Back 11

12-15%

Front 12

Breathing dry gas via ETT in ONE hour causes what 3 things?

Back 12

1. Depressed ciliary and surfactant function
2. Thickened secretions
3. Bronchoconstriction

Front 13

What is the recommended min humidity for anesthetic gases?

Back 13

60% or 12mg/L

Optimum values 14-30mg/L

Front 14

Compare RH in closed, Bain, SCCA systems and semi-open systems

Back 14

Closed: 40-100% RH, 29 mg/L
Bain: 65-80% RH, 21-25mg/L
SCCA: 30-60% RH, 5-18mg/L
Semi-open: 10-26%, 4-10mg/L

Front 15

In a SCCA, if FGF<5...

Back 15

Will not require humidification

Front 16

What are 3 different types of humidifiers?

Back 16

HME
Heated Cascade Humidifier
Nebulizers

Front 17

How does an HME work?

Back 17

Hygroscopic media that retains water and heat
Delivers 28-30mg/L at 28-30C

Front 18

What is better for humidification, hydrophobic membrane ro hygroscopic media?

Back 18

Hygroscopic media (more moisture and heat conservation)

Front 19

When is an HME contraindicated?

Back 19

With thick/bloody secretions

Front 20

HME most effective if placed where?

Back 20

Just distal to ETT

Front 21

Disadvantages of an HME?

Back 21

Adds dead space, especially with low TV (can be signifcant in a child)
Efficiency dec with large TV

Front 22

How does a heated cascade humidifier work?

Back 22

Breaks inspiratory gases into tiny bubbles that pass thru heated water.

100% humidity at 37C

Front 23

Hazards of heated cascade humidifier?

Back 23

Bacterial infection
Overhydration
Thermal injury**
Inc resistance

Front 24

Can a nebulizer produce 100% humidity at RA?

Back 24

Yes

Front 25

Antiseptic safe for ____ ____
Disinfectant safe for ____ ____

Back 25

Antiseptic--human tissue
Disinfectant--inanimate object

Front 26

High level disinfectant destroys all microorganisms except what 2 things?

Back 26

Bacterial spores
Mad-Cow dz

Front 27

Does low level disinfectant kill TB?

Back 27

No.
Intermediate and High level does

Front 28

What is sterilization?

Back 28

Destruction fo all microorganisms including bacterial spores

Front 29

4 ways to sterilize something:

Back 29

1. Pasteurization
2. Autoclaving
3. Dry Heat Sterilization
4. Chemical Disinfection and Sterilization

Front 30

Immersion in hot water for 30 min is definition of what?

Back 30

Pasteurization

Front 31

How does autoclaving work?

Back 31

Steam under pressure--inc temp causes coagulation and denaturation of cellular protein

Kills all bacteria, spores and viruses

Front 32

Can you autoclave something for just a few seconds?

Back 32

Yup. If it's at 150C and 15psi it only needs a few sec.

121C--15 min
126C--10min
134C--3 min

Front 33

What is a disadvantage to autoclaving?

Back 33

Damage to heat sensitive items (rubber, plastic)

Also:
Blunting of cutting edges
Corrosion of metal surfaces
Degredation of drugs

Front 34

T/F:
Dry heat sterilization is FASTER than steam sterilization

Back 34

False

Dry heat: slower than steam sterilization but doesnt corrode metals or blunt instruments

Front 35

Glutaraldehyde

Back 35

High level disinfectant: 30 min
Sterilization: 3-10hrs
Evaporates at room temp

Front 36

Exposure to Glutaraldehyde would suck because it causes...

Back 36

bronchospasm, headaches, skin eye and mucous membrane irritation

Front 37

What chemical cleans FOB scopes and laryngoscope blades?

Back 37

Peracetic Acid

Front 38

What chemical is used to clean up a blood spill/contaimination?

Back 38

Chlorine

Front 39

Ethylene Oxide (EtO) effective against what? Used for what items?

Back 39

Effective against ALL organisms
Used for heat/mositure sensitive items

Front 40

Disadvantages to EtO use

Back 40

Flammable and explosive
Repeated exposure weakens structural integreity of plastics
Time delay for aeration

Front 41

EtO is a possible human _____.

Back 41

Carcinogen.

Exposure--> NV, eye irritation, HA, incoordination, memory loss, peripheral neuropathies

Front 42

If a cleaning person at the hospital suddenly becomes uncoordinated, cant remember stuff and has a bad HA, what might have happened?

Back 42

Acute toxic exposure to EtO

Front 43

Limited daily exposure to EtO is:

Back 43

1ppm/8hrs

Front 44

Gamma Radiation uses electromagnetic waves to kill all organisms, including spores

Back 44

My wrist hurts!!!

Front 45

Most causes of injury/death in anesthesia are related to what 3 things:

Back 45

hypoxemia
excessive airway pressure
overdose

Front 46

What are different sources of hypoxia?

Back 46

Gas source (pipeline fail, wrong gas in cylinder)
Machine (flowmeter leak, inadequate O2 conc, vent failure, leak in bellows)
Failure to maintian airway (esoph intubation, aspiration, laryngospasm, obstruction)
Unrecognized pt disconnection

Front 47

If there is a ______ failure, pt is a risk for barotrauma

Back 47

Scavenger

Front 48

CO formation: greatest w/____, least with _____

Back 48

Greatest w/Des
Least w/Sevo

Front 49

Pt awareness can be caused by what 3 things:

Back 49

1. Empty vaporizer
2. Sub-threapeutic doses of inhalation agents
3. Faulty vaporizer

Front 50

T/F:
TB has been known to transmit thru the anesthesia machine

Back 50

False.
No documented trasmission.

Front 51

Most closed claims in anesthesia are related to:
A-breathing circuit
B-vent
C-vaporizer
D-machine

Back 51

Correct answer:
A--breathing circuit!

Front 52

What is usually at fault for cases that result in death/brain damage due to an anesthesia mishap, the machine or the provider?

Back 52

The anesthesia provider boooooo