User Manual Spacelabs Sirius en
User Manual Spacelabs Sirius en
User Manual Spacelabs Sirius en
Anesthesia Systems
User Manual
BleaseSirius User Manual 073-0212-00/REV. 1B
2 BleaseSirius User Manual
BleaseSirius
User
Manual
MODIFICATIONS LABEL
PR023470 PR023930
ECO F ECO G ECO H ECO I ECO J
IMPORTANT
The user must be familiar with the machine and its various functions
before using it on a patient.
Warning Notices
Caution Notices
Notes
This symbol signifies relevant or helpful information.
Notes
This manual has four sections: the first contains information about the
BleaseSirius Anesthesia Machine, the second describes the 700/900 Series
Ventilator, third discusses the CAS Absorber, and fourth lists Notices and
Important User Information.
Canister
Electrostatic Discharge/Electrostatic- Canister seal
Sensitive Devices Canister
ESD
hectoPascal. Gauge pressure ex- Federal law restricts this device for sale
hPa by or on the order of a physician.
pressed in hectopascals.
O2 Oxygen l or L Liters
1.1 Introduction
For safety reasons, be sure to read the Warnings and Cautions in Section 4 of
this manual and any that appear throughout.
Before you set up or operate this machine, familiarize yourself with the
BleaseSirius Anesthesia System by reading through this entire manual and the
machines associated documentation. Also read the manuals for any optional
monitors and accessories that are installed in the system.
Keep this manual with the system as a reference for any questions that
arise about the systems operation, maintenance or, if necessary, repair.
The BleaseSirius is latex free. Note that any replacement parts must not
contain latex.
All ESD must be stored in approved conductive packaging, DIP tubes, shipping
bags, foam or tote bins.
All persons handling ESD must be properly grounded via a 1mW resistive
grounded wrist strap.
Cover all ESD bench tops with grounded conductive mats and connect all work
surfaces and equipment to earth ground.
Do not use cellophane adhesive tape to wrap DIP (dual in-line package) tubes
together.
DO NOT handle ESD by their pins or mix them with other routine electronic
parts.
Use only properly designed heat lamps, heat chambers and/or antistatic
quick-chill sprays during troubleshooting or stress testing procedures.
1.2 Description
1.2.1 General
The BleaseSirius anesthesia machines contain all the pneumatic circuitry,
controls, monitoring, ancillaries and storage required to control, distribute and
mix medical gases and anesthetic agents in order to deliver them to a patient
system. Figure 1 on the next page identifies the major system components.
ASTM F-1850
UL 60601-1
ISO 5358, IEC 60601-1
IEC 60601-2-13
BS EN 740 and other International Standards.
The references made to sterilization within this manual do not indicate that the
anesthesia machine and its components are sterile as supplied or are required
to be sterile for their operation.
A CO2 monitor complying with ISO 9918 shall be used when the
anesthetic machine is in use.
Adult breathing circuits with the anesthetic machines shall comply with
ISO 8835-2.
T
S
A
R B
Q C
O
N G
H
L I
J
K
Figure 1 Key
A Monitor Shelf
B Ventilator
C Vaporizer
D Cylinder/Pipeline Gauges
E Pneumatic Unit - (behind gauge panel)
F Handle
G Oxygen Flush
H Common Gas Outlet (or option A.C.G.O.)
I Drawer
J Frame
K Brake Pedal
L A.G.S.S.
M Absorber
N Bag Arm Link Pipe
O Adjustable Bag Arm
P Suction Controller
Q Main On/Off Switch
R Flow Control Valves with Hypoxic Guard
S Mechanical Flowblock Assembly (pictured) or
(or optional Electronic Flowmeter)
T Auxiliary Flowmeter
C
E
Figure 2 Key
A Electrical Socket Bank
B Electrical On/Off Switch
C Pipeline Inlets
D Circuit Breakers
E Cylinder Yokes
F Cable and Pipeline Strap Fixing
In the U.S.A., use a cord fitted with a NEMA 5-15 hospital grade plug to
connect the BleaseSirius to the mains power supply.
1.3 Specification
1.3.1 Physical
1.3.1.1 Machine Dimensions
Height Maximum Width Depth Average Weight
1486 mm/58.5 inches 705 mm/27.7 inches 747 mm/29 inches 110 kg/242.5 lbs
Connect this equipment only to gas pipeline supply lines that are fitted
with pressure relief valves that limit the supply pressure to less than 700
kPa/max, (101.5 psi/max).
1.3.3 Pneumatics
1.3.3.1 Gas-Specific Color Specifications
Gas Color (ISO Countries) Color (ANSI Countries)
Oxygen White Green
Nitrous Oxide Blue Blue
Medical Air Black Yellow
1.3.3.3 Miscellaneous
Item Maximum
Number of Gases 3
Number of Cylinders 4
Number of Pipelines 3
Number of Gauges 7
Cylinder Size E
Control Specification
Oxygen Flush Non-locking 45 to 55 l/m for inlet pres-
sures 45 psi to 60 psi
Vaporizers Accepts Selectatec
Hypoxic Gases Minimum 21% oxygen/nitrous oxide
mixture allowed
If you have the Electronic Flowmeter, see Section 1.5.5.2.2 in this manual
for the technical specifications for that option.
1.3.4.2 Ventilator
Depending on the system configuration, a 700- or 900-series ventilator is inte-
grated into the BleaseSirius.
1.3.4.3 Alarms/Indicators
Oxygen Failure Audible alarm for minimum of 8 secs, when oxygen
pressure falls below 225 kPa/32.6 psi.
The auxiliary sockets are numbered 1 through 4, from top to bottom and
are rated as shown in the following tables. If the machine has the switching
sockets option, sockets 3 and 4 will switch On and Off when the Main system
On/Off (Figure 1, P) is switched On and Off, not the electrical On/Off switch
(Figure 3, B).
Electrical labeling is shown on the next page.
230V 110V
Socket Outlet Rating Breaker Fuse Socket Outlet Rating Breaker Fuse
1 2A 3A 4A 1-4 2A 3A 4A
2-4 1A 2A 3.15A
B Figure 3 Key
A Switched Outlet Label
B Isolation Transformer
Label
Figure 3 - Electrical
Labeling
Required Features
Air and/or N2O pipeline fittings (Note: If the system has the electronic
flowmeter, it can have 2-gas fittings, O2 and Air)
Anesthetic Gas Scavenging System
Drawer Options
Market Specific Localization
Optional Features
1.3.5.1 Vaporizers
1.4 Installation
Upon delivery, inspect the system and its accessories for any damage that
may have occurred during shipment. If you find any damage, immediately
notify the transportation company and file a damage claim. Save the original
shipping container, packaging, materials and any manuals or instructions.
Many of the installation steps given in the following sections are performed
by a Spacelabs Healthcare service representative. However, you may need
to disconenct/reconnect certain components during use, maintenance or
sterilization. Always verify that the system is properly setup any time you
disconnect, then reconnect components.
7. Verify that the pin indexing on the cylinder valve corresponds to that in the
cylinder yoke on the machine.
8. Align the cylinder connection with the corresponding connection in the
cylinder yoke. Position the valve in the opening in the yoke.
Do not leave gas cylinder valves open if the pipeline supply is in use and
the system master switch is turned ON. Pressures from both supplies
may become equal and, if simultaneously used, cylinder supplies could
become depleted, leaving an insufficient reserve supply in case of
pipeline failure.
Figure 4a Key
A Cylinder
B Yoke
C Locking Handle
D Bridge
Figure 4b Key
A Inlets
B Securing Straps
C Securing Chains
D Large Cylinder Tray
9. Align the yokes connector and pins with the corresponding holes in the
cylinder valve, then push the cylinder into the opening of the yoke so that
the connector is fully engaged.
10. While supporting the cylinder from underneath, close the cylinder yoke. by
turning the bridge clockwise until its cutout is fully engaged in the coupling
on the yoke body.
11. Secure the cylinder by turning the T-screw clockwise so that the screw
engages with the location in the cylinder valve. Tighten the screw until the
cylinder is firmly secured against the connecting face of the yoke.
12. Repeat steps 1 through 10 to install the remaining cylinder(s) on the
machine.
Always keep the cylinder valves shut when not in use to prevent leakage
from the cylinder valve gland nut.
Do not use wrenches on the yoke bridge T-screw to avoid stripping the
threads. Use only one cylinder gasket per yoke. Using more than one
gasket could cause cylinder gas leakage.
3. Plug the oxygen sensor into the socket on the front of the absorber.
Step 1 Step 2
Step 3
1. Remove the protective caps from the inlet ports on the vaporizer. Discard
the caps.
2. Check that the O rings on the connectors on the backbar manifold are
present and undamaged (replace the O rings, if necessary).
3. Ensure that there is no foreign matter present on the mainfold and
vaporizer connectors.
4. Turn the vaporizer locking lever fully counter-clockwise.
5. Turn the vaporizer concentration setting control fully clockwise to off.
6. Position the vaporizer on to the backbar manifold so the manifold ports
align with the vaporizer ports.
7. Push the vaporizer down on to the backbar manifold and secure in
position by turning the locking lever fully clockwise.
Vaporizer Warnings
Refer to the vaporizer operating manual before use, for filling, operating and
service instructions. The manual also contains information concerning the
extent to which the delivered vapor concentration is affected by changes in
ambient temperature and pressure, and accuracy and calibration details, which
should be understood before use. Vaporizers should not be used when set
between the OFF position (or the ZERO position, if this is also the OFF position)
and the first graduation mark.
Do not use any vaporizer that is visibly misaligned on the manifold or that, when
it is locked, can be lifted off the manifold. Incorrect mounting may result in
incorrect delivery of gases.
A vaporizer is calibrated and labeled for one agent only. Do not fill with anything
other than the designated agent. If a vaporizer is filled with the wrong agent,
draining will not eliminate the agent, because the wick will have absorbed some
of the agent. The wick must be thoroughly cleaned and dried by approved
technical engineers.
The vaporizers must be completely upright for the sight glass to properly
indicate agent levels.
Never oil or grease any oxygen equipment unless the lubricant is made
and approved for this type of service. In general, oils and greases oxidize
readily, and - in the presence of oxygen - will burn violently. Fomblin is the
recommended oxygen service lubricant.
N
L A M O
K
J
I B
C
H
G D
F E
Figure 6 Key
A APL Valve
B Bypass Switch (optional) (not available in the
USA)
C Expiratory Non-return Valve
D Canister
E Bag Arm Link Pipe [Bag Port] (Optional)
F Patient Expiratory Connector (22 mm male and
15 mm female taper)
G Oxygen Sensor Port and Oxygen Sensor Port
Blanking Plug
H Patient Inspiratory Connector (22mm/0.8 male
and 15mm/0.5 female taper)
I Bag Arm and Port (optional)
J Inspiratory Non-return Valve
K Bag/Vent Switch
L Manometer Gauge
M Fresh Gas Port
N APL Exhaust Port
O Vent Port
Figure 6 - CAS Absorber and Components
Figure 10 - Extended
Work Surface Closed
White Cap
Remove the white cap from side of patient sensor and screw the luer
connection onto the end of the gas sample line.
If the gas sample line is not in use, then replace white cap. The Pedi
Sensor does not have a gas sampling port.
The patient airway flow sensor must be correctly installed at either the
distal location in the patient systems expiratory limb or the proximal end
of the Y connector. If the sensor is installed incorrectly, volume data will
be inaccurate and associated alarms, including the low minute volume
alarm will not function properly.
Position the patient airway flow sensor tubing with care. If the tubing
is pinched or cut, the ventilators volume monitoring may not function
properly.
Check the flow sensor tubing regularly for trapped water, as it could
affect ventilator readings.
1.4.7.1 Filter
A patient filter is recommended, but not essential since all parts of the
patient circuit may be sterilized.
Incorrect and correct ways of setting up the breathing circuit with filter
are shown in Figures 12a and 12b on the next page. Ensure that the
sensor is not contaminated by moisture and the patient circuit does not
produce a jetting effect onto sensor.
Pic.2
Sensor
PREFERRED ways of connecting the HME Filter
patient circuits are shown below (Pics 3,
To absorber
4, 5 and 6).
Pic.3 To patient
Pic.4 Pic.6
Pic.5
1.4.8.4 Cleaning
Follow the directions given on the receiver jar to clean it.
T A
B
S
R
Q C
P
D
F
O
G
N H
M I
Figure 14 Key
A Monitor Shelf
B Ventilator
C Vaporizer
D Cylinder/Pipeline Gauges
E Pneumatic Unit - (behind gauge panel)
F Handle
G Oxygen Flush
H Common Gas Outlet (or option A.C.G.O)
I Drawer
J Frame
K Brake Pedal
L A.G.S.S.
M Absorber
N Bag Arm Link Pipe
O Adjustable Bag Arm
P Suction Controller
Q Main On/Off Switch
R Flow Control Valves with Hypoxic Guard
S Mechanical Flowblock Assembly(or optional
Electronic Flowmeter, if installed)
T Auxiliary Flowmeter
1.4.10 Ventilators
See Section 2: 700/900 Series Ventilators in this manual for information on
your ventilator.
The pneumatics that regulate the gas supply pressures consist of high
pressure regulators to reduce the cylinder gas pressures and non-return
valves to ensure that gases do not flow from one inlet to another. Each
cylinder yoke and pipeline inlet has an associated pressure gauge located at
the rear of the work surface. The cylinder-contents gauges are mounted on
the right side and the pipeline pressure gauges on the left side. The sequence
of the cylinder gauges is the same as that of the cylinder yokes.
The regulated gases are coupled to their flow control valves (R in Figure 14)
via the oxygen failure warning device.
The oxygen failure warning device monitors the pressure of the oxygen supply.
If the oxygen supply pressure falls below (225kPa/32.6psi), nitrous oxide is cut
off and the pneumatic audible alarm are activated.
If the oxygen supply fails, the nitrous oxide shuts off and an Oxygen
Failure Alarm sounds. The ventilator is also supplied with MED AIR
as an emergency driving gas. Restoration of the oxygen supply will
automatically return gases to their default settings.
The gases flow from the pneumatic valves through the flow control valves and
their flowblock assemblies. Each gas has an associated flow control valve
and flowblock assembly. Turn the flow control valve dials counter-clockwise to
increase the gas flow and clockwise to reduce it.
If you have the electronic flow meter (EFM) option, the backlight feature is not
available. For the EFM, the work surface light is always on.
All the gases can be turned off by turning the dials fully clockwise, except for
the oxygen control which has a minimum (basal) flow of 150 ml/min 20 ml/
min to 170 ml/min and the O2 flowmeter. To turn off the oxygen, the On/Off
switch (P) at the front of the machine must be used.
The valves are independent of each other except for the mechanical hypoxic
guard which links the oxygen and nitrous oxide flow controls together such
that the ratio of oxygen to nitrous oxide is not less than 25%.
Gases flow from the flow control valves to the vaporizers (if installed) at C
and then to the common gas outlet (H) located on the front edge of the work
surface. The common gas outlet is a male 22mm/15mm female taper.
The oxygen flush control (G) is located on the front of the work surface and
connects the regulated or pipeline oxygen supply directly to the common gas
outlet when it is operated. The control is pressed in to supply oxygen. The
oxygen flush is non-locking.
The On/Off switch (P) is located on the front of the flowblock assembly and is
used to turn all the gases of the machine on or off (except the supply to the
oxygen flush control and the oxygen/air power outlet). The switch is turned
clockwise to turn the machine on and counter-clockwise to turn it off.
Figure 15 Key
A Air Pipeline
B Air Cylinder Yoke
C N2O Pipeline
D N2O Cylinder Yoke
E O2 Pipeline
F O2 Cylinder Yoke
G O2 Failure Alarm Valve
H Reservoir
I O2 Failure Whistle
Figure 15 Key
J Air Takeover Valve
K N2O Cutoff Valve
L O2 Failure Alarm Switch
M On/Off Switch
N Vent Supply
O Air Secondary Regulator
P N2O Secondary Regulator
Q Oxygen Secondary Regulator
R Oxygen Flush
S Air Flowmeter or Air Flow Sensor (on
EFM)
T N2O Flowmeter or N2O Flow Sensor
(on EFM)
U Hypoxic Protection Link System
V Oxygen Flowmeter or Oxygen Flow
Sensor (on EFM)
W Vaporizer Backbar
X C.G.O. or A.C.G.O.
Y Relief Valve
Z Fresh Gas Flow Sensor
AA Absorber/A.C.G.O. Switch
AB Fresh Gas to Absorber
AC O2 High Pressure Outlet
AD Air High Pressure Outlet
AE Auxiliary O2 Supply
Oxygen is conducted from each oxygen yoke block (F), if installed, to the
appropriate high pressure oxygen regulator input and cylinder contents gauge
which indicates the cylinder pressure.
Oxygen may also be conducted from the oxygen pipeline input (E) to its
pipeline pressure gauge, which indicates the pipeline pressure, and through a
non-return valve to the common oxygen supply line.
The common oxygen supply line is connected directly to the input of the On/
Off switch (M), the oxygen flush control (R), and the input of the oxygen high
pressure outlets I, and some of the control valve pilots.
The output of the On/Off switch (M) is connected to:
the input of the oxygen failure warning device (I)
the input to the secondary oxygen regulator Q for the mechanical
hypoxic guard
Each of the gases except oxygen and MED AIR have their outputs controlled
by a cutout valve. The purpose of the cutout valves is to shut the gases off if
the oxygen supply pressure falls below 225kPa/32.6psi. In such an event MED
AIR, if requested, will automatically be supplied to the ventilator and is also
supplied to the MED AIR flowmeter.
The cutoff system also activates the oxygen failure warning device (I), which
produces a warning signal in the form of a whistle when the oxygen supply
pressure falls below 225kPa/32.6psi. It has its own reservoir (H) to ensure
that the warning signal lasts for at least 8 seconds. An alarm also sounds on
the ventilator.
When the On/Off switch (M) is turned On, oxygen is supplied to the oxygen
flow control (via the secondary regulator (Q), the reservoir (H) and control
inputs of the other gases cutouts. An alarm sounds on the ventilator.
When the switch is turned Off the oxygen no longer reaches the oxygen flow
control or the signal inputs of the cutouts and they switch off, thus cutting off
all the gases from the flowblock assembly.
The oxygen flow control adjusts the flow of oxygen into the gas mixing section
of the machine. The flow of oxygen is measured by the mechanical flow tube
or the electronic flow sensor (EFM) that is mounted directly above the oxygen
flow control.
The oxygen passes from the flow tube or flow sensor into an oxygen-
preferential mixing chamber where it mixes with the other gases and then
to the vaporizer backbar or manifold assembly. It then passes through the
vaporizer (W) where it picks up anesthetic vapor and passes to the common
gas outlet (X) of the machine via a non-return valve.
The non-return valve prevents the oxygen flush control from pressurizing the
vaporizers when it is operated, as both the output of the oxygen flush control
and the vaporizers are connected to the common/auxiliary common gas outlet.
There is a relief valve (Y), which will open to atmosphere if the gas pressure at
the outlet reaches approximately 27.6-34.5kPa/3-4psi (as a result of the outlet
being blocked or some fault in the patient system). The entrainment valve,
where installed, will open to atmosphere if the gas pressure at the outlet falls
to less than -4cmH2O as a result of a patient attempting to breathe when the
supply of gas to the auxiliary common gas outlet is insufficient.
The system will also give an alarm on the ventilator if oxygen fails.
Do not use the anesthesia system if the hypoxic guard control system
does not operate within permitted ranges. Using an incorrectly
operating control system may result in incorrect gas mixtures and injury
to the patient.
Nitrous oxide is conducted from each nitrous oxide yoke block (D) to the
appropriate high-pressure nitrous oxide regulator input and cylinder contents
gauge which indicates the cylinder pressure.
The regulator reduces and regulates the pressure to a nominal
310.3kPa/45psi. The outlet of each regulator is coupled by a non-return valve
to a common nitrous oxide supply line. The cylinder regulator pressure is
deliberately set low to give preference to the pipeline supply.
Nitrous oxide may also be conducted from the nitrous oxide pipeline input
(C) to a pipeline pressure gauge which indicates the pipeline pressure and
through a non-return valve to the common nitrous oxide supply line.
The common nitrous oxide supply line is connected to the input of the nitrous
oxide cutout . The output of the nitrous oxide cutout is connected to the
input of the secondary nitrous oxide regulator (P), onto the nitrous oxide flow
control, (T).
When the On/Off switch is turned On the oxygen pressure at the control input
of the nitrous oxide cutout valve causes it to open and allow nitrous oxide to
reach the nitrous oxide flow control. If the On/Off switch is in the Off position or
the oxygen supply pressure has fallen to less than 225kPa/32.6psi, the nitrous
oxide cutout will shut, thus cutting off the flow of nitrous oxide.
The nitrous oxide flow control adjusts the flow of nitrous oxide into the gas
mixing section of the machine. The value of the nitrous oxide flow is measured
by using a flow tube/flow sensor (EFM) mounted directly above the nitrous
oxide flow control.
The nitrous oxide passes from the flow tube/flow sensor into a mixing chamber
where it mixes with the other gases, and then to the vaporizer backbar or
manifold assembly. It then passes through the vaporizer (Y) where it picks up
an anesthetic vapor and passes to the common gas outlet (X) of the machine
via a non-return valve.
Medical air is conducted from the pipeline system input (A) to a pipeline
pressure gauge, which indicates the pipeline pressure via a non-return valve
to the O2 failure MED AIR switching device. The output of the non-return valve
is also conducted to the auxiliary MED AIR output, if required.
A MED AIR cylinder yoke option is available and the connection is similar to
other gases, i.e. Yoke/Regulator/NRV, etc. In the event of an Oxygen supply
failure, MED AIR is supplied to the ventilator and the MED AIR switch is
overridden, thereby supplying MED AIR to the breathing system via the MED
AIR flowtube.
1.5.5 Controls
1.5.5.1 On/Off Switch
The On/Off switch is located on the front of the machine below the flowmeters.
It must be in the On position for oxygen to flow through the machine.
Since the machine has a hypoxic guard installed, the On/Off switch must
be turned to the Off position to reduce oxygen flow to zero. The O2 flow
control valve can only reduce the flow to 150ml/min 20ml/min.
Excessive force on the O2 or N2O control valves may damage the
hypoxic guard mechanism.
The On/Off switch also activates the O2 failure warning system. You may hear
a brief warning whistle when the switch is activated.
Always check that the gas flows are off or at a low flow before turning
on the machine to prevent damaging the hypoxic guard.
Excessive force applied to the control valves may damage the hypoxic
guard. To reduce the oxygen flow to zero, turn the machine On/Off
switch to OFF.
The oxygen control valve is always located on the extreme left of the flowblock
assembly housing on ISO-specification machines and on the extreme right on
ANSI-specification machines.
EFM-Specific Alarms
If you see the warning triangle on the EFM screen at any time, do not
use the machine. Contact your local Spacelabs Healthcare service
representative or Spacelabs Global Technical Support as soon as
possible.
One priority alarm is associated with the EFM - Check Total Flow. This alarm
is displayed on the Ventilator screen during one of three conditions:
Excessive force applied to the flow control valves may damage the
hypoxic guard. To reduce the oxygen flow to zero, turn the machine On/
Off switch to OFF.
1.5.5.6 Vaporizers
The level of anesthetic gas vapor is selected using the control dial on the
vaporizer unit. See the Vaporizer User Manual for more information before
use.
Maintain sufficient fresh gas flow when using sevoflurane.
The performance of the anesthesia machine and the vaporizers
may be degraded if the two are mismatched. Refer to the vaporizer
manufacturers instruction manual before use.
1.5.5.8 Drawers
The BleaseSirius is fitted with either 1,2 or 3 drawers, depending on the
system configuration. The drawer(s) slide open and closed .
*At the end of the Pre-use Check, you have the option to perform a
full system test. Although it is not necessary to perform each time the
machine is turned on, you should perform a full system test daily.
Prior to connecting the machine to the patient carry out the pre-use check
to verify correct alarm operation. To verify the O2 alarm, set the flowmeters
to give a concentration of 50% oxygen. Using the controls on the oxygen
monitor panel, set the low oxygen level to 60% and verify the oxygen low
alarm operates. Set the high oxygen alarm level to 40% and verify that the
oxygen high alarm operates.
Any vaporizer installed on the anesthetic machine shall comply with ISO
8835-4. Additionally, while the vaporizer is in use, an anesthetic agent
monitor complying with ISO 11196 must be used.
1.7.8 General
1. Confirm correct operation of vaporizers, APL valve, ventilator, scavenging
and absorbers according to the instructions given in their respective
manuals.
2. Check that:
a. The absorbent is fresh.
b. The vaporizers are not empty.
c. The breathing system is gas tight by performing the ventilator pre-
use tests.
d. All alarms are working.
Always perform the ventilator pre-use test procedures for volume
sensing functions after cleaning or replacing the volume sensor and/or
reconnecting any components of the breathing system before use.
Leaking gases and vapors (downstream of the flow control valves and
oxygen flush valve) may deprive the patient of metabolic gases and
anesthetic agent may pollute the atmosphere. Tests that detect leaks
must be performed frequently. If detected, the leak must be rectified.
1.9 Cleaning
Stainless steel, painted and anodized aluminum components and surfaces
should be cleaned with a damp cloth and a mild soap. Do not use abrasive
cleaners. Clear plastic areas (the flowblock assembly cover or gauge faces)
should be cleaned with a damp, soft clean cloth and dried immediately with a
dry cloth to prevent spotting.
Some anesthetic agents may adversely affect the paint work. Any
spillage should be removed immediately.
Rubber and plastic parts of the machine can be cleaned with a mild
detergent and a soft cloth.
1.10 Sterilization
Patient flow sensor, tubing and breathing circuits and the bellows may require
sterilization. Please refer to the respective manufacturers manuals and current
hospital policy for more information.
Following ethylene oxide sterilization, quarantine the equipment in a well
ventilated area to allow dissipation of absorbed ethylene oxide gas. In
some cases, aeration periods of seven days or more may be required.
Aeration time can be decreased when special aeration devices are used.
Follow the sterilizer manufacturers recommendations for required
aeration time.
The control unit houses the electronic and pneumatic control systems. It sets
the desired ventilatory parameters and generates alarm, warning and status
messages. The control unit also calculates and implements the functions nec-
essary to drive the bellows pneumatically.
The Blease700/900 series ventilator is designed for use with a circle-type ab-
sorber and is ideally suited to both low-flow and high-flow applications. The
patient flow sensor(s) and its associated tubing are an important part of the
ventilator. This gives the ventilator the inspired and expired flow and patient
airway pressure measurements. The ventilator may also be used with either a
Bain-type coaxial circuit or a Jackson-Rees/Ayres T-piece type pediatric circuit
by using an adaptor.
Variations are based on the drive gas used (MED AIR or oxygen) and the drive
gas connector type (depending on the eventual country of use).
2.1.2 Features
The features available for your ventilator depend on the operating mode.
The mains and battery alarms also have light emitting diode (LED) indication.
Do not block the drive gas exhaust. Blocking the drive gas
exhaust may impede ventilator function.
The differences between the two patient modes, Adult and Pediatric, are:
The ventilator sustained pressure requires a greater pressure
movement in adult mode to avoid being activated.
Pressure limiting is a safety feature. It should not be used for any other
purpose, such as creation of micro-breaths or emulation of specialized
high frequency/low volume ventilation systems, otherwise injury to the
patient may result.
When the tidal volume limit is reached, the ventilator immediately cycles into
expiration.
The ventilator delivers volume until the set pressure limit is reached, then
it maintains the pressure until the end of the inspiratory time. The effect of
Volume and Pressure modes on the pressure and flow waveforms is shown
below:
To prevent hyperventilation, any changes in the breathing rate are only al-
lowed to take place over a number of breaths. If the patient fails to make any
effort to breathe, the SIMV function automatically defaults to the ventilation
function, identical to Volume Control Mode/Pressure Control Mode at the set
SIMV rate.
The SIMV modes use a flow trigger to sense the patients attempt to
breathe. Therefore, SIMV modes cannot work with the patient sensor
placed at the absorber.
When the software switches to an SIMV mode, the rules are as follows:
1. Continue with the I:E ratio that was already set. If this ratio is possible,
then the breathing pattern should remain unchanged.
2. If, however, this switch puts the inspired time at greater than 2 seconds
in adult or greater than 1 second in pediatric, then you should limit the
inspired time to that figure.
1. When increasing the BPM, limit the highest BPM value to a point where
the I:E ratio becomes 2:1.
2. When increasing Inspired Time, limit the Inspired Time to a point where
the I:E ratio becomes 2:1.
2.1.3.5 Sigh
When Sigh is activated, the delivered tidal volume in Volume Control Mode
is increased by the set percentage of the duration of one breath at the set
frequency. The default percentage is 10% and default frequency is once every
tenth breath.
The fresh gas flow compensation will continue to function during a set
pause period.
The start in inspiration is set by the flow trigger. After the patient has made an
attempt to breathe that exceeds the set flow trigger, the ventilator delivers at
the support pressure, until the flow is reduced to 25% of the peak flow. The
ventilator then goes into expiration.
In Pressure mode, bpm, tidal volume and I:E ratio are all monitored values.
The user must set two parameters:
the Trigger Threshold (1 L/min to 15 L/min),
the Support Pressure which is referenced to the PEEP level
(3 to 20cmH2O).
The flow and pressure are measured and monitored by the microprocessor
feedback system.
Expiration occurs when the flow control valve is closed and the expiratory
solenoid opens and releases the gas from the bellows assembly.
In the Pressure Control Mode, the set pressure is achieved during inspiration
and maintained at that level by allowing a controlled bypass through the ex-
piratory valve. This allows the required pressure level to be maintained while
compensating for any fresh gas flow into the patient circuit.
For expiration, the expiratory solenoid is opened, which releases the gas from
the bellows assembly.
2.1.5 Parameters
The following parameters can be set and/or monitored when the ventilator is in
operation.
2.1.5.1 PEEP
The Blease 700/900 series ventilator
continuously monitors and displays
the Positive End Expiratory Pressure
(PEEP). By default, a PEEP of 2 to
4cmH2O is introduced to the circuit,
caused by the bellows assembly,
which is shown as OFF, but a meas-
urement may still be displayed. A
PEEP value between 3 and 20cmH2O
can be set from the panel, with an
automatic PEEP HIGH alarm at Figure 27 - PEEP Waveform
10cmH2O above set PEEP.
For best operation of the PEEP function, avoid the use of high fresh gas
flows.
When the user changes a value such that it does not comply with the required
difference, the box surrounding the feature being adjusted and the value of the
feature causing limiting to be enforced is highlighted in red. The value being
adjusted could either be the PEEP level or the relevant pressure control.
The user can:
Accept the value being adjusted, in which case it will be set to the
nearest acceptable value.
BleaseSirius User Manual 95
Section 2 - 700/900 Series Ventilators
2.1.5.2 Trigger
The level of negative flow caused by the patients attempt to breathe before
the ventilator initiates flow to assist the patient with the spontaneous breath.
Range: 1 L/min to 15L/min all modes (SIMV + PSV and Pressure Support).
2.2.5.5 Oxygen
A fuel cell sensor can be connected to allow monitoring of 0% to 110% O2,
with alarms of 18% to 110%. The sensor can be calibrated.
2.1.5.16 Compliance
System compliance in ml/ cmH2O.
Patient compliance in ml/ cmH2O.
3
Figure 28 - Ventilator Front Panel
Figure 28 Key
1 LCD Touch Screen (Blease700 is
monochrome, Blease900 is color.)
2 Battery-Status LED
3 Trak Wheel
Figure 29 Key
1 Alarms List
3
2 Parameters
2 3 Measurements
4 Activity
3
1
2
Figure 31 Key
1 Waveform Display
2 Peak Marker
3 Status Line
High level alarms are displayed as a red banner and white text in the
alarm list.
Medium level alarms are displayed in a yellow banner and white text in
the alarm list.
Low level alarms are only displayed in yellow text in the alarm list.
Figure 32 Key
3
1 Monitored Value
1
2 2 Pre-Set Level
3 Parameter
Figure 32 - Parameter Display Area
The Touch Screen allows you to select options and confirm settings by tapping
the screen. You can use a combination of both touchscreen and Trak Wheel
controls to select and change parameters.
If you do not touch the Confirm button, the original value will be
restored. If you do not make a selection within 30 seconds, the menu will
timeout and the original value will be restored.
The green light shows whenever the charge unit is active and should not
be interpreted as a direct indication of battery status.
Pressure limiting is a safety feature and is also used in the adult and
pediatric mode to provide ventilation (Precision Pressure Control).
Do not use this feature for any other purpose, such as creation of
micro-breaths or emulation of specialized high frequency/low volume
ventilation systems. Otherwise, injury to the patient may result.
Monitored values require a few minutes to stabilize after the initial ventilator
activation. The ventilator and set values will function correctly.
Figure 36 - Bag/
Vent Switch - Vent
At the end of the Pre-use check, you are given the option to do a full
system test. Although not necessary to do each time the machine is
turned on, you should perform the full System Test daily.
The patient airway flow sensor must be installed the patient breathing
circuit (see section 2.2.17 for positioning) and the associated sensor
tubing must not be trapped, kinked, split or damaged in any way to
ensure correct performance.
Having measured the dead space at the start, the leak test displays the upper
left screen and concludes with the upper right screen after 20 seconds. Next,
set the Absorber to Bag to complete the Compliance Test.
After you have verified that the manual system works, you can test the ventila-
tor in the Adult mode using an Adult flow sensor at nominal settings of:
TV 500mL
12 BPM
I:E 1:2.0
Or, you can test the ventilator in the Pediatric mode with the pedi sensor using
the default settings:
TV 150mL
15 BPM
I:E 1:2.0
1. Set up the system for the type of sensor/patient mode you will test.
2. Connect a breathing bag or a test lung to the breathing circuit.
3. Press the Trak Wheel when ready.
4. Set the Bag/Vent switch to Vent.
5. Ensure that the Bag and Bellows are full.
6. Observe the displayed wave form and expired volume are consistent with
the expected result. Other tests can be carried out at the users discretion.
Error 01
The patient pressure is too high (>4cmH2O)
to begin the test.
Error 02
If the absorber is not set to Vent when
starting the test, the system reminds you
(Figure 49).
Error 03
The Fresh Gas is too High. Reduce the
fresh gas flow and restart the system test.
Error 04
The absorber is not installed correctly. Pull
the absorber forward a few centimeters.
Check that no materials are between the
absorber and main frame. Push absorber
firmly back in position. You will hear a click
when it is engaged.
Error 05
The gas supply pressure is too low.
Check the pipeline/cylinder gauges for
the correct gas supply.
Error 06
The bellows are empty. Fill the bellows
and select Confirm to continue.
Error 07
If the system has a leak that is too large or
if the circuit is not occluded correctly, the
test will fail at this point.
Error 08
If a leak is detected, the causes listed on the
screen are possible places to check. Note that
these are not the only possibilities. Small holes
in the sensor tubing and cracks in breathing
circuits may also cause leaks.
Figure 55 -Pre-use Test Error
Message (08)
After three breaths are detected, the ventilator switches from Standby to Bag
Mode. When a breathing pattern is identified, the Apnea detector activates and
will detect a failure to breathe after the user-defined period (Apnea Alarm set-
ting). When the ventilator detects that a patient is breathing spontaneously, the
ventilator switches from STANDBY mode to Bag mode and BAG is displayed
on the screen. In this condition, all relevant alarms are active. The alarms not
in use at this time are:
Pressure Low
MV Low
-or-
2. Press on the Adult/Pediatric button on the main screen to change the
current patient mode.
In either case, select the mode, then confirm the choice by pressing Return.
Ensure that you select the correct Patient Mode for the flow sensor type
(Adult or Pediatric) you will use to ventilate the patient.
The Patient Mode can only be changed while the ventilator is in BAG or
Standby mode, not in Run mode.
Figure 74 - Adult Flow Sensor (L) and Pediatric Flow Sensor (R)
For reference purposes in this guide, the word Sensor refers to the
adult flow sensor. Pedi Sensor refers to the pediatric flow sensor.
Use the adult flow sensor for TV over 300ml or in cases when you choose
to place the sensor at the absorber. When setting a tidal volume of less than
200 ml on the ventilator in Volume Control or SIMV-VC + PSV modes and the
patient type is adult, the patient type and sensor type boxes will be highlighted
amber on the screen (color systems only) when ventilation is on. It is strongly
recommended that the pediatric patient type along with the proper sensor
selection be made on the ventilator in this setting range.
Use the Pedi Sensor for TV less than 300 ml, where dead space or sensor
placement is a concern and when peak flow rates are below 30 lpm. This sen-
sor can only be used at the patient wye-piece.
The sensor measures inspired and expired flow into and from patient, it
also measures pressure in patient airway.
2. Press the Sensor button located below the Alarm panel on the screen.
You can only change the sensor placement in Standby mode, not in Run
mode.
4. Turn the absorber switch to VENT to start the ventilator. When the adult
sensor is at the absorber expiratory port, the ventilator can only be run in
Volume Control and Pressure Control modes.
Placing the sensor at the absorber has several implications for ventilator
operation.
When the sensor placement is at the absorber. tidal volume may appear
higher than expected due to the effect of compressible volume in the
patient circuit.
5. When switching to the Vent mode from Standby, a sensor position check
is performed. If the sensor is not in the position that has been selected,
the message check sensors position (either at patient or at absorber) is
displayed.
When setting up the breathing circuit with a patient filter, ensure that
the sensor is not contaminated by moisture and that the patient circuit
doesnt produce a jetting effect on the sensor(s).
Position the patient airway flow sensor tubing with care. If the tubing
is pinched or cut, the ventilators volume monitoring may not function
properly.
At Patient At Absorber
The patient airway flow sensor must be correctly installed at either the
distal location in the patient systems expiratory limb or the proximal
end of the Y connector. If the sensor is installed incorrectly or the
sensor placement selection is incorrect, volume data will be inaccurate
and associated alarms, including the low minute volume alarm will not
function properly.
Previous Peak
When you are satisfied that the patient is in a stable pre-operative condition,
you can save the next loop to be displayed.
1. Highlight the Store Loop button (Figure 80).
2. Select Confirm. A Saving message is displayed. The next loop will be
saved and identified by the time it was saved. This waveform is displayed
in red on the waveform area. You can save up to six loops, depending on
the ventilator model.
There may be a slight delay while the loop is saved. Do not select
Confirm again, during this delay.
Step 1: Highlight
Store Loop Step 2: Select a
button Loop by saved
time
Step 4: Turn
Off Saved Loop
Display
Figure 85 - Bronchospasm
Loop
Figure 88 - Cuff or Laryngeal mask Leak Loop and Kinked Tracheal Tube Loop
Zero Baseline
Inspired Flow to
Patient
If you change a ventilation mode while the ventilator is operating (in VENT
mode), a prompt asks you to confirm or adjust the main parameter for the new
mode.
Select Accept or Cancel to confirm or bypass the suggested setting. You can
also change the setting using the Trak Wheel.
2.2.21.1 Pause
Pause is available in the Volume Control and SIMV-VC + PSV ventilation
modes. To select a percent pause:
1. Select Pause on the Mode menu.
2. Select the percent pause.
3. Press Return to confirm your selection.
4. Press Return again to display the Normal
Figure 96 - Pause Options
screen.
BleaseSirius User Manual 133
Section 2 - 700/900 Series Ventilators
To exit Cardiac Bypass, turn the absorber switch to VENT or deselect Cardiac
Bypass on the Ventilation Mode menu.
2.2.23 Alarms
The 700/900 series ventilator contains a number of pre-set and user-defined
alarms for patient and ventilator monitoring.
The high and low pressure alarms are important for patient safety.
Alarm Activity
Alarm Message Area
The active alarm is listed in the alarm activity area for a minimum of 30 sec-
onds. If the alarm condition is resolved during this time, the alarm is automati-
cally cleared from the list. If more than one alarm is activated, each new alarm
is added to the top of the list.
Sustained Pressure* Pre-set. Less than 5cmH2O (adult) or 3cmH2O in (pediatric) change in pressure 1
per breath.
Battery Low pre-set. <15 minutes battery life remaining. Also visually as a decaying battery 2
symbol.
Minute Vol. High* User defined. 1 l/m to 25 l/m adult. 1 l/m to 25 l/m pediatric. 2
Minute Vol. Low* User defined. 0 l/m to 24 l/m adult. 0 l/m to 24 l/m pediatric. 2
Do not set alarms to extreme values because those settings can cause the alarm
system to operate incorrectly.
Alarms marked with a (*) are inhibited for 20secs, when the ventilator mode is
changed. Refer to Alarms Summary.
If the supply gas pressure is reduced, the patient minute volume may be
reduced and injury to the patient could result. Do not use the ventilator
if the supply pressure cannot be maintained.
Do not set alarms to extreme values that can cause the alarm system to
function incorrectly.
This alarm is only active on systems that have the EFM installed.
The system will also sound an alarm on the ventilator if the oxygen fails.
A few seconds after mains failure occurs, the Power Fail indicator is RED. If
the condition persists for more than one minute, the alarm is activated and the
LED remains RED.
To conserve power, the display is switched off while the Power Fail alarm is
activated. To restore power to the display, press a key or turn the Trak Wheel.
The ventilator continues to function normally, powered by its internal battery
for a minimum of 30 minutes. Typical operating time is a minimum of 60
minutes.
When the internal battery charge is nearly exhausted and has less than
15 minutes of running capacity left, the Battery Low alarm is activated and the
Battery Low indicator flashes RED.
When mains power is restored, the Battery Low indicator may remain lit, as
the battery recharges. If the Battery Low indicator illuminates without a mains
failure, there may be a battery or charging fault. The ventilator will then have
no battery backup and must not be used until the fault has been repaired.
The ventilator settings (BPM, I:E, TV) require a flow greater than 100
Ipm or less than 1.5 Ipm.
The internal feedback systems cannot accurately provide the values set.
If extreme control settings are used, the resulting combination of
patient compliance and resistance may cause the ventilator to exceed
its specification, as the ventilator feedback systems attempt to
compensate, but do not quite reach the selected settings.
If you open the Set Alarms Menu while the auto alarms are set, the
previous alarm values are restored without warning.
The user can restore the previous set of alarm limits at any time by either
selecting Off in the auto box, or going into the Alarm Limits Menu and
making no changes.
High and low alarms are linked, so that a low alarm value greater than a
high alarm value cannot be set.
Only those alarms that are relevant to the current operating mode are
displayed.
4. Press the up/down arrows or turn the Trak Wheel clockwise to increase or
counterclockwise to decrease the value.
5. When the desired value is displayed, press the Trak Wheel or press
Confirm to select the value.
6. Select Return to close the screen and return to the alarm options.
You can store parameter settings in Adult and Pediatric patient modes
under the same name. Before you select Settings or the Defaults, select
the correct patient mode (Adult or Pediatric).
You must define at least one user name before you can save settings.
7. Repeat steps 5 and 6 until the settings name is complete. You must enter
a total of 10 characters or spacesto complete the name. Press the Trak
wheel at the 10th character to save the name.
8. Repeat steps 3-7 to enter more names for the settings or to change a
name previously entered.
9. Select Return to display the Default Menu.
After you recall settings, verify that the settings displayed on the screen
are correct.
2.2.27.7 Configuration
When you select Configuration, the following menu is displayed:
The system audit function stores events about the machine and the ventilator,
including:
2.3 Installation
Cautions
Use of a driving gas other than oxygen or MED AIR may damage the ventilator
and will cause inaccurate operation, resulting in potential injury to the patient.
Do not use any other driving gas.
This equipment may be damaged if the gas supply pressure is too high.
The ventilator must only be connected to gas pipeline supply lines that are
installed with pressure relief valves that limit the supply pressure to less than
700kPa/101.5psi.
Cautions Continued.
Connection of the equipment to the socket outlets will increase leakage currents.
It is the users responsibility to ensure compliance to IEC 60601-1-1 (collateral
standard for electrical medical systems). In the USA, equipment connected to
the socket outlets must comply with UL 60601-1 and the total sum of the system
leakage current shall not exceed 300 micro amps. It is the USERs responsibility
to ensure compliance with the above standard and that the leakage current limits
are not exceeded.
When using external patient circuits, there is a possible risk of high pressure.
To preserve battery life, never store the ventilator with its battery discharged. Do
not store or use the ventilator in close proximity to heat sources of any kind.
In the event of a mains electrical power failure when the ventilator is running
from its internal battery, do not remove the mains plug from the mains supply
as this would prevent the immediate resumption of normal operation when the
mains power is restored.
The driving gas is discharged through the port on the rear panel of the
ventilator. This port must be completely free of any obstruction and
should have nothing connected to it. The exhaust gas is oxygen or MED
AIR and does not contaminate the environment.
Pre-Use Cautions
The oxygen monitor needs at least 10 minutes to stabilize after it has been
turned on. The oxygen sensor should always remain plugged into the machine to
ensure that it is ready to use.
If the gas sample line is not in use on the adult flow sensor, then replace white
cap on the port. The Pedi Sensor does not have a gas sample port.
The adult patient flow sensor must be correctly installed at either the distal
location in the patient systems expiratory limb or the proximal end of the wye
piece. The Pedi Sensor can only be installed at the patient wye piece. If the
sensor is installed incorrectly, volume data will be inaccurate and associated
alarms, including the low minute volume alarm will not function properly.
Position the patient airway flow sensor tubing with care. If the tubing is pinched
or cut, the ventilators volume monitoring may not function properly.
Upon receipt of new machines, you should sterilize/clean all parts of the machine
before use.
Prior to connecting the machine to the patient, carry out the pre-use check to
verify correct alarm operation. To verify the O2 alarm, set the flow meters to
give a concentration of 50% oxygen. Using the controls on the oxygen monitor
panel, set the low oxygen level to 60% and verify the oxygen low alarm operates.
Set the high oxygen alarm level to 40% and verify that the oxygen high alarm
operates.
Always perform the pre-use check procedures for volume sensing functions
after cleaning or replacing the volume sensor.
To preserve battery life, never store the ventilator with its battery
discharged. Do not store or use the ventilator in close proximity to heat
sources of any kind.
Therefore
This value is retained in memory until the ventilator is switched off or retested.
4. When the ventilator is set to use on a patient and when the ventilation
is stable, the total compliance of system and patient (Ct) is measured.
The TV can then be increased to compensate for the volume lost due to
compression within the breathing system. The increase in tidal volume is
calculated by the following formula:
For example:
A system test measurement at a TV of 200ml provided a pressure rise of
25cmH2O.
Running the ventilator on a patient with a set 500ml TV provided a peak pres-
sure of 20cmH2O.
The 735ml is the actual ventilator output into the breathing circuit to provide
500ml at the catheter mount. The value must be recalculated every time
volume-controlled ventilation starts.
Use the same length of patient circuit that you will use on the patient to
calculate TV.
Injury to the patient may result if you use a faulty ventilator. If there
is any ventilator malfunction, do not use the ventilator. Refer to the
Troubleshooting section for help. If the malfunction cannot be rectified,
contact an authorized Spacelabs Healthcare technical engineer or return
the ventilator to your local distributor.
2.4.4.3 Bellows
Only the bellows base and the parts inside the bellows require
sterilization.
To avoid damage to the equipment:
Peak sterilization temperature must not exceed 134C.
Do not sterilize the control unit.
Gas sterilization should be followed by quarantine in a well-
ventilated area to allow dissipation of residual absorbed gas.
Follow the sterilization agent manufacturers instructions.
Pop-off valve must be autoclaved separately.
Perform the Pre-use Check procedures after cleaning and sterilizing the
bellows.
Unlike the current adult bellows cover, you cannot autoclave the
pediatric bellows cover. The pediatric bellows cover should never need
to be disinfected. However, if required, you can disinfect the pediatric
bellows cover using non-alcoholic surgical wipes. It is also possible
to gas sterilize (Ethylene Oxide, 54oC) and cold sterilize (Sporicidin,
Sonacide) the pediatric bellows. Do not use alcohol or chlorine-based
cleaning agents to disinfect the pediatric bellows cover.
When refitting pop-off valve, ensure that thumb screws are evenly
tightened, finger tight only.
If the valve seat is damaged, the pop-off valve will leak and may cause
serious malfunction. Take care not to damage the precision-molded
surface of the valve seat while cleaning. Never use a hard object or
abrasive detergent. Use only a soft, lint-free cloth.
Notes:
1. Ethylene oxide, 54C max.
2. e.g. Sporicidin, Sonacide.
3. Steam autoclave, 134C max.
If any foreign materials or liquids are trapped in the driving gas circuit,
or the pop off valve or the bellows base that could impair the valves
operation. Do not use the bellows assembly if you suspect that materials
are trapped. Have the assembly repaired by a qualified technical
engineer.
2.5 Troubleshooting
The table below describes faults, probable causes and recommended corrective ac-
tions. If a fault persists, do not use the ventilator. Contact your Spacelabs Healthcare
service representative for assistance.
FAULT CAUSE ACTION
MAINS FAIL Power cable not connected. Connect power cable.
alarm activated
when ventilator Defective mains supply. Check supply.
switched on. Blown Fuse(s). Replace fuses.
Bellows cannot Breathing system hose Check hose. Replace the
be filled or disconnected or leaking. hose, if damaged.
collapses.
Broken bellows base. Replace bellows base.
Defective or detached Check bellows. Replace, if
bellows. damaged.
Damaged pop-off valve. Replace pop-off valve.
Replace hose, if
damaged.
Unwanted PEEP and Defective or poorly Adjust or exchange
overfull bellows. regulated scavenging scavenging system.
system.
Remove obstruction.
Partially obstructed
exhaust.
2.8.2 Protocol
Message Function
Set User set value
Measured Monitored measured value
Event Monitor events
Alarm Alarm status and message
The following strings are only sent when the ventilator is in Vent mode
and the user chooses a new ventilation mode, then confirms that
selection. This command is concatenation of other set strings, with an
additive and an xor checksum as follows:-
In this document the string is split up for clarity, in reality all strings are
sent together
[MPMxxx\r Measured breath pressure min. xxx= 3 digit value in cmH20*10 (if
less than zero is DISABLED)
[MOxxxx\r Measured oxygen % concentration xxxx=4 digit value * 0.1%
[MIExx\r Measured I:E ratio xx= 2 digit value *0.1
[MFGxxx\r Measured fresh gas flow. The measured
fresh gas flow is from EFM unless the
EFM is not installed or has an error in
which case the internal flow sensor is used. xxx=deciliters/minute
[MFGVddd\r Measured fresh gas volume during
inspiratory, in mL, sent on a timed
basis while running.
[MMVIxxx\r Measured minute volume inspired. xxx = 3 digit value in deciliters
[MPLxxx\r Measured breath pressure plateau. xxx= 3 digit value in cmH20*10
[MPL---\r Measured breath pressure plateau invalid
[MFGOddd\r Oxygen fresh gas flow message ddd=decimal value of gas flow
in dL/min
[MFGO-\r Oxygen fresh gas flow invalid
[MFGNddd\r Nitrogen fresh gas flow message ddd=decimal value of gas flow i
n dL/min
[MFGN-\r Nitrogen fresh gas flow invalid
[MFGAddd\r Air fresh gas flow message ddd=decimal value of gas flow
in dL/min
[MFGA-\r Air fresh gas flow invalid
[MFGTOddd\r Oxygen gas consumption message ddd=decimal value of gas flow in dL
[MFGTO-\r Oxygen gas consumption invalid
[MFGTNddd\r Nitrogen gas consumption message ddd=decimal value of gas flow in dL
[MFGTN-\r Nitrogen gas consumption invalid
[MFGTAddd\r Air gas consumption message ddd=decimal value of gas flow in dL
[MFGTA-\r Air gas consumption invalid
[MGNinO_2ddd\r Inspired oxygen volume ddd=decimal value in volume * 10
[MGNinN_2Oddd\r Inspired nitrogen ddd=decimal value in mmhG * 10
[MGNinAGTddd\r Inspired agent ddd=decimal value in mmhG * 10
[MGNIMCO_2ddd\r Inspired minimum CO2 ddd=decimal value in mmhG * 10
[MGNetO_2ddd\r End tidal oxygen volume ddd=decimal value in volume * 10
[MGNetN_2Oddd\r End tidal nitrogen ddd=decimal value in mmhG * 10
[MGNetAGTddd\r End tidal agent ddd=decimal value in mmhG * 10
The cgo bit is set at the point of switching into cgo mode. In ventilation mode this
will be 10 seconds after the switch is first switched.
[ESVCCC,FFF\r Ascii software version strings where CCC is the control system
software version number,FFF the front panel software version number.
[MXSNddddddd\r 7 digit serial number
[MXMSMAO\r Current mode is adult running
[MXMSMAS\r Current mode is adult standby
[MXMSMPO\r Current mode is pediatric running
[MXMSMPS\r Current mode is pediatric standby
[MXSMPWD\r Unit is entering 10 second power down phase
[EIOxxx\r Control inoperative xxx three digit code
[WFFFF,PPPP\r Waveform information. Where FFFF is a four digit flow value in deciliters per
minute and PPPP is a four digit pressure value in cms H2O *10
flow data has not been received from the Front Panel for greater than
90 seconds
the FgO2 indicated from the EFM is less than 100 ml/min.
30-31 Not Used Note: The relevant bits are set if an alarm has occurred. Unused bits should never
be set.
Notes:
M N O
L A
L
K
J
I B
C
H
G D
F
E
3.1 Description
3.1.1 Introduction
Please refer to Figure 112 on the previous page as you read this section.
Two models of the CAS Absorber are available - CAS I and CAS II. The CAS
I model houses one soda lime canister, while the CAS II model houses two
canisters.
All of the plastic moldings are made from fully autoclavable polymers.
An Airway Pressure Limiting [APL] valve (A) sets the ventilating pressure
during manual operation mode. The APL valve incorporates a 65 cmH2O
safety valve.
The optional Bypass Valve (B) allows gas flow to completely bypass the ab-
sorbent. This valve can be used to allow a build-up of CO2 or enable canister
removal/replacement without disconnecting the breathing circuit.
The Bag/Vent switch (K) allows the ventilator or bag to be connected to the
absorber at the same time. Use the selector switch to choose the desired
mode of ventilation.
Upon exhalation, the gas flows through the expiratory non-return valve (E),
some gas is blown through the APL valve (G), which should be set to balance
the fresh gas flow, while the bulk is returned to the bag via the bag port (N).
3.1.2.3 Scavenging
The APL valve (G) has a 30 mm taper port for removing exhaust gases.
3.1.2.4 Absorbent
Gas flows down the center through the soda lime canister(s) and then up be-
tween the outer and inner canisters.
Under some conditions, this gas flow will cause condensation on the
inside of the outer canister. This condensation is normal and does not
interfere with its normal function.
Normally, soda lime contains an indicator that changes color when the soda
lime is exhausted. When the color change reaches the top of the lower
canister on a CAS II Absorber, you should replace its contents and switch the
positions of the two canisters. Also, if the CO2 monitor registers a rise in the
inspired CO2 level, you should check the absorbent to determine if it needs to
be replaced. For a CAS I Absorber, the contents of the single canister should
simply be replaced. Alternatively, you may use disposable canisters.
3.2 Installation
The absorber is supported on two shafts which are integral to the machine. A
ventilator bellows is mounted behind the absorber and all connections be-
tween the two are made when the absorber is docked into position.
Use the absorber only in the upright position. Use in any other
orientation may affect the gas flow or damage the absorber.
2. Attach the ventilator bellows to the machine bracket arm with the
fasteners provided.
After an absorber canister has been filled/refilled with soda lime, verify
that the upper seal has been properly replaced. This seal is located
above the upper soda lime canister attached to the molding within
the body of the absorber. Always ensure that all seals are correctly
replaced when re-assembling the absorber to prevent leaks.
If you will use disposable canister(s), the following types have been
tested with CAS I/II Absorbers. These disposable canisters seal
correctly and are approved for use with Spacelabs Healthcare
Anesthesia equipment. Note that checking for a correct seal with any
manufacturers disposable canisters is the responsibility of the user.
Contact Spacelabs Healthcare Technical Support for more information.
3. Remove the inner canister(s). If you have two inner canisters, remove the
center seal.
4. Remove any protective wrapping from the disposable canister(s).
Keep the canister upright at all times to prevent spills. Be sure to wear
protective gear when handling soda lime.
5. Insert one disposable soda lime canister in the outer canister.
2. Remove the outer canister from the absorber. Using both hands, grasp
the outer canister and turn it clockwise until it is released.
4. Remove the inner canister(s). If you have two inner canisters, remove
the center seal.
5. Fill the inner canister(s) with fresh soda lime just below the top of the
canister.
When filling a canister, pour the soda lime carefully and steadily. Gently
tap the sides to settle the granules and carry on filling until the canister is
almost full. Do not tap the canister violently as this action creates dust.
7. If you have the CAS II Absorber, place the center seal on top of the inner
canister. Orient the seal so the tabs are on the bottom (Figure 116). The
double arrow icon on the side of the seal (Figure 117) should point up.
Place the second disposable canister on top of the seal.
8. Check that the upper seal on the absorber is in place and seated
securely (Figure 118).
Injury to the patient may result if you use a faulty absorber. If the
absorber malfunctions, or if the absorber does not pass all pre-use
tests, do not use the absorber. Injury to the patient may result. Contact
an authorized technical engineer or return the unit to your local
distributor.
Before you use the absorber, always perform the following inspections and
tests.
1. Carefully inspect the absorber for damage.
2. Verify that the absorbent canisters are installed. Verify that all canister
seals are present and are correctly installed.
3. Remove the two non-return valve covers and check that both the
inspiratory and expiratory valve discs are clean and free to operate.
Check the valve seats for chips, damage, etc. Replace the discs and
covers, if necessary.
4. If installed, check that the bypass switch is in the ABSORBER ON
position.
5. Verify that the oxygen sensor port either has an oxygen sensor installed
or that the oxygen sensor port blanking plug is installed.
To perform this test, follow the steps given in Section 2.3.4.2 in the
Ventilator section of this manual.
If the APL valve is not in the OPEN position, it will not operate until
the pressure reaches approximately 65 cm H2O. To allow Spontaneous
breathing, set the APL valve to OPEN.
Always perform the Leak Test after changing the soda lime.
For the CAS II Absorber: Replace the soda lime when the color change
reaches the top of the lower canister or when inspired CO2 is noted on the CO2
monitor. Replace its contents and switch the positions of the two canisters.
2. Remove the outer canister from the absorber. Using both hands, grasp
the outer canister and turn it clockwise until it is released.
6. Carefully empty the inner canister(s) by pouring the used soda lime out of
the hole at the top of the canister. Discard the soda lime according to the
policies of your facility.
7. Check that the bottom of the inner canister(s) and the central seal (for the
CAS II Absorber) are free from soda lime dust. Clean, if necessary.
1. Wear protective eye, face and hand protection for this procedure. You will
be handling caustic substances.
2. Remove the outer canister from the absorber. Using both hands, grasp
the outer canister and turn it clockwise until it is released.
4. Remove the inner canister(s). If you have two inner canisters, remove the
center seal.
6. Insert one filled disposable soda lime canister in the outer canister.
7. If you have the CAS II Absorber, place the center seal on top of the
inner canister. Orient the seal so the tabs are on the bottom. The double
arrow icon on the side of the seal (Figure 123) should point up. Place the
second disposable canister on top of the seal.
8. Check that the large upper seal around the molding (Figure 121), on the
underside of the absorber, is free from soda lime dust. Remove the seal
to clean, if necessary. Check that the seal is firmly in place. The absorber
cannot function correctly without it.
Other than stated, the components and materials of the absorber are
compatible with autoclaving and Ethylene Oxide sterilization processes.
1. Wear appropriate eye, hand and face protection when cleaning the
absorber. You will be handling caustic substances.
2. Remove the outer canister from the absorber. Using both hands, grasp
the outer canister and turn it clockwise until it is released.
4. Remove the large upper seal around the absorber molding (Figure 10) on
the underside of the absorber.
7. Remove the APL valve. Lift up the spring-loaded APL cover stop, then
turn the cover counterclockwise to disengage the bayonet fitting and lift
out. Remove the valve disc.
9. If bag arm option is installed, remove bag and bag arm link pipe.
11. Wash all components in hot water. Check each component and the
seals for any small particles of soda lime, which can destroy the
integrity of valves and seals. Remove any accumulated soda lime.
12. Pack all components that can be sterilized separately in the autoclave for
sterilization at 134C max.
15. Refill the soda lime canister(s) as instructed earlier in this chapter and
insert it in the outer canister. Reattach the outer canister to the absorber.
Lock it in place by turning it fully counterclockwise.
16. Perform the pre-use checks. See Section 3.2.5 for instructions.
4. Repeat steps 1-3 to replace the other non-return valve disc, if needed.
The absorber service kit contains the items listed in the table below. Be sure to
order the correct kit for the CAS absorber installed on your machine.
3.5 Manometer
When not in use, the blanking plug should be parked in the recess located in
the underside of the absorbers lower, (interface) molding, at the front right
hand corner.
3.7.1 Dimensions
Dimension 2kg/4.4lbs 1kg/2.2lbs
Height (excluding manometer) 340mm/13.3 244mm/9.6
Width 184mm/7.2 184mm/7.2
Depth 320mm/12.5 320mm/12.5
Weight
Full 7.1kg/15.6lbs 6.0kg/13.2lbs
3.7.2 Performance
Bypass >5ml/min
Expiratory Resistance Absorbing 1.8cmH2O As per GG.6
Bypass 2.1cmH2O
Inspiratory Resistance Absorbing -3.9cmH2O As per GG.7
Bypass -2.2cmH2O
Notes
4.4 Disclaimer
Opening of the control unit by unauthorized personnel automatically voids all
warranties and specifications. The prevention of tampering is solely the users
responsibility; the manufacturer assumes no liability for any malfunction or
failure of the ventilator if the control unit is opened.
The contents of this manual are not binding. If any significant difference
is found between the product and this manual, please notify Spacelabs
Healthcare.
For all communication with Spacelabs Healthcare, quote the model and
serial number of the equipment, with the approximate date of purchase. If the
equipment is being returned for repair, indicate the nature of the fault or the
work you require to be carried out.
4.7 Copyright
2010, Spacelabs Healthcare Limited,
Anesthesia Delivery and Ventilation Division
All rights reserved. The information contained in this publication may not be
used for any other purpose than that for which it was originally intended.
This publication may not be reproduced in part or in whole without the written
consent of Spacelabs Healthcare.
4.8 CE Marking
The product is labeled with the CE mark and notified body number.
Warning Notices
Caution Notices
Note
The Note symbol identifies relevant or helpful information
BleaseSirius Warnings
USE OF EQUIPMENT
Incorrect use of the equipment described herein may result in injury to the
patient. Read this manual before operating the machine. You must be familiar
with the machine and its functions before using it on a patient.
Be sure to pay special attention to warnings, cautions and notes within the
manual. A full list of these can be found in Section 4 of this manual.
*MANDATORY EQUIPMENT*
The following equipment is mandatory, please refer to the relevant user
manuals for instructions in usage; blood oxygen monitor, CO2 alarm, blood
pressure alarm, ECG alarm, anesthesia agent concentration.
*SCAVENGING*
This machine is to be equipped with an anesthetic gas scavenging transfer
and receiving system, complying with ISO 8835-3 or applicable local standard
before being put into service.
*OXYGEN MONITOR*
If the integrated oxygen monitor is not installed, an oxygen monitor complying
with ISO 7767 shall be used when the anesthetic machine is used.
*CO2 MONITOR*
A CO2 monitor complying with ISO 9918 shall be used when the anesthetic
machine is in use.
BREATHING CIRCUIT
Adult breathing circuits with the anesthetic machines shall comply with ISO
8835-2.
*LEAKAGE CURRENTS*
Connection of equipment to the auxiliary mains socket outlets may increase
leakage currents to values exceeding the allowable limits.
*MRI ENVIRONMENTS*
The BleaseSirius machine and its absorber are not suitable for use in a MRI
environment.
LEAKAGE CURRENTS
Connection of the equipment to the socket outlets will increase leakage
currents. It is the users responsibility to ensure compliance to IEC 60601-1-1
(collateral standard for electrical medical systems). In the USA, equipment
connected to the socket outlets must comply with UL 60601-1 and the total
sum of the system leakage current shall not exceed 300 micro amps. It is the
USERs responsibility to ensure compliance with the above standard and that
the leakage current limits are not exceeded.
SEMICONDUCTOR DEVICES
The units use semiconductor devices which are susceptible to damage by
overloading, reversed polarity, electrostatic discharge and excessive heat or
radiation. Avoid hazards such as reversal of batteries, prolonged soldering,
strong RF fields, or other forms of radiation, use of insulation testers or
accidentally applied short circuits. Even the leakage current from an unearthed
soldering iron may cause trouble.
CYLINDERS
The cylinder should be cracked to ensure that no foreign material enters the
yoke when the cylinder is opened on a machine.
YOKES
To avoid stripping threads, do not use wrenches on the yoke bridge T screw.
Use only one cylinder gasket per yoke. Using more than one gasket could
cause cylinder gas leakage.
MANEUVERING MACHINE
When maneuvering machine with large cylinders attached, do not have either
the top monitor shelf or the vaporizer parking block loaded.
PIPELINE CONNECTIONS
The pipeline connections are not interchangeable, as they are installed with
gas-specific male NIST connectors (DISS on USA-specification machines).
SENSOR
Do not attempt to disassemble or modify the sensor.
VAPORIZER OPERATION
Refer to the vaporizer operating manual, before use, for filling, operating
and service instructions. The manual also contains information concerning
the extent to which the delivered vapor concentration is affected by changes
in ambient temperature and pressure, and accuracy and calibration details,
which should be understood before use. Vaporizers should not be used when
set between the OFF position (or the ZERO position if this is also the OFF
position) and the first graduation mark.
Do not use any vaporizer that is visibly misaligned on the manifold or that,
when it is locked, can be lifted off the manifold. Incorrect mounting may result
in incorrect delivery of gases.
A vaporizer is calibrated and labeled for one agent only. Do not fill with
anything other than the designated agent.
If a vaporizer is filled with the wrong agent, draining will not eliminate the
agent, because the wick will have absorbed some of the agent. The wick
must be thoroughly cleaned and dried by approved technical engineers. The
vaporizers must be completely upright for the sight glass to properly indicate
agent levels.
Never oil or grease any oxygen equipment unless the lubricant is made
and approved for this type of service. In general, oils and greases oxidize
readily, and - in the presence of oxygen - will burn violently. Fomblin is the
recommended oxygen service lubricant.
VAPORIZER STERILIZATION
Following ethylene oxide sterilization, quarantine the equipment in a well
ventilated area to allow dissipation of absorbed ethylene oxide gas. In some
cases, aeration periods of seven days or more may be required. Aeration
time can be decreased when special aeration devices are used. Follow the
sterilizer manufacturers recommendations for aeration periods required.
SAMPLE LINE
If a gas sample line is not in use, then replace white cap on the adult flow
sensor.
AGSS
The machine is to be equipped with an anesthetic gas scavenging system,
complying with ISO 8835-3 or applicable local standard before being put into
service.
Position the patient airway flow sensor tubing with care. If the tubing is
pinched or cut, the ventilators volume monitoring may not function properly.
SUCTION CONTROLLER
Note there is no locking or securing mechanism.
ON/OFF SWITCH
Note the Oxygen/MED AIR power outlets are not switched on or off by the
machines On/Off switch.
STERILIZATION
Upon receipt of new machines, it is advisable to sterilize/clean all parts of the
BleaseSirius anesthesia machine before use.
*CHECKING OF EQUIPMENT*
The equipment must be periodically checked and maintained to ensure proper
operation.
CYLINDERS
In order to minimize the possibility of running the oxygen supply cylinders
down it is recommended that the machine be switched off when it is not in use.
HYPOXIC GUARD
Do not use the anesthesia system if the hypoxic guard control system does
not operate within permitted ranges. Using an incorrectly operating control
system may result in incorrect gas mixtures and injury to the patient.
As the machine has a hypoxic guard installed, the On/Off switch must be
turned to the Off position to reduce oxygen flow to zero. The O2 flow control
dial can only reduce the flow to 150ml/min 20ml/min.
Excessive force on the O2 or N2O control dials may damage the hypoxic guard
mechanism.
O2 FLUSH CONTROL
The O2 Flush control is non-locking.
EXCESSIVE FORCE
Excessive force applied to the control dials may damage the hypoxic guard.
To reduce the oxygen flow to zero, turn the On/Off switch to the OFF position.
GAS MIXTURES
25% is the minimum nominal mixture. The tolerance is 25-30% throughout the
range, except where N2O is set to 10.0 lpm when it is 25-35%.
The hypoxic guard control system only ensures that oxygen - nitrous mixtures
will have a minimum oxygen concentration. HYPOXIC MIXTURES MAY BE
DELIVERED IF GASES OTHER THAN OXYGEN, NITROUS OXIDE OR MED
AIR ARE USED, OR WHEN OPERATING AT LOW OXYGEN FLOW RATES.
*COMPATBILITY*
The performance of the anesthetic machines and vaporizers may be degraded
if the two are mismatched. Refer to the vaporizer manufacturers instruction
manual before use.
CLEANING
Some anesthetic agents may adversely affect the paintwork. Any spillage
should be removed immediately.
Rubber and plastic parts of the machine can be cleaned with a mild detergent
and a soft cloth.
*VAPORIZER COMPLIANCE*
Any vaporizer installed on the anesthetic machine shall comply with ISO
8835-4. Additionally while the vaporizer is in use an anesthetic agent monitor
complying with ISO 11196 is to be used.
BleaseSirius Cautions
SALE OF DEVICE
Federal law restricts this device to sale by or on the order of a physician.
SECURE SHELVING
Secure any equipment placed on shelves.
OVERLOADING
Overloading may cause damage to the shelves or cause instability.
PIPELINES
The input to the machine pipelines should be regulated to 275-482kPa (40-
70psi). To ensure the cylinder supply is only used as a backup, the pressure
should be regulated to a lower pressure than primary pipeline.
HIGH PRESSURE
When using external patient circuits, there is possible risk of high pressure.
LEAKING GASES
Leaking gases and vapors (downstream of the flow control valves and oxygen
flush valve) may deprive the patient of metabolic gases and anesthetic agent
may pollute the atmosphere. Tests that detect leaks must be preformed
frequently. If detected, leakage must be reduced to an acceptable level.
BleaseSirius Notes
USER RESPONSIBILITY
The user must be familiar with the machine and its various functions before
using it on a patient.
USER RESPONSIBILITY
Keep this manual with the system to refer to and to answer any questions that
arise about the systems operation, maintenance or, if necessary, repair.
All pictures shown in this manual are of the BleaseSirius machine.
ESD
Electronic assemblies in the BleaseSirius range of machines are easily
damaged by ESD and require special handling.
MAINS SUPPLY
In US markets a cord fitted with a NEMA 5-15 hospital grade plug should be
used to connect the BleaseSirius to the mains supply.
GROSS LOADING
Gross loading = 250kg/551.1lbs
PRESSURE MEASUREMENT
The units of pressure measurement can be expressed in either cmH2O or hPa.
CYLINDERS
To prevent leakage from the cylinder valve gland nut, keep the cylinder valves
shut when not in use.
OXYGEN SENSOR
The oxygen sensor measures the concentration of oxygen in the patient
circuit.
VAPORIZER MANUAL
Refer to the vaporizer operating manual for filling and operating instructions.
The system will also give an alarm on the ventilator if oxygen fails.
OUTLETS
An additional auxiliary MED AIR or oxygen outlet with a barbed fitting is
available to provide flow of up to 80 lpm max up to max 400kPa/58.0psi at 0
flow.
FLOWMETER BACKLIGHT
Function of the flowmeter backlight is to illuminate readings on the mechanical
fresh gas flowmeter tubes. It is possible to disable this feature in the software.
The backlight is not available if your system has the electronic flowmeter
(EFM).
CHECKLISTS
We recommend that you refer to recommendations of your local professional
association regarding checklists, Spacelabs Healthcare instructions are
provided in section 1.9.
Ventilator Warnings
PRESSURE LIMITING
Pressure limiting is a safety feature and is also used in adult and pediatric
mode to provide ventilation (Precision Pressure Control). It should not be
used for any other purpose, such as creation of micro-breaths or emulation of
specialized high frequency/low volume ventilation systems, otherwise injury to
the patient may result.
SIMV MODES
The SIMV modes use a flow trigger to sense the patient attempt to breath.
Therefore, the SIMV modes will not work with patient sensor placed at the
absorber.
VTE MEASUREMENTS
Periodically check that VTE measurements match expected delivery.
INSPIRATORY TIMES
Short inspiratory times may result in inconsistent breath delivery. Avoid control
combinations which may produce very short inspiratory times (<150ms).
PRESSURE LIMITING
Pressure limiting is a safety feature and is also used in adult and pediatric
mode to provide ventilation (Precision Pressure Control). It should not be
used for any other purpose, such as creation of micro-breaths or emulation of
specialized high frequency/low volume ventilation systems, otherwise injury to
the patient may result.
Monitored values require a few minutes to stabilize after initial activation. The
ventilator and set values will function correctly.
SENSOR TUBING
The patient airway flow sensor must be in the patient breathing circuit (see
section 2.2.18 for positioning) and the associated sensor tubing must not
be trapped, kinked, split or damaged in any way in order to ensure correct
performance.
A.C.G.O. WARNING
The ventilator displays the warning A.C.G.O. while the auxiliary common gas
outlet is in use. If the A.C.G.O. switch is activated during ventilation, the ven-
tilator will continue for about 10 seconds before switching over. To reactivate
the ventilator, switch to Bag mode, then back to Vent mode.
AUDIBLE ALARM
An audible alarm indicates an anomalous condition that may result in damage
to the equipment or injury to the patient. The cause of each alarm should
be investigated and any necessary measures taken to remove the alarm
condition.
The pressure high and pressure low alarms are important for patient care.
If an alarm condition cannot be resolved, do not use the system.
ALARM SETTING
Alarms should not be set to extreme values that can cause the alarm system
to function improperly.
ALARM MUTE
Do not attempt to use the ventilator if the alarm mute button does not silence
alarms.
RECALLING SETTINGS
When recalling previously saved settings, always ensure that the settings and
alarm limits are clinically appropriate for use.
OXYGEN SENSOR
The oxygen monitor requires at least 10 minutes to stabilize after it has been
turned on. The transducer should always remain plugged into the machine to
ensure that it is ready to use.
Prior to connecting the machine to the patient, carry out the pre-use check to
verify correct alarm operation. To verify the O2 alarm, set the flow meters to
give a concentration of 50% oxygen. Using the controls on the oxygen monitor
panel, set the low oxygen level to 60% and verify the oxygen low alarm
operates. Set the high oxygen alarm level to 40% and verify that the oxygen
high alarm operates.
Always perform the pre-use check procedures for volume sensing functions
after cleaning or replacing the volume sensor.
OXYGEN MONITORING
If you remove the Oxygen parameter from the Measurements area on the
Normal screen, the pre-defined O2 concentration alarms remain active. If you
will use an alternate O2 monitoring device, you can disable O2 monitoring and
alarms via a password protected area in the Service Mode. Contact your local
Spacelabs representative for more information.
FLOW SENSOR
Do not attempt to disassemble or modify the sensor. If the sample line on the
sensor is not in use, replace the white blanking cap on the flow sensor.
The patient airway flow sensor must be correctly installed at either the distal
location in the patient systems expiratory limb or the proximal end of the Y
connector. If the sensor is installed incorrectly, volume data will be inaccurate
and associated alarms, including the low minute volume alarm, will not
function properly.
FLOW SENSOR
Position the patient airway flow sensor tubing with care. If the tubing is
pinched or cut, the ventilators volume monitoring may not function properly.
Upon receipt of new machines, sterilize/clean all parts of the machine before
use.
PRE-USE CHECKS
Prior to connecting the machine to a patient carry out the pre-use check to
verify correct alarm operation. To verify the O2 alarm, set the flowmeters to
give a concentration of 50% oxygen. Using the controls on the oxygen monitor
panel, set the low oxygen level to 60%.
BELLOWS PRESSURE
At pressures above 10cmH2O differential positive pressure, the bellows may
be dislodged from the mounting ring, resulting in a dangerous malfunction of
the ventilator. Do not exceed the stated pressure.
VENTILATOR MALFUNCTION
Injury to the patient may result if a faulty ventilator is used. If there is any
malfunction, do not use the ventilator. Refer to the Ventilator Troubleshooting
section for help. If the malfunction cannot be rectified, contact Spacelabs
Healthcare Global Technical Support or your local Spacelabs representative.
LIQUID INGRESS
Ingress of liquid into the control unit may damage the unit or result in injury to
personnel. Ensure that no liquid enters the control unit, and always disconnect
the unit from the mains electrical supply before cleaning.
BELLOWS CLEANING
Sterilize the bellows assembly periodically to minimize the risk of cross
infecting patients. Follow a sterilization schedule that complies with your
institutions infection control and risk management policy. Only use Spacelabs
Healthcare approved sterilization methods.
Foreign materials or liquids trapped in the driving gas circuit, the pop off valve
or the bellows base can impair the valve operation. Do not use the bellows
assembly if you suspect that materials are trapped. Have the assembly
repaired by a qualified Spacelabs Healthcare technical engineer.
Perform the Pre-use Check procedures after cleaning and sterilizing the
bellows.
Ventilator Cautions
BATTERY LIFE
To preserve battery life, never store the ventilator with its battery discharged.
Do not store the ventilator in close proximity to heat sources of any kind.
A.C.G.O.
100% oxygen calibration is NOT available when the machine is in A.C.G.O.
(see section 2.2.13).
SOCKET CONNECTIONS
Connection of equipment to the auxiliary mains socket outlets may increase
leakage currents to values exceeding the allowable limits.
Connection of the equipment to the socket outlets will increase leakage
currents. It is the users responsibility to ensure compliance to IEC 60601-1-1
(collateral standard for electrical medical systems). In the USA, equipment
connected to the socket outlets must comply with UL 60601-1 and the total
sum of the system leakage current shall not exceed 300 micro amps. It is the
USERs responsibility to ensure compliance with the above standard and that
the leakage current limits are not exceeded.
When using external patient circuits, there is a possible risk of high pressure.
EXPLOSION HAZARD
An explosion hazard could occur if this equipment is used with flammable
anesthetic agents such as ether or cyclopropane. To avoid the risk of
explosion, use this equipment only with anesthetic agents that comply with
the requirements on non-flammable anesthetic agents in the IEC 60601-2-13
Particular Requirements for the Safety of Anesthetic Machines.
DRIVING GAS
Use of a driving gas other than oxygen or MED AIR may damage the ventilator
and will cause inaccurate operation, resulting in potential injury to the patient.
Only use oxygen or MED AIR as the driving gas.
OPERATING TEMPERATURE
The performance of this equipment may be adversely affected by extremes of
temperature. The equipment should not be used if the ambient temperature is
below 10C (50F) or above 40C (104F).
The ventilator is not suitable for use with flammable anesthetic agents, such
as ether and cyclopropane, and therefore the use of antistatic breathing tubes
and face masks is unnecessary.
This equipment may be damaged if the gas supply pressure is too high.
The ventilator must only be connected to gas pipeline supply lines that are
fitted with pressure relief valves that limit the supply pressure to less than
700kPa/101.5psi.
POWER FAILURE
In the event of a mains electrical power failure when the ventilator is running
from its internal battery, do not remove the mains plug from the mains supply
as this would prevent the immediate resumption of normal operation when the
mains power is restored.
ELECTROMAGNETIC INTERFERENCE
Excessive electronic noise caused by poorly regulated devices may interfere
with the proper functioning of the ventilator. To avoid electronic noise, do not
connect the ventilator to the same mains supply outlet as electrically noisy
equipment such as electrocautery units. Do not use a mains extension lead to
connect the ventilator to the mains electrical supply.
EXHAUST GAS
The driving gas is discharged through the port on the rear panel of the
ventilator. This port must be completely free of any obstruction and should
have nothing connected to it. The exhaust gas is oxygen or MED AIR and
does not contaminate the environment.
BELLOWS EXHAUST
A negative or positive pressure applied to the EXHAUST port of the bellows
assembly results in positive pressure in the patient breathing system. The
scavenging system must therefore not generate more than 5cmH2O of positive
or negative pressure when connected to the ventilator.
VENTILATOR FAULTS
Injury to the patient may result if a faulty ventilator is used. If there is any
malfunction, do not use the ventilator. Refer to the Troubleshooting section
for help. If the malfunction cannot be rectified, contact Spacelabs Healthcare
Technical Support or your local Spacelabs representative.
ALARM OPERATION
If an alarm condition is ignored, injury to the patient may result. Always check
the alarms before connecting the ventilator to a patient. If the audible alarm
or the visual indicator of any alarm function fails to activate during an alarm
condition, or fails to reset after the alarm has been cleared, do not use the
ventilator. Contact an authorized technical engineer.
CLEANING AGENTS
The ventilator surfaces are not scratch-resistant. Do not use abrasive cleaning
agents that may damage the surfaces.
AUTOCLAVING SENSOR
If you are autoclaving the sensor, follow autoclave manufacturers directions.
Temperature are not to exceed 134C.
BLANKING CAP
Blanking cap on the patient flow sensor is NOT autoclavable.
STERILIZATION (BELLOWS)
Only the bellows base and the parts inside the bellows require sterilization.
To avoid damage to the equipment:
Peak sterilization temperature must not exceed 134C.
Do not sterilize the control unit.
Gas sterilization should be followed by quarantine in a well-ventilated
area to allow dissipation of residual absorbed gas.
Follow the sterilization agent manufacturers instructions.
Pop-off valve must be autoclaved separately.
VALVE SEAT
If the valve seat is damaged, the pop-off valve will leak and may cause serious
malfunction. Take care not to damage the precision-molded surface of the
valve seat while cleaning. Never use a hard object or abrasive detergent to
clean the valve. Use only a soft, lint-free cloth.
Ventilator Notes
CALIBRATION PORT
Improper connection of equipment or any power sources to the calibration port
may permanently damage the ventilator. Only an approved technical engineer
should connect monitoring equipment to the recorder output. Such equipment
must be Spacelabs-compatible and meet the regulatory standards of the
countries in which the ventilator is used.
VENTILATOR FEATURES
Some features of the ventilator are only available in certain ventilatory models.
SAFETY VALVE
A safety valve is present in the drive pressure exhaust 75cmH2O. Its function
is to protect the patient against pressures exceeding 75cmH2O 2cmH2O by
relieving the drive pressure on the bellows.
NEEP
NEEP is not supported by this machine, but patient-generated pressures may
be measured to - 10cmH2O at which point an alarm will sound.
BATTERY STATUS
Additional battery status information (Volts) may be obtained from the System
Information screens - See Section 2.2.27.9.
PRE-USE TESTING
Please read the following instructions in conjunction with the information on
Compliance compensation contained in the Installation Section 2.3.4.2 of this
manual.
CHECKLISTS
Refer to recommendations of your local professional association regarding
checklists.
PRE-USE CHECK
At the end of the Pre-use check you can choose to perform a full system test.
Although not necessary to do each time machine is turned on, it should be
done once a month.
PRE-USE TEST
During the pre-use test, the second stage pressure rise has been increased
from 20cmH2O to 40cmH2O.
The on-screen steps are just a set of instructions and not an active test. Set
the controls as instructed and carry out the manual test as instructed making
the necessary observations that all is working as correctly.
CONNECTIONS
A leak detection error can be caused by fitting a Re-Breathing bag to the
Y connector instead of occluding the circuit on the plug provided on the
absorber.
OXYGEN CALIBRATION
O2 Calibration is only possible if the ventilator is in Standby and an O2 probe is
connected.
CONFIGURATION
The features available will depend on the operating mode.
PATIENT MODES
The patient mode can only be changed while the ventilator is in BAG or
Standby mode and not in run mode.
SENSOR
The sensor measures inspired and expired flow into and from patient. It also
measures pressure in patient airway.
SENSOR BUTTON
You can only change the sensor placement location in standby mode and not
in run mode.
PATIENT FILTER
A patient filter is recommended but not essential since all parts in the patient
circuit may be sterilized. (Refer to section 1.4.8.1 for filter placement).
All Y circuit tubing must conform to ASTM F-1205.
Before changing the ventilation mode when the ventilator is in run mode, you
will see a prompt to confirm or adjust the main parameter for that mode.
ALARMS
Check alarms periodically at clinically suitable intervals. If the audible alarm
or visual indicator of any alarm function fails to activate during any alarm
condition, or fails to reset after the alarm has been cleared, refer the unit to an
authorized technical engineer.
ALARMS
In the Alarms Summary (Section 2.2.24.1), alarms marked with a (*) are
inhibited for 20secs, when the ventilator mode is changed.
LOW PRESSURES
Due to the connection with the pressure limit control, it is possible with some
patients that the alarm may occasionally be activated when pressure limiting
at low pressures in the pediatric mode. The alarm is automatically cleared
when the pressure rises.
OXYGEN ALARM
The system will also sound an alarm on the ventilator if the oxygen fails.
ALARM INDICATORS
Alarms are indicated by a change in color of the LED adjacent to the display.
Under normal conditions the LED will be GREEN.
APNEA ALARM
If apnea is registered at approximately 5mins in BAG mode and there is no
flow detected, the machine will automatically go into STANDBY.
AUTO ALARMS
If the user displays the Set Alarms Menu while the auto alarms are set, the
previous values will be restored without warning.
The user can restore the previous set of alarm limits at any time by either
selecting Off in the auto box, or going into the Alarm Limits Menu and making
no changes.
SETTING ALARMS
High and low alarms are linked intelligently so that a low alarm value greater
than a high alarm value cannot be set.
Only those alarms that are relevant to the current operating mode are
displayed.
DEFAULTS MENU
Settings and hospital defaults can be stored in Adult or Pediatric mode.
Ensure that the Patient Selection Switch is in the required position before
selecting these items.
CHANGE NAMES
A user name must be entered before any settings can be saved.
SERVICE MENU
These options are password protected. Contact Spacelabs Healthcare
Technical Support or your local Spacelabs representative for more information.
PRE-USE CHECKS
Prior to connecting the ventilator to a patient, the unit must be run to verify that
it is functioning correctly. Before using the ventilator, check that all connections
are correct and that there are no leaks.
Other alarms may also be activated, i.e., sustained pressure.
COMPLIANCE
To calculate the effect of breathing system compliance on the delivered TV, it
is necessary to measure the capacity or compliance (Cs) of the system. This
can only be done as part of a pre-use check procedure.
Absorber Warnings
ABSORBER ORIENTATION
Use the absorber only in the upright position. Use in any other orientation may
affect the gas flow or damage the absorber.
SODA LIME
Soda Lime is caustic. Observe the manufacturers instructions for correct
handling and storage. When handling soda lime, always wear suitable eye,
face and hand protection, as crushed soda lime can degrade to a fine dust
which may be harmful by inhalation.
To minimize the levels of soda lime dust, ensure that the soda lime is not
crushed and that regular cleaning of the absorbers and breathing circuits is
carried out.
To prevent injury to the patient, always protect the patients face using a
facemask.
FILLING CANISTERS
Under filling of canisters can lead to inefficient CO2 absorption. Overfilling can
result in poor canister sealing. Fill the reusable canisters only to recommended
level.
CONDENSATE
The condensate in the bottom of the canister is caustic. Drain it periodically.
Accidental splashes should be rinsed immediately with water.
DESICCATED ABSORBENT
Desiccated (dehydrated) absorbent material may produce dangerous chemical
reactions when exposed to inhalation anesthetics. Adequate precautions
should be taken to ensure that absorbent does not dry out. Turn off all gasses
when finished using the system.
DISPOSABLE CANISTERS
Amsorb The canister seal must be removed PRIOR to use in a BleaseSirius
Absorber.
ABSORBER MALFUNCTION
Injury to the patient may result if a faulty absorber is used. If there is any
malfunction, or if the absorber does not pass all pre-use tests, do not use
the absorber - injury to the patient may result. Contact Spacelabs Healthcare
Technical Support or your local Spacelabs representative.
SPONTANEOUS BREATHING
If the APL valve is not in the OPEN position, it will not operate until the
pressure reaches approx 65cmH2O. To allow Spontaneous breathing, set the
APL valve to OPEN.
CAUSTIC CONDENSATE
The condensate in the bottom of the outer canister is caustic. Drain it
periodically. Accidental splashes should be rinsed immediately with water.
Absorber Cautions
CAUSTIC CONDENSATE
The condensate in the bottom of the outer canister is caustic. Drain it
periodically. Accidental splashes should be rinsed immediately with water.
DISPOSABLE CANISTERS
Only the following disposable canisters have been tested and shown to seal
correctly and are therefore approved for use with Spacelabs Healthcare
Anesthesia equipment. Checking for a correct seal with any manufacturers
disposable canisters is the responsibility of the user. Please contact Spacelabs
Healthcare for advice if in any doubt.
Intersurgical The Drum
GE MediSorb Pre-packed cartridge disposable.
Allied Healthcare Carbolime.
Armstrong MedicalAmsorb (canister seal must be removed)
Therefore, when filling the bellows, use the flush control to bring the bellows
up to within 25mm/1inch of the top of the canister and then allow the
flowmeter/fresh gas flow to bring the bellows up to its full extent.
CLEANING
Do not use caustic substances such as trichlorethylene for cleaning the
absorber, as it may damage the surfaces.
STERILIZATION
Do not autoclave the manometer.
MANOMETER
Sterilization will damage the manometer - Remove it before sterilizing the
absorber.
Absorber Notes
ABSORBER USEAGE
Read Section 3 of this manual before operating the absorber.
CONDENSATE
Gas flows between the inner and outer canisters will, under some conditions,
cause condensation on the inside of the outer canister. This condensation is
normal and does not interfere with normal function of the absorber.
CANISTER ASSEMBLY
When filling a canister, pour the soda lime carefully and steadily. Gently tap
the sides to settle the granules and carry on filling until the canister is almost
full. Do not tap the canister violently because this will create dust.
LEAK TEST
These instructions assume that you have performed the absorber leak test
immediately prior to this test.
EXTERNAL MONITORING
It is recommended that some external monitoring of O2 , CO2 and anesthetic
agent are used when the absorber is used with a ventilator.
ABSORBER STERILIZATION
Other than stated, the components and materials of the absorber are
compatible with autoclaving and Ethylene Oxide sterilization processes.
AUTOCLAVING
Autoclave the canisters and separate plastic parts in an upright position and
away from other components.
APL ALIGNMENT
Ensure the APL valve remains vertical during re-fitting, by aligning the scallop
in the cover edge with the cover stop before engaging the bayonet fitting.
OXYGEN SENSOR
The oxygen sensor measures the concentration of oxygen on the patient
circuit.
WARRANTY
During the warranty period, if the equipment is serviced by an unauthorized
party, the warranty will be void.
Glossary
Term Definition
Apnea Apnea occurs when the patient fails to receive
or perform a breath during a period of 30
seconds or as set.
Compliance Compensation for back pressure.
Pause When Pause is activated, a percentage of the
inspiratory time is used as a plateau before
starting the expiratory phase.
Precision Pressure Control Precision pressure control ventilation
Pressure Support Pressure support ventilation
Sigh If Sigh is selected, the delivered volume
is increased by 10% for every 10th breath
(volume ventilation only).
Volume Control Controlled mandatory ventilation
l
The use of mobile phones or RF emitting equipment near the system may cause
adverse operation. Use of electrical equipment near this system may cause
interference. Always monitor system operation before and during use on a
patient.
Emissions
Emissions Test Compliance Electromagnetic Environment Guidance
RF Emissions Group 1 The system uses RF energy only for its internal
CISPR 11 function. Therefore, its RF emissions are very low
and are not likely to cause any interference in nearby
electronic equipment.
RF Emissions Class A The system is suitable for use in all establishments,
CISPR 11 including domestic establishments and those directly
connected to the public low-voltage power supply
network that supplies buildings used for domestic
purposes.
Harmonic Emissions Class A
IES 61000-3-2
Power Immunity
Immunity IEC 60601-1-2 Compliance Electromagnetic
Test Test Level Level Environment Guidance
Electrostatic 6 kV contact 6 kV contact Floors should be wood, concrete
Discharge 8 kV air 8 kV air or ceramic tile. If floors are
(ESD) IEC covered with synthetic material,
61000-4-2 the relative humidity should be
at least 30%.
Electrical Fast 2 kV for power 2 kV for power Mains power quality should be
Transient/Burst supply lines, supply lines, that of a typical commercial and/
IEC 61000-4-4 1 kV for input/out- 1 kV for input/out- or hospital environment.
put lines put lines
Surge IEC 1 kV differential 1 kV differential Mains power quality should be
61000-4-5 mode mode that of a typical commercial and/
2 kV common 2 kV common or hospital environment.
mode mode
Voltage Dips, < 5% UT (> 95% dip < 5% UT (> 95% dip Mains power quality should be
Short Inter- that of a typical commercial and/
in UT) for 0.5 cycle in UT) for 0.5 cycle
ruptions and or hospital environment. If the
Voltage Varia- 40% UT (60% dip in 40% UT (60% dip in system user requires continued
tions on Power UT) for 5 cycles UT) for 5 cycles operation during power mains
Supply Input interruptions, it is recommended
Lines IEC 70% UT (30% dip in 70% UT (30% dip in that the system be powered
61000-4-11 UT) for 25 cycles UT) for 25 cycles from an uninterruptible power
< 5% UT (> 95% dip < 5% UT (> 95% dip supply or a battery.
in UT) for 5 sec. in UT) for 5 sec.
Power Fre- 3 A/m 3 A/m Power frequency magnetic fields
quency (50/60 should be at levels characteristic
Hz) Mag- of a typical location in a typical
netic Field IEC commercial or hospital environ-
61000-4-8 3 ment.
Radiated Immunity
Immunity IEC 60601-1-2 Compliance Electromagnetic Environment
Test Test Level Level Guidance Recommended
Separation Distance
Portable and mobile RF communications
equipment should be used no closer to
any part of the system, including cables,
than the recommended separation
distance calculated from the equation
appropriate for the frequency of the
transmitter.
Recommended Separation Distance:
Conducted 3 Vrms 10 Vrms (V1) d = (3.5/V1) P
RF IEC 150 kHz to 80 MHz
61000-4-6 A.M. Modulated
with 2Hz at an
80% Depth, 10 Vrms (V2) d = (12/V2) P
outside ISM bandsa
10 Vrms
150 kHz to 80 MHz
A.M. Modulated
with 2Hz at an
80% Depth,
in ISM bands
Radiated RF 10 V/m 10 V/m (E1) d = (12/E1) P (80MHz to 800MHz)
IEC d = (23/E1) P (800MHz to 2.5GHz)
61000-4-6 80 MHz to 2.5 GHz
A.M. Modulated
with 2Hz at an Where P is the maximum output power
80% Depth rating of the transmitter in watts (W) ac-
cording to the transmitter manufacturer
and d is the recommended separation
distance in meters (m).b
Field strengths from fixed RF transmit-
ters, as determined by an electromag-
netic site survey,c should be less than
the compliance level in each frequency
range.d
Interference may occur in the vicinity
of equipment marked with the following
symbol:
Note 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects and people.
a
The ISM (industrial, scientific and medical) bands between 150 kHz and 80 MHz are 6.765 MHz
to 6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70
MHz.
b
The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in the
frequency range 80 MHz to 2.5 GHz are intended to decrease the likelihood that a portable
communications device could cause interference if it is inadvertently brought into patient areas.
For this reason, an additional factor of 10/3 is used in calculating the recommended separation
distance for transmitters in these frequency ranges.
c
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast, and TV broadcast
cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due
to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured
field strength in the location in which the system is used exceeds the applicable RF compliance
level above, the system should be observed to verify normal operation. If abnormal performance
is observed, additional measures may be necessary, such as re-orienting or relocating the system.
d
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 1 V/m.
For transmitters rated at a maximum output power not listed above, the recommended separation
distance d in meters (m) can be determined using the equation applicable to the frequency of the
transmitter, where P is the maximum output power rating of the transmitter in watts (W) according
to the transmitter manufacturer.
Note 1: At 80 MHz to 800 MHz the separation distance for the higher frequency range applies.
Note 2: The ISM (Industrial, Scientific and Medical) bands between 150 kHz and 80 MHz are
6.765 MHz to 6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66
MHz to 40.70 MHz.
Note 3: An additional factor of 10/3 is used in calculating the recommended separation distance
for transmitters in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency
range 80 MHz to 2.5 GHz to decrease the likelihood that mobile/portable communications equip-
ment could cause interference if it is inadvertently brought into patient areas.
Note 4: These guidelines may not apply in all situations. Electromagnetic propagation is affected
by absorption and reflection from structures, objects and people.
I N
Identify your Ventilator 84 Nitrous Oxide System 66
I:E Ratio 97 Non-return Valve Discs 202
I:E Setting 119 Normal Screen 100
Indicators 35 Note to Service Personnel 210
inspiratory and expiratory valve discs
194 O
Inspiratory Pause 91 O2 Calibration with A.C.G.O. System
Installation 40, 152, 205 121
Introduction 25 O2 Sensor Error 137
K O2 Supply Fail 139
On/Off Switch 80
Key Fill Vaporizer 39 Operating Modes 88
Operation 58
L Optional Features 37, 38
Leak Test 79 Other Maintenance 161
Low Battery Indicator 87 Outer Canister 191, 192, 198, 199,
Low BPM Alarm 142 202
Low Oxygen Alarm 141 Overview 85
Low Supply Gas Pressure Alarm 137 Oxygen Calibration 120
Oxygen Failure Warning Device 64
M Oxygen Failure Warning System
Check 76
Machine Dimensions 32 Oxygen Flush 71
Maintenance 196 Oxygen Flush Tap Test 81
Manometer 205 Oxygen Probe 44
Maximum Loading 32 Handling 45
Measured Value Messages 175 Oxygen Sensor 205
Measurements Menu 122 oxygen Sensor Port 194
Mechanical Hypoxic Guard Test 81 Oxygen System 64
Medical Air System 67 Oxygen Transducer 43
Menu Tree 105 Connecting 43
Methods of Sterilization 165
Miscellaneous 33
Mode Dependant Features 171
Monitor Shelf 31
Monitor Shelf Dimensions 32
MV High Alarm 142
MV Low Alarm 142
V
Vaporizers 39, 72
Fitting 45
Ventilator 34
Activating and monitoring alarms
108
Description 85
End of Case 108
Features 86
Powering Down 108
Powering Up 107
Starting 107
Stopping 108
Using 107
Ventilators 58
Ventilator Surfaces 162
Ventilator Test 82
Vent Inoperative Alarm 138
Volume Control 89
Volume Control Defaults 169
W
Warning System Checks 80
Waveform Select Menu 128
Weekly Checks 161
When to Replace the Soda Lime 197
Work Surface Dimensions 32