CASI & CASII Circle Absorbers Operator User Manual Issue 1 Oct 2003

CAS Absorber

Blease CAS I / CAS II Absorber User and Maintenance Manual MODIFICATIONS LABEL

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Part Number: 122UM006 Issue 1 /October 2003 CAS Absorber User Manual

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CAS Absorber

Read this Manual before operating the Absorber.

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CAS Absorber User Manual

CAS Absorber

Contents

Table of Contents Product Improvement ... 6 Responsibilities of the Manufacturer ... 6 Disclaimer ... 6 Technology Disclaimer/Tamper Proof Seal ... 6 Note to Service Personnel ... 7 Copyright ... 8 CE Marking ... 8 Trademarks & Acknowledgements ... 9 1. Introduction ... 11 1.1 Hazard Notices ... 12 Warning Notices ... 13 Cautionary Notices ... 14 1.2 Symbols & Abbreviations ... 15 2. Description ... 17 2.1 Introduction ... 17 2.2 Principles of Operation ... 18 2.2.1 Spontaneous Breathing ... 18 2.2.2 Bypass ... 18 2.2.3 Scavenging ... 18 2.2.4 Absorbent ... 18 3. Installation ... 21 3.1 Mounting the Absorber ... 21 3.2 Pre-Use Checks ... 22 3.2.1 APL Valve Test (if applicable) ... 23 3.2.2 Spontaneous Breathing Setup ... 24 3.2.3 Mechanical Ventilation Setup ... 24 3.2.4 Intermittent Positive Pressure Ventilation ... 24 3.2.5 Bypassing the Absorber ... 24 3.2.6 Replenishing the Soda Lime Canister ... 25 3.2.7 Duration of Canister Usage ... 27 3.2.8 Storage of Soda Lime... 27 4. Maintenance ... 28 4.1 Cleaning & Sterilization ... 28 4.1.1 PEEP Cleaning ... 29 4.2 Routine Maintenance Checks ... 30 4.2.1 Exchanging Non-return Valve Discs ... 30 4.2.2 Annual Service ... 30 5. Appendix ... 31 CAS Absorber User Manual

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Contents

CAS Absorber

5.1 Spare Parts & Accessories ... 31 5.2 PEEP Valve ... 32 5.2.1 Installation ... 32 5.2.2 Operation ... 32 5.2.3 Absorber Leak Test ... 33 5.3 Manometer... 34 5.3.1 Installation ... 34 5.3.2 Removal... 34 5.4 Oxygen Sensor ... 34 5.5 Technical Data ... 35 5.5.1 Dimensions ... 35 5.6 Performance ... 35 5.6.1 Performance as defined in EN 740; 1998 E ... 35 Index ... 36

List of Figures Figure 1 CAS I & II Absorber ... 16 Figure 2 Absorber Flow Circuit ... 19 Figure 3 Absorber Mounting ... 21 Figure 4 Attaching Absorber Tubing ... 22 Figure 5 Soda Lime Canister Replenishment ... 25 Figure 6 Soda lime Canister with Central Seal in Position... 26 Figure 7 PEEP Valve ... 32 Figure 8 Manometer... 34

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CAS Absorber User Manual

CAS Absorber

CAS I & II Absorber How to Use This Manual This manual is designed as a guide for learning to operate the Blease CAS I & II Absorber, and also as a reference tool to use once you are familiar with the system.

CAS Absorber User Manual

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Notices

CAS Absorber

Product Improvement Blease Medical Equipment Limited has a policy of continued product improvement and therefore reserves the right to make changes which may affect the information contained in the manual without giving prior notice.

Respo nsibilities of the Manufacturer The manufacturer accepts responsibility for the effects on safety, reliability and performance of the equipment only if:

• • •

assembly operations, extensions, adjustments, modifications and repairs are carried out by persons with written authorisation from the manufacturer; the equipment is used in accordance with the instructions for use; the electrical installation of the relevant room complies with the ‘Regulations for the Electrical Equipment of Buildings’.

NB If during the warranty period the equipment is serviced by an unauthorised party, the warranty will be void.

Disclaimer Opening of the control unit by unauthorised personnel automatically voids all warranties and specifications. The prevention of tampering is solely the user's responsibility; the manufacturer assumes no liability for any malfunction or failure of the ventilator if the control unit is opened.

Technology Disclaimer / Tamper Proof Seal Unauthorised removal of or damage to seal will invalidate product warranty and could affect accuracy and performance of this product. In the interest of both patient and user safety no unauthorised calibration or access to technical techniques and practices including calibration information of this product will be issued.

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CAS Absorber User Manual

CAS Absorber

Notices

The technical performance and characteristics of this product belong to Blease. Under no circumstances will those details be issued to nonBlease personnel. Technical data, calibration co-efficients and all intellectual property rights of this product remain the property of Blease. To ensure correct functioning, the equipment must be serviced at regular intervals.

Note to Service Personnel The Blease CAS I & II Absorber and integrated equipment must only be serviced by Qualified Service personnel. The contents of this manual are not binding. If any significant difference is found between the product and this manual please contact Blease Medical Equipment Limited for further information. To ensure correct functioning, the equipment must be serviced at regular intervals. Blease Medical Equipment Limited recommends that the machine should be serviced at intervals not exceeding three months. Qualified Service Personnel and genuine spare parts should be used for all servicing and repairs. Blease Medical Equipment Limited will not otherwise assume responsibility for the materials used, the work performed or any possible consequences of the same. In communication with Blease Medical Equipment Limited, quote the model and serial number of the equipment, with the approximate date of purchase. If the equipment is being returned for repair, indicate the nature of the fault or the work you require to be carried out. Contact: Blease Medical Equipment Limited Beech House • Chiltern Court • Asheridge Road • Chesham • Buckinghamshire HP5 2PX • England Tel: +44 (0)1494 784422 Fax: +44 (0)1494 791497 e-mail (enquiries): [email protected] e-mail (technical): [email protected] www.blease.com CAS Absorber User Manual

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Notices

CAS Absorber

Copyright ©2003, Blease Medical Equipment Limited. E & OE. All rights reserved. The information contained in this publication may not be used for any other purpose than that for which it was originally supplied. This publication may not be reproduced in part or in whole without the written consent of Blease Medical Equipment Limited.

CE Marking The product is labelled with the CE mark.

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CAS Absorber User Manual

CAS Absorber

Trademarks & Acknowledgements

Trademarks and Acknowledgements The following trademarks and acknowledgements may appear in Blease Medical Equipment Manuals. is the trademark of Abbott Laboratories. Da-LitesTM is a trademark of Blease Medical Equipment Limited UK. Datum® is a registered trademark of Blease Medical Equipment Limited UK. Dowty is a trademark of Dowty Seals Limited. Draeger is a trademark of Draegerwerk AG Germany. Dzus is a trademark of Dzus Fasteners Limited. Fomblin® is a registered trademark of Rocol Limited. Frontline Sirius 1000® is a registered trademark of Blease Medical Equipment Limited. Frontline Sirius 2000® is a registered trademark of Blease Medical Equipment Limited. Frontline Sirius 3000® is a registered trademark of Blease Medical Equipment Limited. Legrand® is registered trademark of Legrand Electric Limited. Loctite® is a registered trademark of Loctite Corporation USA. Megger is a trademark of AVO Megger Instruments Ltd. Plug-in® is a registered trademark of Draegerwerk DAG Germany. Quik-Fil® is a trademark of Abbott Laboratories. Rigel is a trademark of Seaward Electronics Ltd. Scotchbrite® is a registered trademark of 3M. SELECTATEC® is a registered trademark of Ohmeda/BOC UK Ltd. Snoop® is a registered trademark of the Nupro® Company Ohio USA. Trak Wheel ® is a registered trademark of Blease Medical Equipment Ltd.

CAS Absorber User Manual

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CAS Absorber

Read this Manual before operating the Absorber.

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CAS Absorber User Manual

CAS Absorber

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1. Introduction

Introduction

Welcome to the User and Maintenance Manual for the CAS I & CAS II Absorber. This manual is intended for users and service personnel. It contains detailed installation and operating instructions. It also includes cleaning and sterilisation methods, basic troubleshooting and maintenance procedures. Personnel operating the CAS I & CAS II Absorber must become thoroughly familiar with the instructions contained in this manual prior to using the equipment with patients. The Absorber is intended for use by a qualified practitioner under the direction of a qualified anaesthetist. When the absorber is used with a ventilator and connected to a patient, it is recommended that a licensed medical practitioner be in attendance at all times to react to an alarm or other indication of a problem. Incorrect use of the equipment described herein may result in injury to the patient. Read this manual before operating the machine. You must be familiar with the machine and its functions before using it on a patient.

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1. Introduction

1.1

CAS Absorber

Hazard Notices

This manual contains important hazard information. You must read this hazard information before using the CAS I & CAS II Absorber. Warning notices Warning notices denote a potential hazard to the health and safety of users and/or pati ents. These notices clearly state the nature of the respective hazard and the means by which it can be avoided. Warning notice s, together with the warning symbol shown on the left, appear in full in the preliminary pages and are summarised at their point s of application in the manual .

Caution Notices Cautionary notices denote a potential hazard to the physical integrity of eq uipment/software but NOT a danger to personnel. These notices clearly state the nature of the hazard and the means by which it c an be avoided. Cautionary notices appear in full in the preliminary pages and are summarised at their points of application in t he manual.

Relevant or helpful information.

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CAS Absorber User Manual

CAS Absorber

1. Introduction

Warning Notices 1.

Use of Equipment Incorrect use of the equipment described herein may result in injury to the patient. Rea d this manual before operating the machine. You must be familiar with the equipment and its functions before using it on a patient.

2.

Absorber Malfunction Injury to the patient may result if a faulty absorber is used. If there is any malfunction, o r if the absorber does not pass all pre -use tests, do not use the absorber. If the malfunction cannot be rectified, call an authorised service engineer or return the absorber to the supplier.

3.

Spontaneous Breathing If the APL valve is not in the OP EN position it will not operate until the pressure reaches approximately 65 cmH 2O. This may result in injury to the patient. Set the APL valve to the OPEN position to allow spontaneous breathing.

4.

Soda Lime Soda lime is caustic. Observe the manufactur er’s instructions for correct handling and storage. When handling, always wear suitable eye, face and hand protection as crushed soda lime can degrade to a fine dust which may be harmful by inhalation. To minimise the levels of soda lime dust, ensure that the soda lime is not crushed and that regular cleaning of the absorbers and breathing circuits is carried out. To prevent injury to the patient, always protect the patients face using a facemask.

5.

Filling Canisters Under -filling of canisters can lead to inefficient CO 2 absorption; overfilling can result in poor canister sealing. Fill the reusable canisters only to the recommen ded level.

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1. Introduction 6.

CAS Absorber

Condensate The condensate in the bottom of the circuit is caustic. Drain the condensate periodically. Accidental splashes sh ould be rinsed immediately with water.

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Absorber Orientation Use the absorber only in the upright position. Use in any other orientation may affect the gas flow or damage the absorber.

Cautionary Notices 1.

PEEP Valve Only the “ears” on the plast ic cover should be used for mounting and removal of the PEEP valve.

2.

Cleaning The surfaces of the absorber may be damaged by caustic substances. Do not use caustic substances such as trichlorethylene for cleaning.

3.

Sterilisation Sterilisation will damage the manometer. Remove this item before sterilising the Absorber. The PEEP valve should be separated, (see section 4 Mai ntenance).

4.

Refilling Soda Lime Canister When refilling the absorber canister with Soda lime there have been instances when t he upper seal (Part No. 12200235) has not been replaced resulting in a leak. This seal is located above the upper soda lime can ister, attached to the black moulding within the body of the absorber. Please ensure all seals are correctly replaced when re -assembling the absorber.

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CAS Absorber User Manual

CAS Absorber

1.2

1. Introduction

Symbols and Abbreviations bpm BPM

Breaths per minute

cmH2O

Gauge pressure expressed in centimetres of water

CPAP

Continuous positive airway pressure

PEEP

Positive end expiratory pressure

I:E Ratio

A ratio of inspiratory to expiratory time IEC symbol to consult the instructions for use

IEC symbol denoting type of equipment (B)

WARNING: There is danger of personal injury to the user or patient Further relevant or helpful information

Caution: Denotes a potential hazard to the physical integrity of equipment/software and NOT a danger to personnel. Absorber Bypass Absorber ON

Manometer P

Vent

Bag

O2 %

Oxygen Sensor Port

Power off

Power on

Dangerous voltage

l/m

lpm

Litres per minute

ml

Millilitres

O2

Oxygen

psi

Pounds per square inch

psig

Pounds per square inch gauge

l

Litres IEC symbol for alternating current Confirms approval under the European Medical Device Directive

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1. Introduction

CAS Absorber

Figure 1 CAS I and CAS II Absorber K

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L

N

A J I P

H

O B C G D O2 %

F E

Key

H

Patient Inspiratory Connector

I

Inspiratory Non-return Valve

J

Bag/Vent Valve

A

APL Valve

B

Bypass Valve

C

Expiratory Non-return Valve

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Outer Canister

K

Manometer Gauge

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BagPort

L

Fresh Gas Port

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Patient Expiratory Connector

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Exhaust Port

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Oxygen Sensor Port & Oxygen Sensor Port Blanking Plug

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Vent Port

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PEEP Valve

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CAS Absorber User Manual

CAS Absorber

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2. Description

Description

2.1

Introduction

Two models of the CAS Absorber are available - CAS I & CAS II. The difference between the two models is that the I model houses only one soda lime canister, while the II model houses two. All the plastic mouldings are made from fully autoclavable polymers. An Airway Pressure Limiting (APL) valve sets the ventilating pressure during manual operation mode. The APL valve incorporates a 65 cmH2O safety valve. The Bypass valve allows gas flow to completely bypass the absorbent. This can be used to allow a build-up of CO2, or enable canister removal/replacement without disconnecting the breathing circuit. The Bag/Vent valve allows the ventilator and bag to be connected to the absorber at the same time. The required mode is chosen using a selector knob. Optional accessories available for the absorber include:

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detachable Manometer (-10 cmH2O to 100 cmH2O); detachable PEEP valve (0 cmH2O to 20 cmH2O);

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2. Description

2.2

CAS Absorber

Principles of Operation

Please refer to Figure 2.

2.2.1

Spontaneous Breathing

When used with spontaneously breathing patients, the required gas flow is set and continuously tops up the bag. When the patient breathes in, gas is drawn through the inspiratory non-return valve (B) from the bag via the canisters (F) containing soda lime. On exhalation the gas flows through the expiratory non-return valve (E), some gas is blown through the APL valve (G), which should be set to balance the fresh gas flow, while the bulk is returned to the bag via the bag port (N). Correct operation of the inspiratory (B) and expiratory non-return valves (E) can be checked visually during use.

2.2.2

Bypass

The Bypass valve (I) allows gas to be delivered to the patient without passing through the canister(s), so that CO2 levels can be increased or the canister(s) can be replaced while the absorber remains in use.

2.2.3

Scavenging

The APL valve (G) is provided with a 30 mm taper port for ducting exhaust gases away.

2.2.4

Absorbent

Gas flows downwards between the soda lime canister(s) and the outer canister, then up through the absorbent soda lime, entering at the base of the canister(s), exiting via the top of the soda lime canister. Soda lime is normally supplied with an indicator that changes colour when the soda lime is exhausted. When the colour change reaches the top of the lower canister on a CAS II Absorber, its contents should be replenished and the canister placed in the upper position and the other canister should be placed in the lower position, while on a CAS I Absorber, the contents of the single canister should simply be replenished. Alternatively, disposable canisters may be used.

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CAS Absorber User Manual

CAS Absorber

2. Description

Figure 2 Absorber Flow Circuit

Key A

Manometer

I

Absorber Bypass Valve

B

Inspiratory Non-return Valve

J

APL Exhaust Port

C

Patient Inspiratory Connector

K

Fresh Gas Port

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Patient Expiratory Connector

L

Bag/Vent Valve

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Expiratory Non-return Valve & PEEP Valve

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Ventilatory Port

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Canister(s)

N

Bag Port

G

APL Valve

H

Oxygen Sensor Port

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