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What is the function of breathing systems?
- deliver oxygen
- deliver anesthetic agent
- remove carbon dioxide
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What are the three different types of breathing systems?
- rebreathing
- non-rebreathing
- old open drop method
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What are the two types of rebreathing systems?
- total rebreathing
- partial rebreathing
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What is total rebreathing?
closed
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What is partial rebreathing?
semi-closed
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What kind of anesthesia machine do you use for rebreathing?
circle anesthesia machine
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What is non-rebreathing?
open
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What are the two different attachments we can use for non-rebreathing?
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What is the old open drop method?
- original anesthesia machine
- inaccurate and dangerous
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Describe how old open drop method works.
- uses room air
- liquid anesthetic on cloth or cotton ball
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What are the differences between the breathing systems?
- are exhaled gases breathed in or not?
- different O2 and N2O flow rates
- position of pop-off valve (open or closed)
- type of equipment used (circle anesthesia machine, attachments)
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How does the rebreathing system work?
- patient rebreathes some exhaled gases
- CO2 is removed
- new O2 and anesthetic vapor is added
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How does the total rebreathing system work?
- pop-off valve is closed
- low fresh gas flow rate
- rebreath everything, the only thing that is replaced is what is used up in the body
- recirculates all exhaled gases except CO2
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What are the advantages of the total rebreathing system?
- cheaper - conserves O2 and anesthetic vapor
- conserves patient body heat and moisture
- less room air pollution
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What are the disadvantages to the total rebreathing system?
- not as safe
- CO2 may build up
- pressure may build up
- can't change anesthetic concentration as quickly
- may get O2 depletion and N2O buildup
- avoid use in patients under 20kg - makes it hard for them to breathe and push air all the way through system
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How does partial rebreathing work?
- pop-off valve open or partly open
- higher fresh gas flow rate
- some exhaled gases removed by scavenger
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What are the disadvantages of partial rebreathing?
- more expensive
- uses more O2 and anesthetic agents
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What are the advantages of partial rebreathing?
safer than total rebreathing
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How does non-rebreathing systems work (NRB)?
- little or no exhaled gas is rebreathed by patient
- exhaled gases are removed by scavenger
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What attachements do the NRB system use and what attachments do they not use?
- Use: O2 tank, flowmeter, vaporizer
- Not use: breathing tubes, flutter valves, CO2 absorber, manometer
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What are the components to a NRB system?
- fresh gas inlet
- reservoir bag
- tubing
- scavenger outlet
- endotracheal tube connection
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When do we use NRB systems?
- good for small patients under 7 kgs (15 pounds)
- less resistance, easier to breathe
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When do we usually not use NRB systems?
not used in large animals (it will work but it's just too expensive)
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What kind of O2 flow rates do NRB systems use?
high
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Do NRB systems have a CO2 absorber?
no
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What are the advantages of NRB systems?
- low resistance - gas flow not impeded by soda lime, valves
- less effort to breathe
- not as heavy and bulky as circle system - less drag on patient's endotracheal tube
- can change anesthetic depth quickly
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What are the disadvantages to NRB systems?
- high gas flow - expensive in large animals
- room air pollution if not scavenged properly
- loss of body heat and moisture
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Which vaporizer is the most complicated and most expensive?
precision vaporizer
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Precision vaporizers are designed to do what?
deliver exact % of anesthetic specified by anesthetist
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What is the maximum vapoizer percent used with volatile anesthetics (halothane, iso, sevo)?
30%
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What will happen if a patient if 30% of vaporizer is delivered?
it will be fatal
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What vaporizer percent do we usually use for iso?
5%
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What vaporizer percent do we usually use with sevo?
7%
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How do we use the dial on the percision vaporizer?
depress lock button to get it off zero then turn the dial
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Precision vaporizers are designed for what kinds of anesthetic?
- halothane
- isoflurane
- secoflurane
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What do you do if you accidently put in the wrong anesthetic liquid into the vaporizer?
- drain it
- flush it with O2
- air it out overnight
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What do we use the indicator window for in the precision vaporizer?
- is there enough fluid for next anesthetic procedure?
- is fluid nice and clear?
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What are the other factors that affect % anesthetic that is delivered?
- temperature
- flow rate
- back pressure
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What does VOC stand for?
vaporizer out of circle (rebreathing gas)
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What is the position of the precision vaporizer?
outside of the patient breathing circuit
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Why do we use non-precision vaporizers over precision vaporizers?
- simpler
- cheaper
- easier to care for
- use with non-volatile anesthetic agents (methoxyflurane)
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What is the stephen's vaporizer?
no wick - evaporation less efficient, safer for volatile anesthetics
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What are the advantages to using a non-precision vaporizer?
- cheap
- uses low flow rates
- saves O2 and anesthetic
- vaporizer itself is cheaper
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What are the disadvantages to using a non-precision vaporizer?
- does not compensate for temperature, carrier gas flow rate, or back pressure
- less precise control of anesthetic depth
- glass jar breakage
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What is this?
circle anesthesia machine
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What kind of attachment is this?
bains circuit
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What kind of attachement is this?
Ayre's T-piece
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What is this?
vaporizer
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What is this person's finger on?
vaporizer lock dial
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What is this?
vaporizer dial
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What is this?
vaporizer window
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What is this?
VOC
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What is this?
non-precision vaporizer
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What is this?
non-precision vaporizer wick
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What is this?
VIC
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What is this?
vaporizer fill inlet
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