Term
| what are the three ways to analyze FiO2 content? |
|
Definition
1. oxygen galvanic cell
2. Polarographic sensors
3. Paramagnetic Analyzer |
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Term
| Each oxygen galvanic cell has sensor with a lifetime expectancy of? |
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Definition
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Term
| What two things can affect the voltage in the oxygen galvanic cell and therefore skew its numbers therefore these are measured and taken into consideration with the machine |
|
Definition
1. temperature
2. Pressure |
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Term
| What is the mechanism of action of the oxygen galvanic cell sensors |
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Definition
| Works by creating a voltage. The amount of voltage dictates the % FiO2. Voltage is directly proportional to Oxygen content. There is a semi-permeable membrane for oxygen. The higher the O2 amounts then the more O2 in the device. More O2 means more Redox Reactions. More Redox = Increase in Volage. |
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Term
| Name are the two mechanical components in the oxygen galvanic cell that react with oxygen and what are they made out of? |
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Definition
| there is an anode made of lead and a cathode made from a noble metal. |
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Term
| What solution is in the oxygen galvanic cell? |
|
Definition
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|
Term
| is the oxygen galvanic cell affected by anesthetic gases? |
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Definition
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Term
| What is the mechanism of action of the polarographic FiO2 sensors? |
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Definition
| O2 crosses a semi-permeable membrane. Increase O2 reacts to make hydroxide ions. The result is an electrical current (NO VOLTS LIKE GALVANIC CELLS). Increase current = increase FiO2 levels. |
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Term
| What solution is found in the polarographic sensors |
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Definition
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Term
| Describe the mechanism of action for paramagnetic analyzers in FiO2 analyzation |
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Definition
| Oxygen O2 has two unpaired electrons. These are naturally attracted to magnetic fields. So a paramagnetic analyzer creates a magnetic field. This artificial field attracts and repels O2 molecules causing shifts in pressure in the line which the sensor calculates into the FiO2 %. |
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Term
| What are the 3x major benefits of the paramagnetic anaylzers over the polarographic and galvanic FiO2 analyzers |
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Definition
1. NEVER NEEDS to be calibrated
2. no replacement of the sensor ever
3. instant readings sicne it does not depend on chemical reactions. |
|
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Term
| name five causes of O2 failure UPSTREAM of the anesthesia machine (so failures before gas physically enters the back of the machine) |
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Definition
1. failure of hte liquid O2 resevoir
2. Crossed pipelines
3. closed O2 valves
4. disconnected hoses
5. failure of the reserve system |
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Term
| hyperoxia is only a problem with long durations of oxygen of more than? |
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Definition
|
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Term
| Does dead space or shunting result in hypercarbia |
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Definition
| DEAD SPACE. Anything that increases dead space will result in hypercarbia. |
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Term
| why does dead space result in hypercarbia |
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Definition
| dead space is any area of bidirectional airflow. Meaning that Fresh gas and Used gas are constantly flowing in both directions. Remember that CO2 will diffuse MUCH more readily than Oxygen. And linger. Eventually causing a diffusion hypoxia. |
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Term
| What are the minimum fresh gas flows for the Mapleson A and Mapleson D circuits |
|
Definition
Mapleson A: A for AWAKE patients(FGF at bag, APL at PT) Spontaneous: 70-100mL mL/kg/min
Controlled: 200-300mL/kg/min
Mapleson D: D for Dependent Ventilation(FGF at pt, APL at bag)
Spontaneous: 200-300 mL/kg/min
Controlled: 70-100 mL/Kg/min |
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Term
| two possible causes of hypocarbia. Most common is? |
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Definition
1. hyperventilation (Most common)
2. Bellows leak (air being used to drive the bellows is leaking into the air that goes to the lungs thereby increasing your tidal volumes) |
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Term
| the most common site for leak in your circuit is? |
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Definition
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Term
| What component of the ventilator may fail and result in high pressure in your breathing system |
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Definition
| Failure of the ventilator spill valve to vent off excess gas creating high pressure |
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Term
| Pressure higher than _______ cm H20 can result in Barotrauma |
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Definition
| > 50 cm H20 can result in barotrauma |
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Term
| one millimeter of liquid anesthetic can increase your concentration by how much |
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Definition
| 2 %!!!!!! Regardless of the volatile this is a massive increase in anesthetic and can be lethal. |
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Term
| Is adding sevo to a isoflurane vaporizer more dangerous or adding isoflurane to a sevo vaporizer? WHY. |
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Definition
| If the volatile with the higher vapor pressure is added to the vaporizer for the volatile with the lower vaporizer pressure will be the most dangerous. Because that vaporizer is calibrated for a lower vapor pressure. When a gas with a higher SVP is added then MORE VOLATILE WILL INADVERNTLY BE ADDED! TOXIC! |
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Term
| how can you defeat a interlock device on your anesthesia machine |
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Definition
| If the machine has two vaporizer units you leave a space between them then you defeat the safety interlocking device. |
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Term
| How do you line up your vaporizers..in what order |
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Definition
| Vaporizers should be lined up in order of increasing vapor pressure in order to minimize cross contamination. |
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|
Term
| if the power fails in the OR how long of battery power do you have on the machine? |
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Definition
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Term
| if power failure in the operating room which component of the anesthesia machine will not have back up power? What do you do? |
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Definition
| The ventilator will not have back up power! So you have to bag the patient. The anesthesia machine will have power for 30 minutes. |
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Term
| normothermia is the result of what control mechanisms |
|
Definition
1. basal metabolic rate
2. sympathetic tone
3. vascular tone
4. muscle activity |
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|
Term
| Hypothermia is defined as a C of? |
|
Definition
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|
Term
| Shivering can increase oxygen consumption by a factor of? |
|
Definition
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|
Term
| Name 9 consequences of hypothermia |
|
Definition
1. 5x increase O2 consumption
2. increase plasma plasma catecholamine levels
3. left shift in Hb dissociation curve
4. Coagulopathy
5. Immunosuppresion
6. Hyperglycemia
7. Immunosuppresion
8. Decreased MAC
9. ECG Changes - appearance of J waves then V-fib |
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|
Term
| The largest source of heat loss is by what method |
|
Definition
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|
Term
| ONE MAC reduces shivering threshold by how many degrees C |
|
Definition
| decreases shivering threshold by 2-4 C. |
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|
Term
| Name the three phases of hypothermia |
|
Definition
1. Redistribution of heat from core to periphery. Occurs in the first hour and results in a 1-2 C decrease
2. Steady decline: next 2-3 hours
3. Equilibration: occurs when heat loss equals metabolic heat production. |
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|
Term
| Name four accurate core temperature locations |
|
Definition
1. PA Catheter
2. Distal esophagus
3. tympanic membrane
4. Nasopharynx |
|
|
Term
| the best mechanism for hypothermia management |
|
Definition
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|
Term
| What special considerations should you have with patients who have PVD and external heat sources |
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Definition
| external heat sources are contradicted in patients with PVD. |
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|
Term
| LASER for medical lasers stands for |
|
Definition
LASER
L: Light
A: Amplification
S: Stimulated
E: Emission
R: Radiation |
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|
Term
| Describe the qualities and characteristics of a laser beam |
|
Definition
1. coherent
2. columnated
3. monochromatic |
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|
Term
| columnated when refering to a laser beam means |
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Definition
| columnated means the laser beam will always be the same size and straight line no matter where you point it |
|
|
Term
| what does monochromatic mean when describing a laser |
|
Definition
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|
Term
| CO2 lasers can be blocked by what kind of substances |
|
Definition
|
|
Term
| which type of laser has the most limited penetration |
|
Definition
|
|
Term
| what is the penetration depth for a CO2 laser |
|
Definition
|
|
Term
| Which type of laser is used to identify O2 levels on Hb |
|
Definition
|
|
Term
| what is the depth of penetration for Nd:YAG lasers |
|
Definition
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|
Term
| are Nd:YAG lasers absorbed by light or dark tissue |
|
Definition
|
|
Term
| What classification system is used for lasers and how are they classfiied |
|
Definition
| ANSI Classifies lasers by their potential hazards |
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|
Term
| What is the classification range for lasers by ANSI. Whats the highest level possible |
|
Definition
| 1-4. 4 being the highest hazard |
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|
Term
| a laser with a ANSI of 3 or 2 is more hazardous |
|
Definition
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|
Term
| Does the YAH or CO2 laser cause cornea or retina damage. |
|
Definition
Tissue damage depends on laser.
Cornea: Injuried by CO2 laser. (superifial penetration and cornea is superficial)
Retina: injuried by YAG (deeper penetration) |
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Term
| what are some concerns with the laser plume |
|
Definition
| THe laser plume is what comes from the laser being used on the patient. It contains steam and byproducts of the patient and can cause bronchial irritation, and produce mutagenic chemicals. Can also release viral particles. |
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|
Term
| what three elements in OR equipment can ignite |
|
Definition
1. PVC
2. Red rubber
3. Silicon
ALL IGNITABLE |
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|
Term
| What is the first two things you do if you have a airway fire. |
|
Definition
STEP 1: STOP FLOW
STEP 2: REMOVE TUBE.
IF you remove the tube before you stop the flow then the tube is a like a torch as it is removed from the patient and you burn everything on the way up. Hopefully by stopping the flow you eliminate part of the fire tetrahedron and the fire goes out. |
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|
Term
| Write down Ohms law and describe what each letter is |
|
Definition
E = IR
E: Voltage
I: Amperage
R: Resistance |
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|
Term
| What is the body's equivalent for Ohms law |
|
Definition
E: Voltage (BP)
I: Amperage (FLOW)
R: Resistance (Resistance) |
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|
Term
| What is the difference between AC and DC |
|
Definition
| DC current always goes in one direction while AC current can go in both directions |
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|
Term
| resistance when describing AC we use what to describe it |
|
Definition
|
|
Term
| IS AC or DC power more dangerous to humans |
|
Definition
| AC. Only 1/3 of AC power needed to kill you compared to DC |
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|
Term
| Power in the US is supplied at how many volts and megahertz |
|
Definition
|
|
Term
| Two ways electricity can injure tissue |
|
Definition
1. disruption of normal cellular electrical activity via noise disrupting natural electrical signals
2. Direct thermal injury |
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|
Term
|
Definition
| 5mA or more will cause a macroshock |
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|
Term
| The threshold for perception is how many mA |
|
Definition
| 1 mA is threshold for perception |
|
|
Term
| how many mA will cause complete loss of control of your hands (You can undue your grip) |
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Definition
| mA of 10-20 will simultaneously activate your flexor and extensor muscles. The problem is your flexor muscles are STRONGER then your extensor so your hand stays gripped. |
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Term
| extreme pain is associated with mA shocks of? |
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Definition
|
|
Term
| V-fib arrest is possible with mA of? |
|
Definition
| 100-300 mA can cause V-fib |
|
|
Term
| A cauterizing device in the OR applies how much mA to a very fine area of tissue? What kind of tissue injury occurs |
|
Definition
| Thermal injury occurs. From cauterizing devices that apply pin point mA of 5-6,000. |
|
|
Term
| Whats the difference in shock between macro shock and microshock |
|
Definition
| macroshock is 5 mA while microshock is measured in MICRO units. |
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|
Term
| in the OR is power grounded or ungrounded? Why? |
|
Definition
| UNGROUNDED IN OR = SAFER. This means neither wire is hot or neutral relative to ground. |
|
|
Term
| how do we achieve ungrounded OR electricity? |
|
Definition
| by having isolation transformers |
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|
Term
| Equipment that may be used near patient must not leak more than ____ b/c why? |
|
Definition
| max leak of 10 MICROUNITS. WAY LESS THAN THE POSSIBLE AMOUNT FOR A MIlli-AMP. B/c IF someone has an open heart cavity a microshock of 20 microunits directly to the heart can cause VFIB |
|
|
Term
| When will a GFCI plug be triggered |
|
Definition
| if difference between hot and neutral is greater than 5 milli amps |
|
|
Term
| What are the hertz used in electrosurgery |
|
Definition
|
|
Term
| why does electrosurgery use such high hertz? |
|
Definition
| b/c at extremely high hertz the heart and normal electrical system does not get noise interference at that high hertz level. |
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|
Term
| what device part of electrosurgery assists in preventing unwanted spread or arching |
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Definition
| pads cause diffusion of the current. So that you exactly destroy a small area but heat can't spread and destroy surrounding tissue because it spreads out to reach the large surface area of the pad. |
|
|
Term
| if something has high frequency then does it have high current or low |
|
Definition
|
|
Term
| are unipolar or bipolar cautery devices more common |
|
Definition
| unipolar (Cautery to pad - one direction) |
|
|
Term
| are forecepts used in cautery bipolar or unipolar |
|
Definition
| bipolar. Just like Defib pads. Electricity goes back and forth. |
|
|
Term
| Minimum distance from an ACID or pacemaker and using a cautery device is? |
|
Definition
|
|
Term
| what considerations should you have with a cautery pad placement in relation to AICD or pacemaker |
|
Definition
| MAKE SURE THAT FROM CAUTERY TO ITS PAD..that imaginary line DOES NOT CROSS THROUGH YOUR AICD/PACEMAKER Components. |
|
|
Term
| why does electrosurgery use such high hertz? |
|
Definition
| b/c at extremely high hertz the heart and normal electrical system does not get noise interference at that high hertz level. |
|
|
Term
| what device part of electrosurgery assists in preventing unwanted spread or arching |
|
Definition
| pads cause diffusion of the current. So that you exactly destroy a small area but heat can't spread and destroy surrounding tissue because it spreads out to reach the large surface area of the pad. |
|
|
Term
| if something has high frequency then does it have high current or low |
|
Definition
|
|
Term
| are unipolar or bipolar cautery devices more common |
|
Definition
| unipolar (Cautery to pad - one direction) |
|
|
Term
| are forecepts used in cautery bipolar or unipolar |
|
Definition
| bipolar. Just like Defib pads. Electricity goes back and forth. |
|
|
Term
| Minimum distance from an ACID or pacemaker and using a cautery device is? |
|
Definition
| 15 sonameters. sonameters = cm |
|
|
Term
| what considerations should you have with a cautery pad placement in relation to AICD or pacemaker |
|
Definition
| MAKE SURE THAT FROM CAUTERY TO ITS PAD..that imaginary line DOES NOT CROSS THROUGH YOUR AICD/PACEMAKER Components. |
|
|
Term
| sound frequency is measured in |
|
Definition
|
|
Term
| Frequency is the number of cycles per ___ |
|
Definition
| Frequency = # of cycles per second |
|
|
Term
| 50 Hz is how many cycles in one second |
|
Definition
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