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What does ASTM stand for, and What do they do?
American Society of Testing and Materials
How many systems are there on an anesthesia machine? Name them.
2 systems. Electrical and Pnuematic.
What do the systems do, what is their function?
The Electrical system supplies power for the electrical ventilator parameters (timing of breaths, alarms, breathing pressure monitor, & respiratory settings) And the Physiological monitors; in our lab the EKG, pulse Ox, and Respiratory Gas.
The Pnuematic System opens the Oxygen piping circuit of the machine and as a result allows other gases to flow through the machine to the flow control valves. If there is NO OXYGEN PRESSURE NO OTHER GAS (NITROUS OXIDE, MEDICAL AIR) WILL FLOW THRU THE MACHINE.
Why should the anesthesia machine be plugged into an outlet served by a back-up emergency generator?
If main power is lost, the emergency generator will continue to recharge the battery.
What does the master or main switch control?
The master switch turns on both systems, pneumatic and electrical.
Does the Fabius GS machine have a power failure indicator light?
Yes, it is located on the screen and LED.
How long is a fully charged battery good for?
At least 30 minutes.
Will the battery recharge if the machine is unplugged?
If there's a button available to test it, how often should back-up battery status be checked?
Every morning or anytime the machine is being turned on.
What, if anything, should be plugged into the outlets on the back of the anesthesia machine?
Anesthesia Monitors ONLY!
What should you immediately suspect if anesthesia machine power suddenly cuts out?
You should suspect that someone plugged in a blood warmer or some other power eater into the back of the machine and a circuit breaker popped.
When a circuit breaker on an anesthesia machine trips, does it pop in or out?
Pops out.
How many circuit breakers are there on each of our machines (that we've been able to find)?
2 sets
If there is no unusual equipment plugged into the machine, what other possibility could account for a sudden cut-out of power to the machine?
The machine was never plugged in and it was running on battery power the entire time. PLUG THE MACHINE IN!!!
Wht should be done if a power hungry piece of equipment is plugged into the anesthesia machine and causes the circuit breaker to pop?
The piece of equipment should be unplugged and the circuit breaker reset.
Where should the offending piece of equipment be plugged in?
Plug the offending piece of equipment into an available wall outlet.
How many components (parts) are there to the pneumatic system of the anesthesia machine?
There are 3 components to the anesthesia machine. The high pressure system, intermediate pressure system, and the low pressure system.
What pressures are commonly encountered in each of the tree parts?
High, intermediate, and low.
State where each part of the High pressure system begins and ends and what components are included in each.
High Pressure:The cylinder system and any parts that come into contact with the cylinders and the high pressure gas that comes form them. The components consist of: the hanger yoke, cylinder pressure indicator (guage), Pressure reducing device (regulator)
State where each part of the Intermediate pressure system begins and ends and what components are included in each.
Intermediate pressure system begins at the quick connects to the DISS to the point where the gas enters the flow control valve. The components of the Intermediate pressure system are; the Quick connect, pressure guages (pipeline) 0-160psi Fabius/0-100psi 2B).
State where each part of the Low pressure system begins and ends and what components are included in each.
The Low pressure system begins at the flow control tubes and Fresh gas outlet. The components of the Low pressure system are: The flow control tubes (indicators), flow indicator blocks, common gas manifold, allarms, Aux. O2 flow regulator, low pressure piping, vaporizors, and Common Gas Outlet.
Does the pipeline pressure drop when the main O2 supply hose is disconnected? Why doesn't (or wouldn't) that happen if the oxygen cylinder was disconnected?
No. Because the pressure from the O2 cylinder would still flow and become the primary source of O2. It would not still flow if the O2 cylinder were disconnected because there would be no O2 flow and O2 flow is required for all other gasses to flow.
Briefly state how a pressure-reducing device on an anesthesia machine works.
It works by allowing a small amount of high pressure cylinder gas (1000-1900psi) to flow through a narrow opening into a relatively larger area thereby decreasing its pressure to 40-48 psi.
Wha pressure range does the cylinder pressure reducing device drop the working cylinder pressure to inside the anesthesia machine?
From 1000-1900psi to 40-48psi.
Why is the reduced cylinder pressure lower than the pipeline pressure?
Because if the cylinder pressure was higher than the pipeline pressure it would become the primary source of O2 and would quickly become depleated.
What is the main source of gas supply and what is the back-up source?
The main source of gas supply is the pipeline or the source with the higher pressure coming into the anesthesia machine. The back-source is the cylinder O2 or the source with the lower pressure entering the anesthesia machine.
What is the purpose of a back-check valve? How does it work?
The back-check valve reduces back pressure from the ventilator or breathing bag. It also allows you to check the machine for leaks.
What is the danger of leaving gas cylinders open?
If you have a fluctuation in the pipeline system and the machine compensates by taking gas from the cylinder every time the pipeline pressure drops you will end up with no gas in the cylinders if you eventually lose the pipeline.
How much pressure must the internal piping of an anesthesia machine be able to withstand? What is an acceptable leak level?
Must withstand 4 times the normal servcie pressure.(4x40-55 psi= 160-220psi)
Less than 25ml/min at 50 psi are allowable.
State one problem that could be encountered with the internal piping of an anesthesia machine.
Cross connections, Disconnections, and stupid repair attempts, like using duct tape to seal a broken connection.
In simple terms, how does the cylinder pressure reducing device work?
It works by allowing a small amount of high pressure cylinder gas (1000-1900psi) to flow through a narrow opening into a relatively larger area thereby decreasing its pressure to 40-48 psi.
What pressure system of the machine is the main switch associated with? What does it turn on? What two components are available even if the main switch isn't turned on?
The Intermediate pressure system. It turns on the electrical and pnuematic systems of the anesthesia machine. The two components that remain on are the O2 flush and the auxiliary O2 flowmeter.
What is the purpose of the gas power outlet? Is there one on both the Draeger 2A and the Fabius GS?
The gas poer outlet supplies 02 or air to drive the ventilator. 2A,yes/Fabius, no
Why are there oxygen pressure failure devices on the anesthesia machine?
To prevent delivery of anoxic (no O2 content) mixtures. (O2 concentration at common gas outlet must be at least 19%)
How many types of these devices are there? How do they work?
Two. Electronic and Pnuematic. As O2 pressure falls the device will decrease and eventually shut off flow of ALL other gasses.
Oxygen analyzers aren't needed because the oxygen pressure failure alarms are present. T or F
False. ASTM standards require the use of O2 analyzers in conjunction with the O2 pressure failure devices.
What are 2 uses for the oxygen flush valve?
Can be used as source of O2 during an emergency and during transtracheal ventilation.
How much oxygen is delivered when teh flush valve is activated?
35-75 L/min. (whether the machine is on or off)
State 3 possible problems associated with the oxygen flush valve.
Valve can be stuck in "on" position, Barotrauma caused by activation during inspirattion, accidental activation.
Why is there a gas selector switch available on some Draeger anesthesia machines?
ON older machines it allows a choice of N2O& O2 or All Gas (N2O, O2,and Medical Air)
What is the purpose of a second stage rducing device and what pressures for what gasses are associated with them?
The purpose is to decrease anesthesia machine piping presure to apporximately 26psi just before gas enters flow control valve. O2
What are the 3 components of the flow control valves?
Control knob is connected to stem that regulates gas flow for each gas. O2 know looks and feels different from other knobs, and all knobs should be tight enough to avoid accidental movement.
Name 4 problems with flow control valves.
Inadvertent alterations. Old,worn,loose valves may move very easily when accidentally brushed against or bumped, inablility to turn control knobs caused by damage, leak thru open flow control valve, failure to allow adequate gas flow because of damaged stem or linkage of O2 and N2O conrol knobs.
At what pressure is the breathing mix in the low pressure system delivered?
14.7 psi, atmospheric pressure.
Name 3 components of the low pressure system.
Components: Flow control tubes (indicators), flow indicator blocks, common gas outlet.
What are the components of the flow indicator blocks?
Tubes, floats, stop, scale, lights, and arrangement of flow indicator tubes-O2, N2O, and Med Air, safety devices.
What are lights on the anesthesia machine used for?
To be used when OR ceiling lights are turned down to allow easier view of TV monitors during laproscopic procedures.
Why is the arrangement of the flow indicator tubes important? What could happen if the arrangement was different?
By placing the indicators in an arrangement where O2 is downstream and would least affect the patient. If O2 was placed upstream of the patient the patient could concievably recieve a hypoxic mix if there was a leak.
What is the best location for the oxygen flowtube on the anesthesia machine?
Downstrem or closet to the patient.
What are 2 safety devices that help prevent delivery of a hypoxic gas mixture?
2 devices that help prevent delivery of a hypoxic gas mixture are teh Mechanical linkage (chain)and the Pneumatic linkage.
If a flowtube cracks it can simply be replaced with anew flowtube. T or F
State 3 possible problems with flowtubes.
Inaccurate at low flows, float problems, leaks.
If an anesthesia machine is equipped with a pressure relief device in the low pressure system, what is its inteded purpose?
It opens when the pressure fromt eh machine is too high and could cause barotrauma to the patient, or back pressure from the patient, possibly due to obstruction in breathing system is high enough to cause machine damage.
What is the ASTM standard for the CGO?
Fresh gas tube must be difficult to accidentally disconnect from the Common Gas Outlet.
State one advantage of an anesthesia work station.
All the necessary equipment used during an operation is centralized instead of on seperate carts. Te physiological and breathing system monitors as well as teh anesthesia record data collection and storage are all arranege on the machine.
Is it important to keep service records for the anesthesia machines? Why?
It is required by the JCAHO the machine undergo quarterly preventative mantenance, and a service record log kept.
What are 3 things to be considered in choosing an anesthesia machine, other than will it fit under the Christmas tree?
You should consider the level of service you have received or will receive, the size of your work space and machine should be symbiotic, and will you need any special features (MRI capability).

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