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52 Cards in this Set
- Front
- Back
Upper airways heat and humidfy inhlaed gases to __C and ___% humidity
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37C
95% Humidity |
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Purpose of mucous?
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Traps foreign particles and soluble irritant gases
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T/F:
Mucociliary transport works best at 80-90% RH and 32-33C |
True
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Absolute Humidity=
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ACTUAL mass of water in a given vol of gas at a given temp (mg/L)
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Maximum (Saturated) Humidity=
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Maximum mass of water vapor that a given volume of gas can hold at a given temp (saturated water content)
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What is the water content at 37C?
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44mg/L water
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Relative humidity=
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Absolute Humidity / Maximum Humidity x 100
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Insensible water loss of ____-___ ml/day from respiratory tract
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250-350ml/day
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We inspire air at 50% humidity that has 9mg water/L, must increase it to ___mg/L
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Must increase it from 9 to 44mg/L (35 mg/L difference or water loss of 13gm/hr)
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Warming of inspired gas to 37C burns ___cal/min
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40
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___-___% body heat lost humidifying inspired air
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12-15%
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Breathing dry gas via ETT in ONE hour causes what 3 things?
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1. Depressed ciliary and surfactant function
2. Thickened secretions 3. Bronchoconstriction |
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What is the recommended min humidity for anesthetic gases?
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60% or 12mg/L
Optimum values 14-30mg/L |
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Compare RH in closed, Bain, SCCA systems and semi-open systems
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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 |
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In a SCCA, if FGF<5...
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Will not require humidification
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What are 3 different types of humidifiers?
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HME
Heated Cascade Humidifier Nebulizers |
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How does an HME work?
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Hygroscopic media that retains water and heat
Delivers 28-30mg/L at 28-30C |
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What is better for humidification, hydrophobic membrane ro hygroscopic media?
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Hygroscopic media (more moisture and heat conservation)
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When is an HME contraindicated?
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With thick/bloody secretions
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HME most effective if placed where?
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Just distal to ETT
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Disadvantages of an HME?
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Adds dead space, especially with low TV (can be signifcant in a child)
Efficiency dec with large TV |
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How does a heated cascade humidifier work?
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Breaks inspiratory gases into tiny bubbles that pass thru heated water.
100% humidity at 37C |
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Hazards of heated cascade humidifier?
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Bacterial infection
Overhydration Thermal injury** Inc resistance |
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Can a nebulizer produce 100% humidity at RA?
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Yes
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Antiseptic safe for ____ ____
Disinfectant safe for ____ ____ |
Antiseptic--human tissue
Disinfectant--inanimate object |
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High level disinfectant destroys all microorganisms except what 2 things?
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Bacterial spores
Mad-Cow dz |
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Does low level disinfectant kill TB?
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No.
Intermediate and High level does |
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What is sterilization?
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Destruction fo all microorganisms including bacterial spores
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4 ways to sterilize something:
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1. Pasteurization
2. Autoclaving 3. Dry Heat Sterilization 4. Chemical Disinfection and Sterilization |
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Immersion in hot water for 30 min is definition of what?
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Pasteurization
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How does autoclaving work?
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Steam under pressure--inc temp causes coagulation and denaturation of cellular protein
Kills all bacteria, spores and viruses |
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Can you autoclave something for just a few seconds?
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Yup. If it's at 150C and 15psi it only needs a few sec.
121C--15 min 126C--10min 134C--3 min |
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What is a disadvantage to autoclaving?
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Damage to heat sensitive items (rubber, plastic)
Also: Blunting of cutting edges Corrosion of metal surfaces Degredation of drugs |
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T/F:
Dry heat sterilization is FASTER than steam sterilization |
False
Dry heat: slower than steam sterilization but doesnt corrode metals or blunt instruments |
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Glutaraldehyde
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High level disinfectant: 30 min
Sterilization: 3-10hrs Evaporates at room temp |
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Exposure to Glutaraldehyde would suck because it causes...
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bronchospasm, headaches, skin eye and mucous membrane irritation
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What chemical cleans FOB scopes and laryngoscope blades?
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Peracetic Acid
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What chemical is used to clean up a blood spill/contaimination?
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Chlorine
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Ethylene Oxide (EtO) effective against what? Used for what items?
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Effective against ALL organisms
Used for heat/mositure sensitive items |
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Disadvantages to EtO use
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Flammable and explosive
Repeated exposure weakens structural integreity of plastics Time delay for aeration |
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EtO is a possible human _____.
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Carcinogen.
Exposure--> NV, eye irritation, HA, incoordination, memory loss, peripheral neuropathies |
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If a cleaning person at the hospital suddenly becomes uncoordinated, cant remember stuff and has a bad HA, what might have happened?
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Acute toxic exposure to EtO
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Limited daily exposure to EtO is:
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1ppm/8hrs
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Gamma Radiation uses electromagnetic waves to kill all organisms, including spores
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My wrist hurts!!!
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Most causes of injury/death in anesthesia are related to what 3 things:
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hypoxemia
excessive airway pressure overdose |
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What are different sources of hypoxia?
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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 |
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If there is a ______ failure, pt is a risk for barotrauma
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Scavenger
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CO formation: greatest w/____, least with _____
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Greatest w/Des
Least w/Sevo |
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Pt awareness can be caused by what 3 things:
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1. Empty vaporizer
2. Sub-threapeutic doses of inhalation agents 3. Faulty vaporizer |
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T/F:
TB has been known to transmit thru the anesthesia machine |
False.
No documented trasmission. |
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Most closed claims in anesthesia are related to:
A-breathing circuit B-vent C-vaporizer D-machine |
Correct answer:
A--breathing circuit! |
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What is usually at fault for cases that result in death/brain damage due to an anesthesia mishap, the machine or the provider?
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The anesthesia provider boooooo
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