Equipment Anesthesia Machine

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  1. What equipment is needed to use the anesthesia machine?
    • endotracheal tubes
    • stylets
    • IV catheter
    • administration set
    • IV fluid bag
    • KY jelly
    • lidocaine spray
    • ophthalmic ointment
    • face mask
    • inhalation anesthesia machine
    • emergency drugs
    • monitoring equipment
    • scavenger system
  2. What is the goal of anesthesia?
    to deliver a precise amount of anesthetic vapor and O2 to patient
  3. Why do we use the anesthesia machine?
    increases safety and convenience of inhalation anesthesia
  4. What type of volatile inhalation anesthetic gases do we use?
    • halothane
    • isoflurane
    • sevoflurane
    • methoxyflurane
  5. What are carrier gases?
    volatile anesthetic gas is mixed with carrier gas for delivery?
  6. What carrier gases do we use?
    • oxygen
    • oxygen + nitrous oxide
  7. What is the function of the anesthesia machine?
    • deliver oxygen
    • vaporize anesthetic
    • mix anesthesic with oxygen
    • deliver mixture to patient
    • remove exhaled gases
  8. How is inhalation anesthetic supplied?
    as a liquid
  9. Vaporize anesthetic must be _____.
  10. Vaporize anesthetic must be delivered at a specific _____.
  11. How is exhaled gas removed?
    through the scavenger system and may recirculate to patient after removing CO2
  12. Should oxygen be continuously supplied to the patient?
  13. What color tank is the oxygen tank?
    • green in USA
    • white everywhere else
  14. What is the O2 pressure gauge?
    direct relationship between amount of O2 in tank and it's pressure
  15. Where is the O2 pressure gauge located?
    near top of tank
  16. What will the O2 pressure gauge say if it is a full tank?
    2000 psi
  17. What will the O2 pressure gauge say if the tank is half full?
    1000 psi
  18. What will the O2 pressure gauge say if the tank is considered empty?
    100 psi
  19. What is the atm pressure?
    15 psi
  20. What are the cautions about oxygen?
    • oxygen supports combustion
    • keep away from flames
    • no smoking or sparks near equipment
  21. What color are N2O tanks?
  22. What does the N2O pressure gauge say if it is full?
    770 psi
  23. What is N2O?
    a combination of liquid and gas at a certain pressure (770 psi)
  24. When does the N2O pressure drop?
    when the tank is almost empty
  25. When is the N2O tank considered empty?
    500 psi
  26. What can happen to the patient as a result of N2O not used correctly?
  27. How do you keep track of the N2O pressure?
    weigh the tank
  28. What size tank is the little size?
  29. What size tank is the bigger sizes?
    G, H, M
  30. How do you open the tank valve?
    turn counterclockwise
  31. How do you close the tank?
    turn clockwise
  32. What does the pressure gauge read on the tank when it is turned off?
  33. How do you evacuate the pressure in the tank?
    • turn off tank
    • leave flowmeter on until it reads zero
    • then turn off flowmeter
    • OR
    • turn off tank
    • push the oxygen flush valve until pressure is gone
  34. What are the different attachments for the tank?
    • gas line (for free standing tanks)
    • yoke (for small tanks attached directly to the machine)
    • safety systems
  35. What is the purpose of the safety system on the tanks?
    prevents the wrong tank from being attached
  36. What are the different safety systems for the tanks?
    • pin-index saftey system (for yokes)
    • special outlets (for gas lines)
    • color coding
  37. What is the pressure regulator valve?
    • on O2 and N2O tanks
    • reduces pressure down to 50 psi
    • prevents damage ot patient and machine
  38. Are there separate flowmeters for oxygen and nitrous oxide?
  39. What must be turned on in order for O2 to be delievered to the patient?
    O2 tank and flowmeter
  40. What is the flowmeter?
    allows rate of gas flow to be set
  41. How is the flowmeter set?
    • rate is set according to patient's size and need
    • expressed in L/min
  42. What does the flowmeter look like?
    graduated narrow glass tube with loose ball inside
  43. How do you turn the flowmeter on?
    turn dial to the left
  44. Where do you read the flowmeter?
    at the center of the ball
  45. Gas enters the flowmeter at the _____ at _____.
    • botton
    • 50 psi
  46. Gas leave the flowmeter at the _____ at _____.
    • top
    • 15 psi
  47. How can the flowmeter be damaged?
    • not handling carefully
    • over tightening the dial
    • not turning it off after use
  48. What is fresh gas?
    gas that has not been exhaled from the patient and which is not mixed with gas exhaled from the patient
  49. What does the fresh gas include?
    • O2
    • N2O (if being used)
    • anesthetic vapor if using VOC
  50. Where is the fresh gas inlet?
    where the fresh gas enters the patient breathing circuit
  51. What is another name for the patient breating circuit?
    patient ciruit or anesthetic circuit
  52. What does the patient circuit include?
    • one way flutter valves
    • breathing hoses
    • CO2 absorber
    • pop-off valve
    • reservoir bag
  53. What is the reservoir bag?
    • rebreathing bag
    • adjusts to the changing gas volume within the breathing circuit
  54. When a patient inhales what happens to the reservoir bag?
  55. When a patient exhales what happens to the reservoir bag?
  56. What goes in the reservoir bag?
    fresh gas
  57. What happens when the reservoir bag is too small?
    • not enough gas is available and patient can not breathe easily
    • bag can fill up too fast
  58. What happens when the reservoir bag is too large?
    difficult to monitor the bag - there is little volume change between inspiration and expiration
  59. What are the functions of the reservoir bag?
    • easier for patient to breath from bag than from gas flow in tube
    • allows observation of rate, depth, and rhythm of respiration
    • movement of bag from breathing confirms placement of endotracheal tube into trachea
    • allows the anethetist to "bag" the patient's lungs
  60. What are the advantages of bagging the patient?
    • helps prevent atelectasis (no exchange through collapsed alveoli)
    • flushes airways and alveoli with fresh air
    • can ventilate patient who can't breathe on his own
    • life-saving
  61. How full should the bag be?
    about 1/2 - 3/4 full
  62. How do fill the reservoir bag just right?
    adjust flowmeter, pop-off valve, and scavenger
  63. Should we use the oxygen flush to keep refilling the bag? Why or why not?
    • no
    • delivers 100% oxygen and no anesthetic
    • dilutes - patient lightens
  64. Whats another name for the one-way valve?
    flutter valve or unidirectional valve
  65. What is the purpose of one-way valves?
    allows orderly circulation
  66. What is the inhalation valve?
    allows gas flow towards patient in the inspiratory or inhalation breathing tube
  67. What is the exhalation valve?
    allows gas flow away from patient in the expiratory or exhalation breathing tube
  68. What is the importance of one-way valves?
    forces exhaled gas to pass through CO2 absorber for the most efficient delivery
  69. What is the purpose of the y-piece?
    attaches together the inhalation and exhalation tubes
  70. What is the purpose of the oxygen flush valve?
    allows O2 to bypass flowmeter and vaporizer to deliver 100% O2 into breathign circuit
  71. When can the O2 flush valve be good?
    when the patient is too deep because it dilutes the anesthetic gas
  72. When can the O2 flush valve be bad?
    when the patient is too light because it dilute the anesthetic gas
  73. What is the purpose of the pop-off valve?
    • prevents pressure from building up in patient breathing circuit
    • controls patient ventilation (able to bag the patient)
    • can keep fully or partly open during most anesthetic procedures
  74. When is the pop-off valve fully closed?
    • when bagging the patient
    • when using closed or total rebreathing system
  75. What is the scavenger system?
    • removal of waste gases
    • can either be physically removed from building or can pass through an activated charcoal cartridge
  76. How is the waste gas physically removed from the building using the scavenger system?
    • active suction: fan or pump
    • passive: pressure or gravity
  77. What does the carbon dioxide absorber canister contain?
    soda lime
  78. What is the purpose of the carbon dioxide absorber canister?
    remove exhaled CO2 from breathing circuit and prevents acidosis
  79. What is the active ingredient in the soda lime or barium hydroxide granules?
    calcium hydroxide
  80. What chemical reaction takes place in the carbon dioxide absorber canister? And what does it produce?
    • takes place between CO2 and calcium hydroxide
    • heat and water
  81. How do you know when the carbon dioxide granules are good?
    • canister is warm while in use
    • stay normal color when in use
    • feel soft and crumbly
  82. How do you know when the carbon dioxide granules are bad?
    • no warmth when in use
    • change color in use
    • feel hard and brittle
  83. When replacing the carbon dioxide granules, how much space should you leave at the top?
    2 cm
  84. What is another name for the pressure manometer?
    ventilation pressure gauge
  85. What is the purpose of the pressure manometer?
    measures pressure inside breathing circuit and patient
  86. Where is the pressure manometer located?
    on top of CO2 absorber
  87. Manometer pressure should not exceed _____ during non-bagging use?
    15 cm H2O
  88. Manometer pressure should not exceed _____ during bagging use?
    20 cm H2O
  89. When does barotrauma occur?
    when the manometer pressure exceeds 60 cm H2O
  90. What does barotrauma cause?
    • pneumothorax
    • subcutaneous emphysema
    • air embolism
  91. What is the purpose of the negative pressure relief valve?
    to prevent negative pressure or a vaccum from developing inside the breathing circuit
  92. Where is the negative pressure relief valve located?
    on top of the inhalation flutter valve
  93. When does a vaccum occur?
    • when the oxygen tank becomes empty
    • reservoir bag is flat
  94. What are the different ways to check for leaks in the system?
    • turn on O2 and close pop-off valve
    • hold off trach tube opening of y-piece
    • fill reservoir bag with oxygen and squeeze bag
  95. If leaks are detected...
    • minor: tape up
    • major: replace parts
    • really major: send of for repairs
Card Set:
Equipment Anesthesia Machine
2012-03-13 00:35:24
Clinical Practice

Clinical Practice
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