julian_instructions_for_use_sw_2-n.pdf
Page 1
1-36-96
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Julian
Anaesthetic Workstation
Instructions for Use
Software 2.n
Page 2
How to use these Instructions for Use
How to use these Instructions for Use
In the header is the subject…
of the main chapter.
Underneath is the title of the subchapter, to help you
find your way around quickly.
Operation
Selecting the ventilation mode
MAN/SPONT
1
Press the »MAN/SPONT« key,
2
and confirm with the rotary knob.
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Julian
On each page…
the instructions for use
combining text with illustrations. The information is
translated directly into actions to enable the user to
learn „hands-on“ how to use the workstation.
Left-hand column: the text…
provides explanations and guides the user clearly and
ergonomically with brief directions on the use of the
product.
Bullet points indicate the steps to be followed, and
where there are several steps, numbers refer to the
illustration and indicate the sequence.
2
1
Display (example):
MAN/SPONT
Pleth
SpO2
et
CO2
CO2
40
AMV
0
VT
0.35
--
O2
0
0.5
1
Volumeter --s
0
Volumeter starten:
5
10
Hal.
N 2O
98
38
5.2
L/min
30 4.00
Right-hand column: the illustration…
provides the link with the text and serves as a guide
to the workstation. Points mentioned in the text are
emphasised and non-essential information is omitted.
Screen displays guide the user and confirm the steps
to be followed.
For flushing and rapidly filling the breathing
system and breathing bag with O2 while
bypassing the Vapor unit.
40
0.8
58
36
0.6
56
Bestätigen!
Frischgas
intern
extern
3
Press the »O2 +« button.
O2 flows into the breathing system without
anaesthetic gas as long as the button is held
down.
D
Julian
3
2
8
Fet
O2 flush
–
Freq
Fi
Frischgas O2 + N2O
O2 %
67
Grenzen
CO2-Al.
aus/ein
Alarm
Info
Liste
Kurven
Konfig.
Page 3
Contents
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Contents
For Your Safety and that of Your Patients
5
Intended Use
7
Operating Concept
11
Before Using for the First Time
19
Preparation
21
Starting Up
25
Operation
35
Monitoring
55
Configuring in Standby Mode
81
Care
95
Julian as Wall-mounted Unit
113
Maintenance Intervals
115
Fault – Cause – Remedy
119
What's what
125
Technical Data
131
Abbreviations / Symbols
139
Index
142
3
Page 4
4
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Page 5
For Your Safety and that of Your Patients
For Your Safety and that of Your
Patients
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Strictly follow the Instructions for Use
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.
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.
Liability for proper function or damage
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.
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
5
Page 6
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Page 7
Intended Use
Contents
Intended Use
Contents
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Intended Use............................................................................................. 9
7
Page 8
8
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Page 9
Intended Use
Intended Use
Intended Use
Julian Anaesthetic Workstation for patients with a body
weight of 5 kg and over with the use of IPPV ventilation.
For the use of:
Monitoring
by means of adjustable alarm limits that are automatically
adapted to the ventilation mode.
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
– Inhalation anaesthesia in rebreathing systems
– Inhalation anaesthesia in semi-closed to virtually
closed systems with "low flow" and "minimal flow"
techniques (for minimal gas and anaesthetic agent
consumption).
The workstation may only be used under the
supervision of qualified medical personnel, so that
assistance can be provided immediately in the event
of any malfunctions.
– Inhalation anaesthesia in non-rebreathing systems,
with separate fresh gas outlet for the connection of
e.g. the Bain system or Magill system
with a fresh gas flow of 0.5 to 12 L/min.
Ventilation modes:
– Automatic ventilation (IPPV)
and
pressure-controlled ventilation (PCV).
Explosive anaesthetics, such as ether or cyclopropane, must not be used due to the risk of fire.
– Manual ventilation (MAN).
– Spontaneous ventilation (SPONT).
The following measured values are displayed:
– Peak pressure, mean pressure, plateau pressure and
PEEP
– Expiratory minute ventilation
Tidal volume VT
Breathing rate
Patient compliance
Mobile radio telephones must not be used within
10 metres of the workstation!
Mobile telephones may interfere with the operation of
electrical and electronic medical equipment.
Julian must not be used with nuclear spin
tomography (MRT, NMR, NMI)!
Operation of the apparatus may be impaired.
– Inspiratory and expiratory concentration of O2, N2O,
anaesthetic gas and CO2
optional:
– Functional oxygen saturation (SpO2) and pulse rate.
The following parameters are displayed as curves:
– Airway pressure
– Expiratory flow
– Inspiratory and expiratory concentration of O2, CO2
and anaesthetic gas
optional:
– Plethysmogram
Trend curves and measured value lists are also available.
9
Page 10
10
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Page 11
Operating Concept
Contents
Operating Concept
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Contents
Screen ergonomics.................................................................................12
Selecting / setting ventilation parameters.................................................. 14
Selecting / setting monitoring functions.....................................................15
Screen layout.......................................................................................... 16
Three basic screens for monitoring........................................................... 17
The standard screen.................................................................................17
The data screen....................................................................................... 17
The trend screen...................................................................................... 18
11
Page 12
Operating Concept
Screen ergonomics
Operating Concept
Screen ergonomics
Monitoring
All the settings required for
IPPV
– Fresh gas delivery
Pleth
SpO2
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
– Ventilation
– Monitoring
are entered on the system screen using the appropriate
keys and the rotary knob.
The keys are grouped in function fields:
etCO2
CO2
40
MV
0
O2
PAW
20
Hal.
0
N 2O
Freshgas O2+N2O
O2 %
L/min
30 4.00
Right-hand field
Ventilation
Middle field
Monitoring
Pmax
VT
mbar
mL
MAN
SPONT
AIR
N 2O
The main functions for anaesthesia, e.g. selection of
N2O or AIR, or selection of ventilation modes, can be
selected directly by keys with permanently defined
functions ("hardkeys"):
Freq.
10
alarm
info
Fet
TI:TE
36
0.6
56
list
config.
TIP:TI
PEEP
%
mbar
10
0
1:2
..
12...
curves
PCV
Ventilation
IPPV
Pleth
SpO2
etCO2
CO2
40
MV
98
38
6.0
Fi
0
O2
PAW
20
0
N 2O
Freshgas O2+N2O
O2 %
L/min
30 4.00
AIR
N 2O
1
12
freq
Ve
40
0.8
58
IPPV
Hal.
These function keys are located in the bottom row on the
control panel.
Left-hand block for fresh gas setting
Right-hand block for ventilation
_
alarm
limits
auto set
limits
1/min
25 600 10
Fresh gas
delivery
2 Right-hand block
The »MAN SPONT«, »IPPV« oder »PCV«
keys select the ventilation mode.
38
6.0
67
CO2
Fi
Left-hand field
Fresh gas delivery
1 Left-hand block
The »N2O« or »AIR« keys are used to select the gas
to be mixed with O2 for the fresh gas mix.
98
Pmax
VT
mbar
mL
Freq.
TI:TE
1/min
25 600 10
MAN
SPONT
40
0.8
58
IPPV
2
1:2
PCV
67
_
freq
alarm
limits
auto set
limits
Ve
10
alarm
info
Fet
list
CO2
36
0.6
56
curves
config.
TIP:TI
PEEP
%
mbar
10
0
..
12...
Page 13
Operating Concept
Screen ergonomics
Complementary "softkeys" with variable functions are
provided at the bottom edge of the screen, above each
group of hardkeys. These softkeys are used to set the
fresh gas delivery parameters and ventilation parameters.
IPPV
Pleth
etCO2
CO2
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
1 Left-hand block:
The keys for setting the O2 concentration and fresh
gas flow.
40
MV
0
Hal.
0
N 2O
Freshgas O2+N2O
O2 %
Pmax
VT
mbar
mL
L/min
30 4.00
N 2O
Freq.
TI:TE
25 600 10
list
..
12...
curves
config.
TIP:TI
PEEP
%
mbar
10
0
1:2
2
MAN
SPONT
AIR
IPPV
Pleth
SpO2
etCO2
CO2
40
MV
PCV
98
38
6.0
Fi
0
O2
PAW
20
Hal.
0
N 2O
– to set and confirm the parameters for fresh gas and
ventilation modes,
alarm
info
Fet
IPPV
In a prominent position at the bottom right-hand side:
– to confirm the selected carrier gas or a ventilation
mode,
freq
alarm
limits
auto set
limits
10
36
0.6
56
1/min
1
The current parameter values are displayed in the softkey
field.
4 confirm = press
_
Ve
40
0.8
58
O2
PAW
20
These softkeys have different functions, depending on
the operating status or ventilation mode.
3 select = turn
38
6.0
67
CO2
Fi
2 Right-hand block:
The keys for setting the parameters for the relevant
ventilation mode. The example shows the parameters
for IPPV controlled ventilation.
The "turn-and-push" rotary knob
is the main operating control of the apparatus and has the
following functions in all setting operations:
98
SpO2
Freshgas O2+N2O
O2 %
L/min
30 4.00
Pmax
VT
mbar
mL
Freq.
40
0.8
58
AIR
MAN
SPONT
freq
10
alarm
info
Fet
list
36
0.6
56
..
12...
curves
config.
TI:TE
TIP:TI
PEEP
%
mbar
10
0
– to set and confirm the monitoring functions.
N 2O
_
Ve
alarm
limits
auto set
limits
1:2
1/min
25 600 10
67
CO2
3
IPPV
PCV
Beside the rotary knob:
The standby key E for switching over to standby mode.
5 Press standby key E and confirm by pressing the
rotary knob.
5
4
13
Page 14
Operating Concept
Screen ergonomics
Selecting / setting ventilation parameters
Julian
Example: PEEP ventilation parameter
1 Press the softkey »PEEP«.
2 Select the PEEP value = turn the rotary knob.
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
3 Confirm the PEEP value = press the rotary knob.
1
2
3
The keys for the various monitoring functions are located
on the right-hand side of the screen.
IPPV
Pleth
SpO2
These keys also have different functions = softkeys,
depending on the monitoring screen required.
etCO2
CO2
40
MV
98
38
6.0
Fi
0
O2
PAW
20
Hal.
0
N 2O
Freshgas O2+N2O
O2 %
L/min
30 4.00
N 2O
14
AIR
Pmax
VT
mbar
mL
Freq.
TI:TE
1/min
25 600 10
MAN
SPONT
40
0.8
58
IPPV
1:2
PCV
67
freq
alarm
limits
auto set
limits
10
alarm
info
Fet
list
CO2
_
Ve
36
0.6
56
curves
config.
TIP:TI
PEEP
%
mbar
10
0
..
12...
Page 15
Operating Concept
Screen ergonomics
Selecting / setting monitoring functions
Julian
For example, to change the lower alarm limit of the endtidal CO2 concentration.
1
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
1 Press the »alarm limits« softkey. The alarm limits
menu is displayed on the screen.
IPPV
Pleth
SpO2
CO2
etCO2
40
MV
0
FiO2
PAW
20
FiHal.
98
67
38
6.0
29
0.8
-95
120
50
42
30
alarm
limits
auto set
limits
alarm
info
-3.0
list
-20
curves
1.0
0.0
0
config.
40
8
PAW
Select limit: Turn and confirm ! !
Freshgas O2 + N2O
Pmax
O2 %
L/min
50 1.00
●
VT
mL
Freq.
TIP:TI
PEEP
%
mbar
25 600 10 1:2 10
0
IPPV
Pleth
Set the alarm limit value = turn the rotary knob.
SpO2
●
TI:TE
1/min
Select the alarm limit value = turn the rotary knob.
Confirm the selection = press the rotary knob.
The limit value is highlighted.
Example: lower alarm limit etCO2: <30
●
mbar
Confirm the new alarm limit = press the rotary knob.
The cursor returns to the zsymbol.
CO2
etCO2
40
MV
0
FiO2
PAW
20
FiHal.
-95
98
67
38
6.0
29
0.8
120
50
42
30
-3.0
-20
1.0
0.0
0
auto set
limits
alarm
info
list
curves
config.
40
8
PAW
Adjust limit value: Turn and confirm
alarm
limits
!
Freshgas O2 + N2O
O2 %
L/min
50 1.00
Pmax
VT
Freq.
mbar
mL
1/min
TI:TE
TIP:TI
PEEP
%
mbar
25 600 10 1:2 10
0
15
Page 16
Operating Concept
Screen ergonomics
Screen layout
Exit the alarm limits menu:
Julian
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
1 Press the rotary knob
or
2 Press the Q key.
2
1
The function keys for standard functions are located on
the right-hand side of the control panel.
IPPV
Pleth
G Suppress the acoustic alarm for 2 minutes.
S Select the screen page.
Q Back to standard page.
98
SpO2
etCO2
CO2
40
MV
38
6.0
0
40
0.8
58
O2
PAW
Hal.
0
N 2O
Freshgas O2+N2O
O2 %
L/min
30 4.00
VT
mbar
mL
MAN
SPONT
➀
Displays information on the current operating mode
Freq.
TI:TE
1/min
25 600 10
AIR
N 2O
Screen layout
➀ Status field:
Pmax
1:2
IPPV
For numerical values
➄ Lower softkeys – for fresh gas parameters
➅ Prompt field:
For user guidance
➆ Lower softkeys – for ventilation parameters
➇ Right-hand softkeys – for monitoring:
For rapid selection of the desired monitoring function
16
alarm
info
Fet
list
36
0.6
56
..
12...
curves
config.
TIP:TI
PEEP
%
mbar
10
0
➂
➃
IPPV
Pleth
SpO2
For curves and bargraphs
➃ Numerical value field:
10
PCV
➁
➁ Graphics field:
Displays information on the alarms, warnings, etc.
and their priority
freq
alarm
limits
auto set
limits
_
Ve
Fi
20
➂ Alarm field:
67
CO2
etCO2
CO2
40
MV
98
38
6.0
Fi
0
O2
PAW
20
Hal.
0
N 2O
Freshgas O2+N2O
O2 %
L/min
30 4.00
➄
Pmax
VT
mbar
mL
Freq.
TI:TE
1/min
25 600 10
➅
40
0.8
58
➆
1:2
67
CO2
alarm
limits
_
freq
auto set
limits
Ve
10
alarm
info
Fet
list
36
0.6
56
curves
config.
TIP:TI
PEEP
%
mbar
10
0
➇
Page 17
Operating Concept
Screen layout
Three basic screens for monitoring
To call up the standard screen, data screen and trend
screen in succession:
Julian
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
1 Briefly press the S key until the desired screen is
displayed.
2
1
Back to the standard screen:
2 Press the Q key.
The fresh gas and ventilation parameters can be set by
means of the softkeys in each of the three basic screens.
The standard screen
with three selectable curves.
The most important numerical values are displayed in
groups on the right-hand side of the screen.
IPPV
Pleth
98
SpO2
etCO2
CO2
40
MV
38
6.0
67
CO2
_
freq
Ve
10
Fi
0
O2
PAW
20
Hal.
0
N 2O
Freshgas O2+N2O
O2 %
L/min
30 4.00
The data screen
contains all the numerical values with their units of
measure.
Pmax
VT
mL
mbar
40
0.8
58
Freq.
TI:TE
Fet
36
0.6
56
1:2
27
20
5
15
65
98
auto set
limits
alarm
info
list
curves
config.
TIP:TI
PEEP
%
mbar
10
0
1/min
25 600 10
alarm
limits
IPPV
PAW
peak
plat.
40
PEEP
mean
compliance
mbar
mL/mbar
O2
%
6.0
VT
0.60
freq
10
AW-temp.
34
L/min
Hal.
%
0
N2O
%
L
1/min
°C
67
1/min
CO2
mmHg
20
MV
SpO2
%
Fi
Fet
0
40
0.8
58
36
33
0.6
56
01. Nov. 98
12 : 00
sys. comp. 6.40 mL/mbar
leckage
10 mL/min
alarm
limits
auto set
limits
alarm
info
list
config.
01-10
8 : 00
Freshgas O2 + N2O
Pmax
O2 %
L/min
50 1.00
mbar
VT
mL
Freq.
TI:TE
1/min
25 600 10
1:2
TIP:TI
PEEP
%
mbar
10
0
17
Page 18
Operating Concept
Screen layout
The trend screen
displays the recorded progress of the numerical values
over time since measurement started. The current
measured values are displayed on the right-hand side.
IPPV
PAW
60
SpO2
40
0
11:00
20
12:00
13:00
MV
O2
Iso.
5
N 2O
0
Select zoom area: Turn
CO2
Fi
10
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
67
38
6.0
MV
15
0
98
30
etCO2
Display (example):
Trends for CO2 and minute ventilation MV
CO2
40
0.8
58
Zoom in: Press
!
alarm
limits
CO2
MV
_
freq
Ve
10
AGas
N 2O
Fet
O2
compl.
36
0.6
56
SpO2
pulse
full
trend
!
Freshgas O2 + N2O
O2 %
L/min
50 1.00
18
Pmax
VT
Freq.
mbar
mL
1/min
25 600 10
TI:TE
TIP:TI
PEEP
%
mbar
1:2 10
0
Page 19
Before Using for the First Time
Contents
Before Using for the First Time
Contents
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Charging the battery for emergency operation...................................... 20
When Julian is not in use........................................................................ 20
19
Page 20
Before Using for the First Time
Charging the battery for emergency operation
When Julian is not in use
Before Using for the First Time
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Fit the enclosed O2 sensor,
page 117 "Replacing O2 sensor"
Fit the flow sensor, page 106
Charging the battery for emergency
operation
Julian has a built-in uninterruptible power supply UPS
which maintains the power supply for 30 minutes in the
event of a mains failure, provided that the battery is
charged.
The switch-over to the battery-powered UPS is automatic
and is indicated on the screen by the message:
POWER FAIL!
The battery recharges automatically when the workstation
is plugged into the mains.
1
The battery must be charged for 10 hours before using
the Workstation for the first time.
●
Plug the mains plug of the Julian workstation into the
mains socket. The mains voltage must correspond to
the voltage specified on the nameplate.
1 The green LED
●
N lights up.
Leave Julian connected to the mains for 10 hours.
The workstation does not have to be switched on.
The devices connected to auxiliary power sockets will
not be powered by the UPS in the event of a power
failure.
When Julian is not in use
●
Charge battery at least every 4 weeks.
Allowing it to run down can lead to damage.
If Julian is out of use for an extended period:
●
Leave the workstation connected to the mains at all
times.
1 The green LED
20
N is lit.
Page 21
Preparation
Contents
Preparation
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Contents
Connecting the gas supply..................................................................... 22
Connecting the backup gas cylinders for O2 and N2O .............................23
Caution when handling O2 cylinders......................................................... 23
Connecting the anaesthetic gas scavenging system............................. 23
Connecting the power supply................................................................. 24
Connecting auxiliary systems.................................................................... 24
Equipotential bonding............................................................................... 24
Connecting the power supply................................................................... 24
21
Page 22
Preparation
Connecting the gas supply
Preparation
Use only cleaned and disinfected parts!
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Connecting the gas supply
1 Screw the central gas supply pressure hoses for O2,
AIR and N2O into the ports on the back of the gas
supply block.
The two ports at the front are reserved for the backup
gas cylinders.
1
2
N2O AIR O2 VAC
2 The vacuum supply block (VAC) is available as option
for secretion aspiration.
Plug the other end of the pressure hoses into the wall
supply points.
●
Make sure the gas pressures of the central gas
supply are between 2.7 and 5.5 bar:
D
Julian
3 All three pressure gauges in the green zone.
3
22
Page 23
Preparation
Connecting the gas supply
Connecting the anaesthetic gas scavenging system
Connecting the backup gas cylinders for O2 and N2O
Even if the workstation is connected to a central gas
supply, the cylinders must remain on the apparatus as
backup supply.
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
●
2
2
On the back of the workstation:
place full cylinders in the cylinder holders and secure
in position.
1 Screw the pressure reducing adapters onto the
cylinder valves.
2 Screw the gas hoses into the ports on the front of the
gas supply block.
1
1
Switch over immediately to cylinder supply if the central
gas supply fails:
●
Open the cylinder valves.
Caution when handling O2 cylinders
●
Do not oil or grease the O2 cylinder valves or O2
pressure reducing adapters, and do not handle with
greasy fingers.
Danger of explosion!
●
The cylinder valves must be opened / closed by hand.
Do not use tools.
●
If a cylinder valve is leaky or difficult to operate, it
must be repaired by an expert.
N2O
O2
Connecting the anaesthetic gas scavenging
system
3 Connect the transfer hose to the waste gas port and
to the port of the scavenging system.
3
4 Connect the scavenging hose to the port of the
scavenging system.
3
5 Connect the anaesthetic waste gas probe to the
aspirating hose.
5
6 Ensure that the second connection to the scavenging
system is sealed by a screw plug.
●
Follow the Instructions for Use of the anaesthetic gas
scavenging system.
6
3
4
23
Page 24
Preparation
Connecting the power supply
Connecting the power supply
Connecting auxiliary systems
1
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
1 connect to auxiliary sockets on the back of the
workstation.
The auxiliary sockets are not powered by the
uninterruptible power supply UPS in the event of a
power failure!
Do not connect HF surgical devices to the auxiliary
sockets!
Connecting equipment to the auxiliary sockets may cause
the patient leakage current to rise above the permitted
values in the event of failure of a protective earth
conductor.
The risk of electric shock cannot be excluded in such
cases.
Additional power adapter sockets must not be connected
to the auxiliary sockets.
Equipotential bonding
e.g. for intracardial or intracranial operations.
2 Connect one end of the earth cable to one of the
connecting pins on the back of the workstation.
●
Connect the other end of the earth cable to the
specified equipotential bonding point, e.g. on the
operating table or ceiling lamp.
Connecting the power supply
The mains voltage must be the same as specified on the
nameplate on the back of the workstation.
Voltage range: 90 to 265 V
●
24
Plug the mains plug into the wall socket.
2
Page 25
Starting Up
Contents
Starting Up
Contents
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
Checking the workstation against the checklist.................................... 26
Switching on............................................................................................ 26
Gas pressures.........................................................................................29
Central gas supply................................................................................... 29
Backup gas cylinders............................................................................... 29
Suction system.........................................................................................30
O2 flush .................................................................................................. 30
O2 emergency metering........................................................................... 30
Preparing Julian for the self-test................................................................ 31
Self-test...................................................................................................31
Electronics............................................................................................... 31
Fresh gas mixer........................................................................................31
Ventilator and breathing system ............................................................... 31
System compliance................................................................................ 32
Leakage................................................................................................... 32
Emergency start......................................................................................33
25