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Draeger Medical, Inc.

Narkomed GS Operator’s Instruction Manual

10-7

AV2+ Anesthesia Ventilator

Problem Resolution

Table 10-1. Problem Resolution

PROBLEM

POSSIBLE CAUSE

REMEDY

Excessive PEEP

Improperly adjusted
ventilator relief valve

Contact Draeger Medical
qualified technical service
representative.

Insufficient suction
scavenger flow setting

Increase suction
scavenger flow valve.

PEEP valve active

Decrease PEEP valve
setting.

Inverse I:E ratios

Reset ratios.

Excessive NEEP

Excessive suction
scavenger flow

Reduce suction
scavenger flow rate.

Bellows won't reach tidal
volume stop setting
during expiration

Frequency too high for
selected tidal volume

Decrease frequency.

Increase expiratory phase
time.

Improperly adjusted
ventilator relief valve

Contact Draeger Medical
qualified technical service
representative.

Breathing system leak

Repair leak.

Ventilator won't cycle

Low oxygen supply
pressure

Provide sufficient oxygen
supply pressure.

Moving manual/
automatic selector valve
lever to AUTO position
does not activate
ventilator.

SYSTEM POWER switch
is in STANDBY position

Turn SYSTEM POWER
switch to ON.

Interface cable is not
connected

Connect interface cable.

Ventilator does not
operate; yellow FAULT
LED on ventilator lights

Selector switch on the
absorber is in the BAG
position

Turn the selector switch
on the absorber to the
AUTO position

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Summary of Contents for Narkomed GS

Page 1: ...tion Manual Operator s Part Number 4113801 007 Rev G WARNING For a full understanding of the performance characteristics of this anesthesia machine the user should carefully read this manual before operating RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 2: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 3: ...eneral Warnings and Cautions 1 6 Section 2 General Description Overview 2 2 Gas Delivery System 2 2 Vaporizers 2 12 Absorber 2 13 Bain Circuit Adapters 2 16 Scavenger Systems 2 18 AV2 Ventilator 2 20 Main Switch Panel 2 22 Power Supply System 2 23 Sensor Interfaces 2 26 Monitoring System 2 27 Monitor Screen and Controls 2 27 Alarm System 2 28 Manual Sphygmomanometer optional 2 30 Section 3 Daily C...

Page 4: ...ection 7 Open Reservoir Scavenger Overview 7 2 Connecting the Open Reservoir Scavenger System 7 3 Operating the Open Reservoir Scavenger System 7 4 Section 8 Scavenger Interface for Passive Systems Overview 8 2 Operating the Scavenger Interface for Passive Systems 8 3 Section 9 Main Switch Panel Overview 9 2 System Power Switch 9 3 Testing the Battery 9 3 Section 10 AV2 Anesthesia Ventilator Overv...

Page 5: ...e Volume Low Alarm Limit 13 5 Turning Respiratory Volume Alarms Off 13 5 Turning Respiratory Volume Alarms On 13 5 Respiratory Volume Alarm Messages 13 6 Problem Resolution 13 8 Section 14 Breathing Pressure Monitoring Overview 14 2 Choice of Breathing Pressure Monitoring Location 14 2 Installing the Breathing Pressure Pilot Line 14 4 Monitor Displays 14 6 Monitor Controls 14 10 Setting the Pressu...

Page 6: ...ations General 17 2 Environmental 17 2 Gas Delivery System 17 3 Vaporizers Vapor 19 1 and 19 3 17 4 Ventilator 17 4 Absorber System 17 5 Oxygen Monitoring 17 5 Breathing Pressure Monitoring 17 6 Respiratory Volume Monitoring 17 6 Serial Interface 17 6 Appendix Spare and Replacement Parts Manuals A 2 Absorber System A 2 Vaporizers 19 1 A 3 Bellows A 3 Oxygen Monitoring Accessories A 3 Breathing Pre...

Page 7: ...lay 2 28 Section 5 Gas Delivery System Figure 5 1 Pipeline Gas Supply Connections 5 3 Figure 5 2 Connecting the Gas Cylinders 5 4 Figure 5 3 Oxygen Flush Control 5 5 Section 6 Vaporizer Figure 6 1 Vaporizer Filling Systems 6 3 Figure 6 2 Fixed Mount Exclusion System 6 4 Figure 6 3 Removable Vaporizer Exclusion System 6 4 Figure 6 4 Installing Removing the Vapor 19 3 at the Mounting Block 6 5 Figur...

Page 8: ...5 Figure 12 4 Measurement Error Due to Incorrect Calibration 12 7 Section 13 Respiratory Volume Monitoring Figure 13 1 Respiratory Volume System 13 2 Figure 13 2 Monitor Display 13 3 Figure 13 3 Monitor Controls 13 4 Section 14 Breathing Pressure Monitoring Figure 14 1 Absorber Monitoring 14 4 Figure 14 2 Y piece Monitoring 14 5 Figure 14 3 Monitor Displays 14 6 Figure 14 4 Breathing Pressure Moni...

Page 9: ...re 16 4 Open Reservoir Scavenger Maintenance 16 7 Figure 16 5 Scavenger Interface for Passive Systems Maintenance 16 9 Figure 16 6 Removing the Pressure Gauge 16 11 Figure 16 7 Removing the Bellows Assembly 16 12 Figure 16 8 Disassembling the Inspiratory and Expiratory Valves 16 14 Figure 16 9 Open Reservoir Scavenger Connections 16 24 Figure 16 10 Passive System Scavenger Connections 16 25 RETURN...

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Page 11: ...Section 12 Oxygen Monitoring Table 12 1 Alarm Limits 12 3 Table 12 2 Unsuccessful Calibration Causes and Solutions 12 6 Table 12 3 Oxygen Monitoring Problem Resolution 12 9 Section 13 Respiratory Volume Monitoring Table 13 1 Respiratory Volume Monitoring Problem Resolution 13 8 Section 14 Breathing Pressure Monitoring Table 14 1 Breathing Pressure Monitoring Problem Resolution 14 16 Section 15 Man...

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Page 13: ...y for Patient Safety 1 2 Limitation of Liability 1 3 Restriction 1 3 Copyright 1 3 Trademark Notices 1 3 Disclaimer 1 4 Recommendations 1 4 Symbol Definition 1 4 Purpose of This Manual 1 5 How This Manual Is Organized 1 5 Conventions Used in This Manual 1 6 General Warnings and Cautions 1 6 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 14: ...on is not endorsed by Draeger Medical The operator of the anesthesia system must recognize that the means of monitoring and discovering hazardous conditions are specific to the composition of the system and the various components of the system It is the operator and not the various manufacturers or suppliers of components who has control over the final composition and arrangement of the anesthesia...

Page 15: ... liability arising from a combination of its product with products from another manufacturer if the combination has not been endorsed by Draeger Medical Buyer understands that the remedies noted in Draeger Medical s limited warranty are its sole and exclusive remedies Furthermore buyer acknowledges that the consideration for the products equipment and parts sold reflects the allocation of risk and...

Page 16: ...vice at 800 543 5047 for service of this equipment Draeger Medical also recommends that its anesthesia equipment be serviced at three month intervals Periodic Manufacturer s Service Agreements are available for equipment manufactured by Draeger Medical For further information concerning these agreements contact DrägerService at 800 543 5047 Symbol Definition The following symbols appear on the lab...

Page 17: ...n delivery of anesthesia and patient monitoring How This Manual Is Organized All users of the Narkomed GS must read this manual completely before using the machine In order to make this document more convenient for future reference it has been divided into several independent sections Section 2 General Description provides a summary of Narkomed GS features and functions Section 3 Daily Checkout co...

Page 18: ...lead directly to personal injury Caution statements give important information that if ignored could lead directly to equipment damage and indirectly to personal injury General Warnings and Cautions The following list of warnings and cautions apply to general operation and maintenance of the Narkomed GS Warnings and cautions about installing and operating specific parts appear with those topics WA...

Page 19: ...es around corners and across thresholds for example in door frames and elevators Do not attempt to pull the machine over any hoses cords or other obstacles on the floor CAUTION Although the Narkomed GS is designed to minimize the effects of ambient radio frequency interference machine functions may be adversely affected by the operation of electrosurgical equipment or short wave or microwave diath...

Page 20: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 21: ...ery System 2 2 Vaporizers 2 12 Absorber 2 13 Bain Circuit Adapters 2 16 Scavenger Systems 2 18 AV2 Ventilator 2 20 Main Switch Panel 2 22 Power Supply System 2 23 Sensor Interfaces 2 26 Monitoring System 2 27 Monitor Screen and Controls 2 27 Alarm System 2 28 Manual Sphygmomanometer optional 2 30 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 22: ...agent from a selection of up to three Oxygen and nitrous oxide are standard on all Narkomed GS machines Optional gases are air and carbon dioxide Gas is supplied to the system through pipelines and cylinders Connections for oxygen and nitrous oxide are standard on all machines and a pipeline connection for air is also available Gas cylinder yokes are available for up to two oxygen cylinders and tw...

Page 23: ...ylinders are in use Each pipeline connection is equipped with a filter to prevent foreign material from entering the internal gas piping of the Narkomed GS Pipeline gases should be supplied at 50 55 psi Pipeline Pressure Gauges The anesthesia machine includes pipeline pressure gauges for oxygen and nitrous oxide On machines equipped with air a pipeline pressure gauge for air is also included The g...

Page 24: ...the corresponding reserve cylinder and deplete its contents if the reserve cylinder valve was left in the open position CAUTION To ensure that gas supplies are at adequate pressure pipeline pressure gauges should indicate steady pressures of 50 55 psi 10 9 8 7 6 5 4 3 2 1 10 9 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 9 10 1000 1000 900 800 700 600 500 400 300 200 100 900 800 700 600 500 400 300 200 100 100...

Page 25: ...handle s threaded bolt and the yoke s gas inlet When attaching a cylinder make sure that only one washer is installed between the cylinder and the yoke gas inlet Using multiple washers may compromise the pin indexed safety system Be sure to verify the integrity of both index pins whenever you install a new cylinder WARNING Check cylinder yokes for the presence of two index pins each time you attac...

Page 26: ... device OFPD is a pneumatically operated valve that protects the patient in the event of partial or complete loss of oxygen pressure Each gas circuit in the anesthesia machine except the oxygen circuit is controlled by one of these valves These valves in turn are controlled by the gas pressure in the oxygen supply line When oxygen pressure is adequate the valves remain open for an unrestricted gas...

Page 27: ...ivers this volume of oxygen even if the oxygen flow control valve is fully closed Flow Control Valves A needle valve is located below the fine flowmeter tube for each gas This valve is used to adjust the flow of gas Turning the valve knob counterclockwise increases flow turning the knob clockwise decreases flow A zero stop prevents damage to the flow control valve seats If necessary a Draeger Medi...

Page 28: ...ncreased Similarly if you decrease the oxygen flow without also decreasing the nitrous oxide flow the nitrous oxide flow will automatically drop in proportion to the oxygen flow WARNING In circle systems the gas mixture in the patient circuit is not necessarily the same as that in the fresh gas flow This is particularly true at low fresh gas flow rates when the patient rebreathes a significant por...

Page 29: ...designed to accept a 15 mm male fitting on the absorber fresh gas hose The male fitting slides into a retaining slot in the spring loaded safety locking bar to prevent inadvertent disconnection of the fresh gas hose The 15 mm male fitting on the fresh gas hose is unique to Draeger Medical design and cannot be replaced by a hose from any other manufacturer Figure 2 3 Fresh Gas Outlet O2 FLUSH CONTR...

Page 30: ...ng such as those supplied with Draeger Medical Absorbers and Bain Circuit Adapters When using a 15 mm fitting place the spring loaded locking bar over the male fitting to secure it to the female fitting A 22 mm female fitting with a load bearing threaded mount such as those for Magill circuits or ISO type non rebreathing adapters When using an ISO type non rebreathing adapter swing the spring load...

Page 31: ...centration Depending on the fresh gas flow and the respiratory minute volume the inspiratory oxygen concentration may be lower than fresh gas oxygen concentration due to rebreathing of previously exhaled gases Auxiliary Oxygen Flowmeter Optional For the delivery of a metered flow of pure oxygen for example delivery of oxygen through a nasal cannula an optional auxiliary oxygen flowmeter can be mou...

Page 32: ...an one vaporizer from being activated at a time The exclusion system is incorporated into the vaporizer bank and requires all unused vaporizers to be locked in their zero percent positions WARNING Only one vaporizer can be activated at a time If the exclusion system permits simultaneous activation of more than one vaporizer do not use the anesthesia machine Contact a Draeger Medical qualified tech...

Page 33: ...ons for sensing the following breathing pressure respiratory volume frequency and oxygen concentration The absorber system is shown in Figure 2 7 Figure 2 7 Absorber OP98103A RESPIRATORY VOLUME SENSOR ULTRASONIC FLOW SENSOR EXPIRATORY VALVE PEEP BYPASS CONTROL APL VALVE OXYGEN SENSOR INSPIRATORY VALVE PEEP VALVE OPTIONAL ABSORBENT CANISTER FRESH GAS HOSE DUST CUP MANUAL AUTOMATIC SELECTOR VALVE BR...

Page 34: ... toward the patient only with no backflow to the absorber The expiratory valve allows gas to flow to the absorber only with no backflow to the patient The valves are not interchangeable They must be connected to the correct mounts inspiratory valve to inspiratory mount expiratory valve to expiratory mount to ensure the proper flow direction through the absorber system Different size mounting threa...

Page 35: ...le quick visual determination of breathing circuit pressure The gauge is marked for measurements from 20 to 80 cm H2O in increments of 2 cm H2O WARNING Frequent observation of the breathing system pressure gauge is mandatory to ensure adequate pressure buildup and relief regardless of the mode of operation RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 36: ...valve a breathing pressure gauge a quick connect fitting for the breathing pressure pilot line a port for the oxygen sensor a 15 22 mm port for non rebreathing circuits and a connector for a patient breathing bag Figure 2 8 Absorber Mount Bain Circuit Adapter OXYGEN SENSOR 22MM M 15MM F EXPIRATION TERMINAL BAIN CIRCUIT BAIN CIRCUIT HOSE BARB FOR FRESH GAS HOSE BREATHING BAG BREATHING PRESSURE PILO...

Page 37: ...gure 2 9 Pole Mount Bain Circuit Adapter OXYGEN SENSOR BAIN CIRCUIT BREATHING BAG MOUNT 19 MM SCAVENGER HOSE 22MM VENTILATOR HOSE BAIN CIRCUIT HOSE BARB FOR FRESH GAS HOSE MOUNTING STUD FRESH GAS HOSE OP00200A SET SCREW BREATHING PRESSURE PILOT LINE MANUAL AUTOMATIC SELECTOR VALVE PEEP BYPASS CONTROL OPTIONAL ABSORBER POLE PEEP CONTROL KNOB OPTIONAL BREATHING SYSTEM PRESSURE GAUGE APL VALVE RETURN...

Page 38: ...ith suction vacuum waste gas disposal systems This scavenger is an open system featuring continually open relief ports to provide positive and negative pressure relief The open reservoir scavenger is shown in Figure 2 10 Figure 2 10 Open Reservoir Scavenger VACUUM DISS HOSE TERMINAL THREADED INPUT PORT CAP 19MM SCAVENGER HOSE TERMINAL RELIEF PORT NEEDLE VALVE KNOB FLOWMETER RESERVOIR CANISTER 19MM...

Page 39: ...ve pressure relief See Figure 2 11 WARNING Do not use this device with a waste gas disposal system capable of applying a negative pressure to the scavenger interface a suction or vacuum waste gas disposal system Figure 2 11 Scavenger Interface for Passive Systems WASTE GAS INPUT PORT 19MM HOSE TERMINAL INPUT PORT CAP SAFETY RELIEF VALVE SHOWN CLOSED WASTE GAS INPUT PORT 19MM HOSE TERMINAL WASTE GA...

Page 40: ...ble pressure limiter APL valve for manual ventilation or the ventilator bellows for automatic ventilation During automatic ventilation the manual automatic selector valve isolates the absorber s APL valve from the breathing system To compensate for the continuous introduction of fresh gas into the breathing system the ventilator incorporates a relief valve mounted behind the bellows chamber When t...

Page 41: ...R ON OFF CONTROL TIDAL VOLUME CONTROL PRESSURE LIMIT CONTROL TIDAL VOLUME SETTING INDICATOR BELLOWS CANISTER BREATHING CIRCUIT CONNECTOR OP91018c 10 1 2 5 FREQUENCY min I E RATIO INSPIRATORY FLOW VENTILATOR ON FAULT 1400 1200 1000 800 600 400 200 PRESET TIDAL VOLUME ml EXTENDED RANGE ACCESS EXTENDED RANGE AV2 INSPIRATORY PRESSURE LIMIT cmH2O TIDAL VOLUME PUSH TO TURN RETURN TO THIS MANUAL S TABLE ...

Page 42: ...gas pneumatic and electric power circuits are actuated and the green LED indicator adjacent to the switch illuminates In the STANDBY position the switch shuts down the gas supplies the monitoring system and all electrical power to the machine except the convenience receptacles and battery charging circuit RED O2 SUPPLY PRESSURE LOW INDICATOR YELLOW AC POWER LOW INDICATOR YELLOW BATTERY LOW INDICAT...

Page 43: ... not activated Power Supply System The Narkomed GS is equipped with a central power supply for the ventilator alarm system and monitoring system When in use the Narkomed GS must be plugged into an AC outlet Convenience Receptacles The Narkomed GS can be equipped with convenience receptacles mounted vertically on the lower rear of the anesthesia machine see Figure 2 14 Machines with the 120 VAC pow...

Page 44: ... tripped when its plunger extends beyond its base If a breaker is tripped the cause must be found and corrected before using the anesthesia system Backup Battery System The backup battery system consists of a rechargeable battery and a built in battery charging system Although most hospitals have emergency generators to supply AC power when line power fails a delay may occur before generator power...

Page 45: ...ystem The yellow AC POWER FAIL indicator on the anesthesia machine s alarm panel comes on The Caution message AC POWER FAIL appears on the alarm display A three pulse pattern audio alarm sounds every 30 seconds When the battery reserve approaches depletion following an AC power loss The yellow BATTERY LOW main switch panel indicator illuminates NOTE The BATTERY LOW indicator will only illuminate d...

Page 46: ...OXYGEN SENSOR interface for the oxygen sensor cord A BREATHING PRESSURE interface for the breathing pressure pilot line An AUTO BAG SELECTOR interface for the manual automatic selector valve interface cable Figure 2 15 Sensor Interfaces OP00208 BREATHING PRESSURE INTERFACE AUTO BAG SELECTOR INTERFACE REAR PANEL OF VENTILATOR BOX VOLUME SENSOR INTERFACE OXYGEN SENSOR INTERFACE UNDERNEATH VENTILATOR...

Page 47: ...n The control keys on either side of the screen allow you to establish monitoring settings With the left keypad you can control system wide settings such as alarm annunciation and monitor configuration With the right keypad you can control settings for specific monitors oxygen concentration breathing pressure and respiratory volume See Figure 2 16 Figure 2 16 Monitor Screen and Controls Alarms Con...

Page 48: ...onditions in the Alarm window at the top of the monitor screen as shown in Figure 2 17 Messages are displayed for up to six of the highest priority active alarm conditions Any additional lower priority active alarm conditions are retained in the monitor s memory Messages for these lower priority conditions are displayed when the higher priority alarm conditions have been resolved and their message...

Page 49: ... activated The backup speaker has a tinny sound to distinguish it from the primary speaker Another indication of the failure of the primary speaker is the appearance of the Advisory message SPEAKER FAIL on the alarm display Ventilation Alarms When the system power switch is turned from STANDBY to ON the volume and pressure apnea alarms default to Standby to allow machine setup without nuisance ala...

Page 50: ...l Description Manual Sphygmomanometer optional Noninvasive blood pressure can be measured with the manual sphygmomanometer Several cuff sizes are available to accommodate varying patient requirements RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 51: ...n Manual 3 Daily Checkout Procedure This section describes the daily checkout procedure that you are to perform on the Narkomed GS anesthesia machine Daily Checkout Procedure 3 2 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 52: ... If the anesthesia machine is not already plugged in connect the electrical power cable to an active AC outlet that accepts and properly grounds the power cable Do not use cheater plugs The term cheater plug implies any and all electrical plugs or other devices that can inhibit or prohibit the proper grounding of the anesthesia machine System Software Diagnostics 5 Turn the SYSTEM POWER switch to ...

Page 53: ...e cylinder gasket and there are two index pins Verify that the cylinder matches the yoke label Place the cylinder back in its yoke b Open the nitrous oxide flow control valve until the nitrous oxide pipeline and cylinder pressure gauges indicate zero pressure Open a nitrous oxide cylinder and check the cylinder pressure gauge A full nitrous oxide cylinder registers about 745 psi Replace any cylind...

Page 54: ...ures typical full load Pipeline Supply System Verification 11 Pipeline Supply Verification a Inspect the supply hoses for cracks or wear b Connect the appropriate hospital pipeline supply hoses from the wall outlet fittings to the pipeline inlet connectors c Check for sufficient pipeline pressure readings for each gas on the pipeline pressure gauges located below the flow control valves The pressu...

Page 55: ...pplies and deplete the pressure from the system OFPD Verification 15 Check the oxygen failure protection device With all gases available on the machine set to a flow of about 4 l min close the oxygen supply by disconnecting the oxygen pipeline supply hose and closing the oxygen cylinder s The flow of all other gases indicated by their flowmeters must decrease in proportion to the decrease in oxyge...

Page 56: ...gh flow of gas through the Bain circuit s inner tube will draw in gas from the outer tube As a result the breathing bag should deflate If the breathing bag does not deflate or it inflates the fresh gas hose or inner tube may be improperly connected Absorber System Verification 20 To check the absorber system a Check the hose connections in the breathing system b Make sure the fresh gas hose of the...

Page 57: ...control valves Check for free gas passage in the patient breathing system Wear a surgical mask to inhale and exhale through the breathing system each limb individually if possible Verify the unidirectional flow in each limb and then reconnect the tubing APL Valve 23 Check the APL valve to be sure it can relieve excess gas from the breathing system into the scavenger system To check the APL valve s...

Page 58: ...ssure gauge When the pressure is at 50 cm H2O begin counting seconds The pressure must not drop more than 20 cm H2O in 30 seconds Scavenger System 25 Verify the performance of the scavenger system To test the open reservoir scavenger system a Make sure a 19 mm scavenger hose is connected between the ventilator relief valve and the scavenger interface b Make sure a 19 mm scavenger hose is connected...

Page 59: ... bag terminal q The flow of oxygen must now exit through the relief ports located on top of the canister The absorber system s breathing pressure gauge must indicate a pressure less than 5 cm H2O r After the test adjust the scavenger needle valve to a flowmeter indication halfway between the two white lines To test the scavenger interface for passive systems a Make sure a 19 mm scavenger hose is c...

Page 60: ...ge must indicate a pressure over 30 cm H2O when the bellows completes its downward travel The pressure should not exceed 3 cm H2O at the end of the expiratory phase when the bellows completes its upward travel b If the system is equipped with a PEEP valve verify the PEEP valve s performance Attach a breathing bag to the patient Y piece with an appropriate adapter such as an Draeger Medical combina...

Page 61: ...en analyzer is properly calibrated See Calibrating the Oxygen Sensor on page 12 4 for more information When removing the oxygen sensor during calibration insert the oxygen sensor port plug into the fresh gas adapter port Final Position 31 When the daily checkout procedure is complete verify that a all vaporizers are off the handwheels are set to zero b the APL Valve is open fully counterclockwise ...

Page 62: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 63: ...ction Manual 4 Preuse Checkout This section describes the daily checkout procedure that you are to perform on the Narkomed GS anesthesia machine Preuse Checkout Procedure 4 2 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 64: ...at the anesthesia machine has been plugged in for 12 hours The battery charging system works only when the machine is connected to an active AC power source The charging system takes about 12 hours to charge a fully discharged battery Bain Circuit Adapter Verification 2 Verify that the inner tube of the Bain circuit is intact and not occluded First deliver a flow of oxygen to the Bain circuit thro...

Page 65: ...eneration after a rest period Flushing the anesthesia machine continuously with 100 oxygen for at least one minute before the first case of the day is recommended Remove accumulated absorbent dust and water from the absorber dust cup WARNING Absorbent is caustic and is a strong eye skin and respiratory tract irritant When emptying the absorber dust cup take care not to spill its caustic contents N...

Page 66: ...ion d Interconnect the inspiratory valve and the expiratory hose terminal on the ultrasonic flow sensor with a 22 mm breathing hose e Set the manual automatic selector valve to BAG f Close the APL valve by turning the knob fully clockwise to its stop position g Check that the breathing pressure gauge is on 0 h Attach the supplied test terminal to the breathing bag mount i Connect a sphygmomanomete...

Page 67: ...n waste gas disposal system is active j Adjust the scavenger needle valve to a flowmeter indication between the two white lines k Close all flow control valves on the anesthesia system l Occlude the absorber breathing bag terminal and observe the breathing pressure gauge on the absorber The gauge should indicate only a negligible negative pressure no lower than 0 5 cm H2O To test for positive pres...

Page 68: ...s point the absorber system s breathing pressure gauge must indicate a pressure of less than 10 cm H2O Manual and Automatic Ventilation Systems 9 Test the ventilator a Check for proper pressure and flow at the Y piece during the inspiratory and expiratory phases Turn the SYSTEM POWER switch and ventilator power switch to their ON positions Place the manual automatic selector valve in the AUTO posi...

Page 69: ...limits can be adjusted at the beginning of or during a procedure Also make sure that any external monitors if any are connected properly 11 Test the alarm functions for all monitors Simulate alarm conditions and check for appropriate alarm signals System Flush 12 Flush the system with 100 oxygen by pressing the oxygen flush button Fresh Gas Oxygen Sensor Adapter Option Verification 13 If the optio...

Page 70: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 71: ...he gas delivery system of the Narkomed GS anesthesia machine Overview 5 2 Connecting the Pipeline Gas Supply 5 2 Connecting the Gas Cylinders 5 3 Connecting the Fresh Gas Hose 5 5 Adjusting the Gas Flow 5 5 Using the Oxygen Flush 5 5 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 72: ...ilable inlets are Diameter Indexed Safety System DISS inlets body or nut fitting or National Institute for Standards and Technology NIST inlets The available gas inlets are shown in Figure 5 1 To connect a pipeline supply to the Narkomed GS 1 Connect the gas fitting on the supply hose to the corresponding gas fitting on the side of the flowmeter housing Use a wrench to tighten the hex nut WARNING ...

Page 73: ...gas cylinder to its yoke 1 Place a new washer on the seat of the yoke gas inlet connection WARNING Use only one cylinder washer per yoke Using more than one washer could cause leakage of the cylinder gas and compromise the pin indexing system 2 Verify the presence and integrity of the two index pins below the gas inlet O2 NIST GAS FITTING AIR NIST GAS FITTING O2 DISS NUT GAS FITTING O2 DISS BODY G...

Page 74: ... indexing holes with the index pins Screw the yoke handle clockwise against the cylinder head so that the point of the yoke handle bolt is aligned with the countersunk recess on the back of the cylinder head 5 Verify that the sealing washer is in place that the index pins are engaged and that the cylinder hangs vertically Tighten the handle securely Figure 5 2 Connecting the Gas Cylinders YOKE ASS...

Page 75: ...increases flow turning the knob clockwise decreases flow 2 As you adjust the flow control knob observe the flow rate Flow rate is indicated by the flowmeter scale reading at the center of the float CAUTION The flow of oxygen cannot be completely shut off see Minimum Oxygen Flow on page 2 7 Do not force the oxygen flow control knob past the zero stop in an effort to shut off the minimum flow forcin...

Page 76: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 77: ... Exclusion Systems 6 3 Fixed Mount Exclusion System 6 4 Removable Vaporizer Exclusion System 6 4 Installing Removing the Vapor 19 3 Vaporizer 6 5 Selecting a Vapor 19 3 Vaporizer 6 6 Operating the Vaporizers 6 6 Filling the Vaporizer 6 7 Filling the Vaporizer During a Case 6 8 Draining the Vaporizer 6 13 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 78: ...aporizer setting When performing anesthesia with low flow or closed system techniques it is essential to monitor inspiratory and expiratory anesthesia concentration oxygen concentration expiratory volume and airway pressure in the circuit The carrier gases used must be dry and free of oil and dust The limits for moisture are as follows dew point of oxygen 5 C dew point of air 5 C water contents of...

Page 79: ...uires all unused vaporizers to be locked in their zero percent positions WARNING Only one vaporizer can be activated at a time If the exclusion system permits simultaneous activation of two or more vaporizers do not use the anesthesia machine contact a Draeger Medical qualified technical service representative for adjustment With the fixed mount exclusion system if the system permits simultaneous ...

Page 80: ...t Exclusion System Removable Vaporizer Exclusion System The removable vaporizer exclusion system shown in Figure 6 3 has a manual selector lever used to select which vaporizer is active This selector lever provides an interlock function which ensures that only one vaporizer can be turned on at a time Figure 6 3 Removable Vaporizer Exclusion System VAPOR MOUNT PIN OP00056 OP00161 SELECTOR LEVER RET...

Page 81: ...lector lever to the position opposite of the install position 5 Lower the vaporizer onto the ports on the mounting block turn the locking lever 90 clockwise until it engages to secure the vaporizer to the mounting block To remove the Vapor 19 3 1 Turn the handwheel to 0 until it engages 2 Move the locking lever 90 counterclockwise to the open position over the handwheel 3 Lift the vaporizer off th...

Page 82: ...sure the handwheel is set to 0 zero point interlock and that the button is engaged NOTE Machines equipped with fixed mount vaporizers are configured internally with information about what types of vaporizers are located in the vaporizer positions left right and if applicable center If a vaporizer is installed and the Narkomed s internal configuration is not set the Advisory message VAP NOT CONFIG ...

Page 83: ...etic vapors is injurious to health Before filling a vaporizer note the expiration date of the anesthetic agent Do not use anesthetics beyond the date of expiration CAUTION Each vaporizer is specifically designed and calibrated for one particular anesthetic agent Do not fill a vaporizer with any anesthetic other than the particular agent indicated on the vaporizer The Isoflurane vaporizer must be f...

Page 84: ...ater or other liquid cleaning solutions 3 Make sure the drain valve is closed 4 Open the inlet valve by turning it counterclockwise about three turns CAUTION Be sure to fill the vaporizer in an upright position filling the vaporizer in a tilted position may cause overfilling Overfilling may cause the anesthetic concentration rate to be higher or lower than the handwheel setting 5 Remove the cap fr...

Page 85: ...n 2 Remove the cap and seal from the anesthetic agent bottle Check the sealing edge of bottle for chipping or other damage DO NOT use if damaged 3 Attach the keyed bottle adapter to the keyed collar on the bottle Screw the parts together tightly to form an airtight seal 4 Turn the filler port lock screw counterclockwise and remove the filler port plug from the filler port 5 Insert the keyed adapte...

Page 86: ...he sight glass while the vaporizer is filling and close the filler valve when the liquid level reaches the lower of the two marks at the upper end of the sight glass The lower mark is the FULL mark the upper mark is the OVERFLOW mark NOTE The capacity of the vaporizer is approximately 140 cm3 with wet wick and approximately 200 cm3 with dry wick 10 Remove the adapter from the filler port 11 Allow ...

Page 87: ...ed Safety System SIGHT GLASS OVERFLOW LINE FULL LINE REFILL LINE DRAIN VALVE KNOB KEYED BOTTLE ADAPTER KEYED DRAIN PORT DRAIN PORT LOCKSCREW KEYED BOTTLE ADAPTER FILLER PORT PLUG KEYED FILLER PORT FILLER PORT LOCKSCREW FILLER VALVE KNOB OP10621a RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 88: ...truction Manual Draeger Medical Inc 6 Vaporizer Figure 6 7 Keyed Bottle Adapters HALOTHANE RED ENFLURANE ORANGE ISOFLURANE PURPLE OP10620 SEVOFLURANE YELLOW RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 89: ...Open the drain valve by turning it counterclockwise about three turns Do not unscrew the valve completely 4 Close the drain valve WARNING Do not re use drained agent 5 Place the cap back on the bottle and dispose of the bottle in accordance with approved hospital procedures Draining Vaporizer With Key Indexed Safety System The key indexed safety system employs a matching pin and socket assembly to...

Page 90: ... avoid kinking the plastic tube Open the drain valve by rotating the knob counterclockwise Allow the liquid to drain into the bottle until the vaporizer is empty The vaporizer is empty when no anesthetic flows from the drain 6 Close the drain valve and remove the adapter from the drain port WARNING Do not re use drained agent 7 Place the cap back on the bottle and dispose of the bottle in accordan...

Page 91: ...nger This section describes the open reservoir scavenger of the Narkomed GS anesthesia machine Overview 7 2 Connecting the Open Reservoir Scavenger System 7 3 Operating the Open Reservoir Scavenger System 7 4 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 92: ...disposal system The open reservoir scavenger is an open system which uses continually open relief ports to provide positive and negative pressure relief The open reservoir scavenger is shown in Figure 7 1 Figure 7 1 Open Reservoir Scavenger VACUUM DISS HOSE TERMINAL THREADED INPUT PORT CAP 19MM SCAVENGER HOSE TERMINAL RELIEF PORT NEEDLE VALVE KNOB FLOWMETER RESERVOIR CANISTER 19MM SCAVENGER HOSE T...

Page 93: ...marked SCAVENGER HOSE on the rear of the APL valve and the 19 mm terminal marked SCAVENGER HOSE on the right side of the scavenger WARNING Make sure the 19 mm scavenger hose leading from the absorber is not pinched kinked or blocked in any manner 2 Attach another 19 mm scavenger hose between the 19 mm terminal marked SCAVENGER HOSE on the ventilator relief valve and the 19 mm terminal marked SCAVE...

Page 94: ...ister Thus positive pressure does not build up within the patient breathing system CAUTION Waste gas vented from the relief ports may contaminate the operating room To prevent such contamination be sure to adjust the needle valve properly If the disposal system s flow rate suction exceeds the waste gas flow rate from the patient breathing system the disposal system draws room air through the relie...

Page 95: ...ction flow rate of about 25 l min Depending on the fresh gas flow rate the needle valve setting may have to be increased or decreased to settings either above or below the lines on the flowmeter If the suction flow rate is set too low waste gas will exit the canister through the relief ports around the top of the canister and contaminate the operating room If the suction flow rate is too high the ...

Page 96: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 97: ...erface for Passive Systems This section describes the scavenger interface for passive systems of the Narkomed GS anesthesia machine Overview 8 2 Operating the Scavenger Interface for Passive Systems 8 3 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 98: ...a closed system which uses a spring loaded valve for positive pressure relief The scavenger interface is shown in Figure 8 1 WARNING Do not use this device with a waste gas disposal system capable of applying a negative pressure to the scavenger interface a suction or vacuum waste gas disposal system Figure 8 1 Scavenger Interface for Passive Systems WASTE GAS INPUT PORT 19MM HOSE TERMINAL INPUT P...

Page 99: ...ve pressure relief valve is set to open at a pressure of 5 cm H2O Waste gas then exits through the holes in the relief valve housing Therefore you do not have to adjust this scavenger You must however make sure that hoses are properly connected and that the positive pressure safety relief valve is functioning Hose connections are shown in Figure 8 2 WARNING The positive pressure relief valve must ...

Page 100: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 101: ...tion Manual 9 Main Switch Panel This section describes the main switch panel of the Narkomed GS anesthesia machine Overview 9 2 System Power Switch 9 3 Testing the Battery 9 3 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 102: ...s for low O2 supply pressure AC power failure and battery low alarms These alarms are annunciated and displayed on the monitor screen s alarm window Figure 9 1 Main Switch Panel RED O2 SUPPLY PRESSURE LOW INDICATOR YELLOW AC POWER LOW INDICATOR YELLOW BATTERY LOW INDICATOR GREEN BATTERY TEST INDICATOR BATTERY TEST PUSH BUTTON SYSTEM POWER SWITCH OP20050 RETURN TO THIS MANUAL S TABLE OF CONTENTS RE...

Page 103: ... s power plug from the electrical outlet 3 Press and hold the BATTERY TEST button 4 If the battery is sufficiently charged the green BATTERY TEST light illuminates after a short delay Usually a fully charged battery can power the electrical components of the anesthesia machine for at least 30 minutes in the event of a power failure NOTE During an AC power loss the BATTERY LOW indicator is illumina...

Page 104: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 105: ...sia machine Overview 10 2 Activating the Ventilator 10 3 Adjusting the Tidal Volume 10 5 Setting the Respiratory Frequency 10 5 Setting the Inspiratory Expiratory I E Phase Time Ratio 10 6 Setting the Inspiratory Flow Rate 10 6 Setting the Inspiratory Pressure Limit 10 6 Problem Resolution 10 7 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 106: ...bag and adjustable pressure limiter APL valve for manual ventilation or the ventilator bellows for automatic ventilation During automatic ventilation the manual automatic selector valve isolates the absorber s APL valve from the breathing system To compensate for the continuous introduction of fresh gas into the breathing system the ventilator incorporates a relief valve mounted behind the bellows...

Page 107: ...valve housing and the AUTO BAG SELECTOR interface as shown in Figure 10 2 When the interface cable is disconnected the position of the selector lever has no effect on the ventilator I E RATIO CONTROL I E RATIO DISPLAY FREQUENCY CONTROL FREQUENCY DISPLAY INSPIRATORY FLOW GAUGE INSPIRATORY FLOW CONTROL VENTILATOR ON OFF CONTROL TIDAL VOLUME CONTROL PRESSURE LIMIT CONTROL TIDAL VOLUME SETTING INDICAT...

Page 108: ...ilator turn the switch clockwise the green ON indicator is then turned on and the switch returns to its center position NOTE The ventilator can only be activated when the manual automatic selector valve is in the AUTO position with the interface cable between the selector valve housing and AUTO BAG SELECTOR interface connected If you attempt to activate the ventilator with the selector lever in th...

Page 109: ...t To adjust the tidal volume press the self locking knob so that it can turn then set the desired tidal volume as shown by the setting indicator on the bellows chamber scale marked 200 1400 ml The tidal volume can be adjusted to achieve volumes between 20 and 1500 ml Smaller tidal volumes can be adjusted by setting the pointer below the 200 ml marking on the bellows chamber larger tidal volumes ca...

Page 110: ...ith nominal zones of LOW MEDIUM and HIGH You should adjust the flow setting to a point where the ventilator bellows is fully compressed but not deformed at the end of the inspiratory phase of the breathing cycle You can also use the inspiratory flow control to create an inspiratory plateau at the end of the inspiratory cycle and to affect the potential peak inspiratory pressure within the patient ...

Page 111: ...equency too high for selected tidal volume Decrease frequency Increase expiratory phase time Improperly adjusted ventilator relief valve Contact Draeger Medical qualified technical service representative Breathing system leak Repair leak Ventilator won t cycle Low oxygen supply pressure Provide sufficient oxygen supply pressure Moving manual automatic selector valve lever to AUTO position does not...

Page 112: ...omatic selector valve in BAG position Place selector valve in AUTO position Inspiratory flow control setting on ventilator too low Increase inspiratory flow control setting Frequency too high Decrease frequency Inspiratory pressure limit setting on ventilator too low Increase inspiratory pressure limit setting RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 113: ...bes the monitoring system of the Narkomed GS anesthesia machine Overview 11 2 Power On Screen 11 2 Monitor Screen and Controls 11 3 Configuring the Anesthesia Machine 11 7 Setting Alarms to Standby 11 10 Silencing Alarms 11 10 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 114: ...stics one of three possible conclusions to the self tests is posted on the screen FUNCTIONAL Every component of the monitoring system is in satisfactory operational order After a brief delay the Monitor screen appears CONDITION ALLY FUNCTIONAL A noncritical fault was detected such as a speaker failure The Narkomed GS may be used but a Draeger Medical qualified technical service representative shou...

Page 115: ...ntrol keys to the left and right of this screen allow you to establish monitoring settings See Figure 11 2 Figure 11 2 Monitor Screen and System Controls Alarms Config Oxygen Breathing Volume Breathing Pressure Liters cm H O 2 High Limit Low Limit Cal Low Limit Off On Off On High Limit Auto Set All Stby WARNING CAUTION ADVISORY INSP O2 LOW SUB ATM PRESSURE AC BATTERY FAIL O2 SUPPLY LOW SERVICE VEN...

Page 116: ... volume low alarm limit Breathing Pressure Monitor Window Displays the patient s peak airway pressure mean airway pressure and positive end expiratory pressure PEEP Breathing Pressure Trace Window Displays a trace or waveform of the patient s breathing pressure and the anesthesia machine s breathing pressure alarm limits to the left of the waveform WARNING CAUTION ADVISORY INSP O2 LOW SUB ATM PRES...

Page 117: ...olume alarms until a valid breath is detected If the ventilator is on only the respiratory volume alarms are affected Silence Alarms Silences all audible alarm tones for 2 minutes Configure Displays the Configure screen where you can set system parameters such as the time date and alarm volume You also enter the Alarm Log by way of the Configure screen These functions are described in detail later...

Page 118: ...ons are described in the following sections Section 12 Oxygen Monitoring Section 13 Respiratory Volume Monitoring and Section 14 Breathing Pressure Monitoring Figure 11 5 Right Keypad Oxygen Breathing Volume Breathing Pressure Liters cm H O 2 High Limit Low Limit Cal Low Limit Off On Off On High Limit Auto Set OP87008 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 119: ...s indicates that the anesthesia machine s Alarm window will not display alarms instead alarms will be displayed on the other product s central alarm display When you start the anesthesia machine it uses the values that were established the last time the machine was configured You can view or change these values on the Configure screen Displaying the Configure Screen To display the Configure screen...

Page 120: ...re pressed When you exit the Configure screen the values displayed on the screen are saved The monitoring system uses these values until they are changed Using the Alarm Log If you miss a warning or caution message in the Alarm window you can look for it in the Alarm Log It contains up to 100 of the most recent warning and caution messages When there are more than 100 warnings and cautions the old...

Page 121: ...all of the messages from the Alarm Log press the CLEAR LOG key The messages are permanently deleted from the Log Exiting the Alarm Log To exit the Alarm Log immediately press the EXIT key NOTE The monitoring system automatically exits the Alarm Log if a minute passes and no keys are pressed When you exit the Alarm Log you are returned to the Monitor screen Low Limit ALARM LOG OP87029 EXIT TIME 12 ...

Page 122: ...silence alarm tones for 2 minutes press the Silence Alarms key The LED next to the Silence Alarms key lights and remains lit for the duration of the silence period Pressing the Silence Alarms key while the LED is lit restarts the 2 minute silence period If a new alarm condition occurs during the silence period a single tone pattern sounds corresponding to the priority of the alarm After the silenc...

Page 123: ...Narkomed GS anesthesia machine Overview 12 2 Monitor Display 12 2 Monitor Controls 12 3 Setting Alarm Limits 12 3 Calibrating the Oxygen Sensor 12 4 Unsuccessful Calibration 12 6 Oxygen Alarm Messages 12 8 Low Oxygen Supply Whistle 12 9 Problem Resolution 12 9 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 124: ...me that the sensor spent outside the housing Calibrate the sensor NOTE When the machine is not in use remove the oxygen sensor assembly from the inspiratory valve dome and insert the inspiratory valve dome plug into the inspiratory valve dome Monitor Display Information about the oxygen analysis is presented in the Oxygen Monitor window at the top right of the monitor display as shown in Figure 12...

Page 125: ...set to their system defaults You can adjust these limits within specified ranges Valid settings for the alarm limits and their system defaults are shown in Table 12 1 Table 12 1 Alarm Limits Oxygen Breathing Volume Breathing Pressure Liters cm H O 2 High Limit Low Limit Cal Low Limit Off On Off On High Limit Auto Set OP87011 HIGH OXYGEN CONCENTRATION ALARM LIMIT KEY LOW OXYGEN CONCENTRATION ALARM ...

Page 126: ...the dome with the inspiratory valve dome plug Do not disassemble the sensor assembly further 2 Expose the sensor to ambient air only 21 oxygen concentration and allow it to stabilize for several minutes To ensure an ambient air exposure hold the sensor away from any open part of the breathing system 3 With the sensor exposed only to room air press the Cal key Calibration begins 4 View the monitor ...

Page 127: ...hen the Narkomed GS successfully completes the calibration pull the inspiratory valve dome plug and reinsert the sensor assembly OP00202A SENSOR ASSEMBLY REAR PANEL OF VENTILATOR BOX 2 EXPIRATORY VALVE DOME INSPIRATORY VALVE DOME PLUG INSPIRATORY VALVE DOME RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 128: ...ing period If the sensor capsule was removed from the sensor assembly a waiting period equal to the time that the capsule spent outside the sensor assembly up to one week is necessary prior to calibration New sensors require a 15 minute waiting period Sensor is exhausted If the oxygen sensor has decayed beyond its useful service life see the Specifications section of the manual replace the decayed...

Page 129: ...the actual oxygen percentage Therefore make sure that the sensor is exposed only to room air during the entire calibration period Figure 12 4 illustrates the relationship between the calibration mixture and the accuracy of oxygen measurement Figure 12 4 Measurement Error Due to Incorrect Calibration DISPLAYED O2 PERCENTAGE ACTUAL O2 PERCENTAGE Correct calibration of room air 21 O2 for entire calib...

Page 130: ...ation and monitoring the Narkomed GS checks for a difference between the outputs of the two sensor channels If the difference exceeds a predetermined percentage the Advisory message REPLACE O2 CELL appears in the Alarm window During oxygen sensor calibration the Narkomed GS also checks the sensor s output against a range of acceptable output voltages There are three possible causes for deviation f...

Page 131: ... it sounds a 7 second whistle when the oxygen supply drops too low to properly pressurize the fresh gas circuit below about 37 psi If this alarm sounds it cannot be silenced Problem Resolution Table 12 3 Oxygen Monitoring Problem Resolution PROBLEM POSSIBLE CAUSE REMEDY Display area remains blank when a reading is expected CAL O2 SENSOR message in Alarm window Needs calibration Perform proper cali...

Page 132: ...sensor to room air for 21 calibration Sensor exposed to constantly changing calibration mixture Sensor capsule was removed from housing for a prolonged period Allow a waiting period equal to duration of capsule removal New capsule not given proper waiting period Allow 15 minute waiting period Exhausted or defective sensor capsule Replace housing cable assembly O2 SENSOR DISC message appears in ala...

Page 133: ... Narkomed GS anesthesia machine Overview 13 2 Monitor Display 13 3 Monitor Controls 13 4 Setting the Minute Volume Low Alarm Limit 13 5 Turning Respiratory Volume Alarms Off 13 5 Turning Respiratory Volume Alarms On 13 5 Respiratory Volume Alarm Messages 13 6 Problem Resolution 13 8 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 134: ...ence in time of flight is used to determine the velocity and the flow rate of gas through the patient circuit The flow sensor output is converted into meaningful readings for minute volume tidal volume and respiratory rate displays Figure 13 1 Respiratory Volume System WARNING The ultrasonic flow sensor can be used with all normal anesthetic gases except oxygen helium heliox Incorrect flow measure...

Page 135: ...play as shown in Figure 13 2 From left to right numerical values are shown in large type for tidal volume respiratory rate and minute volume At the extreme right in small type is the minute volume low alarm limit Figure 13 2 Monitor Display Tidal Volume Measurement TID VOL Displays the volume for each breath If the monitor does not detect a valid breath within 30 seconds the display area goes blan...

Page 136: ...dow See Figure 13 3 Figure 13 3 Monitor Controls Fixed alarms are provided for low tidal volume apnea volume low minute volume and reverse flow through the sensor While the ventilator is on apnea volume alarms are generated at 15 seconds Caution and 30 seconds Warning if the respiratory volume monitor does not sense a valid breath While the ventilator is off these alarms are generated at 30 second...

Page 137: ...rease the highlighted alarm limit 3 To save the new value stop pressing arrow keys until the highlighting box disappears 5 seconds or press a different alarm Limit key The new value is saved as the alarm limit Turning Respiratory Volume Alarms Off To turn off the respiratory volume alarms press the Breathing Volume Off key The alarms stop sounding and their messages are erased from the display In ...

Page 138: ... condition does not occur until 60 seconds have elapsed During apneic conditions the respiratory volume measurements disappear after 30 seconds When a valid breath is detected alarm annunciation ceases and a tidal volume measurement appears in the display window However a full minute of respiratory activity must be registered before the minute volume and respiratory rate appear NOTE You can disabl...

Page 139: ...ENSOR DISC advisory message appears in the Alarm window if the sensor cable is not properly connected to the interface panel if there is an internal sensor fault or if the electronics housing is not properly seated on the flow housing transducer assembly VOLALARMS STBY Advisory When the volume alarms have been set to Standby the Advisory message VOL ALARMS STBY appears in the Alarm window SERVICE ...

Page 140: ...nk display area VOL SENSOR DISC alarm message in Alarm window Sensor cable disconnected Reconnect sensor cable to interface panel on anesthesia machine Sensor fault Replace sensor assembly Electronics housing is not properly seated on flow housing transducer assembly Reseat electronics housing on the flow housing transducer assembly and ensure it is locked in place REVERSE FLOW alarm message in Al...

Page 141: ... Breathing Pressure Monitoring Location 14 2 Installing the Breathing Pressure Pilot Line 14 4 Monitor Displays 14 6 Monitor Controls 14 10 Setting the Threshold Pressure Alarm Limit 14 11 Turning the Apnea Pressure Alarm Off 14 14 Turning the Apnea Pressure Alarm On 14 14 Breathing Pressure Alarm Messages 14 14 Problem Resolution 14 16 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TA...

Page 142: ...ocked breathing system can be more easily detected with this method when compared with pressure monitoring at the absorber For example if the inspiratory breathing hose became kinked or blocked during automatic ventilation the ventilator bellows would continue to cycle against the blocked hose A pressure monitor connected at the Y piece downstream of the occlusion could sense either an absence of ...

Page 143: ...on within the pilot line and the introduction of additional disconnection points if the pilot line connects to a 15 mm adapter In conclusion the responsibility for the selection of pressure monitoring at either the absorber or the Y piece rests with you the operator Your clinical considerations over which Draeger Medical has no control must be included in this decision Draeger Medical is available...

Page 144: ...install the short pilot line which has quick connect fittings on both ends as follows refer to Figure 14 1 1 Connect one end of the pilot line to the fitting mounted on the rear of the pipe extending from the absorber top assembly 2 Connect the other end of the pilot line to the BREATHING PRESSURE interface underneath the rear panel of the ventilator box Figure 14 1 Absorber Monitoring OP00204A QU...

Page 145: ...absorber is self closing You can leave it unused when installing the long pilot line for Y piece monitoring 2 Connect the Luer fitting on the other end of the pilot line to a Luer fitting on either the patient Y piece or a 15 mm adapter on the patient side of the Y piece 3 Using the four plastic hose clips attached to the pilot line mount the pilot line on either of the breathing hoses leading to ...

Page 146: ...trace or waveform To the left of the waveform in small type are the pressure high and threshold pressure alarm limits Breathing Pressure Monitor Window This small window on the right contains numerical breathing pressure measurements OP87017 WARNING CAUTION ADVISORY INSP O2 LOW SUB ATM PRESSURE AC BATTERY FAIL O2 SUPPLY LOW SERVICE VENT MON PORT A ERROR OXYGEN 100 30 32 TID VOL 0 35 BPM 10 MIN VOL...

Page 147: ... Expiratory Pressure The breathing pressure at the end of exhalation During apneic conditions the pressure monitor displays numeric information as long as it detects a peak pressure at least 10 cm H2O greater than PEEP pressure When this pressure difference drops below 10 cm H2O the numeric information remains 1 minute longer and then disappears WARNING CAUTION ADVISORY INSP O2 LOW SUB ATM PRESSUR...

Page 148: ...Breathing Pressure Trace Window The peak of the waveform corresponds to the peak pressure The slope of the trace as it rises toward the peak pressure is correlated with the inspiratory flow rate the steeper the slope the higher the flow rate The amount of pressure that the baseline is raised from zero corresponds to the patient s positive end expiratory pressure PEEP The length of the plateau from...

Page 149: ... by a marker on the Y axis only when it is less than or equal to the top of the scale set by the system In Figure 14 5 the pressure high alarm limit 35 cm H2O is greater than the top of the scale 20 cm H2O When a high alarm limit marker is displayed its appearance depends on whether the pressure high alarm limit is less than or equal to the top of the scale Figure 14 6 illustrates the difference i...

Page 150: ... high alarm limit follow these steps 1 Press the Breathing Pressure High Limit key A box is drawn around the pressure high alarm limit 2 Press the up arrow or down arrow key to increase or decrease the pressure high alarm limit 3 To save the new value stop pressing arrow keys until the highlighting box disappears 5 seconds or press a different Alarm Limit key The new value is saved and displayed a...

Page 151: ...ithin the range of 5 30 cm H2O and less than the pressure high alarm limit 1 Press the Breathing Pressure Threshold key A box is drawn around the threshold pressure alarm limit 2 Press the up arrow or down arrow key to increase or decrease the threshold pressure alarm limit 3 To save the new value stop pressing arrow keys until the highlighting box disappears 5 seconds or press a different Alarm L...

Page 152: ...roblem the Advisory message THRESHOLD LOW appears in the Alarm window when either of the following conditions occurs The sensed peak pressure exceeds the set threshold by more than 6 cm H2O at threshold pressure alarm limit settings of 5 20 cm H2O The sensed peak pressure exceeds the set threshold by more than 8 cm H2O at threshold pressure alarm limit settings of 21 29 cm H2O NOTE The threshold s...

Page 153: ...m H2O below peak pressure 2 Thus after partial breathing system disconnection or leak small pressure fluctuation in system satisfies incorrectly set threshold pressure alarm limit Operator is not alerted of apnea condition 1 2 Thus after partial breathing system disconnection or leak small pressure fluctuation does not cross threshold pressure alarm limit Operator is warned of apnea condition Thre...

Page 154: ... list contains all warning caution and advisory alarms associated with breathing pressure monitoring APNEA PRESSURE Warning Caution When the ventilator is on If the measured breathing pressure remains below the threshold pressure alarm limit for more than 15 seconds the Caution message APNEA PRESSURE appears in the Alarm window and an intermittent audible alarm sounds If the breathing pressure rem...

Page 155: ...ermittent audible alarm sounds When the measured breathing pressure drops below the threshold pressure alarm limit alarm annunciation ceases PEEP 25 Caution Any time that the monitor measures a PEEP of 26 cm H2O or greater the Caution message PEEP 25 appears in the Alarm window and an intermittent audible alarm sounds Alarm annunciation ceases when the measured PEEP drops below 26 cm H2O Also an A...

Page 156: ...l qualified technical service representative Problem Resolution Table 14 1 Breathing Pressure Monitoring Problem Resolution PROBLEM POSSIBLE CAUSE REMEDY No pressure readout in display area during ventilation Pilot line not connected Make sure pilot line is properly connected Pilot line blocked or kinked Make sure that lumen of pilot line is free of obstructions Erratic readings Condensation accum...

Page 157: ...Sphygmomanometer This section describes the sphygmomanometer of the Narkomed GS anesthesia machine Overview 15 2 Selecting a Blood Pressure Cuff 15 3 Connecting the Cuff 15 3 Placing the Cuff 15 4 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 158: ...lator bellows The cuff inflation bulb is located to the right of the oxygen flush button on the front of the machine See Figure 15 1 Figure 15 1 Manual Sphygmomanometer THREADED HOSE FITTINGS FOR GAUGE AND CUFF INTERNAL PIPING CONNECTS BULB FITTING TO GAUGE AND CUFF FITTING FEMALE LUER FITTING SLIP FIT FOR CUFF INFLATION BULB OP87028 SPHYGMOMANOMETER GAUGE BP CUFF O2 FLUSH FRONT OF FRAME HANDLE RE...

Page 159: ...uff hose into the Luer lock fitting on the extension hose and twist until they lock together 2 Attach the other end of the extension hose to the fitting on the patient interface panel labeled BP CUFF Hand tighten the threaded hose fitting onto the threaded fitting of the interface panel 3 Make sure that none of the hoses are pinched or kinked After connecting the manual sphygmomanometer check the ...

Page 160: ...nt s heart Placing the cuff above the heart causes the reading to be falsely low placing the cuff below the heart causes the reading to be falsely high In instances where you cannot place the cuff at the same level as the heart use the following general rule For every inch of elevation above the heart add 1 8 mm Hg to the reading For every inch of elevation below the heart subtract 1 8 mm Hg from ...

Page 161: ...GS anesthesia machine Overview 16 2 Routine Maintenance 16 2 Scavenger Interface for Passive Systems Maintenance 16 8 Removing Parts for Cleaning and Disinfection 16 10 Disassembling Parts for Cleaning and Disinfection 16 13 General Guidelines for Cleaning and Disinfection 16 15 Reassembly Instructions 16 22 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 162: ...argin for replacing absorbent When using loose absorbent do not fill above the maximum fill level line located about a quarter inch from the top of the canister The clearance and the ratio of canister diameter to screen opening minimize the potential for channeling In channeling gas flows through the canister along the path of least resistance The gas depletes the efficiency of the absorbent along...

Page 163: ...and place a prepack into each canister When using loose absorbent fill the canister to the fill line Do not overfill 6 Stack one canister on top of the other and center the stack on the gasket of the bottom dome 7 Raise the bottom dome remove and empty the dust cup if loose absorbent is present and replace the dust cup ABSORBER DOME AND GASKET CANISTER CANISTER GASKET BOTTOM DOME AND GASKET DUST C...

Page 164: ...nscrew the cover from the sensor housing and remove the sensor capsule 4 Install the replacement sensor in the housing Verify that the copper rings on the capsule mate with the electrical contacts in the sensor housing 5 Wait 15 minutes to let the sensor capsule stabilize to ambient air If you do not wait calibration the next step will not be successful 6 Restore power to the machine and calibrate...

Page 165: ...ing nut counterclockwise 2 Remove the patient hose from the expiratory hose terminal on the flow sensor 3 Lift the flow sensor off the bracket 4 Press down on the lever under the flow housing and remove the flow housing transducer assembly from the electronics housing 5 Pull both transducers out of the flow housing Figure 16 3 Clearing Condensation in the Ultrasonic Flow Sensor 6 Tip and shake the...

Page 166: ...nics housing make sure the flow housing is facing the right direction Compare the direction to the illustration on the electronics housing The index pin on the electronics housing should align with the hole in the flow housing 11 Slide the flow sensor onto the bracket 12 Connect the patient hose to the expiratory hose terminal on the flow sensor 13 Install the connector hose assembly between the f...

Page 167: ... scavenger hoses for signs of deterioration Replace any worn hoses 3 If applicable unscrew the wing nut until the needle valve assembly can be removed from its seat Remove the nut and disassemble the valve Inspect the needle valve and seat for lint or dust accumulation Clean with compressed air if necessary Figure 16 4 Open Reservoir Scavenger Maintenance VACUUM SOURCE TERMINAL ADAPTER INPUT PORT ...

Page 168: ...dy with a moist cloth 2 Inspect all scavenger hoses for deterioration Replace any worn hoses 3 Remove the relief valve housing by unscrewing it counterclockwise 4 Inspect the rubber O ring If it is worn replace it 5 Remove the relief valve by twisting it counterclockwise out of the housing You can use the tips of a needle nose pliers to turn the valve but take care not to damage the relief valve s...

Page 169: ...ed remove the sphygmomanometer gauge assembly hoses and blood pressure cuff from the anesthesia machine and sterilize them with ethylene oxide gas cold cycle followed by appropriate aeration according to the sterilizer manufacturer s instructions NOTE Do not autoclave the gauge assembly it cannot withstand the heat of autoclaving OP00277 INPUT PORT CAP SECONDARY WASTE GAS INPUT PORT WASTE GAS EXHA...

Page 170: ...e Systems Maintenance for disassembly instructions 4 Remove the oxygen sensor assembly from the inspiratory valve and disconnect the sensor cord from the system interface panel 5 Disconnect the flow sensor cable from the system interface panel 6 Remove the connector hose assembly between the flow sensor and the expiratory valve by turning the ring nut counterclockwise 7 Lift the flow sensor off th...

Page 171: ... gauge assembly off the gauge mount Do not misplace the O ring See Figure 16 6 Figure 16 6 Removing the Pressure Gauge 13 Remove the absorber using a 3 16 inch hex screwdriver to loosen the hex screw securing the absorber assembly to the absorber pole Do not remove the screw Lift the absorber off the absorber pole OP00262 GAUGE MOUNT O RING BREATHING PRESSURE GAUGE RING NUT RETURN TO THIS MANUAL S...

Page 172: ...s assembly by loosening the two wing nuts on the bottom of the assembly until the assembly releases from the canister See Figure 16 7 Figure 16 7 Removing the Bellows Assembly OP00260A WINGNUT 2X PILOT LINE RELIEF VALVE BODY BELLOWS BELLOWS CANISTER RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 173: ...nsducer assembly out of the electronics housing 2 Pull both transducers out of the flow housing Disassem bling the Ventilator Bellows Assembly 1 Remove the bellows from the ventilator bottom assembly by unscrewing it in a counterclockwise direction until it is released 2 Unscrew the knurled ring nut around the ventilator relief valve and pull the relief valve dome and pilot line away from the reli...

Page 174: ...tory Valves OP00642 INSPIRATORY VALVE DOME INSPIRATORY VALVE DOME PLUG INSPIRATORY VALVE BODY INSPIRATORY VALVE MOUNT EXPIRATORY VALVE BODY EXPIRATORY VALVE MOUNT EXPIRATORY VALVE DOME RING NUT DOME PINS INSIDE DOME GASKET VALVE DISK VALVE PINS CAPTIVE RING NUT VALVE MOUNT GASKET RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 175: ...cy of cleaning or disinfecting any particular component is the responsibility of the user institution These procedures should be performed according to procedures established by the user institution following the specific instructions provided by the manufacturer of the equipment or agent used For additional information about infection control practice refer to the APIC Guideline for Selection and...

Page 176: ...rrugated Breathing Hoses Mask Elbow and Breathing Bag x x x x Y Piece and Mask x x x Ventilator Bellows x x x Ventilator Bellows Bottom Assembly x Oxygen Sensor Capsule x Oxygen Sensor Housing x x Oxygen Sensor Housing Cover x x x Inspiratory Expiratory Valves x x x x Ultrasonic Flow Sensor Housing and Transducers x Ultrasonic Flow Sensor Electronics Housing and Cable x x Breathing Pressure Pilot ...

Page 177: ... Medical makes no claims about the efficacy of these agents or this method of cleaning for infection control Consult your hospital s infection control officer or epidemiologist Cleaning and Disinfecting Corrugated Breathing Hoses Mask Elbow and Bag Contact with oxygen ether mineral or vegetable oils phenols cresois terpenes hydrocarbon solvents chlorinated hydrocarbons esters or oxidizing acids ha...

Page 178: ...Cleaning and Disinfecting the Y Piece and Mask The Y piece and mask can be disinfected by wiping or immersion with glutaraldehyde based formulations EtO and wet pasteurization processes can also be used Cleaning and Disinfecting the Ventilator Bellows The ventilator bellows and its bottom assembly are the only ventilator components that come in contact with the patient s breath Refer back to Clean...

Page 179: ...r an EtO process Cleaning and Disinfecting the Inspiratory and Expiratory Valves The inspiratory and expiratory valves come into contact with the patient s breath Clean these parts with soft lint free cloth moistened with mild alkali detergent and water Dry the parts before reassembling The valve assemblies can be immersed in a 2 glutaraldehyde based solution wet pasteurized gas sterilized or auto...

Page 180: ...e cannot withstand immersion or the heat and pressure of autoclaving Cleaning and Disinfecting the Absorber Canister Assemblies and Dust Cup Refer to Replacing the Absorbent on page 16 2 for instructions on removing the absorbent canister assemblies from the absorber Clean the canisters frequently Remove used absorbent and clean absorbent residues for the canister and gasket surfaces Check the dus...

Page 181: ...contains a stabilization additive called thymol which evaporates more slowly than halothane and collects in the vaporizer Over time thymol may decompose into compounds that affect the wick material and turn the halothane yellow If you see particles in the sight glass of a halothane vaporizer or if the halothane turns yellow rinse the vaporizer chamber with fresh halothane as follows 1 Drain the di...

Page 182: ... reassembling the machine after cleaning and disinfection procedures 1 Reassemble the ventilator bellows assembly Fit the relief valve dome onto the relief valve body and tighten the knurled ring nut Place the ventilator bellows on bellows bottom assembly and turn it clockwise until it is secure 2 Replace the bellows assembly Fit the bellows assembly into the ventilator bellows canister and tighte...

Page 183: ...1 Connect the patient hose to the expiratory hose terminal on the flow sensor 12 Install the connector hose assembly between the flow sensor and the expiratory valve and secure it by turning the ring nut clockwise 13 Connect the sensor cable to the volume sensor receptacle on the system interface panel 14 Replace the oxygen sensor in the inspiratory valve port Connect the sensor cord to the system...

Page 184: ...6 9 Open Reservoir Scavenger Connections OP00143C 19MM SCAVENGER HOSE VENTILATOR RELIEF VALVE 19MM SCAVENGER HOSE TERMINAL VACUUM TERMINAL 19MM SCAVENGER HOSE TERMINAL 19MM SCAVENGER HOSE OPEN RESERVOIR SCAVENGER ABSORBER POLE APL VALVE RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 185: ...6 10 Passive System Scavenger Connections OP00141B TO HOSPITAL EXHAUST SYSTEM 19MM SCAVENGER HOSE ABSORBER POLE VENTILATOR RELIEF VALVE 19MM SCAVENGER HOSE TERMINAL SCAVENGER INTERFACE FOR NON ACTIVE SYSTEMS 19MM SCAVENGER HOSE APL VALVE RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 186: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 187: ... anesthesia machine General 17 2 Environmental 17 2 Gas Delivery System 17 3 Vaporizers Vapor 19 1 and 19 3 17 4 Ventilator 17 4 Absorber System 17 5 Oxygen Monitoring 17 5 Breathing Pressure Monitoring 17 6 Respiratory Volume Monitoring 17 6 Serial Interface 17 6 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 188: ...s operation IPX0 Leakage current 300 microamps per UL 544 Ground impedance 0 1 ohm 60 Hz source Dielectric withstand 1500 VAC per UL 544 Chassis resistance between any metallic point and ground pin on power cord 0 1 ohm 120 Volt Power Supply Primary input voltage acceptable range 100 120 VAC 50 60 Hz Primary input current 10 amps RMS total 3 amps machine 7 amps receptacles 220 240 Volt Power Suppl...

Page 189: ...w at 50 psi pipeline pressure 150 50 ml min Low oxygen supply pressure alarm 34 40 psi Cylinder gauge accuracy 90 psi 0 750 psi 60 psi 751 2250 psi 90 psi 2251 3000 psi Cylinder Gas Pressures typical full loads at 70 F 21 C Oxygen Air 1900 psi 13100 kPa Nitrous oxide 745 psi 5130 kPa Carbon dioxide 838 psi 5770 kPa Flowmeter Accuracy at 20 C and 760 mmHg Oxygen Nitrous Oxide Air Fine 100 1000 ml m...

Page 190: ...ion volume or 15 whichever is higher Enflurane Adjustment range 0 3 7 vol Accuracy 0 2 concentration volume or 20 whichever is higher or 20 30 with flow settings 6 0 15 l min and handwheel settings higher than 5 0 volume concentration Isoflurane Adjustment range 0 2 5 vol Accuracy 0 15 concentration volume or 15 whichever is higher Sevoflurane Adjustment range 0 3 8 vol Accuracy 0 2 concentration ...

Page 191: ...5 to 55 cm H2O 2 FS 55 to 80 cm H2O 3 FS Mounting ring nut size 1 1 8 x 18 APL Valve Nominal low flow resistance 2 cm H2O at 8 l min Hose terminal 19 mm male Breathing Bag Terminal Bag terminal 22 mm male Oxygen Monitoring Range 10 100 vol O2 Resolution 1 vol O2 Accuracy 3 vol O2 When calibrated within 18 hours and constant temperature and pressure Response time 25 sec T90 Zero drift 0 1 vol O2 mo...

Page 192: ... 0 l Resolution 0 1 l Accuracy 10 of reading or 0 01 l x breath rate whichever is greater Tidal Volume Display Range 0 01 2 0 l Note the standard bellows will deliver up to 1 5 l Resolution 0 01 l Accuracy 10 of reading or 0 015 l whichever is greater Volume Apnea Threshold 0 02 l Respiratory Rate Numeric display range 2 99 bpm Resolution 1 bpm Accuracy 10 of reading or 1 bpm whichever is greater ...

Page 193: ...ction Manual Appendix Spare and Replacement Parts This section describes the spare and replacement parts for the Narkomed GS anesthesia machine along with their part numbers RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 194: ...e Assembly Inspiratory with ported dome assembly and plug assembly 4107649 Valve Assembly Expiratory 4107650 Ring Nut inspiratory or expiratory valve upper ring nut 2109228 Gasket flat washer inspiratory or expiratory valve mount 1101690 Dust Cup 4106874 Spring Clip absorber rod 1100097 Hose Assembly patient pressure Luer 4108528 O ring 237 Silicone dust cup fitting 4102940 Breathing System Access...

Page 195: ...ic Bellows 4109700 Oxygen Monitoring Accessories Oxygen Sensor Capsule 6850645 Sensor Housing Cable Assembly 4106363 Inspiratory Valve Dome 4108329 Inspiratory Valve Dome Plug 4106387 Breathing Pressure Monitoring Accessories Breathing Pressure Pilot Line to absorber 4109368 Breathing Pressure Pilot Line with Luer to Y piece 4108528 Respiratory Volume Monitoring Accessories Flow Sensor Assembly 41...

Page 196: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 197: ...5 respiratory volume 13 4 13 6 silencing 11 10 speaker failure 2 29 Auxiliary oxygen flowmeter 2 11 B Bain circuit adapter 2 16 Battery backup system 2 24 machine functions 2 24 test 9 3 Breathing pressure monitoring adjusting alarm limits 14 10 14 11 alarm summary 14 14 measuring the pressure 14 2 numerical data 14 7 14 8 14 11 pilot line installation 14 4 problem resolution 14 16 trace data 14 6...

Page 198: ...7 Flow sensor description 13 2 maintenance 16 5 Flowmeters 2 7 Frequency control 10 5 Fresh gas hose connection 5 5 outlet 2 9 oxygen sensor adapter 2 11 G Gas delivery system general description 2 2 Gases 2 2 Guidelines for cleaning and disinfection 16 15 I Inspiratory flow control 10 6 Inspiratory Expiratory Phase Time Ratio 10 6 Inverse ratios 10 6 K Keypad left 11 5 right 11 6 Keys alarm log 1...

Page 199: ...essure 14 7 14 8 14 11 oxygen concentration 12 2 respiratory volume 13 3 O Open reservoir scavenger maintenance 16 7 Optional gases 2 2 Oxygen analysis adjusting alarm limits 12 3 alarms summary 12 8 measuring the concentration 12 2 numerical data 12 2 problem resolution 12 9 sensor calibration 12 4 12 6 Oxygen flush 2 7 5 5 Oxygen ratio controller 2 8 Oxygen sensor calibration 12 4 12 6 replaceme...

Page 200: ...ume low alarm limit 13 5 alarm summary 13 6 measuring the volume 13 2 problem resolution 13 8 Routine maintenance 16 2 S Scavenger interface for passive systems 2 19 open reservoir 2 18 Screen Alarm Log 2 29 11 8 Configure 11 7 monitor 2 27 11 3 power on 11 2 Self tests 11 2 Sensor Interfaces 2 26 Serial port 11 7 Sphygmomanometer 2 30 15 2 Standard gases 2 2 Sterilization 16 15 System control key...

Page 201: ...2 maintenance 16 5 V Vaporizer general description 2 12 Ventilator general description 2 20 W Warnings breathing pressure 14 14 oxygen 12 8 respiratory volume 13 6 Y Yokes 2 5 5 3 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 202: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 203: ...RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

Page 204: ...cal Inc 3135 Quarry Road Telford PA 18969 Tel 215 721 5404 800 462 7566 Fax 215 721 9561 Web www draegermedical com Printed in the U S A RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS ...

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