- Terminal units provide connection points for gas delivery from the pipeline system to anesthesia machines and other medical devices. They contain primary and secondary valves to prevent backflow and shut off gas delivery.
- Gas specific connectors like DISS fittings and quick connectors provide non-interchangeable connections between terminal units and equipment outlets to prevent mixing of different gases.
- Alarms monitor the central gas supply and distribution systems for issues like pressure changes, which are indicated on master and local alarm panels. The pipeline network branches from main lines and risers to deliver gases at standardized pressures.
- A breathing system connects a patient's airway to an anesthetic machine and creates an artificial atmosphere. It consists of a fresh gas entry port, connection to the patient's airway, reservoir bag or tubing, and expiratory port.
- The Mapleson systems are types of breathing circuits classified by their design. Mapleson A uses a reservoir bag and has high rebreathing during controlled ventilation. Mapleson B and C shift the gas entry point but are still inefficient. The Bain circuit is a modified Mapleson D that reduces rebreathing using a coaxial tube design.
- The T-piece or Mapleson F system is commonly used for children, consisting of a T-shaped connector,
The document discusses various aspects of medical gas cylinders and piped gas systems. It describes the parts of a cylinder including the body, valve, and pressure relief devices. It discusses safe handling practices like color coding, markings, and precautions during use. Hazards associated with cylinders are also summarized. The document then provides an overview of piped medical gas systems including the primary components, pressures, and terminal units where gases are delivered.
This document provides information about gas cylinders used in healthcare. It discusses the parts of cylinders including bodies, valves, and pressure relief devices. It explains how gases are measured in psi and other units of pressure. The document outlines safety rules for handling, storing, and using cylinders including proper labeling and preventing damage. Medical gas pipeline systems are described along with components like terminal units, hoses, and testing procedures to ensure safety.
The key points of the document are:
1) The most important part of pre-use checks on an anesthesia workstation is verifying the presence of a self-inflating resuscitation bag in case of issues with ventilation or oxygenation.
2) An ideal vaporizer would maintain a constant output concentration regardless of changes in gas flow, temperature, pressure, or carrier gas composition, but real vaporizers are affected by these factors.
3) Modern vaporizers use various techniques like temperature compensation and automatic controls to minimize fluctuations in vapor concentration due to changes in ambient conditions.
Medical gas supply systems provide gases to hospitals through cylinders and pipelines. Cylinders contain gases like oxygen, nitrous oxide, and air in compressed form. They have steel bodies, valves to fill and release gas, and pressure relief devices. Pipelines distribute gases from a central source through a main line, risers, and branch lines to terminal units where gases are delivered. Terminal units have automatic shut-off valves and gas-specific connectors to prevent mixing of different gases. Extensive testing ensures medical gas pipelines deliver the proper gas at adequate pressures and purity levels to support patient care.
The document discusses carbon dioxide absorbers and soda lime, which are used to absorb carbon dioxide exhaled by patients during anesthesia. It provides details on:
- How soda lime chemically absorbs carbon dioxide through a neutralization reaction, forming carbonates, water, and heat.
- The components and function of the canister containing the soda lime granules.
- Factors that influence the efficiency of carbon dioxide absorption, such as granule size and minimizing channeling of gases.
- Signs that the soda lime is exhausted and needs to be replaced, including color change of indicator dyes and increased end-tidal carbon dioxide.
Bougie, trachlite , laryngeal tube , combitube , i gel ,truviewDhritiman Chakrabarti
The document discusses various supraglottic airway devices including the bougie, tracheal light, laryngeal tube, and combitube.
The bougie is an intubation aid that is inserted through the vocal cords to help guide placement of an endotracheal tube. The tracheal light uses transillumination to help visualize placement of an endotracheal tube in difficult airways. The laryngeal tube is a new supraglottic airway device made of silicone that provides an alternative to endotracheal intubation or laryngeal mask airway placement. The combitube is a double lumen tube that can provide ventilation whether placed in the trachea or esoph
Brian Sellick developed cricoid pressure in 1961 to prevent regurgitation during anesthesia induction. Cricoid pressure involves applying 30 newtons of pressure on the cricoid cartilage before and during intubation to compress the esophagus against the cervical spine. While it improves patient safety, cricoid pressure can interfere with intubation. An alternative is the BURP maneuver, which applies backward, upward and rightward pressure on the thyroid cartilage to improve laryngeal views during intubation without blocking the airway. Both techniques aim to protect the airway but must be applied carefully and released if interfering with ventilation or intubation.
- A breathing system connects a patient's airway to an anesthetic machine and creates an artificial atmosphere. It consists of a fresh gas entry port, connection to the patient's airway, reservoir bag or tubing, and expiratory port.
- The Mapleson systems are types of breathing circuits classified by their design. Mapleson A uses a reservoir bag and has high rebreathing during controlled ventilation. Mapleson B and C shift the gas entry point but are still inefficient. The Bain circuit is a modified Mapleson D that reduces rebreathing using a coaxial tube design.
- The T-piece or Mapleson F system is commonly used for children, consisting of a T-shaped connector,
The document discusses various aspects of medical gas cylinders and piped gas systems. It describes the parts of a cylinder including the body, valve, and pressure relief devices. It discusses safe handling practices like color coding, markings, and precautions during use. Hazards associated with cylinders are also summarized. The document then provides an overview of piped medical gas systems including the primary components, pressures, and terminal units where gases are delivered.
This document provides information about gas cylinders used in healthcare. It discusses the parts of cylinders including bodies, valves, and pressure relief devices. It explains how gases are measured in psi and other units of pressure. The document outlines safety rules for handling, storing, and using cylinders including proper labeling and preventing damage. Medical gas pipeline systems are described along with components like terminal units, hoses, and testing procedures to ensure safety.
The key points of the document are:
1) The most important part of pre-use checks on an anesthesia workstation is verifying the presence of a self-inflating resuscitation bag in case of issues with ventilation or oxygenation.
2) An ideal vaporizer would maintain a constant output concentration regardless of changes in gas flow, temperature, pressure, or carrier gas composition, but real vaporizers are affected by these factors.
3) Modern vaporizers use various techniques like temperature compensation and automatic controls to minimize fluctuations in vapor concentration due to changes in ambient conditions.
Medical gas supply systems provide gases to hospitals through cylinders and pipelines. Cylinders contain gases like oxygen, nitrous oxide, and air in compressed form. They have steel bodies, valves to fill and release gas, and pressure relief devices. Pipelines distribute gases from a central source through a main line, risers, and branch lines to terminal units where gases are delivered. Terminal units have automatic shut-off valves and gas-specific connectors to prevent mixing of different gases. Extensive testing ensures medical gas pipelines deliver the proper gas at adequate pressures and purity levels to support patient care.
The document discusses carbon dioxide absorbers and soda lime, which are used to absorb carbon dioxide exhaled by patients during anesthesia. It provides details on:
- How soda lime chemically absorbs carbon dioxide through a neutralization reaction, forming carbonates, water, and heat.
- The components and function of the canister containing the soda lime granules.
- Factors that influence the efficiency of carbon dioxide absorption, such as granule size and minimizing channeling of gases.
- Signs that the soda lime is exhausted and needs to be replaced, including color change of indicator dyes and increased end-tidal carbon dioxide.
Bougie, trachlite , laryngeal tube , combitube , i gel ,truviewDhritiman Chakrabarti
The document discusses various supraglottic airway devices including the bougie, tracheal light, laryngeal tube, and combitube.
The bougie is an intubation aid that is inserted through the vocal cords to help guide placement of an endotracheal tube. The tracheal light uses transillumination to help visualize placement of an endotracheal tube in difficult airways. The laryngeal tube is a new supraglottic airway device made of silicone that provides an alternative to endotracheal intubation or laryngeal mask airway placement. The combitube is a double lumen tube that can provide ventilation whether placed in the trachea or esoph
Brian Sellick developed cricoid pressure in 1961 to prevent regurgitation during anesthesia induction. Cricoid pressure involves applying 30 newtons of pressure on the cricoid cartilage before and during intubation to compress the esophagus against the cervical spine. While it improves patient safety, cricoid pressure can interfere with intubation. An alternative is the BURP maneuver, which applies backward, upward and rightward pressure on the thyroid cartilage to improve laryngeal views during intubation without blocking the airway. Both techniques aim to protect the airway but must be applied carefully and released if interfering with ventilation or intubation.
The document provides information on the history and evolution of anesthesia machines. It discusses key developments from the early prototypes in the 1900s to modern safety features. Some of the major developments include the introduction of oxygen and nitrous oxide cylinders in the late 19th century, the addition of vaporizing bottles in the early 20th century, and the introduction of the circle absorption system in the 1930s. The document outlines the essential safety features of modern anesthesia workstations, including non-interchangeable gas connections, pin index safety systems, oxygen monitors and alarms, and vaporizer interlocks. It also describes the functional anatomy of an anesthesia machine in terms of the high, intermediate, and low pressure systems.
This document discusses different types of endotracheal tubes. It begins with a brief history of endotracheal intubation and then describes the standard design features of endotracheal tubes including the patient end, curvature, markings, materials, sizes, tube cuffs, and machine end. It then discusses several speciality endotracheal tubes designed for specific purposes like neonatal resuscitation, microlaryngeal surgeries, nasal intubation, and monitoring electrodes during laryngeal surgery. In total, over 15 different endotracheal tube varieties are outlined.
Low pressure system in anaesthesia machineSwadheen Rout
This document provides information about Boyle's anesthesia machine. It discusses the components and functions of an anesthesia machine, including the pneumatic and electrical systems. It describes the different parts of the machine like the flowmeters, vaporizers, check valves, and safety features. The document explains how flowmeters work using the Hagen-Poiseuille equation and factors like viscosity, density, and laminar vs turbulent flow. It discusses temperature and pressure effects on flowmeters as well as protections against delivering a hypoxic gas mixture to the patient.
This document provides information on compressed medical gases used in anesthesia. It discusses various pressure units like PSI, PSIG and PSID. It describes properties of common medical gases like oxygen, nitrous oxide and differences between gases and vapors. The document outlines cylinder construction materials, sizes and labeling requirements. It also summarizes safe practices for gas storage, cylinder transportation, connection and disconnection.
This document presents a portable oxygen concentrator that uses pressure swing adsorption and membrane gas separation to provide oxygen for patients requiring long-term home oxygen. It consists of an air intake filter, compressor, molecular sieve beds, oxygen tank, flow regulator, and other components. The concentrator works by compressing and passing room air through a molecular sieve bed that adsorbs nitrogen, leaving concentrated oxygen stored in a tank. A pressure regulator then delivers the oxygen to the patient. The goal of the portable design is to provide concentrated oxygen without the need to refill heavy oxygen tanks, allowing patients mobility.
This document discusses the laryngeal mask airway (LMA), including its history, design, indications, contraindications, side effects, necessary equipment, proper preparation and placement technique, verification of correct placement, securing, and potential problems. It also describes different types of LMAs such as the flexible, intubating, C-Trach, ProSeal, and classic LMAs.
This document describes various components and types of breathing circuits used in anesthesia. It discusses the basic principles of delivering oxygen/gases and eliminating carbon dioxide. The key components described include the reservoir bag, breathing tubes, adjustable pressure limiting valve, and filters. Circuits are classified based on gas flow and include open, semi-open, closed, and semi-closed types. Specific circuits discussed in detail include the Mapleson A-F circuits, Bain's circuit, and the circle breathing system. Advantages and disadvantages of each system are provided.
The document discusses different types of breathing circuits used in anesthesia. It begins by describing the basic components and functions of a breathing circuit, which delivers oxygen and anesthetic gases to patients while removing carbon dioxide. Circuits are classified as open, semi-open, semi-closed, or closed based on how exhaust gases are handled. Several specific circuit types are then outlined in detail, including the Mapleson A, Bain, Ayres T-piece, and Jackson-Rees systems. Key features and uses of each system are provided. Semi-closed circuits are explained as using a carbon dioxide absorber to remove carbon dioxide from exhaled gases so they can be rebreathed, allowing for lower fresh gas flow rates than open systems
This document discusses vaporizers, which are devices used to convert liquid anesthetic agents into their gaseous state for inhalation. It covers the basic principles of vaporizers including:
- The process of vaporization and factors that affect it such as boiling point, critical temperature, and latent heat of vaporization.
- The two main types of vaporizers - draw-over and plenum vaporizers. Plenum vaporizers are more accurate due to mechanisms for temperature compensation and maximizing vaporization surface area.
- Features of modern vaporizers like the Tec series, which are agent-specific, temperature compensated, and able to deliver consistent concentrations across a wide range of flows.
Airway anatomy its assessment and anaesthetic implicationAPARNA SAHU
The document discusses airway anatomy, including definitions of the airway and its subdivisions. It describes the structures of the upper airway from the oral cavity to the larynx in detail. This includes the muscles, cartilages, and functions of the oral cavity, nose, pharynx, larynx. It discusses the implications of airway anatomy for airway management and anesthesia, such as the need for humidification during intubation. Difficulties that can arise from various anatomical structures are also summarized, such as from deviations of the nasal septum or injuries to the turbinates during nasotracheal intubation.
This document provides an overview of supraglottic airway devices. It discusses their history, classifications, indications, contraindications, complications and techniques. It describes some of the major devices including the Classic LMA, LMA Unique, Flexible LMA, LMA Fastrach, Air-Q, and LMA CTrach. Supraglottic devices are used to maintain airway patency and provide ventilation above the vocal cords. They have advantages over face masks and endotracheal tubes in certain situations but also have potential complications if not properly placed.
The document discusses the history and components of an anesthesia machine. It originated from Boyle's machine developed in 1917. The machine has 3 circuits - high, intermediate, and low pressure circuits. It precisely delivers a mixture of gases including oxygen, nitrous oxide, and other gases. Key components discussed include the hanger yoke, pressure regulators, flow meters, vaporizers, and safety features like the oxygen failure device.
This document provides information about the basic components and functioning of an anaesthesia machine. It discusses the key components of the machine's pneumatic and electrical systems. The pneumatic system includes the high pressure, intermediate pressure and low pressure systems which are responsible for delivering precisely controlled gas mixtures from pressurized cylinders or central pipelines. The electrical components power and monitor the machine. The document also provides details on cylinders, pressure regulators and other individual parts that make up the overall anaesthesia machine.
The document discusses various paediatric breathing circuits used in anaesthesia. It describes the key components and classifications of breathing circuits. The most commonly used circuits include the Mapleson A (Magill) system, which is best for spontaneous breathing but requires high fresh gas flows. The Mapleson D and Bain circuits are efferent reservoir systems that work efficiently for controlled ventilation. The Ayre's T-piece is a simple no-valve circuit designed for paediatric use. The document provides details on the construction, functioning and advantages of these different breathing circuit designs.
Vaporizers are devices that convert liquid anesthetic agents into vapor for inhalation. They work by splitting the fresh gas flow, with some passing through the vaporizing chamber where it picks up vapor from the liquid, and the rest bypassing directly to recombine downstream. Key factors that influence vaporizer output include temperature, surface area contact between gas and liquid, flow rates, ambient pressure, and carrier gas composition. Back pressure from ventilation can increase output via the pumping effect, compressing gas in the vaporizer and pushing additional vapor downstream on expiration. Vaporizers are classified based on their method of regulating output, vaporization technique, location, temperature compensation, and resistance to gas flow.
An anesthesia workstation integrates components for anesthesia administration into one unit. It consists of an anesthesia machine, vaporizers, ventilator, breathing system, scavenging system, and monitors. Key components include the gas supply system, which receives gases from cylinders and pipelines and regulates pressures, and the vaporizer manifold and anesthetic vaporizers. Modern workstations have additional safety features to prevent delivery of hypoxic gas mixtures and other hazards.
The document describes several Mapleson breathing systems used in anesthesia. It provides details on the Mapleson A, B, C, D systems as well as modifications like the Mapleson A-Lack system and the Bain circuit. The Bain circuit is highlighted as having advantages over other systems like being lightweight, causing minimal drag on the endotracheal tube, having low resistance, allowing for visualization of the inner tube, and facilitating both spontaneous and controlled ventilation with easier changeover between the two.
The breathing system delivers gases from the anesthesia machine to the patient's airway. It starts from the fresh gas inlet and ends where gases escape. The circle system uses a circular pathway where exhaled CO2 is removed by an absorbent in the CO2 absorber. Key components include the absorber, unidirectional valves, inspiratory and expiratory ports, fresh gas inlet, Y-piece, APL valve, and breathing tubes. The absorbent, usually sodalime, neutralizes CO2 through an exothermic reaction in the canister. Placement of components and fresh gas flow influences gas flows and absorbent desiccation. The circle system reduces agent use and waste gas exposure while increasing tracheal warmth and
An anesthesia circuit connects the anesthesia machine to the patient to deliver anesthetic gases and remove carbon dioxide. Various circuit designs exist, including open, semi-open, semi-closed, and closed systems. The ideal circuit is reliable, safe, and easy to use while imposing minimal resistance and dead space. The circle system allows for rebreathing of gases using low fresh gas flows and includes unidirectional valves, tubing, a Y-piece, reservoir bag, and carbon dioxide absorber. Soda lime is commonly used for carbon dioxide absorption but its interaction with anesthetic agents can produce toxic compounds.
1) Vaporizers are devices that convert liquid anesthetic agents into vapor and add a controlled amount of vapor to the breathing system.
2) There are various types of vaporizers that use different mechanisms for vaporization and temperature compensation. Common vaporizers include the TEC, Goldman, and Copper Kettle vaporizers.
3) Special desflurane vaporizers are required due to desflurane's high vapor pressure, as standard vaporizers could result in dangerously high concentrations being delivered to the patient.
The document discusses the components and design of medical gas pipeline systems used to deliver gases like oxygen, nitrous oxide, and air to patient care areas. Key points:
- Pipeline systems include a central gas supply, piping that distributes the gases, and terminal units where gases are used. Two cylinder banks provide at least a day's supply and automatically switch so one is always running.
- Oxygen can be supplied as compressed gas cylinders or cryogenic liquid. Liquid oxygen is stored in insulated containers to prevent evaporation. Nitrous oxide is also commonly stored in manifolded cylinders.
- Piping uses identified copper tubing. Manual and service shutoff valves allow isolating parts
The document provides information on the history and evolution of anesthesia machines. It discusses key developments from the early prototypes in the 1900s to modern safety features. Some of the major developments include the introduction of oxygen and nitrous oxide cylinders in the late 19th century, the addition of vaporizing bottles in the early 20th century, and the introduction of the circle absorption system in the 1930s. The document outlines the essential safety features of modern anesthesia workstations, including non-interchangeable gas connections, pin index safety systems, oxygen monitors and alarms, and vaporizer interlocks. It also describes the functional anatomy of an anesthesia machine in terms of the high, intermediate, and low pressure systems.
This document discusses different types of endotracheal tubes. It begins with a brief history of endotracheal intubation and then describes the standard design features of endotracheal tubes including the patient end, curvature, markings, materials, sizes, tube cuffs, and machine end. It then discusses several speciality endotracheal tubes designed for specific purposes like neonatal resuscitation, microlaryngeal surgeries, nasal intubation, and monitoring electrodes during laryngeal surgery. In total, over 15 different endotracheal tube varieties are outlined.
Low pressure system in anaesthesia machineSwadheen Rout
This document provides information about Boyle's anesthesia machine. It discusses the components and functions of an anesthesia machine, including the pneumatic and electrical systems. It describes the different parts of the machine like the flowmeters, vaporizers, check valves, and safety features. The document explains how flowmeters work using the Hagen-Poiseuille equation and factors like viscosity, density, and laminar vs turbulent flow. It discusses temperature and pressure effects on flowmeters as well as protections against delivering a hypoxic gas mixture to the patient.
This document provides information on compressed medical gases used in anesthesia. It discusses various pressure units like PSI, PSIG and PSID. It describes properties of common medical gases like oxygen, nitrous oxide and differences between gases and vapors. The document outlines cylinder construction materials, sizes and labeling requirements. It also summarizes safe practices for gas storage, cylinder transportation, connection and disconnection.
This document presents a portable oxygen concentrator that uses pressure swing adsorption and membrane gas separation to provide oxygen for patients requiring long-term home oxygen. It consists of an air intake filter, compressor, molecular sieve beds, oxygen tank, flow regulator, and other components. The concentrator works by compressing and passing room air through a molecular sieve bed that adsorbs nitrogen, leaving concentrated oxygen stored in a tank. A pressure regulator then delivers the oxygen to the patient. The goal of the portable design is to provide concentrated oxygen without the need to refill heavy oxygen tanks, allowing patients mobility.
This document discusses the laryngeal mask airway (LMA), including its history, design, indications, contraindications, side effects, necessary equipment, proper preparation and placement technique, verification of correct placement, securing, and potential problems. It also describes different types of LMAs such as the flexible, intubating, C-Trach, ProSeal, and classic LMAs.
This document describes various components and types of breathing circuits used in anesthesia. It discusses the basic principles of delivering oxygen/gases and eliminating carbon dioxide. The key components described include the reservoir bag, breathing tubes, adjustable pressure limiting valve, and filters. Circuits are classified based on gas flow and include open, semi-open, closed, and semi-closed types. Specific circuits discussed in detail include the Mapleson A-F circuits, Bain's circuit, and the circle breathing system. Advantages and disadvantages of each system are provided.
The document discusses different types of breathing circuits used in anesthesia. It begins by describing the basic components and functions of a breathing circuit, which delivers oxygen and anesthetic gases to patients while removing carbon dioxide. Circuits are classified as open, semi-open, semi-closed, or closed based on how exhaust gases are handled. Several specific circuit types are then outlined in detail, including the Mapleson A, Bain, Ayres T-piece, and Jackson-Rees systems. Key features and uses of each system are provided. Semi-closed circuits are explained as using a carbon dioxide absorber to remove carbon dioxide from exhaled gases so they can be rebreathed, allowing for lower fresh gas flow rates than open systems
This document discusses vaporizers, which are devices used to convert liquid anesthetic agents into their gaseous state for inhalation. It covers the basic principles of vaporizers including:
- The process of vaporization and factors that affect it such as boiling point, critical temperature, and latent heat of vaporization.
- The two main types of vaporizers - draw-over and plenum vaporizers. Plenum vaporizers are more accurate due to mechanisms for temperature compensation and maximizing vaporization surface area.
- Features of modern vaporizers like the Tec series, which are agent-specific, temperature compensated, and able to deliver consistent concentrations across a wide range of flows.
Airway anatomy its assessment and anaesthetic implicationAPARNA SAHU
The document discusses airway anatomy, including definitions of the airway and its subdivisions. It describes the structures of the upper airway from the oral cavity to the larynx in detail. This includes the muscles, cartilages, and functions of the oral cavity, nose, pharynx, larynx. It discusses the implications of airway anatomy for airway management and anesthesia, such as the need for humidification during intubation. Difficulties that can arise from various anatomical structures are also summarized, such as from deviations of the nasal septum or injuries to the turbinates during nasotracheal intubation.
This document provides an overview of supraglottic airway devices. It discusses their history, classifications, indications, contraindications, complications and techniques. It describes some of the major devices including the Classic LMA, LMA Unique, Flexible LMA, LMA Fastrach, Air-Q, and LMA CTrach. Supraglottic devices are used to maintain airway patency and provide ventilation above the vocal cords. They have advantages over face masks and endotracheal tubes in certain situations but also have potential complications if not properly placed.
The document discusses the history and components of an anesthesia machine. It originated from Boyle's machine developed in 1917. The machine has 3 circuits - high, intermediate, and low pressure circuits. It precisely delivers a mixture of gases including oxygen, nitrous oxide, and other gases. Key components discussed include the hanger yoke, pressure regulators, flow meters, vaporizers, and safety features like the oxygen failure device.
This document provides information about the basic components and functioning of an anaesthesia machine. It discusses the key components of the machine's pneumatic and electrical systems. The pneumatic system includes the high pressure, intermediate pressure and low pressure systems which are responsible for delivering precisely controlled gas mixtures from pressurized cylinders or central pipelines. The electrical components power and monitor the machine. The document also provides details on cylinders, pressure regulators and other individual parts that make up the overall anaesthesia machine.
The document discusses various paediatric breathing circuits used in anaesthesia. It describes the key components and classifications of breathing circuits. The most commonly used circuits include the Mapleson A (Magill) system, which is best for spontaneous breathing but requires high fresh gas flows. The Mapleson D and Bain circuits are efferent reservoir systems that work efficiently for controlled ventilation. The Ayre's T-piece is a simple no-valve circuit designed for paediatric use. The document provides details on the construction, functioning and advantages of these different breathing circuit designs.
Vaporizers are devices that convert liquid anesthetic agents into vapor for inhalation. They work by splitting the fresh gas flow, with some passing through the vaporizing chamber where it picks up vapor from the liquid, and the rest bypassing directly to recombine downstream. Key factors that influence vaporizer output include temperature, surface area contact between gas and liquid, flow rates, ambient pressure, and carrier gas composition. Back pressure from ventilation can increase output via the pumping effect, compressing gas in the vaporizer and pushing additional vapor downstream on expiration. Vaporizers are classified based on their method of regulating output, vaporization technique, location, temperature compensation, and resistance to gas flow.
An anesthesia workstation integrates components for anesthesia administration into one unit. It consists of an anesthesia machine, vaporizers, ventilator, breathing system, scavenging system, and monitors. Key components include the gas supply system, which receives gases from cylinders and pipelines and regulates pressures, and the vaporizer manifold and anesthetic vaporizers. Modern workstations have additional safety features to prevent delivery of hypoxic gas mixtures and other hazards.
The document describes several Mapleson breathing systems used in anesthesia. It provides details on the Mapleson A, B, C, D systems as well as modifications like the Mapleson A-Lack system and the Bain circuit. The Bain circuit is highlighted as having advantages over other systems like being lightweight, causing minimal drag on the endotracheal tube, having low resistance, allowing for visualization of the inner tube, and facilitating both spontaneous and controlled ventilation with easier changeover between the two.
The breathing system delivers gases from the anesthesia machine to the patient's airway. It starts from the fresh gas inlet and ends where gases escape. The circle system uses a circular pathway where exhaled CO2 is removed by an absorbent in the CO2 absorber. Key components include the absorber, unidirectional valves, inspiratory and expiratory ports, fresh gas inlet, Y-piece, APL valve, and breathing tubes. The absorbent, usually sodalime, neutralizes CO2 through an exothermic reaction in the canister. Placement of components and fresh gas flow influences gas flows and absorbent desiccation. The circle system reduces agent use and waste gas exposure while increasing tracheal warmth and
An anesthesia circuit connects the anesthesia machine to the patient to deliver anesthetic gases and remove carbon dioxide. Various circuit designs exist, including open, semi-open, semi-closed, and closed systems. The ideal circuit is reliable, safe, and easy to use while imposing minimal resistance and dead space. The circle system allows for rebreathing of gases using low fresh gas flows and includes unidirectional valves, tubing, a Y-piece, reservoir bag, and carbon dioxide absorber. Soda lime is commonly used for carbon dioxide absorption but its interaction with anesthetic agents can produce toxic compounds.
1) Vaporizers are devices that convert liquid anesthetic agents into vapor and add a controlled amount of vapor to the breathing system.
2) There are various types of vaporizers that use different mechanisms for vaporization and temperature compensation. Common vaporizers include the TEC, Goldman, and Copper Kettle vaporizers.
3) Special desflurane vaporizers are required due to desflurane's high vapor pressure, as standard vaporizers could result in dangerously high concentrations being delivered to the patient.
The document discusses the components and design of medical gas pipeline systems used to deliver gases like oxygen, nitrous oxide, and air to patient care areas. Key points:
- Pipeline systems include a central gas supply, piping that distributes the gases, and terminal units where gases are used. Two cylinder banks provide at least a day's supply and automatically switch so one is always running.
- Oxygen can be supplied as compressed gas cylinders or cryogenic liquid. Liquid oxygen is stored in insulated containers to prevent evaporation. Nitrous oxide is also commonly stored in manifolded cylinders.
- Piping uses identified copper tubing. Manual and service shutoff valves allow isolating parts
The document discusses the components and functioning of the anesthesia machine. It describes the anesthesia machine as integrating components for anesthesia administration. The machine consists of the anesthesia machine itself, ventilator, breathing system, scavenging system, monitors and may include drug delivery systems. The document outlines the history of developments to the anesthesia machine since its original conception in 1917. It also describes the types of machines, standards, and basic schematics including electrical, pneumatic and gas supply components.
Anesthesia workstation , electrical components , high pressureKunal Agarwal
The document summarizes key components and functions of an anesthesia machine. It discusses the electrical components that power devices on the machine. It describes the high pressure and intermediate pressure systems that deliver medical gases from cylinders to the patient. It also provides an overview of medical gas cylinders including components, standards, color coding and pressure relationships.
The document summarizes the history and development of Boyle's anesthesia machine from 1917 to 1965. It traces how Boyle originally designed the machine in 1917 and how it was progressively improved over time with additions like a second vaporizing bottle, bypass controls, and a plunger device. By the 1930s, improvements like dry-bobbin flowmeters were incorporated.
The most common type of anaesthetic machine in use in the developed world is the continuous flow anaesthetic machine, which is designed to provide an accurate & continuous supply of medical gases(such as O2 & NO2)mixed with an accurate concentration of anaesthetic vapour(such as halothane,isoflurane)& deliver this to the patient at a safe pressure & flow.
Modern machine incorporate a ventilator,suction unit & patient monitoring devices.
The document summarizes the key components and functions of an anesthetic machine. It describes the high pressure and low pressure systems, including gas supplies, cylinders, manifolds, regulators and flow meters. It explains the purpose and mechanisms of vaporizers and breathing circuits. Safety features like oxygen failure alarms and leak tests are also summarized.
Oxygen MANUFACTRE STORAGE PREPERATION AND CLINICAL ASPECTDr.RMLIMS lucknow
Oxygen is produced primarily through two main methods - fractional distillation of air and pressure swing absorption. It is stored in large bulk systems or compressed gas cylinders. Cylinders come in various standardized sizes and have safety features like pressure relief valves and color coding. Oxygen is delivered to patients through devices like nasal cannulas, masks, or venturi masks which mix oxygen with air to precisely control the fraction of inspired oxygen. While oxygen therapy is useful for treating hypoxemia, high concentrations over long periods can cause toxicity issues like pulmonary fibrosis or retinopathy of prematurity in newborns.
recent advances in anesthesia machine design (2).pptSayedAhmad24
The document provides a history of anesthesia machines and describes their key components and safety features. It discusses how machines have evolved from Morton's ether inhaler in 1864 to modern machines with components like gas delivery systems, ventilators, vaporizers, and monitoring systems. Modern safety features help prevent hypoxic events, ensure minimum oxygen levels, and include vaporizer interlocks and gas connection standards. Regular checklists are important for verifying machine safety and functionality.
An anesthesia machine uses gas supply and delivery systems to provide precise mixtures of medical gases like oxygen, nitrous oxide, and anesthetic vapors to patients during surgery. Key components include connections to hospital gas lines, reserve gas cylinders, flow meters, vaporizers, and monitors. Modern machines also integrate ventilators and monitors for vital signs. Anesthesia machines allow anesthesiologists to safely induce and maintain general anesthesia, while carefully controlling gas concentrations and supporting patient breathing.
This document discusses gas management systems used in medical facilities. It describes the various medical gases used, including oxygen, nitrous oxide, compressed air, vacuum, and carbon dioxide. It also outlines the key components of gas pipeline systems, including main lines, risers, and branch lines. Specific components are medical gas outlets, alarms, manifolds, and zone valves. The document provides diagrams of medical gas pipeline systems and outlines oxygen supply systems using gas cylinders or cryogenic liquid tanks. It also discusses the components and setup of medical compressed air and vacuum systems. Terminal units and area control units are described as well.
An anesthetic machine consists of several key components:
1. Medical gas supplies from cylinders or central pipelines
2. Pressure regulators to reduce gas pressures
3. Flowmeters to deliver known gas flows
4. Vaporizers to convert liquid anesthetics to vapor
5. Breathing circuits to deliver gases to patients
The document then provides further details on each component and how the overall anesthesia delivery system functions.
updated slides from previous slides too much precise and very help full information for Bio-medical Engineers, Doctors, thanks for slides comment below email.
The anesthesia machine delivers precise gas mixtures including oxygen and anesthetic gases. Newer machines have advanced ventilators and electronic components compared to older models. An anesthesia workstation integrates components like gas cylinders, flow meters, ventilators into a single unit. Key components include pressure regulators, flow meters, and safety features to prevent gas shortage or hypoxic mixtures from being delivered. Modern machines use digital displays and computer controls for improved monitoring and safety.
Central Medical Gas Distribution System
MedicalGasDistributionSystemisacentralsupplysystemtosupplyamedicalgas(O2,N2O,N2),medicalair,andmedicalvacuumtoeachwardofhospitalsafelyandconvenientlythroughacentralsupplypipingfrommedicalgassupplysources.
•Thesystemhasathoroughgoingcolorcoordinationaccordingtothekindofgas.
•Anaudio-visualmonitoringsystemcapableofcheckingthesituation
Centralised medical gas pipeline systems deliver oxygen, nitrous oxide, medical air, and other gases from a central location directly to outlets near patients for safer, purer, and more reliable gas supply. The piped systems remove dangerous gas cylinders from bedsides and provide easier quality control since gases come from centralized pumps and manifolds. A well-designed system has separate manifold and plant rooms, uses copper piping tested for leaks, and provides oxygen from liquid tanks for large hospitals. Outlets include wall mounts and ceiling pendants correctly color-coded for each gas.
The document discusses the components and functions of an anesthesia machine. An anesthesia machine provides medical gases like oxygen and nitrous oxide mixed with anesthetic vapors to patients. It has several key components including pressure regulators, vaporizers, reservoirs, carbon dioxide absorbers, adjustable pressure limiting valves, ventilators, and scavenging systems. The machine precisely delivers gas mixtures to maintain anesthesia and ventilation. It is designed with three pressure systems - high, intermediate, and low - to safely regulate gas delivery.
The document provides guidance on selecting solenoid valves, noting that it is important to identify parameters like capacity, pressure conditions, media conditions, and discusses choosing valves suitable for open systems with defined pressure or closed circuit systems with undefined pressure, and covers direct-operated and servo-operated valve options.
The document provides instructions for checking an anesthesia machine. It outlines 14 steps to check the emergency ventilation equipment, oxygen and gas supplies, low pressure and scavenging systems, breathing circuit, ventilation systems and monitors. Key checks include verifying backup ventilation, oxygen cylinder levels, gas pipeline pressures, checking for leaks in the low pressure and breathing systems, calibrating monitors, and ensuring the final status of the machine is safe. The checkout is recommended before each use to ensure the anesthesia machine is functioning properly and can deliver a safe gas mixture to patients.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
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ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
PIPELINE.pptx
1. PIPELINE/SUPPLY OF GASSES TO
OPERATING ROOM,
OXYGEN THERAPY
SPEAKER: DR.SUMAN GORAI
MODERATOR: DR.APURBA BISWAS
DR.JISHNU NAYEK
2. INTRODUCTION
Practice of anaesthesia involves the use of compressed gases day in and out.
Gases used in anaesthesia as well as medical practice are either provided in the form of
cylinders or medical gas piping system.
Smaller cylinders up to a certain specific size can be fitted to anaesthesia machine or work
station where as bigger cylinders are used in central manifold room (Bank of large cylinders)
and from there gases are supplied via pipelines to OT, CCU and Wards.
The central supply area can have Large cylinders or it can receive gases from a large insulated
tank of liquid gas. These gases are then delivered through pipelines to the wall outlets.
It is very important for anaesthesiologist to understand the complicacy of these system
,safety measures to be undertaken so as to be able to rectify and prevent the mishaps like
cross connection ,system running out of supply and so on that can lead to disasters.
Anaesthesia personnel should play a key role in designing the piping system.
3. SUPPLY OF GASSES
1. OXYGEN
MANUFACTURING:
The most common method of manufacturing oxygen commercially is by the
fractional distillation of liquefied air. This method produces oxygen which is over
99% pure.
Alternatively, oxygen concentrators containing zeolite adsorbents can be used.
Zeolite selectively adsorbs nitrogen and so delivers oxygen that is 90–95% pure.
The major contaminant is argon. Oxygen concentrators are commonly used in
aircraft, submarines, military field hospitals and at home.
4. STORAGE
The main hospital supply of oxygen comes from a vacuum-insulated evaporator
(VIE), which holds up to 1500 L of liquid oxygen. This is the most economical and
space-saving way of storing oxygen. The liquid oxygen is stored at a temperature
between −150 and −170 °C (below its critical temperature of −119 °C) and at a
pressure of 7bar (this is the saturated vapour pressure (SVP) of oxygen at its
stored temperature). One volume of liquid oxygen yields 842 times of its volume
of oxygen in gaseous form at 15°C temperature and one atmospheric pressure.
The hospital back-up oxygen supply comes from a cylinder manifold (size J
cylinders arranged in series), which stores oxygen as a compressed gas at room
temperature.
Oxygen on the anaesthetic machine is stored as a compressed gas in molybdenum
steel cylinders (size E cylinders) with black bodies and white shoulders at a
pressure of 137bar (13700kPa). Aluminium cylinders are used in MRI suites.
5. 2. NITROUS OXIDE
Nitrous oxide (N2O) is manufactured by the thermal decomposition of
ammonium nitrate.
The critical temperature of nitrous oxide is 36.5 °C and therefore at
room temperature N2O exists as a liquid with its vapour. On the
anaesthetic machine, N2O is stored as a liquid in molybdenum steel
cylinders with blue bodies and blue shoulders at a pressure of 52bar
(this is the SVP of N2O vapour above its liquid).
N2O cylinders have different filling ratios. In tropical countries the
filling ratio is 0.67 but in temperate climates it is 0.75.
The main hospital supply of N2O comes from a cylinder manifold
where once again the N2O is stored as a liquid at room temperature.
6. CYLINDER MANIFOLD
Manifolds are used to supply oxygen, nitrous oxide and
Entonox.
An average cylinder manifold configuration contains two
equal banks of gas cylinders with a centrally located control
panel, which provides a normal output pressure of four bar.
Large cylinders are usually divided into two groups: Primary
(duty bank) and secondary (standby bank). The two groups
alternate in supplying the pipelines.
All cylinders in each group are connected to the manifold via
a copper tail-pipe with a gas specific connection and seal.
Each connection has a non-return valve fitted to enable
single cylinder to be changed if a leak or tail-pipe rupture
occurs. The cylinders are held captive by individual chains to
the backbar. All the cylinders are connected through non-
return valves to a common pipe. This in turn is connected to
the pipeline through pressure regulators.
7. CYLINDER MANIFOLD (cont.)
In either group, all the cylinder valves are opened.
This allows them to empty simultaneously. The
supply is automatically changed to the secondary
group when the primary group is nearly empty. The
changeover is achieved through a pressure-sensitive
device that detects when the cylinders are nearly
empty.
The total storage capacity of the manifold should be
based on 1 weeks supply with a minimum of 2 days
supply on each bank and a supply of 3 days spare
cylinders held in the manifold room.
8. PIPELINES
The medical gas supply includes pipelines
linking VIEs, cylinder banks and air
compressors to terminal units (Wall outlets
,ceiling pendants and bed head panels.
The pipeline is made of a special high
quality(phosphorous containing de-oxidized,
non-arsenical copper to prevent corrosion or
contamination.
Gases are supplied at 400kPa (4Bar), with the
exception of air which is supplied at 400kPa
for therapeutic use and 700kPa to power
surgical equipments.
9. Pipeline distribution system
There are 3 general classes of piping:
Main lines :- Pipes connecting the source to risers or
branch lines or both.
Risers :- Vertical pipes connecting the main line with
branch lines on various levels of the facility.
Branch (lateral) lines :- The sections of the piping system
that service a room or group of rooms on the same level
of the facility.
10. Pressure Relief Valves
Each central supply system must have a pressure relief valve set at
33% above normal line pressure downstream of the line regulators and
upstream of any shutoff valve.
This relief valve prevents pressure buildup if a shutoff valve is closed.
The valve should close automatically when the excess pressure has
been relieved.
11. Shutoff Valves
Shutoff valves permit specific areas of the piping system to be isolated in
the event of a problem as well as for maintenance, repair,testing,or
expansion without the whole system being turned off.
There are 2 types of shutoff valves:
Manual: must be installed where they are visible and accessible at all
times for authorised persons.
Service shutoff valves: are designed to be used only by authorised
personnel. They are in locked cases or have their handle secured and
tagged to prevent accidental closing.
12. Alarms
Alarm types:
1.Master Alarm System:
A master alarm system monitors the central supply and
the distribution system for all medical gas systems.
To ensure continuous responsible observation, master
signal panels must be located in two separate locations,
wired in parallel to a single sensor for each condition.
A centralised computer system may be substituted for
one of the master alarms.
13. 2. Area Alarm System :
Critical life support areas, such as operating room suites,
postanesthesia care units, ICU, coronary care units, etc. must
have an area (local) alarm system to indicate if the pressure
increases or decreases 20% from normal line pressure.
It will be placed downstream of the shut-off valve for the area.
3. Local alarms:
Local alarms are installed to monitor the function of the central
medical and instrument air systems as well as the vacuum and
anesthetic gas scavenging systems.
The signals may be located on or in the control panel of the
machinery being monitored, within a monitoring device or on a
separate alarm panel.
15. TERMINAL UNIT
Component:-
1. Base block : This is the part of a terminal unit that is attached to
pipeline distribution system.
• Primary valve-(automatic shutoff valve ; terminal unit valve; self sealing valve;
primary check valve)
It opens and allows the gas to flow when the male probe is inserted and close
automatically when the connection is broken.
• Secondary valve-(shutoff valve; terminal stop valve; secondary check valve)
It is designed so that when primary valve is removed (e.g,, for cleaning or
servicing)the gas flow is shut off. When primary valve is in place secondary valve
stays open.
16. Gas specific Connection Point( Socket Assembly)
The receptor for a noninterchangeable gas specific connector that is either a
part of or attached to the base block is incorporated into each terminal unit.
The connector may be a threaded Diameter Index Safety System(DISS) or a
proprietary (manufacture specific) quick connector.
The corresponding male component of the noninterchangeable connection is
attached to the equipment to be used or to a flexible hose leading to the
equipment.
The female component is called an outlet connector or socket.The male
member is called an inlet connector, probe, plug, striker or jack.
Each DISS or quick connector must have backflow check valve to prevent gas
floe from the anaesthesia apparatus.
17. Diameter Index Safety System
• It consists of a body, nipple and nut combination.
• There are two concentric bores in the body which
connects with concentric and specific shoulders on the
nipple
• To achieve non-interchangeability between different
connectors, the two diameter on the body bores and the
nipple shoulder increases/decreases proportionally
which allows proper fitting.
18. Quick connectors
Quick connectors allow apparatus (hoses, flowmeters, etc.) to be connected
or disconnected by a single action using one or both hands without the use of
tools or undue force.
Quick connectors are more convenient than DISS fittings but tend to leak
more.
Each quick connector consists of a pair of gas-specific male and female
components.
A releasable spring mechanism locks the components together.
Hoses and other equipment are prevented from being inserted into an
incorrect outlet by using different shapes and/or different spacing of mating
portions
19. Types of Terminal unit
Wall Outlets:
Wall outlets are simple and well suited where the equipment to be connected is
near the wall.
However, it leads to personnel tripping over the hoses, difficulty in moving
equipment, wear and tear on the hoses.
For large room , more than one set of wall outlets may be advisable.
Ceiling-mounted Hoses:
Ceiling-mounted hoses with the terminal unit at the end of the hose may be
used.
A spring-actuated chain keeps the hose close to the ceiling.
20. FLEXIBLE HOSES
Flexible colour-coded hoses (O2-white,N2O-blue,Air-
black/white,vaccume-yellow) connect the outlets to the
anaesthetic machine.
They have a Schraeder probe at one end and a gas-specific
threaded connector at the other end. The gas specific
Schraeder valve, uses a unique collar indexing system with a
unique diameter that fits the matching recess on the terminal
outlet for a specific gas only.
The hose connects to the anaesthetic machine by means of a
Non-Interchangeable Screw Thread (NIST) which cannot be
attached to the wrong connector.In the USA a similar system is
employed called Diameter index safety system(DISS)
21. Testing Medical Gas Distribution System
After the pipeline have been installed but before installation of terminal units
and other system component ( source equipment, alarms, pressure gauge,
pressure relieve valve) the line must be blown clear of foreign materials by
using oil free nitrogen.
23. HYPOXIA
Hypoxia - reduced oxygen for tissue respiration.
Oxygen Delivery to the tissues depends on
1.) Supply of oxygen during inspiration
2.) Transfer of oxygen from the Alveoli to the pulmonary capillaries
3.) Transport of oxygen by blood to the tissue
26. ANAEMIC HYPOXIA
Anaemic hypoxia - due to decrease concentration of functional
hemoglobin.
1. Anaemia-reduced hb%.
2. CO Poisoning –affinity of Hb for CO is about 250 times higher
then O2.
3. Methaemoglobinaemia - Methemoglobin lacks the electron that
is needed to form a bond with oxygen and, thus, is incapable
of oxygen transport.
4. Sulphhaemoglobinaemia- rare blood condition that occurs
when a sulfur atom is incorporated into the hemoglobin
molecule.
27. STAGNANT HYPOXIA
Stagnant hypoxia –type of hypoxia which is caused by
inadequate blood flow which results in less oxygen
available to the tissues.
Decrease tissue perfusion is due to
General – Decrease Cardiac output.
Local – Arterial or venous occlusion e.g. atheroma,
embolism, trauma,
Vasoconstriction.
28. HISTOTOXIC HYPOXIA
Histotoxic hypoxia– adequate amount of oxygen is inhaled through the lungs
and delivered to tissue, but the tissues are unable to use the oxygen.
Sodium nitroprusside contains a cyanide radical, so overdose of this drug can
cause histotoxic hypoxia.
29. Post operative Hypoxia –
i. Fink effect
ii. Increase V / Q mismatch due to decrease FRC.
iii. Stagnant Hypoxia
iv. Hypoventilation
(a) Drugs
(b) Obstruction
(c) Pain
(d) Intra operative Hyperventilation.
30.
31.
32. Objectives:
To correct documented or suspected acute Hypoxemia.
To Decrease symptoms associated with chronic Hypoxemia.
To Decrease workload that hypoxemia imposes on the
cardiopulmonary system.
34. ASSESSMENT
The need for oxygen therapy should be assessed
by
1. monitoring of ABG - PaO2, SpO2.
2. clinical assessment findings.
35. PaO2 as an indicator for Oxygen therapy
• PaO2 : 80 – 100 mm Hg : Normal
60 – 80 mm Hg : cold, clammy
extremities
< 60 mm Hg : cyanosis
< 40 mm Hg : mental deficiency
memory loss
< 30 mm Hg : bradycardia
cardiac arrest
PaO2 < 60 mm Hg is a strong indicator for oxygen therapy
37. Oxygen Delivery System
Oxygen delivery system is a device which is used to administer, regulate and
supplement oxygen to a subject to increase the arterial oxygenation.
Classification:
DESIGNS
o Low flow system
o Reservoir system
o High flow system
o Enclosure
PERFORMANCE (Based on predictability and consistency of FiO2 provided)
o Fixed
o variable
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61. HYPERBARIC OXYGEN THERAPY
DEFINITION: A mode of medical treatment wherein the patient breathes 100%
oxygen at a pressure greater than one atmosphere absolute (1 ATA)
1 ATA is equal to 760 mm of hg at sea level.
Basis of Hyperbaric O2 Therapy:
Dissolved o2 in plasma: 0.003ml/100 ml of blood/mm PO2
(Henry’s Law: The concentration of any gas in solution is proportional to its
partial pressure.)
Breathing Air(PaO2- 100 mmHg)=0.3ml/100ml of blood.
Breathing 100%O2(PaO2- 600 mmHg)=1.8ml/100 ml of blood.
Breathing 100% O2 at 3 ATA(PaO2- 2000 mmHg)=6ml/100 ml of blood.
71. 2. Depression of Ventilation
Seen in COPD patients with chronic hypercapnia
Mechanism
↑PaO2
suppresses peripheral V/Q mismatch
chemoreceptors
depresses ventilatory drive ↑ dead space/tidal
volume ratio
↑PaCO2
72. 3. Retinopathy of prematurity (ROP)
Premature or low-birth-weight infants who receive
supplemental O2
Mechanism
↑PaO2
↓
retinal vasoconstriction
↓
necrosis of blood vessels
↓
new vessels formation
↓
Hemorrhage → retinal detachment and
blindness
To minimize the risk of ROP - PaO2 below 80 mmHg
73. 4. Absorption atelectasis: Hypoxic Pulmonary
Vasoconstriction
Absorption atelectasis
refers to the tendency
for airways to collapse
if proximally
obstructed. Alveolar
gases are reabsorbed;
this process is
accelerated by nitrogen
washout techniques.
74. 5. Fire hazard
High FiO2 increases the risk of fire
Preventive measures
Lowest effective FiO2 should be used
Use of scavenging systems
Avoid use of outdated equipment such as aluminium gas regulators
Fire prevention protocols should be followed for hyperbaric O2 therapy