Datex-Ohmeda Anesthesia Delivery Unit User`s

Transcription

Datex-Ohmeda
Anesthesia Delivery Unit
User’s Reference Manual
Conformity according to the Council Directive 93/42/EEC concerning Medical Devices
All specifications subject to change without notice.
Document No. 8501700-2
March 24, 2003
Distributor:
Manufacturer:
Datex-Ohmeda Division
Instrumentarium AB
Box 20109, SE-161 02 Bromma, Sweden
Tel. +46 8 555 22 100 Fax +46 8 555 22 101
www.datex-ohmeda.com
 Instrumentarium Corp. All rights reserved
Table of contents
Table of contents
About this manual
1
Related Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1
Safety
3
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
General Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
System Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Equipment Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Classification according to IEC 60601-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Classification according to IEC 529 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Classification according to the EU Medical Device Directive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Responsibility of the Manufacturer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ADU - Compliance with safety standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ADU Safety Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2
System description
9
Front view of the ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Rear view of the ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Rear connection panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Auxiliary mains outlets and gas supply inlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Gas delivery system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Vaporizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Anesthesia Delivery Unit without N2O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Anesthesia Delivery Unit with neutral color coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Parts of the ADU affected by the neutral color coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Ventilator bellows unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Bag-in-bottle principle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Breathing phases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Tidal volume compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Ventilator with compact patient circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Compact block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
Ventilator with Standard Patient circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
Module Frame Rack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Backup systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Battery backup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
Equipment safety symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
Other symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
Symbols for Datex-Ohmeda Compact Block with Compact Canister . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36
3
Assembly and preparations
37
Connecting gas and power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
Assembling ventilator bellows block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
i
Datex-Ohmeda ADU
Assembling the patient circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
Compact patient circuit description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
Standard Patient circuit description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Water traps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58
Bain and Jackson Rees breathing systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
Electronically controlled vaporizer and Aladin cassettes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61
Filling Aladin cassettes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Preparation for Patient SpirometryTM monitoring (Datex-Ohmeda monitors) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68
Selecting spirometry sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68
Connecting the spirometry sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
Sampling gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
4
System check
71
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
The System Check procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72
Performing a full System Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
Full System Check step by step . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
Performing separate checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
N2O delivery and hypoxic mixture control check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
Agent delivery check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76
AUTO ventilation check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
MAN ventilation check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
Checklog . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
Bypass check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81
Failed checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
Failed N2O delivery check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
Failed agent delivery check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
Failed AUTO Ventilation check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
Failed Manual ventilation check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86
Leak detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88
Leakage limits of ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88
System Check performed on an ADU without N2O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
5
Operating and adjusting the settings
91
ADU controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91
Display/keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92
Handling the menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95
Moving in menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95
Start of case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Reset of previous case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Fresh gas delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Fresh gas display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
O2, N2O and Air . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97
02 flush . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98
Anesthetic agent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99
Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100
CO2 absorber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100
Spontaneous ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101
Manual ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102
Controlled mechanical ventilation (Auto) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103
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Table of contents
Volume Controlled Ventilation, VCV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104
Synchronized Intermittent Mandatory Ventilation, SIMV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104
Pressure Controlled Ventilation, PCV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105
Ventilator settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
Measuring conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116
Sampling gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116
Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Set the screen layout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Set time and date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
Change Install settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Service menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124
End of case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Gas usage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Gas disconnection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Battery charge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
6
Alarms
127
Alarm Signals and Sequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127
Alarms and alarm limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
French and Japanese Version settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Oxygen failure alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Alarms setups and adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Adjust limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Default limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Cancel changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Alarm volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131
Audio On/Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Alarm history . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Silencing alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Silencing auditory alarms temporarily . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Disabling auditory alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Unexpected Reset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Display description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Recommended actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
7
Trends
135
Graphical trend pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Numeric trend pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Changing trend pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137
Trend cursor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Graphical trend length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Scales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Resetting trend data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .140
8
Cleaning and maintenance
141
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141
Cleaning and disinfection methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142
Intermediate level disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142
High level disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
iii
Datex-Ohmeda ADU
Disinfection frequency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
Disinfection methods table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .144
Patient circuit tubing, manual bag tubing & connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .145
Cleaning and disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .145
Compact Blocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .146
Compact Block I and Compact Block II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .146
Mechanical cleaning and disinfection in washer-disinfector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147
Manual cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
High level disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
Before reusing the compact block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152
Standard Circuit absorber and valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Canister assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Inspiration valve assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Expiration valve assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Disassembling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
Emptying condensed water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
The unidirectional valves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
Reassembling the absorber and valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155
Ventilator bellows assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157
Disassembling before cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157
Cleaning and disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161
Bellows and manual ventilation bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163
Aladin cassette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Storing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Sampling adapters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Sampling line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Recommended periodic maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Check and maintenance schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Health and safety declaration form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166
9
Troubleshooting
167
Leak detection and correction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167
Leakage limits of the ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167
Leakage during ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167
Patient circuit hoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168
Compact block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169
Standard Circuit valve and absorber assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169
Bellows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170
Bellows chamber positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170
Overflow valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172
Bellows block bottom plate gasket . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173
Manual bag and bag hose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173
Alarm messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
System status messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175
Electronic ventilator messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175
Electronic vaporizer messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176
Other messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177
iv
Table of contents
10 Technical specifications
179
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179
Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179
Environmental conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Electrical requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Electrical connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Gas delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Gas supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Fresh gas control unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Electronically controlled vaporizer and Aladin cassette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187
Electronic ventilator including bellows block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187
Patient breathing systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191
Scavenging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191
Vaporizer output graphs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Anesthetic agent concentration output . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
11 Glossary
197
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197
Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
Anesthesia machine vocabulary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
12 Appendices
205
Appendix A – Compressible volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Compensation for compressible volume in the delivery system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
13 Brief instructions
207
Datex-Ohmeda ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Front view of the ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Preparing the ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
Daily System Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Setting alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .211
Adjusting fresh gas delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .212
Returning sampled gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213
Starting ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213
Monitor integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .215
Disinfection methods table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .216
Index
217
v
Datex-Ohmeda ADU
vi
About this manual
About this manual
This User’s Reference Manual describes all necessary functions for the safe use of the Datex-Ohmeda
S/5 Anesthesia Delivery Unit (ADU) and AS/3 ADU from S/N: 40 000 000 and onwards. Some of the
described functions may work in alternative ways. In those cases the alternatives are described. Be
sure to follow the relevant description.
In this manual, both the S/5 ADU and the AS/3 ADU will be referred to as “ADU” only.
Before using your ADU, please read this User’s Reference Manual thoroughly. Pay special attention to
WARNINGS and CAUTIONS.
Information about the terms used throughout the manual is found in chapter 11, Glossary.
Design of anesthetic system is largely controlled by relevant international or regional standards.
Depending on the area in which the system will be used, IEC (international), ASTM (US), or other
standards may apply. In this User’s Reference Manual the pictures and text refer to an ADU designed
according to IEC standards.
Related Documents
User’s Guide, UG
The “User’s Guide“ describes the most common features and functions for the use of the equipment.
The Guide is intended to be a complement to the reference manuals and support the user in the daily
work. The guide has a table of contents, index and tabs with headings for a quick and easy way to find
desired information.
Cleaning Instructions Poster
The “Cleaning Instructions Poster” describes how to clean the most common parts of the equipment.
The poster is a complement to the User’s Reference Manual and the User’s Guide.
Technical Reference Manual, TRM
The “Technical Reference Manual” contains information required to service and repair the
equipment. It is intended for service personnel and engineers who have been trained to perform
maintenance procedures.
Related clinical information
For related clinical information, refer to the following documents:
•
•
•
•
•
Quick Guide, Patient Spirometry
Appliguide, Patient Spirometry
Appliguide, Patient Oxygen
Appliguide, First Steps in CO2 Monitoring
Appliguide, Optimizing low and minimal flow anesthesia
Monitoring functions are explained in more detail in:
•
•
Datex-Ohmeda S/5 Anesthesia Monitor User’s Reference Manual
Capnomac Ultima Operator’s Manual
Conventions used
Names of touch keys are entered in a larger and bold typeface, for example Setup.
Software menu items are entered in bold italic typeface, for example Gas Usage.
1
Datex-Ohmeda ADU
Menu access is described from top to bottom. For example, the selection of the Screen Layout menu
item and the CO2 Setup menu item below would be written as Screen Layout-CO2 Setup.
Messages (alarm messages, informative messages) displayed on the screen are entered inside
single quotes, for example ‘PEEP high’.
When referring to different documents, sections or paragraphs, the name is entered in italic typeface
and enclosed in double quotes, for example “User’s guide”.
Trademarks
Datex®, Ohmeda® and other trademarks S/5, AS/3, CS/3, D-lite, D-lite+, Pedi-lite, Pedi-lite+,
D-fend, D-fend+, MemCard, ComWheel, PatientO2, Patient Spirometry and Tonometrics, are
property of Instrumentarium Corp or its subsidiaries. All other product and company names are
property of their respective owners.
2
1 Safety
1 Safety
Intended Use
The Anesthesia Delivery Unit (ADU) is intended for administration of anesthetic breathing gas and
manual or mechanical ventilation for patients undergoing anesthesia. It is intended for all patient
categories.
General Requirements
The ADU must only be operated by qualified Anesthesia personnel, and it must be connected to
mains electrical power and gas supplies which meet the requirements specified in section 10 Technical Specifications. The ADU is not MRI compatible.
Warnings and Cautions
Throughout this manual, a WARNING indicates a hazardous situation which - if not corrected - may
result in patient injury or death. A CAUTION indicates a situation in which the ADU or devices
connected to it, may be damaged.
Any WARNINGS or CAUTIONS in the text of this User’s Reference Manual, are placed in such a way
that they are clearly identifiable with the relevant situation.
WARNING
The ADU is only to be operated by, or on the order of a physician.
WARNING
The constant attention of qualified personnel is required whenever a patient is
under anesthesia and connected to the ADU.
WARNING
To prevent hazards arising from incorrect delivery of gases, the ADU shall always
be used with the following monitoring:
WARNING
•
O2 monitor according to ISO 7767/EN 12598
•
•
Agent monitor according to ISO 11196/EN ISO 11196
CO2 monitor according to ISO 9918/EN 864
•
Expired volume monitor according to IEC 60601-2-13/EN 740
Hazard related to explosion, fire, and burns. To avoid the risk of explosion, fire, or
burns, the following precautions must be observed:
•
•
•
Flammable anesthetic gases such as ether and cyclopropane must not be
used with this workstation. Only agents which comply with the requirements
for non-flammable anesthetic agents according to IEC 60601-1, shall be
used.
There is always a risk wherever anesthetic agents are used and handled. Do
not use the ADU in insufficiently ventilated areas, thus avoiding raised
concentrations of anesthetic agents in operating rooms. Use gas scavenging
at all times.
As this workstation is not to be used with flammable anesthetic agents, the
use of antistatic breathing tubes and face mask is not recommended. Burns
3
Datex-Ohmeda ADU
•
•
WARNING
Electric shock hazard. To avoid the risk of electric shock hazard, the following
precautions must be observed:
•
•
•
•
WARNING
may occur if antistatic or electrically-conductive breathing tubes are used
while high-frequency electric surgery equipment is in use.
High pressure or pure oxygen may cause explosion or burn strongly when
reacting with organic material such as lubricants, paint, greasy fingerprints,
dirt, dust fluff, and other organic waste.
No oil, grease, or silicone-based lubricants must be used. Only PTFE-based,
oxygen compatible lubricants are allowed.
In order to reduce the risk arising from excessive leakage currents, and in
accordance with EN 740, an anesthetic workstation shall not be provided
with more than four operator accessible auxiliary mains socket outlets. The
connection of equipment to auxiliary mains socket outlets may increase the
patient leakage currents to values exceeding the allowable limits in the
event of a defective protectice earth conductor.
Always unplug the electric power cord before cleaning or maintenance of the
ADU
When cleaning the exterior - make sure that no liquid enters the interior of
the ADU.
Do not autoclave any part of the ADU system except those specified in this
manual, with steam or ethylene oxide.
Do not connect external equipment to the ADU system other than those specified
by Datex-Ohmeda. (Also see the Installation section in the Datex-Ohmeda ADU
Technical Reference Manual).
Electromagnetic compatibility (EMC)
Most medical electrical devices emit electromagnetic radiation disturbances which may interfere
with other equipment used in their vicinity. Likewise, most electrical medical devices are susceptible
to electromagnetic disturbances. The ADU has been designed such that it does not emit electromagnetic radiation disturbance levels exceeding the limits specified in IEC 60601-1-2, and in order to
ensure the safe function of the device, it is important that it operates in an electromagnetic environment which complies with the requirements of IEC 60601-1-2. Mobile telephones and other equipment which emit radiated fields, should be switched off in the vicinity of the ADU.
CAUTION
The function of this machine may be adversely affected by the operation of equipment
such as high frequency surgical apparatus or short-wave therapy equipment in the
vicinity.
CAUTION
The function of this anesthetic workstation or module, as applicable, may be
adversely affected by electromagnetic interference exceeding the levels specified in
IEC 60601-1-2.
4
1 Safety
System Safety
When the ADU is used together with, or connected to other equipment, it is important that the whole
system complies with the safety requirements of IEC 60601-1-1: Safety requirements for medical
electrical systems. Compliance with IEC 60601-1-1 means that any other equipment forming part of
the system, should meet the requirements of IEC 60601-1. The use of an extra isolation transformer
may also be considered. Please contact your local technical service personnel to verify system safety.
CAUTION
In order to prevent overheating of the ADU while in operation, sufficient space should
be left around the machine.
Equipment Classification
Classification according to IEC 60601-1
CLASS I EQUIPMENT according to the type of protection against electrical shock.
TYPE B equipment according to the degree of protection against electrical shock.
EQUIPMENT not suitable for use in the presence of a FLAMMABLE ANESTHETIC MIXTURE WITH AIR or
with OXYGEN or NITROUS OXIDE.
CONTINUOUS OPERATION according to the mode of operation.
Classification according to IEC 529
Degree of protection against ingress of water as detailed in IEC 529: IPX1
Classification according to the EU Medical Device Directive
The Datex-Ohmeda Anesthesia Delivery Unit is classified as IIb.
5
Datex-Ohmeda ADU
Responsibility of the Manufacturer
The Datex-Ohmeda Division, Instrumentarium Corp. is responsible for the effects on safety, reliability
and performance of the equipment only if:
•
Personnel authorized by Datex-Ohmeda carry out assembly, operations, extensions,
readjustments, modifications, periodical service or repairs.
•
•
The electrical installation of the relevant room complies with the appropriate requirements.
The equipment is used in accordance with this User’s Reference Manual.
ADU - Compliance with safety standards
With the deviations listed below the ADU complies with the following standards:
• IEC 60601-1:1988 - General requirements for safety
• IEC 60601-2-13:1998 - Particular requirements for the safety of anaesthetic workstations
• EN 740:1998 - Anaesthetic workstations and their modules - Particular requirements
• ISO 8835-3:1997 - Inhalational anaesthesia systems - Anaesthetic gas scavenging systems Receiving and transfer systems
NOTE: Units sold in Canada also comply with CSA standards 601.1 and 601.2.13
Deviations
6
Standard
Deviation
EN 740
Cross connection between the ventilator port and the reservoir bag port is
prevented by means of incompatible connectors and not by labelling.
EN 740 and
IEC 60601-2-13
With an active scavenging ejector in combination with extreme inspiratory flow
settings the time-weighted average input flow required by the ADU for each
gas type may exceed 60 l/min at a pressure of 280 kPa (41 psi) measured at
the gas inlet port.
ISO 8835-3
The resistance to extract flow of the transfer and receiving system is 29
cmH2O at 25 l/min (required max 20 cmH2O).
1 Safety
ADU Safety Features
The safety features listed below are incorporated in the Anesthesia Delivery Unit.
Gas supply
• O2, N2O and Air supply failure alarm
• Overpressure limitation for wall inlets O2, Air and N2O at 900 kPa (130 psi)
Gas mixer
• Electronic O2/N2O/AA ratio control and N2O cut-off
• Automatic switching from N2O to Air if N2O pressure is lost
Vaporizer: Aladin Cassette
• Overfilling protection
• The Desflurane cassette is equipped with a special over-pressure relief valve.
• Automatic cassette identification
• Prevents delivery of more than one agent at a time
• Automatic vaporizer shut-off
- in case fresh gas flow is lost
- in case cassette is removed
Ventilator
• With loss of primary ventilator driving gas (Air or O2) automatic switch to the
secondary driving gas. (O2 or Air)
• Visible rising bellows allow fast and easy leakage detection
• Adjustable maximum pressure release in AUTO mode (mechanical ventilation),
Pmax Release with automatic switch to expiration
• Overpressure release valve in fresh gas outlet at 80 cmH2O
• Single switch operation of the ventilator
• High pressure alarm in the breathing system
• Low pressure alarm in the breathing system
• Sustained pressure alarm
• APL valve in the manual breathing circuit
Datex-Ohmeda Compact
Patient circuit (optional)
• Absorber locking mechanism allows easy canister/absorber replacement during
operation.
• Clearly visible absorber canister and vertical one-way valves
Other safety features
• Mains power failure alarm
• Full battery back up for 20 minutes *)
• Optional reserve gas cylinders
*) NOTE: The backup battery supplies power only to the ADU, not to the patient monitor unless outfitted with a UPS
system.
7
Datex-Ohmeda ADU
8
2 System description
The Anesthesia Delivery Unit is designed to mix and dose respiratory gases and to ventilate the
patient.
The delivery unit is the basis for a flexible anesthesia system with full monitoring and data
management capabilities.
The ADU anesthesia system enables you to design an optimal system for each operating room by
adding or interchanging modules. Additionally, it is designed to include future products.
9
Datex-Ohmeda ADU
Front view of the ADU
6
5
7
4
8
3
9
10
11
12
2
17
13
14
1
15
16
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Fresh gas outlet (Optional gas flow
indicator)
Compact patient circuit
Ventilator bellows block
Fresh gas flow controls
Setup keys
ADU LCD display
Ventilator “quick” function keys
Anesthesia Monitor (optional LCD display)
ComWheel
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
Aladin Vaporizer Cassette
Agent wheel
Switch for On / Standby
Anesthesia Monitor central unit and
modules (option)
Vaporizer cassette storage slots (optional)
Drawers (optional)
O2 flush button
O2 flush button (early version)
NOTE: The ADU can be used with a 10.4” display. See “Display/keys” on page 92 for further
information.
10
Rear view of the ADU
4
3
2
1
5
1
(1)
(2)
(3)
(4)
(5)
Auxiliary gas and vacuum outlets (optional)
Cylinder yokes (optional)
Auxiliary mains outlets (optional)
Gas supply and scavenging connectors
Scavenging ejector (optional) or scavenging flow indicator (optional)
11
Datex-Ohmeda ADU
Rear connection panel
1
3
4
2
5
6
(1)
(2)
(3)
(4)
(5)
(6)
12
Product labels. Contains information on type of device, Serial No. (S/N), year of manufacture
and electrical requirements.
ADU mains power cord (or connection cord for box of Auxiliary Mains Outlets).
Auxiliary main outlets
Mains fuses to Auxiliary main outlets (two fuses per outlet)
Auxiliary Mains Outlets box
Potential Equalization Terminal
Auxiliary mains outlets and gas supply inlets
The three mains socket outlets are reserved for monitors and other electrical devices mounted on the
ADU.
WARNING
In order to reduce the risk arising from excessive leakage currents, and in
accordance with EN 740, an anesthetic workstation shall not be provided with
more than four operator accessible auxiliary mains socket outlets.
1
2
4
Figure 1
Auxiliary main outlets
Figure 2
Scavenging ejector with indicator
(1)
(2)
(3)
5
Gas supply connectors
7
6
Figure 3
3
Figure 4
Scavenging flow indicator
Nitrous oxide inlet
Air inlet
O2 inlet
(4) Gas scavenging outlet (EVAC)
(5) Vacuum outlet (optional)
Each connector is designed to be coupled to its corresponding hose. The connectors and hoses are
color-coded.
(6) Optional - Built-in scavenging ejector with indicator. Max. flow is achieved by adjusting the flow
ejector knob according to the indicator response.
(7) Optional - Built-in scavenging indicator.
13
Datex-Ohmeda ADU
Gas delivery system
EVAC
Outlet
Bellows
unit
Manual
bag
Driving gas
Ventilator
Patient
circuit
O2
Flush
Fresh gas
outlet
Gas
inlets
O2
Fresh gas
control unit
Air
N2O
Extra
gas
outlets
Pressure gauges
Reserve gas
cylinders
Figure 5
Gas system diagram
The gases, O2, Air and N2O, are supplied to the Fresh Gas Control unit from the ADU gas inlets. Air and
O2 are also supplied to the ventilator unit.
The optional reserve gas cylinders supply both the ventilator unit and the Fresh Gas Control unit. (The
gas combinations and number of cylinders can vary.)
When the O2 Flush button is pushed, 100 % O2 is flushed directly to the fresh gas outlet, to which the
patient circuit is connected.
Depending on which sypply is used, the pressure gauges show either the pressure from the pipeline
supply system or the regulated cylinder pressure. There is also a pressure gauge mounted for each
cylinder, which shows the actual cylinder pressure (before it is regulated).
The Fresh Gas Control unit mixes supply gases and dosages the anesthetic agent and distributes the
mixture to the fresh gas outlet.
During the AUTO ventilation the driving gas from the ventilator is used to push the breathing gas into
the patient. During Manual ventilation the operator manually ventilates the patient with a bag.
Waste gases from the breathing system are transferred to the EVAC outlet. Gas can also for security
reasons be evacuated directly to the EVAC outlet from the Fresh Gas Control unit.
14
Vaporizer
The electronically controlled Datex-Ohmeda Vaporizer consists of two parts: the internal electronic
control unit and the Aladin Agent Cassette.
The Aladin agent cassette is the liquid container. The agent cassettes are color-coded for each
anesthetic agent. The cassettes are also magnetically coded so that the ADU can identify the inserted
anesthetic agent cassette.
Figure 6
Aladin cassette
The electronic control unit governs the flow through the agent cassette and the agent concentration in
the fresh gas flow.
1
P
AA O2 N2O
O2 N2O
2
P
3
P
T
6
5
4
Figure 7
Anesthetic agent delivery flow diagram
Measurement part
(1) Bypass flow
(2) Flow through the cassette
(3) Cassette pressure
(4) Cassette temperature
Agent control
(5) Agent setting
(6) Control valve
15
Datex-Ohmeda ADU
Anesthesia Delivery Unit without N2O
An ADU configured to operate without the use of N2O, has a locking device between the N2O flow
control and the Air/N20 switch. The Air/N2O switch cannot be rotated and only O2 and Air can be
used.
Figure 8
Fresh gas flow controls with locking device
The screen layout and some menus will differ when you are using the ADU without N2O. This
especially applies to the System Check menu. The System Check has been modified so it can pass
without the use of N2O. For further information see “System Check performed on an ADU without
N2O” on page 89.
Figure 9
Display when using an ADU without N2O
The fresh gas field “% N20 in fresh gas” will display OFF, and Air will automatically be made to flow
together with O2.
16
Anesthesia Delivery Unit with neutral color coding
Whereas the majority of countries within Europe apply ISO 32 for color coding of medical gases and
connection systems, some countries, for example Germany, Austria, Hungary and Switzerland, have
been using country-specific color coding. In order to harmonize the situation among member
countries it has been agreed that as of July 1, 2006, only color coding according to ISO 32 shall be
applied throughout EU. During the transitional period, countries using a different color coding system
are recommending the use of "neutral color coding". Datex-Ohmeda has decided to use the color
black as "neutral color". It should also be pointed out that according to applicable safety standards
color coding of gases and connection systems is always optional, only the gas name or chemical
symbol is mandated.
Parts of the ADU affected by the neutral color coding
Front of ADU
On the front of the Anesthesia Delivery Unit, the fresh gas flow controls, the pressure gauges and the
O2 flush have neutral color coding. On the ADU display the gases are presented in neutral color in the
fresh gas field.
NOTE: On the fresh gas flow controls and the pressure gauges the English word “Air“ is used as a
symbol for air. When presented in the fresh gas field on the display the translated term is used.
Figure 10
Fresh gas flow controls with neutral color
1
2
Figure 11
Pressure gauges (1) and O2 flush (2) with neutral color
17
Datex-Ohmeda ADU
NOTE: On earlier versions of the ADU the O2 flush is placed on the front panel, to the left of the
pressure gauges.
Figure 12
Fresh gas field with neutral color
Wall Gas Unit, A-WGU
The neutral color can be found on the labels on top of gas supply connectors.
Figure 13
Gas supply connectors with neutral color
Neutral color coding is used on the auxiliary outlet connectors (O2/Air/Vacuum), as well as on the
labels next to the outlets.
Figure 14
18
Auxiliary gas and vacuum outlets with neutral color
The optional cylinder yokes are marked with labels in neutral color.
The type and the number of cylinder yokes can vary.
Figure 15
Auxiliary outlet and cylinder yokes (DIN type) with neutral color
A neutral color label can also be found on the optional scavenging ejector with indicator.
NOTE: On labels the English word “Air“ is used as a symbol for air and the English abbreviations
“EVAC” and “VAC” are used for scavenging and vacuum respectively.
19
Datex-Ohmeda ADU
Ventilator
The ventilator consists of the electronic control unit and the bellows unit. The electronic control unit is
situated behind the ADU main display.
Pressurized gas, either Air or O2 powers the ventilator. One of these gases is the primary driving gas. If
the primary driving gas is lost, the ADU automatically switches to the other driving gas.
Ventilator bellows unit
6
5
7
4
PicAdu0154
3
2
1
11
Figure 16
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
20
10
8
9
Auto / Manual selector
Chamber locking handle
Bellows block
Overflow valve
Bellows chamber
Bellows
Bellows base
APL valve
Manual bag quick connector
Occluder cone
Patient circuit connector
Bag-in-bottle principle
The ADU ventilator uses the Bag-In-Bottle principle with a standing bellows. This means that the
driving gas, which is compressed Air or O2, is separated from the fresh gas to the patient and from the
patient’s expiratory gas.
During inspiration the driving gas passes into the pressure chamber, compresses the bellows,
thereby pushing the gas inside the bellows into the patient circuit.
(See sequences 1 and 2 below.)
The increased pressure is due to the flow either from the ventilator during mechanical ventilation or
from the manual bag when it is squeezed during manual ventilation.
During expiration the driving gas escapes from the pressure chamber into the atmosphere. The
bellows is filled with the expiratory gas. (See sequences 3 and 4 below)
The standing bellows system maintains a small positive pressure (2 to 3 cmH2O) in the circuit.
Expiration
Inspiration
1.
2.
4.
3.
Driving
gas
Patient
Figure 17
Driving
gas
Patient
Bag-in-bottle ventilator principle
21
Datex-Ohmeda ADU
Breathing phases
Inspiration phase - gas flow diagram
3
4
5
6
1
(1)
(2)
(3)
(4)
(5)
(6)
22
2
Fresh gas hose
Ventilator driving gas
Rubber membrane & metal lid
To EVAC
To Patient Circuit
Expiration phase - gas flow diagram
3
4
5
6
1
(1)
(2)
(3)
(4)
(5)
(6)
2
Fresh gas hose
Ventilator driving gas
Rubber membrane & metal lid
To EVAC
From Patient Circuit
23
Datex-Ohmeda ADU
Tidal volume compensation
Independent of gas composition, the ADU compensates for the fresh gas inflow during inspiration, as
well as for the compressible volume of the patient circuit - thus securing set tidal volume (TV) to the
patient.
•
•
•
Compressible volume in the patient circuit (compliance) is measured during the System Check.
The fresh gas flow is measured continuously.
The Tidal Volume required by the bellows is calculated.
Set TV (1) = TV bellow (2) + Fresh gas flow (3) - Circuit compressed volume (4) = Patient TV (5)
1
2
5
Figure 18
4
3
Tidal volume compensation
See Section 12, Appendix A for more information.
24
Ventilator with compact patient circuit
10
11
9
8
7
6
Figure 19
5
4
3
2
1
(1)
12
Figure 20
Fresh gas flow indicator
Fresh gas supply connection (Common gas
outlet)
(2) Circuit boom
(3) Ventilation hose
(4) Compact Block II
(5) Valves for inspiration and expiration
(6) Locking/releasing latch for absorber canister
(7) Manual ventilation bag with hose
(8) Inspiration and expiration hoses with Y-piece
(9) Cable management arm
(10) Absorber canister
(11) Bellows block
(12) Fresh gas flow indicator (optional)
25
Datex-Ohmeda ADU
Compact block
Gas flow within the compact block and the Single Use Absorber. The compact block may be used
without an absorber. There are two different compact blocks; the Compact Block I and the Compact
Block II.
Compact Block I
Exp
Exp
Insp
Insp
Figure 21
Inspiratory flow
Figure 22
Expiratory flow
Fresh gas flow inlet
Bellows connection
Exp
Expiration connector
Insp
Inspiration connector
Figure 23
26
Inspiratory flow without
absorber
Compact Block II
Water trap
Figure 24
Inspiratory flow
Figure 25
Expiratory flow
Bellows connection
Water trap
Figure 26
Inspiratory flow without absorber
27
Datex-Ohmeda ADU
Ventilator with Standard Patient circuit
NOTE: The “Standard Patient circuit” is an early version which has been replaced by the “Compact
Patient circuit”.
8
7
5
O
9
10
4
6
3
Figure 27
2
1
Standard Patient circuit
(1)
11
Figure 28
28
Fresh gas flow indicator
Fresh gas supply connection (Common gas
outlet)
(2) Circuit boom
(3) Patient circuit block
(4) Absorber canister (one or two)
(5) Inspiratory valve
(6) Expiratory valve
(7) Inspiratory and expiratory hoses with Y-piece
(8) Manual ventilation bag
(9) Bellows block
(10) Ventilation hose
(11) Fresh gas flow indicator (optional)
Module Frame Rack
The rack that holds the modules may - as an option - be moved to either of two positions. An outer
position to make the modules more accessable and an inner position when accessability is less
important. The rack moves on rails and is locked in both positions.
To move the module rack from its inner position into outer position:
1. Unlock by pushing both latches outwards. At the same time, pull the rack outwards. As soon as
the rack has moved a bit - let go of the latches.
2. Move the rack all the way into outer position. The locking device will “click” into operation when
the rack is in proper position.
To move the rack from the outer position into inner position:
•
Unlock, move and lock the rack in a corresponding manner to what is described above.
29
Datex-Ohmeda ADU
Monitoring
The Anesthesia Delivery Unit is compatible with the Datex-Ohmeda Anesthesia Monitor and the
Datex-Ohmeda Capnomac Ultima.
The interfaced values may be displayed in the optional field in the middle of the screen. The CO2
waveform may be configured in the second waveform field.
NOTE: When, due to a mains power failure, the ADU runs on power from its internal battery, everything
except the AM (optional) monitor will function.
WARNING
•
•
•
Integration of following Datex-Ohmeda
monitors
Information transferred to the ADU
Anesthesia Monitor
CO2 waveform with Et/FiCO2, RR (MAN only),
Exp. minute volume and tidal volume numerics,
O2, N2O, CO2 and AA numerics
Capnomac Ultima
as above
Installation is described in the Installation section in the ADU Technical Reference Manual.
The Anesthesia Monitor Central Unit may be installed in the cabinet below the desk. The video display
as well as the Capnomac Ultima, are preferably placed on the top shelf.
NOTE: The power at the auxiliary electrical outlets is always available when the delivery unit is
connected to the mains supply but unavailable when the unit is running on battery power.
30
Backup systems
Battery backup
The Anesthesia Delivery Unit is a mains operated device with battery back up. The batteries are
activated when the power cord is not connected, or when the mains power (wall outlet source) is lost
during operation. The batteries are also activated in the case of mains over-voltage. When the mains
power is lost, the power failure alarm is immediately activated. A green light above the On/ Standby
switch indicates that the mains power is connected.
NOTE: The battery should be periodically replaced. See the ADU Technical Reference Manual for more
details.
NOTE: The power at the auxiliary electrical outlets is always On when the delivery unit is connected to
mains voltage and Off when running on the battery.
Battery capacity
The internal battery capacity is at least 20 minutes with fully charged batteries. A symbol on the
monitor display indicates the remaining battery capacity. When about 30 seconds remains of battery
operating time, a HIGH priority alarm message “Battery Empty Go Manual” is activated.
Figure 29
Remaining battery capacity
When the battery is empty a “battery empty” symbol is displayed for 30 s before the ADU is
automatically shut off.
Empty
Figure 30
Battery empty symbol
Charging
The battery is automatically charged when the ADU is connected to mains power. If the batteries are
not fully charged, a “charging symbol” is displayed to indicate that the specified battery operation
time is not available. Charging an empty battery takes approximately 4 hours.
Charge
Figure 31
Battery charging symbol
NOTE: If the ADU is stored more than two months it is recommended to connect the ADU to the mains
supply to let the batteries become fully charged.
Checking battery condition
1.
Disconnect the power cord from the mains power supply outlet and check that the ADU is
running on battery power. Check that a battery symbol with a green bar appears in the upper
right corner of the screen. (The green bar indicates the remaining battery capacity).
31
Datex-Ohmeda ADU
2.
If the batteries are discharged, they should be charged for at least 4 hours by keeping the power
cord connected to the mains outlet. The ‘Charge’ battery symbol should then disappear from
the message screen.
NOTE: The batteries are always recharged when the mains plug is connected and the green light lit on
the front panel.
Fresh gas supply
If N2O pressure is lost during operation, the ADU automatically switches from N2O to Air
independently of the front panel selector position. The following alarm message is displayed:
“N2O supply pressure lost” and “Air selected”
If the supply pressure for O2 and/or Air is lost the following alarm message is displayed:
“O2 supply pressure loss” or “Air supply pressure loss” *
* If Air is used as primary driving gas
When no wall mounted gas supply is available; gases can be supplied from reserve gas cylinders.
The unit can be equipped with up to 3 reserve gas yokes. The corresponding number of pressure
gauges is added to the front of the unit when the unit is equipped with reserve gas yokes.
N2O
32
O2
Figure 32
Reserve gas yokes (DIN type)
Figure 33
Reserve gas yokes (Pin type)
Check daily the gas cylinder pressure. To avoid gas escaping accidentally, always remember to keep
the cylinders closed when wall gases are used.
Figure 34
CAUTION
Reserve gas cylinder
Be aware that the reserve gas cylinders will be emptied more quickly if the auxiliary
gas outlets are used.
Driving gas
The primary driving gas is either Air or O2. If the driving gas pressure is lost, the ADU will automatically
use the auxiliary driving gas. When the driving gas is switched, the message “Driving gas to:
Secondary” is displayed. When the primary driving gas is restored the message disappears.
If the pressure of both the primary and secondary driving gases is lost the message “Loss of driving
pressure” appears.
WARNING
Patient oxygen may be exhausted very quickly if the ventilator driving gas is
oxygen and this gas is supplied from a reserve gas cylinder.
33
Datex-Ohmeda ADU
Symbols
Equipment safety symbols
Attention, consult accompanying documents.
When this symbol is displayed beside the monitored O2 value, the FiO2 low alarm limit
is set below 21 %.
This symbol on the rear panel means the following warnings and cautions:
• Electric shock hazard. Do not open the cover or the back. Refer servicing to
qualified personnel.
• For continued protection against fire hazard, replace only with same type and
rating of fuse.
• Disconnect power supply before servicing.
Type B (IEC-601-1) protection against electrical shock.
IPX1
Degree of protection provided by enclosure according to the IEC 529: Vertically falling
water drops shall have no harmful effects.
Silence alarm indicator
Other symbols
Power On
Stand-by
Variability
Rotation in two directions
O2 flush
Flow direction
• * Silence alarms
• * Alarm silenced for given time
• * All alarms silenced
Remaining battery capacity
34
Empty
Charge
Battery empty symbol
Battery charging symbol
Protective earth
Battery
Alternating current
Fuse
SN, S/N
Serial Number
Sub menu. Choosing an alternative with this symbol in a menu opens a new
menu.
Potential equalizer
Bellows connection
Do not expose the bellows chamber to sideforce. Keep free from gastubes,
cables etc. Sideforce or impact on the chamber may create a leak in the
ventilator bellows drive circuit.
Oxygen
Nitrous oxide
Air
35
Datex-Ohmeda ADU
Symbols for Datex-Ohmeda Compact Block with Compact Canister
Bellows connection
Gas flow direction
2
Single use
36
3 Assembly and preparations
WARNING
Do not operate the machine outside the specified working temperature range
(+10°C to +35°C) and specified operating humidity 0 to 85% (non-condensing
conditions). If the ADU is colder or warmer than the specified operating
temperature, let the ADU temperature stabilize for at least 4 hours before use.
WARNING
Always use adequate means for monitoring that is appropriate for the particular
patient category.
Connecting gas and power supply
1.
2.
3.
4.
5.
6.
Connect the color-coded gas supply hoses to the wall outlets.
Confirm the availability of sufficient pipeline and/or cylinder gas supply pressures (270 to 800
kPa/ 39 to 116 psi) from the pressure gauges on the front panel.
If your machine is equipped with gas cylinder(s) these should normally be turned off. Cylinders
should be opened only in the event of a loss of wall supply pressure.
Estimate the amount of gas remaining in the cylinder and make sure you have a sufficient
reserve at your disposal.
Connect the power cord to the power supply outlet.
To start the ADU - set the On/Standby switch on the front panel to On.
CAUTION
Before connecting the power cord to the power supply outlet; check that the local
voltage and frequency matches those stated on the ID label on the rear panel.
CAUTION
Before any connection on the rear panel - set the On/Standby switch in standby
position.
CAUTION
On units operating on 100 to 120 V, the sum of current from any devices connected to
the auxiliary electrical outlets must not exceed 8 A.
37
Datex-Ohmeda ADU
Assembling ventilator bellows block
1.
Assemble ventilator bellows block:
−
Make sure the locking handle (1) is in open position (pull outwards).
−
Check that the selector switch (2) is in the position ”Manual”.
−
Place the bellows block (3) on the bottom plate (4).
3
2
1
4
Figure 35
38
Bellows block inserted into the bottom plate
2.
WARNING
Assemble the bellows block overflow valve:
-
Place the rubber membrane over the valve duct.
-
Feel with the finger (wear gloves) along the edge to
make sure that the groove on the outer rim of the
membrane sits tightly on the outside wall of the duct.
-
Check the tightness by lifting the membrane by the
metal weight. The membrane should flex upwards
slightly but not disconnect from the edges.
-
Reassemble the overflow valve by entering (1) and
then turning (2) the valve retaining ring. Be careful not
to tighten it too tightly, as the membrane may become
kinked and prone to leak.
1
2
If the overflow valve is placed incorrectly with the metal part facing downwards,
the pressure in the patient circuit may not be sufficient to guarantee adequate
patient ventilation.
39
Datex-Ohmeda ADU
3.
40
Carefully stretch the mouth of the bellows over and around the edge of the bellows base.
4.
Insert and lock the bellows chamber.
−
Make sure that the handle (3) of the chamber locking mechanism is in extended
(unlocked) position. Insert (1) the bellows chamber into the bellows base.
−
Turn (2) the bellows chamber clockwise until it stops. Check that the chamber bayonet
tabs are aligned with the metal locking ring indent. The chamber should stand straight up.
−
Push (3) the locking handle upward against the block to ensure proper leak tightness.
WARNING
To avoid the risk of injury to the fingers, push the handle into locked position with
an open hand.
CAUTION
Make sure that the bellows chamber is not forced to the side during use as this could
create a leak in the patient circuit.
1
2
3
Figure 36
Inserting and locking the bellows chamber
41
Datex-Ohmeda ADU
Assembling the patient circuit
Figure 37
Standard Patient circuit boom
The boom may be swung in any suitable direction and locked at the required angle with its locking
wheel at the pivot.
The circuit boom is normally positioned on the left side of the ADU. To move it to its alternative
position on the right side:
1. Release the arm by turning the locking wheel counterclockwise.
2. Move the arm and lock it with the right hand locking wheel, turning it clockwise.
3. Insert the long rod of the patient circuit block through the hole in the circuit boom.
42
Compact patient circuit description
10
11
9
8
7
6
Figure 38
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
5
4
3
2
1
Fresh gas connection
Circuit boom
Ventilator hoses
Compact Block II
Valves for inspiration and expiration
Locking/releasing latch for absorber canister
Manual ventilation bag
Inspiration and expiration hoses with Y-piece
Cable management arm
Absorber canister
Bellows block
43
Datex-Ohmeda ADU
The Datex-Ohmeda compact blocks
The compact block is the connection manifold for the patient hoses, for the fresh gas as well as for the
CO2 absorber. The compact blocks can be used with either Datex-Ohmeda Compact Absorber (single
use) or Datex-Ohmeda Compact Canister (reusable). Both are herein referred to as Compact
Absorber.
There are two different compact blocks, Compact Block I and Compact Block II. The difference
between the two blocks, is that the Compact Block II is equipped with a water trap and a water
container. The following instruction applies for both blocks unless otherwise stated.
2
3
1
4
5
6
Figure 39
(1)
(2)
(3)
(4)
(5)
(6)
Exploded view of Compact Block II
Latch
Piston valve
Valve membrane
Valve covers
Water trap valve
Water container
2
1
3
4
Figure 40
(1)
(2)
(3)
(4)
44
Compact Block I
Latch
Piston Valve
Valve membrane
Valve cover
Assembling the compact block
1.
2.
3.
Visually check that the block is clean, dry and undamaged.
Visually check that the O-rings are undamaged.
Make sure that the expiratory and inspiratory valves are in the bottom position, by lifting the
green membranes (1) and smoothly pressing the valve housings (2).
1
2
Figure 41
4.
Ensuring that the valves are in the correct position
Attach the transparent valve covers over the valves, by first pushing (3) and then twisting (4)
them to lock.
3
Figure 42
5.
6.
4
Attaching the transparent valve covers
Put the water container in place (Compact Block II).
Attach the compact block on the circuit boom.
45
Datex-Ohmeda ADU
Attachment of the absorber on the compact block
1.
2.
3.
Hook rear end of the Compact Absorber under the plastic pins on the block (1).
Push down the locking latch of the block (2). Push down the Compact Absorber (3) and release
the latch.
Make sure the Compact Absorber sits tightly on and is safely locked to the compact block.
3
2
1
Figure 43
Attachment of the absorber
Consult the ”Instructions for Use” leaflet included in the absorber package, on how to connect and
handle the Compact Absorber.
NOTE: Check the color of the absorbent. If it is purple and rebreathing can be observed on the CO2
monitoring display, the Compact Absorber should be replaced. This may be done during ventilation.
When the canister is removed, CO2 will be accumulated in the circuit.
46
Hose connectors
8
7
6
Figure 44
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
5
4
3
2
1
Compact circuit connectors
Fresh gas outlet
Manual bag connector
Occluder cone
Ventilator inlet connector
Fresh gas inlet connector
Patient circuit connector
47
Datex-Ohmeda ADU
Circuit connection
O
NO
Figure 45
Connecting the fresh gas hose to Compact Block I
Figure 46
Connecting the fresh gas hose to Compact Block II
1.
2.
48
Ai
Push the conical connector of the fresh gas hose onto the fresh gas outlet.
Connect the quick coupling, at the other end of the fresh gas hose, to the fresh gas inlet
connector on the underside of the Compact Block I. See Figure 46 on page 48 for location of
the fresh gas inlet on the side of Compact Block II.
O
Figure 47
3.
4.
WARNING
Compact circuit inspiratory and expiratory hoses
Connect the inspiratory hose of the circuit to the compact block inspiratory connector.
Connect the expiratory hose of the circuit to the compact block expiratory connector.
Only use patient hoses and accessories approved by Datex-Ohmeda.
49
Datex-Ohmeda ADU
O
Figure 48
5.
50
Compact circuit ventilator hose
Push the ventilator hose onto the ventilator connector underneath the compact block and to the
patient circuit connector underneath the bellows block.
Connection of manual ventilation hose
O
Figure 49
Compact circuit manual patient bag with hose
Attaching the manual ventilation hose to the ventilation connector beneath the APL valve
NOTE: Only use Datex-Ohmeda hose and keyed connector.
1.
2.
3.
4.
Push the locking ring around the connector inlet upwards and hold it there
Insert the hose end firmly into the connector
Let go of the locking ring and let it spring back into locking position
Check the connection by lightly pulling the hose downwards
WARNING
Do not to use anti-static or electrically conductive breathing tubes.
WARNING
Only use manual patient bags which comply with ISO 5362.
51
Datex-Ohmeda ADU
Standard Patient circuit description
NOTE: The Standard Patient circuit is an old version and has been replaced with Compact Patient
circuit.
8
7
5
O
9
4
10
6
3
Figure 50
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
52
2
1
Standard Patient circuit
Fresh gas supply connection (Common gas outlet)
Circuit boom
Patient circuit block
Absorber canister (one or two)
Inspiratory valve
Expiratory valve
Inspiratory and expiratory hoses with Y-piece
Manual ventilation bag
Bellows block
Ventilation hose
Assembling absorber unit and valves
Figure 51
1.
2.
3.
Standard Circuit absorber unit
Place the absorber canister on the patient circuit block by gently pushing it to the bottom of the
connector. Absorber canisters may be stacked on top of each other.
Place the inspiration valve in the recess on the top of the absorber unit and gently press it.
Place the expiration valve on the patient circuit block. Lock the valve in place by turning the
threaded locking ring all the way down.
NOTE: Check the color of absorbent. If the color has changed, fill the canister with new absorbent.
See section 8, “Cleaning and Maintenance”, for canister filling instructions.
53
Datex-Ohmeda ADU
Circuit Connection
O
Figure 52
1.
2.
54
Standard Circuit fresh gas hose
Push the conical fresh gas hose connector onto the fresh gas outlet.
Connect the quick coupling connector at the other end of the fresh gas hose to the inspiration
valve on top of the absorber canister.
O
Figure 53
3.
4.
Standard Circuit inspiratory and expiratory hoses
Connect the inspiration hose of the circuit to the inspiration valve.
Connect the expiration hose of the circuit to the expiration valve.
55
Datex-Ohmeda ADU
O
Figure 54
5.
56
Standard Circuit ventilator hose
Push the ventilator hose onto the ventilator connector underneath the patient circuit block and
onto the patient circuit connector under the bellows block.
Connection of manual ventilation hose
O
Figure 55
Standard Circuit manual bag and hose
Attaching the manual ventilation hose to the ventilation connector beneath the APL valve:
1. Push the locking ring around the connector inlet upwards and hold it there
2. Insert the hose end firmly into the connector
3. Let go of the locking ring and let it spring back into locking position
4. Check the connection by lightly pulling the hose downwards
WARNING
Do not to use anti-static or electrically conductive breathing tubes.
WARNING
Only use patient bags which comply with ISO 5362.
The absorber and valve assembly is shown in detail in section 8, “Cleaning and Maintenance”.
57
Datex-Ohmeda ADU
Water traps
It is recommended to use water traps in the patient circuit during low flow Anesthesia and when
excessive condensed water accumulates in the limbs.
Use water traps in both the expiration and inspiration limbs to remove water condensation.
Agent
On
O
Figure 56
58
Air
Water traps connected to inspiratory and expiratory limbs
Bain and Jackson Rees breathing systems
Bain breathing system
Figure 57
Bain breathing system connected to ADU
The Bain breathing system can be used in both the manual and auto ventilation modes when
connected as in the picture below.
•
•
WARNING
The system should be connected to the fresh gas outlet.
Always use airway gas and volume monitoring.
Always use oxygen, expired volume, carbon dioxide and agent monitoring on every
patient.
59
Datex-Ohmeda ADU
Jackson Rees breathing system
To passive
scavenging
Figure 58
Jackson Rees breathing system connected to ADU
The Jackson Rees breathing system can be used for manual ventilation with small volumes.
•
•
WARNING
60
The system should be connected to the fresh gas outlet.
Always use airway gas and volume monitoring.
Always use oxygen, expired volume, carbon dioxide and agent monitoring on every
patient.
Electronically controlled vaporizer and Aladin cassettes
The electronically controlled vaporizer is ready to use when the relevant Aladin cassette is inserted
and locked into its slot on the front of the ADU.
The Aladin cassettes are color-coded according to the agent they contain. The ADU identifies the
inserted cassette and the name and color-code of the agent is displayed on the agent field.
The vaporizer cassette should be removed from the ADU when not administering anesthetic agent.
Aladin cassettes may be equipped with three types of filling systems. Cassettes for halothane,
enflurane and isoflurane are filled with the aid of color-coded and keyed fillers.
The sevoflurane cassette is available with the keyed filler mechanism described above, or as an
alternative, with a Quik Fil™ mechanism. The Desflurane cassette is equipped with a filling
mechanism compatible with Saf-T-Fill™ desflurane bottles.
4
1
2
Figure 59
(1)
(2)
(3)
(4)
3
Aladin cassette for Halothane, Enflurane, Isoflurane and Sevoflurane with Keyed
Filler system
Lock & Fill Wheel
Agent filling port
Liquid level indicator
Handle with release trigger
61
Datex-Ohmeda ADU
1
2
3
Figure 60
(1)
(2)
(3)
Aladin cassette for Sevoflurane with Quik Fil
Agent filling port
NOTE: In some countries Sevoflurane Aladin cassettes are only available with a traditional Keyed
Filler mechanism.
2
1
3
Figure 61
(1)
(2)
(3)
CAUTION
62
Aladin cassette for Desflurane with Saf-T-Fill compatible filler system
Agent filler block
Do not wipe Aladin cassettes with alcohol based detergents as this may harm the
surface of the cassette.
Filling Aladin cassettes
Always unlock and remove the cassette from the machine before filling. It is important that the Aladin
cassette is in a horizontal position during filling. If the cassette is tilted the flow of liquid is shut off to
prevent overfilling.
During filling, ensure that the pins in the back of the cassette are not coming in contact with the
machine or any other object that could depress the pins and let air out of the cassette.
The sight glass of the cassette should be observed during filling, when the liquid level reaches the full
mark the filling should be stopped.
Anesthetic Agent filler Systems Table:
Anesthetic agent
Type of filling system
Color code
Halothane
Keyed
Purple
Enflurane
Keyed
Orange
Isoflurane
Keyed
Violet
Sevoflurane
Keyed or Quik Fil
Yellow
Desflurane
Keyed for Saf-T-Fill
Blue
WARNING
Always remove the Aladin cassette from its slot and put it on a horizontal surface
before filling. Never try to fill the cassette in its slot.
WARNING
Inaccurate anesthetic agent dosages may temporarily occur after filling, if the
temperature of the liquid is considerably lower than the normal operating
temperature.
63
Datex-Ohmeda ADU
Filling the Aladin cassette with Keyed Filler System
Halothane, Enflurane, Isoflurane, Sevoflurane
Figure 62
1.
2.
3.
4.
5.
6.
7.
8.
WARNING
64
Aladin cassette with Keyed Filler System
Remove the cassette from its slot and place it on a horizontal surface. Ensure that the pins in
the back of the cassette not are coming in contact with the machine or any other object.
Screw the bottle adaptor for the keyed filler system firmly onto the relevant bottle.
Insert the bottle adaptor into the agent filling port on the cassette. Be sure to fit the adaptor
properly, so that the end of its square part is flush with the cassette body as shown.
Lock the bottle adaptor by turning the Lock & Fill Wheel fully clockwise.
Turn the bottle upside down and check that the liquid flows evenly into the cassette. If it
doesn’t, tighten the wheel until the liquid starts to flow. Follow the rise of the indicator ball in the
vertical-viewing window. The position of the ball indicates the liquid level inside the cassette.
When the cassette is full, shut off the liquid flow by lowering the bottle, turning it upright and
releasing the bottle adaptor by turning the Lock & Fill Wheel counterclockwise. Start by turning
it half a turn to close the filling port and wait for the residual anesthetic agent to trickle back into
the bottle.
Remove the bottle adaptor from the vaporizer filling port by turning the Lock & Fill Wheel fully
counterclockwise.
Remove the bottle adaptor from the anesthetic agent bottle and close the bottle with its cap.
The cassette is now prepared for use.
To avoid exposure to anesthetic agent during filling, make sure that the bottle
adaptor is properly connected to the bottle. Also, if Air leaks into the system the
overfill protection mechanism of the cassette will not function properly.
Overfilling may result in overdosage of anesthetic agent.
Filling the Aladin cassette with Quik Fil™ System for Sevoflurane
Figure 63
1.
2.
3.
4.
5.
6.
Filling Aladin cassette with Quik Fil™ System
Remove the yellow protection cap from the anesthetic agent bottle. Check that the filling
mechanism of the bottle is undamaged.
Remove the filling port cap from the cassette by turning the cap counterclockwise. Insert the
nozzle of the bottle into the filler port.
Push the agent bottle firmly into the filling port. Let the agent flow into the cassette. The position
of the ball in the level indicator window indicates the level of the liquid inside the cassette.
Remove the bottle from the filling port; close the filling port and the bottle with their caps.
Lock the cassette in its slot. The cassette is now prepared for use.
NOTE: The cassette may be emptied for service needs by authorized service personnel only. See the
ADU Technical Reference Manual.
WARNING
Do not open or press the cassette filling port or gas connection valves with the
fingers or any kind of instrument. If the vaporizer is pressurized, the anesthetic
agent liquid or gas may squirt into the air.
65
Datex-Ohmeda ADU
Filling of the Aladin cassette for Desflurane
1
2
3
4
Figure 64
1.
2.
3.
Filling Aladin cassette with Saf-T-Fill™ Desflurane bottle
Remove the cap from the Desflurane bottle. Check that the O-ring is correctly fitted on the
bottle nozzle.
Insert the nozzle of the bottle into the filler port and push the bottle firmly against the spring
pressure till it stops.
NOTE: Ensure that the nozzle is fully inserted before attempting to turn the bottle upwards.
4.
5.
6.
7.
Turn the bottle upwards while keeping it firmly inserted. Bubbles into the bottle indicate the
liquid flow into the cassette. The position of the ball in the level indicator window indicates the
level of the liquid inside the cassette. Do not leave the bottle unattended while attached to the
cassette.
When the bubbles into the bottle ceases or when the liquid level reaches the full mark,
whichever occurs first, lower the bottle to stop liquid flow.
Remove the bottle from the agent filling port and close the bottle with the cap.
Lock the cassette in its slot. The cassette is now ready for use.
CAUTION
Do not attempt to fill the cassette with desflurane warmer than + 26° C/78.8° F.
CAUTION
The message ‘Draining cassette’ indicates that the Aladin cassette has been
overfilled and that it is automatically being drained. When the message disappears
the vaporizer can be turned on again.
WARNING
Do not leave the Desflurane bottle unattended while filling the Aladin cassette.
WARNING
Do not store filled or partly filled desflurane cassettes above the normal working
temperature of + 35° C/95° F. Storage at an excessively high temperature, may
cause the overpressure valve to vent desflurane vapor into the ambient air.
66
WARNING
Do not open or press the cassette filling port or gas connection valves with the
fingers or any kind of instrument. If the vaporizer is pressurized, the anesthetic
agent liquid or gas may squirt into the air.
WARNING
The Aladin Cassette does not normally need to be drained. If the cassette needs
to be sent for repair, the cassette shall be drained by authorized service
personnel.
67
Datex-Ohmeda ADU
Preparation for Patient SpirometryTM monitoring (Datex-Ohmeda monitors)
Optimal anesthesia delivery is achieved by adjusting ventilator settings with the help of measured
patient data. Gas and spirometry data are measured by the Datex-Ohmeda D-liteTM and Pedi-liteTM
sensors.
WARNING
•
O2 monitor in according to ISO7767/EN 12598
•
•
CO2 monitor according to ISO 9918/EN864
•
Expired volume monitor according to ISO 8835-1/EN 740
NOTE: If required, an alarm signaling when a volume monitor is not connected or is switched off, may
be installed by a qualified technician.
Selecting spirometry sensor
Adult and pediatric patients are measured with different sensors.
Note: The monitor cannot recognize the size of the patient or which sensor is in use. Adult or pediatric
sensor mode must be selected on the monitor.
D-lite sensors
The D-lite sensor is intended for patients having a tidal volume from 150 to 2000 ml. There is a
reusable D-lite sensor (733910) available as well as a disposable D-lite+ (896952 pkg of 50 pcs),
which also is designed for humid conditions (e.g. low flow).
Figure 65
68
D-lite and D-lite+ sensor
Pedi-lite sensors
The Pedi-lite sensor is intended for pediatric patients with tidal volumes from 15 to 300 ml. There is a
reusable Pedi-lite (73393) available as well as a disposable Pedi-lite+ (8001948 pkg of 50 pcs),
which also is designed for humid conditions (e.g. low flow).
Figure 66
Pedi-lite sensor
Connecting the spirometry sensor
No specific instruction can be given here as the connection of the spirometry sensor varies from one
type of monitor to another. Please refer to the instruction manual for the monitor used.
Note: It is recommended to use a microbiological filter between the endotracheal tube and the
D-lite/Pedi-lite sensor. Replace the filter after each patient in order to prevent sensor and patient
tubing from being contaminated. Adding a filter will, of course, increase dead space.
Figure 67
Microbiological filter between endotracheal tube and D-lite sensor
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Datex-Ohmeda ADU
Sampling gas
The gas monitors draw sampling gas from the patient circuit at a rate of approx. 200 ml/min. Avoid
letting sampling gas escape into room air! The sampling gas may be directed to the scavenging
connector under the bellows block as shown below.
Figure 68
Sample gas returned to scavenging in bellows block
The sampling gas may also be returned to the patient circuit with an optional adapter. The adapter is
connected to the patient breathing tubes as shown below.
Figure 69
70
Sample gas returned to patient
4 System check
4 System check
General
Each time the ADU is powered on, at least once every day, Datex-Ohmeda recommends that a
System Check should be performed. Datex-Ohmeda also strongly recommends that a System Check
always is performed when the pneumatics system has been disassembled, or the size of the patient
circuit has been changed, i.e. from adult to pediatric.
When the power is turned on, the display is blank for a moment. During the system Self-Check,
including the battery check that follows, the Datex-Ohmeda logotype is displayed. If the self-check is
still going on when the System Check menu appears, some items are blue - i.e. not selectable. When
the self-check is finished, the blue items on the System Check menu turn white i.e. selectable. The
System Check menu may also be attained by pushing the System Check key. However, the
ventilation must be switched to Manual mode before all menu items are selectable.
WARNING
Always perform the System Check with the breathing circuit in the state in which
it will be used. If the breathing circuit is changed in any way after the System
Check has been performed (e.g. removing the absorber, changing the volume of
the expandable breathing hoses), another System Check is imperative!
WARNING
Do not perform a System Check while a patient is connected to the delivery unit.
WARNING
Before performing the System Check, verify that the breathing circuit is set up
correctly, according to the picture below.
NOTE: During the Start-up and System Check procedures, the ADU will do some ”valve exercising”.
This produces clicking sounds which are perfectly normal and should be ignored.
NOTE: The System Check performed on an ADU without N2O differs in some ways from what is
described in this chapter. For more information about System Check on an N2O free machine, see
“System Check performed on an ADU without N2O” on page 89.
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Datex-Ohmeda ADU
The System Check procedure
The System Check menu consists of different checks, these can be performed either separately or
automatically. If automatically then this will be a Full Check in which all individual checks will be
performed in sequence.
The System Check proceeds in the following way:
Full Check
N2O Delivery
Agent delivery
AUTO ventilation
MAN ventilation
Checklist
Start Full Check
Start separate checks
Figure 70
System Check order
The System Check menu items:
Full Check
Checks Air, O2 and N2O pressure, scavenging, patient circuit and makes
other preparations for the automatic Full Check.
N2O Delivery
Checks the delivery of adequate N2O flow and prevents the delivery of a
hypoxic mixture.
Agent Delivery
Checks the function of the anesthetic agent delivery system.
AUTO Ventilation
Checks the amount of internal and external leaks and calculates the
compressible volume of the Patient Circuit.
MAN Ventilation
Checks for leaks in the respiratory tubes and in the manual bag.
Checklist
Manual check of Suction, CO2 absorber, Gas cylinders, Insp./Exp. Valve,
Level indicator and Gas monitor.
Checklog
Record of performed checks. The nine last error entries are shown in Error
History.
Bypass Check
Bypasses all the checks.
NOTE: During the System Check a 2 to 3 liter test lung must be used.
NOTE: Do not use the Datex-Ohmeda D-lite Sensor during the System Check.
72
4 System check
Performing a full System Check
1.
2.
3.
4.
Push System Check key.
Select Full Check and Confirm on the menu.
Read the instructions displayed in the Help Field at the bottom of each menu.
While for some tests the next step comes up automatically as the previous test is completed,
some others need to be verified manually by pushing the ComWheel to acknowledge.
NOTE: During the AUTO and MAN ventilation checks the gas sampling monitors must be
disconnected. See “AUTO ventilation check” on page 77 and “MAN ventilation check” on page 78.
NOTE: Make sure that every Aladin cassette to be used during the day is checked before use. See
“Agent delivery check” on page 76.
Full System Check step by step
Figure 71
The Full Check menu 1 and 2
Air Pressure, O2 Pressure and N2O Pressure automatically examine the connected Air, O2 and N2O
supply pressure. If the pressure is below 270 kPa (39 psi), the check fails and if it is below 20 kPa
(2.9 psi) the display shows ” - - -”.
1. Check Scavenging - Check that the scavenging hose is connected and that scavenging is
active. Push the ComWheel.
2. Patient circuit - Check the assembly of the breathing tubes (circuit). Push the ComWheel.
3. Occlude Y-piece - Connect the Y-piece to the occluder tap under the Bellows block. Do not
connect the gas sampling or spirometry tubing as this will result in a leak. Push the ComWheel.
4. Switch to AUTO - Turn the Auto/Man. selector to AUTO position.
5. O2 over 6 l/min. - Set O2 flow above 6 l/min. (When Air is adjusted upwards O2 flow may drop to
below 6 l/min.)
6. Select Air - Turn Air / N2O selector to Air.
7.
8.
Air over 6 l/min. - Set Air flow above 6 l/min.
Close flows - Close O2 and Air needle valves.
9.
Select N2O - Turn Air / N2O selector to N2O.
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Datex-Ohmeda ADU
10. N2O over 6 l/min. - Set N2O flow above 6 l/min.
11. Insert Cassette - Check that the amount of liquid agent is adequate and install the agent
cassette. The cassette is properly inserted when the agent is identified on the display screen.
The first part of the automatic Full Check is started.
If the checks are successful, the results from the first part of the Full Check are immediately
presented in the menu.
Figure 72
The automatic Full Check menu
12. Close Agents - Set agent wheel to OFF position.
13. Close N20 - Close N2O needle valves.
14. Manual APL to 80 - Set the APL valve to 80 cmH2O (closed). Push the ComWheel.
15. Switch to MAN - Turn the Auto/Man. selector to MAN position.
When the Auto/Man. mode selector is turned to Man. position, the corresponding check for Manual
Ventilation starts immediately.
When the MAN Ventilation leak check is successfully passed, the ADU automatically goes to the
Checklist menu. The APL valve control should be set to 1.5 cmH2O or to any preferred value for
Manual Ventilation.
16. Manual APL to 20 - Set the APL valve to 20 cmH2O to check valve function.
17. Manual APL to 1.5 - Set the APL valve to 1,5 cmH2O (fully open).
18. Checklist - Check all of the items in the list, for further instructions see“Checklist” on page 79.
19. Main Menu - To display the initial menu - push the ComWheel.
When the System Check has been completed, the ADU automatically returns to the System Check
menu thus confirming that the checking procedure is finished.
74
4 System check
Performing separate checks
1.
2.
Push System Check key.
Select N20 Delivery, Agent Delivery, AUTO Ventilation or MAN Ventilation.
3. Select Confirm.
When a check is separately selected, the item Continue on the menu may be selected to get from one
check to another.
To quit after separate check, select Main Menu.
N2O delivery and hypoxic mixture control check
The N2O delivery and hypoxic mixture control is checked for delivery of adequate flow of N2O and for
hypoxic mixture prevention.
Figure 73
1.
N2O Delivery check menu
3.
4.
Check Scavenging - Check that the scavenging hose is connected and that scavenging is
Occlude Y-piece - Connect the Y-piece to the occluder tap under the Bellows block. Push the
ComWheel.
Switch to AUTO - Turn the Auto/Man. selector to AUTO position.
Select N2O - Turn the Air/ N2O selector to N2O.
5.
N2O over 6 l/min. - Set N2O flow above 6 l/min. After this the check starts automatically.
6.
Close N2O - Close the N2O needle valve.
7.
8.
9.
Continue - Push the ComWheel to continue with Agent Delivery Check.
Repeat Prev Check - Try to resolve a failure and repeat the check.
Main Menu - Push the ComWheel to return to System Check main menu.
2.
NOTE: The clicking sound heard during the operation of the valves is normal and expected.
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Datex-Ohmeda ADU
Agent delivery check
The automatic anesthetic agent delivery check checks the function of the anesthetic agent delivery
system.
NOTE: To prevent air pollution, check that the waste gas evacuation is functioning and that the
Y-piece is properly occluded.
Figure 74
1.
2.
3.
4.
Agent delivery check menu
ComWheel.
Close flows - Close the O2, N2O and Air needle valves.
5.
Insert Cassette - Fill the requested cassette with agent liquid and install it. The cassette is
properly inserted when the agent is identified on the display screen.
Make sure that every Aladin cassette to be used during the day is checked before use. During a Full
Check the installed cassette is checked, but other cassettes shall be checked one by one through
separate Agent Delivery checks. When selecting the item Another Cassette, the check will be
repeated but in an abbreviated form that only involves the cassette itself.
6. Close Agent - Set the agent wheel to OFF position.
7. Main Menu - Push the ComWheel to return to System Check main menu.
8. Continue - Push the ComWheel to continue with the AUTO ventilation check.
9. Repeat Prev Check - Try to resolve a failure and repeat the check.
76
4 System check
AUTO ventilation check
In Auto mode, the automatic leak check checks the amount of both internal and external leakage as
well as the condition of the respiratory tubing assembly. It also calculates the compressible volume of
the Patient Circuit. If the leakage is less than 150 ml/min. and lost volume, due to compressibility
and patient circuit compliance, is less than 10 ml/cmH2O, the check is automatically regarded as
successful.
For more information about leak detection and correction see “Leak detection” on page 88.
WARNING
Do not attempt an AUTO Ventilation check while a patient is connected to the
delivery unit.
The ventilator block and patient circuit is checked. The breathing system is pressurized four times to
about 30 cmH2O for 4 seconds and a fifth time to a higher pressure to check the overpressure release
valve. In the case of a leak the pressure in the system falls. A pressure drop can be seen on the
pressure curve on the screen.
NOTE: Gas monitor sample lines must be disconnected during the check so that the sampling is not
considered leakage, causing subsequent check failure.
Figure 75
AUTO ventilation check menu
1.
Close flows - Close the O2, Air, N2O needle valves.
2.
4.
5.
ComWheel.
Close N2O - Close the N2O needle valve.
6.
7.
8.
Continue - Push the ComWheel to continue with the MAN ventilation check.
Repeat Prev Check - Try to resolve a failure and repeat the check.
Main Menu - Push the ComWheel to return to System Check main menu.
3.
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Datex-Ohmeda ADU
MAN ventilation check
The automatic leak check of the Manual mode (Man./Spont. selector), checks the amount of leakage
in the respiratory tubes and in the manual bag.
If the leakage is less than 100 ml/min, the check is automatically regarded as successful. If the
check fails, instructions to correct the problem are displayed in the Help Field. Follow the instructions
and repeat the check of the Manual mode.
NOTE: Gas monitor sample lines must be disconnected during the check so that the sampling is not
considered leakage, causing subsequent check failure.
Figure 76
MAN ventilation check menu
1.
Close Flows - Close the O2, Air and N2O needle valves.
2.
ComWheel.
Switch to MAN - Turn the Auto/Man. selector to MAN position.
Manual APL to 80 - Set the APL valve to 80 cmH2O (closed). Push the ComWheel.
3.
4.
5.
The manual bag and hose are checked. The pressure is built up in the manual ventilation circuit and
any leaks are detected.
6. Manual APL to 20 - Set the APL valve to 20 cmH2O to check valve function.
7.
Manual APL to 1.5 - Set the APL valve to 1,5 cmH2O (fully open).
8.
Continue - Push the ComWheel. The check continues with a checklist of 5 items to be inspected
at least once a day.
9. Repeat Prev Check - Try to resolve a failure and repeat the check.
78
4 System check
Checklist
The items on the Checklist should be checked at least once a day.
The Help Field includes brief advice on the checking procedure for each step.
Figure 77
1.
2.
3.
4.
The checklist menu
Suction - Check the functionality of the suction unit.
CO2 absorber - Check that the absorbent is available and functioning. Check functionality by
observing the inspiratory CO2 value during patient monitoring. Make sure spare absorber is
available.
Gas cylinders - Check the content of reserve gas cylinders. After checking, close the cylinders
valves.
Insp./Exp. Valves - Connect a test lung or a bag to the Y-piece. Turn the Auto/Man. selector to
Man. position. Set the APL valve to 20 cmH2O. Fill up the breathing system with gas using the
O2+ button.
Squeeze and release the manual bag and verify that the inspiratory and expiratory valves are
opening and closing correctly, (in opposite directions).
5.
O2+ flush - Set the APL valve to 1,5 cmH2O (fully open). Push the O2+ button. Check that the
manual bag fills up and that the O2 monitor approaches 100 % O2.
6.
Gas monitor - Connect the gas monitor adapter (D-lite/Pedi-lite) close to the breathing tubes.
Remove the CO2 sample line and make sure that the gas monitor reads 21 % of room air.
7.
8.
Verify that backup ventilation equipment is available and functioning.
Main Menu - Push the ComWheel to display the menu.
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Datex-Ohmeda ADU
Checklog
The ADU keeps a record of the performed checks.
1. Push the System Check key to display the menu.
2. Select Checklog and then Error History.
The nine last error entries are shown in the Error HIstory list with the last one at the top. An entry falls
off the list after 360 days.
Figure 78
80
The Check Log and Error HIstory menus
4 System check
Bypass check
Figure 79
Bypass check
The estimated time for a Full Check is 3 to 4 minutes. In case of emergency when a faster start-up is
required, then the System Check can be bypassed.
•
Select Bypass Check.
The ADU is immediately put into operational state. Until the System Check is successfully performed,
the message ”System Check bypassed” is shown on the normal screen.
If the ventilator is in AUTO mode when leaving the System Check mode, the command ”Switch to
MAN before connecting the patient to the delivery unit” will appear.
WARNING
When Bypass Check is selected the factory default value for compressible volume
is 2 ml/cmH2O. All alarms are still active. The delivered tidal volume might not be
correct.
WARNING
The System Check is designed to ensure correct and safe functioning of the ADU
unit. The Bypass Check command on the System Check menu must only be used
when patient safety requires an immediate start-up of a surgical procedure.
Normal Screen may be selected (with the ”Quick” key) instead of the Bypass Check command
if the Full Check has been successfully passed today or it was passed yesterday and the machine has
not been turned on today and no ventilator/fresh gas unit failure alarm has occurred since the check
was passed.
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Datex-Ohmeda ADU
Failed checks
If any of the checks fail, the Full Check is interrupted. Instructions to correct the failure appear in the
Help Field at the bottom of the menu. Follow these instructions and repeat the failed check.
If the check is successful this time, it will be automatically check marked and the Full Check will
automatically be resumed.
If the check still fails, the option to accept the failure and then continue the Full Check may be
chosen.
Failed N2O delivery check
Figure 80
Failed N2O delivery check
Possible causes for failure:
Action:
The N2O flow is less than 6 l/min.
1. Increase the N2O flow.
2. Repeat test.
The position of the Air/ N2O selector has been
changed during the automatic check.
1. Turn the Air/ N2O selector to N2O.
2. Repeat the check and make sure the selector
stays in this position.
The position of the Auto/Man. selector has been 1. Turn the Auto/Man. selector to AUTO
position.
Component failure with subsequent need for
technical service.
82
Contact service personnel.
4 System check
Failed agent delivery check
Figure 81
Failed agent delivery check
Possible causes for failure:
Action:
The Aladin cassette is not properly inserted or
has been removed during the check.
1. Fill the requested cassette with agent liquid
and install it. The cassette is properly
inserted when the agent is identified on the
display screen.
2. Repeat the check.
The fresh gas flow controls have not been fully
closed.
1. Close the fresh gas flow controls fully.
The position of the Auto/Man. selector has been 1. Turn the Auto/Man. selector to AUTO
position.
The vaporizer cassette is leaking inernally.
1. Remove cassette and use another one.
The vaporizer calibration is out of specification.
technical service.
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Datex-Ohmeda ADU
Failed AUTO Ventilation check
The AUTO Ventilation check fails when leakage is >150 ml/min.
Figure 82
Failed AUTO ventilation check
Possible causes for leak:
Action:
Respiratory tubing/connections are leaking/
disconnected.
1. Check the tubing and connections.
2. Alternative leak check: bypass the patient
circuit by connecting the ventilator hose
directly from the block to the fresh gas outlet.
Check the leak hose by hose.
3. Perform a manual leak check to find the leak.
The limit is 100 ml/min. If the manual side is
tight it means that the ventilator block is
leaking.
Patient Circuit connections, absorber or insp./
exp. valves are leaking.
1. Remove the absorber from the compact
block and repeat the test. If it passes, the
leak is in the absorber.
Y-piece is not properly occluded.
1. Occlude the y-piece again.
Bellows chamber or bellows is leaking.
1. Assemble the bellows block.
2. Reassemble the block again.
O-ring seals in the bellows block are not properly 1. Check that available time for the pressure
seated.
build up is not too short at the start. Use O2
flush to fill the bellows.
84
4 System check
Overflow valve is not properly installed.
1. Check the overflow valve connection.
A gas monitor is connected to the circuit and is
drawing gas samples
1. Check that the gas monitor is not sampling
gas from the circuit.
Possible causes for other failure:
Action:
The fresh gas flow controls have not been
properly closed.
The position of the Auto/Man. selector has been 1. Turn the Auto/Man. selector to MAN position.
altered during the check.
An extra pressure peak is detected during the
Repeat the check.
check (may have been caused accidentally while
handling the respiratory tubing).
technical service.
If compliance is more than 10 ml/cmH2O the check fails. The volume loss due to compliance is
automatically compensated for.
NOTE: In case a check is bypassed, a default value of 2 ml/cmH2O is used.
Possible causes Failed Circuit Compressible
Volume check:
Action:
The Y-piece is not properly occluded or a
spirometry adapter is connected to it.
1. Remove spirometry adapter if such is
connected and occlude the y-piece.
The total volume of the breathing circuit is too
large.
1. Check the length of the tubings in the
breathing circuit. Change long tubings to
shorter ones.
NOTE: Leakage over 150 ml/min does not automatically prevent the ADU from being used. It is up to
the user to accept the leak or not.
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Datex-Ohmeda ADU
Failed Manual ventilation check
The MAN Ventilation check fails when leakage is > 100 ml/min.
Figure 83
Failed Manual ventilation check
Possible causes for leak:
Action:
The manual APL valve is still open.
1. Check that the APL valve is closed.
The respiratory tubing and/or its connections are 1. Check the tubing and connections.
leaking.
2. Alternative leak check; bypass the patient
circuit by connecting the ventilator hose
directly from the block to the fresh gas outlet.
Check the leak hose by hose.
The manual ventilation bag is leaking
1. Change manual ventilation bag.
A gas monitor is connected to the circuit and is
sampling gas
1. Check that the gas monitor is not sampling
gas from the circuit.
Possible causes for other failures:
Action:
The fresh gas flow controls have not been
properly closed.
The position of the Auto/Man. selector has been 1. Turn the Auto/Man. selector to MAN position.
altered during the check.
An extra pressure peak is detected during the
Repeat the check.
check (may have been caused accidentally while
handling the respiratory tubing).
86
4 System check
The pressure was higher than 20 cmH2O at the
start of the MAN Leak Check.
1. Open APL valve to decrease the pressure
before adjusting it to 80 cmH2O.
technical service
87
Datex-Ohmeda ADU
Leak detection
The ADU checks for leaks during the AUTO Ventilation check. Avoid making any modifications to the
bellows block assembly or the patient circuit during operation, as any new leaks may go unnoticed.
During the System check AUTO ventilation test, the breathing system is pressurized four times to
about 30 cmH2O and a fifth time at a higher pressure to check the overpressure valve. If there is a
leak, the pressure in the system falls and this can be seen on the pressure curve on the ADU screen.
A leak below 150 ml/min is accepted by the ADU whereas leaks over 150 ml/min result in a FAILED
message. Leaks over 150 ml/min do not prevent the use of ADU. The user may decide whether to
accept the leakage or not.
Figure 84
Pressure waveform during System Check
During daily operation the most likely leak sources are the bellows chamber, the patient circuit hoses,
the compact block, the absorber and their connections.
If the Bellows Block has been dismantled, the overflow valve and rubber sealing of the bellows base
should be checked too.
For further details, see “Leak detection and correction” on page 167.
Leakage limits of ADU
•
•
The AUTO Ventilation check fails when leakage is >150 ml/min.
The MAN Ventilation check fails when leakage is > 100 ml/min.
The user may select ”Continue” although a leak check has failed.
88
4 System check
System Check performed on an ADU without N2O
The System Check on an ADU without N2O differs in some ways from what has been described earlier
in this chapter. This section will not describe the whole System Check procedure, only the parts that
are different on an ADU without N2O are shown.
The System Check has been modified so it can pass without use of N2O.
Full Check
Agent delivery
AUTO ventilation
MAN ventilation
Checklist
Start Full Check
Figure 85
The System Check procedure.
The separate check for N2O Delivery is disabled when using the ADU without N2O. The item N20
Delivery is not included in the System Check menu.
Figure 86
Full Check menu 1 and 2
89
Datex-Ohmeda ADU
When performing a Full Check the N2O pressure is not displayed. The items Select N2O and N2O over
6 l/min. will automatically be confirmed and displayed with the blue text OFF in Full Check menu 2.
During the automatic Full Check, the N2O Delivery text is replaced with the text N2O OFF.
After a Full Check the result from N2O Delivery is marked with the text OFF. Close N2O is automatically
confirmed by the system and the text is OFF.
All the results from the System Check are displayed in the Check Log. The top item in the Check Log
menu, N2O Delivery, is marked with OFF when using an ADU without N2O.
90
5 Operating and adjusting the settings
ADU controls
9
10
8
7
11
6
12
13
5
1
4
Figure 87
(1)
(2)
(3)
(4)
(5)
3
2
ADU controls
ON/STBY switch. Green light when the ADU is connected to mains power.
Agent Wheel. Turn counterclockwise to increase (+), turn clockwise to decrease (-) the agent
concentration.
N2O/Air selector. Turn the selector to point towards the desired gas.
(6)
Adjustable pressure limiting valve (APL valve) for manual ventilation.
Auto/Manual selector for selecting controlled mechanical ventilation (Auto) or the manual
(Manual) spontaneous (Spont.) ventilation mode.
O2 flow control. Turn counterclockwise to increase flow.
(7)
(8)
Air flow control. Turn counterclockwise to increase flow.
N2O flow control. Turn counterclockwise to increase flow.
(9)
(10)
(11)
(12)
(13)
Short cut menu keys.
The ADU LCD color display.
Ventilator quick function keys.
ComWheel.
Anesthetic agent vaporizer cassette, Aladin Cassette. Select agent by inserting the desired
vaporizer cassette.
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Datex-Ohmeda ADU
Display/keys
The ADU can be used with a 12.1” display or a 10.4” display. The differences, beside the size, are the
placement of the short cut menu keys and that the 12.1” display has an additional key, Reset Case.
Start/Stop
Timer
Reset
Timer
Ventilator
Volume/
Pressure
Rate
I:E
PEEP
Silence
Alarms
Help
Figure 88
ComWheel, navigate
in menus and confirm
choices
Normal
Screen
Reset
Case
Trends
Setup
Alarms
Setup
System
Check
ADU 12.1” display
Start/Stop
Timer
Reset
Timer
Alarms
Setup
System
Check
Setup
Trends
Volume/
Pressure
Rate
I:E
PEEP
Normal
Screen
Silence
Alarms
Ventilator
ComWheel, navigate
in menus and confirm
choices
Help
Figure 89
92
ADU 10.4” display
Key
Function
Start/Stop Timer
Start the timer and pause it
Reset Timer
Reset the timer
Volume Pressure
Quick key to adjust Volume/Pressure settings
Rate
Quick key to adjust Rate settings
I:E
Quick key to adjust I:E Ratio settings
PEEP
Quick key to adjust PEEP settings
Ventilator
Adjust Ventilator settings
Silence Alarms
Silence active alarms or presilence alarms
Help
The key is not in use
Normal Screen
Close menus, return to basic screen
Setup
Reset case, adjust screen layout, set time and date or
view gas usage
Reset Case
Reset settings, trends and/or screen (Only on ADU with
12.1” display)
Trends
Review trends
Alarms Setup
Review alarm limits, adjust volume or view alarm history
System Check
To perform full or separate checks
93
Datex-Ohmeda ADU
ADU display fields
6
5
7
4
1
Figure 90
(1)
(2)
(3)
(4)
3
2
Display Fields
Fresh gas field
Ventilator settings field
Middle field with trends or gas and volume monitoring information
Airway Pressure/CO2 waveform field
(5) Alarm message field
(6) Battery and clock field
(7) Timer field
Always use a monitor to confirm that the inspiratory gas values and the ventilatory settings on the
ADU are correct.
94
Handling the menus
A menu is a list of functions or commands, displayed on the ADU screen. To display a menu push one
of the short cut menu keys next to the screen or push the ComWheel to view the Menu Functions
menu.
Cursor
Symbol for submenu
Frame with help text
Figure 91
Menu functions
Moving in menus
The ComWheel is used to navigate in menus and confirm choices.
Setup
1. Push a menu key.
2. Turn the ComWheel to move
around in the menu and to
change values.
3. Confirm your choice by
pushing the ComWheel.
Confirmation of a selected change of setting, can be achieved by either:
•
•
•
Pushing the ComWheel
Pushing the corresponding quick key
Pushing any of the keys grouped around the display screen
NOTE: This is also valid if Normal screen is pushed.
WARNING
If you do not want to confirm a change of setting, always use the ComWheel to
return to the previous setting before exiting the menu.
WARNING
Pressing any of the keys grouped around the display directly after adjustment of a
parameter by means of the ComWheel, may result in an unintentional
confirmation of a setting.
In current mode, the setting values on the display are colored yellow when active and cyan when not
active. However, cyan colored values may be pre-set.
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Datex-Ohmeda ADU
Start of case
Reset of previous case
Before a new case it may be desirable to reset all anesthesia machine settings, screen layouts, trend
data or alarm settings used during the previous case. It is possible to reset each separately or all at
the same time.
To return to preset default settings:
WARNING
•
Push the Reset Case key if you have a 12.1” display,
otherwise select Setup - Reset Case.
•
•
Select Reset All.
Select Confirm.
This device is to be used only by, or on order of a
physician.
Fresh gas delivery
The fresh gas flow controls are for mixing and adjusting the fresh gas flow of O2, N2O or Air and one
anesthetic agent.
NOTE: The ADU can be configured to operate without N20, for further information see “Anesthesia
Delivery Unit without N2O” on page 16.
The gas flows are electronically measured and the flows are displayed on the ADU main screen.
Fresh gas display
The gas flows of O2, Air and N2O are measured electronically and displayed on the ADU main screen
as graphical flowmeters and as numerical flow values.
Figure 92
96
Fresh gas field
Optionally the fresh gas field can include the Total Flow Data with total fresh gas flow and the
calculated percentage for each gas.
WARNING
The ADU O2 % is a calculated value of measured flow data and not a value
measured by an oxygen analyzer. In the case of a hospital pipeline cross
connection, erroneous values will be displayed.
WARNING
The O2 percentage in the patient circuit may differ significantly from the O2
percentage of the fresh gas.
The anesthetic agent setting is displayed in a box to the right of the flowmeter numerical display. The
name of the anesthetic agent is identified and the background color under the name is identical to
the color of the vaporizer cassette. When the Desflurane cassette is installed, the liquid level is
indicated on the display.
The concentration of the fresh gas anesthetic agent is displayed numerically in percentages and also
graphically relative to the maximum fresh gas concentration of each anesthetic agent.
The anesthetic agent fresh gas concentration is the set value and not a value measured by an
anesthetic agent analyzer.
NOTE: The displayed values are ATPD.
O2, N2O and Air
O2 delivery
To increase O2 flow, turn the O2 flow control counter clockwise. The control knob is fluted in
accordance with relevant IEC standards. The flow is shown numerically and also as a 'flowmeter bar
graph' on the color display.
Agent
Figure 93
O2 flow adjustment control
Air or N2O selection
In addition to O2, either Air or N2O may be administered. To select Air or N2O, turn the selector to the
right for N2O or to the left for Air.
Agent
Figure 94
Air / N2O selector
For confirmation of the gas selection, the chosen gas is also indicated on the color display.
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Datex-Ohmeda ADU
NOTE: The N2O flow is automatically cut off if the N2O supply pressure drops below 240 kPa (35 psi).
The ADU will then automatically switch from N2O to Air and sound an alarm.
Air or N2O delivery
To increase the flow of the chosen gas, turn the flow adjustment control of the selected gas counter
clockwise.
Agent
Figure 95
WARNING
Air and N2O flow adjustment controls
During a complete mains and battery power loss, the ADU will automatically cut
off the N2O flow and anesthetic agent administration. It will also switch to Air.
Air will flow if the needle valve is opened. O2 is also available during a power loss.
02 flush
To flush the system with a high flow of O2 - press the O2 flush button, located on the front edge of the
table (or on the front panel, to the left of the pressure gauges). This will activate the O2 flow to the
fresh gas outlet.
Figure 96
WARNING
O2 flush on table edge
Figure 97
O2 flush on the front panel
(early version)
Pressing O2 flush during inspiration, will increase inspiratory pressure. The set
pressure limit however, will remain effective and help protect against excessive
pressures.
The ADU is equipped with a proportional regulator, which prevents the operator administering an O2/
N2O/AA mixture containing less than 25% O2 in the fresh gas. If the O2 flow is decreased or the AA
content is increased, the N2O flow will also start to decrease when the O2 concentration goes below
25%. Increasing the O2 flow, or decreasing AA content again, will also restore the N2O flow if its
control position has remained unchanged.
98
Anesthetic agent
Agent selection
Five volatile agents can be administered; Enflurane, Halothane, Isoflurane, Sevoflurane and
Desflurane. Only one agent can be administered at a time.
Selecting the agent is done by inserting the desired agent cassette into the cassette slot so it locks
into place. When a cassette is installed, the agent field on the display will switch from showing 'Insert
Cassette' to showing the identity of the installed cassette. Make sure that the ADU identifies the
correct agent.
Figure 98
Cassette identification
Figure 99
Desflurane liquid level
To remove the cassette, squeeze the handle and pull the cassette out.
Agent adjustment
Agent adjustment in the fresh gas flow is done by turning the Agent wheel counter clockwise to
increase the agent concentration and clockwise to decrease the concentration.
Agent
Figure 100
Agent adjustment
NOTE: The ADU vaporizer performs as an ordinary concentration calibrated vaporizer to the effects of
varying ambient pressure. The nominal agent volume % setting is graduated at sea level ambient
pressure (760 mmHg). If the vaporizer is used at higher altitudes (decreased ambient pressure), the
delivered agent volume % will be higher than the set agent volume % in relation to the decrease of the
ambient pressure. This is due to the agent partial pressure being independent of the ambient
pressure.
NOTE: If required, an alarm signal when the Sevoflurane control has been set above 5 %, may be
installed by a qualified technician.
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Datex-Ohmeda ADU
Safety
Agent administration
Agent administration can always be stopped by removing the cassette. Squeeze the cassette handle
and pull out the cassette.
The cassette can be carried in any position e.g. by its handle. There is no risk of an overdose when the
cassette is reinstalled into the machine after a transport.
To avoid the risk of inadvertently filling a cassette with a wrong agent, the keyed filler system shall be
used.
The anesthetic agent cassette alarms and switches off if the fresh gas flow is decreased below 150
ml per minute, displaying Agent Shut Off. The anesthetic agent cassette is operational when the flow
is increased above 200 ml/min., but the agent delivery must be turned on again.
In case of a fresh gas unit failure, increase the O2 flow to secure optimal oxygenation, and replace the
machine.
NOTE: If there is an overpressure in the Desflurane cassette, caused by a high working temperature
(above +35 ºC), the pressure is released into the scavenging system and an alarm sounds.
NOTE: If a cassette is overfilled, the excess liquid is released into the scavenging system and an
alarm sounds. Additional O2 flow should be used to flush the cassette. This will increase the O2 flow
at the fresh gas outlet.
NOTE: Remove the Aladin Cassette when the ADU is not in use.
Mains failure
If the hospital electrical supply is lost, the machine will automatically switch to battery operation and
give the operator a message indicating battery life. The ADU will give the operator messages rising to
alarms when the battery supply is nearing its end. When the message BATTERY EMPTY GO MANUAL
appears there is approximately 30 seconds of operation time. When the vaporizer loses power the
valves will automatically close the flows to and from the vaporizer.
WARNING
During a complete mains and battery power failure the vaporizer will not deliver
any anesthetic agent.
Display failure
If the display should fail, the ”agent on” lamp next to the agent wheel will indicate that agent is being
administered. The setting will not change unless the control is adjusted. Turn off the agent by turning
the agent wheel clockwise until the lamp goes out. Also turn off the N2O flow and increase the O2 flow
to secure optimal oxygenation. Monitor inspired/expired agent concentrations on monitor.
CO2 absorber
NOTE: Check the color of absorbent. If the color is changed and rebreathing can be observed from
CO2 monitoring, replace the absorber canister. The absorber canister can also be replaced during
ventilation. Follow the instruction included in the absorber package.
100
Spontaneous ventilation
Spontaneous patient breathing is possible at any time.
•
Turn the Auto/Man. selector to the Man. position.
•
Turn the APL valve control fully open.
With spontaneously breathing patients the APL valve should be fully open. In practice, this equals a
circuit pressure of 1.5 cmH2O. This helps to ensure a lightly filled manual ventilation bag (inspiratory
reserve).
Pressure
Exp
Insp
Time
Insp
Pressure curve, spontaneous breathing
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Datex-Ohmeda ADU
Manual ventilation
•
Turn the Auto/Man. selector to Man. position.
•
•
Turn the APL valve control to adjust the pressure in the patient circuit.
Read the circuit pressure curve on the display.
In the manual ventilation mode, the APL valve adjusts the peak pressure in the patient circuit and the
amount of gas in the manual ventilation bag. When the pressure rises to the set pressure limit of the
APL valve, the valve opens and lets out excessive gas from the patient circuit. The APL functions as a
pressure relief valve.
In manual ventilation the APL valve is customarily set to 20 to 30 cmH2O.
Pressure
10
Insp
Insp
Time
Exp
Figure 101
102
Pressure curve, manual ventilation
Controlled mechanical ventilation (Auto)
Before starting Controlled Mechanical Ventilation, check that the patient circuit pressure alarm limits
have been adjusted to values appropriate for the patient. Push Alarm Setup key to view alarm limits
and adjust if necessary.
•
Turn the selector on the ventilator bellows unit from Man./Spont. to Auto position to start the
controlled mechanical ventilation.
The brackets around the ventilator settings disappear.
The ventilator is electronically controlled and pneumatically driven. The controlled mechanical
ventilation modes are:
•
•
•
Volume Controlled Ventilation (VCV)
SIMV
Pressure Controlled Ventilation (PCV)
Select ventilation mode
1. Push the Ventilator key.
2. Review the settings for the new mode.
3. Select Mode.
4. Select the desired mode.
A mode is changed immediately on selection.
NOTE: Some setting combinations may not allow
switching from one mode to another. In such cases,
advice on what to do is stated in the Help Field.
NOTE: I:E ratio, which is automatically adjusted in SIMV
mode, remains unchanged if not adjusted before
switching to another ventilation mode.
NOTE: When changing mode from SIMV to VCV or PCV,
I:E ratios can be reached which normally cannot be set
using only these modes.
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WARNING
Before activating Volume Controlled Mode, ensure that Tidal Volume, Resp. Rate
and I:E ratio are correctly adjusted.
WARNING
Before switching from PCV to Volume or SIMV, ensure that the set Tidal Volume is
appropriate for the patient.
Volume Controlled Ventilation, VCV
The Volume-controlled ventilation (TV or MV) is time cycled (RR) and the delivered tidal volume is
independent of flow settings.
Pressure
Mechanical PEAK inflation pressure
Time
Pressure curve, volume-controlled ventilation
Adjust to VCV mode
1.
2.
3.
4.
Review the settings for the PCV mode.
Push Ventilator key.
Select Mode.
Select VCV.
VCV controls
Controls
Optional settings
Tidal volume/Minute Volume
Sigh
Respiration Rate
Inspiratory Pause
I/E ratio (alternative I:E time or Insp. time %)
PEEP (Positive End Expiratory Pressure)
Synchronized Intermittent Mandatory Ventilation, SIMV
SIMV mode provides ventilatory assistance during times when a patient may have the ability to
breath but lacks either the required rate or tidal volume. The patient can trigger a mechanical breath
of the pre-set Tidal volume within a ”Trigger Window”. In this way mandatory breaths are synchronized
with spontaneous efforts. Triggered breaths are indicated by a color change on the pressure curve
and can also be monitored on the trend curve.
104
P (cm H2O)
20.0
t (sec)
0
6 sec
Trigger window
Figure 102
SIMV mode pressure curve
Adjust to SIMV mode
1.
2.
3.
Select Mode.
4.
Select SIMV.
SIMV controls
Controls
Optional settings
Tidal volume / Minute Volume
Trigger window
Respiration Rate
Inspiratory Pause
Sensitivity
I:E time sec
Pressure Controlled Ventilation, PCV
In the PCV mode the ventilator builds up the patient circuit pressure to a given level and maintains the
pressure until the expiration phase. The inspiratory flow is decelerating and optimized to provide the
set pressure limit as quickly as possible (adjusted automatically). There is no measurement of
volume in PCV. Use of a volume monitor is therefore required.
Pressure
Set pressure above PEEP
Time
Figure 103
Pressure controlled mode pressure curve
Adjust to PCV mode
1.
105
Datex-Ohmeda ADU
2.
3.
Select Mode.
4.
Select PCV.
PCV controls
Controls
Optional settings
Pressure limit
Inspiratory Rise Time
Respiration Rate
I/E ratio (alternative I:E time or Insp. time %)
Ventilator settings
Ventilator settings are displayed on the screen. The settings presented to the left, see Figure 104 on
page 106, are calculated values.
Figure 104
Ventilator settings
NOTE: In the Manual mode the ventilator settings are always shown within brackets [ ] on the
display. The settings may be set or checked before starting the Controlled Mechanical Ventilation.
Ventilator settings shown within brackets
There are three alternative ways of altering the setting of a parameter.
•
106
Push “quick function” keys (Volume/Pressure, Rate, I: E or PEEP). The corresponding field is
highlighted. Adjust the setting by turning the ComWheel. The current setting is displayed
above the adjustment value.
Volume/
Pressure
Rate
I:E
PEEP
•
Another way of accessing the ventilator menu is by pushing the Ventilator key. Values within
brackets and/or cyan colored are not valid for the current mode. Adjusting the settings in the
Ventilator menu is convenient when setting up the ADU for the next patient.
•
A third way of accessing the ventilator menu is by pushing the ComWheel to display the Menu
Functions menu and select Ventilator.
•
•
•
This is also valid if Normal screen is pushed.
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Datex-Ohmeda ADU
When the ventilator has accepted the new setting the ”Current” row disappears. If the new setting is
not confirmed within 20 s, it is cancelled.
If the setting is within brackets, it is not effective until a corresponding mode is selected.
The machine responds to the adjustments immediately but not during the present breath. If the
display should fail, the setting will not change unless the controls are moved.
WARNING
WARNING
In the case of a display malfunction, do as follows:
1.
Turn off the delivery of N2O and anesthetic agent
2.
Increase the O2 flow
3.
4.
Switch to manual ventilation
If the malfunction remains - replace the faulty machine with a checked unit
Patient weight
The patient’s weight automatically calculates - and
suggests – setting values for the following parameters:
• Tidal volume
• Respiration rate
• Minute volume
NOTE: As a change of the Patient Weight value affects
other settings, it is only possible to enter the Patient
Weight value while in the Manual mode.
When entering a Patient Weight menu for the first time,
the patient weight (Factory default, 60 kg, corresponds
to a TV of 500 ml and a RR of 10) is the weight value that
was entered together with the other ventilator settings.
When the weight value is adjusted, new settings are calculated and shown as suggested new
ventilator settings in the help and ventilator fields. The new settings are entered in the ventilator when
leaving the Patient Weight menu.
Although a changed Patient Weight value does not effect the Set Pressure value in the Pressurecontrolled mode, it is still good practice always to enter the Patient Weight value.
NOTE: If a patient‘s weight exceeds 100 kg or is below 5 kg, the tidal volume should be adjusted
separately.
Tidal volume settings
Volume/
Pressure
Adjustable range: 20 to 1400 ml
Default setting: 500 ml
108
Set in ventilation modes: VCV and SIMV
The calculated minute volume changes when the tidal volume or the respiration rate is adjusted.
Minute volume = tidal volume x respiration rate.
Set tidal volume = Delivered tidal volume
NOTE: Perform a leak test every time the patient circuit has been altered or changed to help ensure
correct volumes.
Minute volume settings (Optional)
Adjustable range: 0.1 to 30 l/min
Default setting: 0.5 ml
Can be chosen as default settings in the set up mode (contact the local representative). The
calculated tidal volume changes when the minute volume or respiration rate is adjusted.
Pressure settings
Volume/
Pressure
Adjustable range: 5 to 40 cmH2O above PEEP.
Default setting: 12 cmH2O above PEEP.
Set in ventilation modes: PCV
The inspiration pressure is constant.
NOTE: The set pressure limit is always above PEEP. In the PCV mode the Inspiratory Pause, Sigh
settings, Sensitivity and Trigger Window are not available.
Respiration rate settings
Rate
Adjustable range: 2 to 60 breaths / min
Default setting: 10 breaths / min
Set in ventilation modes: VCV, PCV and SIMV
Respiration rate (RR) changes affects ”I/E times” value and tidal volume (when MV is the default
setting). If attempting to set an RR value which conflicts with other settings or limits, as indicated by
the message ”max. MV” for example, the RR value is rejected and cannot be entered.
I/E ratio settings
I:E
Available I:E ratios (insp./exp.): 2:1, 1:1, 1:1.5, 1:2, 1:2.5, 1:3, 1:4.5
Default setting: 1:2
Set in ventilation modes: VCV and PCV
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Datex-Ohmeda ADU
The I:E ratio automatically determines and shows I:E Time in seconds if I:E Times is selected to be
displayed.
It is the I:E ratio that is the factory default. An optional default setting is however available on the
Install menu - Units.
NOTE: If an inverse ratio/prolonged insp. (2:1) is selected, it is shown in yellow on the Normal screen.
I
E
Time
2
I:E ratio pressure curve
I:E time sec (optional default setting)
I:E
Adjustable range: 0.35 to 20 s
Default setting: 2.0 s
Setting Insp. time in sec automatically displays Exp. time in sec.
I:E time is always used in SIMV mode and may be chosen as default setting in the Volume and
Pressure control modes. The I:E setting also automatically determines and shows the value of the I:E
Ratio.
To change default settings; contact a service technician.
Insp. time % (optional default setting)
I:E
Adjustable range: 18 to 67 % of complete breathing cycle.
Default setting: 33 % of complete breathing cycle.
Insp./time in % of total I:E time (one breathing cycle). May be chosen as default setting. The setting
automatically determines and shows the value of the I:E Time in seconds.
To change default settings; contact a service technician.
PEEP settings
PEEP
Adjustable range: 5 to 20 cmH2O
110
Default setting: OFF
NOTE: Because of the standing bellows and the overflow valve design, there is a minimum positive
end-expiratory pressure between +2 and +4 cmH2O.
For Tidal Volumes below 100 ml, PEEP cannot be adjusted to values above 10 cmH2O.
Setting the PEEP value also adjusts: Peak low pressure alarm (PEEP+4 cmH2O)
Pressure
Pause
PEEP
Time
Inspiration
PEEP curve
Trigger sensitivity settings
Adjustable range: - 0.5 to -5 cmH2O
Default setting: -1.0 cmH2O
Set in ventilation modes: SIMV
1. Push Ventilator key to display menu.
2. Select Sensitivity.
3. Turn ComWheel to adjust Sensitivity.
4. Push ComWheel or Normal Screen.
In the SIMV mode a negative pressure (in relation to actual
PEEP value) created by the patient, triggers the delivery of a
mechanical breath.
The triggered breath is indicated by a color change of the
pressure curve. The delivery is very smooth as the breath is
delivered as a natural progression of the negative pressure,
which initiated the breath. A high sensitivity corresponds to a
low threshold level for triggering and conversely, low
sensibility means a high threshold level.
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Datex-Ohmeda ADU
Trigger window (optional setting)
Adjustable range: 5 to 95 % of the expiration
Default setting: 50 % of the expiration
Set in ventilation modes: SIMV
1. Push Ventilator key to display menu.
2. Select Options and then Trigger window.
3. Turn ComWheel to adjust Trigger window.
4. Push ComWheel or Normal Screen.
In the SIMV mode, the patient may trigger a mechanical tidal
volume breath within a ”Trigger window”. The window is
placed at the end of the expiration phase as defined by the
respiratory rate (RR). In this way mandatory breaths are
synchronized with spontaneous efforts.
Pressure
Spontaneous breaths
Mandatory breaths
+
0
- Trigg sens level
cm H2O
Patient triggering
Figure 105
Time
Trigger window
Trigger window and sensitivity level
The trigger function is activated by a spontaneously created negative pressure (in relation to PEEP
value) which exceeds the set Trigger Sensitivity level.
The frequency of the mandatory breaths can never be lower than the pre-set Respiration Rate (RR).
On the other hand, the possibility for the patient to trigger mandatory breaths within the Trigger
Window may lead to a situation where the actual mechanical breaths are more than the pre-set value
for RR. This gives also rise to an increased Minute Volume. To avoid hyperventilation and still support
spontaneous breaths - decrease pre-set RR on the ventilator and adjust the Trigger Window
accordingly.
Some setting combinations may not allow switching from one mode to another. In such cases, advice
on what to do is stated in the Help Field.
Inspiratory pause setting (optional setting)
Adjustable range: 0 to 60 % of inspiratory time
Default setting: 25 % of inspiratory time
1.
2.
112
Push Ventilator key to display menu.
Select Option and then Inspiratory Pause.
3.
Turn ComWheel to adjust inspiratory pause setting.
4.
Push ComWheel or Normal Screen.
Pressure
Pause
Time
Inspiration
Figure 106
Pause in the pressure curve
The pause is a part of the inspiration phase and does not affect the expiration time or the length of
the breathing cycle. With Inspiratory Pause selected, the inspiratory volume is delivered faster and
the inspiratory flow is automatically increased accordingly.
Inspiratory rise time setting (optional setting)
Adjustable range: Fast - Medium - Slow.
Default setting: Medium
Set in ventilation modes: PCV
1.
2.
Select Options and then Inspiratory Rise.
3.
Turn ComWheel to adjust Inspiratory Rise Time setting.
4.
Push ComWheel or Normal Screen.
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Datex-Ohmeda ADU
In Pressure controlled mode the inspiratory flow is by default automatically adjusted to reach the set
pressure limit as fast as possible. The inspiratory rise time can be adjusted for individual patient care.
Sigh setting (optional setting)
Adjustable range: ON or OFF
Default setting: OFF
Set in ventilation modes: VCV
1.
2.
Select Options and then Sigh.
3. Select either ON or OFF.
When sigh is used, every 100th breath is 1.5 times larger than normal tidal volume. The maximum
tidal volume is limited to 1400 ml.
.
Time
Figure 107
114
Sigh pressure curve
Monitoring
Optimal anesthesia delivery results are achieved by adjusting ventilator settings in relation to
measured patient data.
By using a Datex-Ohmeda Anesthesia Monitor or Datex-Ohmeda Capnomac Ultima, the monitored
patient values may be displayed next to the fresh gas and ventilator settings, or on the optional
monitoring screen.
WARNING
•
•
•
•
CAUTION
Only use specified monitoring system interface cables.
CAUTION
Only use specified Datex-Ohmeda Capnomac Ultima Interface Cable.
1
2
3
4
5
Figure 108
ADU Display Monitoring Data
(1)
(2)
Pressure data for delivery unit circuit
Patient gas monitor CO2 waveform and numeric value
(3)
(4)
(5)
Ventilator settings
Spirometry data
Patient gas monitoring data
115
Datex-Ohmeda ADU
Measuring conditions
NOTE: The ADU measures volumes under ATPD (Ambient Temperature & Pressure, Dry gas)
conditions.
The Anesthesia Monitor and Capnomac Ultima measure volumes under BTPS (Body Temperature &
Pressure, Saturated gas) conditions. To use the same measuring conditions for both the ADU and
monitor, change the monitor setting. (AM in Airway Gas, Flow & Vol. Setup and Ultima in User
Configurations).
Sampling gas
The gas monitors draw sampling gas from the patient circuit at an approx. rate of 100 to 200 ml/min.
This should be taken into account when the gas monitor sampling gas is not returned to the patient
circuit, especially during low flow ventilation. The minimum fresh gas flow rate should be the patient
oxygen uptake plus the monitor-sampling rate. (See chapter Sampling Gas in section 3, Assembly
and Preparations)
116
Setup
•
Push the Setup key to display menu.
NOTE: The adjustments made in this menu are only valid
until the delivery unit is reset. Time and date are stored.
Set the screen layout
1.
2.
Push Setup key.
Select Screen Layout to configure waveforms and digital fields at the far right on the Normal
Screen.
Figure 109
Screen Layout menu
117
Datex-Ohmeda ADU
Select waveforms
Up to two waveforms can be displayed at the same time. Circuit pressure - Pcirc - is always displayed
but the second waveform may either show interfaced CO2 or be turned off. If only one waveform is
selected, it is enlarged to fill out the available area.
Figure 110
Waveform fields
Pcircuit setup
1. Push Setup key.
2. Select Pcirc Setup.
3. Select Scale, Sweep Speed or Color.
Sweep Speed can be either Fast or Slow.
CO2 setup
1. Push Setup key.
2. Select Screen Layout and then CO2 Setup.
3. Select Field 2.
4. Select CO2 or OFF.
5. Select Scale, Sweep Speed or Color.
CO2 requires interfaced gas monitoring. Sweep Speed can be
either Fast or Slow.
118
Show menu graphs
1. Push Setup key.
2. Select Screen layout.
3. Select Show Menu Graphs.
4. Select YES 0r NO.
In addition, an advisory menu can always be presented when Volume / Pressure, Resp. Rate, I:E
Ratio, or PEEP is set.
Figure 111
Optional Advisory Menu
Adjust flowmeter height
1.
2.
3.
4.
Push Setup key to display Setup menu.
Select Screen Layout.
Select Flowmeter Height.
Select the desired presentation.
Similarly, short or long flowmeters may be chosen by selecting AUTO. The length of the flowmeter will
automatically adjust itself according to the current flow rate.
119
Datex-Ohmeda ADU
Figure 112
Fresh gas field
Show total flow
1. Push the Setup key.
2. Select Screen Layout.
3. Select Show total flow.
4. Select YES or NO.
Total flow data may either be displayed or removed.
Adjust middle field layout
1. Push the Setup key.
3. Select Middle Field.
The Middle field may be vacant or it may contain either
trends or digital information interfaced from a patient
monitor. Either the Datex-Ohmeda Capnomac Ultima or the
Datex-Ohmeda Anesthesia Monitor can be interfaced to
show values in this field.
Figure 113
120
Middle field setting
Add remove boxes in ventilator setting field
1. Push Setup key.
3. Select Minute Volume, Inspiratory pause or Extra I:E Times.
4. Select YES or NO.
The most important settings such as TV (MV), Pressure limit (in PCV), RR, I:E, PEEP and ventilation
mode, are always displayed.
The calculated values for MV (TV), Inspiratory Pause, Extra I:E Times may be removed.
Figure 114
Ventilator settings field and Screen Layout menu
Set time and date
1.
2.
3.
4.
5.
Push Setup key.
Select Set Time and Date.
Highlight the desired setting.
Adjust the setting.
Push the ComWheel to confirm the new setting.
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Datex-Ohmeda ADU
Time is shown on the upper right corner of the screen. If
an Anesthesia Monitor is interfaced, the clock is set in
the Anesthesia Monitor only. The ADU clock cannot be
set in this case.
Figure 115
Time display
Change Install settings
1. Push Setup key.
2. Select Install.
Select Password digits 10.
In Install menu, the user has the possibility to change the
measurement units, interfacing, trend setup, save default
setting for screen layout, trend layout, alarm setting and
ventilation settings.
Saving changed default settings
Push Setup key.
Select Install.
Select Save As Defaults.
Select specific setting or Save ALL for saving all of the
settings.
This menu allows the user to save permanent changes of the
default settings. Screen and trend layout as well as operating
parameters such as alarm limits and ventilator settings may be
saved. The factory default settings may be retrieved for all
changed settings.
1.
2.
3.
4.
NOTE: It is not possible to save Ventilator mode, PEEP or Sigh
default settings.
122
Change units
1.
2.
3.
4.
Push Setup key.
Select Install.
Select Units.
Select Pressure, Weight or CO2 to select unit.
Interfacing
Monitors that may be interfaced are either the Datex-Ohmeda Capnomac Ultima or the Anesthesia
Monitor.
Gas and spirometry numerics are shown in the Middle field. CO2 waveform and numerics are shown
in the waveform field.
1.
2.
3.
4.
Push Setup key.
Select Install.
Select Interfacing.
Highlight the desired monitor.
123
Datex-Ohmeda ADU
Figure 116
Interfacing AM
Trend setup
1.
2.
3.
4.
5.
Push Setup key.
Select Install.
Select Trend Setup.
Highlight the desired setting.
Adjust the setting.
6.
Push the ComWheel to
confirm the new setting.
7.
Push Normal Screen key.
Service menus
Special ”passwords” are required for access to the
”Diagnostic” and ”Calibration” service menus.
Refer to the ADU Technical Reference Manual.
124
End of case
Gas usage
After a case it is possible to check the gas consumption since power-up.
•
Push the Setup key to display gas usage menu.
Figure 117
Gas Usage menu
Before beginning a new case it may prove practical to reset Gas Usage. In the case of a power-off the
Gas Usage is reset automatically.
Gas consumption calculations
The consumption of fresh gas is calculated from the measured flow values. The consumption of
anesthetic agent is calculated from the set value. The values are integrated every second, which
makes the accuracy close to the accuracy of the current values. (Accuracy ±10 %; less accuracy at
low flows.)
Cumulative usage
View the total amount of fresh gas used since Cumulative
Usage was cleared.
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Datex-Ohmeda ADU
Gas disconnection
There are two alternative ways of preventing breathing gases from leaking from the ADU when it is not
in use.
Either:
1.
Close the O2 and Air flow adjustment controls while the scavenging system still is activated.
2. Turn off the ADU mains switch.
Or:
1. Disconnect the ADU gas hoses from the wall supply connectors and close the reserve gas
cylinders if they have been used.
2. Turn off the ADU mains switch.
CAUTION
When not in use - be sure to follow the above gas disconnection instructions to
prevent gas leakage from the ADU.
Battery charge
Check that the mains electric power is connected to ensure continuous battery recharging.
WARNING
126
Do not store the ADU below -10 or above +60º C.
6 Alarms
6 Alarms
Alarm Signals and Sequences
The alarms are classified into categories according to their priority. The priority of an alarm depends
primarily upon the cause and duration.
The priority increases with the duration of the alarm condition. Also, the more significant the cause of
an alarm, the more rapidly the alarm advances to HIGH priority. Thus e.g. ‘Ppeak High’ advances
rapidly to HIGH priority, whereas disconnection is allowed a longer time.
The following alarm categories are used:
Priority
Meaning
Tone pattern
HIGH
Situation requiring
immediate operator
response
Triple + double beep 1 s
Alarm message
pause, then triple + double 5 displayed in a red box
s pause...
--- -- 1 s --- -- 5 s --- -- 1s --- --
MEDIUM
Situation requiring prompt
operator response
Triple beep every 19 s
--- 19 s --- 19 s ---
LOW
Situation requiring operator Single beep
awareness
-
INFORMATION Additional information
None
Visual
Alarm message
displayed in a grey or
black box with a
yellow frame
Alarm message
displayed in a grey or
black box with a white
frame
Information displayed
in a grey or black box
NOTE: On earlier versions of the ADU the priority level “INFORMATION” does not exist and the visual
appearance of the alarm messages is different. The HIGH priority alarms are displayed in a box with a
red frame, the MEDIUM priority with a yellow frame and the LOW priority with a white frame.
When an alarm becomes active:
•
•
•
WARNING
A message appears in the order of priority in the message field at the top of the display.
The corresponding parameter value flashes as yellow or red.
An auditory alarm is sounded.
Always make sure that alarm limits are appropriately set when a patient is
connected to the ADU.
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Datex-Ohmeda ADU
Alarms and alarm limits
The pressure limit alarms are listed below. System status alarm messages are listed and explained in
the Troubleshooting chapter.
Limit alarm message
Default limit
Adjustment range
Adjustment step
Pmax Release (AUTO)
40 or user default
Ppeak High - 80
1 cmH2O
Ppeak High (AUTO)
30 or user default.
Ppeak Low + 2 to 80
1 cmH2O
Ppeak High (MAN)
40 or user default
6 to 80
1 cmH2O
Ppeak Low (AUTO)
6 (cannot be saved)
Change with PEEP
adjustment
(6/ PEEP+4)... (Ppeak
High-2)
1 cmH2O
PEEP High (AUTO)
PEEP+5
N/A
N/A
PEEP High (MAN)
10
N/A
N/A
Negative Pressure
(AUTO) excluding
(SIMV)
Pmin ≤ -0.7
Pmin ≤ -3
Pmin ≤ -8
N/A
N/A
Negative Pressure
(MAN), (SIMV)
-3≤ Pcirc ≤ -0.7 (20 s) N/A
(continuous negative)
N/A
NOTE: Other alarms, System Status, see Chapter 9 - Troubleshooting for explanation and course of
action.
French and Japanese Version settings
The User configuration settings French Version and Japanese Version effects the alarms. Ask your
service technician for your configuration settings.
In French Version the User Alarm ‘Volume monitor removed’ is displayed if no volume monitor is
connected or it is switched off.
In Japanese version the user alarm ‘Agent % setting high’ is displayed if sevoflurane anesthetic agent
is set above 5 % and ‘Ppeak low’ is advanced to HIGH priority after 120 s.
Oxygen failure alarm
In case the O2 supply to the machine is interrupted, the oxygen failure alarm is activated. The alarm
limit pressure is 250 kPa (36.2 psi). If lack of supply pressure stops the O2 flow, the flow of N2O is
automatically cut off.
The alarm may be silenced momentarily but returns after 2 minutes.
128
6 Alarms
Alarms setups and adjustments
Set the alarm parameters using the Alarms Setup menu. High and low alarm limits as well as alarm
volume may be adjusted. The audio alarms may be permanently silenced and the alarm status may
be viewed (10-minute circuit pressure trend).
2
3
1
4
5
Figure 118
(1)
(2)
(3)
(4)
(5)
Alarms setup view
List menu items
Exit from limit adjustment back to menu items
Parameter box with current pressure release and pressure alarm limits
Visual indicator of alarm limit
10-minute circuit pressure trend
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Datex-Ohmeda ADU
Adjust limits
1.
2.
Push the Alarms Setup key.
Select Adjust Limits.
3.
Turn the ComWheel to move the highlight to the parameter box that you want to adjust.
4.
Push and turn the ComWheel to adjust the alarm limit. A white line in a 10-minute trend
indicates the alarm limit in relation to measured values.
5.
6.
Push the ComWheel to confirm the new limit value.
Move the highlight to the next parameter box or to EXIT.
1
Figure 119
(1)
(2)
2
Ppeak alarm limit indicators
Ppeak Low alarm limit indicator
Ppeak High alarm limit indicator
Default limits
To set the alarms at the default alarm limits.
•
Select Default Limits from the Alarms Setup menu.
Also the Reset Case function will return the alarm limits to their default values.
To change the default limits:
•
•
•
•
Set the desired alarm limits in the Alarms Setup menu.
Push the Setup key and select Installation. See “Changing Measurement Units” in previous
chapter.
Select Save as Defaults and select Alarm Settings.
Confirm by selecting Save.
Cancel changes
Cancel Changes cancels any alarm limit changes and returns to the previous limits. Cancel Changes
must be selected before leaving the Alarm Setup menu, after the menu is closed it is no longer
possible to cancel changes.
130
6 Alarms
Alarm volume
The Alarm Volume may be set from 1 to 10. The ADU emits a ”beep” for each alarm volume setting.
Default value is 5.
WARNING
Make sure that the alarm sound level is set loud enough to be heard above the
background noise!
NOTE: The Pmax Release level and the Ppeak High alarm limits are set separately.
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Datex-Ohmeda ADU
Audio On/Off
All auditory alarms may be disabled or activated except:
‘Ppeak high’ (HIGH priority), ‘Peep high’ (HIGH priority), ‘O2 supply lost’, ‘Ventilator failure’, ‘Batteries
empty. Go manual’, ‘Hypoxic mixture’, ‘Fresh gas occlusion’ and ‘Fresh gas unit failure’ (HIGH priority).
In French Version also ‘Volume monitor’ removed. In Japanese Version ‘Ppeak Low’ cannot be
disabled more than 120 s.
For more information see “Disabling auditory alarms” on page 133.
Alarm history
The menu displays a list of alarms and the time when they were activated.
132
6 Alarms
Silencing alarms
Silencing auditory alarms temporarily1
WARNING
Do not silence auditory alarms without providing continuous, direct observation
of the patient.
To silence all alarms for 2 minutes, push Silence Alarms key once. Push it twice to silence individual
alarms.
Pushing the Silence Alarms key once
−
silences alarms that are currently active
−
presilences the upcoming alarms
A Silence Alarms symbol
with a countdown timer is displayed in the upper left corner of the
screen to indicate that all alarms are silenced. The message field at the top of the display is cleared of
all the alarm and note messages. The visual alarms in the digit and waveform fields remains as long
as they are valid. During the 2-minute silencing period, all new upcoming alarms or alarm priority
changes are indicated visually.
Pushing the Silence Alarms key twice
−
silences the individual alarm that are currently active
−
does not presilences the upcoming alarms
Reactivating alarms
Pushing Silence Alarms key during the 2-minute silencing period will reactivate the auditory
component of new alarms. The alarms that were active when the key was first pressed will not sound
before the two minute period is over.
Disabling auditory alarms1
For special cases, such as open heart surgery or lung operations, it may de desirable to disable
certain auditory alarms entirely.
1. Push the Alarm Setup key.
2. Select Audio ON/OFF.
3. Select Silence ALL.
A warning symbol is displayed.
If an active alarm is disabled, there is a reminder beep every two minutes. You can adjust the volume
of the beep through Alarm Setup - Reminder volume.
NOTE: In French Version there is a reminder beep every two minutes even though no active alarm is
disabled.
Reactivating alarms
1.
Push the Alarm Setup key.
1. NOTE: ‘Ppeak High’ (HIGH priority), ‘Peep High’ (HIGH priority), ‘O2 supply lost’, ‘Ventilator failure’, ‘Hypoxic mixture’,
‘Fresh gas occlusion’ and ‘Fresh gas unit failure’ (HIGH priority) cannot be presilenced or disabled. ‘Batteries empty
Go manual’ and ‘Volume monitor removed’ (in French Version) cannot be silenced or disabled. In Japanese Version
‘Ppeak low’ cannot be silenced or disabled more than 120 s.
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Datex-Ohmeda ADU
2.
3.
Select Audio ON/OFF.
Select Activate Alarms.
Unexpected Reset
Microprocessor-controlled systems can go into a reset condition. When in a reset condition, the
control display may show only the message “Unexpected Reset.”
The Ventilator and Fresh Gas Control units continue to deliver gas as set, but you will be unable to
adjust the ventilator settings. Fresh gas flows and anesthetic agent settings can be adjusted, but the
settings are not displayed on the screen.
Display description
When a reset condition occurs, the ADU displays the following:
1. The screen blanks out.
2. After approximately 10 seconds, the “Datex-Ohmeda” logotype is shown.
3. After another 20 seconds, the screen will appear as if in a normal start-up.
4. After another 20 seconds, the message “System Failure - Unexpected Reset, Please call for
service” appears in red.
Recommended actions
If a reset condition occurs, perform the following steps:
1. Observe the information on the Patient Monitor to follow the patient conditions.
2. If you need to adjust the ventilator pattern, switch to manual ventilation and continue
ventilation as needed.
3. Follow the inspired/expired concentrations of gases on the Patient Monitor and adjust
concentration settings if needed.
4. Call for service and replace the anesthesia unit after completion of the case.
Alternative method:
1. Switch to manual ventilation and continue ventilation.
2. Turn off the main switch. Note that after the switch off, only O2 is delivered until N2O and
Anesthetic Agent can be reactivated (see #4 below).
3. Wait a few seconds and turn on the main switch to restart the system.
4. Adjust all desired settings.
5. Bypass the “System Check.”
6. Switch to Automatic ventilation.
7. After the completion of the case, replace the anesthesia unit and call for service.
134
7 Trends
7 Trends
The ADU is able to show both numerical and graphical trends for the latest 24 hours of all set values:
PEEP, TV/MV, pressure limit, respiration rate, I:E ratio, inspiratory pause, as well as measured fresh
gas pressure values: peak, plateau and PEEP.
The machine accumulates and displays trend data for user selected periods between 20 minutes and
24 hours
In addition, a 10-minute circuit pressure trend is displayed in the Alarm Setup menu.
During trend display, the machine and all alarms are active and the numeric information is
continuously updated and displayed.
Graphical trend pages
There are a total of six graphical trend pages of which three are arranged according to the factory
settings. Each trend page can have up to six parameter fields.
Push the Trends key
Select Graphical
1.
2.
3
1
2
4
Figure 120
(1)
(2)
(3)
(4)
Graphical trend page
List of selections
Parameter field
Trend cursor
Ventilation mode
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Datex-Ohmeda ADU
Numeric trend pages
The numeric trend information is updated every five minutes. The last minute information is displayed
at the bottom of the page. The first of three pages is shown below.
Push the Trends key
Select Numerical
1.
2.
3
1
2
5
4
Figure 121
(1)
(2)
(3)
(4)
(5)
Numeric trend page
List of selections
Time of measurement
Parameter row
Ventilation mode
Trend cursor
NOTE: The last accessed page is saved in the memory. When entering the Trends menu again, it
appears as the first page.
136
7 Trends
Changing trend pages
• Select Next Trend to see the other graphical or
numerical trend pages.
Next Trend has a scrolling function. When all the pages have been displayed, the first page is again
displayed.
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Datex-Ohmeda ADU
Trend cursor
The trend cursor displays the values of a graphical trend at a certain moment.
1. Selecting Move Cursor to activate trend cursor.
Turn the ComWheel to move the cursor.
2.
6
5
1
2
6
3
4
Figure 122
Graphical trend cursor
6
3
1
2
Figure 123
(1)
(2)
(3)
(4)
(5)
(6)
138
Numerical trend cursor
Trend cursor
Ventilation mode
Time where the cursor is situated
Difference between current time and ”cursor time”.
Scale
Parameter values
7 Trends
Graphical trend length
1. Push Trends key
2. Select Graph Time
3. Adjust the trend time
Trend
Resolution
20 minutes
10 seconds
2 hours
1 minute
4 hours
2 minutes
12 hours
6 minutes
24 hours
12 minutes
Scales
Scales are selected in the Set Scales submenu.
Push Trends key
Select the trend page, by using Next Trend
Select Set Scales
Select the field you want to change the scale for in the Field
menu.
5. Select Graph Scale and adjust the scale
1.
2.
3.
4.
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Datex-Ohmeda ADU
Resetting trend data
Trend data should be reset always before a new patient.
1.
2.
Push the Reset Case key if you have a 12.1” display, otherwise select Setup - Reset Case.
Select Reset Trends and then Confirm. If all screen settings are to be reset along with the
trends, simply select Reset All, then confirm.
Trend page setups
Trend page setups are changed in the installation menu. Only the graphical trend pages can be
changed.
1.
2.
3.
4.
5.
6.
7.
8.
140
Push the Setup key.
Select Install
Enter password ”10”.
Select Trend Setup.
Select the trend page to be changed.
Select Change Field.
Select the field to be changed one to six.
Select the desired parameter.
8 Cleaning and maintenance
General
For safe reliable function and operation of the Anesthesia Delivery Unit, regular cleaning and
maintenance has to be carried out according to the instructions in this User’s Reference Manual and
the maintenance procedures described in the Technical Reference Manual.
WARNING
Always unplug the electric power cord before cleaning or maintenance of the
Anesthesia Delivery Unit. Let it dry completely before reconnecting it to the
electrical outlet.
WARNING
A full System Check must be performed before patient use if the ADU has been
disassembled for cleaning. A leak test should be performed every time any of the
breathing system parts have been replaced.
CAUTION
Do not perform any cleaning or maintenance procedures other than those described
in this manual.
CAUTION
Clean the cooling fan dust filters (behind the rear cover) at least once a month.
Cleaning should be carried out by a qualified technician.
Follow the general cleaning and disinfection instructions described below, unless some other
instructions are described for a component later in this chapter.
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Datex-Ohmeda ADU
Cleaning and disinfection methods
All parts of the patient circuit and ventilator bellows unit - except the bellows chamber - are machine
washable. All parts, including the Datex-Ohmeda Compact Block II, may be autoclaved (Compact
Block I may not be autoclaved). Also; the ADU is completely free of latex.
Different methods and levels for cleaning and disinfection are described below.
Datex-Ohmeda recommends that hospital routines are always followed to select appropriate level
and frequency of cleaning and disinfection. This is especially important if there is a risk that the
patient suffers from a contagious disease. Further, Datex-Ohmeda recommends that Universal
Precautions for infection control are considered in the protocols of hospitals using the ADU.
Cleaning
Cleaning (or precleaning): The removal, usually with detergent and water, of adherent visible soil,
blood, protein substances, and other debris from the surfaces, crevices, serrations, joints, and
lumens of instruments, devices, and equipment by a manual or mechanical process that prepares
the items for safe handling and/or further decontamination. (FDA)
Cleaning methods
Always clean the equipment properly before disinfection.
NOTE: Cleaning in a washer or washer-disinfector.
If the washer or washer-disinfector has a washing program with 85° C/185° F for 10 minutes or
more, this provides an intermediate level disinfection as well.
•
•
Wiping away organic material with mild soap-based solution.
Washing by hand using warm water and mild detergent.
Let the cleaned parts dry in a warming closet or at room temperature.
Intermediate level disinfection
Disinfection: The destruction of pathogenic and other kinds of microorganisms by physical or
chemical means. Disinfection is a less lethal process than sterilization, since it destroys most
recognized pathogenic microorganisms, but not necessarily all microbial forms, such as bacterial
spores. Disinfection processes do not ensure the margin of safety associated with sterilization
processes. (FDA)
Disinfection in a washer or washer-disinfector at high temperatures (85° C/185° F) is the most
effective and primary disinfection method for the breathing system parts in contact with the patient’s
airway.
Intermediate level disinfection methods
• Clean the parts with a decontamination program in a washer or washer-disinfector, minimum
10 minutes at 85° C/185° F. The detergent should be alkaline (pH value 10 to 11).
•
CAUTION
142
Clean away organic material with mild soap-based solution and let dry. Wipe with 70% alcohol
and let dry.
Avoid cleaners based on ammonia, phenol or acetone as they may damage the parts.
High level disinfection
High Level Disinfectant: A germicide that inactivates all microbial pathogens, except large numbers
of bacterial endospores, when used according to labeling. The FDA further defines a high level
disinfectant as a sterilant used under the same contact conditions except for a shorter contact time.
(FDA)
High level disinfection methods
• Liquid-chemical, for example glutaraldehyde 2% or an equivalent chemical that the hospital
uses for chemical high level disinfections. Always follow the manufacturer instructions for the
agent.
•
Steam autoclave at maximum 134° C/273° F.
Disinfection frequency
The following parts should be considered for disinfection with the hospital protocols/frequency,
taking into account types of patients, risk of infections, cross contamination risks etc.
•
•
•
Patient circuit tubing, manual bag tubing & connectors.
Compact blocks and Standard Circuit absorber and valve.
Ventilator bellows - bellows block including the APL and overflow valves.
NOTE: To help ensure correct operation of the compact blocks, Datex-Ohmeda recommends that they
are cleaned at least twice a week.
Microbial filter
When using a microbial filter, less cleaning and disinfection may be required, although, always
consider the type of patients, risk of infections, cross contamination risks etc. Fewer cleaning cycles
will increase the lifetime of the accessories and parts. It is essential that the filter provides effective
protection against bacteria, viruses and dust from CO2 absorbers. The filter needs to be placed close
to the patient to give proper protection, that is between the endotracheal tube and the D-lite sensor.
Datex-Ohmeda recommends that the filter and any parts between the filter and patient should be
replaced between patients. Prior to use, always read the “Instructions for use” for the filter.
143
•
•
•
•
•
•
Compact block II
Compact canister reusable
Standard Circuit absorber and
valve assembly
•
•
•
•
•
•
•
•
•
•
Bellows block incl. APL valve
and overflow valve
Bellows chamber
Overflow valve rubber
membrane
Manual bag
•
•*
• **
•
•*
•
•
•
•
•
144
* NOTE: May change shape and has to be replaced after repeated autoclaving. The bellows should be hung so that the lower folds can hang freely during the autoclaving cycle.
**NOTE: Does not normally have to be autoclaved since it is not in direct contact with patient gases. May develop small cracks on surface after repeated autoclaving.
•
•
Bellows
Ventilator bellows assembly:
Wash by hand using water and Steam autoclave at maximum Liquid chemical,
mild detergent AND wipe with 134° C
glutaraldehyd 2%
70% alcohol
•
•
Washer-disinfector with a
decontaminating program
(min. 10 minutes at 85° C)
Compact block I
Compact patient circuit:
Reusable patient circuit
tubing, manual bag tubing and
connectors, Y-piece, D-lite
Equipment
Concerning the level and frequency of disinfection, always follow the hospital routines.
Disinfection methods table
Cleaning and maintenance
Patient circuit tubing, manual bag tubing & connectors
Cleaning and disinfection
Figure 124
1.
2.
Patient circuit tubing & connectors
Disconnect the patient circuit hoses from the inspiratory and expiratory check valve
connectors.
Disinfect the hoses and connectors according to the methods described in “Disinfection
methods table” on page 144.
To prevent damage of the hose, hold the hose connector at the ends of the hose.
Hytrel reusable patient tubing
CAUTION
The following solutions should not be used as they may cause disintegration of the
tubing: hypochlorite, phenol, formaldehyde, ketone, chlorinated hydrocarbons,
aromatic hydrocarbons, inorganic acids.
If autoclaving, use tube holders to prevent tubes coming into contact with hot elements, shelves etc.
in the autoclave itself.
Autoclaving or heat drying will affect the hytrel and may develop cracks or pin holes over time.
Autoclaving will eventually cause a slight color change of the tubing.
Storing
Avoid prolonged exposure to ultraviolet light. Ultraviolet light has a degenerative effect on the tubing
over time, causing the tubes to crack and pin holes to form.
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Datex-Ohmeda ADU
Compact Blocks
Compact Block I and Compact Block II
There are two different Compact blocks, Compact Block I and Compact Block II. The difference
between the two blocks is that the Compact Block II can be autoclaved and is also equipped with a
water trap and a water container. The following instruction applies for both blocks unless otherwise
stated.
The Compact blocks can be used with either Datex-Ohmeda Compact Absorber Single use or DatexOhmeda Compact Canister Reusable (both are herein referred to as Compact Absorber).
WARNING
Soda lime is a caustic substance and is a strong irritant to eyes, skin and the
respiratory system. Affected parts should be flushed with water for at least 15
minutes.
2
3
1
4
5
6
Figure 125
(1)
(2)
(3)
(4)
(5)
(6)
146
Exploded view of Compact Block II
Latch
Piston valve
Valve membrane
Valve covers
Water trap valve
Water container
2
1
3
4
Figure 126
Compact Block I
(1) Latch
(2) Piston Valve
(3) Valve membrane
(4) Valve cover
The following instruction describes different methods to clean and disinfect the Compact blocks. For
further information see the “Disinfection methods table” on page 144. For frequency and level of
disinfection, follow hospital routines. However, to help ensure correct operation of the Compact
blocks, Datex-Ohmeda recommends that they are cleaned at least twice a week.
There are two methods to clean the Compact blocks – manually or mechanically in a washer or
washer-disinfector (herein called washer-disinfector). Both methods are described below.
Mechanical cleaning and disinfection in washer-disinfector
Use Datex-Ohmeda Cleaning Cassette II (herein Cleaning Cassette II) for mechanical cleaning.
1. Disconnect the patient circuit hoses from the compact block.
2. Remove the Compact Absorber by pushing the latch (1) down and lifting the Compact Absorber
(2) off the compact block.
2
1
Figure 127
3.
4.
5.
6.
Removing the Compact Absorber from the Compact Block II
Remove the water container from Compact Block II.
Do NOT remove the block valves and their covers.
Place the Cleaning Cassette II on the compact block by hooking one end of the Cleaning
Cassette II under the pins on the compact block.
Push down the latch on the compact block. Push down the Cleaning Cassette II until it locks.
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Datex-Ohmeda ADU
Figure 128
7.
8.
Attaching the Cleaning Cassette
Turn the compact block so that the Cleaning Cassette is underneath. Connect the white exp.
labeled tube on the Cleaning Cassette II to the expiratory port on the compact block.
Connect a hytrel tube to the Cleaning Cassette.
Figure 129
Connecting the hytrel and exp. labeled tubes
9. Place the compact block, with the Cleaning Cassette II underneath, into the washer-disinfector.
10. Connect the hytrel tube on the Cleaning Cassette II to the water source in the washer-disinfector
and clean the Compact Block with a decontaminating program.
Figure 130
Connecting the hytrel tube to the water source
11. After cleaning, dismount the Cleaning Cassette II and remove the valve covers by twisting the
latch until the cover comes loose. Drain any remaining water by rotating the compact block in
all directions.
148
12. Dry the compact block and the valve covers in a warming closet (maximum 80° C/176° F) or at
room temperature.
13. If the washer-disinfector is not used for disinfection of equipment, Datex-Ohmeda recommends
that a further intermediate or high level disinfection is conducted.
Manual cleaning
Do not use Cleaning Cassette II for manual cleaning.
1. Disconnect the hoses from the compact block. Remove the Compact Absorber by pushing the
latch down and lifting up the Compact Absorber.
2
1
Figure 131
2.
3.
Remove the water container from Compact Block II.
Remove the valve covers.
Figure 132
Removing the Compact Absorber from the Compact Block II
Removing the valve covers
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Datex-Ohmeda ADU
4.
Flush the compact block with fresh running water for 1 minute. Press down the piston valve
while flushing the compact block. Flush into all openings.
Figure 133
5.
Clean the compact block, valve covers and water container (CB II) with total immersion in a sink
filled with water and cleaning agent for at least 3 minutes. The water temperature should be
approximately 40° C/104° F. Press down the piston valve while cleaning the compact block.
Figure 134
6.
150
Flushing the Compact Block with fresh running water
Cleaning the compact block while pressing down the piston valve
Flush the compact block with fresh running water for 1 minute. Flush into all openings. Press
down the piston valve while flushing the compact block.
Figure 135
7.
8.
9.
Flushing the compact block again
After cleaning, drain any remaining water by rotating the compact block in all directions.
Dry the compact block and the valve covers in a warming closet (maximum 80° C/176° F) or at
room temperature.
Datex-Ohmeda recommends that manual cleaning is always followed by an intermediate or
high level disinfection.
Always clean before high level disinfection.
Compact Block II
Compact Block II can be steam autoclaved. Recommended temperature is 134° C/273° F.
Autoclave valve covers and water container dismantled from Compact Block II.
Compact Block I
The valve covers are the only parts of the Compact Block I that may be steam autoclaved (121° C/
250° F). The rest of the Compact Block I cannot be autoclaved. If high level disinfection is required,
use a glutaraldehyde based disinfectant and rinse thoroughly according to the instructions supplied
by the manufacturer of that agent.
Drain any remaining water by rotating the Compact Block I in all directions. Dry the Compact Block I in
a warming closet (maximum 80° C/176° F) or at room temperature.
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Datex-Ohmeda ADU
Before reusing the compact block
1.
2.
3.
Check visually that the compact block is clean, dry and undamaged.
Check visually that the O-rings are undamaged.
Ensure that the expiratory and inspiratory valves are in bottom position, by lifting the green
membranes (1) and smoothly pressing the valve housings (2).
1
2
Figure 136
4.
5.
Ensuring that the valves are in the correct position
Ensure that the green membranes are in contact with the valve seats. Verify also that the green
membranes do not have any visible damage.
Attach the transparent valve covers over the valves, by first pushing (3) and then twisting (4)
them to lock.
3
Figure 137
4
Attaching the transparent valve covers
6. Put the water container in place (Compact Block II).
See further the ”Instructions for use” leaflets for the Cleaning Cassette and for the Compact Block.
152
Standard Circuit absorber and valve
NOTE: The Standard Circuit absorber and valve may not be available for sales in all countries, and
specifically is not available within the United States. Check with your local sales office for further
information.
14
12
13
11
15
10
9
8
22
7
21
6
20
5
19
4
18
3
16
2
17
1
Canister assembly
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Patient circuit block
O-ring
Absorber lower compartment
Absorber seal
Absorber canister
Valve adapter O-ring
Valve adapter
Inspiration valve assembly
(8)
(9)
Valve body O-ring
Inspiration valve body (large diameter
base)
(10) Fresh gas inlet
(11) Dome O-ring
(12) Flap valve
(13) Dome
(14) Dome retaining ring
(15) Inspiratory hose connection with O-ring
Expiration valve assembly
(16) Expiration valve body (small diameter
valve base)
(17) Valve base locking ring
(18) Expiration hose connection with O-ring
(19) Dome O-ring
(20) Flap valve
(21) Dome
(22) Dome retaining ring
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Datex-Ohmeda ADU
Disassembling
1.
2.
3.
4.
5.
6.
7.
WARNING
Remove the expiratory valve (16) from the patient circuit block (1) by unscrewing the valve base
locking ring (17).
Disassemble the expiratory valve (16), by unscrewing the dome retaining ring (22) and then
removing the dome (21) and the flap valve (20).
Disconnect the fresh gas hose from the fresh gas inlet (10) on the inspiratory valve (9) and
remove the valve.
Disassemble the inspiratory valve (9), by unscrewing the dome retaining ring (14) and then
removing the dome (13) and the flap valve (12).
Lift up the entire canister (5) from the patient circuit block (1).
Pour out the absorbent. Disposal of the exhausted soda lime must be in strict accordance with
the hospital regulations.
Disassemble the absorber by unscrewing the valve adapter (7).
Soda lime is a caustic substance and is a strong irritant to eyes, skin and the
respiratory system. Affected parts should be flushed with water for at least 15
minutes.
Emptying condensed water
The absorber develops humidity and when extensive, it will condense in the vertical metal rod under
the absorber. To drain the condensed water:
1. Remove the unidirectional valves (insp. valve (9) and exp. valve (16)) and the canister (5).
2. Lift the circuit block (1) off the circuit boom that holds the patient breathing system.
3. Turn the circuit block (1) upside down to drain the water.
4. Assemble in reversed order.
To maintain leak tightness, check regularly the quality of all O-rings and the absorber seal (4). Also
apply a thin layer of silicon grease to the O-rings and seal each time the absorber is sterilized or
disinfected.
Disinfection
Disinfect all parts according to the methods described in “Disinfection methods table” on page 144.
The unidirectional valves
It is recommended to regularly control the quality of the O-rings (11, 19) and the flap valves (12, 20)
of the unidirectional valves (insp. valve (9) and exp. valve (16)).
1. Open the retaining ring (14, 22) of the valve dome (13, 21).
2. Remove the dome (13, 21), flap valve (12, 20) and O-ring (11, 19).
Apply a thin layer of silicon grease to the O-rings each time the unidirectional valves have been
sterilized or disinfected.
154
Reassembling the absorber and valve
Canister assembly
1.
2.
3.
4.
5.
6.
Apply a thin coat of silicone grease on the absorber seal (4) and then fit it onto the absorber
lower compartment (3).
Carefully place the transparent canister (5) on the seal.
Apply a thin coat of silicon grease on the valve adapter O-ring (6) and fit it in the groove of the
adapter (7).
Screw the valve adapter onto the lower compartment rod.
Fit the O-ring (2) into the groove on the lower compartment base and push the base into the
patient circuit block (1).
Fill the absorber canister with absorbent.
Filling the absorber with new absorbent
1.
2.
3.
4.
WARNING
Pull out the inspiration valve (7).
Very carefully pour the soda lime into the absorber canister (5) until it is completely filled. Be
sure not to overfill.
Tap the canister to ensure an even settlement of the soda lime.
Refit the inspiration valve.
Soda-lime dust is caustic and can produce burns in the respiratory tract if
inhaled. Use breathing protection to ensure that no soda-lime dust is inhaled by
personnel.
7
6
5
4
3
2
1
Figure 138
Canister assembly
155
Datex-Ohmeda ADU
5.
6.
7.
8.
Fit the valve body O-ring (8) into the groove of the valve body and push the valve body (9) into
the valve adapter.
Fit the dome O-ring (11) into the groove at the top of the valve body.
Place the flap valve (12), any side up, flat over the hole at the top of the valve body.
Put the dome (13) on the valve body and lock it with the dome retaining ring (14).
14
13
12
11
10
15
9
8
Figure 139
9.
Connect the expiration valve to the circuit block (1) with the threaded locking ring (17). The
threaded locking ring ensures that the inspiration and expiration valves cannot be
interchanged.
10. Fit the dome O-ring (19) into the groove at the top of the valve body.
11. Place the flap valve (20), any side up, flat over the hole at the top of the valve body.
12. Put the dome (21) on the valve body and lock it with the dome retaining ring (22).
NOTE: The parts (19 to 22) are interchangeable with parts (11 to 14).
22
21
20
19
18
16
17
Figure 140
156
Ventilator bellows assembly
The following instruction describes different methods to clean and disinfect the Ventilator bellows
assembly. For further information see the “Disinfection methods table” on page 144. For frequency
and level of disinfection, follow hospital routines.
Figure 141
Ventilator bellows assembly on the ADU
Disassembling before cleaning
1.
Turn the ventilation selector to Manual position.
157
Datex-Ohmeda ADU
2.
Disconnect the ventilator and manual bag hoses.
3.
Open the locking handle for bellows block.
4.
Turn the bellows chamber counterclockwise and remove it.
1
2
158
5.
Remove the bellows.
6.
Turn the overflow valve retaining ring counterclockwise and remove it.
7.
Remove overflow valve.
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Datex-Ohmeda ADU
8.
Refit the retaining ring.
9.
Open the APL valve to 1,5 cmH2O.
10. Lift the bellows block off the bottom plate.
160
There are two ways to clean the Bellows block – manually or mechanically in a washer or
washer-disinfector (herein called washer-disinfector). Both methods are described below.
Mechanical cleaning and disinfection in washer-disinfector
1.
Turn the block upside down and connect a hytrel tube to the connector.
Connector
2.
3.
Place the bellows block into the washer-disinfector.
Connect the hytrel tube to the water source in the washer-disinfector and clean the bellows
block with a decontaminating program.
4.
5.
Dry the bellows block in a warming closet or in room temperature.
If the washer-disinfector is not used for disinfection of equipment, Datex-Ohmeda recommends
that a further intermediate or high level disinfection is conducted.
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Datex-Ohmeda ADU
Manual cleaning
1.
Flush the bellows block with fresh running water for 1 minute. It is important to flush into the
correct connector, see the figure below.
Connector
162
2.
Clean the bellows block in a sink with water and cleaning agent for at least 3 minutes. The water
temperature should be 40° Celsius or 104° Fahrenheit.
3.
Flush the bellows block with fresh running water for 1 minute.
4.
It is recommended that manual cleaning is followed by a high level disinfection.
After cleaning and disinfection
1.
CAUTION
Remove the retaining ring. Apply a thin layer of oxygen safe silicon grease to the o-ring and the
threads of the retaining ring.
Do not apply grease to the overflow valve
2.
3.
Refit the overflow valve and the retaining ring.
Carefully inspect the bellows visually for damage.
Bellows and manual ventilation bag
Clean in a washer-disinfector or by hand using warm water and mild soap. Rinse in clean water and
dry at a temperature less than 70° C/158° F. Room temperature is ideal.
If autoclaving is necessary, the maximum temperature is 121° C. Dry at room temperature. Carefully
check the condition of the bellows, overflow valve membrane and manual bag when they have been
autoclaved.
CAUTION
The use of automatic washers or washer-disinfectors and sterilizers may prove
harmful to the rubber bags and bellows. The exposure to detergents during long
periods may cause the rubber to loose elasticity and become sticky.
Storing
Store in a cool place (below 25° C/77° F), away from natural or artificial light and sources of ionizing
radiation. Store free from condensation and away from direct contact with metals, solvents, oils,
grease and strong detergents.
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Datex-Ohmeda ADU
Aladin cassette
Disinfection
Unlock the cassette from the ADU. Clean the Aladin cassette’s surface with a cloth moistened in mild
soap solution.
Storing
Datex-Ohmeda recommends that Desflurane cassettes are empty when storing them for more than
one month. Contact a service technician for draining of cassettes.
Service
All types of Aladin cassettes must be emptied before shipping.
Contact a service technician for draining of cassettes.
The cassettes shall be shipped in a suitable wrapping.
Sampling adapters
Single use adapter
Datex-Ohmeda recommends that the single use adapter is discarded after each patient. If a
bacterial/viral filter is used between the adapter and patient, Datex-Ohmeda recommends that the
adapter is replaced with every patient.
Reusable adapter
Follow hospital routines concerning the level and frequency of disinfection or consult the
recommendations from Datex-Ohmeda in “Disinfection methods table” on page 144.
Sampling line
Do not reuse a sampling line as a cleaned sampling line may affect the accuracy of the
measurements.
164
Recommended periodic maintenance
Check and maintenance schedule
There are four different checks and maintenance procedures for the Anesthesia Delivery Unit, which
should be carried out according to the following schedule:
Check
Frequency
System Check
Daily
Functional Check
Every 6 months
Annual maintenance
Once a year
Three year maintenance
Every 3 years
A System Check should be performed every day before usage of the ADU and always after a
Functional Check.
A Functional Check should be performed every 6 months and always after servicing the ADU. Only
trained service technicians should carry out the Functional Check.
Service
Before submitting the ADU for service, the unit must be properly cleaned and decontaminated as well
as free from any toxic and hazardous substances.
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Datex-Ohmeda ADU
Health and safety declaration form
1.
2.
Please note that equipment returned for service, will not be accepted until this form is properly
completed.
Failure to complete the form or to comply with health and safety cleaning procedures, may
endanger Datex-Ohmeda service personnel and may lead to delay in servicing the equipment.
Equipment type/Product No:
State if the equipment has been in contact with
any toxic or hazardous substances that require
the service personnel to wear:
Serial No:
Gloves
I hereby confirm that the above equipment has
been properly cleaned and decontaminated.
I also agree to give Datex-Ohmeda the sole
control of the instrument / system.
Inhalation filter
Protective clothing
Other.................................…………
...........................................……….
...........................................……….
Cleaning certified:
(signature)
166
Name:
(Block letters)
None of the above
Position in institution or company:
State phone number where Datex-Ohmeda may
obtain more information concerning the
instrument / system.
Date (Year/Month/Day)
Phone No:
............../............../..............
...............................................................
9 Troubleshooting
9 Troubleshooting
Leak detection and correction
The ADU checks for leaks during the System Check. Avoid making any modifications of the bellows
block assembly or to the patient circuit after the System Check as any new leaks may go unnoticed.
The best indication of a large leak is that the standing bellows does not reach the top of the chamber.
This is especially important with low fresh gas flows; less than 1 l/min.
During daily operation, the points most subject to a leak are the hoses, the compact block, the
absorber and the bellows chamber.
If the bellows block has been dismantled, the overflow valve and the bellows base rubber sealing
should be checked.
If the following instructions do not correct the leak, call for a service technician.
Leakage limits of the ADU
•
•
•
The AUTO LEAK check fails when a leak is > 150 ml/min.
The MAN LEAK check fails when a leak is > 100 ml/min.
Measured compliance of the breathing system should be within 1.0 to 10.0 ml/cmH2O.
It is, however, up to the user to decide whether the leakage is acceptable or not.
Leakage during ventilation
When a patient is connected to the ADU, the actual leak is much less than that calculated in the leak
test. In clinical practice the EFFECTIVE MEAN PRESSURE during one complete ventilation cycle and
thus the actual leak is lower than during the leak test. In addition to the effective mean pressure, the
amount of the leak also depends on the rate of the pressure increase, the I:E RATIO and the plateau
time.
cmH2O
15
PEAK
pressure
10
MEAN
pressure
Inspiration
Figure 142
Expiration
Time
Effective mean pressure
In normal ventilation (mean pressure 10 cmH2O, I:E ratio 1:2) the actual leak is approximately 10% of
the leakage calculated during the leak test. This can be calculated with the following formula:
(Mean Pressure) * (Insp. time) * (Leakage in leak test)
(30 cmH2O) * (Cycle time)
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Datex-Ohmeda ADU
MEAN PRESSURE
in cmH2O
I:E -ratio
leakage ml/min.
System Checks leak test
30
insp. only
150
Normal ventilation cycle
10
1:2
17
NOTE: The best indication of a large leak is when the standing bellows does not reach the top of the
chamber. This is especially important with low fresh gas flows (< 1.0 l/min.).
Patient circuit hoses
Check the leakage of each patient hose (= 3 pcs).
1. Connect the hose to the ventilator connector under the bellows block, and to the fresh gas
outlet.
2. Repeat the AUTO LEAK test with each hose to check each individual hose for leaks.
O
Figure 143
3.
168
Checking Hoses for Leakage
Repeat the AUTO LEAK test once more with normal hose connection.
If there still is a major leak, check the compact block.
9 Troubleshooting
Compact block
1.
2.
3.
4.
5.
6.
Check visually that the O-rings are undamaged.
Remove the transparent valve covers.
Check that the insp./exp. valves are in good condition. Make sure they are correctly seated by
lifting the green membranes and carefully pushing the valves down with the fingers.
Replace the valve covers.
Check the ventilator connections.
Repeat the AUTO LEAK test.
Figure 144
Compact block leakage
If the above does not help, exchange the complete compact block and repeat the AUTO LEAK test.
If the compact block does not leak, check the bellows block.
Standard Circuit valve and absorber assembly
Also see the picture and a more detailed description of the Standard Patient circuit in the chapter
Cleaning and Maintenance.
•
Check the hose connections.
Standard absorber assembly
• Lift up the absorber and check that the O-ring on the absorber base is correctly positioned and
that it is soft and tight.
•
•
Push the absorber tightly onto the circuit block.
Check that the absorber lock at the top is tightened.
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Datex-Ohmeda ADU
Inspiratory valve assembly
• Lift up the inspiratory valve assembly and check the O-ring.
• Push the valve assembly tightly into the absorber top lock.
• Tighten the valve dome locking ring.
Expiratory valve assembly
• Tighten the valve base locking ring.
• Tighten the valve dome locking ring.
For a more careful check, remove the dome and dome retaining ring of the absorber and check the
position of the O-rings and that they are soft and tight. If the Standard Circuit absorber and valve
assemblies are not leaking, check the bellows block.
Bellows
The functioning of the ADU bellows system is checked during the System Check. If there is a failure or
an alarm during operation, this is an indication of the following:
1. Failure situation
When the bellows does not reach its top position during automatic ventilation but only about halfway, it is an indication of:
a) The patient is still ventilated but there is a leak. The leak is either:
•
•
•
In the circuit
In the D-lite connection site
In the patient. During lung operations for instance, gases escape through the lung.
b) The volume in the circuit is not sufficient. This is, for instance, typical during low flow anesthesia
and when the sample gas is scavenged.
What to do: Find the leak or compensate the shortage of the fresh gas flow by increasing the fresh
gas flow or by bringing the sample gas back into the circuit.
2. Alarm situation
When the bellows collapses completely, the ADU gives an alarm and the message FILL BELLOWS
appears.
In this case the desired volume cannot be delivered and the patient cannot be ventilated.
What to do: Flush the bellows with O2 by pressing O2 flush button.
Bellows chamber positioning
The bellows chamber sealing might leak if the chamber has not been properly locked in its position or
it has been knocked to the side and is no longer standing upright.
170
9 Troubleshooting
Figure 145
Bellows Chamber Leakage
1.
2.
3.
Release the chamber by pulling out the handle.
Adjust the position of the bellows chamber.
Lock the bellows chamber by pressing down and twisting it into place. Press down the metal
locking ring around the bellows chamber and at the same time, push the handle.
4. Repeat the AUTO LEAK test.
If the bellows block has been disassembled for cleaning and disinfection, the rubber gasket under
the bellows chamber might be leaking. Check that the gasket is correctly seated.
The chamber may also be broken if it was incorrectly positioned while the locking handle was forced
into the locked position.
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Datex-Ohmeda ADU
Overflow valve
Check that the bellows block overflow valve is correctly positioned. If not, open the overflow valve,
reassemble and repeat the AUTO LEAK check.
• Place the rubber membrane over the valve duct.
• Feel with the finger (wear gloves) along the edge to make
sure that the groove on the outer rim of the membrane sits
tightly on the outside wall of the duct.
• Check the tightness by lifting the membrane by the metal
weight. The membrane should flex slightly upwards but not
disconnect from the edges.
• Reassemble the overflow valve by entering (1) and then
turning (2) the valve retaining ring. Be careful not to tighten
it too hard, as the membrane may become kinked and
prone to leak.
WARNING
172
1
2
If the overflow valve is placed incorrectly with the metal part facing downwards,
the pressure in the patient circuit may not be sufficient to guarantee adequate
patient ventilation.
9 Troubleshooting
Bellows block bottom plate gasket
When the bellows block was disassembled during cleaning, the gasket may have gotten out of
position or even been lost.
Figure 146
•
•
Bottom plate with gasket
Lift up the bellows block.
Check that the rubber gasket is not chafed or incorrectly positioned.
Manual bag and bag hose
MAN leak > 100 ml /min.
1. Exchange the ventilation bag or bag hose.
2. Open the APL valve to 1.5.
3. Repeat the MAN LEAK check.
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Datex-Ohmeda ADU
Alarm messages
Limit alarm message
Possible cause of alarm
Recommended action
Ppeak High (AUTO & MANUAL)
Obstructed hose or endotracheal
tube.
Switch to manual and clear
obstruction.
Ppeak Low (AUTO)
Disconnected or leaking hose or
Ppeak low limit too high.
PEEP valve does not work correctly
1. Check hose and connections.
2. Adjust alarm limit.
3. Call for service
PEEP High (AUTO & MANUAL)
Sustained pressure.
Scavenging system obstructed or
overflow valve stuck.
1. Disconnect scavenging.
2. Switch to manual ventilation.
Negative Pressure (AUTO & MANUAL) Scavenging system malfunction
(leak). Spontaneous breathing.
1. Disconnect scavenging.
2. Increase fresh gas flow.
Pmax Release (AUTO)
1. Switch to manual ventilation.
2. Check the patient circuit.
174
Obstruction.
9 Troubleshooting
System status messages
Electronic ventilator messages
Status alarm
Alarm condition
Recommended action
Air supply pressure lost
When the pressure does not reach the Switch to Air reserve gas cylinder.
minimum pressure limit.
Calibrate ventilator
Calibration coefficients returned to
factory defaults.
Call for service.
Cannot deliver set vol.
EV detects that delivered TV differs
from set during four EV cycles.
Change ventilator or fresh gas
settings. Check for leakage.
Cannot reach PCV pressure
Pressure limit not reached during five Check for disconnections or some
consecutive breaths.
other malfunction that would cause a
major leak.
Check bellows chamber or call service Following the message “Ventilator or
circuit leak”.
Driving gas to: Secondary
Driving gas switched from primary to
secondary.
Restore the availability of primary
driving gas. If using cylinder as driving
gas source, be aware of greater
consumption of cylinder gas.
Faulty PEEP valve
PEEP control error.
Use system without PEEP. Call for
service.
Fill bellows
Leak or fresh gas flow too low.
Remove the leak or increase fresh gas
flow.
Loss of driving pressure
Neither primary nor secondary driving Use manual ventilation. Restore
gas available. Ventilator inoperable. driving pressure.
O2 supply pressure lost
When the pressure does not reach the Switch to O2 reserve gas cylinder
minimum pressure limit.
Select MAN or AUTO mode
The AUTO/MAN switch is in neither
position.
Select either position.
Sigh cycle
Starting sigh cycle.
None. Notification to user.
Switch to MAN mode
System is in AUTO mode after System Switch to manual ventilation.
Check.
To prevent the ADU from starting to
ventilate immediately it is required
that user switches to MAN first.
Ventilate manually
See previous. Is shown together with
Ventilator failure message.
Ventilate manually.
Ventilator communication error
Communication failure between EV
and main SW. Settings not accepted
by EV.
Use previous settings. Try new
settings. Switch to manual
ventilation.Call for service
Ventilator failure
Safe state.
Use manual ventilation. Call for
service
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Datex-Ohmeda ADU
Status alarm
Alarm condition
Recommended action
Ventilator or circuit leak
Leak in ventilator circuit or bellows
Check bellows chamber or call for
chamber. System stuck in Self Check. service.
Electronic vaporizer messages
Status alarm
Alarm condition
Recommended action
AA liquid sensor failure
Liquid measurement malfunction.
Check the level indicated by the liquid
level indicator.
Agent % not delivered. Decr. flow
Insufficient agent delivery. The
Decrease fresh gas flow.
concentration control valve cannot be
opened, as the set value requires.
Agent setting high 1
Sevoflurane setting above 5 %.
Agent shut OFF
Vaporizer agent on/off valve is closed Increase fresh gas flow and then set
because of low fresh gas flow or
agent percentage in fresh gas. If this
vaporizer malfunction.
does not help - call for service.
Air selected
System changes automatically to Air. Increase O2 fresh gas flow. Check N2O
supply pressure. Check that ratio
control works properly.
Calibrate fresh gas unit
Calibrations returned to factory
defaults.
Call for service.
Cannot identify cassette
The ID coding of the cassette cannot
be interpreted.
Exchange the cassette and have the
faulty cassette serviced.
Cassette empty
Aladin cassette is empty.
Fill the Aladin cassette.
Decrease fresh gas flow
Vaporizer’s dynamic range exceeded. Reduce fresh gas flow.
Draining cassette
Aladin cassette is overfilled or
overpressurized.
Ensure adequate agent %
Heated vaporizer, vapor pressure may Check actual agent percentage from a
be higher than normal.
gas monitor. FiAA corresponds to
fresh gas percentage and EtAA to the
concentration in patient’s lungs.
Ensure adequate oxygen
Shown together with messages:
Increase O2 fresh gas flow and check
Hypoxic mixture, Fresh gas occlusion, from a patient monitor that the
Fresh gas unit failure, Air selected
patient gets enough O2.
Faulty N2O/Air switch
The gas selector switch malfunctions. Call for service.
Fresh gas occlusion. FG outlet
Occlusion detected in fresh gas
outlet.
Clear occlusion or call for service.
Fresh gas unit failure
1) Safe state.
2) Communication failure.
Call for service.
1.
Lower the setting to below 5 %.
If the message appears frequently,
call for service. Otherwise wait until
the message disappears and
continue normal operation.
If this alternative is installed.
176
9 Troubleshooting
Status alarm
Alarm condition
Recommended action
Fresh gas unit meas. error
Flow measurement malfunction.
Call for service.
Hypoxic mixture
Calculated O2 concentration falls
below 21 %.
Increase O2 flow; decrease N2O flow.
N2O supply pressure lost
N2O supply pressure lost.
Restore N2O supply pressure.
Select N2O or Air
The gas selector switch points neither Select N2O or Air.
N2O nor Air.
Vapor. Leak Cassette? Service?
Leakage detected in the vaporizer.
Change cassette.
If changing cassette doesn’t help call
for service.
Vaporizer failure
Various fresh gas control unit errors.
Communication failure.
Call for service.
Status alarm
Alarm condition
Recommended action
Batteries empty
Go manual
Batteries exhausted.
Ventilate manually.
Battery failure
HW error in battery circuit.
Call for service.
Check battery
Uneven battery voltage.
Call for service.
Keyboard failure
Hardware failure.
Ventilate manually. Call for service.
Mains power lost
Loss of mains power.
Operate with batteries or restore
mains power.
Patient monitor removed
Install/Interfacing: Monitor is ULT or
AM. Interface between
the ADU and a patient monitor is set
up but disconnected.
Connect patient monitor or change
the interface setup.
Software mismatch
Main SW 6.2/7.2 or newer that has
been configured to operate without
N20, and A-FGC1 SW 7.4 or older
installed.
Install A-FGC1 SW 7.5 or newer.
System Busy
System is not yet ready to process
new keyboard commands.
Wait 30 s. Switch the ADU OFF and
then ON again. If this does not help call for service.
System check bypassed
Bypass Check is selected in System
Check menu.
Perform Full Check or separate test.
Unexpected Reset
System Reset
See “Unexpected Reset” on
page 134.
Volume monitor removed 1
Connection lost between the ADU and Restore connection.
the interfaced spirometry monitor ULT
or AM.
Other messages
1.
If this alternative is installed.
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Datex-Ohmeda ADU
178
General
Dimensions
Basic unit with cart
Height
Two optional heights: 1410 / 1540 mm
Display viewing level
1242 / 1372 mm
Depth
770 mm
Width
840 mm
Floor space
705 mm x 726 mm
Weight
110 to 130 kg
Basic unit without cart
Height
670 mm
Depth
750 mm
Width
840 mm
Weight
85 kg
Drawer (optional)
Height
145 mm
Depth
405 mm
Width
480 mm
Table
Width
510 mm
Depth
353 mm
Folding table (optional)
Width
262 mm
Depth
312 mm
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Datex-Ohmeda ADU
Environmental conditions
Temperature
+10°C to +35°C (50 to 95°F)
Relative humidity
0 to 85 % (non-condensing, in operation)
Atmospheric pressure
660 to 1060 hPa (500 to 800 mmHg),
corresponding to altitudes up to about 3000
meters above sea level
Storage temperature
-10°C to +60°C (14 to 140°F)
Electrical requirements
The unit is designed to be powered from the mains power supply. A back-up battery function is
provided.
Power supply
220 to 240 VAC (±10%), 50/60 Hz
or 100 to 120 VAC (±10%), 50/60 Hz
Maximum power consumption
220 to 240 V:
2 A (ADU + AM with CRT display)
10 A (above + auxiliary outlet)
100 to 120 V:
4 A (ADU + AM with CRT display) 12 A (above +
auxiliary outlet)
Grounding
Hospital grade
Safety class
IEC Class I, type B
Protection against ingress of water
Class IPX1
Back-up battery capacity
Capacity for > 20 min. (typically 30 min.) of use
of the ADU.
Four (4) hours
Charging time
Electrical connections
180
Auxiliary outlets
1 mains power outlet on the rear side for an
Anesthesia Monitor. Option: 3 outlets
Fuses
2 x T2.5 A in 220 to 240 V units
2 x T5 A in 100 to 120 V units
Voltage
220 to 240 VAC, 50/60 Hz
100 to 120 VAC, 50/60 Hz
Nominal output currents
220 to 240 V units, 2 A socket
100 to 120 V units, 3 A socket.
Max. total 8 A
Data connector
9-pin female D-connector for serial I/O and
analogue input
Display
12.1” display
Display type
Active matrix color LCD
Size
12.1" diagonal
Display resolution
SVGA resolution, 800X600
Controls
15 membrane switches, ComWheel™
Indicators
Red and yellow LCDs
10.4” display
Display type
Active matrix color LCD
Size
10.4" diagonal
Display resolution
VGA resolution, 640X480
Controls
14 membrane switches, ComWheel™
Indicators
Red and yellow LCDs
Trends
Trend resolution
Resolutions for continuous data:
up to 20 min.
10 s
up to 2 hours,
1 min.
up to 4 hours
2 min.
up to 12 hours
6 min.
up to 24 hours
12 min.
Continuous trend information together with time discrete events are stored for the latest 24 hours
with one-minute resolution for all ADU parameters.
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Alarms
The following alarms are user adjustable:
High pressure alarm, Ppeak High (in AUTO mode) 8 to 80 cmH2O,
always > Ppeak Low + 2 cmH2O
(factory default 30 cmH2O)
High pressure alarm, Ppeak High (in MAN mode) 6 to 80 cmH2O
(factory default 40 cmH2O)
Low pressure alarm, Ppeak Low (in AUTO mode) 6 to 78 cmH2O
or PEEP + 4 to Ppeak High - 2
NOTE: Cannot be set higher than Ppeak High
The following pressure alarms are non-adjustable:
182
Negative pressure alarm
Alarm if the airway pressure stays below a (subatmospheric) limit continuing for a certain time.
In Manual mode:
MEDIUM priority alarm when airway pressure has
stayed below -0.7 cmH2O continuously for 20 s.
In Auto modes VCV and PCV:
NOTE when min pressure of all cycles within a
period of 1 s has fallen below -3 cmH2O.
MEDIUM priority alarm when min pressure of all
cycles within a period of 20 s has fallen below 0.7 cmH2O or when all cycles within a period of 5
s has fallen below -3 cmH2O.
HIGH priority alarm when the min pressure of all
cycles within a period of 20 s has fallen below -3
cmH2O or when min pressureof all cycles within a
period of1 s has fallen below -8 cmH2O.
In Auto mode SIMV:
MEDIUM priority alarm when min pressure of all
cycles within 20 s has fallen below -0.7 cmH2O
Sustained pressure alarm, PEEP High
Alarm if the airway pressure exceed a limit
continuing for longer than 15 seconds.
Gas delivery
Gas supply
Wall supply
Gas connectors
O2 - AIR - N2O - VAC (optional) - EVAC
Inlet pressure
270 to 800 kPa (39 to 116 psi)
Gauges
O2, Air, N2O: 0 to 1000 kPa (0 to 145 psi)
Accuracy of gauges
± 4 % of full scale
O2, Air, N2O safety valves opening pressure
900 kPa (130.5 psi)
Reserve gas cylinders
Reserve gas yokes
Pin/DIN index for O2, N2O, Air
Gauges
O2: 0 to 31.5 MPa (0 to 4568 psi)
N2O: 0 to 10 MPa (0 to 1450 psi)
Air: 0 to 31.5 MPa (0 to 4568 psi)
Accuracy of gauges
± 4 % of full scale
Safety valves opening pressure
700 kPa (102 psi)
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Fresh gas control unit
Fresh gas outlet
The ADU has a coaxial 22 mm /15 mm conical
fresh gas outlet in compliance with ISO 5356-1/
to 50EN 1281-1.
Overpressure valve in fresh gas outlet
80 cmH2O
Extra outlets
Optional outlets for vacuum (max 1ea), O2 (max
2ea) and Air (max 2ea). Max total number of
outlets is: three on the left and one on the right
side. Flow from and pressure at the outlets are
dependent on the hospital wall pressure.
O2 flush
35 to 50 l/min.
Flow control adjustments
Flow delivery ranges
O2
0 to 10 l/min. as single gas.
0 to 8.5 l/min. together with max. 4 l/min. Air or
N2O flow.
AIR
0 to 10 l/min. as single gas.
0 to 8.5 l/min. together with max. 4 l/min. O2
flow.
N2O
0 to 8.5 l/min. together with max. 4 l/min. O2
flow.
Accuracy specifications applied to above mentioned nominal adjustment ranges. Available
maximum flows may exceed the above mentioned values.
Electronic flow measurement
Accuracy *
O2
± 10 % or ±20 ml/min., whichever greatest
AIR
N2O
*) NOTE: All accuracy specifications refer to the 0.1 to 10 l/min. flow range.
184
O2, Air, N2O:
Resolution
0 to 1.0 l/min.
0.05 l/min.
1.0 to 10 l/min.
0.1 l/min.
Hypoxic Control
Electronic O2% control is calibrated to guarantee
25 ± 4 vol. % O2 concentration
Electronically controlled vaporizer and Aladin cassette
Electronically controlled vaporizer for delivery of five agents: Halothane, Isoflurane, Enflurane,
Sevoflurane and Desflurane.
The Aladin Cassettes can be handled safely without excessive leakage of anesthetic agent to the
environment.
NOTE: The ADU vaporizer performs as an ordinary concentration calibrated vaporizer regarding the
effects of varying ambient pressure. The nominal agent volume % setting is graduated at sea level
ambient pressure (760 mmHg). If the vaporizer is used at higher altitudes (decreased ambient
pressure), the delivered agent volume % will be higher than the set agent volume % in relation to the
decrease of the ambient pressure. This is due to the agent partial pressure being independent of the
ambient pressure.
Filling
Filling system
Adapter filling:
Rectangular keyed adapter filler system for
Halothane, Isoflurane, Enflurane and
Sevoflurane.
Quik Fil system according to Abbot’s for
Sevoflurane.
Cylindrical keyed adapter filler system
compatible to the Datex-Ohmeda Saf-T-Fil
bottle for desflurane.
Filling speed
> 2 ml/s
Overfilling protection
Overfilling prevention systems built into the
cassettes.
Liquid capacity
Maximum
250 ml
Normally possible to fill up when cassette
indicator shows empty
150 ml
(residual volume 100 ml)
Cassette
Empty weight
Enflurane, Isoflurane, Sevoflurane with keyed
filler - 2.0 kg. Halothane with keyed filler,
Sevoflurane Quik Fil - 2.5 kg, Desflurane - 3 kg
Height
7 cm
Depth
23 cm
Width
14 cm
16 cm for keyed filler system
Anesthetic agent delivery
Minimum fresh gas flow for agent delivery
0.2 l/min.
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Agent setting ranges
Halothane, Enflurane, Isoflurane
OFF, 0.1 to 5 % in fresh gas flow,
resolution 0,1 %
Sevoflurane
OFF, 0.1 to 8 % in fresh gas flow,
resolution 0.1 %
Desflurane
OFF, 0.5 to18 % in fresh gas flow,
resolution 0.5 %
Accuracy
All agents in typical operating conditions. Fresh
gas flow range 0.2 to 8 l/min.
Ambient temperature 18 to 25 ºC.
Sea level ambient pressure.
± 10 % of setting or ±3 % of full scale whichever
is the greatest
In other operating conditions
± 20 % of setting or ±5 % of full scale whichever
is the greatest
NOTE: Sevoflurane concentrations above 5%
may not be reached if the ambient temperature
is below 18 °C and the fresh gas flow above 5 l/
min.
NOTE: Sevoflurane and Desflurane concentration
at high fresh gas flows (>5 l/min) and high
concentration settings (SEV >5%; DES >12%)
will decline after some minutes of use. The rate of
decline will increase with higher setting, higher
fresh gas flow and lower temperature.
NOTE: The effect of the fresh gas composition,
back pressure and temperature variations on the
agent concentration are included in the accuracy
specification.
NOTE: The nominal volume % setting of the
vaporizer is graduated at sea level ambient
pressure or 1013 hPa. The delivered agent vol %
for a set vol %, will increase in relation to the
ambient pressure decrease, since the anesthetic
agent partial pressure is independent of the
ambient pressure
Response time
To 90 % of step; measured at fresh gas outlet
186
< 20 s at a fresh gas flow of 3 l/min.
Ventilation
Electronic ventilator including bellows block
Description
The ventilator is an electronically controlled, time cycled flow generator delivering tidal volumes
compensated for the actual inspiratory fresh gas flow and measured breathing circuit compliance.
The ventilator includes a maintenance free internally integrated PEEP-valve.
The ventilator incorporates a switch operation from manual or spontaneous ventilation (Man/Spont)
to controlled mechanical ventilation (AUTO). Manual ventilation is direct, i.e. the rebreathing bag is
directly connected to the patient breathing circuit.
General
Driving gas
Compressed Air or O2. If the supply of primary
gas is lost the secondary gas is automatically
switched in. Switch activating pressure: 250 kPa
(36.3 psi)
Driving gas pressure
270 to 800 kPa (39to116 psi)
Driving gas consumption
Approx. same as minute volume in volume
controlled mode. In PCV the consumption is
dependent on the Pressure Limit.
Gas supply, O2 alarm
Alarm activating pressure: 250 kPa (36.3 psi)
Max. inspiratory flow
≥80 l/min.
Minute volume (max.)
30 l/min.
Inspiratory flow pattern
Constant flow in volume controlled mode
Decelerating flow in pressure controlled mode
Controls
Ventilation control
AUTO/MAN selector (mechanical)
Tidal volume
Option: alternative minute volume setting
20 to 1400 ml, (factory default 500 ml)
Tidal volume resolution:
20 to 50 ml
50 to 100 ml
100 to 300 ml
300 to 1000 ml
above 1000 ml
2 ml
5 ml
10 ml
25 ml
50 ml
Minute volume
Option: alternative tidal volume setting
Resolution
0.1 to 30 l/min. (factory default 5.0 l/min.)
Pressure limit
Resolution
5 to 40 cmH2O above measured PEEP
1 cmH2O
0.1 l/min.
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Controls
Respiration rate
Resolution
2 to 60 breaths/minute (factory default, 10)
1 breath/minute
Patient weight (kilos)
Resolution
3 to 100 kg, (7 to 220 lbs)
0.5 kg within 3 to 10 kg range
1 kg within 10 to 30 kg range
5 kg within 30 to 100 kg range
Inspiration/expiration ratios
1:4.5, 1:3, 1:2.5, 1:2, 1:1.5, 1:1, 2:1, (factory
default, 1:2)
Not available in SIMV.
Optional: Inspiratory time in seconds or %.
Inspiratory time
0.35 to 20 sec
Optional: I:E ratio or Inspiratory time percentage Note: Minimum expiratory time: 0.5 sec
Inspiratory time percentage
Optional: alternative I:E ratio or inspiratory time
in seconds
18 to 67 % of whole cycle (1:4.5 - > 18 % and
2:1 - > 67 %)
Not available in SIMV
Inspiratory pause
0 to 60 % of inspiratory time with 5 %
increments, (factory default 25%), available in
Volume Controlled Ventilation and SIMV
PEEP
OFF:
2 to 4 cmH2O due to the weight of a standing
bellows system.
5 to 20 cmH2O.
Resolution 1 cmH2O, factory default OFF.
PEEP is limited to 10 cmH2O if Tidal Volume is
less than 100 ml.
188
Sigh
OFF/ON, 1.5 x TV every 100th breath. Not
available in SIMV or Pressure Control. Maximum
volume 1400 ml.
Trigger level for SIMV from baseline
Resolution
-0.5 to - 5 cmH2O (default -1.0)
0.1 cmH2O
Trigger window for SIMV
Resolution
5 to 95 % from expiratory time
Minimum expiratory time: 0.5 sec
1%
Inspiratory Rise Time
Pressure rise in PCV mode as % of inspiration
time: Slow (90%), medium (50%) (default), fast
(10%). Shortest time is 300 ms.
Accuracy
Tidal volume accuracy
20 to 50 ml: ±20 % of set value or 5 ml,
whichever is the greater.
≥50 ml: typically ±5 % of set value or 10 ml,
whichever is the greater.
Typically is defined so that 90 % of machines are
within ±5 %. All machine < ±10% of set value.
Compensated for fresh gas flow up to 50% of
actual minute volume.
Compensated for machine compliance.
Independent of gas composition
Accuracy valid for airway pressures ≤ 30 cmH2O.
Delivered volume will decrease at high pressure;
-20% at 100 cmH2O.
Tidal volume repeatability
Variation < 10% in the range 20 to 100 ml
Minute volume accuracy
See tidal volume
Pressure control accuracy
± 2 cmH2O
Resp. Rate, I:E, Pause, Insp. time accuracy
± 60 ms
PEEP accuracy
± 2 cmH2O up to 20 cmH2O
Sigh accuracy
± 10 % of volume
± 60 ms timing
Circuit pressure monitoring
Measuring range
- 40 to 100 cmH2O
Measuring accuracy
± 4 % of value or ± 2 cmH2O
Display resolution
1 cmH2O
Displayed values
Parameters
Volume mode
SIMV mode
PCV mode
Man mode
Ppeak, Pplat, PEEP
Ppeak, Pplat, Pmin
Ppeak, PEEP
Ppeak, Pmin
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Datex-Ohmeda ADU
Circuit pressure regulation
Automatic ventilation mode (AUTO mode)
Adjustable maximum pressure release, Pmax
Release (Software controlled pressure limiting)
(Ppeak Low + 2). 80 cmH2O (Default 40 cmH2O)
Circuit pressure regulation
Manual/Spontaneous ventilation mode
(MANUAL mode)
190
APL valve adjustment range
1.5 to 80 cmH2O
APL setting
1.5 cmH2O
20 cmH2O
80 cmH2O
0.5 to 5 cmH2O, Fresh gas flow 3 to 10 l/min
15 to 30 cmH2O, Fresh gas flow 3 to 10 l/min
64 to 96 cmH2O, Fresh gas flow 3 to 10 l/min
Patient breathing systems
Refer to the technical information tables for the Compact block patient circuit and the Standard
Patient circuit with absorber.
Any breathing circuit compatible with a 22/15 mm coaxial fresh gas outlet may be used. A patient
circuit used together with tubing and Bellows block must comply with the maximum resistance
requirements as specified in prEN740. The compliance for the entire breathing circuit must not
exceed 7 ml/ cmH2O.
The patient circuit used must have unidirectional valves for the inspiratory and expiratory lines as well
as a connection for fresh gas when required (Bain type circuits excluded).
NOTE: Patient circuits with built in APL valve must not be used for the ADU to avoid the risk for
confusion due to multiple pressure limiting devices.
NOTE: It has been found that carbon monoxide (CO) tends to build up in unused anesthesia units.
Exchange absorbent in a unit that has been idle for more than 48 hours. Also flush the system with O2
before use.
Scavenging
Maximum extracted flow
50 l/min.
or
40 l/min. if silencer (8502504) installed
Normal minimum extracted flow
25 l/min. (independent of fresh gas flow)
Passive scavenging
Rear panel scavenging connector.
Differential pressure 29 cmH2O at 25 l/min.
Extracted flow with A-SEJ2 ejector
(Active scavenging with optional scavenging
ejector)
Minimum 25 l/min at a driving pressure of 250
to 800 kPa (36.3to116 psi)
Driving gas: Air
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Vaporizer output graphs
Anesthetic agent concentration output
Halothane
Typical output at 20 °C, 10 °C and 35 °C as functions of fresh gas flow and vaporizer settings.
Concentration [%]
Halothane in O2 at 20°C
5%
4%
2%
1%
0,5%
Flowrate [l/min.]
Concentration [%]
Concentration [%]
6
5
4
3
2
1
0
Flowrate [l/min.]
192
0
2
4
6
8
10
Flowrate [l/min.]
Sevoflurane
Concentration [%]
Sevoflurane in O2 at 20°C
5%
4%
2%
1%
0,5%
Flowrate [l/min.]
Concentration [%]
Concentration [%]
Flowrate [l/min.]
Flowrate [l/min.]
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Enflurane
Concentration [%]
Enflurane in O2 at 20°C
5%
4%
2%
1%
0,5%
Flowrate [l/min.]
Concentration [%]
Concentration [%]
Flowrate [l/min.]
194
Flowrate [l/min.]
Isoflurane
Concentration [%]
Isoflurane in O2 at 20°C
5%
4%
2%
1%
0,5%
Flowrate [l/min.]
Concentration [%]
Concentration [%]
Flowrate [l/min.]
Flowrate [l/min.]
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Desflurane
Concentration [%]
Desflurane in O2 at 20°C
5%
4%
2%
1%
0,5%
Flowrate [l/min.]
Concentration [%]
Concentration [%]
Flowrate [l/min.]
196
Flowrate [l/min.]
11 Glossary
11 Glossary
Abbreviations
APL
APN
ATPD
CO2
Airway Pressure Limiting (valve)
Apnea
Ambient Temperature Pressure Dry
Carbon dioxide
CMV
Compl
DES
EV
ENF
ET
Exp.
FI
HAL
I:E
Insp.
ISO
MAC
mbar
MV
MVexp
Controlled Mechanical Ventilation
Compliance
Desflurane
Electronic Ventilator
Enflurane
End tidal gas concentration
Expiratory/Expiration
Fractional concentration of inspired gas
Halothane
Inspiratory: Expiratory time ratio
Inspiratory/Inspiration
Isoflurane
Minimum Alveolar Concentration
Millibar (unit of pressure)
Minute volume
Expired minute volume
MVinsp
N2O
inspired minute volume
Nitrous oxide
O2
Oxygen
Pa
Paw
Pascal (unit of pressure)
Airway pressure
Ppeak
Peak pressure
PEEP
Pplat
Positive end-expiratory pressure
Plateau pressure
Pcirc
Resp
RR
SEV
PCV
PS
SIMV
TV
Vol.
Circuit pressure
Respiration
Respiration Rate
Sevoflurane
Pressure-controlled ventilation
Patient Spirometry
Synchronized Intermittent Mandatory Ventilation
Tidal volume
Volume
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Units
Pressure units
kPa = kiloPascal
cmH2O = centimeters of water
bar = 1 atmosphere
mmHg = millimeters of Mercury
psi = Pounds per square inch
Torr = Torr; unit of pressure, named after Italian physicist Torelli. = mmHg
kPa = about 10 cmH2O = 7.5 mmHg
100 kPa = 1 bar = about 1 atm = 750 mmHg
100 kPa = about 15 psi
Time units
s = seconds
min = minutes
h = hours
Volume units
l = liters (1000 cc)
ml = milliliters (1 cc)
l/min = litters per minute
198
11 Glossary
Anesthesia machine vocabulary
Key words and basic definitions
Some of the definitions below are established European Standard (CEN) or International Standard
(ISO).
Absorbent
Substance, usually soda lime, used to absorb carbon dioxide in a breathing system.
Airway pressure
Pressure at a specified point in the patient's airways. ISO
Anesthetic gas scavenging system (AGSS)
A system which is connected to the exhaust port(s) of an anesthetic workstation for the purpose of
conveying expired and/or excess anesthetic gases to an appropriate place of discharge. CEN
Anesthesia machine (UK: Anesthetic Machine)
Integrity of equipment, including gas supply and control system, a breathing and ventilation system
and a scavenging system for dispensing and delivering anesthetic gases and vapors into a breathing
system.
Anesthesia system (UK: Anesthetic System)
Any of a variety of assemblies designed to administer an anesthetic.
Anesthetic agent
A drug used, usually in vaporized form, to reduce or abolish sensation of pain, consciousness or
muscle activity. Examples of anesthetic agents are e.g. Halothane, Enflurane and Isoflurane.
Anesthetic agent vapor
The gaseous phase of an anesthetic agent that is a liquid at room temperature and atmospheric
pressure (as an exception desflurane has a boiling point of 23.5o C).
Anesthetic agent concentration
The percentage of anesthetic agent present in the total anesthetic gas mixture.
Anesthetic gas
CEN: Any gas and/or vapor of volatile agent used in anesthesia.
Anesthetic vaporizer
A device designed to facilitate the change of an anesthetic agent from a liquid to a vapor. ISO
Anesthetic work station
A system for the administration of inhalational anesthesia which includes one or more actuator
modules, monitoring, and their particular alarm modules, and essential hazard protection modules.
CEN
APL valve (= Adjustable Pressure Limiting valve)
Pressure limiting valve, also called a "POP OFF valve, which releases gas over an adjustable range of
pressures in purpose: ISO/CEN
•
•
to control system pressure and thus intrapulmonary pressure
to release excess anesthetic gases and vapors
Auxiliary mains socket outlet
Electrical outlets built into the ventilator for connecting other electrical equipment.
Bain circuit
Breathing system for partial rebreathing without CO2 absorber. Coaxial tubes are used.
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Bellows
An active part of a ventilator system acting as a reservoir for the gases. It separates gas breathed by
the patient from the ventilator driving gas.
Ascending (standing)
The bellows moves upwards during expiration.
Descending (= hanging)
The bellows moves downwards during expiration.
Berner valve
A valve specially designed for manually assisted ventilation having options for spontaneous
breathing as well as for volume and pressure controlled assistance of the ventilation. The Berner
valve is named after the inventor, the Danish doctor Berner.
Breathing system
Gas pathway in direct connection with the patient through which intermittent or reciprocating gas flow
occurs and into which a mixture of a controlled composition of anesthetic gas mixture may be
dispensed. ISO
Carbon Dioxide (CO2)
CO2 is an end product of metabolism resulting from oxidation of carbon in the tissues, and being
eliminated from the body by exhalation through lungs. CO2 acts as a breathing center stimulator. In
some countries (for example in UK) CO2 is administered to the patient at the end of anesthesia in
order to activate spontaneous breathing.
CO2 absorber
An absorbent, usually soda lime, in a container is used to remove CO2 chemically from the patient
expired gas. Primarily used in the circle breathing system.
Circle system
Anesthetic breathing system in which the direction of gas flow through separate inspiratory and
expiratory pathways is determined e.g. by unidirectional valves, and in which the two pathways form a
circle. CEN
Circle absorption system
Circle system incorporating a carbon dioxide absorber. ISO/CEN
Circuit compressible volume
Distensibility of the patient circuit. Volume change per unit of pressure change. Also called patient
circuit compliance.
Common gas outlet
The port through which the dispensed mixture from the anesthetic gas supply device is delivered to
the breathing system. (See FRESH GAS INLET). ISO
NOTE: The above definition is related to function. In structural terms, any gas outlet port will be known
by the component of which it is a port; for example vaporizer outlet, machine outlet, cabin outlet. (A
note from ISO-standard.)
"Complete" rebreathing system; closed system
System from which no expired mixture is discharged. In anesthetic practice, carbon dioxide is
removed from the mixture within the system, completely, partially or not at all. ISO
Continuous flow apparatus
Device delivering continuous flow of anesthetic gases and/or vapors at the ambient pressure, to
meet the patient's respiratory requirements. ISO
Cylinder (for medical gas)
Color-coded cylindrical-shaped tanks containing specified medical gases e.g. O2, Air or N2O, CO2 etc.
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11 Glossary
Cylinder pressure gauge
A gauge used to monitor the pressure of gas within the cylinder.
Dead space
Area in patient's respiratory tract, or portion of a breathing system, not taking part in the gas
exchange. Dead space areas can be divided into the following:
Anatomical dead space
Physiological dead space
Mechanical dead space
Diameter index safety system
DISS; A safety gas supply system to the anesthesia machine incorporating a specifically indexed
pipeline gas inlet. Inlets between gases supplied into the anesthesia machine are noninterchangeable.
Exhaustion time
Length of time an absorbent may be used before it fails to keep CO2 concentration at an acceptable
level.
Expiration (or exhalation)
The act of breathing out.
Expiratory valve
Valve which, when open, allows gas to pass through it from the patient only during the expiratory
phase. ISO
Flow control valve
Device that controls the rate of flow of a gas or a mixture of gases (ISO).
Flow direction sensitive component
Component through which the gas flow must be in one specific direction only for its proper
functioning and/or patient safety. ISO
Flowmeter
Any device which measures the flow of a specific gas or gas mixture passing through it. CEN
Fresh gas
Mixture of "fresh" gases (O2, N2O, Air + anesthetic agent) administered from flow meters and
vaporizer to the patient breathing system for administration of anesthesia.
Fresh gas inlet
That port on a breathing attachment through which the dispensed mixture from the anesthetic gas
delivery module is delivered to the anesthetic breathing system. (See COMMON GAS OUTLET) CEN
Gas power outlet
An accessory outlet of an anesthesia machine that supplies driving gas (Air or O2) for auxiliary
equipment, e.g. suction.
Inhalation anesthesia apparatus
Equipment intended for dispensing and delivering anesthetic gases and vapors into a breathing
system for delivery to the patient. ISO
Inspiration (or inhalation)
The drawing of air (or other substances) into the lungs.
In mechanical ventilation air is pushed into the lungs.
Inspiratory pause time
ISO: Interval from the end of inspiratory flow to the start of expiratory flow.
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Inspiratory-expiratory phase time ratio (I:E ratio)
Ratio of the inspiratory phase time to the expiratory phase time. ISO
Normally I:E ratio used in controlled mechanical ventilation
is 1:2 meaning that expiratory phase is twice as long as inspiratory phase.
Inspiratory valve
Valve which, when open, allows gas to pass through it to the patient only during the inspiratory
phase. ISO
Jackson-Rees
Non-rebreathing system suitable for assisted ventilation.
Low flow
Fresh gas flows below 1 l/min.
Medical air
Cleaned compressed air that can be used for patient ventilation. (Complies with ISO Standard
Specification).
Medical gas
Any gaseous substance that meets medical purity standards and has application in medical
environment, e.g. O2, N2O and Air.
Minute volume (MV)
Volume of gas, expressed in litters per minute entering or leaving the patient- or lung model. The
physical conditions under which measuring was made should be given. ISO
mmHg
Millimeter of mercury (a unit of pressure)
Non-rebreathing system
System from which all the expired mixture of gases is discharged. ISO
O2 flush valve
Manually operated valve for delivery of a relatively large flow of O2 close to the common gas outlet
without having passed through flowmeter and/or vaporizer. This so-called "emergency oxygen flow"
is directed directly into the patient breathing system. ISO
Oxygen supply failure alarm
An auditory alarm which must last at least 7 seconds (= ISO standard) to give a warning about
insufficient O2 pressure supply to the anesthesia machine.
Partial rebreathing system
System in which a portion of the expired mixture is retained within the system. Carbon dioxide may be
totally or partially eliminated.
Patient connection port
That opening at the patient end of an expiratory valve unit; a Y-pISOe fitting or a unidirectional valve to
which may be connected either a tracheal tube adapter or a face mask angle pISOe. ISO
Pin index safety system
PISS; Safety pin indexed coding system of the cylinder yokes and cylinders.
Pipeline gas (central wall gas supply)
Medical gas delivered by permanently piped, hospital distribution system, usually O2, N2O and Air.
Pneumatic
Relating to or using gases under pressure.
Pediatrics
Branch of medicine dealing with development, care and diseases of children (premature/new-born
to 15 years of age).
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11 Glossary
Pressure gauge
Any device used to measure pressure within a specified system; usually metric system is calibrated in
kPa (kiloPascal).
Pressure relief valve
Pressure limiting valve, the prime function of which is to serve as a safety device, for example APLvalve. ISO
Proportional regulator
Regulator controlling the proportion of O2 in the O2/N2O gas mixture (e.g. minimum of 25% of O2). If
O2 setting is reduced also N2O supply is automatically reduced to maintain the minimum O2
percentage in the specified level.
Rebreathing
Inhalation of previously respired mixture of gases from which carbon dioxide (CO2) may or may not
have been removed. ISO
Respiration
Exchange of gases (O2 and CO2) between atmosphere/alveoli and between blood/body cells.
Respiration rate
Respiratory rate of breathing in and out in one minute.
Scavenging system
An assembly of specific components that serve to collect excessive expired gases and exhaust them
out of the operating room.
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204
12 Appendices
12 Appendices
Appendix A – Compressible volume
Compensation for compressible volume in the delivery system
1. Measurement of compressible volume
The compressible volume in the patient circuit (Compliance) is measured during the daily System
Check - AUTO Leak test - in the following way:
•
The circuit is filled with O2 by the shunt valve in the O2 channel being opened to allow a
6 l/min. flow.
•
The bellows either delivers a volume of 155 ml or any volume of a 27 cmH2O pressure,
whichever comes first.
•
•
The pressure rise is measured by the pressure sensor in the ventilator port of the bellows block.
The compressible volume is calculated using the following formula:
C = delivered volume / pressure change
The default value for the compressible volume is 2 ml/cmH2O. This value is kept low (in comparison
with the compressible volume of the patient circuit = 4.5 ml/cmH2O) in order to avoid the risks with
large volumes. The ”compliance” of a volume of 1 l is approximately 1 ml/cmH2O. The default value of
the compressible volume thus corresponds to a volume of 2 l, close to the volume of the bellows.
NOTE: 75 % of the volume is lost due to the contractility of the patient circuit gases. The remaining 25
% are lost due to the expansion of the circuit system.
2. Correction of compressible volume during ventilation
During ventilation the pressure is measured continuously. The volume added to the patient circuit to
compensate for lost volume due to compression, is:
Vcompl = Pplat - PEEP x C
(C is either the value calculated during the System Check or it is the default value.)
The volume delivered to the patient is calculated as follows:
Vpat = Vsyst - Vcompl + Vfgf
•
•
Vpat is the volume set by the operator and thus delivered to the patient
•
Vfgf is the fresh gas flow times inspiration time
Vsyst is the volume delivered by the ventilator to the whole system (total integrated flow during
inspiration time)
For safety reasons the compressible volume is only compensated for to 75 % at Pplat values
exceeding 30 cm/H2O. For values over 45 cmH2O, the compensation is not increased at all.
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Datex-Ohmeda ADU
NOTE: This section is intended to provide a brief overview of the use of the ADU. It is not intended to
replace the relevant detailed sections. For step-by-step instructions, please refer to the appropriate
detailed chapter.
Front view of the ADU
6
5
7
4
8
3
9
10
11
12
2
17
13
14
1
15
16
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Fresh gas outlet (Optional gas flow
indicator)
Ventilator bellows block
Fresh gas flow controls
Setup keys
ADU LCD display
Ventilator “quick” function keys
Anesthesia Monitor (optional LCD display)
ComWheel
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
Aladin Vaporizer Cassette
Agent wheel
Switch for On / Standby
Anesthesia Monitor central unit and
modules (option)
Vaporizer cassette storage slots (optional)
Drawers (optional)
O2 flush button
O2 flush button (early version)
NOTE: The ADU can be used with a 10.4” display. See “Display/keys” on page 92 for further
information.
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Datex-Ohmeda ADU
Preparing the ADU
1.
2.
Check that the electrical power cord is connected to the power supply outlet.
Connect the gas supply hoses and the scavenging hose on the rear panel to the wall
connectors.
Check that the gas inlet pressures are between 270 and 800 kPa (39 to 116 psi).
Assemble the patient circuit.
3.
4.
9
8
7
6
Figure 147
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
208
5
4
3
2
1
Fresh gas supply connection (Common gas outlet)
Circuit boom
Ventilation hose
Compact Block II
Valves for inspiration and expiration
Locking/releasing latch for absorber canister
Manual ventilation bag with hose
Inspiration and expiration hoses with Y-piece
Absorber canister
5.
Check that the Manual/Spont (MAN) mode is engaged.
6.
Check and connect the gas sampling and spirometry lines and turn on the Anesthesia Monitor.
The lines need to be connected while the monitor performs the zeroing.
7. Check the monitor according to the instructions. (See Short Instructions for the Anesthesia
Monitor.)
8. Turn on the ADU with the On/Standby switch.
9. The ADU automatically performs the self-check (about 1 min.) for the ventilator driving gas part
and for the batteries.
10. Perform the daily System Check according to the instructions displayed on the main screen.
In manual/spontaneous ventilation the pressure limit and the filling of the bag is adjusted with the
APL valve (Airway Pressure Limiting valve). The adjustment range is 1.5 to 80 cmH2O.
For a spontaneously breathing patient, the APL valve should be fully open = 1.5 cmH2O. This is to
ensure a moderately filled manual bag (inspiratory reserve).
During manual ventilation, the APL adjusts the peak pressure in the patient circuit and the amount of
gas in the bag. If the pressure rises to the set pressure limit, normally between 20 to 40 cmH2O, the
valve opens and lets out excessive gas from the patient circuit.
NOTE: Manual ventilation is always operable when there is no power as long as the gas supplies are
connected.
Daily System Check
Daily System Check is easy to do by following the System Check menu on the ADU display.
The the daily System Check can in an emergency situation be bypassed by selecting Bypass Check.
WARNING
The System Check is designed to ensure correct and safe function of the ADU. The
Bypass Check command on the System Check menu must only be used when
patient safety requires an immediate start-up procedure of anesthesia.
The checks may also be selected separately from the menu.
The System Check proceeds in the following way:
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Datex-Ohmeda ADU
Full Check
N2O Delivery
Agent delivery
AUTO ventilation
MAN ventilation
Checklist
Start Full Check
Full Check
Checks Air, O2 and N2O pressure, scavenging, patient circuit and makes
other preparations for the automatic Full Check.
N2O Delivery
Checks the delivery of adequate N2O flow and prevents the delivery of a
hypoxic mixture.
Agent Delivery
Gas delivery check for anesthetic agent. The Aladin cassettes may also be
checked one by one through the separate Agent Delivery check.
AUTO Ventilation
Checks the amount of internal and external leaks and calculates the
compressible volume of the Patient Circuit.
MAN Ventilation
Checks for leaks in the respiratory tubes and in the manual bag.
Checklist
Manual check of Suction, CO2 absorber, Gas cylinders, Insp./Exp. Valve,
Level indicator and Gas monitor.
Checklog
Check record. The nine last error entries are shown in Error History.
Bypass Check
Bypasses all the checks. Appears as a choice either if a Full Check has not
been successfully passed within 24 hours or there has been a ventilator/
fresh gas unit failure alarm since the check was passed.
NOTE: On an ADU configured to operate without N2O the System Check menu differ in some ways
from what is described in this chapter, for further information see “System Check performed on an
ADU without N2O” on page 89.
When a procedure is finished, the ADU automatically check marks the selection with a ✔ and moves
to the next step. If a procedure has already been carried out, the corresponding selection appears as
dimmed and chickenhearted. Confirm procedures by pushing the ComWheel.
•
210
The instructions are displayed in the Help Field at the bottom of each menu page.
•
WARNING
When starting the checks, choose top row (Full Check) by pushing the ComWheel.
Always perform and confirm checks before connecting a patient to the ADU.
NOTE: Gas sampling monitors must be disconnected from the circuit during the check so that the gas
samples are not counted as leaks which may lead to a failed check.
Setting alarms
Select the correct alarm settings for the airway pressure in the Alarms Setup menu. To get to the
menu, push Alarms Setup key, or push the ComWheel and select Alarms Setup.
The patient circuit pressure is measured in the ventilator part of the bellows block. On the screen, the
circuit pressure scale displays the alarm limits for low (1) and high (2) airway pressures.
1
Figure 148
2
Circuit pressure scale
The functional safety limit for high airway pressure is Pmax Release (factory default = 40 cmH2O), (1)
in Figure 148. When the airway pressure exceeds the set limit, the ventilator cycles to expiration. The
Pmax Release limit must be set higher for patients who, for some reason, need higher ventilation
pressure. Raising the limit level is necessary for the ventilation of those patients. The limit for the high
airway pressure alarm cannot be set higher than Pmax Release, (2) in Figure 148. Default limit for the
high airway pressure is 30 cmH2O. When the pressure exceeds Ppeak High, an alarm sounds.
Figure 149
Adjusting alarm limits
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Datex-Ohmeda ADU
In the Anesthesia Monitor, verify the settings of the fresh gas delivery and ventilation from the ADU
before setting the alarms for FiO2, EtO2, EtCO2 and MV. After the check procedure and alarm settings,
the ADU is prepared to deliver anesthesia.
Adjusting fresh gas delivery
Fresh gas flows are adjusted with the needle valves. The flows are displayed on the screen as
bargraphs and digits (liters per minute). Fresh gas flows from a minimal value of 0.5 l/min. and
higher, are available. Additionally, O2 and N2O percentages as well as total flow values are displayed.
The ratio of O2 to N2O in the fresh gas flow is calculated, taking the used volatile anesthetic into
account.
Figure 150
Fresh gas values display.
NOTE: The ADU can also be configured to operate without N2O, for further information see
“Anesthesia Delivery Unit without N2O” on page 16.
Anesthetic agent concentration is set with the agent wheel. The scale and the set value are displayed
above the agent wheel. The value is the % of anesthetic agent in the fresh gas flow.
Agent wheel
Figure 151
212
Anesthetic agent concentration on the display
Spirometry and real time inspiratory and expiratory values for all the gases (O2, N2O, volatile agent,
CO2) are measured and monitored with a D-lite or Pedi-lite sensor. The sensor should be placed next
to the patient’s airway in the Y-piece.
The degree of rebreathing and the composition of gases inspired by the patient is determined by the
fresh gas flow rate. When using low fresh gas flows, the fresh gas settings and inspired
concentrations may differ.
The lower the flow, the greater the difference. Thus, in a rebreathing system, the inspired
concentration may be significantly different from the set value. The difference is due to the fresh gas
being diluted by the expired gas.
Returning sampled gas
Returning the sampled gas to the scavenging system
The accumulation of nitrogen is reduced if the
sampled gas is connected directly to the
scavenging system.
Returning the sampled gas to the circle system
The sampled gas and room air may also be
returned to the circuit. The best place for
returning gas is under the bellows block, close to
the overflow valve.
NOTE: In addition to 200 ml of returned sample
gas, 30 ml/min. of room air is also added to the
returned gas. Room air serves as a reference gas
for O2 measurement.
Starting ventilation
Start the mechanical ventilation by turning the ventilation selector to Auto position. The ventilator will
use either the default factory settings or the settings pre-set by the user.
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Datex-Ohmeda ADU
Figure 152
Starting Mechanical Ventilation
Figure 153
Volume control, pressure control or SIMV
The default settings are suitable for most adult patients. When Patient Weight (can only be entered in
Manual mode) is adjusted, the new settings are calculated and shown as suggested new values. The
settings can, however, be altered before or during ventilation.
There are three alternative ways of altering the setting of a parameter.
•
Push “quick function” keys (Volume/Pressure, Rate, I: E or PEEP). The corresponding field is
highlighted. Adjust the setting by turning the ComWheel. The current setting is displayed
above the adjustment value.
Volume/
Pressure
•
Rate
I:E
PEEP
Another way of accessing the ventilator menu is by pushing the Ventilator key. Values within
brackets and/or cyan colored are not valid for the current mode. Adjusting the settings in the
Ventilator menu is convenient when setting up the ADU for the next patient.
•
A third way of accessing the ventilator menu is by pushing the ComWheel to display the Menu
Functions menu and select Ventilator.
•
•
•
This is also valid if Normal screen is pushed.
WARNING
214
To ensure adequate ventilation, be sure to have EtCO2 monitored. The quality of ventilation may be
estimated with the help of spirometry.
Monitor integration
The ADU measures the circuit pressure (= Pcirc) under the bellows block. The delivery unit also
transmits and displays numerical pressure values and corresponding curve.
The Anesthesia Monitor measures the airway pressure with the D-Lite, D-Lite+ or Pedi-Lite close to
the patient’s airway.
The different measurement sites result in different measured values. With the Anesthesia Monitor,
peak pressures are 2 to 3 cmH2O lower.
The Anesthesia Monitor keeps a check on all patient values for gases, spirometry and
hemodynamics.
The gas and spirometry values may be displayed on the ADU, showing set and measured values side
by side.
1
2
3
4
5
Figure 154
Displaying set and measured gas and spirometry values
(1)
(2)
Pressure data for delivery unit circuit
Patient gas monitor CO2 waveform and numeric value
(3)
(4)
(5)
Ventilator settings
Spirometry data
Patient gas monitoring data
215
•
•
•
•
•
•
Compact block II
Compact canister reusable
Standard Circuit absorber and
valve assembly
•
•
•
•
•
•
•
•
•
•
Bellows block incl. APL valve
and overflow valve
Bellows chamber
Overflow valve rubber
membrane
Manual bag
•
•*
• **
•
•*
•
•
•
•
•
216
* NOTE: May change shape and has to be replaced after repeated autoclaving. The bellows should be hung so that the lower folds can hang freely during the autoclaving cycle.
**NOTE: Does not normally have to be autoclaved since it is not in direct contact with patient gases. May develop small cracks on surface after repeated autoclaving.
•
•
Bellows
Ventilator bellows assembly:
Wash by hand using water and Steam autoclave at maximum Liquid chemical,
mild detergent AND wipe with 134° C
glutaraldehyd 2%
70% alcohol
•
•
Washer-disinfector with a
decontaminating program
(min. 10 minutes at 85° C)
Compact block I
Compact patient circuit:
Reusable patient circuit
tubing, manual bag tubing and
connectors, Y-piece, D-lite
Equipment
Concerning the level and frequency of disinfection, always follow the hospital routines.
Disinfection methods table
Brief instructions
Index
Index
Numerics
3 year maintenance 165
A
Abbreviations 197
Absorbent 100
Absorber 25, 28, 43, 52, 100
Assembly 53
Canister 25, 28, 153
Compact patient circuit 25, 43
Leak check 169
Lower compartment 153
Standard patient circuit 28, 52
Adjust
Agent 99
Adjustable pressure limiting valve (APL)
Adjusting
Alarms 211
Fresh gas 212
ADU
Front prespective 10, 207
Adult
Sensor 68
Agent 96
Adjustment 99
Flow 15
Identification 99
Selection 99
Agent cassette 15, 91, 99, 100
Agent wheel 91, 99
Air 96
Air flow 91
Airway pressure
Limits 211
Aladin 15
Cleaning 164
Alarm 182
Activate 132, 133
Adjusting 129
Audio On/Off 132, 133
Battery supply 100
Cancel changes 130
Colors 127
Current limits 129
Default limits 130
History 132
91
Limits 128
Adjusting 211
Messages 174
Negative pressure 128
Oxygen failure 128
PEEP High 128
Pmax Release 128
Ppeak High 128
Ppeak High limit 130
Ppeak Low 128
Ppeak Low limit 130
Priority 127, 133
Sequence 127
Setting 211
Silencing 133
Status 129
Timer 133
Volume 129, 131
Anesthetic agent 96, 99
Anesthetic agent concentration 212
APL valve 78, 91, 101, 102, 173, 209
View 20
Assembly 37
Atmospheric pressure 180
ATPD 97
Audible alarms silencing 133
Audio On/Off 132
Auditory alarms silencing 133
Auto / Manual selector 20, 91
Auxiliary electrical outlets 30
B
Backup 31
Backup supply 32
Bacteria 143
Bag 25, 28, 43, 52, 173, 208
Checking the functionality 78
Cleaning 163
Bain 59
Battery 30, 35, 94, 100
Backup system 31
Capacity 31
Charging 31
Bellows
Cleaning 163
Problem-solving tool 170
View 20
Bellows base 40
View 20
Bellows block 28, 52
Assembling 38
217
Datex-Ohmeda ADU
Cleaning 143, 147
Gasket 173
View 20
Bellows chamber 170
Insertion and locking 41
View 20
Bottom plate gasket 173
Breathing phases 22
Breathing system 25, 28, 59
Bypass 85, 209
C
Cancel 130
Cassette
Agent 15
Caustic 146, 154
Chamber locking handle 20
Charging battery 31
Checking system
Daily 209
Circuit block 153, 169
Cleaning 142
Circuit boom 25, 43, 208
Circuit pressure 215
Classification 5
Cleaning 142
Aladin cassette 164
Bellows 163
Compact patient circuit 146
Hytrel tube 145
Sampling line 164
Ventilation bag 163
CO2 setup 118
Compact Block 25, 43, 169, 208
Cleaning 147
Compact patient circuit 25, 43
Assembly 43
Cleaning 146
Compact patient circuit block
Cleaning 142
Compatibility 30
Compensation 24
Compliance 24
Compressed volume 24
ComWheel 91, 95, 138
Concentration
Setting for anesthetic agents 212
Condensation 58
Condensed water 154
Connector
Expiratory 47
218
Fresh gas inlet 47
Fresh gas outlet 47
Inspiratory 47
Manual bag 20
Patient circuit 20, 47
Serial input/output 13
Ventilation hose 28, 52
Ventilator 47
Controlled mechanical ventilation 103
Controlled mechanical ventilation (Auto) 91
Controls 92
Cursor 138
Cut off 98
Cylinder 37
D
Daily system check 209
Declaration form 166
Default limits 130
Default settings
Save changes 122
Diagram
Gas flow during expiration 23
Gas flow during inspiration 22
Dimensions 179
Disinfecting 143
Display 92, 94, 181
Display 10.4" 92
Display 12.1" 92
D-lite 68, 143
Dome 153
Driving gas 20, 21
Backup 33
Dust 143
E
Electrical connections 180
Electrical supply 100
Endotracheal tube 143
Engström 143
Environmental conditions 180
Erasing trends 140
Expiration phase 23
Expiratory hose connection 153
Expiratory valve 52, 153, 156
Body 153
Leak check 170
Index
F
I
Filling mechanism
of Aladin 61
Flap valve 153
Flow
O2 97
Flow controls 96
Flowmeter height
Adjust settings 119
Fresh Gas
Display 96
Fresh gas 32, 94
Adjusting delivery 212
Compensation 24
Controls 96, 184
Hose 25, 43, 208
Inlet 153
Supply hose 28, 52
Function keys 91
Fuse 35, 180
I/E ratio
Settings 109
IE time sec
Settings 110
IEC 601 5
Insp. time
Settings 110
Inspiration phase 22
Inspiratory and expiratory hose 28, 52
Inspiratory hose connection with O-ring 153
Inspiratory pause
Settings 112
Inspiratory rise time
Settings 113
Inspiratory valve 52, 153, 156
Body 153
Leak check 170
Inspiratory/Expiratory valve 169
Inspiratory/expiratory valve unit 25, 43, 208
Install 122
Installation 140
of interfaced monitors 30
Integration
of monitors 215
Interfacing 30, 215
G
Gas
Cylinder 37
Monitoring 30, 68, 94
Sample 70
Schematics 14
Supply 183
Backup 32
Pressure 37
Gasket 173
Gauges 37
Graphical trends 135
H
Handle for locking chamber 20
Health and Safety Declaration Form 166
History, alarms 132
Hose 168
Expiratory 28, 52
Fresh gas 25, 28, 43, 48, 52, 54, 208
Inspiratory 28, 52
Inspiratory and expiratory 55
Manual bag 173
Ventilator 25, 43, 56, 208
Humidity 154, 180
Hytrel tubes
Cleaning 145
J
Jackson Rees 59
K
keyed 64
Keyed Filler System
64
L
LCD 91
Leak correction 167
Leak test
Absorber assembly 169
Bellows chamber positioning 170
Bottom plate gasket 173
Compact Block 169
Expiratory valve assembly 170
Hoses 168
Inspiratory valve assembly 170
Leak limits 167
Manual bag and hose 173
Overflow valve 172
219
Datex-Ohmeda ADU
Standard circuit 169
Leaks 88
LED 100
List of alarms 132
Locking ring for the dome 153
Low flow 58, 167, 213
M
Mains 30, 31
Maintenance 165
MAN leak 173
Manual bag connector 20
Manual ventilation 102
Manual ventilation bag 25, 28, 43, 52, 173, 208
Measuring techniques 215
Mechanical ventilation 213
Medical Device Directive 5
Membrane 39, 172
Menu 95
Menu graphs 119
Messages 94
Alarm 174
MAN leak 173
Others 177
Status 175
Vaporizer 176
Ventilator 175
Middle field
Adjust layout 120
Minimal flow 213
Minute volume
Settings 109
Module frame rack 29
Monitoring 30, 68
N
N2O/Air selector 91
Nitrous oxide 96, 97
Numeric trends 136
O
O2 and N2O ratio 98
O2 flow 91
O2 flush 79, 98
ON/STBY switch 91
O-ring
Absorber bottom 153
Absorber lower compartment
Expiratory dome 153
220
169
Inspiratory dome 153
Inspiratory valve assembly 170
Overfill
Protection mechanism of vaporizer cassette 64
Overflow valve 172
Assembling 39
View 20
Oxygen failure alarm 128
Oxygen flush 98
P
Password 140
Patient Circuit
Assembly 43
Compact, assembly 43
Patient circuit 28
Assembly 52
Block 28, 52
Compact 25, 43
Connector 20
Hoses 168
Jackson Rees 60
Standard 28
Standard, assembly 52
Patient weight 108
Pcircuit setup 118
Peak pressure 102
Pediatric
Sensor 68
Pedi-lite 69
Cleaning 164
PEEP
Settings 110
Periodic maintenance 165
Pmax Release 211
Power cord 31
Power supply 180
Ppeak High 130
Limits 211
Ppeak Low 130
Pressure 209
Circuit 101
Curve 101
Gas supply 37
Gauges 37
in standing bellows 21
Limits in airway 211
Relief valve 102
Pressure Controlled Ventilation, PCV
Problem-solving
Bellows 170
105
Index
Proportional regulator
Purpose 3
98
Q
Quik Fil
61
R
Ratio control 98
Rebreathing system 213
Reserve gas cylinders 32
Reserve yokes 32
Reserve, inspiratory 101
Reset case 96, 130, 140
Respiration rate
Settings 109
Rubber gasket 171
Rubber membrane 172
S
Safety 3
Agent cassette 100
Battery 7
Compact circuit 7
Features 7
Gas mixer 7
Gas supply 7
Symbols 34
Vaporizer 7
Ventilator 7
Safety standards 6
Sampling gas 70
Returning gas 213
Sampling line
Cleaning 164
Scale 138, 139
Scavenging 70, 213
Screen layout 117
Seal 153
Sealing 171
Select N2O/Air 97
Selector
Auto/Manual 20, 91
N2O/Air 91
Self-check 209
Sensor
Adult 68
Pediatric 68
Service 165
Service menu 124
Service personnel 165
Set time and date 121
Settings 122
Ventilator 94
Setup 117
Setups, trend pages 140
Sevoflurane 62
Short instructions 207
Show total flow 120
Shunt valve 205
Sigh
Settings 114
Silence alarms 133
Silicon grease 154
Soda-lime 146, 154
Spirometry 213
tube 69
Spontaneous Ventilation 101
Spontaneous ventilation 101
Standard patient circuit 28
Assembly 52
Cleaning 145
Starting 208
Ventilation 213
Startup 208
Status messages 175
Storage 180
Storing
Bellows 163
Ventilation bag 163
Supply pressure 98
Symbols 34
Synchronized Intermittent Mandatory Ventilation 104
System Check
Leak test 88
T
Temperature 63
Tidal Volume 24
Compensation 24
Tidal volume
Settings 108
Time 138
Timer 94
Timer, alarm silence 133
Tone, alarm 131
Total flow data 97
Trend setup 124
Trends 129, 181
Changing setups 137
Cursor 138
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Datex-Ohmeda ADU
Erasing 140
Graphical 135
Length 139
Numeric 136
Scales 139
Setup 140
Trigger sensitivity
Settings 111
Trigger window
Settings 112
Tube
Electrically conductive 51, 57
Hytrel, cleaning 145
TV 24
U
Ultraviolet light 145
Unidirectional valves 154
Units
Change settings 123
V
Values
Set and measured 215
Valve 15
APL 91, 101, 102, 173, 209
Assembling overflow valve 39
Compact block 25, 43, 208
Expiratory 52
expiratory 28
Expiratory, standard circuit 153, 156
Inspiratory 28, 52
Standard circuit 153, 156
Membrane 39
Unidirectional 154
Valve base
Locking ring 153
O-ring 153
Vaporizer 15, 91, 185
Messages 176
Ventilation
Controlled mechanical 103
Manual 102
Modes 101
Pressure Controlled 105
Select mode 103
Spontaneous 101
Starting 213
Synchronized Intermittent Mandatory 104
Volume Controlled 104
222
Ventilation bag 25, 43, 208
Cleaning 163
Ventilator 16, 17, 187
Assembling 38
Hose 25, 43, 208
Ventilator setting field
Adjusting settings 121
Ventilator settings 94, 106
Viruses 143
Vocabulary 199
Volume Controlled Ventilation, VCV
Volume, alarm 129, 131
104
W
Wall outlets 37
Wall pressure 33
Water condensation
Water traps 58
Waveforms
Selecting 118
Words 199
58
Y
Yokes 32
Y-piece 55

Datex-Ohmeda Anesthesia Delivery Unit User`s

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