S5 Avance Users Reference Manual - Part 1 of 2 Rev 4.x

User Responsibility This Product will perform in conformity with the description thereof contained in this User s Reference manual and accompanying labels and/or inserts, when assembled, operated, maintained, and repaired in accordance with the instructions provided. This Product must be checked periodically. A defective Product should not be used. Parts that are broken, missing, plainly worn, distorted, or contaminated should be replaced immediately. Should repair or replacement become necessary, Datex-Ohmeda recommends that a telephonic or written request for service advice be made to the nearest Datex-Ohmeda Customer Service Center. This Product or any of its parts should not be repaired other than in accordance with written instructions provided by Datex-Ohmeda and by Datex-Ohmeda trained personnel. The Product must not be altered without the prior written approval of Datex-Ohmeda. The user of this Product shall have the sole responsibility for any malfunction which results from improper use, faulty maintenance, improper repair, damage, or alteration by anyone other than Datex-Ohmeda.

CAUTION

U.S. Federal law restricts this device to sale by or on the order of a licensed medical practitioner. Outside the U.S.A., check local laws for any restriction that may apply. Datex-Ohmeda products have unit serial numbers with coded logic which indicates a product group code, the year of manufacture, and a sequential unit number for identification. The serial number can be in one of two formats.

AAAX11111 The X represents an alpha character indicating the year the product was manufactured; H = 2004, J = 2005, etc. I and O are not used.

AAAXX111111AA The XX represents a number indicating the year the product was manufactured; 04 = 2004, 05 = 2005, etc.

Avance, Disposable Multi Absorber, Reusable Multi Absorber, ComWheel, Tec 7, Tec 6 Plus, D-Fend, and PSVPro are registered trademarks of Datex-Ohmeda, Inc. Other brand names or product names used in this manual are trademarks or registered trademarks of their respective holders.

Table of Contents 1 Introduction What is an Avance anesthesia machine?... 1-2 Symbols used in the manual or on the equipment... 1-3 Typeface conventions used... 1-6 Abbreviations... 1-6

2 System Controls and Menus System overview... 2-2 Advanced breathing system (ABS) components... 2-5 Optional ABS components... 2-7 Non-circle circuit... 2-8 ACGO (optional)... 2-8 Scavenging the ACGO sample flow... 2-9 Scavenging from an auxiliary manual breathing circuit... 2-9 Scavenging a gas monitor sample flow... 2-9 Vaporizer controls...2-10 Display controls...2-12 Anesthesia system display...2-13 Using menus...2-15

3 Operation and Tutorial Turning on the system... 3-2 Start gas flow (start case)... 3-3 End case... 3-3 Ventilator setup... 3-4 Using quick keys... 3-4 Using Vent Setup menu... 3-4 Changing ventilator modes and settings... 3-4 Gas setup... 3-5 Using quick keys... 3-5

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Avance Using Gas Setup menu... 3-5 Changing gas and settings... 3-5 Changing circuit type... 3-5 Screen configuration... 3-6 Split screen... 3-6 Setting alarm limits... 3-6 Viewing trends... 3-7 Viewing spirometry loops... 3-7 Spirometry split screen... 3-8 Spirometry menu... 3-8 Alternate O2 control... 3-9 EZchange Canister (optional)...3-10 Condenser (optional)...3-10 Passive AGSS (optional)...3-11 Active AGSS (optional)...3-12 Connecting active AGSS with a flow indicator...3-12 Connecting active AGSS without a flow indicator...3-13

4 Preoperative Checkout Every day before your first patient... 4-2 Before every patient... 4-3

5 Preoperative Tests Inspect the system... 5-2 Leak < 250 ml... 5-3 No... 5-3 Yes... 5-3 Machine Check... 5-3 Machine Check -System... 5-4 Machine Check - Circuit... 5-4 Machine CheckCircuit O2... 5-4 Individual Checks... 5-5 System... 5-5 Circuit... 5-5 Circuit O2 Cell... 5-6 Low P Leak... 5-6

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Low P Leak (machines with ACGO)... 5-6 Positive low-pressure leak test (ACGO systems only)... 5-7 Vaporizer installation... 5-8 Vaporizer back pressure test... 5-9 Flow sensor calibration... 5-9

6 Airway Modules Airway modules... 6-2 Connection to a patient... 6-4 Parameters setup... 6-5 CO2 setup... 6-5 O2 setup... 6-5 Agent setup... 6-5 Spirometry setup... 6-5 Automatic agent identification... 6-5 Calibration... 6-6

7 Alarms and Troubleshooting Alarms... 7-2 Alarm priorities... 7-2 Display changes during alarms... 7-2 Battery indicator... 7-3 Internal failure... 7-3 Alarm setup... 7-3 Technical and parameter alarms... 7-3 Alarm ranges and default values...7-10 Alarm tests...7-11 Breathing system problems...7-12 Electrical problems...7-13 Pneumatic problems...7-14

Index Warranty

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iii

Avance

iv

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1 Introduction

In this section

What is an Avance anesthesia machine?... 1-2 Symbols used in the manual or on the equipment... 1-3 Typeface conventions used... 1-5 Abbreviations... 1-5

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1-1

Avance

What is an Avance anesthesia machine? The Avance anesthesia machine is a compact and integrated anesthesia delivery system. It has electronic gas mixing and optional integrated respiratory gas monitoring. The Avance is not suitable for use in a MRI environment. Configurations available for this product depend on local market and standards requirements. Illustrations in this manual may not represent all configurations of the product. This manual does not cover the operation of every accessory and option.

AB.91.021

Note

Figure 1-1 • Avance system

1-2

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1 Introduction

Symbols used in the manual or on the equipment Symbols replace words on the equipment, on the display, or in Datex-Ohmeda manuals. Warnings and Cautions tell you about dangerous conditions that can occur if you do not follow all instructions in this manual. Warnings tell about a condition that can cause injury to the operator or the patient. Cautions tell about a condition that can cause damage to the equipment. Read and follow all warnings and cautions.

SN

MAX

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On (power)

Off (power)

Standby

Type B equipment

Dangerous voltage

Alternating current

Caution, ISO 7000-0434

Attention, refer to product instructions, IEC 60601-1

Electrical input

Electrical output

Pneumatic inlet

Pneumatic outlet

Serial number

REF

Stock number

Equipotential

Lamp, lighting, illumination

Variability

Variability in steps

Suction bottle outlet

Vacuum inlet

Maximum

VACUUM

Vacuum

1-3

Avance

+

N N

134°C

Plus, positive polarity

-

Bag position/manual ventilation

Mechanical ventilation

Inspiratory flow

Expiratory flow

Movement in one direction

Movement in two directions

Lock

Unlock

Isolation transformer

Low pressure leak test

Autoclavable

Not autoclavable

This way up

O2%

Caution: federal law prohibits dispensing without prescription.

APL settings are approximate

O2 cell connection

Alarm silence touch key (Tec 6 Plus)

AGSS

Anesthetic Gas Scavenging System

Alarm silence

Submenu

No battery/battery failure

Battery in use. Bar indicates amount of battery power remaining.

Read to center of float

Pipeline

1-4

Minus, negative polarity

O2+

O2 Flush button

Cylinder

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1 Introduction

XXXX

Systems with this mark agree with the European Council Directive (93/42/EEC) for Medical Devices when they are used as specified in their User’s Reference manuals. The xxxx is the certification number of the Notified Body used by Datex-Ohmeda’s Quality Systems. Manufacturer

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European Union Representative

EZchange Canister (CO2 bypass)

1-5

Avance

Typeface conventions used Names of hard keys on the display and modules are written in bold typeface; for example, Normal Screen. Menu items are written in bold italic typeface; for example, Patient Setup. Messages that are displayed on the screen are enclosed in single quotes; for example, ‘Check sample gas out.’ When referring to different sections and other documents, the names are written in italic typeface and enclosed in double quotes; for example, “ System Controls and Menus.”

Abbreviations

Abbreviation

Definition

C CO2

Carbon dioxide

Compl

Compliance

E ET

End-tidal concentration

EtCO2

End-tidal carbon dioxide

EtO2

End-tidal oxygen

F F-V

Flow-Volume loop

FI

Fraction of inspired gas

FI-ET

Difference between inspiratory and expiratory concentrations

FiO2

Fraction of inspired oxygen

I I:E

Inspiratory-expiratory ratio

Insp Pause

Inspiratory pause time

M

1-6

MVexp

Expired minute volume

MVinsp

Inspired minute volume

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1 Introduction

Abbreviation

Definition

O O2

Oxygen

P P-F

Pressure-Flow loop

P-V

Pressure-Volume loop

Pair

Air supply pressure

Paux

Auxiliary pressure

Paw

Airway pressure

PCV

Pressure controlled ventilation

PEEP

Positive end expiratory pressure

PEEPe

Extrinsic positive end expiratory pressure

Pexp

Expiratory pressure

Pinsp

Inspiratory pressure

Plimit

High pressure limit

Pmax

Maximum pressure

Pmean

Mean pressure

PO2

Oxygen supply pressure

Ppeak

Peak pressure

Pplat

Plateau pressure

Psupp

Support pressure

PSVPro

Pressure supported ventilation with apnea backup

R

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Rate

Respiratory rate

Raw

Airway resistance

RR

Respiratory rate

1-7

Avance

Abbreviation

Definition

S SIMV-PC

Synchronized intermittent mandatory ventilation - pressure controlled

SIMV/PSV

Synchronized intermittent mandatory ventilation/pressure supported ventilation

SIMV-VC

Synchronized intermittent mandatory ventilation - volume controlled

T TV

Tidal volume

TVexp

Expired tidal volume

TVinsp

Inspired tidal volume

V

1-8

VCO2

Carbon dioxide production

VCV

Volume controlled ventilation

Vol

Volume

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2 System Controls and Menus

In this section

System overview... 2-2 Advanced breathing system (ABS) components... 2-5 Vaporizer controls... 2-9 Display controls...2-11 Anesthesia system display...2-12 Using menus...2-14

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System overview WARNING

Explosion Hazard. Do not use this system with flammable anesthetic agents.

12 1

11

2 3 10

4 5 6

9

8

AB.91.028

7

1. Light switch 2. Dovetail rails 3. Vaporizer 4. Alternate O2 control* 5. System switch* 6. Mains indicator 7. Integrated suction* 8. Brake* 9. O2 flush button* 10. Advanced breathing system 11. Auxiliary O2 flow control* 12. Anesthesia system display

Figure 2-1 • Front view *These items are described in further detail in the following table.

2-2

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2 System Controls and Menus

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Item, Figure 2-1 4 Alternate O2 control

Description Alternate O2 control activates automatically in the case of certain failures or errors. It can also be activated manually by pushing the Alternate O2 control button if the display fails. Turn the knob counterclockwise to increase the flow. Turn the knob clockwise to decrease the flow.

5

System switch

Set the switch to the On (|) position to permit gas flow and to turn on the system.

7

Integrated suction

Turn the switch to Max for full vacuum. Turn the switch to Off for no vacuum. Turn the switch to On for adjustable vacuum. When in adjustable vacuum, turn the knob clockwise to increase the vacuum and counterclockwise to decrease the vacuum.

8

Brake

Push down to lock. Lift to release.

9

O2 flush button

Push the O2 flush button to supply high flows of O2 to the breathing system.

11

Auxiliary O2 flow control

Turn the knob counterclockwise to increase the flow. Turn the knob clockwise to decrease the flow.

2-3

Avance

1 2 3 4 5 6

11

10 9 8

AB.91.029

7

1. Outlet circuit breaker 2. Isolated electrical outlet (optional) 3. Cable access door 4. Vacuum connection 5. Collection bottle connection 6. Cylinder yoke 7. AGSS (Anesthesia Gas Scavenging System) 8. Equipotential stud 9. Mains inlet 10. System circuit breaker 11. Pipeline connections

Figure 2-2 • Rear view

2-4

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2 System Controls and Menus

Advanced breathing system (ABS) components

14 13 12 11 10

1 2

9

8

6

5

3 4

AB.91.023

7

1. Expiratory check valve 2. Inspiratory check valve 3. Inspiratory flow sensor* 4. Expiratory flow sensor* 5. Absorber canister 6. Absorber canister release* 7. Leak test plug 8. Breathing system release 9. Manual bag port 10. Adjustable pressure-limiting (APL) valve* 11. Bag/Vent switch* 12. Bellows assembly 13. Sample gas return port 14. AGSS indicator (only available on some AGSS versions)

Figure 2-3 • Advanced breathing system *These items are described in further detail in the following table.

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Avance Item, Figure 2-3 3,4 Flow sensor 6 Absorber canister release

Description Flow sensors provide volume measurements for some monitoring functions. Push to remove the canister. This causes the breathing system to vent to the room (unless the EZchage Canister option is installed). Be sure to hold the canister by the handle before releasing the canister. Note: Always do a leak test after operating the canister release.

10

Adjusts breathing system pressure limit during manual ventilation. The scale shows approximate pressures. Above 30 cm H2O, the knob will click as it turns. MI

N

30

70

APL valve

20

11

2-6

Bag/Vent switch

Selects between manual ventilation (bag) or mechanical ventilation (ventilator).

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