Anesthesia Gas Delivery System

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Questions and Answers

What is the primary function of the oxygen pressure failure alarm within the anesthesia machine?

  • To restrict the flow of nitrous oxide if oxygen pressure is inadequate.
  • To alert the user if the oxygen pressure drops too low. (correct)
  • To bypass the vaporizers and deliver high-flow oxygen to the patient.
  • To control the amount of oxygen delivered to the patient.

How does the oxygen pressure failure device (fail-safe) contribute to patient safety in the anesthesia machine?

  • By delivering high-flow oxygen directly to the patient in emergencies.
  • By cutting off or restricting the flow of other gases if oxygen pressure is inadequate. (correct)
  • By monitoring oxygen concentration in the inspired gas mixture.
  • By controlling the precise amount of oxygen administered.

What role does the hypoxic guard play in the function of the anesthesia machine?

  • It ensures oxygen's flowmeter interacts with other gases to prevent delivery of a hypoxic mixture. (correct)
  • It allows the delivery of a hypoxic mixture when needed.
  • It regulates the pressure of oxygen entering the machine.
  • It controls the flow of anesthetic agents.

What is the primary function of the oxygen flush valve in an anesthesia machine?

<p>To allow high-flow oxygen to bypass the vaporizers and go directly to the patient. (D)</p> Signup and view all the answers

Which component of the anesthesia machine is responsible for removing carbon dioxide from the breathing circuit?

<p>The absorber. (A)</p> Signup and view all the answers

How does a sudden decrease in total gas flow affect the anesthetic concentration delivered by a historical copper kettle vaporizer?

<p>It raises the anesthetic concentration to potentially dangerous levels. (A)</p> Signup and view all the answers

How do modern vaporizers compensate for temperature changes to maintain a consistent output of anesthetic vapor?

<p>By using a bimetallic strip that adjusts gas flow depending on temperature. (D)</p> Signup and view all the answers

Why is it dangerous to tip a modern vaporizer?

<p>It can cause the liquid anesthetic to enter the bypass chamber, affecting concentration. (D)</p> Signup and view all the answers

What should be done if a vaporizer is accidentally tipped over?

<p>Purge the vaporizer with high gas flow for 20 to 30 minutes at a high concentration setting. (B)</p> Signup and view all the answers

In the context of vaporizers, what does 'split ratio' refer to?

<p>The ratio of gas flow entering the bypass chamber to gas flow entering the vaporizing chamber. (C)</p> Signup and view all the answers

For desflurane, which of the following is true regarding its physical properties and vaporizer requirements?

<p>It is heated and pressurized because its vapor pressure is close to 1 atmosphere at room temperature. (D)</p> Signup and view all the answers

What unique characteristic of the Tec 6 Desflurane vaporizer requires manual adjustment when used at high altitudes?

<p>The desflurane concentration control needs to be manually increased. (B)</p> Signup and view all the answers

What is the primary distinguishing feature of the Aladin cassette vaporizer system compared to traditional vaporizers?

<p>It utilizes agent-specific, magnetically coded cassettes. (A)</p> Signup and view all the answers

In the Aladin cassette vaporizer, what component precisely controls the flow of fresh gas to achieve the desired anesthetic concentration?

<p>The CPU and flow control valve. (D)</p> Signup and view all the answers

What unique safety feature is present in the Aladin cassette vaporizer system?

<p>A one-way valve that prevents retrograde flow of anesthetic vapor. (D)</p> Signup and view all the answers

How does the Maquet FLOW-i electronic injector vaporizer deliver anesthetic agents?

<p>It measures and injects precise amounts of liquid anesthetic directly into the fresh gas flow. (D)</p> Signup and view all the answers

What is the 'pumping effect' related to vaporizers, and how have modern machines addressed it?

<p>It is the back pressure transmitted to the low-pressure system; modern machines incorporate one-way check valves. (B)</p> Signup and view all the answers

A circle system is set to semi-closed. Which of the following is true?

<p>It has rebreathing of gasses, and consists of valves. (A)</p> Signup and view all the answers

Which of the following is a disadvantage of the Circle System?

<p>It has a higher opportunity for malfunction. (D)</p> Signup and view all the answers

During spontaneous ventilation, how should the Adjustable Pressure-Limiting (APL) valve be configured within a circle system?

<p>Fully open to facilitate unrestricted patient breathing. (B)</p> Signup and view all the answers

Which best describes 'Dead Space' in regards to breathing systems?

<p>The volume of the breathing system occupied by gases that are rebreathed without change in composition. (D)</p> Signup and view all the answers

What is a primary advantage of allowing a controlled amount of rebreathing during anesthesia?

<p>It helps with heat and humidity retention. (C)</p> Signup and view all the answers

Which of the following statements is true regarding Mapleson circuits?

<p>ABCDEF are semi-closed. (C)</p> Signup and view all the answers

What is the general guideline for fresh gas flow (FGF) settings when using a Mapleson circuit to prevent rebreathing?

<p>FGF should be 2.5 times the patient's minute ventilation. (C)</p> Signup and view all the answers

What is the best use case scenario for Mapleson A?

<p>For spontaneous ventilation. (D)</p> Signup and view all the answers

What is a unique disadvantage of Mapleson A when compared to the other Mapleson configurations?

<p>It is inefficient for controlled ventilation. (D)</p> Signup and view all the answers

Which Mapleson circuit is considered the most suitable for controlled ventilation?

<p>Mapleson D. (B)</p> Signup and view all the answers

Which Mapleson circuit is best for transport & resuscitation?

<p>Mapleson C. (B)</p> Signup and view all the answers

Which of the following Mapleson circuits is essentially Mapleson E or Ayre's T-Piece circuit with a reservoir bag added?

<p>Mapleson F. (A)</p> Signup and view all the answers

Which statement accurately describes the Mapleson F (Jackson-Rees) modification?

<p>Requires high fresh gas flows. (D)</p> Signup and view all the answers

When performing the Pethick test on a Bain circuit, what observation indicates a patent inner tube?

<p>The reservoir bag collapses when the oxygen flush valve is activated. (C)</p> Signup and view all the answers

What is the function of the exhalation check valve in the Circle System breathing circuit?

<p>Ensure one-way flow. (C)</p> Signup and view all the answers

What is the purpose of the APL (adjustable pressure-limiting) valve in a circle system?

<p>To vent excess gas and control pressure in the circuit during manual ventilation. (D)</p> Signup and view all the answers

What may occur if inspiratory valve is stuck open?

<p>Rebreathing and hypercapnia. (A)</p> Signup and view all the answers

Which of the following characteristics of corrugated tubing creates the best component for the ventilation circuit?

<p>Minimal length and maximal internal diameter without sharp curves. (C)</p> Signup and view all the answers

What is a key characteristic of historical copper kettle vaporizers that influences anesthetic delivery?

<p>Use of a separate flowmeter and saturation of all entering gas with vapor (D)</p> Signup and view all the answers

Why is it imperative to dilute the gas exiting a historical copper kettle vaporizer before it reaches the patient?

<p>Because the vapor pressure of volatile anesthetics is greater than the partial pressure needed for anesthesia (C)</p> Signup and view all the answers

How does altering the flow rate affect the anesthetic concentration when using modern vaporizers?

<p>Only extremes of flow rates affect anesthetic concentration (D)</p> Signup and view all the answers

What mechanism do modern vaporizers employ to maintain a consistent anesthetic concentration despite cooling?

<p>Bimetallic strip (A)</p> Signup and view all the answers

What occurs within a modern vaporizer when the temperature of the liquid anesthetic decreases?

<p>The bimetallic strip increases gas flow into the vaporizing chamber. (B)</p> Signup and view all the answers

What is a significant danger associated with overfilling a modern vaporizer?

<p>Anesthetic liquid may enter the bypass chamber (B)</p> Signup and view all the answers

If a modern vaporizer is found to be leaking, where is the most likely source of the leak?

<p>Loose filler cap (B)</p> Signup and view all the answers

What is the purpose of the surface area created by baffles and wicks inside the vaporizing chamber of a modern vaporizer?

<p>To increase turbulence promoting fresh gas saturation (B)</p> Signup and view all the answers

What is the split ratio in a vaporizer? (Select best answer)

<p>The proportion of carrier gas flowing in each of the two streams. (B)</p> Signup and view all the answers

What does the saturated vapor pressure of an anesthetic agent primarily determine?

<p>The concentration of anesthetic that can be achieved at a given temperature (B)</p> Signup and view all the answers

After a vaporizer has been significantly tipped, what actions are recommended?

<p>Purge the vaporizer with a high flow rate and confirm output with an agent analyzer. (D)</p> Signup and view all the answers

For Dräger Vapor 2000 and 3000 series vaporizers, what specific feature is designed to prevent issues related to tipping?

<p>Transport (T) dial setting to prevent tipping related issues (D)</p> Signup and view all the answers

How does the Tec 6 desflurane vaporizer achieve the necessary vapor pressure for desflurane delivery?

<p>It heats and pressurizes the agent to approximately 2 atm (B)</p> Signup and view all the answers

What is a crucial consideration when using a Tec 6 desflurane vaporizer at high altitudes?

<p>Increase the set concentration to compensate for the decreased atmospheric pressure (A)</p> Signup and view all the answers

How is the Tec 6 accurately described in terms of gas blending and vaporization?

<p>Dual-gas blender (D)</p> Signup and view all the answers

What is the reference working pressure used for fresh gas entering the Tec 6?

<p>After passing resistor R1 (A)</p> Signup and view all the answers

In the Tec 6, what role does the differential pressure transducer play?

<p>It compares the pressure in the bypass flow with that in the vapor circuit (C)</p> Signup and view all the answers

In the Aladin cassette vaporizer, how do the fresh gas and liquid chamber flows combine?

<p>They combine after passing through a mixing chamber. (B)</p> Signup and view all the answers

What specific feature prevents retrograde flow of anesthetic vapor back into the bypass chamber within the Aladin cassette system?

<p>One way check valve (A)</p> Signup and view all the answers

In the Maquet FLOW-i electronic injector vaporizer system, how is the delivery of liquid anesthetic achieved?

<p>By injection measured amounts of liquid anesthetic are injected into the FGC stream (A)</p> Signup and view all the answers

What is the primary cause of the 'pumping effect' in older vaporizer designs?

<p>Pressure fluctuations due to events/ventilation (C)</p> Signup and view all the answers

How has the industry minimized the 'pumping effect'?

<p>One-way check valves (C)</p> Signup and view all the answers

What is the primary goal of the anesthesia breathing circuit?

<p>To deliver oxygen/agent while eliminating CO2 (B)</p> Signup and view all the answers

How does FGF relate to rebreathing?

<p>Rebreathing varies inversely with FGF (B)</p> Signup and view all the answers

Which statement highlights the utility of controlled rebreathing?

<p>Heat and moisture retention/balances gas tensions (E)</p> Signup and view all the answers

What is a key design factor for Mapleson systems?

<p>Low resistance to gas flow. (B)</p> Signup and view all the answers

A fresh gas flow of how many times the patient's minute ventilation is sufficient to prevent rebreathing?

<p>2.5 (D)</p> Signup and view all the answers

Which Mapleson circuit requires a relatively high, specific, FGF to prevent rebreathing?

<p>Mapleson A (A)</p> Signup and view all the answers

Which is most true regarding alveolar gas in Mapleson D during spontaneous?

<p>Expiratory all gas mix into back excess gas escapes when back full (A)</p> Signup and view all the answers

Which choice is most true regarding alveolar gas in Mapleson A during spontaneous?

<p>Expiration-Bag fills, APL valve opens, alveolar gas escapes (C)</p> Signup and view all the answers

During assisted or controlled ventilation, how does the adjustable pressure-limiting (APL) valve function?

<p>Pressure release via scavenging. (D)</p> Signup and view all the answers

During which moment should the APL be open?

<p>Fully open spontaneous ventilation (D)</p> Signup and view all the answers

What is a prominent disadvantage of circle systems?

<p>Bulky and complex. (A)</p> Signup and view all the answers

In a closed breathing system, what is the relationship between fresh gas inflow and patient oxygen consumption?

<p>Fresh gas flow matches oxygen flow. (A)</p> Signup and view all the answers

What is a key disadvantage of closed systems?

<p>Fast switch over to adjust the gas or oxygen. (C)</p> Signup and view all the answers

How should tubing length and diameter impact your equipment choice?

<p>Length = short (B)</p> Signup and view all the answers

What should the standard for reservoir bags larger than 1.5 L?

<p>No less than 35 or over 60 cm H20 at 4 X capacity (C)</p> Signup and view all the answers

During circle systems, what best describes the relationship between the inhalation/exhalation and the fresh gas inlet?

<p>Enters the circle between the exhalation and inhalation valve (C)</p> Signup and view all the answers

Which of the following best describes the function of the hypoxic guard in an anesthesia machine?

<p>It prevents the delivery of a hypoxic gas mixture by linking the flow of nitrous oxide and oxygen. (B)</p> Signup and view all the answers

What is the correct sequence of gas flow through the components of an anesthesia machine?

<p>Cylinder → Flowmeter → Common manifold → Vaporizer → Patient (A)</p> Signup and view all the answers

What is the purpose of the baffles and wicks found within the vaporizing chamber of a modern vaporizer?

<p>To increase the surface area available for vaporization and promote turbulence. (D)</p> Signup and view all the answers

How does the decreased temperature impact the bimetallic strip in a modern vaporizer?

<p>The bimetallic strip contracts, allowing more gas to pass through the vaporizer. (C)</p> Signup and view all the answers

Which of the following is a key step in managing a modern vaporizer that has been tipped over?

<p>Purging the vaporizer with high FGF for 20-30 minutes, and confirming output with an agent analyzer. (A)</p> Signup and view all the answers

Which factor determines the flow of gas through a historical copper kettle vaporizer?

<p>A separate, dedicated flowmeter upstream of the vaporizer. (B)</p> Signup and view all the answers

What is the primary reason for the need to dilute the gas exiting a historical copper kettle vaporizer before it's delivered to the patient?

<p>Because the vaporizer output is fully saturated with anesthetic vapor and would be dangerously high if delivered undiluted. (C)</p> Signup and view all the answers

In the Tec 6 desflurane vaporizer, a 'pressure-regulating valve' is located downstream from what component?

<p>The shut-off valve (C)</p> Signup and view all the answers

What role does the reference working pressure play in the Tec 6 desflurane vaporizer?

<p>It assists in accurately mixing desflurane vapor with fresh gas. (B)</p> Signup and view all the answers

How do the Aladin cassette vaporizers prevent liquid anesthetic agent from entering the fresh gas line when the cassette is removed from the anesthesia machine?

<p>A series of valves prevent both the loss of fresh gas from the mount and liquid anesthetic agent from entering the fresh gas line. (C)</p> Signup and view all the answers

In the Maquet FLOW-i electronic injector vaporizer, the volume of vapor produced is calculated based on what?

<p>The set concentration and the physical properties of the selected agent. (C)</p> Signup and view all the answers

Why does the pressure of the breathing system fluctuate when positive pressure ventilation or the oxygen flush valve are in use?

<p>The low pressure system receives increased pressure. (B)</p> Signup and view all the answers

Which of the following best describes a semi-closed circuit within the anesthesia breathing system?

<p>Rebreathing of gases, consists of valves, most common system in US (FGF &lt; MV) <em>Circle System</em> Conserves heat and humidity. (D)</p> Signup and view all the answers

What is the main function of the circle system in an anesthesia breathing circuit?

<p>To eliminate carbon dioxide, deliver oxygen and anesthetic gases, which conserves airway moisture and body heat. (D)</p> Signup and view all the answers

What is the implication of increased tidal volume when using a Mapleson circuit?

<p>Increased rebreathing as more alveolar gas is pushed into the corrugated tubing. (C)</p> Signup and view all the answers

Which Mapleson circuit configuration places the fresh gas inlet and APL valve nearest the patient?

<p>Mapleson B (A)</p> Signup and view all the answers

What is a crucial step of the Pethick test on the Bain circuit?

<p>Occluding the elbow at the patient end while flushing with oxygen. (B)</p> Signup and view all the answers

The ASTM standard for reservoir bags larger than 1.5L requires the pressure (at 4x capacity) to:

<p>Not be less than 35 or over 60 cm H2O. (B)</p> Signup and view all the answers

If the inspiratory valve of a circle system malfunctions and remains stuck in the open position, which of the following complications is most likely to occur?

<p>Rebreathing and hypercapnia. (B)</p> Signup and view all the answers

What action does the Adjustable Pressure-Limiting (APL) valve perform?

<p>To maintain circuit pressure below a set limit. (D)</p> Signup and view all the answers

In a historical copper kettle vaporizer, what is a critical consideration for the carrier gas after it passes through the vaporizing chamber?

<p>The carrier gas must be diluted because it is fully saturated with anesthetic vapor. (A)</p> Signup and view all the answers

How does a modern vaporizer compensate for decreases in ambient pressure to maintain a constant anesthetic concentration?

<p>Modern vaporizers automatically compensate for changes in ambient pressures; altitude change e.g. (B)</p> Signup and view all the answers

Why is it critical to avoid overfilling modern vaporizers?

<p>The excess liquid anesthetic can enter the bypass chamber, leading to dangerously high concentrations delivered to the patient. (D)</p> Signup and view all the answers

What design element of a modern vaporizer ensures that the proportion of gas exposed to the liquid anesthetic remains constant regardless of flow rate?

<p>A variable-bypass system that splits and recombines gas flow. (C)</p> Signup and view all the answers

What is the immediate next step if a modern vaporizer has been significantly tipped over?

<p>Set the concentration dial to a high concentration and flush high FGF to sit for 20-30 minutes allows excess anesthetic to evaporate. (C)</p> Signup and view all the answers

What does increasing dial setting do to gas flow within a modern vaporizer?

<p>More gas flows into the vaporizing chamber, causing a higher concentration of anesthetic gas delivered. (C)</p> Signup and view all the answers

What is the function of the wick inside a variable-bypass vaporizer?

<p>To increase the surface area of the liquid anesthetic available for vaporization. (C)</p> Signup and view all the answers

What could result if the Tec 6 desflurane vaporizer attempts to be used without being warmed up?

<p>The vaporizer will not deliver any desflurane. An alarm will sound until the device is warmed up. (D)</p> Signup and view all the answers

Within the Tec 6 desflurane vaporizer, what is the purpose of the pressure-regulating valve located downstream from the shut-off valve?

<p>It reduces the pressure to approximately 1.1 atm absolute to accurately control desflurane output. (C)</p> Signup and view all the answers

How does the Aladin cassette vaporizer primarily control the concentration of anesthetic agent delivered to the patient?

<p>By electronically regulating the flow of fresh gas through a flow control valve in the vaporizing chamber. (A)</p> Signup and view all the answers

In the Maquet FLOW-i electronic injector vaporizer system, what physical principle is analogous to the system's method of anesthetic delivery?

<p>Fuel injection in an automobile engine. (D)</p> Signup and view all the answers

What technical advancement substantially reduced, but did not eliminate, the 'pumping effect' in modern vaporizers?

<p>The incorporation of one-way check valves. (C)</p> Signup and view all the answers

What is the primary advantage of a semi-closed circle system, compared to a semi-open system, in terms of heat and humidity?

<p>Semi-closed systems allow for rebreathing, which conserves both heat and humidity, whereas semi-open systems do not. (D)</p> Signup and view all the answers

What aspect presents a challenge to closed anesthesia breathing systems?

<p>Difficulty in achieving and maintaining stable anesthetic concentrations. (C)</p> Signup and view all the answers

Why do Mapleson circuits lack unidirectional valves and carbon dioxide absorbers?

<p>To minimize the cost and complexity of the circuit. (B)</p> Signup and view all the answers

In Mapleson circuits, what results from changes in fresh gas flow?

<p>Rapid and similar changes in the breathing circuit's gas makeup. (D)</p> Signup and view all the answers

During spontaneous ventilation with a Mapleson A circuit, where are the fresh gas inlet and APL valve located with respect to the patient?

<p>Fresh gas inlet is located near the reservoir bag, and the APL valve is located near the patient. (D)</p> Signup and view all the answers

Why does Mapleson A require 10 L/min fresh gas flows?

<p>To match the patient's minute ventilation to prevent rebreathing. (C)</p> Signup and view all the answers

Which Mapleson circuit is preferred for its efficiency during controlled ventilation, and why?

<p>Mapleson D, because the fresh gas inlet is located near the patient, and the downstream APL valve promotes efficient scavenging. (D)</p> Signup and view all the answers

During a Pethick test on a Bain circuit, what observation concerning fresh gas flow indicates a leak in the inner tube?

<p>Fresh gas escaping into the expiratory limb, and the reservoir bag remains inflated. (A)</p> Signup and view all the answers

What are the benefits of fresh gas flow?

<p>Speed induction and recovery, compensate for leaks. (C)</p> Signup and view all the answers

In a circle system, how is the direction of gas flow maintained, preventing bidirectional movement?

<p>Through the use of unidirectional valves within the inspiratory and expiratory limbs. (B)</p> Signup and view all the answers

What is the purpose of the exhalation check valve in the Circle System breathing circuit?

<p>To prevent rebreathing by ensuring exhaled gases flow towards the CO2 absorber and away from the patient. (A)</p> Signup and view all the answers

According to ASTM standards, what is the minimum pressure requirement for reservoir bags larger than 1.5 L when inflated to four times their capacity?

<p>The pressure should not be less than 35 or over 60 cm H2O. (D)</p> Signup and view all the answers

In a circle system, what is the primary effect of an incompetent expiratory valve (stuck open)?

<p>Rebreathing with hypercapnia. (A)</p> Signup and view all the answers

What design consideration of corrugated tubing is most important for reducing resistance to gas flow within the breathing circuit?

<p>Minimal length and maximal internal diameter without sharp curves or sudden diameter changes. (D)</p> Signup and view all the answers

During which phase of respiration within a Mapleson A circuit is alveolar gas most likely to be eliminated from the system?

<p>During expiration, provided there is sufficient fresh gas flow to 'wash out' the exhaled gases. (A)</p> Signup and view all the answers

How the fresh gas inlet relate to the exhalation/inspiration ports?

<p>These two are unrelated in a circle system. (A)</p> Signup and view all the answers

What is the most important indication for use for Mapleson F?

<p>Transport circuits for the NICU. (D)</p> Signup and view all the answers

What has the most influence in the amount of rebreathing that occurs?

<p>Fresh Gas Flow (C)</p> Signup and view all the answers

What is Volume in dead space?

<p>It occupies by gases that are rebreathed without change in composition. (A)</p> Signup and view all the answers

Why is a controlled amount of rebreathing needed?

<p>It is beneficial for increasing heat and moisture. (A)</p> Signup and view all the answers

Aside from FGF, what is the other parameter best controlled in breathing to lower rebreathing?

<p>The expiratory pause. (D)</p> Signup and view all the answers

How should the APL be set to function normally?

<p>Fully open (D)</p> Signup and view all the answers

What constitutes the biggest disadvantage of circle circuits?

<p>The increased resistance. (B)</p> Signup and view all the answers

When is APL closed/restricted?

<p>Controlled Ventilation (B)</p> Signup and view all the answers

In a historical copper kettle vaporizer, if the carrier gas becomes insufficiently diluted after passing through the vaporizing chamber, what is the most probable consequence for the patient?

<p>Unpredictable and potentially dangerously high anesthetic concentration delivered. (D)</p> Signup and view all the answers

How does the bimetallic strip within a modern vaporizer contribute to maintaining a stable anesthetic concentration during temperature fluctuations?

<p>It alters the proportion of gas flowing through the vaporizing chamber and bypass chamber. (C)</p> Signup and view all the answers

What is the likely consequence of failing to set a vaporizer concentration dial to its highest setting when purging a recently tipped-over modern vaporizer?

<p>Incomplete removal of liquid anesthetic, leading to potential overdose. (C)</p> Signup and view all the answers

What is the most likely consequence if the Aladin cassette vaporizer is removed mid-case?

<p>A built-in valve will close, which will prevent both agent from spilling and gas from escaping. (A)</p> Signup and view all the answers

In the context of a Tec 6 desflurane vaporizer, how does the concentration control valve (R2) precisely regulate the output of desflurane vapor?

<p>By acting as a variable restrictor to control the flow of desflurane vapor into the fresh gas stream. (A)</p> Signup and view all the answers

In the Maquet FLOW-i electronic injector vaporizer system, what is the fundamental principle that allows precisely measured amounts of liquid anesthetic to be injected into the fresh gas flow (FGF) stream?

<p>The ability to calculate volume of vapor produced per ml of liquid agent. (D)</p> Signup and view all the answers

What is the primary factor differentiating the Mapleson A circuit's efficacy during spontaneous versus controlled ventilation?

<p>During spontaneous ventilation, Mapleson A relies on high FGF to 'wash out' exhaled gases, a process less effective in controlled ventilation. (D)</p> Signup and view all the answers

A technician discovers that the internal diameter of the corrugated tubing in a circle system is significantly smaller than the standard. How might this affect a patient?

<p>Increased airway resistance, leading to greater work of breathing (B)</p> Signup and view all the answers

What is the underlying reason that a fully closed anesthesia breathing system is generally avoided despite its environmental and cost-saving benefits?

<p>The risk of delivering unpredictable and potentially insufficient concentrations of oxygen. (D)</p> Signup and view all the answers

Why is it crucial to avoid overfilling a modern variable-bypass vaporizer, such as a Dräger Vapor 2000, with volatile anesthetic agent?

<p>The excess liquid can enter the bypass chamber, leading to a dangerously high anesthetic concentration. (C)</p> Signup and view all the answers

What is the primary advantage of incorporating baffles and wicks within the vaporizing chamber of a modern vaporizer?

<p>To increase the surface area for vaporization and promote turbulence. (D)</p> Signup and view all the answers

How does the Aladin cassette vaporizer system prevent liquid anesthetic agent from contaminating the fresh gas line upon cassette removal?

<p>It utilizes a series of interconnected valves that automatically close upon cassette removal. (D)</p> Signup and view all the answers

What critical adjustment must be made when utilizing a Tec 6 desflurane vaporizer at high altitudes to ensure adequate anesthetic delivery?

<p>Increase vaporizer output. (A)</p> Signup and view all the answers

Considering the design of the Mapleson circuits, what strategy would be most effective in minimizing rebreathing of carbon dioxide during mechanical ventilation?

<p>Employ a longer expiratory pause. (D)</p> Signup and view all the answers

How should the APL valve be managed during spontaneous ventilation?

<p>The APL valve should be fully open. (D)</p> Signup and view all the answers

In a circle system, if the exhalation check valve fails (stuck open), what is the acute risk to the patient?

<p>Increased dead space and rebreathing, leading to hypercapnia. (D)</p> Signup and view all the answers

If you're using a brand new circle system, what do you need to consider?

<p>That you need to check for leaks around the seal. (A)</p> Signup and view all the answers

In a faulty circle system, the inspiratory limb ends up with an obstruction of flow, what would happen?

<p>The patient will not get any air until it is fixed. (B)</p> Signup and view all the answers

What is the standard for pressure in reservoir bags?

<p>The pressure should not be higher than 35 and over 60cm H2O. (D)</p> Signup and view all the answers

Why does increasing the fresh gas flow impact rebreathing?

<p>It will wash out more gasses. (C)</p> Signup and view all the answers

With a Mapleson circuit, what happens if the tidal volume is too high?

<p>It will enter the corrugated tubing and increase rebreathing. (B)</p> Signup and view all the answers

What is not the greatest disadvantage of a circle system?

<p>Need to have appropriate fresh gas flow. (C)</p> Signup and view all the answers

In what circumstance is a semi-open breathing system preferable to a semi-closed system?

<p>When higher concentrations of anesthetic agent is required. (D)</p> Signup and view all the answers

If it is determined that you need a spontaneous breathing circuit, what setup do you need?

<p>Mapleson A (B)</p> Signup and view all the answers

Which of the following is not the utility of rebreathing?

<p>It improves the efficiency of gas exchange. (B)</p> Signup and view all the answers

All Mapleson circuits have the following except:

<p>A carbon dioxide absorber. (B)</p> Signup and view all the answers

What is dead space volume?

<p>The system occupied by gases that are rebreathed without composition changes. (B)</p> Signup and view all the answers

In a Bain circuit, what does the Pethick test assess?

<p>Patency of the inner tubing (fresh gas). (D)</p> Signup and view all the answers

You are planning to perform a procedure using a Mapleson F circuit. What patient would be most appropriate?

<p>A pediatric patient. (C)</p> Signup and view all the answers

What is the relationship between the exhalation/inspiration and fresh gas ports?

<p>The exhalation/inspiration happen separately as air travels around the circuit. (D)</p> Signup and view all the answers

How will the vaporizer dial control anesthetic deliver?

<p>More dial, more gas flows into the vaporizing chamber, higher anesthetic concentration delivered. (D)</p> Signup and view all the answers

What function does the wick serve inside the vaporizer chamber?

<p>The wick increases surface area and promotes turbulence. (A)</p> Signup and view all the answers

In the Tec 6 desflurane vaporizer and prior to the concentration valve, what does the reference working pressure impact?

<p>The reference working pressure is essential for accurate metered vapor. (A)</p> Signup and view all the answers

Using a Mapleson A circuit, if you increase the weight of the patient, how will the alveolar gas change?

<p>Exhaled gases return down the tube and add to gas concentrations. (B)</p> Signup and view all the answers

During anesthesia with controlled ventilation, what represents the function of the APL valve?

<p>The user has to restrict. (B)</p> Signup and view all the answers

During the use of Mapleson D circuit, what causes more waste?

<p>Expiratory effort. (D)</p> Signup and view all the answers

The Mapleson A circuit requires 10 L/min fresh gas flows, why?

<p>To prevent rebreathing. (A)</p> Signup and view all the answers

As long as which of the following occurs are we able to control rebreathing?

<p>Expiratory pause. (C)</p> Signup and view all the answers

Within a circle system, to remove reverse gas flow, what must we do?

<p>Ensure operational unidirectional valve flow. (B)</p> Signup and view all the answers

If it is determined to be high altitude, and you are utilizing the Tec 6, what is needed?

<p>Must manually increase the desflurane concentration control. (B)</p> Signup and view all the answers

Which patient type would be best for undergoing a Mapleson F procedure?

<p>Infant (B)</p> Signup and view all the answers

In a historical copper kettle vaporizer, what is the most critical factor in determining the final concentration of anesthetic delivered to the patient?

<p>The precision with which the gas exiting the vaporizer is subsequently diluted. (A)</p> Signup and view all the answers

A modern vaporizer is designed to maintain a constant output, however, at very low and very high fresh gas flows (FGF), the concentration can become unpredictable. Why might this occur?

<p>At extreme flows, adequate turbulence within the vaporizing chamber is not achieved, hindering the saturation of carrier gas. (D)</p> Signup and view all the answers

After a significant temperature drop within a modern vaporizer, how does the bimetallic strip ensure consistent anesthetic delivery?

<p>It adjusts the proportion of gas flowing through the vaporizing chamber, compensating for lower vapor pressure. (D)</p> Signup and view all the answers

How might you purge a modern vaporizer after it has been tipped over?

<p>Set the concentration dial to its highest setting. (D)</p> Signup and view all the answers

When troubleshooting a tipped vaporizer, why should the concentration dial be set to a high concentration?

<p>To maximize vaporizing chamber inlet and outlet flows, facilitating rapid evaporation and removal of excess agent. (C)</p> Signup and view all the answers

What is the core operational principle behind the Tec 6 desflurane vaporizer's accurate control of desflurane output?

<p>A dual-gas blender configuration that ensures consistent vapor pressure and output. (A)</p> Signup and view all the answers

Within the Tec 6 desflurane vaporizer, what is the functional role of the pressure-regulating valve located downstream from the shut-off valve?

<p>It down-regulates the pressure to a constant output, ensuring predictable desflurane delivery. (B)</p> Signup and view all the answers

Why is it essential to manually increase the desflurane concentration control when using a Tec 6 vaporizer at high altitudes?

<p>To deliver the appropriate partial pressure of desflurane, since the vaporizer cannot compensate for changes in elevation. (C)</p> Signup and view all the answers

After the Aladin cassette is removed from the unit, what is the immediate impact if the valves malfunction? (Select the most likely single answer.)

<p>Loss of fresh gas (O2, air, N2O) from the mount. (C)</p> Signup and view all the answers

Considering the complexities of variable-bypass vaporizers, under what conditions would the inspired concentration most closely match the vaporizer dial setting?

<p>When the temperature of the liquid anesthetic remains constant. (A)</p> Signup and view all the answers

In the context of a circle system, what is the most detrimental consequence of a malfunctioning inspiratory valve that is stuck in the open position?

<p>Progressive hypercarbia due to rebreathing of exhaled gases. (B)</p> Signup and view all the answers

How does increasing fresh gas flow (FGF) lead to decreased rebreathing?

<p>It decreases inspired gas tensions. (B)</p> Signup and view all the answers

After a rapid change to a higher fresh gas flow rate, what adaptation occurs within the anesthesia circle system to best maintain sufficient pressure?

<p>The APL valve is manually closed to a greater extent. (C)</p> Signup and view all the answers

In a Mapleson A circuit during spontaneous ventilation, why does alveolar gas elimination primarily occur during exhalation?

<p>The APL valve is located near the patient, facilitating direct expulsion of alveolar gas during exhalation. (A)</p> Signup and view all the answers

Which factor in a Mapleson circuit has the greatest impact on rebreathing, besides fresh gas flow (FGF)?

<p>Length of expiratory pause. (B)</p> Signup and view all the answers

For a Mapleson D circuit being utilizing new corrugated tubing (long) at high altitude on an obese patient, what alteration should be implemented?

<p>Increasing fresh gas flows. (B)</p> Signup and view all the answers

During a Pethick test on a Bain circuit, failure to remove all slack from the reservoir bag could lead to which false conclusion?

<p>That there is no defect in the tested system. (A)</p> Signup and view all the answers

If it is determined you are providing assisted ventilation, what parameter is MOST important parameter?

<p>Scavenging. (D)</p> Signup and view all the answers

An anesthesia provider is using a circle system with sevoflurane for a patient undergoing a two-hour surgery. Halfway through the procedure, the provider notices the inspired CO2 level is gradually increasing despite adequate minute ventilation. What is the MOST immediate action to resolve this issue?

<p>Change the CO2 absorbent canister. (B)</p> Signup and view all the answers

The ASTM standard establishes pressure requirements for reservoir bags larger than 1.5 L when inflated to four times their capacity. Which best supports why this standard is set?

<p>To ensure there aren't any leaks at higher pressures. (B)</p> Signup and view all the answers

Flashcards

What three gases are delivered by the anesthesia gas delivery system?

Oxygen, nitrous oxide, and air.

What is the O2 Pressure Failure Alarm?

Alerts if oxygen pressure drops too low.

What is the O2 Pressure Failure Device (Fail-safe)?

Cuts off or restricts flow of other gases if O2 pressure is inadequate, preventing hypoxia.

What does the O2 Flowmeter do?

Controls the amount of oxygen delivered.

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What is the O2 Flush Valve function?

Allows high-flow O2 to bypass vaporizers and go straight to the patient in emergencies.

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What is the Ventilator Drive Gas?

O2 powers the ventilator mechanism.

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What happens in the common manifold?

Gases combine after flowmeters.

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What do vaporizers do?

Add volatile anesthetic agents to the gas mixture.

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What happens at the Common Gas Outlet?

Gas mixture exits the machine here to enter the breathing circuit.

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What does breathing circuit include?

Includes absorber (removes CO2) and ventilator.

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What happens to exhaled gases?

Pass into the scavenger system and then to disposal.

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Why are vaporizers important?

Anesthetic gases must vaporize before delivery.

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What is vapor pressure?

Equilibrium between liquid and gas.

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What is unique for each anesthetic gas?

Each anesthetic gas has a unique property.

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How does temperature relates to vapor pressure?

Temperature decreases vapor pressure and fewer molecules vaporize.

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What does vaporization require?

Requires energy, resulting in heat loss from the liquid.

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What is a liquid's boiling point?

The temperature at which vapor pressure equals atmospheric.

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What are modern vaporizers?

Variable-bypass, flow-over vaporizers.

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Why is copper used in the historical kettle?

Conserves gas and maintains constant temperature.

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What is temperature compensation?

Maintains consistent anesthetic concentration.

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What does the bimetallic strip do?

Expands or contracts with temperature changes.

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Why are agent-specific fillers used?

Avoid misfiling anesthetics.

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What can reduce vaporizer output?

High or low FGF will reduce vaporizer output.

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What is split ratio?

Ration of bypassed to vaporized gas.

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What results from tipping a vaporizer?

Can cause extremely concentrated output.

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How do you troubleshoot a tipped vaporizer?

Set to high concentration to maximize bypass flow.

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Dräger vaporizer tipping prevention?

Has a transport dial to prevent tipping problems.

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Tec 6 desflurane vaporizer method

Heated, pressurizing the agent to 2 atm.

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Tec 6 desflurane vaporizer is a?

Dual-gas blender, not a vaporizer.

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Which vaporizer cant compensate changes in elevation?

Tec 6 desflurane vaporizer.

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Aladin cassette vaporizer feature?

Is magnetically coded and agent specific.

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How heat works in cassette vaporizer?

It is heated through ''agent heating resistor'' - warm air is blown to it.

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Maquet FLOW-i vaporizer ability?

Calculate vapor per ml of liquid agent.

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What minimizes the pumping effect?

Check valves minimize the effect.

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Formula to determine how long can agent last?

It is equal to Vol % X FGF (L/min) X 3.

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What is Primary function of the breathing circuit?

Delivers oxygen and agent, eliminates CO2.

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What defines the Open anesthesia circuit system?

Exchange with atmosphere (ether, NC, insufflation).

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What defines the Semi-open anesthesia circuit system?

Very high gas flows to prevent rebreathing.

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What defines the Semi-closed anesthesia circuit system?

Rebreathing of gases, consists of valves. Conserves heat and humidity.

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What defines the Closed anesthesia circuit system?

Complete rebreathing. Inflow matches patient use

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Circle system features

Most popular in US, delivers oxygen and gases, eliminates CO2, conserves heat and reduces pollution

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What happen if Increasing FGF with Circle system?

Turning into semi-open config. by increase FGF

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What impacts rebreathing?

Fresh Gas Flow (FGF).

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What is Dead Space?

Volume occupied by gases, rebreathed without change.

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What happens without Rebreathing

Will limit heat, moisture, and alter tension.

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Mapleson features

Have low resistance

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Mapleson circuits is classified as

Semi-open or non-rebreathing circuits.

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Mapleson design

Gas flow in same tubing, risk of rebreathing.

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Mapleson features?

No unidirectional valves, no CO2 absorber.

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Mapleson advantages?

low resistance, have small parts.

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Mapleson effect on breathing circuit?

Gas is flow quickly to breathing circuit.

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What can use to prevent rebreathing?

Have 2.5 times the patient's minute ventilation

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Mapleson A

Requires 10 L/min

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DEF mapleson known as the type of?

The T-piece group type

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Mapleson location

Near reservoir bag for best spontaneous ventilation.

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Can be used both ventilation.

Is testable

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Bain System inner issue is?

It can Kink

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If inside tubing is patent in Pethick Test

the bag will collapse

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a lead in the inner tube test

It can remains inflated.

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What does that corrugated tube do

Large bore reduces resistance.

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Y-piece connection

to fit in face-mask and ETT tube

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It limites pressure on breathing

that is a saftey device?

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ventilates in

Allows compressed manually

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APL Valve can be during that ventilation

To be open in spontaneous

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You can to rotate to

Increase the pressure in the bag

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disadvantages of

valves (and absorbent).

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anesthetic gas is has to?

150-250 ml/min that is replace the tissue uptake.

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Maximal humidification?

And gases.

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Less?

of the the atmosphere.

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Disadvantages the delivered by.

Inability to change.

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Flowmeters (Per Gas)

Found on anesthesia machines, these measure individual gas flow.

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Hypoxic guard

A safety feature that prevents hypoxic gas mixtures.

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Thermal Conductivity

Ability to maintain a constant temperature.

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Vapor Pressure

The pressure exerted by a vapor when it's in equilibrium with its liquid phase.

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Flow-Over Vaporizers

Modern vaporizers where carrier gas flows over liquid anesthetic.

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Temperature compensation

The fact that is cooling.

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Bimetallic strip

Automatically adjust gas flow to compensate for temperature.

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Don't overfill

What can happen if that liquid get into the bypass chamber, therefore be carrefull?

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Bypass Chamber

Part of gas that goes through the bypass chamber and meets with anesthetic.

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Concentration Control Dial

Is the dial that increases or decreases on the amount of gas that we can used on vaporizer.

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Aladin Valves

Used in Aladin Vaporaizers; valves that allow no fresh gas loss when is not used.

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Pressure-Matching System

A system that maintains the pressure to ~atm with diferential pressure.

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Tec 6 Function

A dual-gas blender functions by operation the is more precisely.

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Semi-open config

All aspects of mapleson must be in what config

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What happen after the absorbent

is in where the absorbed is exhaustion

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To prevent that there is rebreathing

All gases in the tubing will travels the risk

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You will need a FGF

As you know to make the rebreathing easy

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Mapleson Position

The position that helps best is the FgF near reservoir bag

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D- Near MAP

Thee will be a good one. to control the great point that is ised in the transportation unit

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ASTM standard for bags

That will the pressure when the bag is larger and will require 4/2

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The circuit valve

Which can tell us what can be that the CO2 is

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Study Notes

Anesthesia Gas Delivery System

  • Medical gases such as Oâ‚‚, Nâ‚‚O, and air are delivered via an anesthesia machine to the patient
  • Oxygen's 5 tasks involve critical safety and function mechanisms that depend on oxygen pressure

Gas Supply Sources

  • Oxygen is green
  • Nitrous Oxide (Nâ‚‚O) is blue
  • Air is yellow
  • Gases come from a pipeline, the primary source in hospitals
  • Cylinders are a source for backup

Flow Through the System

  • As oxygen enters the anesthesia machine, it first encounters a safety and regulatory system for five key tasks

Oxygen's 5 Tasks

  • An Oâ‚‚ pressure failure alarm alerts if pressure drops too low
  • An Oâ‚‚ pressure failure device, a fail-safe, cuts off or restricts flow of other gases like Nâ‚‚O and air if Oâ‚‚ pressure is inadequate
  • An Oâ‚‚ flowmeter controls the amount of oxygen delivered
  • An Oâ‚‚ flush valve allows high-flow Oâ‚‚ (35–75 L/min) to bypass the vaporizers straight to the patient, which is used in emergencies
  • Ventilator drive gas: Oâ‚‚ powers the ventilator mechanism

Flowmeters

  • Each gas has a flowmeter to control gas flow
  • Oxygen's flowmeter interacts with the hypoxic guard, a safety feature, to prevent delivery of a hypoxic mixture of too much Nâ‚‚O or too little Oâ‚‚

Common Manifold & Vaporizers

  • Gases combine in a common manifold after flowmeters
  • Gases then pass through vaporizers, which add volatile anesthetic agents like sevoflurane

Common Gas Outlet

  • The gas mixture exits the machine to enter the breathing circuit
  • Gas enters the breathing circuit's absorber, which removes COâ‚‚, as well as the ventilator
  • Patients inhale the controlled gas mixture
  • Exhaled gases pass into a scavenger system then to disposal, preventing OR contamination

Vaporizers

  • Anesthetic gases must be vaporized before delivery to the patient
  • Vaporizers contain a chamber in which carrier gas becomes saturated with the volatile agent
  • Equilibrium is produced between liquid and gas, or the vapor pressure
  • Vapor pressure is unique for each anesthetic gas

Historical Copper Kettle

  • Measured flow bubbles through a separate flowmeter
  • Copper has high specific heat and high thermal conductivity (enhanced ability to maintain constant temperature)
  • All gas entering the vaporizer becomes saturated with vapor
  • Vapor pressure of volatile anesthetics is greater than the partial pressure needed for anesthesia so the gas must be diluted
  • With fixed total flow, flow through the vaporizer determines the ultimate concentration
  • A sudden decrease in flow raises anesthetic concentration to dangerous levels

Vaporizers and Temperature

  • A decrease in temperature leads to a decrease in vapor pressure and fewer molecules in vapor phase
  • Vaporization requires energy, or latent heat of vaporization, which results in a loss of heat from the liquid
  • A liquid's boiling point is where its vapor pressure equals atmospheric pressure including desflurane which has is B.P. 22.8 C/73.4 F at 1 ATM

Modern Vaporizers

  • Agent-specific
  • Variable-bypass, flow-over
  • Same proportion of gas is exposed to the liquid regardless of flow rate
  • Altering flow rates does not alter anesthetic concentration except at extremes
  • Temperature is compensated due to cooling:
    • Strip with two different metals
    • Metals expand and contract differently to temperature changes
    • Strip bends to allow more or less gas to pass through vaporizer
  • Are out of circuit when turned off

Temperature Compensation

  • Bimetallic strip is temperature-sensitive
  • Expands and contracts in response to ambient temperature changes
  • Alters total gas flow between vaporizing and bypass chambers
  • If the liquid anesthetic decreases in temperature, the bimetallic strip allows more gas flow into the vaporizing chamber to compensate for a decreased vapor pressure of the cooler liquid

Fresh Gas Inlet

  • Fresh carrier gas of Oâ‚‚ or air enters the vaporizer from the anesthesia machine
  • It is split into two streams:
    • One goes through the bypass chamber
    • The other goes to the vaporizing chamber where it picks up anesthetic vapor

Bypass Chamber

  • The bypass chamber passes gas that does not contact liquid agent
  • It travels directly through the bypass channel and rejoins the vaporizing stream at the outlet.
  • The amount of gas taking this route is controlled by the concentration control dial

Vaporizing Chamber

  • A chamber where the other gas stream enters, includes the liquid anesthetic agent
  • Gas bubbles over or passes across the liquid agent and it becomes saturated with anesthetic vapor.
  • This is known as the saturated vapor pressure of the agent at that temperature

Mixing and Output

  • Vapor-laden gas exits the vaporizing chamber and mixes with gas from the bypass chamber
  • The total mixture exits via the outlet, delivering desired concentration of anesthetic to the patient via the concentration control dial

Concentration Control Dial

  • Turning this dial increases or decreases amount of gas directed into the vaporizing chamber:
    • Increase dial means more gas flows into vaporizing chamber and higher anesthetic concentration is delivered
    • Decrease dial means less gas enters vaporizing chamber and lower concentration is delivered

Ambient Pressure

  • Modern vaporizers automatically compensate for changes in ambient pressure including altitude shifts
  • Safety Interlocking/Exclusion Mechanism: Can only turn on one at a time
  • Color-coded
  • Agent-specific keyed filler device avoids misfiling
  • Avoid overfilling or tipping
  • Liquid can disrupt liquid and affect the concentration
  • Leaks are often associated with a loose filler cap

Surface Area and Turbulence

  • Fresh gas enters the vaporizing chamber and flows over series of baffles and wicks
  • Baffles and wicks increase surface area and turbulence, ensuring fresh gas becomes 100% saturated
  • Very low or very high fresh gas flow reduces vaporizer output

Split Ratio

  • Split ratio is needed to know
  • Saturated vapor pressure is also needed to know

Split Ratio example

  • Sevo 1% split ratio is 25:1, 2% split ratio is 12:1, and 3% split ratio is 8:1
  • Sevo's 160 mm Hg is SVP
  • 12:1 is ~ 1850/150
  • 160 of 760 equals 21%
  • 150/0.79 is 190, 150/190 is 79%
  • X equals 40 ml Sevo or 190-150

Diagram Key

  • Fresh Gas In flow is 2000 mL/min, the total carrier gas from the anesthesia machine
  • The Split Ratio is 12:1
    • 12 parts bypass chamber and 1 part vaporizing chamber
  • Bypass Flow is 1850 mL/min
  • Flow to Vaporizing Chamber is 150 mL/min
  • Sevoflurane Vaporized is 40 mL/min
  • Total Output is 2040 mL/min
  • 1850 + 150 + 40 equals 2040

Step-by-Step Breakdown

  • Fresh Gas of 2000 mL/min from total is used
  • 1850 mL/min goes through bypass chamber
  • 150 mL/min is diverted into the vaporizing chamber, where it contacts the liquid sevoflurane

Vaporizing Chamber Function

  • The 150 mL/min of gas receives saturation with sevoflurane vapor
  • At 20°C, sevoflurane has a saturated vapor pressure of ~160 mmHg
  • With this chamber, ~40 mL/min of pure sevoflurane vapor is in the mix

Recombination and Output

  • Bypass gas and vapor-saturated gas recombine with 1850 mL/min bypass, 150 mL/min carrier gas from vaporizing chamber, and 40 mL/min vapor
  • Final concentration is calculated as the volatile agent
  • 40 mL Sevo/2040 mL Total Output is approximately 0.0196 which is nearly 2%
  • In pressure terms: 2%x760 mmHg is equal to 15.2 mmHg of sevoflurane partial pressure

Split Ratio Takeaways

  • Split ratio is rate bypassed to vaporized gas
  • It's controlled by a dial which specifies anesthetic flow

Saturated Vapor Pressure Takeaways

  • Saturated vapor pressure if pressure of vapor equals equilibrium with its liquid
  • Determines how something is how volatile a chemical agent is and how it can be used.

Variable Bypass

  • Variable bypass
  • Delivers 1% sevo at 2 L/min and 20°C

Vaporizer Tipping

  • Tipping excessively leads liquid agent to enter the bypass chamber, leading to an output with extremely high agent vapor concentration
  • One milliliter of liquid anesthetic produces approximately 200 ml of anesthetic vapor at 20°C and 1 atm pressure so small quantity of liquid anesthetic in bypass produces large amount of vapor
  • When tipped, it shouldn't be used clinically until purged for 20-30 min using high FGF rate by the machine's flowmeters

Tipped Device Troubleshooting

  • In this period, concentration control dial should be at high to maximize bypass chamber flow and vaporizing chamber inlet and outlet flows
  • Accuracy of vaporizer output must be demonstrated using agent analyzer before placing back in clinical use
  • Dräger Vapor 2000 and 3000 series vaporizers have "T" dial that prevents tipping related issues
  • GE-Datex-Ohmeda Tec 6 and Aladin cassette vaporizer systems remove dangers of tipping if using those units

Electronic Vaporizers

  • Electronic equipment is used

Tec 6 Desflurane Vaporizer

  • Desflurane vapor pressure is near 1 atm at 20 C (68 F) and is a high volatility so it's heated and pressurized to 2 atm
  • Then it's heated to 39C to create a vapor pressure of 2 atm
  • Potency is is only one-fifth that of other agents.
  • A pure desflurane vapor joins fresh gas as it exits
  • No fresh gas flows through the sump

Vaporizer Limitations

  • Not able to compensate changes to elevations
  • One must increase the desflurane concentration control, partial pressure, to counter high altitudes
  • Required dial setting is Normal % x 760/Ambient pressure
  • External heating helps compensate for heat loss with vaporization
  • Des is also unstable at room temperature
  • Overdoses and hypoxia are possible with Tec 6 without proper high FGF

Dual-Gas Blender

  • Operation of Tec 6 more accurately described as dual-gas blender than as a vaporizer
  • The vaporizer has two independent gas circuits which are arranged in a parallel
  • Fresh gas from flowmeters enters at the fresh gas inlet, passes through fixed restrictor (R1), exits at the vaporizer gas outlet
  • vapor circuit originates at desflurane sump as the reservoir
  • After the vaporizer becomes warmed, it has a shut-off valve, downstream of the sump, that fully opens when the concentration control valve is "on"

Heated Sump

  • Liquid desflurane stored in sump heated to 39°C well above boiling point
  • This keeps desflurane in vapor state, with equal to 2 atm

Carrier Gas Inlet

  • Fresh gas enters the Tec 6 vaporizer through the inlet so it passes resistor to create a reference working pressure.

Pressure-Matching System

  • Differential pressure transducer compares pressure in bypass flow with that in the vapor circuit
  • Control electronics then adjust a pressure-regulating valve on the vapor to match pressures in both circuits.
  • This allows accurate mixing

Concentration

  • Operator can sets desired concentration
  • This valve controls desflurane vapor entring the fresh gas stream.
  • The resistor provides resistance to stay stable

Outlet

  • Blended gas will exit to help the patient breathe

Pressure Regulation

  • A pressure-regulating valve lowers pressure to 1.1 atm
  • The operator controls output of liquid for a select concentation
  • Vapor and fresh gas flow

Transducer

  • The differential pressure transducer conveys pressure difference between circuits in the control system.
  • The electronics system manages the pressure for gas circuits
  • Also has accurate and easy use

###Aladin (GE) Cassette Vaporizers

  • Has color coded for specific agent
  • Machine excepts only 1 unit at a time
  • Divided gas flow
  • Changes in ratio

Vapor

  • Liquid and gas reunited to regulate
  • Machine use coded to help
  • Machine has workstation.
  • CPU regulator to maintain proper amount

Flow

  • System inlet so the fixed and liquid are separate.
  • Passes to create good effect
  • Unique valve with proper flow
  • No way to revert gases back

Breathing Circuits' purpose (Anesthesia breathing)

  • It's to deliver gas but eliminate contamination with correct O² with no buildup with reations

Open gas circuits

  • Non-contained with all elements

Semi

  • Gas for best ventilation to assist

Semi Closed

  • US rebreathing and humidity is maintained

Closed

  • complete for best

Semi closed facts

  • Helps to eliminate carbon
  • Contributes to both heart protection
  • decreases overall contamination and pollution
  • More effective

High Rate of Gas

  • Air and water for patients
  • Inverse is a cause for rebreather
  • It will change the air composition

Major Air

  • Fresh air with is helpful

Proper Air

  • Amount is proper and effective

Mapleson circuits

  • They will act a semi open if needed!

Tubes For Help

  • Open circuit helps to flow proper

Valve Facts

  • No proper CO² is used and applied

Gas and Air

Small in size to help improve air and gas

Gas Help

  • Two and a half will help all patients
  • However the amount is at a required ten

Air Facts

  • Helps and assist for a greater effect

Explanation for Both

  • Bag need help so make it
  • Better to have than not or used or what is needed = More help!

D and C

Short and helpful no matter the case = Helps a lot!

Ayre (E and D)

= Used for mostly children

  • Must use some sort of oxygen always and or mostly

Jackson System used (and other cases)

Helps and may added for the best to occur

  • Can help with all and any

Spont

  • Gas is with them in what is done
  • With support they benefit
  • Limited air is also an issue

Ventilation

  • The gas also works more
  • Some times will make a difference in air

Air facts

  • Should do so with APL
  • Gas and also pop off

Air flow

  • They will either move from patient
  • Or end it so all works together

Key is To assist

  • Make sure the bag is good to perform
  • In check so what ever comes makes a huge difference

Extra Key Info (Absorb Facts)

  • Bag and switch must be in use!

Fresh help facts

  • All is needed so its key
  • In circuit to help assist

Pressure to help

  • For gases and some sorts of bag modes
  • Isnt on for gas

Higher Resistance

  • Due to the flow or air amount
  • And more

Bulk Facts

  • Used for complex issues and more

Total Use

  • Make it easier
  • To use and do as needed

Pressure

  • Air and help for 8L limit in set to 70-80 mark. Helpful for air to push through!

Rotation

  • Increase so more is added and to help in best case scenario

Bags of Help

  • Needs air to help make breathing easiler
  • As to go for smaller cases set as is:
  • A smaller has less than 30 or up to 50 and X4
  • Larger goes up high:
  • With 35 and X4 it changes for air

Proper facts for most.

  • Make sure to monitor what gas is needed

Breathing info

  • Easy to help a lot

Best flow

  • Also helpful to push oxygen

Also must

  • Be in check.

Extra Tips

  • In a flow of check will make sure all is proper

Check points

  • Flow as such to help properly

Proper help

  • Air will work if okay

The Flow

  • Will cause great damage

Gas amount

  • It works and more
  • The extra help the patient

High pressure test

  • Material must be clean
  • Use will force and help with patient

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