Instructions for Use
16 Pages
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Page 1
Analgesic Demand Valve Instructions for Use
702-0038.21 January 2020
702-0038.21 January 2020
Contents 1.
Symbols ... 2
2.
Warnings and Cautions ... 2
3.
4.
5.
6.
2.1.
Warnings! ... 2
2.2.
Cautions! ... 3
2.3.
Notes ... 3
Functional Description ... 3 3.1.
Intended Use ... 3
3.2.
Technical Description ... 3
Operating Instructions ... 4 4.1.
Fitting the Exhalation Valve ... 4
4.2.
Removing the Lanyard ... 4
4.3.
Refitting the Lanyard ... 4
4.4.
Connecting to the Analgesic Gas Supply ... 4
4.5.
Testing Prior to Use ... 5
4.6.
Fitting an Exhalation Valve ... 5
4.7.
Fitting an Exhalation Valve (AGSS) ... 6
4.8.
Operation ... 6
4.9.
After Use ... 6
Cleaning and Disinfection ... 6 5.1.
After Every Use ... 6
5.2.
Suspected Contamination ... 7
Maintenance... 7 6.1.
Servicing ... 7
7.
Specification ... 8
8.
Troubleshooting... 9
9.
Parts and Spares... 10
1.
Symbols Warning!
Indicates a potentially hazardous situation which, if not avoided, could result in personal injury to the user or others
Caution!
Indicates a potentially hazardous situation which, if not avoided, could result in damage to the equipment or property
Note
Highlights points that might allow more convenient or efficient operation of the equipment Use no oil
Service due date
2.
Warnings and Cautions
2.1.
Warnings! Read through this entire instruction manual before using or showing others how to use this demand valve. As with all medical equipment, attempting to use this device without a thorough understanding of its operation may result in patient or user injury. N2O/O2 50%/50% V/V, hereinafter referred to as analgesic gas, is or should be considered a drug and should only be used for medical purposes as prescribed by a physician or authorised clinician and in accordance with the medicinal product labelling. Continuous exposure to elevated levels of nitrous oxide can be harmful. National standards for exposure levels (Time Weighted Average (TWA)), if available, should be applied. Risk controls measures such as adequate room ventilation, gas scavenging and/or environmental monitoring may be necessary. Ensure that the analgesic gas supply is sufficient for the proposed therapy and is supplied within the pressure range given in the Device Specification. If the supply is a gas cylinder, check the cylinder contents gauge regularly. This demand valve is only for use with medical grade analgesic gas. Check the cylinder or supply is medical grade analgesic gas before use. Use a new exhalation valve for each new patient or after 30 days of use for the same patient. Gas specific connectors are fitted to the demand valve. Do not attempt to modify the fittings to suit other gases or fitting systems. Oxygen and nitrous oxide analgesic gas mixture is not flammable; however the presence of it will drastically increase the rate and severity of combustion. Oil and/or grease in the presence of an oxygen enriched atmosphere will become highly combustible. Analgesic gas must never be allowed to come into contact with oil, grease or other petroleum-based substances. Do not use oil or grease on this demand valve. Many hand creams and moisturisers contain paraffin and petroleum bases which are highly flammable and must never be allowed to contact the Demand Valve. Ensure hands are clean and dry before operating the equipment. Do not use or store analgesic gas near excessive heat (>50°C/125°F) or below 10°C (50°F). Always refer to the medical gas suppliers recommendations. 2
Do not smoke around analgesic gas equipment. Only appropriately trained personnel working in controlled conditions may disassemble or assemble this demand valve. Do not submerge an assembled demand valve in any fluid. If using a cylinder and regulator, ensure that the device is connected to the regulator and the cylinder valve is properly opened before beginning therapy. When therapy is complete, disconnect the demand valve from the gas supply. When the source of analgesic gas is from a gas cylinder, always close the gas cylinder valve when the demand valve is not in use and disconnect the demand valve from the pressure regulator. Arrange the gas hose carefully to avoid damage to the hose and the potential for causing a trip hazard. Never pull or apply excessive force to the gas hose. A leaking hose may result in high local oxygen and nitrous oxide concentrations and an increased risk of fire.
2.2.
Cautions! The performance of the demand valve may be affected if it is stored or transported in temperatures outside of the range -20°C to 60°C (-4°F to 140°F). The demand valve is not suitable for autoclaving. The handset is protected from contamination in normal use by a single patient use exhalation valve. The single patient use exhalation valve is not suitable for cleaning. If the exhalation valve becomes visually soiled or discoloured it should be replaced.
2.3.
Notes Peak flow through the demand valve might be restricted resulting in increased work of breathing for the patient in the following circumstances: o
If the analgesic gas regulator or analgesic gas supply used does not meet the specification.
o
If an extension hose other than those listed in this manual for use with the demand valve is used.
3.
Functional Description
3.1.
Intended Use The Ultraflow™ Analgesic Demand Valve is intended to be used for self-administration of N2O/O2 50%/50% V/V, hereinafter referred to as analgesic gas, in response to the patient’s inspiratory effort. Analgesic gas is or should be considered a drug and should only be used for medical purposes on the authority of a physician and then strictly in accordance with their instructions. The demand valve is designed for use in all types of clinical environment. Always refer to the medical gas product labelling.
3.2.
Technical Description The demand valve comprises of two main components; a demand valve handset and a single patient use exhalation valve (supplied separately). The exhalation valve is single patient use to prevent cross contamination between patients. It may be used by a single patient for up to 30 days.
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The demand valve handset is designed to be reused and can be cleaned and disinfected, although routine disinfection is not necessary as it is protected from contamination by the single patient use exhalation valve. The demand valve handset contains a specially designed tilt valve mechanism that opens when the diaphragm in the back of the demand valve handset moves forward as a result of the patient inhaling. When the tilt valve opens, the gas, which is under pressure behind the tilt valve, passes through the handset and is inhaled by the patient. The deeper the patient breathes, the greater the volume of gas delivered. When the patient exhales the diaphragm moves back, the tilt valve closes and no further gas is delivered. The demand valve offers a very low resistance to flow during both patient inhalation and exhalation, which means less effort for the patient. This is achieved by the unique, patented exhalation valve design that diverts exhaled gas out through a special valve, thus eliminating the need for the patient to exhale through a highly resistant patient filter as is the case with other demand valve systems. The demand valve can be driven directly from the terminal unit of a medical gas pipeline system or from a medical gas cylinder via a suitable pressure regulator. A gas hose complying with BS EN ISO 5359 carries the gas from the gas supply source to the demand valve. The demand valve should be used with either a mouthpiece or a facemask. The exhalation valve has a viral filter that allows the flow of inhaled gas to the patient and prevents contamination of the demand valve handset from the patient’s expired breath.
4.
Operating Instructions
4.1.
Fitting the Exhalation Valve Use a new exhalation valve for each new patient or after 30 days of use for the same patient. The exhalation valve should be replaced if it becomes soiled or discoloured.
4.2.
Removing the Lanyard The lanyard helps to prevent the patient dropping the demand valve when they are not actively using it. Should a patient not want the lanyard then it can be removed. To remove the lanyard, simply pull the lanyard retainer downwards until it is free of the moulded cover and lift the lanyard away. Then refit the lanyard retainer.
4.3.
Refitting the Lanyard 1. To refit the lanyard, simply pull away the lanyard retainer.
4.4.
2. Fit the lanyard into the groove in the handset cover.
3. Refit the lanyard retainer taking care to line up the slots in the lanyard retainer with the lanyard.
Connecting to the Analgesic Gas Supply Before use, visually check both the hose and demand valve for any damage or contamination. Do not connect or use the device if there are any doubts about its condition. 4
The demand valve is supplied with a gas specific connector that is designed to connect to a mating gas outlet. Gas outlets might be part of a terminal unit in a medical gas pipeline system or part of a pressure regulator outlet on a gas cylinder. If you are using a cylinder supply, ensure that the cylinder contents are adequate for planned therapy. Connect the gas specific inlet connector to the appropriate gas outlet. Warning! Where the gas specific connector is dependent on a threaded fastener (e.g. DISS CGA V-5 1240), make sure that the connection is tight before turning on the supply pressure. For quick connector probes (e.g. BS5682, SIS, AFNOR), ensure that the connection is correctly made by gently pulling the gas hose before turning on the supply pressure.
4.5.
Testing Prior to Use Confirm the correct operation of the demand valve before beginning therapy by pressing the Test Button. Gas should flow freely when the Test Button is pressed and should stop when the Test Button is released. If the demand valve does not operate correctly, remove it from use and refer to the trouble shooting guide in Section 8 of this booklet.
4.6.
Fitting an Exhalation Valve Use a new exhalation valve for each new patient or after 30 days of use. The exhalation valve should be replaced if it becomes soiled or discoloured. 1. Place the exhalation valve on the demand valve handset as shown. Do not apply any force at this stage this stage.
2. Rotate the exhalation valve until it ‘clicks’ into place then press down.
4. Fit a face mask or mouthpiece.
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3. Press down the securing clip on each side to lock into place.
4.7.
Fitting an Exhalation Valve (AGSS) 1. Place the AGSS* adaptor over the exhalation valve as shown. Do not apply any force at this stage.
2. Press down until it ‘clicks’ into place.
3. Fit face mask or mouthpiece.
*AGSS = Anaesthetic Gas Scavenging System
4.8.
Operation The patient should place the mouthpiece into their mouth or the face mask over their nose and mouth and inhale. The deeper the patient breathes, the greater the volume of gas delivered. The demand valve is designed for self-administration of analgesic gas and should not be used for periods beyond those prescribed. Do not attach the face mask with a head strap or harness. Continue to monitor the gas cylinder contents (if applicable) during use of the demand valve and be aware that the hose may be a trip hazard.
4.9.
After Use When therapy is complete, disconnect the demand valve from the gas supply. Where the analgesic gas is being supplied from a cylinder, turn the cylinder off and depressurise the handset before disconnection by pressing the Test Button until the gas is fully exhausted. Store the demand valve in a clean dry environment between uses.
5.
Cleaning and Disinfection
Ensure the demand valve handset is disconnected from the gas supply before attempting to clean it. Caution! The demand valve is not suitable for autoclaving. The handset is protected against contamination during normal use by a single patient use exhalation valve.
5.1.
After Every Use Wipe over the outside of the demand valve handset and the gas supply hose with an alcohol or disinfecting wipe.
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5.2.
Suspected Contamination If there is reason to believe that the demand valve handset is contaminated it can be disinfected using a cold disinfection process but will need to be disassembled first. Full details of how to disassemble, clean and disinfect the device can be found in the Service Manual. Never immerse the demand valve handset in any fluid or attempt to clean internal parts whilst the demand valve handset is assembled.
6.
Maintenance
6.1.
Servicing The demand valve handset has an intended life of 10 years and must be serviced after 5 years to ensure that it continues to perform in accordance with its specification. Full details of the recommended servicing requirements can be found in the Service Manual or on SupportWeb. Contact your local distributor for information about SupportWeb online service training. When serviced by BPR Medical Ltd. and where the time to end of life is less than the normal service interval, the Service Due date will be replaced by the End of Life date and preceded by a symbol ( ). In these cases, the date now indicates when the device reaches end of life. As an alternative to servicing the demand valve, a service exchange option is available to replace a used handset with a new one. The Service Manual and access to SupportWeb can be obtained from your local BPR Medical distributor, details of which can be found at www.bprmedical.com.
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7.
Specification
Specification Inspiratory Resistance
Supply Pressure1
Value <1.5 kPa (0.22 psi) at 200 l/min <0.25 kPa (0.036 psi) at 10 l/min Maximum 600 kPa (87 psi) Minimum 310 kPa (45 psi)
Supply Flow Capacity1
>120 l/min
Demand Valve Peak Flow
>200 l/min
Intended Life
10 years Transport and Storage Temperature: -20°C to 60°C (-4°F to 140°F)
Environmental
Operating Temperature: 5°C to 40°C (41°F to 104°F) Humidity: 0-100% RH non-condensing
Regulatory
CE: Medical Device Directive 93/42/EEC – Active Medical Device – Class IIa
Applied Standards
1
BS 4272-2
Anaesthetic and analgesic machines. Specification for intermittent (demand) flow analgesic machines for use with 50/50% (V/V) nitrous oxide and oxygen
BS 5682
Probes (quick connectors) for use with medical gas pipeline systems
BS EN ISO 5356-1
Anaesthetic and respiratory equipment. Conical connectors. Cones and sockets
BS EN ISO 5359
Low pressure hose assemblies for use with medical gases
BS EN ISO 15001
Anaesthetic and respiratory equipment. Compatibility with oxygen
BS EN ISO 15223-1
Medical devices. Symbols to be used with medical device labels, labelling and information to be supplied. General requirements
NF S 90 116
Medico-surgical equipment. Terminal units and related probes for medical fluids
DIN 13260-2
Supply systems for medical gases. Part 2: Dimensions and allocation of probes and gas specific connection points for terminal units for compressed medical gases and vacuum
SS 875 24 30
Medical gas pipeline systems. Connectors for medical gases
CGA V-5
DISS Diameter Index Safety System
SANS 1409
Outlet sockets and probes for medical (gas and vacuum) service used in hospitals
AS 2902
Medical gas systems. Low pressure flexible hose assemblies
Indicates minimum supply pressure at stated value of gas flow. Based upon an adult breathing at 30 bpm with a tidal volume of 1 litre and I:E ratio
of 1:2
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8.
Troubleshooting
Fault
Possible Cause
Solution
No gas flow
Demand valve handset is not connected properly.
Check gas supply. Check that the gas specific probe is correctly connected.
Gas cylinder empty.
Replace gas cylinder.
Medical gas terminal unit on a pipeline system is isolated.
Seek advice from someone authorised to operate the medical gas pipeline system isolation valves.
Demand valve probe blocked.
Repair or service required.
Hole in demand valve diaphragm. Repair or service required. In this instance, the demand valve will work with the Test Button but not when used conventionally by inhaling through the mouthpiece or face mask. Audible gas leak
Valve or diaphragm has become dislodged.
Remove the exhalation valve and check that the diaphragm is laying flat and that it moves forwards and backwards when the Test Button is pressed
Tilt valve worn, bent or broken.
Repair or service required.
Constant gas flow
Tilt valve damaged or blocked.
Repair or service required.
Insufficient gas flow
Tilt valve damaged.
Repair or service required.
Diaphragm perforated.
Repair or service required.
Supply pressure too low and/or gas Check gas supply and/or replace gas cylinder. cylinder nearly empty. Exhalation valve will not fit to or be retained on the demand valve body
Single patient use exhalation valve Check the underside of the single use exhalation valve has damaged location lugs. to see if the locating lugs have been bent over or otherwise damaged. It is important to rotate the single use exhalation valve until it locates in the demand valve housing before pressing it down and engaging the locating ears. Trying to force the single patient use exhalation valve down before correctly locating it will damage the exhalation valve beyond repair. Fit a new single patient use exhalation valve.
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9.
Parts and Spares
Part Number
Description
828-0013
Analgesic Demand Valve - 2m Hose - BS 5682 connector
828-0001
Analgesic Demand Valve - 3m Hose - BS 5682 connector
828-0014
Analgesic Demand Valve - 4m Hose - BS 5682 connector
828-0015
Analgesic Demand Valve - 5m Hose - BS 5682 connector
828-0016
Analgesic Demand Valve - 6m Hose - BS 5682 connector
828-1002
Analgesic Demand Valve - 2m Hose - AFNOR connector (NF S 90 116)
828-1003
Analgesic Demand Valve - 3m Hose - AFNOR connector (NF S 90 116)
828-1004
Analgesic Demand Valve - 4m Hose - AFNOR connector (NF S 90 116)
828-1005
Analgesic Demand Valve - 5m Hose - AFNOR connector (NF S 90 116)
828-1006
Analgesic Demand Valve - 6m Hose - AFNOR connector (NF S 90 116)
828-3002
Analgesic Demand Valve - 2m Hose - Nordica AGA connector (SS 875 24 30)
828-3003
Analgesic Demand Valve - 3m Hose - Nordica AGA connector (SS 875 24 30)
828-3004
Analgesic Demand Valve - 4m Hose - Nordica AGA connector (SS 875 24 30)
828-3005
Analgesic Demand Valve - 5m Hose - Nordica AGA connector (SS 875 24 30)
828-3006
Analgesic Demand Valve - 6m Hose - Nordica AGA connector (SS 875 24 30)
828-5002
Analgesic Demand Valve - 2m Hose - DISS connector (CGA V-5 2020)
828-5003
Analgesic Demand Valve - 3m Hose - DISS connector (CGA V-5 2020)
828-5004
Analgesic Demand Valve - 4m Hose - DISS connector (CGA V-5 2020)
828-6002
Analgesic Demand Valve - 2m Hose - SANS connector (SANS 1409)
828-6003
Analgesic Demand Valve - 3m Hose - SANS connector (SANS 1409)
828-6004
Analgesic Demand Valve - 4m Hose - SANS connector (SANS 1409)
828-6005
Analgesic Demand Valve - 5m Hose - SANS connector (SANS 1409)
828-6006
Analgesic Demand Valve - 6m Hose - SANS connector (SANS 1409)
828-7002
Analgesic Demand Valve - 2m Hose - SIS connector (AS 2896)
828-7003
Analgesic Demand Valve - 3m Hose - SIS connector (AS 2896)
828-7004
Analgesic Demand Valve - 4m Hose - SIS connector (AS 2896)
828-7005
Analgesic Demand Valve - 5m Hose - SIS connector (AS 2896)
828-7006
Analgesic Demand Valve - 6m Hose - SIS connector (AS 2896)
828-9002
Analgesic Demand Valve - 2m Hose - ¼ BSP connector
828-9003
Analgesic Demand Valve - 3m Hose - ¼ BSP connector
828-9004
Analgesic Demand Valve - 4m Hose - ¼ BSP connector
828-9005
Analgesic Demand Valve - 5m Hose - ¼ BSP connector
828-9006
Analgesic Demand Valve - 6m Hose - ¼ BSP connector
Consumables 828-0040
Single Patient Use Exhalation Valve with Mouthpiece (25) EN 1281-1 (22mm)
828-0002
Single Patient Use Exhalation Valve with Mouthpiece (100) EN 1281-1 (22mm) 10
828-0039
Single Patient Use Exhalation Valve for use with Face Mask (25) EN 1281-1 (22mm)
828-0042
Single Patient Use Exhalation Valve for use with Face Mask (100) EN 1281-1 (22mm)
828-0049
Single Patient Use Exhalation Valve (AGSS) for use with Face Mask (50) EN 1281-1 (22mm)
828-0019
Single Patient Use Exhalation Valve (AGSS) with Mouthpiece (50) EN 1281-1 (22mm)
828-0046
Single Patient Use Face Mask (Box 40) EN 1281-1 (22mm)
Spare Parts and Servicing 609-0034
Analgesic Demand Valve Cover - Blue
610-0084
Demand Valve Lanyard (10)
999-1000
Demand Valve Factory Service
999-1102
Analgesic Demand Valve Service Kit - 2m Hose - AFNOR
999-1103
Analgesic Demand Valve Service Kit - 3m Hose - AFNOR
999-1104
Analgesic Demand Valve Service Kit - 4m Hose - AFNOR
999-1105
Analgesic Demand Valve Service Kit - 5m Hose - AFNOR
999-1106
Analgesic Demand Valve Service Kit - 6m Hose - AFNOR
999-3302
Analgesic Demand Valve Service Kit - 2m Hose - Nordica AGA
999-3303
Analgesic Demand Valve Service Kit - 3m Hose - Nordica AGA
999-3304
Analgesic Demand Valve Service Kit - 4m Hose - Nordica AGA
999-3305
Analgesic Demand Valve Service Kit - 5m Hose - Nordica AGA
999-3306
Analgesic Demand Valve Service Kit - 6m Hose - Nordica AGA
999-4402
Analgesic Demand Valve Service Kit - 2m Hose - BS 5682
999-4403
Analgesic Demand Valve Service Kit - 3m Hose - BS 5682
999-4404
Analgesic Demand Valve Service Kit - 4m Hose - BS 5682
999-4405
Analgesic Demand Valve Service Kit - 5m Hose - BS 5682
999-4406
Analgesic Demand Valve Service Kit - 6m Hose - BS 5682
999-5502
Analgesic Demand Valve Service Kit - 2m Hose - DISS
999-5503
Analgesic Demand Valve Service Kit - 3m Hose - DISS
999-5504
Analgesic Demand Valve Service Kit - 4m Hose - DISS
999-6602
Analgesic Demand Valve Service Kit - 2m Hose - SANS
999-6603
Analgesic Demand Valve Service Kit - 3m Hose - SANS
999-6604
Analgesic Demand Valve Service Kit - 4m Hose - SANS
999-6605
Analgesic Demand Valve Service Kit - 5m Hose - SANS
999-6606
Analgesic Demand Valve Service Kit - 6m Hose - SANS
999-7702
Analgesic Demand Valve Service Kit - 2m Hose - SIS
999-7703
Analgesic Demand Valve Service Kit - 3m Hose - SIS
999-7704
Analgesic Demand Valve Service Kit - 4m Hose - SIS
999-7705
Analgesic Demand Valve Service Kit - 5m Hose - SIS
999-7706
Analgesic Demand Valve Service Kit - 6m Hose - SIS
999-9902
Analgesic Demand Valve Service Kit - 2m Hose - ¼ BSP
999-9903
Analgesic Demand Valve Service Kit - 3m Hose - ¼ BSP 11
999-9904
Analgesic Demand Valve Service Kit - 4m Hose - ¼ BSP
999-9905
Analgesic Demand Valve Service Kit - 5m Hose - ¼ BSP
999-9906
Analgesic Demand Valve Service Kit - 6m Hose - ¼ BSP
Demand Valve Test Instrument 828-0053
Demand Valve Test Instrument
605-0060
Demand Valve Test Instrument supply hose - MA4 CPC (BS 5682)
605-0067
Demand Valve Test Instrument adaptor hose - MA4 N2O/O2 (BS 5682)
12
10.
Distributor Details
Australia BOC Healthcare Customer Service Centre 10 Julius Avenue North Ryde Sydney NSW, 2113 T: +61 (0)2 8874 4400 F: +61 (0)2 9886 9000 www.boc.com.au New Zealand BOC Healthcare Customer Service Centre 970-992 Great South Road Penrose 1061 Auckland New Zealand T: +64 (0)9 525 5600 www.boc.co.nz Canada BOMImed Inc. 96 Terracon Place Winnipeg MB R2J 4G& Canada T: +1 204.633.2664 F: +1 204.632.1064 www.bomimed.com BPR Medical Ltd License No: 86841
South Africa AFROX Hospital Care PO Box 5404 Johannesburg 2000 T: +27 (0)11-490-0400 F: +27 (0)11-490-0451 www.afrox.co.za ENDV25/11/09/V2
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BPR Medical Limited
T: +44 (0)1623 628 281
22 Hamilton Way, Mansfield
F: +44 (0)1623 628 289
Nottinghamshire
NG18 5BU, United Kingdom
www.bprmedical.com