Equipment 4 flow rates, acidosis, cautions, equipment care
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What are the carrier gases?
oxygen or oxygen + nitrous oxide
For non-rebreathing systems, how much oxygen do we give?
What kind of attachment do we need to give oxygen using non-rebreathing systems?
What kind of animals do we use the non-rebreathing systems on?
cats and small dogs
For rebreathing systems, how much oxygen do we use for induction? For maintenance?
- induction: 50ml/kg/min
- maintenance: 10 - 20ml/kg/min
How much oxygen should a patient get if we are using oxygen + N2O?
We use ____ flow rates for induction than during maintenance.
Why do we use higher flow rates for induction than for maintenance?
- need to saturate the anesthetic circuit with proper anesthetic gases
- need to dilute expired gases to prevent high CO2
What is denitrogenation?
need to flush nitrogen out of patients lungs
How long do we run higher flow rates during induction?
How much nitrogen is in room air?
What kind of flow rate do we use for non-rebreathing systems?
What kind of flow rates do we use for partial rebreathing systems?
lower than NRB and higher than total rebreathing
What is the flow rate for total rebreathing systems?
lowest flow rate - just enough O2 to meet patients needs
What do we do with the flow rate at the end of anesthesia?
- vaporizer is turned off
- oxygen flow should be increased (back to induction rates)
How do we flush anesthetic vapors out of the system?
- open pop-off valve
- emptu reservoir bag
- refill with O2
- flush valve
What is the importance of acidosis?
why we should not let the patient rebreathe his own exhaled CO2
What is normal arterial CO2 blood levels?
40 mm Hg
What happens when arterial CO2 blood levels are over 60 mm Hg?
What is hypoxia?
decreased Hg transport of O2
What are some problems with high blood CO2?
- increased BP
- increased HR
- peripheral vasoconstriction
- cerebral vasodilation
- cardia arrhythmias
What is peripheral vasoconstriction?
cuts off blood flow to other parts of the body to allow more blood to go to the brain
What can cerebral vasodilation cause?
- increased intracranial pressure
- CNS damage
What are signs of hypercapnia?
- caridac arrhythmias
- irregular respiratory patterns (tachypnea, abdominal breathing)
- blood pressure variable (hypertension followed by hypotension)
- flushed skin
What is hypercapnia?
too much CO2
Are the clinical signs of hypercapnia easy to see?
How do we treat high CO2?
- support ventilation (bag the patient)
- determine cause and correct it
What cautions do we need to take when using an anesthesia machine?
- always check machine before use
- make sure there is enough O2
- make sure the correct vaporizer is in the system
- make sure the vaporizer isn't set too high
- make sure the anesthetic liquid does not run out
- make sure the N2O isn't accidently connected to the O2 line
- make sure everything is okay with the soda lime
What happens to the soda lime when it isn't good anymore?
it turns purple
How do we check the anesthesia machine?
- check to make sure there is liquid in the vaporizer
- check to make sure there is O2 in the tank and there is a back up tank
- check for leaks
- check to make sure it is assembled properly
What kind of tanks do we use?
O2 and N2O
How often do we clean and recalibrate the vaporizer?
every 1 - 2 years
How do we check to make sure the CO2 absorber is okay?
- during procedure: make sure it doesn't turn purple
- between uses: make sure you can't crush the granules with your fingers
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