Objectives: Physics I—Physical Laws

Upon completion of the lecture, the learner will have a workingknowledge of:

1. Ideal gas lawsa) Boyle's lawb) Charles' Lawc) Gay-Lussac's Lawd) Combined Gas Lawe) Avogadro's Hypothesis

2. Diffusion lawsa) Pick's Lawb) Graham's Lawc) Henry's Lawd) Dalton's Law

3. Units of Measurea) Metric systemb) temperature conversion

4. Solubility coefficientsa) blood-gasb) oil-gasc) tissue-gas

5. Physics of the circulatory systema) Ohm's Lawb) Hagan-Pouseille equationc) La Place equation

Objectives: Physics II—Medical Gases

Upon completion of the lecture, the learner will have a workingknowledge of:

1. Compressed gas cylindersa)Eb) H

2. Oxygen tanksa) capacitiesb) pressures

3. Nitrous oxide tanksa) capacitiesb) pressures

4. Air Tanksa) compositionb) pressures

5. Pressure relief valves6. Connectors

a) pin index safety system (PISS)7. Yoke assembly

a) contents8. Proper storage/handling of tanks9. Central supply of medical gases

a) oxygenb) nitrous oxidec) central vacuum system

Objectives: Physics III—The Anesthesia Machine

Upon completion of the lecture, the learner will have a workingknowledge of:

1. The general schematic of the anesthesia machinea) oxygen supply

a. tankb. central pipeline

i. diameter index safety system(DISS)

ii. gauges1. Bourden principle

iii. pressure regulatorsiv. flush valvev. oxygen supply failure alarmvi. fail-safe valvevii. flow meters

1. construction2. low and high flows

a. gas viscosity vs.density

3. effect of barometric pressureb) Nitrous oxide and air

2. Oxygen ratio monitoring and proportioning systems3. Common gas outlets/check valves4. FDA (1993) recommendations for apparatus checkout5. Vaporizers

a) general principlesb) vapor, evaporation, and vapor pressurec) minimum alveolar concentration (MAC)d) regulation of outpute) variable bypass vaporizersf) effects of changes in barometric pressureg) vaporizer arrangementh) the pumping effecti) the desflurane vaporizer

6. Anesthesia breathing systemsa) the circle system

i. advantages and disadvantages

ii. components

a. CO2 absorber1) chemical reaction

b. APL valvec. inspiratory and expiratory valvesd. reservoir bage. circuit hosesf. fresh gas supply

b) The Mapleson circuitsa. Ab. D

Objectives: Physics IV—Waste Anesthetic Gases

Upon completion of the lecture, the learner will have a workingknowledge of:

1. The history and standards of measurement of wasteanesthetic gases

a) OSHAActof 1970b) NIOSH recommendations

i. halogenated agentsii. nitrous oxide

2. Sources of anesthetic gas spillagea) techniques to reduce OR pollution

3. OR ventilation systems4. waste scavenging systems

a) closed vs. open reservoiri. hosesii. disposal routes

1. active vs. passive

Objectives: Physics V—Ventilators

Upon completion of the lecture, the learner will have a workingknowledge of:

1. Intermittent positive pressure ventilation (IPPV)a. physiologic dead spaceb. CO2 productionc. O2 consumptiond. lung function under IPPVe. types of ventilation

i. spontaneousii. controllediii. assistediv. IMV

1. assistedv. airway pressure release ventilationvi. jet ventilation

f. machine complianceg. classifications of ventilators

i. volume limitedii. pressure limited

h. controlled ventilation variablesi. minute volumeii. tidal volumeiii. inspiratory flow and plateau

i. volume ventilatorsi. bellowsii. control box

1. rate2. minute volume3. VT4. I:E ratio5. sigh6. alarma7. manual cycle

j. the ventilatory cyclek. limitations of PPVI. subclasses of ventilators on various anesthesia

machines

Objectives: Physics VI—Capnography

Upon completion of the lecture, the learner will have a workingknowledge of:

a. types of capnographsi. side stream vs. main stream

b. measurement techniquesi. infrared vs. mass spectrometry

c. the normal capnogrami. 4 phases

1. inspiratory baseline2. expiratory upstroke3. expiratory plateau4. inspiratory downstroke

d. the abnormal capnogrami. COPDii. increased inspiratory resistanceiii. rebreathingiv. cardiac oscillationsv. "Curare Clefts"

e. differences between PaCO2 and PeCO2

Objectives: Physics VII—Oximetry

Upon completion of the lecture, the learner will have a workingknowledge of:

1. Modes of oxygen transporta) functional saturation (SaO2)b) oxyhemoglobin (O2Hb)c) oxygen content (CaO2)d) oxyhemoglobin dissociation curve

1. Psoe) O2 deliveryf) O2 consumption (VO2)

1. Pick equation2. Physics of the pulse oximeter

a) light wavelengthsb) blood pulsationsc) ratio of O2Hb and RHb

3. Sources of errora) dyesb) COHb and MetHbc) wavelength uncertaintyd) signal to noise ratio

1. weak pulses2. Penumbra effect3. patient movement4. venous blood pulsations5. Bovie interference

4. Accuracy

Objectives: Physics VIII—Blood Pressure Monitoring

Upon completion of the lecture, the learner will have a workingknowledge of:

1. Definition of CO2. modes of invasive BP monitoring

a) waveforms3. manual BP monitoring4. oscillometric BP monitoring5. Penaz technique of BP monitoring6. Arterial tonometric BP monitoring7. Pulse transit technique of BP monitoring

Objectives: Physics IX—Hazards of the Delivery System

Upon completion of the lecture, the learner will have a workingknowledge of:

1. causative factors of anesthetic mishaps2. definition of hypoxia

a) causative factors3. measurement of FiO2

b) O2 analyzersi. O2 galvanic cellii. polarographic sensorsiii. paramagnetic analyzers

4. causes of O2 failure in the anesthesia machinea) upstreamb) within the machine or circuit

5. definition of hyperoxia6. definition of hypercarbia

a. causative factors7. definition of hypocarbia

a. causative factors8. circuit pressure and volume problems9. anesthetic overdose and underdose10. electrical failure

Objectives: Physics X—Lasers

Upon completion of the lecture, the learner will have a workingknowledge of:

1. definition of laser2. medical lasers

a. CO2b. Nd:YAGc. Argond. KTPe. Dye

3. laser hazardsa. ANSI classifications

i. ranges 1-4b. eye damage from lasers

4. considerations during laser surgery of the airwaya. ventilationb. ET tubesc. selection of airway gasesd. management of airway fires

Objectives: Physics XI—Electrical Safety

Upon completion of the lecture, the learner will have a workingknowledge of:

1. Principles of electricitya. Ohm's lawb. powerc. electrical workd. impedancee. capacitancef. inductance

2. electrical shock hazards3. grounded electrical power4. ungrounded power

a. line isolation monitori. conditions for alarmsii. equipment ground wireiii. ground fault circuit interrupter (GFCI)

5. microshock6. electrosurgery