Aisys Users Reference Manual Sw Rev 6.X

Datex-Ohmeda, Inc., a General Electric Company, doing business as GE Healthcare.

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.

Aisys, Carestation, Easy-Fil, Advanced Breathing System, ComWheel, D-fend, EZchange, Disposable Multi Absorber, Reusable Multi Absorber, PSVPro, SmartVent, Aladin, and Aladin2 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 Intended use... 1-2 Symbols used in the manual or on the equipment... 1-4 Typeface conventions used... 1-7 Abbreviations... 1-7

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)... 2-9 Scavenging the ACGO sample flow... 2-9 Scavenging from an auxiliary manual breathing circuit 2-10 Scavenging a gas monitor sample flow... 2-10 Aladin cassette controls... 2-11 Display controls... 2-12 Anesthesia system display... 2-13 Waveform fields... 2-15 Digit field... 2-15 Using menus... 2-16

3 Operation Turning on the system... 3-2 Start case (start gas flow)... 3-3 Using default settings... 3-4 Using customized settings... 3-4 Minimum Alveolar Concentration (MAC)... 3-5 End case... 3-6

M1156637

i

Aisys Ventilator setup... 3-7 Using quick keys... 3-7 Using Vent Setup menu... 3-8 Changing ventilator modes and settings... 3-8 Gas setup... 3-9 Using quick keys... 3-9 Using Gas Setup menu... 3-9 Changing gas and settings... 3-9 Changing circuit type... 3-10 Spirometry... 3-11 Setting loop type... 3-12 Scaling... 3-13 Spirometry setup... 3-14 Setting patient and sensor type... 3-14 Selecting a data source... 3-15 Setting spirometry split screen... 3-15 Main Menu... 3-16 Trends... 3-17 Cardiac bypass... 3-18 Fresh gas usage... 3-19 Screen configuration... 3-20 Select page... 3-20 Screen setup... 3-21 Alarm setup... 3-23 Setting alarm limits... 3-23 Volume apnea... 3-24 MV/TV alarms... 3-24 CO2 alarms... 3-24 Auto MV limit... 3-25 Alternate O2 control... 3-26 EZchange canister (optional)... 3-27 Condenser (optional)... 3-28 Passive AGSS (optional)... 3-29

ii

M1156637

Table of Contents Active AGSS (optional)... 3-30 Connecting active AGSS with a flow indicator... 3-31 Connecting active adjustable AGSS... 3-31

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

5 Preoperative Tests Inspect the system... 5-2 Aladin cassette installation... 5-3 Flow and pressure calibration... 5-4 Circuit compliance compensation... 5-4 Checkout menu... 5-5 Leak < 250 ml... 5-5 No... 5-5 Yes... 5-5 Machine check... 5-6 Machine check - system... 5-6 Machine check - circuit... 5-7 Machine check - circuit O2... 5-7 Machine check - monitor... 5-7 Individual checks... 5-8 System... 5-8 Circuit... 5-8 Circuit O2 cell... 5-9 Low P leak... 5-9 Low P leak (machines with ACGO)... 5-9 Agent delivery... 5-10 Positive low pressure leak test (ACGO systems only)... 5-11

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

7 Alarms and Troubleshooting Alarms... 7-2 Alarm priorities... 7-2 Silencing alarms... 7-2 Display changes during alarms... 7-2 De-escalating alarms... 7-3 Battery indicator... 7-3 Internal failure... 7-3 List of alarms... 7-4 Alarm ranges... 7-13 Alarm tests... 7-15 Breathing system problems... 7-17 Electrical problems... 7-18 Pneumatic problems... 7-19

8 Setup and Connections Setup warnings... 8-2 Canister setup... 8-4 When to change the absorbent... 8-5 Removing a canister... 8-6 Removing an EZchange canister... 8-6 Reusable Multi Absorber canister filling... 8-7

iv

M1156637

Table of Contents Electrical connections... 8-9 Mains inlet... 8-9 Outlets... 8-9 Patient monitoring battery backup... 8-9 Serial port... 8-10 Pneumatic connections... 8-11 Pipeline inlets... 8-11 Scavenging... 8-11 Sample gas return port... 8-12 Pneumatic power outlet... 8-12 Vacuum suction regulator (optional)... 8-13 Venturi suction regulator (optional)... 8-13 Auxiliary O2 flowmeter (optional)... 8-14 How to install gas cylinders... 8-15 Pin indexed cylinder yokes... 8-15 DIN cylinder connections... 8-15 High-pressure leak test... 8-16 How to attach equipment to the top of the machine... 8-17

9 User Maintenance Repair policy... 9-2 Maintenance summary and schedule... 9-2 Datex-Ohmeda approved service... 9-3 Circuit O2 cell replacement... 9-4 Calibration menu... 9-5 Flow and pressure calibration... 9-5 Circuit O2 cell calibration... 9-6 21% O2 calibration... 9-6 100% O2 calibration... 9-6 Airway gas calibration... 9-6 Backlight test... 9-7 How to help prevent water buildup... 9-7

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Aisys 10 Parts Flow sensor module... 10-2 Breathing circuit module... 10-3 Bellows... 10-4 Complete Advanced Breathing System... 10-5 Absorber canister... 10-6 Exhalation valve assembly... 10-7 AGSS... 10-8 EZchange canister system... 10-9 Condenser... 10-10 Test tools and system parts... 10-11

11 Specifications and Theory of Operation System pneumatic circuits... 11-2 Gas supplies... 11-4 O2 flow... 11-4 Air and N2O... 11-4 Mixed gas... 11-4 EZchange canister... 11-5 Condenser... 11-5 Pneumatic specifications... 11-5 Gas supplies... 11-5 ACGO Port relief... 11-5 Non-circle circuit relief... 11-5 Pneumatic power outlet... 11-6 Electrical block diagram... 11-7 Electrical power... 11-9 Power cord... 11-9 Battery information... 11-10 Flow specifications... 11-10 Breathing system specifications... 11-11 Gas scavenging... 11-12 Physical specifications... 11-13 Environmental requirements... 11-13

vi

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Table of Contents Airway module specifications... 11-14 Gas specifications... 11-14 Typical performance... 11-15 Suction regulators (optional)... 11-16 Ventilator theory... 11-17 O2 monitoring theory of operation... 11-18 Ventilation modes... 11-18 Ventilation modes factory default settings... 11-26 Ventilation mode transition... 11-26 Ventilator operating specifications... 11-27 Pneumatics... 11-27 Fresh gas compensation... 11-27 Pressure... 11-27 Volume... 11-27 Oxygen... 11-27 Ventilator accuracy data... 11-28 Electronically controlled vaporizer and Aladin cassette . . 11-29 Aladin2 cassettes... 11-30 Aladin cassettes... 11-31 Electromagnetic compatibility (EMC)... 11-32 Guidance and manufacturer’s declaration electromagnetic emissions... 11-32 Guidance and manufacturer’s declaration electromagnetic immunity... 11-33 Recommended separation distances... 11-35 Electrical safety... 11-36 IEC 60601-1 Classification... 11-37 Standards... 11-37 System components... 11-38 Integral... 11-38 Not integral... 11-38

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Aisys 12 Super User Mode Install/Service menu... 12-2 Using super user mode... 12-3 Menus... 12-4 Cumulative gas usage... 12-4 Volume apnea setup... 12-5 Setting time and date... 12-6 Trends setup... 12-7 Setting colors and units... 12-9 Parameter settings... 12-10 Page Setup... 12-10 Configuring case defaults... 12-12

13 Vaporizer cassettes Vaporizer... 13-2 Aladin2 cassette variants... 13-2 Aladin cassette variants... 13-4 Installing cassettes... 13-6 Cleaning... 13-6 Draining cassettes... 13-6 Draining halothane cassettes... 13-7 Filling Aladin2 cassettes... 13-7 Filling with Easy-Fil system... 13-8 Filling with Quik-Fil system... 13-9 Filling with Saf-T-Fil bottle... 13-10 Filling Aladin cassettes... 13-12 Filling with keyed filler system... 13-12 Filling with Quik-Fil system

... 13-14

Filling with Saf-T-Fil bottle... 13-15

Index Warranty

viii

M1156637

1 Introduction

WARNING

w

w

In this section

Read each component’s User’s Reference manual and understand the following before using this system: •

All system connections.

•

All warnings and cautions.

•

How to use each system component.

•

How to test each system component.

Before using the system: •

Complete all of the tests in the “Preoperative Tests” section.

•

Test all other system components.

If a test fails, do not use the equipment. Have a Datex-Ohmeda trained service representative repair the equipment. Intended use... 1-2 Symbols used in the manual or on the equipment... 1-4 Typeface conventions used... 1-7 Abbreviations... 1-7

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1-1

Aisys

Intended use Aisys means Anesthesia Integrated System. The Aisys Carestation is scalable, flexible, and functionally integrated, featuring the most advanced design, ventilation, respiratory monitoring, and breathing system. In addition, module bays allow for the physical integration of legacy Datex-Ohmeda patient monitors and supports mounting of other GE Healthcare monitors. Optionally, the open architecture design supports mounting of non-Datex-Ohmeda patient monitors, record keeping, and connections to the hospital information system. The INview movable display arm helps keep the anesthetist’s focus on the patient by offering control of all hemodynamic, gas delivery, anesthetic agent, and ventilation parameters. This anesthesia system uses SmartVent ventilation technology offering Volume Control Ventilation with tidal volume compensation and electronic PEEP. The proven SmartVent technology also features optional Pressure Control Ventilation, Pressure Support Ventilation with an Apnea Backup (PSVPro) that is used for spontaneously breathing patients, Synchronized Intermittent Mandatory Ventilation (SIMV) modes, Pressure Control VentilationVolume Guarantee (PCV-VG), and VCV cardiac bypass. These advanced features allow for the ventilation of a broad patient range. This anesthesia system uses the Advanced Breathing System (ABS). This integrated breathing system is easy to remove and disassemble and is fully autoclavable. Its fully integrated design enhances the system’s elegance while minimizing tube connections, minimizing circuit volume, and increasing the work surface area. This anesthesia system is designed for expansion and upgrades, so it is easy to add new technologies and ventilation capabilities without investing in a new system. This anesthesia system is not suitable for use in an MRI environment. This system must only be operated by authorized medical personnel well trained in the use of this product. It must be operated according to the instructions in this User’s Reference manual.

1-2

WARNING

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

Note

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. Refer to the accessory documentation for further information.

M1156637

AB.75.100

1 Introduction

Figure 1-1 • Front view

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1-3

Aisys

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.

On (power)

Standby

1-4

Off (power)

O2 +

O2 Flush button

Type BF equipment

Type B equipment

Airway module indicator

ACGO active

Dangerous voltage

Frame or chassis ground

Protective earth ground

Earth ground

Direct current

Alternating current

Caution/Warning

Attention, refer to product instructions

Refer to product instructions

Pinch hazard

Electrical input

Electrical output

Electrical input/output

Sample gas inlet to scavenging

M1156637

1 Introduction Pneumatic inlet

SN

+

134°C

Serial number

REF

Stock number

Equipotential

Lamp, lighting, illumination

Variability

Variability in steps

Suction bottle outlet

Vacuum inlet

Maximum

Vacuum

Exhaust

Bellows volumes are approximate

Plus, positive polarity

-

Minus, negative 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

APL settings are approximate

M1156637

Pneumatic outlet

O2%

O2 cell connection

Anesthetic Gas Scavenging System

1-5

Aisys

1-6

O2% indicator on left and balance gas indictor on right. Colors associated with gas settings.

Gas indicator. Color associated with gas settings.

Alarm silence

Submenu

No battery/battery failure

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

Read to center of float

EZchange canister (CO2 bypass)

Open drain (remove liquid)

Close drain

Pipeline

Cylinder

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.

Authorized representative in the European Community

Date of manufacture

Manufacturer

Indicates that the waste of electrical and electronic equipment must not be disposed as unsorted municipal waste and must be collected separately. Please contact an authorized representative of the manufacturer for information concerning the decommissioning of equipment.

GOST R Russian certification

This product consists of devices that may contain mercury, which must be recycled or disposed of in accordance with local, state, or country laws. (Within this system, the backlight lamps in the monitor display contain mercury.

Caution: federal law prohibits dispensing without prescription.

Enhanced temperature sensing

Agent level unknown

M1156637

1 Introduction Agent level sensing supported. Bar indicates amount of agent remaining.

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, Vent 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

A AA

Anesthetic agent

ABS

Advanced breathing system

ACGO

Auxiliary Common Gas Outlet

AGSS

Anesthesia Gas Scavenging System

Alt O2

Alternate O2

APL

Adjustable pressure-limiting

APN

Apnea

C CGO

Common Gas Outlet

CO2

Carbon dioxide

Compl

Compliance

E ET

End-tidal concentration

EtCO2

End-tidal carbon dioxide

EtO2

End-tidal oxygen

Exp

Expiratory

F

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FI

Fraction of inspired gas

FiCO2

Fraction of inspired carbon dioxide

1-7

Aisys Abbreviation

Definition

FI-ET

Difference between inspiratory and expiratory concentrations

FiO2

Fraction of inspired oxygen

F-V

Flow-volume loop

I I:E

Inspiratory-expiratory ratio

Insp

Inspiratory

Insp Pause

Inspriatory pause time

M MAC

Minimum Alveolar Concentration

MV

Minute volume

MVexp

Expired minute volume

MVinsp

Inspired minute volume

N N2O

Nitrous oxide

O O2

Oxygen

P Pair

1-8

Air supply pressure

Paux

Auxiliary pressure

Paw

Airway pressure

PCV

Pressure controlled ventilation

PCV-VG

Pressure controlled ventilation - volume guaranteed

PEEP

Positive end expiratory pressure

PEEPe

Extrinsic positive end expiratory pressure

Pexp

Expiratory pressure

P-F

Pressure-flow loop

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

PSV

Pressure supported ventilation

PSVPro

Pressure supported ventilation with apnea backup

P-V

Pressure-volume loop

M1156637

1 Introduction Abbreviation

Definition

R Rate

Respiratory rate

Raw

Airway resistance

RR

Respiratory rate

S SIMV/PSV

Synchronized intermittent mandatory ventilation with pressure supported ventilation

SIMV-PC

Synchronized intermittent mandatory ventilation pressure controlled

T TV

Tidal volume

TVexp

Expired tidal volume

TVinsp

Inspired tidal volume

V

M1156637

VCO2

Carbon dioxide production

VCV

Volume controlled ventilation

Vol

Volume

1-9

Aisys

1-10

M1156637

2 System Controls and Menus

WARNING

Do not use antistatic or electrically-conductive breathing tubes or masks. They can cause burns if used near highfrequency surgical equipment.

w

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

In this section

System overview... 2-2 Advanced breathing system (ABS) components... 2-5 Display controls... 2-12 Anesthesia system display... 2-13 Using menus... 2-16

M1156637

2-1

Aisys

System overview 14

13 12

11 1 2 10

3 4 5 6 7

15

9

1. 2. 3. 4. 5. 6. 7. 8.

Light switch Dovetail Aladin cassette and active bay Alternate O2 control System switch Mains indicator Integrated suction (optional) Brake

AB.75.097

8

9. O2 flush button 10. Advanced breathing system 11. Auxiliary O2 flow control (optional) 12. Anesthesia display 13. Patient monitoring modules (optional) 14. Patient monitoring display (optional) 15. Aladin cassette storage bay

Figure 2-1 • Front view

2-2

M1156637

2 System Controls and Menus

Item, Figure 2-1

Description

4

Alternate O2 control 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. See “Alternate O2 control” in the Operation section.

5

System switch

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

6 7

Mains indicator Integrated suction (optional)

The mains indicator will come on when AC power is connected. Turn the switch to MAX for full vacuum. Turn the switch to Off (0) 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 (optional)

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

M1156637

2-3

Aisys

1

2 3 4 5

AB.75.046

6

11 10

1. 2. 3. 4. 5. 6.

7 8

9

Serial port Collection bottle connection Cylinder wrench (key) storage Cylinder yoke AGSS (Anesthesia Gas Scavenging System) Pipeline connections

7. Mains inlet 8. System circuit breaker 9. Equipotential stud 10. Outlet circuit breaker 11. Isolated electrical outlet

Figure 2-2 • Rear view

2-4

M1156637

2 System Controls and Menus

Advanced breathing system (ABS) components

13

12 11 10

1 2

9 8 7

3 4

6

AB.75.098

5

1. 2. 3. 4. 5. 6. 7.

Expiratory check valve Inspiratory check valve Inspiratory flow sensor Expiratory flow sensor Absorber canister Absorber canister release 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. Airway module (optional)

Figure 2-3 • Advanced breathing system

M1156637

2-5

Aisys

Item, Figure 2-3

Description

3, 4

Inspiratory flow sensor Expiratory flow sensor Absorber canister release

Flow sensors provide volume measurements for some monitoring functions and tidal volume delivery. Push to remove the canister. This causes the breathing system to vent to the room (unless the EZchange canister option is installed). Be sure to hold the canister by the handle before releasing the canister.

Adjustable pressure-limiting (APL) valve

Adjusts breathing system pressure limit during manual ventilation. The scale shows approximate pressures. Above 30 cmH2O, the knob will click as it turns.

10

N MI

30

70

6

20

11

2-6

Bag/Vent switch

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

M1156637

2 System Controls and Menus

Optional ABS components

1

4

7

3 2

1. 2. 3. 4. 5. 6. 7.

6

AB.75.049 AB.82.043

5

Bag support arm Auxiliary Common Gas Outlet (ACGO) switch ACGO port EZchange canister module (CO2 bypass) EZchange canister release Condenser drain button Condenser

Figure 2-4 • Breathing system options Item, Figure 2-4

Description

1

Bag support arm

Squeeze the button to raise or lower the arm.

2

Auxiliary Common Gas Outlet (ACGO) switch EZchange canister release

Set switch to ACGO position for fresh gas to flow through the ACGO port. The ACGO may be used to provide fresh gas to an auxiliary manual breathing circuit. Push to drop the canister to EZchange position. This seals the breathing circuit, permitting continued ventilation and rebreathing of exhaled gases. Be sure to hold the canister by the handle before releasing the canister. Push to drain water out of the condenser.

5

6

Condenser drain button

M1156637

2-7

Aisys

Non-circle circuit

Fresh gas flow is diverted around the inspiratory check valve and out through the inspiratory port when non-circle ventilation is selected. This fresh gas source may be used with circuits without CO2 absorbent capability (for example, Mapleson variants). Mechanical ventilation is not available when using the non-circle circuit. Tidal volume monitoring is not available. O2 monitoring of fresh gas is available automatically when using the non-circle circuit if the system has the airway module option or the O2 cell monitoring option. Fresh gas oxygen concentration is displayed on the screen. Set the alarm limits appropriately. Note that fresh gas oxygen concentration may not reflect FiO2 when using these types of circuits. Use an external O2 monitor when using a rebreathing circuit with the noncircle circuit. Systems with both an airway module and an O2 cell will display the circuit O2 value obtained from the airway module. Do not use an external ventilator when using the non-circle circuit. Do not use the non-circle circuit to drive external ventilators or for jet ventilation.

WARNING

2-8

The maximum pressure at the non-circle circuit can be up to 27 kPa (4 psi). Use a breathing circuit with pressure relief.

M1156637

2 System Controls and Menus

ACGO (optional)

Fresh gas flow is directed through the Auxiliary Common Gas Outlet (ACGO) on the front of the machine when the ACGO switch is in the ACGO position. Mechanical ventilation is not available when operating an auxiliary manual breathing circuit with fresh gas from the ACGO. The Bag/Vent switch, APL valve, and bag arm are not part of the external circuit. Volume and pressure monitoring are not available. O2 monitoring of fresh gas is available automatically when the ACGO is selected if the system has the airway module option or the O2 cell monitoring option. A sample of the fresh gas is diverted to the O2 cell in the breathing system. The sample flow to the O2 cell is dependent on the pressure in the external circuit. The sample flow reduces the fresh gas flow rate to the auxiliary breathing circuit equal to the amount diverted to the O2 cell. Fresh gas oxygen concentration is displayed on the screen. Set the alarm limits appropriately. Note that fresh gas oxygen concentration may not reflect FiO2 during spontaneous breathing or in rebreathing circuits. Use an external O2 monitor if using a rebreathing circuit on ACGO. Systems with both an airway module and an O2 cell will display the circuit O2 value obtained from the airway module. Do not use an external ventilator on the ACGO. Do not use the ACGO to drive external ventilators or for jet ventilation.

WARNING

The maximum pressure at the ACGO can be up to 55 kPa (8 psi). Use a breathing circuit with pressure relief.

Scavenging the ACGO sample flow

A sample of the fresh gas is diverted to the airway module or the O2 cell in the breathing system to show the O2 numerics on the screen. This sample flow should be scavenged when an auxiliary manual breathing circuit is used with N2O or volatile anesthetics. If scavenging is not connected, the sample flow is emptied into the room. To connect the scavenging: 1. Attach a circle breathing circuit to the inspiratory and expiratory ports. 2. Occlude the breathing circuit by connecting the Y-piece to the leak test plug located behind the expiratory port. 3. Check for clinically correct settings. 4. Check the position of the Bag/Vent switch. • If the Bag/Vent switch is set to mechanical ventilation mode, the bellows fills slowly with the sample flow. When the bellows is full, the sample flow goes to the AGSS. (Mechanical ventilation does not start when the ACGO switch is set to ACGO.) • If the Bag/Vent switch is set to the bag mode, set the APL valve to MIN, and attach a bag. The bag fills slowly with the sample flow. When the bag is full, the sample flow goes to the AGSS.

M1156637

2-9

Aisys

Scavenging from an auxiliary manual breathing circuit

Scavenge the exhaust if an auxiliary manual breathing circuit is used with N2O or volatile anesthetics. An auxiliary inlet is available for active and passive AGSS units. It provides a female connection with 30 mm - 30 mm male connector (or a 30 mm -19 mm male connector) into the auxiliary port under the breathing system. Do not use these connectors as an outlet for exhaust flow. The auxiliary inlet is a convenience inlet to the air brake of active AGSS units. There is a reservoir to capture exhaust flows higher than the extract flow. A separate exhaust hose is needed from the auxiliary manual breathing circuit to the disposal point for all AGSS units.

Scavenging a gas monitor sample flow

2-10

Sample gas from a gas monitor can be scavenged using the sample gas return port or the AGSS. • To scavenge from a gas monitor using the sample gas return port, connect the tubing from the monitor to the sample gas return port. • To scavenge from a gas monitor using the AGSS, connect tubing from the monitor to the male luer inlet on the bottom of the AGSS underneath the breathing system.

M1156637

2 System Controls and Menus

Aladin cassette controls

The electronically controlled vaporizer consists of the internal electronic control unit and the Aladin agent cassette. See the “Vaporizer” section for more information.

1

4 1. 2. 3. 4.

3

AB.60.038

2

Handle with release trigger Lock Liquid level indicator Agent filling port

Figure 2-5 • Aladin2 cassette

M1156637

2-11

Aisys

Display controls 8

7

1

6 2

5

2

1.

Silence Alarms key

2. 3.

Menu keys ComWheel

4. 5.

Normal Screen key Quick keys

6. 7. 8.

Timer keys MV/TV Alarms key Alarm LEDs

4

AB.75.099

3

Push to silence any active, silenceable high and medium priority alarms or to suspend/acknowledge any non-active medium or high priority alarms. Alarm is silenced for 120 seconds or alarm is suspended for 90 seconds. Push to show corresponding menu. Push to select a menu item or confirm a setting. Turn clockwise or counterclockwise to scroll menu items or change settings. Push to remove all menus from the screen. Push to change corresponding gas setting or ventilator setting. Turn the ComWheel to make a change. Push the ComWheel to activate the change. Push to start or stop the timer. Push to reset the timer back to zero. Push to turn off the MV and TV alarms. Push again to turn the MV and TV alarms on. Turn on solid or flash to indicate alarm priority.

Figure 2-6 • Display controls

2-12

M1156637

2 System Controls and Menus

Anesthesia system display

2

1

3

4

Plug in power cable. On battery. Paw

5

6

Timer:

7 cmH2O

Measured l/min

Agent

Ppeak

Pmean

PEEP

RR /min

Et %

Fi %

8 MAC 40

CO2

O2

Fresh Gas: O2+Air O2 %

PCV-VG: Ventilator On Total Flow l/min

12

TV ml

Des %

Off

FiO2 %

EtO2 %

FiO2 %

Exp Flow RR /min

PEEP cmH2O

MV l/min

TVexp ml Off

11

10

9

AB.75.189

Air

EtCO2 %

1. Split screen area showing electronic gas flow indicators 2. Alarm silence symbol and countdown 3. Alarm message fields 4. Waveform fields 5. General message field or timer field 6. Clock 7. Battery indicator field 8. Measured values field 9. Pipeline and cylinder supply or respiratory data or digit field 10. Ventilator settings 11. Ventilation mode 12. Gas settings

Figure 2-7 • Normal view

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2-13