Mindray wato ex 35 руководство

Наркозный аппарат Mindray WATO EX-35

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Русский

Стандрат электропитания (Europe)

Стандарт исполнения European (ID)

Стандарт ввода газовых коммуникаций в аппарат NIST-2

Стандарт шлангов высокого давления Ger (Gas hose mode)

Привод от встроенного компрессора

Стандартный вариант

WATO EX-35 базовая стойка, включая:
цветной сенсорный дисплей с диагональю 10.4 дюйма,
анестезиологический вентилятор с дыхательным объёмом(TV) 20-1500 мл в режиме VCV,
каскадные ротаметры с защитой от гипоксии,
рабочая поверхность анестезиолога,
3 или 1 выдвижных ящика(все закрывается на ключ),
1 батарея (90 мин), шланги высокого давления,
полное руководство пользователя,
упаковочный материал

Режим вентиляции с контролем по давлению (PCV)

Состав комплекта

• Page 1
  WATO EX-65 Anesthesia Machine Operator’s Manual…
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  Revision 1.0 is the initial release of the document. Revision number: Release time: 2009-1 © Copyright 2009 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. All rights reserved. WARNING Federal Law (USA) restricts this device to sale by or on the order of a physician.
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  WATO are the registered trademarks or trademarks owned by Mindray in China and other countries. All other trademarks that appear in this manual are used only for editorial purposes without the intention of improperly using them. They are the property of their respective owners.
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  Manufacturer’s Responsibility All information contained in this manual is believed to be correct. Mindray shall not be liable for errors contained herein nor for incidental or consequential damages in connection with the furnishing, performance, or use of this manual. Mindray is responsible for the effects on safety, reliability and performance of this product…
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  Return Policy In the event that it becomes necessary to return a unit to Mindray, follow the instructions below. Return authorization. Contact the Customer Service Department and obtain a Customer Service Authorization number. This number must appear on the outside of the shipping container. Returned shipments will not be accepted if the number is not clearly visible.
• Page 7
  Preface Manual Purpose This manual contains the instructions necessary to operate the product safely and in accordance with its function and intended use. Observance of this manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety. This manual is based on the maximum configuration and therefore some contents may not apply to your product.
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  FOR YOUR NOTES…
• Page 9
  Contents 1 Safety ……………………..1-1 1.1 Safety Information ………………….1-1 1.1.1 Dangers ………………….1-2 1.1.2 Warnings………………….1-2 1.1.3 Cautions ………………….1-3 1.1.4 Notes ……………………1-4 1.2 Equipment Symbols ………………….1-5 2 The Basics ……………………. 2-1 2.1 System Description ………………….2-1 2.1.1 Intended Use…………………..
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  4.4.3 Volume Control Ventilation (VCV)…………..4-5 4.4.4 Pressure Control Ventilation (PCV) …………..4-8 4.4.5 Synchronized Intermittent Mandatory Ventilation (SIMV)…….4-11 4.4.6 Pressure Support Ventilation (PSV) …………..4-17 4.5 Start Mechanical Ventilation ………………4-21 4.6 Set the Timer ……………………. 4-22 4.6.1 Start the Timer………………..4-22 4.6.2 Stop the Timer ………………..
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  6.6.1 Without O2 Sensor ………………… 6-5 6.6.2 With O2 Sensor ………………..6-7 6.7 Vaporizer Back Pressure Test ………………6-8 6.8 Breathing System Tests ………………..6-9 6.8.1 Bellows Test ………………….. 6-9 6.8.2 Breathing System Leak Test in Mechanical Ventilation Status ……6-10 6.8.3 Breathing System Leak Test in Manual Ventilation Status……..6-11 6.8.4 APL Valve Test ………………..6-11 6.9 Alarm Tests……………………
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  8.3.7 Calibrate the Sensor ………………. 8-7 8.4 Use a Microstream CO2 Module ………………8-8 8.4.1 Prepare to Measure CO2 ………………8-8 8.4.2 Make CO2 Settings ……………….. 8-8 8.4.3 Measurement Limitations………………8-11 8.4.4 Scavenge the Sample Gas ……………..8-11 8.4.5 Zero the Sensor ………………..8-12 8.4.6 Calibrate the Sensor ………………
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  10.9 Set BIS Smoothing Rate………………..10-7 10.10 Restore Defaults ………………….10-7 10.11 Set BIS Related Waveforms ………………10-8 11 Alarms ……………………..11-1 11.1 Introduction ……………………11-1 11.1.1 Alarm Categories…………………11-1 11.1.2 Alarm Levels ………………..11-2 11.2 Alarm Indicators………………….11-2 11.2.1 Alarm Lamp…………………11-2 11.2.2 Audible Alarm Tones………………11-3 11.2.3 Alarm Message………………..11-3 11.2.4 Flashing Alarm Numeric ……………..11-3 11.2.5 Alarm Status Symbols ………………11-3…
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  13.2 Install the Breathing Tubes………………13-19 13.3 Install the Manual Bag ………………..13-20 13.4 Install the Vaporizer ………………..13-21 13.4.1 Assemble the Vaporizer …………….13-21 13.4.2 Fill the Vaporizer………………13-25 13.4.3 Drain the Vaporizer ………………13-27 13.5 Install/Replace the Gas Cylinder…………….13-29 13.6 Install Modules………………….
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  14.3.7 Sodalime Canister ………………14-19 14.3.8 Breathing Tubes and Y Piece……………. 14-20 14.3.9 Flow Sensor………………..14-20 14.3.10 O2 Sensor ………………..14-21 14.3.11 AGSS Transfer and Receiving System …………14-21 15 Accessories ……………………15-1 A Theory of Operation………………….. A-1 A.1 Pneumatic Circuit System ………………… A-1 A.2 Electrical System Structure ……………….
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  FOR YOUR NOTES…
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  Safety 1.1 Safety Information DANGER Indicates an imminent hazard that, if not avoided, will result in death or serious injury. WARNING Indicates a potential hazard or unsafe practice that, if not avoided, could result in death or serious injury. CAUTION Indicates a potential hazard or unsafe practice that, if not avoided, could result in minor personal injury or product/property damage.
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  1.1.1 Dangers There are no dangers that refer to the product in general. Specific “Danger” statements may be given in the respective sections of this manual. 1.1.2 Warnings WARNING Before putting the system into operation, the operator must verify that the equipment, connecting cables and accessories are in correct working order and operating condition.
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  WARNING Use appropriate electrodes and place them according to the instructions provided by the manufacturer. The display restores to normal within 10 seconds after defibrillation. 1.1.3 Cautions CAUTION To ensure patient safety, use only parts and accessories specified in this manual. At the end of its service life, the equipment, as well as its accessories, must be disposed of in compliance with the guidelines regulating the disposal of such products.
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  1.1.4 Notes NOTE Put the equipment in a location where you can easily see the screen and access the operating controls. Keep this manual close to the equipment so that it can be obtained conveniently when needed. The software was developed in compliance with IEC 60601-1-4. The possibility of hazards arising from software errors is minimized.
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  1.2 Equipment Symbols Attention: Consult accompanying documents (this Dangerous voltage manual) Alternating current Fuse Battery Equipotential Operating state Autoclavable Material description Not autoclavable Power On Power Off Reset Standby Alarm silence key MV&TVe alarm key Normal screen key flush button ACGO On ACGO Off Bag position/ manual…
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  VGA connector supply connector Table top light AGSS outlet Cylinder PEEP outlet Manufacture date Vaporizer Manufacturer Isolation transformer European community Serial number representative APL valve CAUTION HOT Maximum level of the Lock or unlock as the sodalime canister arrow shows Gas input direction Unlock the lifting device Lock the lifting device…
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  The Basics 2.1 System Description 2.1.1 Intended Use The anesthesia machine is intended to provide breathing anesthesia for adult, pediatric and infant patients during surgery. The anesthesia machine must only be operated by qualified anesthesia personnel who have received adequate training in its use. WARNING This anesthesia machine is intended for use by qualified anesthesia personnel only or under their guidance.
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  2.1.3 Components The anesthesia machine consists of a main unit, vaporizer (five optional anesthetic agents: enflurane, isoflurane, sevoflurane, desflurane and halothane), anesthetic ventilator, electronic flowmeter assembly, breathing system etc. The anesthesia machine provides monitoring and displaying of respiratory mechanics (RM) parameters (airway resistance and compliance) and spirometry loops as well.
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  2.2 Equipment Appearance 2.2.1 Front View ——Display and control panel…
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  Brake Pipeline pressure gauge (s) Displays the pipeline pressure or the cylinder pressure after relief. Total flowmeter The medium level of flowtube float indicates the current flow of the mixed gas. Flow control (s) When the system switch is set to the ON position: Turn the control counterclockwise to increase the gas flow.
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  ——Breathing system…
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  sensor connector Inspiration connector Expiration connector Inspiratory check valve Expiratory check valve Bellows housing Sample gas return port (to the AGSS) Manual bag port Bag/mechanical ventilation switch Select the position to use bag for manual ventilation. Select the position to use ventilator for mechanical ventilation. 10.
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  2.2.2 Rear View ——Power supply…
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  Cylinder connector (s) Equipotential stud Mains inlet Network connector CIS 12 V power supply connector Speaker Auxiliary O2 supply ACGO (Auxiliary Common Gas Outlet) switch Set the switch to the position to stop mechanical ventilation. Then, fresh gas is sent to the externally connected manual breathing system through the ACGO outlet and the technical alarm of [ACGO On] is triggered.
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  ——Anesthesia information system (CIS)
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  This rear view is based on the situation that the anesthesia machine is configured with anesthesia information system (CIS). Display Rail Mounting bracket Keyboard CIS main unit A. Reset key : Press to restart the CIS. CIS switch : Press to switch on/off the CIS. USB connector D.
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  WARNING Connect to the AC mains in compliance with B.3 Power Requirements. Failure to do so may cause damage to the equipment or affect its normal operation. Make sure that the jacket on the electrical outlet is already fixed to avoid power cord off during surgery.
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  2.3 Batteries NOTE Use batteries at least once every month to extend their life. Charge the batteries before their capacities are worn out. Inspect and replace batteries regularly. Battery life depends on how frequent and how long it is used. For a properly maintained and stored lithium battery, its life expectancy is approximately 3 years.
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  System Controls and Basic Settings 3.1 Display Control Alarm lamp High level alarms: the lamp quickly flashes red. Medium level alarms: the lamp slowly flashes yellow. Low level alarms: the lamp turns yellow without flashing. Menu shortcut key(s) Push the menu shortcut key to access the corresponding menu. Control knob Push the control knob to select a menu option or confirm your setting.
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  MV&TVe alarm key In case of manual ventilation mode: Push the key to switch off MV and TVe overrange alarms and apnea alarm. Push the key again to switch on MV and TVe overrange alarms and apnea alarm. In case of mechanical ventilation mode: Push the key to switch off MV and TVe overrange alarms.
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  3.2 Display Screen This anesthesia machine adopts a high-resolution color TFT LCD to display various parameters and graphs, such as ventilation parameters and pressure/flow/volume waveforms. Depending on how your anesthesia machine is configured, it may display gas module parameters and waveforms, BIS parameters, BIS trend waveform, spirometry loops etc.The following is a standard display screen.
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  Physiological alarm area Displays physiological alarm messages. Apnea alarm off icon area Displays apnea alarm off icon when apnea alarm is switched off in non-mechanical ventilation mode. Alarm silence icon area Displays alarm silence icon and 120 s countdown time. System time area Displays system time of the anesthesia machine.
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  Displays information about system operating state. 18 Parameter&graph area Displays the parameters, waveforms, spirometry loops, or electronic flowmeter graphs which the anesthesia ventilator, gas module or BIS module monitors. Different types of screens are displayed based on the actual system configuration or screen layout settings. For details, refer to 5 User Interface and Parameter Monitoring.
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  3.3.3 Set System Time Select the [Maintenance] shortcut key → [User Maintenance >>] → [Set System Time >>]. Set [Date] and [Time]. Select [Date Format] and toggle between [YYYY-MM-DD], [MM-DD-YYYY] and [DD-MM-YYYY]. Select [Time Format] and toggle between [24 h] and [12 h]. CAUTION Changing date and time will affect the storage of trends and log information.
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  Select [Ok] from the pop-up menu. After [Ok] is selected, the following settings restore their default values: User screen Ventilator parameters Alarm limits of ventilator-related parameters O2 monitoring source Alarm sound volume and key sound volume Screen brightness Paw display unit 3.3.6.2 Restore the Factory Default Configuration of the Gas Module If the anesthesia machine is configured with CO or AG module, you can directly restore the…
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  FOR YOUR NOTES…
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  Operations and Ventilation Setup WARNING Before using this anesthesia machine on the patient, make sure that the system is correctly connected and in good condition, and that all the tests described in 6 Preoperative Test are already completed. In case of test failure, do not use the system.
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  4.3 Input Fresh Gas 4.3.1 Set O O and Air Inputs Connect the gas supplies correctly and ensure adequate gas pressure. You can control the O O and Air flows in the fresh gas through the O O and Air flow controls.
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  4.3.2 Set Anesthetic Agent NOTE You do not need to perform this operation if inspiratory anesthetic agent is not used. This anesthesia machine can be mounted with vaporizers corresponding with halothane, enflurane, isoflurane, sevoflurane and desflurane. Only one of the five vaporizers can be opened at a time because the vaporizers are featured with interlock.
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  4.4 Set Ventilation Mode 4.4.1 Set Manual Ventilation Mode Turn the APL valve control to adjust the pressure in the breathing system within the appropriate range. Set the bag/mechanical ventilation switch to the position. The ventilation mode prompt area displays the icon for manual ventilation mode. Besides, the system prompt message area displays [Manual Vent.].
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  NOTE When using the anesthesia machine on the patient, make sure that manual ventilation mode is available. 4.4.2 Make Settings before Starting Mechanical Ventilation Mode Make sure that the system is Standby. Set the appropriate Plimit value in the parameter setup shortcut keys area. Check the ACGO switch to make sure that it is OFF.
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  To ensure the set tidal volume gas delivery, the ventilator adjusts gas flow based on the measured inspiratory volume, dynamically compensates for the loss of tidal volume arising from breathing system compliance and system leakage and eliminates the effect of fresh gas as well.
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  NOTE When it is necessary to switch over to VCV mode, confirm the setting of TV first. Otherwise, the system works in the previous ventilation mode. If the setting of TV is not confirmed for 10 s, the screen returns to the previous mode automatically. Before activating a new mechanical ventilation mode, make sure that all related parameters are set appropriately.
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  NOTE If the parameter value is adjusted outside of the range, the system prompt message area displays [Parameter Settings Outside the Safety Range]. Confirm the adjustment of one parameter before adjusting another parameter. If you want to restore the value before adjustment, you have to reset the parameter value.
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  4.4.4.2 Waveforms The following figures show the Paw waveform and flow waveform in the PCV mode. Generally, in the PCV mode, the Paw waveform rises sharply during inspiration and stays at the plateau for a relatively long time without peak. The flow waveform declines in the same period.
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  4.4.4.4 Parameter Setup Shortcut Keys Area in PCV Mode When selection of PCV mode is confirmed, the parameter setup shortcut keys area at the bottom of the screen is automatically switched over to the parameter setup area in this mode. The following figure shows all related parameters to be set in PCV mode.
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  4.4.4.6 Parameter Range and Default Value in PCV Mode Parameter Range Step Default Pinsp 5 to 60 cmH2O 1 cmH2O 15 cmH2O Rate 4 to 100 BPM 1 BPM 12 BPM 4:1 to 1:8 Plimit 10 to 100 cmH2O 1 cmH2O 30 cmH2O PEEP OFF, 4 to 30 cmH2O…
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  4.4.5.2 Waveforms SIMV-VC: The following figures show the Paw waveform and flow waveform in the SIMV-VC mode. 【SIMV-VC】+【PSV】 SIMV-PC: The following figures show the Paw waveform and flow waveform in the SIMV-PC mode. 【SIMV-PC】+【PSV】 4-12…
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  4.4.5.3 Start SIMV Mode You can select [SIMV-VC] or [SIMV-PC] as required. To start SIMV-VC, do as follows: Select the [Vent Mode] shortcut key to open the [Vent Mode Setup] menu. Select [SIMV-VC >>] in the [Vent Mode Setup] menu. Select [Ok] directly in the [SIMV-VC Setup] menu.
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  4.4.5.4 Parameter Setup Shortcut Keys Area in SIMV Mode When selection of SIMV mode is confirmed, the parameter setup shortcut keys area at the bottom of the screen is automatically switched over to the parameter setup area in this mode. The specific parameters vary depending on SMIV modes, namely, SIMV-VC and SIMV-PC.
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  NOTE When SIMV mode, either SIMV-VC or SIMV-PC, is selected, pressure support ventilation (PSV) mode is used for triggering outside of the trigger window. Therefore, you also need to set the parameters in PSV mode appropriately, [Psupp], [Finsp] and [PSV Insp Termination Level]. 4.4.5.5 Set Parameters in SIMV Mode Similar to setting the parameters in VCV and PCV modes, you can use the shortcut keys and control knob to set the parameters in SIMV mode.
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  [Trigger Level] In the SIMV-VC mode, select the [Vent Mode] shortcut key → [SIMV –VC >>] → [Trigger Level]. Or, in the SIMV-PC mode, select the [Vent Mode] shortcut key → [SIMV-PC >>] → [Trigger Level]. Or, in the PSV mode, select the [Vent Mode] shortcut key →…
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  4.4.5.6 Parameter Range and Default Value in SIMV Mode Parameter Range Step Default SIMV mode 20 to 100 ml: 5 ml SIMV-VC 20 to 1500 ml 100 to 300 ml: 10 ml 300 to 1500 ml: 25 ml Pinsp 5 to 60 cmH2O 1 cmH2O 15 cmH2O SIMV-PC…
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  When PSV mode is applied alone, the PCV backup mode is available. If within the preset time (Backup Mode Active), no spontaneous breathing occurs or spontaneous breathing is not strong enough to reach Trigger Level, the PCV backup mode is activated automatically when the time for Backup Mode Active is up to enable mechanical ventilation forcibly.
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  4.4.6.4 Parameter Setup Shortcut Keys Area in PSV Mode When selection of PSV mode is confirmed, the parameter setup shortcut keys area at the bottom of the screen is automatically switched over to the parameter setup area in this mode. The following figure shows all related parameters to be set in PSV mode.
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  In PSV mode, you also need to set: [Trigger Level] Select the [Vent Mode] shortcut key → [PSV >>] → [Trigger Level]. Select [Pressure] or [Flow] for trigger type. Turn the control knob to set [Trigger Level] to the appropriate value. Push the control knob to confirm the setting.
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  4.4.6.6 Parameter Range and Default Value in PSV Mode Parameter Range Step Default Ventilation mode Pinsp 5 to 60 cmH2O 1 cmH2O 15 cmH2O (backup ventilation mode) Rate 4 to 60 BPM 1 BPM 10 BPM 4 to 100 BPM 1 BPM 12 BPM Finsp…
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  4.6 Set the Timer 4.6.1 Start the Timer To start the timer, select the timer setup shortcut key and select [Start]. NOTE During timing, if you select [Start] from the [Timer Setup] menu again, timing continues normally instead of restart. 4.6.2 Stop the Timer To stop the timer, select the timer setup shortcut key and then [Stop].
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  4.7 Stop Mechanical Ventilation To stop mechanical ventilation, do as follows: Make sure that the breathing system is set up and the APL valve is set properly before stopping mechanical ventilation. The APL valve adjusts the breathing system pressure limit during manual ventilation. Its scale shows approximate pressure.
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  FOR YOUR NOTES 4-24…
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  User Interface and Parameter Monitoring 5.1 Screen Layout Depending on module and functional configurations, user screens differ in parameter&graph area and parameter setup shortcut keys area. User screens fall into four categories: Standby screen Normal screen Big numerics screen Measured values screen The standby screen is switched over through the Standby key on the panel.
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  5.1.1 Standby Screen When the anesthesia machine is not in use for a short period of time, entering standby status can help save power and extend service life of the machine. The anesthesia machine enters standby status automatically after start-up. To enter standby status, you can also push the key in operating mode and then select [Ok] from the pop-up menu.
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  5.1.2 Normal Screen On the normal screen, parameter/graph area and waveform area are divided. Parameter/graph area Waveform area The structure of these two areas varies depending on the configurations. 5.1.2.1 Parameter&graph Area This area displays parameters and spirometry loops or electronic flowmeters as well. The parameter&graph combinations displayed vary depending on the configurations.
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  5.1.3 Special Screen Special screen includes big numerics screen and measured values screen. The screen layout Parameter&graph Big numerics/measured area values sharing area 5.1.3.1 Parameter&graph Area This area may display: CO2 parameters AG parameters BIS parameters Electronic flowmeters For details, refer to the respective sections of this chapter. 5.1.3.2 Big Numerics/Measured Values Sharing Area This area displays either big numerics or measured values.
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  When screen layout is set to measured values screen, this area displays Paw waveform and ventilation parameters as shown below. 5.2 Screen Setup To set the desired screen style, Select the [Screens] shortcut key and select [Screens]. You can toggle between [Normal Screen], [Big Numerics] and [Measured Values]. 5.3 Parameter Monitoring 5.3.1 O2 Concentration Monitoring If your anesthesia machine is configured with an O2 sensor, select [Maintenance] →…
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  5.3.1.2 Set FiO2 Alarm Limits Select the [Alarm Setup] shortcut key and select [Ventilator >>]. Set FiO2 high and low alarm limits in the [Ventilator Alarm Limits] menu. When the measured FiO2 exceeds the alarm limit, an alarm is generated. Select to exit the current menu.
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  5.3.1.4 Display O2 Waveform If the AG module which your anesthesia machine is configured with incorporates an O2 module, an O2 waveform is displayed as shown below. 5.3.2 Anesthetic Agent (AA) Concentration Monitoring If your anesthesia machine is configured with AG module, you can monitor FiAA and EtAA by setting up the AG module.
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  NOTE As required by the relevant international rules and regulations, anesthetic agent concentration monitoring needs to be performed when the anesthesia machine is used on the patient. If your anesthesia machine is not configured with such monitoring function, use a qualified monitor for anesthetic agent concentration monitoring.
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  5.3.3.3 Other Settings For details, refer to 8CO2 Monitoring and 9AG and O2 Concentration Monitoring. NOTE As required by the relevant international rules and regulations, CO2 concentration monitoring needs to be performed when the anesthesia machine is used on the patient.
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  Select to exit the current menu. Set waveform scale. The Paw waveform scale is automatically adjusted based on the set Plimit. You can set the Paw waveform scale appropriately by setting Plimit. 5.3.4.4 Set Paw Unit Select the [Maintenance] shortcut key and select [User Maintenance >>]. Select [Paw Unit] and toggle between [cmH2O], [hPa] and [mbar].
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  If your anesthesia machine is not configured with CO2 or AG module, tidal volume and breath rate related parameters are displayed as shown below. [MV]: Minute ventilation [TVe]: Expired tidal volume [Rate]: Breath rate [FiO2]: Fraction of inspired oxygen 5.3.5.2 Display Flow Waveform 5.3.5.3 Set Flow Waveform Select the flow waveform area to access the [Flow Waveform Setup] menu.
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  5.3.5.4 Set MV and TVe Alarm Limits Select the [Alarm Setup] shortcut key and select [Ventilator >>]. Set MV high and low alarm limits in the [Ventilator Alarm Limits] menu. Set TVe high and low alarm limits as required. Select to exit the current menu.
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  5.3.7 Volume Monitoring 5.3.7.1 Display Volume Waveform 5.3.7.2 Set Volume Waveform Select the waveform area to access the waveform setup menu. Select [Waveform] and select [Volume]. Select [Sweep] and toggle between [6.25 mm/s] and [12.5 mm/s]. The greater the value is, the faster the waveform sweeps.
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  5.3.9 BIS Monitoring 5.3.9.1 Display BIS Parameters If your anesthesia machine is configured with BIS module, on the normal screen, BIS related parameters are displayed as shown below. [BIS]: Bispectral index [SQI]: Signal quality index [EMG]: Electromyograph If your anesthesia machine is configured with BIS module, on the special screen, BIS related parameters are displayed as shown below.
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  5.3.9.2 Display BIS EEG Waveform If your anesthesia machine is configured with BIS module, BIS EEG and BIS Trend waveforms are displayed as shown below. BIS EEG waveform: BIS Trend waveform: 5.3.9.3 Set BIS EEG Waveform Select the waveform area to access the waveform setup menu. Select [Waveform] and select [BIS EEG].
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  5.4 Display Electronic Flowmeter Gas flow can be displayed either in a standard-resolution mode or high-resolution mode. These two resolution modes vary in scale and accuracy. Switchover between the standard-resolution mode and the high-resolution mode can be performed manually based on gas flow. The default is high-resolution mode. The scale range of the standard-resolution mode is 0 to 10 L/min and that of the high-resolution mode 0 to 6 L/min.
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  Preoperative Test 6.1 Preoperative Test Schedules 6.1.1 Test Intervals Perform the preoperative tests listed below at these events: Before each patient. When required after a maintenance or service procedure. The following table indicates when a test must be done. Test Item Test Intervals Every day before the first patient Pipeline tests…
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  6.2 Inspect the System NOTE Make sure that the breathing system is correctly connected and not damaged. The top shelf weight limit is 30 kg. Make sure that: The anesthesia machine is undamaged. All components are correctly attached. The breathing system is correctly connected, and the breathing tubes are undamaged. The vaporizers are locked in position and contain sufficient agent.
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  Make sure that the AC mains indicator is illuminated and the battery indicator stops flashing and continues illuminated. Meanwhile, the prompt message [Battery in Use] disappears. Set the system switch to the position. 6.4 Pipeline Tests NOTE Do not leave gas cylinder valves open if the pipeline supply is in use. Cylinder supplies could be depleted, leaving an insufficient reserve supply in case of pipeline failure.
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  6.4.2 N2O Pipeline Test Connect an O supply before doing the N O pipeline test. For details, refer to 6.4.1O2 Pipeline Test NOTE When doing the N O pipeline test, connect O supply first to enable N O flow control. Different from O pipeline supply, when N O supply is disconnected, no alarms…
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  6.5.2 O2 Cylinder High Pressure Leak Test Set the system switch to the position and stop O pipeline supply. Turn off the O flowmeter. Open the O cylinder valve. Record the current cylinder pressure. Close the O cylinder valve. Record the cylinder pressure after one minute. If the cylinder pressure decreases more than 5000 kPa (725 psi), there is a leak.
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  NOTE After doing the cylinder tests, close all cylinder valves if cylinder supplies are not used. Turn the flow controls slowly. Do not turn further when the flow indicated on the flowmeter is outside of the range to avoid damaging the control valve. When the flow control is turned to the minimum, the reading indicated on the flowmeter should be zero.
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  NOTE When O supply is disconnected, alarms for [O2 Supply Failure] and [Drive Gas Pressure Low] occur as O pressure decreases. Set the system switch to the position. 6.6.2 With O2 Sensor Do as described in 6.9.2 Test the O2 Concentration Monitoring and Alarms before testing. To do the flow control system tests: Connect the pipeline supplies or slowly open the cylinder valves.
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  Make sure that the N O flow decreases. The measured O concentration must be ≥21% through the full range. Disconnect the O pipeline supply or close the O cylinder valve. Make sure that: O and O flows stop. The O flow stops last.
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  NOTE Do not perform test on the vaporizer when the concentration control is between “OFF” and the first graduation above “0” (zero) as the amount of anesthetic drug outputted is very small within this range. 6.8 Breathing System Tests WARNING Objects in the breathing system can stop gas flow to the patient.
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  6.8.2 Breathing System Leak Test in Mechanical Ventilation Status NOTE Breathing system leak test must be performed when the system is in standby status. Before doing the breathing system leak test, make sure that the breathing system is correctly connected and the breathing tubes not damaged. Make sure that the system is Standby.
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  6.8.3 Breathing System Leak Test in Manual Ventilation Status Make sure that the system is Standby. If not, press the key and select [Ok] from the pop-up menu to enter standby status. Set the bag/mechanical ventilation switch to the bag position. Connect the manual bag to the manual bag port.
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  6.9 Alarm Tests The anesthesia machine performs a self test after started. The alarm lamp flashes yellow and red once in turn and then a beep is given. Then the display shows the start-up screen and enters the standby screen after 30 seconds. This means that audio and visual alarm indicators begin to work normally.
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  6.9.2 Test the O2 Concentration Monitoring and Alarms NOTE This test is not required if no O sensor is configured. Set the bag/mechanical ventilation switch to the bag position. Remove the O sensor. After two to three minutes, make sure that the sensor measures approximately 21% O in room air.
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  6.9.4 Test the Apnea Alarm Connect the manual bag to the manual bag port Set the bag/mechanical ventilation switch to the bag position. Turn the APL valve control to set the APL valve to the minimum position. 4. Inflate the manual bag to make sure that a complete breathing cycle occurs. Stop inflating the manual bag and wait for more than 20 seconds to make sure that the apnea alarm occurs.
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  6.9.7 Test the Low Paw Alarm Set the bag/mechanical ventilation switch to the mechanical position. Select the [Alarm Setup] shortcut key and then [Ventilator >>]. Set the Paw low alarm limit to 2 cmH Disconnect the manual bag from the Y piece patient connection. Wait for 20 seconds.
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  WARNING Before connecting a patient, flush the anesthesia machine with 5 L/min of O for at least one minute. This removes unwanted mixtures and by-products from the system. 6.11 Inspect the AGSS Assemble the AGSS as described in 13.10.2Assemble the AGSS and then turn on the waste gas disposal system.
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  User Maintenance 7.1 Repair Policy WARNING Only use lubricants approved for anesthesia or O equipment. Do not use lubricants that contain oil or grease. They burn or explode in high O concentrations. Obey infection control and safety procedures. Used equipment may contain blood and body fluids.
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  7.2 Maintenance Schedule NOTE These schedules are the minimum frequency based on typical usage of 2000 hours per year. You should service the equipment more frequently if you use it more than the typical yearly usage. Minimum Maintenance frequency Clean the external surfaces. Daily 21%O2 calibration (O sensor in breathing system).
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  7.3 Breathing System Maintenance When cleaning the breathing system, replace any parts that are visibly cracked, chipped, distorted or worn. For details, refer to 13 Installations and Connections and 14 Cleaning and Disinfection. 7.4 Flow Sensor Calibration NOTE Do not perform calibration while the unit is connected to a patient. During calibration, do not operate the pneumatic parts.
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  Plug the Y piece into the leak test plug to close the breathing system. Remove the water collection cup. For details, refer to 14.2.11 Water Collection Cup. Make sure that the system is Standby. If not, press the key and then select [Ok] from the pop-up menu to enter standby status.
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  NOTE In case of calibration failure, check for sensor malfunctioning alarm and then troubleshoot it if there is. If it still fails or great measurement error occurs after calibration, select [Defaults] to restore the factory default calibration values. If the measurement error is still great, replace the flow sensor and repeat the above operation.
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  To calibrate at 21% O , do as follows: Make sure that the system is Standby. If not, press the key and then select [Ok] from the pop-up menu to enter standby status. Select the [Maintenance] shortcut key → [O2 Sensor Cal. >>] → [21% O2 Cal. >>] to open the [O2 21% Cal.] menu.
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  Position the patient O sensor connector to the air. Turn on ACGO. Turn on the O inlet and adjust the flow above 8 L/min. Turn off other gas supplies. After two to three minutes, select [Start] from the menu to start to calibrate at 100% O The screen prompts [Calibrating].
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  7.6.2 Clear Water Build-up The water built up inside the flow sensor will result in inaccurate measured value of tidal volume and trigger the [TV Comp Disabled] alarm. If there is water built up inside the flow sensor, remove the sensor and clear the water. Then reinstall the sensor for use.
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  Use a screwdriver to adjust the zeroing screw, letting the pressure gauge pointer go to zero. Zeroing point Set the bag/mechanical ventilation switch to the mechanical position. Plug the Y piece into the leak test plug to close the breathing system. Push the O2 flush button repeatedly to sweep the pointer across the pressure gauge.
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  7.8 AGSS Transfer Tube Maintenance Check the tube of the AGSS transfer system. Replace it if it is damaged. 7-10…
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  CO2 Monitoring 8.1 Introduction monitoring is a continuous, non-invasive technique for determining the concentration of in the patient’ airway by measuring the absorption of infrared (IR) light of specific wavelengths. The CO has its own absorption characteristic and the amount of light passing the gas probe depends on the concentration of the measured CO When a specific band of IR light is passed through respiratory gas samples, some of IR light will be absorbed by the CO…
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  8.2 Identify CO2 Module Sidestream CO module, microstream CO module and mainstream CO module are shown below from left to right. setup key Measure/standby key Gas outlet watertrap fixer Sampling tube connector sensor connector If you measure CO using AG module, refer to 9 AG and O2 Concentration Monitoring…
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  8.3 Use a Sidestream CO2 Module NOTE This section is only applicable to the anesthesia machine configured with sidestream CO2 module. 8.3.1 Prepare to Measure CO2 Attach the watertrap to the watertrap fixer and then connect the CO2 components as shown below.
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  CAUTION The watertrap collects water drops condensed in the sampling line and therefore prevents them from entering the module. If the collected water reaches a certain amount, you should drain it to avoid airway blockage. The watertrap has a filter preventing bacterium, vapor and patient secretions from entering the module.
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  8.3.2.4 Set Gas Compensations WARNING Make sure that the appropriate compensations are used. Inappropriate compensations may cause inaccurate measured values and result in misdiagnosis. Access the [Gas Module Setup >>] menu. Set the following compensations based on the actual conditions: [O2 Comp] [N2O Comp] [Des Comp]…
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  8.3.2.7 Set CO2 Waveform Select the waveform area to access the waveform setup menu. Select [Waveform] and select [CO2]. Select [Sweep] and set waveform sweep speed to an appropriate value. The greater the value is, the faster the waveform sweeps, the wider the waveform is. Select [Scale] and toggle between: [40], [60] and [80] if the unit is mmHg;…
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  8.3.5 Scavenge the Sample Gas Metal chip Exhaust tube To scavenge the sample gas to the waste gas disposal system, depress the metal chip and then plug the exhaust tube to the ports marked (sample gas return to the AGSS) on the anesthesia machine as shown in the above picture.
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  8.4 Use a Microstream CO2 Module NOTE This section is only applicable to the anesthesia machine configured with microstream CO2 module. 8.4.1 Prepare to Measure CO2 Plug the sampling tube into the sampling tube connector and then connect the CO2 components as shown below.
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  8.4.2.1 Set Working Mode The default working mode of the CO2 module is [Measure] when the anesthesia machine is turned on for the first time. If the current CO2 module is Standby, you must push the key or select the [User Setup] shortcut key → [Gas Module Setup >>] → [Working Mode] →…
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  8.4.2.4 Set Maximum Hold In the CO2 parameter area, EtCO2 and FiCO2 values are refreshed in real-time. To set EtCO2 and FiCO2: Access the [Gas Module Setup >>] menu. Select [Max Hold] and select: [Single Breath]: EtCO and FiCO are calculated based on each breath. [10 s], [20 s] and [30 s]: EtCO and FiCO2 refer to the highest and the lowest CO2 values measured respectively within the configured time period (10 s, 20 s or 30 s).
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  8.4.3 Measurement Limitations Measurement accuracy may degrade due to: Leakage or internal leakage of the sample gas. Mechanical shock Cyclic pressure which is greater than 10 kPa (100 cmH2O) Other interference source (if available) 8.4.4 Scavenge the Sample Gas Metal chip Exhaust tube To scavenge the sample gas to the waste gas disposal system, depress the metal chip and then plug the exhaust tube to the ports marked…
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  8.4.5 Zero the Sensor Zeroing the sensor aims to eliminate the effect of baseline drift on the readings during the measurement so as to ensure measurement accuracy. For microstream CO2 module, a zero calibration is carried out automatically when necessary. You can also start a manual zero calibration when deemed necessary.
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  8.5 Use a Mainstream CO2 Module NOTE This section is only applicable to the anesthesia machine configured with mainstream CO2 module. 8.5.1 Prepare to Measure CO2 Connect the sensor to the CO2 module. By default, the mainstream CO2 module is in measure mode. The [CO2 Warmup] message appears on the screen when the CO2 module is plugged in.
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  8.5.2 Make CO2 Settings By selecting the [User Setup] shortcut key and then [Gas Module Setup >>], you can make CO2 settings described below. 8.5.2.1 Set Working Mode The default working mode of the CO2 module is [Measure] when the anesthesia machine is turned on for the first time.
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  [AG Comp]: enters the concentration of anesthetic gas (if there is) in the ventilation gas mixture to compensate for the effect of anesthetic gas upon the readings. The total of the concentrations of O2 compensation and AG compensation cannot be greater than 100%.
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  8.5.3 Measurement Limitations Measurement accuracy may degrade due to: Leakage or internal leakage of the sample gas. Mechanical shock Cyclic pressure which is greater than 10 kPa (100 cmH2O) Other interference source (if available) 8.5.4 Zero the Sensor Zeroing the sensor aims to eliminate the effect of baseline drift on the readings during the measurement so as to ensure measurement accuracy.
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  AG and O2 Concentration Monitoring 9.1 Introduction The anaesthetic gas (AG) module measures the patient’s anesthetic and respiratory gases, and incorporates the features of the O module and BIS module as well. The AG (anesthesia gas) module determines the concentrations of certain gases using the infrared (IR) light absorption measurement.
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  9.2 Understand MAC Values Minimum alveolar concentration (hereinafter referred to as MAC) is a basic index indicating the depth of inhaled anesthesia. The ISO 21647 defines MAC as follows: alveolar concentration of an inhaled anesthetic agent that, in the absence of other anesthetic agents and at equilibrium, prevents 50% of subjects from moving in response to a standard surgical stimulus.
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  9.3 Identify AG Modules There are two types of AG modules available. M-type, which cannot identify anesthesia gas automatically. A-type, which can identify anesthesia gas automatically. AG setup key Measure/standby key Indicator Gas outlet AG watertrap fixer BIS sensor connector For details about BIS, refer to 10 BIS Monitoring.
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  Connect the exhaust tube to the gas outlet on the module to scavenge the sample gas to the waste gas disposal system. AG module Airway adapter Exhaust tube Gas sampling tube Connect to the patient By default, the AG module is in measure mode. The message [AG Startup] appears on the screen when the AG module is plugged in.
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  9.5 Make AG Settings By selecting the [User Setup] shortcut key and then [Gas Module Setup >>], you can make AG settings described below. 9.5.1 Set Anesthetic Agent As M-type AG module cannot identify the type of anesthetic agent automatically, you need to set [Agent] to select the correct type of anesthetic agent before venting the anesthetic agent.
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  When [Working Mode] is set to [Measure], the message [AG Startup] appears on the screen. After start-up is finished, the message [AG Warmup] is displayed. The AG module is in ISO accuracy mode .After warm-up is finished, the .AG module enters full accuracy mode. 9.5.5 Set CO2 Unit In the [Gas Module Setup >>] menu, select [CO2 Unit] and toggle between [mmHg], [%], and [kPa].
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  The A-type AG module can identify anesthetic agent automatically. When one anesthetic agent decreases below the threshold value and another anesthetic agent plays the dominant role, the anesthesia machine can identify such exchange automatically and displays the name and data of the dominant anesthetic agent. 9.7 Measurement Limitations Measurement accuracy may degrade due to: Leakage or internal leakage of the sample gas.
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  9.9 Scavenge the Sample Gas Metal chip Exhaust tube To scavenge the sample gas to the waste gas disposal system, depress the metal chip and then plug the exhaust tube to the ports marked (sample gas return to the AGSS) on the anesthesia machine as shown in the above picture.
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  BIS Monitoring 10.1 Introduction Bispectral index (BIS) monitoring is for use on adult and pediatric patients within a hospital or medial facility providing patient care to monitor the state of the brain by data acquisition of EEG signals. The BIS, a processed EEG variable, may be used as an aid in monitoring the effects of certain anesthetic agents.
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  10.3 Safety Information For patients with neurological disorders, patients taking psychoactive medication, and children under one year of age, BIS values should be interpreted cautiously. WARNING The conductive parts of sensors and connectors should not come into contact with other conductive parts, including earth. To reduce the hazard of burns in the high-frequency surgical neutral electrode connection, the BIS sensor should not be located between the surgical site and the electro-surgical unit return electrode.
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  10.4 Understand BIS Parameters BIS monitoring provides the following parameters for display as shown below. Non-Extend sensor Extend sensor Bispectral Index (BIS) The BIS numeric reflects the patient’s level of consciousness. Typically, it ranges from 40 to 60 for a patient under general anesthesia during surgery. BIS numeric Description The patient is widely awake.
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  Spectral Edge Frequency (SEF) The SEF is the frequency below which 95% of the total power is measured. Total Power (TP) TP numeric which only monitors the state of the brain indicates the power in the frequency band 0.5-30Hz. The useful range is 40-100db. Burst Count (BC) A burst means a period (at least 0.5 second) of EEG activity followed and preceded by inactivity.
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  Connect the BIS sensor to the patient cable. As soon as a valid sensor is detected, the impedances of all electrodes are measured automatically and the impedance value for each electrode is displayed in the sensor check window. CAUTION Do not attach the BISx model to the patient’s skin for a long time. Otherwise, the BISx heats while on the patient and may cause discomfort.
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  10.7 Cyclic Impedance Check This measures the exact impedance of each individual electrode. It causes a disturbed EEG wave, and a prompt message is displayed on the screen. The cyclic impedance check is automatically initiated when a sensor is connected. To manually start a cyclic impedance check manually, you can either: Select [Cyc.
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  Measure electrode impedance Time of the most recent impedance check Start/stop cyclic impedance checks Show sensor information The measured electrode-to-skin impedance and electrode status are displayed above each electrode: Status Description Action [Lead off] Electrode falls off and has no skin Reconnect electrode, or check the contact.
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  10.11 Set BIS Related Waveforms To set BIS EEG waveform: Select the waveform area, open the corresponding menu. Select [BIS EEG] for [Waveform]. Select [Sweep] and set waveform sweep speed to an appropriate value. The greater the value is set to, the faster the waveform sweeps, the wider the waveform is. Select [Scale] and set waveform scale to an appropriate value.
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  Alarms 11.1 Introduction Alarms, triggered by a vital sign that appears abnormal or by technical problems of the anesthesia machine, are indicated to the user by visual and audible alarm indications. NOTE When the anesthesia machine is started, the system detects whether alarm lamp and audible alarm tones function normally.
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  11.1.2 Alarm Levels By severity, the anesthesia machine’s alarms fall into three categories: high level alarms, medium level alarms and low level alarms. High level alarms Indicates that the patient is in a life threatening situation and an emergency treatment is demanded.
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  11.2.2 Audible Alarm Tones The anesthesia machine uses different alarm tone patterns to match the alarm level: High level alarms: triple+double+triple+double beep. Medium level alarms: triple beep. Low level alarms: single beep. 11.2.3 Alarm Message When an alarm occurs, an alarm message will appear in the technical or physiological alarm area.
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  11.3 Set Alarm Volume Select the [User Setup] shortcut key. Select [Screen and Audio Setup >>] and then [Alarm Sound Volume] to select an appropriate value ranging from 1 to 10. The value 1 is for the lowest and 10 for the loudest.
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  11.4.3 Set AG Alarm Limits Select the [Alarm Setup] shortcut key and then [Gas Module >>]. Set [High Limit] and [Low Limit] respectively for each parameter. Select to exit the current menu. 11.4.4 Set BIS Alarm Limits Select the [Alarm Setup] shortcut key and then [Gas Module >>]. Set [High Limit] and [Low Limit] respectively for each parameter.
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  WARNING Take care to set [CPB] to [ON] because some physiological alarms are not triggered under this setting. These disabled physiological alarms include: apnea alarm, Volume Apnea>2 min, Paw too low, TVe too high, TVe too low, MV too high, MV too low, Rate too high, Rate too low, EtCO2 too low, FiCO2 too low, EtN2O too low, FiN2O too low, EtHal too low, FiHal too low, EtEnf too low, FiEnf too low, EtIso too low, FiIso too low, EtSev too low, FiSev too low, EtDes too low and FiDes too low.
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  11.9 Alarm Silence 11.9.1 Set 120 s Alarm Silence Pressing the 120 s alarm silence key will set the system to alarm silenced status. Sound alarm will be disabled. Besides, the alarm silence symbol and 120 s countdown time will appear in the upper right corner of the screen.
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  FOR YOUR NOTES 11-8…
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  Trend and Logbook 12.1 Trend Graph A trend graph is used to review the trend of parameter values within a specific time period. The trend is reflected through a curve. Every point on the curve corresponds to the parameter value at a specific time point. You can review TVe, MV, Ppeak, FiO EtCO , Plat, PEEP, Pmean, Rate and BIS data within a maximum of 24-hour operating time.
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  12.2 Trend Table A trend table is used to recall the patient’s physiological parameter data at a specific time point. The parameter data are reflected through a table. You can recall TVe, MV, Ppeak, FiO EtC0 , Plat, PEEP, Pmean, Rate and BIS data at the selected resolution within a maximum of 24-hour operating time.
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  12.3 Alarm Logbook For alarm logbook, the system provides up to 100 events, which are stored in chronological order. When a new event occurs after 100 events are already stored, the new event overwrites the earliest one. To access the Alarm Logbook window, select the [Maintenance] shortcut key → [Trend and Logbook >>] →…
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  FOR YOUR NOTES 12-4…
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  Installations and Connections WARNING Continuous use of desiccated sodalime may endanger patient safety. Adequate precautions should be taken to ensure that the sodalime in the sodalime canister does not become desiccated. Turn off all gases when finished using the system. When electrosurgical equipment is used, keep the electrosurgical leads away from the breathing system, the O sensor and other parts of the anesthesia machine.
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  13.1.1 Breathing System Diagrams 13-2…
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  Bellows housing Expiration connector Bag arm Inspiration connector Bag/mechanical ventilation switch Water collection cup APL valve Locking hook Inspiratory check valve Drive gas connector Expiratory check valve Guide pin hole Plug for O sensor (O sensor optional) Locking catch retainer Rotary handle Pressure sampling connector(s) Sodalime canister…
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  NOTE The heating module does not work when the anesthesia machine is battery powered. Do not overbear the bag arm, such as depressing it forcibly or hanging heavy objects onto it. When the difference between the reading on the airway pressure gauge and the Paw value displayed is great, please contact us.
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  Push the breathing system into the circuit adapter with force to let the breathing system connected to the adapter seamlessly. Set the locking catches on the circuit adapter to the position and make sure that the breathing system is safely locked. WARNING Set the locking catches to the position after the breathing system is installed…
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  NOTE If it is hard to push the breathing system into or out of the circuit adapter, you need to apply some lubricant (M6F-020003— ： “Dupont Krytox high-performance fluorine lubricating grease”)to the seal on the pneumatic connector to reduce friction. 13.1.4 Install the Bag Arm Align the bag arm with the connector on the breathing system.
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  Turn the locking nut clockwise to tighten the bag arm. 13.1.5 Install the Bellows Attach the bottom ring of the folding bag to the bellows base on the breathing system and make sure that the bag is tightly connected to the base. Folding bag Bellows base Seal…
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  Align the bellows housing bayonet tabs with the slots on the breathing system and then lower the bellows housing. Make sure that the housing is depressing the seal evenly. Hold the bellows housing tightly and turn it clockwise until it stops. Make sure that the side of the housing marked with scale is facing the operator.
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  13.1.6 Install the Flow sensor Make sure that the direction of arrow on the flow sensor is same to that on the breathing system and the side with silkscreen is facing upward. Insert the flow sensor horizontally. Align the inspiration/expiration connectors and their locking nuts with the flow sensor connectors.
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  Tighten the locking nuts clockwise. WARNING Tighten the locking nuts when installing the flow sensor. Failure to do so may result in invalid measurement. Exert care when moving the anesthesia machine to prevent the flow sensor from getting damaged. The end of inspiration/expiration connectors which connects the breathing tube shall be kept downward to prevent condensed water from entering the breathing system.
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  Align the threads of the O sensor with the O sensor connector marked on the breathing system and turn the sensor clockwise to tighten it. Insert one end of the O sensor cable into the sensor jack 13-11…
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  Insert the other end of the O sensor cable into the O sensor connector marked the circuit adapter. 13.1.8 Install the Sodalime Canister WARNING Obey applicable safety precautions. Do not use the sodalime canister with chloroform or trichloroethylene. Disposable sodalime canister is a sealed unit which should not be opened or refilled.
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  WARNING Inspect sodalime color during the surgery or at the end of a case. During non-use, sodalime may go back to the original color. Refer to the sodalime labelling for more information about color changes. Adequate precautions should be taken to ensure that the sodalime in the sodalime canister does not become desiccated.
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  13.1.8.1 Assemble the Sodalime Canister The following figures show the components of a sodalime canister: A. Sodalime Canister support Sodalime canister D. Canister handle Canister support buckle Press the buckle as shown in the figure to remove the canister support. 13-14…
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  Before installing the sodalime canister, inspect the canister mouth, canister support and seal for sodalime particles. If there is, please clear it. Canister seal Canister support Canister mouth Align the sodalime canister with the mounting slot. Canister mounting slot Push the sodalime canister into the mounting slot. 13-15…
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  Turn the rotary handle clockwise for 90 degrees. Let the rotary handle fall to lock the sodalime canister. 13-16…
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  CAUTION Remember to do a breathing system leak test after reinstalling the sodalime canister. 13.1.8.2 Change the Sodalime NOTE A gradual color change of the sodalime in the canister indicates absorption of carbon dioxide. The color change of the sodalime is only a rough indicator. Use carbon dioxide monitoring to determine when to change the sodalime.
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  Pour new sodalime into the sodalime canister. When pouring, prevent the sodalime from falling on the venthole of the canister support, which may increase airway resistance. Install the canister support into the canister. Depress the canister support buckle to lock the canister.
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  NOTE The sodalime which is poured in cannot exceed the level marked on the sodalime canister. 13.2 Install the Breathing Tubes NOTE When installing the breathing tube, hold the tube connector at both ends of the tube to prevent damage of the tube. Do not reuse the filter to prevent cross-contamination.
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  Connect the filter to the Y piece. 13.3 Install the Manual Bag Connect the manual bag to the manual bag port on the breathing system. The anesthesia machine is configured with bag arm: The anesthesia machine is not configured with bag arm: 13-20…
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  13.4 Install the Vaporizer WARNING If the vaporizer is incompatible with the anesthesia machine, the performance of the anesthetic agent in the vaporizer will be degraded. Use the vaporizer matching the anesthesia machine. NOTE For details about how to install and use the vaporizer, refer to the Vaporizer Instructions for Use.
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  Push and turn the locking lever A clockwise to lock the vaporizer in position. Make sure that the top of the vaporizer is horizontal. If not, remove the vaporizer and reinstall it. In case of reinstalling the vaporizer, try to lift each vaporizer straight up off the manifold rather than pulling forward.
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  With a Desflurane vaporizer: Make sure that the vaporizer is connected to an electrical outlet. Plug in the electrical input cable. Push the adapter into the mounting box. 13-23…
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  Lift the hand-pull block, rotate it counterclockwise for 270 degrees and then release it to fix the adapter onto the mounting box. Connect the power cord at the other end of the adapter to the power source. Try to turn on more than one vaporizer at the same time. NOTE For details about how to use the Desflurane vaporizer, refer to Instructions for Use of Desflurane vaporizer.
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  13.4.2 Fill the Vaporizer WARNING Make sure that the correct anesthetic agent is used. The vaporizer is designed with the specific anesthetic agent named on it and further indicated by color coded labelling. The concentration of the anesthetic agent actually output will vary if the vaporizer is filled with the wrong agent.
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  13.4.2.2 Quik-Fil System Check that the vaporizer concentration control is in the off (“0”) position. Remove the protective cap from the anesthetic agent bottle filler, checking that the bottle and filler mechanism are not damaged. Remove the vaporizer filler block cap and insert the bottle nozzle into the filler block. Rotate the bottle to align the bottle filler keys with the slots in the filler block.
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  13.4.3 Drain the Vaporizer WARNING Do not reuse the agent drained from the vaporizer. Treat as a hazardous chemical. 13.4.3.1 Pour Fill System Check that the vaporizer concentration control A is in the 0 (zero) position. Unscrew the filler cap B. Place a bottle marked with the drug name on the vaporizer under the drain tube in the base of the filler block.
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  13.4.3.2 Quik-Fil System NOTE To avoid spillage, check that the bottle to be used for draining has sufficient capacity for the volume of liquid to be drained. WARNING The filler cap must be refitted before using the vaporizer. Remove the protective cap from an empty bottle. Insert the bottle nozzle into the drain funnel.
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  13.5 Install/Replace the Gas Cylinder To install/change a gas cylinder, do as follows: Turn the handle of the cylinder valve clockwise. Close the cylinder valve on the cylinder to be replaced Handle of the cylinder valve Turn the tee handle counterclockwise. Tee handle Fully loosen the tee handle to open the yoke gate.
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  Remove the used cylinder and the used gasket. Gasket Point the cylinder outlet away from all items that can be damaged by a release of high pressure gas. Quickly open and close the cylinder valve. This removes dirt from the cylinder outlet. Install a new gasket.
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  13.6 Install Modules Push the module into the slot with force until you hear a click, indicating the module is installed in place. To remove the module, lift the wrench at the bottom of the module and then drag the module outward. After inserting the module, make sure that the indicator on the module is lit up.
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  13.6.3 Install the BIS Module 13.7 Pneumatic Connectors This anesthesia machine provides two types of connectors —pipeline connectors (for O O and AIR) and cylinder connectors (for O and N For the pipeline connectors, four types of configuration are available: and N and AIR O and AIR…
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  WARNING The anesthesia machine stops gas delivery when the supply gas pressure is lower than 200 kPa. 13.7.1 Connect the Pipeline Gas Supplies The anesthesia machine provides three (O2, N O and AIR) pipeline supply connectors which are connected to three tubes of different colors and cannot be exchanged. Connect the pipeline gas supplies as follows: Check that the seal at the tube connector is in good condition before connecting the gas supply tube.
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  13.8 CIS Connector The anesthesia machine can be connected to an anesthesia information system (CIS), which is to be installed, serviced and updated by Mindray authorized or approved personnel. For details, refer to the Instructions for Use accompanying the CIS.
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  13.10 AGSS Transfer and Receiving System 13.10.1 Components Top cover The AGSS outlet on the top cover is connected with the AGSS active scavenging tube. Filter screen Sight glass Float “MIN” mark AGSS inlet Pressure compensation opening 30 mm male conical connector Hook 10.
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  13.10.2 Assemble the AGSS Mount the AGSS bracket onto the lower left decorative plate of the anesthesia machine. Install M4 socket head screws and spring washers Install fixed pins Mount the AGSS system already equipped with hook onto the AGSS bracket. Connect the 30 mm male conical connector of the transfer tube to the gas inlet of the receiving system.
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  Connect the 30 mm female conical connector of the transfer tube to the AGSS waste gas outlet on the anesthesia machine. NOTE Remove the AGSS transfer and receiving system from the main unit when transporting or moving the anesthesia machine. 13.10.3 Waste Gas Disposal System The AGSS transfer and receiving system is of high flow and low vacuum type, which is in compliance with ISO 8835-3:1997.
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  WARNING This AGSS transfer and receiving system cannot be used with flammable anesthetic agent. Gas inside the AGSS may overflow when the gas flow exceeds 100 mL/min if the tube between the waste gas disposal system and the AGSS is occluded, the extract flow of the waste gas flow system is insufficient, or the waste gas disposal system malfunctions.
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  Cleaning and Disinfection WARNING Obey applicable safety precautions. Read the material safety data sheet for each cleaning agent. Read the operation and service manual for all disinfection equipment. Wear gloves and safety glasses. A damaged O sensor can leak and cause burns (contains potassium hydroxide).
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  NOTE Do not soak synthetic rubber parts for more than 15 minutes. Swelling or faster aging can occur. Only autoclave parts marked 134ºC. Cleaning solutions must have a pH of 7.0 to 10.5. 14.1 Clean and Disinfect the Anesthesia Machine Housing Clean the surface of the anesthesia machine housing with a damp cloth soaked in mild detergent (such as 70% ethanol).
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  14.2.1 O2 Sensor Remove one end of the O sensor cable from the connector on the anesthesia machine. Unplug the other end of the cable from the O sensor. Turn the O sensor counterclockwise to take it out. 14-3…
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  14.2.2 Manual Bag Remove the manual bag from the manual bag port on the breathing system as shown below. The anesthesia machine is configured with bag arm: The anesthesia machine is not configured with bag arm: 14-4…
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  14.2.3 Breathing Tubes NOTE When disassembling the breathing tube, hold the tube connectors at both ends of the tube to prevent damage to the tube. Do not reuse the filter. Follow local regulations regarding disposal of hospital waste when the filter is discarded. Remove the filter from the Y piece.
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  14.2.4 Airway Pressure Gauge Pull off the airway pressure gauge as shown below. 14.2.5 Bag Arm Loosen the locking nut counterclockwise. Remove the bag arm from the breathing system. 14-6…
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  14.2.6 Bellows Assembly Turn the bellows housing counterclockwise. Lift off and remove the housing. Remove the folding bag from the bellows base. 14-7…
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  14.2.7 Flow Sensor Turn the locking nuts counterclockwise. Pull out the inspiration/expiration connectors and their locking nuts. Pull out the flow sensors horizontally. 14-8…
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  14.2.8 Expiratory Check Valve Assembly Turn the check valve cover counterclockwise to remove it. Pull out the check valve. 14.2.9 Inspiratory Check Valve Assembly For details about how to disassemble the inspiratory check valve assembly, refer to 14.2.8 Expiratory Check Valve Assembly. 14-9…
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  14.2.10 Sodalime Canister Hold and pull up the rotary handle for 90 degrees. Turn the rotary handle for 90 degrees counterclockwise. 14-10…
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  Pull off the sodalime canister from the lifting device. To reassemble the canister, refer to 13.1.8 Install the Sodalime Canister. WARNING Sodalime is a caustic substance and is a strong irritant to eyes, skin and respiratory system. Affected parts should be flushed with water. If irritation continues after flushed by water, seek medical assistance immediately.
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  14.2.12 Breathing system Hold the breathing system with one hand. Pull up the locking catches on the circuit adapter with the other hand to unlock it. Remove the breathing system from the circuit adapter with both hands. 14-12…
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  NOTE If it is hard to push the breathing system into or out of the circuit adapter, you need to apply some lubricant to the seal on the pneumatic connector to reduce friction. 14.2.13 AGSS Transfer and Receiving System 14.2.13.1 Filter Turn the nut on the AGSS active scavenging tube counterclockwise to disconnect the tube from the top cover.
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  Take out the nut, fixed plate and filter screen by turn. Fixed plate Filter screen 14.2.13.2 Float Disconnect the waste gas disposal system from the top cover. Rotate the top cover counterclockwise to separate it from the sight glass. Take out the sight glass. Sight glass Take out the float.
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  14.2.13.3 Spoiler After taking out the float, remove the spoiler. Spoiler 14.3 Clean&Disinfect and Re-install the Breathing System Parts marked are autoclavable. Metal and glass parts can be steam autoclaved. Maximum recommended temperature is 134ºC. By using autoclave to solidify bacterioprotein rapidly, quick and reliable sterilization can be achieved.
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  All parts of the breathing system can be cleaned and disinfected. The cleaning and disinfection methods are different for different parts. You need to select the appropriate method to clean and disinfect the parts based on the actual situations to avoid cross-contamination. This table is our recommended cleaning and disinfection methods for all parts of the breathing system.
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  14.3.1 Breathing system Refer to methods recommended in the table of 14.3 Clean&Disinfect and Re-install the Breathing System to clean and disinfect the breathing system. Make sure that the breathing system is fully dry before installing it with reference to 13.1.3Install the Breathing system in the reverse order.
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  14.3.4 Breathing Mask Refer to the methods recommended in the table of 14.3 Clean&Disinfect and Re-install the Breathing System to clean and disinfect the breathing mask. 14.3.5 Inspiratory and Expiratory Check Valves Assembly Refer to the methods recommended in the table of 14.3 Clean&Disinfect and Re-install the Breathing System to clean and disinfect the inspiratory and expiratory check valves assembly.
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  NOTE Disassemble the bellows assembly before cleaning it. If not, it will take a very long time to dry. If autoclaving is necessary, assemble the bellows assembly first. Turn over the bellows assembly to autoclave it. Refer to the methods recommended in the table of 14.3 Clean&Disinfect and Re-install the Breathing System to clean and disinfect the bellows assembly.
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  14.3.8 Breathing Tubes and Y Piece NOTE When installing or cleaning the breathing tube, hold the tube connectors at both ends of the tube to prevent damage to the tube. Refer to the methods recommended in the table of 14.3 Clean&Disinfect and Re-install the Breathing System to clean and disinfect the breathing tubes and Y piece.
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  WARNING The end of inspiration/expiration connectors which connects the breathing tube shall be kept downward to prevent condensed water from entering the breathing system. 14.3.10 O2 Sensor WARNING Do not put both of the breathing system and the O sensor in liquid or autoclave them.
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  WARNING Do not autoclave the AGSS. NOTE Make sure that the float is fully dry before installing it onto the AGSS after cleaning. Even a very amount of liquid may cause the float to stick to the guide bar or sight glass, resulting in inaccurate flow indication. Immerse, disinfect and clean the AGSS by strictly following the concentration specified in the Instructions for Use provided by the disinfectant supplier.
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  Accessories WARNING Use only accessories specified in this chapter. Using other accessories may cause incorrect measured valued or equipment damage. Disposable accessories can not be reused. Reuse may degrade performance or cause cross-contamination. Check the accessories and their packages for damage. Do not use them if any sign of damage is detected.
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  Mask Mask.Sil-Flex Silicone,Size 1,Infant Large,15mm OD M6Q-150003— Mask.Sil-Flex Silicone,Size 2,Child,22mm ID M6Q-150004— Mask.Economy Silicone,Size 3,Child Large,22mm ID M6Q-150005— Mask.Economy Silicone,Size 4,Adult,22mm ID M6Q-150006— Mask.Economy Silicone,Size 5,Adult Large,22mm ID M6Q-150007— Aircushion Mask,Size 2 w/valve,Infant Large,15mm M6Q-150009— Aircushion Mask,Size 3 w/valve,Child,22mm M6Q-150010— Aircushion Mask,Size 4 w/valve,Child Large,22mm M6Q-150011— Aircushion Mask,Size 5 w/valve,Adult,22mm…
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  Sidestream CO module DRYLINE Watertrap (Adult/pediatric, Reusable) 9200-10-10530 Sampling Line, Adult 2.5m (Adult/pediatric, Disposable) 9200-10-10533 DRYLINE Airway Adapter (Straight, Adult/pediatric, Disposable) 9000-10-07486 Microstream CO module Sampling line, XS04620, adult/pediatric, disposable 0010-10-42560 Sampling line, XS04624, adult/pediatric, high humidity, disposable 0010-10-42561 Sampling line, 007768, adult/pediatric, long, disposable 0010-10-42563 Sampling line, 007737, adult/pediatric, long, high humidity, disposable 0010-10-42564…
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  Power cord Power cord, European style, 5m 0000-10-11215 Power cord, British style, 5m 009-000093-00 Power cord, American style, 5m 009-000094-00 Battery Lithium battery/DK-MR-644 M05-010001-06 BIS module BIS sensor, adult 0010-10-42672 BIS sensor, pediatric 0010-10-42673 BIS patient cable, adult/pediatric 6800-30-50761 AGSS AGSS transfer tube assembly 0611-30-67693 (tube connecting the anesthesia machine to the AGSS main unit.
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  Theory of Operation A.1 Pneumatic Circuit System A.1.1 Pneumatic Circuit Diagram…
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  A.1.2 Parts List P-Line Flow indicator cylinder Double-vaporizer manifold Air P-Line Check valve O P-Line Pressure relief valve (38 kPa) O cylinder ACGO selector switch Regulator (0.4 MPa) Inspiratory check valve Safety valve (0.7 MPa) absorber Filter BYPASS stop valve Regulator (0.2 MPa) Expiratory check valve 10 Inspiratory flow control valve…
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  A.1.3 Description Gas supplies The anesthesia machine has pipeline and cylinder gas supplies available. Pipeline gas supplies, O O and Air, go into the system through pipeline connectors 1, 3 and 4 respectively. The pipeline pressure ranges between 280 and 600 kPa. Cylinder gas supplies, and N O, go into the system through cylinder connectors 2 and 5 respectively.
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  the microprocessor-controlled valve 10 creates the preset inspiratory flow and expiratory valve 17 closes. The drive gas goes into the bellows 45 and depresses the bag inside the bellows to move downward. This forces the gas inside the bag to go through the sodalime canister 34 to enter the patient lung until the end of inspiration.
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  A.2.2 Parts List AC mains filter Main board Electrical outlet Infrared backplane Fuse 1 Electronic flowmeter board Isolation transformer board Heater AC conversion board Table top light board Fuse 2 Ship-shaped switch Power supply conversion board of the Power board anesthesia information system Battery assembly Anesthesia information system…
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  FOR YOUR NOTES…
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  Product Specifications The anesthesia machine is integrated with pressure restriction device, expiratory volume monitor, breathing system with alarm system, pressure measurement device, anesthetic ventilation system, AGSS transfer and receiving system, anesthetic gas delivery device, anesthetic ventilator, O2 monitor, CO2 monitor and AG monitor, where: The pressure restriction device, expiratory volume monitor and breathing system with alarm system comply with GB 9706.29 and IEC 60601-2-13.
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  B.2 Environmental Specifications Main unit Item Temperature (ºC) Related humidity Barometric pressure (kPa) (non-condensing) Operating 10 to 40 15 to 95% 70 to 106 Transport storage –20 to +55 10 to 95% 50 to 106 AG module Item Temperature (ºC) Related humidity Barometric pressure (kPa)
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  Internal battery Number of batteries One or two Battery type Lithium-ion battery Rated voltage 11.1 VDC Capacity 4400 mAh (a single battery) 5 min at least (powered by new fully-charged batteries after the Time to shutdown first low-power alarm) 60 min in case of one battery or 120 min in case of two batteries Operating time (powered by new fully-charged batteries at 25℃…
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  Size 10.4″ Resolution 800 x 600 pixels Brightness Adjustable LED indication One (yellow and red. When high and medium level alarms occur Alarm lamp simultaneously, it flashes red only) AC power LED One (green; lit when connected to the AC power source). One (green;…
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  O2 flush 35 to 75 L/min Flowmeter Air range: 0 to 10 L/min O2 range: 0 to 10 L/min N2O range: 0 to 10 L/min Electronic flowmeters Accuracy: < ±10% of the indicated value (under 20 ℃ and 101.3 kPa, for flow between 10% of full scale or 300 mL/min (whichever is greater) and full scale) Type: Rotameter…
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  Volume Approximately 6 ml Interface and connector Male 22 mm conical connector incorporating a coaxial female 15 mm Expiration end conical connector Male 22 mm conical connector incorporating a coaxial female 15 mm Inspiration end conical connector Male 22 mm conical connector incorporating a coaxial female 15 mm Bag end conical connector Airway pressure gauge…
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  Expiratory resistance Mechanical Manual Flow (L/min) Inspiratory resistance Mechanical Manual Flow (L/min) B.7 Ventilator Specifications Ventilator parameter setting range Parameter Setting range Step Operating mode Plimit 10 to 100 cmH 1 cmH All modes Pinsp PEEP+5 to 60 cmH 1 cmH2O PCV, PSV, SIMV-PC Psupp…
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  Rate 4 to 100 BPM 1 BPM VCV, PCV, PSV Ｉ:Ｅ 4:1 to 1:8 VCV, PCV, PSV TIP:TI OFF, 5 to 60% Finsp 20 to 85 L/min 1 L/min PSV、SIMV-VC、 SIMV-PC Trigger Window 5 to 90% SIMV-PC, SIMV-VC SIMV Rate 4 to 60 BPM 1 BPM SIMV-VC,SIMV-PC…
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  B.8 Ventilator Accuracy Control and monitoring accuracy <75 ml: ±15 ml; Volume control ≥75 ml: ±20 ml or ±10% of the set value, whichever is greater. Pinsp: ±3.0 cmH O or ±8% of the set value, whichever is greater. Pressure control Plimit: ±4.0 cmH O or ±10% of the set value, whichever is greater.
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  B.9 Anesthetic vaporizer Anesthetic vaporizer (for details, refer to the vaporizer Instructions for Use) Penlon Sigma Delta or Sigma Alpha anesthetic vaporizers. Five Type types of vaporizers with anesthetic agents halothane, enflurane, isoflurane, sevoflurane, desflurane are available. Vaporizer position Single or double vaporizer positions (optional) Selectatec®, with interlocking function (Selectatec®…
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  B.11 O2 Sensor Specifications sensor Output 9-13 mV at 210 hPa O2 Range 0 to 1500 hPa O2 100% O2 signal deviation 100±1% Resolution 1 hPa O2 Expected working life 1.5 x 106 % for measurement (20°C) 0.8 x 106 % for measurement (40°C) Response time (21% air to 100% O2) <…
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  Theory of Operation O2 sensor can monitor the patient’s FiO2. O2 sensor is of the self-powered, diffusion limited, metal-air battery type comprising an anode, electrolyte, diffusion barrier and air cathode as shown below: Air supply Solid membrane Diffusion barrier Cathode Electrolyte Load resistor Anode…
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  Humidity Effects Under conditions where liquid condensation may occur, care is needed to ensure the gas access holes do not become blocked. If liquids form in the region of the gas access hole, the flow of gas to the sensor will be restricted. With gas access restricted, a low signal will result. If a sensor shows signs of being affected by condensation, normal operation may be restored by drying the sensor with a soft tissue.
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  B.12 CO2 Module Specifications Mainstream CO2 Module Specifications Mainstream CO module Measurement mode Mainstream Measurement range Accuracy 0 to 40 mmHg ±2 mmHg Measurement range and 41 to 70 mmHg ±5% of the reading accuracy 71 to 100 mmHg ±8% of the reading 101 to 150 mmHg ±10% of the reading 0 to 69 mmHg…
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  Microstream CO module Flow 50 mL/min (accuracy: -7.5 mL/min +15 mL/min) 30 s (typical), reaching ±5% of the accuracy in stable state within 3 Initialization time minutes Rise time ＜190 ms（10 to 90%） Delay time 2.7 s (typical) System total 2.9 s (typical), including rise time and delay time response time Calibrate the module for the first time after it has worked for 1200 hours…
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  Sidestream CO module <4 s@70 mL/min Measured by using neonatal watertrap and 2.5 m neonatal sampling line. <5.5 s@100 mL/min <7 s@70 mL/min Measured by using adult watertrap and 2.5 m adult sampling line. Pump rate 70 mL/min and 100 mL/min optional Pump rate accuracy ±15﹪…
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  B.13 AG Module Specifications AG Module Type Three-slot module (BIS and O modules are optional) Standard ISO 11196 Measurement mode Sidestream ISO accuracy mode ＜45 s Warm-up time Full accuracy mode ＜10 min Pump rate: 120/150/200 mL/min optional Pump rate Accuracy: ±10 mL/min or ±10%, whichever is greater CO2, O2 (optional), N2O, and any of the five anesthetic agents: Des, Iso,…
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  ±0.4 5 to 10 ±0.6 10 to 15 ±1 15 to 18 Not specified ＞18 ±0.15 0 to 1 ±0.2 1 to 5 ±0.4 5 to 8 Not specified ＞8 ±0.15 Enf, Iso, Hal 0 to 1 ±0.2 1 to 5 Not specified ＞5 Rise time*…
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  AG alarm limits Range Step Unit EtCO High Limit (low limit + 2) to 76 mmHg EtCO Low Limit 0 to (high limit – 2) FiCO2 High Limit (low limit + 2) to 76 FiCO2 Low Limit 0 to (high limit – 2) O High Limit (low limit + 2) to 100 O Low Limit…
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  Effect of interfering gas on AG measured value ） Quantitive effect（% Concentration （％） Agent AG1) 0.13) Nitrogen ≤78％ Xenon ＜100% Helium ＜50％ Ethanol ＜0.1％ Acetone ＜1％ Methane ＜1％ Methoxyflurane Unspecified Unspecified Unspecified Unspecified 1) Multiple agent interference on CO2, N2O and O2 is typically the same as single agent interference.
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  B.14 BIS Module Specifications BIS Module Type Single-slot module Standard IEC60601-2-26 Measurement method Bispectral index, power spectrum analysis Measured parameters BIS: 0 to 100 Calculated parameters Impedance range 0 to 999 kΩ Sweep speed 6.25, 12.5, 25 or 50 mm/s Input impedance ＞50 MΩ…
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  FOR YOUR NOTES B-22…
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  This anesthesia machine meets the requirements of IEC 60601-1-2:2001+A1:2004. NOTE Using accessories, sensors and cables other than those specified may result in increased electromagnetic emission or decreased electromagnetic immunity of the equipment. The anesthesia machine or its components should not be used adjacent to or stacked with other equipment.
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  Guidance and Declaration — Electromagnetic Emissions The anesthesia machine is suitable for use in the specified electromagnetic environment. The customer or the user of the anesthesia machine should assure that it is used in such an environment as described below. Emissions test Compliance Electromagnetic environment — guidance Radio frequency (RF)
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  <5 % U (>95 % dip Voltage dips, <5 % U (>95 % dip Mains power quality should in U ) for 0.5 cycle short in U ) for 0.5 cycle be that of a typical interruptions and commercial or hospital 40 % U (60 % dip in voltage variations…
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  ⎡ ⎤ Radiated RF 10V/m 10 V/m 80 MHz～800 MHz ⎢ ⎣ ⎥ ⎦ （E1） IEC61000-4-3 80MHz～ ⎡ ⎤ 2.5GHz 800 MHz～2.5 GHz ⎢ ⎣ ⎥ ⎦ Where, is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer and is the recommended separation distance in meters (m).
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  Recommended Separation Distance between Portable/Mobile RF Communications Equipment and the Anesthesia Machine The anesthesia machine is suitable for use in an electromagnetic environment in which radiated RF disturbance are controlled. The customer or the user of the anesthesia machine can help prevent electromagnetic interference by maintaining a minimum distance between portable/mobile RF communications equipment (transmitters) and the anesthesia machine as recommended below, according to the maximum output power of the communications equipment.
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  FOR YOUR NOTES…
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  Alarm Messages This chapter lists only the most important physiological and technical alarm messages. Some messages appearing on your ventilator display may not be included. Note that in this chapter: Column L stands for the default alarm level: H for high, M for medium and L for low. “●” indicates that the alarm level is user-adjustable.
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  TVe Below In the VCV mode, TVe is lower than the minimum tidal Control Range volume setting for five continuous breathing cycles. Check the patient’s condition, pneumatic circuit connection and flow sensor. MV Too High MV is higher than the high alarm limit setting. If ventilation mode is switched or settings for ventilator parameters are changed, this alarm is disabled temporarily within nine breathing cycles or one minute (whichever is less) after…
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  EtCO2 Too High The measured value has risen above the high alarm limit or ● fallen below the low alarm limit. Check the patient’s module EtCO2 Too Low ● physiological condition. Make sure that patient type and FiCO2 Too High ●…
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  D.2 Technical Alarm Messages Source Alarm message Cause and action RT Clock Need There is no button cell available in the system, or the System Reset battery is empty. Replace with a new button cell. RT Clock Not Exist RT chip malfunction. Contact your service personnel. Low Battery The battery voltage is too low.
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  Device Fault, Equipment malfunction. Mechanical ventilation and Ventilator Ventilate Manually monitoring did not work. Use manual ventilation mode to help the patient breathe and restart the anesthesia machine. If the alarm cancels, restart mechanical ventilation. Ventilator CPU error. Unreliable monitoring. Use Hardware Error 01 manual ventilation mode to help the patient breathe Contact your…
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  Drive Gas Pressure The pressure of drive gas is low. Unreliable monitoring. Use manual ventilation mode to help the patient breathe Contact your service personnel. O2 Supply Failure The O pressure is low. If Air supply is connected, use manual ventilation mode to help the patient breathe. Make sure that O supply with sufficient pressure is connected.
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  Sensor failed. Or, great drift occurred to the flow sensor and inspiratory valve. Use manual ventilation mode to help the patient breathe. Calibrate the flow sensor and inspiratory valve. Calibrate PEEP Last calibration of the Paw sensor and PEEP valve failed. Valve Or, great drift occurred to the Paw sensor and PEEP valve.
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  TVe>TVi TVe is greater than TVi for consecutive six cycles. Check the flow sensor. TV Delivery Too TVi is greater than the set value by 20% for consecutive High six times. Check the fresh gas flow. Insp Reverse Flow M There is gas flowing through the inspiratory flow sensor during expiration for consecutive six cycles.
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  Flowmeter Flash selftest error Hardware Error 06 Flowmeter Watchdog selftest error Hardware Error 07 Flowmeter Cal. Air, O and N O data empty Data Error 01 Flowmeter Cal. Air, O and N O data error Data Error 02 Flowmeter Comm XX module failed to Error communicate with the main…
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  AG Watertrap Type The watertrap of the AG module is of wrong type. Wrong Replace with a correct watertrap. AG Data Limit AG module malfunction Error AG Accuracy Error The measured value is outside of the measurement accuracy range. FiO2 ALM LMT The FiO2 alarm limit settings are outside of the range.
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  MAC < 3 MAC value was less than 3. Mixed Agent and More than more anesthetic agents were detected ant the MAC >= 3 MAC value was not less than 3. EtCO2 ALM LMT The EtCO alarm limit settings are outside of the range. module FiCO2 ALM LMT The FiCO2 alarm limit settings are outside of the range.
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  CO2 Hardware Errors occurred to: Error 1. External A/D sampling 2.5 V 2. 12V power supply voltage 3. Internal A/D sampling 2.5 V 4. Pump. 5. 3-way valve. CO2 Sampleline An error or occlusion occurred to the sampling line. Occluded CO2 Zero Failed Deviation of gain input signal is too great to be adjusted.
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  BIS Overrange The measured value is outside of the measurement range. Contact your service personnel. SQI Overrange SR Overrange BIS High Imped. Check sensor connections. Re-connect the sensor. BIS Sensor Off BIS DSC Error BIS DSC signal reception error. Check the DSC. BIS DSC Malf BIS DSC switched off due to malfunction.
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  FOR YOUR NOTES D-14…
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  Symbols and Abbreviations E.1 Symbols ampere ampere hour Breaths per minute centigrade ºC cubic centimeter centimeter decibel fahrenheit ℉ gram hour hertz inch inch kilo kilogram kilopascal litre pound meter microampere hour mbar mbar milligrams minute milliliter millimeters mmHg millimeters of mercury millisecond millivolt…
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  milliwatt nanometer part per million second volt volt ampere Ω µA microampere µV microvolt watt minus percent per；divide；or ～ power plus ＋ ＝ equal to less than ＜ ＞ greater than ≤ less than or equal to ≥ greater than or equal to ±…
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  E.2 Abbreviations Anaesthetic agent AGSS Anesthesia Gas Scavenging System ACGO Auxiliary Common Gas Outlet BTPS body temperature and pressure，Saturated Compliance (Cdyn) Airway Pressure Limit Desflurane Enflurane EtCO2 End-tidal carbon dioxide Finsp Flow of inspiration FiCO2 Fraction of inspired carbon dioxide Fractional concentration of O in inspired gas Flow…
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  Rate Breath rate Sevoflurane SIMV Synchronized intermittent mandatory ventilation SIMV-PC Synchronized intermittent mandatory ventilation — Pressure control SIMV-VC Synchronized intermittent mandatory ventilation — Volume control SIMV Rate Frequency of SIMV Tinsp Time of inspiration TIP:TI Percentage of inspiratory plateau time in inspiratory time Tidal volume Volume control ventilation Volume…
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  Factory Defaults This chapter lists the most important factory default settings which are not user-adjustable. When necessary, you can restore the factory default settings. F.1 CO2 Module module alarm limits Factory default settings Alarm Level EtCO2 High Limit (mmHg) EtCO2 Low Limit (mmHg) FiCO2 High Limit (mmHg) F.1.1 Mainstream CO2 Module Setup…
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  F.1.3 Sidestream CO2 Module CO2 Setup Factory default settings Paw Unit mmHg Working Mode Measure Pump Rate High N2O Comp (%) O2 Comp (%) Des Comp (%) Humidity Comp F.2 AG Module AG Setup Factory default settings Agent Pump Rate O2 Comp Working Mode Measure…
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  EtEnf Low Limit (%) FiEnf High Limit (%) FiEnf Low Limit (%) EtIso High Limit (%) EtIso Low Limit (%) FiIso High Limit (%) FiIso Low Limit (%) EtSev High Limit (%) EtSev Low Limit (%) FiSev High Limit (%) FiSev Low Limit (%) EtDes High Limit (%) EtDes Low Limit (%)
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  F.4 Ventilator Ventilator Setup Factory default settings VCV Mode TV (ml) Plimit (cmH2O) Rate (BPM) TIP:TI PEEP (cmH2O） PCV Mode Plimit (cmH2O) Pinsp (cmH2O) Rate (BPM) PEEP (cmH2O） PSV Mode Pinsp (cmH2O) Rate (BPM) Finsp (L/min) Plimit (cmH2O) Psupp (cmH2O) PEEP (cmH2O）…
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  SIMV-VC and SIMV-PC Modes Tinsp (s) SIMV Rate (BPM) Psupp (cmH2O) 15 cmH Trigger Window Trigger Level -2 cmH O (pressure-triggered) 3.0 L/min (L/min) (flow -triggered) PSV Insp Termination Level Ventilator alarm limits FiO2 High Limit (%) FiO2 Low Limit (%) TVe High Limit (ml) 1000 TVe Low Limit (ml)
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  P/N：046-000203-00（1.0）…