11
10545100-Australia Rev.
– 08/2018
PREPARATION FOR USE
CAUTION: Before using the Digital MDM Mixer, check the operation of the unit by performing the following tests.
Performance Checks:
These preliminary tests must be
conducted to ensure that your analgesia mixer is performing
correctly. If the unit fails any one of the following
performance checks, the unit must be returned for service.
Machine Turn-On Test:
Press the ON/OFF key, as shown
in Figure 1. After the device goes through an initialization
routine, the % OXYGEN and LPM FLOW displays should
indicate 100% and 5 LPM.
Alarm Indicator / Lamp Test:
Press the alarm test / silence
key, as shown in Figure 1, and observe that all the alarm
readouts illuminate. The % OXYGEN and LPM FLOW
displays should show 8.8.8. and 8.8 respectively. The alarm
readouts should illuminate with the numerical displays. 10
bars on each gas should illuminate. The audible alarm
should also sound.
Oxygen Failure Test:
Set the LPM FLOW display to 9.9
LPM. Set the % OXYGEN display to 50%. Turn off the
oxygen gas supply to the unit. When the gas runs out, check
for each of the following:
•
The OXYGEN FAILURE alarm illuminates
•
The audible alarm sounds
•
The flow indicators are off
•
The LPM FLOW and % OXYGEN displays are off
Turn on the oxygen gas supply, and the unit should return
to normal operation. (The alarm may continue to chime for
up to 20 seconds after restoration of gas pressure.)
Nitrous Failure Test:
Set the LPM FLOW display to 9.9
LPM. Set the % OXYGEN display to 30%. Turn off the
nitrous oxide gas supply to the unit. When the gas runs out,
make sure each of the following occurs:
•
The NITROUS FAILURE alarm illuminates
•
The audible alarm sounds
•
The LPM FLOW display indicates the oxygen flow
being delivered
•
The % OXYGEN display is OFF
•
The N
2
O gas flow indicator is OFF
•
The O
2
gas flow indicator shows at least 3 bars
Turn on the nitrous oxide gas supply. The unit should return
to normal operation. (The alarm may continue to chime for
up to 20 seconds after restoration of gas pressure.)
Indicated Flow Delivery Test:
Set the % OXYGEN display
to 100%. Press the [
▼]
flow key and hold, as shown in
Figure 1. The flow rate should decrease to 1.0 LPM. An
audible alarm sounds at the lower limit while the key is held.
Press the [
▲]
flow key and hold. The flow rate should
increase to 9.9 LPM. An audible alarm will sound at the
upper limit as long as the key is held.
Indicated Percentage (%) Delivery Test:
Set the LPM
FLOW display to 9.9 LPM. Press and hold the [
▼] %
OXYGEN key. The % OXYGEN display should decrease to
30%. The audible alarm sounds at the lower limit while the
key is held. Press and hold the [
▲] % OXYGEN key, as
shown in Figure 1. The % OXYGEN display should increase
to 100%. An audible alarm sounds at the upper limit while
the key is held.
DIRECTIONS FOR USE
CAUTION:
U s e p a t ie n t o b s e r va t io n t o
p r e v e n t o ve r s e d a t io n i n t h e e ve n t o f a n
o x yg e n f a i ls a f e m a lf u n c t i o n o r c r o s s e d
l in e s . I f a p a t ie n t b e c o m e s o v e r s e d a t e d w h e n
b e i n g d e l i v e r e d 1 0 0 % o x yg e n [ d u r i n g a n a p p a r e n t
l o s s o f n it r o u s o x i d e s u p p l y] , i t is a d e f i n it e
i n d ic a t i o n
o f
c r o s s e d
l i n e s
o r
a
f a i ls a f e
m a lf u n c t i o n . R e m o v e t h e m a s k im m e d ia t e l y a n d
e n c o u r a g e m o u t h b r e a t h i n g . D e l i v e r p u r e o x yg e n
f r o m a n o x yg e n d e m a n d v a l ve o n l y i f t h e o x yg e n
s o u r c e is in d e p e n d e n t f r o m t h e s u s p e c t e d
c r o s s e d l i n e s a r e a .
Note:
These directions detail a basic delivery technique.
However, this is not a comprehensive description and not a
substitute for a training course that emphasizes a practical,
hands-on approach together with instruction on safe
administration techniques.
Topics covered in such a course
will include experiences of practitioners in specific clinical
settings, the pharmacokinetic properties of Nitrous Oxide,
strategies to avoid over sedation and allow for biological
variability, and strategies to maximize patient satisfaction.
Important: Before using the Digital MDM mixer, check the
operation of the unit by performing the Preparation for Use
Tests to ensure that your analgesia unit is performing
correctly.
Basic Delivery Technique:
Practice titration. Titration is a method of administering a
substance by adding definitive amounts of a drug until an
endpoint is reached. For nitrous oxide/oxygen (N
2
O/O
2
)
sedation, N
2
O is given in incremental doses until a patient
has reached a comfortable relaxed state of sedation. The
ability to titrate N
2
O is a significant advantage because it
limits the amount of drug to that which is required by the
patient. If titration is done properly, the patient does not
receive any more of the drug than is necessary. The amount
of N
2
O required by a patient on any given day or time varies.
