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Ventilation with automatic adjustment of
rebreathing to match fresh gas flow 

Most of the breathing systems used for anaesthesia today
are based on the rebreathing principle. Part of the expired
gas is redelivered to the patient after absorbing CO

2

 and

enriching with anaesthetic gases and anaesthetic agent.
The excess anaesthetic is scavenged, the amount of
scavenged anaesthetic gas essentially depending on the
set fresh gas flow.

Administration of anaesthetic gas with reduced fresh gas
flow (low-flow technique) yields a number of major
advantages: lower consumption of anaesthetic gases and
agents, more effective humidification and heating of the
inspiratory gas, lower environmental burden and good
manual ventilation properties.

The design of the breathing system is an aspect of
essential importance for low-flow anaesthesia. The high
degree of fresh gas utilization is a major prerequisite.
Systems suitable for low-flow techniques should be
designed so that it is impossible, firstly, for too much
expiration gas to disappear in the anaesthetic scavenging
line without building up a constant pressure and,
secondly, for fresh gas to escape without first having
been administered to the patient.

In closed anaesthesia systems, anaesthetic gas cannot
escape from the breathing system and no more fresh gas
is delivered than is actually required by the patient. How-
ever, closed systems must also meet additional require-
ments:

the breathing system must be absolutely tight and must
feature additional monitoring and control elements.

The breathing system implemented in the Cato auto-
matically matches its degree of openness to the fresh 
gas flow.

During inspiration, breathing gas streams from the piston
pump to the patient. Valve V2 of the excess gas outlet
and the fresh gas shutoff valve V1 are closed. Expiration
is initiated when the fresh gas shutoff valve V1 is opened.

Expired gas from the patient's lungs streams into the
breathing bag which serves as a reservoir and also into
the retracting piston pump. The excess gas outlet valve
V2 is closed.

Unlike the case with conventional semi-closed breathing
systems, the valve opening time for discharging excess
gas is controlled as required. The system remains open
longer for anaesthesia with high fresh gas flow.

If the fresh gas flow is inadequate in closed anaesthesia
systems, the pressure measuring function will detect that
the patient's expiratory pressure has dropped below
approx. – 3 mbar.

This shortage of fresh gas is signalled by the Cato and
the piston pump stops in order to avoid a negative
pressure in the patient.

Descriptions
Ventilation with automatic adjustment of 
rebreathing to match fresh gas flow

126

Piston pump

Fresh gas

Breathing bag

Exp.(V5)

V3

V8

V9

Insp.(V4)

V1

PEEP (V6)

APL

*

Pressure O

2

MAN/SPONT
changeover

V2

V7

Legend

Subsystem 1

Subsystem 3

Sensor

Filter

Pilot-operated diaphragm valve

Variable-resistance valve

Directional valve

Spring-loaded directional valve

Manually actuated two-way valve

Subsystem 2

Measured gas return line

A-Gas, CO

2

, O

2

⁄

Patient

Absorber

07928971

Содержание Cato

Страница 1: ...Cato edition Anaesthetic Workstation Instructions for Use Software versions Ventilator 7 n Monitor 2 n MT 439 2000 D ...

Страница 2: ...by screen displays which confirm the operating sequence Working with these Instructions for Use Manual Spontaneous Before connecting a patient Check workstation with checklist see page 21 Check that breathing system is complete see page 20 and perform leakage test see page 31 Select Manual Spontaneous mode 1 Press MAN SPONT on ventilator for at least one second 2 Display in dialogue field MAN SPON...

Страница 3: ... patients 4 Quick start in an emergency 7 Operating concept 9 Preparing for use 17 Operation 35 Monitor functions 49 Troubleshooting messages cause remedy 71 Care 79 Check operational readiness 101 What s what 107 Technical data 115 Descriptions 123 Intended use 5 ...

Страница 4: ... This apparatus is neither approved nor certified for use in areas where combustible or explosive gas mixtures are likely to occur Safe connection with other electrical equipment Electrical connections to equipment which is not listed in these Instructions for Use should only be made following consultations with the respective manufacturers or an expert Liability for proper function or damage The ...

Страница 5: ...commended for this equipment The workstation should be moved using the handles only Dräger medical appliances comply with the interference immunity requirements of the specific standards for the products or EN 60601 1 2 IEC 601 1 2 However depending on the design of the mobile phone and situation of use field strengths may occur in the immediate environment of a mobile phone that exceed the values...

Страница 6: ... the haemodynamic patient values ECG arrhythmia analysis Pulse rate Respiration Invasive 2 channels and non invasive blood pressure Functional O2 saturation and pulse Body temperature 2 channels Aquapor1 for humidifying and heating the breathing gas Secretion aspirator1 Vapor1 Anaesthetic vaporiser for halothane enflurane isoflurane and sevoflurane Connection for two Vapor anaesthetic vaporisers1 ...

Страница 7: ... bag rapidly 7 Switch the pressure limiting valve APL to MAN 8 Set maximum pressure Turn the lever of the pressure limiting valve clockwise until the indicator plate stands at maximum pressure No more than ten consecutive quick starts are allowed between two complete self tests This maximum is only permitted if the previous completed self test revealed no fault After the 10th consecutive quick sta...

Страница 8: ...O2 and air fail Ventilate the patient immediately with the separate emergency ventilation bag Auto WakeUp Manual ventilation cannot be performed in standby mode Any attempt to perform manual ventilation in standby mode is detected by the system on account of the pressure thrust in the breathing bag and it automatically switches to MAN SPONT mode in which manual ventilation can then be performed Th...

Страница 9: ...unction 11 Display window without dialogue function 12 Display window with dialogue function 12 Operating concept of the monitor 13 Keys with dedicated function 13 Displays 13 Measured values with grey numerals 13 Screen structure 14 Screen saver 14 Rotary control 14 The various screen displays 16 9 Operating concept Contents Operating concept ...

Страница 10: ...ol is adopted as a valid parameter or a process is started or ended Displays For presenting all information on the screen and on the display windows of the ventilator Tone sequences As an acoustic supplement to the messages They are coupled with certain sounds or tone sequences according to priority classes Tone sequences accompanying warnings are output continuously every 30 seconds with caution ...

Страница 11: ...isplay window Key for setting the maximum pressure for IPPV and SIMV ventilation Key for setting the tidal volume Key for setting the ventilation frequency in IPPV mode Key for setting the time ratio between inspiration and expiration Key for setting the relative inspiratory pause Key for setting the PEEP pressure for IPPV mode Key for setting the ventilation frequency in SIMV mode 11 Operating co...

Страница 12: ...ing the maximum pressure In the black field beside the rotary control 1 The set value appears on the right and left hand sides of the field when a parameter key Pmax VT fIPPV is pressed Here 23 2 The value on the right hand side is changed by turning the rotary control Here 28 The old and new values are consequently always displayed together 3 The value on the right 28 is confirmed as the definiti...

Страница 13: ...rom one screen to the next in succession This key is always used to call up the Standard screen see page 57 Displays Two bar shaped indicator lamps are located above the G key these lamps continue to indicate the alarm states even when the acoustic alam is switched off Red upper lamp flashing Warning Yellow lower lamp flashing Caution Yellow lamp constant Advisory Measured values with grey numeral...

Страница 14: ...r calling up the menu of default values via the softkey config in standby after entering a code Turn rotary control selection The cursor frame moves horizontally in the dashed area Press rotary control confirm selection The selection is confirmed and appears in dark type on a light background The cursor frame is positioned over the arrow symbol z to the next higher menu Turn rotary control the cur...

Страница 15: ...as Halothane Enflurane Isoflurane Sevoflurane Desflurane no anaesth gas warning default calibrating O2 sensor 21 Vol flow sensor Ventilator start up test more Alarms inactive defaults pulse to 0 1 2 3 4 5 6 7 8 9 alarm tone 1 2 3 4 5 6 7 8 9 mode adult Neo parameters record interfaces alarm limits curves basic configuration Standby Configuration Alarms inactive anaesth gas warning calibrating defa...

Страница 16: ...ncept of the monitor The various screen displays 16 alarm limits auto set vent al list IPPV alarm limits alarm info 10 03 97 8 00 PAW peak 37 mbar plat 30 PEEP 5 mean 20 compliance 15 ml mbar MV 6 0 L min VT 0 60 L freq 10 1 min AW temp 38 o C 20 40 0 Fi Fet SpO2 98 67 1 min 0 36 29 25 0 8 0 6 70 68 CO2 mmHg O2 Hal N2O sys compl 1 5 from 10 03 leakage 5 8 00 18 config alarm limits auto set vent al...

Страница 17: ...2 Breathing system 23 Soda lime 23 Emergency ventilation bag 23 Water traps 24 Reserve gas cylinders optional 24 Pipelinie gas supply 24 Gas delivery 24 Oxygen Ratio Control ORC 25 O2 Flush 25 Secretion aspirator optional 25 Power supply 26 Self test 26 Fresh gas External outlet optional 27 Selecting anaesthetic agent 28 Automatic calibration of O2 flow sensors 29 Manual calibration of the O2 sens...

Страница 18: ...urrent per socket 2 A The auxiliary power sockets are not controlled by the main switch If there is a power failure the auxiliary power sockets will be de energised because they are not powered by the uninterruptible power supply UPS Do not connect high frequency surgery appliances to the auxiliary power sockets Do not connect any other multiple sockets e g multiple socket adapters to the auxiliar...

Страница 19: ...plug Follow the specific Instructions for Use of the anaesthetic gas scavenging system Anaesthetic agent vaporiser The illustration shows a Vapor 2000 If using the double connector for two Vapors the automatic Vapor identification system is disabled Only use Vapors listed in the Order List Follow the specific Instructions for Use of the Vapor For each anaesthetic agent only use the specified Vapor...

Страница 20: ... Cato and connected auxiliaries with electrical energy for about 45 minutes It is auto matically activated in the event of a power failure External equipment See page 53 for the configuration of the interfaces Connection via the protocol interface 3 with data cable for printers with serial interface e g Desk Jet Hewlett Packard or e g the PM 8060 Vitara Patient Monitor with the MEDIBUS protocol Se...

Страница 21: ...x 5 minutes depending on the scope of calibration The equipment is subsequently in standby mode when ready for use Anaesthesia ventilation can immediately be started at any time in this mode refer to page 36 onwards Update the checklist by adding or deleting points in accordance with the Instructions for Use the equipment type and configuration concerned and the various supplementary units connect...

Страница 22: ...em is locked locking lever turned clockwise until it engages Anaesthetic gas scavenging Is indicator in wall socket green Only when using Dräger systems note sounds of gas flow in other cases Hose connector engaged below breathing system The auxiliary air holes in the tube below the connector must not be sealed otherwise the breathing system will be drained Note the separate Instructions for Use f...

Страница 23: ...discs inserted Pressure limiting valve APL present Inspiratory microbial filter Symbol Expiratory microbial filter Symbol Soda lime 7 Lime has not noticeably changed colour purple Filling level adequate up to the mark Soda lime container is securely tightened up to the end stop clockwise Emergency ventilation bag not shown Bag is complete with mask and hung from the side of the Cato Bag functions ...

Страница 24: ...dicator on N2O cylinder exceeds 30 bar Replace cylinders if not Close cylinder valves Pipelinie gas supply Have connectors been pressed right into the wall sockets for O2 AIR and N2O not in holding position Check and tick off 2 Pointers of all three pressure indicators are in the green range Gas delivery 3 Switch over to AIR 4 Open O2 and AIR delivery valves until more than 9 L min are indicated 5...

Страница 25: ...distinctly audible flow noise Does the manual ventilation bag inflate Check and tick off Secretion aspirator optional 4 Open ejector valve 5 Seal the aspiration holes on aspirator hose with your finger or fold over the hose Negative pressure indicated approx 0 8 bar Check and tick off Close ejector valve Secretion aspirator may only be used in MAN SPONT mode or with disconnected Y piece 25 Prepari...

Страница 26: ... sound The internal program memories are tested The self test is completed after approx 1 minute The following display appears on the monitor Self test is displayed on the ventilator If the self test reveals a fault of no relevance to the safety of the equipment and not affecting any of the measuring functions the following message appears on the monitor Ready within limits together with a specifi...

Страница 27: ...s MAN SPONT on the ventilator 4 The lamp in the FRESH GAS OUTLET key does not light up Check that pressure is building up in the circle system 4 Switch on the fresh gas outlet Press FRESH GAS OUTLET key The lamp in the key lights up Check that pressure builds up in the semi open system 27 Preparing for use Checking readiness for operation with checklist Self test Fresh gas External outlet Standby ...

Страница 28: ...llowing the machine to identify the Vapor when the equipment is started up when the Vapor is changed during operation Incorrect anaesthetics are not detected However the user can quite deliberately select a different Vapor instead of that identified automatically The following advisory message is then displayed in the alarm field on the monitor AGT NOT SEL If the Vapor has not been encoded The mes...

Страница 29: ...or from the inspiratory valve and expose it to the ambient air place it on the table and wait at least two minutes 2 Use the rotary control to select calibrating in the Standby Configuration menu and press to confirm Move the cursor frame to O2 sensor 21Vol by means of the rotary control Press rotary control to confirm calibration starts 1 Then plug O2 sensor onto the inspiratory valve again Tick ...

Страница 30: ... A tick appears on the screen when calibration has been completed correctly Tick off in checklist The cursor frame has automatically jumped to Ventilator start up test With removal 4 Remove flow sensor Unscrew expiration nozzle Remove flow sensor Briefly swing it to flush with ambient air Hold it horizontally with the cable connection pointing downwards calibration in installation position improve...

Страница 31: ...flow chart on pages 124 125 for further details Messages in the display are accompanied by a brief advisory tone which is repeated every 15 seconds if the operator does not undertake some kind of action on the equipment The test pressure is displayed as an analog and digital value Display example 31 Preparing for use Checking readiness for operation with checklist Ventilatorstart uptest Standby Co...

Страница 32: ...m cone or exercise thorax Confirm 2 Press rotary control on ventilator 1 Display Self test 1 Display Ypiece occluded 5 Plug Y piece onto cone The sampling line is connected to the Y piece and the water trap Confirm 2 Press rotary control on ventilator 1 Display with test block No 4 Self test The test then continues automatically block by block wait approx 1 minute 1 Display Leaktest IPPV 32 Prepar...

Страница 33: ...e indication disappears Press the rotary control on the monitor again to confirm and exit the configuration menu Configuration is now complete Tick off the ventilator self test and monitor self test on the checklist 33 Preparing for use Checking readiness for operation with checklist Ventilatorstart uptest 1 1 2 Standby Configuration anaesth gas Halothane Enflurane Isoflurane Sevoflurane Desfluran...

Страница 34: ...al ventilation in standby mode is immediately detected and causes the system to start operation in MAN SPONT mode Auto WakeUp function see page 8 The equipment is now ready for operation The monitor and ventilator self tests have been completed successfully Tick off in checklist select the settings required for the patient and tick off in checklist Remember to sign and date the checklist 34 Prepar...

Страница 35: ...rs 39 Automatic compliance correction 40 Ventilation with pressure limitation PCV 40 Limit settings 40 SIMV 41 Selecting SIMV mode 41 Paediatric use 42 Anaesthesia ventilation with the Kuhn system 43 Monitoring with reduced alarm limits 44 Checking water traps 44 at the water separator in the gas sampling hose 44 in the breathing hoses 44 Checking the soda lime 45 Anaesthetic vaporiser 45 Secretio...

Страница 36: ...breathing PEEP and pressure limitation Pmax are inactive 3 Set pressure limiting valve APL to SPONT It is now open regardless of the set pressure To fill system 4 Press O2 to inflate the breathing bag rapidly 5 Set fresh gas detailed information on setting the fresh gas flow can be found in the Annex on page 128 Operation Manual Spontaneous Select Manual Spontaneous mode Spontaneous breathing 36 1...

Страница 37: ...e limiting valve APL to MAN 3 temporarily increase fresh gas flow or 2 press O2 3 Set fresh gas with O2 N2O or AIR delivery valve start manual ventilation Emergency ventilation following a gas failure AIR changeover The ventilator drive and ejector generating a negative pressure in the secretion aspirator are normally supplied with gas from the compressed air supply AIR If AIR fails the system aut...

Страница 38: ... automatically switched on again The external fresh gas outlet is then disabled 4 Monitoring the breathing gas O2 and anaesthetic gases in semi open mode with aspiration measurement at the fresh gas supply connector of the semi open system and with the screen in HLM mode Intake measurement is performed without connection to the breathing phase There is no pressure monitoring When switching on and ...

Страница 39: ...tilator The monitor is also started and the IPPV alarm limits are activated Adjusting ventilation parameters Pmax for example 6 Press Pmax 1 The set value appears in the window above while 4 the set value left the parameter and its unit of measure middle and the value to be adjusted right appear in the dialogue window 5 Turn rotary control 4 the value on the right changes 5 continue turning until ...

Страница 40: ... maximum ventilation pressure Pmax has been reached the inspiratory stroke is adjusted so that the pressure remains constant up to the end of inspiration The set tidal volume is not fully applied in this case 1 Display on ventilator Pressure limit 2 The bar graph on the ventilator does not reach 100 If the pressure increases by more than 5 mbar above the maximum ventilation pressure Pmax e g becau...

Страница 41: ...ration time ratio 10 If the ventilation frequency is equal to or greater than 6 breaths per minute in SIMV mode the IPPV alarm limits become active and the alarm mode IPPV alarm limits is automatically displayed on the monitor If the ventilation frequency is less than 6 breaths per minute in SIMV mode special SIMV alarm limits become active and the advisory message SIMV alarm limits flashes in the...

Страница 42: ...This is particularly possible in combination with long inspiration times and can be avoided by reducing the fresh gas flow or using a 1 5 L breathing bag The adjustment intervals and metering accuracy for the tidal volume VT depend on the selected range The system must calculate its new system compliance following a change of hoses The patient must be disconnected for this purpose and the leakage ...

Страница 43: ...system is performed as follows Prepare the Kuhn set in accordance with separate Instructions for Use connect anaesthetic gas scavenging hose see page 92 3 Press MAN SPONT on ventilator for at least one second 4 set pressure limiting valve APL to MAN Connect inspiration hose via 5 connecting sleeve Symbol 6 Expiration connector remains open Symbol 7 Seal manual ventilation connector with cap Symbol...

Страница 44: ...ce water trap when severely fouled if the error message persists even after draining the water trap when the maximum service period of four weeks is exceeded Grasp the ribbed sides of the water trap and draw it out Remove a new water trap from the package Enter the date in the field provided on the water trap Grasp the ribbed sides of the water trap and slide it into the holder until it tangibly e...

Страница 45: ...st be changed when two thirds of the charge has changed colour The colour may also fade again due to drying out after prolonged breaks Changing soda lime during operation see also page 91 Prepare a replacement soda lime container Occlude the Vapor and stop N2O delivery Set ventilator to MAN SPONT and the pressure limiting valve to SPONT 1 Briefly turn the soda lime container anticlockwise and pull...

Страница 46: ...now be removed Secretion aspirator optional To prevent negative pressures in the breathing system and in the patient s lungs we recommend that you only carry out suction with the Y piece disconnected from the patient tube 2 Open ejector valve 3 cover the Fingertip with your index finger The aspiration capacity can be adjusted very accurately with the aid of auxiliary air on this surface Check fill...

Страница 47: ...nsert an empty syringe without cannula at least 20 mL into the connector Extract the water remove syringe and dispose of the full syringe as ordinary domestic waste Push water trap back into holder until it tangibly engages An overfull container or a faulty water trap could lead to failure in sidestream measurement The following must also be changed when working without microbial filter 3 O2 senso...

Страница 48: ... set control dial to 0 After use If operation is interrupted for several hours we recommend that you do not leave the Cato in Standby mode but switch it off completely Turn the master switch to O Off the switch symbol is no longer white After switching off an OFF delay displays the message Power off in the Ventilator display for about 10 seconds Disconnect the gas hoses from the wall sockets or cl...

Страница 49: ...t data screen 57 Select trend screen with zoom function 58 Other trend combinations 59 Return to full trend 59 Erase trend memory 59 Softkeys 60 Displaying and setting alarm limits during operation 60 Activate and deactivate CO2 alarms 61 Auto set Ventilation alarm 61 Alarm information 62 Select list screen 62 Select curves 63 Using the volumeter function 63 Configuration during operation 64 Alarm...

Страница 50: ...sible if the ventilator is also on standby Press the softkey erase trend The system enquires again whether the trend is indeed to be erased Press the softkey erase to confirm The former screen is restored without change if the softkey Do not erase is pressed The saved anaesthetic concentration trend is erased when changing the anaesthetic vaporizer Monitor functions Screen saver Standby screen 50 ...

Страница 51: ...functions This function can be deactivated by DrägerService Use the rotary control to select and confirm individual numbers from the line displayed below The password is represented by asterisks below the line When the correct password has been entered the cursor frame jumps to the selection field for the default values 51 Monitor functions Configuring monitor functions in standby Invoking the con...

Страница 52: ...y Configuration Alarms inactive Check ventilator anaesth gas Halothane Enflurane Isoflurane Sevoflurane Desflurane no anaesth gas warning default calibrating O2 sensor 21 Vol flow sensor Ventilator start up test more defaults pulse to 0 1 2 3 4 5 6 7 8 9 alarm tone 1 2 3 4 5 6 7 8 9 mode adult Neo parameters record interfaces alarm limits curves basic configuration Standby Configuration Alarms ina...

Страница 53: ...ters Record Interfaces Alarms inactive anaesth gas warning calibrating Menu for configuration of Medibus and printer ports Standby Configuration defaults pulse tone 0 1 2 3 4 5 6 7 8 9 alarm tone 1 2 3 4 5 6 7 8 9 mode adult Neo parameters record interfaces alarm limits curves basic configuration RS 232 Medibus baud rate 1 2 9 6 parity even data bits 8 stop bits 1 record printer protocol printer M...

Страница 54: ...ndby Alarm limits Curves Basic configuration 54 Standby Configuration Alarms inactive anaesth gas warning calibrating Menu for setting default alarm limits 95 40 30 120 50 3 0 20 0 6 0 0 40 8 SpO2 etCO2 MV FiO2 FiHal PAW defaults pulse tone 0 1 2 3 4 5 6 7 8 9 alarm tone 1 2 3 4 5 6 7 8 9 mode adult Neo parameters record interfaces alarm limits curves basic configuration Standby Configuration anae...

Страница 55: ...ng monitor functions in standby Calibration Standby Configuration Alarms inactive calibrating O2 sensor 21 Vol flow sensor Ventilator start up test more Calibrate O2 sensor after replacing sensor and after 24 hrs Detach O2 sensor and expose for 2 min to ambient air confirm Standby Configuration Alarms inactive calibrating O2 sensor 21 Vol flow sensor Ventilator start up test more Only necessary if...

Страница 56: ...ame to the required anaesthetic agent with the aid of the rotary control Press the rotary control to confirm The stored trend for the anaesthetic agent concen tration is automatically erased when changing the anaesthetic vaporizer Monitor functions Configuring monitor functions in standby Alarms Anaesthetic agent 56 Standby Configuration warning default calibrating O2 sensor 21 Vol flow sensor Ven...

Страница 57: ...red values 3 Press W repeatedly until the data screen is displayed Display example The airway pressure Paw is continuously indicated by the bar graph on the left hand side of the screen 57 Monitor functions Monitor functions during operation Changing to measuring mode from standby Select standard screen Select data screen 2 1 alarm limits auto set vent al list IPPV alarm limits alarm info 10 03 97...

Страница 58: ...area moves until it includes the interval of interest Press rotary knob the dashed area is enlarged to the full display width When the monitor has been in operation for a sufficiently long time a new dashed area appears and can be extended as described above The maximum has been reached when no new dashed border appears Monitor functions Monitor functions during operation Select trend screen with ...

Страница 59: ...not erase is pressed The saved anaesthetic concentration trend is erased when the anaesthetic vaporizer is changed 59 Monitor functions Monitor functions during operation Select trend screen with zoom function alarm full trend AGas N2O IPPV alarm limits Zoom locate select Increase confirm CO2 MV O2 compl etCO2 38 AMV 6 0 Freq 10 Fi Fet O2 29 25 Hal 0 8 0 6 N2O 70 68 N2O Isoflurane 3 2 0 11 00 12 0...

Страница 60: ...arm limits when the Cato is switched off the setting default is selected and confirmed under warning To change alarm limits Move the cursor frame to the value for the required alarm limit with the rotary control and press to confirm The value can then be altered by turning the rotary control until the required value has been obtained The value is confirmed by pressing the rotary control this value...

Страница 61: ...ncept on page 65 The new tolerance ranges generated for the current measured values depend on the parameter in question The default alarm limits are not affected by Auto set and can be reactivated at any time via the functions config warning and defaults Deactivated alarm limits are not activated by Auto set 61 Monitor functions Softkeys Activate and deactivate CO2 alarms Auto set Ventilation alar...

Страница 62: ... list Press standby key E and softkey erase trend Press new softkey erase in response to system enquiry Monitor functions Softkeys Alarm information Selectlistdisplay 62 IPPV alarm limits next page previous page warning time HR pulse NiBP mmHg SpO2 etCO2 MV O2 AGas PAW sys m dia Fi Fet Fi Fet peak Peep HAL HIGH 12 13 65 99 40 6 0 30 26 1 6 0 6 33 10 O2 LOW 12 15 65 98 38 5 9 25 20 0 8 0 7 30 10 12...

Страница 63: ...atory volume of a breath VT is indicated graphically by the middle bar and numerically on the left Minute volumeter The minute volume represented by the bottom bar runs for 60 seconds during which the tidal volume is summed The time expired is shown in seconds above the bar the total volume appearing on the left The individual breaths are separated by segments in the bar graph The volumeter automa...

Страница 64: ...rs warning default Activates all default alarm limits configured in standby CO2 Activates deactivates all CO2 alarms including Apnoea SpO2 Activates deactivates all SpO2 alarms HLM mode Activates deactivates the heart lung machine monitoring mode See page 68 Pmax on Ventilator pressure limitation generates a caution message off Ventilator pressure limitation generates an advisory message The off s...

Страница 65: ...er A value of 28 is measured The settings menu appears automatically The violated alarm limit is shown in inverted form The symbol for the lower alarm limit and the parameter designation etCO2 appear in the advisory field for caution messages The yellow LED lights up The corresponding tone is heard The value can be altered by turning the rotary control and confirmed by pressing the control The ala...

Страница 66: ...ate the alarm tone during the 2 minutes 1 Press G again and the corresponding yellow LED goes out CO2 alarm on off The CO2 alarms can be deactivated by the CO2 al on off key In this case CO2 is not monitored Press the key again to reactivate the alarm When the CO2 alarm is on the inspiratory CO2 concentration in the breathing air is monitored with a fixed maximum limit of 5 mmHg Monitor functions ...

Страница 67: ...eactivated by selecting IPPV mode or by setting the ventilation frequency to a value equal to or greater than 6 breaths per minute 67 Monitor functions Alarm concept Adjusting to the ventilation mode _ _ _ _ _ _ _ Alarm limits in MAN SIMV SIMV with fIMV 6 MAN SPONT IPPV SIMV ventilation mode SPONT with fIMV 6 and IPPV HLM HLM Minute ventilation AMV off on on off on off on on off on Insp anaestheti...

Страница 68: ...de They are automatically reactivated when pulsations are detected again after ending HLM mode In this alarm mode the parameters are monitored with the same limits as are set in the ventilation mode from which HLM was selected Heart lung mode can be deactivated either via the Configuration menu or via the softkey HLM off Monitor functions Alarm concept Heart lung mode HLM 68 alarm limits HLM off c...

Страница 69: ...69 ...

Страница 70: ...70 ...

Страница 71: ...Contents Page Where messages occur 72 Location of valves and subsystems 73 Messages on the monitor 74 Messages on the ventilator 78 71 Messages cause and remedy Inhalt Messages cause and remedy ...

Страница 72: ...form DrägerService if necessary specifying the malfunction number and software number Call DrägerService if the malfunctions and or advisory messages cannot be remedied in accordance with the descriptions or by repeatedly switching off and on again with a delay of approx 5 seconds in between via the master power switch and repeating the self test All malfunctions are signalled acoustically In the ...

Страница 73: ...iaphragm valve Variable resistance valve Directional valve Spring loaded directional valve Manually actuated two way valve Subsystem 2 Measured gas return line A Gas CO2 O2 Patient Absorber POP OFF 1 2 3 6 7 8 9 4 5 Inspiration Exspiration Pressure limitation APL Location of valves in the breathing system Location of the subsystems Subsystem 1 Subsystem 2 Subsystem 3 Piston pumpe Vapor Pneumatic i...

Страница 74: ...O2 HIGH Inspiratory O2 concentration exceeds upper alarm limit O2 flush used Check O2 concentration in fresh gas flow O2 LOW The inspiratory O2 concentration is below the lower alarm limit Check O2 supply Check setting on O2 flow meter AGT ERR Anaesthetic gas measurement faulty Call DrägerService AGT NOT SEL Anaesthetic agent not selected or selection differs from that detected by Vapor identifica...

Страница 75: ...g gas temperature over 40 C Disconnect breathing gas humidifier Set lower heating level when temperature has dropped to 37 C CO2 ERR Sidestream measurement is faulty Call DrägerService CO2 LINE BLK Sample line blocked Replace sample line and water trap if necessary Check sample line is not kinked Examine measuring gas return line for stenosis replace microbial filter if necessary CO2 OFF _ CO2 ala...

Страница 76: ...L LOW Minute volume below lower alarm limit Tube clogged kinked Leak in breathing system Ventilation volume limited by pressure limitation Check tube and hoses Seal breathing system Correct ventilation pattern N2O ERR N2O gas measurement faulty Call DrägerService NO SPO2 PULS No pulse signal detected by SpO2 measurement for approx 10 seconds Check SpO2 sensor dropped off NiBP measurement on same a...

Страница 77: ...LO Pulse rate has dropped below the set alarm limit Check patient s condition SPO2 PULSE HI Pulse rate exceeds upper alarm limit Check patient s condition Correct alarm limit if necessary SPO2SEN DISC No pulse detected by pulsoxymeter although heart is clearly beating Check patient s condition disturbed circulation Check SpO2 sensor positioned correctly VENT ERR Fault in ventilator pressure sensor...

Страница 78: ... less than 200 mL Use infant hoses Run leakage test to measure new compliance otherwise limited accuracy Press rotary control to confirm piston test The system occasionally runs a self test to detect major leaks and faults in the inspiration valve Pressure release A static excess pressure continued for too long after AutoWakeUp The system is relieved Switch ventilator to standby Disconnect fresh g...

Страница 79: ...ehyde vapour 85 Sterilization with ethylene oxide 86 Steam sterilization 121 C 134 C 86 Tabular summary 87 Disposal of used batteries and O2 sensors 88 Disposal of apparatus 88 Reassembling system 89 SpO2 measurement optional 95 Safety and precautions 95 Choice of sensor 95 C Lock ECG synchronization optional 96 Tips to avoid artefacts 97 Applying sensors 98 Durasensor DS 100 A 98 Oxisensor D 25 a...

Страница 80: ... do not use force Do not damage flat seals avoid contact with sharp edges It must be put down so that the sealing elements are not subject to constant pressure 1 Swing lever back to original position otherwise table top cannot be reclosed Remove anaesthetic gas scavenging system Refer to separate Instructions for Use for anaesthetic gas scavenging system Unplug anaesthetic gas scavenging hose from...

Страница 81: ...sable cloth moistened with distilled water Temperature sensor breathing gas optional Draw temperature sensor out of Y piece remove Y piece from ventilation hoses Prise lead out of hose clips Pull connector out of socket Wipe dirt off with damp disposable cloth Flow sensor The flow sensor cannot be disinfected or sterilized Contamination by infectious patients dispose of as directed If contaminatio...

Страница 82: ...pty soda lime container see page 45 Dispose of with household refuse but not when treating infectious patients Piston pump 3 Release the two quick release screws by turning through a quarter turn with a 6 mm hexagon key 4 Remove cylinder head 5 Completely unscrew the central screw on the piston no quick release 6 Remove piston and roller diaphragm The remainder of the piston pump does not come in ...

Страница 83: ...iberating halogen strong organic acids and compounds liberating oxygen Users in the Federal Republic of Germany are advised to use disinfectants specified in the current list published by the German Society for Hygiene and Microbiology DGHM The list also specifies the active agent in each disinfectant Users in countries in which the DGHM list is not available are advised to use the agents mentione...

Страница 84: ...crobial filters with or without microbial filters Tube mask after every patient after every patient after every patient Y piece after every patient after every patient after every patient Both breathing hoses after every patient after every patient after every patient Temperature sensor with lead after every patient after every patient after every patient T piece and filter of measured gas samplin...

Страница 85: ... vapour Cato parts which can be treated in this way are listed in the table on page 87 Parts in contact with breathing gas breathing hoses breathing bag breathing system soda lime container piston pump must not be disinfected with formaldehyde vapour Parts containing water such as the humidifier or water traps should be removed since formaldehyde accu mulates here to a particularly large extent Th...

Страница 86: ...hich can be sterilized in this way are listed in the table on page 87 Steam sterilization must be preceded by sterilization with moist heat and or wipe cleaning All parts must be dry Steam sterilization is only required after treating an infectious patient Minimum exposure times 20 minutes at 121 C and 10 minutes at 134 C Parts should preferably be sterilized at 134 C since less time is required f...

Страница 87: ...Housing of piston pump Soda line container with screen T piece for sidestream gas measurement Water trap for measured gas Water traps for airway Filters Microbial filter 24 times Sensors Temperature sensor airway temperature Temperature sensor skin rectal oesophagus O2 sensor housing Flow sensor externally The following parts cannot be processed and prepared must be replaced if damaged or possibly...

Страница 88: ...echarged Used batteries must be treated as special waste Dispose of used batteries in accordance with local waste disposal regulations Used O2 sensors can be returned to Dräger Disposal of apparatus at the end of its useful life Cato can be returned to Dräger for disposal in accordance with environmental regulations Care Disposal of used batteries and O2 sensors Disposal of apparatus 88 ...

Страница 89: ...on into position no quick release catch 4 Fit cylinder head and secure in position two quick release catches Assemble the breathing system Check individual parts Gaskets pressure marks cracks Diaphragms cracks holes deformation Valve discs chipped Defective parts must be replaced 5 The six holes must be clear 6 Fit valves if necessary Place upper and lower parts of breathing system on top of one a...

Страница 90: ...ticlockwise Draw used sensor or blank out of the knurled screw and insert new sensor Screw knurled screw back into place When operating without sidestream O2 sensor Insert blank instead of O2 sensor to seal the measuring system Fit valves 6 Fit valve discs in expiration and inspiration valves screw on valve caps 7 Screw on pressure limitation valve APL scale facing the front Assemble and fit the i...

Страница 91: ...it dries although the absorption capacity is exhausted Place the chain on the bottom of the container Insert mesh must not be forgotten Absolutely essential for absorption Uniformly fill the container with fresh soda lime all round until the MAX mark is reached approx 3 cm below top edge Gently shake the container or knock against the table to settle the contents Remove any dust and granulated mat...

Страница 92: ... filter into T piece 5 Insert T piece into the patient connection of the Y piece filter facing upwards to prevent congestion by droplets of liquid 6 Securely screw sample line onto filter and water trap Only use original sample lines others may lead to changes in the machine s technical specifications 7 The Y piece with direct connection for the sample line can also be used instead of the T piece ...

Страница 93: ... free from condensation 4 Route the sensor lead back to the machine with hose clips along the inspiration hose of the anaesthetic system Install secretion aspirator Position the secretion aspirator on the mount on the frame with two secretion collecting vessels 5 Install hose between negative pressure outlet and secretion collecting vessels 6 Connect the gas outlet on the Cato to the ejector 7 Plu...

Страница 94: ...st be secured with the screws provided Connecting equipotential bonding e g for intracardiac or intracranial operations 3 Connect one end of the grounding cable to the pin at the rear Connect the other end to the equipotential bonding pin on the operating table or ceiling pendant Connecting to electricity supply The mains voltage must correspond to that specified on the rating plate on the rear of...

Страница 95: ...eria Patient s weight Mobility of the patient Possible application site Perfusion of the patient Period of use The following table listing the various sensors available and their specific characteristics may prove useful here OXISENSOR I 20 OXISENSOR D 20 DURASENSOR DS 100A OXISENSOR D 25 and OXISENSOR R 15 are registered trademarks 1 in undamaged unopened packaging 95 Care Reassembling system SpO...

Страница 96: ...he ECG monitor The monitor uses the R wave of the ECG signal to detect the pulse and for synchronization with the SpO2 measurement Connect the ECG signal from the ECG monitor to the rear of the monitor by means of a lead and pawl type plug Prerequisites for the electrical signal and pin assignment can be found in the Technical Data on page 121 In the event of a delayed ECG signal Synchronization m...

Страница 97: ...ia The sensor must be covered in bright light e g surgical lamps and direct sunlight otherwise the pulse signal may fail or inaccurate results may be obtained The sensor should not be positioned on limbs together with an arterial catheter sphygmomanometer cuff or intravascular venous infusion pulse signal may fail and measurement becomes inaccurate Major concentrations of dyshaemoglobins such as c...

Страница 98: ...ghing from 15 to more than 50 kg Long nails make application of the sensor more difficult and coloured nail varnish impairs the accuracy of measurement Cut the nail if necessary Remove nail varnish if necessary Draw the protective film off the adhesive strip Place the sensor on a flat surface with the adhesive side facing upwards Place the tip of the index finger onto the middle of the optical ele...

Страница 99: ...pots by the blue tags peel them off the backing paper and remove the protective film Affix one spot to the middle of each optical element Position the sensor as described above Other measuring point The sensor is preferably applied to the big toe because it moves less than the patient s hand If the big toe is not available however the sensor can also be applied to the thumb Peel off the protective...

Страница 100: ...the liquid in the enclosed ampoule keep away from the eyes Peel off the protective film on the sensor Align the sensor symmetrically on the bridge of the nose the two symbols should lie on the bone cartilage boundary Press the sensor firmly into place and hold for 10 seconds to ensure good adhesion The R 15 sensor must not be used on patients with nasal intubation or a mask 100 Care Reassembling s...

Страница 101: ...failure alarm 104 Self test 103 Calibrate flow sensor 103 Calibrate inspiratory O2 sensor with 100 O2 103 Calibrate O2 sensor for sidestream measurement with 100 O2 104 Linearity 104 Manual ventilation function 105 Automatic ventilation function 105 Maintenance intervals 106 101 Check operational readiness Contents Check operational readiness ...

Страница 102: ...ent 2 Check filling level top up anaesthetic agent if necessary in accordance with separate Instructions for Use of the anaesthetic agent vaporiser If the last inspection was more than 6 months ago sticker on Vapor Change Vapor 3 Lock control dial in 0 position Temperature measurement optional Remove temperature sensor from Y piece and place in a water bath 21 to 49 C compare measured value on scr...

Страница 103: ... Remove O2 sensor and place test adapter 68 01 349 on sensor Allow an O2 flow of approx 1 L min to flow over the O2 sensor for approx 2 minutes Select more with the rotary control Select O2 sensor 100 Vol with the rotary control Display When the O2 sensor has been flushed with O2 for approx 2 minutes Press rotary control to confirm calibration is then started and continues automatically The clock ...

Страница 104: ...the O2 measurement used inspiratory or sidestream with 100 O2 see above Then Expose the inspiratory O2 sensor to ambient air for approx 2 minutes or in the case of the O2 sensor for sidestream measurement unscrew the sampling hose from the water trap and allow it to take in air for approx 2 minutes Display on screen should show between 18 and 24 vol O2 If value displayed is outside 18 to 24 vol O2...

Страница 105: ...on monitor with setting on pressure limiting valve If excess pressure has to be relieved quickly 2 Press vertically down on the lever of the pressure limiting valve Automatic ventilation function Connect lung simulator exercise thorax or breathing bag to Y piece 4 Set fresh gas 5 Press IPPV 6 Press rotary control 7 Piston movement is indicated on the bar graph The machine starts with the ventilati...

Страница 106: ...above 800 C with low pollutant emissions Bacterial filter in measured gas return line Replace every 6 months Can be incinerated at temperatures above 800 C with low pollutant emissions Bacterial filter in pressure measuring line Replace every 6 months Can be incinerated at temperatures above 800 C with low pollutant emissions Cooling air filter Clean monthly and dry well or replace filter Replace ...

Страница 107: ...entilator 109 Operating elements and displays on monitor 110 Operating elements and displays on the gas and anaesthetic agent measuring tube bank 111 Elements on breathing system 112 Connections on the rear of the monitor 113 Dimensions Weight 114 107 Was ist was Contents What s what ...

Страница 108: ...m 10 Grounding pin equipotential bonding 11 Sockets for supplementary equipment 12 Power cable 13 Sub D socket for connecting the uninterruptible power supply UPS 14 AIR connector for secretion aspiration and fresh gas port for the ventilator 15 Water separator with water trap in the gas sampling line 7 6 9 8 12 13 Rear 10 11 P 0 I D 2 3 3 4 4 5 Front 1 D Cato edition Gas and anaesthetic delivery ...

Страница 109: ...ically aided spontaneous breathing SIMV 11 Key for invoking standby mode 12 Key for automatic ventilation IPPV 13 Key for setting the maximum pressure Pmax 14 Key for setting the tidal volume VT 15 Key for setting the ventilation frequency fIPPV 16 Key for setting the ratio of inspiration time to expiration time TI TE 17 Key for setting the ratio of inspiration pause time to inspiration time TIP T...

Страница 110: ...caution advisory LED 7 Keys for deactivating the alarm tone for two minutes and for reactivating it 8 Rotary control for selecting turn and confirming press menu items 9 Key for standby or measuring mode The yellow LED lights up in standby mode Screen layout D 2 5 1 3 8 7 9 6 4 D PM 805 0 0 I D GAS Status field Alarm field Measured value field Operator prompts Graphic field Softkeys Operating elem...

Страница 111: ...uring tubes for O2 AIR N2O 3 Delivery valves for O2 AIR N2O 4 N2O AIR changeover 5 Key for O2 6 Optical code reader for Vapor recognition 7 Vapor connection 8 Supporting pin 9 Whistle for O2 shortage signal 0 I 1 2 4 5 6 7 8 9 6 7 8 9 3 D Cato edition Operating elements and displays on the gas and anaesthetic agent measuring tube bank 03937224 ...

Страница 112: ...pressure setting turn MAN SPONT changeover two way switch and pressure relief press 8 Plug to seal Y piece for leakage test 9 Support for manual ventilation bag 10 Handle of breathing system 11 Quick release catches for dismantling breathing system 5 units 12 Release lever for breathing system and piston pump 13 Release lever and handle of piston pump 14 Piston pump See also page 73 for position o...

Страница 113: ...the front The sampling line is connected to the water trap 9 Cooling air filter 10 Sensor for sidestream O2 measurement 11 Analog output 12 Connection for pressure measuring line 13 Connection for ventilator 14 RS 232 interface printer can also be configured as RS 232 C interface MEDIBUS 15 Connection for identification of the anaesthetic vaporizer 16 Not used 17 RS 232 C interface MEDIBUS only ty...

Страница 114: ...e Ceiling version A 1480 mm A 1415 mm B 785 mm B 785 mm C 530 mm C 530 mm D 730 mm D 730 mm E 830 mm E 760 mm F 900 mm Weight Cato basic machine approx 140 kg Cato with two Vapors and monitor approx 180 kg A B C D E F 581 1 542 873 1 Dimensions 04037224 ...

Страница 115: ...elivery 118 Monitor 118 Pressure measurement 118 Flow measurement 118 O2 measurement in main stream inspiration line 118 O2 CO2 and anaesthetic agent measurement in sidestream sampling 119 SpO2 measurement 120 Data communication 120 C Lock ECG synchronization 121 Operating parameters 121 115 Technical data Contents Technical data ...

Страница 116: ... 60 Hz Conversion only by specially trained personnel Power input Max 280 W without auxiliary power sockets and without accessories Fuses The fuses in the power adapter and master switch on contactor are only accessible to qualified personnel with special tools Auxiliary power sockets 3x 2 fuses installed per socket 2A DIN 41 622 230 240 VAC Auxiliary mains sockets Do not connect any HF surgery de...

Страница 117: ... Drägersorb 800 Binds approx 150 L CO2 sufficient for approx 6 hours of operation Pressure relief 90 10 mbar Pressure limiting valve Variable between 5 and 70 mbar 15 of set value Patient connections ISO cone 22 mm Anaesthetic gas scavenging Nominal socket diameter 27 mm or ISO cone 30 mm EN 1281 1 Leakage ventilation system 120 mL min at 30 mbar Maximum pressure in breathing system 10 to 80 mbar ...

Страница 118: ... 01 L Accuracy better than 0 01 L or 8 1 of the measured value under calibration conditions and 1013 hPa Minute ventilation AMV Range 0 to 99 9 L min Resolution 0 1 L min Accuracy better than 0 2 L min or 8 1 of the measured value under calibration conditions and BTPS BTPS Body Temperature present atmospheric Pressure 100 humidity Saturated Respiration rate Range 0 to 80 per minute Resolution 1 pe...

Страница 119: ...Resolution 0 1 by volume 0 14 Pa or 1 mmHg Response time t10 90 at 200 mL min 300 ms at 60 mL min 1 s Warm up phase 4 minutes to achieve ISO DIS 11196 accuracy level 2 minutes for first measured values Zero drift Within the specified accuracy without limitation in time Anaesthetic agent measurement Display range for N2O 0 to 100 by volume Accuracy 0 to 40 better than 2 5 by volume absolute 41 to 1...

Страница 120: ...ed Resolution 1 SpO2 Pulse rate 20 to 250 per minute Accuracy 2 per minute Resolution 1 per minute Sensors Type compatible with Nellcor sensors Oxisensor Oxiband and Durasensor Wavelengths 660 nm red 920 nm infrared Acoustic pulse signal A tone is generated for each pulse beat detected Pitch proportional to oxygen saturation Data communication Data interface RS 232 C MEDIBUS Connector 25 pin sub D...

Страница 121: ...rength 4 kV Socket for 2 pin pawl type connector dia 3 5 Pin assignment Operating parameters Noise emission Max 56 dB A as determined in a free field over a reflecting surface Protection classes SpO2 sensor Type BF electrically isolated from protective earth conductor Electromagnetic compatibility Tested to EN 60601 1 2 Classification Class II b as per Directive 93 42 EEC Annex IX UMDNS Code 10 13...

Страница 122: ...122 ...

Страница 123: ...ic agent measurement 129 SpO2 measurement 131 Temperature measurement 132 Pressure measurement 132 Definition of low flow and minimal flow anaesthesia 132 SIMV Synchronised Intermittent Mandatory Ventilation 133 S ORC O2 Ratio Control 135 Safety features of gas supply 136 Notes for reducing condensation 136 Operation of the ceiling version 137 Cato with ceiling suspension unit DVE 808X 137 General...

Страница 124: ...sert piston Various electrical tests 2 F Monitor Test operating control pressure Continued on next page 3 A Fresh gas occl A APL 30 mbar A Y piece open A Piston defect A Supply pressure A Contr press low A Service Nr 120 F F F Check piston A Y piece open A P Sensor fault A BreathSys defect F F F Zero pressure sensor Y piece occluded Various electrical tests A Contr press low A BreathSys defect F F...

Страница 125: ... F A Fresh gas occl I Leaktest IPPV F A Subsystem 3 leak A Leak mL min F Leak eleminated A Leak accepted F F End of self test 5 L min I Leaktest MAN Subsystem 3 breathing bag fresh gas line Leak 300 mL min at 30 mbar A Service Nr 119 A Service Nr 115 A Valvedisk defect A Diaphragm defect A pneum Interface A Service Nr 118 F Control pressure test Valve and roller diaphragm test F F A Insp Valve A S...

Страница 126: ... the breathing system must be absolutely tight and must feature additional monitoring and control elements The breathing system implemented in the Cato auto matically matches its degree of openness to the fresh gas flow During inspiration breathing gas streams from the piston pump to the patient Valve V2 of the excess gas outlet and the fresh gas shutoff valve V1 are closed Expiration is initiated...

Страница 127: ...e as well as the measured gas sampling and return lines if installed The overall system compliance is determined at the same time The IPPV leakage test and the leakage test started in standby mode is carried out by building up a constant pressure of 30 mbar The piston movement necessary to compensate the gas escaping through leaks is measured and calculated and indicated as a volume per unit time ...

Страница 128: ... system very slowly This process can be speeded up by increasing the fresh gas flow abruptly Descriptions Notes on setting the fresh gas flow Relationship between fresh gas flow and gas concentration Relationship between fresh gas flow and time constants 128 Notes on setting the fresh gas flow The fresh gas delivered must cover the patient s consumption uptake and any leaks in the system It must a...

Страница 129: ... C which is controlled by a control circuit Heat is dissipated when gas flows past this wire The larger the volume of gas flowing past per unit time the more heat will be dissipated The heating current required to maintain a constant wire temperature is taken as an indicator for the gas stream Gas type compensation The effect of the various types of gas contained in the breathing gas is compensate...

Страница 130: ...ss creates a negative pressure of about 100 to 200 mbar compared to ambient pressure at the concentration measurement site depending on sample flow condensation and water separator The partial pressure measured at the sensor is corrected to the current ambient pressure with the aid of the pressure measured in the measuring cuvette Effect of temperature The gas temperature at the sensor is measured...

Страница 131: ...arterial blood the amount of light absorbed by the other components remains constant as regards the quantity and optical density over a defined unit of time The arterial blood pulsating with every beat of the heart however produces a change of volume synchronous with the pulse in the irradiated tissue In other words absorption of the irradiated light also changes in time with the pulse The light a...

Страница 132: ...ute ventilation When setting such low fresh gas volumes the anaesthetic gases must be returned to the patient via a semi closed or closed rebreathing system The rebreathing volume increases when the fresh gas flow is reduced and the excess gas volume decreases correspondingly Although the fresh gas flow can only be infinitely reduced to the gas volume taken up by the patient at a given moment of a...

Страница 133: ...rder to prevent the next mandatory breath being applied during the expiratory phase of spontaneous breathing a trigger function ensures that the mandatory ventilation stroke is synchronized with the inspiratory spontaneous breathing phase during an expectation period The time between the end of each mandatory ventilation stroke and the beginning of the next is subdivided into a spontaneous breathi...

Страница 134: ...phase The mandatorily applied minute volume may increase if an automatic ventilation stroke is applied at the beginning of each trigger period The duration of a mandatory stroke plus the spontaneous breathing time is calculated as follows 1 TSpont 6 s 3 5 s 9 5 s fIPPV This corresponds to a frequency of approx 6 per minute and the applied minute volume increases to 6 per minute VT TTrigger 1 2 3 4...

Страница 135: ...he range of adjustable O2 N2O ratios S ORC is not an oxygen specific monitoring system By adding anaesthetic vapours e g Desflurane up to 18 by volume the O2 concentration in the fresh gas is reduced Therefore Monitor the O2 concentration with the breathing gas monitor 100 0 Concentration ratio O2 N2O Minimum O2 concentration 90 10 80 20 70 30 60 40 50 50 40 60 30 70 20 80 10 90 0 100 0 200 400 60...

Страница 136: ...ect at the lowest point and cannot flow back to the patient or to the breathing system Condensation must be drained from the hoses at regular intervals Water traps should be used for surgery lasting more than 1 5 hours They must be positioned at the lowest point in the system so that the condensation can flow into the water traps Water traps must be drained regularly Pressure and flow measurement ...

Страница 137: ...g a load of 250 kg with the safety specified by EN 60601 1 It should be noted that these requirements must also be met when the mounting arms are positioned at an adverse angle The structural conditions must also be checked to ensure that they can safely bear the resultant loads Maximum permissible total weight 200 kg Depending on the DVE used and on the prevailing conditions the Cato can be raise...

Страница 138: ...g supporting flap down again The DVE can no longer be operated via its own keypad Plug the mains connector of the Cato into the socket on the DVE Plug the gas withdrawal connectors into the corresponding withdrawal sockets 6 Move Cato right up to the mount on the DVE Descriptions Connecting the Cato ceiling version 138 1 2 3 4 5 ÀÀÀÀÀÀ ÀÀÀÀÀÀ ÀÀÀÀÀÀ ÀÀÀÀÀÀ ÀÀÀÀÀÀ ÀÀÀÀÀÀ ÀÀÀÀÀÀ ÀÀÀÀÀÀ ÀÀÀÀÀÀ ÀÀÀÀÀÀ...

Страница 139: ... bearing Cato can now be swivelled 4 Key to release the brake for the head bearing Cato can be turned Disconnecting the Cato ceiling version Any obstacles in Cato s path as it descends will be subject to Cato s full weight approx 200 kg and may be crushed Before lowering Cato always ensure that there is nothing to prevent it from being deposited directly on the floor 5 Press key until lower limit ...

Страница 140: ...e machine can then only be raised via the keypad on the DVE If the machine subsequently remains at an angle on its mounting journal Briefly lower it onto the ground and pick it up again with the DVE The mount may suffer damage in extreme cases Call DrägerService if damage is suspected Depending on how serious the damage is the Cato may crash to the ground when raised again Additional maintenance a...

Страница 141: ...on rate Hb Haemoglobin HbCO Carbon monoxide haemoglobin HbO2 Oxyhaemoglobin HLM Heart lung machine mode for in CO2 Inspiratory CO2 concentration INOP Malfunctioning Abbreviation Significance IPPV Automatic ventilation mode intermittent positive pressure ventilation LED Light emitting diode LED display 7 segment display with light emitting diodes Man Spont Manual ventilation or spontaneous breathin...

Страница 142: ...dby and measuring modes W Cyclic activation of basic pages Q Display standard page G Suppress alarm tone for 2 minutes Important note P Connection for equipotential bonding Protection class type BF EN 60601 1 Request for calibration Action has been completed successfully u Action is being carried out Warning message Caution message Advisory message Alarm limit inactive Descriptions Symbols used 14...

Страница 143: ...ry mains sockets 18 20 116 Bacterial filter pressure measuring hose 106 Bacterial filter secretion aspiration 106 Basic configuration monitor 54 Batteries disposal 88 Baud rate 53 Breathing system assembling 80 Breathing system checking 23 Breathing system dismantling 82 Breathing system elements 112 Breathing system fitting 90 Breathing system heating 89 Breathing system removing 80 Breathing sys...

Страница 144: ...us 88 Disposal of consumable articles 85 Disposal of soda lime 82 DURASENSOR SpO2 measurement 98 Dyshaemoglobin 97 Elements of the breathing system 112 Emergency 7 Emergency ventilation bag 23 Emergency ventilation gas failure 37 End of operation 48 Environmental factors Technical Data 116 Equipment overview What s what 108 Equipotential bonding connection 5 94 Erasing list 50 62 Erasing trend 50 ...

Страница 145: ...ation 83 Microbial filter breathing system 23 Microbial filter fitting 93 Minimal flow definition 132 Minute volumeter 63 Mobile telephones 5 Monitor functions 49 Monitor activating 57 Monitor configuring in standby 51 Monitor keys 13 60 112 Monitor operating elements 110 Monitor operation 57 Monitor structure 14 110 Monitor Technical data 118 N2O lock 37 Negative pressure secretion aspirator 25 N...

Страница 146: ...king 25 Secretion aspirator installing 93 Selecting the measuring unit 53 Self test 26 Self test flow chart 124 Self test interrupting 34 Sensor selecting SpO2 measurement 94 Shortage alarm O2 37 SIMV mode 41 SIMV mode selecting 41 SIMV ventilation description 133 Soda lime container filling and fitting 91 Soda lime changing during operation 45 91 Soda lime checking 23 45 SpO2 measurement measurin...

Страница 147: ...on manual 36 Ventilation mechanical 39 41 Ventilator messages Messages Cause and Remedy 78 Ventilator operating controls 109 Ventilator Technical Data 117 Voltage current supply 116 Volumeter curve 63 Volumeter starting 63 Warning messages Messages cause and remedy 74 Warning definition display 65 Water traps checking 24 44 47 Water traps gas sampling line 44 47 92 Weight 116 What s what 107 White...

Страница 148: ...nformation only and are not intended for use with any specific machine or device 90 37 225 GA 5170 030 en Dräger Medizintechnik GmbH 1st edition May 2000 Subject to alteration ç Directive 93 42 EEC concerning Medical Devices Dräger Medizintechnik GmbH Germany z Moislinger Allee 53 55 D 23542 Lübeck y 49 451 8 82 0 x 26 80 70 FAX 49 451 8 82 20 80 http www draeger com ...

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