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North

American

Dräger

Operator’s Instruction Manual

Part Number: 4113918-002

Rev: B

Date: 20 November 1998

© 1998 N.A.D., Inc.

Narkomed 2B

Anesthesia System

Содержание Narkomed 2B

Страница 1: ...North American Dräger Operator s Instruction Manual Part Number 4113918 002 Rev B Date 20 November 1998 1998 N A D Inc Narkomed 2B Anesthesia System ...

Страница 2: ......

Страница 3: ...ers 2 11 Absorber 2 12 Bain Circuit Adapters 2 15 Scavenger Systems 2 17 AV2 Ventilator 2 19 Main Switch Panel 2 20 Power Supply System 2 22 System Interface Panel 2 24 Monitoring System 2 25 Alarm System 2 26 Manual Sphygmomanometer 2 27 O R Data Manager 2 28 Section 3 Daily Checkout Daily Checkout Procedure 3 1 Section 4 Preuse Checkout Preuse Checkout Procedure 4 1 Section 5 Operation Gas Deliv...

Страница 4: ...Systems Overview 5 6 1 Operating the Scavenger Interface for Non active Systems 5 6 2 Main Switch Panel Overview 5 7 1 System Power Switch 5 7 1 Testing the Battery 5 7 2 AV2 Anesthesia Ventilator Overview 5 8 1 Activating the Ventilator 5 8 2 Adjusting the Tidal Volume 5 8 4 Setting the Respiratory Frequency 5 8 4 Setting the Inspiratory Expiratory I E Phase Time Ratio 5 8 5 Setting the Inspirato...

Страница 5: ...sure Monitoring Overview 5 12 1 Choice of Breathing Pressure Monitoring Location 5 12 1 Installing the Breathing Pressure Pilot Line 5 12 2 Monitor Displays 5 12 4 Monitor Controls 5 12 6 Setting the Pressure High Alarm Limit 5 12 6 Setting the Threshold Pressure Alarm Limit 5 12 7 Controlling the Apnea Alarm 5 12 9 Breathing Pressure Alarm Messages 5 12 10 Problem Resolution 5 12 11 Manual Sphygm...

Страница 6: ...s General 7 1 Environmental 7 1 Electrical 7 1 Gas Delivery System 7 2 Vaporizers 7 3 Ventilator 7 3 Absorber System 7 3 Oxygen Monitoring 7 4 Breathing Pressure Monitoring 7 4 Respiratory Volume Monitoring 7 4 Serial Interface 7 5 Appendix Spare and Replacement Parts A 1 Index I 1 iv ...

Страница 7: ...a combination is not endorsed by North American Dräger 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 ...

Страница 8: ...m a combination of its product with products from another manufacturer if the combination has not been endorsed by North American Dräger Buyer understands that the remedies noted in North American Dräger 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 the limit...

Страница 9: ...r future reference it has been divided into several independent sections Section 2 General Description provides a summary of Narkomed 2B features and functions Section 3 Daily Checkout contains the checkout procedures that must done on a daily basis Section 4 Preuse Checkout contains the checkout procedures to be performed between successive cases Section 5 Operation provides detailed instructions...

Страница 10: ...n or maintenance of the Narkomed 2B anesthesia system must be thoroughly familiar with this instruction manual WARNING This anesthesia system will not respond automatically to certain changes in patient condition operator error or failure of components The system is designed to be operated under the constant surveillance and control of a qualified operator WARNING No third party components shall b...

Страница 11: ...advocates the use of an oxygen analyzer pressure monitor and either a volume monitor or an end tidal CO2 monitor in the breathing circuit at all times Because of the sophisticated nature of North American Dräger anesthesia equipment and its critical importance in the operating room setting it is highly recommended that only appropriately trained and experienced professionals be permitted to servic...

Страница 12: ......

Страница 13: ...EN FLOWMETER OPTIONAL MAIN SWITCH PANEL FLOWMETER BANK FRESH GAS OUTLET OP20001 OPEN RESERVOIR SCAVENGER Gas Delivery System The pneumatic system can simultaneously deliver up to four gases and one anesthetic agent from a selection of up to three Oxygen and nitrous oxide are standard on all Narkomed 2B machines Optional gases are air carbon dioxide and oxygen helium Gas is supplied to the system t...

Страница 14: ...ng incorrect connection of gas pipes The inlets include check valves which prevent back flow leakage into the atmosphere when supply hoses are not connected or into the attached supply hoses when reserve cylinders are in use Each pipeline connection is equipped with a filter to prevent foreign material from entering the internal gas piping of the Narkomed 2B Pipeline gases should be supplied at 50...

Страница 15: ...n the machine is connected to an active pipeline supply each gauge should indicate a steady pressure of 50 55 psi A deviation from this range indicates an improperly adjusted pipeline supply which may adversely affect the operation of the anesthesia machine A fluctuating pipeline supply pressure for example would cause a corresponding fluctuation of the flow of gas delivered from that pipeline An ...

Страница 16: ...tween the yoke 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...

Страница 17: ...n oxygen failure protection 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 o...

Страница 18: ... are calibrated to provide greater resolution for low flow anesthesia Minimum Oxygen Flow The oxygen dispensing system incorporates a calibrated bypass flow of 150 50 ml min at 50 psi pipeline pressure which delivers 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...

Страница 19: ...w control valve excessively without making a corresponding increase in the oxygen flow control valve setting the flow of nitrous oxide will not increase even though its flow control valve setting has been greatly increased 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 ...

Страница 20: ...fitting is 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 North American Dräger design and cannot be replaced by a hose from any other manufacturer O2 FLUSH CONTROL HANDLE F...

Страница 21: ...s those supplied with North American Dräger 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 loaded ...

Страница 22: ...ing for a non rebreathing circuit OXYGEN SENSOR PORT FRESH GAS LOCKING BAR EXTENDED POSITION FRESH GAS HOSE BARBED FITTING FOR NON REBREATHING GAS CIRCUIT OXYGEN SENSOR FRESH GAS OUTLET OXYGEN SENSOR PLUG OP20997 ADAPTER STEM 15MM MALE FITTING WARNING The fresh gas oxygen sensor adapter measures the fresh gas oxygen concentration not the inspiratory oxygen concentration Depending on the fresh gas ...

Страница 23: ...usion System A cam and lever interlock system incorporated into the vaporizer bank prevents more than one vaporizer from being activated at a time The interlock system requires all unused vaporizers to be locked in their zero volume 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 t...

Страница 24: ...stem pressure gauge a fresh gas line and connections for sensing the following breathing pressure respiratory volume frequency and oxygen concentration OXYGEN SENSOR INSPIRATORY VALVE ABSORBENT CANISTERS CANISTER RELEASE LEVER FRESH GAS HOSE BREATHING BAG MOUNT MANUAL AUTOMATIC SELECTOR VALVE APL VALVE BREATHING SYSTEM PRESSURE GAUGE RESPIRATORY VOLUME SENSOR EXPIRATORY VALVE OP98103 PEEP VALVE OP...

Страница 25: ... EXPIRATION respectively control the direction of gas flow in the absorber system The valves are unidirectional meaning that they permit gas to flow in one direction only The inspiratory valve allows gas to flow 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 The...

Страница 26: ...ottom assembly collects absorbent dust and excess moisture which could cause increased flow resistance in the system Breathing System Pressure Gauge The absorber system is equipped with a pressure gauge to enable quick visual determination of breathing circuit pressure The gauge is marked for measurements from 20 to 80 cmH2O in increments of 2 cmH2O WARNING Frequent observation of the breathing sy...

Страница 27: ...apter includes an adjustable pressure limiter APL 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 OXYGEN SENSOR 22MM M 15MM F EXPIRATION TERMINAL BAIN CIRCUIT BAIN CIRCUIT HOSE BARB FOR FRESH GAS HOSE BREATHING BAG BREATHING PRESSURE P...

Страница 28: ...xpiratory pressure PEEP valve OXYGEN SENSOR BAIN CIRCUIT BREATHING BAG MOUNT 19 MM SCAVENGER HOSE CONNECTS TO 19MM TERMINAL ON REAR OF ABSORBER POLE 22MM HOSE CONNECTS TO VENTILATOR HOSE TERMINAL ON VENTILATOR BELLOWS ASSEMBLY BAIN CIRCUIT HOSE BARB FOR FRESH GAS HOSE MOUNTING STUD FRESH GAS COMMON OUTLET FRESH GAS HOSE OP00200 BREATHING BAG SET SCREW O RING BREATHING PRESSURE PILOT LINE 2 16 ...

Страница 29: ...Scavenger The open reservoir scavenger is used with suction vacuum waste gas disposal systems This scavenger is an open system featuring continually open relief ports to provide positive and negative pressure relief VACUUM DISS HOSE TERMINAL THREADED INPUT PORT CAP 19MM SCAVENGER HOSE TERMINAL RELIEF PORT NEEDLE VALVE KNOB FLOWMETER RESERVOIR CANISTER 19MM SCAVENGER HOSE TERMINAL OP75121 LOCK NUT ...

Страница 30: ...m using a spring loaded valve for positive pressure relief 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 WASTE GAS INPUT PORT 19MM HOSE TERMINAL INPUT PORT CAP SAFETY RELIEF VALVE SHOWN CLOSED WASTE GAS INPUT PORT 19MM HOSE TERMINAL WASTE GAS EXHAUST PORT 19MM HOSE TER...

Страница 31: ...justable 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 W...

Страница 32: ...m Power Switch The SYSTEM POWER switch on the Narkomed 2B has two positions ON and STANDBY In the ON position the 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 batt...

Страница 33: ...pressure in the system falls below approximately 37 psi When the alarm is activated the red O2 SUPPLY PRESSURE LED on the main switch panel lights In addition the Caution message LO O2 SUPPLY appears on the central alarm display and an intermittent audible alarm sounds Depending on the anesthesia machine s configuration a 7 second whistle may also sound NOTE When one source of oxygen pressure eith...

Страница 34: ...e active whenever the Narkomed 2B is plugged into an outlet whether or not the machine is turned on The total current for devices plugged into the receptacles must not exceed 5 amps A 5 amp circuit breaker protects the convenience receptacle circuit This circuit also incorporates an EMI filter which minimizes interference to the anesthesia machine from devices plugged into the convenience receptac...

Страница 35: ...ng the period between line power failure and activation of the hospital s emergency generator The backup battery also provides power if the anesthesia machine s power cord is accidentally unplugged during a case When the hospital s emergency generator comes on line or when a disconnected power cord is reconnected the Narkomed 2B automatically switches back to AC power and recharges its battery The...

Страница 36: ...red NOTE If the Narkomed 2B s power cord is not plugged into an active AC outlet for a period of 30 days or more the backup battery may become depleted Plugging the power cord into an active AC outlet for approximately 16 hours will recharge a depleted battery System Interface Panel The system interface panel is located on the absorber side of the Narkomed 2B The interface panel contains receptacl...

Страница 37: ...respiratory volume The anesthesia machine also monitors key anesthesia system functions such as oxygen supply pressure and backup battery status Left Hand Screen and Controls This screen shows alarms trends and the breathing pressure waveform or trace To the right of the screen are the system control keys which let you control the audio annunciation of alarms and switch between trace and trend dis...

Страница 38: ...f the left hand display screen Messages are displayed in three separate windows WARNING CAUTION or ADVISORY depending on the urgency of the alarm In addition each type of alarm has its own specific audible alarm signal The following table describes each type of alarm The alarms are listed in the table in the same order that they are shown on the screen Type of Alarm Warning Caution Advisory Priori...

Страница 39: ...ou can use the Alarm Silence key on the control key panel labeled with a crossed out speaker If the primary speaker on the Narkomed 2B fails a backup speaker is 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 central alarm display Ventilat...

Страница 40: ...tes an electronic anesthesia record from information automatically recorded by the monitoring system and from input from the keyboard such as patient data events drugs and other case related information as well as interfaced monitors such as the Vitalert 3000 In addition to creating anesthesia records the O R Data Manager can display case information in the form of a graph and can print anesthesia...

Страница 41: ... tethered to the back of the machine next to one of the cylinders 4 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 mac...

Страница 42: ...nent decrease in the pressure D If the machine is equipped with dual oxygen yokes repeat these procedures for the other cylinder yoke 9 Check the nitrous oxide cylinder supplies A Close the nitrous oxide cylinder valve and remove the cylinder from the yoke Verify that there is one cylinder gasket and there are two index pins Verify that the cylinder matches the yoke label Place the cylinder back i...

Страница 43: ...er and check the cylinder pressure gauge Replace the cylinder if its contents are insufficient for the intended procedure To check for a high pressure leak close the cylinder and observe the cylinder pressure gauge for a prominent decrease in the pressure NOTE After testing all of the gas circuits drain the oxygen circuit by closing the oxygen cylinder and actuating the oxygen flush button on the ...

Страница 44: ...ass must be between the minimum and maximum markings B Make sure the fill and drain valves are completely closed C Check the vaporizer exclusion device which prevents more than one vaporizer from being activated simultaneously Make sure that when one vaporizer handwheel is turned to a setting greater than 0 the others remain locked in their 0 positions Test all of the vaporizer positions Then turn...

Страница 45: ...gen is flowing at a minimum rate 150 200 ml min nitrous oxide flows at approximately 500 ml min Oxygen Flush Verification 17 Check the oxygen flush A Press the oxygen flush button and listen for an audible gas flow sound accompanied by a marked increase in oxygen concentration in the breathing system B Check the delivered oxygen concentration Repeatedly flush the patient breathing system by pressi...

Страница 46: ...r valve breathing hose terminal E Make sure a breathing bag of proper capacity and appropriate construction is connected to the breathing bag terminal of the breathing system F Make sure the breathing pressure pilot line is properly connected between the BREATHING PRESSURE interface and either the absorber quick connect fitting or the appropriate fitting at or near the patient Y piece G Make sure ...

Страница 47: ...ieve excess gas from the breathing system into the scavenger system To check the APL valve s flow resistance A Set the manual automatic selector valve to BAG B Remove the bag from the swivel arm bag mount C Interconnect the 22 mm ports of the inspiratory and expiratory valves with a 22 mm hose D Completely open the APL valve by turning the control knob fully counterclockwise to its stop position E...

Страница 48: ...eeze bulb by hand until the breathing system pressure gauge indicates pressure of at least 50 cmH2O not to exceed 80 cmH2O K Observe the pressure drop at the breathing system pressure gauge When the pressure is at 50 cmH2O begin counting seconds The pressure must not drop more than 20 cmH2O in 30 seconds Scavenger System 25 Verify the performance of the scavenger system To test the open reservoir ...

Страница 49: ... Turn the APL valve control knob fully counterclockwise J Verify that the suction waste gas disposal system is active K Adjust the scavenger needle valve to a flowmeter indication between the two white lines L Close all flow control valves on the anesthesia system M Occlude the absorber breathing bag terminal and observe the breathing pressure gauge on the absorber The gauge should indicate only a...

Страница 50: ... sure a 19 mm scavenger hose is connected between the bottom of the absorber pole and the scavenger interface D Check for moisture accumulation in the breathing and scavenger hoses Remove any moisture found E Short circuit the absorber s inspiratory and expiratory valves with a 22 mm breathing hose F Set the absorber s manual automatic selector valve to AUTO G If the system is equipped with a PEEP...

Страница 51: ...tory 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 NAD combination mask elbow with a 22 mm male fitting for the breathing bag and 15 mm male fitting for the Y piece With the manual automatic selector valve in the AUTO position s...

Страница 52: ...s properly calibrated See Operation Oxygen Monitoring Calibrating the Oxygen Sensor in Section 5 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 co...

Страница 53: ...n unlit Plug the power cable back into the electrical outlet NOTE This test assumes that the anesthesia machine has been plugged in for 16 hours The battery charging system works only when the machine is connected to an active AC power source The charging system takes about 16 hours to charge a fully discharged battery Bain Circuit Adapter Verification 2 Verify that the inner tube of the Bain circ...

Страница 54: ...hat signs to expect when the absorbent is exhausted Replace the absorbent when it appears exhausted Make sure that the color change represents the absorbent s true state of depletion and is not due to regeneration 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...

Страница 55: ...de the bag mount opening and watch for a pressure increase on the breathing system pressure gauge This pressure increase must not exceed 3 cmH2O Breathing System Leak Test 7 Perform a breathing and fresh gas delivery system pressure test This test detects leaks from the patient breathing system and fresh gas delivery system To perform the test A Close all flow control valves on the anesthesia mach...

Страница 56: ...een the ventilator relief valve and the scavenger interface B Make sure a 19 mm scavenger hose is connected between the APL valve on the absorber and the 19 mm hose terminal on the back of the absorber pole C Make sure a 19 mm scavenger hose is connected between the bottom of the absorber pole and the scavenger interface D Check for moisture accumulation in the breathing and scavenger hoses Remove...

Страница 57: ... control knob fully counterclockwise to its lowest setting P Adjust the scavenger needle valve to a completely closed position by turning it fully clockwise Q Open the oxygen flow control valve to a flow of 10 l min and occlude the absorber breathing bag terminal R The flow of oxygen must now exit through the relief ports located on top of the canister The absorber system s breathing pressure gaug...

Страница 58: ...ty relief valve At this point the absorber system s breathing pressure gauge must indicate a pressure of less than 10 cmH2O 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 v...

Страница 59: ...bypass switch to the PEEP OFF position Monitors 10 Check the alarm limit settings The monitor alarm limits are automatically set to a default configuration when the SYSTEM POWER switch is turned on Check these settings and adjust them if necessary Alarm limits can be adjusted at the beginning of or during a procedure Also make sure that any external monitors if any are connected properly and that ...

Страница 60: ...izers are off the handwheels are set to zero B the APL Valve is open fully counterclockwise C the manual automatic switch is set to BAG D all flowmeters indicate 0 or minimum E the patient suction is level adequate F the breathing system is ready to use the bag is in place and all hoses are connected properly 4 8 ...

Страница 61: ...dards and regulations the available inlets are Diameter Indexed Safety System DISS inlets body or nut fitting or National Institute for Standards and Technology NIST inlets To connect a pipeline supply to the Narkomed 2B 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 Carefully check hose...

Страница 62: ...rs 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 To connect a gas cylinder to its yoke 1 Place a new washer on the seat of the yoke gas inlet connection WARNING Use only one cyl...

Страница 63: ... gas inlet and indexing pins on the yoke assembly 4 Engage the 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 ha...

Страница 64: ...counterclockwise 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 in Section 2 General Description Do not force the oxygen flow control knob past the zero stop in an effo...

Страница 65: ...derably from the vaporizer 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...

Страница 66: ...e than one vaporizer from being activated at a time The exclusion system 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 North American Dräger qualified technical service representative for a...

Страница 67: ...rly fitted and locking screw is tight 3 Make sure the handwheel is set to 0 zero point interlock and that the button is engaged Turning the Vaporizer On To turn the vaporizer on 1 Adjust the fresh gas flow 2 Turn the vaporizer handwheel to the desired anesthetic concentration Do not set the handwheel between 0 and 0 2 volume concentration 0 3 volume with Enflurane Vapor This part of the handwheel ...

Страница 68: ...ntrolled inhalation of anesthetic 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 I...

Страница 69: ...wheel must be set to 0 zero point interlock before the vaporizer can be filled Filling Vaporizer With Open Funnel System 1 With the vaporizer in an upright position turn the handwheel to 0 zero point interlock and make sure the button engages in the locked position 2 Make sure the filling spout is clean To remove dust or other particles use a clean dry paper towel Do not use water or other liquid ...

Страница 70: ... the inlet valve NOTE The capacity of the vaporizer is approximately 140 cm3 with wet wick and approximately 200 cm3 with dry wick 7 After filling check the level at the sight glass When the vaporizer is in an upright position the level must not exceed the MAX mark If the vaporizer is inadvertently overfilled MAX mark exceeded drain the excess anesthetic For information on draining the vaporizer r...

Страница 71: ...nsert the keyed adapter into the filler port of the vaporizer so that the two holes in the adapter face the Teflon seal surface of the filler port Bend the filler tube so that the liquid level in the bottle is below the filler port Adjust the plastic tubing to avoid kinks 6 Turn the filler port lock screw clockwise to hold the adapter against the Teflon seal 7 Open the filler valve by turning the ...

Страница 72: ... filler port 11 Allow excess liquid to drain from the filler port 12 Fully insert the filler port plug in the filler port and tighten the plug in place by turning the lock screw clockwise 13 After filling check the level at the sight glass When the vaporizer is in an upright position the level must not exceed the FULL mark If the vaporizer is inadvertently overfilled FULL mark exceeded drain the e...

Страница 73: ...10621A OVERFLOW LINE FULL LINE SIGHT GLASS FILLER PORT PLUG DRAIN VALVE KNOB DRAIN PORT LOCK SCREW FILLER VALVE KNOB FILLER PORT LOCK SCREW KEYED BOTTLE ADAPTER KEYED FILLER PORT KEYED DRAIN PORT REFILL LINE KEYED BOTTLE ADAPTER 5 2 9 ...

Страница 74: ...Section 5 Operation Vaporizer HALOTHANE RED ENFLURANE ORANGE ISOFLURANE PURPLE OP10620 SEVOFLURANE YELLOW 5 2 10 ...

Страница 75: ... With the vaporizer in an upright position turn the handwheel to 0 zero point interlock and make sure the button engages in the locked position 2 Place an empty anesthetic specific bottle under the drain hole of the filling spout Mark the bottle to indicate that it contains a previously used anesthetic agent WARNING The vaporizer handwheel must be set to 0 zero point interlock before the vaporizer...

Страница 76: ...ly used anesthetic 3 Insert the bottle adapter fitting into the drain port of the vaporizer The two holes in the adapter fitting must face the Teflon seal surface in the drain port 4 Turn drain port lock screw clockwise to hold the adapter against the Teflon seal WARNING The vaporizer handwheel must be set to 0 zero point interlock before the vaporizer can be drained 5 Hold the bottle below drain ...

Страница 77: ...Section 5 Operation Absorber System REFER TO SEPARATE MANUAL 5 3 1 ...

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Страница 79: ...Section 5 Operation Bain Circuit Adapter REFER TO SEPARATE MANUAL 5 4 1 ...

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Страница 81: ...suction to transfer waste gas from the scavenger to the disposal system The open reservoir scavenger is an open system which uses continually open relief ports to provide positive and negative pressure relief VACUUM DISS HOSE TERMINAL THREADED INPUT PORT CAP 19MM SCAVENGER HOSE TERMINAL RELIEF PORT NEEDLE VALVE KNOB FLOWMETER RESERVOIR CANISTER 19MM SCAVENGER HOSE TERMINAL OP75121 LOCK NUT 5 5 1 ...

Страница 82: ...he right side of the scavenger WARNING Make sure the 19 mm scavenger hoses leading from the absorber are not pinched kinked or blocked in any manner 2 Attach the short 19 mm scavenger hose between the 19 mm terminal marked SCAVENGER HOSE on the rear of the APL valve and the 19 mm terminal marked SCAVENGER HOSE on the rear of the absorber pole 3 Attach another 19 mm scavenger hose between the 19 mm...

Страница 83: ... the disposal system s suction flow rate the canister initially accommodates excess waste gas After excess waste gas fills the canister waste gas then exits through the relief ports around the top of the canister 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 contaminatio...

Страница 84: ...onds to a suction 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 t...

Страница 85: ...scavenger to the disposal system The scavenger interface is a closed system which uses a spring loaded valve for positive pressure relief 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 WASTE GAS INPUT PORT 19MM HOSE TERMINAL INPUT PORT CAP SAFETY RELIEF VALVE SHOWN CLOS...

Страница 86: ...vent such a harmful pressure build up the scavenger s positive 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 WARNING The positive pressure...

Страница 87: ...EM POWER POWER FAIL AC LOW BATTERY BATTERY TEST 2 O SUPPLY PRESSURE BATTERY TEST PUSH BUTTON System Power Switch The SYSTEM POWER switch on the Narkomed 2B has two positions ON and STANDBY In the ON position the gas pneumatic and electric power circuits are activated and the green LED indicator adjacent to the switch is illuminated In the STANDBY position the gas supplies the monitoring system and...

Страница 88: ...east 30 minutes in the event of a power failure NOTE During an AC power loss the BATTERY LOW indicator is illuminated when the battery reserve approaches depletion However do not rely solely on this indicator for an assessment of battery capacity If the backup battery becomes completely depleted and the machine does not have AC power the BATTERY LOW indicator light has no source of power and does ...

Страница 89: ...breathing 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 t...

Страница 90: ...RATORY PRESSURE LIMIT cmH2O TIDAL VOLUME PUSH TO TURN Activating the Ventilator The ventilator can be activated by using the ventilator on off control or optionally by using the lever on the manual automatic selector valve The anesthesia machine s SYSTEM POWER switch must be set to ON in order for the ventilator to function NOTE The selector valve lever can activate the ventilator only when the in...

Страница 91: ...ary switch that returns to its center position after being turned in either direction To activate the ventilator 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 and interface p...

Страница 92: ...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 50 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 can ...

Страница 93: ...is labeled with 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 ...

Страница 94: ...venger 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 NAD qualified technical service representative Breathing system leak Repair leak Ventilator won t cycle Low oxygen supply pressure Provide suf...

Страница 95: ...tion Turn the selector switch on the absorber to the AUTO position Bellows won t compress during inspiration Absorber manual automatic 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 Incr...

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Страница 97: ...of various components of the monitoring system OP20056 FUNCTIONAL PASS PASS PASS PASS PASS PASS PASS PASS PASS PASS FIRMWARE TEST TIMERS TEST AUDIO TEST PRIMARY BACK UP SERIAL I O TEST CLOCK TEST BACKUP MEMORY TEST VIDEO TEST ANALOG TEST MEMORY TEST AC POWER TEST RESERVE POWER TEST PASS PASS NARKOMED 2B VERSION x xx DIAGNOSTICS COPYRIGHT NAD INC 1987 94 At the end of the self diagnostics one of th...

Страница 98: ...eys to the right of each screen allow you to control the displays and other monitor functions Left Hand Screen The top half of the left hand screen displays alarm messages These alarms were discussed in detail in Chapter 2 On the bottom half of the screen you can display graphical trace or trend data You can also use this area of the screen to configure the anesthesia machine The four keys to the ...

Страница 99: ...alibrate the oxygen sensor set alarm limits and turn the apnea and volume alarms on and off Configuration of the machine and control of audible alarms are explained in this section The remaining monitor control functions are described in the following sections Oxygen Monitoring Respiratory Volume Monitoring and Breathing Pressure Monitoring DATA DISPLAY MONITOR CONTROLS CONFIG KEY CONFIG LO HI HI ...

Страница 100: ... 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 press the CONFIG key The CONFIG key is located in the bottom row of keys to the right of the right hand display screen See the figure on the previous page The Configure screen replaces the standard left ha...

Страница 101: ...standard display Changing Parameter Values Follow this procedure for each parameter you want to change 1 Press the SELECT key until the parameter you want to change is highlighted with a box 2 Change the value of the highlighted parameter To increase the value press the INC key To decrease the value press the DEC key Exiting the Configure Screen To exit the Configure screen immediately press the E...

Страница 102: ... seconds of silence After you press the Audible Alarm Silence key a message indicating the silence condition and the silence time remaining is displayed in the Advisory section of the central alarm display If a new alarm occurs during the Audio Silence period a single tone pattern sounds corresponding to the priority of the alarm After the Audio Silence period audio annunciation reverts to normal ...

Страница 103: ...e TRACE key Understanding the Trace Display The breathing pressure waveform provides a visual assessment of lung mechanics and ventilation The waveform is displayed in one of two scales depending on the setting of the high pressure alarm limit When the broader scale is used the threshold pressure alarm limit appears on the display High Pressure Alarm Limit Scale Used Threshold Pressure Alarm Limit...

Страница 104: ...ese variables on the Trace and Trend display area at the bottom of the left hand screen If compatible external monitors i e pulse oximeter NIBP or CO2 have been interfaced with the system trend displays for oxygen saturation pulse temperature blood pressure and CO2 parameters can also appear Displaying Trend Data TREND 1 To display trend data press the TREND key Trend data for the first monitored ...

Страница 105: ... The scale of the vertical axis is fixed The horizontal axis displays the most recent one hour time period 12 20 13 20 above divided into ten minute increments Time measurements are shown in 24 hour format Since the NARKOMED 2B starts trending available data on power up it rounds off the time scale labeling to the previous ten minute increment for ease of reading For example if the NARKOMED 2B is ...

Страница 106: ...representing inspiratory CO2 For more information about specific trend graphs see the following sections Oxygen Monitoring Respiratory Volume Monitoring and Breathing Pressure Monitoring Working with Numerical Data The NARKOMED displays the following numerical information from all monitors on the right hand display screen Current time Oxygen concentration delivered to patient Oxygen Breathing Pres...

Страница 107: ...ates two independent electrochemical cells or sensor halves and the oxygen monitor averages the signals produced by the cells CAUTION Never remove an oxygen sensor from its housing except to replace it If a sensor is removed from its housing you must do the following before continuing normal operations Reinstall the sensor in the housing Wait for a period equal to the time that the sensor spent ou...

Страница 108: ...mation about the oxygen analysis is presented on the two monitor screens Left Hand Screen You can display the inspiratory oxygen trend on this screen by pressing the TREND key until the PERCENT OXYGEN graph appears 100 0 12 20 13 20 PERCENT OXYGEN OP20019 5 10 2 ...

Страница 109: ... O2 CAL OXYGEN ALARMS LO OXYGEN 40 100 OP20057 30 HIGH OXYGEN CONCENTRATION ALARM LIMIT Monitor Controls You use the oxygen monitor control keys to set oxygen concentration alarm limits and calibrate the oxygen sensor These keys are in the top row of the key bank to the right of the right hand display screen INCREMENT KEY LOW OXYGEN CONCENTRATION ALARM LIMIT KEY OXYGEN CALIBRATION KEY OXYGEN 40 10...

Страница 110: ...igh alarm limit Follow these steps to change the high or low alarm limit 1 Press the HI or LO oxygen alarm key depending on which alarm limit you want to change A box is drawn around the selected alarm limit 2 Press the increment up arrow or decrement down arrow key to increase or decrease the highlighted alarm limit If you do not press a key within five seconds the highlighting box disappears To ...

Страница 111: ...sensor assembly from the inspiratory valve dome and close off the dome with the inspiratory valve dome plug Do not disassemble the sensor assembly further INSPIRATORY VALVE DOME EXPIRATORY VALVE DOME OP15750 INSPIRATORY VALVE DOME PLUG TO BREATHING SYSTEM SENSOR INTERFACE PANEL SENSOR ASSEMBLY 2 Expose the sensor to ambient air only 21 oxygen concentration and allow it to stabilize for several min...

Страница 112: ...emoved and the currently sensed oxygen concentration appears in the OXYGEN display If the calibration was not successful the OXYGEN display area is blank See Unsuccessful Calibration in this section for further information Typically calibration lasts less than 30 seconds However the time may vary depending on the amount of oxygen the sensor was exposed to before calibration Oxygen Exposure Typical...

Страница 113: ...ed the proper waiting period If the sensor capsule has been 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 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 decay...

Страница 114: ...entage either greater or less than the actual oxygen percentage Therefore make sure that the sensor is exposed only to room air during the entire calibration period The following figure illustrates the relationship between the calibration mixture and the accuracy of oxygen measurement DISPLAY O2 PERCENTAGE ACTUAL O2 PERCENTAGE Correct calibration of room air 21 O2 for entire calibration period Dis...

Страница 115: ...e panel the O2 SENS DISC message is removed from the central alarm display and the OXYGEN display area remains blank until you perform a new calibration O2 SENS ERR Advisory During oxygen sensor calibration and monitoring the Narkomed 2B checks for a difference between the outputs of the two sensor halves If the difference exceeds a predetermined percentage the Advisory message O2 SENS ERR appears...

Страница 116: ... calibrated This message may appear during monitoring or during calibration During monitoring if the calculated oxygen concentration exceeds 103 the Advisory message O2 CAL ERR appears on the central alarm display and remains there until a new calibration is performed A calculated oxygen concentration of 100 is displayed for all values 100 During monitoring if the calculated oxygen percentage exce...

Страница 117: ...ory power is not available Allow anesthesia machine back up battery to recharge The hardware malfunctioned Contact NAD qualified technical service representative Pressing O2 CAL key does not initiate calibration Sensor cord is disconnected Reconnect sensor cord to input receptacle on anesthesia machine Sensor cord is damaged Replace housing cord assembly Display area has no pressure readout during...

Страница 118: ...moved from housing for a prolonged period of time Allow for waiting period equal to duration of capsule removal New capsule was not given proper waiting period Allow for 15 minute waiting period Sensor capsule is exhausted or defective Replace sensor capsule Allow for 15 minute waiting period During monitoring O2 SENS DISC O2 ALRM OFF O2 NOT CAL messages appear on central alarm display Sensor hous...

Страница 119: ...splays INSPIRATORY VALVE DOME OP15751 EXPIRATORY VALVE DOME RESPIRATORY VOLUME SENSOR TO BREATHING SYSTEM SENSOR INTERFACE PANEL CAUTION Although the Narkomed 2B is designed to minimize the effects of ambient radio frequency interference the functioning of the respiratory volume monitor may be adversely affected by the operation of electrosurgical equipment or short wave or microwave diathermy equ...

Страница 120: ...E VOLUME MEASUREMENT l MIN 3 0 MINUTE VOLUME ALARM LIMIT The tidal volume measurement TID VOL shows the volume for each breath If the monitor does not detect a valid breath within a 30 second period the display area goes blank The breathing rate measurement BPM displays the number of breaths during the previous minute of respiration If the BPM display is blank a full minute of respiration has not ...

Страница 121: ...E ALARMS VOLUME ALARMS DISABLE VOLUME ALARMS DISABLE KEY DECREMENT KEY 3 0 LOW MINUTE VOLUME ALARM LIMIT ADJUSTMENT KEY Fixed alarms are provided for low tidal volume low minute volume and reverse flow through the sensor Apnea volume alarms are generated at 15 seconds Caution and 30 seconds Warning if the respiratory volume monitor does not sense a valid breath The Narkomed 2B s volume alarms are ...

Страница 122: ...ain return to step 1 3 To save the new value simply stop pressing keys In five seconds the highlighting box disappears and the new value is saved as the alarm limit Controlling Volume Alarms VOLUME ALARMS DISABLE You can alternately enable and disable the respiratory volume alarms with the VOLUME ALARMS DISABLE key To disable working respiratory volume alarms press the VOLUME ALARMS DISABLE key Th...

Страница 123: ... If a valid breath is not detected for an additional 15 seconds 30 seconds total the red APNEA LED indicator flashes on and off the Caution message APNEA VOL is upgraded to a Warning on the central alarm display and a continuously repeating audible alarm sounds Also the display area pertaining to the Respiratory Volume Monitor goes blank When a valid breath is detected alarm annunciation ceases an...

Страница 124: ...atory volume sensor cord is not properly connected to its input receptacle on the anesthesia machine or if the cord is damaged enough to cause an open circuit the Advisory messages VOL SENS DISC and VOL ALRM OFF appear on the central alarm display The digital and bar graph display areas also go blank Reconnecting the sensor cord clears the alarm condition VOL ALRM OFF Advisory When the volume alar...

Страница 125: ...onnect sensor cord plug to interface panel on anesthesia machine Sensor cord damaged Repair sensor cord REVERSE FLOW alarm message on central alarm display Leak between sensor and expiratory valve Check gasket make sure it is in good condition and is seated properly Expiratory valve not closing completely during inspiration Check expiratory valve disc and pins Clean repair or replace expiratory va...

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Страница 127: ...gainst the blocked hose A pressure monitor connected at the Y piece downstream of the occlusion could sense either an absence of pressure fluctuation and alarm or could sense a reduced pressure fluctuation below the threshold pressure alarm limit and alarm In contrast a pressure monitor connected at the absorber upstream of the occlusion could sense a pressure fluctuation above the threshold press...

Страница 128: ...pe of pilot line check the line for obstructions and moisture accumulation before and during use Installing the Absorber Pilot Line For breathing pressure monitoring at the absorber install the shorter pilot line which has quick connect fittings on both ends as follows 1 Insert one quick connect fitting on the pilot line into the quick connect fitting mounted on the rear of the gas pipe that exten...

Страница 129: ...ot line into the quick connect fitting on the breathing pressure monitor interface panel 2 Insert the Luer fitting on the pilot line with a Luer fitting on either the patient Y piece or a 15 mm adapter on the patient side of the Y piece Use the four plastic hose clips attached to the pilot line to mount it on either of the breathing hoses leading to the Y piece MALE LUER LOCK FITTING QUICK CONNECT...

Страница 130: ...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 length of the plateau from peak pressure to the decrease in pressure corresponding to expiration is equivalent to the length of the inspiratory pause if present The horizontal dotted line on the waveform represe...

Страница 131: ...PEAK BREATHING PRESSURE 12 50 HIGH PRESSURE ALARM LIMIT THRESHOLD PRESSURE ALARM LIMIT The PEEP pressure is the pressure at the end of exhalation The mean pressure represents the average of all the instantaneous pressure values recorded during each breath The peak pressure is the highest instantaneous pressure value for each breath To the right of the peak variable in small type are two alarm limi...

Страница 132: ...can change this limit within the range of 30 to 125 cmH2O NOTE If you set the pressure high alarm limit on or below 60 cmH2O the breathing pressure waveform is scaled from 0 40 cmH2O If you set the alarm limit higher than 60 cmH2O the waveform is scaled from 0 125 cmH2O At this broader scale the threshold pressure alarm limit a horizontal dotted line is not shown with the trace To adjust the press...

Страница 133: ...hold pressure alarm limit If you do not press a key within five seconds the highlighting box disappears To begin again return to step 1 3 To save the new value simply stop pressing keys In five seconds the highlighting box disappears and the new value is saved as the threshold pressure alarm limit Threshold Limit Guidelines If a breathing system leak or partial disconnection occurs when the thresh...

Страница 134: ...ettings of 5 through 20cm H2O Thus after partial breathing system disconnection or leak small pressure fluctuation does not cross threshold pressure alarm limit Operator is warned of apnea condition Threshold pressure alarm limit incorrectly set more than 6cm H2O below peak pressure 1 BREATHING PRESSURE CmH2O BREATHING PRESSURE CmH2O 40 0 40 0 Thus after partial breathing system disconnection or l...

Страница 135: ...lay To enable a disabled alarm press the APNEA ALARM DISABLE key The APNEA P OFF message disappears from the central alarm display NOTE The apnea alarm is automatically disabled on power up to avoid a spurious alarm with a spontaneously breathing patient When you turn on the ventilator the alarm is automatically enabled or you can enable it manually with the APNEA ALARM DISABLE key The alarm remai...

Страница 136: ...ntral alarm display and a continuously repeating audible alarm sounds This alarm condition is cleared when the measured breathing pressure drops below the high pressure alarm limit However the alarm message is extended for 5 seconds to allow for recognition of a momentary high pressure condition SUB ATM PRES Warning If the measured breathing pressure falls below 10 cmH2O the Warning message SUB AT...

Страница 137: ...essure alarm limit at 30 cmH2O disables the THRESHOLD LO advisory PEEP 4 Advisory Any time the monitor measures a PEEP of 5 cmH2O or greater the Advisory message PEEP 4 appears on the central alarm display When the measured PEEP drops below 5 cmH2O the Advisory message is cleared from the display APNEA P OFF Advisory Any time that the apnea pressure alarm threshold pressure alarm limit has been di...

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Страница 139: ...anesthesia machine next to the ventilator bellows The cuff inflation bulb is located to the right of the oxygen flush button on the front of the machine 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 OP20033 SPHYGMOMANOMETER GAUGE BP CUFF O2 FLUSH FRONT OF FRAME HANDLE 5 13 1 ...

Страница 140: ...ic 18 26cm Adult 25 35cm Large Adult 33 47cm Thigh 46 66cm OP30031 Connecting the Cuff To connect the cuff 1 Connect the cuff hose attached to the cuff to the extension hose with a threaded fitting on one end and a Luer lock fitting on the other end Insert the Luer lock fitting on the cuff hose into the Luer lock fitting on the extension hose and twist until they lock together 2 Attach the other e...

Страница 141: ...acing 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 mmHg to the reading For every inch of elevation below the heart subtract 1 8 mmHg from the reading IND...

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Страница 143: ...schedule with a sufficient safety margin 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 th...

Страница 144: ...ch one When using absorbent prepacks remove all packaging materials some have clear plastic wrappers 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 6 2 ...

Страница 145: ...ensor cannot correctly analyze oxygen concentrations 1 Turn the SYSTEM POWER switch to STANDBY 2 Remove the oxygen sensor housing from the inspiratory valve dome It is a press fit 3 Unscrew 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 housin...

Страница 146: ... water 2 Remove and inspect all 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 VACUUM SOURCE TERMINAL ADAPTER INPUT PORT CAP BLOCK NEEDLE V...

Страница 147: ...ith 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 fra...

Страница 148: ...id disinfection agent However if further disinfection is required 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 6 6 ...

Страница 149: ...does not need disinfection However if your facility requires a disinfection process for the scavenger interface and hoses remove the scavenger and all 19 mm hoses Refer back to the cleaning instructions under Open Reservoir Scavenger Maintenance or Scavenger Interface for Passive Systems Maintenance for disassembly instructions 4 Remove the oxygen sensor assembly from the inspiratory valve and dis...

Страница 150: ...re free of the system 10 Remove the respiratory volume sensor by turning its ring nut counterclockwise until it is free of the absorber dome 11 Remove the pressure gauge by turning the knurled ring nut that connects the pressure gauge to the gauge mount counterclockwise Lift the pressure gauge assembly off the gauge mount Do not misplace the o ring OP00262 GAUGE MOUNT O RING BREATHING PRESSURE GAU...

Страница 151: ...e and Cleaning 13 Remove the bellows assembly by loosening the two wing nuts on the bottom of the assembly until the assembly releases from the canister OP00260A WINGNUT 2X PILOT LINE RELIEF VALVE BODY BELLOWS BELLOWS CANISTER 6 9 ...

Страница 152: ...r Bellows Assembly Remove the bellows from the ventilator bottom assembly by unscrewing it in a counterclockwise direction until it is released Unscrew the knurled ring nut around the ventilator relief valve and pull the relief valve dome and pilot line away from the relief valve body CAUTION Take special care not to change the position of the adjustment lock ring on the ventilator relief valve do...

Страница 153: ...ATORY 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 6 11 ...

Страница 154: ...frequency 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 Select...

Страница 155: ... Gauge x Absorber Canisters Gaskets and Dust Cup x x x x Vaporizer Exterior x x Corrugated Scavenger Hoses do not normally need disinfection x x x x Open Reservoir Scavenger does not normally need disinfection x x x Passive Scavenger Interface does not normally need disinfection x x x A Heat sterilization autoclaving including steam or hot air use manufacturer s recommendations B Ethylene oxide ga...

Страница 156: ...h mild detergent and water Follow up with a 70 to 90 diluted solution of ethyl or isopropyl alcohol or sodium hypochlorite 5 2 household bleach at 1 500 dilution 100 ppm chlorine NOTE North American Dräger 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 ...

Страница 157: ...lso accelerates the natural aging of rubber goods Reusable rubber goods can also be gas sterilized with ethylene oxide After EtO sterilization properly aerate rubber goods before returning them to service Always follow manufacturer s instructions for these procedures CAUTION Do not autoclave face masks Autoclaving causes rapid deterioration of face mask cushions Cleaning and Disinfecting the Y Pie...

Страница 158: ... 2 household bleach l 500 dilution 100 ppm free chlorine or 70 to 90 ethyl or isopropyl alcohol Cleaning and Disinfecting the Oxygen Sensor Housing Cover The oxygen sensor housing cover can be immersed or wiped during cleaning and disinfection Use mild detergent and water for cleaning For disinfection follow up with a 2 glutaraldehyde based formulation wet pasteurization at 70 C for 30 minutes or ...

Страница 159: ...tem pressure gauge cannot withstand immersion or the heat and pressure of autoclaving Cleaning and Disinfecting the Absorber Canister Assemblies and Dust Cup Refer to the instructions provided earlier in this chapter under the heading Replacing the Absorbent for instructions on removing the absorbent canister assemblies from the absorber Clean the canisters frequently Remove used absorbent and cle...

Страница 160: ... immerse the vaporizer or allow water or any other liquid to enter the fill or drain ports or fresh gas inlet or outlet ports Any vaporizer suspected of contamination with water or any other liquid must be returned to North American Dräger s Technical Service Department for a complete overhaul Additional care must be taken with halothane vaporizers Halothane contains a stabilization additive calle...

Страница 161: ...scavenger hoses are not part of the breathing circuit so they do not require disinfection If the user facility requires disinfection refer back to the instructions provided in Cleaning and Disinfecting Corrugated Breathing Hoses Mask Elbow and Bag to select a compatible process Check the hoses frequently for signs of deterioration including swelling tackiness or cracking Replace the affected parts...

Страница 162: ...emble the inspiratory and expiratory valves Place the valve disk and dome gasket in the valve body then replace the dome and ring nut Turn the ring nut clockwise to tighten 8 Replace the inspiratory valve assembly and gasket on the valve mount Turn the valve assembly clockwise to secure it to the valve mount 9 Replace the expiratory valve assembly and gasket on the respiratory volume sensor Turn t...

Страница 163: ... pole to the scavenger as illustrated in the following drawings If the scavenger hoses were removed from the scavenger replace the scavenger hoses as illustrated on the following pages 16 Turn the SYSTEM POWER switch to ON 17 Perform the daily checkout procedure provided in this manual before operating the machine 6 21 ...

Страница 164: ...ction 6 Routine Maintenance and Cleaning Open Reservoir Scavenger Connections OP00143A SHORT 19MM SCAVENGER HOSE 19MM SCAVENGER HOSE VENTILATOR RELIEF VALVE 19MM SCAVENGER HOSE TERMINAL ABSORBER POLE 6 22 ...

Страница 165: ...ive System Scavenger Connections OP00141A SHORT 19MM SCAVENGER HOSE 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 6 23 ...

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Страница 167: ...wer Supply Primary input voltage acceptable range 90 130 VAC 50 60 Hz Primary input current 6 amps RMS total 1 amps machine 5 amps receptacles Primary input power includes receptacles 780 Watts 220 240 Volt Power Supply Primary input voltage acceptable range 200 260 VAC 50 60 Hz Primary input current 0 4 amp 240 VAC 50 Hz Primary input power 104 Watts Backup Battery Type Sealed lead acid maintenan...

Страница 168: ...re 150 50 ml min Low oxygen supply pressure alarm 34 40 psi Cylinder gauge accuracy 90 psi 0 750 psi 60 psi 750 2250 psi 90 psi 2250 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 Oxygen Helium 1900 psi 13100 kPa Flowmeter Accuracy at 20 C and 760 mmHg Oxygen Nitrous Oxide Air Fine 100 100...

Страница 169: ...acy 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 volume or 20 whichever is higher Ventilator Frequency 1 99 1 BPM in 1 BPM incre...

Страница 170: ...t temperature and pressure Response time 25 sec T90 Zero drift 0 1 vol O2 month Span drift 1 vol O2 8 hours Temperature error 3 of reading 15 to 40 C Sensor service life 8 months at 25 C 50 relative humidity 50 O2 gas mixture or 5000 hour CO2 Breathing Pressure Monitoring Numeric display range 10 125 cmH2O Resolution 1 cmH2O Accuracy 3 cmH2O or 10 of reading whichever is greater Waveform display s...

Страница 171: ...play range 2 99 BPM Resolution 1 BPM Accuracy 10 or 1 BPM whichever is greater Sensor Flow Range 5 100 l minute Serial Interface Serial Ports Type RS 232C DTE Baud Rate 300 2400 Parity Odd Even None Data Bits 7 or 8 Stop Bits 1 or 2 Protocols Vitalink 7 5 ...

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Страница 173: ...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 020 Silicone absorber mount 4105868 O ring 237 Silicone dust cup fitting 4102940 Breathing System Accessories Breathing...

Страница 174: ...329 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 Volume Monitor Sensor Assembly 4106362 Volume Sensor Lubrication Kit supplied with Sensor Assembly 2218180 Gasket expiratory valve mount and sensor inlet 1101690 Commu...

Страница 175: ...play area 2 26 oxygen 2 5 2 21 5 10 9 power failure 2 23 respiratory volume 5 11 3 5 11 5 silencing 5 9 6 speaker failure 2 27 Auxiliary oxygen flowmeter 2 11 B Bain circuit adapter 2 15 Battery backup system 2 23 machine functions 2 23 test 5 7 2 Breathing pressure monitoring adjusting alarm limits 5 12 6 5 12 7 alarm summary 5 12 10 apnea alarm disable key 5 12 9 breathing rate 5 12 4 measuring ...

Страница 176: ...en 5 9 4 Convenience receptacles 2 22 Cylinder connections 5 1 2 D Disassembling parts for cleaning and disinfection 6 10 Display screen left hand 2 25 2 26 right hand 2 26 E Exclusion system vaporizer 2 11 5 2 2 F Flow control valves 2 6 Flowmeters 2 6 Frequency control 5 8 4 Fresh gas hose connection 5 1 4 outlet 2 8 oxygen sensor adapter 2 10 G Gas delivery system general description 2 1 operat...

Страница 177: ... 13 1 Manual sphygmomanometer maintenance 6 6 Minimum oxygen flow 2 6 Minute volume 5 11 2 Monitor control keys 2 26 5 9 2 screens 5 9 2 Monitoring system general description 2 25 operation 5 9 1 N Numerical data 5 9 3 5 9 10 breathing pressure 5 12 5 oxygen concentration 5 10 3 respiratory volume 5 11 2 O O R Data Manager 2 28 Open reservoir scavenger maintenance 6 4 Optional gases 2 1 Oxygen ana...

Страница 178: ...tion breathing pressure monitoring 5 12 11 oxygen analysis 5 10 11 respiratory volume monitoring 5 11 7 R Removing parts for cleaning and disinfection 6 7 Respiratory rate 5 11 2 Respiratory frequency 5 8 4 Respiratory volume monitoring adjusting the minute volume low alarm limit 5 11 4 alarm summary 5 11 5 measuring the volume 5 11 1 numerical data 5 11 2 problem resolution 5 11 7 trend data 5 11...

Страница 179: ...1 2 Tidal volume adjustment 5 8 4 Trace data 5 9 2 5 9 7 5 12 4 Trend data 5 9 2 5 9 8 breathing pressure 5 12 4 oxygen concentration 5 10 2 respiratory volume 5 11 2 V Vaporizer general description 2 11 operation 5 2 1 Ventilator general description 2 19 operation 5 8 1 W Warnings breathing pressure 5 12 10 display area 2 26 oxygen 5 10 9 respiratory volume 5 11 5 Y Yokes 2 4 5 1 2 I 5 ...

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Страница 182: ...North American Dräger 3135 Quarry Road Telford PA 18969 USA 215 721 5400 215 721 9561 Sales Fax 215 723 5935 Service Fax ...

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