A breathing system → assembly of components which connects the ______________ to the ____________ creating an artificial atmosphere, from and into which the patient breathes.
patient’s airway ; anaesthetic machine
The Ideal Breathing system
Simple and safe to use Sturdy, (small or large ?) and (light or dark?) Pressure relief [____________)
(Low or High?) resistance
Delivers the right gas mixture
Allows all methods of ventilation in all age group ( ___________ & ___________)
Efficient → (Low or High?) FGF, _______ elimination
Allows easy removal of waste gases
Easy to maintain with low running costs
small ; light ; barotrauma
Low ; spontaneous & controlled
Low ; CO2
Components
_________ port/_________ tube→ gases are delivered from the machine to the systems
_________ → connects to the patient’s airway
_________ → reservoir for FGF
_________ tube → conduit for gas
_________ port/valve → through which the expired gas is vented to the atmosphere
±_________ (rebreathing)
Fresh gas entry port/delivery tube
Port ; Reservoir bag
Corrugated tube ; Expiratory port/valve
carbon dioxide absorber
TYPES OF SYSTEMS
_______________
_______________
_______________ circuits
_______________ system
_______________ systems
Insufflation
Draw-over
Mapleson circuits
The circle system
Resuscitation systems
INSUFFLATION
Because Insufflation avoids _______________ , there is no _________ of exhaled gases if the _____ is ________ enough.
__________ cannot be controlled with this technique, however, and the inspired gas contains ___________ amounts of entrained ______________ .
any direct patient contact
rebreathing ; flow ; high
Ventilation ;unpredictable
Atmospheric air
INSUFFLATION
The —————- of anaesthetic gases across a patient’s face
Avoids ____________ between a breathing circuit and patient’s airway
Paediatrics (IV cannulation)
blowing ; direct connection
OPEN DROP ANAESTHESIA
Not used in modern medicine
A _________________ anesthetic is dripped
onto a gauze–covered mask applied
to the patient’s face vaporization →↓ _________ →__________________ → ↓______________ patient
highly volatile
mask temp
moisture condensation
anesthetic vapor
Anesthesia Circuits
Basically 2 systems : 1,_______ systems and 2. _________ systems
Circle
Mapleson
Circle System
Allows ________ of anesthetic gases
(Lower or Higher?) FGF rates
(More or Less?) pollution
Requires ___________
Conserves _______ and ___________
rebreathing
Lower
Less
CO2 absorption
heat and humidity
Advantages of Circle Sysytem
Highly efficient
Minimal ____________
Conserves _______ and _______
Minimal _________
Disadvantage - many places to _____
dead space
heat and moisture
pollution
leak
Components of the Circle System
__________ source
__________ valves
__________ __________ tubing
________ connector
_______ valve
_________ bag
______________
Fresh gas source
Unidirectional valves
Inspiratory expiratory tubing
Y-piece connector
APL valve
Reservoir bag
Co2 absorber
Rules for Circle System
Unidirectional valve must be ___________________
FGF cannot enter between __________________
APL cannot be located between ______________
between patient bag on both sides
patient expiratory valve
patient inspiratory valve
Four Basic Circuits
List them
Open
Semi-open
Semi-closed
Closed
Open Systems
Eg ____________
blow anesthetic gas over ____, no _________
(rebreathing or no rebreathing?) of gases
ventilation (can or cannot?) be controlled (known or unknown?) amount delivered
Insufflation
face ; direct contact
no rebreathing ;cannot
unknown
Semi-open Systems
A Breathing system which ________________
_____________________________ system
entrains room air
Self inflating resuscitator
Semi-closed System
Gas _________________, part leaves via ___________
Eg
_______ system
_______ system
enters from machine
scavenger
Circle; Bain
Closed System
Only enough gas enters to ________________
___________ is closed
Eg: ________ system
__________ system
meet metabolic needs
Scavenger
Closed circle
To-and-fro
To-and-fro system
AnesthesiaTechnique (commonly or not commonly?) used
APL is _______ and only enough O2 is added to meet metabolic needs
Anesthetic added based on __________________
__________ anesthetic gas and ___________ pollution
Not commonly
closed; square root of time
Conserves; eliminates
The Scavenger System
Releases ____________ from the system
Prevents ___________ pollution
Gases leave through ______
May put too much ______________ on the system
excess pressure
operating room; APL
negative pressure
Open System
(Reservoir or No reservoir?) (Rebreathing or No rebreathing?)
Semi-closed System
______ reservoir _______ rebreathing
Semi-open System
_____ reservoir _______ rebreathing
Closed System
_______ reservoir ________ rebreathing
No reservoir No rebreathing
Has reservoir partial rebreathing
Has reservoir No rebreathing
Has reservoir Complete rebreathing
Mapleson A
FGI near ______
Breathing tube
Expiratory valve near _______
Volume of breathing tube should be ______________
__________ ventilation
__________ flushes tubing between breaths
Using __________ enables controlled ventilation but also causes ______________
bag
mask
as great as the tidal volume
Spontaneous
High FGF; pop-off ; CO2 rebreathing
Mapleson B
Similar to A with FGI near _____________
System fills with _______
inhaled by patient
Exhaled gas forced out through ___________
expiratory valve
FGF
expiratory valve
Mapleson C
Mapleson C is similar to Mapleson B but with _____________ and _____________
Current use?
Shorter breathing tubing
less dead space
Mapleson D
_______ breathing tube
FGI near ________
Exhalation valve at _______ end of breathing tubing
Long; mask
distal
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BASIC LIFE SUPPORT (BLS)40
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Unconsciousness23
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Airway Management44
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Advanced Life Support39
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Fluid & Electrolyte Therapy40
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Muscle Relaxants63
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INTRAVENOUS ANAESTHETIC AGENTS46
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Local Anaesthetic Agents39
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GENERAL ANAESTHETIC AGENTS56
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BREATHING SYSTEMS35
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Monitoring in Anaesthesia62
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Emergency Anaesthesia53
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SPINAL AND EPIDURAL ANAESTHESIA38
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Obstetric Anaesthesia24
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POST-ANAESTHETIC CARE AND COMPLICATIONS35
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Paediatric Anaesthesia41
