Why should diathermy be avoided in patients with pacemakers?
Click to see answer
Electrical interference can cause pacemakers and ICDs to malfunction.
Click to see question
Why should diathermy be avoided in patients with pacemakers?
Electrical interference can cause pacemakers and ICDs to malfunction.
What is the leakage current limit for b and bF equipment in normal condition (NC)?
Up to 0.1 mA.
What type of current is mains electricity?
Alternating current (AC) supplied at 50 Hz and 240 V.
What can happen if the neutral plate of diathermy is disconnected?
Current may pass through an alternative route, causing electrical shocks and burns to the patient.
What is the definition of saturated vapor pressure (SVP)?
The pressure exerted by a vapor when in contact with and in equilibrium with its liquid phase within a closed system at a given temperature.
What happens to AC electricity in terms of flow?
The flow of electric charge reverses direction periodically, producing a sine wave pattern.
What is the simplified equation for flow?
F = Q/t.
What happens above the triple point in a phase diagram?
The substance progresses from solid to liquid to gas at a given pressure.
How is the Hagen–Poiseuille equation applied clinically when administering blood?
By using a short, wide-bore cannula, raising the height of the giving set, applying a pressure bag, and warming the blood to reduce viscosity.
What are the limitations of the Wright respirometer?
Inaccurate for continuous flow; over-reads at high flow rates and under-reads at low flow rates.
What are the three states of matter shown in a typical phase diagram?
Solid, liquid, and gas.
What are 'single fault conditions' (SFCs)?
Conditions where an external voltage appears on a part of equipment applied to the patient.
What is the latent heat of fusion?
The heat required to convert 1 kg of solid at its melting point into liquid at the same temperature.
What are the units of Molar Heat Capacity?
Joule per mole per kelvin (J mol−1 K−1).
What is the 'can't let go' phenomenon?
It refers to the tetanic muscular contractions caused by AC at frequencies peaking at 50 Hz, making it difficult for a person to release their grip.
Who invented the Ritchie whistle?
John Ritchie, a New Zealand anaesthetist.
What are the characteristics of turbulent flow?
Flow characterized by swirls and eddies, varying fluid velocity across the tube, and a non-linear relationship between pressure and flow.
What is a supercritical fluid?
A substance at a temperature and pressure above its critical point, where distinct liquid and gas phases do not exist.
What is heat capacity?
The amount of energy given to a material to cause a 1 °C rise in temperature.
What is Specific Heat Capacity?
The amount of heat required to raise the temperature of 1 kg of a substance by 1 kelvin (or 1 °C).
What is the primary function of defibrillators?
To restore normal cardiac rhythm by delivering a burst of electrical energy to the heart.
What is the leakage current limit for b and bF equipment under single fault conditions (SFC)?
Up to 0.5 mA.
What do the boundaries in a phase diagram represent?
The conditions of temperature and pressure where two of the three phases are in equilibrium.
What is the unit of specific latent heat?
Joule per kilogram (J kg−1).
What technology do modern oxygen failure devices use?
Electronic sensors.
What happens to the vapor pressure when the temperature of a liquid in a closed container is increased?
The saturated vapor pressure increases due to more molecules gaining sufficient energy to escape the liquid surface.
What should be done prior to surgery for patients with pacemakers?
Pacemaker devices must be checked, and alternative pacing techniques should be available.
What is resistance in electrical components?
Opposition to the flow of direct current, represented by R and measured in ohms (Ω).
How does the complexity of a chemical structure affect heat capacity?
More complex structures have higher heat capacity due to more ways for molecules to vibrate.
What is the purpose of electrical devices being designed to 'fail safe'?
To ensure that no safety hazard arises if a single fault occurs.
What are the units of Specific Heat Capacity?
Joule per kilogram per kelvin (J kg−1 K−1).
What are the two main types of flow?
Laminar flow and turbulent flow.
What is the Ritchie whistle?
An oxygen failure alarm powered by falling oxygen pressures.
What is the working principle of the Ritchie whistle?
As oxygen pressure falls, the diaphragm's force reduces, allowing the valve to open and activate the whistle.
What is the triple point of water?
The specific temperature and pressure at which water can exist simultaneously in solid, liquid, and gas phases.
What does a phase diagram represent?
The states of a substance at different temperatures and pressures.
What safety feature should be linked to the Ritchie whistle?
A system that shuts off the supply of all other gases apart from oxygen and air.
How does a pneumotachograph measure flow?
By measuring the pressure difference across a fixed orifice.
What is Molar Heat Capacity?
The amount of heat required to raise the temperature of 1 mole of the substance by 1 K (or 1 °C).
What role does the gauze screen play in a pneumotachograph?
It acts as a resistance to flow and maintains laminar flow.
What happens to myocytes during defibrillation?
They are depolarized, essentially re-setting the electrical status of the heart.
What is the primary function of an inductor in electrical components?
To prolong the duration of current discharge.
What frequency range do diathermy devices operate at?
0.5–1.0 MHz.
What does bF denote in electrical equipment?
A 'floating circuit' where parts attached to the patient are isolated from the rest of the equipment.
When was the Ritchie whistle introduced into practice?
In the mid-1960s.
What sound level must current oxygen failure devices produce?
At least 60 dB lasting for 7 seconds.
At what oxygen pressure should the Ritchie whistle activate?
When oxygen pressure falls to 200 kPa.
Why is AC used for long-distance electricity transmission?
It allows for minimal power loss over large distances.
What device measures gas volumes and allows flow calculation in anesthesia?
Wright respirometer.
What is a pneumotachograph used for?
To measure gas flow using a constant orifice, variable-pressure method.
What is flow in the context of anesthesia?
Flow (F) is the quantity (Q) of a liquid or gas passing a point per unit time (t).
What is diathermy and why must patients be protected from contact with earth?
Diathermy involves the deliberate application of tissue-damaging currents, and patients must be protected from contact with earth to prevent severe burns and leakage currents from faulty equipment.
What are diathermy devices used for?
To cut tissues and coagulate blood vessels.
What is the arrangement of particles in a solid?
Particles are arranged in a regular pattern or lattice with minimal spacing.
What is a rotameter?
A constant pressure, variable orifice device used to measure gas flow.
How does Heliox affect Reynolds number and breathing?
Heliox, being less dense than air, lowers the Reynolds number, changing turbulent flow to laminar flow, which reduces the work of breathing.
What precautions should be taken if monopolar diathermy is necessary?
Limit use to short bursts of less than 5 seconds and ensure the neutral plate is well adhered and far from the pacemaker.
How is charge (Q) measured?
In coulombs (C).
What phase change occurs during melting?
Fusion (melting).
What is the Reynolds number for turbulent flow?
Reynolds number > 2000.
What is the energy range used by internal cardiac defibrillators (ICDs)?
20–50 J.
What is the purpose of synchronizing a DC shock during cardioversion?
To prevent the 'R on T' phenomenon, which can trigger VF.
What are some hazards associated with diathermy?
Burns, incorrect positioning of the neutral plate, ignition of flammable skin preps, and inadvertent activation of the diathermy probe.
What are some safety risks associated with using a defibrillator?
Burns, ignition of flammable materials, interference with electrical components, precipitation of VF, and electrocution.
Why are capacitors useful in diathermy devices?
Because they have low reactance at high frequencies (e.g., 1.5 mHz) and can conduct, while mains electricity at 50 Hz has high reactance and will not be conducted.
What is Reynolds number?
A dimensionless number that predicts the onset of turbulent flow, calculated as velocity of fluid × Density × Tube diameter / Viscosity.
What are the two types of waveforms in defibrillators?
Monophasic and biphasic.
What is the condition for dynamic equilibrium in a closed container with a liquid?
A dynamic equilibrium forms when the number of particles escaping the liquid equals the number rejoining it.
What is induced when a current flows through the coils of an inductor?
A magnetic flux.
How does the bobbin in a rotameter indicate flow?
The bobbin rises in a tapered glass tube as flow increases.
What is the leakage current limit for cF equipment in normal condition (NC)?
Up to 0.01 mA.
What is fluidics?
The technology of using the flow characteristics of a liquid or gas to perform operations similar to mechanical or electronic systems.
What is a macroshock?
Macroshocks occur due to the passage of current from one part of the body to another, such as from lightning or direct contact with a live instrument.
What happens during condensation?
Latent heat is given out to the surroundings.
What equation is used to calculate laminar flow?
Hagen–Poiseuille equation.
What is generated when current flows through a coiled wire in an inductor?
A magnetic field.
What is the exception regarding the melting point and pressure?
Water's melting point decreases with pressure.
What is a transducer?
A device that changes one form of energy into another, typically into an electronic signal for interpretation and recording.
What types of filters can amplifiers use?
Bandwidth filters, high or low pass filters, notch filters, and amplitude filters.
What is the latent heat of vaporisation?
The heat required to convert 1 kg of liquid at its melting point into vapour at the same temperature.
How do particles behave in a liquid state?
Particles jiggle about, have no fixed form, and are free to move without a regular structure.
What does the neutral wire connect to?
It is connected to the earth at the mains transformer, making its electrical potential 'neutral' with the earth.
What is the critical velocity in fluid dynamics?
The velocity above which the flow of a fluid within a tube is likely to change from laminar to turbulent.
What happens if the live wire contacts a conducting part of an appliance?
Electricity would flow through the earth wire to earth, preventing a shock to the user.
What is a vapor?
A gas that is below its critical temperature.
What factors are important for calibration in a rotameter?
Viscosity and density of the fluid.
Where does evaporation occur in a liquid?
Only at the surface of the liquid.
How does ethyl chloride provide local anaesthesia?
Vaporisation of the liquid phase from the skin surface causes cooling, rendering the area numb.
Why does a steam burn cause more tissue damage than a burn from boiling water?
Because steam contains latent heat, which releases more energy upon condensation.
What is the purpose of a transformer?
To transfer electrical energy between circuits through electromagnetic induction.
What is the gain in amplification?
The difference in the size of the input signal and the amplified signal, measured in bels or decibels.
How does the type of current affect its danger level?
AC is significantly more dangerous than DC; AC can cause tetanic muscular contractions and is particularly dangerous to the heart, while DC typically results in a single muscle contraction.
What are the three wires in a UK mains electricity supply?
Live wire (brown), neutral wire (blue), and earth wire (green and yellow).
What is the maximum saturated vapor pressure of an open system at sea level?
1 atmosphere.
What is the primary function of a capacitor in a defibrillator?
To store and rapidly discharge energy.
What is vapor pressure?
The pressure exerted by particles that escape from the surface of a liquid.
What is one measure taken in theatres to prevent electrical injury?
Anti-static flooring that has high impedance to mains electricity.
What is the energy delivered by monophasic defibrillators?
360 J.
What role does a capacitor play in a defibrillator?
It stores charge and consists of two conducting plates separated by an insulating material.
How do isolating capacitors work in diathermy systems?
They block conduction of low-frequency currents while allowing conduction of high-frequency diathermy currents.
What is the role of temperature compensation mechanisms in vaporisers?
To avoid fluctuations in the delivery of the volatile agent.
What is the formula for energy stored in a capacitor?
Energy (e) = ½ C v².
How does a capacitor behave with DC and AC?
It blocks DC (high resistance) but passes AC (low reactance) as the plates get alternately charged and discharged.
What are the two components of a galvanic cell?
Positive anode and negative cathode, connected by a conductive electrolyte.
What is common mode rejection?
The ability of differential amplifiers to reject signals that are common to both leads while amplifying varying signals.
What is the role of the earth wire in electrical circuits?
It protects people from exposure to the full current of mains electricity in faulty appliances.
What current amplitude causes tingling?
0–5 mA causes tingling.
Does saturated vapor pressure depend on atmospheric pressure?
No, it depends only on temperature.
How does relative humidity of 50% help in preventing electrical injury?
It inhibits the build-up of static electricity.
What happens during the melting process?
The kinetic energy of particles overcomes intermolecular forces, causing the lattice to break up.
What is the function of an inductor?
To resist a change in electric current.
What is the formula for charge stored in a capacitor?
Charge (q) = Capacitance (C) × Voltage (v).
What determines the change in voltage in a transformer?
The ratio of the number of coils of each circuit around the transformer core.
What does a Reynolds number less than 2000 indicate?
It predicts laminar flow.
How does the heating effect in diathermy occur?
Through high frequency AC passing through tissues of high impedance.
What distinguishes a gas from solids and liquids?
Gas particles are very far apart, move in rapid random motion, and completely fill any container.
What is Ohm's law?
A fundamental equation in electronics represented as V = i × r, where V is voltage, i is current, and r is resistance.
What does latent heat refer to?
It refers to heat used to overcome the attraction of inter-molecular bonds during phase changes.
What formula represents the energy stored by a capacitor?
E = ½QV or E = ½ c V².
How does inductive reactance change with frequency?
It increases with increasing frequency.
What is the effect of pressure on the melting point of most substances?
The melting point increases with pressure.
What occurs at the anode and cathode in a galvanic cell?
Oxidation occurs at the anode and reduction at the cathode.
How does a monophasic waveform function?
It is a damped sinusoidal wave where current flows in one direction only.
What does 1 Ω represent in terms of current and voltage?
It allows 1 ampere of current to flow when a potential of 1 volt is applied across it.
How do inductors react to AC and DC?
They have high reactance to AC (block AC) and low resistance to DC (pass DC).
What is the difference between cutting and coagulation modes in diathermy?
Cutting mode uses an alternating sine wave pattern, while coagulation mode uses a pulsed sine wave pattern.
What monitoring is essential during diathermy use?
ECG monitoring is paramount.
What is the Bernoulli principle?
It states that fluid pressure decreases in regions where flow velocity increases, maintaining constant total energy.
What causes a substance to change state?
Changes in composition and temperature, specifically the increase in average kinetic energy of the particles.
How is capacitance measured?
In farads (F).
What is the point where the three phases of a substance meet called?
Triple point.
What type of current do inductors block and pass?
Block AC (high reactance) and pass DC (low resistance).
How do transformers change voltage?
They can step up or step down the voltages of alternating current.
How does temperature affect the rate of evaporation?
Higher temperatures increase the proportion of particles with sufficient energy to evaporate.
How can amplifiers reduce noise?
By acting as filters, often using differential amplification to reject common signals.
What is the safer option between bipolar and monopolar diathermy?
Bipolar diathermy is safer than monopolar diathermy.
What happens to temperature during phase changes like fusion and vaporization?
The temperature remains constant even though heat is still being applied.
How do shoes provide safety from electrical current?
Shoes have a high resistance (200,000 Ω), which increases the total resistance encountered by the current, reducing the magnitude of current that can flow through the body.
What is the power range for monopolar diathermy?
100–400 watts.
What is the Venturi principle?
It describes how a pressure drop induced by increased fluid velocity through a narrow orifice can entrain a second fluid.
What is the function of circuit breakers in electrical safety?
To break a circuit or sound an alarm if a stray current above a set limit is detected flowing to earth.
How can you calculate the energy delivered during a shock?
Using the equation e = ½ c V².
What is a capacitor?
A device that can store charge, consisting of two conducting plates separated by an insulator (dielectric).
What is the purpose of earthing in electrical safety?
To protect people from the effects of faulty insulation by providing a path for electricity to flow to the ground.
Give an example of a transducer.
A microphone, which converts sound energy into an electrical signal.
What are the characteristics of laminar flow?
Fluid moves steadily, flow rate is greatest at the center, a pressure difference must exist, and flow is directly proportional to this pressure difference.
How does resistance vary with physical stresses?
It can change with temperature and stretch, which is exploited in electrical thermometers and transducers.
What is latent heat?
The amount of heat energy absorbed (or released) by a substance as it changes phase at a given temperature.
What voltage do defibrillators typically use?
5000 V d.c.
How does bipolar diathermy work?
Current is passed between two probes within a modified pair of forceps, heating tissues between them.
How does capacitative reactance change with frequency?
It decreases with increasing frequency.
What type of switches and plugs are used to enhance electrical safety?
Non-sparking switches and plugs.
What is impedance?
Total opposition to current flow in an alternating current circuit, made up of resistance and reactance.
What is evaporation?
The process where particles of a liquid move to the vapor state at any temperature.
What is sublimation?
The process where a solid changes directly to a vapor without going through the liquid phase.
How is the resistance of a tube calculated?
By the ratio of pressure to flow.
What is an example of sublimation?
Solid carbon dioxide (dry ice) changing directly to CO2 vapor at normal atmospheric pressure.
What is the energy delivered by external biphasic defibrillators?
150 J.
Why is the earth wire considered a safety feature?
It provides a path for electricity to flow to the ground instead of through a person, reducing the risk of electric shock.
What is reactance?
Opposition to the flow of alternating current caused by inductance and capacitance, rather than resistance.
What is the Coanda effect?
The tendency of a fluid jet to stay attached to an adjacent curved surface, affecting gas flow distribution in the lungs.
What is vaporization?
The process where liquid particles gain enough energy to overcome residual forces and become a gas.
What is essential for maintaining electrical safety in medical equipment?
Regular checks and maintenance of equipment.
What pressure corresponds to the triple point of water?
611.73 Pa (0.006 atm).
What is a battery (galvanic or voltaic cell)?
A collection of galvanic cells that convert stored chemical energy into electrical energy when part of an electrical circuit.
How does an amplifier differ from a transducer?
An amplifier makes the input signal larger for easier interpretation, rather than changing it from one form to another.
What is a key feature of biphasic waveform defibrillators?
Current flows in alternating directions, completing one cycle in approximately 10 ms.
Why is the specific latent heat of vaporisation greater than that of fusion?
Because more energy is required to overcome the intermolecular bonds to liberate a gas.
What is the Reynolds number for laminar flow?
Reynolds number < 2000.
What is capacitance measured in?
Farads (F).
What design features minimize the risk of electrical shock in diathermy systems?
Use of an isolated patient circuit and an isolating capacitor.
How is electrical equipment classified?
Electrical equipment is classified by its protection from mains electricity and allowable leakage current into Class I (earthed), Class II (double insulated), and Class III (battery-operated).
What factors affect laminar flow according to the Hagen–Poiseuille equation?
Flow is proportional to the pressure drop and radius to the power of 4, and inversely proportional to the length of the tube and viscosity of the fluid.
What is the overall power generated by bipolar diathermy?
Approximately 40 watts.
How does boiling point change with pressure?
The boiling point increases with pressure.
What does a diode do?
Allows current to flow in one direction only.
What is the signal to noise ratio?
A measure of the performance of the system, comparing the amount of noise introduced to the signal.
Why is biphasic defibrillation advantageous?
It lowers the electrical threshold for successful defibrillation, allowing lower energy levels to be used and reducing the risk of burns and myocardial damage.
How does diathermy interfere with monitoring devices?
It interferes with pulse oximetry, ECG, and oesophageal Doppler.
What is a microshock?
Microshocks occur due to the passage of current directly to the myocardium, often from small leakage currents through central lines or pacing wires.
Why is the diathermy pad checked at the end of surgery?
To ensure the current density is low enough to prevent injury and burns.
What is the triple point of water in Kelvin?
273.16 K.
What precautions should be taken to minimize risks when using a defibrillator?
Only trained personnel should deliver shocks, ensure all personnel are standing clear, maintain and check the defibrillator regularly, and have dry surroundings.
Why are amplifiers used in biological signal processing?
Because biological signals are often very small and need to be amplified for display.
What is noise in the context of amplification?
Unwanted signal that is amplified along with the desired signal.
What causes surface tension in a liquid?
The net inward force experienced by particles at the surface due to surrounding particles.