howpipedo2issupplied-lgh-anaesthesia（138页）.docVIP

Question No. 1 How piped O2 is supplied? Answer: - Large O2 cylinders are kept outside the theatre. Each cylinder is connected by a coiled tube to a pipeline, which passes to a central control box. The pressure in the cylinder is 137 bars which are reduced to 10 bars. The change over valve has a pneumatic shuttle mechanism. Warning devices are also provided when cylinder pressure falls to a certain level. A second stage reducing valve brings the pressure from 10 bars to 4.1 bars which is the normal pipe line pressure. ____________(____________ Question No. 2 Define Entonox. Describe its uses, storage and effects of low temperature. Answer: - Entonox is the compressed gas mixture containing50% O2 and 50% N2O. It is compressed into cylinder containing gas at a pressure of 137 bar (2000 lb/in2). If a full cylinder is cooled, a liquid phase containing about 20% O2 and 80% N2O may form below the gas. Entonox is useful in labour pain and chest physiotherapy especially because of analgesic effect of N2O. The Entonox cylinder has a demand valve (Marlin valve), which allows gas flow. The patient holds the mask herself and with each inspiration gas flows in. Although the critical temp of N2O is 36.50C, it does not liquefy because the presence of O2 reduces its critical temp. The critical temp of Entonox is -70C. Cooling of cylinder to a temp below –70C results in separation of liquid N2O. Use of such a cylinder results in O2 rich gas being emitted initially followed by hypoxic N2O rich gas. To prevent this, a dip tube in large cylinder is present, which draws off any liquid phase first. This prevents the delivered O2 conc. falling below 20% at any time. Storage area for Entonox cylinder should be maintained above 100C. When an Entonox cylinder may have been exposed to low temp, it should be stored horizontally for a period of not less than 24 hr at a temp of 50C or above. In addition, the cylinder should be inverted several times or pu