cicero_em_integrated_anaesthetic_worthstation_instr.pdf
Page 1
Cicero EM
Integrated Anaesthetic Workstation
Instructions for Use
Ventilator: ................. 6.n/7.n
Monitor:.................... 4.n
23529278
Software-Versionen:
Page 2
Working with these Instructions for Use
Each page is organized according to the following
principles:
At the top – the subject ...
of the main chapter as listed in the Overall Contents
on page 3.
It is always contained in a headline and printed in
bold type at the beginning of the chapter.
Xxxxxxx Yxxxxxxxxx
Xxxxxxxxx
● Xxxxxxxxxxxxxxxxxxxxxxxxxxxx:
Xxxxxxxxxx:
Vxxxxxxxxx?
Xxxxxxxxxxxxx:
Hxxxxxxx ?, Fxxxxxxx ?, Dxxxxxx ?
Xxxxxxxxx:
Sxxxxxxxxxxxxx ?
1
Xxxxxxxxxx Xxxxxxx xxxxxxxxxxxxxxx
1 Xxxxxxxxxxx Xxxxxxxxxx xxxxx ● Xxxxxxxxxxxxx XXXXXXXXXX cccxxxxxxxxxxxxx xxxxx x
2 Xxxxxxxxxxxxxxxxxx xxxxxxxxx (X xxxxxxxxx).
2
Xxxxxxxxxxxxxxxxxxx
Checkliste Cicero EM
● Xxxxxxxxxxxxxxx xxx Xxxxxxxxxxx xxxxxxxxx xxxxxxxx ● Xxxxxxxxxx - xxxxxx xxxxxxxxxxxx ! - xxx xxx Xxxxxxxxxx
xxxxxxxxxxxx xxxxx !
● Xxxxxxxxxx xxxxxxxx xxxxxx xxx xxxxxxxxx Xxxxxxxxxx xxxxxx
xxx xxx Xxxxxxxxxxxxx:
Vor jeder Benutzung vom Anwender zu prüfen
Vapor
Sicherheitsfüllvorrichtung
Stecksystem
Narkosegasfortleitung
Atemsystem
Atemkalk
Notbeatmungsbeutel
– xxxx. –
Zentralversorgung (ZV)
Reservegasflaschen
Sekretabsaugung
(xxxxxxxx X xxxxxxxx Xxxxxxxxxxx)
● Xxxxxx xxxxxxxxx xxxx xxxxxx Xxxxxxx xxxx Xxxxxxxxx.
● Xxxxxx xxx Xxxxxxx xxx Xxxxxxxx xxxxxxxxxx.
Gasversorgung
ORC
O2-Flush
06.12.98
11:59
00:00
Druck O2, Air, N2O > 2,7 bar
Druck O2, Air > 50 bar
Unterdruck vorhanden
Cicero nach Checkliste o.k ? Bitte bestätigen
Pleth
Xxxxxxxxx xxxxxxxxx
● Xxxxxxxxxxxx xxxxxxxx
3 Xxxx xx Xxxxx xxx xx Xxxxx xxxxxxxxxx xcxxxxxxxx - xxx xxx
Xxxxxxxcxx -
3
xxxxxx Xxxxxx Xxxxxxxxxxxxxxx xxxxx xxxxxxxxxxxxxx !
● Xxxxxxxxxxxxx xx Xxxxxxxx xxxxx xxx xxxxxxxxxxxxx
4 Xxxxxxxx xxx xxx Xxxxxxxxxxx xcxx xxxxxxx xxxxxxxxx
(xxxxxxxxxxxx) -
XYZ
Left-hand column – the text ...
contains explanations, prompts the user to do
something and describes the machine's response.
The dots and numbers refer to actions, while the
numbers also draw attention to details in the
illustrations supplementing the text.
The numbering starts anew on each page.
Right-hand column - the illustrations ...
make it easier to locate the various parts of the
equipment.
Details mentioned in the text are highlighted in
bold type or coloured black.
Schauzeichen grün
Fester Sitz und vollständig
Kalk erneuert, kein Farbumschlag
Funktion gewährleistet
Flow O2, Air, N2O vorhanden
Funktion Umschalter Air/N2O gewährleistet
Flow N2O sinkt proportional mit Flow O2
Strömungsgeräusch, Beutel füllt sich
O2-Xxxxxxx
● Xxxxxxxxxxxxx xxx Xxxxxx xxxxxx xxxxxcxxx !
Xxxxxxxx xxx xxx Xxxxxxxxxxxxxxx xxx Xxxxxxxx xxxxxxxx ● xxxxxxxxxxxxxxxx xxxxxxxxxxxxx xxxxxxxxxxxx
Nullstellung
Füllung
Zeit seit letzter Inspektion 6<Monate
Verschlußschieber
eingeschoben und festgezogen
Adapter liegt gleichmäßig auf
Verriegelt
4
TestAbbruch
Page 3
Overall contents
For your safety and that of your patients
4
Intended use
5
Emergency Quick-Start
Notes
Power failure
Gas failure
6
Operating concepts
Master switch
Ventilator operating concept
Monitor operating concept
9
Preparing for use
Power supply
Compressed gas supply
Connecting external equipment
Checking workstation with checklist
15
Anaesthesia ventilation
Spontaneous breathing/manual ventilation
IPPV mode
SIMV mode
PCV mode
Paediatric use
Changing patients
After use
Basic screen configuring
Monitoring functions in operation
Alarm concept
31
System screen functions
45
Parameter Box
Function keys and indicators
Measurement functions
85
Messages - Cause - Remedy
Location of valves and subsystems
Warning, caution and advisory messages
99
Care
Stripping down machine
Disinfection, cleaning and sterilization
Disposing of throw-away articles
Re-assembling machine
117
Checking readiness for operation
Checking machine functions
Maintenance intervals
131
What's what
139
Technical data
151
Descriptions
Machine functions
Operation of the ceiling version
163
Abbreviations and symbols
189
Index
191
3
Page 4
For your safety and that of your patients
For your safety and that of your
patients
Strictly follow the Instructions for Use
Liability for proper function or damage
Any use of the apparatus requires full understanding and
strict observation of these instructions. The apparatus is
only to be used for purposes specified here.
The liability for the proper function of the apparatus is
irrevocably transferred to the owner or operator to the
extent that the apparatus is serviced or repaired by
personnel not employed or authorized by DrägerService
or if the apparatus is used in a manner not conforming to
its intended use.
Maintenance
The apparatus must be inspected and serviced regularly
by trained service personnel at six monthly intervals (and
a record kept).
Repair and general overhaul of the apparatus may only be
carried out by trained service personnel.
We recommend that a service contract be obtained with
DrägerService and that all repairs also be carried out by
them. Only authentic Dräger spare parts may be used for
maintenance.
Observe chapter "Maintenance Intervals".
Accessories
Do not use accessory parts other than those in the order
list.
Not for use in areas of explosion hazard
This apparatus is neither approved nor certified for use in
areas where combustible or explosive gas mixtures are
likely to occur.
Safe connection with other electrical equipment
Electrical connections to equipment which is not listed in
these Instructions for Use should only be made following
consultations with the respective manufacturers or an
expert.
4
Dräger cannot be held responsible for damage caused by
non-compliance with the recommendations given above.
The warranty and liability provisions of the terms of sale
and delivery of Dräger are likewise not modified by the
recommendations given above.
Dräger Medizintechnik GmbH
Page 5
Intended use
Intended Use
Integrated anaesthetic workstation
»Cicero EM« with system monitor
Universally applicable, integrated anaesthetic workstation
for
– Inhalation anaesthesia for adults, children and
neonates.
– Inhalation anaesthesia in semi-closed to virtually
closed systems with »low flow« and »minimal flow«
techniques (for minimum gas and anaesthetic
consumption).
– Automatic ventilation (IPPV).
– Synchronized intermittent mandatory ventilation
(SIMV).
– Pressure-controlled breathing (PCV) in the PCV
ventilator.
– Manual ventilation (MAN).
– Spontaneous breathing (SPONT).
– Automatic anaesthetic agent recognition.
The following information is displayed in colour on the
system monitor:
– Airway pressure and temperature
– Inspiratory O2 concentration
– Expiratory tidal volume
– Patient compliance
– CO2 and anaesthetic concentration at the Y-piece
– Fresh gas balance
together with the main haemodynamic parameters
monitored with the parameter box:
– ECG curve with heart rate and ST segment analysis.
– The real-time curve of the invasive blood pressure
(iBP) in two channels, with the systolic, diastolic and
mean pressure values.
– The values of the non-invasive blood pressure (NiBP)
with the systolic, diastolic and mean pressure values.
– The body temperature in two channels.
– The functional O2 saturation (SpO2) with the pulse
rate.
– The plethysmogram.
Other accessories (optional)
Notes on operation
Only non-flammable anaesthetic agents conforming to
EN 740 may be used. Risk of fire!
Since this apparatus is not approved for use with
inflammable anaesthetics (ether, cyclopropane, etc.),
it is not necessary to use antistatic (conductive) breathing
hoses or face masks.
Conductive breathing hoses and face masks may cause
burns during high-frequency surgery and are therefore
not recommended for this apparatus.
Any additional electrical equipment which is latched
onto the top of the workstation must also be connected to the base unit by means of an equipotential
bonding conductor!
Electromagnetic fields exceeding the limits specified
in EN 60601-1-2 may interfere with the operation of
the device and therefore put patients at risk.
Mobile radio telephones must not be used within
10 metres of the workstation!
Cicero EM must not be used with magnetic resonance
tomography (MRT, NMR, NMI).
The workstation should only be moved by the handles!
Always operate the device under the supervision of
qualified medical personnel in order to obtain prompt
assistance in the event of malfunction.
Retrofitting in different devices
The software described in these Instructions for Use, in
combination with the »Cicero EM«, has passed a conformity
evaluation procedure conforming to 93/42/EEC (medical
appliances); the corresponding conversion kits therefore
bear the
mark of conformity.
C
C
The conversion kit can also be installed in the »Cicero EM
color« even if the unit itself does not bear the
symbol,
because the conformity evaluation procedure has confirmed
the suitability of the product for this type of device.
Vapor*)
Anaesthetic vaporizer for enflurane, isoflurane, halothane
and sevoflurane.
Connection for two Vapor vaporisers*)
Devapor*)
Anaesthetic vaporizer for desflurane.
Anaesthetic gas scavenging system*)
Uninterruptible power supply*)
Passive air conditioning*)
Heated breathing hoses.
pEEG*)
*) Refer to the separate Instructions for Use for this equipment.
5
Page 6
Emergency Quick-Start
D
Emergency Quick-Start
Press the master switch (1)
–
The pressure gauges (2) are in the green zone.
–
All lamps on the ventilator light up.
2
Gas/Power
ON / I
Press
I
Press a function key on the ventilator
Recommendation: Press and hold down
longer than 1 second.
key for
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MAN
SPONT
TEST
IPPV
SIMV
PCV
Pmax
PPCV
VT
fIPPV
TI:TE
TIP:TI
Flow
PEEP
O
fIMV
The message »Test interrupted« is displayed.
00229278
–
M
1
O
For devices without PCV mode (software 6.n):
Deliver fresh gas
O2
–
With the delivery valve buttons (3) under the
measuring tubes
–
If necessary fill the system rapidly with the O2
flush (4).
–
The manual ventilation bag should fill.
Set the APL pressure limiting valve (5) to »MAN«
Set maximum pressure
–
4
AIR
5
6
3
Turn the valve head (6) until the disc is at the
desired maximum pressure.
MAN
SPONT
TEST
IPPV
PCV
Pmax
PPCV
VT
fIPPV
TI:TE
TIP:TI
Flow
PEEP
fIMV
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SIMV
Lecktest ?
6
Page 7
Emergency Quick-Start
Notes on Quick Start
The Quick Start procedure is permitted a maximum of
10 times in succession, and only if the previous (full) selftest was completed without error.
Otherwise, the display on the ventilator and the system
screen instruct the user to run through the complete selftest.
Self-test
Manual ventilation remains possible under all conditions!
Quick Start can also be triggered by the »Cancel
Test« softkey.
●
Quick Start can be triggered at any time, even during
a self-test.
cancel
test
06-12-98
16:47
00:00
00429278
●
Self-test cancelled
If there is a power failure (manual ventilation is
possible)
Make sure that the master switch is pressed down
–
The acoustic power failure warning is muted after
30 seconds.
Deliver fresh gas - set APL valve
–
If required, press the O2 flush button (»O2 +«).
Note: If there is a power failure, the piston of the
ventilator is pushed to its end position by the
airway pressure. This increases the system volume
by a maximum of 1.4 litres.
If there is a gas failure
In case of AIR failure (medical air)
–
The system automatically switches over to O2
supply.
In case of O2 failure
–
The system automatically switches over to the
AIR supply. An acoustic alarm is sounded (O2
shortage signal). The supply of N2O is disabled.
If both O2 and air fail
The patient must immediately be ventilated with the
separate emergency ventilation bag!
7
Page 8
8
Page 9
Operating concepts
Page
Master switch.......................................................... 10
Ventilator operating concept .................................. 10
Monitor operating concept ..................................... 12
9
Page 10
Operating concepts
Ventilator operating concept
Ventilator operating concept
Master switch for power and gas
D
1 Press to switch on. The switch clicks into position.
2 Turn clockwise to switch off.
Gas/Power
ON / I
Press
2
Hardkeys –
for setting the operating modes
I
»IPPV« key
for IPPV mode.
1
O
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»MAN / SPONT« key
for manual ventilation or spontaneous breathing.
D
»SIMV« key
for SIMV mode (see illustrations for the specific
ventilator versions)
A
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»PCV« key
for PCV mode (for PCV ventilator).
»TEST« key
for leakage test and compliance measurement.
Standby key.
for setting ventilation parameters
Ventilator with PCV
MAN
SPONT
TEST
IPPV
The same key is used in PCV mode to set the
plateau pressure.
»VT« key for setting the tidal volume.
»IPPV« key
for setting the ventilation frequency in IPPV
mode.
»TI : TE« key
for setting the time ratio between inspiration
and expiration.
»TIP : TI / Flow« key
for setting the relative inspiratory pause for
IPPV and SIMV ventilation.
The same key is used in PCV mode to set the
inspiratory flow.
»PEEP« key
for setting the PEEP pressure for IPPV mode.
»fIMV« key
for setting the ventilation frequency in SIMV
mode.
10
PCV
Pmax
PPCV
VT
fIPPV
TI:TE
TIP:TI
Flow
PEEP
fIMV
O
00729278
»Pmax / PPCV« key
for setting the maximum pressure for IPPV and
SIMV ventilation.
SIMV
Ventilator without PCV
MAN
SPONT
TEST
IPPV
SIMV
Pmax
VT
fIPPV
TI:TE TIP:TI PEEP
fIMV
O
00729278
Below the display window:
Page 11
Operating concepts
Operating concept of ventilator
Display window with dialogue function
(in combination with the rotary control)
Example: adjusting the maximum pressure
In the black field, beside the rotary control:
2 The value on the right-hand side is changed by
turning the rotary control. Here: »28«.
The old and new values are consequently always
displayed together.
23
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1
Pmax / mbar
28
2
3 The value on the right (»28«) is confirmed as the
definitive value by pressing the control.
3
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1 The set value appears on the right and left-hand sides
of the field when a parameter key (Pmax, VT, fIPPV) is
pressed. Here: »23«.
If the rotary control is not pressed and not turned again,
the machine is reset after 10 seconds without changing
the setting.
MAN
SPONT
TEST
IPPV
SIMV
Pmax
PPCV
VT
fIPPV
TI:TE
TIP:TI
Flow
PEEP
O
fIMV
This dialogue window also displays advisory
messages (see page 100) –
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●
PCV
Kinderschlaeuche
Infant hoses
Example »Infant hoses«:
Display window without dialogue function
Top left:
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Continuous indication of the relative piston movement
(in % referred to the set stroke volume VT).
The set operating parameters correspond with the keys
below:
– Indication of the maximum pressure Pmax in mbar.
– Indication of the tidal volume VT in mL or L.
0%
100%
23
600
12
mbar
ml/L
1/min
Pmax
PPCV
VT
fIPPV
01229278
– Indication of the ventilation frequency fIPPV in
breaths per minute.
11
Page 12
Operating concepts
Monitor operating concept
Monitor operating concept
Hardkeys
The right-hand side is reserved for operating elements,
the left-hand side for displays.
E
This key switches the system screen from standby
to measuring mode and vice versa.
The system screen mode depends on the
ventilator mode:
Standby can only be selected on the system
screen if the ventilator is also in standby.
This key is used to deactivate the alarm tone for
two minutes. It is reactivated by pressing the key
again. The yellow LED in the key lights up while
alarms are suppressed (see page 79).
01329278
G
The system screen starts up when the ventilator is
started.
During this period, any new advisory and caution
messages will not be audibly signalled but will
appear as text in the alarm fields. Only new
warnings will be signalled once by the appropriate
tone sequence.
Inside the dark area, there are four keys acting directly on
the screen contents:
S
Q
s
U
This key is used to call up a menu of the available
display options on the system screen. Selection is
made by turning and pressing the rotary control
(see page 68).
This key always calls up the last standard screen
used (see page 68).
This key is used to »freeze« the curves on the
display so that they can be viewed in more detail.
This key is used to generate a manual entry in the
list screen (see page 70).
G
01429278
Indicators
Above the
key are two bar-shaped indicators that
indicate the alarm status even when the acoustic alarm
has been switched off.
Red (upper) flashing lamp
Yellow (lower) flashing lamp
Yellow lamp constantly lit
12
Warning
Caution
Advisory
!!!
!!
!
Page 13
Operating concepts
Monitor operating concept
Softkeys
2 1
1 Beside the screen, on the right-hand side, there is
an unmarked touch-sensitive keypad.
2 The function of these keys depends on the software
and is indicated on the screen itself.
Only those keys which can be activated are actually
shown.
S
3
Pressing some of the softkeys or the screen selector
key
will open a menu.
The area where selections can now be made is
turquoise, and the cursor is a yellow rectangle.
To select:
Turn rotary control.
01529278
●
The cursor moves within the turquoise
area.
●
To confirm: Press rotary control.
The selected function appears.
Standby / Configuration
alarms inactive !
Settings
iBP 1
All menu levels are displayed in staggered arrangement.
Inactivated menus are grey. The selected menu item is
highlighted in black and white.
iBP 2
function
OFF
location
ART
sensitivity
42.5
50
ON
function
OFF
location
CVP
sensitivity
42.5
ON
50
ECG
mode adult neon.
NiBP
alarm limits
iBP locations
parameter
iBP channels
screen
SpO2 / Pleth
acoustic
CO2 / O2
list entry
pEEG
transport
RS 232 (Medibus)
record (printer)
11:59
00:00
01629278
basic config.
Select a menu position. Please confirm !
Change the settings. Please confirm again !
IPPV alarm limits
Anesth. Agent
Alarms
Calibration
3 Press the »Config« softkey.
mode
4 Under »Settings«, select the option »Colours«.
●
●
Settings
alarm sound
ART
AORTA
A.Pulm
ZVD
ICP
iBP ?
NiBP
EKG
SpO2/Pleth
Temp.
pEEG
CO2
Flow
Paw
Select the desired parameter in the colour menu and
confirm.
Turn the rotary control until the desired colour is
displayed and then confirm
06-12-98
11:59
00:00
adult
neon.
1 2 3 4 5 6 7 8 9
pulse tone
0 1 2 3 4 5 6 7 8 9
pulse tone
source
ECG
Pleth.
4
colours
curve speed
mm/s
12,5
25
50
call standard
Hintergrund
hell
dunkel
Module
farbig
ja
nein
Wählen Sie mit dem Drehknopf einen Parameter aus. Bestätigen !
Wählen Sie die gewünschte Farbe. Bestätigen !
01729278
Configuring the colours
13
Page 14
14
Page 15
Preparing for use
Page
Electrical power supply........................................... 16
Equipotential bonding............................................. 16
Uninterruptible Power Supply................................. 17
Compressed gas supply ......................................... 17
Anaesthetic gas scavenging system ...................... 18
Anaesthetic vaporizer ............................................. 19
Connecting external equipment ............................ 19
Parameter box ........................................................ 20
Checking workstation with checklist...................... 21
Manual tests............................................................. 21
Check Vapor....................................................... 22
Check anaesthetic gas scavenging...................... 22
Check breathing system ...................................... 23
Check soda lime ................................................. 23
Check emergency ventilation bag ........................ 23
Check piped medical gas supply ......................... 24
Check reserve cylinders (optional)....................... 24
Checking the secretion aspiration system ............ 24
Check gas delivery.............................................. 25
Check Oxygen Ratio Control (ORC).................... 25
Check O2 flush ................................................... 25
End of manual test according to checklist ................. 25
Self-test................................................................... 26
Semi-automatic part of the self-test........................... 26
Automatic self test .................................................... 27
Fresh gas outlet (option).......................................... 29
15
Page 16
Preparing for use
Electrical power supply
Equipotential bonding
Preparing for use
The device must be correctly prepared and checked
before every use!
Connecting the electrical power supply
The mains voltage must be within the voltage range
specified on the nameplate on the back panel.
1 Plug the power plug into the wall socket.
Auxiliary mains sockets:
2 Sockets for additional devices that are switched on
and off with the master switch.
(3 sockets. Maximum current per socket: 2 A)
The sum of the derived current in the mains line must not
exceed 500 µA (IEC 601/1).
P
3
2
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1
Equipotential bonding
(e.g. for intracardial or intracranial operations)
3 Connect one end of the earthing cable to the terminal
stud on the back panel.
●
16
Connect the other end to the equipotential bonding
stud, e.g. on the operating table or ceiling lamps.
Page 17
Preparing for use
UPS
Compressed gas supply
Uninterruptible Power Supply (optional, see
Instructions for Use of the UPS)
When the machine is powered by the UPS battery
during a mains power failure, no power is supplied to
the auxiliary sockets!
The Desflurane Vapor unit is powered by the side
connector for non-heating apparatus (No. 9 on page 140)
and will therefore continue to run as normal.
1 Plug the Cicero power plug into the socket of the
UPS.
2 Plug the UPS mains plug into the mains socket.
The UPS can supply the Cicero EM with electrical energy
for about 45 minutes. It is activated automatically in the
event of a power failure.
1
S3
S4
F2
F2
g
F3
F4
S5
I
0
S6
2
USV - Ein / On
manuell
01929278
In the case of a ceiling unit, the auxiliary sockets are
not fitted.
Connecting the compressed gas supply
3 Screw hoses for O2, AIR and N2O into the rear of the
apparatus and plug connectors into the wall sockets.
Switch-on lock:
If the machine is switched on without pressure on the
O2 line, it is impossible to meter the other gases for
safety reasons!
3
4
»Pressure supply« appears on the ventilator.
●
Connect O2 supply and confirm.
●
Check that the supply pressure is adequate on the
pressure gauges on the front (pointers must be in the
green area).
4 Holder for anaesthetic gas scavenging. See next page
and separate Instructions for Use.
If the machine is equipped with a vacuum bronchial
aspirator (option), a vacuum supply system must be
connected.
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●
17
Page 18
Preparing for use
AGS-system
Bronchial aspirator
Installing the anaesthetic gas scavenging
system:
●
D
Hook the collecting system to the mount on the back
of the Cicero:
Place the slots of the receiving system over the
holders and slide the receiving system down.
See also "What's what" on page 146, No. 14.
Detailed view
from below after
removing soda
lime container.
Connecting the transfer hoses
1 Pass transfer hose from behind through the hole in
the Cicero EM and
2
1
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2 connect the hose to the scavenging connector of the
breathing system (only on first installation - the hose
then remains on the connector).
3 Connect the transfer hose to the connector on the
receiving system.
●
4
Make sure the connection is secure!
4 Make sure that the connector for the second transfer
hose is sealed with a screw plug.
Do not plug the openings of the receiving system, otherwise the breathing system could be drained.
3
5
1
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5 Connect the scavenging hose to the output connector
of the scavenging system.
6
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6 Plug the connector of the scavenging hose into the
wall socket. The visual indicator shows »green«.
D
18
Page 19
Preparing for use
Anaesthetic vaporizer
External equipment
Anaesthetic vaporizer:
–
Only use the Vapors listed in the list of accessories!
–
Note the separate Instructions for Use of the Vapor.
–
3
2
0
Vol.
Only use the Vapor intended for each anaesthetic
agent!
%
1 The fill plug must always be inserted and securely
tightened!
2 The thumbwheel must always be set to zero when
there is no fresh gas flow.
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3 Vapor must always be secured by means of the
locking lever (set to the left-hand limit).
1
Connecting external equipment
Connection via the printer interface:
4 with a data cable for printers with serial interface,
such as:
Deskjet (made by Hewlett-Packard)
4
Connection via the Dräger RS 232 MEDIBUS interface:
5 with data cable for standard PCs or other monitors.
●
6
Paw
CAN
P-Box
VGA extern
m
7 8
VGA intern
O2
Temp. * / Spiro
P
02529278
5
For interface configuration, see page 64.
RS 232 C
Equipment plugs must be secured with screws!
Vent.
●
RS 232 C
This connector may also be used as an
RS 232 MEDIBUS interface.
Equipment plugs must be secured with screws!
For interface configuration, see page 63.
After removing the outer back panel, the following
connections are accessible:
External screen
6 Any S-VGA-compatible screen can be connected.
External O2 sensor for inspiratory measurement:
7 Connect to the socket marked »O2«.
Airway temperature sensor
8 Connect to the socket marked »Temp«.
19
Page 20
Preparing for use
Parameter box
Fitting the parameter box
The parameter box can be operated either in the blue
holder or in the slot-in housing. The slot-in housing can
be mounted by Dräger Service on the left-hand side of
the Cicero EM.
The blue holder can be mounted by the user in any
position on a standard rail (10 x 25 mm).
EM
ero
Cic
D
1
In the blue holder, the parameter box can be tilted up and
down. In the slot-in housing its position is rigidly fixed.
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In both cases, the synchronising output for an
external defibrillator is accessible from the rear.
Slot-in housing:
1 Push the parameter box straight into the slot-in
housing. The parameter box locks into position, and
the electrical connections are made.
3
2
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To remove the parameter box, pull the blue handle on
the box to release the locking lever. The parameter
box can then be simply pulled out of the housing.
Blue holder:
2 Fix the blue holder in a suitable position.
3 Connect the cable of the mounting base to the
connector on the side of the Cicero EM.
6
4 Hang the parameter box onto the mount from above.
The plug connector must engage.
6 Defibrillator connection.
02529094
5 To remove, pull the blue handle on the parameter box.
The parameter box is released and can be taken out
of the blue holder.
5
4
02629094
Tilting the parameter box:
7 The parameter box can be swivelled up and down.
7
02729094
The parameter box is the central component of the
Dräger transport function. See the separate section in
these Instructions for Use, page 86.
20
Page 21
Preparing for use
Checking workstation with checklist
D
Checking workstation with checklist
Manual tests:
After switching on, the apparatus runs through a self-test.
Prerequisites:
Gas/Power
Machine is fully equipped Instructions for Use are familiar User has been instructed on using the machine -
ON / I
Press
I
Switching on:
O
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1
Duration: approx. 5 minutes
1 Press the master switch.
(Combined master switch for gas and power)
The self-test starts
The user must first check:
On the ventilator:
Self-Test
– Indication of software version, all indicator lamps light
up for approx. 2 seconds. A single tone sounds.
»Self-test«
appears briefly in the display window.
The Ventilator display goes dark. No operations on the
ventilator are required during the self test.
On the screen:
02929278
D
– The message
Technology for Life
– The internal program memories are tested. All LEDs
and display elements light up for approx. 2 seconds.
The LED in the standby key
remains lit.
E
Cicero EM
Version 4.0
06-12-98
– Two warning tones sound.
Self-test
In case of emergency: press any ventilator function key for quick startup
03029278
– A clock symbol u appears on the screen = duration
of self-test.
– The keys are still inactive.
Please wait!
Check-list Cicero EM
Shortly afterwards:
To be verified by the user prior to each use
Vapor
– The checklist appears.
Safety-fill
Indication in user advisory field:
Is the Cicero EM o.k. according to checklist?
Please confirm!
●
Gas scavenger
Breathing system
Soda lime
Emergency breathing bag
The user is consequently prompted to check the
points listed.
Central gas supply
Backup cylinders
Suction
The equipment must be checked every time,
immediately before being used!
Gas delivery
ORC
O2-flush
06-12-98
11:59
00:00
operational
complete, locked in place
no colour change
present, functional
all pressures greater than 2.7 bar
all pressures greater than 50 bar
functional
cancel
test
O2, Air, N2O present
N2O flow changes proportionally to O2
audible flow, breathing bag fills
03129278
●
handwheel set to zero
fill - level ok
less than 6 months since last inspection
correctly seated and locked
plug secured in place
Is the Cicero EM o.k. according to check-list ? Please confirm !
21
Page 22
Preparing for use
Checking workstation with checklist
Check Vapor:
Check-list Cicero EM
To be verified by the user prior to each use
– Set the handwheel to »O «.
Vapor
handwheel set to zero
fill - level ok
less than 6 months since last inspection
correctly seated and locked
plug secured in place
– Filling level OK?
Safety-fill
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– Last inspection less than six months ago?
Safety filler:
– The plug is inserted and secured.
Vaporiser mount:
0
– Vaporiser is correctly seated.
Vol.
%
Locking mechanism:
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– Plug-in system is locked (lever to the left as far as
possible).
Gas scavenger
Breathing system
Soda lime
Emergency breathing bag
C
t l
l
Check anaesthetic gas scavenging:
ll
p ug secu ed n p ace
operational
complete, locked in place
no colour change
present, functional
t
th
27b
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Safety f
D
– Is indicator in wall socket green? (Only when using
Dräger systems; note sounds of gas flow in other
cases.)
– Hose connected to breathing system?
– Are the two hoses fitted correctly?
1
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– Is the anaesthetic gas scavenging system correctly
installed?
– Are the vents open?
– Are all hoses free of kinks?
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1 Is the transfer hose of the anaesthetic gas scavenging
system free of condensate? Drain if necessary.
22
Page 23
Preparing for use
Checking workstation with checklist
Check breathing system:
Lift table top:
1 Lever set to the position shown in black.
1
Check completeness:
03329278
2 Valve discs inserted.
– Pressure limiting valve (APL) present.
– Inspiratory microbial filter (optional). Symbol:
– Expiratory microbial filter (optional).
3
Symbol:
3 Pressure measuring hose with filter connected.
5 Hose with manual ventilation bag
present. (Connected from below;
not shown)
Symbol:
2
4
Symbol:
APL
– Correct breathing hoses connected.
(Adult or infant hoses)
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4 Measured gas return hose
connected.
6 Fresh gas hose connected.
(Connected from below; not shown)
Water trap (option)
7 Water traps are recommended in both the inspiratory
and the expiratory lines during prolonged anaesthesia,
low-flow anaesthesia and when using a humidifier.
– Water traps must be fitted at the lowest point in the
hose and hang downwards.
– Check regularly and drain if necessary.
Observe hygiene regulations –
risk of infection !
The hose system remains sealed. The container must
be replaced securely!
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7
7
Check soda lime:
8 Soda lime has not noticeably changed colour (purple).
– Filling level adequate (up to the mark).
– The absorber vessel must be screwed in (counterclockwise) as far as it will go.
Emergency ventilation bag:
(not shown)
8
5
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– Bag is complete and hung from the side of the
Cicero EM.
6
– Bag functions correctly.
23
Page 24
Preparing for use
Checking workstation with checklist
Soda ime
Emergency breathing bag
– The connectors have been pressed right into the wall
sockets for O2, AIR and N2O (not in holding
position!).
1 Pointers of all three pressure gauges are in the green
range.
Central gas supply
Backup cylinders
Suction
Gas delivery
all pressures greater than 2.7 bar
all pressures greater than 50 bar
functional
O2 Air N2O present
D
Reserve cylinders (option)
2 Open cylinder valves.
Pressure indicator on O2 and AIR cylinders exceeds
50 bar?
no co our change
present, functional
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Central medical gas supply
1
Replace cylinders if not!
●
Close cylinder valves (to prevent gas leaks).
Checking the secretion aspirating system:
3 Negative pressure switch to »I «.
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2
D
4 Set negative pressure to required intensity by means
of rotary control.
Seal the aspiration holes (or fold over the hose) and
ON / I
Press
5 Check negative pressure on pressure gauge.
If the negative pressure generated is insufficient,
●
replace microbial filter in ejector system
(see »Maintenance intervals«, page 137 and
»What's what«, page 140, No. 11).
●
Check adequate supply of compressed gas.
24
3
4
5
I
O
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3 Negative pressure switch to »O «.
Page 25
Preparing for use
Checking workstation with checklist
Check gas delivery
1 Switch over to »AIR«.
Gas delivery
ORC
O2-flush
03129278
2 Open O2 and AIR delivery valves until the floats in the
measuring tubes indicate more than 9 L/min.
O2, Air, N2O present
N2O flow changes proportionally to O2
audible flow, breathing bag fills
Open N2O delivery valve completely.
– Does N2O measuring tube indicate »O «?
1 Switch over to »N2O«.
– Does N2O measuring tube indicate more than
9 L/min?
Does AIR measuring tube indicate »O «?
Check Sensitive Oxygen Ratio Control (S-ORC)
2 Slowly close O2 delivery valve -
3
1
O2
AIR
N2O
– check:
N2O indication decreases to »O « proportionally
with O2.
1 Switch over to »AIR«.
●
Close N2O delivery valve.
Check O2 flush
2
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3 Press button »O2 +« –
– Is there a distinctly audible flow noise?
– Does the manual ventilation bag inflate?
End of manual test according to checklist:
Check-list Cicero EM
– Confirm if all points are OK:
To be verified by the user prior to each use
Vapor
handwheel set to zero
fill - level ok
less than 6 months since last inspection
correctly seated and locked
plug secured in place
Press rotary control on system screen.
Safety-fill
Gas scavenger
Breathing system
Soda lime
Emergency breathing bag
Central gas supply
Backup cylinders
Suction
Now the interactive part of the self-test begins (see
following page)
The following symbols are used:
Gas delivery
ORC
O2-flush
06-12-98
11:59
00:00
operational
complete, locked in place
no colour change
present, functional
all pressures greater than 2.7 bar
all pressures greater than 50 bar
functional
cancel
test
O2, Air, N2O present
N2O flow changes proportionally to O2
audible flow, breathing bag fills
03129278
●
Is the Cicero EM o.k. according to check-list ? Please confirm !
? = Enquires whether an action has been performed
or a setting made.
u = Waiting period. The selected test step is being
performed by the machine.
✔ = The action has been completed successfully.
25