Perseus A500 Quick Guide ver 2.0

This Quick Guide is intended to provide information on the basic functions of the Perseus A500. This guide presupposes a knowledge of the Perseus A500 Instructions for Use and is not intended to replace them.

Contents

What’s what • Front view • Rear view • Top view • Breathing system • Mixer unit • User interface Preparation for Use • Checking central gas supply and cylinder supply • Checking electrical supply • Checking compact breathing system • In addition…. Start Up • Preparing the device for the entire system test • Entire system test • Leakage assistant • Potential test results • System leakage test Operation • New case • Setting fresh gas delivery • Selecting a ventilation mode - Spontaneous breathing - Manual ventilation - Mechanical ventilation • External fresh gas outlet • Switching to standby • Switch off Alarms • Alarm priorities • Changing alarm limits Emergency Scenarios • Emergency start up • Power failure • Gas supply failure • Ventilator failure • Mixer failure Cleaning • Disassembling the breathing system • Reassembling the breathing system Consumable Items

4 4 5 6 7 8 9 10 10 10 10 10 11 11 11 11 12 12 13 13 13 14 14 14 14 15 15 15 16 16 16 17 17 17 18 18 18 19 19 19 21

What’s What? Front View

A

M L K

B C D

J I

E

H G

A Screen with illumination B Mixer unit C Work surface D Extendible writing tray with compartment for instructions for use (optional) E Central brake F Castors with central brake G Footrest H Trolley

4

F

I Anaesthetic gas receiving system with flow indicator J CO2 absorber K APL valve L External fresh-gas outlet (optional) M Plug-in connection for vaporisers with option Vapor View

What’s What? Rear View

A H B A

A

G

C

F

D

D

E

E

A Standard rail B Gas inlets C Strain relief for compressed gas hose D Connection possibility for 38 mm tube (optional) E Castor with castor brake F Gas cylinder holders (optional) with velcro strap to secure gas cylinders G Interfaces H Rating plate

5

What’s What? Top View Auxiliary power sockets View with column cover removed:

A

B

C A Auxiliary power sockets, depending on equipment variant B Isolation transformer switch (optional) C Circuit breakers or fuses, depending on equipment variant

6

Note: The device you are using has UK sockets rather than those shown.

What’s What? Breathing system

A

B

C

D

E

F

H

G

A Water trap with connection for sample line B Inspiratory port C Bag elbow with cone for occluding purposes e.g., for leakage test D APL valve E Expiratory port F Holder for breathing bag hose G CO2 absorber H Anaesthetic gas receiving system

7

What’s What? Mixer unit

I

J A

H G F

B

E

D

C

A Status display B O2 flow tube (for Aux. O2 and Add. O2) C Current time or time for Auto On D O2 switch (between Aux. O2 and Add. O2) E Outlet for Aux. O2 (O2 insufflation) F Symbol for programmed Auto On G Display of pressure in the internal breathing system, see page 7 H O2+ button (O2 flush) I Symbols for mains power supply and power supply from internal battery J Symbols for gas supply (O2, Air, N2O) through central supply and gas cylinders

8

What’s What? User interface

A

B

G

C

D

E

F

A Device switch B Serial interfaces (COM 1 and COM 2) C USB interface D Network interface E Interface for work light (optional) F IEC connector (socket for power cable) G Potential equalisation pin

9

Preparation for Use

Checking central gas supply and cylinder supply • Connect hose fittings for O2, N2O and Air to corresponding fittings on the back of the device. • Plug wall fittings for O2, Air and N2O into the central gas supply wall outlets. • Observe the pipeline icons on the mixer unit display. If the pipelines are not connected, there will be a X through the icon. • Open the cylinder valves. • Observe the cylinder icons on the mixer unit display. If the cylinders are not connected, there will be a X through the icon • Close the cylinders. The specific pressures for the pipelines and the cylinders can be seen on the main screen of the device. Checking the electrical supply • Ensure the mains power cord is plugged in. • Observe the plug icon on the mixer unit screen. If the mains power is not connected, there will be a X through the icon. Checking the compact breathing system • Ensure the compact breathing system is connected and locked into place. • Check the status of the soda lime, breathing bag and patient hoses. In addition….. • Test the O2 flush. • Check the Add O2. • Ensure the vaporisers are in position, locked and filled. • Check the water trap and the sample gas line connection. • Check the function of the suction system • Connect and check the AGS system. 10

Gas Block

Mixer Unit

Start Up

Prepare the device for the entire system test • Press the power on button on the system screen. • Occlude the Y piece on the occlusion port • Set the APL valve to 30. • Close the Add O2. • Confirm the checklist if all the points are checked and ok. Entire system test • Press the entire system test and confirm by pressing the rotary knob to start the test. • The entire system test includes a pre-test. This will identify any common errors that occur during the self test (for example, incorrect setting of the APL valve) within 60 seconds, allowing the user to rectify them quickly before continuing the entire system test. In the event of such a failure, resolve the issue and repeat the test. The leakage assistant will assist in identifying the location of any leaks that occur in the breathing system. Press the leakage assistant button and follow the on screen instructions. • On completion of the pre-test, the entire test system will continue automatically. Leakage test • Complete after changing breathing circuits Breathing system test • Complete after replacing the flow sensors 11

Start Up

Potential test results Test Result - Colour

Test Result

Message

Green Red Yellow

Test successful Test unsuccessful Test partially successful

Fully operable Not operable Not fully operable

Grey

Not tested

Not tested

On completion of the entire system test, the standby screen will appear

Leakage assistant test •

12

This should be carried out after the vaporisers have been replaced or reusable soda lime canister has been refilled. In addition, it should be performed following the self test to check the integrity of the breathing system including the vaporisers.

Operation

New case The start up dialogue appears by touching the start button on the screen (located in the bottom right hand corner) • Select the required profile – one of 3 on the screen. The default profile is in dark green. • Set the patients details (weight, age, height) by touching the relevant button on the screen, using the rotary knob to set the required value and confirming by pressing the rotary knob. • Check that the gas delivery and ventilator settings are appropriate for the patient. • Start by selecting the ventilation mode required and confirming with the rotary knob. Setting fresh gas delivery • To change the carrier gas used, select the gas required and confirm by pressing the rotary knob. • To adjust O2 concentration, change the concentration as required and confirm by pressing the rotary knob. • To adjust the fresh gas flow, change the flow as required and confirm by pressing the rotary knob.

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Operation

Hypoxic guard function (SORC) The Perseus A500 is fitted with a hypoxic guard function (SORC). This is an electronic O2 minimum delivery system that guarantees at least 25% O2 whenever N2O is used as the carrier gas. This prevents the delivery of hypoxic gas mixtures. Selecting a ventilation mode Spontaneous breathing (Spont) • Select man/spont and confirm. • Adjust the APL valve to SPONT – the breathing system is now open for spontaneous breathing. Manual ventilation (Man) • Select man/spont and confirm • Switch the APL valve to MAN and adjust accordingly. • Note - the breathing system pressure can be quickly released by pulling the APL valve upwards. Mechanical ventilation • Select the ventilation mode required by pressing the appropriate tab. • Set the ventilation parameters as required by selecting the parameter, adjusting and confirming by pressing the rotary knob • Confirm the ventilation mode by pressing the rotary knob. When changing between different modes, the parameters from the previous mode are transferred directly or suitably derived.

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Operation

External fresh gas outlet

The Perseus A500 has an external fresh gas outlet to facilitate the use of non rebreathing systems such as an Ayres T piece. • Prepare the circuit in accordance with the manufacturers recommendations. • Attach the circuit to the external fresh gas outlet on the Perseus A500. • Select the Ext FG outlet tab on the screen and confirm by pressing the rotary knob. Switching to standby At the end of a case, stop ventilation by pressing the start/standby button in the bottom right hand corner of the screen and confirm by pressing the rotary knob. Fresh gas delivery ceases at this point. Switching the device off • Switch the Perseus A500 to standby as described above. • Press the green on/off hard key located on the bottom left hand corner of the screen and follow the on screen instructions.

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Alarms

Alarm priorities Alarms are displayed in 3 priorities: Priority Highest Medium

Display Red Yellow

Tone Sequence Continuous Every 30 seconds

Low

Cyan

Once

If an alarm situation occurs you will be notified in 2 ways: • The relevant parameter field will flash in the appropriate colour. Press the parameter box to access the alarm information. • An alarm message appears at the top of the screen in an appropriately coloured box. Press this box to access the alarm information. Changing alarm limits To change an alarm limit either • Press the Alarms key at the top right hand side of the screen. Or • Press the parameter box for direct access to the specific alarm limit.

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Significance Immediate action required Action required at earliest convenience Attention & action if necessary

Emergency Scenarios

Emergency start up • Adjust the APL valve according to the patient. • Connect the patient. • Switch to Add.O2 on the mixer unit. • Set appropriate O2 flow on the flowtube. Note: The O2 is channelled through the vaporiser which should also be set accordingly • Ventilate the patient manually viewing the airway pressure display on the mixer unit screen. • Press on/off switch to power on the device. • The standby screen will appear after approximately 20 seconds. You may start the case in the normal manner. • Switch off the Add O2. Note: A self test must be performed at the earliest opportunity. Power failure In the event of central power supply failure, the message POWER FAILURE appears on the screen. If the battery is fully charges, the device can continue to operate for at least 30 minutes. The remaining battery capacity will be displayed on the mixer unit screen. When the battery is almost empty, the message BATTERY LOW and then BATTERY VERY LOW will be displayed. If the battery is completely empty, the device will automatically switch to Man/Spont. Manual ventilation is available at any time. • Switch to Add O2 on the mixer unit and set the desired O2 flow via the flowtube.

POWER FAIL

• The O2 is channelled via the vaporiser. 17

Emergency Scenarios

Gas supply failure If the central gas supply fails, the message No N2O, O2 or AIR delivery appears on the screen. Air or O2 will be delivered in place of the gas mixture previously delivered; the amount of fresh gas (l/min) will remain the same. 100% Air will be delivered if O2 fails. 100% O2 will be delivered if N2O or Air fails. • Open the appropriate back up cylinder or reconnect the central gas supply. If the carrier gas N2O fails, you are able to use Air and vice versa. Ventilator failure In case of ventilator error, the ventilator will stop and display the error message VENTILATOR FAILURE on the screen.

VENTILATOR FAILURE

Fresh gas flow and monitoring functionality are not affected. Switch to Man/Spont and manually ventilate the patient. Mixer failure The message GAS MIXER FAILURE appears on the screen. • Ventilation and monitoring functionality are not affected. • Switch to Add O2 on the mixer unit screen and set the required O2 flow on the flowtube. The O2 flow is channelled via the vaporiser.

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GAS MIXER FAILURE

Cleaning

Disassembling the breathing system 1. Unscrew and dispose of sample line. 2. Remove water trap. 3. Disassemble CO2 absorber: a. CLIC absorber (single use) Or b. Reusable CO2 absorber: i. Remove the CO2 absorber from the breathing system. ii. Remove and dispose of the soda lime dust filter. iii. Empty the CO2 absorber. iv. Remove the absorber insert from the absorber. container. Leave the inner and outer sealing rings on the absorber insert. 4. Remove the manual breathing bag. 5. Remove the breathing circuit and the filter. 6. Unscrew the flexible arm for the manual breathing bag (optional). 7. Remove the breathing system. a. Remove the breathing system cover. b. Turn the middle lever counterclockwise about 120° c. Remove the assembled breathing system vertically upwards from the breathing system mount. 8. Unscrew the CLIC adapter (optional). 9. Remove the flow sensors. a. Loosen and pull out the expiration port. b. Loosen and pull out the inspiration port. c. Remove the flow sensors. 10. Remove the upper housing of the breathing system. a. Turn the three levers counterclockwise about 120°. b. Lift off the upper housing of the breathing system. 11. Screw off the APL valve. 12. Remove the non-return valves (red and blue). 13. Remove the TurboVent 2 blower module. Reassembling the breathing system To reassemble follow steps 1 – 13 in reverse order. 19

Consumable Items

The items below are the most frequently used with the Perseus A500. Part Number

Description

Pack Size

6872020

Watertrap

12

8290286

Sample Line

10

6871980

Spirolog flow sensor

5

MP01805

Twinstar® HME Filter

50

MP01850

Ergostar® CM50 (catheter mount)

50

MP02400

Adult Test Lung

1

MX50004

Drägersorb Soda Lime Clic Canister (1.3 litre)

6

MK00514

Bacterial Filter

1

MP01850

MP01805

6871980

MK00514

8290286

MX50004

6872020

21