Podcast
Questions and Answers
According to Standard 6 for anesthesia workstations, when should the function of anesthesia equipment be verified?
According to Standard 6 for anesthesia workstations, when should the function of anesthesia equipment be verified?
- Weekly, according to hospital policy
- At the end of each surgical case
- Prior to each anesthetic (correct)
- Only when equipment malfunction is suspected
What is the primary purpose of the oxygen flush valve on an anesthesia machine?
What is the primary purpose of the oxygen flush valve on an anesthesia machine?
- To provide a high flow of oxygen directly to the patient, bypassing the ventilator
- To rapidly refill or flush the circuit with oxygen, bypassing the vaporizers and flowmeters (correct)
- To regulate the pressure of oxygen delivered to the patient
- To administer a precise mixture of oxygen and anesthetic gases
In the context of anesthesia workstations, what does the term 'DISS' refer to?
In the context of anesthesia workstations, what does the term 'DISS' refer to?
- Direct Injection Scavenging System
- Differential Impedance Sensor System
- Digital Information Support System
- Diameter Index Safety System (correct)
What is the approximate pressure of the central gas supply that is delivered to the anesthesia workstation?
What is the approximate pressure of the central gas supply that is delivered to the anesthesia workstation?
What is the purpose of a one-way check valve in a central gas supply system?
What is the purpose of a one-way check valve in a central gas supply system?
According to the standards, when should a daily anesthesia equipment check be performed?
According to the standards, when should a daily anesthesia equipment check be performed?
The oxygen flow valves in the anesthesia machine are designed to:
The oxygen flow valves in the anesthesia machine are designed to:
What is the purpose of the fail-safe valve or oxygen failure cut-off valve in an anesthesia machine?
What is the purpose of the fail-safe valve or oxygen failure cut-off valve in an anesthesia machine?
If pipeline oxygen pressure is lost and a cylinder is left open, what will be the first indication of this to the anesthesia provider?
If pipeline oxygen pressure is lost and a cylinder is left open, what will be the first indication of this to the anesthesia provider?
What is the purpose of pressure regulators in an anesthesia machine?
What is the purpose of pressure regulators in an anesthesia machine?
What pressure is maintained by the first-stage regulators that reduce cylinder pressure for both oxygen (O2) and nitrous oxide (N2O)?
What pressure is maintained by the first-stage regulators that reduce cylinder pressure for both oxygen (O2) and nitrous oxide (N2O)?
How do second-stage regulators affect pipeline and cylinder pressure in an anesthesia machine?
How do second-stage regulators affect pipeline and cylinder pressure in an anesthesia machine?
Which best describes the functionality of a free floating valve (check valve)?
Which best describes the functionality of a free floating valve (check valve)?
What is the main function of a diaphragm valve in the context of anesthesia machines?
What is the main function of a diaphragm valve in the context of anesthesia machines?
A minimal oxygen flow of about 150 ml/min is usually delivered when the machine is on. What is the purpose of this?
A minimal oxygen flow of about 150 ml/min is usually delivered when the machine is on. What is the purpose of this?
Which of the following is true regarding the information displayed on Bourdon pressure gauges?
Which of the following is true regarding the information displayed on Bourdon pressure gauges?
What do the color-coded hoses attached to the wall outlets in an operating room do?
What do the color-coded hoses attached to the wall outlets in an operating room do?
What is the typical pressure of the central supply of gasses connected to the anesthesia machine?
What is the typical pressure of the central supply of gasses connected to the anesthesia machine?
On an anesthesia workstation, where does the low-pressure circuit begin?
On an anesthesia workstation, where does the low-pressure circuit begin?
Most anesthesia machines are designed such that the oxygen flowmeter is positioned downstream relative to other flowmeters. Why?
Most anesthesia machines are designed such that the oxygen flowmeter is positioned downstream relative to other flowmeters. Why?
What feature is found on the oxygen knob of flowmeters to ensure easy identification?
What feature is found on the oxygen knob of flowmeters to ensure easy identification?
According to cylinder supply guidelines, which organization sets the potency and purity standards for medical gases?
According to cylinder supply guidelines, which organization sets the potency and purity standards for medical gases?
What does the acronym 'PISS' stand for, in relation to anesthesia equipment?
What does the acronym 'PISS' stand for, in relation to anesthesia equipment?
What's one reason it's important to reboot anesthesia machines every 24 hours?
What's one reason it's important to reboot anesthesia machines every 24 hours?
What pressure is typically associated with a full nitrous oxide cylinder where liquid is present?
What pressure is typically associated with a full nitrous oxide cylinder where liquid is present?
What type of flowmeter is characterized by constant pressure and a variable orifice?
What type of flowmeter is characterized by constant pressure and a variable orifice?
What can occur to N2O cylinders with high flows?
What can occur to N2O cylinders with high flows?
Electrical outlets with circuit breakers are a feature of which part of the anesthesia workstation?
Electrical outlets with circuit breakers are a feature of which part of the anesthesia workstation?
Which of the following components is responsible for removing carbon dioxide from the breathing system?
Which of the following components is responsible for removing carbon dioxide from the breathing system?
According to the information provided, what is often lacking among anesthesia practitioners, leading to use error?
According to the information provided, what is often lacking among anesthesia practitioners, leading to use error?
Which parameter is used to determine proportionality between pressure and flow in a flowmeter?
Which parameter is used to determine proportionality between pressure and flow in a flowmeter?
What is the primary function of an anesthesia machine?
What is the primary function of an anesthesia machine?
What is the purpose of the Flow Proportioning Device?
What is the purpose of the Flow Proportioning Device?
Which piece of equipment is powered by both electric and pneumatic power?
Which piece of equipment is powered by both electric and pneumatic power?
What does Drager use to monitor the oxygen-nitrous oxide ratio?
What does Drager use to monitor the oxygen-nitrous oxide ratio?
What is the function of a high pressure relief valve?
What is the function of a high pressure relief valve?
What piece of equipment receives medical gasses from a gas supply?
What piece of equipment receives medical gasses from a gas supply?
What is the expected outcome of adjusting a pressure regulator on an anesthesia machine?
What is the expected outcome of adjusting a pressure regulator on an anesthesia machine?
What is the purpose of the manual bag port on an anesthesia machine?
What is the purpose of the manual bag port on an anesthesia machine?
Why is it recommended to reboot anesthesia machines approximately every 24 hours?
Why is it recommended to reboot anesthesia machines approximately every 24 hours?
What is the function of the 'balance regulator' in some GE Datex anesthesia machines?
What is the function of the 'balance regulator' in some GE Datex anesthesia machines?
What is the primary reason for performing a daily anesthesia equipment check?
What is the primary reason for performing a daily anesthesia equipment check?
What distinguishes a 'high-pressure' circuit from other pressure circuits in an anesthesia machine?
What distinguishes a 'high-pressure' circuit from other pressure circuits in an anesthesia machine?
If the pipeline oxygen supply fails and an oxygen cylinder is open, what action ensures continuous gas delivery?
If the pipeline oxygen supply fails and an oxygen cylinder is open, what action ensures continuous gas delivery?
What is the implication of the oxygen supply pressure dropping below a threshold in the anesthesia machine's fail-safe system?
What is the implication of the oxygen supply pressure dropping below a threshold in the anesthesia machine's fail-safe system?
What criteria determines the proportionality between pressure and flow within a flowmeter?
What criteria determines the proportionality between pressure and flow within a flowmeter?
What is a key function of the rotameter in an anesthesia workstation?
What is a key function of the rotameter in an anesthesia workstation?
What is the function of the oxygen knob fluting found on anesthesia machines?
What is the function of the oxygen knob fluting found on anesthesia machines?
Why is oxygen typically the last gas added in the flowmeter sequence of anesthesia machines?
Why is oxygen typically the last gas added in the flowmeter sequence of anesthesia machines?
What does the term 'diameter index safety system' (DISS) refer to in the context of anesthesia equipment?
What does the term 'diameter index safety system' (DISS) refer to in the context of anesthesia equipment?
Which factor makes anesthesia machines unsuitable for long-term ventilator use?
Which factor makes anesthesia machines unsuitable for long-term ventilator use?
Why is a fully charged backup battery on an anesthesia machine designed to last only approximately 30-45 minutes?
Why is a fully charged backup battery on an anesthesia machine designed to last only approximately 30-45 minutes?
What action is recommended in response to finding the cylinder pressure lower than the pipeline pressure?
What action is recommended in response to finding the cylinder pressure lower than the pipeline pressure?
Which parameter will activate a high pressure relief valve?
Which parameter will activate a high pressure relief valve?
What gases do free floating valves prevent from leaking out of?
What gases do free floating valves prevent from leaking out of?
Approximately what percentage of air is oxygen?
Approximately what percentage of air is oxygen?
About how much pressure does Central Supply deliver?
About how much pressure does Central Supply deliver?
According to cylinder supply standards, which of the following does the US Pharmacopeia set?
According to cylinder supply standards, which of the following does the US Pharmacopeia set?
A cylinder requires 7 markings to be on it by ICC, which one of the following is NOT on the cylinder?
A cylinder requires 7 markings to be on it by ICC, which one of the following is NOT on the cylinder?
What is the pressure of a full nitrous oxide tank?
What is the pressure of a full nitrous oxide tank?
How can you calculate the Minutes Left Before Tank Expires?
How can you calculate the Minutes Left Before Tank Expires?
Where would you find electrical outlets on the anesthesia machine?
Where would you find electrical outlets on the anesthesia machine?
Which of these devices can be powered by electricity?
Which of these devices can be powered by electricity?
What is the purpose for pressure regulators?
What is the purpose for pressure regulators?
What is the last thing that gasses go through, before reaching the patient?
What is the last thing that gasses go through, before reaching the patient?
Diaphragm valves are used in:?
Diaphragm valves are used in:?
The GE Aespire Proportioning device is?
The GE Aespire Proportioning device is?
According to the graphic, what piece of equipment has a check valve
According to the graphic, what piece of equipment has a check valve
Flowmeters are downstream of?
Flowmeters are downstream of?
What is the color in the picture for air
What is the color in the picture for air
What is a critical consideration when using the oxygen flush valve in conjunction with mechanically delivered inspiration?
What is a critical consideration when using the oxygen flush valve in conjunction with mechanically delivered inspiration?
What is the most crucial preventative measure to mitigate risks associated with the hypoxic mixture?
What is the most crucial preventative measure to mitigate risks associated with the hypoxic mixture?
What is the rationale behind performing a daily anesthesia equipment check, as stated in Standard 6?
What is the rationale behind performing a daily anesthesia equipment check, as stated in Standard 6?
In the event of both pipeline oxygen supply failure and an open oxygen cylinder, why is awareness of cylinder depletion important?
In the event of both pipeline oxygen supply failure and an open oxygen cylinder, why is awareness of cylinder depletion important?
What is the functional difference between the newer 'balance regulator' and traditional fail-safe valves in anesthesia machines?
What is the functional difference between the newer 'balance regulator' and traditional fail-safe valves in anesthesia machines?
What is the mechanism by which the 'balance regulator' in GE Datex-Ohmeda machines acts as a fail-safe?
What is the mechanism by which the 'balance regulator' in GE Datex-Ohmeda machines acts as a fail-safe?
Which factor determines the proportionality between pressure and flow in a flowmeter?
Which factor determines the proportionality between pressure and flow in a flowmeter?
How does the design of the oxygen knob prioritize user safety?
How does the design of the oxygen knob prioritize user safety?
What operational difference should be considered regarding Bourdon pressure gauges on anesthesia machines?
What operational difference should be considered regarding Bourdon pressure gauges on anesthesia machines?
What is the primary objective of the Diameter Index Safety System (DISS) regarding the central gas supply?
What is the primary objective of the Diameter Index Safety System (DISS) regarding the central gas supply?
Why are anesthesia machines generally considered unsuitable for long-term ventilator use, despite their ability to provide mechanical ventilation?
Why are anesthesia machines generally considered unsuitable for long-term ventilator use, despite their ability to provide mechanical ventilation?
In the context of anesthesia workstations, what specific function do diaphragm valves serve within pressure regulators?
In the context of anesthesia workstations, what specific function do diaphragm valves serve within pressure regulators?
What is the purpose of the one-way check valve in the central gas supply?
What is the purpose of the one-way check valve in the central gas supply?
What conditions could cause N2O cylinders to get cold and frost to accumulate?
What conditions could cause N2O cylinders to get cold and frost to accumulate?
Why is oxygen positioned last in the flowmeter sequence?
Why is oxygen positioned last in the flowmeter sequence?
What are the implications of the American Society for Testing Materials (ASTM) mandating specific positioning for the zero reading on Bourdon pressure gauges?
What are the implications of the American Society for Testing Materials (ASTM) mandating specific positioning for the zero reading on Bourdon pressure gauges?
When the oxygen supply pressure falls below a specified threshold, what is the immediate consequence within the anesthesia machine?
When the oxygen supply pressure falls below a specified threshold, what is the immediate consequence within the anesthesia machine?
How does the physical property that the flowmeter is designed for affect flow at high flows?
How does the physical property that the flowmeter is designed for affect flow at high flows?
How do second-stage regulators affect pipeline and cylinder pressure?
How do second-stage regulators affect pipeline and cylinder pressure?
What inherent limitation exists regarding the ability of the fail-safe valve to prevent all causes of hypoxic accidents?
What inherent limitation exists regarding the ability of the fail-safe valve to prevent all causes of hypoxic accidents?
Following a pipeline oxygen supply failure, why does the anesthesia machine continue to function normally when an oxygen cylinder is left open?
Following a pipeline oxygen supply failure, why does the anesthesia machine continue to function normally when an oxygen cylinder is left open?
How does the design of free-floating valves, also known as check valves, ensure unidirectional gas flow?
How does the design of free-floating valves, also known as check valves, ensure unidirectional gas flow?
What is the initial action if a cylinder connected to the anesthesia machine is found to have lower pressure than the pipeline supply?
What is the initial action if a cylinder connected to the anesthesia machine is found to have lower pressure than the pipeline supply?
In the context of anesthesia machine components, what is the role of the 'yoke' in the high-pressure system?
In the context of anesthesia machine components, what is the role of the 'yoke' in the high-pressure system?
What specific condition triggers the activation of the high-pressure relief valve?
What specific condition triggers the activation of the high-pressure relief valve?
What is the typical oxygen percentage of air?
What is the typical oxygen percentage of air?
Besides the DOT (Regulatory body), what else does the ICC require be on all cylinders?
Besides the DOT (Regulatory body), what else does the ICC require be on all cylinders?
What could be a result of not seating the pipeline connection correctly?
What could be a result of not seating the pipeline connection correctly?
What part of the central gas supply filters debris from the wall supply?
What part of the central gas supply filters debris from the wall supply?
According to the content, how do you calculate the minutes left before the gas tank expires?
According to the content, how do you calculate the minutes left before the gas tank expires?
What determines the proportionality between pressure and flow?
What determines the proportionality between pressure and flow?
What does the flow control valve turn?
What does the flow control valve turn?
What is the typical minimal oxygen flow when the anesthesia machine is left on?
What is the typical minimal oxygen flow when the anesthesia machine is left on?
What is one of the limitations of the Drager oxygen ratio controller system?
What is one of the limitations of the Drager oxygen ratio controller system?
What typically happens to the flowmeters following a leak?
What typically happens to the flowmeters following a leak?
What is the most critical consideration when using the oxygen flush valve?
What is the most critical consideration when using the oxygen flush valve?
What is the initial indicator of pipeline oxygen loss when a cylinder is inadvertently left open during anesthesia, as designed in modern anesthesia machines?
What is the initial indicator of pipeline oxygen loss when a cylinder is inadvertently left open during anesthesia, as designed in modern anesthesia machines?
In the GE Datex-Ohmeda Aestiva/5, what best describes the role of the 'balance regulator' in the event of decreasing oxygen pressure?
In the GE Datex-Ohmeda Aestiva/5, what best describes the role of the 'balance regulator' in the event of decreasing oxygen pressure?
How does the design of the Diameter Index Safety System (DISS) mitigate the risk of misconnection of gas pipelines?
How does the design of the Diameter Index Safety System (DISS) mitigate the risk of misconnection of gas pipelines?
When a cylinder connected to the anesthesia machine is found to have a lower pressure than the pipeline supply, what immediate action should be taken?
When a cylinder connected to the anesthesia machine is found to have a lower pressure than the pipeline supply, what immediate action should be taken?
In the context of vaporizers on the anesthesia machine, what best describes the purpose of the interlock system?
In the context of vaporizers on the anesthesia machine, what best describes the purpose of the interlock system?
Within the high-pressure system of an anesthesia machine, what function does the yoke serve besides securing the cylinder?
Within the high-pressure system of an anesthesia machine, what function does the yoke serve besides securing the cylinder?
Why is it important to be vigilant of oxygen levels when a fail-safe valve has already been put in place?
Why is it important to be vigilant of oxygen levels when a fail-safe valve has already been put in place?
Considering the limitations of the oxygen ratio controller in the Dräger anesthesia machine, why does its safety mechanism not provide fail-safe protection against hypoxic mixtures?
Considering the limitations of the oxygen ratio controller in the Dräger anesthesia machine, why does its safety mechanism not provide fail-safe protection against hypoxic mixtures?
Given that anesthesia machines are not intended for long-term ventilator use, what describes the key differences that make ICU ventilators more suitable for extended respiratory support?
Given that anesthesia machines are not intended for long-term ventilator use, what describes the key differences that make ICU ventilators more suitable for extended respiratory support?
What accounts for the variation in flow behavior within a flowmeter between low and high flow rates?
What accounts for the variation in flow behavior within a flowmeter between low and high flow rates?
How does the American Society for Testing and Materials (ASTM) ensures standardization and reliability regarding pressure readings on anesthesia machines?
How does the American Society for Testing and Materials (ASTM) ensures standardization and reliability regarding pressure readings on anesthesia machines?
Under what circumstance would the high pressure relief valve open?
Under what circumstance would the high pressure relief valve open?
Why does the anesthesia machine continue to function normally with an oxygen cylinder still open, even after the pipeline oxygen supply fails?
Why does the anesthesia machine continue to function normally with an oxygen cylinder still open, even after the pipeline oxygen supply fails?
If a leak were to occur, what would you expect of the flowmeters?
If a leak were to occur, what would you expect of the flowmeters?
Which statement accurately reflects a risk associated with the physical characteristics of nitrous oxide cylinders?
Which statement accurately reflects a risk associated with the physical characteristics of nitrous oxide cylinders?
When does the O2 supply failure alarm alert you to dropping pressure?
When does the O2 supply failure alarm alert you to dropping pressure?
How are cylinders constructed?
How are cylinders constructed?
Why are electrical outlets incorporated into the anesthesia workstation design an important safety feature?
Why are electrical outlets incorporated into the anesthesia workstation design an important safety feature?
Regarding the potential for delivering a hypoxic mixture, what is the significance of positioning the oxygen flowmeter downstream relative to other flowmeters?
Regarding the potential for delivering a hypoxic mixture, what is the significance of positioning the oxygen flowmeter downstream relative to other flowmeters?
What aspect of Bourdon pressure gauges creates a challenge in interpreting gas cylinder pressure?
What aspect of Bourdon pressure gauges creates a challenge in interpreting gas cylinder pressure?
What can result from incorrectly seating the pipeline connection within the anesthesia workstation?
What can result from incorrectly seating the pipeline connection within the anesthesia workstation?
When calculating tank life, which value do you multiply by when using an oxygen tank?
When calculating tank life, which value do you multiply by when using an oxygen tank?
How should free-floating valves, also know as check valves, be?
How should free-floating valves, also know as check valves, be?
What best describes the operation of flowmeters within the anesthesia machine?
What best describes the operation of flowmeters within the anesthesia machine?
What action should be taken when the backup battery of the anesthesia machine is malfunctioning?
What action should be taken when the backup battery of the anesthesia machine is malfunctioning?
What is the key factor determining proportionality between pressure and flow?
What is the key factor determining proportionality between pressure and flow?
Which of the following parameters typically activates the oxygen supply failure alarm in an anesthesia machine?
Which of the following parameters typically activates the oxygen supply failure alarm in an anesthesia machine?
How are the flow control valve turned?
How are the flow control valve turned?
What is one of the reasons that most anesthesia practitioners make errors?
What is one of the reasons that most anesthesia practitioners make errors?
In anesthesia machines, what role do diaphragm valves primarily serve?
In anesthesia machines, what role do diaphragm valves primarily serve?
In an anesthesia machine, what is the function of a one-way check valve?
In an anesthesia machine, what is the function of a one-way check valve?
Aside from securing the cylinder, what else does the machine use the hanger yoke in the high pressure system for?
Aside from securing the cylinder, what else does the machine use the hanger yoke in the high pressure system for?
How is indexing achieved through the DISS
How is indexing achieved through the DISS
Given the intricate pneumatic and electronic integration within modern anesthesia workstations, what are the potential ramifications of failing to regularly reboot the system, particularly concerning the calibration of gas sensors and the performance of automated self-tests?
Given the intricate pneumatic and electronic integration within modern anesthesia workstations, what are the potential ramifications of failing to regularly reboot the system, particularly concerning the calibration of gas sensors and the performance of automated self-tests?
In the event of a total pipeline oxygen supply failure, coupled with the inadvertent depletion of the oxygen cylinder reserve, what immediate and preemptive measure can an astute anesthesia provider employ to maintain patient oxygenation, circumventing reliance on the machine's fail-safe mechanism?
In the event of a total pipeline oxygen supply failure, coupled with the inadvertent depletion of the oxygen cylinder reserve, what immediate and preemptive measure can an astute anesthesia provider employ to maintain patient oxygenation, circumventing reliance on the machine's fail-safe mechanism?
Within the architecture of contemporary anesthesia workstations featuring electronic gas mixing, how does the 'balance regulator' in GE Datex-Ohmeda machines interface with and modulate the delivery of nitrous oxide in response to fluctuations in oxygen supply pressure?
Within the architecture of contemporary anesthesia workstations featuring electronic gas mixing, how does the 'balance regulator' in GE Datex-Ohmeda machines interface with and modulate the delivery of nitrous oxide in response to fluctuations in oxygen supply pressure?
In the context of the Diameter Index Safety System (DISS), what engineering principle ensures the prevention of gas-pipeline misconnections, even when a provider attempts to forcefully attach a non-compatible gas hose to a wall outlet?
In the context of the Diameter Index Safety System (DISS), what engineering principle ensures the prevention of gas-pipeline misconnections, even when a provider attempts to forcefully attach a non-compatible gas hose to a wall outlet?
Considering the intricate design of the oxygen knob on anesthesia machines, how might its specific textural features and spatial positioning relative to other control knobs serve to mitigate the potential for errors in low-visibility or high-cognitive-load scenarios?
Considering the intricate design of the oxygen knob on anesthesia machines, how might its specific textural features and spatial positioning relative to other control knobs serve to mitigate the potential for errors in low-visibility or high-cognitive-load scenarios?
What are the functional distinctions between first-stage and second-stage pressure regulators within the anesthesia machine, with respect to their specific roles in modulating gas pressure and ensuring stable gas delivery to downstream components?
What are the functional distinctions between first-stage and second-stage pressure regulators within the anesthesia machine, with respect to their specific roles in modulating gas pressure and ensuring stable gas delivery to downstream components?
Given the potential for substantial errors stemming from inadequate knowledge of anesthesia delivery systems, what specific area of knowledge should be emphasized to enhance anesthesia practitioners’ ability to effectively troubleshoot and resolve system-related complications?
Given the potential for substantial errors stemming from inadequate knowledge of anesthesia delivery systems, what specific area of knowledge should be emphasized to enhance anesthesia practitioners’ ability to effectively troubleshoot and resolve system-related complications?
In the context of Bourdon pressure gauges on anesthesia machines, what inherent limitation should an anesthesia provider consider when interpreting pressure readings, especially in situations where ambient temperature fluctuates significantly?
In the context of Bourdon pressure gauges on anesthesia machines, what inherent limitation should an anesthesia provider consider when interpreting pressure readings, especially in situations where ambient temperature fluctuates significantly?
What implications arise from the fact that anesthesia machines are not designed for long-term ventilator use, particularly concerning the synchronization algorithms, humidification capabilities, and responsive modes of ventilation support?
What implications arise from the fact that anesthesia machines are not designed for long-term ventilator use, particularly concerning the synchronization algorithms, humidification capabilities, and responsive modes of ventilation support?
Free-floating valves open with pressure, and close with pressure. Considering the design and function of free-floating valves, also known as check valves, how do these valves ensure unidirectional gas flow, preventing retrograde flow even under fluctuating pressure conditions?
Free-floating valves open with pressure, and close with pressure. Considering the design and function of free-floating valves, also known as check valves, how do these valves ensure unidirectional gas flow, preventing retrograde flow even under fluctuating pressure conditions?
In the event that the pressure of a cylinder connected to the anesthesia machine is found to be lower than the pipeline supply pressure, what intricate sequence of diagnostic and corrective actions should be undertaken to avert potential complications related to inadequate gas delivery?
In the event that the pressure of a cylinder connected to the anesthesia machine is found to be lower than the pipeline supply pressure, what intricate sequence of diagnostic and corrective actions should be undertaken to avert potential complications related to inadequate gas delivery?
Given the limitations of the oxygen ratio controller in the Dräger anesthesia machine, particularly when a third gas aside from oxygen and nitrous oxide is introduced into the system, how might an astute anesthesia provider circumvent this safety mechanism to avert the delivery of a potentially hypoxic mixture?
Given the limitations of the oxygen ratio controller in the Dräger anesthesia machine, particularly when a third gas aside from oxygen and nitrous oxide is introduced into the system, how might an astute anesthesia provider circumvent this safety mechanism to avert the delivery of a potentially hypoxic mixture?
Which factor most critically determines the proportionality between pressure and flow within a flowmeter, significantly influencing the precision of gas delivery across a wide range of flow rates encountered during diverse anesthetic procedures?
Which factor most critically determines the proportionality between pressure and flow within a flowmeter, significantly influencing the precision of gas delivery across a wide range of flow rates encountered during diverse anesthetic procedures?
How do the operational characteristics of flowmeters change as the gas transitions from low to high flow rates, specifically concerning the dominant physical properties governing gas behavior within the flowmeter?
How do the operational characteristics of flowmeters change as the gas transitions from low to high flow rates, specifically concerning the dominant physical properties governing gas behavior within the flowmeter?
How does the American Society for Testing and Materials (ASTM) ensure standardization and reliability regarding pressure readings on anesthesia machines, considering potential variations in manufacturing tolerances and component aging?
How does the American Society for Testing and Materials (ASTM) ensure standardization and reliability regarding pressure readings on anesthesia machines, considering potential variations in manufacturing tolerances and component aging?
Given the crucial role of the oxygen flush valve in emergency situations, what specific risk does its activation pose, and what strategies can mitigate such harm?
Given the crucial role of the oxygen flush valve in emergency situations, what specific risk does its activation pose, and what strategies can mitigate such harm?
In which pressure circuit does the yoke reside?
In which pressure circuit does the yoke reside?
What percentage of air is oxygen?
What percentage of air is oxygen?
Besides safety, what purpose do electrical outlets serve within the anesthesia workstation design?
Besides safety, what purpose do electrical outlets serve within the anesthesia workstation design?
What is the formula to calculate the 'Minutes Left Before Tank Expires'?
What is the formula to calculate the 'Minutes Left Before Tank Expires'?
What is the function of diaphragm valves in anesthesia machines?
What is the function of diaphragm valves in anesthesia machines?
What criteria do flowmeters utilize to measure the proportionality between pressure and gas flow?
What criteria do flowmeters utilize to measure the proportionality between pressure and gas flow?
What purpose does the manual bag port serve?
What purpose does the manual bag port serve?
According to central gas supply guidelines, what pressure is expected from central supply?
According to central gas supply guidelines, what pressure is expected from central supply?
According to cylinder supply guidelines, what is constructed according to Interstate Commerce Commission (ICC) specifications?
According to cylinder supply guidelines, what is constructed according to Interstate Commerce Commission (ICC) specifications?
How can one-way check valves be described?
How can one-way check valves be described?
A cylinder requires 7 markings to be on it by ICC, which one of the following is NOT one of them?
A cylinder requires 7 markings to be on it by ICC, which one of the following is NOT one of them?
What typically happens to the flowmeters if a leak were to occur?
What typically happens to the flowmeters if a leak were to occur?
According to the oxygen failure safety guidelines, what happens at < 30 psi of pressure?
According to the oxygen failure safety guidelines, what happens at < 30 psi of pressure?
Why is oxygen the last gas added in the flowmeter sequence of anesthesia machines?
Why is oxygen the last gas added in the flowmeter sequence of anesthesia machines?
What is the danger to using the O2 flush valve during what part of the breath cycle?
What is the danger to using the O2 flush valve during what part of the breath cycle?
According to slide #5, what bypasses CO2?
According to slide #5, what bypasses CO2?
Which statement accurately refutes the misconception that the fail-safe valve provides absolute protection against hypoxic gas mixtures?
Which statement accurately refutes the misconception that the fail-safe valve provides absolute protection against hypoxic gas mixtures?
What is the primary goal behind performing a daily anesthesia equipment check?
What is the primary goal behind performing a daily anesthesia equipment check?
What part of the central gas supply works traps debris from the wall supply?
What part of the central gas supply works traps debris from the wall supply?
In cases of increased pressure, which valve is responsible for pressure release?
In cases of increased pressure, which valve is responsible for pressure release?
What powers Drager's oxygen ratio monitor?
What powers Drager's oxygen ratio monitor?
Color-coded E-cylinders attach to machine by hanger yoke assembly. What's important to note about this assembly?
Color-coded E-cylinders attach to machine by hanger yoke assembly. What's important to note about this assembly?
In an Ohmeda flowmeter, the nitrous oxide flowmeter is set at 26 psig, and a 14-Teeth drive this flowmeter. Which of the following is true of the oxygen flowmeter, if the chain is connected and the flowmeter is also set at 26 psig?
In an Ohmeda flowmeter, the nitrous oxide flowmeter is set at 26 psig, and a 14-Teeth drive this flowmeter. Which of the following is true of the oxygen flowmeter, if the chain is connected and the flowmeter is also set at 26 psig?
Flashcards
Anesthesia Delivery System Knowledge
Anesthesia Delivery System Knowledge
Anesthesia practitioners' knowledge of the delivery system is often lacking, leading to critical incidents primarily due to use error.
Equipment check
Equipment check
Adhere to manufacturer's operating instructions and safety precautions during the equipment check.
Operating Equipment Standard
Operating Equipment Standard
Minimizes the risk of fire, explosion, electrical shock, and equipment malfunction.
Secondary Gas Supply Gauges
Secondary Gas Supply Gauges
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Auxiliary Common Gas Outlet (ACGO)
Auxiliary Common Gas Outlet (ACGO)
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O2 Pressure Failure Alarm
O2 Pressure Failure Alarm
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O2 Failure Device (failsafe)
O2 Failure Device (failsafe)
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Anesthesia Machine Function
Anesthesia Machine Function
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Anesthesia Machine Control
Anesthesia Machine Control
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Anesthesia Vaporization
Anesthesia Vaporization
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Anesthesia Machine Delivery
Anesthesia Machine Delivery
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Anesthesia Machine Design
Anesthesia Machine Design
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Anesthesia Machine Maintenance
Anesthesia Machine Maintenance
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Anesthesia Machine Function
Anesthesia Machine Function
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Pressure Regulation Component
Pressure Regulation Component
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Physiologic Monitoring systems
Physiologic Monitoring systems
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Flow Proportioning Device
Flow Proportioning Device
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Automated Record Keeping
Automated Record Keeping
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High-pressure circuit
High-pressure circuit
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Intermediate-pressure circuit
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Low-pressure system
Low-pressure system
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Cylinder Regulator Intent
Cylinder Regulator Intent
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Low Pipeline O2 Alarm
Low Pipeline O2 Alarm
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First-stage regulators Role
First-stage regulators Role
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Second-stage regulators Role
Second-stage regulators Role
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Free Floating Valve (Check Valve)
Free Floating Valve (Check Valve)
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Ball and Spring Valve
Ball and Spring Valve
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Diaphragm Valve
Diaphragm Valve
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Fail-safe Valve
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Fail-safe Benefit
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Fail-Safe Reaction
Fail-Safe Reaction
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Old School Pneumatic Alarm
Old School Pneumatic Alarm
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Fail-safe Limitations
Fail-safe Limitations
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Fail-safe Alternative
Fail-safe Alternative
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Bourdon Gauges Mechanism
Bourdon Gauges Mechanism
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Bourdon Applications
Bourdon Applications
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Central Gas Supply
Central Gas Supply
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Central Supply Pressure
Central Supply Pressure
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Cylinder Connection
Cylinder Connection
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Bodok Seal
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ICC Cylinder
ICC Cylinder
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Pin Index Safety System (PISS)
Pin Index Safety System (PISS)
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N2O Cylinders
N2O Cylinders
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Oxygen, Air Cylinder
Oxygen, Air Cylinder
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Nitrous oxide Cylinder
Nitrous oxide Cylinder
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Oxygen Flush
Oxygen Flush
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Equipment verification
Equipment verification
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System switch
System switch
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EZchange canister module
EZchange canister module
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Anesthesia machine
Anesthesia machine
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Anesthesia Machine
Anesthesia Machine
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Datex-Ohmeda & Dräger
Datex-Ohmeda & Dräger
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Cylinders
Cylinders
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Interstate Commerce Commission (ICC)
Interstate Commerce Commission (ICC)
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Federal Food, Drug, & Cosmetic Act
Federal Food, Drug, & Cosmetic Act
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US Pharmacopeia
US Pharmacopeia
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Cylinders
Cylinders
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High pressure relief valve
High pressure relief valve
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Temperatures
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Fusible plug
Fusible plug
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Wood's metal
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Gaseous state
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Pressure system
Pressure system
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Nitrous
Nitrous
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NonInterchangeable
NonInterchangeable
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Glass flow tubes
Glass flow tubes
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Oxygen Flow
Oxygen Flow
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Oxygen limiting safety system
Oxygen limiting safety system
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Safety relief valve
Safety relief valve
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Alternate 02
Alternate 02
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Rapidly refill or flush
Rapidly refill or flush
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Daily Equipment Check
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Flowmeter
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Datex-Ohmeda
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Dräger Medical
Dräger Medical
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Suction regulator
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Ventilator Component
Ventilator Component
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Scavenging system
Scavenging system
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Gas supply
Gas supply
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Pressure Gauges
Pressure Gauges
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Safety Devices
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Flow Control Valve
Flow Control Valve
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Oxygen flow control Knob
Oxygen flow control Knob
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Vaporizer
Vaporizer
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Common gas outlet
Common gas outlet
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One-way check valve
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Pressure regulator
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Gas Inlet
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Study Notes
- Anesthesia practitioners' knowledge about the delivery system is often lacking.
- Critical incidents related to use of anesthesia delivery systems most commonly stem from use error.
Standard 6: Equipment
- Complete a daily anesthesia equipment check, adhering to manufacturer's instructions and safety precautions.
- Verify the function of anesthesia equipment prior to each anesthetic.
- Operate equipment to minimize risks like fire, explosion, electrical shock, and equipment malfunction.
Anesthesia Machine Basics
- The anesthesia machine receives medical gases from a supply.
- The machine controls the flow and reduces the pressure of the gases to a safe level.
- This machine vaporizes volatile anesthetics into the final gas mixture.
- Gases are delivered at a common gas outlet, connected to the breathing circuit and patient.
- Oxygen flow valves are designed to deliver a minimum flow when the machine is on.
- These machines is not intended for long-term ventilator use.
- Reboot every 24 hours for self-tests and machine checkout.
- Never turn off machine alarms; pause to assess the patient.
- They are not intended or designed for patient transport.
- The fully charged backup battery only last 30-45 minutes.
Components of Anesthesia Workstations
- Anesthesia machine function elements:
- Oxygen and inhaled anesthetic delivery
- Carbon dioxide removal
- Pressure regulation
- Gas mixing
- The machine is powered by electric and pneumatic power.
- Major manufacturers include Datex-Ohmeda (GE Healthcare) and Dräger Medical.
- Some are designed for mobility, compactness, and MRI compatibility.
- Additional components:
- Vaporizers
- Anesthetic breathing circuit
- Ventilator
- Scavenging system
- Suction regulator
- Respiratory and physiologic monitoring systems:
- ECG
- BP
- Temperature
- Oxygen saturation
- Inhaled and exhaled concentrations of oxygen
- Carbon dioxide
- Anesthetic gases
- Flow Proportioning Device (hypoxic guard)
- Protection and alarm systems
- Automatic recordkeeping and networking with hospital systems
Gas Pressure Circuits
- Consist of high-pressure, intermediate-pressure, and low-pressure circuits.
- High-Pressure Circuit: Begins at the cylinder and concludes at cylinder regulators (45 psig).
- Intermediate-Pressure Circuit: Begins at the pipeline and ends at the flowmeter valve (50-55 psig).
- Low-Pressure Circuit: Begins at flowmeters and ends at the common gas outlet (16 psig).
- Cylinder regulators intentionally set at a lower pressure.
- This ensures flow from the higher-pressure pipeline is used first.
- If pipeline oxygen is lost and a cylinder is left open, delivery begins from cylinder without warning.
- The first sign is that the cylinder is empty.
Pressure Regulators
- Adjust for high and variable pressures.
- Diaphragm valves reduce pressure.
- Enhance safety and cylinder use.
- First-stage regulators reduce cylinder pressure to 45 psig, from:
- 2200 for O2
- 745 for N2O
- Cylinder pressure slightly lower than pipeline pressure.
- A high-pressure relief valve opens if pressure becomes excessive (95-110 psi).
- Second-stage regulators drop pipeline and cylinder pressure further (14-26 psi).
Valves
- Free Floating (Check Valve)
- Moves in the direction of gas flow.
- Prevents gas leaks.
- Ball and Spring Valve
- Permits gas flow after a connection like accessing pipeline gas.
- Requires applied energy.
- Examples: flush valves
- Requires correctly seated pipeline connection.
- Diaphragm Valve
- Allow pressure regulators to function to reduce pressure.
Fail-Safe Valve
- Minimal oxygen flow of 150 ml/min is supplied when the machine is on (if > 12-14 psig).
- It prevents hypoxic gas mixtures if oxygen supply fails.
- Nitrous oxide flow stops if oxygen supply PRESSURE fails.
- If oxygen pressure falls below 30 psig, other gases shut off, or proportionately decrease (Pneumatic alarm).
- Oxygen supply low-pressure alarm sounds when pressure drops below threshold (20-30 psi).
- These don't protect against all causes of hypoxic accidents; an oxygen analyzer and vigilance are vital.
- In GE Datex Aestiva/5 the ""fail-safe"" valve is a variable valve in the balance regulator.
- A second-stage pressure regulator for oxygen reduces pressure to about 30 psig (intermediate pressure).
- Oxygen pressure pilots the balance regulator, then oxygen pressure pushes on the diaphragm and opens the nitrous oxide path.
- Acts as a fail-safe valve.
Bourdon Pressure Gauges
- Coiled tube expands as pressure is applied.
- Linkage connects coil to a rotating arm to record pressure.
- The American Society for Testing Materials (ASTM) requires a zero reading is between 6 and 9 o’clock.
- Bourdon gauges measure both pipeline and cylinder pressures.
Central Gas Supply
- Pipelines connect to color-coded wall outlets for:
- Yellow - Air
- Blue - Nitrous oxide
- Green - Oxygen
- Color-coded hoses with gas-specific fittings prevent misconnections.
- Diameter Index Safety System (DISS): Noninterchangeable threaded connections.
- Indexing is achieved by diameters of the connections.
- Oxygen or air may power a ventilator (pneumatic) or an auxiliary oxygen flow meter.
- Filters trap debris from the wall supply.
- Pressure from central supply is about 50 psi.
- Adequate pressure is necessary for flow meters.
- Color-coded Bourdon pressure gauges.
- One-way check valve prevents retrograde flow.
- Free-floating valves open/close with pressure.
Cylinder Supply Overview
- Constructed according to Interstate Commerce Commission (ICC) specifications.
- The Federal, Food, Drug, and Cosmetic Act regulates medical gases.
- Potency and purity standards set by the US Pharmacopeia.
- ICC requires 7 markings:
- DOT (Regulatory body)
- Serial Number
- Purchaser, user, manufacturer
- Manufacturer’s manual and symbol
- Retest date, retester, ID symbol, 110% filling, ten-year test interval
- Neck ring owner's identification
- Color-coded E-cylinders attach to machine by hanger yoke assembly.
- Assembly provides gas-tight seal (Bodok seal between tank and hanger yoke).
- Cylinders are backup supply.
- Cylinder pressure is about 45 psi.
- Pin Index Safety System (PISS):
- Two metal pins correspond to holes.
- Oxygen: 2, 5
- Nitrous: 3, 5
- Two metal pins correspond to holes.
- Features a one-way check valve preventing retrograde flow.
- Free-floating valves open/close with pressure.
- N2O cylinders get cold and frost with high flows.
- Vaporization/expansion absorbs heat from the metal cylinder.
- Oxygen and nitrous oxide act as oxidizers.
- Temperatures over 130°F (57°C) increase fire risk.
- Safety relief devices:
- Fusible plug – Melts at elevated temperatures.
- Valve - Opens at elevated pressures.
- Frangible disks – Ruptures under pressure.
- Oxygen and Air Cylinders
- They are in a gaseous state.
- Pressure is proportional to volume.
- The duration of the tank is calculable based on flow rate.
- Air contains 21% oxygen.
- Nitrous Oxide Cylinders
- They contain liquid (90-95% capacity) and gas.
- Pressure is 750 psig as long as liquid remains.
- Pressure decreases when all liquid is vaporized.
- Expect pressures to fall (~400 liters) after 75-85% of contents are used.
Oxygen Cylinder Duration Calculation
- Tank Capacity (L) / Full Tank Pressure (psi) = Contents Remaining (L) / Gauge Pressure (psi)
- Contents Remaining (L) / Flow Rate (L/min) = Minutes Left Before Tank Expires
- Use 660 L/1900 psig to calculate contents
Flowmeters
- Color-coded and calibrated to specific gases.
- Thorpe tube flowmeters are used.
- Newer machines use electronic flowmeters.
- Flow Control Valve turns counterclockwise to the desired flow.
- Gas enters the bottom of a vertical, tapered (Thorpe) tube.
- A bobbin or ball float indicates flow.
- Floats are designed to rotate, keeping them centered.
- Shape of the tube (resistance)
- Gas' physical properties (density and viscosity)
- Oxygen enters the circuit, even if the operator forgets to turn on the flow.
- Minimum oxygen flow (usually around 150 ml/min) is supplied.
- Auxiliary flow meters may be present.
- Some contain two glass tubes for different flow rates.
- Malfunctions involving:
- Dirt in flow tube
- Vertical tube misalignment
- Sticking of a float
- Broken/fallen float
- Oxygen knob is fluted, larger, and protrudes furthest to the right.
- Oxygen/nitrous ratio controllers include:
- Dräger oxygen ratio controller system (pressure control piston)
- Datex-Ohmeda proportion limiting control system (chain connects knobs)
- Mechanically/pneumatically/electronically linking oxygen and nitrous oxide
- These ensure a minimum oxygen of 21-25%.
- This does not affect the flow of a third gas (e.g., air, helium, or carbon dioxide).
- Oxygen Flowmeter positioned downstream, relative to other flowmeters.
- It is the most fragile component.
- Potential leaks introducing hypoxic mixture.
- Flowmeters are downstream from safety devices except for the oxygen analyzer.
Drager Oxygen Ratio Monitor Controller/Sensitive Oxygen Ratio Controller
- When oxygen flow is less than 200ml/min, the slave control valve closes completely, preventing nitrous oxide flow.
Alternate Oxygen Control
- If the anesthesia display is not working, this control is activated.
- The Alternate O2 control delivers through an independent pneumatic path to the vaporizer and patient circuit.
- Depending on the machine, anesthesia gas may be delivered with this control during electronic/power failure.
Oxygen Flush Valve
- Delivers 35-75 L/min
- It bypasses flowmeters, manifold, and vaporizers.
- Direct link between intermediate and low-pressure circuit.
- Delivers a large volume of oxygen for emergency use.
- Used to rapidly refill or flush the circuit, but should be used with caution.
- Possible risks:
- Barotrauma during mechanically delivered inspiration.
- Dilution of anesthesia gases.
- It is controversial for jet ventilation.
- The protective rim around the flush button limits accidental activation.
- It should not be used if the bag is empty.
- Instead one should increase the flow of gas.
Common Gas Outlet
- The oxygen/medical gas/anesthetic agent mixture exits the machine through this outlet.
- Some machines have an auxiliary common gas outlet, which can be used in certain circumstances.
- Bain circuit
- T-piece pediatric circuit
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