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Questions and Answers
What is the maximum safe ratio of N2O to O2 when using a proportioning device?
What is the maximum safe ratio of N2O to O2 when using a proportioning device?
- 2:1 N2O to O2
- 3:1 N2O to O2 (correct)
- 4:1 N2O to O2
- 5:1 N2O to O2
What is the purpose of a hypoxia prevention device?
What is the purpose of a hypoxia prevention device?
- To provide oxygen to the user
- To prevent setting a hypoxic mixture with the flow control valves (correct)
- To monitor oxygen levels in the air
- To regulate the flow of volatiles
What is the oxygen pressure failure device?
What is the oxygen pressure failure device?
- A device that increases oxygen flow if nitrogen oxide levels rise
- A failsafe device that will shut off or proportionately reduce N2O flow if O2 pressure drops below 20 psi (correct)
- A device that monitors oxygen levels in the atmosphere
- A device that converts oxygen to nitrogen oxide
When will the hypoxic prevention safety device not alarm?
When will the hypoxic prevention safety device not alarm?
What is the main difference between an oxygen pressure failure device and a hypoxia prevention safety device?
What is the main difference between an oxygen pressure failure device and a hypoxia prevention safety device?
How does the Link 25 proportioning system work? (select 2)
How does the Link 25 proportioning system work? (select 2)
What are the pressure and boundaries of the high pressure system? (select 2)
What are the pressure and boundaries of the high pressure system? (select 2)
What is the pipeline pressure?
What is the pipeline pressure?
What is the pressure of the air from the cylinders (high pressure system) after the pressure regulator?
What is the pressure of the air from the cylinders (high pressure system) after the pressure regulator?
What are the boundaries of an intermediate-pressure system?
What are the boundaries of an intermediate-pressure system?
Where is the DISS used?
Where is the DISS used?
Where is the pin-indexed safety system used?
Where is the pin-indexed safety system used?
What are the boundaries of the low pressure system in an anesthesia machine?
What are the boundaries of the low pressure system in an anesthesia machine?
What is composed of the low-pressure system?
What is composed of the low-pressure system?
What is the pressure of the low-pressure system in an anesthesia machine?
What is the pressure of the low-pressure system in an anesthesia machine?
What system contains the failsafe device, O2 flush valve, flowmeter valve, O2 supply failure alarm, and pneumatic master switch?
What system contains the failsafe device, O2 flush valve, flowmeter valve, O2 supply failure alarm, and pneumatic master switch?
What is the function of the flowmeter valve?
What is the function of the flowmeter valve?
How do you perform a low-pressure leak test (negative pressure test) on an anesthesia machine?
How do you perform a low-pressure leak test (negative pressure test) on an anesthesia machine?
What is a passed negative pressure leak test indicated by?
What is a passed negative pressure leak test indicated by?
What should be done with the vaporizers during a negative pressure leak test?
What should be done with the vaporizers during a negative pressure leak test?
How do you perform a positive pressure (high pressure) leak test on an anesthesia machine?
How do you perform a positive pressure (high pressure) leak test on an anesthesia machine?
What is the primary purpose of the positive pressure leak test on an anesthesia machine?
What is the primary purpose of the positive pressure leak test on an anesthesia machine?
When a leak is present in the low-pressure circuit, what happens to the suction bulb during a negative pressure test?
When a leak is present in the low-pressure circuit, what happens to the suction bulb during a negative pressure test?
During spontaneous breathing, what is the position of the APL valve?
During spontaneous breathing, what is the position of the APL valve?
During manual bag ventilation, what is the position of the APL valve?
During manual bag ventilation, what is the position of the APL valve?
What is the consequence of too high or too low APL valve settings in bag ventilation?
What is the consequence of too high or too low APL valve settings in bag ventilation?
What is the position of the APL valve during mechanical ventilation?
What is the position of the APL valve during mechanical ventilation?
During mechanical ventilation, the bellows serve as the?
During mechanical ventilation, the bellows serve as the?
What is the position of the bellows during inspiration and expiration?
What is the position of the bellows during inspiration and expiration?
The vent outflow valve is the same as the ___
The vent outflow valve is the same as the ___
What is the purpose of the APL and vent outflow valve?
What is the purpose of the APL and vent outflow valve?
Modern vaporizers are outside of the circle system
Modern vaporizers are outside of the circle system
Why does desflurane require a special vaporizer?
Why does desflurane require a special vaporizer?
What is the purpose of the variable bypass vaporizer?
What is the purpose of the variable bypass vaporizer?
What is the purpose of the temperature compensating valve?
What is the purpose of the temperature compensating valve?
Where does fresh gas flow that does not come in contact with volatile agents in the vaporizer?
Where does fresh gas flow that does not come in contact with volatile agents in the vaporizer?
What is the definition of the splitting ratio in an anesthesia machine?
What is the definition of the splitting ratio in an anesthesia machine?
What happens to the output concentration of the vaporizer when the temperature of the liquid agent drops?
What happens to the output concentration of the vaporizer when the temperature of the liquid agent drops?
Vapor pressure is directly proportional to ___
Vapor pressure is directly proportional to ___
What is the effect of changing pressure affecting the output of the vaporiser called?
What is the effect of changing pressure affecting the output of the vaporiser called?
During PPV, where is the pressure transmitted?
During PPV, where is the pressure transmitted?
Where does the increased flow of backpressure travel to during positive pressure ventilation (PPV)?
Where does the increased flow of backpressure travel to during positive pressure ventilation (PPV)?
When the positive pressure is released during PPV (i.e. exhalation), what is the result of the rapid expansion of compressed gas in the vaporizer chamber?
When the positive pressure is released during PPV (i.e. exhalation), what is the result of the rapid expansion of compressed gas in the vaporizer chamber?
What is the end result of the pumping effect in an anesthesia machine?
What is the end result of the pumping effect in an anesthesia machine?
What is the result of tipping of the vaporizer?
What is the result of tipping of the vaporizer?
When can a leak in the vaporizer be identified?
When can a leak in the vaporizer be identified?
How does a TEC 6 desflurane vaporizer work?
How does a TEC 6 desflurane vaporizer work?
What is the effect of higher ambient pressure (hyperbaric oxygen tank) on the desflurane vaporizer?
What is the effect of higher ambient pressure (hyperbaric oxygen tank) on the desflurane vaporizer?
What is the result of a lower ambient pressure (higher altitude) when using desflurane?
What is the result of a lower ambient pressure (higher altitude) when using desflurane?
Why must desflurane be heated and pressurized to 39°C and 2 atm?
Why must desflurane be heated and pressurized to 39°C and 2 atm?
What is the purpose of the oxygen alternate flowmeter?
What is the purpose of the oxygen alternate flowmeter?
The master switch is normally linked to the ____ switch
The master switch is normally linked to the ____ switch
In the intermediate system, what is the purpose of the pipeline pressure (50) being higher than the cylinder pressure (45)?
In the intermediate system, what is the purpose of the pipeline pressure (50) being higher than the cylinder pressure (45)?
The O2 flush valve and auxiliary O2 are not controlled by the master switch
The O2 flush valve and auxiliary O2 are not controlled by the master switch
Why is oxygen used as a driving gas in the bellows?
Why is oxygen used as a driving gas in the bellows?
How does the failsafe work in the intermediate system?
How does the failsafe work in the intermediate system?
What is a Thorpe tube?
What is a Thorpe tube?
Higher flow rates tend to be which type of flow?
Higher flow rates tend to be which type of flow?
What is the ideal position of oxygen in a flowmeter?
What is the ideal position of oxygen in a flowmeter?
What can alert you to the presence of a leak in the flowmeter?
What can alert you to the presence of a leak in the flowmeter?
What can cause retrograde flow in an anesthesia machine?
What can cause retrograde flow in an anesthesia machine?
What is the typical flow rate of the flush valve on an anesthesia machine?
What is the typical flow rate of the flush valve on an anesthesia machine?
What is the typical pressure range of a flush valve?
What is the typical pressure range of a flush valve?
Pushing the O2 flush valve while the patient is breathing spontaneously can result in what?
Pushing the O2 flush valve while the patient is breathing spontaneously can result in what?
What are the three most important preoperative checks on an anesthesia machine?
What are the three most important preoperative checks on an anesthesia machine?
How do you calibrate the oxygen analyzer?
How do you calibrate the oxygen analyzer?
What can you conclude about the integrity of the system from the flowmeter assembly to the breathing circuit if you have pressure tested your breathing system by closing the adjustable pressure limiting (APL) valve and manually occluding the Y-connector while flushing the circuit with oxygen?
What can you conclude about the integrity of the system from the flowmeter assembly to the breathing circuit if you have pressure tested your breathing system by closing the adjustable pressure limiting (APL) valve and manually occluding the Y-connector while flushing the circuit with oxygen?
What does the positive pressure leak test primarily test in an anesthesia machine?
What does the positive pressure leak test primarily test in an anesthesia machine?
When would you want to use transtracheal jet ventilation?
When would you want to use transtracheal jet ventilation?
Where is the oxygen analyzer typically located, and what is its primary purpose?
Where is the oxygen analyzer typically located, and what is its primary purpose?
How does the piston ventilator work?
How does the piston ventilator work?
What are the advantages of piston bellows?
What are the advantages of piston bellows?
How do piston ventilators deliver a constant tidal volume?
How do piston ventilators deliver a constant tidal volume?
What is the consequence of coupling of VT to fresh gas flow in pneumatic bellows ventilators?
What is the consequence of coupling of VT to fresh gas flow in pneumatic bellows ventilators?
What is the frequency of the positive pressure leak test?
What is the frequency of the positive pressure leak test?
What is the frequency of the negative pressure leak test?
What is the frequency of the negative pressure leak test?
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Study Notes
Anesthesia Machine Components and Functions
- The maximum safe ratio of N2O to O2 when using a proportioning device is 3:1 or less.
- A hypoxia prevention device prevents accidental delivery of a hypoxic gas mixture.
Hypoxia Prevention Devices
- A hypoxia prevention safety device will not alarm when the oxygen pressure is above a minimum threshold.
- The main difference between an oxygen pressure failure device and a hypoxia prevention safety device is that the former alarms when oxygen pressure drops below a set point, while the latter alarms when the oxygen percentage in the mixed gas falls below a set point.
Link 25 Proportioning System
- The Link 25 proportioning system works by sensing the oxygen pressure and adjusting the nitrous oxide flow accordingly to maintain a safe ratio.
High-Pressure System
- The pressure boundaries of the high-pressure system are between 400 and 1370 psi.
- The pipeline pressure is typically 50 psi.
- The pressure of air from the cylinders after the pressure regulator is typically 45 psi.
Low-Pressure System
- The boundaries of the low-pressure system in a hypoxia prevention device are between 10 and 14 psi.
- The low-pressure system in an anesthesia machine includes the flowmeter valve, O2 supply failure alarm, pneumatic master switch, and failsafe device.
- The pressure of the low-pressure system in an anesthesia machine is typically around 10-14 psi.
Failsafe Device and Oxygen Flush Valve
- The failsafe device, O2 flush valve, flowmeter valve, O2 supply failure alarm, and pneumatic master switch are all part of the low-pressure system.
- The function of the flowmeter valve is to regulate gas flow to the patient.
Leak Testing
- A low-pressure leak test (negative pressure test) is performed on an anesthesia machine to detect leaks in the low-pressure circuit.
- A passed negative pressure leak test is indicated by the suction bulb remaining collapsed.
- During a negative pressure leak test, the vaporizers should be turned off.
- A positive pressure leak test (high-pressure leak test) is performed to detect leaks in the high-pressure circuit.
- The primary purpose of the positive pressure leak test is to detect leaks in the high-pressure circuit.
APL Valve and Vent Outflow Valve
- During spontaneous breathing, the APL valve is open.
- During manual bag ventilation, the APL valve is closed.
- The consequence of too high or too low APL valve settings in bag ventilation is inadequate ventilation.
- During mechanical ventilation, the APL valve is closed.
- The APL valve and vent outflow valve serve to vent excess gas from the breathing circuit.
Vaporizers
- Modern vaporizers are outside of the circle system.
- Desflurane requires a special vaporizer that is heated and pressurized to 39°C and 2 atm.
- The purpose of the variable bypass vaporizer is to maintain a consistent output concentration despite changes in temperature or pressure.
- The purpose of the temperature compensating valve is to adjust the vaporizer output concentration based on temperature changes.
Anesthesia Machine Operation
- The splitting ratio in an anesthesia machine is the proportion of fresh gas that flows through the vaporizer versus that which bypasses it.
- The output concentration of the vaporizer increases when the temperature of the liquid agent drops.
- Vapor pressure is directly proportional to temperature.
- The effect of changing pressure affecting the output of the vaporizer is called the pumping effect.
Pressure and Flow
- During PPV, pressure is transmitted to the breathing circuit.
- The increased flow of backpressure travels to the vaporizer chamber during PPV.
- When the positive pressure is released during PPV, the result is a rapid expansion of compressed gas in the vaporizer chamber.
- The end result of the pumping effect is an increased output concentration of the vaporizer.
Desflurane Vaporizer
- The TEC 6 desflurane vaporizer works by heating and pressurizing the desflurane to 39°C and 2 atm.
- The effect of higher ambient pressure on the desflurane vaporizer is an increased output concentration.
- The result of a lower ambient pressure when using desflurane is a decreased output concentration.
- Desflurane must be heated and pressurized to 39°C and 2 atm to achieve a consistent output concentration.
Miscellaneous
- The oxygen alternate flowmeter is used to measure oxygen flow separately from other gases.
- The master switch is normally linked to the O2 flush valve switch.
- Pipeline pressure (50) is higher than cylinder pressure (45) to ensure a reliable supply of oxygen to the anesthesia machine.
- Oxygen is used as a driving gas in the bellows because it is safer and more efficient.
- The failsafe device in the intermediate system shuts off the machine in case of failure.
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