Gas Machine

Question 0

What type of equipment was involved (and the percentage)in 88% of cases which had mortality/ morbidity noted.

Answer 0

• breathing circuit 39%

- Oxygen supply tanks/ lines 11%

Question 1

Gas Machine Definition

Answer 1

A device which delivers a precise-known but variable gas mixture, including anesthetizing & life sustaining gases

Question 2

Misuse of equipment counted for what percentage in cases leading to mortality/ morbidity?

Answer 2

75% (3x more common than equipment failure at 24%)

Question 3

Vaporizers accounted for what percentage of the 83% of claims from 1990-2011?

Answer 3

35%

Question 4

How much did the breathing circuit accounted death/morbidity in 83% of claims from 1990-2011. What was the cause of this?

Answer 4

4 cases r/t obstruction of circuit due to sticking inspiratory or expiratory unidirectional valves

Question 5

85% of all errors involve_____

Answer 5

provider error

Question 6

What’s the normal working pressure of the machine?

Answer 6

50 psi

Question 7

How much flow from the oxygen flush?

Answer 7

35-75L/min

Question 8

NIOSH Standard for halogen WAG (with & w/out N2O)

Answer 8

2 ppm

0.5 ppm with N2O

Question 9

what is WAG

Answer 9

waste anesthesia gas

Question 10

NIOSH standard for nitrous oxide WAG

Answer 10

25ppm

Question 11

What are scavenger tube sizes

Answer 11

19 or 30mm

Question 12

Size of ETT or CGO (common gas outlet)

Answer 12

15mm

Question 13

Size of the breathing circuit

Answer 13

22mm

Question 14

What is the gas machine standard

Answer 14

ASTN F1850 Anesthesia workstation standard (per the industry advising group)

Question 15

How many liters per second is 35-75L/min O2

Answer 15

1L/sec

Question 16

What helps prevent exposure to WAG

Answer 16

scavenging

Question 17

What is the function of the ASTM F1850

Answer 17

Specifies what is needed for an anesthesia work station (typically built into new machines)

Question 18

ASTN F1850 required components

not sure if on exam…each topic has more details written in notes/ N&P

Answer 18

1. Back up batteries for 30 min.
2. Alarms (high, medium, and low priority alarms)
3. Required monitors (ex. O2 supply failure, ETCO2, EKG, etc.)
4. Pressure in breathing circuit limited to 12.5kPa (125cm H20)
5. Non-detachable/ resistant to detaching electric supply cord
6. Cylinder supplies
7. Flow meters
8. O2 flush capable of 35-75L/min flow that doesn’t proceed through any vaporizers
9. Vaporizers
10. Only 1 common gas outlet @ 22-mm outer diameter, 15mm inner diameter designed to prevent accidental disconnection
11. Pipeline gas supply
12. Checklist provided
13. Digital data interface

Question 19

Five tasks of O2

Answer 19

1. Ventilator
2. Oxygen Pressure fail alarm (decrease pressure)
3. Flush valve
4. Flowmeter
5. “Fail Safe” (pressure sensor shutoff valve)

Question 20

That does “SPPD” (model) mean?

Answer 20

• Supply
• Processing
• Delivery
• Demand

Question 21

What components of the gas machine are in the “High” pressure category? (5)

Answer 21

• Pressure Regulator
• Hanger Yoke
• Yoke block with check valves
• Check Valve
• Cylinder Pressure Gauge

Question 22

High-Pressure system is exposed to what type of pressure?

Answer 22

Cylinder pressure

Question 23

Low Pressure Circuit components of AGM & its location

Answer 23

(Located distal to flowmeter needle valve)

• Flowmeters (tubes)
• Vaporizers (calibrated)
• Check valve (if present)
• common gas outlet
• Flow control valve (on handout)

Question 24

Intermediate parts of AGM and its location

Answer 24

(exposed to pipeline pressure, 50psi) - Pipeline inlets - Ventilator power outlet - O2 pressure-failure devices - Flowmeter valve - O2 2nd stage regulator - Flush valve (oxygen)

Question 25

***Where is O2 added to the machine and why that location

Answer 25

Added to the COMMON MANIFOLD downstream to prevent O2 lost if there's a leak (leak more likely to happen upstream)

Question 26

***Where does O2 first mix with other gases

Answer 26

common manifold

Question 27

What part of the AGM seperates components wMin the machine from external components

Answer 27

The common gas outlet (machine outlet)

Question 28

How many tasks does N20 & air have each w/in the AGM

Answer 28

One

Question 29

How many tasks does O2 have & what are they

Answer 29

(5) 1. Low pressure alarm (Oxygen pressure failure alarm) (Notifies if loss or decrease in pressure) 2. Ventilator driving gas 3. O2 flush valkve 4. Fail safe 5. Flow meter

Question 30

***What are shrader valves & what component of the AGM do they belong?

Answer 30

- part of the supply system | - "quick connects" where machine connects & disconnects from wall gases

Question 31

What are the concerns of the concept of supply

Answer 31

- How gases & electrical power come into the AGM | - What are the likely faults & hazards (Naglehout p. 245)

Question 32

What 2 things are included with "Supply"

Answer 32

Pipeline & cylinders

Question 33

****Supply of gases pipeline source includes....

Answer 33

- The primary gas source - DISS (Diameter index safety system) pipeline connector - Pipeline check valve (prevents gas from leaking) - Pipeline gauges

Question 34

***What equipments are part of the pipeline

Answer 34

1. Wall outlets 2. Connecting valves & holes 3. Filters & check valves 4. Pressure gauges

Question 35

Parts of the Cylinder

Answer 35

1. hanger yokes, (Yoke block) 2. filters & check valves 3. Pressure gauge 4. pressure regulator

Question 36

What is a hanger yoke

Answer 36

part that allows cylinder tank to orient to machine