Fabius Plus: Instructions For Use

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Instructions for use

Fabius plus

WARNING Anesthesia workstation


To properly use this medical device, Software 3.n
read and comply with these
instructions for use.
Typographical conventions

1 Consecutive numbers indicate steps of action, Use of terms


with the numbering restarting with "1" for each
new sequence of actions. – The product Fabius plus is also referred to as
Fabius.
 Bullet points indicate individual actions or dif-
ferent options for action. – Dräger uses the term "Accessory" not only for
accessories in the sense of IEC 60601-1, but
– Dashes indicate the listing of data, options, or also for consumable parts, removable parts,
objects. and attached parts.
(A) Letters in parentheses refer to elements in the
related illustration.
A Letters in illustrations denote elements Screen layouts and illustrations of the
referred to in the text. device

Any text shown on the screen and any labeling on The actual screen layout or the device may differ in
the device are printed in bold and italics, e.g., appearance or in configuration from the
PEEP or Man/Spon. illustrations.

Trademarks

Trademark Trademark owner Trademark Trademark owner


®plus
Fabius Incidin® Ecolab
®
DrägerService Incidur®
Spirolog®
SpiroLife®
D-Vapor® Dräger
Drägersorb®
MEDIBUS®
Vitalink®
Vapor®
Selectatec® Datex-Ohmeda
Korsolex® BODE Chemie
Neodisher Medi-
Dr. Weigert
clean®
Gigasept FF® Schülke & Mayr

2 Instructions for use Fabius plus SW 3.n


Safety information definitions

WARNING CAUTION
A WARNING statement provides important A CAUTION statement provides important
information about a potentially hazardous information about a potentially hazardous
situation which, if not avoided, could result in situation which, if not avoided, may result in
death or serious injury. minor or moderate injury to the user or patient or
in damage to the medical device or other
property.

NOTE
A NOTE provides additional information intended
to avoid inconvenience during operation.

Definition of target groups

For this product, users, service personnel, and Service personnel


experts are defined as target groups.
These target groups must have received Service personnel are persons who are
instruction in the use of the product and must have responsible for the maintenance of the product.
the necessary training and knowledge to use, Service personnel must be trained in the
install, reprocess, maintain, or repair the product. maintenance of medical devices and install,
The target groups must understand the language reprocess, and maintain the product.
of the present document.
The product must be used, installed, reprocessed,
maintained, or repaired exclusively by defined Experts
target groups.
Experts are persons who perform repair or
complex maintenance work on the product.
Users Experts must have the necessary knowledge and
experience with complex maintenance work on the
Users are persons who use the product in product.
accordance with its intended use.

Instructions for use Fabius plus SW 3.n 3


Abbreviations and symbols

Explanations can be found in the sections


''Abbreviations'' and ''Symbols'' in chapter
''Symbols''.

4 Instructions for use Fabius plus SW 3.n


Contents

Contents

For your safety and that of your patients.... 7 Connecting the sensors and measurement
General safety information .............................. 8 lines ................................................................. 79
Product-specific safety information.................. 12 Fastening the manual resuscitator .................. 82
Instructions for mounting the accessories ....... 82
Application ..................................................... 15
Intended use.................................................... 16 Getting started............................................... 85
Indications/Contraindications........................... 17 Daily checkout and pre-use checkout ............. 86
Further information on application ................... 18 Switching on .................................................... 86
The MEDIBUS and Vitalink protocols.............. 19 Checking the readiness for operation.............. 88
Overview......................................................... 20 Operation ....................................................... 89
Fabius plus as trolley version (front view) ....... 21 Standby page after start-up............................. 90
Compact breathing system COSY (top view) .. 22 Setting the fresh-gas flow................................ 90
Power supply unit for COSY heating (front Setting the anesthetic gas concentration ........ 92
view) ................................................................ 23 O2 flush ........................................................... 93
Power supply unit for COSY heating (rear Low-flow anesthesia........................................ 94
view) ................................................................ 24 Nitrogen rinsing (as needed) ........................... 94
Rear view......................................................... 25 Replacing the soda lime .................................. 95
Interface panel................................................. 27 Ventilation........................................................ 96
Vaporizer ......................................................... 28 Safety functions of the ventilator ..................... 108
Ceiling-mounted version (optional).................. 29 Patient change ................................................ 109
Wall-mounted version (optional)...................... 30 Using the external fresh-gas outlet as a
Supplemental O2 delivery (optional)................ 31 common gas outlet (optional) .......................... 110
APL valve ........................................................ 32 Using the external fresh-gas outlet with an
Interfaces......................................................... 33 auxiliary switch (optional) ................................ 112
External fresh-gas outlet.................................. 34 Ending operation ............................................. 114
Abbreviations................................................... 36 Preparing for storage or transport ................... 115
Symbols........................................................... 38
Alarms ............................................................ 117
Product labels.................................................. 40
Alarm signaling................................................ 118
Operating concept......................................... 41
Monitoring...................................................... 121
Control panel ................................................... 42
Screen display ................................................. 44 Main screen..................................................... 122
Selecting and setting ....................................... 45 O2 monitoring .................................................. 122
Fresh-gas delivery (version for 3 gases) ......... 47 Breathing volume monitoring........................... 126
LED indicators ................................................. 48 Airway pressure monitoring............................. 128
Color coding for anesthetic agents and medical Configuration................................................. 130
gases ............................................................... 49
Screen colors (optional)................................... 49 Configuration in standby mode........................ 131
Page Standby Set-up ...................................... 139
Assembly and preparation ........................... 50 Configuration during operation ........................ 147
Before first operation ....................................... 51 Troubleshooting ............................................ 153
Connecting the gas supply .............................. 54
Ensuring the gas supply .................................. 60 Locating and remedying leakages................... 154
Assembling the breathing system.................... 61 Power supply failure ........................................ 156

Instructions for use Fabius plus SW 3.n 5


Contents

Ventilator failure .............................................. 158 Password ....................................................... 227


Failure of the O2 sensor .................................. 159 Configuration password for Fabius plus
Low O2 supply ................................................. 159 Software 3.n .................................................... 227
Alarm – Cause – Remedy ............................... 160

Cleaning, disinfection and sterilization....... 169


Disassembly .................................................... 170
Removing the compact breathing system ....... 172
Reprocessing procedures ............................... 174
Reprocessing list ............................................. 178
Before using on patients again........................ 181
Maintenance................................................... 182
Overview ......................................................... 183
Inspection ........................................................ 184
Preventive maintenance.................................. 185
Repair.............................................................. 186
Disposal ......................................................... 187
Disposing of the medical device...................... 188
Disposal of accessories................................... 188
Disposal of non-rechargeable batteries........... 189
Technical data ............................................... 190
General information......................................... 191
Ambient conditions .......................................... 191
Device data ..................................................... 192
Fuses............................................................... 195
External fresh-gas outlet ................................. 195
Electrical safety ............................................... 195
General safety standards for anesthesia
workstations .................................................... 196
Ventilator ......................................................... 198
Anesthetic gas supply module......................... 200
Vaporizer interface .......................................... 201
Breathing system............................................. 203
Alarm for low oxygen supply pressure ............ 206
Alarm tone sequence IEC ............................... 206
Characteristics of additional acoustic signals.. 206
S-ORC (Sensitive Oxygen Ratio Controller) ... 207
Device outlets.................................................. 207
Essential performance characteristics............. 208
EMC declaration.............................................. 209
Device combinations ....................................... 214
Connections to IT networks............................. 215
Illustrations ...................................................... 216
Annex ............................................................. 218
Form for daily checkout and pre-use checkout 219

6 Instructions for use Fabius plus SW 3.n


For your safety and that of your patients

For your safety and that of your patients

General safety information ........................... 8


Strictly follow these instructions for use........... 8
Maintenance .................................................... 8
Safety checks .................................................. 8
Accessories ..................................................... 9
Connected devices .......................................... 9
No operation in potentially explosive areas ..... 9
Safe coupling with electrical equipment .......... 10
Patient safety................................................... 10
Patient monitoring............................................ 10
Information on electromagnetic compatibility .. 11
Installing accessories ...................................... 11
Keeping the instructions for use ...................... 11
Training............................................................ 11
Product-specific safety information ............ 12

Instructions for use Fabius plus SW 3.n 7


For your safety and that of your patients

General safety information

The following WARNING and CAUTION Maintenance


statements apply to general operation of the
medical device.
WARNING and CAUTION statements specific to WARNING
its subsystems or particular features appear in the Risk of medical device failure and patient
respective sections of these instructions for use or injury
in the instructions for use of any other product
being used with this device. The medical device must be inspected and
serviced regularly by service personnel.
Repair and complex maintenance carried out
Strictly follow these instructions for use on the medical device must be performed by
experts. If the above is not complied with,
medical device failure and patient injury may
WARNING occur. Observe chapter ''Maintenance''.
Risk of incorrect operation and incorrect use Dräger recommends DrägerService for a
service contract and for repairs. Dräger also
Any use of the medical device requires full
recommends using original Dräger parts for
understanding and strict observation of all
maintenance.
sections of these instructions for use. The
medical device must only be used for the
purpose specified under ''Intended use'' on
page 16 and in conjunction with an Safety checks
appropriate patient monitoring system (see
page 10). Strictly observe all WARNING and The medical device must be subject to regular
CAUTION statements throughout these safety checks. See chapter ''Maintenance''.
instructions for use and all statements on
medical device labels.
Failure to observe these safety information
statements constitutes a use of the medical
device that is inconsistent with its intended
use.

8 Instructions for use Fabius plus SW 3.n


For your safety and that of your patients

Accessories Connected devices

WARNING WARNING
Risk due to incompatible accessories Risk of electric shock and device malfunction
Dräger has only tested the compatibility of Any connected devices or device
accessories that appear in the current list of combinations not complying with the
accessories or in separate declarations by requirements in these instructions for use
Dräger. If other, incompatible accessories are may compromise correct functioning of the
used, there is a risk of patient injury due to medical device.
medical device failure.
Before using the medical device, refer to and
Dräger recommends using the medical device strictly comply with the instructions for use
only with accessories from the current list of of all connected devices and device
accessories. combinations.

WARNING WARNING
Risk of operating errors and incorrect use Risk of device malfunction
Strictly observe the instructions for use of all This medical device can be operated in
accessory parts, e.g.,: combination with other Dräger devices or
– Water traps with devices from other manufacturers. If a
– Flow sensors device combination is not approved by
– CLIC adapter Dräger, the safety and the functional state of
– CLIC absorber the individual devices can be compromised.
– Soda lime – The operating organization must ensure
– Breathing hoses that the device combination complies with
– Masks the applicable editions of the relevant
– Filter standards for medical devices.
– Endotracheal suction – Strictly observe the assembly instructions
– Vaporizer and instructions for use of each
– Manual resuscitator connected device.
– AGSS terminal unit

No operation in potentially explosive


areas

WARNING
Risk of explosion and fire
This medical device is neither approved nor
certified for use in areas where oxygen
concentrations greater than 25 Vol%,
combustible or explosive gas mixtures are
likely to occur.

Instructions for use Fabius plus SW 3.n 9


For your safety and that of your patients

Safe coupling with electrical equipment Patient monitoring

The user of the medical device is responsible for


CAUTION
choosing suitable monitoring that provides
Risk of patient injury appropriate information about medical device
performance and the patient's condition.
Coupling with electrical equipment that is not
mentioned in these instructions for use or Patient safety may be achieved by a wide variety
assembly instructions may only be done with the of means ranging from electronic surveillance of
respective device manufacturer. medical device performance and patient condition
to simple, direct observation of clinical signs.
The responsibility for selecting the best level of
Patient safety patient monitoring lies solely with the user of the
medical device.
The design of the medical device, the
accompanying documentation, and the labeling on
the medical device are based on the assumption
that the purchase and the use of the medical
device are restricted to users, and that certain
inherent characteristics of the medical device are
known to the user. Instructions and WARNING and
CAUTION statements are therefore largely limited
to the specifics of the Dräger medical device.
These instructions for use do not contain
references to various hazards which are obvious to
users who operate this medical device as well as
references to the consequences of medical device
misuse, and to potentially adverse effects in
patients with different underlying diseases. Medical
device modification or misuse can be dangerous.

CAUTION
Risk of patient injury
Do not make therapeutic decisions based solely
on individual measured values and monitoring
parameters.

10 Instructions for use Fabius plus SW 3.n


For your safety and that of your patients

Information on electromagnetic WARNING


compatibility
Risk of electric shock
General information on electromagnetic The connection of devices to auxiliary power
compatibility (EMC) according to the international sockets can lead to an increased leakage
EMC standard IEC 60601-1-2: current. If the protective ground of one of
Medical electric equipment is subject to special these devices fails, the leakage current may
precautionary measures concerning rise above the permissible values.
electromagnetic compatibility (EMC) and must be – Only connect with the approval of the
installed and put into operation in accordance with respective device manufacturer.
the EMC information provided (see page 190). – Have the leakage current checked by
service personnel.
Portable and mobile RF communications – If the permissible value is exceeded, use a
equipment can affect medical electrical equipment. mains power socket on a wall instead of
the auxiliary power socket of the device.
WARNING
Risk of electric shock
Installing accessories
Do not connect connectors with an
ESD warning symbol and do not
touch the pins of such connectors CAUTION
without implementing ESD protective
Risk of device failure
measures. Such protective measures may
include antistatic clothing and shoes, Install the accessory on the basic device in
touching a potential equalization pin before accordance with the instructions of the basic
and during connection of the pins, or using device.
electrically insulating and antistatic gloves.
Check for secure connection to the basic device.
All relevant users must be instructed in these
ESD protective measures. Stricly observe the instructions for use and
assembly instructions.
WARNING
Risk of device failure Keeping the instructions for use
Electromagnetic fields, e.g., those generated
by radio frequency communication CAUTION
equipment such as mobile phones, high-
frequency electrical surgery equipment, Risk of incorrect use
defibrillators or shortwave therapy devices The instructions for use must be kept in an
can disrupt the function of the medical accessible location for users.
device.
Only operate radio frequency devices at a
sufficient safety clearance of at least 20 Training
cm (7.9 in).
User training is offered by the responsible Dräger
organization, see www.draeger.com.

Instructions for use Fabius plus SW 3.n 11


For your safety and that of your patients

Product-specific safety information

WARNING WARNING
Risk of misinterpretation Risk of patient injury
Misinterpretation of measured values or other Every user has the obligation to assess
parameters or misdiagnosis can endanger independently which components are
the patient. required corresponding to the specific
prerequisites for the anesthesia workstation.
Do not make therapeutic decisions based
In accordance with the general safety
solely on individual measured values and
standards for anesthesia systems, additional
monitoring parameters. Therapeutic
monitoring of the concentrations of CO2 and
decisions must be made solely by the user.
anesthetic agent is required when operating
the device. To guarantee patient safety,
WARNING however, the following components must
Risk of burns always be used:
– O2 monitor
Conductive breathing hoses or face masks – Pressure monitor
can cause burns during HF surgery. – Volume monitor
Do not use this type of hose and mask
combined with HF surgery. WARNING
Risk of malfunction
WARNING
Unallowed modifications to the medical
Risk of malfunction device lead to malfunctions.
Device failure or user error can compromise This medical device may not be changed
the correct functioning of the device. The without permission from Dräger.
medical device does not react automatically
to certain changes in the patient condition,
WARNING
operating errors, or failure of components.
Risk of accidental movement of the medical
Continuously monitor the medical device so
device
that corrective measures can be initiated
immediately. During operation the medical device can
move accidentally.
WARNING Activate the castor brakes.
Risk of device failure
The device can fail if the power supply is
interrupted.
Always connect the device on an
uninterruptible power supply.

12 Instructions for use Fabius plus SW 3.n


For your safety and that of your patients

WARNING WARNING
Risk of tipping over during transport Risk due to failure of flow measurement
The medical device may tip over if handled Deposits that were not removed during
incorrectly. Observe the following points reprocessing can damage the measuring
when transporting medical devices: wires in the flow sensor or cause a fire.
– The medical device may only be moved by – Before inserting the flow sensor check for
people who have the physical ability to do visible damage, soiling, and particles.
so. Repeat this check regularly.
– To improve the maneuverability, transport – Replace flow sensors when damaged,
the device with 2 persons. soiled, or not particle-free.
– When transporting over inclines, around
corners, or over thresholds (e.g., through WARNING
doors or in elevators), make sure that the
medical device does not bump against Risk of insufficient ventilation
anything. Device failure or operating errors can lead to
– Remove any devices mounted to the ventilation failure.
holding arms or the top of the device. – To ensure immediate remedial action in
– Clear the writing tray and fold it down case of device failure, only operate the
completely or slide it into the device. device under permanent supervision of
– Do not pull the medical device over hoses, users.
cables, or other obstacles lying on the – The general safety standards for
floor. anesthesia systems require that a manual
– Do not activate the brake while the resuscitator be kept at the ready for
medical device is being moved. emergency ventilation.
– Always use the handles on the device to
push or pull it. WARNING

WARNING Risk of injury to the lungs

Risk of fire Endotracheal suction can cause negative


pressure in the lungs. This pressure can
The flow sensor can ignite medications or injure the lungs.
other substances that are easily flammable.
– Do not nebulize medications or other Be careful during suction.
substances that are easily flammable or
spray them into the device. WARNING
– Do not use substances containing alcohol.
Risk of not hearing the alarm tone
– Do not allow combustible or explosive
substances to enter the breathing system Dräger recommends that the user remain in
or breathing circuit. the vicinity of the anesthesia machine, i.e.,
– Do not use cyclopropane or ether. within a distance of up to four meters (12
feet). This facilitates fast recognition and
response in the event of an alarm.

Instructions for use Fabius plus SW 3.n 13


For your safety and that of your patients

WARNING WARNING
Risk of crushing Risk of electric shock
If the writing tray is not correctly locked in This device is only intended for use in rooms
place, objects can fall down or fingers and in which the power lines correspond to the
breathing hoses, for example, can be national applicable safety standards for
pinched. patient's rooms in hospitals. Observe the
following points to avoid electric shock:
Make sure that the writing tray is correctly
– The covers of the components must not
locked when folding down or sliding into the
be removed.
device.
– Maintenance work must only be
performed by DrägerService. Use only
WARNING grounded electrical connections and
Risk of crushing power cables that meet hospital
standards.
Movable device parts or attached – Before connecting the medical device,
components may cause crushing due to make sure that external devices are
clamping. Pay special attention to edges, grounded to meet the hospital standard (in
movable parts, and corners when working accordance with national applicable
with the following components: regulations).
– Breathing system cover – Before cleaning work or maintenance
– Drawers work is performed, disconnect all plugs
– Extensible writing tray for the power supply.
– Swivel arms for mounted devices – If the medical device has come in contact
– Accessories such as gas cylinders, with liquids, let it dry completely before it
vaporizers, CLIC absorber, and CLIC is reconnected to the power supply.
adapter – Check that the power cable is securely
clamped to the power inlet.
– Only connect additional devices if they
have been approved by Dräger.

WARNING
Risk of device failures
If the anesthesia workstation is used in a
tipped position, parts can be damaged or
their function can be comprised.
Do not use the anesthesia workstation at an
inclination over 1°.

NOTE
The device software of Fabius must be installed
by experts. Dräger recommends having the
software installation performed by
DrägerService.

14 Instructions for use Fabius plus SW 3.n


Application

Application

Intended use .................................................. 16

Indications/Contraindications ...................... 17
Indications ....................................................... 17
Contraindications............................................. 17
Further information on application.............. 18
Environment of use.......................................... 18
The MEDIBUS and Vitalink protocols .......... 19

Instructions for use Fabius plus SW 3.n 15


Application

Intended use

The Fabius anesthesia workstation for inhalational


WARNING
anesthesia is appropriate for use in operating
rooms, induction rooms, and recovery rooms. Risk of patient injury
Fabius is equipped with an electrically driven and In accordance with the general safety
electronically controlled ventilator. The following standards for anesthesia systems, additional
parameters are monitored: monitoring of the concentrations of CO2 and
– Airway pressure (PAW), anesthetic agent is required.

– Tidal volume (VT)


WARNING
– Inspiratory oxygen concentration (FiO2)
Risk of insufficient ventilation
Anesthesia is achieved through a mixture of pure
oxygen and Air (medical compressed air) or pure Device failure or operating errors can lead to
oxygen and nitrous oxide, with the addition of ventilation failure.
volatile anesthetic agents. A Dräger anesthetic – To ensure immediate remedial action in
vaporizer is used to enrich the fresh gas with case of device failure, only operate the
volatile anesthetic agents. The gas supply is done device under permanent supervision of
via a central gas supply system or via externally users.
connected gas cylinders. – The general safety standards for
anesthesia systems require that a manual
Fabius is equipped with a compact breathing resuscitator be kept at the ready for
system that offers fresh gas decoupling, PEEP, emergency ventilation.
and pressure limitation.
The following ventilation modes are available: WARNING
– Volume Control (volume-controlled Risk due to malignant hyperthermia
ventilation)
Volatile anesthetic agents may cause
– Pressure Control* (pressure-controlled malignant hyperthermia.
ventilation)
For patients suspected of suffering from
– Pressure Support* (pressure-supported malignant hyperthermia: Do not use any
ventilation) volatile anesthetic agent or Fabius with
– SIMV/PS* (synchronized intermittent residual concentrations of these gases above
ventilation with pressure support) 5 ppm.
– ManSpont (manual ventilation/spontaneous
breathing) WARNING
Risk due to the accumulation of acetone in
the patient
Do not perform low-flow anesthesia on
patients with ketoacidosis or patients under
the influence of alcohol. The risk of
accumulation of acetone in the patient
increases in such cases.

* optional

16 Instructions for use Fabius plus SW 3.n


Application

NOTE NOTE
CO2 values and anesthetic gas values can be O2 monitoring can be deactivated on site by an
monitored if the Fabius is combined with a gas authorized service partner. More information can
monitor (e.g., Vamos) or a gas analyzer (e.g., be found in chapter ''Deactivating the O2
Scio with Dräger patient monitor). monitoring'' on page 125. If O2 monitoring is
deactivated, use external O2 monitoring.

Indications/Contraindications

Indications

Fabius is specified for inhalational anesthesia


and/or patient ventilation in accordance with the
intended use during surgical or diagnostic
interventions.

Contraindications

The device has no product-specific


contraindications.
It is the responsibility of the user to select the
appropriate treatment for the patient's underlying
disease.
Patient status must be continuously monitored for
potential changes.

NOTE
Fabius applies medical gases such as O2, N2O,
or volatile anesthetic agents. For
contraindications to the applied medical gases,
strictly observe the instructions for use of the
medical gas.

Instructions for use Fabius plus SW 3.n 17


Application

Further information on application

Environment of use

Fabius is designed for use in rooms in which


therapeutic or diagnostic interventions can be
carried out.

WARNING
Risk of explosion
This medical device is neither approved nor
certified for use in areas where oxygen
concentrations greater than 25 Vol%,
combustible or explosive gas mixtures are
likely to occur.

WARNING
Risk of device malfunctions and/or patient
injury and user injury
Magnetic fields can negatively influence the
correct functioning of the medical device and
therefore endanger the patient or user.
Do not use the medical device near magnetic
resonance imagers.

WARNING
Do not use soda lime based on potassium
hydroxide. Otherwise, there is a risk of CO
formation.

Do not use Fabius in the following environments:


– Outside of massive buildings
– In intensive care units
– During patient transport
– In vehicles, airplanes, or helicopters

18 Instructions for use Fabius plus SW 3.n


Application

The MEDIBUS and Vitalink protocols

MEDIBUS and Vitalink are software protocols for


the transfer of data between Fabius and an
external medical or non-medical product (e.g.,
hemodynamic monitors, data management
systems, or Windows-based computers) via an
RS232 interface (see instructions for use 9038530,
3rd edition or higher).

WARNING
Risk of patient injury
All data transferred via the MEDIBUS
interface are for information only and must
not be used as the sole basis for diagnostic
or therapeutic decisions. The data accessible
via this interface are not intended for use with
a distributed alarm system in accordance
with IEC 60601-1-8:2012 (in the sense of
remote monitoring).

WARNING
For the protection of patients and users from
electrical risk, it is required that all systems
that consist of medical devices and other
electrical devices, such as computers,
printers, etc., are assembled exclusively by
trained personnel.

The system must meet the requirements of


standards IEC 60601-1-1 and IEC 60601-1-2, or of
IEC 60601-1:2005 for medical electrical
equipment.

Instructions for use Fabius plus SW 3.n 19


Overview

Overview

Fabius plus as trolley version (front view) . 21

Compact breathing system COSY (top


view) ............................................................... 22

Power supply unit for COSY heating (front


view) ............................................................... 23

Power supply unit for COSY heating (rear


view) ............................................................... 24

Rear view........................................................ 25
Pin-index connection ....................................... 25
Screw connections .......................................... 26
Interface panel ............................................... 27

Vaporizer ........................................................ 28

Ceiling-mounted version (optional)............. 29

Wall-mounted version (optional) ................. 30

Supplemental O2 delivery (optional) ........... 31


Functional check of the supplemental O2
delivery ............................................................ 31
APL valve ....................................................... 32

Interfaces ....................................................... 33
Recommended device configuration ............... 33
External fresh-gas outlet .............................. 34
Using the external fresh-gas outlet as a
common gas outlet .......................................... 35
Use of the external fresh-gas outlet with an
additional switch .............................................. 35
Abbreviations ................................................ 36

Symbols ......................................................... 38

Product labels................................................ 40

20 Instructions for use Fabius plus SW 3.n


Overview

Fabius plus as trolley version (front view)

A B
plus

C
P O2

D
O

N E
M
L F
G

K H

25292

A Ventilator control panel (settings for ventilation H Drawers


parameters and airway monitoring) I Locking brake
B Screen J Power supply unit for COSY breathing system
C Pressure gauges for gas cylinders (O2 and heating*
N2O)* K CO2 absorber
D Pressure gauges for the central supply (O2, Air, L Compact breathing system (COSY)
N2O)
M Ventilator
E Flow tubes
N Supplemental O2 delivery for O2 insufflation*
F Fresh-gas delivery
O Vaporizer mount
G Writing tray
P O2 flush
* optional

Instructions for use Fabius plus SW 3.n 21


Overview

Compact breathing system COSY (top view)

A B C D E
O

M F

L
G

K J I
20983

A External fresh-gas outlet* L Mount with locking pin


B Connection for PEEP/PMAX valve M APL valve with selection for manual ventilation
C Breathing bag holder (Man) and spontaneous breathing (Spont)

D Expiratory valve N Connection for sample line

E Flow-sensor guard or COSY guard (not O Holder for sample line (optional)
illustrated)
F Expiratory port
G Connection for breathing bag
H Inspiratory port
I Inspiratory valve
J Fresh gas decoupling valve
K Connection for APL bypass valve

* optional

22 Instructions for use Fabius plus SW 3.n


Overview

Power supply unit for COSY heating (front view)

21014

A LED indicator for COSY heating


B On/Off switch
C Fuse

Instructions for use Fabius plus SW 3.n 23


Overview

Power supply unit for COSY heating (rear view)

C
21015

A Power inlet
B LED indicator for power supply
C Cable clamp

24 Instructions for use Fabius plus SW 3.n


Overview

Rear view

Pin-index connection

F
G
E
D
C

H
2.8-6.0 kPa 2.8-6.0 kPa
x 100 (bar) x 100 (bar)

N2O
N2O

2.8-6.0 kPa 2.8-6.0 kPa


x 100 (bar) x 100 (bar)

AIR AIR

2.8-6.0 kPa 2.8-6.0 kPa


x 100 (bar) x 100 (bar)

O2 O2

A 25295

A Gas cylinder H Connection for ventilator hose


*
B Pin-index connection
C Power inlet with main fuses
D On/Off switch
E Battery fuse
F Potential equalization pin
G Interface panel

* optional

Instructions for use Fabius plus SW 3.n 25


Overview

Screw connections

A 2.8-6.0 kPa
x 100 (bar)
2.8-6.0 kPa
x 100 (bar)

N2O

2.8-6.0 kPa
N2O

2.8-6.0 kPa
B
x 100 (bar) x 100 (bar)

AIR
AIR

2.8-6.0 kPa 2.8-6.0 kPa


x 100 (bar) x 100 (bar)

O2 O2

25298

A Connections for compressed gas hoses of gas


cylinders with O2, O2 and N2O, or O2 and Air
(screw connections)
B Connections for central supply hoses
C Gas cylinders

26 Instructions for use Fabius plus SW 3.n


Overview

Interface panel

A
B
C
D
E
F

25301
A COM 1 port
B Connection for PEEP hose
C Connection for APL hose
D Socket for O2 sensor
E Socket for airway pressure sensor
F Socket for flow sensor

Instructions for use Fabius plus SW 3.n 27


Overview

Vaporizer

23424

Anesthetic vaporizers are used to enrich fresh gas


with a precisely delivered concentration of a
volatile anesthetic agent.

Vaporizer Anesthetic agent


Isoflurane
Halothane
Vapor 2000/3000
Enflurane
Sevoflurane
D-Vapor/ D-Vapor 3000 Desflurane

Vapor 2000/3000 is an unheated, calibrated


anesthetic vaporizer for enriching dry, medical
fresh gas for an anesthesia workstation with a
precisely delivered concentration of a volatile
anesthetic agent.
D-Vapor/D-Vapor 3000 is a heated, calibrated
anesthetic vaporizer for enriching dry, medical
fresh gas of an anesthesia workstation with the
anesthetic agent desflurane.
There are various connector systems with which
vaporizes can be connected to an anesthesia
workstation.
Dräger recommends using only anesthetic
vaporizers that are listed in the list of accessories.
More information can be found in the respective
instructions for use of the anesthetic vaporizers
used.

28 Instructions for use Fabius plus SW 3.n


Overview

Ceiling-mounted version (optional)

CAUTION
Risk of crushing
When the medical device is set on the floor, body
parts can be crushed.
Make sure there is sufficient free space.

CAUTION
Risk of injury or risk of damage to the medical
device
If the medical device is let down to the floor,
obstructions can damage the medical device. If
the medical device is lifted or lowered, protruding
parts can be damaged.
– Remove all obstructions from under the
device.
– Watch out for protruding parts.
25512

Fabius can be used in combination with the ceiling CAUTION


supply units Movita/Movita lift or Forta lift as a Risk of device failure
ceiling-mounted version. In this case, the
anesthesia workstation is not placed on a trolley, If the medical device is used in a tipped position,
(see chapter ''Fabius plus as trolley version (front parts can be damaged or their function can be
view)'' on page 21), but rather on the mount of a comprised.
ceiling supply unit. Do not use the anesthesia workstation at an
Observe the corresponding assembly instructions inclination over 1°.
(9037202).
CAUTION
CAUTION
Risk of injury or risk of damage to the medical
Risk of tipping over device
If the device is dismounted from the ceiling If the maximum weight is exceeded, the holder
supply unit and set on the floor, it can tip over. can release from the wall mount.
Observe the following steps before setting the
The total weight of the anesthesia workstation,
device on the floor:
including all accessories, must not be exceeded,
– Remove all additionally mounted
see ''Instructions for mounting the accessories''
components.
and ''Technical data''.
– Fold the holding arms in on the Fabius.
– Make sure there is sufficient free space.

Instructions for use Fabius plus SW 3.n 29


Overview

Wall-mounted version (optional)

CAUTION
Risk of injury or risk of damage to the medical
device
If the maximum weight is exceeded, the holder
can release from the wall mount.
The total weight of the anesthesia workstation,
including all accessories, must not be exceeded,
see ''Instructions for mounting the accessories''
and ''Technical data''.

CAUTION
Risk of injury or risk of damage to the medical
device
25307

When the device is being mounted to the wall,


Fabius can also be mounted on the wall. In this
pivoted in its holder, or removed from the wall,
case, the anesthesia workstation is not placed on a
the cables and hoses may be damaged and
trolley, (see chapter ''Fabius plus as trolley version
personal damage may occur.
(front view)'' on page 21), but rather on a mount on
– Ensure that cables and hoses are not
the wall.
pinched, kinked, or torn.
Observe the corresponding assembly instructions – When mounting, removing, or pivoting the
(9037202). device, ensure that body parts are not
crushed.
CAUTION – The device may only be moved by people
who have the physical ability to do so. Dräger
Risk of tipping over
recommends that such tasks be carried out
If the device is removed from the mount and set by two people.
on the floor, it can tip over. Observe the following
steps before setting the device on the floor:
– All additionally mounted components must be
removed beforehand.
– Fold the holding arms in on the Fabius.
– Make sure there is sufficient free space.

CAUTION
Risk of device failure
If the medical device is used in a tipped position,
parts can be damaged or their function can be
comprised.
Do not use the anesthesia workstation at an
inclination over 1°.

30 Instructions for use Fabius plus SW 3.n


Overview

Supplemental O2 delivery (optional)

The supplemental O2 delivery supplies pure


WARNING
oxygen with an exact metered flow, e.g., for O2
Risk due to overpressure insufflation using a face mask during a regional
anesthesia. The supplemental O2 delivery is not
When the patient's connection to the
only possible in standby mode and during
supplemental O2 delivery is made using a
operation, but also if Fabius is switched off.
breathing circuit without relief valve,
increased pressure may be applied to the The supplemental O2 delivery can supply
patient. additional inspiratory oxygen for the patient for the
following types of anesthesia:
When connecting the patient, only use a
breathing circuit with relief valve or do not – Spinal anesthesia
connect pressure-tight. – Epidural anesthesia
– Other regional anesthesia
WARNING
To increase the O2 concentration in the breathing
Risk of fire gas, the supplemental O2 delivery can be used in
The oxygen can ignite when cauterizing near combination with a breathing bag*.
an oxygen source.
– Make sure that all connections (e.g., Y-
piece, breathing hoses) do not leak. Functional check of the supplemental
– Before cauterizing, close the flow control O2 delivery
valve.
– Remove mask. – Turn the flow control valve (A)
– Wait a few moments. counterclockwise.
– Check that the float can move freely in the flow
tube.
Fabius plus
After the O2 insufflation is ended, the flow control
valve of the supplementary O2 delivery must be
completely closed:
 Turn the flow control valve (A) clockwise to the
final position stop.
O2

A
25317

* ASTM F1850-22(2005) §76

Instructions for use Fabius plus SW 3.n 31


Overview

APL valve

WARNING NOTE
Risk of patient injury The APL valve is automatically separated from
the breathing system as soon as an automatic
Wires and cables can get caught under the
ventilation mode is selected.
APL valve adjustment knob and block the
APL valve.
WARNING
Lay all cables and wires, e.g., sample line so
that they do not get caught. Risk of excessively high airway pressures
If the ventilator fails, the device switches into
The APL valve has 2 functions: the ManSpont ventilation mode.
– During manual ventilation, the maximum
The APL valve should also be set to a
airway pressure is limited.
pressure limitation value suitable for the
– During manual ventilation and spontaneous patient when using automatic ventilation
breathing, excess gas is discharged into the modes. If the ventilator fails, ventilate the
anesthetic gas scavenging system. patient manually.
The functional state is only guaranteed if the
ventilator is in ManSpont mode or is bypassed.
20956

Different settings can be made on the APL valve


adjustment knob:
– Change between manual ventilation (Man) and
spontaneous breathing (Spont)
– Setting of the maximum airway pressure for
manual ventilation

32 Instructions for use Fabius plus SW 3.n


Overview

Interfaces

CAUTION
Risk to electrical safety
A To ensure electrical safety, only connect devices
to the serial port (COM 1) with a maximum
nominal voltage of 24 Vdc that meet one of the
following standards:
– IEC 60950-1: Ungrounded SELV circuits
– IEC 60601-1 (as of 2nd edition): Exposed
secondary circuits

CAUTION
25321

Risk of device failure


A There is a port on the rear of Fabius for
communication with external devices. The port Use only monitors, mounting parts, and
is labeled COM 1. This port is used for data connection cables approved by Dräger.
communication using the Dräger MEDIBUS or
Vitalink data protocols. NOTE
The data transmission of the gas analysis data
WARNING
must be activated by DrägerService or the
Risk of electric shock authorized local service partner.
Connecting devices to the MEDIBUS
interfaces can lead to an increased leakage
current. If the protective ground of one of
Recommended device configuration
these devices fails, the leakage current may
rise above the permissible values. Configuration 1
– Only connect with the approval of the
respective device manufacturer.
– Have the leakage current checked by
service personnel.
– If the permissible value is exceeded, A
disconnect the devices from the MEDIBUS
interface.
25330

– Fabius plus
– Breathing gas monitor (Vamos)
1 Connect the breathing gas monitor to COM 1
(A).

Instructions for use Fabius plus SW 3.n 33


Overview

External fresh-gas outlet

The external fresh-gas outlet is used for


WARNING
connecting different non-rebreathing systems, e.g.,
Magill, Kuhn, Waters, Bain. Risk of faulty gas delivery
O2 and CO2 and any anesthetic gases must
WARNING
also be monitored for non-rebreathing
Risk of excessive airway pressure systems.
Without a pressure-relief valve or breathing The sample line must be connected with the
bag, airway pressure may become too high. connector of the non-rebreathing system and
the connector of the gas analyzer (e.g., Scio,
Only connect non-rebreathing systems with
Vamos).
breathing bag or pressure-relief valves that
comply with applicable safety standards.
NOTE
WARNING Strictly observe the instructions for use of the
non-rebreathing system (e.g., Magill, Waters,
Insufficient gas supply to the patient
Bain).
Non-rebreathing systems are only intended
for manual ventilation or spontaneous
breathing and must only be connected to the
external fresh-gas outlet.
When using a non-rebreathing system,
ensure an adequate gas monitoring.

WARNING
Risk of misinterpretation of measured values
The values for O2, pressure, and volume
displayed on Fabius do not correspond to the
values for the patient connected to external
fresh-gas outlet as they are based on
measurements taken at the compact
breathing system.
When using the external fresh-gas outlet,
change into the Standby mode.

34 Instructions for use Fabius plus SW 3.n


Overview

Using the external fresh-gas outlet as a Use of the external fresh-gas outlet with
common gas outlet an additional switch*

The switch enables the simple switching of the


Overview
fresh-gas supply from the compact breathing
system to the non-rebreathing system.
A B
F
Overview

A B
F
C
E
D
C
21001

A External fresh-gas outlet E


B Long fresh-gas hose (on Fabius) D

21002
C Short fresh-gas hose (on compact breathing
system) A External fresh-gas outlet with an additional
D Compact breathing system switch
E Sample line B Long fresh-gas hose (on Fabius)
F Non-rebreathing system (e.g., Bain) C Short fresh-gas hose (on compact breathing
system)
D Compact breathing system
E Sample line
F Non-rebreathing system (e.g., Bain)

* optional

Instructions for use Fabius plus SW 3.n 35


Overview

Abbreviations

Abbreviation Explanation Abbreviation Explanation


%, Vol % Percentage gas ratio, related to kPa Kilopascal
total volume L/min Liters per minute
A Ampere lbs Pound; unit of mass
AGS Anesthetic gas receiving system LED Light emitting diode
AGSS Anesthetic gas scavenging sys- ManSpont Manual ventilation/Spontaneous
tem breathing
Air Medical compressed air mbar Millibar
APL Adjustable Pressure Limitation, MEAN Mean airway pressure
adjustable pressure limitation
MEDIBUS.X Dräger communications proto-
bpm Breaths per minute col for medical devices with uni-
BTPS Body Temperature and Pres- form data definition for all
sure, Saturated devices
37 °C (98.6 °F), ambient pres- min Minute
sure, 100 % relative humidity
mL Milliliter
CAL Display when a measurement
value is calibrated. mmHg Millimeter of mercury
cmH2O Centimeters of water MRI Magnetic resonance imaging
CO Carbon monoxide MV Minute volume
CO2 Carbon dioxide N2O Nitrous oxide, dinitrogen monox-
ide
COM Serial interface
NMI Nuclear magnetic imaging
COSY Compact breathing system
NMR Magnetic resonance
CSA Canadian Standards Agency
O2 Oxygen
dB(A) Decibel, rated sound level unit
O2+ O2 flush
EMC Electromagnetic compatibility
PAW Airway pressure
ESD Electrostatic Discharge, electro-
static discharge PEAK Peak airway pressure

FiO2 Inspiratory oxygen fraction PEEP Positive end-expiratory pressure


Freq Respiratory rate PINSP Inspiratory pressure
Freq Min Mandatory minimal respiratory PLAT Plateau pressure
rate in Pressure Support mode PMAX Pressure limitation
psi pounds per square inch
HF High-frequency
SIMV Synchronized Intermittent Man-
hPa Hectopascal datory Ventilation
Insp Flow Inspiratory flow

36 Instructions for use Fabius plus SW 3.n


Overview

Abbreviation Explanation
S-ORC Sensitive Oxygen Ratio Control-
ler, maintains a minimum O2
concentration
STAPD Standard Temperature, Ambient
Pressure, Dry
20 °C (68 °F), ambient pres-
sure, dry gas
TI, TINSP Inspiratory time
TE Expiratory time
TI:TE Ratio of inspiratory time to expi-
ratory time
TIP:TI Ratio of inspiratory pause to
inspiratory time
Trigger Trigger
UMDNS Universal Medical Device
Nomenclature System, nomen-
clature for medical devices
USB Universal Serial Bus, computer
interface
VT Tidal volume
∆PPS Differential pressure of the pres-
sure support in Pressure Sup-
port mode

Instructions for use Fabius plus SW 3.n 37


Overview

Symbols

Symbol Explanation Symbol Explanation

Manufacturer LOT Batch designation

XXXX Date of manufacture Keep away from sunlight

Use by Storage temperature

Relative humidity
WEEE label, Directive
2002/96/EC
Atmospheric pressure
Consult instructions for use
Do not use if package damaged
Warning! Strictly follow these
instructions for use
Do not reuse
Caution! Observe the accompa-
nying documentation!(symbol)
Alarm inactive
Attention! (safety sign)
The alarm tone is suppressed for
Caution! Risk of electric shock. 2 minutes.
Do not remove cover.
Mains power
Applied part, protection class BF
(Body Floating)
Partial power supply switched on
Applied part of protection class B
Total power supply switched on
ESD warning label, observe the
warning statement, see ''Infor- Connection for potential equal-
mation on electromagnetic com- ization
patibility'' on page 11
Auto Exclusion Plug-in connec-
tion
Risk of crushing
Gas cylinder connection
Label on device surfaces where
the risk of tipping is increased by
e.g., leaning on or against the CO2 absorber bypass
surface or pushing
Read the flow at the center of the
Serial number float.

REF Order number Non-rebreathing system

38 Instructions for use Fabius plus SW 3.n


Overview

Symbol Explanation Symbol Explanation

Vaporizer plug-in system, "fixed" Key for switching the workstation


position light on and off
Key to call up the configuration
O2 flush menu
Key for suppressing the acoustic
Connection to central gas supply alarm signal for 2 minutes

Breathing bag Standby key

Power supply of the breathing


system heating

Battery charge

Caution when touching hot sur-


faces.

Upper and lower alarm limits

Lower alarm limit

Upper alarm limit

Socket for O2 sensor

Socket for flow sensor

Socket for airway pressure sen-


sor

Ventilator connection

Fuse

Do not oil!

Close menu

Key for access to alarm limits

Key to call up main screen

Instructions for use Fabius plus SW 3.n 39


Overview

Product labels

Product label Explanation


When connecting auxiliary devices, be aware of
the leakage current.

Transport instructions, see ''Preparing for storage


or transport'' on page 115

Trolley version: Observe the weight of the nominal


nom. 110 kg configuration and the total permissible weight, see
''Technical data''.
max. 280 kg
Wall-mounted version / ceiling-mounted version:
nom. 69 kg Observe the weight of the nominal configuration
and the total permissible weight, see ''Technical
max. 125 kg
data''.

40 Instructions for use Fabius plus SW 3.n


Operating concept

Operating concept

Control panel ................................................. 42


Softkeys........................................................... 43
Screen display ............................................... 44

Selecting and setting .................................... 45


Monitoring settings and system settings.......... 45
Changing the ventilation mode ........................ 45
Selecting and setting the ventilation
parameters ...................................................... 46
Fresh-gas delivery (version for 3 gases)..... 47

LED indicators ............................................... 48


LEDs for operating status ................................ 48
LEDs for alarm status ...................................... 48
Color coding for anesthetic agents and
medical gases ................................................ 49

Screen colors (optional) ............................... 49

Instructions for use Fabius plus SW 3.n 41


Operating concept

Control panel

C
B

E
C

25357
The control panel contains the following main Key Function
elements:
 In the mode Standby:
A Screen
Opens a menu for configuring the system
B Key to select ventilation modes
settings and default settings, see chapter
– Volume Control ''Configuration in standby mode'' on page
– Pressure Control 131
– Pressure Support *  In a ventilation mode:
– SIMV/PS *
Opens a menu for displaying and chang-
– ManSpont ing the monitoring settings, see chapter
C Key for more functions ''Configuration during operation'' on page
147
Key Function
Changes from displayed screen to the
Opens the window with alarm limits. main screen.
The alarm tone of all active alarms is sup-
pressed for 2 minutes.
Switches to Standby mode. Monitoring is
switched off and the ventilator stops.

* optional

42 Instructions for use Fabius plus SW 3.n


Operating concept

D Keys with variable functions (called "softkeys"


in this document)
E Rotary knob to select and confirm screen
settings
F LED indicators

Softkeys

The labeling on the softkeys depends on the active


ventilation mode.
In all ventilation modes, the softkeys only display
those ventilation parameters and ventilation
functions that are available in the respective
ventilation mode.
Example for Volume Control mode:
– PMAX
– VT
– Freq
– TI:TE
– TIP:TI
– PEEP
More information can be found in chapter
''Configuration in standby mode'' on page 131.

Instructions for use Fabius plus SW 3.n 43


Operating concept

Screen display

The main screen displays the most important


information regarding anesthesia and ventilation.

G
25358

A Status bar B Alarm message field


The following information is displayed in the status Display of a maximum of 4 alarm messages* with
bar: highest priority
– Current ventilation mode C O2 monitoring
– Remaining time of alarm tone suppression Display of the inspiratory oxygen concentration in
– Status of the desflurane compensation percent (%) as well as the upper and lower alarm
– Remaining battery charge limits
– Current time
* for Japan and China maximum 3 alarm messages

44 Instructions for use Fabius plus SW 3.n


Operating concept

D Volume monitoring E Airway pressure monitoring


Display of: Display of:
– Respiratory rate of the patient in breaths – Positive end-expiratory pressure (PEEP)
per minute (Freq) – Mean airway pressure (MEAN)
– Tidal volume (VT) – Plateau pressure (PLAT)
– Minute volume (MV) – Peak pressure (PEAK)
– Upper and lower alarm limits of the minute F Pressure waveform for airway pressure
volume
G Softkeys (labeling depending on ventilation
mode)

Selecting and setting

Monitoring settings and system settings Changing the ventilation mode

Each of these settings requires a selection and


confirmation by pressing the rotary knob.
– To change a value or parameter or to navigate
in the menus, turn the rotary knob.
In this document, these procedural steps are
simply called "select." A
– To confirm a value or a selection, press the B
rotary knob.
Without confirmation with the rotary knob the value
or parameter is not changed. In this document,
these procedural steps are simply called "confirm."
25359

1 Select a ventilation mode (A).


– The LED in the key flashes.
– The pressure waveform is replaced by a
dialog window with ventilation settings.
– A message with further instructions (B) is
displayed.
2 Confirm the ventilation mode.
– The LED in the key is continuously lit up.
– The pressure waveform is displayed again.

Instructions for use Fabius plus SW 3.n 45


Operating concept

Selecting and setting the ventilation NOTE


parameters
The time limit for changes of ventilation
Example: Changing the parameter VT in Volume parameters is 15 seconds. After 10 seconds, an
Control mode acoustic signal consisting of 3 tones is sounded.
If the new setting is not confirmed within the time
Prerequisite: Fabius is in Volume Control mode limit, the current ventilation settings remain
effective. Instead of the window with the
Volume Control ventilation settings, the pressure waveform is
again displayed.

B
25360

1 Press the VT softkey (B).


– The pressure waveform (A) is replaced by a
dialog window with ventilation settings (C).
– The key (D) is highlighted.

Volume Control

C
D
25361

2 Select new value and confirm.


– The pressure waveform is displayed again.

46 Instructions for use Fabius plus SW 3.n


Operating concept

Fresh-gas delivery (version for 3 gases)

If the pressure drops below 20 psi (1.4 kPa x100),


the LED warning indicator lights up.
B
A NOTE
C
If the float does not turn, the accuracy may be
less than that specified in the technical data.

E
F
G
25384

The flow tubes and the pressure gauges are


located on the front of the device below the screen.
There are 2 flow control valves for Air and O2 on
the gas mixer for 2 gases. There is a third flow
control valve for N2O on the gas mixer for 3 gases.
All flow control valves are labeled and provided
with a color coding, see chapter ''Color coding for
anesthetic agents and medical gases'' on page 49.
The O2 flow control valve is additionally provided
with grooves on the gripping surface.
A Pressure gauge for the central O2 supply
B Pressure gauge for the central Air supply
C Pressure gauge for the central N2O supply
D Flow tubes
E O2 flow control valve
F Air flow control valve
G N2O flow control valve

Instructions for use Fabius plus SW 3.n 47


Operating concept

LED indicators

There are several LED indicators on the front of LEDs for alarm status
the device.
Fabius has alarm LEDs that signal alarms and
indicate the alarm priority. Further information in
LEDs for operating status chapter ''Alarms''.

Alarm LEDs

A
B
C B A C
25411

– If the device is connected to the mains power

25411
supply, the mains power LED (A) is lit.
– In addition, the standby key (B) and all keys of – Red LED (A) flashes: indicates a warning
the ventilation modes (C) have small LEDs that – Yellow LED (B) flashes: indicates a caution
light up when the respective mode is active. – Yellow LED (B) lit constantly: indicates a note
– Red LED (C) flashes: indicates low O2 supply

48 Instructions for use Fabius plus SW 3.n


Operating concept

Color coding for anesthetic agents and medical gases

The standardized color coding specified in


ISO 5359 / ISO 32 / ISO 5360 is used for
anesthetic agents and medical gases.
The colors for O2, Air, and N2O are adapted
according to locally applicable standards.

Screen colors (optional)

For improved visibility, Fabius displays the


following screen elements in different colors:
– Softkeys (Default)
– Alarm messages (see chapter ''Alarm
priorities'')
– Screen background (bright/dark)
The screen elements are only represented in color
when the "Color display" option is activated.

Instructions for use Fabius plus SW 3.n 49


Assembly and preparation

Assembly and preparation

Before first operation.................................... 51 Instructions for mounting the accessories. 82


Activating the battery....................................... 51 Trolley version ................................................. 83
Connecting the mains power supply ............... 52 Wall-mounted version and ceiling-mounted
Auxiliary power sockets................................... 53 version............................................................. 83
Establishing potential equalization .................. 53
Connecting the gas supply .......................... 54
Central gas supply........................................... 55
Gas cylinders with pin-index system (optional) 56
Gas cylinders with screw connections
(optional) ......................................................... 58
Mounting the anesthetic vaporizers................. 59
Ensuring the gas supply............................... 60
Connecting the anesthetic gas receiving
system (optional) ............................................. 60
Assembling the breathing system............... 61
Preparing the ventilator ................................... 61
Mounting the CO2 absorber to the compact
breathing system ............................................. 62
Mounting the COSY heating and the power
supply unit (optional) ....................................... 65
Connecting the compact breathing system ..... 66
Inserting the flow sensor ................................. 67
Connecting the exhaust port ........................... 67
Connecting the breathing bag ......................... 68
Connecting the endotracheal suction system
(optional) ......................................................... 70
Connecting the breathing hoses and the filters 72
Inserting a new O2 sensor capsule ................. 78
Connecting the sensors and measurement
lines ................................................................ 79
Connecting the O2 sensor ............................... 79
Connecting the pressure sensor ..................... 79
Connection of the pressure gauge for
measurement of the airway pressure (optional)
........................................................................ 80
Connecting the flow sensor ............................. 80
Connecting the APL bypass hose and
PEEP/PMAX hose ............................................ 81
Fastening the manual resuscitator .............. 82

50 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Before first operation

Activating the battery

To prevent discharging of the battery during


transport and during storage, the fuse of the
battery is not connected with the device.

WARNING A
Risk of device malfunction
If the battery is not sufficiently charged and
the mains power supply fails, operation
cannot be maintained long enough.
Before first operation or after storage, charge
the battery for at least 8 hours.

WARNING
Risk due to reduced power supply from the

25413
internal battery
Batteries are wear parts. The capacity of the 1 Remove the packaging of the battery fuse.
battery diminishes with the period of use. 2 Remove the fuse holder.
Check the functional state of the battery by 3 Insert fuse (A) in the fuse holder.
performing preventive maintenance on a 4 Screw the fuse holder in securely with a
regular basis. quarter turn clockwise.

Instructions for use Fabius plus SW 3.n 51


Assembly and preparation

Connecting the mains power supply 1 Connect the power cable with the device.
2 Plug the power cable into the mains power
The mains voltage must correspond to the voltage socket on the wall.
range indicated by the rating plate on the rear of
LED on the front of the device lights up
the device:
green.
100 V to 240 V
3 Set On/Off switch (A) to position .
4 Check the status bar for the battery indicator.

A
25413

WARNING
Risk of electric shock and device malfunction
If the device is connected to a power socket
with incorrect mains voltage or without a
protective ground, the user can be injured
and the device damaged.
Only connect the power cable to power
sockets with a protective ground, see
''Technical data''.

NOTE
The mains plug must be freely accessible so that
the power supply to Fabius can be quickly
interrupted in the event of device failure.

52 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Auxiliary power sockets Establishing potential equalization

Differences in electrical potential between devices


WARNING
can be reduced by potential equalization.
Risk of electric shock Potential equalization does not replace the
The connection of devices to auxiliary power protective ground connection.
sockets can lead to an increased leakage In operation, the potential equalization connectors
current. If the protective ground of one of must be readily accessible and must be removable
these devices fails, the leakage current may without tools.
rise above the permissible values.
– Only connect with the approval of the
respective device manufacturer. Connecting the potential equalization cable
– Have the leakage current checked by
service personnel.
– If the permissible value is exceeded, use a
mains power socket on a wall instead of
the auxiliary power socket of the device.

WARNING
A
Risk of device malfunction
If the mains power fails, devices connected to
the auxiliary power sockets are not supplied
from the uninterruptible power supply.
– Do not connect any life-supporting
devices to the auxiliary power sockets of
the anesthesia workstation.
– Ensure an alternative power supply for
connected devices.

25413
WARNING
Risk of device malfunction 1 Connect the potential equalization cable to the
potential equalization pin (A) on the left-hand
If high-frequency surgical devices are
side (rear view).
connected to the auxiliary power sockets, the
leakage current can damage the electronics 2 Connect the potential equalization cable to a
of the medical device and lead to a failure. potential equalization connector of the hospital
(e.g., wall, ceiling supply unit, operating table).
Do not connect any high-frequency surgical
devices to the auxiliary power sockets of the 3 Establish potential equalization to the auxiliary
medical device. devices.

NOTE
If the good condition of the protective ground or
its correct connection with the medical device
cannot be ensured, the device must be operated
via the internal power supply (battery).

Instructions for use Fabius plus SW 3.n 53


Assembly and preparation

Connecting the gas supply

WARNING
Risk due to gas supply failure
All gas supplies (central gas supply, gas
cylinders) must be correctly connected since
otherwise the backup system (gas cylinders)
will not be available if gas supply fails.
– Make sure that all compressed gas hoses
are correctly connected to the rear side of
the device.
– After connecting the gas supply, check for
correct function.
– Even when the anesthesia machine is
connected to the central gas supply, the
gas cylinders should remain at the device
with valves closed as backup.

WARNING
Risk of contamination of ambient air and risk
of fire/explosion
O2 or N2O can get into the ambient air as a
result of leakages.
– Make sure the compressed gas hoses are
connected properly.
– Avoid and remedy all leakages.
– Ensure sufficient ventilation of the room.
– Use an anesthetic gas scavenging
system.

54 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Central gas supply

Version for 3 gases

WARNING CAUTION
Risk to patient through incorrect gas Risk of insufficient gas pressure
connection
If the supply pressure of the central gas supply is
If the connections of the central gas supply too low, the functionality of the anesthesia
hoses between the central gas supply and workstation is compromised.
Fabius are interchanged, serious accidents
The pressure gauge of the individual gases must
can occur.
display a constant pressure between 41 and
If Fabius is connected to the central gas 87 psi (2.8 and 6 kPa x 100).
supply, it must be checked whether the marks
on the hoses agree with the connections of NOTE
the central gas supply.
A failure of the gas supply can lead to a failure of
the connected devices.
A
B
2.8-6.0 kPa
x 100 (bar)

N2O

2.8-6.0 kPa
x 100 (bar)

AIR

2.8-6.0 kPa
x 100 (bar)

O2
25414

1 Screw the connection piece of every individual


central gas supply hose hand-tight on the
corresponding connection (A) on the device
side.
2 Plug the probes of the central gas supply
hoses in the appropriate wall terminal units (B).
3 Check if all central gas supply hoses are
correctly connected.

Instructions for use Fabius plus SW 3.n 55


Assembly and preparation

Gas cylinders with pin-index system Connecting the gas cylinders


(optional)
I J A
WARNING B
Risk due to incorrect mounting of the gas H
cylinder C
When using several sealing washers between D
the gas cylinder and the gas inlet of the
cylinder holder, the pin-index safety system
is compromised. E
If a gas cylinder is connected, always check
G
whether the pin-index pins are present. Never F

20973
attempt to bypass the pin-index safety
system. 1 Remove the old sealing washer (D).
2 Insert a new sealing washer (D) at the cylinder
WARNING holder (J).
Risk of explosion 3 Make sure that both pin-index pins (A) are
present below the gas inlet (B).
If the gas cylinder valves are opened too
quickly, a sudden increase in pressure may 4 Align the gas cylinder (F) so that the pin-index
occur. holes on the cylinder head (E) are pointing
– Open and close the gas cylinders valve towards the pin-index pins (A) on the cylinder
slowly by hand. holder (J).
– Do not use tools. 5 Insert the cylinder head (E) of the gas cylinder
(F) from below into the cylinder holder (J).
CAUTION 6 Allow the pin-index pins (A) to engage in the
Risk due to gas supply failure pin-index holes.

Leave gas cylinders as a backup at the 7 Turn the handle (I) on the cylinder holder (J)
anesthesia workstation, even if there is a clockwise. The tip of the threaded retaining pin
connection to the central gas supply. will then be turned into the visible recess on the
cylinder head. Make sure that the gas cylinder
is suspended vertically.
NOTE
8 Tighten the handle (I) of the cylinder holder (J).
Leaky and stiff gas cylinder valves must be
repaired according to manufacturer's If required, the gas cylinder valve (C) can be
specifications. opened with the supplied wrench (G).
If the gas cylinder is removed, insert the plug (H) in
the mounted gas cylinder holder and tighten.

56 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Checking the gas cylinders Maximum permissible dimensions of the gas


cylinders
2.8-6.0 kPa 2.8-6.0 kPa
x 100 (bar) x 100 (bar)

N2O

2.8-6.0 kPa
x 100 (bar)
N2O

2.8-6.0 kPa
x 100 (bar)
Gas cylin- Left Right
AIR AIR

der con-
A
2.8-6.0 kPa
x 100 (bar) 2.8-6.0 kPa
x 100 (bar)

nection
O2 O2

Length Length
Ø Ø
[mm] [mm]
Max. Max.
Pin-index 700 700
105 105

25416
Pressure
102/142 750 102/142 1100
reducers
The pressure specifications are based on gas
cylinders of size E at 21 °C/70 °F. If the pressure in Min. Ø of
a gas cylinder does not reach the recommended gas cylin- 85/110 85/110
minimum pressure (PSI - MIN), the gas cylinder der
must be replaced by a full gas cylinder.
Observe the following points:
Gas PSI - FULL (kPa x PSI - MIN – Do not exceed the maximum length of the gas
100 - FULL) (kPa x 100 - MIN) cylinder including the pressure reducer / pin-
(normal full load) index connection.

Air 1900 (131) 1000 (69) – The gas cylinders must not protrude over the
lower edge of the trolley (observe maximum
N2O 745 (51) 600 (42) length of the gas cylinders).
O2 1900 (131) 1000 (69) – The O2 cylinder must not be mounted on the
right side (looking from the rear).
1 Open cylinder valves (A).
Make sure that the pressure gauges on the gas
cylinders indicate the appropriate pressure
recommended in the following table.
No hissing must sound when opening the cylinder
valves.
In this case, the connection is leaking. The gas
cylinder must be mounted again.
2 Close the cylinder valves again.

Instructions for use Fabius plus SW 3.n 57


Assembly and preparation

Gas cylinders with screw connections


(optional)
2.8-6.0 kPa
x 100 (bar) 2.8-6.0 kPa
x 100 (bar)

N2O N2O

2.8-6.0 kPa
x 100 (bar) 2.8-6.0 kPa
x 100 (bar)

AIR AIR

2.8-6.0 kPa
x 100 (bar) 2.8-6.0 kPa
x 100 (bar)

O2 O2

WARNING
Risk of explosion
B
When pressurized, O2 is self-igniting in A
combination with oil or grease.

25417
Do not oil or grease the gas cylinder valve or
the pressure reducer of the O2 cylinder. Do
not touch with oily or greasy fingers. WARNING
O2 gas cylinders must not be mounted on the
WARNING right side of the device (looking from the
Risk of explosion rear).

If the gas cylinder valves are opened too 1 Place the full gas cylinders (A) in the cylinder
quickly, a sudden increase in pressure may holder and secure them.
occur.
2 Connect the pressure reducers to the cylinder
– Open and close the gas cylinders valve
valves. The connections must fit directly to
slowly by hand.
each other. Do not use transition pieces.
– Do not use tools.
3 Screw the compressed gas hoses (B) to the
CAUTION pressure reducers and to the connections of
the gas supply block.
Risk due to gas supply failure
4 Open the cylinder valves.
Leave gas cylinders as a backup at the
anesthesia workstation, even if there is a
connection to the central gas supply.

CAUTION
Risk of patient injury
Do not connect gas cylinders without the
pressure reducers listed in the current list of
accessories.

Have service personnel repair any leaky or stiff


gas cylinder valves.

NOTE
Keep gas cylinders closed as long as they are
not being used. There is the risk of accidental
emptying of the gas cylinders.

58 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Mounting the anesthetic vaporizers

Depending on the configuration, Fabius can be


operated with vaporizers that have a plug-in
adapter for the following connectors:
– Selectatec
– Interlock S
– Dräger Auto Exclusion
The anesthetic vaporizers must be mounted in
accordance with the respective instructions for
use.
The vaporizers used must conform to the
applicable safety standard.
If an independent gas measurement system is
used, it must conform to the applicable safety
standard.

WARNING
Risk due to incorrect anesthetic agent
delivery
If the vaporizer is filled with the wrong
anesthetic agent or if it is not filled
sufficiently, incorrect anesthetic gas
concentrations or concentrations that are too
low can occur as a result.
– Strictly observe the instructions for use of
the vaporizer.
– Compare the color coding on the
vaporizer with the anesthetic agent bottle.

WARNING
Risk due to improperly mounted vaporizers
Incorrectly mounted vaporizers can cause
leakage. This can cause the fresh-gas flow to
be too low or contaminate the ambient air.
Patient and user can be endangered.
– Make sure that the vaporizers are
mounted levelly.
– When using D-Vapor vaporizers, make
sure that the power cable is not pinched.
– After mounting the vaporizers, perform a
leakage test.

Instructions for use Fabius plus SW 3.n 59


Assembly and preparation

Ensuring the gas supply

Connecting the anesthetic gas receiving WARNING


system (optional)
Risk of patient injury
The anesthetic gas receiving system, in If the side openings of the anesthetic gas
combination with Dräger anesthesia workstations receiving system are blocked, this can lead to
and their modules, meets the requirements of a lack of fresh gas in the breathing system.
general safety standards.
Make sure that the side openings of the
The anesthetic gas receiving system does not receiving system are not blocked.
work as a stand-alone system, but is used as one
of 3 components of an anesthetic gas scavenging
system (AGSS).

A
B C
D
E
20981

20974

1 Fit the receiving system, with the slots resting The top edge of the float (D) in the flow tube must
on the corresponding pegs, on Fabius and move between the two marks (E).
slide down.
More information can be found in the instructions
2 Use the screw plug (A) to seal the connection for use (9038579) of the anesthetic gas receiving
not in use. system.
3 Slide the transfer hose (B) to the provided port.
4 Connect the other end of the transfer hose to
the exhaust port on the bottom of the COSY.
5 Connect the scavenging hose (C) to the
corresponding port of the receiving system.
6 Connect the probe of the scavenging hose (C)
to the terminal unit of the anesthetic gas
scavenging system. Observe the associated
instructions for use of the AGSS terminal unit.

60 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Assembling the breathing system

Only disinfected and sterilized components must


WARNING
be used.
Risk of insufficient anesthetic gas 1 Open the ventilator door (A) with the attached
concentrations ventilator unit.
If the component connections of the 2 Release the 3 clamps (B).
breathing system are not leak-tight enough,
3 Remove the cover (D).
ambient air may get into the breathing gas.
4 Insert the ventilator membrane (C). After
Make sure that all components of the assembly, the Dräger inscription must be
breathing system are connected tightly. visible.
5 Fit the cover (D) and close the 3 clamps (B).
Preparing the ventilator 6 Connect the pressure sensor line (E) of the
ventilator chamber with the appropriate
connector.
7 Close the ventilator door with the attached
F G ventilator unit.
D
Safety functions of the ventilator

E – Overpressure safety valve (F)


– Underpressure safety valve (G)
– Pressure sensor in the ventilator chamber
C
B

A
20993

Instructions for use Fabius plus SW 3.n 61


Assembly and preparation

Mounting the CO2 absorber to the NOTE


compact breathing system
Only use pelletized soda lime. Otherwise, there is
a risk of faulty measurement or incorrect delivery
WARNING and progressive damage to the breathing system
Risk of high inspiratory CO2 values due to dust.

If the soda lime is used too long, carbon If conventional, non-pelletized soda lime is used,
dioxide can no longer be completely then a soda lime dust filter must be used.
absorbed.
Check the color of the soda lime regularly, Reusable CO2 absorber
especially if the inspiratory CO2 value
increases unexpectedly. Replace if CAUTION
necessary. Risk of chemical burns

WARNING Soda lime is caustic and is a strong irritant for


eyes, skin, and airway.
Risk due to soda lime drying out
Handle the soda lime carefully and do not spill it.
The soda lime loses moisture. If the moisture
falls below the minimum moisture, the
following adverse reactions occur Dismounting and emptying
independent of the type of soda lime and
inhalational anesthetic used: Decreased CO2
absorption, increased generation of heat in
the CO2 absorber resulting in increased
breathing gas temperature, formation of CO,
absorption and/or degradation of the
inhalational anesthetics. B
– Do not use unnecessarily high fresh-gas
flows.
– Only use the supplemental O2 delivery if
necessary.
– Do not leave the flow control valves open A
unnecessarily long.

WARNING
Do not use soda lime based on potassium
hydroxide. Otherwise, there is a risk of CO
21023

formation.
1 Turn the CO2 absorber (A) clockwise and
remove it from below.
2 Remove and dispose of the soda lime dust
filter* (B).

* optional

62 Instructions for use Fabius plus SW 3.n


Assembly and preparation

3 Empty used soda lime and dispose of


WARNING
according to the instructions for use.
Risk of hypoventilation
Reuse of the soda lime dust filter can
increase filter resistance and impair the
ventilation function of Fabius.
C Replace the soda lime dust filter each time
the soda lime is replaced.

NOTE
Make sure that no soda lime residues are
between the seals and the seal surfaces. This
21022 type of residue can cause system leakages.
4 If it is necessary to clean the absorber insert
(C), remove the absorber insert from the If conventional, non-pelletized soda lime is used,
absorber container. Leave the inner and outer then a soda lime dust filter* must be used.
sealing rings on the absorber insert.

Filling and mounting

D
F
21021

20977

1 After any cleaning, push the absorber insert


back into the absorber container (D) 3 Insert a new soda lime dust filter (E). Only use
completely. soda lime dust filters indicated in the list of
accessories.
2 Fill CO2 absorber with fresh soda lime to the
upper mark. Only use undamaged filters, as exterior
damage to the filter decreases protection!
Dräger recommends the use of
Drägersorb 800 Plus or Drägersorb FREE. 4 Place the CO2 absorber (F) below the compact
breathing system in position and turn
counterclockwise to the final position stop.

* optional

Instructions for use Fabius plus SW 3.n 63


Assembly and preparation

CAUTION
Risk of patient recovering consciousness
If the CO2 absorber is not correctly locked into G
place, system leakage may occur.
Make sure that the absorber container is
connected tightly to the compact breathing
system during the ventilation. H

Disposable CO2 absorber with Drägersorb


CLIC (optional)
As an alternative to reusable CO2 absorbers, the

20992
disposable CO2 absorber may also be used.
CLIC adapter allows the following single-use CO2 1 Press the button (G): The CLIC adapter flips
absorbers to be used: open.

– CLIC Absorber 800+ 2 Loosen the soda lime in the disposable CO2
absorber, e.g., turn over the disposable CO2
– CLIC Absorber Free absorber a few times.
– Infinity ID CLIC Absorber 800+ 3 Remove the seal of the new disposable CO2
– Infinity ID CLIC Absorber Free absorber. Push the disposable CO2 absorber in
the Clic adapter.
More information on the connection of Drägersorb
CLIC-Adapters can be found in the associated 4 Push the disposable CO2 absorber (H)
instructions for use. upwards into the CLIC adapter, until the CLIC
adapter engages.
WARNING
Risk of insufficient ventilation
If the CO2 absorber is not correctly locked
into place, system leakage may occur. The
CO2 absorber must audibly engage before
Fabius is switched on. This ensures that the
CO2 absorber is included into the leakage test
and compliance test of the device.
After mounting and replacing, make sure the
CO2 absorber is firmly locked into place.

64 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Mounting the COSY heating and the The heating must be switched off if it is not being
power supply unit (optional) used. This will prevent drying out of the soda lime.

The compact breathing system can be operated WARNING


heated. This reduces the condensation of moisture Risk due to soda lime drying out
in the breathing system during low-flow operation
(fresh-gas flow less than 1 L/min). The soda lime loses moisture. If the moisture
falls below the minimum moisture, the
 Before installation of the COSY heating, the following adverse reactions occur
leakage test must be performed, see chapter independent of the type of soda lime and
''Leakage test'' on page 135. inhalational anesthetic used: Decreased CO2
Follow the assembly instructions for breathing absorption, increased generation of heat in
system heating (9038262 and 8605899). the CO2 absorber resulting in increased
breathing gas temperature, formation of CO,
absorption and/or degradation of the
Establishing the power supply of the breathing inhalational anesthetics.
system heating
– Do not use unnecessarily high fresh-gas
flows.
– Only use the supplemental O2 delivery if
necessary.
– Do not leave the flow control valves open
unnecessarily long.

A B
25425

1 Plug in the connector of the heating cable (A)


in the corresponding socket (B) on the bottom
of the compact breathing system. When doing
so align the red mark of the plug to the red
mark of the socket.
 After installation of the breathing system
heating, perform the leakage test on Fabius.

Instructions for use Fabius plus SW 3.n 65


Assembly and preparation

Connecting the compact breathing


system
D

E
20942

1 Completely pull out the locking pin (A) and hold


it in that position.
2 Insert the assembled compact breathing
system in the provided holder (B).

20943
3 Release the locking pin again and turn the
5 Connect the ventilator hose to the
compact breathing system until the locking pin corresponding connector (D) on the anesthesia
engages.
workstation.
6 Connect the other end of the ventilator hose to
the ventilator connector (E) of the compact
breathing system.
If Fabius has a screw connection, the sealing rings
of this screw connection must be undamaged and
clean.
Only hand-tighten the screw connection. Do not
use tools.

C
25428

4 Connect the fresh-gas hose (C) to the


corresponding connection of the compact
breathing system.

66 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Inserting the flow sensor Connecting the exhaust port

WARNING
Risk of fire
Residual vapors of easily flammable
disinfectants (e.g., alcohols) and deposits
that were not removed during reprocessing
can ignite when the flow sensor is in use.
– Ensure particle-free cleaning and
disinfection.
– After disinfection, allow the flow sensor to
air for at least 30 minutes.
– Before inserting the flow sensor, check for A
visible damage and soiling such as
residual mucus, medication aerosols, and
particles.
– Replace flow sensors when damaged,
soiled, or not particle-free.

20968
 Screw on the exhaust port (A) in the compact
breathing system from below.

A B C
20967

1 Screw out the expiratory port (A).


2 Remove the flow-sensor guard* (B).
3 Insert the flow sensor (C).
4 Replace the flow-sensor guard* (B).
5 Screw the expiratory port (C) back on.

* optional

Instructions for use Fabius plus SW 3.n 67


Assembly and preparation

Connecting the breathing bag Mounting the flexible arm


Prerequisite: Before mounting the flexible
WARNING breathing bag holder, the bag elbow on the
compact breathing system must be removed.
Risk of use of toxic or incompatible materials
The breathing bag used must comply with the
current standards.
D
A
WARNING
Risk of too high airway pressure or
insufficient fresh-gas
If the breathing bag is pinched, excessive
airway pressures or a lack of fresh gas can
occur. C
Attach and position the breathing bag so that B
it is not pinched and can inflate freely.

20975
CAUTION
Risk of patient recovering consciousness 1 Position and align the connection adapter (A)
of the flexible arm on the connection of the
A blocked or incorrectly positioned breathing bag
compact breathing system.
can lead to lack of fresh gas for patients. Manual
ventilation is also not possible. 2 Tighten the knurled screws (B). Check that the
arm is fixed securely.
Make sure that the breathing bag is connected
tightly to the bag holder during the ventilation. 3 Fasten the elbow (D) at the end of the flexible
arm.
The breathing bag can be mounted to the compact 4 Fasten the breathing bag (C) on the other end
breathing system with the following variants: of the elbow.
– On a flexible arm
– On a rigid arm
– On the bag elbow directly on the compact
breathing system

68 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Mounting the rigid arm Mounting the bag elbow


Prerequisite: Before mounting the rigid breathing
bag holder, the bag elbow on the compact
breathing system must be removed.

A
A

B
C

21013
21012

1 Attach the bag elbow (A) on the connection of


1 Position and align the connection adapter (A) the compact breathing system.
of the rigid arm on the connection of the
2 Attach the breathing bag (B) on the connector
compact breathing system.
of the bag elbow.
2 Tighten the knurled screws (B). Check that the
arm is fixed securely.
3 Fasten the breathing bag (C) at the other end
of the rigid arm.

Instructions for use Fabius plus SW 3.n 69


Assembly and preparation

Connecting the endotracheal suction Version with one suction bottle:


system (optional)

The endotracheal suction system for Fabius


consists of: B
– Suction regulator (A)
– Suction bottle (D)
A
1 The suction regulator (A) is attached to a
holder (B). The holder is fastened on the side
GCX rail (C) on Fabius.
2 The suction bottle (D) is attached to a separate
holder. C
Version with two suction bottles:

B
D

C
21442

D
20949

70 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Suction systems used


When using an ejector suction with drive gas:
 Connect the Air connection hose of the suction
system via a 3-way adapter to the gas supply
block or the central gas supply.
For vacuum suction:
 Connect the vacuum hose of the suction
system directly to the central gas supply.
Prepare the suction system in accordance with the
associated instructions for use.

WARNING
Risk of patient injury
Only use the suction system if the ventilation
mode ManSpont is active or the patient is
disconnected from the Y-piece.

Instructions for use Fabius plus SW 3.n 71


Assembly and preparation

Connecting the breathing hoses and the WARNING


filters
Risk of strangulation

WARNING Negligent placement of hoses, cables, and


similar device components can endanger the
Risk of burns patient.
Conductive breathing hoses or face masks Use particular caution when establishing
can cause burns during HF surgery. connections to the patient.
Do not use this type of hose and mask
combined with HF surgery. WARNING
Risk of use of toxic or incompatible materials
The breathing hoses must comply with the
current standards.

WARNING
Risk due to particles and dust
In order to protect the patient from particles
and dust, a filter must be used between the
inspiratory limb of the breathing system and
the patient.
Use a patient-side filter or a filter at the
inspiratory port.
20969

NOTE
CAUTION If it is not possible to use an expiratory filter (e.g.,
Risk to patients by damaged breathing hoses due to an intrinsic PEEP due to air trapping),
hygienically reprocess the device after use with
If the coil reinforcement of a breathing hose is this patient, see chapter Cleaning, disinfection
damaged, there is risk of kinking or occlusion. and sterilization.
When attaching or removing the breathing hoses,
always hold them at the connection sleeve and WARNING
not at the coil reinforcement. Otherwise the coil
Risk of infection
reinforcement can become separated from the
connection sleeve. Check the breathing hoses If no microbial filter is used, the breathing
for damage before each use. system may become contaminated with
disease-causing germs.
In this case, hygienically reprocess the
breathing system after each patient.

72 Instructions for use Fabius plus SW 3.n


Assembly and preparation

NOTE
Fabius contains no components made of natural
rubber latex.
For latex-free use, use a latex-free breathing bag
and breathing hoses.

1 Select suitable accessories for the respective patient category.

Adults Pediatric patients Neonates

Tidal volume >700 mL 201 to 700 mL 50 to 200 mL <50 mL


Breathing bag 3L 2L 1L 0.5 L
Breathing circuit Adults Pediatric Neonates (or pedi-
atric)
Filter Filter, HMEF, or HME Use filters with low
resistance and
compliance.

NOTE
When applying tidal volumes in the range of the
maximum or minimum values indicated for each
patient category, use the smaller breathing bag
and the smaller breathing circuit.

Instructions for use Fabius plus SW 3.n 73


Assembly and preparation

B A

D
E
21456

2 Connect a breathing hose (A) on each of the


inspiratory port and expiratory port, optional
with microbial filter installed.
3 Connect both breathing hoses on the Y-piece
(B).
4 Connect the sample line (D) to the connector of
the Y-piece (B) and to the connector of the
water trap (E) on the patient-gas measurement
module.
5 Connect the breathing bag hose (C) with the
breathing bag to the corresponding connector.

74 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Table with recommended hose configurations*

Adults Pediatric patients Neonates


Filter or HMEF with connection for sample line between Y-piece and Filter at inspiratory port, connec-
patient: tion for sample line as close to
patient as possible:

LQVS
LQVS

H[S
H[S
Or
Lateral connections for the sam-
Filter at inspiratory port and expiratory port, connection for sample ple line support CO2 measure-
line at Y-piece: ment and help to flush the dead-
space between Y-piece and hose
adapter.
LQVS

H[S
21458

* The resistance of the breathing system and connected accessories must be observed.

Instructions for use Fabius plus SW 3.n 75


Assembly and preparation

WARNING CAUTION
Risk of underpressure in the lungs Risk due to misleading data
If filters are blocked, the sample gas flow can Replacing breathing hoses, filters, vaporizers, or
immediately cause underpressure in the soda lime can change the determined leakage
lungs. values and compliance values of the anesthesia
machine and thus affect therapy.
When ventilating pediatric patients and
– Perform a leakage test and compliance test
neonates, do not use HMEF or other filters at
after replacing breathing hoses, particularly
the Y-piece in connection with a hose adapter
flex hoses, vaporizers, or soda lime.
that have a patient-side connection for a
– Perform a leakage test and compliance test
sample line.
after changing the length of extendable
For measurement purposes, a permanent hoses.
sidestream flow flows through the sample line to
the patient-gas measurement module. With CAUTION
blocked HME filter or filter in this position on the Y- Risk due to changed hose lengths
piece, the measurement system will cause
underpressure situations in the patients lungs. Changed hose lengths can change resistance
and compliance. For neonates, this can cause
increased or reduced breathing volumes.
Observing the resistance and compliance
For neonates in particular, do not use flex hoses.
WARNING
Higher resistance values during spontaneous
Risk due to accessory components in breathing lead to an increased work of breathing in
breathing circuit the patient.
When using additional components or hose During volume-controlled ventilation, an increased
configurations which deviate from the resistance during inspiration has a slight effect on
standard breathing circuit, the inspiratory the applied volume. The peak pressure increases,
and expiratory resistance values may be however, with constant plateau pressure.
increased beyond standard requirements. Therefore, the time constant increases during the
When using such configurations, the user expiratory phase. When applying too short
must pay special attention to the measured expiratory times, this can lead to an incomplete
values. emptying of the lungs. This leads to a dynamic
overinflation of the lungs (airtrapping).
WARNING During pressure-controlled ventilation, an
increased resistance can decrease the inspiratory
Risk of increased rebreathing
and expiratory volumes.
Leakages between the inner and outer hose
Before performing the selftest, all accessories* to
of a coaxial breathing circuit cannot be
be used must be connected. Extendable hoses
detected during the leakage test.
must be pulled out to the length intended by the
To prevent insufficient gas exchange or CO2 user. Only in this way is the compliance correctly
rebreathing, pay strict attention to the determined and with volume-controlled ventilation
measured gas concentration. a correct tidal volume applied.

* If necessary, take additional parts such as water traps or


additional hoses in consideration.

76 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Calculating the resistance of the breathing


system and connected accessories
To keep the patients' work of breathing as low as
possible, according to general safety standards a
total inspiratory and expiratory resistance of
6.0 hPa (cmH2O) at 60 L/min must not be
exceeded.
The chapter ''Technical data'' contains the
inspiratory and expiratory resistance values of the
breathing system without taking into consideration
the breathing hoses. In this manner it is possible to
determine the respective resistance of the patient
when using different breathing hose sets and/or
filters.
The following formula is used to calculate the
resistance (R):
RInspiration = RBreathing system_insp + RInsp hose +
RBreathing bag hose + RInsp filter(port) + RInsp filter(Y-
piece)

RExpiration = RBreathing system_exsp + RExsp hose +


RExsp filter(port) + RExsp(Y-piece)
Make sure that for the calculation of the resistance
only the accessories resistance values and the
peak flows are used for the respective accessory
category and patient category, e.g., resistance
values for adults at 60 L/min, for children at
30 L/min, and for neonates at 5 L/min.

Instructions for use Fabius plus SW 3.n 77


Assembly and preparation

Inserting a new O2 sensor capsule

WARNING
Risk of electric shock
If the O2 sensor is replaced during operation,
it can lead to transferring of leakage current.
Do not touch the patient.

A
20971

1 Remove the O2 sensor housing from the


inspiratory valve.
2 Unscrew the screw cap (A) from the O2 sensor
housing.
3 Take the new O2 sensor capsule from the
package.
4 Place the O2 sensor capsule (B) in the housing
so that the ring-shaped conductor touches the
contacts in the housing.
5 Screw on the screw cap (A) tightly by hand.
6 Reinsert the O2 sensor housing in the
inspiratory valve.

WARNING
Danger of erroneous O2 measurement.
An incorrectly mounted O2 sensor will lead to
incorrect measurement results.
Make sure that the O2 sensor is inserted
correctly in the inspiratory valve, see page 22.

78 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Connecting the sensors and measurement lines

Connecting the O2 sensor Connecting the pressure sensor

A B
B

A
C
25444

25446
1 Insert the O2 sensor (A) into the opening of the
inspiratory valve on the compact breathing 1 Connect the pressure measurement hose (C)
system. to the corresponding connection on the bottom
of the compact breathing system.
2 Connect the plug (B) of the O2 sensor cable
with the connection marked with on the Make sure that the pressure measurement
rear of the device. hose is not pinched.
2 Connect the other end of the pressure
measurement hose with the bacterial filter (B).
3 Plug in the bacterial filter into the connection
(C) marked with on the rear of the device.

Instructions for use Fabius plus SW 3.n 79


Assembly and preparation

Connection of the pressure gauge for Connecting the flow sensor


measurement of the airway pressure
(optional)

C
B
D

25449
A
B 1 Connect the flow sensor cable to the
25447

corresponding connection (A) on the bottom of


1 Connect the pressure measurement hose (C) the compact breathing system.
to the corresponding connection on the bottom 2 Plug in the other end of the flow sensor cable
of the compact breathing system. into the connection (B) marked with on the
2 Connect the T-piece (B) with the pressure rear of the device.
measurement hose and the pressure gauge.
3 Connect the other end of the pressure
measurement hose with the bacterial filter (B).
4 Plug in the bacterial filter into the connection
(D) marked with on the rear of the device.

80 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Connecting the APL bypass hose and


PEEP/PMAX hose

A
25454

1 Connect the APL bypass hose to the


corresponding connection port of the APL
bypass valve (A) on the compact breathing
system.
2 Connect the other end to the hose on the
connection marked with APL (C) on the rear of
the device.
3 Connect the PEEP/PMAX hose to the
corresponding connection port of the
PEEP/PMAX valve (D) on the compact
breathing system.
4 Connect the other end of the hose on the
connection marked with PEEP (B) to the rear of
the device.

NOTE
The APL bypass hose is thicker than the
PEEP/PMAX hose.

Instructions for use Fabius plus SW 3.n 81


Assembly and preparation

Fastening the manual resuscitator

For wall-mounted devices, the transport rail is


located on the holder.

A
25455

1 Hang the completely prepared and functionally


checked manual resuscitator (A) to the right on
the transport rail.

Instructions for mounting the accessories

CAUTION WARNING
Observe the assembly instructions of the Risk of tipping and risk of injury
accessory.
If the maximum permissible weight is
exceeded or if monitors and other auxiliary
devices are placed on the medical device, the
device can fall. Especially if the medical
device is rolled over door thresholds and
similar obstacles.
Before moving the device, remove the
monitors and other additional devices.

82 Instructions for use Fabius plus SW 3.n


Assembly and preparation

Trolley version

Left side Top of device Right side


– The maximum per- The maximum permissible weight of accessories – The maximum per-
missible weight of the on the monitor housing is 18 kg (40 lbs). missible weight of the
accessories is 25 kg A maximum of 10 kg (22
plus accessories is 25 kg
(55 lbs). lbs) can be set on the (55 lbs).
O2

– A max. of 20 kg optionally available – A max. of 20 kg


(44 lbs) may be Fabius pull-out writing (44 lbs) may be
attached in the rear tray. attached in the rear
top GCX rail at a dis- The standard rail may be top GCX rail at a dis-
tance of max. 30 cm loaded with max. 5 kg tance of max. 40 cm
(12") at the top posi- (11 lbs) (16") at the top posi-
tion. tion.
The individual drawers in
– The remaining the trolley may be loaded – The remaining
weight must be with maximum 6.8 kg (15 weight must be
attached with a dis- lbs). attached with a dis-
tance of max. 10 cm tance of max. 10 cm
(4"). On the rear of the device, a maximum of 35 kg (4").
(77 lbs) (gas cylinders, including holder and acces-
sories) can be attached.

Wall-mounted version and ceiling-


mounted version

Left side Top of device Right side


– The maximum per- The maximum permissible weight of accessories – The maximum per-
missible weight of the on the monitor housing is 10 kg (22 lbs). missible weight of the
accessories is 15 kg A maximum of 10 kg (22
Fabius plus accessories is 15 kg
(33 lbs). lbs) can be set on the (33 lbs).
O2

– A max. of 10 kg optionally available – A max. of 10 kg


(22 lbs) may be Fabius pull-out writing (22 lbs) may be
attached in the rear tray. attached in the rear
top GCX rail at a dis- top GCX rail at a dis-
tance of max. 30 cm tance of max. 30 cm
(12") at the top posi- The standard rail may be (12") at the top posi-
tion. loaded with max. 5 kg tion.
(11 lbs)
– The remaining – The remaining
weight must be weight must be
attached with a dis- attached with a dis-
tance of max. 10 cm tance of max. 10 cm
Other accessory parts must be fastened on wall
(4"). (4").
rails if necessary.

Instructions for use Fabius plus SW 3.n 83


Assembly and preparation

To increase the tipping stability:


 Remove all monitors and other additional
devices from the top shelf.
 Dismount any additional devices mounted to
the swivel arms or the top of the device (e.g.,
patient monitors, data management systems,
syringe pumps).
 Clear the writing tray and slide it completely
into the device.
 Position the optional flexible arm for breathing
bag close to the device.
Prepare additional components as described in the
respective instructions for use.

84 Instructions for use Fabius plus SW 3.n


Getting started

Getting started

Daily checkout and pre-use checkout ......... 86

Switching on .................................................. 86

Checking the readiness for operation ......... 88


FUNCTIONAL.................................................. 88
CONDITIONALLY FUNCTIONAL.................... 88
NON-FUNCTIONAL ........................................ 88

Instructions for use Fabius plus SW 3.n 85


Getting started

Daily checkout and pre-use checkout

After preparing the medical device, the daily


checkout and the pre-use checkout must be
performed according to the appendix to these
instructions for use. This ensures that the medical
device is ready for operation.

WARNING
Risk of device malfunction
Some safety systems are only checked
during start-up.
– A selftest should be performed once daily.
– Switch the Fabius on and off or press the
softkey Run System Test.

Switching on

Prerequisite: The device has been reprocessed


WARNING
(see chapter ''Cleaning, disinfection and
sterilization'' on page 169) and assembled ready Risk of accidental movement of the medical
for operation (see chapter ''Assembly and device
preparation'' on page 50).
During operation the medical device can
To prevent condensation and resulting failures of move accidentally.
electrical components, do not switch on the device
Activate the castor brakes.
after abrupt temperature changes for 1 to 2 hours
(e.g., after storage in unheated rooms).

WARNING
Risk of explosion and fire
Do not set the device into operation if oxygen
leakage is suspected in the medical device or
its vicinity.
Stop oxygen supply and contact service
personnel.

86 Instructions for use Fabius plus SW 3.n


Getting started

CAUTION
Malfunction of the device function
The user must check whether the test tones were
actually sounded. The device only checks
whether the speakers are connected. A complete
loss of the ventilation function and monitoring
function would possibly not be noticed if the
A speakers failed.
If not tone or only one tone is sounded, the
device is only conditionally ready for operation.
Contact DrägerService.
25413

 Set the On/Off switch (A) to the position.


After switching on, the anesthesia workstation
starts as follows:
– A system test is performed that checks various
components. The entire results of the tests, as
well as the test results for each component, are
displayed on the screen.
– Passed: Pass
– Failed: Fail
– During the system test, 2 test tones are
sounded to test the speakers. To hear these
tones, do not stand any further than 4 meters
(13 feet) from the device.
– After completion of the system test, the default
settings for ventilation are loaded.

Instructions for use Fabius plus SW 3.n 87


Getting started

Checking the readiness for operation

NON-FUNCTIONAL

A serious malfunction was found and the operation


of the monitoring functions and ventilation
functions are blocked.
A – Do not use the device.
– Immediately contact DrägerService or the
authorized local service partner.
25462

At the end of the system test, one of 3 possible


results (A) are displayed on the screen:
– FUNCTIONAL
– CONDITIONALLY FUNCTIONAL
– NON-FUNCTIONAL

FUNCTIONAL

The device is ready for operation. After a short


delay, the page Standby is displayed.

CONDITIONALLY FUNCTIONAL

A non-critical malfunction was found. The


anesthesia workstation can be used.
– To open the page Standby, press the rotary
knob.
– Check if an alarm message is displayed.
– Contact DrägerService or the authorized local
service partner.

88 Instructions for use Fabius plus SW 3.n


Operation

Operation

Standby page after start-up.......................... 90 Preparing for storage or transport .............. 115

Setting the fresh-gas flow............................. 90


S-ORC (Sensitive Oxygen Ratio Controller).... 90
Setting the anesthetic gas concentration ... 92

O2 flush........................................................... 93

Low-flow anesthesia ..................................... 94

Nitrogen rinsing (as needed)........................ 94

Replacing the soda lime ............................... 95

Ventilation ...................................................... 96
Ventilation mode ManSpont ............................ 96
Ventilation mode Volume Control .................... 99
Ventilation mode Pressure Control (optional).. 101
Ventilation mode Pressure Support (optional). 103
Ventilation mode SIMV/PS (optional) .............. 105
Adopting ventilation settings during mode
change............................................................. 107
Safety functions of the ventilator................. 108
Behavior with too low fresh-gas supply ........... 108
Behavior of Fabius if the user does not take
any action ........................................................ 108
Patient change ............................................... 109

Using the external fresh-gas outlet as a


common gas outlet (optional) ...................... 110
Preparation ...................................................... 110
Operation......................................................... 111
Ending operation ............................................. 111
Using the external fresh-gas outlet with an
auxiliary switch (optional) ............................ 112
Preparation ...................................................... 112
Operation with non-rebreathing system........... 113
Operation with the compact breathing system
(COSY) ............................................................ 113
Ending operation ............................................. 113
Ending operation ........................................... 114

Instructions for use Fabius plus SW 3.n 89


Operation

Standby page after start-up

In Standby mode, different instructions (A) and


Standby information (B) are displayed on the screen.
A To start operation press one of the keys
located to the left of the display
A B Last system test, last leakage/compliance test,
system leakage, ventilator leakage,
compliance
B
25463

Setting the fresh-gas flow

The fresh-gas settings can be changed before a S-ORC inhibits the N2O flow under the following
ventilation mode is selected. conditions:
 Set the fresh-gas flow. – N2O flow control valve is open, even though
the O2 flow control valve is closed.
– O2 flow is below 0.2 L/min.
S-ORC (Sensitive Oxygen Ratio
Controller) With an N2O failure, O2 can continue to be
supplied. An alarm is not triggered. The float in the
Fabius is equipped with a mechanical minimum O2 N2O flow tube drops to zero.
delivery (S-ORC). This safety device prevents S-ORC has no oxygen-specific monitoring function
hypoxic gas mixtures if N2O is selected as the and offers no protection for the consequences of
carrier gas. an accidental interchange of gases.
Starting at a flow of approx. 200 mL/min, the N2O Therefore, the O2 concentration must always be
concentration in the fresh gas can be set to a value monitored.
between 0% and 75%.
When a lack of O2 is present, the S-ORC limits the
N2O concentration in the fresh gas so that the O2
concentration will not fall below 23 Vol%.

90 Instructions for use Fabius plus SW 3.n


Operation

CAUTION
Risk of inaccurate measured values
When the O2 supply is again established after a
failure of the O2 supply, a supply pressure of at
least 2.7 kPa x 100 must be maintained for at
least 20 seconds. New failure of the O2 supply
will only be detected if the supply pressure is
stable for at least 20 seconds.
Do not use any functions during this time that
require O2, for example:
– O2 flush
– O2 fresh-gas flow
– Endotracheal suction

WARNING
Risk of material damage and risk to health
A vaporizer must never remain in operation
without a fresh-gas flow. High concentrations
of the anesthetic gas flow into the ventilation
circuit and the ambient air. This can lead to
material damage and contamination of the
ambient air with anesthetic gases.
Never cut off the fresh-gas flow before the
vaporizer is switched off.

Instructions for use Fabius plus SW 3.n 91


Operation

Setting the anesthetic gas concentration

If the control dial is in position T:


1 Press the 0 key (A) and engage the control
dial (B) to position 0. To ensure pressure
B equalization, wait at least 15 seconds.
2 Press the 0 key (A) and set the control dial (B)
A
T
ON counterclockwise to the desired anesthetic gas
concentration.
3 Check the filling level on the sight glass (C)
regularly. The filling level must be between
minimum and maximum.
4 When the refill mark (D) is reached, 250 mL
(normal anesthetic agent bottle) can be refilled.
5 Fill the vaporizer at the latest when the
minimum mark (E) is reached, refer to
C instructions for use of the respective vaporizer.
D
E
20964

Prerequisite: The vaporizer is mounted in


accordance with the instructions for use of the
respective vaporizer.

WARNING
Risk of patient injury
When the vaporizer is in the control dial
position T, has heated up due to high ambient
temperature, and is then used, a high
anesthetic gas concentration might be
delivered.
After connecting the vaporizer to the
anesthesia workstation, always turn the
control dial of the vaporizer to position 0 and
wait at least 15 seconds to enable a pressure
equalization.

The following section describes the operation of


Vapor 2000.
 Set the fresh-gas flow on the anesthesia
workstation.

92 Instructions for use Fabius plus SW 3.n


Operation

O2 flush

+ A

20960

The O2 flush is used for flushing and quickly filling


the breathing system and breathing bag with O2
while bypassing the vaporizer.
During this an unmetered flow of at least 35 L/min
is given to the breathing system and the breathing
bag.
 Press the (A) key. O2 flows for as long as
the key is held down.
Use of the O2 flush can increase airway pressure
very quickly and abruptly change the gas
concentration.

NOTE
In ManSpont mode, the pressure can increase
quickly and thus trigger the APL valve.

Instructions for use Fabius plus SW 3.n 93


Operation

Low-flow anesthesia

In low-flow anesthesia (flow ≤1.0 L/min), moisture


CAUTION
naturally condenses from the patient's exhaled air
in the hoses. To prevent water collection in the Risk of patient injury
hoses, a water trap must be integrated in the
The use of minimum-flow or low-flow settings can
ventilator hose.
lead to accumulation of metabolic by-products in
For longer low-flow anesthesia, the additional use the breathing system.
of water traps in the expiratory hose is
If minimum-flow or low-flow settings are used,
recommended. When the filling height exceeds the
flush the breathing system regularly with the O2
maximum mark, empty the water trap.
flush.
WARNING
CAUTION
Risk due to the accumulation of acetone in
the patient Risk of patient injury

Do not perform low-flow anesthesia on Unsuitable soda lime can result in disintegration
patients with ketoacidosis or patients under products from the anesthetic gases.
the influence of alcohol. The risk of Use suitable soda lime such as Drägersorb Free.
accumulation of acetone in the patient
increases in such cases.

Nitrogen rinsing (as needed)

There is still air in the lungs of the patient and the


breathing system during anesthesia introduction,
which contains a fraction of approx. 77 % nitrogen.
If the device is used for a low-flow anesthesia,
press the key. This removes the nitrogen.

94 Instructions for use Fabius plus SW 3.n


Operation

Replacing the soda lime

Soda lime changes color if no more CO2 can be


CAUTION
absorbed. When 2/3 of the soda lime has changed
color, the soda lime must be replaced. Risk of chemical burns
Dräger recommends the use of Soda lime is caustic and is a strong irritant for
Drägersorb 800 Plus or Drägersorb FREE. eyes, skin, and airway. If soda lime has escaped,
Drägersorb 800 Plus and Drägersorb FREE e g., from damage of the disposable CO2
change color from white to violet. absorber:
– Do not inhale or swallow lime dust.
For instructions for replacing the CO2 absorber, – Wear protective gloves and safety glasses or
see chapter ''Mounting the CO2 absorber to the face protection.
compact breathing system'' on page 62. – In case of contact with the eyes, immediately
rinse with water thoroughly and immediately
WARNING see a doctor.
– In case of skin contact, immediately wash the
Risk due to soda lime drying out
skin.
The soda lime loses moisture. If the moisture
falls below the minimum moisture, the NOTE
following adverse reactions occur
independent of the type of soda lime and Follow the respective instructions for use for
inhalational anesthetic used: Decreased CO2 Drägersorb 800 Plus or Drägersorb FREE.
absorption, increased generation of heat in
the CO2 absorber resulting in increased
breathing gas temperature, formation of CO,
absorption and/or degradation of the
inhalational anesthetics.
– Do not use unnecessarily high fresh-gas
flows.
– Only use the supplemental O2 delivery if
necessary.
– Do not leave the flow control valves open
unnecessarily long.

Instructions for use Fabius plus SW 3.n 95


Operation

Ventilation

The user is responsible for setting the gas delivery Changing to spontaneous breathing
and ventilation according to the individual patient
status. Patient status must be continually
monitored for any potential changes.

WARNING
Risk of strangulation
Negligent placement of hoses, cables, and
similar device components can endanger the
patient.

20945
Use particular caution when establishing
connections to the patient. 1 Turn the APL valve head counterclockwise to
its final position stop.
The label Spont and both points are vertical to
Ventilation mode ManSpont each other. The valve head lifts.
The pressure limitation is disabled and the
ManSpont (Manual/Spontaneous, manual valve is open for free spontaneous breathing.
ventilation/spontaneous breathing) is a non-
2 Set suitable fresh-gas flow.
automatic ventilation mode. However, ventilation
monitoring and alarm monitoring are still active.
Volume Control
The selection between manual ventilation and
spontaneous breathing is made on the APL valve.
If the APL valve is in the Spont position,
spontaneous breathing is enabled.

WARNING
Risk of excessively high airway pressures
If the ventilator fails, the device switches into
the ManSpont ventilation mode. A
The APL valve should also be set to a
25465

pressure limitation value suitable for the


patient when using automatic ventilation 3 Press the ManSpont (A) key.
modes since in case of a ventilator failure the 4 Confirm the new mode.
patient must be ventilated manually.

In the following examples and illustrations, the


change from Volume Control mode to ManSpont
mode is described:

96 Instructions for use Fabius plus SW 3.n


Operation

Changing to manual ventilation


ManSpont
NOTE
In ManSpont mode, the apnea alarm time for
triggering apnea volume alarms is extended from
15 seconds to 30 seconds (Caution category)
and from 30 seconds to 60 seconds (Warning
category).

B B
25466
The following alarms can be activated or
10 20
deactivated on the ManSpont screen with the ON
/ OFF key (B):
– Apnoea Pressure (see chapter ''Pressure

20946
alarms in automatic ventilation modes'' on
page 128) 1 Set the APL valve head to the desired
– Volume Alarms (see chapter ''Volume alarms'' maximum airway pressure.
on page 127) Settings between the grid marks are also
possible.

Volume Control

A
25465

2 Press the ManSpont (A) key.


3 Confirm the new mode.

Instructions for use Fabius plus SW 3.n 97


Operation

ManSpont

B B
25466

The following alarms can be activated or


deactivated in ManSpont mode with the ON/OFF
key (B):
– Apnoea Pressure (see chapter ''Pressure
alarms in automatic ventilation modes'' on
page 128)
– Volume Alarms (see chapter ''Volume
alarms'' on page 127)
4 To refill the breathing bag, press the key.
5 Set suitable fresh-gas flow.
6 Start manual ventilation with the breathing bag.
The pressure is limited to the value that is set
on the APL valve.

Pressure release

10 20 30
20947

In the ManSpont mode, lifting the valve head


relieves pressure from the breathing system.

98 Instructions for use Fabius plus SW 3.n


Operation

Ventilation mode Volume Control Changing to Volume Control mode


In the following examples and illustrations, the
Compensation of ventilator compliance change from Pressure Control mode to Volume
Control mode is described:
Ventilator compliance compensation is active in
Volume Control mode so that the tidal volume Pressure Control
administered to the patient (VT) corresponds to the
tidal volume setting. The ventilator compliance is A
determined during the leakage test in Standby
mode, see chapter ''Leakage test'' on page 135.
The breathing hoses used during the leakage test
and compliance test must also be used during
operation. B
This guarantees an exact compliance

25467
compensation.
1 Press the Volume Control (A) key.
NOTE 2 Adjust ventilation settings (B).
If the ventilator works at its performance limit due 3 Confirm the new mode.
to the volume control settings, Fabius cannot
make the compliance compensation. If the Volume Control
performance limit of the ventilator is reached, it is
not possible to increase the setting for tidal
volume VT.

25468

Instructions for use Fabius plus SW 3.n 99


Operation

In the following table, all parameters (B) in Volume For every mandatory breath, the patient receives
Control mode, together with the corresponding the set tidal volume (VT) with a constant
setting ranges and factory settings, are listed. inspiratory flow (Insp Flow). The set tidal volume
is based on a defined respiratory rate (Freq) and a
Parameter Setting range Factory set- defined ratio of inspiratory time to expiratory time
ting (TI:TE).
Pressure limita- 15 to 70, 40 The inspiratory flow (Insp Flow) results from the
tion PMAX min. PEEP +10 tidal volume (VT) and the ratio of inspiratory pause
[cmH2O] to inspiratory time (TIP:TI).
([hPa])
If TIP:TI is set to 0, the tidal volume VT) is supplied
Tidal volume 20 to 1400 600
with the lowest inspiratory flow (Insp Flow) that is
VT [mL]
possible at the corresponding respiratory rate
Respiratory 4 to 60 12 (Freq). In addition, a positive end-expiratory
rate Freq [bpm] pressure (PEEP) can be set.
([1/min])
To prevent too high-pressure, the alarm limit
Inspiratory 4:1 to 1:4 1:2 PMAX can be set corresponding to the
time:expiratory physiological condition of the patient.
time TI:TE
The lower alarm limit of the airway pressure (PAW
Inspiratory 0 to 50 10 low) is used for the airway pressure monitoring to
pause detect apnea (disconnection) and continuous
time:inspira- pressure.
tory time TIP:TI
[%] If the pressure waveform does not cross the
pressure threshold either from above or below, an
PEEP [cmH2O] 0 to 20 0
alarm is sounded.
([hPa])

PAW
PMAX
PEAK
PLAT
PAW ORZ
PEEP

7, 7(
7LPH


Freq
)ORZ
Insp Flow

VT

7,3 7LPH
7,
21741

100 Instructions for use Fabius plus SW 3.n


Operation

Ventilation mode Pressure Control In the following table, all parameters (B) in
(optional) Pressure Control mode, together with the
corresponding setting ranges and factory settings,
are listed.
Changing to Pressure Control mode
Parameter Setting range Factory set-
In the following examples and illustrations, the
ting
change from Volume Control mode to Pressure
Control mode is described: Inspiratory 5 to 65, 15
pressure min. PEEP +5
Volume Control PINSP
[cmH2O]
A ([hPa])
Respiratory 4 to 60 12
rate Freq [bpm]
([1/min])
B Inspiratory 4:1 to 1:4 1:2
time:expiratory
time TI:TE
25472

Inspiratory flow 10 to 75 30
1 Press the Pressure Control (A) key.
Insp Flow
2 Adjust ventilation settings (B). [L/min]
3 Confirm the new mode. PEEP [cmH2O] 0 to 20 0
Due to the influence of compliance and resistance, ([hPa])
the set value for Freq Min in Pressure Control
mode might not exactly be applied.

Pressure Control
25473

Instructions for use Fabius plus SW 3.n 101


Operation

PAW

PINSP
PAW ORZ

7, 7(
7LPH


)ORZ Freq

7LPH
21742

A tidal volume is supplied based on a defined


respiratory rate (Freq) and a defined ratio of
inspiratory time to expiratory time (TI:TE).
This tidal volume is dependent on the set
inspiratory pressure (PINSP) and from the patient
compliance. The parameter Insp Flow is used to
set the increase of the slope of the pressure
waveform. In addition, a positive end-expiratory
pressure (PEEP) can be set.
The lower alarm limit of the airway pressure (PAW
low) is used for the airway pressure monitoring to
detect apnea (disconnection) and continuous
pressure.
If the pressure waveform does not cross the
pressure threshold either from above or below, an
alarm is sounded.

102 Instructions for use Fabius plus SW 3.n


Operation

Ventilation mode Pressure Support Changing to Pressure Support mode


(optional) In the following examples and illustrations, the
change from Volume Control mode to Pressure
Pressure Support (Pressure Support) is a Support mode is described:
pressure-supported ventilation mode for patients
with spontaneous breathing. Patients who make Volume Control
no inspiratory effort must not be ventilated with
Pressure Support.
The ventilation mode Pressure Support is
triggered by the inspiratory effort of the patient. A
Most anesthetic agents cause a reduced reaction
of the patient to carbon dioxide and hypoxemia.
Therefore ventilation modes, which are triggered B
by patients, do not ensure adequate ventilation in

25476
these conditions. In addition, the use of muscle
relaxants negatively influences the triggering by 1 Press the Pressure Support (A) key.
the patient.
2 Adjust ventilation settings (B).
In Pressure Support ventilation mode, the apnea
3 Confirm the new mode.
ventilation function is available, which can ensure
a minimum ventilation. To activate apnea
Pressure Support
ventilation, for the setting Freq Min another setting
must be selected than OFF. If the detected
spontaneous respiratory rate of the patient drops
under the set value for Freq Min, a mechanical
breath is applied. Apnea ventilation is not intended
to be a primary ventilation mode.
For apnea ventilation, Fabius uses the settings for
the following parameters:
– ∆PPS
– Freq Min
– Insp Flow 25475

– PEEP
If 2 successive mechanical breaths occur with
apnea ventilation, the alarm message APNOEA
VENTILATION !! is displayed in the alarm
message field. The alarm message is deleted as
soon as a spontaneous breath is detected.

Instructions for use Fabius plus SW 3.n 103


Operation

In the following table, all parameters (B) in If the inspiratory flow (Insp Flow) during
Pressure Support mode, together with the inspiratory effort is greater than the set trigger flow
corresponding setting ranges and factory settings, (Trigger), the device supports the patient with the
are listed. setting ∆PPS.

Parameter Setting range Factory set- The set inspiratory flow (Insp Flow) defines how
ting fast the ∆PPS pressure is reached. When 25 % of
the maximum inspiratory flow (Insp Flow) is
Support pres- 3 to 20, 10 reached (or after maximum 4 seconds), the
sure ∆PPS OFF inspiration is automatically ended. The value Freq
[cmH2O] Min (e.g., 3 bpm (1/min)) defines a safety period
([hPa]) (safety period = 1/Freq Min, e.g., 20 seconds). If
Minimum respi- 3 to 20, 3 no inspiratory effort is detected and the safety
ratory rate for OFF period has elapsed, the device generates a
apnea ventila- pressure-controlled breath with PINSP=∆PPS.
tion Freq Min
The lower alarm limit of the airway pressure PAW
[bpm] ([1/min])
low is used for the airway pressure monitoring to
Trigger sensi- 2 to 15 2 detect apnea (disconnection) and continuous
tivity Trigger pressure.
[L/min]
If the pressure waveform does not cross the
Inspiratory flow 10 to 85 30 pressure threshold either from above or below, an
Insp Flow alarm is sounded.
[L/min]
PEEP [cmH2O] 0 to 20 0
([hPa])

PAW
Trigger Trigger $SQHD
PD[ 9HQWLODWLRQ
VHF
∆PPS PAW ORZ

Insp Flow 7LPH


Freq Min 
)ORZ Freq Min

 

7LPH

)ORZWULJJHU )ORZWULJJHU QRIORZWULJJHU


21743

104 Instructions for use Fabius plus SW 3.n


Operation

Ventilation mode SIMV/PS (optional) Changing to SIMV mode


In the following examples and illustrations, the
The ventilation mode SIMV (synchronized change from Volume Control mode to SIMV/PS
intermittent mandatory ventilation) is a mixture of mode is described:
ventilation and spontaneous breathing. In
ventilation SIMV mode, the patient can breathe Volume Control
spontaneously. The ventilation is done
synchronously to the inspiratory effort of the
patient.
The mandatory breaths are defined based on the
following parameters:
A
– VT
– Freq B

25477
– TINSP
– TIP:TI 1 Press the SIMV/PS (A) key.
– PEEP 2 Adjust ventilation settings (B).
To support the inspiratory effort of the patient in  To set the following additional parameters,
ventilation SIMV mode, pressure support ∆PPS press the MORE (C) key:
can be switched on. The setting of ∆PPS to – Trigger
another value than OFF activates the mode – Insp Flow
Pressure Support, see chapter ''Ventilation mode – TINSP
Pressure Support (optional)'' on page 103.
– TIP:TI
3 Confirm the new mode.

SIMV/PS

25478

Instructions for use Fabius plus SW 3.n 105


Operation

In the following table, all parameters (B) in


PAW
SIMV/PS mode, together with the corresponding
PMAX
setting ranges and factory settings, are listed.
PEAK Trigger Trigger
Parameter Setting range Factory set- PLAT
ting ∆PPS PAW ORZ
Pressure limita- 15 to 70, 40 7,3 Insp Flow 7LPH
tion PMAX min. PEEP +10
7,163 7(;63
[cmH2O] ([hPa]) and
>∆PPS +PEEP 
Freq
Tidal volume VT 20 to 1100 600
)ORZ
[mL]
VT
Respiratory rate 4 to 60 12
Freq [bpm]
([1/min]) 7LPH

Pressure sup- 3 to 20 10 )ORZWULJJHUZLQGRZ

21744
)ORZWULJJHU PD[VHF
port ∆PPS OFF
[cmH2O] ([hPa]) The respiratory rate Freq defines the time between
PEEP [cmH2O] 0 to 20 0 the individual volume-controlled breaths. The
([hPa]) synchronization of the mechanical breaths is done
Trigger sensitiv- 2 to 15 2 with a trigger sensitivity (Trigger) that is activated
ity Trigger a specific time before administering a new
[L/min] mechanical breath: 5 seconds for respiratory rates
(Freq) below 12 bpm (1/min). For higher
Inspiratory flow 10 to 85 30 respiratory rates, the synchronization is done
Insp Flow immediately after the preceding expiration.
[L/min] Between these mandatory breaths, the patient can
Inspiratory time 0.3 to 4.0 1.7 breathe spontaneously. Mandatory breaths are
TINSP synchronized with the spontaneous breaths of the
[seconds] patient. These spontaneous breaths can be
supported with ∆PPS.
Inspiratory 0 to 50 10
pause The lower alarm limit of the airway pressure PAW
time:inspiratory low is used for the airway pressure monitoring to
time TIP:TI [%] detect apnea (disconnection) and continuous
pressure.
If the pressure waveform does not cross the
pressure threshold either from above or below, an
alarm is sounded.

106 Instructions for use Fabius plus SW 3.n


Operation

Adopting ventilation settings during When changing from Volume Control to


mode change Pressure Support:
– Insp Flow is set to the last used value or the
Volume Control factory setting.
– ∆PPS is set to the last used value or the
factory setting.
– Trigger is set to the last used value or the
factory setting.
When changing from Pressure Control to
A Pressure Support:
– Insp Flow is set to the last used value or the
factory setting.
25472
– ∆PPS is set to the last used value or the
The ventilation settings for the new ventilation factory setting.
mode are automatically derived from the settings
of the previous ventilation mode. The – Trigger is set to the last used value or the
corresponding settings (A) in the new ventilation factory setting.
mode are highlighted. When changing from Volume Control to SIMV/PS
The settings for Freq, TI:TE and PEEP are – PMAX and PEEP are automatically adopted for
adopted directly from the settings of the previous the new ventilation mode from the previous
ventilation mode if necessary. mode.
When changing from Volume Control to When changing from Pressure Support to
Pressure Control: SIMV/PS:
– PINSP is set to the plateau pressure (PLAT) – ∆PPS , Insp Flow , Trigger, and PEEP are
that occurred in Volume Control. automatically adopted for the new ventilation
– Insp Flow is set to the last used value or the mode from the previous mode.
factory setting. When changing from SIMV/PS with Pressure
When changing from Pressure Support to Support to Pressure Support:
Pressure Control: – ∆PPS and Insp Flow are automatically
– Insp Flow is set to the last used value or the adopted for the new ventilation mode from the
factory setting. previous mode.

When changing from Pressure Control to When changing from SIMV/PS to Pressure
Volume Control: Support:
– VT is set to the value that results from the – Trigger and PEEP are automatically adopted
division of the last minute volume (MV) by the for the new ventilation mode from the previous
respiratory rate (Freq). mode.
– TIP:TI is set to the last used value or the
factory setting.
– PMAX is set to a value that lies 10 cmH2O
(hPa) above the plateau pressure (PLAT) that
occurred in Pressure Control.

Instructions for use Fabius plus SW 3.n 107


Operation

Safety functions of the ventilator

Behavior of Fabius if the user does not


take any action
A B – Breathing bag empties completely little by little.
– After 2 more mechanical breaths, the FRESH
GAS LOW !! alarm and other alarms are
triggered.
– Since the ventilator does not contain sufficient
fresh gas, the reserve volume is absorbed.
As long as there is insufficient fresh gas, the safety
valve (B) for ambient air remains open during
expiration.

CAUTION
20979

Risk of patient recovering consciousness

– Overpressure safety valve (A) If the gas supply fails completely, further
operation of the anesthesia machine takes place
– Underpressure safety valve (B)
with gas supply with ambient air. Anesthetic
– Pressure sensor in the ventilator chamber agents are no longer delivered and the
inspiratory anesthetic gas concentration in the
breathing gas decreases.
Behavior with too low fresh-gas supply Monitor the gas mixture carefully and use
intravenous anesthetic agents if need be.
For very low fresh-gas flow or an extremely large
leakage in the breathing system circuit, there can This allows for emergency ventilation with limited
be insufficient fresh gas. This is detected by the VT even with extremely low fresh-gas supply.
gradual emptying of the breathing bag. There will be no sudden switch-off of the ventilator.

NOTE
To remedy this, the user must take actions, e.g.,
increasing the fresh-gas flow.

108 Instructions for use Fabius plus SW 3.n


Operation

Patient change

3 Check all components. For details on the test


WARNING
steps, see chapter ''Form for daily checkout
Risk due to incorrect settings and pre-use checkout'' on page 219.
For anesthesia machines within the same 4 If necessary, perform the leakage test, see
care area, different standard alarm limits or chapter ''Leakage test'' on page 135.
ventilation settings might be configured. The Dräger recommends performing the leakage
user must observe the following points: test in the following cases:
– Make sure that the values set for new – When the soda lime is replaced.
patients are appropriate.
– Make sure that the alarm system is neither – When the breathing hoses are replaced.
rendered useless by setting extreme – When a vaporizer is replaced or filled.
values for the alarm limits nor deactivated
by switching off the alarms. WARNING
– Check the start settings for alarms and Risk of patient injury
alarm settings each time the ventilation
mode is changed. During the leakage test, the breathing system
is pressurized.
To avoid patient injuries, disconnect the
patient before the leakage test.

5 Set the ventilation mode and continue, see


chapter ''Ventilation'' on page 96.
A
25411

Carry out the following steps when changing


patients:
1 Press the button (A) and confirm.
– Ventilation monitoring and alarm monitoring
are switched off.
– The ventilator stops.
– Fresh-gas monitoring is continued.
– The current settings remain the same.
– The Standby screen is active.
– Default settings are activated.
2 Press the Restore Site Defaults key, see
chapter ''Restoring the default settings'' on
page 138.

Instructions for use Fabius plus SW 3.n 109


Operation

Using the external fresh-gas outlet as a common gas outlet (optional)

WARNING
Preparation

Insufficient gas supply to the patient Example: Bain non-rebreathing system


Non-rebreathing systems are only intended
for manual ventilation or spontaneous
breathing and must only be connected to the
external fresh-gas outlet.
When using a non-rebreathing system,
ensure an adequate gas monitoring.
A
WARNING
Risk of misinterpretation of measured values
The values for O2, pressure, and volume
displayed on Fabius do not correspond to the

21000
values for the patient connected to external
fresh-gas outlet as they are based on 1 Remove fresh-gas hose from the external
measurements taken at the compact fresh-gas outlet (A).
breathing system.
When using the external fresh-gas outlet, C B
change into the Standby mode.

WARNING
Risk of faulty gas delivery A
O2 and CO2 and any anesthetic gases must
also be monitored for non-rebreathing
systems.
21001

The sample line must be connected with the


connector of the non-rebreathing system and
2 Connect the non-rebreathing system (B) to the
the connector of the gas analyzer (e.g., Scio,
external fresh-gas outlet (A).
Vamos).
3 Screw on the sample line (C) to the Luer Lock
connector of the ventilation mask or of the
breathing system filter and to the water trap on
the patient-gas measurement module.

110 Instructions for use Fabius plus SW 3.n


Operation

Ending operation

21020

21000
4 If necessary, connect the anesthetic gas
scavenging hose of the non-rebreathing 1 Close all flow control valves on the device.
system to the second connection (D) of the
anesthetic gas receiving system. 2 Disconnect the non-rebreathing system from
the external fresh-gas outlet.
Observe the instructions for use of the non-
3 Connect the fresh-gas hose to the external
rebreathing system and the anesthetic gas
fresh-gas outlet (A).
receiving system.
4 Screw the sample line back to the Y-piece on
the breathing circuit.
Operation

1 Change to Standby mode.


2 Set the fresh-gas flow.
To prevent rebreathing, the fresh-gas supply
must be at least double the minute volume.
3 Operate the non-rebreathing system according
to the corresponding instructions for use.

Instructions for use Fabius plus SW 3.n 111


Operation

Using the external fresh-gas outlet with an auxiliary switch (optional)

WARNING
Preparation

Insufficient gas supply to the patient Example: Bain non-rebreathing system


Non-rebreathing systems are only intended
for manual ventilation or spontaneous C
breathing and must only be connected to the B
external fresh-gas outlet.
When using a non-rebreathing system,
ensure an adequate gas monitoring.
A
WARNING
Risk of misinterpretation of measured values

21002
The values for O2, pressure, and volume
displayed on Fabius do not correspond to the
1 Connect the non-rebreathing system (B) to the
values for the patient connected to external
external fresh-gas outlet (A).
fresh-gas outlet as they are based on
measurements taken at the compact 2 Screw on the sample line (C) to the Luer Lock
breathing system. connector of the ventilation mask or of the
breathing system filter and to the water trap on
When using the external fresh-gas outlet,
the gas monitor.
change into the Standby mode.

WARNING
Risk of faulty gas delivery
O2 and CO2 and any anesthetic gases must D
also be monitored for non-rebreathing
systems.
The sample line must be connected with the
connector of the non-rebreathing system and
the connector of the gas analyzer (e.g., Scio,
Vamos).
21020

3 If necessary, connect the non-rebreathing


system scavenging hose to the second
connection (D) of the anesthetic gas receiving
system.
Observe the instructions for use of the non-
rebreathing system and the anesthetic gas
receiving system.

112 Instructions for use Fabius plus SW 3.n


Operation

Operation with non-rebreathing system Operation with the compact breathing


system (COSY)
125 hPa
Pmax=

COSY
20998

21003
Diverting the fresh-gas flow to the non-rebreathing
system: Diverting the fresh-gas flow to the compact
1 Place the switch lever to . breathing system:

The lever points in the direction of the non- 1 Place the switch lever to COSY.
rebreathing system. The lever points in the direction of the fresh-
2 Set the fresh-gas flow. gas inlet.

To prevent rebreathing, the fresh-gas supply


must be at least double the minute volume. Ending operation
3 Operate the non-rebreathing system according
to the corresponding instructions for use. 1 Close all flow control valves on the device.
2 Screw the sample line back to the Y-piece on
the breathing circuit.

Instructions for use Fabius plus SW 3.n 113


Operation

Ending operation

WARNING
Risk of material damage and risk to health
A vaporizer must never remain in operation
A without a fresh-gas flow. High concentrations
of the anesthetic gas flow into the ventilation
circuit and the ambient air. This can lead to
material damage and contamination of the
25411

ambient air with anesthetic gases.


1 Press the button (A) and confirm. Never cut off the fresh-gas flow before the
Ventilation monitoring and alarm monitoring are vaporizer is switched off.
switched off. The ventilator stops.
3 Close the flow control valves.
Power-saving mode is activated after 2.5
minutes.
4 Close the cylinder valves.
B
NOTE
Leave Fabius connected to the mains power
supply so that the battery is not discharged
20965

2 Set the control dial (B) of the vaporizer until it


engages on 0.

114 Instructions for use Fabius plus SW 3.n


Operation

Preparing for storage or transport

4 Close the cylinder valves of the gas cylinders.


WARNING
5 Pull off the O2 sensor from the inspiratory valve
Risk of tipping over during transport and expose to the ambient air.
The medical device may tip over if handled
incorrectly. Observe the following points
when transporting medical devices:
– The medical device may only be moved by
people who have the physical ability to do
so.
– To improve the maneuverability, transport
the device with 2 persons.
– When transporting over inclines, around
corners, or over thresholds (e.g., through B
doors or in elevators), make sure that the
medical device does not bump against
anything.
– Remove any devices mounted to the
holding arms or the top of the device.
– Clear the writing tray and fold it down
completely or slide it into the device.
– Do not pull the medical device over hoses,
cables, or other obstacles lying on the

25413
floor.
– Do not activate the brake while the 6 Switch off Fabius with the On/Off switch (B) on
medical device is being moved. the rear and pull out the plug.
– Always use the handles on the device to 7 Remove hoses of the anesthetic gas receiving
push or pull it. system.

A
25411

1 Press the button (A) and confirm.


Monitoring and alarm monitoring are switched
off. The ventilator stops.
2 Set the control dial (B) of the vaporizer until it
engages on 0.
3 Close the flow control valves.

Instructions for use Fabius plus SW 3.n 115


Operation

C
2.8-6.0 kPa
x 100 (bar)

N2O

2.8-6.0 kPa
x 100 (bar)

AIR

2.8-6.0 kPa
x 100 (bar)

O2
25414

8 Remove central supply hoses (C).


9 To bring the entire system to normal pressure,
press the key.

116 Instructions for use Fabius plus SW 3.n


Alarms

Alarms

Alarm signaling.............................................. 118


Display of alarms ............................................. 118
Acoustic signal................................................. 118
Alarm priorities................................................. 119
Suppressing the alarm tone............................. 120
Adjusting the alarm limits................................. 120

Instructions for use Fabius plus SW 3.n 117


Alarms

Alarm signaling

Alarms are signaled optically and acoustically. Alarm Display


Caution – A message of caution category
Display of alarms with 2 exclamation points (!!) is
displayed in the alarm message
In the event of an alarm, the system displays the field (A).
relevant alarm message in the alarm message – The yellow LED (B) flashes,
field (A). accompanied by a repeating alarm
tone sequence of 3 alarm tones:
An LED indicator (B) lights up.
G-G-between G# and A
Note – A notice with 1 exclamation point
A B (!) is displayed in the alarm mes-
sage field (A).
– The yellow LED lights continu-
ously, accompanied by a singe
alarm tone sequence of 2 alarm
tones:
E-E"
25411

– with internal priority ≥6:


alarm tone sequence of
Acoustic signal 2 tones
– with internal priority <6:
An alarm tone or alarm tone sequence sounds. no tone
It always is the alarm with the highest priority that
is acoustically signaled. The signal is emitted until
either the cause of the alarm is remedied or the
key is pressed.

Alarm Display
Warning – A warning message with 3 excla-
mation points (!!!) is displayed in
the alarm message field (A).
– The red LED (B) flashes, accom-
panied by a repeating alarm tone
sequence:
E-E-E--E-Bb-----E-E-E--E-Bb
– The alarm tone sequence (2x5
alarm tones) sounds every
10 seconds.

118 Instructions for use Fabius plus SW 3.n


Alarms

Alarm priorities

Fabius assigns the appropriate priority to each


alarm.
The background color of the alarm message field
indicates the priority of the active alarm.
The alarm messages are only displayed on
colored background if the option "Color display" is
activated.

Color Priority of the alarm message Action required


Red Warning Alarm with high priority !!! Immediate action is necessary in order to
avert imminent danger.
Yellow Caution Alarm with medium priority !! Fast action is necessary in order to avert a
danger.
Note Alarm with low priority ! Attention is necessary, but a delayed
response is sufficient.

The alarm messages are sorted according to these


priorities and displayed corresponding to the
internal priority system. Priority 31 has the highest
and priority 1 the lowest priority. The priority
numbers are listed in the table in chapter ''Alarm –
Cause – Remedy'' on page 160.
A maximum of 4 alarm messages* can be
displayed at the same time in a list. Alarm
messages with higher priority are displayed before
alarm messages with lower priority. Alarm
messages with low priority are only displayed if the
cause for a high-priority alarm is remedied.

* optionally, 3 alarm messages for Japan and China

Instructions for use Fabius plus SW 3.n 119


Alarms

Example for sounding the alarm tone when


several alarms are present

Priority of the existing alarm Priority of the new alarm Reaction from Fabius
(!!!) WARNING (!!!) WARNING – Alarm tone sequence starts
from the beginning.
(!!!) WARNING (!!) CAUTION – Alarm tone sequence for the
existing alarm is not inter-
rupted.
– No acoustic alarm signal for
the new alarm
(!!) CAUTION (!!) CAUTION – Alarm tone sequence starts
from the beginning.
(!!) CAUTION (!!!) WARNING – Alarm tone sequence for the
new alarm is started.

Suppressing the alarm tone

The alarm tone can be suppressed for a maximum Reactivating the suppressed alarm tone
of 2 minutes.
 Press the (A) key again.
The LED in the key (A) goes out.
B
A
Adjusting the alarm limits

If an alarm is triggered due to a value falling below


or exceeding the alarm limit, it might be necessary
to adjust the standard alarm limits. More
25411

information for setting the alarm limits can be


 Press the (A) key. found in chapter ''Changing the alarm limits'' on
page 141.
The LED in the key (A) lights up.
Setting the alarm limits in current ventilation mode:
In the status bar (B), the symbol and the
remaining time for the alarm tone suppression are  Press the key.
displayed. More information can be found in chapter
''Monitoring'' on page 121.
During the alarm tone suppression, only the new
alarms are acoustically signaled whose alarm
priority or internal priority number is higher than
the suppressed alarm, see chapter ''Alarm –
Cause – Remedy'' on page 160.

120 Instructions for use Fabius plus SW 3.n


Monitoring

Monitoring

Main screen.................................................... 122

O2 monitoring ................................................ 122


Parameter field for O2 monitoring.................... 123
Setting the O2 alarm limits............................... 123
Calibrating the O2 sensor ................................ 124
Consequences of incorrect O2 calibration ....... 124
Deactivating the O2 monitoring........................ 125
Breathing volume monitoring ...................... 126
Parameter field for breathing volume .............. 126
Volume alarms................................................. 127
Setting the minute volume alarm limits............ 127
Deactivating the volume alarms ...................... 127
Airway pressure monitoring......................... 128
Parameter field and waveform window for
airway pressure ............................................... 128
Setting the upper alarm limit and the pressure
threshold.......................................................... 129

Instructions for use Fabius plus SW 3.n 121


Monitoring

Main screen

The following information is displayed on the


screen:
– Current alarm messages
– Data of the O2 monitoring
A
– Data of the airway pressure monitoring
25411 – Data of the breathing volume monitoring

 Press the (A) key.


The current dialog window changes to the main
screen.

O2 monitoring

The inspiratory oxygen concentration is measured


with a dual galvanic sensor, which is located in the
cover of the inspiratory valve, see chapter
''Compact breathing system COSY (top view)'' on
page 22.

CAUTION
Risk of inaccurate measured values
If the O2 sensor is removed, this can lead to
leaks in the breathing system.
When the O2 sensor is replaced or removed, it
must be recalibrated.

NOTE
If the anesthesia workstation is not used, remove
the O2 sensor from the cover of the inspiratory
valve and insert the sealing plug provided.

122 Instructions for use Fabius plus SW 3.n


Monitoring

Parameter field for O2 monitoring Setting the O2 alarm limits

The standard alarm limits configured for the


Volume Control
B ventilation mode can be used unchanged, see
chapter ''Restoring the factory settings'' on page
A C 142.
or
The alarm limits can be set individually for the
current case:

A
25479

The following information is displayed in the


parameter field for O2 monitoring:

25411
A Numerical value for the inspiratory O2
concentration in percent (%) in the range from 1 Press the (A) key.
10 % to 100 %
B Upper alarm limit for the O2 concentration in Volume Control
(%) C
C Lower alarm limit for the O2 concentration in
(%)
B

25480

The dialog window with the alarm limits (B) opens.


2 Adjust the upper and lower alarm limit values of
the O2 concentration (C), see setting ranges of
the alarm parameters in chapter ''Changing the
alarm limits'' on page 141.
3 Confirm new values.

Instructions for use Fabius plus SW 3.n 123


Monitoring

Calibrating the O2 sensor The diagram illustrates the correlation between the
air mixture during calibration and the accuracy of
The O2 sensor must be exposed to the ambient air the oxygen measurement.
during the entire calibration. The calibration of the
O2 sensor is done in the scope of the daily 100
checkout of the readiness for operation of Fabius.
90
The O2 sensor can be calibrated in the following
80
C
ventilation modes:
70
– In Standby mode, see chapter ''Calibrating the
O2 sensor'' on page 134. 60

– During ventilation (in all available ventilation


modes), see chapter ''Calibrating the O2
A 50
40
sensor'' on page 149.
30 D
20
Consequences of incorrect O2
calibration 10 E
0

If the O2 sensor is not correctly calibrated, it can 10 20 30 40 50 60 70 80 90 100

lead to faulty measurements. With an air mixture B

20957
with too high or too low O2 concentration, Fabius
does not perform a calibration completely.
A Displayed O2 percentage
However, if the deviating concentration is within
defined limits, Fabius completes the calibration B Actual O2 percentage
even with non-optimal conditions. This can have C During calibration, the sensor was exposed to
the consequence that the displayed, measured ambient air with <21 % O2. Therefore, the
sensor values indicate an O2 percentage that is displayed O2 percentage is higher than the
higher or lower than the actual percentage. During actual O2 percentage.
the entire calibration, it must therefore be ensured
D Correct calibration with ambient air (21 % O2)
that the O2 sensor is only exposed to ambient air.
during the entire calibration time period.
Displayed O2 percentage = actual O2
percentage
E During calibration, the sensor was exposed to
ambient air with >21 % O2. Therefore, the
displayed O2 percentage is lower than the
actual O2 percentage.

124 Instructions for use Fabius plus SW 3.n


Monitoring

Deactivating the O2 monitoring

Volume Control

25481

If Fabius is configured by DrägerService for


operation with deactivated O2 monitoring, the
following functions of the O2 monitoring, are
deactivated:
– Parameter field for O2 monitoring
– Setting of O2 alarm limits
– Calibration of O2 sensor
– Alarm for the inspiratory O2 concentration and
the O2 sensor
The message No Integrated O2 Monitoring! is
displayed in the O2 monitoring window (A).

NOTE
If the internal FiO2 monitoring is deactivated, an
external FiO2 monitoring must be available in
accordance with general safety standards.

Instructions for use Fabius plus SW 3.n 125


Monitoring

Breathing volume monitoring

The breathing volume is measured by the flow Parameter field for breathing volume
sensor based on thermal anemometry. The values
of the flow sensor are converted in the following
parameters and displayed: Volume Control

– Minute volume (MV)


– Tidal volume (VT) D
A B C
– Respiratory rate (Freq)
E
CAUTION
Risk of incorrect measured values
The breathing volume monitoring can be
compromised by the operation of electrosurgical
devices or short-wave and microwave diathermy
devices in the immediate vicinity.

25479
The following information is displayed in the
NOTE
parameter field for breathing volume:
Sudden, irregular expiratory flow can cause A The respiratory rate (Freq) indicates the
erratic changes in the display of the tidal volume breaths during the past minute in breaths per
and the respiratory rate. Before reading the minute (bpm) (1/min).
display again, wait at least one minute.
The display is activated after 2 breaths.
The display range is between 2 bpm (1/min)
and 99 bpm (1/min).
B The tidal volume (VT) indicates the expiratory
volume for every breath in milliliters (mL).
The display range is between 0 mL and
1400 mL.
C The measured value for the minute volume
(MV) continually indicates the volume of the
gas breathed out in the past minute in liters per
minute (L/min).
The display range is between 0.0 L/min and
99.9 L/min.
D Upper alarm limit of the minute volume in L/min
E Lower alarm limit of the minute volume in L/min

126 Instructions for use Fabius plus SW 3.n


Monitoring

Volume alarms
Volume Control

Volume alarms in automatic ventilation modes


B
If the volume alarm messages are activated and
Fabius does not detect a breath in a specific time
period, the alarm APNOEA FLOW !! or APNOEA
FLOW !!! is triggered, see chapter ''Alarm – Cause
– Remedy'' on page 160.

Volume alarms in ManSpont


If the volume alarm messages are activated and
Fabius does not detect a breath in a specific time

25480
period, after 30 seconds the alarm APNOEA
FLOW !! with the priority CAUTION is triggered. If The dialog window (B) with the alarm limits opens.
this alarm is not remedied, the priority increases 2 Adjust upper and lower alarm limit values of the
after a further 30 seconds to WARNING. minute volume (MV), see setting ranges of the
The volume alarm messages are automatically alarm parameters in chapter ''Changing the
activated when changing from Standby mode in a alarm limits'' on page 141.
ventilation mode. 3 Confirm new values.

Setting the minute volume alarm limits Deactivating the volume alarms
The standard alarm limits configured for the
ventilation mode can be used unchanged, see
chapter ''Changing the alarm limits'' on page 141,
A
or
the alarm limits can be set individually for the
current case.
25411

A
The volume alarms can be switched on and off
during operation by pressing the key (A), see
chapter ''Switching the volume alarms on and off''
on page 148.
25411

1 Press the (A) key.

Instructions for use Fabius plus SW 3.n 127


Monitoring

Airway pressure monitoring

Parameter field and waveform window C The peak pressure (PEAK) indicates the
for airway pressure highest pressure value of each breath in
cmH2O (hPa). The display range is between 0
and 80 cmH2O (0 and 80 hPa).
Volume Control
D Upper alarm limit
E Pressure threshold
F Pressure waveform
G Pressure threshold as a line

A B C D The pressure threshold is used for the


detection of apnea (disconnection) and
E continuous pressure. If the pressure waveform
H G F does not cross the pressure threshold either
from above or below, an alarm is sounded.
H Scale of the pressure waveform with display
range from 0 to 20, 0 to 50, or 0 to 100 cmH2O
25360

(0 to 20, 0 to 50, or 0 to 100 hPa). The scaling


is done automatically.
The following parameters are displayed in
numerical and graphical form in the parameter field
and in waveform window for the airway pressure: Pressure alarms in automatic ventilation
modes
A The positive end-expiratory pressure (PEEP)
indicates the airway pressure at the end of the If Fabius does not detect a breath in a specific time
expiration in cmH2O (hPa). The display range period, the alarm APNOEA PRESSURE !! or
is between 0 and 30 cmH2O (0 and 30 hPa). APNOEA PRESSURE !!! is triggered, see chapter
B The plateau pressure (PLAT) indicates the ''Alarm – Cause – Remedy'' on page 160.
airway pressure at the end of the inspiration in
cmH2O (hPa). The display range is between 0 Pressure alarms in ManSpont
and 80 cmH2O (0 and 80 hPa).
If Fabius does not detect a breath in a specific time
or period, after 30 seconds the alarm APNOEA
The mean airway pressure (MEAN) indicates PRESSURE !! with the priority CAUTION is
the average of all pressure values that were triggered. If this alarm is not remedied, the priority
recorded during a breath in cmH2O (hPa). The increases after a further 30 seconds to WARNING.
display range is between 0 and 50 cmH2O (0
and 50 hPa).

NOTE
Fabius can be configured by DrägerService or an
authorized local service partner so that the mean
airway pressure (MEAN) is displayed instead of
the plateau pressure (PLAT).

128 Instructions for use Fabius plus SW 3.n


Monitoring

Setting the upper alarm limit and the NOTE


pressure threshold
The pressure threshold is preferably to be set so
The standard alarm limits configured for the that the value lies approx. 4 cmH2O (hPa) under
ventilation mode can be used unchanged, see the current peak pressure.
chapter ''Changing the alarm limits'' on page 141.
or
The alarm limits can be set individually for the
current case:

A
25411

1 Press the (A) key.

Volume Control

C
25480

The dialog window (B) with the alarm limits opens.


2 Adjust upper alarm limit and pressure threshold
of the peak pressure (PEAK) (C), see chapter
''Changing the alarm limits'' on page 141.
3 Confirm new values.

Instructions for use Fabius plus SW 3.n 129


Configuration

Configuration

Configuration in standby mode ................... 131


Power-saving mode......................................... 132
Performing the system test.............................. 132
Calibrating the flow sensor .............................. 133
Calibrating the O2 sensor ................................ 134
Leakage test.................................................... 135
Accessing the alarm logbook .......................... 137
Restoring the default settings.......................... 138
Page Standby Set-up .................................... 139
Changing the default settings.......................... 139
Changing the configurations............................ 143
Configuration during operation ................... 147
Switching the volume alarms on and off.......... 148
Automatic setting of the pressure threshold .... 148
Calibrating the O2 sensor ................................ 149
Switching the desflurane compensation on and
off .................................................................... 150
Automatic desflurane compensation ............... 150
Accessing the alarm logbook .......................... 151
Clearing the alarm logbook ............................. 151
Closing the alarm logbook ............................... 151
Changing the alarm volume ............................ 152

130 Instructions for use Fabius plus SW 3.n


Configuration

Configuration in standby mode

The following configuration functions are available 2 Confirm the new mode.
in Standby mode: The ventilator changes to Standby mode. The
– Calibrations previous screen is replaced by the start screen
– System tests Standby and the standby LED is continually lit.

– Management of default settings Standby

A
C
25411

1 Press the (A) key.

25463
ManSpont
The following softkeys (C) are displayed on the
start screen:

– Run System Test


– Calibrate Flow Sensor
– Calibrate O2 Sensor
– Leak / Compl Test
B
– Access Alarm Log
– Restore Site Defaults
25491

The pressure waveform window is replaced by a


confirmation message (B) and instructions to turn
off the flow.
The LED of the key (A) starts flashing. It
flashes until the Standby mode is confirmed.

NOTE
If the confirmation is not done within 15 seconds,
the ventilator remains in the previous mode and
the pressure waveform window is restored.

Instructions for use Fabius plus SW 3.n 131


Configuration

Performing the system test


Standby D
In Standby mode, a system test can be started.
This test corresponds to the test that is performed
automatically after switching on the anesthesia
workstation. More information can be found in
chapter ''Switching on'' on page 86.

WARNING
25492 Risk of patient injury
If the flow control valves are not closed before
accessing Standby mode, the following message During the system test, the system is
(D) is shown on the start screen: pressurized.
Gas still flowing - shut off all gas flow control To prevent patient injury, do not perform the
valves to activate Sleep Mode. system test on the medical device if a patient
As soon as the flow control valves are closed, the is connected.
message disappears.
3 Close the flow control valves. Standby

Power-saving mode

A
25463

1 Press the Run System Test softkey (A).


25493

– Electrical system components are tested.


When Fabius is in Standby mode and there is no – Default settings are restored.
user input for 2.5 minutes, the power-saving mode
is activated. The screen is then replaced by the
screensaver. Press any key to end the
screensaver.

132 Instructions for use Fabius plus SW 3.n


Configuration

At the start of the calibration, the instructions are


hidden and the following message is displayed
above the standby softkeys (B):
Flow Calibration in progress
B C After the calibration, one of the following two
messages are displayed above the standby
softkeys (B):
Flow Calibration completed - reconnect
expiratory hose
or
Flow Calibration Failed
25494

The test results (B) are displayed on the screen. Troubleshooting with failed flow calibration
After completion of the system test, the total test  Repeat the calibration.
results (C) are displayed, see chapter ''Checking
the readiness for operation'' on page 88. If the  Replace the flow sensor.
system test was successful, the Standby mode is If the calibration continues to fail, contact
activated. DrägerService or the authorized local service
partner.

Calibrating the flow sensor

Standby

A
25463

1 Press the Calibrate Flow Sensor softkey (A).


2 Follow the instructions on the screen.

Instructions for use Fabius plus SW 3.n 133


Configuration

Calibrating the O2 sensor Troubleshooting with failed O2 calibration


 Replace the O2 sensor capsule in the O2
In order for the O2 sensor to be correctly sensor housing, see chapter ''Inserting a new
calibrated, it must be exposed to the ambient air O2 sensor capsule'' on page 78.
during the entire calibration.
If the calibration continues to fail, contact
To avoid leakage, remove the O2 sensor from the DrägerService or the authorized local service
cover of the inspiratory valve. Seal the cover of the partner.
inspiratory valve with the valve cover plug.

Standby

A
25463

1 Press the Calibrate O2 Sensor softkey (A).


2 Follow the instructions on the screen.
At the start of the calibration, the instructions are
hidden and the following message is displayed
above the standby softkeys (B):
O2 Calibration in progress
After the calibration, one of the following two
messages are displayed above the standby
softkeys (B):
O2 Sensor Calibration completed - reinsert O2
sensor
or
O2 Sensor Calibration Failed

134 Instructions for use Fabius plus SW 3.n


Configuration

Leakage test Results of the compliance test


This test determines the system compliance
The following tests are initiated during the leakage including breathing system, breathing hoses, filter,
test: and Y-piece.
– Compliance Test
The system compliance is required to ensure in
– System Leak Test Volume Control mode that the applied tidal
– Ventilator Leak Test volume corresponds to the set tidal volume.
– Safety Relief Valves Test System compliance Displayed result
[mL/cmH2O] [mL/cmH2O]
Standby
≤6.5 Measured value and
PASSED

The value of the compliance is displayed on the


Standby screen.

Results of the ventilator leakage test


The test of the ventilator leakage can have the
following results:

A Ventilator leakage Displayed result


[mL/min] [mL/min]
25463

150 Measured value and


1 Press the Leak /ComplTest softkey (A). PASSED
2 Follow the instructions on the screen. 151 to 250 Measured value and
FAILED
Standby
>250 >250 and FAILED

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2

After completion of the tests, the results (B) are 2IOXVK


displayed on the screen. %UHDWKLQJEDJ 6FDYHQJLQJ
21465

3 To return to the start screen, press the rotary


knob.

Instructions for use Fabius plus SW 3.n 135


Configuration

Results of the system leakage test Troubleshooting with failed test of the
overpressure safety valve
The test of the system leakage can have the
following results:
WARNING
System leakage Displayed result Risk of unexpected occurring overpressure
[mL/min] [mL/min]
A soiled or non-functioning overpressure
250 Measured value and
safety valve is not able to compensate for
PASSED
suddenly occurring overpressure in the
251 to 350 Measured value and breathing system.
FAILED
Perform the leakage test before start-up of
>350 >350 and FAILED the device. Observe the test results of the
overpressure safety valve.
<SLHFHRFFOXGHG
/XHU/RFNFRQQHFWRUFORVHG
 Repeat leakage test. If the test of the
overpressure safety valve continues to fail,
)UHVKJDVGHFRXSOLQJ contact DrägerService or the authorized local
service partner.
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21464

Test of the overpressure safety valve


This test checks the functionality of the
overpressure safety valve.
The test results are displayed on the screen with
the leakage test results (B).

136 Instructions for use Fabius plus SW 3.n


Configuration

Accessing the alarm logbook Clearing the alarm logbook


 Select Clear Alarm Log (C) and confirm.
The alarm logbook lists all alarm messages with
the respective date and time.
Closing the alarm logbook
Up to a maximum of 100 entries can be saved.
 Select the input arrow (D) and confirm.
When the storage limit is reached, the oldest
entries will be overwritten. The screen changes to Standby mode.

Standby CAUTION
Risk of losing data
All data in the alarm logbook are cleared in the
following cases:
– Fabius is switched off.
– The system test is started in standby mode.
– The power supply fails.

A
25463

1 Press the Access Alarm Log softkey (A).

Standby

D
C
B
25495

2 To scroll through the alarm logbook (B), turn


the rotary knob.

Instructions for use Fabius plus SW 3.n 137


Configuration

Restoring the default settings

The default settings are restored in the following


cases:
– Switching Fabius on and off
– Performing the system test
– Pressing the Restore Site Defaults softkey

Standby

A
25463

1 Press the Restore Site Defaults softkey (A).


The default settings are restored. The following
message is displayed using the standby softkeys
(B):
Site Default settings restored
The default settings can be adjusted on the
Standby Set-up screen. Adjustment of the default
settings is password-protected.

WARNING
Risk due to unsuitable ventilation settings
After the default settings are restored, check
whether the settings for the ventilation and
monitoring are suitable for the patient.

138 Instructions for use Fabius plus SW 3.n


Configuration

Page Standby Set-up

Pressing the key in Standby mode provides Changing the default settings
access to various default settings and
configuration settings. 1 On the Standby Set-up screen, select Default
Access is password-protected. On request the Settings (A) and confirm.
password can be deactivated or a personal
password can be defined. Standby Set-up
A
The settings made are saved as default settings
and configurations.

A
25411

22103
1 Press the (A) key. The screen with the password query opens.
The Standby Set-up screen opens
Standby Set-up
Standby Set-up
B C D
B

22107
22103

2 In the displayed row, select the digits in


2 Select Default Settings (B) or Configuration sequence and confirm.
(C) with the cursor.
By selecting and confirming with the input
arrow (D), the screen changes back to the
Standby screen.

Instructions for use Fabius plus SW 3.n 139


Configuration

The screen with the default settings opens. Default settings for Volume Control

Standby Set-up Standby Set-up

C D
E

F
22105

22111
The following settings can be changed: 1 Select Volume Settings (E) and confirm.
– Volume Settings 2 Press softkey (F) of the parameter to be
– Pressure Settings * changed.

– Pressure Support Settings* 3 Select new value and confirm.

– SIMV/PS Settings* 4 If necessary, repeat steps 2 and 3 for other


parameters.
– Alarm Limits
5 Finally, confirm all changes once again.
– Minimum Alarm Volume
The window is closed, the cursor is on the input
– Restore Factory Defaults arrow (D).
 To return to the Standby Set-up screen, select
the input arrow (C) and confirm.
Default settings for Pressure Control, Pressure
Support, and SIMV/PS
 Change the parameters (see description in
section ''Default settings for Volume Control''
on page 140).

* optional

140 Instructions for use Fabius plus SW 3.n


Configuration

Changing the alarm limits Changing the minimum alarm volume

Standby Set-up Standby Set-up

I J
H

G K

22113
22109

1 Select Alarm Limits (G) and confirm. 1 Select Minimum Alarm Volume (K) and
confirm.
2 Select the alarm limits (H) to be changed and
confirm. The current minimum alarm volume (L) is
displayed on the screen.
3 Select new value and confirm.
2 Set the new minimum alarm volume to a value
4 If necessary, repeat steps 2 and 3 for other
between 1 (minimum) and 10 (maximum) and
alarm limits.
confirm.
5 Select the input arrow (I) and confirm.
The window is closed, the cursor is on the input
The window is closed. arrow (J).
In the following table, the values for the setting
ranges and factory settings are listed for all alarm
limits of Fabius.

Alarm parame- Setting range Factory setting


ter
O2 19 to 100 100
[%] 18 to 99 20
MV 0.1 to 20.0 12.0
[L/min] 0.0 to 19.9 3.0
Pressure 10 to 70 40
[[cmH2O ] 5 to 30 8
(hPa)]

Instructions for use Fabius plus SW 3.n 141


Configuration

Restoring the factory settings Parameter Factory setting

Standby Set-up
Pressure Support ∆PPS= 10
Freq Min= 3
Trigger= 2
Insp Flow= 30
PEEP= 0
SIMV/PS PMAX= 40
M
VT= 600
N Freq= 12
∆PPS= 10
22115

PEEP= 0
1 Select Restore Factory Defaults (M) and Trigger= 2
confirm.
Insp Flow= 30
2 Select Yes or No (N) and confirm.
TINSP= 1.7
If Yes is selected, the factory settings are restored.
The factory settings replace the current default TIP:TI= 10
settings. Alarm limits for O2 Upper value = 100
The values for the factory settings for Fabius are Lower value = 20
listed in the following table. Alarm limits for MV Upper value = 12.0
Parameter Factory setting Lower value = 3.0
Volume Control PMAX= 40 Upper alarm limit and Upper value = 40
pressure threshold for
VT= 600 Lower value = 8
PEAK
Freq= 12
Minimum Alarm Vol- Volume = 5
TI:TE= 1:2.0 ume
TIP:TI= 10
PEEP= 0
Pressure Control PINSP= 15
Freq= 12
TI:TE= 1:2.0
Insp Flow= 30
PEEP= 0

142 Instructions for use Fabius plus SW 3.n


Configuration

Changing the configurations Changing the time

1 On the Standby Set-up screen, select Standby Set-up


Configuration and confirm.

Standby Set-up B

22127
1 Select Time Set (B) and confirm.
The cursor is in the hour field.
22124

2 Select new value and confirm.


The screen with the configuration settings opens.
The cursor moves to the minute field.
The following settings can be changed:
3 Select new value and confirm.
– Time Set
The window is closed.
– Time Format
– Date Set
– Date Format
– Language
– Pressure Unit
– Acoustic Confirmation
– Waveform Display
– Display Background
 To return to the Standby Set-up screen, select
the input arrow (A) and confirm.

Instructions for use Fabius plus SW 3.n 143


Configuration

Changing the time format Changing the date format

Standby Set-up Standby Set-up

C
E

22133
22129

1 Select Time Format (C) and confirm. 1 Select Date Format (E) and confirm.
2 Select new format and confirm. 2 Select new format and confirm.
The window is closed. The window is closed.

Changing the date Changing the language

Standby Set-up Standby Set-up

D
F
22135
22131

1 Select Date Set (D) and confirm. 1 Select Language (F) and confirm.
2 Select new value and confirm. 2 Select language and confirm.
The window is closed. The window is closed.

144 Instructions for use Fabius plus SW 3.n


Configuration

Changing the pressure unit Activating the acoustic confirmation

Standby Set-up Standby Set-up

G
H

22137
22136

1 Select Pressure Unit (G) and confirm. When the function Acoustic Confirmation is
switched on, a tone is sounded when pressing the
The following units can be selected:
rotary knob.
– hPa
1 Select Acoustic Confirmation (H) and
– cmH2O
confirm.
– mbar
2 Select On or Off and confirm.
– kPa
The window is closed.
2 Select new unit and confirm.
The window is closed.

Instructions for use Fabius plus SW 3.n 145


Configuration

Changing the waveform display Changing the screen brightness*

Standby Set-up Standby Set-up

I K
22139

22143
1 Select Waveform Display (I) and confirm. 1 Select Display Background (K) and confirm.
2 Select Normal or Filled curve display and 2 Select Light or Dark screen brightness and
confirm. confirm.
The window is closed. The window is closed.

Volume Control

J
25496

When the setting Normal is selected, the pressure


waveform (J) is not shown as a filled area, but as a
line.

* available only with optional color screen

146 Instructions for use Fabius plus SW 3.n


Configuration

Configuration during operation

If Fabius is in one of the ventilation modes, the The following softkeys (C) are displayed on the
following configuration functions can be screen, e.g., in Volume Control mode:
performed: – Volume Alarms ON/OFF
– Calibration of the O2 sensor – Auto Set
– Displaying and changing the monitoring – Calibrate O2 Sensor
settings
– DesComp ON/OFF
– Changing configurations
– Access Alarm Log
– Access Alarm Volume
If no change is made within 15 seconds, the
A pressure waveform is displayed again.
B
Pressing the key (B) will also cause the
pressure waveform window to be displayed again.
25411

Volume Control

C
25505

The pressure waveform is no longer displayed.

Instructions for use Fabius plus SW 3.n 147


Configuration

Switching the volume alarms on and off Automatic setting of the pressure
threshold
Volume Control
Volume Control

A
A
25505

25505
1 Press the Volume Alarms ON/OFF softkey
(A). 1 Press the Auto Set softkey (A).
The key label changes from Volume Alarms The pressure threshold for the peak pressure
ON to Volume Alarms OFF. (PEAK) is set to 4 cmH2O (hPa) below the
Instead of the upper and lower alarm limits, the current plateau pressure (PLAT).
symbol appears, indicating the alarm is
deactivated. NOTE

The volume alarms are deactivated. The pressure threshold must not be below
5 cmH2O (5 hPa) or above 30 cmH2O (30 hPa).
NOTE
NOTE
The function Volume Alarms ON /OFF is
available in the standard view of the ManSpont If no current measured value is available for the
mode. If the key is pressed in ManSpont plateau pressure (PLAT), pressing the softkey
mode, the softkey Volume Alarms ON /OFF is has no effect.
not displayed.
NOTE
In SIMV/PS mode, the pressure threshold
depends on the pressure of the mandatory
breaths.

148 Instructions for use Fabius plus SW 3.n


Configuration

Calibrating the O2 sensor  If the calibration was not successful, replace


the O2 sensor capsule in the O2 sensor
housing, see chapter ''Inserting a new O2
Volume Control sensor capsule'' on page 78.
If the calibration continues to fail, contact
DrägerService or the authorized local service
partner.

A 25505

1 Press the Calibrate O2 Sensor softkey (A).


2 Follow the instructions on the screen.
To calibrate the O2 sensor, proceed as described
in chapter ''Calibrating the O2 sensor'' on page
134.

Volume Control

B
25506

During the calibration, the O2 value in the window


(B) of the O2 monitoring is replaced by the word
CAL. The calibration time is approx. 15 seconds.
After successful calibration, the O2 measured
value is again displayed.

Instructions for use Fabius plus SW 3.n 149


Configuration

Switching the desflurane compensation CAUTION


on and off
Risk of inaccurate measured values

Volume Control B Desflurane influences the measurement


accuracy of the flow sensor.
If desflurane is used, activate the desflurane
compensation.

1 Press the DesComp OFF softkey (A).


The key label changes from DesComp OFF to
DesComp ON.
The desflurane compensation is activated.
A The message Des on is displayed in the status bar
(B).
25505

The desflurane compensation optimizes the Automatic desflurane compensation


volume measurement when desflurane is used.
Prerequisite: External gas analyzer is connected to
CAUTION Fabius via the RS232 interface.
Risk of inaccurate measured values
If the activation of the desflurane compensation
Volume Control A
is forgotten during the use of desflurane or if the
desflurane compensation is activated even
though desflurane is not being used, the
accuracy of the volume measurement can be
influenced.
Only switch on desflurane compensation if
desflurane is used.

CAUTION
B
Risk of inaccurate measured values
25507

If an anesthetic gas monitor is used, the


automatic desflurane compensation is activated.
NOTE
Faulty anesthetic gas monitors can influence the
accuracy of the measured volume. If data for anesthetic gas concentration is
available via the communication with an external
Make sure that the anesthetic gas monitor
gas analyzer, Fabius compensates desflurane
functions correctly.
automatically. In this case, the transmitted data
cancel the function of the softkey for desflurane
compensation.

150 Instructions for use Fabius plus SW 3.n


Configuration

If the connected anesthetic gas monitor detects


Volume Control
desflurane, Fabius reacts as follows:
– Des auto is displayed in the status bar (A).
– The softkey DesComp ON/OFF (B) is no
longer displayed.
If the communication to the anesthetic gas monitor
fails, Fabius reacts as follows:
– The automatic desflurane compensation is
switched off. B
– The message Des auto in the status bar (A) is C
no longer displayed. D
– The softkey DesComp OFF (B) is displayed.

25508
To switch the desflurane compensation back on:
2 To scroll through the alarm logbook (D), turn
 Press the DesComp OFF softkey (B). the rotary knob.
The label of the softkey changes to DesComp ON.

Clearing the alarm logbook


Accessing the alarm logbook
 Select Clear Alarm Log (C) and confirm.

Volume Control
Closing the alarm logbook

 Select the input arrow (B) and confirm.


The pressure waveform and softkeys are
displayed again.

A
25505

1 Press the AccessAlarm Log softkey (A).

Instructions for use Fabius plus SW 3.n 151


Configuration

Changing the alarm volume The lower value is limited by the setting in the
standby configuration (see chapter ''Changing the
minimum alarm volume'' on page 141).
WARNING
The pressure waveform and softkeys are
Risk of not hearing the alarm tone displayed again.
When operating in a loud environment, the
acoustic alarm signals may not be heard.
Always set the alarm tone to a sufficient
volume.

Volume Control

A
25505

1 Press the AccessAlarm Volume softkey (A).

Volume Control
25509

2 Set the new alarm volume to a value between 1


(minimum) and 10 (maximum) and confirm.

152 Instructions for use Fabius plus SW 3.n


Troubleshooting

Troubleshooting

Locating and remedying leakages............... 154


Possible causes of leakage ............................. 154
Systematic localization of leakages................. 155
Power supply failure ..................................... 156
Mains power supply failure .............................. 156
Ventilator failure ............................................ 158
Alarm VENTILATOR FAIL !!! ........................... 158
Failure of the O2 sensor................................ 159
Causes for faulty calibration ............................ 159
Low O2 supply ............................................... 159

Alarm – Cause – Remedy.............................. 160

Instructions for use Fabius plus SW 3.n 153


Troubleshooting

Locating and remedying leakages

Leakages can lead to a failure of the system test or Possible causes of leakage
the leakage test and must be remedied.
– The CO2 absorber or the CLIC adapter is not
CAUTION securely screwed to the breathing system.
Risk due to contamination – The APL valve is not correctly fitted to the
breathing system or is not set to 30 hPa
Anesthetic gas can get into the ambient air as a
(cmH2O).
result of leakages.
– Perform the leakage test before using the – The breathing bag, the breathing hoses, the Y-
device. piece, or the microbial filter is incorrectly fitted
– Remedy all leakages. or damaged.
– The holder for the breathing bag is incorrectly
CAUTION mounted to the breathing system. The sealing
ring is soiled or damaged.
Risk due to leakage at the valves
– The water trap is not connected.
Leakages at valves can allow ambient air to enter
the breathing system and alter the composition of – The sample line is not connected, is kinked, or
the breathing gas. is leaking.
– Perform the leakage test before using the – The connections for the sample line are
device. damaged.
– Check all valves for leakage.
– The O-rings on the inspiratory port or
expiratory port are damaged, soiled, or
CAUTION missing.
Risk of insufficient ventilation – The flow sensor is incorrectly installed or
damaged. The rear O-ring is missing.
Breathing gas may escape because of leakages,
with the result that the applied volume is less – The valves or seals of the breathing system are
than the set volume. damaged.
– Perform the leakage test before using the – The cone for occluding the Y-piece is scratched
device. or damaged.
– Remedy all leakages.
– The filling or emptying connections on the
vaporizer are leaking or are open. The
vaporizer is incorrectly fitted. The O-ring is
missing or damaged. The control dial is not in
the 0 position.

154 Instructions for use Fabius plus SW 3.n


Troubleshooting

Systematic localization of leakages

To find causes of leakages, isolate individual


components from the leakage test.

Component Measure
Sample line Remove the sample line.
Occlude the Luer Lock con-
nector on the Y-piece.
Breathing hoses Disconnect the breathing
hoses. Connect the inspiratory
port and expiratory port with a
hose that is known to be with-
out leakages. Connect the
breathing bag directly to the
breathing system.
Vaporizers Remove the vaporizers.

1 Perform the leakage test, see chapter


''Leakage test'' on page 135.
2 Contact service personnel if the leakages
cannot be localized.

Instructions for use Fabius plus SW 3.n 155


Troubleshooting

Power supply failure

Mains power supply failure The monitoring functions remain in operation until
the battery is completely discharged and all
If mains power fails, Fabius automatically switches electronic components are switched off.
to the internal battery. With a fully charged battery
the supply of the ventilator and the internal monitor CAUTION
functions are maintained for up to 2 hours. Risk of device malfunction
The remaining battery charge is displayed in the If mains power fails, devices connected to the
status bar. auxiliary power sockets are not supplied from the
The operating time of the battery depends on the internal battery.
ventilation settings and the condition of the battery Ensure an alternative power supply for
(age and battery charge). A completely charged connected devices.
battery can ensure supply for at least 45 minutes.
In battery operation and in case of decreasing WARNING
battery charge, the following information is
displayed: Insufficient ventilation of the patient

– The battery symbol is displayed in the If the alarm message BATTERY LOW !!
status bar and the LED indicator for mains (remaining battery charge 10%) is displayed
power supply goes out. for the first time, the ventilator still remains in
operation for up to 10 minutes.
– The note POWER FAIL ! is displayed in the
alarm window. Restore mains power supply. Afterwards, the
automatic ventilation is available again.
– When the remaining battery charge drops
below 20%, the note BATTERY LOW ! is
displayed in the alarm window. WARNING

– When the remaining battery charge drops Risk of patient injury


below 10%, the note in the alarm window is When the battery is empty, Fabius switches
replaced by the alarm BATTERY LOW !!. off automatically.
– Shortly before the battery is empty, the
Never completely discharge the battery.
ventilator is switched off and the alarm
However, if there is a complete discharge of
VENTILATOR FAIL !!! is displayed in the
the battery, charge the battery immediately.
alarm window.
The device must not be used until the battery
– If no manual ventilation follows, the following is completely charged again.
alarm messages are displayed:
– APNOEA PRESSURE !!!
– APNOEA FLOW !!!
– MINUTE VOLUME LOW !!

156 Instructions for use Fabius plus SW 3.n


Troubleshooting

When the battery is completely empty, Fabius


switches off and generates an acoustic alarm
signal (continuous tone for approx. 30 seconds).
All customized settings, including the alarm limits,
that deviate from the default settings are lost.
The following ventilation modes are still possible:
– Manual ventilation
– Spontaneous breathing
All pneumatic functions of Fabius are still
available:
– APL valve
– Pressure gauge for the airway pressure
– Pressure gauge for gas cylinders and central
gas supply
– Fresh-gas supply and anesthetic agent delivery
– S-ORC
– Flow control valves for O2, Air, and N2O

WARNING
Incorrect patient settings
When the power supply is restored and
Fabius is restarted, all ventilation and alarm
settings are reset to default settings.
After the restart of Fabius, check all settings
and adjust to the patient if necessary.

Instructions for use Fabius plus SW 3.n 157


Troubleshooting

Ventilator failure

Alarm VENTILATOR FAIL !!! Fabius restarts and performs a selftest. More
information on the selftest can be found in section
If the ventilator does not return to its initial state, ''Checking the readiness for operation'' on page
the alarm VENTILATOR FAIL !!! activates. 88.
Only manual ventilation or spontaneous breathing 1 Select ventilation mode ManSpont.
is possible. 2 Set the APL valve to position Man.
No other ventilation modes can be selected. 3 Set the APL valve to the desired pressure.
In this case, proceed as follows: 4 Fill the breathing bag, if necessary with the aid
of the O2 flush key.
1 Change to ManSpont ventilation mode.
5 Manually ventilate the patient.
2 Set the APL valve to position Man.
Before starting the ventilation with an automatic
3 Set the APL valve to the desired pressure.
ventilation mode, contact DrägerService or the
4 Fill the breathing bag, if necessary with the aid authorized local service partner.
of the O2 flush key.
5 Manually ventilate the patient.

Bypassing the ventilator


In the following cases, the ventilator must be
bypassed so that the ventilation can be continued.
– The ventilator does not return to its initial state
after a malfunction.
and
– The spontaneous breathing mode cannot be
activated.
To bypass the ventilator, proceed as follows:
1 Set the On/Off switch on the rear of Fabius to
(off).
2 Set the On/Off switch back to (on).

158 Instructions for use Fabius plus SW 3.n


Troubleshooting

Failure of the O2 sensor

Causes for faulty calibration

The calibration was not successful if, after the


calibration of the O2 sensor, the alarm message
O2 SENSOR FAIL ! is displayed.
Possible causes and remedial measures are
described in the following table.

Cause Remedy
During the calibration, the O2 sensor was exposed Make sure that the O2 sensor is exposed to ambi-
to an air mixture with extremely high or low oxygen ent air during the entire calibration.
concentration.
During the calibration, the O2 sensor was exposed Make sure that the O2 sensor is exposed to ambi-
to an air mixture with fluctuating oxygen concentra- ent air during the entire calibration.
tion.
The O2 sensor was not exposed to ambient air long Expose the O2 sensor to ambient air for 2 minutes.
enough before the calibration. When a new O2 sensor is connected, expose the
new sensor to ambient air for 15 minutes.
The maximum period of use of the O2 sensor has Replace the O2 sensor. Expose the new O2 sensor
elapsed. to ambient air 15 minutes before calibration.
The O2 sensor is not connected. Check the O2 sensor. Connect the O2 sensor cor-
rectly and recalibrate.

Low O2 supply

If the pressure of the O2 gas supply falls below the


permissible minimum pressure of 20 psi (approx.
1.4 kPa x 100), an additional alarm O2 SUPPLY
A LOW !!! will be generated.
LED (A) starts flashing.
If the alarm occurs in the Standby mode and the
user switches to a ventilation mode, an acoustic
alarm signal will sound (continuous tone for
25411

approx. seven seconds).

Instructions for use Fabius plus SW 3.n 159


Troubleshooting

Alarm – Cause – Remedy

Alarm messages are displayed in hierarchical form


in the alarm message field of the main screen, see
chapter ''Screen display'' on page 44.
The priority of the alarm messages is marked by
exclamation points.
The alarm messages are only displayed on
colored background if the option "Color display" is
activated.

Warning !!! Red


Caution !! Yellow
Note ! White

Within an alarm priority, the alarm messages are


assigned internal priorities. In the following table,
these internal priorities are indicated as numbers.
The alarm message with the highest priority has
the number 31. The lower the priority, the lower the
number.
The table shows possible causes for an alarm and
corresponding remedies. Causes and remedies
must be worked through in the order listed until the
alarm has been resolved. The alarm messages are
listed in alphabetical order.
Some alarms appear in this table several times
with different alarm priorities because their priority
can change under certain conditions.

160 Instructions for use Fabius plus SW 3.n


Troubleshooting

Alarm Alarm Cause Remedy


priority
(31) AIRWAY PRESSURE HIGH !!! The upper alarm limit for the Check the breathing circuit
airway pressure was connected to the anesthe-
exceeded, the breathing hose sia workstation.
is kinked.
The alarm limit was set too Check the breathing sys-
low. tem or the alarm limit.
(23/31) APNOEA FLOW !! The apnea flow alarm based
on a time staggering.
In the Volume Control,
Pressure Control, SIMV/PS
modes with Freq ≥ 6 or in
Pressure Support mode
with apnea ventilation deacti-
vated:
Caution = VT <20 mL for >15
seconds
In the ManSpont, SIMV/PS
modes with Freq < 6 or in
Pressure Support mode
with apnea ventilation acti-
vated:
Caution = VT <20 mL for >30
seconds
Breathing/ventilation Check ventilator.
stopped.
Leakage or disconnection in Check breathing system.
the breathing system.

Instructions for use Fabius plus SW 3.n 161


Troubleshooting

Alarm Alarm Cause Remedy


priority
(23/31) APNOEA FLOW !!! The apnea flow alarm based
on a time staggering.
In the Volume Control,
Pressure Control, SIMV/PS
modes with Freq ≥ 6 or in
Pressure Support mode
with apnea ventilation deacti-
vated:
Warning = VT <20 mL for >30
seconds
In the ManSpont, SIMV/PS
modes with Freq < 6 or in
Pressure Support mode
with apnea ventilation acti-
vated:
Warning = VT <20 mL for >60
seconds
Breathing/ventilation Check ventilator.
stopped.
Leakage or disconnection in Check breathing system.
the breathing system.

162 Instructions for use Fabius plus SW 3.n


Troubleshooting

Alarm Alarm Cause Remedy


priority
(23/31) APNOEA PRESSURE !! The apnea pressure alarm is
based on a time staggering.
In the Volume Control,
Pressure Control, SIMV/PS
modes with Freq ≥ 6 or in
Pressure Support mode
with apnea ventilation deacti-
vated:
Caution = PAW did not
exceed the pressure thresh-
old value for a duration of >15
seconds.
In the ManSpont, SIMV/PS
modes with Freq < 6 or in
Pressure Support mode
with apnea ventilation acti-
vated:
Caution = PAW did not
exceed the pressure thresh-
old value for a duration of >30
seconds.
Breathing/ventilation Check ventilator.
stopped.
Leakage or disconnection in Check breathing system.
the breathing system.

Instructions for use Fabius plus SW 3.n 163


Troubleshooting

Alarm Alarm Cause Remedy


priority
(23/31) APNOEA PRESSURE !!! The apnea pressure alarm is
based on a time staggering.
In the Volume Control,
Pressure Control, SIMV/PS
modes with Freq ≥ 6 or in
Pressure Support mode
with apnea ventilation deacti-
vated:
Warning = PAW did not
exceed the pressure thresh-
old value for a duration of >30
seconds.
In the ManSpont, SIMV/PS
modes with Freq < 6 or in
Pressure Support mode
with apnea ventilation acti-
vated:
Warning = PAW did not
exceed the pressure thresh-
old value for a duration of >60
seconds
Breathing/ventilation Check ventilator.
stopped.
Leakage or disconnection in Check breathing system.
the breathing system.
(20) APNOEA VENTILATION !! Breathing/ventilation Check ventilator.
stopped.
Leakage or disconnection in Check breathing system.
the breathing system.
If two or more successive Fabius detects a sponta-
breaths of the apnea ventila- neous breath of the patient.
tion are automatically trig- Check settings for Pres-
gered, the settings for sure Support.
Pressure Support are not
correct.
(7) BATTERY LOW ! No mains power and battery Restore mains power sup-
<20 % ply.
(17) BATTERY LOW !! No mains power and battery Restore mains power sup-
<10 % ply.

164 Instructions for use Fabius plus SW 3.n


Troubleshooting

Alarm Alarm Cause Remedy


priority
(26) CHECK APL VALVE !!! Fault in APL bypass valve. Check membrane of the
ventilator and close cover.
Check the connection of
the APL bypass valve and
for leakage. Select
Standby mode and then
switch to the previous ven-
tilation mode. Check APL
valve setting.
(7) CHECK BATTERY ! The backup power is 0 % of Replace fuse. Contact
the full charge. DrägerService or the
authorized local service
partner.
(31) CONTINUOUS PRESSURE !!! Airway pressure above Check breathing system.
threshold value for more than Check fresh-gas flow in
15 seconds. mode ManSpont. Check
the set limit value for
the pressure threshold
value.
(5) EXP PORT LEAKAGE !! In mode Volume Control, Check expiratory valve and
Pressure Control, or Pres- valve disk. Check hose line
sure Support an expiratory of the expiratory control
flow of more than 15 mL was line. Check flow sensor.
measured during the inspira- Perform the procedure for
tion. calibration of the flow sen-
sor (see page 133). Con-
tact DrägerService or the
authorized local service
partner.
(16) EXP PRESSURE HI !! In an automatic ventilation Check PEEP/PMAX hoses
mode PEEP is more than and other hoses for kinks.
4 cmH2O (hPa) above the
setting for PEEP.
(4) FLOW SENSOR CAL DUE ! More than 18 hours have Perform the procedure for
passed since the last sensor calibration of the flow sen-
calibration. The cable was sor, (see page 133).
removed and reconnected.

Instructions for use Fabius plus SW 3.n 165


Troubleshooting

Alarm Alarm Cause Remedy


priority
(8) FLOW SENSOR FAIL ! Sensor cable is not con- Reconnect the sensor
nected. cable to the sensor of the
breathing system.
(8) FLOW SENSOR FAIL ! The flow sensor was not cor- Perform the procedure for
rectly calibrated. Sensor calibration of the flow sen-
error. sor, (see page 133).
Replace sensor and cali-
brate. Contact DrägerSer-
vice or the authorized local
service partner.
(21) FRESH GAS LOW !! Insufficient fresh-gas supply Ensure sufficient fresh-gas
in all ventilation modes. supply.
Hose blocked/kinked. Check hoses.
Leakage or disconnection in Check breathing system.
the breathing system.
(13) INSP O2 HIGH !! Inspiratory O2 concentration Check the setting of the
is above the upper alarm flow control valve and
limit. upper O2 alarm limit.
(31) INSP O2 LOW !!! Inspiratory O2 concentration Check O2 supply. Check
is below the lower alarm limit. the setting of the flow con-
trol valve and lower O2
alarm limit.
(11) INSP PRES NOT REACH !! The plateau pressure during Check the ventilator set-
ventilation in Pressure Con- tings, patient circuit and
trol, Pressure Support, or settings for PINSP.
SIMV/PS mode is more than
3 cmH2O (hPa) below the
PINSP setting and the
expected PLAT value.
(14) MINUTE VOLUME HIGH !! The minute volume has
exceeded the upper alarm
limit.
The flow sensor was not cali- Calibrate the flow sensor
brated. (see page 133).
Sensor error. If necessary, replace the
flow sensor (see page 67).

166 Instructions for use Fabius plus SW 3.n


Troubleshooting

Alarm Alarm Cause Remedy


priority
(22) MINUTE VOLUME LOW !! The minute volume is below Check the breathing sys-
the lower alarm limit. tem and alarm limit.
Hose blocked/kinked. Check breathing system.
Leakage in breathing system. Check breathing system.
Reduced volume due to pres- Check setting for PMAX.
sure limitation.
Reduced lung compliance. Check ventilator settings.
Flow sensor not calibrated or Perform the procedure for
faulty. calibration of the flow sen-
sor, (see page 133).
Replace sensor and cali-
brate.
(31) NO FRESH GAS !!! Insufficient fresh-gas supply. Ensure sufficient fresh-gas
supply.
Valve for fresh-gas delivery is Open valve for fresh-gas
closed. Underpressure safety delivery.
valve is automatically
opened.
(6) O2 SENSOR CAL DUE ! More than 18 hours have Perform the procedure for
passed since the last O2 sen- calibration of the O2 sensor
sor calibration. (see page 134).
(8) O2 SENSOR FAIL ! The O2 sensor was not cor- Perform the procedure for
rectly calibrated. calibration of the O2 sensor
(see page 134).
O2 sensor replaced and/ or Perform the procedure for
not calibrated. calibration of the O2 sensor
(see page 134).
O2 sensor used up. Replace the sensor cap-
sule and calibrate it, (see
page 134).
O2 sensor not connected. Connect O2 sensor unit.
Sensor cable faulty. Replace O2 sensor housing
unit.
(30) O2 SUPPLY LOW !!! The value for the O2 supply Check O2 supply and
line has fallen below the per- backup cylinder.
missible minimum pressure
of 20 psi (approx. 1.4 kPa x
100).
(9) PEEP HIGH ! In ManSpont mode, PEEP is Check APL valve setting
above 8 cmH2O (hPa). and/or fresh-gas flow.

Instructions for use Fabius plus SW 3.n 167


Troubleshooting

Alarm Alarm Cause Remedy


priority
(7) POWER FAIL ! Fabius not connected to Plug in the mains plug.
mains power. General power
failure.
(1) PRES APNOEA ALARM OFF ! Pressure alarm messages Activate the pressure alarm
are deactivated in mode messages.
ManSpont.
(2) PRES THRESHOLD LOW ! The ventilation parameters Press AutoSet softkey and
are modified without chang- check ventilator settings.
ing the alarm settings (see
chapter ''Changing the alarm
limits'' on page 141).
(9) PRESSURE LIMITING ! (Mode The measured pressure is Check the ventilator set-
Volume Control) the same as the ventilator tings and settings for
setting for PMAX or exceeds PMAX.
it.
(25) PRESSURE NEGATIVE !!! The measured PAW value is Check the breathing sys-
≤6.5 cmH2O (hPa). tem and ventilator settings.
(8) PRESSURE SENSOR FAIL ! Sensor faulty or pressure not Contact DrägerService or
calibrated. the authorized local service
partner.
(1) RS232 COM1 FAIL ! External monitor cable not Check connection cable of
connected with external com- the monitor.
munication connector 1.
(1) SPEAKER FAIL ! Speaker is not ready for oper- Contact DrägerService or
ation. the authorized local service
partner.
(28) VENTILATOR FAIL !!! Ventilator not mounted cor- Check membrane and
rectly. close cover. Check whether
the PEEP/PMAX line is
connected and without
leakage. Select Standby
mode and then switch to
the previous ventilation
mode.
(1) VOLUME ALARMS OFF ! Volume alarms deactivated Reactivate the volume
by user. alarms.

168 Instructions for use Fabius plus SW 3.n


Cleaning, disinfection and sterilization

Cleaning, disinfection and sterilization

Disassembly................................................... 170
Observe before disassembling ........................ 170
Sequence of disassembly................................ 170
Information concerning dismounted accessory
parts and attached devices.............................. 171
Removing the compact breathing system .. 172
Removing the inspiratory valve ....................... 172
Removing the expiratory valve ........................ 172
Removing the exhaust port.............................. 172
Removing the flow sensor ............................... 173
Removing the APL valve ................................. 173
Removing the ventilator parts.......................... 173
Removing the anesthetic gas receiving system
........................................................................ 173
Removing the endotracheal suction system.... 174
Reprocessing procedures ............................ 174
Classification of medical devices..................... 174
Testing of procedures and agents ................... 174
Non-critical medical devices ............................ 175
Semi-critical medical devices .......................... 175
Visual inspection.............................................. 176
Sterilization ...................................................... 177
Reprocessing list........................................... 178
Uncritical medical devices ............................... 178
Semicritical medical devices............................ 180
Before using on patients again .................... 181

Instructions for use Fabius plus SW 3.n 169


Cleaning, disinfection and sterilization

Disassembly

Observe before disassembling 11 Remove the compact breathing system:


– Remove the breathing system cover
 Switch off the device and accessory devices (optional).
and remove their mains plugs. – Remove the inspiratory valve.
– Remove the expiratory valve.
Sequence of disassembly – Unscrew the exhaust port.
– Unscrew the inspiratory port and the
1 Unscrew the sample line and dispose of. expiratory port.
2 Remove the flow sensor cable. – Remove the flow sensor.
3 Remove the O2 sensor and the O2 sensor – Unscrew the APL valve.
cable.
WARNING
4 Remove the pressure measurement hose.
Risk of damage to breathing system
5 Remove the APL bypass hose and the
PEEP/PMAX hose. If the APL valve is not disassembled before
the breathing system is reprocessed, this can
6 Remove the water trap.
lead to leakages in the breathing system.
7 Disassemble the CO2 absorber:
Always remove the APL valve prior to
 CLIC absorber (disposable) or
reprocessing.
 Reusable CO2 absorber:
– Unscrew the CO2 absorber from the CAUTION
breathing system.
Risk of injury due to breathing system heating
– Remove and dispose of the soda lime
dust filter (optional). When the breathing system heating is switched
– Empty the CO2 absorber. on, the bottom side of the compact breathing
system and the heating plate beneath it can
– Remove the absorber insert from the
become hot.
absorber container. Leave the inner and
outer sealing rings on the absorber Allow the breathing system to cool off before
insert. removing.
8 Remove the breathing bag.
12 Remove the ventilator parts.
9 Disassemble the breathing circuit and the
filters. NOTE
10 Unscrew the holder for the breathing bag. To prevent accidental penetration of soda lime
into the breathing system, do not transport the
breathing system with a filled reusable CO2
absorber.

170 Instructions for use Fabius plus SW 3.n


Cleaning, disinfection and sterilization

Information concerning dismounted CAUTION


accessory parts and attached devices
Material damage due to disinfectants
Observe the instructions for use of the following When the sample line is disinfected and residues
accessory parts: of the agent remain in the sample line, these
residues can get into the water trap and the gas
Accessory parts measurement module later. This may result in
faulty measurements.
– Flow sensor
Sample lines are single-use items and may not
– CLIC adapter
be disinfected.
– CLIC absorber, Infinity ID CLIC absorber
– Breathing hoses
– Filter
– Breathing bag
– Masks
– Water trap
– Vaporizer

Attached devices
– Endotracheal suction
– Hinged arms
– Monitors
– Sensors and cables
– IT systems
– AGS

Single-use articles without instructions for use


– Soda lime dust filter (optional)
– Sample line

WARNING
Risk of infection
Used sample lines may be infectious due to
the breathing gases that passed through
them.
Replace the sample lines regularly, see table
''Semicritical medical devices''.

Instructions for use Fabius plus SW 3.n 171


Cleaning, disinfection and sterilization

Removing the compact breathing system

Before removing the compact breathing system, Removing the expiratory valve
the following hoses and cables must be removed:
– Flow sensor cable 1 Screw off the cap nut (G).
– O2 sensor cable and O2 sensor capsule 2 Remove the sight glass (H).
– Pressure measurement hose 3 Take out the valve plate (I).
– APL bypass hose 4 Remove the sealing ring (J) from the socket
(K).
– PEEP/PMAX hose

Removing the exhaust port


Removing the inspiratory valve

A G
B
C H
D I
E J
F K A
20980

1 Remove the valve cover plug (B) or the O2


sensor from the dome (C) of the inspiratory
20994

valve.
2 Screw off the cap nut (A).  Screw off the exhaust port (A).
3 Remove the dome (C).
4 Take out the valve plate (D).
5 Remove the sealing ring (E) from the socket
(F).

172 Instructions for use Fabius plus SW 3.n


Cleaning, disinfection and sterilization

Removing the flow sensor Removing the ventilator parts

A
B

A B C C
D
20982

20979
1 Loosen the expiratory port (A) and remove. 1 Open the ventilator door.
2 Remove the flow-sensor guard (B). 2 Remove the pressure sensor line (B) of the
3 Remove the flow sensor (C). ventilator chamber from the corresponding
connection.
3 Release the 3 clamps (D).
Removing the APL valve 4 Remove the cover (A).
5 Remove the ventilator membrane (C).

Removing the anesthetic gas receiving


system

To disassemble, follow the steps in reverse order


as listed in chapter ''Connecting the anesthetic gas
A receiving system (optional)'' on page 60.
20945

1 Loosen the knurled nut (A).


2 Remove the valve.

Instructions for use Fabius plus SW 3.n 173


Cleaning, disinfection and sterilization

Removing the endotracheal suction WARNING


system
Risk of infection
 Remove the suction regulator and suction The contents of the suction bottle can be
bottle, see the associated instructions for use. highly infectious.
– When emptying the suction container,
wear protective gloves.
– Follow the hospital hygiene regulations.

Reprocessing procedures

Non-critical medical devices


WARNING
Manual disinfection with simultaneous cleaning:
Risk of infection
– Incidin Extra N from Ecolab
Use validated reprocessing procedures when
reprocessing the device and accessories. – Incidur from Ecolab

Semi-critical medical devices


Classification of medical devices Manual cleaning:
For reprocessing, the medical devices and their – Neodisher FA, Neodisher Medizym from Dr.
components are classified according to their type Weigert
of application and the resulting risks: Manual disinfection:
– Non-critical medical devices: Surfaces – Korsolex extra from Bode Chemie
accessible to the user and patient, e.g., device
surfaces, cables – Gigasept FF from Schülke & Mayr

– Semi-critical medical devices: parts conducting Machine cleaning:


breathing gas, e.g., breathing hoses, masks – Neodisher FA, Neodisher Medizym from Dr.
Weigert
Machine disinfection:
Testing of procedures and agents
– Thermal, 93 °C (199.4 °F) for 10 minutes
The cleaning, disinfection, and sterilization of Sterilization:
medical devices were tested using the following
procedures and agents. The following agents – Hot steam, 134 °C (273.2 °F) for 5 minutes
showed good material compatibility and
effectiveness at the time of the test:

174 Instructions for use Fabius plus SW 3.n


Cleaning, disinfection and sterilization

Non-critical medical devices Semi-critical medical devices

Manual disinfection with simultaneous Manual cleaning


cleaning
Perform manual cleaning preferably under flowing
When selecting a suitable disinfectant, adhere to water and with commercially available cleaning
the country-specific lists of disinfectants. The list of agent (pH value ≤ 12).
the German Association for Applied Hygiene
Procedures:
(Verbund für Angewandte Hygiene VAH) applies in
German-speaking countries. 1 Wash off surface soiling under flowing water.
Strictly observe the manufacturer's specifications 2 Use cleaning agents in accordance with
on the disinfectants. Manufacturers may change manufacturer’s specifications. Make sure that
the composition of disinfectants over time. all surfaces and interior spaces to be cleaned
Procedures: can be reached. Use suitable brushes if
necessary.
1 Remove soiling immediately with a cloth
soaked in disinfectant. 3 Thoroughly rinse components under running
water until cleaning agent residues are no
WARNING longer discernible.
4 Inspect components for visible soiling and
Risk of electric shock or device malfunction
damage. Repeat manual cleaning if
Liquid that enters into the device can cause necessary.
the device to malfunction or may damage the
device and endanger the patient.
Manual disinfection
Only scrub-and-wipe-disinfect device
When selecting a suitable disinfectant, adhere to
surfaces and cables and make sure no liquids
the country-specific lists of disinfectants. The list of
penetrate into the device.
the German Association for Applied Hygiene
2 Perform surface disinfection by scrubbing and (Verbund für Angewandte Hygiene VAH) applies in
wiping. German-speaking countries.

3 Remove disinfectant residues after the contact Strictly observe the manufacturer's specifications
time has elapsed. on the disinfectants. Manufacturers may change
the composition of disinfectants over time.
Procedures:
1 Disinfect components by immersing.
2 After the contact time has elapsed, rinse the
components thoroughly under running water
until disinfectant residues are no longer
discernible.
3 Inspect components for visible soiling and
damage. Repeat manual disinfection if
necessary.
4 Shake off all excess water. Allow components
to dry thoroughly.

Instructions for use Fabius plus SW 3.n 175


Cleaning, disinfection and sterilization

Machine cleaning and disinfection Visual inspection


Perform machine cleaning and disinfection with a
washer-disinfector in accordance with EN ISO Check all parts for damage and external wear such
15883, preferably with a cart for anesthesia as cracking, brittleness or severe hardening, and
accessories and ventilation accessories. remnants of contamination.

Procedures: CAUTION
1 Strictly observe the instructions for use of the Risk from faulty accessories
washer-disinfector.
Even reusable accessories have a limited
2 Position the parts in the basket in a stable
maximum period of use, e.g., residues from
position. Make sure that all interior spaces and
disinfectants can attack the material in the
surfaces are completely flushed and water can
autoclave. Signs of external wear can show up,
drain off freely.
e.g., cracks, deformation, discoloration, or
3 Use a suitable cleaning agent. delamination).
4 Select a suitable program, preferably If signs of external wear occur, replace the
anesthesia program. affected accessory.
– Cleaning must be performed at 40 °C to
60 °C (104 °F to 140 °F) for at least CAUTION
5 minutes.
Risk of failure of flow measurement
– Thermal disinfection must be performed at
80 °C to 95 °C (176 °F to 203 °F) and with Improper reprocessing and soiling, such as
corresponding contact time. deposits or particles, can damage the flow
5 Carry out final rinsing with demineralized water. sensor.
– No machine cleaning or disinfection
6 Immediately remove the components from – No plasma sterilization or radiation
washer-disinfector. sterilization
7 Inspect components for visible soiling and – No water jets, compressed air, brushes or the
damage. If necessary, repeat the program or like
perform manual cleaning or manual – No ultrasonic bath
disinfection. – No hot-steam sterilization with Spirolog and
Infinity ID flow sensors
8 Allow components to dry thoroughly.
– Clean and disinfect the flow sensor in
accordance with the corresponding
WARNING
instructions for use.
Risk of device failure – For disinfecting the flow sensor use only
clean disinfectant solutions.
If the control areas located in the valve plate
are not sufficiently dried, this may
compromise the device function or may lead
to failure of the medical device.
After cleaning, the breathing system must be
sterilized with steam until it is completely dry.

176 Instructions for use Fabius plus SW 3.n


Cleaning, disinfection and sterilization

WARNING
Risk of fire
Residual vapors of easily flammable
disinfectants (e.g., alcohols) and deposits
that were not removed during reprocessing
can ignite when the flow sensor is in use.
– Ensure particle-free cleaning and
disinfection.
– After disinfection, allow the flow sensor to
air for at least 30 minutes.
– Before inserting the flow sensor, check for
visible damage and soiling such as
residual mucus, medication aerosols, and
particles.
– Replace flow sensors when damaged,
soiled, or not particle-free.

Sterilization

Sterilization eliminates living microorganisms from


semicritical medical devices and dries residual
water in the interior of components.
 Sterilize only components that have been
cleaned and disinfected.
For sterilization, use a vacuum steam sterilizer (in
accordance with DIN EN 285), preferably with
fractional vacuum.

Instructions for use Fabius plus SW 3.n 177


Cleaning, disinfection and sterilization

Reprocessing list

Applicable to non-infectious patients.


The reprocessing list contains approximate values
only. The instructions of the hospital’s infection
control officer responsible have priority.

Uncritical medical devices

Items which can be reprocessed Recommended repro- Manual


cessing intervals Cleaning Disinfection
Control elements and device sur- After each patient Outside Outside
faces including:
– Screen
– Softkeys
– Rotary knob
– O2 flush key
– Flow control valves
– APL valve
– Writing tray
– Grip bar on trolley
– Drawer handles
– Standard rails on both sides
– Clic adapter, Clic absorber

178 Instructions for use Fabius plus SW 3.n


Cleaning, disinfection and sterilization

Items which can be reprocessed Recommended repro- Manual


cessing intervals Cleaning Disinfection
Other surfaces which are fre- Daily Outside Outside
quently touched:
– Side parts of the housings of
the screen and of other patient
monitors
– Accessory parts:
– Storage trays
– Shelf
– Hinged arms
– Probes of compressed gas
hoses
– Mains plug
– Gas cylinder valves
– Transfer hose of the anes-
thetic gas receiving system
– Cables and hoses that lie
on floor
– Brake
Surfaces which are touched less Weekly Outside Outside
frequently:
– Network cables and data
cables
– Compressed gas hoses
– Pressure reducers
– Gas cylinders
– Drawer surfaces, outside and
inside
– Anesthetic gas receiving sys-
tem
– Holder for sample line

Instructions for use Fabius plus SW 3.n 179


Cleaning, disinfection and sterilization

Semicritical medical devices

Items which can be Recommended Pre- Machine Manual Steriliza-


reprocessed reprocessing cleaning cleaning and Cleaning Disinfec- tion
intervals disinfection tion
Breathing system: Weekly Yes Yes Possible Possible Possible
– Breathing system
housing
– Inspiratory/expira-
tory ports, APL
valve
– Inspiratory valve,
expiratory valve
– Bag elbow
– Rigid arm for
breathing bag
(optional)
– Flexible arm for
breathing bag
(optional)
– Breathing hoses After each patient Observe the associated instructions for use.
Absorber container Weekly Yes Yes Possible Possible Possible
and absorber insert
Soda lime dust filter Replace each No No No No No
(optional) time soda lime is
changed.
Sample line Replacement
only
– When the sample Daily
line is fitted to the
filter on the Y-
piece.
No No No No No
– When the sample After each patient
line is fitted directly
to the Y-piece and
the filters are fit-
ted on the breath-
ing system
Ventilator lid After each patient Yes Yes No Yes Yes
Ventilator membrane After each patient Yes Yes No Yes Yes
Ventilator hose After each patient Observe the associated instructions for use.

180 Instructions for use Fabius plus SW 3.n


Cleaning, disinfection and sterilization

Items which can be Recommended Pre- Machine Manual Steriliza-


reprocessed reprocessing cleaning cleaning and Cleaning Disinfec- tion
intervals disinfection tion
Flow sensor Weekly Observe the associated instructions for use.

Before using on patients again

1 Assemble the device components, see


''Assembly and preparation'' on page 50.
2 Mount the parts in the reverse oder of the
disassembly, see ''Disassembly'' on page 170.
3 Check readiness for operation, see ''Checking
the readiness for operation'' on page 88.

Instructions for use Fabius plus SW 3.n 181


Maintenance

Maintenance

Overview ........................................................ 183

Inspection ...................................................... 184


Safety checks .................................................. 184
Preventive maintenance ............................... 185

Repair ............................................................. 186

182 Instructions for use Fabius plus SW 3.n


Maintenance

Overview

This chapter describes the required maintenance


WARNING
measures required to maintain the proper
functioning of the medical device. Maintenance Risk of electric shock
measures must be performed by the personnel
There are conducting components under the
responsible.
housing cover.
– Do not remove the housing cover.
WARNING
– Maintenance measures must be
Risk of infection performed by the personnel responsible.
Dräger recommends DrägerService for
The responsible personnel may be infected
repairs and complex maintenance tasks.
by pathogenic germs.
Disinfect and clean device or device parts WARNING
before any maintenance measures and also
before returning the medical device for repair. Risk of fire
When replacing the battery, short-circuits or
excessive temperatures can occur, resulting
in fire or explosion.
The battery must only be replaced by experts.

Definitions of maintenance terms

Term Definition
Maintenance All measures (inspection, preventive maintenance, repair) intended to maintain
and restore the functional condition of a medical device
Inspection Measures intended to determine and assess the actual state of a medical device
Service Recurrent specified measures intended to maintain the functional condition of a
medical device
Repair Measures intended to restore the functional condition of a medical device after a
device malfunction

Instructions for use Fabius plus SW 3.n 183


Maintenance

Inspection

Inspections must be carried out regularly


according to the following guidelines and within the
specified intervals. Technical documentation is
available on request.

Checks Interval Personnel responsible


1)
Inspection and safety checks Every 12 months Experts
1) Designation applies to the Federal Republic of Germany; corresponds to the “Recurring safety inspection” in the Federal
Republic of Austria

Safety checks

The safety checks are no substitute for service – Check the function of the O2 flush.
measures indicated by the manufacturer, including – Check the function of the pressure reducer
the preventive replacement of wearing parts. (optional) of the compressed gas cylinder.

WARNING 3 Check that the device combination is in good


condition:
Risk of medical device failure – All labels are complete and legible
If safety checks are not performed on a – There is no visible damage
regular basis, the proper operation of the – Fuses which are accessible from the
medical device can be compromised. outside are in compliance with the specified
Perform safety checks at the indicated values
intervals. – Country-specific labeling of gas types
4 Using the instructions for use, check that all
1 Check accompanying documents:
components and accessories needed to use
– Latest instructions for use are available the product are available.
2 Perform a functional test of the following 5 Check for electrical safety in compliance with
features according to the instructions for use: IEC 62353.
– Check the proper function of the flow 6 Check safety features:
measurement.
– Check the functional state of the optical and
– Check the function of the pressure acoustic alarm generators.
measurement based on parameters PAW,
– Check the functional state of the O2 failure
PEEP, PMAX.
alarm.
– Check the proper function of the O2
– Check the locking device of the anesthetic
measurement
vaporizer.
– Check the function of the anesthetic
– Check the function of the power failure
vaporizer according to the associated
alarm and the battery function.
instructions for use.
– Check S-ORC functionality.

184 Instructions for use Fabius plus SW 3.n


Maintenance

Preventive maintenance

WARNING WARNING
Risk of faulty components Risk of electric shock
Device failure is possible due to wear or Before performing any service work,
material fatigue of the components. disconnect all electrical connections and gas
connections from power and gas supplies.
To maintain the function of all components,
this device must be inspected and serviced at
the intervals specified by the manufacturer.

The following table shows the preventive maintenance intervals:

Component Interval Measure Personnel responsible


CO2 absorber If colored violet Replace Users
Water trap As needed or if Replace Users
soiled
Flow sensor As needed or if Clean/Replace Users
calibration is no
longer possible
Internal lithium battery Every 36 months Replace Experts
Fabius plus Every 12 months Inspection and service Experts
Breathing system Every 12 months Inspection and service Service personnel
Vaporizers Every 12 months Inspection and service Service personnel
Sensors Every 12 months Inspection and service Service personnel
Lead-gel battery Every 3 years Replace Experts
Cylinder pressure reducer for After 6 years Basic overhauling Experts
high-pressure cylinders1)
Pressure reducer for Pin- After 6 years Replace Experts
index1)
1) optional

Instructions for use Fabius plus SW 3.n 185


Maintenance

Repair

For repairs, Dräger recommends DrägerService


and the use of original Dräger parts.

186 Instructions for use Fabius plus SW 3.n


Disposal

Disposal

Disposing of the medical device.................. 188


For countries subject to the EU Directive
2002/96/EC...................................................... 188
Disposal of accessories................................ 188

Disposal of non-rechargeable batteries ...... 189

Instructions for use Fabius plus SW 3.n 187


Disposal

Disposing of the medical device

WARNING
For countries subject to the EU
Directive 2002/96/EC
Risk of infection
The device and its components must be This device is subject to EU Directive 2002/96/EC
disinfected and cleaned before disposal! (WEEE). In order to comply with its registration
according to this directive, this device may not be
At the end of its service life: disposed of at municipal collection points for waste
electrical and electronic equipment. Dräger has
 Have the medical device appropriately
authorized a company to collect and dispose of
disposed of in accordance with applicable laws
this device. To initiate collection or for further
and regulations.
information, visit Dräger on the Internet at
www.draeger.com. Use the search function with
the keyword "WEEE" to find the relevant
information. If access to the Dräger website is not
possible, contact the local Dräger organization.

Disposal of accessories

When disposing of the following accessory parts,


observe the hospital hygiene regulations and the
respective instructions for use:
– Flow sensor
– Breathing hoses
– Filter, HME, HMEF
– Breathing bag
– Masks
– Water trap
– CLIC absorber, Infinity ID CLIC absorber
– Soda lime
Dispose on the following articles according to
hospital hygiene regulations:
– Sample line
– Soda lime dust filter
– Anesthetic gas receiving system

188 Instructions for use Fabius plus SW 3.n


Disposal

Disposal of non-rechargeable batteries

WARNING
Risk of explosion and chemical burns
Improper handling of batteries can result in
explosions and chemical burns.
– Do not throw batteries in the fire.
– Do not force batteries open.

 Do not recharge batteries.


The following applies to the Federal Republic of
Germany: According to the battery law, the end
user is obligated to return batteries containing toxic
material to the distributor or the public waste
management organization. The battery used in this
device must therefore be removed by experts prior
to disposal of the device. In countries other than
Germany the respective national regulations must
be complied with.

Instructions for use Fabius plus SW 3.n 189


Technical data

Technical data

General information ...................................... 191 Device combinations .................................... 214

Ambient conditions....................................... 191 Connections to IT networks ......................... 215


Information for connecting to an IT network .... 215
Device data .................................................... 192
Illustrations .................................................... 216
Fuses .............................................................. 195
Gas flow plan of the breathing system ............ 216
External fresh-gas outlet .............................. 195 Gas delivery unit (3-gas version)..................... 217

Electrical safety ............................................. 195

General safety standards for anesthesia


workstations .................................................. 196

Ventilator........................................................ 198

Anesthetic gas supply module .................... 200

Vaporizer interface ........................................ 201

Breathing system .......................................... 203

Alarm for low oxygen supply pressure ....... 206

Alarm tone sequence IEC ............................. 206

Characteristics of additional acoustic


signals ............................................................ 206

S-ORC (Sensitive Oxygen Ratio Controller) 207

Device outlets ................................................ 207

Essential performance characteristics ....... 208

EMC declaration ............................................ 209


General information......................................... 209
Electromagnetic emissions.............................. 209
Electromagnetic environment.......................... 210
Electromagnetic immunity ............................... 211
Recommended safety clearance for portable
and mobile high-frequency communication
equipment........................................................ 213
Reduced safety clearance for portable and
mobile high-frequency communication
equipment........................................................ 213

190 Instructions for use Fabius plus SW 3.n


Technical data

General information

Units of measurement for pressure 1 hPa = 1 mbar = 1 cmH2O


100 kPa = 0.1 MPa = 1 bar = 1 kPa x 100
All specified tolerances apply for 20 °C (68 °F),
60 % relative humidity, and 1013 hPa (760 mmHg).
The accuracies indicated below change according
to atmospheric pressure, temperature, and relative
humidity. If one of the ambient conditions is
changed up to the permissible limit, the accuracy of
the corresponding value can change by up to 50
%.If more than one of the ambient conditions are
changed, the accuracy may change by up to
100 %.Example: Accuracy of a pressure measure-
ment value: ±4 % at standard conditions. At 10 °C,
the accuracy changes to ±6 %; at 10 °C and 20 %
relative humidity, to ±8 %.
All patient-related volumes and flow values are nor-
malized to the conditions in the lungs. (BTPS)

Ambient conditions

During operation
Temperature 10 to 35 °C (50 to 95 °F)
Air pressure 700 to 1060 cmH2O (hPa)
Relative humidity 20 to 80 % (without condensation)
Height Up to 3000 m (9843 ft)

During storage and transport


Temperature -10 to 60 °C (14 to 140 °F)
Air pressure 700 to 1060 cmH2O (hPa)
Relative humidity 10 to 90 % (without condensation)

The conditions for use when using additional devices can limit the environment of use of a system as a
whole. Vaporizers and anesthetic agents can limit the use of an anesthesia workstation with regard to its
temperature range and maximum fresh-gas flow. Therefore when using additional devices, follow the
associated instructions for use.

Instructions for use Fabius plus SW 3.n 191


Technical data

Device data

Medical gas supply through central gas supply


Pressure range on device connection
O2, N2O, Air 41 to 87 psi (2.8 to 6 kPa x 100)
Note: Pressure fluctuations in the central gas sup-
ply must not exceed ±10 %
Gas supply connection NIST or DISS (if required)
(Every gas inlet is equipped with a non-return valve)
Accuracy of the pressure displays ±2 % of the maximum scale value + 4 % of dis-
played value

Medical gas supply from O2 and N2O cylinders


(with NIST scew connections)

Pressure at the device connection


O2, N2O 73 psi (5 kPa x 100)
(Every gas inlet is equipped with a non-return valve)

Medical gas supply from O2, O2 and N2O or O2


and Air cylinders
(with pin-index connections)

Cylinder connection Pin-index hanger yokes (CGA V-1-1994)


Gas cylinder pressure O2, Air 1900 psi (131 kPa x 100)
(normal full load at 21 °C, 70 °F) N2O 745 psi (51.3 kPa x 100)
Pressure gauge for gas cylinders In accordance with ASME B40.1 grade B
Pressure measurement range for gas cylinders O2 0 to 3000 psi (206.8 kPa x 100)
N2O 0 to 3000 psi (206.8 kPa x 100)
Air 0 to 3000 psi (206.8 kPa x 100)

Medical gas supply at device inlet


Dew point >5 °C (41 °F) at ambient temperature
Oil content <0.1 mg/m
Particles Dust-free air (filtered with pore size < 1 µm)

192 Instructions for use Fabius plus SW 3.n


Technical data

Opening pressure of the internal safety valve 70 psi (4.8 kPa x 100)

Protection class
Device I, in compliance with IEC 60601-1
Application parts, connections for breathing hoses Type BF

Classification in compliance with Directive II b


93/42/EEC, Annex IX

UMDNS Code Universal Medical Device Nomen- 10-134


clature System - nomenclature system for medi-
cal devices

GMDN Code Global Medical Device Nomencla- 37710


ture - worldwide nomenclature for medical
devices

Use of latex Not made with natural rubber latex.

Penetration of liquids IP20 in accordance with IEC 60529

Power supply
The power rating cannot be configured, with optional 100 to 240 VAC, 50/60 Hz, 2.3 A max
Dräger power socket strip (see instructions for use of
power socket strip for medical devices, 9038776)

Internal battery
Power rating 24 V; 3.5 Ah
Type Closed, lead/acid, gel
Charge time 16 hours on mains power for full operating time
Backup time with fully charged battery Minimum 45 minutes

Instructions for use Fabius plus SW 3.n 193


Technical data

Weight
Fabius plus as wall-mounted version:
Basic device with COSY but no gas cylinders or 69 kg(152.1 lb)
vaporizers
Total weight including all accessories 125 kg(275.5 lb)

Fabius plus as trolley version:


Basic device with COSY but no gas cylinders or 110 kg(242.5 lb)
vaporizers
Total weight including all accessories 280 kg(617.3 lb)

Dimensions W x H x D
Trolley version with compact breathing system and 2 91 x 140 x 77 cm (35.8 x 55 x 30.3 in)
vaporizer mounts1)
Wall-mounted version with compact breathing sys- 85 x 73 x 50 cm (33.5 x 28.7 x 19.7 in)
tem and 2 vaporizer mounts1)
1) Width varies depending on the position of the COSY arm

194 Instructions for use Fabius plus SW 3.n


Technical data

Fuses

Main fuses For 100 to 240 V power supply


2x T2.5AH 250 V IEC 60127-2/V
Size: Length 20 mm, ø5 mm (glass 4.4 mm)

Battery fuse 1x T3.15AH 250 V IEC 60127-2/V


Size: Length 20 mm, ø5 mm (glass 4.4 mm)

External fresh-gas outlet

Connection 22 mm outer taper / 15 mm inner taper (ISO)


Pressure limitation Max. 80 cmH2O (hPa) at 18 L/min
Fresh-gas flow 0 and 0.2 to 18 L/min

Electrical safety

In compliance with UL 60601-1


IEC 60601-1
CAN/CSA C22.2 No. 601.1-M90

Instructions for use Fabius plus SW 3.n 195


Technical data

General safety standards for anesthesia workstations

Relevant standards
In addition to the standards listed here, this medical
device meets various other standards, e.g., stan-
dards concerning special national requirements.
IEC 60601-1 2nd ed. Part 1:
Medical electrical equipment General requirements for safety

IEC 60601-1-2 Part 1-2:


Medical electrical equipment General requirements for safety, collateral stan-
dard: Electromagnetic compatibility – Requirements
and tests

IEC 60601-1-4 Part 1-4


Medical electrical equipment General requirements for safety, collateral stan-
dard: Programmable electrical medical systems

IEC 60601-1-8 Part 1-8:


Medical electrical equipment General requirements for safety, collateral stan-
dard: General requirements, tests, and guidance for
alarm systems in medical electrical systems

IEC 60601-2-13 Part 2-13:


Medical electrical equipment Particular requirements for the safety of anaesthetic
systems

ISO 8835-2 Part 2:


Systems for inhalational anaesthesia Anaesthetic breathing systems

ISO 8835-3 Part 3:


Systems for inhalational anesthesia Transfer and receiving systems of active anesthetic
gas scavenging systems

ISO 8835-4 Part 4:


Systems for inhalational anesthesia Anesthetic vapor delivery devices

ISO 8835-5 Part 5:


Systems for inhalational anesthesia Anesthetic ventilators

196 Instructions for use Fabius plus SW 3.n


Technical data

Relevant standards (continued)


ISO 21647 Particular requirements for the basic safety and
Medical electrical equipment essential performance of respiratory gas monitors

The following also apply for devices manufactured from July 2014 on:
IEC 60601-1 3rd ed. Part 1:
Medical electrical equipment General requirements for basic safety and essential
performance

IEC 60601-1-2 Part 1-2:


Medical electrical equipment General requirements for safety, collateral stan-
dard: Electromagnetic compatibility – Requirements
and tests

IEC 60601-1-8 Part 1-8:


General requirements for basic safety and essential
performance – collateral standard: General require-
ments, tests, and guidance for alarm systems in
medical equipment and medical electrical systems

ISO 80601-2-13 Part 2-13:


Medical electrical equipment Particular requirements for basic safety and essen-
tial performance of an anaesthetic workstation

ISO 80601-2-55 Part 2-55:


Particular requirements for basic safety and essen-
tial performance of respiratory gas monitors

Instructions for use Fabius plus SW 3.n 197


Technical data

Ventilator

In compliance with ISO 80601-2-13

Control ranges
Pressure limitation (PMAX) 15 to 70 cmH2O (resolution: 1 cmH2O)
(15 to 70 hPa (resolution: 1 hPa))
(setting must be at least 10 cmH2O (10 hPa)
above PEEP, in SIMV/PS mode, the PMAX set-
ting must be greater than ∆PPS+PEEP)
Tidal volume (VT) 20 to 1400 mL (resolution: 10 mL)
Tidal volume (VT) 20 to 1100 mL (resolution: 10 mL), in SIMV/PS
mode
Respiratory rate (Freq) 4 to 60 bpm (resolution: 1 bpm)
(4 to 60 1/min (resolution: 1/min))
Ratio of inspiratory time to expiratory time (TI:TE) 4:1 to 1:4
Inspiratory pause (TIP:TI) 0 % to 50 % (resolution: 1%)
Positive end-expiratory pressure (PEEP) 0 to 20 cmH2O (resolution: 1 cmH2O)
(0 to 20 hPa (resolution: 1 hPa))
Inspiratory pressure (PINSP) 5 to 65 cmH2O (resolution: 1 cmH2O)
(5 to 65 hPa (resolution: 1 hPa)) (setting must be
at least 5 cmH2O (5 hPa) above PEEP)
Inspiratory flow (Insp Flow) 10 to 75 L/min (resolution: 1 L/min) in Pressure
Control mode
10 to 85 L/min (resolution: 1 L/min) in Pressure
Support and SIMV/PS modes
Support pressure (∆PPS) 3 to 20 cmH2O (resolution: 1 cmH2O)
(3 to 20 hPa (resolution: 1 hPa)), in Pressure
Support mode
Support pressure (∆PPS) 3 to 20 cmH2O, OFF (resolution: 1 cmH2O)
(3 to 20 hPa OFF (resolution: 1 hPa)), in
SIMV/PS mode
Minimum respiratory rate for apnea ventilation (Freq 3 to 20 bpm (resolution: 1 bpm) and OFF
Min) (3 to 20 1/min (resolution: 1/min) and OFF)
Trigger value (Trigger) 2 to 15 L/min (resolution: 1 L/min)
Inspiratory time (TINSP) 0.3 bis 4.0 sec.

198 Instructions for use Fabius plus SW 3.n


Technical data

Accuracy
Pressure limitation (PMAX) ±5 cmH2O (±5 hPa) of the setting
Tidal volume (VT) ±5 % of the setting or 20 mL, depending on which
value is higher (discharged to atmosphere, no
compliance correction)
Respiratory rate (Freq) ±1 bpm (±1 1/min) of the setting or ±5 %, depend-
ing on which value is higher
Ratio of inspiratory time to expiratory time (TI:TE) ±5 % of the setting
Inspiratory pause (TIP:TI) ±25 % of the setting
Positive end-expiratory pressure (PEEP) ±2 cmH2O (±2 hPa) or ±20 % of the setting,
depending on which value is higher
Inspiratory pressure (PINSP) ±2 cmH2O (±2 hPa) or ±20 % of the setting,
depending on which value is higher

Overpressure safety valve 75 ±5 cmH2O (75 ±5 hPa)

Underpressure safety valve (inlet valve for ambi- -7.5 to -9 cmH2O (-7.5 to -9 hPa)
ent air)

Minimum pressure limit -9 cmH2O (-9 hPa)

Measuring the system compliance 0.2 to 6.0 mL/cmH2O (0.2 to 6.0 mL/hPa)
±0.2 mL/cmH2O (±0.2 mL/hPa) or ±10 % of the
actual compliance depending which value is
higher

Instructions for use Fabius plus SW 3.n 199


Technical data

Anesthetic gas supply module

Fresh-gas delivery, low-flow measuring tubes


(calibrated in accordance with IEC 60601-2-13 for Range and accuracy:
ambient air 20 °C (68 °F) (±3 °C), 1013 cmH2O
(hPa):
O2 0.02 to 10.0 L/min ±10 % of the indicated value
for flows between 1 and 10 L/min
N2O 0.02 to 10.0 L/min ±10 % of the indicated value
for flows between 1 and 10 L/min
Air 0.2 to 12.0 L/min ±10 % of the indicated value for
flows between 1 and 12 L/min

Fresh-gas flow stability


O2 and N2O: ±10% of the setting at supply pressures of 41 to 87 psi (2.8 to 6 kPa x 100)
Air: ±10% of the setting at supply pressures of 50 to 55 psi (3.4 to 3.8 kPa x 100).
Outside the range of 50 to 55 psi (3.4 to 3.8 kPa x 100), the Air flow varies proportionally to the supply
pressures.

O2 flush at 87 psi (6 kPa x 100): max. 75 L/min


at 41 psi (2.8 kPa x 100): min. 25 L/min

Pressure limit of the common gas outlet Maximum 13 psi (0.9 kPa x 100) ±5%

Flow tube for O2 supplemental delivery (optional)


Connection Stepped connection for use with hoses of different
diameters
Flow 0 to 10 L/min
Accuracy ±5 % of the measurement range
Resolution 0.5 L/min

200 Instructions for use Fabius plus SW 3.n


Technical data

Vaporizer interface

The anesthesia workstation is equipped with an interlock system.


When removing the vaporizer, the connection is automatically closed and sealed.
The following vaporizers can be used:

– Dräger-Vapor for halothane


– Dräger-Vapor for enflurane
– Dräger-Vapor for isoflurane
– Dräger-Vapor for sevoflurane
– Datex-Ohmeda Devapor/D-Tec for desflurane
– Dräger D-Vapor
Technical data of the vaporizers are contained in the corresponding instructions for use.

Measured value or Range Resolution Accuracy Condition


waveform
PAW Airway pressure -20 to 99 cmH2O 1 cmH2O ±4 %1)
(numeric) (hPa) (hPa)
Airway pressure 0 to 99 cmH2O
(waveform) (hPa)
Pressure gauge -20 to 80 cmH2O 2 cmH2O 1.28 cmH2O (hPa)
(mechanical) (hPa) (hPa)
MVe Expiratory minute 0 to 32.0 L/min 0.1 L/min ±15% or ±0.2 mL, Based on 20 °C
volume depending on which (68 °F) Ambient
value is higher2) pressure and satu-
rated gas
VTe Expiratory tidal 0 to 1500 mL 1 mL ±15 %2) or ±20 mL,
volume depending on which
value is higher

Instructions for use Fabius plus SW 3.n 201


Technical data

Measured value or Range Resolution Accuracy Condition


waveform
Note: If the end-tidal desflurane concentration increases to above 12%, the measurement accuracy of
the tidal volume and minute volume can deviate by more than 15%.
Freq Respiratory rate 2 to 99 bpm ±1 bpm ±1 bpm (±1 1/min) of
(1/min) (1/min) the setting or ±5%,
depending on which
value is higher
FiO2 O2 measurement 10 to 100 Vol% 1 Vol% ±2.5 Vol% +2.5 % of Based on the
in the mainstream the measured values in ambient pressure
accordance with during calibration
ISO 21647 and
ISO 80601-2-55
1) Max. ±4 % of the measured value or ±2 cmH2O (±2 hPa), depending on which value is higher.
2) With standard test conditions in accordance with ISO 80601-2-13.

O2 sensor
Response time (T90) Less than 16 seconds Measured values are not pressure
compensated.
Heat-up time after 5 minutes Error with ≤ 3% of the measured value
Drift sensitivity ±1 % of the measured value/ 8 h
Cross sensitivity 1 Vol% O2 at 70 Vol% N2O and 5 Vol%
CO2
With 4 Vol% halothane
or with 5 Vol% enflurane
or with 15 Vol% desflurane
or with 5 Vol% isoflurane
or with 10 Vol% sevoflurane
Measurement deviation due to Max. ±0.02% of the measured value per % relative humidity
humidity
Maximum period of use of O2 >12 months at 25 °C (77 °F), 50 % relative humidity, 50 % O2 in fresh
sensor cell gas (or >5000 hours at 100 Vol% O2)

202 Instructions for use Fabius plus SW 3.n


Technical data

Breathing system

Volume with reusable CO2 absorber


(including absorber volume, measured in ManSpont)
Filled, without hoses typically 4000 mL + volume of the breathing bag

Volume with Drägersorb CLIC adapter


(including absorber volume, measured in ManSpont)
Filled, without hoses typically 3700 mL + volume of the breathing bag

Absorber volume
Reusable CO2 absorber, filled 1500 mL
Disposable CO2 absorber CLIC absorber Free 1200 mL
Disposable CO2 absorber CLIC Absorber 800 Free 1200 mL

Compliance
including ventilator hose (without breathing hoses)
0.8 mL/cmH2O (0.8 mL/hPa)

Flexible arm for breathing bag (optional)


Volume 0.13 L
Compliance 0.13 mL/cmH2O (0.13 mL/hPa)

Rigid arm for breathing bag (optional)


Volume 0.11 L
Compliance 0.11 mL/cmH2O (0.11 mL/hPa)

Resistance
In accordance with ISO 80601-2-13, dry, with adult Inspiratory: Expira- -4.7 cmH2O (-4.7 hPa)
breathing hose set M301461) tory: 4.4 cmH2O (4.4 hPa)

In accordance with ISO 80601-2-13, dry, without hos- Inspiratory: Expira- -3.7 cmH2O (-3.7 hPa)
es1) tory: 3.7 cmH2O (3.7 hPa)

Typical leakage <50 mL/min

Instructions for use Fabius plus SW 3.n 203


Technical data

Control ranges
APL valve
Manual ventilation mode 5 to 70 cmH2O (hPa)
Spontaneous breathing 1.5 cmH2O (hPa)
mode
Accuracy from 5 to 15 L/min ±15 % of the set value or ±3 cmH2O (hPa) (the
higher value applies)
Pressure drop at 30 L/min 3.4 cmH2O (hPa)
(wet and dry)
1) Depending on the current ventilation settings, the indicated values may deviate by ±0.3 cmH2O (0.3 hPa)

204 Instructions for use Fabius plus SW 3.n


Technical data

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Instructions for use Fabius plus SW 3.n 205


Technical data

Alarm for low oxygen supply pressure

Alarm limit Warning signal (continuous tone 10 s, adjustable


from approx. 61 dB(A) to 74 dB(A)) as soon as the
pressure drops below 20 ±4 psi (1.4
±0.3 kPa x 100).
Alarm priority High priority (warning)
Optical alarm signal The red LED below the key flashes.

Alarm tone sequence IEC

Sound pressure level L(A) of the alarm tones at


the workstation, measured in accordance with
IEC 60601-1-8
Alarm volume (high priority) Settable from approximately 57 dB(A) to 70 dB(A)
Alarm volume (medium priority) Settable from approximately 52 dB(A) to 64 dB(A)
Alarm volume (low priority) Settable from approximately 49 dB(A) to 62 dB(A)

Characteristics of additional acoustic signals

Alarm in the event of failure of power supply and Continuous tone (approx. 30 s) at approx. 56 dB(A)
battery supply

Confirmation of selection using rotary knob Single tone when rotary knob is pressed
(approx. 55 dB(A) at max. alarm tone volume)

Time exceeded when changing ventilation mode 3 tones adjustable from 46 dB(A) to approx. 57
dB(A)

Selection of alarm volume Single tone per level (corresponds to volume of


alarm tone)

206 Instructions for use Fabius plus SW 3.n


Technical data

S-ORC (Sensitive Oxygen Ratio Controller)

At a flow of approx. 200 mL Set the N2O concentration in the fresh gas
between 0 and 75 %.
In case of insufficient O2 S-ORC limits the N2O concentration in the fresh
gas so that the O2 concentration does not drop
below 23 Vol%.

N2O flow control valve is open and at the same S-ORC prevents N2O flow.
time the O2 flow control valve is closed or set at
less than 0.2 L/min.

In case of N2O failure O2 can continue to be supplied. No alarm.

Device outlets

Serial interfaces COM 1


Only connect to devices that meet the require-
ments of IEC 60950-1 for ungrounded SELV
circuits and the requirements of IEC 60601-1
(as of the 2nd edition) for exposed secondary
circuits with maximum 24 Vdc nominal voltage.
Protocol Vitalink, MEDIBUS
Connector 9-pole Sub-D, galvanically isolated with 1.5 kV
against internal electronics, 0.5 kV against
housing
Baud rate 1200, 2400, 4800, 9600, 19200, 38400 baud
Data bits 7 or 8
Parity Uneven, even, none
Start bit 1
Stop bit 1 or 2

Instructions for use Fabius plus SW 3.n 207


Technical data

Pin assignment
Pin 1 n/c
Pin 2 TXD
Pin 3 RXD
Pin 4 n/c
Pin 5 GND
Pin 6 n/c
Pin 7 n/c
Pin 8 n/c
Pin 9 n/c

Essential performance characteristics

The essential performance features comprise:


– Supplying the anesthesia workstation with O2
If the O2 supply (central gas supply or gas
cylinder) fails, an alarm is issued.
– Supply of the patient with adequately
oxygenated breathing gas
If the breathing gas contains insufficient levels
of O2, an alarm is issued.
– Monitoring of the airway pressure and the
expiratory minute volume
Alarms are issued depending on the set alarm
limits.
– Measurement accuracy of the O2
measurement.
Alarms are issued depending on the set alarm
limits. If the O2 sensor fails, an alarm is issued.

NOTE
In accordance with general safety standards,
additional components are required for a
complete anesthesia workstation.

208 Instructions for use Fabius plus SW 3.n


Technical data

EMC declaration

General information Detailed radio frequency characteristics


Communication devices in accordance with
The EMC compliance of the product has been IEEE 802.11b:
evaluated with the external cables, transducers,
and accessories specified in the list of – 2412 to 2472 MHz
accessories. Other accessories which do not affect – DSSS (direct-sequence spread spectrum)
EMC compliance may be used if no other reasons limited to 100 mW
forbid their use (see other sections of the
– Applicable to access points and client adapters
instructions for use).The use of noncompliant
accessories can result in increased emissions or Communication devices in accordance with
decreased immunity of the medical device. IEEE 802.15.1:
The medical device must only be used adjacent to – 2400 to 2485 MHz
or stacked with other devices if this configuration is – FHSS (frequency-hopping spread spectrum)
approved by Dräger. If adjacent or stacked use of limited to 2.5 mW
configurations not approved by Dräger is
inevitable, verify correct functioning of the medical See the instructions for use of the wireless devices
device in this configuration before it is used. In any for further details.
case, strictly observe the instructions for use of the
other devices.

Electromagnetic emissions

When using wireless networking, be aware that the


system operates at 2.4 GHz range. Other
equipment, even if compliant with CISPR emission
requirements, can interfere with reception of
wireless data. When selecting wireless systems
(wireless communication media, pager systems,
etc.) for use in installations where wireless
networking is used, care must always be used to
ensure that operating frequencies are compatible.
For example, selecting wireless communication
media that operate at 2.4 GHz will likely cause
difficulty with the networking components. Low-
level signals such as ECG signals are particular
susceptible to interference from electromagnetic
energy.Even if the equipment meets the test
requirements described below, smooth operation
cannot be guaranteed – the ‘quieter‘ the electrical
environment the better.In general, increasing the
distance between electrical devices decreases the
likelihood of interference.

Instructions for use Fabius plus SW 3.n 209


Technical data

Electromagnetic environment

The medical device is intended for use in an


electromagnetic environment as specified below.
The user must ensure that the medical device is
used in such an environment.

Emissions Compliance according to Electromagnetic environment


Radio frequency emissions Group 1 The medical device uses radio
(CISPR 11) frequency energy only for its
internal function. Therefore, its
radio frequency emissions are
very low and are not likely to
cause any interference in nearby
electronic equipment.
Class A The medical device is suitable for
use in all establishments other
than domestic establishments
and those directly connected
(without transformer) to the public
low-voltage power supply net-
work that supplies buildings used
for domestic purposes.
Harmonic emissions (IEC 61000- Not applicable
3-2)
Voltage fluctuations/flicker emis- Not applicable
sions (IEC 61000-3-3)

210 Instructions for use Fabius plus SW 3.n


Technical data

Electromagnetic immunity

The medical device is intended for use in an


electromagnetic environment as specified below.
The user must ensure that the medical device is
used in such an environment.

Immunity against IEC 60601-1-2 test Compliance level Electromagnetic environ-


level (medical device) ment
Electrostatic discharge Contact discharge: ±6 kV Floors should be wood, con-
(ESD) ±6 kV crete, or ceramic tiles. If
(IEC 61000-4-2) Air discharge: ±8 kV ±8 kV floors are covered with syn-
thetic material, the relative
humidity should be at least
30 %.
Electrical fast tran- Power supply lines: ±2 kV Mains voltage quality should
sients/bursts ±2 kV be that of a typical commer-
(IEC 61000-4-4) Longer input lines/out- ±1 kV cial or hospital environment.
put lines: ±1 kV
Surges Common mode: ±2 kV ±2 kV Mains voltage quality should
(IEC 61000-4-5) Differential mode: ±1 kV ±1 kV be that of a typical commer-
cial or hospital environment.
Magnetic field with sup- 3 A/m 3 A/m Power frequency magnetic
ply frequency fields should be at levels
(50/60 Hz) characteristic of a typical
(IEC 61000-4-8) commercial or hospital envi-
ronment.
Voltage dips and short Voltage dip >95 %, >95 %, Mains voltage quality should
interruptions of supply 0.5 periods 0.5 periods be that of a typical commer-
voltage Voltage dip 60 %, 60 %, cial or hospital environment.
(IEC 61000-4-11) 5 periods 5 periods If the user of the medical
device requires continued
Voltage dip 30 %, 30 %, operation during mains
25 periods 25 periods power supply interruptions,
Voltage dip >95 %, >95 %, it is recommended that the
5 seconds 5 seconds medical device is powered
from an uninterruptible
power supply or a battery.

Instructions for use Fabius plus SW 3.n 211


Technical data

Immunity against IEC 60601-1-2 test Compliance level Electromagnetic environ-


level (medical device) ment
Radiated radio fre- 80 MHz to 2.5 GHz: 10 V/m Recommended minimum
quency disturbance 10 V/m distance to portable and
(IEC 61000-4-3) mobile radio frequency
transmitters with transmis-
sion power PEIRP to the
medical device including its
lines:1)
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IWၮ3(,53>ZDWWV@ 
Conducted radio fre- 150 kHz to 80 MHz: 10 V Recommended minimum
quency disturbance 10 V inside ISM distance from portable and
(IEC 61000-4-6) bands2) mobile radio frequency
150 kHz to 80 MHz: 3V transmitters with transmis-
3 V outside ISM sion power PEIRP to the
bands2) medical device including its
lines: 1)
Pၮ3(,53>ZDWWV@
IWၮ3(,53>ZDWWV@ 
1) For PEIRP, insert the highest possible "equivalent isotropic radiated power" of the adjacent radio frequency transmitter. In
the vicinity of equipment marked with the symbol , interference can occur. Field strengths from fixed, portable, or mobile
radio frequency transmitters at the location of the medical device should be less than 3 V/m in the frequency range from
150 kHz to 2.5 GHz and less than 1 V/m above 2.5 GHz.
2) ISM bands in this frequency range are: 6.765 MHz to 6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to
27.283 MHz; 40.66 MHz to 40.70 MHz.

212 Instructions for use Fabius plus SW 3.n


Technical data

Recommended safety clearance for portable and mobile high-frequency


communication equipment

The safety clearances listed in the following


comply with IEC 60601-1-2.

Max. PEIRP 150 kHz to 2.5 GHz All other frequen- Examples
(watts) cies
0.03 0.32 m (1.1 ft) 0.96 m (3.2 ft) WLAN 5250 / 5775 (Europe)
0.10 0.58 m (1.9 ft) 1.8 m (5.9 ft) WLAN 2440 (Europe)
0.17 0.76 m (2.5 ft) 2.3 m (7.6 ft) Bluetooth, RFID 2.5 GHz
0.20 0.82 m (2.7 ft) 2.5 m (8.2 ft) WLAN 5250 (not in Europe)
0.25 0.92 m (3.0 ft) 2.8 m (9.2 ft) UMTS mobiles
0.41 1.2 m (3.9 ft) 3.5 m (12 ft) Cordless DECT devices
0.82 1.7 m (5.6 ft) 5.0 m (16 ft) RFID 13.56 MHz
1.00 1.8 m (5.9 ft) 5.5 m (18 ft) WLAN 5600 (not in Europe)
1.64 2.4 m (7.9 ft) 7.1 m (23 ft) GSM 1800 / GSM 1900
3.3 3.3 m (11 ft) 10 m (33 ft) GSM 900 mobile phones, RFID 868 MHz

Reduced safety clearance for portable


and mobile high-frequency
communication equipment

The safety clearances listed in the following are


the result of tests that Dräger has performed to
determine the minimum necessary safety
clearances. These reduced safety clearances
apply only to mobile high-frequency
communication equipment that uses the standards
specified.

Mobile high-frequency communication equipment with ... Safety clearance


GSM 850, GSM 900, RFID 868 MHz (limited to 2 W ERP) 0.30 m (12 in)
GSM 1800, GSM 1900 (limited to 1 W ERP) 0.30 m (12 in)
UMTS, DECT (limited to 0.25 W ERP) 0.15 m (6 in)
Bluetooth, WLAN 2450, RFID 2450 (limited to 0.1 W ERP) 0.30 m (12 in)

Instructions for use Fabius plus SW 3.n 213


Technical data

Device combinations

This device can be operated in combination with


other Dräger devices or with devices from other
manufacturers. Observe the accompanying
documents of the individual devices.
If a device combination is not approved by Dräger,
the safety and the functional state of the individual
devices can be compromised. The operating
organization must ensure that the device
combination complies with the applicable editions
of the relevant standards for medical devices.
Device combinations approved by Dräger meet the
requirements of the following standards (as
applicable):
– IEC 60601-1, 3rd edition (general requirements
for safety, device combinations, software-
controlled functions)
– IEC 60601-1-2 (electromagnetic
compatibility)
– IEC 60601-1-8 (alarm systems)
Or:
– IEC 60601-1, 2nd edition (general
requirements for safety)
– IEC 60601-1-1 (device combinations)
– IEC 60601-1-2 (electromagnetic
compatibility)
– IEC 60601-1-4 (software-controlled
functions)
– IEC 60601-1-8 (alarm systems)

214 Instructions for use Fabius plus SW 3.n


Technical data

Connections to IT networks

Data can be exchanged in an IT network using Electrical requirements of connected devices


hard-wired and wireless technologies. An IT and networks
network can be any data interface (e.g., RS232)
The serial port is only appropriate for connecting
that is described in standards and conventions.
devices or networks that have a nominal voltage
During operation, this device can exchange on the network side of max. 24 V DC and meet the
information with other devices by means of IT requirements of one of the following standards:
networks and supports the following functions: – IEC 60950-1: Ungrounded SELV circuits
– Display of waveforms and parameter data – IEC 60601-1 (2nd edition or later): Exposed
– Signaling of alarms secondary electrical circuits
– Service mode, access to logbooks

Information for connecting to an IT


network

Prerequisites
This device must only be connected to the network
by service personnel. The IT representative of the
hospital must be consulted in advance.
The following documents must be followed:
– Accompanying documents of this device
– Descriptions of the network interface
– Description of the network-based alarm
systems
Dräger recommends complying with IEC 80001-1
(risk management for IT networks with medical
devices).

Serial interfaces
The following interfaces are supported:
– RS232 interfaces complying with EIA RS--232
(CCITT V.24/V.28) for the following
applications:
– MEDIBUS, MEDIBUS.X
– Connections to medical devices from other
manufacturers

Instructions for use Fabius plus SW 3.n 215


Technical data

Illustrations

Gas flow plan of the breathing system

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216 Instructions for use Fabius plus SW 3.n


Technical data

Gas delivery unit (3-gas version)

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Instructions for use Fabius plus SW 3.n 217


Annex

Annex

Form for daily checkout and pre-use


checkout......................................................... 219
Checklist.......................................................... 220

218 Instructions for use Fabius plus SW 3.n


Annex

Form for daily checkout and pre-use checkout

To ensure that Fabius is ready for operation, the


following form must be filled in before start-up.
After starting the check, no additional components
may be added and no changes may be made to
the anesthesia workstation.
This is a recommendation. The checking
guidelines of the respective healthcare facility
must be followed.

CAUTION
If one of the checks does not pass, the device
must not be used.
Contact DrägerService or the responsible service
partner.

NOTE
The following applies in this section: cmH2O =
mbar = hPa.

Instructions for use Fabius plus SW 3.n 219


Annex

Checklist

The checklist for daily checkout before using the Battery


medical device takes into consideration all
possible configurations of Fabius. If a test point P Make sure that the battery is completely
does not apply to the Fabius to be tested due to charged. (Battery operation of 45 minutes
configuration deviations, skip the respective test is only guaranteed with a completely
point. charged battery.)

All checks must be performed daily before use of


the device. Personnel who perform the checks Gas supply
must be fully familiar with the instructions for use. Visually inspect the central gas supply and
the gas cylinders. Connect all hoses.
P This test point must be performed before
Makes sure that the hoses are tightly con-
each patient change.
nected.
Box to check if the test point passed.
Make sure that the supply pressures of the
Mark off the individual functions after successful central gas supply lie within the permissi-
check. ble range.

Make copies of these pages so that they can be


used as a daily record for the device check. Gas cylinders

Fabius plus Open the gas cylinders (if present).


Part number: O2 pressure is higher than 1000 psi
(70 kPa x 100).
Prerequisites
N2O pressure is higher than 600 psi
The maintenance intervals of the device (43 kPa x 100).
and accessories have not been exceeded.
Air pressure is higher than 1000 psi
P The device is completely assembled and (70 kPa x 100).
connected.
Close the gas cylinders.
All monitoring functions (e.g., O2 monitor-
ing) and external monitors (e.g., breathing
gas monitor) are switched on and function- O2 flush
ing. Press the O2 flush key: Check whether a
The system test for Fabius has been per- strong gas flow escapes from the patient
formed. connection on the Y-piece.
P The sample line for gas monitoring (if Release the O2 flush key: Check that the
present) is connected to the Luer Lock gas flow stops.
connection on the Y-piece.
P An appropriate anesthetic agent was
selected.
P D-Vapor (if present) is switched on.

220 Instructions for use Fabius plus SW 3.n


Annex

Fresh-gas delivery and S-ORC Check type of gas


Activate the ManSpont mode. Set the O2 flow control valve to 3 L/min.
Open the O2 flow control valve completely. Check whether the measured O2 concen-
Check whether the O2 fresh-gas flow dis- tration is at approx. 90 to 100 Vol%.
play shows at least 10 L/min. Close the O2 flow control valve.
Close the Air flow control valve. Open the
N2O flow control valve completely. Check
whether the N2O fresh-gas flow display Vapor 19.n, Vapor 2000/3000 (Tec 5)
shows at least 10 L/min. P Vaporizer is firmly connected, locked, and
Shut off O2 supply: is hanging vertically.

– Remove the O2 connection of the cen- P Control dial is in position 0.


tral gas supply. P Filling level is between the minimum mark
– Close the O2 cylinder valve. and the maximum mark.
– Check whether the red LED for low O2 P Safety filling device:
supply pressure is flashing. – Sealing block is inserted and closed
– N2O flow is interrupted. tightly.
Restore O2 supply: – Filling inlet is locked.
– N2O flow is present. – Drain valve is closed.
Set the O2 flow control valve to 1.5 L/min. P Filling device Quik Fil:
N2O gas delivery = 3 L/min to 5 L/min. – Drain valve is closed.
Close the O2 flow control valve: – Sealing cap is tightly closed.
– N2O flow is interrupted. P Dräger Fill filling system:
Open the Air flow control valve. Check – Drain valve is closed.
whether the Air fresh-gas flow display – Sealing cap is tightly closed.
shows at least 10 L/min.
Close all flow control valves.
D-Vapor (optional)
P Vaporizer is firmly connected, locked, and
Calibration of the sensors is hanging vertically.
Remove the O2 sensor housing from the P Control dial is in position 0.
cover of the inspiratory valve.
P Filling level is between the minimum mark
Expose the O2 sensor to ambient air for and maximum mark.
2 minutes.
P Operation LED is lit.
Start the calibration.
Insert the O2 sensor housing back in the
cover of the inspiratory valve.
Calibrate the flow sensor.

Instructions for use Fabius plus SW 3.n 221


Annex

Anesthetic vaporizers with Selectatec connec- If the system has leakage (the pressure drops):
tion  Check all plug connections and screw con-
P Vaporizer is firmly connected, locked, and nections for a tight seat.
is hanging vertically.  Replace missing or damaged seals. If nec-
P Control dial is in position 0. essary, contact DrägerService or the
P Filling level is between the minimum mark authorized local service partner
and maximum mark.
Inspiratory valve and expiratory valve
Soda lime  Press the ManSpont key and confirm.
P CO2 absorber is present on the device and  Set the APL valve to position Man and to
is adequately filled. 30 cmH2O (hPa).
P Maximum 50 % are discolored.  Press O2 flush.
P The breathing bag fills.
Airway pressure sensor P When the breathing bag is squeezed and
Change to standby mode and start the leakage released, the valve plates in the inspiratory
test. valve and expiratory valve move.

Close all flow control valves.


Set the Y-piece on the circuit plug on the APL valve
bag elbow for the breathing bag. P Set the APL valve to position Man and to
If necessary, occlude the sample line. 30 cmH2O (hPa). Set the fresh-gas flow to
20 L/min.
Remove the pressure measurement hose
from the socket for the airway pressure P Press the ManSpont key and confirm.
sensor on the rear of the device. P When the pressure waveform has stabi-
The pressure displayed in the leakage test lized (e.g., in the shape of a flat line), set
is at "0". Up to ±2 is permissible. If the the APL valve to Spont to release the
deviation is larger, contact DrägerService. pressure.

Reconnect the pressure measurement P The displayed measured value for the
hose to the socket for the airway pressure peak pressure (PEAK) is between 24 to
sensor on the rear of the device 36 cmH2O (hPa).

Localizing leakages in the breathing circuit Ventilator

The check must be performed once without P Connect the breathing bag to the Y-piece.
vaporizer and once with vaporizer. Control dial is P Press the Pressure Control key and con-
in the zero position. firm.
D-Vapor must be switched on for the leakage test. P The measured values of the ventilation
After the leakage test has ended, switch off the D- parameters are displayed.
Vapor again. P The ventilator piston functions.
Change to Standby mode and then press P The valve plates in the inspiratory valve
the Leak /ComplTest softkey. Follow the and expiratory valve move.
instructions on the screen.

222 Instructions for use Fabius plus SW 3.n


Annex

P The breathing bag fills and empties. P Occlude the Y-piece. Close all flow control
P Press the standby key and confirm. valves.
P Change to the Standby screen.

Monitoring functions and alarms


The alarm function can be checked by setting an Set the APL valve to spontaneous breathing:
alarm limit that causes an alarm message for cer-  Turn the APL valve head counterclockwise
tain. The alarm limits can be adjusted at the start until the Spont mark is reached.
and during a check.  Press the O2 flush key and hold it pressed.
Check the settings of the alarm limits.  With the Y-piece occluded, the airway
Simulate alarm conditions and check pressure is less than 10 cmH2O (hPa).
whether the correct alarm signals are trig-  Release the O2 flush key.
gered.
 The airway pressure is higher than or
Check O2 display and alarm. equals 0 cmH2O (hPa).
Check volume display and alarm.
Check pressure display and alarm. Manual resuscitator
Press the standby key and confirm. When squeezing the bag an audible and
When Fabius is restarted, the default settings for noticeable air flow must escape from the
the alarm limits are automatically restored. mask connection (cone). After releasing,
Check the default settings and adjust if the bag must quickly assume its original
necessary. shape.
Close off the mask connection (cone) with
the ball of the hand: The bag must only be
Other monitors (optional) able to be slightly squeezed.
Make sure that external monitors (if present) are
connected correctly and have been tested in
accordance with the associated instructions for COSY heating (optional)
use. Check cable connections.
Test the alarm functions on all monitors. Check power cable connections.
CO2 monitor and alarm module are func- LED indicator for the power supply lights
tional. up.
Anesthetic agent monitor and alarm mod- Toggle switch is at ON.
ule are functional. LED indicator for COSY heating lights up.
30 minutes after the LED indicator for the
Anesthetic gas scavenging system COSY heating lights up, the temperature
P Hoses are correctly connected. of the bottom of COSY is approx. 35-
40 °C.
P Set the flow control valve on the anes-
thetic gas receiving system so that the
float is located between the "Min." and
"Max." marks.

Instructions for use Fabius plus SW 3.n 223


Annex

P Before connecting to the patient If any one of the test points is not passed, the
device must not be used. Contact DrägerService
– All vaporizers are switched off (the control or the authorized local service partner.
dials are in the 0 position).
– The APL valve is set to the desired pres- Signature for the daily checkout
sure.
– All fresh gas flow indicators show 0. Name
– The scavenging flow of the endotracheal Date
suction is present.
– The breathing system is ready for opera-
tion (the breathing bag is correctly posi-
tioned and all hoses are correctly Signature for pre-use checkout
connected).
– CO2 absorber is present on the device and Name
is adequately filled.
Date

Signature for pre-use checkout

Name
Date

Signature for pre-use checkout

Name
Date

Signature for pre-use checkout

Name
Date

224 Instructions for use Fabius plus SW 3.n


Annex

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Instructions for use Fabius plus SW 3.n 225


Annex

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

Signature for pre-use checkout Signature for pre-use checkout

Name Name
Date Date

226 Instructions for use Fabius plus SW 3.n


Password

Password

Configuration password for Fabius plus Software 3.n

Cut out from the instructions for use for


Fabius plus Software 3.n
To prevent unauthorized alteration, the start
settings of Fabius plus are protected by the
following configuration password:

8088

Information for the configuration


password

To prevent unauthorized alteration, the default


settings of Fabius plus are protected by a 4-digit
password. For information on the start settings,
see page 139.
The configuration password appears on this page
of the instructions for use. Cut out the area with the
password and keep in a place which is safe from
access by unauthorized persons.
Upon request, DrägerService can customize the
password or deactivate the password function.

Instructions for use Fabius plus SW 3.n 227


This page intentionally left blank.

228 Instructions for use Fabius plus SW 3.n


Index

Index

Breathing system. . . . . . . . . . . . . . . . . . . . . . . 203


Assembling . . . . . . . . . . . . . . . . . . . . . . . . . 61
Default settings Breathing volume monitoring. . . . . . . . . . . . . . 126
Volume control . . . . . . . . . . . . . . . . . . . . . . 140

C
A
Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 CO2 absorber
Adopting ventilation settings during mode change Mounting . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Reusable . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Airway pressure monitoring . . . . . . . . . . . . . . . 128 CO2- absorber
Alarm logbook. . . . . . . . . . . . . . . . . . . . . . . . . . 137 Disposable with CLIC adapter . . . . . . . . . . . 64
Accessing . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Compact breathing system
Clearing . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Connecting. . . . . . . . . . . . . . . . . . . . . . . . . . 66
Closing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Removing. . . . . . . . . . . . . . . . . . . . . . . . . . 172
Alarm messages. . . . . . . . . . . . . . . . . . . . . . . . 160 Compact breathing system COSY . . . . . . . . . . 22
Alarm priorities . . . . . . . . . . . . . . . . . . . . . . . . . 119 Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Alarm signaling . . . . . . . . . . . . . . . . . . . . . . . . . 118 Configuration
Alarm tone Automatically setting the pressure threshold
Suppressing . . . . . . . . . . . . . . . . . . . . . . . . 120 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Alarm volume During operation . . . . . . . . . . . . . . . . . . . . 147
Changing . . . . . . . . . . . . . . . . . . . . . . . . . . 152 In standby mode . . . . . . . . . . . . . . . . . . . . 131
Ambient conditions . . . . . . . . . . . . . . . . . . . . . . 191 Leakage test . . . . . . . . . . . . . . . . . . . . . . . 135
Anesthetic gas receiving system Restoring default settings . . . . . . . . . . . . . 138
Connecting . . . . . . . . . . . . . . . . . . . . . . . . . . 60 System test . . . . . . . . . . . . . . . . . . . . . . . . 132
Anesthetic gas supply module . . . . . . . . . . . . . 200 Volume alarms . . . . . . . . . . . . . . . . . . . . . . 148
APL bypass hose Configurations
Connecting . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Acoustic confirmation. . . . . . . . . . . . . . . . . 145
APL valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Changing . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Removing . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Date format . . . . . . . . . . . . . . . . . . . . . . . . 144
Auxiliary power sockets . . . . . . . . . . . . . . . . . . . 53 Date setting . . . . . . . . . . . . . . . . . . . . . . . . 144
Pressure unit . . . . . . . . . . . . . . . . . . . . . . . 145
B Screen brightness . . . . . . . . . . . . . . . . . . . 146
Selecting language . . . . . . . . . . . . . . . . . . 144
Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Setting the time . . . . . . . . . . . . . . . . . . . . . 143
Activating . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Time format . . . . . . . . . . . . . . . . . . . . . . . . 144
Breathing bag
Waveform display . . . . . . . . . . . . . . . . . . . 146
Connecting . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Contraindications. . . . . . . . . . . . . . . . . . . . . . . . 17
Breathing bag holder
Control panel . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Bag elbow . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
COSY heating
Flexible arm . . . . . . . . . . . . . . . . . . . . . . . . . 68
Mounting . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Rigid arm . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Breathing hose configurations . . . . . . . . . . . . . . 75
Breathing hoses and filters . . . . . . . . . . . . . . . . . 72

Instructions for use Fabius plus SW 3.n 229


Index

D I
Default settings Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Changing . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Changing the alarm limits . . . . . . . . . . . . . . 141 Interfaces. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Changing the minimum alarm volume . . . . 141 IT networks . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Pressure Control. . . . . . . . . . . . . . . . . . . . . 140
Pressure Support . . . . . . . . . . . . . . . . . . . . 140 L
Restoring the factory settings . . . . . . . . . . . 142
SIMV/PS . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 Leakages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Desflurane compensation LED indicators . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Automatic . . . . . . . . . . . . . . . . . . . . . . . . . . 150 Low-flow anesthesia . . . . . . . . . . . . . . . . . . . . . 94
Switching on and off . . . . . . . . . . . . . . . . . . 150
Device combinations . . . . . . . . . . . . . . . . . . . . 214 M
Device configurations . . . . . . . . . . . . . . . . . . . . . 33
Device data . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 Mains power supply
Device outlets . . . . . . . . . . . . . . . . . . . . . . . . . . 207 Connecting . . . . . . . . . . . . . . . . . . . . . . . . . 52
Maintenance intervals . . . . . . . . . . . . . . . . . . . 185
Manual resuscitator . . . . . . . . . . . . . . . . . . . . . . 82
E Manual ventilation . . . . . . . . . . . . . . . . . . . . . . . 97
Electrical safety . . . . . . . . . . . . . . . . . . . . . . . . 195 MEDIBUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Electromagnetic compatibility . . . . . . . . . . . . . . . 11 Medical devices
EMC declaration. . . . . . . . . . . . . . . . . . . . . . . . 209 Classification . . . . . . . . . . . . . . . . . . . . . . . 174
Exhaust port Minute volume . . . . . . . . . . . . . . . . . . . . . . . . . 127
Connecting . . . . . . . . . . . . . . . . . . . . . . . . . . 67
External fresh-gas outlet . . . . . . . . . . . . . . 34, 195 N
Additional switch . . . . . . . . . . . . . . . . . . . . . . 35
Auxiliary switch . . . . . . . . . . . . . . . . . . . . . . 112 Non-critical medical devices
Common gas outlet. . . . . . . . . . . . . . . . 35, 110 Reprocessing. . . . . . . . . . . . . . . . . . . . . . . 175

F O
Flow sensor O2 flush . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Calibrating. . . . . . . . . . . . . . . . . . . . . . . . . . 133 O2 insufflation . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Connecting . . . . . . . . . . . . . . . . . . . . . . . . . . 80 O2 monitoring . . . . . . . . . . . . . . . . . . . . . 122, 123
Inserting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 O2 sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Removing . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Calibrating . . . . . . . . . . . . . . . . . 124, 134, 149
Fresh-gas delivery . . . . . . . . . . . . . . . . . . . . . . . 47 Connecting . . . . . . . . . . . . . . . . . . . . . . . . . 79
Fresh-gas flow Replacing the sensor capsule . . . . . . . . . . . 78
Setting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 Operation
Fuses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 Ending . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114

G P
Gas cylinders (screw connections). . . . . . . . . . . 58 Password. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Gas flow plan . . . . . . . . . . . . . . . . . . . . . . . . . . 216 Patient change . . . . . . . . . . . . . . . . . . . . . . . . 109
Gas supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 PEEP/PMAX hose
Connecting . . . . . . . . . . . . . . . . . . . . . . . . . 81
Pin-index system . . . . . . . . . . . . . . . . . . . . . . . . 56

230 Instructions for use Fabius plus SW 3.n


Index

Potential equalization Ventilation mode


Establishing . . . . . . . . . . . . . . . . . . . . . . . . . 53 Changing . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Power supply unit for COSY-heating . . . . . . . . . 23 ManSpont. . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Power-saving mode . . . . . . . . . . . . . . . . . . . . . 132 Ventilation mode Pressure Control . . . . . . . . . 101
Pressure alarm and pressure threshold . . . . . . 129 Ventilation mode Pressure Support. . . . . . . . . 103
Pressure gauge for airway pressure measurement Ventilation mode SIMV/PS . . . . . . . . . . . . . . . 105
Connecting . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Ventilation mode Volume Control . . . . . . . . . . . 99
Pressure sensor Ventilation parameters
Connecting . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Selecting and setting . . . . . . . . . . . . . . . . . . 46
Ventilator . . . . . . . . . . . . . . . . . . . . . 108, 158, 198
R Preparing . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Visual inspection . . . . . . . . . . . . . . . . . . . . . . . 176
Readiness for operation Vitalink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Checking. . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Volume alarms
Reprocessing procedures. . . . . . . . . . . . . . . . . 174 Switching on and off . . . . . . . . . . . . . . . . . 148
Resistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

S
Safety checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Screen colors . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Screen display . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Semi-critical medical devices
Reprocessing . . . . . . . . . . . . . . . . . . . . . . . 175
Sensors and measurement lines . . . . . . . . . . . . 79
Setting the anesthetic gas concentration . . . . . . 92
Soda lime
Replacing . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Softkeys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Spontaneous breathing. . . . . . . . . . . . . . . . . . . . 96
Sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Suction system
Connecting . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
S-ORC . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90, 207

T
Transport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

V
Vaporizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Vaporizer interface . . . . . . . . . . . . . . . . . . . . . . 201
Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Instructions for use Fabius plus SW 3.n 231


These instructions for use only apply to
Fabius plus SW 3.n
with the Serial No.:
If no serial number has been filled in by Dräger,
these instructions for use are provided for
general information only and are not intended
for use with any specific medical device.
These instructions for use are provided for
customer information only and will only be
updated or exchanged upon customer request.

Directive 93/42/EEC concerning medical


devices

Manufacturer

Dräger Medical GmbH


Moislinger Allee 53 – 55
D-23542 Lübeck
Germany
+49 451 8 82-0
FAX +49 451 8 82-2080
http://www.draeger.com

As of 2015-08:
Dräger Medical GmbH
changes to
Drägerwerk AG & Co. KGaA

9054673 – GA 5330.450 en

Á9054673cÈ
© Dräger Medical GmbH
Edition: 1 – 2014-06
Dräger reserves the right to make modifications
to the device without prior notice.
ision]_0000027766_No.2603

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