Upload
veronica-york
View
215
Download
2
Tags:
Embed Size (px)
Citation preview
Components of the Gas Machine
Valves High Pressure System Immediate Pressure System Low Pressure System Circle System/Breathing Systems
Free Floating/Check Valves
Unidirectional Located in various parts of the machine Diameter Index Safety System
Prevents oxygen cylinder gas from escaping the anesthesia machine and going out hospital wall
Check Valve between Vaporizer Outlet and Common Gas Outlet Prevents reversal of flow to vaporizer Not Present on all machines (Ohmeda only)
“Ball and Spring” Type Valve You supply the energy for this valve! Oxygen Flush Valve
Pressurized at 40-50 psi from wall or cylinder
Oxygen delivered to patient at 35-75 L/minute
May cause barotrauma
Is this considered high, intermediate, or low pressure?
Diaphragm Valves
Regulate and Reduce Pressure First Stage Regulator
Cylinder pressure decreased to 45 psi Why is cylinder pressure slightly less than
pipeline pressure? Second Stage Regulator
Receives wall pressure oxygen or from first stage regulator
Only Ohmeda machines
Quick Review Questions: Cylinders What is the cylinder pressure and
capacity for oxygen?
Cylinder pressure and capacity for nitrous oxide?
Who regulates marking, labeling, filling, handling, and transportation of compressed gas cylinders?
Cylinders (continued)
Each valve stem on the cylinder has a safety device under which hazardous conditions of excessive heat or fire will cause the cylinder to become exhausted. What is this safety device called?
What is this safety device composed of? At what temperature will it melt?
High Pressure System
Think Cylinder Pressure! Components
Cylinder Pressure Regulator (aka First Stage Regulator)
Cylinder Pressure Gauge Hanger Yoke, Yoke Block, and Yoke Plug Yoke Block with Check Valves (Free
Floating) Pin Index Safety System
Hanger Yoke Valve and the PISS
Yoke Assembly has pins for E Cylinders to fit on Pin Index Safety System
What is the pin index for Oxygen? Nitrous Oxide? Air? Failure to open cylinder valve will result in no gas
flow to anesthesia machine Hanger Yoke Valve
Acts as a “safety” valve Minimizes transfilling between cylinders Opens with pressure and closes with pressure Considered unidirectional….so what kind of valve is
this?
Cylinder Pressure Gauge
Reflects cylinder pressure Bourdon Pressure
PSI in tank exerted on small piece of copper that is bent into a curve, sealed and linked to clock like mechanism
The higher the pressure the more it wants to straighten out which then turns the pointer
Intermediate Pressure System Think Pipeline Pressure Oxygen Second Stage Regulator Ventilator Power Inlet Pipeline Inlets, Check Valves, Pressure
Gauges Flow Meter Valves Oxygen Pressure Failure Devices Flush Valve
Oxygen Second Stage Regulator Located downstream from oxygen supply
source Supplies constant pressure to the
oxygen flow control valves regardless of fluctuating line pressures
Reduces oxygen pressure to 12-19 psi The pressure shut off VALVES have a higher
threshold of 20-30 psi. Ensures that oxygen is the last gas flow
to decrease if oxygen pressure falls
Oxygen Flush Valve
Separate line to flush valve comes from a common source to the hospital pipeline DISS and cylinder yokes
Used for emergency pressurization on circuit when you lose pressure delivery
Remember, it is what type of valve?
Flowmeter Tubes
Thorpe Tubes Variable Orifice Design Larger diameter at top
than bottom The higher the ball/float,
the more turbulent the air
Gas flows range from 200 mL to 15 L
Flowmeter Tubes (continued) Series of 2 flowtubes per gas/air
Left hand tube = fine flow tube Right hand tube = cooarse flow tube
Traditional flowmeters calibrated at atmospheric pressure and room temperature of 20 degrees Celsius How many “torr” is one atmosphere?
When flowtubes are used at high altitudes, is the actual flow higher or lower than indicated?
Common Gas Outlet
Most susceptible to leakage
Point of exit for gas from anesthesia machine
A fresh gas entry port/delivery tube through which gases are delivered from the anesthesia machine to the breathing circuit system
Circle System Components
CO2 Absorber APL Valve Common Gas Outlet Reservoir Bag Inspiration and Expiration
Check Valves (Flutter Valves) Corrugated Tubing with
Patient Mask
Carbon Dioxide Absorbers
Soda Lime Final Products Calcium Carbonate Sodium Hydroxide Potassium
Hydroxide Water and Heat
Baralyme Final Products Calcium Carbonate Barium Hydroxide Water and Heat
Allows rebreathing Exothermic reaction What size mesh is considered
acceptable for granule size?
Other Nuances to Remember Scavenging System Link 25 system for hypoxic guard system
Draeger or Ohmeda? Oxygen Failure Protection Device is NOT
an all or none phenomenon Draeger or Ohmeda?
What happens when the vaporizer is tipped then leveled? Will the carrier flow carry more or less agent to the patient?
Question 1
The devices that prevents reverse flow of gases from the anesthesia machine to the pipeline or atmosphere is:
A. Diameter Index Safety System B. Check Valve C. Pin Index Safety System D. Pressure Gauge
Question 2
All of the following are functions of the check valve EXCEPT:
A. It reduces pressure in the system. B. It minimizes leakage from an open cylinder
to the atmosphere if one cylinder is absent. C. It minimizes gas transfer from a cylinder at
high pressure to one with lower pressure. D. It allows uninterrupted gas flow from one
cylinder to another.
Question 3
The component of the anesthesia machine that changes the pressure of an incoming gas to a pressure suitable for use in the anesthesia machine:
A. Safety Valve B. Pressure Increasing Valve C. Pressure Regulator D. Check Valve
Question 4
The first stage regulator reduces gas pressure to:
A. 15 psi B. 60 psi C. 20-30 psi D. 45-50 psi
Question 5
The second stage regulator reduces O2 pressure to:
A. 45 psig B. 12-19 psig C. 10 psig D. 45-55 psig
Question 6
Where is the second stage regulator located?
A. At the hanger yoke B. Just before flowmeter C. Just after flowmeter
References
Nagelhout, J.J. (1999). Review of Nurse Anesthesia. Philadelphia: Saunders.
Nagelhout, J. J. & Plaus, K. L. (2014). Nurse Anesthesia. St. Louis: Elsevier Saunders.
Memory Master: Questions & Answers for the Student Registered Nurse Anesthetist (2012). Valley Anesthesia.
Morgan, G. E., Mikhail, M. S., & Murray, M. J. (2006). Clinical Anesthesiology (4th ed). New York: McGraw-Hill.
Teich, A. & Schaus, S. S. (2014). A Comprehensive Certifying Examination Review Course Manual. Valley Anesthesia Educational Programs.
Wiltse-Nicely KL and Macksey LF. CRNA Certification Exam Review. Jones and Bartlett Learning: Burlington, MA; 2014.