Surgery Dr Q: Chapter 4

  1. Determining reservoir bag size
    60 mL/kg
  2. If a reservoir bag is too small a patient...
    • Cant inflate lungs enough
    • Over inflates during expiration and increases thoracic pressures
  3. If a reservoir bag is to big a patient...
    • Difficult to breathe
    • Difficult to see breaths
  4. How to determine ET tube size
    Measure from most rostral aspect of the mouth to the thoracic inlet
  5. What is the risks if ET tube is too long?
    • Only one lung will be infused with oxygen and anesthetic gas
    • Mechanical dead space will be increased leading to hypoxemia
  6. Parts of the compressed gas supply
    • Compressed gas cylinder
    • Tank pressure gauge
    • Pressure-reducing valve
    • Line pressure gauge
    • Flow meters
    • Oxygen flush valve
  7. Parts of the anesthetic vaporizer
    • Vaporizer inlet port
    • Vaporizer outlet port and common gas outlet
  8. Parts of the breathing circuit (rebreathing R or non-rebreathing NR)
    • Fresh gas inlet ( R and NR)
    • Unidirectional valves (R)
    • Pop-off valve (R and NR)
    • Reservoir bag (R and NR)
    • Carbon dioxide absorber canister (R)
    • Pressure manometer (R)
    • Air intake valve (R)
    • Breathing tubes (R)
    • Y-piece (R)
  9. Parts of the scavenging system
    • Discharge hose (passive or active system)
    • Pressure regulator (active system)
    • Outflow pipe (Passive and active system)
    • Pump (active system)
  10. Check both ___ and ___ oxygen supplies at the beginning of the day to be sure they are turned on
    • Primary
    • Secondary
  11. When handling compressed gas cylinders:
    • Avoid contact with flames, sparks or sources of ignition
    • Turn tank on only when its attached to a yoke or pressure regulator
    • Store tanks only attached to a yoke secured in a cart of chained to the wall
    • Never attempt to attach a tank to a yoke that doesnt fit and never tamper with the safety on a tank
  12. Volume in L of oxygen present in a compressed gas cylinder can be calculated by..
    Multiplying the pressure in an E tank by 0.3 or by multiplying the pressure in an H tank by 3
  13. When turning off a flow meter turn ___ just until the ball or rotor drops to ____
    • Clockwise
    • 0 L/min
  14. Helps explain why a change in vaporizer setting takes time t be reflected in the circuit and gives the anesthetist a rough idea as to how long a change in anesthetic concentration will occur
    Time constant
  15. To calculate the time constant..
    Divide total volume of the breathing circuit in L by the carrier gas flow rate in L/min
  16. When the vaporizer setting is changed it takes __ times the constants to effect a __ change in the circuit concentration
    • 5 times
    • 95%
  17. Vaporizers must be checked before each procedure to make sure the liquid anesthetic level is between the ___ and ___ lines of the window. Should be kept at least ___ at all times
    • Upper and lower
    • Half full
  18. What to do if a bottle of liquid inhalant anesthetic breaks?
    Vacate the room ASAP and allow room to air out until anesthetic agent is completely evaporated and evacuated from the room
  19. After use of the non-rebreathing circuit the connector of the rebreathing circuit must be reattached to outlet port before next patient, failure to do so can result in...
    • Inability to keep patient anesthetized
    • Exposure of personnel to anesthetic gas
  20. When manual ventilation is provided the __ must be close before the bag is pressed. Between each breath the pop-off valve must be ___ again to allow the escape of gas.
    • Pop-off valve
    • Opened
  21. During any procedure the reservoir bag must be __ full at peak expiration
  22. Signs that CO2 granules must be changed
    • Hard brittle
    • Slightly off white color
    • Color change of 1/2-1/3¬†
    • CO2 level grater than 0 during peak inspiration as measured with a capnograph
    • Always change after 6-8 hours of use
  23. Maximum safe pressure manometer readings when chest is closed
    • 0-2 cm H20 when patient breathing spontaneously¬†
    • 20 cm H20 in small animals when PPV provided
    • 40 cm H20 in large animals when PPV provided
  24. Small animal tubes are used on small anesthetic machine for patients over ___ and pediatric tubes for patients weighing __ to reduce mechanical dead space
    • 7 kg
    • 2.5-7 kg
  25. Choice of machine, reservoir bag, breathing tubes, oxygen flow rate, and breathing circuit type are all based on patients...
  26. When the oxygen tank is half full the tank pressure gauge will read
    1,100 psi
  27. Nitrous oxide is present in the tank as a...
    Liquid and a gas
  28. Amount of oxygen an animal is receiving is indicated by
    Flow meter
  29. Flow meters that have a ball for reading the gauge should be read from the ___ of the ball
  30. Most commonly recommended ratio for nitrous oxide and oxygen flow rates is
    33% oxygen and 67% nitrous oxide
  31. Minimum size for the reservoir bag can be calculated as
    60 mL/kg
  32. Flutter valves on an anesthetic machine help...
    Control the direction of movement of gases
  33. Pop-off valve is part of the anesthetic machine and helps...
    Prevent excess gas pressure from building up within the breathing circuit
  34. In small animal anesthesia when the patient is bagged the pressure manometer reading should not exceed
    20 cm H20
  35. Rebreathing is determined by...
    Fresh gas flow
  36. Non-rebreathing systems should have maintenance flow rates that are
    Very high at least 200 mL/kg/min
  37. Negative pressure relief valve is important when..
    There is a failure of oxygen flow through the system
  38. Tidal volume of an anesthetized animal is considered to be..
    10 mL/kg of body weight
  39. Scavenging system is generally attached to..
    Pop-off valve
  40. Reservoir bag that is not moving well may indicate that...
    ET tube is not in trachea, animal has decreased tidal volume, and leak around ET tube
  41. Increase in depth of anesthesia can be achieved quickly by...
    Having high oxygen flow rates and high vaporizer settings
  42. Concentration of anesthetic delivered from a nonprecision vaporizer may depend on...
    Temperature of liquid anesthetic, flow of carrier gas through the vaporizer, back pressure and type of anesthetic in the vaporizer
  43. When an anesthetic machine is operating correctly, the pressures in the machine are...
    40-50 psi between the pressure-reducing valve and the flow meters, 15 psi between the flow meters and the breathing circuit, and 15 psi entering a VOC vaporizer
Card Set
Surgery Dr Q: Chapter 4
Surgery Dr Q: Chapter 4