 Flow and Velocity

o Flow = Mass or Volume (Q)/time (t) = Velocity * radius^2

 Directly proportional to pressure gradient
 Patterns of Flow
 Laminar
 Turbulent
 The Anesthesia Machine
o Pressure measurements of gases and liquids
 P = Force (F) / Area (A)
 1 atm = 760 mmHg = 988 cm H20 = 14.7 psi
 Gauges = record pressures above or below existing atm pressure
 Full oxygen E-cylinder:
o gauge pressure = 2000 psi
o Absolute pressure = gauge pressure + atm pressure = 2014.7 psi
 Examples: CVP, arterial line, peak inspiratory pressures
 Manometers = columns of liquid in OPEN ended U shaped tube
 P = pgz = density (p) x gravity (g) x height (z)
 Best for measuring pressures that change slowly
 Bourdon gauges
 Better for measuring high pressures (vs. manometers)
 Example: cylinder pressures
o Pressure regulators
 Used to decrease pressure from cylinders to the machine at slightly lower
pressures than pipeline supply
 Oxygen = 2200 to 45 psi
 Nitrous Oxide = 745 to 45 psi
 Serves as a check valve to determine source with highest pressure = regulator
will shut down cylinder gas supply if pipeline gas supply at normal
approximately 45 psi
o Gas supply
 Most machines have oxygen, nitrous oxide, and air
 Some have a fourth inlet for helium, heliox, CO2, or nitric oxide
 Machines have TWO gas inlet pressure gauges for each gas: one for the pipeline
pressure and another for cylinder pressure
 Pipeline Inlets
 Diameter Index Safety System (DISS) = prevents incorrect hose
attachement due to diameter of the body and connection nipple
o Has a filter
o One way check walve = prevents retrograde flow
 Most machines have oxygen (pneumatic) power outlet = drives ventilator
o DISS fittings for oxygen inlet and oxygen power outlet are the
same = DO NOT MISTAKENLY INTERCHANGE THE TWO
 Pipeline pressure = relatively constant
 Cylinder Inlets
  Pin Index Safety System = yoke assembly = index pins, gas filter, and
check valve
 Cylinders pressurized to 2200 psi, regulators decrease the pressure to 45
psi
 If two reserve cylinders of the SAME gas are opened at the same tiem,
the cylinder pressure gauge will indicate the pressure of the cylinder with
the HIGHER pressure (see figure 4-6)

 Cylinder pressure = high and variable (vs. pipeline) = flow control is

more difficult and dangerous
o Medical Gas Cylinders (E-cylinders)
 Room temp = 20 C
 Critical temp = temperature below which a gas enters liquid phase due to applied
pressure
  Boyles Law: P1V1 = P2V2
 Full oxygen tank = 660 L of oxygen molecules and 2000 psi of pressure
 Gauge that reads 1000 psi, according to Boyle’s Law, = half full = 330 L
of oxygen molecules
 If pt receives 10L/min flow plus 6L/min minute ventilation through ETT
during transport, the cylinder will be depleted in 21 minutes (330
L/16L/min)
 Oxygen
 660 L oxygen molecules
 2000 psi of pressure
 T crit = -119 C (can never be liquid at room temp)
 Nitrous Oxide
 T crit = 36.5 C
 1600 L of gas in full e-cylinder
 750 psi
 Majority of tank is liquid N2O with small gaseous N2O above liquid
o volume can’t be determined by pressure gauge
o have to weight the cylinder and subtract empy cylinder weight to
determine amount of gas
o Pressure remains constant 750 psi until all liquid nitrous oxide
vaporized
 Entonox = mixture of nitrous oxide and oxygen in equal parts
 2000 psi
 Dental procedures, labor, dressing changes
 T crit = > 36.5