Fundamentals of Respiratory Care Test 2 Ch. 40 & 41

-American Standard Safety System
-Pin-Index Safety System
- Diameter-Index Safety Sytem

What are the three basic safety systems for regulation and delivery of medical gases?

green

What color tank should oxygen be?

yellow

What color tank should medical air be?

grey

What color tank should carbon dioxide be?

brown

What color tank should helium be? He

blue

What color tank should Nitrous Oxide be? N2O

black

What color tank should Nitric oxide be? N2

non flammable

does not burn

oxidizing

nonflammable, but supportive of combustion

flammable

burns readily, potentially explosive

OXIDIZING
(non-flammable but greatly accelerates combustion)

Oxygen is what kind of gas?

oxygen

What gas is colorless, odorless, tasteless, occurs in all living matter, oxidizing, and constitutes almost 50% by weight of the earth's crust?

fractional distillation

performed by filtering atmospheric air to remove pollutants, water and COS, then liquefied by compression and cooled by rapid expansion. The resulting mixture of oxygen and nitrogen is heated slowly in a distillation tower. Nitrogen and the trace gases es

cryogenic (low temperature) storage cylinders

What kind of tank is liquid oxygen stored in?

oxygen

What gas can also be converted directly to a gas from the liquid state for storage in high pressure metal containers?

99.0%

The US Food and Drug Administration require that oxygen purity must be at least what?

molecular "sieves

Physical separation occurs by using what to extract Nitrogen, water vapor, and trace gases from the air providing an oxygen concentration of more than 90% oxygen for patient use?

low flow oxygen supplies in the home setting

What are oxygen concentrators?

colorless, odorless, and naturally occurring gas that supports combustion (oxidizing)

Air is what kind of gas?

21% Oxygen and 78% Nitrogen and 1% trace gas(mainly Argon)

Air is made up of?

by filtering and compressing atmospheric air

How is medical grade air produced?

dry, oil, particulate contamination.

For medical use, air must be __________ and free of _________ and ________________ _____________________.

medical air compressors

What can be used to draw atmospheric air in through a filter system by a motor driven piston system into a reservoir tank where it is dried and then reduced to the desired working pressure before being delivered to a piping system?

Large medical air compressors

What must provide a high flow (at least 100 l/min) at the standard working pressure (50 PSI) for all medical equipment use?

small compressors

What size compressors are available for bedside or home use?

small compressors

What utilizes a diaphragm or turbine that compresses the air but does not generally contain a reservoir? Pressure and flow capabilities are limited making them perfect to power small volume nebulizer devices.

small compressors

What size compressor can NEVER be sued to power equipment that needs unrestricted 50 psi, such as mechanical ventilators?

colorless, odorless, nonflammable gas
-does not support combustion or maintain animal life

Carbon Dioxide is what kind of gas?

Carbon Dioxide (CO2)

What gas is produced for medical use by heating limestone in contact with water?

99.0%

What is the FDA purity standard for CO2?

Carbon Dioxide

This gas is used mainly in clinical laboratories, to calibrate blood gas analyzers and to operate heart-lung machines (membrane oxygenators)

Carbon Dioxide

This gas helps regulate pulmonary vascular pressures in some congenital heart disorders.

Helium (He)

This gas is odorless, tasteless, nonflammable, good conductor of heat, sound, and electricity. It is not soluble i water and cannot support life.

At least 20% oxygen

Helium must always be mixed with what?

Helium

This gas is used more in pediatrics to treat large airway obstruction. It helps decrease work of breathing when mixed with oxygen.

Nitrous Oxide (N2O)

colorless gas with a slightly sweet odor and taste,, supportive of combustion

nitrous oxide

This gas is used clinically as an anesthetic. It is supportive of combustion. It does not support life and causes death if inhaled in pure form. Must always be mixed with at least 20% oxygen. Long term exposure can cause neuropathy, fetal disorders, and m

thermal decomposition of ammonium nitrate

Nitrous oxide is produced by?

Nitrous oxide

What gas has limits set by NIOSH for exposure of hospital rooms to be 25 ppm?

nitric oxide

What gas is colorless, nonflammable, toxic, supports combustion, and forms brown fumes when combined with air? (forming Nitrogen Dioxide)

nitric oxide

What gas is a strong resp. irritant that can cause chemical pneumonitis and a fatal form of pulmonary edema/

Nitric oxide

What gas has been approved by the FDA to treat near term infants for serve hypoxic respiratory failure?

portable high pressure cylinders or in large bulk reservoirs

Medical gases are stored in what kinds of cylinders?

made of steel alloy tempered for higher strength

DOT type 3AA cylinders are made of what?

carbon steel

DOT type 3A cylinders are made of what?

aluminum alloy-not magnetic

DOT type 3AL cylinders are made of what?

1. Letter DOT or ICC followed by cylinder classifcation (3A, 3AA, 3AL) and then the normal filling service pressure in psi
2. Letter size of the cylinder
3. cylinder serial number
4. Mark of ownership
5. maufacturer's stamp or a mark identifying the inspe

What marks and identification should be on the cylinders?

elastic expansion of the cylinder in cubic centimeters under the test conditions

The notation E.E. followed by a number indicates what on the cylinder?

DOT approval for 10 year testing

An asterisk * next to the test date indicates what?

indicates that the cylinder is approved for filling to 10% above it service pressure

A plus sign (+) indicates what on the cylinder?

Labels. Not colors.
Cylinder colors are different in other countries and should only be used as a guide.

What is the main source of identification for a cylinder's contents?

E though AA

What sizes are small cylinders?

transporting patient and anesthetic gases

Small cylinders are used for what?

Post valve and yoke connectors

Small cylinders are easily identified because of their unique valves and connecting systems which contain?

F through H and K

What sizes are large cylinders?

have threaded valve outlets

Large cylinders have what outlets?

E cylinder

What is the most common size cylinder?

1. frangible disk
2. fusible plug
3. spring loaded

Gas cylinders come with what three basic types of high pressure relief valves?

metal disks that rupture at a specific pressure

What are frangible disks?

plugs that melt at a specific temperature
(most small cylinders have a fusible plug relief valve)

What are fusible plugs?

valves that open and vent gas at a set high pressure
(they are used for large cylinders)

What are spring loaded valves?

22-40%

What is the Fio2 range for a nasal canula?

22-45%

What is the fio2 range for a nasal catheter?

22-35%

What is the fio2 range for a transtracheal catheter?

22-35%

what is the fio2 range for a reservoir cannula?

35-50%

what is the fio2 range for a simple mask?

40-70%

what is the fio2 range for a partial rebreather?

60-80%

what is the fio2 range for a nonrebreather mask?

air-entrainment

Which breathing systems have fixed fio2?

1/4-6 L/min

What is the normal flow for a nasal cannula?

1/4-5 L/min

Normal flow for a nasal catheter?

1/4-4 L/min

normal flow for a transtracheal catheter?

1/4-4 L/min

normal flow for a reservoir cannula?

5-10 L/min

normal flow for a simple mask?

minimum of 10 L/min

normal flow for a partial and a non rebreather mask?

nothing below 60 L/min

normal flow for an air entrainment nebulizer?

nothing below 60 L/min

normal flow for an air entrainment mask

7 L/min
-to eliminate CO2 build-up

hood enclosures (used mostly for infants) should never be below what L/min?

7.35-7.45

normal ph

35-45

normal PaCO2 mmHg

80-100

normal PaO2 mmHg

22-26 or (24+or-2)

normal HCO3-

90-100%

normal SaO2

24-50%

fio2 for AEM?

28-98%

fio2 for air entrainment nebulizer