Respiratory Modules E-sCAiOVX , E-sCAiOV , E-sCAiO , E-sCOVX , E-sCOV , E-sCO Service Manual 4th edition

Due to continuing product innovation, specifications in this manual are subject to change without notice. For technical documentation purposes, the abbreviation GE is used for the legal entity names, GE Medical Systems Information Technologies, Inc. and GE Healthcare Finland Oy.

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Respiratory Modules E-sCAiOVX, E-sCAiOV, E-sCAiO, E-sCOVX, E-sCOV, E-sCO

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Contents 1

About this manual ... 7 Intended use of this manual... 7 Intended audience of this manual ... 7 Manual conventions ... 7 Illustrations and names ... 8 Related documents... 8 Product availability ... 8 Trademarks ... 8 Third party trademarks ... 8 Manufacturer responsibility ... 8

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Module introduction ...11 Respiratory module introduction ... 11 Module compatibility ... 11 About unpacking the module... 11 Airway gases equipment to patient connections with CARESCAPE respiratory modules... 12 Spirometry equipment to patient connection ... 12 Controls and connectors ... 13 Spirometry module keys ... 14 Measurement principle... 14 CO2, N2O, and agent measurement ... 14 O2 measurement ... 15 Spirometry measurement... 16 Gas exchange measurement ... 18 Main components of respiratory modules ... 19 Gas sampling system... 19 MiniTPX measuring unit ... 23 MiniOM oxygen sensor... 24 MiniPVX measuring unit... 25 Gas exchange... 26 CPU board... 26

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MiniOM board ... 27 MiniPVX board ... 27 Main component interactions ... 27 3

Planned and corrective maintenance ...29 About the maintenance check procedures ... 29 Corrective maintenance ... 29 Planned maintenance... 30 Replacement of planned maintenance parts*... 30 Planned maintenance kits ... 30 Replacing planned maintenance parts*... 31 Performing visual inspection... 32 Performing functional check ... 32 Required tools for the functional check ... 32 Making connections for the functional check ... 33 Configuring monitor for functional check... 33 Testing respiratory module features... 33 Completing the functional check ... 38

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Configuration and calibration...39 Configuration ... 39 Software update... 39 Calibration and adjustments... 39 Sample flow rate adjustment ... 39 Gas calibration ... 41 Spirometry calibration ... 44

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Troubleshooting...47 Troubleshooting guidelines ... 47 Performing visual inspection... 47 Troubleshooting checklist... 48 Gas sampling system troubleshooting ... 48 MiniOM measuring unit troubleshooting ... 49 MiniTPX measuring unit troubleshooting... 49 MiniPVX measuring unit troubleshooting ... 49 CPU board troubleshooting ... 49 Viewing device information... 49

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Service log files... 49 Viewing log files... 50 Downloading log files... 50 Messages related to gases measurement ... 51 Messages related to spirometry measurement ... 53 Messages related to gas exchange measurement ... 54 Messages related to servicing gas modules ... 55 Troubleshooting charts... 58 Troubleshooting CO2 measurement ... 58 Troubleshooting spirometry measurement... 59 Troubleshooting gas exchange measurement ... 60 6

Disassembly and reassembly...63 Disassembly guidelines ... 63 Serviceable parts... 63 Service limitations ... 63 ESD precautions ... 64 Protection from dust ... 64 Before disassembly ... 65 Required tools... 65 Disassembly procedures ... 65 Disassembly workflow ... 65 Detaching the front cover... 65 Detaching the module casing ... 66 Replacing planned maintenance parts ... 66 Replacing the CO2 absorber ... 68 Detaching the latch... 69 Detaching the front chassis unit ... 70 Detaching the main flow connector ... 72 Detaching the PVX unit ... 73 Detaching the pump ... 75 Detaching the OM holder... 75 Reassembling the module ... 77

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Service parts...79 Ordering parts ... 79

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Planned maintenance kits ... 79 Spare parts ... 79 Exploded view of Respiratory module chassis unit... 79 List of FRUs for Respiratory module chassis unit ... 81 Exploded view of Respiratory module ... 81 List of FRUs for Respiratory module... 82 List of FRUs for Respiratory module front covers... 83

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About this manual

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Intended use of this manual This manual contains instructions for the planned and corrective maintenance of the acquisition module. This manual must be used together with the monitor’s service manual for important safety and installation information. Use the manual as a guide for maintenance procedures and repairs considered field repairable. Where necessary the manual identifies additional sources of relevant information and technical assistance. See the monitor’s service manual for an overview of the patient monitoring system, information needed for system installation and for planned and corrective maintenance of the monitor. See the monitor’s supplemental information manual for the technical specifications, default settings and compatibility information, including electromagnetic compatibility. See the monitor’s user manual for the instructions necessary to operate the device safely in accordance with its function and intended use.

Intended audience of this manual This manual is intended for service representatives and technical personnel who maintain, troubleshoot, or repair this device.

Manual conventions This manual uses the following styles to emphasize text or indicate an action. Also note the terminology conventions.

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Item

Description

bold

Indicates hardware keys and connectors.

bold italic

Indicates menu options, software keys and messages.

italic

Indicates terms for emphasis.

>

Indicates menu options to select consecutively.

select

The word select means choosing and confirming.

supplemental information

In this manual, the phrase supplemental information refers to information that appears in the Supplemental Information Manual or supplements provided.

NOTE

Note statements provide application tips or other useful information. Respiratory Modules E-sCAiOVX, E-sCAiOV, E-sCAiO, E-sCOVX, E-sCOV, E-sCO

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About this manual

In this manual, the following product names are used as generic terms: ●

D-lite when referring to D-lite, D-lite+, and D-lite++

●

Pedi-lite when referring Pedi-lite and Pedi-lite+

●

D-fend Pro when referring to D-fend Pro and D-fend Pro+

Illustrations and names This manual uses illustrations as examples only. Illustrations in this manual may not necessarily reflect all system settings, features, configurations, or displayed data. Names of persons, institutions, and places and related information are fictitious; any similarity to actual persons, entities, or places is purely coincidental.

Related documents ●

CARESCAPE monitor’s service manual

●

CARESCAPE monitor’s user manual

●

CARESCAPE monitor’s supplemental information manual

●

Cleaning and Disinfecting Supplement

●

Supplies and Accessories Supplement

Product availability NOTE

Due to continual product innovation, design and specifications for these products are subject to change without notice.

Some of the products mentioned in this manual may not be available in all countries. Please consult your local representative for the availability.

Trademarks GE, GE Monogram, and CARESCAPE are trademarks of General Electric Company.

Third party trademarks All third party product and company names are the property of their respective owners.

Manufacturer responsibility GE is responsible for the effects on safety, reliability, and performance of the equipment only if:

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●

Assembly operations, extensions, readjustments, modifications, servicing, or repairs are carried out by authorized service personnel.

●

The electrical installation of the relevant room complies with the requirements of the appropriate regulations.

●

The equipment is used in accordance with the instructions for use.

●

The equipment is installed, maintained and serviced in accordance with the instructions provided in the related service manuals. Respiratory Modules E-sCAiOVX, E-sCAiOV, E-sCAiO, E-sCOVX, E-sCOV, E-sCO

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About this manual

WARNING

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SAFETY HAZARD. To avoid risks to personnel and patient, or damage to the equipment, only perform maintenance procedures described in this manual. Unauthorized modifications can lead to safety hazards.

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About this manual

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Module introduction Respiratory module introduction

This document provides information for the maintenance and service of the CARESCAPE respiratory modules, E-sCO, E-sCOV, E-sCOVX, E-sCAiO, E-sCAiOV, and E-sCAiOVX. The CARESCAPE Respiratory modules are single width plug-in modules. The CARESCAPE Respiratory modules provide airway and respiratory measurements Letters in the module name stand for: C = CO2 and N2O, O = patient O2, V = spirometry, X = gas exchange, A = anesthetic agents, and i = agent identification Options for CARESCAPE respiratory modules Modules

Parameters / measurements CO2

N2O

O2

E-sCOVX

X

*

E-sCOV

X

E-sCO

Anesthetic agents

Agent ID

Spirometry

Gas exchange

X

X

X

*

X

X

X

*

X

E-sCAiOVX

X

X

X

X

X

X

E-sCAiOV

X

X

X

X

X

X

E-sCAiO

X

X

X

X

X

X

* The E-sCO, E-sCOV, and E-sCOVX modules automatically compensate for N2O in realtime although N2O values are not displayed on screen.

Module compatibility For detailed information regarding module, monitor, and accessory compatibility, see the supplemental information provided.

About unpacking the module When receiving a new or recently serviced module from transport, remove the module from the package and let it remain in ambient air for 48 to 72 hours, if possible. Do not calibrate the module while waiting. The module is ready for use sooner if it successfully passes the calibration check. 2098086–006

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Module introduction

If the calibration check fails, CO2 may have been trapped inside the module during transport. In this case, do not try to calibrate the module until at least 72 hours have passed. NOTE

Typically, gas calibration is not required for received modules. They have already been calibrated either at the factory or at the service depot before shipping.

Airway gases equipment to patient connections with CARESCAPE respiratory modules

1.

CARESCAPE respiratory module

2.

Gas sample, gas sampling line connector on the water trap

3.

Gas sampling line

4.

Gas sampling line connector on the airway adapter; place the connector upwards

5.

Airway adapter with sampling line connector

6.

Heat and moisture exchanger with filter (HMEF) (optional when sampled gas is directed to the scavenging system)

Spirometry equipment to patient connection

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1.

E-sCOV, E-sCOVX, E-sCAiOV, E-sCAiOVX, or E-sCAiOVE module

2.

Gas sample, gas sampling line connector on the water trap

3.

Gas sampling and spirometry tubes

4.

D-lite/Pedi-lite sensor With D-lite++: the sensor design and position of the gas sampling line differ from the above figure. Respiratory Modules E-sCAiOVX, E-sCAiOV, E-sCAiO, E-sCOVX, E-sCOV, E-sCO

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5. 6.

Gas sampling line connector Heat and moisture exchanger with filter (HMEF)

NOTE

Place all D-lite ports upwards with a 25° to 35° tilt to prevent condensed water from entering the sensor interior and the tubings.

Controls and connectors Front of CARESCAPE Respiratory Module, E-sCAiOV, and the back of the module:

1. 2. 3. 4. 5.

D-fend Pro water trap Gas sample, sampling line connector on the water trap Water trap container Connectors for spirometry Gas exhaust, connector for the gas exhaust line (sampling gas out) There are two types of connectors as indicated in the following figure:

a. Module with Luer exhaust connector: use Luer gas exhaust lines. b. Module with GE custom exhaust connector: use GE gas exhaust lines.

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Module keys

Module

Description

Save Loop

E-sCOV, E-sCAiOV, E-sCOVX, and E-sCAiOVX

Save Loop saves a reference loop

Change Loop

E-sCOV, E-sCAiOV, E-sCOVX, and E-sCAiOVX

Change Loop changes a pressure/volume loop to a flow/volume loop or vice versa.

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Module introduction

Connector

Module

Description

D25 connector

all modules

Module bus connector

Spirometry module keys There are two keys on the CARESCAPE respiratory modules E-sCAiOV, E-sCAiOVX, E-sCAiOVE, E-sCOV, and E-sCOVX: Save Loop

Saves the currently active loop with corresponding numeric data.

Change Loop

Toggles between a Paw-Vol and a Flow-Vol loop.

Measurement principle CO2, N2O, and agent measurement MiniTPX is a side stream gas analyzer, measuring real time concentrations of CO2, N2O, and anesthetic agents (Halothane, Enflurane, Isoflurane, Desflurane, and Sevoflurane). The following illustrates the MiniTPX sensor principle:

Anesthetic agents or mixtures of two anesthetic agents are automatically identified, and concentrations of the identified agents are measured. MiniTPX also detects mixtures of more than two agents and issues an alarm. MiniTPX is a non-dispersive infrared analyzer, measuring absorption of the gas sample at seven infrared wavelengths, which are selected using optical narrow band filters. The infrared radiation detectors are thermopiles. Concentrations of CO2 and N2O are calculated from absorption measured at 3-5 µm. The following illustrates the absorbance of N2O and CO2:

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Identification of anesthetic agents and calculation of their concentrations is performed by measuring absorptions at five wavelengths in the 8-9 µm band and solving the concentrations from a set of equations. The following illustrates the infrared absorbance of AAs:

The measuring accuracy is achieved utilizing numerous software compensations. The compensation parameters are determined individually for each MiniTPX during the factory calibration.

O2 measurement The differential oxygen measuring unit uses the paramagnetic principle in a pneumatic bridge configuration. The signal picked up with a differential pressure transducer is generated in a measuring cell with a strong magnetic field that is switched on and off at a main frequency of 164 Hz. The output signal is a DC voltage proportional to the O2 concentration difference between the gas to be measured and the air reference. The following illustrates the O2 measurement principle:

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Module introduction

Spirometry measurement In mechanical ventilation, breaths are delivered to the patient by a ventilator with a proper tidal volume (TV), respiration rate (RR), and inspiration / expiration ratio in time (I:E) determined by the settings of the ventilator. Spirometry monitors patient ventilation.

Displayed volume parameters ●

Expiratory and inspiratory tidal volume (TV) in ml

●

Expiratory and inspiratory minute volume (MV) in l/min

●

Expiratory spontaneous minute volume in l/min

●

Inspiration/expiration ratio (I:E)

Displayed airway pressure parameters ●

Peak pressure (Ppeak)

●

Mean airway pressure (Pmean); available with ICU, NICU and ED software packages

●

End inspiratory plateu pressure (Pplat)

●

PEEPi, PEEPe; available with ICU, NICU and ED software packages

●

Total positive end expiratory pressure (PEEPtot); available with OR and PACU software packages

●

Real time airway pressure waveform (Paw)

●

Static Positive End Expiratory Pressures (Static PEEPi and Static PEEPe); available with ICU, NICU and ED software packages

●

Static Plateau pressure (Static Pplat); available with ICU, NICU and ED software packages

●

Static Compliance (Static Compl); available with ICU, NICU and ED software packages

PEEP, Ppeak, Pmean, and Pplat are measured by a pressure transducer on the MiniPVX board. Ambient pressure is used as a reference in measurement. The pressure measurement is made from the airway part that is closest to the patient between the patient circuit and intubation tube. 16

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PEEPi=intrinsic PEEP, PEEPtot-PEEPe Static pressure measurement maneuvers are automatically identified based on an increased zero flow period at the end of the inspiration or expiration. Static Compliance is calculated, if Static PEEP and Static Pplat measurements were made within a 2 minute period.

Displayed airway flow parameters ●

Real time flow waveform (V')

●

Compliance (Compl)

●

Airway resistance (Raw)

●

Pressure volume loop

●

Flow volume loop

The measurement is based on measuring the kinetic gas pressure and is performed using the Pitot effect. A pressure transducer is used to measure the Pitot pressure. The pressure signal obtained is linearized and corrected according to the density of the gas. Speed of flow is calculated from these pressure values and the TV value is then integrated. The MV value is calculated and averaged using TV and RR (respiratory rate) values.

D-lite Spirometry uses specific sensors called D-lite and Pedi-lite flow sensors. Different types of sensors are available: adult sensor for measuring adults and pediatric sensor for children. Both are available as reusable and disposable versions. D-lite and Pedi-lite adapters are designed to measure kinetic pressure by a two-sided Pitot tube. Velocity is calculated from pressure difference according to Bernoulli's equation. Flow is then determined using the calculated velocity. (from Bernoulli's equation)

Formula 1

where: V’= flow (l/min)

v = velocity (m/s)

A = cross area (m2)

dP = pressure difference (cmH2O

ρ = density (kg/m3)

Finally the volume information is obtained by integrating the flow signal.

Compliance and airway resistance Compliance is calculated for each breath from the equation Formula 2

Compliance describes how large a pressure difference is needed to deliver a certain amount of gas to the patient.

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Module introduction

The airway resistance, Raw, is calculated using an equation that describes the kinetics of the gas flow between the lungs and the D-lite. The equation states that the pressure at the D-lite can at any moment of the breath be approximated using the equation Formula 3

where P(t), V’(t) and V(t) are the pressure, flow and volume measured at the D-lite at a time t, Raw is the airway resistance, Compl is the compliance and PEEPe+PEEPi is the total positive end expiratory pressure (PEEPtot).

Gas exchange measurement The gas exchange measurement uses the D-lite flow sensor and the gas sampling system. The basic data which is needed to obtain O2 consumption and CO2 production are volumes and concentrations. Concentrations have been corrected for delay and deformation during the transport of the gas sample in a sidestream gas measurement sensor. To obtain the amount of O2 consumed in ml/min, the amount which is exhaled is subtracted from the amount that is inhaled. To obtain the amount of CO2 produced in ml/min, the amount which is inhaled is subtracted from the amount that is exhaled. These amounts can be obtained by multiplying each measured volume piece (dv) by the corresponding gas concentration: Formula 4

and Formula 5

Using inspiratory and expiratory minute volumes MVi and MVe and volume-weighted inspiratory concentrations fi and fe, these equations can be rewritten as: Formula 6 Formula 7

To obtain results which are less sensitive to errors in volume measurements, the so-called Haldane transformation is used. This means taking advantage of the fact that the patient is not consuming nor producing nitrogen: the amount of nitrogen inhaled is equal to the amount exhaled fiN2 x MVi=feN2 x MVe VO2 and VCO2 can then be written as: Formula 8 Formula 9

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with fHald = (1-fiCO2 – fiO2 – fiN2O - fiAne1 – fiAne2) / (1-feCO2 – feO2– feN2O - feAne1 – feAne2)

Main components of respiratory modules The respiratory modules consist of: ●

Gas sampling system

●

MiniTPX measuring unit

●

MiniOM measuring unit

●

MiniPVX measuring unit

●

CPU board

Gas sampling system The gas sampling system draws a 120ml/min sample from the patient's airway to the module. The sampling system also takes about 30ml/min flow of room air to the oxygen sensor. When the gas sensors are zeroed, room air is taken through the CO2 absorber to the gas sensors instead of the sampled gas from the patient's breathing. The gas sampling line is connected between the patient circuit and the Gas Sample port on the water trap. The water trap protects the sampling system and gas sensors from liquids and dust. The following diagram illustrates the gas sampling system:

The sampling system has a self diagnostics that detects disturbances in the gas flow, reveals the most common reasons for disturbances, such as occluded sampling line or blocked gas exhaust line, and communicates relevant status messages to the patient monitor.

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Module introduction

The system is designed so that the sampled gas will not flow from the sampling line back to the patient circuit. The parts and connections of the sampling system are streamlined for minimal dead spaces and turbulences in gas flows. All gas inputs of the module have dust filters protecting the sampling system and gas sensors. The water trap acts as a dust filter for the sampled gas and the module should always have the water trap connected. NOTE

It is very important to prevent dust from entering the open gas connections during service operations.

D-fend Pro water trap The gas sampling line is connected to the input of the water trap where a special membrane passes gases and vapors but stops liquids. The gas flowing through the membrane continues via the main flow connector of the water trap to the module. The main flow is about 90% of the sample flow. Liquids stopped below the membrane are moved to the water container by a side flow that goes through the water container and the water separation membrane before entering the side flow connector of the water trap. Thus, the side flow also is free of liquids when it gets into the module. In the module, the side flow is connected directly to the pump input and it does not enter the gas sensors. NOTE

The water trap acts as a dust filter for the sampling system and gas sensors. Thus, the module should always have the water trap connected.

Zero valve and CO2 absorber The zero valve is activated during gas sensor zeroing. Room air is drawn through the CO2 absorber and the zero valve to the gas sensors, and the main flow of sample gas is stopped. The zero gas comes to the sensors through the CO2-absorber that chemically absorbs CO2. The side flow of the water trap flows in the gas sampling line even during zeroing. During normal monitoring, the zero valve is not activated and the sampled gas gets through the zero valve to the gas sensors. The following illustrates the CO2 absorber:

Dehumidification tubes The dehumidification tube between the water trap and the zero valve equalizes the humidity of the sampled gas to ambient level. This will prevent calibration errors caused by the difference in humidities in the sampled breathing gas and the totally dry calibration gas.

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