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Datex-Ohmeda

Anesthesia Delivery Unit

Users Reference Manual

0537
Conformity according to the Council Directive 93/42/EEC concerning Medical Devices

CAUTION: U.S. Federal law restricts this device to sale by or on the order
of a licensed medical practitioner.
Outside the USA, check local laws for any restriction that may apply.

All specifications subject to change without notice.

Document No. 8502304-2

May 6, 2003

Distributor: Manufacturer:
GE Healthcare Finland Oy
Helsinki, Finland
P.O. Box 900
FI-00031 GE
Tel: +358 10 39411
Fax: +358 9 1463310
www.datex-ohmeda.com
www.gehealthcare.com

2005 General Electric Company. All rights reserved.


Table of contents

Table of contents

About this manual 1


Related Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

1 Safety 3
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
General Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
System Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Equipment Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Classification according to IEC 60601-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Classification according to IEC 529 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Classification according to the EU Medical Device Directive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Responsibility of the Manufacturer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ADU - Compliance with safety standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ADU Safety Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

2 System description 9
Front view of the ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Rear view of the ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Rear connection panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Auxiliary mains outlets and gas supply inlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Gas delivery system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Vaporizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Anesthesia Delivery Unit without N2O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Ventilator bellows unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Bag-in-bottle principle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Breathing phases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Tidal volume compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Ventilator with compact patient circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Compact Block II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Module Frame Rack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Backup systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
Battery backup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Equipment safety symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Other symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Symbols for Datex-Ohmeda Compact Block with Compact Canister . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

3 Assembly and preparations 33


Connecting gas and power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Assembling ventilator bellows block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
Compact patient circuit description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
Bain and Jackson Rees breathing systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
Electronically controlled vaporizer and Aladin cassettes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Filling Aladin cassettes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50

Document No. 8502304-2 i


Datex-Ohmeda ADU

Filling of the Aladin cassette for Desflurane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53


Preparation for Patient SpirometryTM monitoring (Datex-Ohmeda monitors) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
Selecting spirometry sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
Connecting the spirometry sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
Sampling gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57

4 System checkout 59
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
The System Checkout procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60
Performing a complete System Checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61
Complete System Checkout step by step . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61
Performing separate checkouts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
N2O delivery and hypoxic mixture control checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Agent delivery checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64
AUTO ventilation checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65
MAN ventilation checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66
Status Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67
Checkout Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68
Bypass checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
Failed checkouts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
Failed N2O delivery checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
Failed agent delivery checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Failed AUTO Ventilation checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72
Failed Manual ventilation checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Leak detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76
Leakage limits of ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76
System Checkout performed on an ADU without N2O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77

5 Operating and adjusting the settings 79


ADU controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
Display/keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
Handling the menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
Moving in menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
Start of case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
Reset of previous case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
Fresh gas delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
Fresh gas display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
O2, N2O and Air . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85
O2 flush . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86
Anesthetic agent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87
Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88
CO2 absorber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88
Spontaneous ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
Manual ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90
Controlled mechanical ventilation (Auto) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91
Volume Controlled Ventilation, VCV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92
Synchronized Intermittent Mandatory Ventilation, SIMV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92
Pressure Controlled Ventilation, PCV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93
Ventilator settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103
Measuring conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104

ii Document No. 8502304-2


Table of contents

Sampling gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104


Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105
Set the screen layout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105
Set time and date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109
Change Install settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110
Service menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112
End of case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
Gas usage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
Gas disconnection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114
Battery charge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114

6 Alarms 115
Alarm Signals and Sequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
Alarms and alarm limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116
French and Japanese Version settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116
Oxygen failure alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116
Alarms setups and adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Adjust limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118
Default limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118
Cancel changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118
Alarm volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119
Audio On/Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Alarm history . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Silencing alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
Silencing auditory alarms temporarily1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
Disabling auditory alarms permanently . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
Unexpected Reset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Display description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Recommended actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

7 Trends 123
Graphical trend pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124
Numeric trend pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Changing trend pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Trend cursor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127
Graphical trend length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Scales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Resetting trend data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

8 Cleaning and maintenance 131


General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131
Cleaning and disinfection methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Intermediate level disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
High level disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Disinfection methods table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Patient circuit tubing, manual bag tubing & connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Cleaning and disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Compact Blocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Compact Block I and Compact Block II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Mechanical cleaning and disinfection in washer-disinfector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137

Document No. 8502304-2 iii


Manual cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
High level disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Before reusing the compact block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142
Ventilator bellows assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
Disassembling before cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
Cleaning and disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147
Bellows and manual ventilation bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Aladin cassette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150
Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150
Storing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150
Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150
Sampling adapters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150
Sampling line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150
Recommended periodic maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
Checkout and maintenance schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
Health and safety declaration form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152

9 Troubleshooting 153
Leak detection and correction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Leakage limits of the ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Leakage during ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Patient circuit hoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
Compact block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155
Bellows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155
Bellows chamber positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156
Overflow valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157
Bellows block bottom plate gasket . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158
Manual bag and bag hose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158
Alarm messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
System status messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160
Electronic ventilator messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160
Electronic vaporizer messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161
Other messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .162

10 Technical specifications 163


General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163
Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163
Environmental conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Electrical requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Electrical connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166
Gas delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167
Gas supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167
Fresh gas control unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168
Electronically controlled vaporizer and Aladin cassette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169
Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Electronic ventilator including bellows block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Patient breathing systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175

iv Document No. 8502304-2


Table of contents

Scavenging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175
Vaporizer output graphs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176
Anesthetic agent concentration output . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176

11 Glossary 181
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Anesthesia machine vocabulary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183

12 Appendices 189
Appendix A Compressible volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Compensation for compressible volume in the delivery system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189

13 Brief instructions 191


Datex-Ohmeda ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191
Preparing the ADU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Daily System Checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Setting alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Adjusting fresh gas delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
Returning sampled gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197
Starting ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
Monitor integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Disinfection methods table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201

Index 203

Document No. 8502304-2 v


Datex-Ohmeda ADU

vi Document No. 8502304-2


About this manual

About this manual


This Users Reference Manual describes all necessary functions for the safe use of the Datex-Ohmeda
S/5 Anesthesia Delivery Unit (ADU). Some of the described functions may work in alternative ways. In
those cases the alternatives are described. Be sure to follow the relevant description.
Before using your ADU, please read this Users Reference Manual thoroughly. Pay special attention to
WARNINGS and CAUTIONS.
Information about the terms used throughout the manual is found in chapter 11, Glossary.
Design of anesthetic system is largely controlled by relevant international or regional standards.
Depending on the area in which the system will be used IEC (international), ASTM (US), or other
standards may apply. In this Users Reference Manual the pictures and text refer to an ADU designed
according to ASTM standards.

Related Documents
Users Guide, UG
The Users Guide describes the most common features and functions for the use of the equipment.
The Guide is intended to be a complement to the reference manuals and support the user in the daily
work. The guide has a table of contents, index and tabs with headings for a quick and easy way to find
desired information.
Cleaning Instructions Poster
The Cleaning Instructions Poster describes how to clean the most common parts of the equipment.
The poster is a complement to the Users Reference Manual and the Users Guide.
Technical Reference Manual, TRM
The Technical Reference Manual contains information required to service and repair the
equipment. It is intended for service personnel and engineers who have been trained to perform
maintenance procedures.
Related clinical information
For related clinical information, refer to the following documents:
Quick Guide, Patient Spirometry
Appliguide, Patient Spirometry
Appliguide, Patient Oxygen
Appliguide, First Steps in CO2 Monitoring
Appliguide, Optimizing low and minimal flow anesthesia
Monitoring functions are explained in more detail in:
Datex-Ohmeda S/5 Anesthesia Monitor Users Reference Manual
Capnomac Ultima Operators Manual

Conventions used
Names of touch keys are entered in a larger and bold typeface, for example Setup.
Software menu items are entered in bold italic typeface, for example Gas Usage.
Menu access is described from top to bottom. For example, the selection of the Screen Layout menu
item and the CO2 Setup menu item below would be written as Screen Layout-CO2 Setup.

Document No. 8502304-2 1


Datex-Ohmeda ADU

Messages (alarm messages, informative messages) displayed on the screen are entered inside
single quotes, for example PEEP high.
When referring to different documents, sections or paragraphs, the name is entered in italic typeface
and enclosed in double quotes, for example Users guide.

Trademarks
Datex, Ohmeda and other trademarks S/5, AS/3, CS/3, D-lite, D-lite+, Pedi-lite, Pedi-lite+,
D-fend, D-fend+, MemCard, ComWheel, PatientO2, Patient Spirometry and Tonometrics, are
property of Instrumentarium Corp or its subsidiaries. All other product and company names are
property of their respective owners.

2 Document No. 8502304-2


1 Safety

1 Safety
Intended Use
The Anesthesia Delivery Unit (ADU) is intended for administration of anesthetic breathing gas and
manual or mechanical ventilation for patients undergoing anesthesia. It is intended for all patient
categories.

General Requirements
The ADU must only be operated by qualified anesthesia personnel, and it must be connected to
mains electrical power and gas supplies which meet the requirements specified in section 10 -
Technical Specifications. The ADU is not MRI compatible.

Warnings and Cautions


Throughout this manual, a WARNING indicates a hazardous situation which - if not corrected - may
result in patient injury or death. A CAUTION indicates a situation in which the ADU or devices
connected to it, may be damaged.
Any WARNINGS or CAUTIONS in the text of this Users Reference Manual, are placed in such a way
that they are clearly identifiable with the relevant situation.
WARNING The ADU is only to be operated by, or on the order of a physician.
WARNING The constant attention of qualified personnel is required whenever a patient is
under anesthesia and connected to the ADU.
WARNING To prevent hazards arising from incorrect delivery of gases, the ADU shall always
be used with the following monitoring:
O2 monitor according to ISO 7767/EN 12598
Agent monitor according to ISO 11196/EN ISO 11196
CO2 monitor according to ISO 9918/EN 864
Expired volume monitor according to IEC 60601-2-13/EN 740
WARNING Hazard related to explosion, fire, and burns. To avoid the risk of explosion, fire, or
burns, the following precautions must be observed:
Flammable anesthetic gases such as ether and cyclopropane must not be
used with this workstation. Only agents which comply with the requirements
for non-flammable anesthetic agents according to IEC 60601-1, shall be
used.
There is always a risk wherever anesthetic agents are used and handled. Do
not use the ADU in insufficiently ventilated areas, thus avoiding raised
concentrations of anesthetic agents in operating rooms. Use gas scavenging
at all times.
As this workstation is not to be used with flammable anesthetic agents, the
use of antistatic breathing tubes and face mask is not recommended. Burns

Document No. 8502304-2 3


Datex-Ohmeda ADU

may occur if antistatic or electrically-conductive breathing tubes are used


while high-frequency electric surgery equipment is in use.
High pressure or pure oxygen may cause explosion or burn strongly when
reacting with organic material such as lubricants, paint, greasy fingerprints,
dirt, dust fluff, and other organic waste.
No oil, grease, or silicone-based lubricants must be used. Only PTFE-based,
oxygen compatible lubricants are allowed, such as KRYTOX.
WARNING Electric shock hazard. To avoid the risk of electric shock hazard, the following
precautions must be observed:
Only use hospital grade, grounded electrical outlets and power cord.
Adequate grounding can only be ensured if the equipment is connected to a
receptacle marked Hospital grade.
Make sure that any external equipment which is to be connected to Datex-
Ohmeda equipment, is hospital grade grounded.
In order to reduce the risk arising from excessive leakage currents, and in
accordance with EN 740, an anesthetic workstation shall not be provided
with more than four operator accessible auxiliary mains socket outlets. The
connection of equipment to auxiliary mains socket outlets may increase the
patient leakage currents to values exceeding the allowable limits in the
event of a defective protectice earth (ground) conductor.
Always unplug the electric power cord before cleaning or maintenance of the
ADU
When cleaning the exterior - make sure that no liquid enters the interior of
the ADU.
Do not autoclave any part of the ADU system except those specified in this
manual, with steam or ethylene oxide.
WARNING Do not connect external equipment to the ADU system other than those specified
by Datex-Ohmeda. (Also see the Installation section in the Datex-Ohmeda ADU
Technical Reference Manual).

4 Document No. 8502304-2


1 Safety

Electromagnetic compatibility (EMC)


Most medical electrical devices emit electromagnetic radiation disturbances which may interfere
with other equipment used in their vicinity. Likewise, most electrical medical devices are susceptible
to electromagnetic disturbances. The ADU has been designed such that it does not emit electromag-
netic radiation disturbance levels exceeding the limits specified in IEC 60601-1-2, and in order to
ensure the safe function of the device, it is important that it operates in an electromagnetic environ-
ment which complies with the requirements of IEC 60601-1-2. Mobile telephones and other equip-
ment which emit radiated fields, should be switched off in the vicinity of the ADU.
CAUTION The function of this machine may be adversely affected by the operation of equipment
such as high frequency surgical apparatus or short-wave therapy equipment in the
vicinity.
CAUTION The function of this anesthetic workstation or module, as applicable, may be
adversely affected by electromagnetic interference exceeding the levels specified in
IEC 60601-1-2.

System Safety
When the ADU is used together with, or connected to other equipment, it is important that the whole
system complies with the safety requirements of IEC 60601-1-1: Safety requirements for medical
electrical systems. Compliance with IEC 60601-1-1 means that any other equipment forming part of
the system, should meet the requirements of IEC 60601-1. The use of an extra isolation transformer
may also be considered. Please contact your local technical service personnel to verify system safety.
CAUTION In order to prevent overheating of the ADU while in operation, sufficient space should
be left around the machine.

Equipment Classification
Classification according to IEC 60601-1
CLASS I EQUIPMENT according to the type of protection against electrical shock.
TYPE B equipment according to the degree of protection against electrical shock.
EQUIPMENT not suitable for use in the presence of a FLAMMABLE ANESTHETIC MIXTURE WITH AIR or
with OXYGEN or NITROUS OXIDE.
CONTINUOUS OPERATION according to the mode of operation.

Classification according to IEC 529


Degree of protection against ingress of water as detailed in IEC 529: IPX1

Classification according to the EU Medical Device Directive


The Datex-Ohmeda Anesthesia Delivery Unit is classified as IIb.

Document No. 8502304-2 5


Datex-Ohmeda ADU

Responsibility of the Manufacturer


The Datex-Ohmeda Division, Instrumentarium Corp. is responsible for the effects on safety, reliability
and performance of the equipment only if:
Personnel authorized by Datex-Ohmeda carry out assembly, operations, extensions,
readjustments, modifications, periodical service or repairs.
The electrical installation of the relevant room complies with the appropriate requirements.
The equipment is used in accordance with this Users Reference Manual.

ADU - Compliance with safety standards


With the deviations listed below the ADU complies with the following standards:
IEC 60601-1:1988 - General requirements for safety
IEC 60601-2-13:1998 - Particular requirements for the safety of anaesthetic workstations
EN 740:1998 - Anaesthetic workstations and their modules - Particular requirements
ISO 8835-3:1997 - Inhalational anaesthesia systems - Anaesthetic gas scavenging systems -
Receiving and transfer systems
ASTM F 1850 - Standard Specification for Particular Requirements for Anesthesia Workstations
and Teir Components
NOTE: Units sold in Canada also comply with CSA standards 601.1 and 601.2.13
Deviations

Standard Deviation
EN 740 Cross connection between the ventilator port and the reservoir bag port is
prevented by means of incompatible connectors and not by labelling.
EN 740 and With an active scavenging ejector in combination with extreme inspiratory flow
IEC 60601-2-13 settings the time-weighted average input flow required by the ADU for each
gas type may exceed 60 l/min at a pressure of 280 kPa (41 psi) measured at
the gas inlet port.
ISO 8835-3 The resistance to extract flow of the transfer and receiving system is 29
cmH2O at 25 l/min (required max 20 cmH2O).

6 Document No. 8502304-2


1 Safety

ADU Safety Features


The safety features listed below are incorporated in the Anesthesia Delivery Unit.

Gas supply O2, N2O and Air supply failure alarm


Overpressure limitation for wall inlets O2, Air and N2O at 900 kPa (130 psi)

Gas mixer Electronic O2/N2O/AA ratio control and N2O cut-off


Automatic switching from N2O to Air if N2O pressure is lost

Vaporizer: Aladin Cassette Overfilling protection


The Desflurane cassette is equipped with a special over-pressure relief valve.
Automatic cassette identification
Prevents delivery of more than one agent at a time
Automatic vaporizer shut-off
- in case fresh gas flow is lost
- in case cassette is removed
Ventilator With loss of primary ventilator driving gas (Air or O2) automatic switch to the
secondary driving gas. (O2 or Air)
Visible rising bellows allow fast and easy leakage detection
Adjustable maximum pressure release in AUTO mode (mechanical ventilation),
Pmax Release with automatic switch to expiration
Overpressure release valve in fresh gas outlet at 80 cmH2O
Single switch operation of the ventilator
High pressure alarm in the breathing system
Low pressure alarm in the breathing system
Sustained pressure alarm
APL valve in the manual breathing circuit
Datex-Ohmeda Compact Absorber locking mechanism allows easy canister/absorber replacement during
Patient circuit (optional) operation.
Clearly visible absorber canister and vertical one-way valves
Other safety features Mains power failure alarm
Full battery backup for 20 minutes *)
Optional reserve gas cylinders (oxygen cylinder standard)

*) NOTE: The backup battery supplies power only to the ADU, not to the patient monitor unless outfitted with a UPS
system. The specified backup time applies to a new and fully charged battery.

Document No. 8502304-2 7


Datex-Ohmeda ADU

8 Document No. 8502304-2


2 System description

2 System description
The Anesthesia Delivery Unit is designed to mix and dose respiratory gases and to ventilate the
patient.
The delivery unit is the basis for a flexible anesthesia system with full monitoring and data
management capabilities.
The ADU anesthesia system enables you to design an optimal system for each operating room by
adding or interchanging modules. Additionally, it is designed to include future products.

Document No. 8502304-2 9


Datex-Ohmeda ADU

Front view of the ADU

7
5

4 8

3 9

10

11

12

13

14
1
15

16

(1) Fresh gas outlet. (Total gas flow indicator) (10) Aladin Vaporizer Cassette
(2) Compact patient circuit (11) Agent wheel
(3) Ventilator bellows block (12) Switch for On / Standby
(4) Fresh gas flow controls (13) Anesthesia Monitor central unit and
(5) Setup keys modules (option)
(6) ADU LCD display (14) Vaporizer cassette storage slots
(7) Ventilator quick function keys (15) Drawers (optional)
(8) Anesthesia Monitor (optional LCD display) (16) O2 flush button
(9) ComWheel

NOTE: The ADU can be used with a 10.4 display. See Display/keys on page 80 for further
information.

10 Document No. 8502304-2


2 System description

Rear view of the ADU

2
1

1 5

(1) Auxiliary gas and vacuum outlets (optional, oxygen standard)


(2) Cylinder yokes (optional, oxygen standard)
(3) Auxiliary mains outlets
(4) Gas supply and scavenging connectors
(5) Scavenging ejector (optional) or scavenging flow indicator (optional)
(6) Hose wraps
(7) Dovetail rail mount for optional equipment

Document No. 8502304-2 11


Datex-Ohmeda ADU

Rear connection panel

1
3

(1) Product labels. Contains information on type of device, Serial No. (S/N), year of manufacture
and electrical requirements.
(2) ADU mains power cord (or connection cord for box of auxiliary mains outlets).
(3) Auxiliary mains outlets
(4) Mains fuses to auxiliary main outlets (two fuses per outlet)
(5) Auxiliary mains outlets box
(6) Potential equalization terminal

12 Document No. 8502304-2


2 System description

Auxiliary mains outlets and gas supply inlets


The three mains socket outlets are reserved for monitors and other electrical devices mounted on the
ADU.
WARNING In order to reduce the risk arising from excessive leakage currents, and in
accordance with EN 740, an anesthetic workstation shall not be provided with
more than four operator accessible auxiliary mains socket outlets.

1 2 3

4 5

PicAdu0261us

Figure 1 Auxiliary main outlets Figure 2 Gas supply connectors

6 7

Figure 3 Scavenging ejector with indicator Figure 4 Scavenging flow indicator

(1) Nitrous oxide inlet


(2) Air inlet
(3) O2 inlet
(4) Gas scavenging outlet (EVAC)
(5) Vacuum outlet (optional)
Each connector is designed to be coupled to its corresponding hose. The connectors and hoses are
color-coded and diameter indexed.
(6) Optional - Built-in scavenging ejector with indicator. Max. flow is achieved by adjusting the flow
ejector knob according to the indicator response.
(7) Optional - Built-in scavenging indicator.

Document No. 8502304-2 13


Datex-Ohmeda ADU

Gas delivery system

EVAC Bellows
Outlet Manual
unit bag

Driving gas

Ventilator
Patient
circuit
O2
Flush
Fresh gas
Gas outlet
inlets

O2

Fresh gas
Air control unit

N2O

Extra
gas
outlets
Pressure gauges
Reserve gas
cylinders

Figure 5 Gas system diagram

The gases, O2, Air and N2O, are supplied to the Fresh Gas Control unit from the ADU gas inlets. Air and
O2 are also supplied to the ventilator unit.
The optional reserve gas cylinders supply both the ventilator unit and the Fresh Gas Control unit. (The
gas combinations and number of cylinders can vary.)
When the O2 Flush button is pushed, 100 % O2 is flushed directly to the fresh gas outlet, to which the
patient circuit is connected.
Depending on which supply is used, the pressure gauges show either the pressure from the pipeline
supply system or the regulated cylinder pressure. There is also a pressure gauge mounted for each
cylinder, which shows the actual cylinder pressure (before it is regulated).
The Fresh Gas Control unit mixes supply gases and dosages the anesthetic agent and distributes the
mixture to the fresh gas outlet.
During the AUTO ventilation the driving gas from the ventilator is used to push the breathing gas into
the patient. During Manual ventilation the operator manually ventilates the patient with a bag.
Waste gases from the breathing system are transferred to the EVAC outlet. Gas can also for security
reasons be evacuated directly to the EVAC outlet from the Fresh Gas Control unit.

14 Document No. 8502304-2


2 System description

Vaporizer
The electronically controlled Datex-Ohmeda Vaporizer consists of two parts: the internal electronic
control unit and the Aladin Agent Cassette.
The Aladin agent cassette is the liquid container. The agent cassettes are color-coded for each
anesthetic agent. The cassettes are also magnetically coded so that the ADU can identify the inserted
anesthetic agent cassette.

Figure 6 Aladin cassette


The electronic control unit governs the flow through the agent cassette and the agent concentration in
the fresh gas flow.

1
P
O2 N2O AA O2 N2O
2
P
3
P T
6

5
4

Figure 7 Anesthetic agent delivery flow diagram

Measurement part
(1) Bypass flow
(2) Flow through the cassette
(3) Cassette pressure
(4) Cassette temperature
Agent control
(5) Agent setting
(6) Control valve

Document No. 8502304-2 15


Datex-Ohmeda ADU

Anesthesia Delivery Unit without N2O


An ADU configured to operate without the use of N2O, has a locking device between the N2O flow
control and the Air/N20 switch. The Air/N2O switch cannot be rotated and only O2 and Air can be
used.

N 2O Air O2

Figure 8 Fresh gas flow controls with locking device

The screen layout and some menus will differ when you are using the ADU without N2O. This
especially applies to the System Checkout menu. The System Checkout has been modified so it can
pass without the use of N2O. For further information see System Checkout performed on an ADU
without N2O on page 77.

Figure 9 Display when using an ADU without N2O

The fresh gas field % N20 in fresh gas will display OFF, and Air will automatically be made to flow
together with O2.

16 Document No. 8502304-2


2 System description

Ventilator
The ventilator consists of the electronic control unit and the bellows unit. The electronic control unit is
situated behind the ADU main display.
Pressurized gas, either Air or O2 powers the ventilator. One of these gases is the primary driving gas. If
the primary driving gas is lost, the ADU automatically switches to the other driving gas.

Ventilator bellows unit

6
5

3
8
PicAdu0154

11 10 9

Figure 10 Ventilator bellows unit

(1) Auto / Manual selector


(2) Chamber locking handle
(3) Bellows block
(4) Overflow valve
(5) Bellows chamber
(6) Bellows
(7) Bellows base
(8) APL valve
(9) Manual bag quick connector
(10) Occluder cone
(11) Patient circuit connector

Document No. 8502304-2 17


Datex-Ohmeda ADU

Bag-in-bottle principle
The ADU ventilator uses the Bag-In-Bottle principle with a standing bellows. This means that the
driving gas, which is compressed Air or O2, is separated from the fresh gas to the patient and from the
patients expiratory gas.
During inspiration the driving gas passes into the pressure chamber, compresses the bellows,
thereby pushing the gas inside the bellows into the patient circuit.
(See sequences 1 and 2 below.)
The increased pressure is due to the flow either from the ventilator during mechanical ventilation or
from the manual bag when it is squeezed during manual ventilation.
During expiration the driving gas escapes from the pressure chamber into the atmosphere. The
bellows is filled with the expiratory gas. (See sequences 3 and 4 below)
The standing bellows system maintains a small positive pressure (physiologic PEEP, 2 to 3 cmH2O) in
the circuit.

Inspiration Expiration
1. 2. 3. 4.

Driving Driving
gas gas

Patient Patient

Figure 11 Bag-in-bottle ventilator principle

18 Document No. 8502304-2


2 System description

Breathing phases
Inspiration phase - gas flow diagram

1 2

(1) Fresh gas hose


(2) Ventilator bellows unit
(3) Ventilator driving gas
(4) Rubber membrane & metal lid
(5) To EVAC
(6) To Patient Circuit

Document No. 8502304-2 19


Datex-Ohmeda ADU

Expiration phase - gas flow diagram

1 2

(1) Fresh gas hose


(2) Ventilator bellows unit
(3) Ventilator driving gas
(4) Rubber membrane & metal lid
(5) To EVAC

20 Document No. 8502304-2


2 System description

Tidal volume compensation


Independent of gas composition, the ADU compensates for the fresh gas inflow during inspiration, as
well as for the compressible volume of the patient circuit - thus securing set tidal volume (TV) to the
patient.

Compressible volume in the patient circuit (compliance) is measured during the System
Checkout.
The fresh gas flow is measured continuously.
The Tidal Volume required by the bellows is calculated.

Set TV (1) = TV bellow (2) + Fresh gas flow (3) - Circuit compressed volume (4) = Patient TV (5)

1
2

5 4 3

Figure 12 Tidal volume compensation

See Section 12, Appendix A for more information.

Document No. 8502304-2 21


Datex-Ohmeda ADU

Ventilator with compact patient circuit


11 12

10

7 6 5 4 3 2 1

Figure 13 Compact patient circuit

(1) Fresh gas supply connection (Common gas


outlet)
(2) Fresh gas flow indicator
(3) Circuit boom
(4) Ventilation hose
(5) Compact block
(6) Valves for inspiration and expiration
(7) Locking/releasing latch for absorber canister
(8) Manual ventilation bag with hose
(9) Inspiration and expiration hoses with Y-piece
(10) Cable management arm
(11) Absorber canister
(12) Bellows block

22 Document No. 8502304-2


2 System description

Compact Block II
Gas flow within the Compact Block II and the Single Use Absorber. The compact block may be used
without an absorber.

Water trap

Figure 14 Inspiratory flow Figure 15 Expiratory flow

Fresh gas flow inlet

Bellows connection

Expiration connector

Inspiration connector

Water trap

Figure 16 Inspiratory flow without absorber

Document No. 8502304-2 23


Datex-Ohmeda ADU

Module Frame Rack


The rack that holds the modules may - as an option - be moved to either of two positions. An outer
position to make the modules more accessable and an inner position when accessability is less
important. The rack moves on rails and is locked in both positions.

To move the module rack from its inner position into outer position:
1. Unlock by pushing both latches outwards. At the same time, pull the rack outwards. As soon as
the rack has moved a bit - let go of the latches.
2. Move the rack all the way into outer position. The locking device will click into operation when
the rack is in proper position.

To move the rack from the outer position into inner position:
Unlock, move and lock the rack in a corresponding manner to what is described above.

24 Document No. 8502304-2


2 System description

Monitoring
The Anesthesia Delivery Unit is compatible with the Datex-Ohmeda Anesthesia Monitor and the
Datex-Ohmeda Capnomac Ultima.
The interfaced values may be displayed in the optional field in the middle of the screen. The CO2
waveform may be configured in the second waveform field.
NOTE: When, due to a mains power failure, the ADU runs on power from its internal battery, everything
except the AM (optional) monitor will function.
WARNING To prevent hazards arising from incorrect delivery of gases, the ADU shall always
be used with the following monitoring:
O2 monitor according to ISO 7767/EN 12598
Agent monitor according to ISO 11196/EN ISO 11196
CO2 monitor according to ISO 9918/EN 864
Expired volume monitor according to IEC 60601-2-13/EN 740

Integration of following Datex-Ohmeda Information transferred to


monitors: the ADU
Anesthesia Monitor CO2 waveform with Et/FiCO2, RR (MAN only),
Exp. minute volume and tidal volume numerics,
O2, N2O, CO2 and AA numerics
Capnomac Ultima as above

Installation is described in the Installation section in the ADU Technical Reference Manual.
The Anesthesia Monitor Central Unit may be installed in the cabinet below the desk. The video display
as well as the Capnomac Ultima, are preferably placed on the top shelf.
NOTE: The power at the auxiliary electrical outlets is always available when the delivery unit is
connected to the mains supply but unavailable when the unit is running on battery power.

Document No. 8502304-2 25


Datex-Ohmeda ADU

Backup systems
Battery backup
The Anesthesia Delivery Unit is a mains operated device with battery backup. The batteries are
activated when the power cord is not connected, or when the mains power (wall outlet source) is lost
during operation. The batteries are also activated in the case of mains over-voltage. When the mains
power is lost, the power failure alarm is immediately activated. A green light above the On/ Standby
switch indicates that the mains power is connected.
NOTE: The battery should be periodically replaced. See the ADU Technical Reference Manual for more
details.
NOTE: The power at the auxiliary electrical outlets is always On when the delivery unit is connected to
mains voltage and Off when running on the battery.
Battery capacity
The internal battery capacity is at least 20 minutes with fully charged batteries. A symbol on the
monitor display indicates the remaining battery capacity. When about 30 seconds remains of battery
operating time, a HIGH priority alarm message Battery Empty Go Manual is activated.

Figure 17 Remaining battery capacity

When the battery is empty a battery empty symbol is displayed for 30 s before the ADU is
automatically shut off.

Empty

Figure 18 Battery empty symbol

Charging
The battery is automatically charged when the ADU is connected to mains power. If the batteries are
not fully charged, a charging symbol is displayed to indicate that the specified battery operation
time is not available. Charging an empty battery takes approximately 4 hours.

Charge

Figure 19 Battery charging symbol

NOTE: If the ADU is stored more than two months it is recommended to connect the ADU to the mains
supply to let the batteries become fully charged.
Checking battery condition
1. Disconnect the power cord from the mains power supply outlet and check that the ADU is
running on battery power. Check that a battery symbol with a green bar appears in the upper
right corner of the screen. (The green bar indicates the remaining battery capacity).

26 Document No. 8502304-2


2 System description

2. If the batteries are discharged, they should be charged for at least 4 hours by keeping the power
cord connected to the mains outlet. The Charge battery symbol should then disappear from
the message screen.
NOTE: The batteries are always recharged when the mains plug is connected and the green light lit on
the front panel.
Fresh gas supply
If N2O pressure is lost during operation, the ADU automatically switches from N2O to Air
independently of the front panel selector position. The following alarm message is displayed:
N2O supply pressure lost and Air selected
If the supply pressure for O2 and/or Air is lost the following alarm message is displayed:
O2 supply pressure loss or Air supply pressure loss *
* If Air is used as primary driving gas
When no wall mounted gas supply is available; gases can be supplied from reserve gas cylinders.
The unit can be equipped with up to 3 reserve gas yokes. The corresponding number of pressure
gauges is added to the front of the unit when the unit is equipped with reserve gas yokes.

Figure 20 Reserve gas yokes (Pin type)

Document No. 8502304-2 27


Datex-Ohmeda ADU

Check daily the gas cylinder pressure. To avoid gas escaping accidentally, always remember to keep
the cylinders closed when wall gases are used.

Figure 21 Reserve gas cylinder

CAUTION Be aware that the reserve gas cylinders will be emptied more quickly if the auxiliary
gas outlets are used.
Driving gas
The primary driving gas is either Air or O2. If the driving gas pressure is lost, the ADU will automatically
use the auxiliary driving gas. When the driving gas is switched, the message Driving gas to:
Secondary is displayed. When the primary driving gas is restored the message disappears.
If the pressure of both the primary and secondary driving gases is lost the message Loss of driving
pressure appears.
WARNING Patient oxygen may be exhausted very quickly if the ventilator driving gas is
oxygen and this gas is supplied from a reserve gas cylinder.

28 Document No. 8502304-2


2 System description

Symbols
Equipment safety symbols
Attention, consult accompanying documents.
When this symbol is displayed beside the monitored O2 value, the FiO2 low alarm limit
is set below 21 %.
This symbol on the rear panel means the following warnings and cautions:
Electric shock hazard. Do not open the cover or the back. Refer servicing to
qualified personnel.
For continued protection against fire hazard, replace only with same type and
rating of fuse.
Disconnect power supply before servicing.

Type B (IEC 60601-1) protection against electrical shock.

IPX1 Degree of protection provided by enclosure according to the IEC 529: Vertically falling
water drops shall have no harmful effects.

Silence alarm indicator

Other symbols

Power On

Stand-by

Variability

Rotation in two directions

O2 flush

Flow direction

* Silence alarms
* Alarm silenced for given time
* All alarms silenced

Remaining battery capacity

Document No. 8502304-2 29


Datex-Ohmeda ADU

Battery empty symbol


Empty

Charge Battery charging symbol

Protective earth (ground)

Battery

Alternating current

Fuse

SN, S/N Serial Number

Sub menu. Choosing an alternative with this symbol in a menu opens a new
menu.

Potential equalizer

Fresh gas flow inlet

Bellows connection

Do not expose the bellows chamber to sideforce. Keep free from gastubes,
cables etc. Sideforce or impact on the chamber may create a leak in the
ventilator bellows drive circuit.

Oxygen

Nitrous oxide

Air

30 Document No. 8502304-2


2 System description

Symbols for Datex-Ohmeda Compact Block with Compact Canister

Bellows connection

Fresh gas flow inlet

Gas flow direction

Single use
2

Expiration connector

Inspiration connector

Document No. 8502304-2 31


Datex-Ohmeda ADU

32 Document No. 8502304-2


3 Assembly and preparations

3 Assembly and preparations


WARNING Do not operate the machine outside the specified working temperature range
(+10C to +35C) and specified operating humidity 0 to 85% (non-condensing
conditions). If the ADU is colder or warmer than the specified operating
temperature, let the ADU temperature stabilize for at least 4 hours before use.
WARNING Always use adequate means for monitoring that is appropriate for the particular
patient category.

Connecting gas and power supply


1. Connect the color-coded gas supply hoses to the wall outlets.
2. Confirm the availability of sufficient pipeline and/or cylinder gas supply pressures (270 to 800
kPa / 39 to 116 psi) from the pressure gauges on the front panel.
3. If your machine is equipped with gas cylinder(s) these should normally be turned off. Cylinders
should be opened only in the event of a loss of wall supply pressure.
4. Estimate the amount of gas remaining in the cylinder and make sure you have a sufficient
reserve at your disposal.
5. Connect the power cord to the power supply outlet.
6. To start the ADU - set the On/Standby switch on the front panel to On.
CAUTION Before connecting the power cord to the power supply outlet; check that the local
voltage and frequency matches those stated on the ID label on the rear panel.
CAUTION Before any connection on the rear panel - set the On/Standby switch in standby
position.
CAUTION On units operating on 100 to 120 V, the sum of current from any devices connected to
the auxiliary electrical outlets must not exceed 8 A.

Document No. 8502304-2 33


Datex-Ohmeda ADU

Assembling ventilator bellows block


1. Assemble ventilator bellows block:
Make sure the locking handle (1) is in open position (pull outwards).
Check that the selector switch (2) is in the position Manual.
Place the bellows block (3) on the bottom plate (4).

4 1

Figure 22 Bellows block inserted into the bottom plate

34 Document No. 8502304-2


3 Assembly and preparations

2. Assemble the bellows block overflow valve:

- Place the rubber membrane over the valve duct.

- Feel with the finger (wear gloves) along the edge to


make sure that the groove on the outer rim of the
membrane sits tightly on the outside wall of the duct.

- Check the tightness by lifting the membrane by the


metal weight. The membrane should flex upwards
slightly but not disconnect from the edges.

- Reassemble the overflow valve by entering (1) and


2
then turning (2) the valve retaining ring. Be careful not 1
to tighten it too tightly, as the membrane may become
kinked and prone to leak.

WARNING If the overflow valve is placed incorrectly with the metal part facing downwards,
the pressure in the patient circuit may not be sufficient to guarantee adequate
patient ventilation.

Document No. 8502304-2 35


Datex-Ohmeda ADU

3. Carefully stretch the mouth of the bellows over and around the edge of the bellows base.

36 Document No. 8502304-2


3 Assembly and preparations

4. Insert and lock the bellows chamber.


Make sure that the handle (3) of the chamber locking mechanism is in extended
(unlocked) position. Insert (1) the bellows chamber into the bellows base.
Turn (2) the bellows chamber clockwise until it stops. Check that the chamber bayonet
tabs are aligned with the metal locking ring indent. The chamber should stand straight up.
Push (3) the locking handle upward against the block to ensure proper leak tightness.
WARNING To avoid the risk of injury to the fingers, push the handle into locked position with
an open hand.
CAUTION Make sure that the bellows chamber is not forced to the side during use as this could
create a leak in the patient circuit.

Figure 23 Inserting and locking the bellows chamber

Document No. 8502304-2 37


Datex-Ohmeda ADU

Compact patient circuit description


11 12

10

7 6 5 4 3 2 1

Figure 24 Compact patient circuit

(1) Fresh gas supply connection (Common gas


outlet)
(2) Fresh gas flow indicator
(3) Circuit boom
(4) Ventilation hose
(5) Compact block II
(6) Valves for inspiration and expiration
(7) Locking/releasing latch for absorber canister
(8) Manual ventilation bag with hose
(9) Inspiration and expiration hoses with Y-piece
(10) Cable management arm
(11) Absorber canister
(12) Bellows block

38 Document No. 8502304-2


3 Assembly and preparations

The Datex-Ohmeda compact block


The compact block is the connection manifold for the patient hoses, for the fresh gas as well as for the
CO2 absorber. The compact blocks can be used with either Datex-Ohmeda Compact Absorber (single
use) or Datex-Ohmeda Compact Canister (reusable). Both are herein referred to as Compact
Absorber.
Compact Block II is equipped with a water trap and a water container.

2 3

Figure 25 Exploded view of Compact Block II


(1) Latch
(2) Piston valve
(3) Valve membrane
(4) Valve covers
(5) Water trap valve
(6) Water container

Document No. 8502304-2 39


Datex-Ohmeda ADU

Assembling the compact block


1. Visually check that the block is clean, dry and undamaged.
2. Visually check that the O-rings are undamaged.
3. Make sure that the expiratory and inspiratory valves are in bottom position, by lifting the green
membranes (1) and smoothly pressing the valve housings (2).

Figure 26 Ensuring that the valves are in the correct position

4. Attach the transparent valve covers over the valves, by first pushing (3) and then twisting (4)
them to lock.

3 4

Figure 27 Attaching the transparent valve covers

5. Put the water container in place.


6. Attach the compact block on the circuit boom.

40 Document No. 8502304-2


3 Assembly and preparations

Attachment of the absorber on the compact block


1. Hook the rear end of the Compact Absorber under the pins on the block (1).
2. Push down the locking latch of the block (2). Push down the Compact Absorber (3) and release
the latch.
3. Make sure the Compact Absorber sits tightly on and is safely locked to the compact block.

Consult the Instructions for Use leaflet included in the absorber package, on how to connect and
handle the Compact Absorber.
NOTE: Check the color of the absorbent. If it is purple and rebreathing can be observed on the CO2
monitoring display, the Compact Absorber should be replaced. This may be done during ventilation.
When the canister is removed, CO2 will be accumulated in the circuit.

Document No. 8502304-2 41


Datex-Ohmeda ADU

Hose connectors

4 3 2 7 8 1

Figure 28 Compact circuit connectors


(1) Fresh gas outlet
(2) Ventilator inlet connector
(3) Inspiration connector
(4) Expiration connector
(5) Fresh gas inlet connector
(6) Patient circuit connector
(7) Occluder cone
(8) Manual bag connector

42 Document No. 8502304-2


3 Assembly and preparations

Circuit connection

Figure 29 Connecting the fresh gas hose to Compact Block II

1. Push the conical connector of the fresh gas hose onto the fresh gas outlet.
2. Connect the quick coupling, at the other end of the fresh gas hose, to the fresh gas inlet
connector on the back of the compact block.

Figure 30 Compact circuit inspiratory and expiratory hoses

3. Connect the inspiratory hose of the circuit to the compact block inspiratory connector.
4. Connect the expiratory hose of the circuit to the compact block expiratory connector.
WARNING Only use patient hoses and accessories approved by Datex-Ohmeda.

Document No. 8502304-2 43


Datex-Ohmeda ADU

Figure 31 Compact circuit ventilator hose


5. Push the ventilator hose onto the ventilator connector underneath the compact block and to the
patient circuit connector underneath the bellows block.

44 Document No. 8502304-2


3 Assembly and preparations

Connection of manual ventilation hose

Figure 32 Compact circuit manual patient bag with hose


Attaching the manual ventilation hose to the ventilation connector beneath the APL valve
NOTE: Only use Datex-Ohmeda hose and keyed connector.
1. Push the locking ring around the connector inlet upwards and hold it there
2. Insert the hose end firmly into the connector
3. Let go of the locking ring and let it spring back into locking position
4. Check the connection by lightly pulling the hose downwards
WARNING Do not to use anti-static or electrically conductive breathing tubes.
WARNING Only use manual patient bags which comply with ISO 5362.

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Datex-Ohmeda ADU

Bain and Jackson Rees breathing systems


Bain breathing system

Figure 33 Bain breathing system connected to ADU

The Bain breathing system can be used in both the manual and auto ventilation modes when
connected as in the picture below.
The system should be connected to the fresh gas outlet.
Always use airway gas and volume monitoring.
WARNING Always use oxygen, expired volume, carbon dioxide and agent monitoring on every
patient.

46 Document No. 8502304-2


3 Assembly and preparations

Jackson Rees breathing system

To passive
scavenging

Figure 34 Jackson Rees breathing system connected to ADU

The Jackson Rees breathing system can be used for manual ventilation with small volumes.
The system should be connected to the fresh gas outlet.
Always use airway gas and volume monitoring.
WARNING Always use oxygen, expired volume, carbon dioxide and agent monitoring on every
patient.

Document No. 8502304-2 47


Datex-Ohmeda ADU

Electronically controlled vaporizer and Aladin cassettes


The electronically controlled vaporizer is ready to use when the relevant Aladin cassette is inserted
and locked into its slot on the front of the ADU.
The Aladin cassettes are color-coded according to the agent they contain. The ADU identifies the
inserted cassette and the name and color-code of the agent is displayed on the agent field.
The vaporizer cassette should be unlocked from its working position, but may be left in its slot when
not administering anesthetic agent.
Aladin cassettes may be equipped with three types of filling systems. Cassettes for halothane,
enflurane and isoflurane are filled with the aid of color-coded and keyed fillers.
The sevoflurane cassette is available with the keyed filler mechanism described above. As an
alternative (only sold in Canada) the sevoflurane cassette also is available with a Quik Fil
mechanism.
The Desflurane cassette is equipped with a filling mechanism compatible with Saf-T-Fill desflurane
bottles.

4
1

2 3

Figure 35 Aladin cassette for Halothane, Enflurane, Isoflurane and Sevoflurane with Keyed
Filler system
(1) Lock & Fill Wheel
(2) Agent filling port
(3) Liquid level indicator
(4) Handle with release trigger

48 Document No. 8502304-2


3 Assembly and preparations

1
2

Figure 36 Aladin cassette for Sevoflurane with Quik Fil

(1) Agent filling port


(2) Handle with release trigger
(3) Liquid level indicator
NOTE: The Sevoflurane Aladin cassette with Quik Fil is only available in Canada.

2
1

Figure 37 Aladin cassette for Desflurane with Saf-T-Fill compatible filler system

(1) Agent filler block


(2) Handle with release trigger
(3) Liquid level indicator
CAUTION Do not wipe Aladin cassettes with alcohol based detergents as this may harm the
surface of the cassette.

Document No. 8502304-2 49


Datex-Ohmeda ADU

Filling Aladin cassettes


Always unlock and remove the cassette from the machine before filling. It is important that the Aladin
cassette is in a horizontal position during filling. If the cassette is tilted the flow of liquid is shut off to
prevent overfilling.
During filling, ensure that the pins in the back of the cassette are not coming in contact with the
machine or any other object that could depress the pins and let air out of the cassette.
The sight glass of the cassette should be observed during filling, when the liquid level reaches the full
mark the filling should be stopped.
Anesthetic Agent filler Systems Table:
Anesthetic agent Type of filling system Color code
Halothane Keyed Red
Enflurane Keyed Orange
Isoflurane Keyed Violet
Sevoflurane Keyed or Quik Fil Yellow
Desflurane Keyed for Saf-T-Fill Blue

WARNING Always remove the Aladin cassette from its slot and put it on a horizontal surface
before filling. Never try to fill the cassette in its slot.
WARNING Inaccurate anesthetic agent dosages may temporarily occur after filling if the
temperature of the liquid is considerably lower than the normal operating
temperature.

50 Document No. 8502304-2


3 Assembly and preparations

Filling the Aladin cassette with Keyed Filler System


Halothane, Enflurane, Isoflurane, Sevoflurane

Figure 38 Aladin cassette with Keyed Filler System

1. Remove the cassette from its slot and place it on a horizontal surface. Ensure that the pins in
the back of the cassette not are coming in contact with the machine or any other object.
2. Screw the bottle adaptor for the keyed filler system firmly onto the relevant bottle.
3. Insert the bottle adaptor into the agent filling port on the cassette. Be sure to fit the adaptor
properly, so that the end of its square part is flush with the cassette body as shown.
4. Lock the bottle adaptor by turning the Lock & Fill Wheel fully clockwise.
5. Turn the bottle upside down and check that the liquid flows evenly into the cassette. If it does
not, tighten the wheel until the liquid starts to flow. Follow the rise of the indicator ball in the
vertical-viewing window. The position of the ball indicates the liquid level inside the cassette.
6. When the cassette is full, shut off the liquid flow by lowering the bottle, turning it upright and
releasing the bottle adaptor by turning the Lock & Fill Wheel counterclockwise. Start by turning
it half a turn to close the filling port and wait for the residual anesthetic agent to trickle back into
the bottle.
7. Remove the bottle adaptor from the vaporizer filling port by turning the Lock & Fill Wheel fully
counterclockwise.
8. Remove the bottle adaptor from the anesthetic agent bottle and close the bottle with its cap.
The cassette is now prepared for use.
WARNING To avoid exposure to anesthetic agent during filling, make sure that the bottle
adaptor is properly connected to the bottle. Also, if air leaks into the system the
overfill protection mechanism of the cassette will not function properly.
Overfilling may result in overdosage of anesthetic agent.

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Datex-Ohmeda ADU

Filling the Aladin cassette with Quik Fil System for Sevoflurane

Figure 39 Filling Aladin cassette with Quik Fil System

1. Remove the cassette from its slot and place it on a horizontal surface. Ensure that the pins in
the back of the cassette not are coming in contact with the machine or any other object.
2. Remove the yellow protection cap from the anesthetic agent bottle. Check that the filling
mechanism of the bottle is undamaged.
3. Remove the filling port cap from the cassette by turning the cap counterclockwise. Insert the
nozzle of the bottle into the filler port.
4. Push the agent bottle firmly into the filling port. Let the agent flow into the cassette. The position
of the ball in the level indicator window indicates the level of the liquid inside the cassette.
5. Remove the bottle from the filling port; close the filling port and the bottle with their caps.
6. Lock the cassette in its slot. The cassette is now prepared for use.
NOTE: The cassette may be emptied for service needs by authorized service personnel only. See the
ADU Technical Reference Manual.
WARNING Do not open or press the cassette filling port or gas connection valves with the
fingers or any kind of instrument. If the vaporizer is pressurized, the anesthetic
agent liquid or gas may squirt into the air.

52 Document No. 8502304-2


3 Assembly and preparations

Filling of the Aladin cassette for Desflurane

1 2

3 4

Figure 40 Filling Aladin cassette with Saf-T-Fill Desflurane bottle

1. Remove the cassette from its slot and place it on a horizontal surface. Ensure that the pins in
the back of the cassette not are coming in contact with the machine or any other object.
2. Remove the cap from the Desflurane bottle. Check that the O-ring is correctly fitted on the
bottle nozzle.
3. Insert the nozzle of the bottle into the filler port and push the bottle firmly against the spring
pressure till it stops.
NOTE: Ensure that the nozzle is fully inserted before attempting to turn the bottle upwards.
4. Turn the bottle upwards while keeping it firmly inserted. The flow of bubbles in the bottle
indicates the liquid flow into the cassette. The position of the ball in the level indicator window
indicates the level of the liquid inside the cassette. Do not leave the bottle unattended while
attached to the cassette.
5. When the flow of bubbles ceases or when the liquid level reaches the full mark, whichever
occurs first, lower the bottle to stop liquid flow.
6. Remove the bottle from the agent filling port and close the bottle with the cap.
7. Lock the cassette in its slot. The cassette is now ready for use.
CAUTION Do not attempt to fill the cassette with desflurane warmer than + 26 C/78.8 F.
CAUTION The message Draining cassette indicates that the Aladin cassette has been
overfilled and that it is automatically being drained. When the message disappears
the vaporizer can be turned on again.
WARNING Do not leave the Desflurane bottle unattended while filling the Aladin cassette.
WARNING Do not store filled or partly filled Desflurane cassettes above the normal working
temperature of + 35 C/95 F. Storage at an excessively high temperature, may
cause the overpressure valve to vent desflurane vapor into the ambient air.

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WARNING Do not open or press the cassette filling port or gas connection valves with the
fingers or any kind of instrument. If the vaporizer is pressurized, the anesthetic
agent liquid or gas may squirt into the air.
WARNING The Aladin Cassette does not normally need to be drained. If the cassette needs
to be sent for repair, the cassette shall be drained by authorized service
personnel.

54 Document No. 8502304-2


3 Assembly and preparations

Preparation for Patient SpirometryTM monitoring (Datex-Ohmeda monitors)


Optimal anesthesia delivery is achieved by adjusting ventilator settings with the help of measured
patient data. Gas and spirometry data are measured by the Datex-Ohmeda D-liteTM and Pedi-liteTM
sensors.
WARNING To prevent hazards arising from incorrect delivery of gases, the ADU shall always
be used with the following monitoring:
O2 monitor in according to ISO7767/EN 12598
Agent monitor according to ISO 11196/EN ISO 11196
CO2 monitor according to ISO 9918/EN864
Expired volume monitor according to IEC 60601-2-13/EN 740
NOTE: If required, an alarm signaling when a volume monitor is not connected or is switched off, may
be installed by a qualified technician.

Selecting spirometry sensor


Adult and pediatric patients are measured with different sensors.
Note: The monitor cannot recognize the size of the patient or which sensor is in use. Adult or pediatric
sensor mode must be selected on the monitor.
D-lite sensors
The D-lite sensor is intended for patients having a tidal volume from 150 to 2000 ml. There is a
reusable D-lite sensor (733910) available as well as a disposable D-lite+ (896952 pkg of 50 pcs),
which also is designed for humid conditions (e.g. low flow).

Figure 41 D-lite and D-lite+ sensor

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Datex-Ohmeda ADU

Pedi-lite sensors
The Pedi-lite sensor is intended for pediatric patients with tidal volumes from 15 to 300 ml. There is a
reusable Pedi-lite (73393) available as well as a disposable Pedi-lite+ (8001948 pkg of 50 pcs),
which also is designed for humid conditions (e.g. low flow).

Figure 42 Pedi-lite sensor

Connecting the spirometry sensor


No specific instruction can be given here as the connection of the spirometry sensor varies from one
type of monitor to another. Please refer to the instruction manual for the monitor used.

Note: It is recommended to use a microbiological filter between the endotracheal tube and the
D-lite/Pedi-lite sensor. Replace the filter after each patient in order to prevent sensor and patient
tubing from being contaminated. Adding a filter will, of course, increase dead space.

Figure 43 Microbiological filter between endotracheal tube and D-lite sensor

56 Document No. 8502304-2


3 Assembly and preparations

Sampling gas
The gas monitors draw sampling gas from the patient circuit at a rate of approx. 200 ml/min. Avoid
letting sampling gas escape into room air! The sampling gas may be directed to the scavenging
connector under the bellows block as shown below.

Figure 44 Sample gas returned to scavenging in bellows block

The sampling gas may also be returned to the patient circuit with an optional adapter. The adapter is
connected to the patient breathing tubes as shown below.

Figure 45 Sample gas returned to patient

Document No. 8502304-2 57


Datex-Ohmeda ADU

58 Document No. 8502304-2


4 System checkout

4 System checkout
General
Each time the ADU is powered on, at least once every day, Datex-Ohmeda recommends that a
System Checkout should be performed. Datex-Ohmeda also strongly recommends that a System
Checkout always is performed when the pneumatics system has been disassembled, or the size of
the patient circuit has been changed, i.e. from adult to pediatric.
When the power is turned on, the display is blank for a moment. During the system Self-Check,
including the battery check that follows, the Datex-Ohmeda logotype is displayed. If the self-check is
still going on when the System Checkout menu appears, some items are blue - i.e. not selectable.
When the self-check is finished, the blue items on the System Checkout menu turn white i.e.
selectable. The System Checkout menu may also be attained by pushing the System Checkout
key. However, the ventilation must be switched to Manual mode before all menu items are selectable.
WARNING Always perform the System Checkout with the breathing circuit in the state in
which it will be used. If the breathing circuit is changed in any way after the
System Checkout has been performed (e.g. removing the absorber, changing the
volume of the expandable breathing hoses), another System Checkout is
imperative!
WARNING Do not perform a System Checkout while a patient is connected to the delivery
unit.
WARNING Before performing the System Checkout, verify that the breathing circuit is set up
correctly, according to the picture below.

NOTE: During the Start-up and System Checkout procedures, the ADU will do some valve
exercising. This produces clicking sounds which are perfectly normal and should be ignored.
NOTE: The System Checkout performed on an ADU without N2O differs in some ways from what is
described in this chapter. For more information about System Checkout on an N2O free machine, see
System Checkout performed on an ADU without N2O on page 77.

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Datex-Ohmeda ADU

The System Checkout procedure


The System Checkout menu consists of different checkouts, these can be performed either
separately or automatically. If automatically then this will be a Complete Checkout in which all
individual checkouts will be performed in sequence.
The System Checkout proceeds in the following way:

Complete Checkout

N2O Delivery

Agent delivery

AUTO ventilation

MAN ventilation

Status Check

Start Complete Checkout


Start separate checkouts
Figure 46 System Checkout order

The System Checkout menu items:

Complete Checkout Checks Air, O2 and N2O pressure, scavenging, patient circuit and makes
other preparations for the automatic Complete Checkout.
N2O Delivery Checks the delivery of adequate N2O flow and prevents the delivery of a
hypoxic mixture.
Agent Delivery Checks the function of the anesthetic agent delivery system.
AUTO Ventilation Checks the amount of internal and external leaks and calculates the
compressible volume of the Patient Circuit.
MAN Ventilation Checks for leaks in the respiratory tubes and in the manual bag.
Status Check Manual check of Suction, CO2 absorber, Gas cylinders, Insp./Exp. Valve,
Level indicator and Gas monitor.
Checkout Log Record of performed checkouts. The nine last error entries are shown in
Checkout Error.
Bypass Checkout Bypasses all the checkouts.

NOTE: During the System Checkout a 2 to 3 liter test lung must be used.
NOTE: Do not use the Datex-Ohmeda D-lite Sensor during the System Checkout.

60 Document No. 8502304-2


4 System checkout

Performing a complete System Checkout


1. Push System Checkout key.
2. Select Complete Checkout and Confirm on the menu.
3. Read the instructions displayed in the Help Field at the bottom of each menu.
4. While for some tests the next step comes up automatically as the previous test is completed,
some others need to be verified manually by pushing the ComWheel to acknowledge.
NOTE: During the AUTO and MAN ventilation checkouts the gas sampling monitors must be
disconnected. See AUTO ventilation checkout on page 65 and MAN ventilation checkout on
page 66.
NOTE: Make sure that every Aladin cassette to be used during the day is checked before use. See
Agent delivery checkout on page 64.

Complete System Checkout step by step

Figure 47 The Complete Checkout menu 1 and 2

Air Pressure, O2 Pressure and N2O Pressure automatically examine the connected Air, O2 and N2O
supply pressure. If the pressure is below 270 kPa (39 psi), the checkout fails and if it is below 20 kPa
(2.9 psi) the display shows - - -.
1. Check Scavenging - Check that the scavenging hose is connected and that scavenging is
active. Push the ComWheel.
2. Patient circuit - Check the assembly of the breathing tubes (circuit). Push the ComWheel.
3. Occlude Y-piece - Connect the Y-piece to the occluder tap under the Bellows block. Do not
connect the gas sampling or spirometry tubing as this will result in a leak. Push the ComWheel.
4. Switch to AUTO - Turn the Auto/Man. selector to AUTO position.
5. O2 over 6 l/min. - Set O2 flow above 6 l/min. (When Air is adjusted upwards O2 flow may drop to
below 6 l/min.)
6. Select Air - Turn Air / N2O selector to Air.
7. Air over 6 l/min. - Set Air flow above 6 l/min.
8. Close flows - Close O2 and Air needle valves.

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9. Select N2O - Turn Air / N2O selector to N2O.


10. N2O over 6 l/min. - Set N2O flow above 6 l/min.
11. Insert Cassette - Check that the amount of liquid agent is adequate and install the agent
cassette. The cassette is properly inserted when the agent is identified on the display screen.
The first part of the automatic Complete Checkout is started.
If the checkouts are successful, the results from the first part of the Complete Checkout are
immediately presented in the menu.

Figure 48 The automatic Complete Checkout menu

12. Close Agents - Set agent wheel to OFF position.


13. Close N20 - Close N2O needle valves.
14. Manual APL to 80 - Set the APL valve to 80 cmH2O (closed). Push the ComWheel.
15. Switch to MAN - Turn the Auto/Man. selector to MAN position.
When the Auto/Man. mode selector is turned to Man. position, the corresponding checkout for
Manual Ventilation starts immediately.
When the MAN Ventilation leak checkout is successfully passed, the ADU automatically goes to the
Status Check menu. The APL valve control should be set to 1.5 cmH2O or to any preferred value for
Manual Ventilation.
16. Manual APL to 20 - Set the APL valve to 20 cmH2O to check valve function.
17. Manual APL to 1.5 - Set the APL valve to 1,5 cmH2O (fully open).
18. Status Check - Check all of the items in the list, for further instructions seeStatus Check on
page 67.
19. Checkout Menu - To display the initial menu - push the ComWheel.

When the System Checkout has been completed, the ADU automatically returns to the System
Checkout menu thus confirming that the checking procedure is finished.

62 Document No. 8502304-2


4 System checkout

Performing separate checkouts


1. Push System Checkout key.
2. Select N20 Delivery, Agent Delivery, AUTO Ventilation or MAN Ventilation.
3. Select Confirm.
When a checkout is separately selected, the item Continue on the menu may be selected to get from
one checkout to another.
To quit after separate checkout, select Checkout Menu.

N2O delivery and hypoxic mixture control checkout


The N2O delivery and hypoxic mixture control is checked for delivery of adequate flow of N2O and for
hypoxic mixture prevention.

Figure 49 N2O Delivery checkout menu

1. Check Scavenging - Check that the scavenging hose is connected and that scavenging is
active. Push the ComWheel.
2. Occlude Y-piece - Connect the Y-piece to the occluder tap under the Bellows block. Push the
ComWheel.
3. Switch to AUTO - Turn the Auto/Man. selector to AUTO position.
4. Select N2O - Turn the Air/ N2O selector to N2O.
5. N2O over 6 l/min. - Set N2O flow above 6 l/min. After this the checkout starts automatically.
6. Close N2O - Close the N2O needle valve.
7. Continue - Push the ComWheel to continue with Agent Delivery Checkout.
8. Repeat Prev Checkout - Try to resolve a failure and repeat the checkout.
9. Checkout Menu - Push the ComWheel to return to System Checkout main menu.
NOTE: The clicking sound heard during the operation of the valves is normal and expected.

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Agent delivery checkout


The automatic anesthetic agent delivery checkout checks the function of the anesthetic agent
delivery system.
NOTE: To prevent air pollution, check that the waste gas evacuation is functioning and that the
Y-piece is properly occluded.

Figure 50 Agent delivery checkout menu

1. Check Scavenging - Check that the scavenging hose is connected and that scavenging is
active. Push the ComWheel.
2. Occlude Y-piece - Connect the Y-piece to the occluder tap under the Bellows block. Push the
ComWheel.
3. Switch to AUTO - Turn the Auto/Man. selector to AUTO position.
4. Close flows - Close the O2, N2O and Air needle valves.
5. Insert Cassette - Fill the requested cassette with agent liquid and install it. The cassette is
properly inserted when the agent is identified on the display screen.
Make sure that every Aladin cassette to be used during the day is checked before use. During a
Complete Checkout the installed cassette is checked, but other cassettes shall be checked one by
one through separate Agent Delivery checkouts. When selecting the item Another Cassette, the
checkout will be repeated but in an abbreviated form that only involves the cassette itself.
6. Close Agent - Set the agent wheel to OFF position.
7. Checkout Menu - Push the ComWheel to return to System Checkout main menu.
8. Continue - Push the ComWheel to continue with the AUTO ventilation checkout.
9. Repeat Prev Checkout - Try to resolve a failure and repeat the checkout.
10. Checkout Menu - Push the ComWheel to return to System Checkout main menu.

64 Document No. 8502304-2


4 System checkout

AUTO ventilation checkout


In Auto mode, the automatic leak checkout checks the amount of both internal and external leakage
as well as the condition of the respiratory tubing assembly. It also calculates the compressible
volume of the Patient Circuit. If the leakage is less than 150 ml/min. and lost volume, due to
compressibility and patient circuit compliance, is less than 10 ml/cmH2O, the checkout is
automatically regarded as successful.
For more information about leak detection and correction see Leak detection on page 4-76.
WARNING Do not attempt an AUTO Ventilation checkout while a patient is connected to the
delivery unit.
The ventilator block and patient circuit is checked. The breathing system is pressurized four times to
about 30 cmH2O for 4 seconds and a fifth time to a higher pressure to check the overpressure release
valve. In the case of a leak the pressure in the system falls. A pressure drop can be seen on the
pressure curve on the screen.
NOTE: Gas monitor sample lines must be disconnected during the checkout so that the sampling is
not considered leakage, causing subsequent checkout failure.

Figure 51 AUTO ventilation checkout menu


1. Close flows - Close the O2, Air, N2O needle valves.
2. Check Scavenging - Check that the scavenging hose is connected and that scavenging is
active. Push the ComWheel.
3. Occlude Y-piece - Connect the Y-piece to the occluder tap under the Bellows block. Push the
ComWheel.
4. Switch to AUTO - Turn the Auto/Man. selector to AUTO position.
5. Close N2O - Close the N2O needle valve.
6. Continue - Push the ComWheel to continue with the MAN ventilation checkout.
7. Repeat Prev Checkout - Try to resolve a failure and repeat the checkout.
8. Checkout Menu - Push the ComWheel to return to System Checkout main menu.

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Datex-Ohmeda ADU

MAN ventilation checkout


The automatic leak checkout of the Manual mode (Man./Spont. selector), checks the amount of
leakage in the respiratory tubes and in the manual bag.
If the leakage is less than 100 ml/min, the checkout is automatically regarded as successful. If the
checkout fails, instructions to correct the problem are displayed in the Help Field. Follow the
instructions and repeat the checkout of the Manual mode.
NOTE: Gas monitor sample lines must be disconnected during the checkout so that the sampling is
not considered leakage, causing subsequent checkout failure.

Figure 52 MAN ventilation checkout menu

1. Close Flows - Close the O2, Air and N2O needle valves.
2. Check Scavenging - Check that the scavenging hose is connected and that scavenging is
active. Push the ComWheel.
3. Occlude Y-piece - Connect the Y-piece to the occluder tap under the Bellows block. Push the
ComWheel.
4. Switch to MAN - Turn the Auto/Man. selector to MAN position.
5. Manual APL to 80 - Set the APL valve to 80 cmH2O (closed). Push the ComWheel.
The manual bag and hose are checked. The pressure is built up in the manual ventilation circuit and
any leaks are detected.
6. Manual APL to 20 - Set the APL valve to 20 cmH2O to check valve function.
7. Manual APL to 1.5 - Set the APL valve to 1,5 cmH2O (fully open).
8. Continue - Push the ComWheel. The checkout continues with a Status check of 5 items to be
inspected at least once a day.
9. Repeat Prev Checkout - Try to resolve a failure and repeat the checkout.
10. Checkout Menu - Push the ComWheel to return to System Checkout main menu.

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4 System checkout

Status Check
The items on the Status Check should be checked at least once a day.
The Help Field includes brief advice on the checking procedure for each step.

Figure 53 The Status Check menu

1. Suction - Check the functionality of the suction unit.


2. CO2 absorber - Check that the absorbent is available and functioning. Check functionality by
observing the inspiratory CO2 value during patient monitoring. Make sure spare absorber is
available.
3. Gas cylinders - Check the content of reserve gas cylinders. After checking, close the cylinders
valves.
4. Insp./Exp. Valves - Connect a test lung or a bag to the Y-piece. Turn the Auto/Man. selector to
Man. position. Set the APL valve to 20 cmH2O. Fill up the breathing system with gas using the
O2+ button.
Squeeze and release the manual bag and verify that the inspiratory and expiratory valves are
opening and closing correctly, (in opposite directions).
5. O2+ flush - Set the APL valve to 1,5 cmH2O (fully open). Push the O2+ button. Check that the
manual bag fills up and that the O2 monitor approaches 100 % O2.
6. Gas monitor - Connect the gas monitor adapter (D-lite/Pedi-lite) close to the breathing tubes.
Remove the CO2 sample line and make sure that the gas monitor reads 21 % of room air.
7. Verify that backup ventilation equipment is available and functioning.
8. Checkout Menu - Push the ComWheel to display the menu.

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Checkout Log
The ADU keeps a record of the performed checkouts.
1. Push the System Checkout key to display the menu.
2. Select Checkout Log and then Checkout Error.
The nine last error entries are shown in the Checkout Error list with the last one at the top. An entry
falls off the list after 360 days.

Figure 54 The Checkout Log and Checkout Error menus

68 Document No. 8502304-2


4 System checkout

Bypass checkout

Figure 55 Bypass checkout

The estimated time for a Complete Checkout is 3 to 4 minutes. In case of emergency when a faster
start-up is required, then the System Checkout can be bypassed.
Select Bypass Checkout.
The ADU is immediately put into operational state. Until the System Checkout is successfully
performed, the message System Checkout bypassed is shown on the normal screen.
If the ventilator is in AUTO mode when leaving the System Checkout mode, the command Switch to
MAN before connecting the patient to the delivery unit will appear.
WARNING When Bypass Checkout is selected the factory default value for compressible
volume is 2 ml/cmH2O. All alarms are still active. The delivered tidal volume
might not be correct.
WARNING The System Checkout is designed to ensure correct and safe functioning of the
ADU unit. The Bypass Checkout command on the System Checkout menu must
only be used when patient safety requires an immediate start-up of a surgical
procedure.
Normal Screen may be selected (with the Quick key) instead of the Bypass Checkout command
if the Complete Checkout has been successfully passed today or it was passed yesterday and the
machine has not been turned on today and no ventilator/fresh gas unit failure alarm has occurred
since the checkout was passed.

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Failed checkouts
If any of the checkouts fail, the Complete Checkout is interrupted. Instructions to correct the failure
appear in the Help Field at the bottom of the menu. Follow these instructions and repeat the failed
checkout.
If the checkout is successful this time, it will be automatically check marked and the Complete
Checkout will automatically be resumed.
If the checkout still fails, the option to accept the failure and then continue the Complete Checkout
may be chosen.

Failed N2O delivery checkout

Figure 56 Failed N2O delivery checkout

Possible causes for failure: Action:


The N2O flow is less than 6 l/min. 1. Increase the N2O flow.
2. Repeat test.
The position of the Air/ N2O selector has been 1. Turn the Air/ N2O selector to N2O.
changed during the automatic checkout. 2. Repeat the checkout and make sure the
selector stays in this position.
The position of the Auto/Man. selector has been 1. Turn the Auto/Man. selector to AUTO
changed during the automatic checkout. position.
2. Repeat the checkout and make sure the
selector stays in this position.
Component failure with subsequent need for Contact service personnel.
technical service.

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4 System checkout

Failed agent delivery checkout

Figure 57 Failed agent delivery checkout

Possible causes for failure: Action:


The Aladin cassette is not properly inserted or 1. Fill the requested cassette with agent liquid
has been removed during the checkout. and install it. The cassette is properly
inserted when the agent is identified on the
display screen.
2. Repeat the checkout.
The fresh gas flow controls have not been fully 1. Close the fresh gas flow controls fully.
closed. 2. Repeat the checkout.
The position of the Auto/Man. selector has been 1. Turn the Auto/Man. selector to AUTO
changed during the automatic checkout. position.
2. Repeat the checkout and make sure the
selector stays in this position.
The vaporizer cassette is leaking internally. 1. Remove cassette and use another one.
2. Repeat the checkout.
The vaporizer calibration is out of specification. Contact service personnel.
Component failure with subsequent need for Contact service personnel.
technical service.

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Failed AUTO Ventilation checkout


The AUTO Ventilation checkout fails when leakage is >150 ml/min.

Figure 58 Failed AUTO ventilation checkout

Possible causes for leak: Action:


Respiratory tubing/connections are leaking/ 1. Check the tubing and connections.
disconnected. 2. Alternative leak checkout: bypass the patient
circuit by connecting the ventilator hose
directly from the block to the fresh gas outlet.
Check the leak hose by hose.
Ensure that the tubing is returned to the
correct position after the leak check.
3. Perform a manual leak checkout to find the
leak. The limit is 100 ml/min. If the manual
side is tight it means that the ventilator block
is leaking.
4. Repeat the checkout.
Patient Circuit connections, absorber or insp./ 1. Remove the absorber from the compact
exp. valves are leaking. block and repeat the test. If it passes, the
leak is in the absorber.
2. Repeat the checkout.
Y-piece is not properly occluded. 1. Occlude the y-piece again.
2. Repeat the checkout.
Bellows chamber or bellows is leaking. 1. Assemble the bellows block.
2. Reassemble the block again.
3. Repeat the checkout.
O-ring seals in the bellows block are not properly 1. Check that available time for the pressure
seated. build up is not too short at the start. Use O2
flush to fill the bellows.
2. Repeat the checkout.

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4 System checkout

Overflow valve is not properly installed. 1. Check the overflow valve connection.
2. Repeat the checkout.
A gas monitor is connected to the circuit and is 1. Check that the gas monitor is not sampling
drawing gas samples gas from the circuit.
2. Repeat the checkout.

Possible causes for other failures: Action:


The fresh gas flow controls have not been 1. Close the fresh gas flow controls fully.
properly closed. 2. Repeat the checkout.
The position of the Auto/Man. selector has been 1. Turn the Auto/Man. selector to MAN position.
altered during the checkout. 2. Repeat the checkout and make sure the
selector stays in this position.
An extra pressure peak is detected during the Repeat the checkout.
checkout (may have been caused accidentally
while handling the respiratory tubing).
Component failure with subsequent need for Contact service personnel.
technical service.

If compliance is more than 10 ml/cmH2O the checkout fails. The volume loss due to compliance is
automatically compensated for.
NOTE: In case a checkout is bypassed, a default value of 2 ml/cmH2O is used.

Possible causes Failed Circuit Compressible Action:


Volume checkout:
The Y-piece is not properly occluded or a 1. Occlude the y-piece again and remove
spirometry adapter is connected to it. spirometry adapter if it is connected to it.
2. Repeat the checkout.

The total volume of the breathing circuit is too 1. Check the length of the tubings in the
large. breathing circuit. Change long tubings to
shorter ones.
2. Repeat the check.

NOTE: Leakage over 150 ml/min does not automatically prevent the ADU from being used. It is up to
the user to accept the leak or not.

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Failed Manual ventilation checkout


The MAN Ventilation checkout fails when leakage is > 100 ml/min.

Figure 59 Failed Manual ventilation checkout

Possible causes for leak: Action:


The manual APL valve is still open. 1. Check that the APL valve is closed.
2. Repeat the checkout.
The respiratory tubing and/or its connections are 1. Check the tubing and connections.
leaking. 2. Alternative leak checkout; bypass the patient
circuit by connecting the ventilator hose
directly from the block to the fresh gas outlet.
Check the leak hose by hose.
3. Repeat the checkout.
The manual ventilation bag is leaking 1. Change manual ventilation bag.
2. Repeat the checkout.
A gas monitor is connected to the circuit and is 1. Check that the gas monitor is not sampling
sampling gas gas from the circuit.
2. Repeat the checkout.

Possible causes for other failures: Action:


The fresh gas flow controls have not been 1. Close the fresh gas flow controls fully.
properly closed. 2. Repeat the checkout.
The position of the Auto/Man. selector has been 1. Turn the Auto/Man. selector to MAN position.
altered during the checkout. 2. Repeat the checkout and make sure the
selector stay in this position.
An extra pressure peak is detected during the Repeat the checkout.
checkout (may have been caused accidentally
while handling the respiratory tubing).

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4 System checkout

The pressure was higher than 20 cmH2O at the 1. Open APL valve to decrease the pressure
start of the MAN Leak checkout. before adjusting it to 80 cmH2O.
2. Repeat the checkout.
Component failure with subsequent need for Contact service personnel.
technical service

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Leak detection
The ADU checks for leaks during the AUTO Ventilation checkout. Avoid making any modifications to
the bellows block assembly or the patient circuit during operation, as any new leaks may go
unnoticed.
During the System Checkout AUTO ventilation test, the breathing system is pressurized four times to
about 30 cmH2O and a fifth time at a higher pressure to check the overpressure valve. If there is a
leak, the pressure in the system falls and this can be seen on the pressure curve on the ADU screen.
A leak below 150 ml/min is accepted by the ADU whereas leaks over 150 ml/min result in a FAILED
message. Leaks over 150 ml/min do not prevent the use of ADU. The user may decide whether to
accept the leakage or not.

Figure 60 Pressure waveform during System Checkout

During daily operation the most likely leak sources are the bellows chamber, the patient circuit hoses,
the compact block, the absorber and their connections.
If the Bellows Block has been dismantled, the overflow valve and rubber sealing of the bellows base
should be checked too.
For further details, see the see Leak detection and correction on page 153.

Leakage limits of ADU


The AUTO Ventilation checkout fails when leakage is >150 ml/min.
The MAN Ventilation checkout fails when leakage is > 100 ml/min.
The user may select Continue although a leak checkout has failed.

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4 System checkout

System Checkout performed on an ADU without N2O


The System Checkout on an ADU without N2O differs in some ways from what has been described
earlier in this chapter. This section will not describe the whole System Checkout procedure, only the
parts that are different on an ADU without N2O are shown.
The System Checkout has been modified so it can pass without use of N2O.

Complete Checkout

Agent delivery

AUTO ventilation

MAN ventilation

Status Check

Start Complete Checkout


Start separate checkouts

Figure 61 The System Checkout procedure

The separate checkout for N2O Delivery is disabled when using the ADU without N2O. The item N20
Delivery is not included in the System Checkout menu.

Figure 62 Complete Checkout menu 1 and 2

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When performing a Complete Checkout the N2O pressure is not displayed. The items Select N2O and
N2O over 6 l/min. will automatically be confirmed and displayed with the blue text OFF in Complete
Checkout menu 2.

During the automatic Complete Checkout, the N2O Delivery text is replaced with the text N2O OFF.
After a Complete Checkout the result from N2O Delivery is marked with the text OFF. Close N2O is
automatically confirmed by the system and the text is OFF.

All the results from the System Checkout are displayed in the Checkout Log. The top item in the
Checkout Log menu, N2O Delivery, is marked with OFF when using an ADU without N2O.

78 Document No. 8502304-2


5 Operating and adjusting the settings

5 Operating and adjusting the settings


ADU controls
10
9
8

6 11

12

5 13

4 3 2

Figure 63 ADU controls

(1) ON/STBY switch. Green light when the ADU is connected to mains power.
(2) Agent Wheel. Turn counterclockwise to increase (+), turn clockwise to decrease (-) the agent
concentration.
(3) N2O/Air selector. Turn the selector to point towards the desired gas.
(4) Adjustable pressure limiting valve (APL valve) for manual ventilation.
(5) Auto/Manual selector for selecting controlled mechanical ventilation (Auto) or the manual
(Manual) spontaneous (Spont.) ventilation mode.
(6) N2O flow control. Turn counterclockwise to increase flow.
(7) Air flow control. Turn counterclockwise to increase flow.
(8) O2 flow control. Turn counterclockwise to increase flow.
(9) Short cut menu keys.
(10) The ADU LCD color display.
(11) Ventilator quick function keys.
(12) ComWheel.
(13) Anesthetic agent vaporizer cassette, Aladin Cassette. Select agent by inserting the desired
vaporizer cassette.

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Display/keys
The ADU can be used with a 12.1 display or a 10.4 display. The differences, beside the size, are the
placement of the short cut menu keys and that the 12.1 display has an additional key, Reset Case.

Start/Stop
Timer

Reset
Timer

Ventilator

Volume/
Pressure

Rate

I:E

PEEP ComWheel, navigate


in menus and confirm
choices
Silence Normal
Alarms Screen

Help Reset System


Trends Setup Alarms
Case Checkout
Setup

Figure 64 ADU 12.1 display

Start/Stop Reset
Timer Timer

Alarms System
Setup Checkout

Setup Trends

Volume/
Pressure

Rate

I:E

PEEP Ventilator

ComWheel, navigate
in menus and confirm
Silence
Alarms
Normal
Screen choices
Help

Figure 65 ADU 10.4 display

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5 Operating and adjusting the settings

Key Function
Start/Stop Timer Start the timer and pause it
Reset Timer Reset the timer
Volume Pressure Quick key to adjust Volume/Pressure settings
Rate Quick key to adjust Rate settings
I:E Quick key to adjust I:E Ratio settings
PEEP Quick key to adjust PEEP settings
Ventilator Adjust Ventilator settings
Silence Alarms Silence active alarms or presilence alarms
Help The key is not in use
Normal Screen Close menus, return to basic screen
Setup Reset case, adjust screen layout, set time and date or
view gas usage
Reset Case Reset settings, trends and/or screen (Only on ADU with
12.1 display)
Trends Review trends
Alarms Setup Review alarm limits, adjust volume or view alarm history
System Checkout To perform complete or separate checkouts

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ADU display fields

5 6

4 7

3
1 2

Figure 66 Display Fields

(1) Fresh gas field


(2) Ventilator settings field
(3) Middle field with trends or gas and volume monitoring information
(4) Airway Pressure/CO2 waveform field
(5) Alarm message field
(6) Battery and clock field
(7) Timer field
Always use a monitor to confirm that the inspiratory gas values and the ventilatory settings on the
ADU are correct.

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5 Operating and adjusting the settings

Handling the menus


A menu is a list of functions or commands, displayed on the ADU screen. To display a menu push one
of the short cut menu keys next to the screen or push the ComWheel to view the Menu Functions
menu.

Cursor

Symbol for submenu

Frame with help text

Figure 67 Menu functions

Moving in menus
The ComWheel is used to navigate in menus and confirm choices.

Setup

1. Push a menu key. 2. Turn the ComWheel to move 3. Confirm your choice by
around in the menu and to pushing the ComWheel.
change values.
Confirmation of a selected change of setting, can be achieved by either:
Pushing the ComWheel
Pushing the corresponding quick key
Pushing any of the keys grouped around the display screen
NOTE: This is also valid if Normal screen is pushed.
WARNING If you do not want to confirm a change of setting, always use the ComWheel to
return to the previous setting before exiting the menu.
WARNING Pressing any of the keys grouped around the display directly after adjustment of a
parameter by means of the ComWheel, may result in an unintentional
confirmation of a setting.
In current mode, the setting values on the display are colored yellow when active and cyan when not
active. However, cyan colored values may be pre-set.

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Start of case
Reset of previous case
Before a new case it may be desirable to reset all anesthesia machine settings, screen layouts, trend
data or alarm settings used during the previous case. It is possible to reset each separately or all at
the same time.
To return to preset default settings:
1. Push the Reset Case key if you have a 12.1 display,
otherwise select Setup - Reset Case.
2. Select Reset Case.
3. Select Reset All.
4. Select Confirm.
WARNING This device is to be used only by, or on order of a
physician.

Fresh gas delivery


The fresh gas flow controls are for mixing and adjusting the fresh gas flow of O2, N2O or Air and one
anesthetic agent.
NOTE: The ADU can be configured to operate without N20, for further information see Anesthesia
Delivery Unit without N2O on page 16.
The gas flows are electronically measured and the flows are displayed on the ADU main screen.

Fresh gas display


The gas flows of O2, Air and N2O are measured electronically and displayed on the ADU main screen
as graphical flowmeters and as numerical flow values.

Figure 68 Fresh gas field

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5 Operating and adjusting the settings

Optionally the fresh gas field can include the Total Flow Data with total fresh gas flow and the
calculated percentage for each gas.
WARNING The ADU O2 % is a calculated value of measured flow data and not a value
measured by an oxygen analyzer. In the case of a hospital pipeline cross
connection, erroneous values will be displayed.
WARNING The O2 percentage in the patient circuit may differ significantly from the O2
percentage of the fresh gas.
The anesthetic agent setting is displayed in a box to the right of the flowmeter numerical display. The
name of the anesthetic agent is identified and the background color under the name is identical to
the color of the vaporizer cassette. When the Desflurane cassette is installed, the liquid level is
indicated on the display.
The concentration of the fresh gas anesthetic agent is displayed numerically in percentages and also
graphically relative to the maximum fresh gas concentration of each anesthetic agent.
The anesthetic agent fresh gas concentration is the set value and not a value measured by an
anesthetic agent analyzer.
NOTE: The displayed values are ATPD.

O2, N2O and Air


O2 delivery
To increase O2 flow, turn the O2 flow control counter clockwise. The control knob is fluted in
accordance with relevant ASTM standards. The flow is shown numerically and also as a 'flowmeter
bar graph' on the color display.

Agent

Figure 69 O2 flow adjustment control

Air or N2O selection


In addition to O2, either Air or N2O may be administered. To select Air or N2O, turn the selector to the
left for N2O or to the right for Air.

Agent

Figure 70 Air / N2O selector

For confirmation of the gas selection, the chosen gas is also indicated on the color display.

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NOTE: The N2O flow is automatically cut off if the N2O supply pressure drops below 240 kPa (35 psi).
The ADU will then automatically switch from N2O to Air and sound an alarm.
Air or N2O delivery
To increase the flow of the chosen gas, turn the flow adjustment control of the selected gas counter
clockwise.

Agent

Figure 71 Air and N2O flow adjustment controls

WARNING During a complete mains and battery power loss, the ADU will automatically cut
off the N2O flow and anesthetic agent administration. It will also switch to Air.
Air will flow if the needle valve is opened. O2 is also available during a power loss.

O2 flush
To flush the system with a high flow of O2- press the O2 flush button, located on the front edge of the
table. This will activate the O2 flow to the fresh gas outlet.

Figure 72 O2 flush on table edge

WARNING Pressing O2 flush during inspiration, will increase inspiratory pressure. The set
pressure limit however, will remain effective and help protect against excessive
pressures.
The ADU is equipped with a proportional regulator, which prevents the operator administering an
O2/N2O/AA mixture containing less than 25% O2 in the fresh gas. If the O2 flow is decreased or the AA
content is increased, the N2O flow will also start to decrease when the O2 concentration goes below
25%. Increasing the O2 flow, or decreasing AA content again, will also restore the N2O flow if its
control position has remained unchanged.

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5 Operating and adjusting the settings

Anesthetic agent
Agent selection
Five volatile agents can be administered; Enflurane, Halothane, Isoflurane, Sevoflurane and
Desflurane. Only one agent can be administered at a time.
Selecting the agent is done by inserting the desired agent cassette into the cassette slot so it locks
into place. When a cassette is installed, the agent field on the display will switch from showing 'Insert
Cassette' to showing the identity of the installed cassette. Make sure that the ADU identifies the
correct agent.

Figure 73 Cassette identification Figure 74 Desflurane liquid level

To remove the cassette, squeeze the handle and pull the cassette out.
Agent adjustment
Agent adjustment in the fresh gas flow is done by turning the Agent wheel counter clockwise to
increase the agent concentration and clockwise to decrease the concentration.

Agent

Figure 75 Agent adjustment


NOTE: The ADU vaporizer performs as an ordinary concentration calibrated vaporizer to the effects of
varying ambient pressure. The nominal agent volume % setting is graduated at sea level ambient
pressure (1013 hPa). If the vaporizer is used at higher altitudes (decreased ambient pressure), the
delivered agent volume % will be higher than the set agent volume % in relation to the decrease of the
ambient pressure. This is due to the agent partial pressure being independent of the ambient
pressure.
NOTE: If required, an alarm signal when the Sevoflurane control has been set above 5 %, may be
installed by a qualified technician.

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Safety
Agent administration
Agent administration can always be stopped by removing the cassette. Squeeze the cassette handle
and pull out the cassette.
The cassette can be carried in any position e.g. by its handle. There is no risk of an overdose when the
cassette is reinstalled into the machine after a transport.
To avoid the risk of inadvertently filling a cassette with a wrong agent, the keyed filler system shall be
used.
The anesthetic agent cassette alarms and switches off if the fresh gas flow is decreased below 150
ml per minute, displaying Agent Shut Off. The anesthetic agent cassette is operational when the flow
is increased above 200 ml/min., but the agent delivery must be turned on again.
In case of a fresh gas unit failure, increase the O2 flow to secure optimal oxygenation, and replace the
machine.
NOTE: If there is an overpressure in the Desflurane cassette, caused by a high working temperature
(above +35 C), the pressure is released into the scavenging system and an alarm sounds.
NOTE: If a cassette is overfilled, the excess liquid is released into the scavenging system and an
alarm sounds. Additional O2 flow should be used to flush the cassette. This will increase the O2 flow
at the fresh gas outlet.
NOTE: When the ADU is not in use, the Aladin should be unlocked from its working position, but may
be left in its compartment.
Mains failure
If the hospital electrical supply is lost, the machine will automatically switch to battery operation and
give the operator a message indicating remaining battery operation time. The ADU will give the
operator messages rising to alarms when the battery supply is nearing its end. When the message
BATTERY EMPTY GO MANUAL appears there is approximately 30 seconds of operation time. When the
vaporizer loses power the valves will automatically close the flows to and from the vaporizer.
WARNING During a complete mains and battery power failure the vaporizer will not deliver
any anesthetic agent.
Display failure
If the display should fail, the agent on lamp next to the agent wheel will indicate that agent is being
administered. The setting will not change unless the control is adjusted. Turn off the agent by turning
the agent wheel clockwise until the lamp goes out. Also turn off the N2O flow and increase the O2 flow
to secure optimal oxygenation. Monitor inspired/expired agent concentrations on gas monitor.

CO2 absorber
NOTE: Check the color of absorbent. If the color is changed and rebreathing can be observed from
CO2 monitoring, replace the absorber canister. The absorber canister can also be replaced during
ventilation. Follow the instruction included in the absorber package.

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5 Operating and adjusting the settings

Spontaneous ventilation
Spontaneous patient breathing is possible at any time.
Turn the Auto/Man. selector to the Man. position.

Turn the APL valve control fully open.


With spontaneously breathing patients the APL valve should be fully open. In practice, this equals a
circuit pressure of 1.5 cmH2O. This helps to ensure a lightly filled manual ventilation bag (inspiratory
reserve).

Pressure

Exp
Time

Insp Insp

Pressure curve, spontaneous breathing

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Manual ventilation
Turn the Auto/Man. selector to Man. position.

Turn the APL valve control to adjust the pressure in the patient circuit.
Read the circuit pressure curve on the display.
In the manual ventilation mode, the APL valve adjusts the peak pressure in the patient circuit and the
amount of gas in the manual ventilation bag. When the pressure rises to the set pressure limit of the
APL valve, the valve opens and lets out excessive gas from the patient circuit. The APL functions as a
pressure relief valve.
In manual ventilation the APL valve is customarily set to 20 to 30 cmH2O.
Pressure
10

Insp Insp Time


Exp

Figure 76 Pressure curve, manual ventilation

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5 Operating and adjusting the settings

Controlled mechanical ventilation (Auto)


Before starting Controlled Mechanical Ventilation, check that the patient circuit pressure alarm limits
have been adjusted to values appropriate for the patient. Push Alarm Setup key to view alarm limits
and adjust if necessary.
Turn the selector on the ventilator bellows unit from Man./Spont. to Auto position to start the
controlled mechanical ventilation.
The brackets around the ventilator settings disappear.

The ventilator is electronically controlled and pneumatically driven. The controlled mechanical
ventilation modes are:
Volume Controlled Ventilation (VCV)
SIMV
Pressure Controlled Ventilation (PCV)

Select ventilation mode


1. Push the Ventilator key.
2. Review the settings for the new mode.
3. Select Mode.
4. Select the desired mode.
A mode is changed immediately on selection.
NOTE: Some setting combinations may not allow
switching from one mode to another. In such cases,
advice on what to do is stated in the Help Field.
NOTE: I:E ratio, which is automatically adjusted in SIMV
mode, remains unchanged if not adjusted before
switching to another ventilation mode.
NOTE: When changing mode from SIMV to VCV or PCV,
I:E ratios can be reached which normally cannot be set
using only these modes.

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WARNING Before activating Volume Controlled Mode, ensure that Tidal Volume, Resp. Rate
and I:E ratio are correctly adjusted.
WARNING Before switching from PCV to Volume or SIMV, ensure that the set Tidal Volume is
appropriate for the patient.

Volume Controlled Ventilation, VCV


The Volume-controlled ventilation (TV or MV) is time cycled (RR) and the delivered tidal volume is
independent of flow settings.

Pressure
Mechanical PEAK inflation pressure

Time

Pressure curve, volume-controlled ventilation


Adjust to VCV mode
1. Review the settings for the VCV mode.
2. Push Ventilator key.
3. Select Mode.
4. Select VCV.

VCV controls
Controls Optional settings
Tidal volume/Minute Volume Sigh
Respiration Rate Inspiratory Pause
I/E ratio (alternative I:E time or Insp. time %)
PEEP (Positive End Expiratory Pressure)

Synchronized Intermittent Mandatory Ventilation, SIMV


SIMV mode provides ventilatory assistance during times when a patient may have the ability to
breath but lacks either the required rate or tidal volume. The patient can trigger a mechanical breath
of the pre-set Tidal volume within a Trigger Window. In this way mandatory breaths are synchronized
with spontaneous efforts. Triggered breaths are indicated by a color change on the pressure curve
and can also be monitored on the trend curve.

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5 Operating and adjusting the settings

P (cm H2O)
20.0

t (sec)
0

6 sec

Trigger window
Figure 77 SIMV mode pressure curve

Adjust to SIMV mode


1. Review the settings for the SIMV mode.
2. Push Ventilator key.
3. Select Mode.
4. Select SIMV.

SIMV controls
Controls Optional settings
Tidal volume / Minute Volume Trigger window
Respiration Rate Inspiratory Pause
PEEP (Positive End Expiratory Pressure)
Sensitivity
I:E time sec

Pressure Controlled Ventilation, PCV


In the PCV mode the ventilator builds up the patient circuit pressure to a given level and maintains the
pressure until the expiration phase. The inspiratory flow is decelerating and optimized to provide the
set pressure limit as quickly as possible (adjusted automatically). There is no measurement of
volume in PCV. Use of a volume monitor is therefore required.

Pressure
Set pressure above PEEP

Time

Figure 78 Pressure controlled mode pressure curve

Adjust to PCV mode


1. Review the settings for the PCV mode.

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2. Push Ventilator key.


3. Select Mode.
4. Select PCV.

PCV controls
Controls Optional settings
Pressure limit Inspiratory Rise Time
Respiration Rate
I/E ratio (alternative I:E time or Insp. time %)
PEEP (Positive End Expiratory Pressure)

Ventilator settings
Ventilator settings are displayed on the screen. The settings presented to the left, see Figure 79 on
page 94, are calculated values.

Figure 79 Ventilator settings

NOTE: In the Manual mode the ventilator settings are always shown within brackets [ ] on the
display. The settings may be set or checked before starting the Controlled Mechanical Ventilation.

Ventilator settings shown within brackets


There are three alternative ways of altering the setting of a parameter.
Push quick function keys (Volume/Pressure, Rate, I: E or PEEP). The corresponding field is
highlighted. Adjust the setting by turning the ComWheel. The current setting is displayed
above the adjustment value.

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5 Operating and adjusting the settings

Volume/
Rate I:E PEEP
Pressure

Another way of accessing the ventilator menu is by pushing the Ventilator key. Values within
brackets and/or cyan colored are not valid for the current mode. Adjusting the settings in the
Ventilator menu is convenient when setting up the ADU for the next patient.

A third way of accessing the ventilator menu is by pushing the ComWheel to display the Menu
Functions menu and select Ventilator.

Confirmation of a selected change of setting, can be achieved by either:


Pushing the ComWheel
Pushing the corresponding quick key
Pushing any of the keys grouped around the display screen
This is also valid if Normal screen is pushed.

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When the ventilator has accepted the new setting the Current row disappears. If the new setting is
not confirmed within 20 s, it is cancelled.
If the setting is within brackets, it is not effective until a corresponding mode is selected.
The machine responds to the adjustments immediately but not during the present breath. If the
display should fail, the setting will not change unless the controls are moved.
WARNING Pressing any of the keys grouped around the display directly after adjustment of a
parameter by means of the ComWheel, may result in an unintentional
confirmation of a setting.
WARNING In the case of a display malfunction, do as follows:
1. Turn off the delivery of N2O and anesthetic agent
2. Increase the O2 flow
3. Switch to manual ventilation
4. If the malfunction remains - replace the faulty machine with a checked unit
Patient weight
The patients weight automatically calculates - and
suggests setting values for the following parameters:
Tidal volume
Respiration rate
Minute volume
NOTE: As a change of the Patient Weight value affects
other settings, it is only possible to enter the Patient
Weight value while in the Manual mode.
When entering a Patient Weight menu for the first time,
the patient weight (Factory default, 60 kg, corresponds
to a TV of 500 ml and a RR of 10) is the weight value that
was entered together with the other ventilator settings.

When the weight value is adjusted, new settings are calculated and shown as suggested new
ventilator settings in the help and ventilator fields. The new settings are entered in the ventilator when
leaving the Patient Weight menu.
Although a changed Patient Weight value does not effect the Set Pressure value in the Pressure-
controlled mode, it is still good practice always to enter the Patient Weight value.
NOTE: If a patients weight exceeds 100 kg or is below 5 kg, the tidal volume should be adjusted
separately.

Tidal volume settings

Volume/
Pressure

Adjustable range: 20 to 1400 ml


Default setting: 500 ml

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5 Operating and adjusting the settings

Set in ventilation modes: VCV and SIMV


The calculated minute volume changes when the tidal volume or the respiration rate is adjusted.
Minute volume = tidal volume x respiration rate.
Set tidal volume = Delivered tidal volume
NOTE: Perform a leak test every time the patient circuit has been altered or changed to help ensure
correct volumes.
Minute volume settings (Optional)
Adjustable range: 0.1 to 30 l/min
Default setting: 0.5 ml
Set in ventilation modes: VCV and SIMV
Can be chosen as default settings in the set up mode (contact the local representative). The
calculated tidal volume changes when the minute volume or respiration rate is adjusted.
Pressure settings

Volume/
Pressure

Adjustable range: 5 to 40 cmH2O above PEEP.


Default setting: 12 cmH2O above PEEP.
Set in ventilation modes: PCV
The inspiration pressure is constant.
NOTE: The set pressure limit is always above PEEP. In the PCV mode the Inspiratory Pause, Sigh
settings, Sensitivity and Trigger Window are not available.
Respiration rate settings

Rate

Adjustable range: 2 to 60 breaths / min


Default setting: 10 breaths / min
Set in ventilation modes: VCV, PCV and SIMV
Respiration rate (RR) changes affects I/E times value and tidal volume (when MV is the default
setting). If attempting to set an RR value which conflicts with other settings or limits, as indicated by
the message max. MV for example, the RR value is rejected and cannot be entered.
I/E ratio settings

I:E

Available I:E ratios (insp./exp.) : 2:1, 1:1, 1:1.5, 1:2, 1:2.5, 1:3, 1:4.5
Default setting: 1:2
Set in ventilation modes: VCV and PCV

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The I:E ratio automatically determines and shows I:E Time in seconds if I:E Times is selected to be
displayed.
It is the I:E ratio that is the factory default. An optional default setting is however available on the
Install menu - Units.
NOTE: If an inverse ratio/prolonged insp. (2:1) is selected, it is shown in yellow on the Normal screen.

I E
Time
2
I:E ratio pressure curve
I:E time sec (optional default setting)

I:E

Adjustable range: 0.35 to 20 s


Default setting: 2.0 s
Set in ventilation modes: VCV, PCV and SIMV
Setting Insp. time in sec automatically displays Exp. time in sec.
I:E time is always used in SIMV mode and may be chosen as default setting in the Volume and
Pressure control modes. The I:E setting also automatically determines and shows the value of the I:E
Ratio.
To change default settings; contact a service technician.
Insp. time % (optional default setting)

I:E

Adjustable range: 18 to 67 % of complete breathing cycle.


Default setting: 33 % of complete breathing cycle.
Set in ventilation modes: VCV, PCV and SIMV
Insp./time in % of total I:E time (one breathing cycle). May be chosen as default setting. The setting
automatically determines and shows the value of the I:E Time in seconds.
To change default settings; contact a service technician.
PEEP settings

PEEP

Adjustable range: 5 to 20 cmH2O

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5 Operating and adjusting the settings

Default setting: OFF


Set in ventilation modes: VCV, PCV and SIMV
NOTE: Because of the standing bellows and the overflow valve design, there is a minimum positive
end-expiratory pressure between +2 and +4 cmH2O.
For Tidal Volumes below 100 ml, PEEP cannot be adjusted to values above 10 cmH2O.
Setting the PEEP value also adjusts: Peak low pressure alarm (PEEP+4 cmH2O)
Pressure
Pause

Time
PEEP
Inspiration
PEEP curve
Trigger sensitivity settings
Adjustable range: - 0.5 to -5 cmH2O
Default setting: -1.0 cmH2O
Set in ventilation modes: SIMV
1. Push Ventilator key to display menu.
2. Select Sensitivity.
3. Turn ComWheel to adjust Sensitivity.
4. Push ComWheel or Normal Screen.
In the SIMV mode a negative pressure (in relation to actual
PEEP value) created by the patient, triggers the delivery of a
mechanical breath.
The triggered breath is indicated by a color change of the
pressure curve. The delivery is very smooth as the breath is
delivered as a natural progression of the negative pressure,
which initiated the breath. A high sensitivity corresponds to a
low threshold level for triggering and conversely, low
sensibility means a high threshold level.

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Trigger window (optional setting)


Adjustable range: 5 to 95 % of the expiration
Default setting: 50 % of the expiration
Set in ventilation modes: SIMV
1. Push Ventilator key to display menu.
2. Select Options and then Trigger window.
3. Turn ComWheel to adjust Trigger window.
4. Push ComWheel or Normal Screen.
In the SIMV mode, the patient may trigger a mechanical tidal
volume breath within a Trigger window. The window is
placed at the end of the expiration phase as defined by the
respiratory rate (RR). In this way mandatory breaths are
synchronized with spontaneous efforts.

Pressure
Mandatory breaths
Spontaneous breaths

+
Time
0
- Trigg sens level
cm H2O
Patient triggering
Trigger window
Figure 80 Trigger window and sensitivity level

The trigger function is activated by a spontaneously created negative pressure (in relation to PEEP
value) which exceeds the set Trigger Sensitivity level.
The frequency of the mandatory breaths can never be lower than the pre-set Respiration Rate (RR).
On the other hand, the possibility for the patient to trigger mandatory breaths within the Trigger
Window may lead to a situation where the actual mechanical breaths are more than the pre-set value
for RR. This gives also rise to an increased Minute Volume. To avoid hyperventilation and still support
spontaneous breaths - decrease pre-set RR on the ventilator and adjust the Trigger Window
accordingly.
Some setting combinations may not allow switching from one mode to another. In such cases, advice
on what to do is stated in the Help Field.
Inspiratory pause setting (optional setting)
Adjustable range: 0 to 60 % of inspiratory time
Default setting: 25 % of inspiratory time
Set in ventilation modes: VCV and SIMV
1. Push Ventilator key to display menu.
2. Select Option and then Inspiratory Pause.

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5 Operating and adjusting the settings

3. Turn ComWheel to adjust inspiratory pause setting.


4. Push ComWheel or Normal Screen.

Pressure
Pause

Time
Inspiration

Figure 81 Pause in the pressure curve

The pause is a part of the inspiration phase and does not affect the expiration time or the length of
the breathing cycle. With Inspiratory Pause selected, the inspiratory volume is delivered faster and
the inspiratory flow is automatically increased accordingly.
Inspiratory rise time setting (optional setting)
Adjustable range: Fast - Medium - Slow.
Default setting: Medium
Set in ventilation modes: PCV
1. Push Ventilator key to display menu.
2. Select Options and then Inspiratory Rise.
3. Turn ComWheel to adjust Inspiratory Rise Time setting.
4. Push ComWheel or Normal Screen.

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In Pressure controlled mode the inspiratory flow is by default automatically adjusted to reach the set
pressure limit as fast as possible. The inspiratory rise time can be adjusted for individual patient care.
Sigh setting (optional setting)
Adjustable range: ON or OFF
Default setting: OFF
Set in ventilation modes: VCV
1. Push Ventilator key to display menu.
2. Select Options and then Sigh.

3. Select either ON or OFF.


When sigh is used, every 100th breath is 1.5 times larger than normal tidal volume. The maximum
tidal volume is limited to 1400 ml.
.

Time

Figure 82 Sigh pressure curve

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5 Operating and adjusting the settings

Monitoring
Optimal anesthesia delivery results are achieved by adjusting ventilator settings in relation to
measured patient data.
By using a Datex-Ohmeda Anesthesia Monitor or Datex-Ohmeda Capnomac Ultima, the monitored
patient values may be displayed next to the fresh gas and ventilator settings, or on the optional
monitoring screen.
WARNING To prevent hazards arising from incorrect delivery of gases, the ADU shall always
be used with the following monitoring:
O2 monitor according to ISO 7767/EN 12598
Agent monitor according to ISO 11196/EN ISO 11196
CO2 monitor according to ISO 9918/EN 864
Expired volume monitor according to IEC 60601-2-13/EN 740
CAUTION Only use specified monitoring system interface cables.
CAUTION Only use specified Datex-Ohmeda Capnomac Ultima Interface Cable.

Figure 83 ADU Display Monitoring Data

(1) Pressure data for delivery unit circuit


(2) Patient gas monitor CO2 waveform and numeric value
(3) Ventilator settings
(4) Spirometry data
(5) Patient gas monitoring data

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Measuring conditions
NOTE: The ADU measures volumes under ATPD (Ambient Temperature & Pressure, Dry gas)
conditions.
The Anesthesia Monitor and Capnomac Ultima measure volumes under BTPS (Body Temperature &
Pressure, Saturated gas) conditions. To use the same measuring conditions for both the ADU and
monitor, change the monitor setting. (AM in Airway Gas, Flow & Vol. Setup and Ultima in User
Configurations).

Sampling gas
The gas monitors draw sampling gas from the patient circuit at an approx. rate of 100 to 200 ml/min.
This should be taken into account when the gas monitor sampling gas is not returned to the patient
circuit, especially during low flow ventilation. The minimum fresh gas flow rate should be the patient
oxygen uptake plus the monitor-sampling rate. (See chapter Sampling Gas in section 3, Assembly
and Preparations)

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5 Operating and adjusting the settings

Setup
Push the Setup key to display menu.
NOTE: The adjustments made in this menu are only valid
until the delivery unit is reset. Time and date are stored.

Set the screen layout


1. Push Setup key.
2. Select Screen Layout to configure waveforms and digital fields at the far right on the Normal
Screen.

Figure 84 Screen Layout menu

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Select waveforms
Up to two waveforms can be displayed at the same time. Circuit pressure - Pcirc - is always displayed
but the second waveform may either show interfaced CO2 or be turned off. If only one waveform is
selected, it is enlarged to fill out the available area.

Figure 85 Waveform fields


Pcircuit setup
1. Push Setup key.
2. Select Pcirc Setup.
3. Select Scale, Sweep Speed or Color.
Sweep Speed can be either Fast or Slow.

CO2 setup

1. Push Setup key.


2. Select Screen Layout and then CO2 Setup.
3. Select Field 2.
4. Select CO2 or OFF.
5. Select Scale, Sweep Speed or Color.
CO2 requires interfaced gas monitoring. Sweep Speed can be
either Fast or Slow.

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5 Operating and adjusting the settings

Show menu graphs


1. Push Setup key.
2. Select Screen layout.
3. Select Show Menu Graphs.
4. Select YES 0r NO.
In addition, an advisory menu can always be presented when Volume / Pressure, Resp. Rate, I:E
Ratio, or PEEP is set.

Figure 86 Optional Advisory Menu

Adjust flowmeter height


1. Push Setup key to display Setup menu.
2. Select Screen Layout.
3. Select Flowmeter Height.
4. Select the desired presentation.

Similarly, short or long flowmeters may be chosen by selecting AUTO. The length of the flowmeter will
automatically adjust itself according to the current flow rate.

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Figure 87 Fresh gas field

Show total flow


1. Push the Setup key.
2. Select Screen Layout.
3. Select Show total flow.
4. Select YES or NO.
Total flow data may either be displayed or removed.

Adjust middle field layout


1. Push the Setup key.
2. Select Screen Layout.
3. Select Middle Field.
The Middle field may be vacant or it may contain either
trends or digital information interfaced from a patient
monitor. Either the Datex-Ohmeda Capnomac Ultima or the
Datex-Ohmeda Anesthesia Monitor can be interfaced to
show values in this field.

Figure 88 Middle field setting

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5 Operating and adjusting the settings

Add remove boxes in ventilator setting field


1. Push Setup key.
2. Select Screen Layout.
3. Select Minute Volume, Inspiratory pause or Extra I:E Times.
4. Select YES or NO.
The most important settings such as TV (MV), Pressure limit (in PCV), RR, I:E, PEEP and ventilation
mode, are always displayed.
The calculated values for MV (TV), Inspiratory Pause, Extra I:E Times may be removed.

Figure 89 Ventilator settings field and Screen Layout menu

Set time and date

1. Push Setup key.


2. Select Set Time and Date.
3. Highlight the desired setting.
4. Adjust the setting.
5. Push the ComWheel to confirm the new setting.

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Time is shown on the upper right corner of the screen. If


an Anesthesia Monitor is interfaced, the clock is set in
the Anesthesia Monitor only. The ADU clock cannot be
set in this case.
Clocks cannot be set during a case, when an Anesthesia
Monitor is interfaced.

Figure 90 Time display

Change Install settings

1. Push Setup key.


2. Select Install.
Select Password digits 10.
In Install menu, the user has the possibility to change the
measurement units, interfacing, trend setup, save default
setting for screen layout, trend layout, alarm setting and
ventilation settings.

Saving changed default settings


1. Push Setup key.
2. Select Install.
3. Select Save As Defaults.
4. Select specific setting or Save ALL for saving all of the
settings.
This menu allows the user to save permanent changes of the
default settings. Screen and trend layout as well as operating
parameters such as alarm limits and ventilator settings may be
saved. The factory default settings may be retrieved for all
changed settings.
NOTE: It is not possible to save PEEP or Sigh default settings. If
it is necessary to save the Ventilator mode, please contact your
local representative to configure the ADU.

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5 Operating and adjusting the settings

Change units
1. Push Setup key.
2. Select Install.
3. Select Units.
4. Select Pressure, Weight or CO2 to select unit.

Interfacing
Monitors that may be interfaced are either the Datex-Ohmeda Capnomac Ultima or the Anesthesia
Monitor.
Gas and spirometry numerics are shown in the Middle field. CO2 waveform and numerics are shown
in the waveform field.
1. Push Setup key.
2. Select Install.
3. Select Interfacing.
4. Highlight the desired monitor.

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Figure 91 Interfacing AM

Trend setup
1. Push Setup key.
2. Select Install.
3. Select Trend Setup.
4. Highlight the desired setting.
5. Adjust the setting.
6. Push the ComWheel to
confirm the new setting.
7. Push Normal Screen key.

Service menus
Special passwords are required for access to the
Diagnostic and Calibration service menus.
Refer to the ADU Technical Reference Manual.

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5 Operating and adjusting the settings

End of case
Gas usage
After a case it is possible to check the gas consumption since power-up.
Push the Setup key to display gas usage menu.

Figure 92 Gas Usage menu

Before beginning a new case it may prove practical to reset Gas Usage. In the case of a power-off the
Gas Usage is reset automatically.
Gas consumption calculations
The consumption of fresh gas is calculated from the measured flow values. The consumption of
anesthetic agent is calculated from the set value. The values are integrated every second, which
makes the accuracy close to the accuracy of the current values. (Accuracy 10 %; less accuracy at
low flows.)
Cumulative usage
View the total amount of fresh gas used since Cumulative
Usage was cleared.

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Gas disconnection
There are two alternative ways of preventing breathing gases from leaking from the ADU when it is not
in use.
Either:
1. Close the O2 and Air flow adjustment controls while the scavenging system still is activated.
2. Turn off the ADU mains switch.
Or:
1. Disconnect the ADU gas hoses from the wall supply connectors and close the reserve gas
cylinders if they have been used.
2. Turn off the ADU mains switch.
CAUTION When not in use - be sure to follow the above gas disconnection instructions to
prevent gas leakage from the ADU.

Battery charge
Check that the mains electric power is connected to ensure continuous battery recharging.
WARNING Do not store the ADU below -10 or above +60 C.

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6 Alarms

6 Alarms
Alarm Signals and Sequences
The alarms are classified into categories according to their priority. The priority of an alarm depends
primarily upon the cause and duration.
The priority increases with the duration of the alarm condition. Also, the more significant the cause of
an alarm, the more rapidly the alarm advances to HIGH priority. Thus e.g. Ppeak High advances
rapidly to HIGH priority, whereas disconnection is allowed a longer time.
The following alarm categories are used:

Priority Meaning Tone pattern Visual


HIGH Situation requiring Triple + double beep 1 s Alarm message
immediate operator pause, then triple + double 5 displayed in a red box
response s pause...
--- -- 1 s --- -- 5 s --- -- 1s --- --
MEDIUM Situation requiring prompt Triple beep every 19 s Alarm message
operator response --- 19 s --- 19 s --- displayed in a grey or
black box with a
yellow frame
LOW Situation requiring operator Single beep Alarm message
awareness - displayed in a grey or
black box with a white
frame
INFORMATION Additional information None Information displayed
in a grey or black box

NOTE: On earlier versions of the ADU the priority level INFORMATION does not exist and the visual
appearance of the alarm messages is different. The HIGH priority alarms are displayed in a box with a
red frame, the MEDIUM priority with a yellow frame and the LOW priority with a white frame.
When an alarm becomes active:
A message appears in the order of priority in the message field at the top of the display.
The corresponding parameter value flashes as yellow or red.
An auditory alarm is sounded.
WARNING Always make sure that alarm limits are appropriately set when a patient is
connected to the ADU.

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Alarms and alarm limits


The pressure limit alarms are listed below. System status alarm messages are listed and explained in
the Troubleshooting chapter.

Limit alarm message Default limit Adjustment range Adjustment step


Pmax Release (AUTO) 40 or user default Ppeak High - 80 1 cmH2O
Ppeak High (AUTO) 30 or user default. Ppeak Low+2 to 80 1 cmH2O
Ppeak High (MAN) 40 or user default 6 to 80 1 cmH2O
Ppeak Low (AUTO) 6 (cannot be saved) (6/ PEEP+4)... (Ppeak 1 cmH2O
Change with PEEP High-2)
adjustment
PEEP High (AUTO) PEEP+5 N/A N/A
PEEP High (MAN) 10 N/A N/A
Negative Pressure Pmin -0.7 N/A N/A
(AUTO) excluding Pmin -3
(SIMV) Pmin -8
Negative Pressure -3 Pcirc -0.7 (20 s) N/A N/A
(MAN), (SIMV) (continuous negative)

Note: Other alarms, System Status, see Chapter 9 - Troubleshooting for explanation and course of
action.

French and Japanese Version settings


The User configuration settings French Version and Japanese Version effect the alarms compared to
normal setting. Ask your service technician for your configuration settings.
In French Version the User Alarm Volume monitor removed is displayed if no volume monitor is
connected or is switched off.
In Japanese version the user alarm Agent % setting high is displayed if sevoflurane anesthetic agent
is set above 5 %. Also Ppeak low is advanced to HIGH priority after 120 s.

Oxygen failure alarm


In case the O2 supply to the machine is interrupted, the oxygen failure alarm is activated. The alarm
limit pressure is 250 kPa (36.2 psi). If lack of supply pressure stops the O2 flow, the flow of N2O is
automatically cut off.
The alarm may be silenced momentarily but returns after 2 minutes.

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6 Alarms

Alarms setups and adjustments


Set the alarm parameters using the Alarms Setup menu. High and low alarm limits as well as alarm
volume may be adjusted. The audio alarms may be permanently silenced and the alarm status may
be viewed (10-minute circuit pressure trend).

1
4

Figure 93 Alarms setup view


(1) List menu items
(2) Exit from limit adjustment back to menu items
(3) Parameter box with current pressure release and pressure alarm limits
(4) Visual indicator of alarm limit
(5) 10-minute circuit pressure trend

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Adjust limits
1. Push the Alarms Setup key.
2. Select Adjust Limits.
3. Turn the ComWheel to move the highlight to the parameter box that you want to adjust.
4. Push and turn the ComWheel to adjust the alarm limit. A white line in a 10-minute trend
indicates the alarm limit in relation to measured values.
5. Push the ComWheel to confirm the new limit value.
6. Move the highlight to the next parameter box or to EXIT.

1 2

Figure 94 Ppeak alarm limit indicators

(1) Ppeak Low alarm limit indicator


(2) Ppeak High alarm limit indicator

Default limits
To set the alarms at the default alarm limits.
Select Default Limits from the Alarms Setup menu.
Also the Reset Case function will return the alarm limits to their default values.
To change the default limits:
Set the desired alarm limits in the Alarms Setup menu.
Push the Setup key and select Installation. See Changing Measurement Units in previous
chapter.
Select Save as Defaults and select Alarm Settings.
Confirm by selecting Save.

Cancel changes
Cancel Changes cancels any alarm limit changes and returns to the previous limits. Cancel Changes
must be selected before leaving the Alarm Setup menu, after the menu is closed it is no longer
possible to cancel changes.

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6 Alarms

Alarm volume
The Alarm Volume may be set from 1 to 10. The ADU emits a beep for each alarm volume setting.
Default value is 5.
WARNING Make sure that the alarm sound level is set loud enough to be heard above the
background noise!

NOTE: The Pmax Release level and the Ppeak High alarm limits are set separately.

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Audio On/Off
All auditory alarms may be disabled or activated except:
Ppeak High (HIGH priority), Peep High (HIGH priority), O2 supply lost, Ventilator failure, Batteries
empty. Go manual, Hypoxic mixture, Fresh gas occlusion and Fresh gas unit failure (HIGH priority).
In French Version also Volume monitor removed. In Japanese Version Ppeak Low cannot be
disabled more than 120 s.
For more information see Disabling auditory alarms permanently on page 121.

Alarm history
The menu displays a list of alarms and the time when they were activated.

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6 Alarms

Silencing alarms
Silencing auditory alarms temporarily1
WARNING Do not silence auditory alarms without providing continuous, direct observation
of the patient.
To silence all alarms for 2 minutes, push Silence Alarms key once. Push it twice to silence individual
alarms.
Pushing the Silence Alarms key once
silences alarms that are currently active
presilences the upcoming alarms

A Silence Alarms symbol with a countdown timer is displayed in the upper left corner of the
screen to indicate that all alarms are silenced. The message field at the top of the display is cleared of
all the alarm and note messages. The visual alarms in the digit and waveform fields remains as long
as they are valid. During the 2-minute silencing period, all new upcoming alarms or alarm priority
changes are indicated visually.
Pushing the Silence Alarms key twice
silences the individual alarm that is currently active
does not presilences the upcoming alarms
Reactivating alarms
Pushing Silence Alarms key during the 2-minute silencing period will reactivate the auditory
component of new alarms. The alarms that were active when the key was first pressed will not sound
before the two minute period is over.

Disabling auditory alarms permanently1


For special cases, such as open heart surgery or lung operations, it may de desirable to disable
certain auditory alarms entirely.
1. Push the Alarm Setup key.
2. Select Audio ON/OFF.
3. Select Silence ALL.
A warning symbol is displayed.
If an active alarm is disabled, there is a reminder beep every two minutes. You can adjust the volume
of the beep through Alarm Setup - Reminder volume.
NOTE: In French Version there is a reminder beep every two minutes even though no active alarm is
disabled.
Reactivating alarms
1. Push the Alarm Setup key.

1. NOTE: Ppeak High (HIGH priority), Peep High (HIGH priority), O2 supply lost, Ventilator failure, Hypoxic mixture,
Fresh gas occlusion and Fresh gas unit failure (HIGH priority) cannot be presilenced or disabled. Batteries empty
Go manual and Volume monitor removed (in French Version) cannot be silenced or disabled. In Japanese Version
Ppeak low cannot be silenced or disabled more than 120 s.

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2. Select Audio ON/OFF.


3. Select Activate Alarms.

Unexpected Reset
Microprocessor-controlled systems can go into a reset condition. When in a reset condition, the
control display may show only the message Unexpected Reset.
The Ventilator and Fresh Gas Control units continue to deliver gas as set, but you will be unable to
adjust the ventilator settings. Fresh gas flows and anesthetic agent settings can be adjusted, but the
settings are not displayed on the screen.

Display description
When a reset condition occurs, the ADU displays the following:
1. The screen blanks out.
2. After approximately 10 seconds, the Datex-Ohmeda logotype is shown.
3. After another 20 seconds, the screen will appear as if in a normal start-up.
4. After another 20 seconds, the message System Failure - Unexpected Reset, Please call for
service appears in red.

Recommended actions
If a reset condition occurs, perform the following steps:
1. Observe the information on the Patient Monitor to follow the patient conditions.
2. If you need to adjust the ventilator pattern, switch to manual ventilation and continue
ventilation as needed.
3. Follow the inspired/expired concentrations of gases on the Patient Monitor and adjust
concentration settings if needed.
4. Call for service and replace the anesthesia unit.
Alternative method:
1. Switch to manual ventilation and continue ventilation.
2. Turn off the main switch. Note that after the switch off, only O2 is delivered until N2O and
Anesthetic Agent can be reactivated (see #4 below).
3. Wait a few seconds and turn on the main switch to restart the system.
4. Adjust all desired settings.
5. Bypass the System Checkout.
6. Switch to Automatic ventilation.
7. After the completion of the case, replace the anesthesia unit and call for service.

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7 Trends

7 Trends
The ADU is able to show both numerical and graphical trends for the latest 24 hours of all set values:
PEEP, TV/MV, pressure limit, respiration rate, I:E ratio, inspiratory pause, as well as measured fresh
gas pressure values: peak, plateau and PEEP.
The machine accumulates and displays trend data for user selected periods between 20 minutes and
24 hours
In addition, a 10-minute circuit pressure trend is displayed in the Alarm Setup menu.
During trend display, the machine and all alarms are active and the numeric information is
continuously updated and displayed.

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Graphical trend pages


There are a total of six graphical trend pages of which three are arranged according to the factory
settings. Each trend page can have up to six parameter fields.
1. Push the Trends key
2. Select Graphical

Figure 95 Graphical trend page

(1) List of selections


(2) Parameter field
(3) Trend cursor
(4) Ventilation mode

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7 Trends

Numeric trend pages


The numeric trend information is updated every five minutes. The last minute information is displayed
at the bottom of the page. The first of three pages is shown below.
1. Push the Trends key
2. Select Numerical

Figure 96 Numeric trend page

(1) List of selections


(2) Time of measurement
(3) Parameter row
(4) Ventilation mode
(5) Trend cursor
NOTE: The last accessed page is saved in the memory. When entering the Trends menu again, it
appears as the first page.

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Changing trend pages


Select Next Trend to see the other graphical or
numerical trend pages.

Next Trend has a scrolling function. When all the pages have been displayed, the first page is again
displayed.

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7 Trends

Trend cursor
The trend cursor displays the values of a graphical trend at a certain moment.
1. Selecting Move Cursor to activate trend cursor.
2. Turn the ComWheel to move the cursor.

6
5

2 6

3 4

Figure 97 Graphical trend cursor

1 2

Figure 98 Numerical trend cursor

(1) Trend cursor


(2) Ventilation mode
(3) Time where the cursor is situated
(4) Difference between current time and cursor time.
(5) Scale
(6) Parameter values

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Graphical trend length


1. Push Trends key
2. Select Graph Time
3. Adjust the trend time

Trend Resolution
20 minutes 10 seconds
2 hours 1 minute
4 hours 2 minutes
12 hours 6 minutes
24 hours 12 minutes

Scales
Scales are selected in the Set Scales submenu.
1. Push Trends key
2. Select the trend page, by using Next Trend
3. Select Set Scales
4. Select the field you want to change the scale for in the
Field menu.
5. Select Graph Scale and adjust the scale

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7 Trends

Resetting trend data


Trend data should always be reset before admitting a new patient.
1. Push the Reset Case key if you have a 12.1 display, otherwise select Setup - Reset Case.
2. Select Reset Trends and then Confirm. If all screen settings are to be reset along with the
trends, simply select Reset All, then Confirm.

Trend page setups


Trend page setups are changed in the installation menu. Only the graphical trend pages can be
changed.
1. Push the Setup key.
2. Select Install
3. Enter password 10.
4. Select Trend Setup.
5. Select the trend page to be changed.
6. Select Change Field.
7. Select the field to be changed one to six.
8. Select the desired parameter.

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130 Document No. 8502304-2


8 Cleaning and maintenance

8 Cleaning and maintenance


General
For safe reliable function and operation of the Anesthesia Delivery Unit, regular cleaning and
maintenance has to be carried out according to the instructions in this Users Reference Manual and
the maintenance procedures described in the Technical Reference Manual.
WARNING Always unplug the electric power cord before cleaning or maintenance of the
Anesthesia Delivery Unit. Let it dry completely before reconnecting it to the
electrical outlet.
WARNING A complete System Checkout must be performed before patient use if the ADU
has been disassembled for cleaning. A leak test should be performed every time
any of the breathing system parts have been replaced.
CAUTION Do not perform any cleaning or maintenance procedures other than those described
in this manual.
CAUTION Clean the cooling fan dust filters (behind the rear cover) at least once a month.
Cleaning should be carried out by a qualified technician.
Follow the general cleaning and disinfection instructions described below, unless some other
instructions are described for a component later in this chapter.

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Cleaning and disinfection methods


All parts of the patient circuit and ventilator bellows unit - except the bellows chamber - are machine
washable. All parts, including the Datex-Ohmeda Compact Block II, may be autoclaved (Compact
Block I may not be autoclaved). Also; the ADU is completely free of latex.
Different methods and levels for cleaning and disinfection are described below.
Datex-Ohmeda recommends that hospital routines are always followed to select appropriate level
and frequency of cleaning and disinfection. This is especially important if there is a risk that the
patient suffers from a contagious disease. Further, Datex-Ohmeda recommends that the Universal
Precautions for infection control are considered in the protocols of hospitals using the ADU.

Cleaning
Cleaning (or precleaning): The removal, usually with detergent and water, of adherent visible soil,
blood, protein substances, and other debris from the surfaces, crevices, serrations, joints, and
lumens of instruments, devices, and equipment by a manual or mechanical process that prepares
the items for safe handling and/or further decontamination. (FDA)
Cleaning methods
Always clean the equipment properly before disinfection.
NOTE: Cleaning in a washer or washer-disinfector.
If the washer or washer-disinfector has a washing program with 85 C/185 F for 10 minutes or
more, this provides an intermediate level disinfection as well.
Wiping away organic material with mild soap-based solution.
Washing by hand using warm water and mild detergent.
Let the cleaned parts dry in a warming closet or at room temperature.

Intermediate level disinfection


Disinfection: The destruction of pathogenic and other kinds of microorganisms by physical or
chemical means. Disinfection is a less lethal process than sterilization, since it destroys most
recognized pathogenic microorganisms, but not necessarily all microbial forms, such as bacterial
spores. Disinfection processes do not ensure the margin of safety associated with sterilization
processes. (FDA)
Always clean the equipment properly before disinfection.
Disinfection in a washer or washer-disinfector at high temperatures (85 C/185 F) is the most
effective and primary disinfection method for the breathing system parts in contact with the patients
airway.
Intermediate level disinfection methods
Clean the parts with a decontamination program in a washer or washer-disinfector, minimum
10 minutes at 85 C/185 F. The detergent should be alkaline (pH value 10 to 11).
Clean away organic material with mild soap-based solution and let dry. Wipe with 70% alcohol
and let dry.
CAUTION Avoid cleaners based on ammonia, phenol or acetone as they may damage the parts.

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8 Cleaning and maintenance

High level disinfection


High Level Disinfectant: A germicide that inactivates all microbial pathogens, except large numbers
of bacterial endospores, when used according to labeling. The FDA further defines a high level
disinfectant as a sterilant used under the same contact conditions except for a shorter contact time.
(FDA)
Always clean the equipment properly before disinfection.
High level disinfection methods
Liquid-chemical, for example glutaraldehyd 2% or an equivalent chemical that the hospital
uses for chemical high level disinfections. Always follow the manufacturer instructions for the
agent.
Steam autoclave at maximum 134 C/273 F.
The following parts should be considered for disinfection with the hospital protocols/frequency,
taking into account types of patients, risk of infections, cross contamination risks etc.
Patient circuit tubing, manual bag tubing & connectors.
Compact blocks and Standard circuit absorber and valve.
Ventilator bellows - bellows block including the APL and overflow valves.
NOTE: To help ensure correct operation of the Compact Blocks, Datex-Ohmeda recommends that
they are cleaned at least twice a week.
Microbial filter
When using a microbial filter, less cleaning and disinfection may be required, although, always
consider the type of patients, risk of infections, cross contamination risks etc. Fewer cleaning cycles
will increase the lifetime of the accessories and parts. It is essential that the filter provides effective
protection against bacteria, viruses and dust from CO2 absorbers. The filter needs to be placed close
to the patient to give proper protection, that is between the endotracheal tube and the D-lite sensor.
Datex-Ohmeda recommends that the filter and any parts between the filter and patient should be
replaced between patients. Prior to use, always read the Instructions for use for the filter.

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Cleaning and maintenance

Disinfection methods table


Concerning the level and frequency of disinfection, always follow the hospital routines.
Intermediate level disinfection High level disinfection

Equipment Washer-disinfector with a Wash by hand using water and mild Steam autoclave at maximum 134 C/273 F
decontaminating program (min. 10 detergent AND wipe with 70% alcohol
minutes at 85 C/185 F)
Reusable patient circuit
tubing, manual bag tubing and
connectors, Y-piece, D-lite
Compact patient circuit:
Compact block II
Compact canister reusable
Ventilator bellows assembly:
Bellows *
Bellows block incl. APL valve and
overflow valve
Bellows chamber **
Overflow valve rubber *
membrane
Manual bag
* NOTE: May change shape and has to be replaced after repeated autoclaving. The bellows should be hung so that the lower folds can hang freely during the autoclaving cycle.
** NOTE: Does not normally have to be autoclaved since it is not in direct contact with patient gases. May develop small cracks on the surface after repeated autoclaving.

134
8 Cleaning and maintenance

Patient circuit tubing, manual bag tubing & connectors


Cleaning and disinfection

Figure 99 Patient circuit tubing & connectors

1. Disconnect the patient circuit hoses from the inspiratory and expiratory check valve
connectors.
2. Disinfect the hoses and connectors according to the methods described in Disinfection
methods table on page 134.
To prevent damage of the hose, hold the hose connector at the ends of the hose.
Hytrel reusable patient tubing
CAUTION The following solutions should not be used as they may cause disintegration of the
tubing: hypochlorite, phenol, formaldehyde, ketone, chlorinated hydrocarbons,
aromatic hydrocarbons, inorganic acids.
If autoclaving, use tube holders to prevent tubes coming into contact with hot elements, shelves etc.
in the autoclave itself.
Autoclaving or heat drying will affect the hytrel and may develop cracks or pin holes over time.
Autoclaving will eventually cause a slight color change of the tubing.
Storing
Avoid prolonged exposure to ultraviolet light. Ultraviolet light has a degenerative effect on the tubing
over time, causing the tubes to crack and pin holes to form.

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Compact Blocks
Compact Block I and Compact Block II
There are two different Compact Blocks, Compact Block I and Compact Block II. The difference
between the two Blocks is that the Compact Block II can be autoclaved and is also equipped with a
water trap and a water container.
The Compact Blocks can be used with either Datex-Ohmeda Compact Absorber Single use or
Datex-Ohmeda Compact Canister Reusable (both are herein referred to as Compact Absorber).
WARNING Soda lime is a caustic substance and is a strong irritant to eyes, skin and the
respiratory system. Affected parts should be flushed with water for at least 15
minutes.

2 3

Figure 100 Exploded view of Compact Block II

(1) Latch
(2) Piston valve
(3) Valve membrane
(4) Valve covers
(5) Water trap valve
(6) Water container

The following instruction describes different methods to clean and disinfect the Compact Blocks. For
further information see the Disinfection methods table on page 134. For frequency and level of
disinfection, follow hospital routines. However, to help ensure correct operation of the Compact
Blocks, Datex-Ohmeda recommends that they are cleaned at least twice a week.
There are two methods to clean the Compact Blocks manually or mechanically in a washer or
washer-disinfector (herein called washer-disinfector). Both methods are described below.

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8 Cleaning and maintenance

Mechanical cleaning and disinfection in washer-disinfector


Use Datex-Ohmeda Cleaning Cassette II (herein Cleaning Cassette II) for mechanical cleaning.
1. Disconnect the patient circuit hoses from the Compact Block.
2. Remove the Compact Absorber by pushing the latch (1) down and lifting the Compact Absorber
(2) off the compact block.

Figure 101 Removing the Compact Absorber from the Compact Block II
3. Remove the water container.
4. Do NOT remove the block valves and their covers.
5. Place the Cleaning Cassette II on the compact block by hooking one end of the Cleaning
Cassette II under the pins on the compact block.
6. Push down the latch on the compact block. Push down the Cleaning Cassette II until it locks.

Figure 102 Attaching the Cleaning Cassette

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7. Turn the compact block so that the Cleaning Cassette is underneath. Connect the white exp.
labeled tube on the Cleaning Cassette II to the expiratory port on the compact block.
8. Connect a hytrel tube to the Cleaning Cassette.

Figure 103 Connecting the hytrel and exp. labeled tubes

9. Place the compact block, with the Cleaning Cassette II underneath, into the washer-disinfector.
10. Connect the hytrel tube on the Cleaning Cassette II to the water source in the washer-disinfector
and clean the compact block with a decontaminating program.

Figure 104 Connecting the hytrel tube to the water source

11. After cleaning, dismount the Cleaning Cassette II and remove the valve covers by twisting the
latch until the cover comes loose. Drain any remaining water by rotating the compact block in
all directions.
12. Dry the compact block and the valve covers in a warming closet (maximum 80 C/176 F) or at
room temperature.
13. If the washer-disinfector is not used for disinfection of equipment, Datex-Ohmeda recommends
that a further intermediate or high level disinfection is conducted.

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8 Cleaning and maintenance

Manual cleaning
Do not use Cleaning Cassette II for manual cleaning.
1. Disconnect the hoses from the compact block. Remove the Compact Absorber by pushing the
latch down and lifting up the Compact Absorber.

Figure 105 Removing the Compact Absorber from the Compact Block II

2. Remove the water container from Compact Block II.


3. Remove the valve covers.

Figure 106 Removing the valve covers

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4. Flush the compact block with fresh running water for 1 minute. Press down the piston valve
while flushing the compact block. Flush into all openings.

Figure 107 Flushing the Compact Block with fresh running water

5. Clean the compact block, valve covers and water container with total immersion in a sink filled
with water and cleaning agent for at least 3 minutes. The water temperature should be
approximately 40 C/104 F. Press down the piston valve while cleaning the compact block.

Figure 108 Cleaning the compact block while pressing down the piston valve

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8 Cleaning and maintenance

6. Flush the compact block with fresh running water for 1 minute. Flush into all openings. Press
down the piston valve while flushing the compact block.

Figure 109 Flushing the compact block again

7. After cleaning, drain any remaining water by rotating the compact block in all directions.
8. Dry the compact block and the valve covers in a warming closet (maximum 80 C/176 F) or at
room temperature.
9. Datex-Ohmeda recommends that manual cleaning is always followed by an intermediate or
high level disinfection.

High level disinfection


Always clean before high level disinfection.
Compact Block II
Compact Block II can be steam autoclaved. Recommended temperature is 134 C/273 F.
Autoclave valve covers and water container dismounted from the Compact Block II.

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Before reusing the compact block


1. Check visually that the compact block is clean, dry and undamaged.
2. Check visually that the O-rings are undamaged.
3. Ensure that the expiratory and inspiratory valves are in bottom position, by lifting the green
membranes (1) and smoothly pressing the valve housings (2).

Figure 110 Ensuring that the valves are in the correct position

4. Ensure that the green membranes are in contact with the valve seats. Verify also that the green
membranes do not have any visible damage.
5. Attach the transparent valve covers over the valves, by first pushing (3) and then twisting (4)
them to lock.

3 4

Figure 111 Attaching the transparent valve covers

6. Put the water container in place.


See further the Instructions for use leaflets for the Cleaning Cassette and for the Compact Block.

142 Document No. 8502304-2


8 Cleaning and maintenance

Ventilator bellows assembly


The following instruction describes different methods to clean and disinfect the Ventilator bellows
assembly. For further information see the Disinfection methods table on page 134. For frequency
and level of disinfection, follow hospital routines.

Figure 112 Ventilator bellows assembly on the ADU

Disassembling before cleaning


1. Turn the ventilation selector to Manual position.

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2. Disconnect the ventilator and manual bag hoses.

3. Open the locking handle for bellows block.

4. Turn the bellows chamber counterclockwise and remove it.

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8 Cleaning and maintenance

5. Remove the bellows.

6. Turn the overflow valve retaining ring counterclockwise and remove it.

7. Remove overflow valve.

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8. Refit the retaining ring.

9. Open the APL valve to 1,5 cmH2O.

10. Lift the bellows block off the bottom plate.

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8 Cleaning and maintenance

Cleaning and disinfection


There are two ways to clean the Bellows block manually or mechanically in a washer or
washer-disinfector (herein called washer-disinfector). Both methods are described below.
Mechanical cleaning and disinfection in washer-disinfector
1. Turn the block upside down and connect a hytrel tube to the connector.

Connector

2. Place the bellows block into the washer-disinfector.


3. Connect the hytrel tube to the water source in the washer-disinfector and clean the bellows
block with a decontaminating program.

4. Dry the bellows block in a warming closet or in room temperature.


5. If the washer-disinfector is not used for disinfection of equipment, Datex-Ohmeda recommends
that a further intermediate or high level disinfection is conducted.

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Manual cleaning
1. Flush the bellows block with fresh running water for 1 minute. It is important to flush into the
correct connector, see the figure below.

Connector

2. Clean the bellows block in a sink with water and cleaning agent for at least 3 minutes. The water
temperature should be 40 Celsius or 104 Fahrenheit.

3. Flush the bellows block with fresh running water for 1 minute.

4. It is recommended that manual cleaning is followed by a high level disinfection.

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8 Cleaning and maintenance

After cleaning and disinfection


1. Remove the retaining ring. Apply a thin layer of oxygen safe silicon grease to the O-ring and the
threads of the retaining ring.
CAUTION Do not apply grease to the overflow valve
2. Refit the overflow valve and the retaining ring.
3. Carefully inspect the bellows visually for damage.

Bellows and manual ventilation bag


Cleaning and disinfection
Clean in a washer-disinfector or by hand using warm water and mild soap. Rinse in clean water and
dry at a temperature less than 70 C/158 F. Room temperature is ideal.
If autoclaving is necessary, the maximum temperature is 121 C. Dry at room temperature. Carefully
check the condition of the bellows, overflow valve membrane and manual bag when they have been
autoclaved.
CAUTION The use of automatic washers or washer-disinfectors and sterilizers may prove
harmful to the rubber bags and bellows. The exposure to detergents during long
periods may cause the rubber to loose elasticity and become sticky.
Storing
Store in a cool place (below 25 C/77 F), away from natural or artificial light and sources of ionizing
radiation. Store free from condensation and away from direct contact with metals, solvents, oils,
grease and strong detergents.

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Aladin cassette
Disinfection
Unlock the cassette from the ADU. Clean the Aladin cassettes surface with a cloth moistened in mild
soap solution.

Storing
Datex-Ohmeda recommends that Desflurane cassettes are empty when storing them for more than
one month. Contact a service technician for draining of cassettes.

Service
All types of Aladin cassettes must be emptied before shipping.
Contact a service technician for draining of cassettes.
The cassettes shall be shipped in a suitable wrapping.

Sampling adapters
Single use adapter
Datex-Ohmeda recommends that the single use adapter is discarded after each patient. If a
bacterial/viral filter is used between the adapter and patient, Datex-Ohmeda recommends that the
filter is replaced with every patient.
Reusable adapter
Follow hospital routines concerning the level and frequency of disinfection or consult the
recommendations from Datex-Ohmeda in Disinfection methods table on page 134.

Sampling line
Do not reuse a sampling line as a cleaned sampling line may affect the accuracy of the
measurements.

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8 Cleaning and maintenance

Recommended periodic maintenance


Checkout and maintenance schedule
There are four different checkouts and maintenance procedures for the Anesthesia Delivery Unit,
which should be carried out according to the following schedule.

Checkout Frequency
System Checkout Daily
Functional Checkout Every 6 months
Annual maintenance Once a year
Three year maintenance Every 3 years

A System Checkout should be performed every day before usage of the ADU and always after a
Functional Checkout.
A Functional Checkout should be performed every 6 months and always after servicing the ADU. Only
trained service technicians should carry out the Functional Checkout.

Service
Before submitting the ADU for service, the unit must be properly cleaned and decontaminated as well
as free from any toxic and hazardous substances.

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Health and safety declaration form


1. Please note that equipment returned for service, will not be accepted until this form is properly
completed.
2. Failure to complete the form or to comply with health and safety cleaning procedures, may
endanger Datex-Ohmeda service personnel and may lead to delay in servicing the equipment.

Equipment type/Product No: State if the equipment has been in contact with
any toxic or hazardous substances that require
the service personnel to wear:
Serial No: Gloves
I hereby confirm that the above equipment has Inhalation filter
been properly cleaned and decontaminated. Protective clothing
I also agree to give Datex-Ohmeda the sole
Other.................................
control of the instrument / system.
............................................
............................................
Cleaning certified:
(signature)
Name: None of the above
(Block letters)

Position in institution or company: State phone number where Datex-Ohmeda may


obtain more information concerning the
instrument / system.
Date (Year/Month/Day) Phone No:

............../............../.............. ...............................................................

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9 Troubleshooting

9 Troubleshooting
Leak detection and correction
The ADU checks for leaks during the system check. Avoid making any modifications of the bellows
block assembly or to the patient circuit after the system check as any new leaks may go unnoticed.
The best indication of a large leak is that the standing bellows does not reach the top of the chamber.
This is especially important with low fresh gas flows; less than 1 l/min.
During daily operation, the points most subject to a leak are the hoses, the compact block, the
absorber and the bellows chamber.
If the bellows block has been dismantled, the overflow valve and the bellows base rubber sealing
should be checked.
If the following instructions do not correct the leak, call for a service technician.

Leakage limits of the ADU


The AUTO LEAK checkout fails when a leak is > 150 ml/min.
The MAN LEAK checkout fails when a leak is > 100 ml/min.
Measured compliance of the breathing system should be within 1.0 to 10.0 ml/cmH2O.
It is, however, up to the user to decide whether the leakage is acceptable or not. Also see appendix A
- Leak Checkout.

Leakage during ventilation


When a patient is connected to the ADU, the actual leak is much less than that calculated in the leak
test. In clinical practice the EFFECTIVE MEAN PRESSURE during one complete ventilation cycle and
thus the actual leak is lower than during the leak test. In addition to the effective mean pressure, the
amount of the leak also depends on the rate of the pressure increase, the I:E RATIO and the plateau
time.

cmH2O
PEAK
15
pressure
MEAN
10 pressure

Inspiration Expiration Time

Figure 113 Effective mean pressure

In normal ventilation (mean pressure 10 cmH2O, I:E ratio 1:2) the actual leak is approximately 10% of
the leakage calculated during the leak test. This can be calculated with the following formula:
(Mean Pressure) * (Insp. time) * (Leakage in leak test)
(30 cmH2O) * (Cycle time)

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MEAN PRESSURE I:E -ratio leakage ml/min.


in cmH2O
System Checkout leak test 30 insp. only 150
Normal ventilation cycle 10 1:2 17

The best indication of a large leak is when the standing bellows does not reach the top of the
chamber. This is especially important with low fresh gas flows (< 1.0 l/min.).

Patient circuit hoses


Check the leakage of each patient hose (= 3 pcs).
1. Connect the hose to the ventilator connector under the bellows block, and to the fresh gas
outlet.
2. Repeat the AUTO LEAK test with each hose to check each individual hose for leaks.

Figure 114 Checking Hoses for Leakage

3. Repeat the AUTO LEAK test once more with normal hose connection.
If there still is a major leak, check the compact block.

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9 Troubleshooting

Compact block
1. Check visually that the O-rings are undamaged.
2. Remove the transparent valve covers.
3. Check that the insp./exp. valves are in good condition. Make sure they are correctly seated by
lifting the green membranes and carefully pushing the valves down with the fingers.
4. Replace the valve covers.
5. Check the ventilator connections.
6. Repeat the AUTO LEAK test.

Figure 115 Compact block leakage

If the above does not help, exchange the complete Compact block and repeat the AUTO LEAK test.
If the compact block does not leak, check the bellows block.

Bellows
The functioning of the ADU bellows system is checked during the System Check. If there is a failure or
an alarm during operation, this is an indication of the following:
1. Failure situation
When the bellows does not reach its top position during automatic ventilation but only about half-
way, it is an indication of:
a) The patient is still ventilated but there is a leak. The leak is either:
In the circuit
In the D-lite connection site
In the patient. During lung operations for instance, gases may leak through the lung.
b) The volume in the circuit is not sufficient. This is, for instance, typical during low flow anesthesia
and when the sample gas is scavenged.
What to do: Find the leak or compensate the shortage of the fresh gas flow by increasing the fresh
gas flow or by bringing the sample gas back into the circuit.
2. Alarm situation
When the bellows collapses completely, the ADU gives an alarm and the message FILL BELLOWS
appears.
In this case the desired volume cannot be delivered and the patient cannot be ventilated.
What to do: Flush the bellows with O2 by pressing O2 flush button.

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Bellows chamber positioning


The bellows chamber sealing might leak if the chamber has not been properly locked in its position or
it has been knocked to the side and is no longer standing upright.

Figure 116 Bellows Chamber Leakage

1. Release the chamber by pulling out the handle.


2. Adjust the position of the bellows chamber.
3. Lock the bellows chamber by pressing down and twisting it into place. Press down the metal
locking ring around the bellows chamber and at the same time, push the handle.
4. Repeat the AUTO LEAK test.
If the bellows block has been disassembled for cleaning and disinfection, the gasket under the
bellows chamber might be leaking. Check that the gasket is correctly seated.
The chamber may also be broken if it was incorrectly positioned while the locking handle was forced
into the locked position.

156 Document No. 8502304-2


9 Troubleshooting

Overflow valve
Check that the bellows block overflow valve is correctly positioned. If not, open the overflow valve,
reassemble and repeat the AUTO LEAK checkout.

Place the rubber membrane over the valve duct.

Feel with the finger (wear gloves) along the edge to make
sure that the groove on the outer rim of the membrane sits
tightly on the outside wall of the duct.

Check the tightness by lifting the membrane by the metal


weight. The membrane should flex slightly upwards but not
disconnect from the edges.

Reassemble the overflow valve by entering (1) and then 2


turning (2) the valve retaining ring. Be careful not to tighten 1
it too hard, as the membrane may become kinked and
prone to leak.

WARNING If the overflow valve is placed incorrectly with the metal part facing downwards,
the pressure in the patient circuit may not be sufficient to guarantee adequate
patient ventilation.

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Bellows block bottom plate gasket


When the bellows block was disassembled during cleaning, the gasket may have gotten out of
position or even been lost.

Figure 117 Bottom plate with gasket

Lift up the bellows block.


Check that the rubber gasket is not chafed or incorrectly positioned.

Manual bag and bag hose


MAN leak > 100 ml /min.
1. Exchange the ventilation bag or bag hose.
2. Open the APL valve to 1.5.
3. Repeat the MAN LEAK checkout.

158 Document No. 8502304-2


9 Troubleshooting

Alarm messages
Limit alarm message Possible cause of alarm Recommended action
Ppeak High (AUTO & MANUAL) Obstructed hose or endotracheal Switch to manual and clear
tube. obstruction.
Ppeak Low (AUTO) Disconnected or leaking hose or 1. Check hose and connections.
Ppeak low limit too high. 2. Adjust alarm limit.
PEEP valve does not work correctly 3. Call for service

PEEP High (AUTO & MANUAL) Sustained pressure. 1. Disconnect scavenging.


Scavenging system obstructed or 2. Switch to manual ventilation.
overflow valve stuck.
Negative Pressure (AUTO & MANUAL) Scavenging system malfunction 1. Disconnect scavenging.
(leak). Spontaneous breathing. 2. Increase fresh gas flow.
Pmax Release (AUTO) Obstruction. 1. Switch to manual ventilation.
2. Check the patient circuit.

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System status messages


Electronic ventilator messages
Status alarm Alarm condition Recommended action
Air supply pressure lost When the pressure does not reach the Switch to Air reserve gas cylinder.
minimum pressure limit.
Calibrate ventilator Calibration coefficients returned to Call for service.
factory defaults.
Cannot deliver set vol. EV detects that delivered TV differs Change ventilator or fresh gas
from set during four EV cycles. settings. Check for leakage.
Cannot reach PCV pressure Pressure limit not reached during five Check for disconnections or some
consecutive breaths. other malfunction that would cause a
major leak.
Check bellows chamber or call service Following the message Ventilator or
circuit leak.
Driving gas to: Secondary Driving gas switched from primary to Restore the availability of primary
secondary. driving gas. If using cylinder as driving
gas source, be aware of greater
consumption of cylinder gas.
Faulty PEEP valve PEEP control error. Use system without PEEP. Call for
service.
Fill bellows Leak or fresh gas flow too low. Remove the leak or increase fresh gas
flow.
Loss of driving pressure Neither primary nor secondary driving Use manual ventilation. Restore
gas available. Ventilator inoperable. driving pressure.
O2 supply pressure lost When the pressure does not reach the Switch to O2 reserve gas cylinder
minimum pressure limit.
Select MAN or AUTO mode The AUTO/MAN switch is in neither Select either position.
position.
Sigh cycle Starting sigh cycle. None. Notification to user.
Switch to MAN mode System is in AUTO mode after system Switch to manual ventilation.
check.
To prevent the ADU from starting to
ventilate immediately it is required
that user switches to MAN first.
Ventilate manually See previous. Is shown together with Ventilate manually.
Ventilator failure message.
Ventilator communication error Communication failure between EV Use previous settings. Try new
and main SW. Settings not accepted settings. Switch to manual
by EV. ventilation.Call for service
Ventilator failure Safe state. Use manual ventilation. Call for
service

160 Document No. 8502304-2


9 Troubleshooting

Status alarm Alarm condition Recommended action


Ventilator or circuit leak Leak in ventilator circuit or bellows Check bellows chamber or call for
chamber. System stuck in Self Check. service.

Electronic vaporizer messages


Status alarm Alarm condition Recommended action
AA liquid sensor failure Liquid measurement malfunction. Check the level indicated by the liquid
level indicator.
Agent % not delivered. Decr. flow Insufficient agent delivery. The Decrease fresh gas flow.
concentration control valve cannot be
opened, as the set value requires.
Agent setting high 1 Sevoflurane setting above 5 %. Lower the setting to below 5 %.
Agent shut OFF Vaporizer agent on/off valve is closed Increase fresh gas flow and then set
because of low fresh gas flow or agent percentage in fresh gas. If this
vaporizer malfunction. does not help - call for service.
Air selected System changes automatically to Air. Increase O2 fresh gas flow. Check N2O
supply pressure. Check that ratio
control works properly.
Calibrate fresh gas unit Calibrations returned to factory Call for service.
defaults.
Cannot identify cassette The ID coding of the cassette cannot Exchange the cassette and have the
be interpreted. faulty cassette serviced.
Cassette empty Aladin cassette is empty. Fill the Aladin cassette.
Decrease fresh gas flow Vaporizers dynamic range exceeded. Reduce fresh gas flow.
Draining cassette Aladin cassette is overfilled or If the message appears frequently,
overpressurized. call for service. Otherwise wait until
the message disappears and
continue normal operation.
Ensure adequate agent % Heated vaporizer, vapor pressure may Check actual agent percentage from a
be higher than normal. gas monitor. FiAA corresponds to
fresh gas percentage and EtAA to the
concentration in patients lungs.
Ensure adequate oxygen Shown together with messages: Increase O2 fresh gas flow and check
Hypoxic mixture, Fresh gas occlusion, from a patient monitor that the
Fresh gas unit failure, Air selected patient gets enough O2.
Faulty N2O/Air switch The gas selector switch malfunctions. Call for service.
Fresh gas occlusion. FG outlet Occlusion detected in fresh gas Clear occlusion or call for service.
outlet.
Fresh gas unit failure 1) Safe state. Call for service.
2) Communication failure.
1. If this alternative is installed.

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Status alarm Alarm condition Recommended action


Fresh gas unit meas. error Flow measurement malfunction. Call for service.
Hypoxic mixture Calculated O2 concentration falls Increase O2 flow; decrease N2O flow.
below 21 %.
N2O supply pressure lost N2O supply pressure lost. Restore N2O supply pressure.
Select N2O or Air The gas selector switch points neither Select N2O or Air.
N2O nor Air.
Vapor. Leak Cassette? Service? Leakage detected in the vaporizer. Change cassette.
If changing cassette doesnt help call
for service.
Vaporizer failure Various fresh gas control unit errors. Call for service.
Communication failure.

Other messages
Status alarm Alarm condition Recommended action
Batteries empty Batteries exhausted. Ventilate manually.
Go manual
Battery failure HW error in battery circuit. Call for service.
Check battery Uneven battery voltage. Call for service.
Keyboard failure Hardware failure. Ventilate manually. Call for service.
Mains power lost Loss of mains power. Operate with batteries or restore
mains power.
Patient monitor removed Install/Interfacing: Monitor is ULT or Connect patient monitor or change
AM. Interface between the interface setup.
the ADU and a patient monitor is set
up but disconnected.
Software mismatch Main SW 6.2/7.2 or newer that has Install A-FGC1 SW 7.5 or newer.
been configured to operate without
N20, and A-FGC1 SW 7.4 or older
installed.
System Busy System is not yet ready to process Wait 30 s. Switch the ADU OFF and
new keyboard commands. then ON again. If this does not help -
call for service.
System check bypassed Bypass Check is selected in System Perform Full Check or separate test.
Check menu.
Unexpected Reset System Reset See Unexpected Reset on page 122
Volume monitor removed 1 Connection lost between the ADU and Restore connection.
the interfaced spirometry monitor ULT
or AM.
1. If this alternative is installed.

162 Document No. 8502304-2


10 Technical specifications

10 Technical specifications
General
Dimensions

Basic unit with cart


Height Two optional heights: 1410 or 1540 mm/55.6 or
60.7 in
Display viewing level 1242 or 1372 mm/49 or 54 in
Depth 770 mm/30.3 in
Width 840 mm/33.1
Floor space 705 mm x 726 mm/27.8 x 28.6 in
Weight 110 to 130 kg/242 to 286 lbs

Basic unit without cart


Height 670 mm/26 in
Depth 750 mm/29.5 in
Width 840 mm/33.1 in
Weight 85 kg/187 lbs

Drawer (optional)
Height 145 mm/5.7 in
Depth 405 mm/16 in
Width 480 mm/19 in

Table
Width 510 mm/20 in
Depth 353 mm/13.9 in

Folding table (optional)


Width 262 mm/10.3 in
Depth 312 mm/12.3 in

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Environmental conditions

Temperature +10C to +35C (50 to 95F)


Relative humidity 0 to 85 % (non-condensing, in operation)
Atmospheric pressure 660 to 1060 hPa (500 to 800 mmHg),
corresponding to altitudes up to about 9840 feet
above sea level
Storage temperature -10C to +60C (14 to 140F)

Electrical requirements
The unit is designed to be powered from the mains power supply. A back-up battery function is
provided.

Power supply 220 to 240 VAC (10%), 50/60 Hz


or 100 to 120 VAC (10%), 50/60 Hz
Maximum power consumption 220 to 240 V:
2 A (ADU + AM with CRT display)
10 A (above + auxiliary outlet)
100 to 120 V:
4 A (ADU + AM with CRT display) 12 A (above +
auxiliary outlet)
Grounding Hospital grade
Safety class IEC Class I, type B
Protection against ingress of water Class IPX1
Back-up battery capacity Capacity for > 20 min. (typically 30 min.) of use
of the ADU.
Charging time Four (4) hours

Electrical connections

Auxiliary outlets 1 mains power outlet on the rear side for an


Anesthesia Monitor. 3 outlets.
Fuses 2 x T2.5 A in 220 to 240 V units
2 x T5 A in 100 to 120 V units
Voltage 220 to 240 VAC, 50/60 Hz
100 to 120 VAC, 50/60 Hz
Nominal output currents 220 to 240 V units, 2 A socket
100 to 120 V units, 3 A socket.
Max. total 8 A
Data connector 9-pin female D-connector for serial I/O and
analogue input

164 Document No. 8502304-2


10 Technical specifications

Display

12.1 display
Display type Active matrix color LCD
Size 12.1" diagonal
Display resolution SVGA resolution, 800X600
Controls 15 membrane switches, ComWheel
Indicators Red and yellow LCDs

10.4 display
Display type Active matrix color LCD
Size 10.4" diagonal
Display resolution VGA resolution, 640X480
Controls 14 membrane switches, ComWheel
Indicators Red and yellow LCDs

Trends

Trend resolution
Resolutions for continuous data:
up to 20 min. 10 s
up to 2 hours, 1 min.
up to 4 hours 2 min.
up to 12 hours 6 min.
up to 24 hours 12 min.

Continuous trend information together with time discrete events are stored for the latest 24 hours
with one-minute resolution for all ADU parameters.

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Alarms
The following alarms are user adjustable:

High pressure alarm, Ppeak High (in AUTO mode) 8 to 80 cmH2O,


always > Ppeak Low + 2 cmH2O
(factory default 30 cmH2O)
High pressure alarm, Ppeak High (in MAN mode) 6 to 80 cmH2O
(factory default 40 cmH2O)
Low pressure alarm, Ppeak Low (in AUTO mode) 6 to 78 cmH2O
or PEEP + 4 to Ppeak High - 2
NOTE: Can not be set higher than Ppeak High

The following pressure alarms are non-adjustable:

Negative pressure alarm Alarm if the airway pressure stays below a (sub-
atmospheric) limit continuing for a certain time.
In Manual mode:
MEDIUM priority alarm when airway pressure has
stayed below -0.7 cmH2O continuously for 20 s.
In Auto modes VCV and PCV:
NOTE when min pressure of all cycles within a
period of 1 s has fallen below -3 cmH2O.
MEDIUM priority alarm when min pressure of all
cycles within a period of 20 s has fallen below -
0.7 cmH2O or when all cycles within a period of 5
s has fallen below -3 cmH2O.
HIGH priority alarm when the min pressure of all
cycles within a period of 20 s has fallen below -3
cmH2O or when min pressure of all cycles within
a period of1 s has fallen below -8 cmH2O.
In Auto mode SIMV:
MEDIUM priority alarm when min pressure of all
cycles within 20 s has fallen below -0.7 cmH2O
Sustained pressure alarm, PEEP High Alarm if the airway pressure exceed a limit
continuing for longer than 15 seconds.

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10 Technical specifications

Gas delivery
Gas supply

Wall supply
Gas connectors O2 - AIR - N2O - VAC (optional) - EVAC
Inlet pressure 270 to 800 kPa (39 to 116 psi)
Gauges O2, Air, N2O: 0 to 1000 kPa (0 to 145 psi)
Accuracy of gauges 4 % of full scale
O2, Air, N2O safety valves opening pressure 900 kPa (130.5 psi)

Reserve gas cylinders


Reserve gas yokes Pin index for O2, N2O, Air
Gauges O2: 0 to 31.5 MPa (0 to 4569 psi)
N2O: 0 to 10 MPa (0 to 1450 psi)
Air: 0 to 31.5 MPa (0 to 4569 psi)
Accuracy of gauges 4 % of full scale
Safety valves opening pressure 700 kPa (102 psi)

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Fresh gas control unit

Fresh gas outlet The ADU has a coaxial 22 mm /15 mm conical


fresh gas outlet in compliance with ISO 5356-1/
EN 1281-1.
Overpressure valve in fresh gas outlet 80 cmH2O
Extra outlets Optional outlets for vacuum (1 ea), O2 (max 2 ea)
and Air (max 2 ea). Max. total number of outlets
is: three on the left and one on the right side.
Flow from and pressure at the outlets are
dependent on the hospital wall pressure.
O2 flush 35 to 50 l/min.

Flow control adjustments Flow delivery ranges


O2 0 to 10 l/min. as single gas.
0 to 8.5 l/min. together with max. 4 l/min. Air or
N2O flow.
AIR 0 to 10 l/min. as single gas.
0 to 8.5 l/min. together with max. 4 l/min. O2
flow.
N2O 0 to 8.5 l/min. together with max. 4 l/min. O2
flow.

Accuracy specifications applied to above mentioned nominal adjustment ranges. Available


maximum flows may exceed the above mentioned values.

Electronic flow measurement Accuracy *


O2 10 % or 20 ml/min., whichever greatest
AIR 10 % or 20 ml/min., whichever greatest
N2O 10 % or 20 ml/min., whichever greatest

*) NOTE: All accuracy specifications refer to the 0.1 to 10 l/min. flow range.

O2, Air, N2O: Resolution


0 to 1.0 l/min. 0.05 l/min.
1.0 to 10 l/min. 0.1 l/min.
Hypoxic Control Electronic O2% control is calibrated to guarantee
25 4 vol. % O2 concentration

168 Document No. 8502304-2


10 Technical specifications

Electronically controlled vaporizer and Aladin cassette


Electronically controlled vaporizer for delivery of five agents: Halothane, Isoflurane, Enflurane,
Sevoflurane and Desflurane.
The Aladin Cassettes can be handled safely without excessive leakage of anesthetic agent to the
environment.
NOTE: The ADU vaporizer performs as an ordinary concentration calibrated vaporizer regarding the
effects of varying ambient pressure. The nominal agent volume % setting is graduated at sea level
ambient pressure (1013 hPa). If the vaporizer is used at higher altitudes (decreased ambient
pressure), the delivered agent volume % will be higher than the set agent volume % in relation to the
decrease of the ambient pressure. This is due to the agent partial pressure being independent of the
ambient pressure.

Filling
Filling system Adapter filling:
Rectangular keyed adapter filler system for
Halothane, Isoflurane, Enflurane and
Sevoflurane.
Quik Fil system according to Abbots for
Sevoflurane.
Cylindrical keyed adapter filler system
compatible to the Datex-Ohmeda Saf-T-Fil
bottle for desflurane.
Filling speed > 2 ml/s
Overfilling protection Overfilling prevention systems built into the
cassettes.

Liquid capacity
Maximum 250 ml
Normally possible to fill up when cassette 150 ml
indicator shows empty (residual volume 100 ml)

Cassette
Empty weight Enflurane, Isoflurane, Sevoflurane with keyed
filler - 2.0 kg. Halothane with keyed filler,
Sevoflurane Quik Fil - 2.5 kg, Desflurane - 3 kg
Height 7 cm
Depth 23 cm
Width 14 cm
16 cm for keyed filler system

Anesthetic agent delivery


Minimum fresh gas flow for agent delivery 0.2 l/min.

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Agent setting ranges


Halothane, Enflurane, Isoflurane OFF, 0.1 to 5 % in fresh gas flow,
resolution 0,1 %
Sevoflurane OFF, 0.1 to 8 % in fresh gas flow,
resolution 0.1 %
Desflurane OFF, 0.5 to18 % in fresh gas flow,
resolution 0.5 %
Accuracy
All agents in typical operating conditions. Fresh 10 % of setting or 3 % of full scale whichever
gas flow range 0.2 to 8 l/min. is the greatest
Ambient temperature 18 to 25 C.
Sea level ambient pressure.

In other operating conditions 20 % of setting or 5 % of full scale whichever


is the greatest
NOTE: Sevoflurane concentrations above 5%
may not be reached if the ambient temperature
is below 18 C and the fresh gas flow above 5 l/
min.
NOTE: Sevoflurane and Desflurane concentration
at high fresh gas flows (>5 l/min) and high
concentration settings (SEV >5%; DES >12%)
will decline after some minutes of use. The rate of
decline will increase with higher setting, higher
fresh gas flow and lower temperature.
NOTE: The effect of the fresh gas composition,
back pressure and temperature variations on the
agent concentration are included in the accuracy
specification.
NOTE: The nominal volume % setting of the
vaporizer is graduated at sea level ambient
pressure or 1013 hPa. The delivered agent vol %
for a set vol %, will increase in relation to the
ambient pressure decrease, since the anesthetic
agent partial pressure is independent of the
ambient pressure
Response time
To 90 % of step; measured at fresh gas outlet < 20 s at a fresh gas flow of 3 l/min.

NOTE: Sevoflurane concentrations above 5 % may not be reached if the ambient temperature is
below 18 C and the fresh gas flow is above 5 l/min.

170 Document No. 8502304-2


10 Technical specifications

Ventilation
Electronic ventilator including bellows block
Description
The ventilator is an electronically controlled, time cycled flow generator delivering tidal volumes
compensated for the actual inspiratory fresh gas flow and measured breathing circuit compliance.
The ventilator includes a maintenance free internally integrated PEEP-valve.
The ventilator incorporates a switch operation from manual or spontaneous ventilation (Man/Spont)
to controlled mechanical ventilation (AUTO). Manual ventilation is direct, i.e. the rebreathing bag is
directly connected to the patient breathing circuit.

General
Driving gas Compressed Air or O2. If the supply of primary
gas is lost the secondary gas is automatically
switched in. Switch activating pressure: 250 kPa
(36.3 psi)
Driving gas pressure 270 to 800 kPa (39 to 116 psi)
Driving gas consumption Approx. same as minute volume in volume
controlled mode. In PCV the consumption is
dependent on the Pressure Limit.
Gas supply, O2 alarm Alarm activating pressure: 250 kPa (36.3 psi)
Max. inspiratory flow 80 l/min.
Minute volume (max.) 30 l/min.
Inspiratory flow pattern Constant flow in volume controlled mode
Decelerating flow in pressure controlled mode

Controls
Ventilation control AUTO/MAN selector (mechanical)
Tidal volume 20 to 1400 ml, (factory default 500 ml)
Option: alternative minute volume setting
Tidal volume resolution:
20 to 50 ml 2 ml
50 to 100 ml 5 ml
100 to 300 ml 10 ml
300 to 1000 ml 25 ml
above 1000 ml 50 ml
Minute volume 0.1 to 30 l/min. (factory default 5.0 l/min.)
Option: alternative tidal volume setting
Resolution 0.1 l/min.
Pressure limit 5 to 40 cmH2O above measured PEEP
Resolution 1 cmH2O

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Controls
Respiration rate 2 to 60 breaths/minute (factory default, 10)
Resolution 1 breath/minute
Patient weight (kilos) 3 to 100 kg/ (7 to 220 lbs)
Resolution 0.5 kg within 3 to 10 kg range
1 kg within 10 to 30 kg range
5 kg within 30 to 100 kg range
Inspiration/expiration ratios 1:4.5, 1:3, 1:2.5, 1:2, 1:1.5, 1:1, 2:1, (factory
default, 1:2)1
Optional: Inspiratory time in seconds or %. Not available in SIMV.
Inspiratory time 0.35 to 20 sec
Optional: I:E ratio or Inspiratory time percentage Note: Minimum expiratory time: 0.5 sec
Inspiratory time percentage 18 to 67 % of whole cycle (1:4.5 - > 18 % and
2:1 - > 67 %)
Optional: alternative I:E ratio or inspiratory time Not available in SIMV
in seconds
Inspiratory pause 0 to 60 % of inspiratory time with 5 %
increments, (factory default 25%), available in
Volume Controlled Ventilation and SIMV
PEEP OFF:
2 to 4 cmH2O due to the weight of a standing
bellows system.
5 to 20 cmH2O.
Resolution 1 cmH2O, factory default OFF.

PEEP is limited to 10 cmH2O if Tidal Volume is


less than 100 ml.
Sigh OFF/ON, 1.5 x TV every 100th breath. Not
available in SIMV or Pressure Control. Maximum
volume 1400 ml.
Trigger level for SIMV from baseline -0.5 to - 5 cmH2O (default -1.0)
Resolution 0.1 cmH2O
Trigger window for SIMV 5 to 95 % from expiratory time
Resolution Minimum expiratory time: 0.5 sec
1%
Inspiratory Rise Time Pressure rise in PCV mode as % of inspiration
time: Slow (90%), medium (50%) (default), fast
(10%). Shortest time is 300 ms.
1. Additional I:E ratios are available when setting I:E times in SIMV. Ratios will remain available in other ventilator modes
until the case is reset or the machine is turned off.

172 Document No. 8502304-2


10 Technical specifications

Accuracy
Tidal volume accuracy 20 to 50 ml: 20 % of set value or 5 ml,
whichever is the greater.
50 ml: typically 5 % of set value or 10 ml,
whichever is the greater.
Typically is defined so that 90 % of machines are
within 5 %. All machine < 10% of set value.
Compensated for fresh gas flow up to 50% of
actual minute volume.
Compensated for machine compliance.
Independent of gas composition
Accuracy valid for airway pressures 30 cmH2O.
Delivered volume will decrease at high pressure;
-20% at 100 cmH2O.
Tidal volume repeatability Variation < 10% in the range 20 to 100 ml
Minute volume accuracy See tidal volume
Pressure control accuracy 2 cmH2O
Resp. Rate, I:E, Pause, Insp. time accuracy 60 ms
PEEP accuracy 2 cmH2O up to 20 cmH2O
Sigh accuracy 10 % of volume
60 ms timing

Circuit pressure monitoring


Measuring range - 40 to 100 cmH2O
Measuring accuracy 4 % of value or 2 cmH2O
Display resolution 1 cmH2O
Displayed values Parameters
Volume mode Ppeak, Pplat, PEEP
SIMV mode Ppeak, Pplat, Pmin
PCV mode Ppeak, PEEP
Man mode Ppeak, Pmin

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Circuit pressure regulation


Automatic ventilation mode (AUTO mode)
Adjustable maximum pressure release, Pmax (Ppeak Low + 2). 80 cmH2O (Default 40 cmH2O).
Release (Software controlled pressure limiting)
Circuit pressure regulation
Manual/Spontaneous ventilation mode
(MANUAL mode)
APL valve adjustment range 1.5 to 80 cmH2O
APL setting
1.5 cmH2O 0.5 to 5 cmH2O, Fresh gas flow 3 to 10 l/min
20 cmH2O 15 to 30 cmH2O, Fresh gas flow 3 to 10 l/min
80 cmH2O 64 to 96 cmH2O, Fresh gas flow 3 to 10 l/min

174 Document No. 8502304-2


10 Technical specifications

Patient breathing systems


Refer to the technical information tables for the Compact Block patient circuit and the standard
patient circuit with absorber.
Any breathing circuit compatible with a 22/15 mm coaxial fresh gas outlet may be used. A patient
circuit used together with tubing and Bellows block must comply with the maximum resistance
requirements as specified in EN 740. The compliance for the entire breathing circuit must not exceed
7 ml/ cmH2O.
The patient circuit used must have unidirectional valves for the inspiratory and expiratory lines as well
as a connection for fresh gas when required (Bain type circuits excluded).
NOTE: Patient circuits with built in APL valve must not be used for the ADU to avoid the risk for
confusion due to multiple pressure limiting devices.
NOTE: It has been found that carbon monoxide (CO) tends to build up in unused anesthesia units.
Exchange absorbent in a unit that has been idle for more than 48 hours. Also flush the system with O2
before use.

Scavenging
Maximum extracted flow 50 l/min.
or
40 l/min if silencer (8502504) installed
Normal minimum extracted flow 25 l/min. (independent of fresh gas flow)
Passive scavenging Rear panel scavenging connector.
Differential pressure 29 cmH2O at 25 l/min.
Extracted flow with A-SEJ2 ejector Minimum 25 l/min at a driving pressure of 250
(Active scavenging with optional scavenging to 800 kPa (36.3 to 116 psi)
ejector) Driving gas: Air

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Vaporizer output graphs


Anesthetic agent concentration output
Halothane
Typical output at 20 C, 10 C and 35 C as functions of fresh gas flow and vaporizer settings.

Halothane in O2 at 20C (68F)


Concentration [%]

5%
4%
2%
1%
0,5%

Flowrate [l/min.]

Halothane in O2 at 10C (50F) Halothane in O2 at 35C (95F)


6
Concentration [%]
Concentration [%]

0
0 2 4 6 8 10
Flowrate [l/min.] Flowrate [l/min.]

176 Document No. 8502304-2


10 Technical specifications

Sevoflurane
Typical output at 20 C, 10 C and 35 C as functions of fresh gas flow and vaporizer settings.

Concentration [%] Sevoflurane in O2 at 20C (68F)

5%
4%
2%
1%
0,5%

Flowrate [l/min.]

Sevoflurane in O2 at 10C (50F) Sevoflurane in O2 at 35C (95F)


Concentration [%]

Concentration [%]

Flowrate [l/min.] Flowrate [l/min.]

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Enflurane
Typical output at 20 C, 10 C and 35 C as functions of fresh gas flow and vaporizer settings.

Concentration [%] Enflurane in O2 at 20C (68F)

5%
4%
2%
1%
0,5%

Flowrate [l/min.]

Enflurane in O2 at 10C (50F) Enflurane in O2 at 35C (95F)


Concentration [%]
Concentration [%]

Flowrate [l/min.] Flowrate [l/min.]

178 Document No. 8502304-2


10 Technical specifications

Isoflurane
Typical output at 20 C, 10 C and 35 C as functions of fresh gas flow and vaporizer settings.

Isoflurane in O2 at 20C (68F)


Concentration [%]

5%
4%
2%
1%
0,5%

Flowrate [l/min.]

Isoflurane in O2 at 10C (50F) Isoflurane in O2 at 35C (95F)


Concentration [%]

Concentration [%]

Flowrate [l/min.] Flowrate [l/min.]

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Desflurane
Typical output at 20 C, 10 C and 35 C as functions of fresh gas flow and vaporizer settings.

Desflurane in O2 at 20C (68F)


Concentration [%]

5%
4%
2%
1%
0,5%

Flowrate [l/min.]

Desflurane in O2 at 10C (50F) Desflurane in O2 at 35C (95F)


Concentration [%]

Concentration [%]

Flowrate [l/min.] Flowrate [l/min.]

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11 Glossary

11 Glossary
Abbreviations
APL Airway Pressure Limiting (valve)
APN Apnea
ATPD Ambient Temperature Pressure Dry
CO2 Carbon dioxide
CMV Controlled Mechanical Ventilation
Compl Compliance
DES Desflurane
EV Electronic Ventilator
ENF Enflurane
ET End tidal gas concentration
Exp. Expiratory/Expiration
FI Fractional concentration of inspired gas
HAL Halothane
I:E Inspiratory: Expiratory time ratio
Insp. Inspiratory/Inspiration
ISO Isoflurane
MAC Minimum Alveolar Concentration
MV Minute volume
MVexp Expired minute volume
MVinsp inspired minute volume
N2O Nitrous oxide
O2 Oxygen
Pa Pascal (unit of pressure)
Paw Airway pressure
Ppeak Peak pressure
PEEP Positive end-expiratory pressure
Pplat Plateau pressure
Pcirc Circuit pressure
Resp Respiration
RR Respiration Rate
SEV Sevoflurane
PCV Pressure-controlled ventilation
PS Patient Spirometry
SIMV Synchronized Intermittent Mandatory Ventilation
TV Tidal volume
Vol. Volume

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Units
Pressure units
hPa = hektoPascal
kPa = kiloPascal
cmH2O = centimeters of water
bar = 1 atmosphere
mmHg = millimeters of Mercury
psi = Pounds per square inch
Torr = Torr; unit of pressure, named after Italian physicist Torelli. = mmHg
kPa = about 10 cmH2O = 7.5 mmHg
100 kPa = 1 bar = about 1 atm = 750 mmHg
100 kPa = about 15 psi

Time units
s = seconds
min = minutes
h = hours

Volume units
l = liters (1000 cc)
ml = milliliters (1 cc)
l/min = litters per minute

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11 Glossary

Anesthesia machine vocabulary


Key words and basic definitions
Some of the definitions below are established European Standard (CEN) or International Standard
(ISO).

Absorbent
Substance, usually soda lime, used to absorb carbon dioxide in a breathing system.
Airway pressure
Pressure at a specified point in the patient's airways. ISO
Anesthetic gas scavenging system (AGSS)
A system which is connected to the exhaust port(s) of an anesthetic workstation for the purpose of
conveying expired and/or excess anesthetic gases to an appropriate place of discharge. CEN
Anesthesia machine
Integrity of equipment, including gas supply and control system, a breathing and ventilation system
and a scavenging system for dispensing and delivering anesthetic gases and vapors into a breathing
system.
Anesthesia system
See Anesthetic workstation.
Anesthetic agent
A drug used, usually in vaporized form, to reduce or abolish sensation of pain, consciousness or
muscle activity. Examples of anesthetic agents are e.g. Halothane, Enflurane and Isoflurane.
Anesthetic agent vapor
The gaseous phase of an anesthetic agent that is a liquid at room temperature and atmospheric
pressure (as an exception desflurane has a boiling point of 23.5o C).
Anesthetic agent concentration
The percentage of anesthetic agent present in the total anesthetic gas mixture.
Anesthetic gas
CEN: Any gas and/or vapor of volatile agent used in anesthesia.
Anesthetic vaporizer
A device designed to facilitate the change of an anesthetic agent from a liquid to a vapor. ISO
Anesthetic workstation
A system for the administration of inhalational anesthesia which includes one or more actuator
modules, monitoring, and their particular alarm modules, and essential hazard protection modules.
CEN
APL valve (= Adjustable Pressure Limiting valve)
Pressure limiting valve, also called a "POP OFF valve, which releases gas over an adjustable range of
pressures in purpose: ISO/CEN
to control system pressure and thus intrapulmonary pressure
to release excess anesthetic gases and vapors
Auxiliary mains socket outlet
Electrical outlets built into the ventilator for connecting other electrical equipment.
Bain circuit
Breathing system for partial rebreathing without CO2 absorber. Coaxial tubes are used.

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Bellows
An active part of a ventilator system acting as a reservoir for the gases. It separates gas breathed by
the patient from the ventilator driving gas.
Ascending (standing)
The bellows moves upwards during expiration.
Descending (= hanging)
The bellows moves downwards during expiration.
Berner valve
A valve specially designed for manually assisted ventilation having options for spontaneous
breathing as well as for volume and pressure controlled assistance of the ventilation. The Berner
valve is named after the inventor, the Danish doctor Berner.
Breathing system
Gas pathway in direct connection with the patient through which intermittent or reciprocating gas flow
occurs and into which a mixture of a controlled composition of anesthetic gas mixture may be
dispensed. ISO
Carbon Dioxide (CO2)
CO2 is an end product of metabolism resulting from oxidation of carbon in the tissues, and being
eliminated from the body by exhalation through lungs. CO2 acts as a breathing center stimulator.
CO2 absorber
An absorbent, usually soda lime, in a container is used to remove CO2 chemically from the patient
expired gas. Primarily used in the circle breathing system.
Circle system
Anesthetic breathing system in which the direction of gas flow through separate inspiratory and
expiratory pathways is determined e.g. by unidirectional valves, and in which the two pathways form a
circle. CEN
Circle absorption system
Circle system incorporating a carbon dioxide absorber. ISO/CEN
Circuit compressible volume
Distensibility of the patient circuit. Volume change per unit of pressure change. Also called patient
circuit compliance.
"Complete" rebreathing system; closed system
System from which no expired mixture is discharged. (ISO)
Continuous flow apparatus
Device delivering continuous flow of anesthetic gases and/or vapors at the ambient pressure, to
meet the patient's respiratory requirements. ISO
Cylinder (for medical gas)
Color-coded cylindrical-shaped tanks containing specified medical gases e.g. O2, Air or N2O, CO2 etc.
Cylinder pressure gauge
A gauge used to monitor the pressure of gas within the cylinder.
Dead space
Area in patient's respiratory tract, or portion of a breathing system, not taking part in the gas
exchange. Dead space areas can be divided into the following:
Anatomical dead space
Physiological dead space
Mechanical dead space

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11 Glossary

Diameter index safety system


DISS; A safety gas supply system to the anesthesia machine incorporating a specifically indexed
pipeline gas inlet. Inlets between gases supplied into the anesthesia machine are non-
interchangeable.
Exhaustion time
Length of time an absorbent may be used before it fails to keep CO2 concentration at an acceptable
level.
Expiration (or exhalation)
The act of breathing out.
Expiratory valve
Valve which, when open, allows gas to pass through it from the patient only during the expiratory
phase. ISO
Flow control valve
Device that controls the rate of flow of a gas or a mixture of gases (ISO).
Flow direction sensitive component
Component through which the gas flow must be in one specific direction only for its proper
functioning and/or patient safety. ISO
Flowmeter
Any device which measures the flow of a specific gas or gas mixture passing through it. CEN
Fresh gas
Mixture of "fresh" gases (O2, N2O, Air + anesthetic agent) administered from flow meters and
vaporizer to the patient breathing system for administration of anesthesia.
Fresh gas inlet
That port on a breathing attachment through which the dispensed mixture from the anesthetic gas
delivery module is delivered to the anesthetic breathing system. (See COMMON GAS OUTLET) CEN
Fresh gas outlet
The port through which the dispensed mixture from the anesthetic gas supply device is delivered to
the breathing system. (See FRESH GAS INLET). ISO
NOTE: The above definition is related to function. In structural terms, any gas outlet port will be known
by the component of which it is a port; for example vaporizer outlet, machine outlet, cabin outlet. (A
note from ISO-standard.)
Gas power outlet
An accessory outlet of an anesthesia machine that supplies driving gas (Air or O2) for auxiliary
equipment, e.g. suction.
Inhalation anesthesia apparatus
Equipment intended for dispensing and delivering anesthetic gases and vapors into a breathing
system for delivery to the patient. ISO
Inspiration (or inhalation)
The drawing of air (or other substances) into the lungs.
In mechanical ventilation air is pushed into the lungs.
Inspiratory pause time
ISO: Interval from the end of inspiratory flow to the start of expiratory flow.
Inspiratory-expiratory phase time ratio (I:E ratio)
Ratio of the inspiratory phase time to the expiratory phase time. ISO
Normally I:E ratio used in controlled mechanical ventilation
is 1:2 meaning that expiratory phase is twice as long as inspiratory phase.

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Inspiratory valve
Valve which, when open, allows gas to pass through it to the patient only during the inspiratory
phase. ISO
Jackson-Rees
Non-rebreathing system suitable for assisted ventilation.
Low flow
Fresh gas flows below 1 l/min.
Medical air
Cleaned compressed air that can be used for patient ventilation. (Complies with ISO Standard
Specification).
Medical gas
Any gaseous substance that meets medical purity standards and has application in medical
environment, e.g. O2, N2O and Air.
Minute volume (MV)
Volume of gas, expressed in litters per minute entering or leaving the patient- or lung model. The
physical conditions under which measuring was made should be given. ISO
Non-rebreathing system
System from which all the expired mixture of gases is discharged. ISO
O2 flush valve
Manually operated valve for delivery of a relatively large flow of O2 close to the common gas outlet
without having passed through flowmeter and/or vaporizer. This so-called "emergency oxygen flow"
is directed directly into the patient breathing system. ISO
Oxygen supply failure alarm
An auditory alarm which must last at least 7 seconds (= ISO standard) to give a warning about
insufficient oxygen pressure supply to the anesthesia machine.
Partial rebreathing system
System in which a portion of the expired mixture is retained within the system. Carbon dioxide may be
totally or partially eliminated.
Patient connection port
That opening at the patient end of an expiratory valve unit; a Y-piee fitting or a unidirectional valve to
which may be connected either a tracheal tube adapter or a face mask angle piece. ISO
Pin index safety system
Safety pin indexed coding system of the cylinder yokes and cylinders.
Pipeline gas (central wall gas supply)
Medical gas delivered by permanently piped, hospital distribution system, usually O2, N2O and Air.
Pneumatic
Relating to or using gases under pressure.
Pediatrics
Branch of medicine dealing with development, care and diseases of children (premature/new-born
to 15 years of age).
Pressure gauge
Any device used to measure pressure within a specified system; usually metric system is calibrated in
kPa (kiloPascal).
Pressure relief valve
Pressure limiting valve, the prime function of which is to serve as a safety device, for example APL-
valve. ISO

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11 Glossary

Proportional regulator
Regulator controlling the proportion of O2 in the O2/N2O gas mixture (e.g. minimum of 25% of O2). If
O2 setting is reduced also N2O supply is automatically reduced to maintain the minimum O2
percentage in the specified level.
Rebreathing
Inhalation of previously respired mixture of gases from which carbon dioxide (CO2) may or may not
have been removed. ISO
Respiration
Exchange of gases (O2 and CO2) between atmosphere/alveoli and between blood/body cells.
Respiration rate
Respiratory rate of breathing in and out in one minute.
Scavenging system
An assembly of specific components that serve to collect excessive expired gases and exhaust them
out of the operating room.

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12 Appendices

12 Appendices
Appendix A Compressible volume
Compensation for compressible volume in the delivery system
1. Measurement of compressible volume
The compressible volume in the patient circuit (Compliance) is measured during the daily System
Checkout - AUTO Leak test - in the following way:
The circuit is filled with O2 by the shunt valve in the O2 channel being opened to allow a
6 l/min. flow.
The bellows either delivers a volume of 155 ml or any volume of a 27 cmH2O pressure,
whichever comes first.
The pressure rise is measured by the pressure sensor in the ventilator port of the bellows block.
The compressible volume is calculated using the following formula:
C = delivered volume / pressure change
The default value for the compressible volume is 2 ml/cmH2O. This value is kept low (in comparison
with the compressible volume of the patient circuit = 4.5 ml/cmH2O) in order to avoid the risks with
large volumes. The compliance of a volume of 1 l is approximately 1 ml/cmH2O. The default value of
the compressible volume thus corresponds to a volume of 2 l, close to the volume of the bellows.
NOTE: 75 % of the volume is lost due to the contractility of the patient circuit gases. The remaining 25
% are lost due to the expansion of the circuit system.
2. Correction of compressible volume during ventilation
During ventilation the pressure is measured continuously. The volume added to the patient circuit to
compensate for lost volume due to compression, is:
Vcompl = Pplat - PEEP x C
(C is either the value calculated during the System Checkout or it is the default value.)
The volume delivered to the patient is calculated as follows:
Vpat = Vsyst - Vcompl + Vfgf
Vpat is the volume set by the operator and thus delivered to the patient
Vsyst is the volume delivered by the ventilator to the whole system (total integrated flow during
inspiration time)
Vfgf is the fresh gas flow times inspiration time
For safety reasons the compressible volume is only compensated for to 75 % at Pplat values
exceeding 30 cm/H2O. For values over 45 cmH2O, the compensation is not increased at all.

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13 Brief instructions

13 Brief instructions
Datex-Ohmeda ADU
NOTE: This section is intended to provide a brief overview of the use of the ADU. It is not intended to
replace the relevant detailed sections. For step-by-step instructions, please refer to the appropriate
detailed chapter.

7
5

4 8

3 9

10

11

12

13

14
1
15

16

(1) Fresh gas outlet. (Total gas flow indicator) (10) Aladin Vaporizer Cassette
(2) Compact patient circuit (11) Agent wheel
(3) Ventilator bellows block (12) Switch for On / Standby
(4) Fresh gas flow controls (13) Anesthesia Monitor central unit and
(5) Setup keys modules (option)
(6) ADU LCD display (14) Vaporizer cassette storage slots
(7) Ventilator quick function keys (15) Drawers (optional)
(8) Anesthesia Monitor (optional LCD display) (16) O2 flush button
(9) ComWheel

NOTE: The ADU can be used with a 10.4 display. See Display/keys on page 80 for further
information.

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Preparing the ADU


1. Check that the electrical power cord is connected to the power supply outlet.
2. Connect the gas supply hoses and the scavenging hose on the rear panel to the wall
connectors.
3. Check that the gas inlet pressures are between 270 and 800 kPa (39 and 116 psi).
4. Assemble the patient circuit.

10

7 6 5 4 3 2 1

Figure 118 Compact patient circuit

(1) Fresh gas outlet


(2) Fresh gas flow indicator
(3) Circuit boom
(4) Ventilation hose
(5) Compact Block II
(6) Insp./Exp. valves
(7) Locking/releasing latch for absorber canister
(8) Manual ventilation bag with hose

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13 Brief instructions

(9) Insp. and exp. hoses with Y-piece (breathing circuit)


(10) Absorber canister
5. Check that the Manual/Spont (MAN) mode is engaged.

6. Check and connect the gas sampling and spirometry lines and turn on the Anesthesia Monitor.
The lines need to be connected while the monitor performs the zeroing.
7. Check the monitor according to the instructions. (See Short Instructions for the Anesthesia
Monitor.)
8. Turn on the ADU with the On/Standby switch.
9. The ADU automatically performs the self-checkout (about 1 min.) for the ventilator driving gas
part and batteries.
10. Perform the daily System Checkout according to the instructions displayed on the main screen.
In manual/spontaneous ventilation the pressure limit and the filling of the bag is adjusted with the
APL valve (Airway Pressure Limiting valve). The adjustment range is 1.5 to 80 cmH2O.
For a spontaneously breathing patient, the APL valve should be fully open = 1.5 cmH2O. This is to
ensure a moderately filled manual bag (inspiratory reserve).
During manual ventilation, the APL adjusts the peak pressure in the patient circuit and the amount of
gas in the bag. If the pressure rises to the set pressure limit, normally between 20 to 40 cmH2O, the
valve opens and lets out excessive gas from the patient circuit.
NOTE: Manual ventilation is always operable when there is no power as long as the gas supplies are
connected.

Daily System Checkout


Daily System Checkout is easy to do by following the System Checkout menu on the ADU display.
In an emergency situation, bypass the daily System Checkout by selecting Bypass Checkout.
WARNING The System Checkout is designed to ensure correct and safe function of the ADU.
The Bypass Checkout command on the System Checkout menu must only be used
when patient safety requires an immediate start-up procedure of anesthesia.
The checkouts may also be selected separately from the menu.
The System Checkout proceeds in the following way:

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Complete Checkout

N2O Delivery

Agent delivery

AUTO ventilation

MAN ventilation

Status Checks

Start Complete Checkout


Start separate checkouts

Complete Checkout Checks Air, O2 and N2O pressure, scavenging, patient circuit and makes
other preparations for the automatic Complete Checkout.
N2O Delivery Checks the delivery of adequate N2O flow and prevents the delivery of a
hypoxic mixture.
Agent Delivery Gas delivery checkout for anesthetic agent. The Aladin cassettes may also
be checked one by one through the separate Agent Delivery checkout.
AUTO Ventilation Checks the amount of internal and external leaks and calculates the
compressible volume of the Patient Circuit.
MAN Ventilation Checks for leaks in the respiratory tubes and in the manual bag.
Status Checks Manual checkout of Suction, CO2 absorber, Gas cylinders, Insp./Exp. Valve,
Level indicator and Gas monitor.
Checkout Log Check record. The nine last error entries are shown in Checkout Errors.
Bypass Checkout Bypasses all the checkouts. Appears as a choice either if a Complete
Checkout has not been successfully passed within 24 hours or there has
been a ventilator/fresh gas unit failure alarm since the checkout was
passed.

NOTE: On an ADU configured to operate without N2O the System Checkout menu differ in some ways
from what is described in this chapter, for further information see System Checkout performed on an
ADU without N2O on page 77.
When a procedure is finished, the ADU automatically check marks the selection with a 4 and moves
to the next step. If a procedure has already been carried out, the corresponding selection appears as
dimmed and check marked. Confirm procedures by pushing the ComWheel.

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13 Brief instructions

The instructions are displayed in the Help Field at the bottom of each menu page.
When starting the checkouts, choose top row (Complete Checkout) by pushing the ComWheel.
WARNING Always perform and confirm checkouts before connecting a patient to the ADU.
NOTE: Gas sampling monitors must be disconnected from the circuit during the checkout so that the
gas samples are not counted as leaks which may lead to a failed checkout.

Setting alarms
Select the correct alarm settings for the airway pressure in the Alarms Setup menu. To get to the
menu, push Alarms Setup key, or push the ComWheel and select Alarms Setup.
The patient circuit pressure is measured in the ventilator part of the bellows block. On the screen, the
circuit pressure scale displays the alarm limits for low (1) and high (2) airway pressures.

1 2

Figure 119 Circuit pressure scale

The functional safety limit for high airway pressure is Pmax Release (factory default = 40 cmH2O), see
(1) Figure 119. When the airway pressure exceeds the set limit, the ventilator cycles to expiration. The
Pmax Release limit must be set higher for patients who, for some reason, need higher ventilation
pressure. Raising the limit level is necessary for the ventilation of those patients. The limit for the high
airway pressure alarm cannot be set higher than Pmax Release, see (2) Figure 119. Default limit for
the high airway pressure is 30 cmH2O. When the pressure exceeds Ppeak High, an alarm sounds.

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Figure 120 Adjusting alarm limits


In the Anesthesia Monitor, verify the settings of the fresh gas delivery and ventilation from the ADU
before setting the alarms for FiO2, EtO2, EtCO2 and MV. After the checkout and alarm settings, the
ADU is prepared to deliver anesthesia.

Adjusting fresh gas delivery


Fresh gas flows are adjusted with the needle valves. The flows are displayed on the screen as
bargraphs and digits (liters per minute). Fresh gas flows from a minimal value of 0.5 l/min. and
higher, are available. Additionally, O2 and N2O percentages as well as total flow values are displayed.
The ratio of O2 to N2O in the fresh gas flow is calculated, taking the set volatile anesthetic into
account.

Figure 121 Fresh gas values display.

NOTE: The ADU can also be configured to operate without N2O, for further information see
Anesthesia Delivery Unit without N2O on page 16.

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13 Brief instructions

Anesthetic agent concentration is set with the agent wheel. The scale and the set value are displayed
above the agent wheel. The value is the % of anesthetic agent in the fresh gas flow.

Agent wheel

Figure 122 Anesthetic agent concentration on the display

Spirometry and real time inspiratory and expiratory values for all the gases (O2, N2O, volatile agent,
CO2) are measured and monitored with a D-lite or Pedi-lite sensor. The sensor shall be placed next to
the patients airway in the Y-piece.
The degree of rebreathing and the composition of gases inspired by the patient is determined by the
fresh gas flow rate. When using low fresh gas flows, the fresh gas settings and inspired
concentrations may differ.
The lower the flow, the greater the difference. Thus, in a rebreathing system, the inspired
concentration may be significantly different from the set value. The difference is due to the fresh gas
being diluted by the expired gas.

Returning sampled gas


Returning the sampled gas to the scavenging system
The accumulation of nitrogen is reduced if the
sampled gas is connected directly to the
scavenging system.

Returning the sampled gas to the circle system

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The sampled gas and room air may also be


returned to the circuit. The best place for
returning gas is under the bellows block, close to
the overflow valve.
NOTE: In addition to 200 ml of returned sample
gas, 30 ml/min. of room air is also added to the
returned gas. Room air serves as a reference gas
for oxygen measurement.

Starting ventilation
Start the mechanical ventilation by turning the ventilation selector to Auto position. The ventilator will
use either the default factory settings or the settings pre-set by the user.

Figure 123 Starting Mechanical Ventilation

Figure 124 Volume control, pressure control or SIMV

The default settings are suitable for most adult patients. When Patient Weight (can only be entered in
Manual mode) is adjusted, the new settings are calculated and shown as suggested new values. The
settings can, however, be altered before or during ventilation.
There are three alternative ways of altering the setting of a parameter.
Push quick function keys (Volume/Pressure, Rate, I: E or PEEP). The corresponding field is
highlighted. Adjust the setting by turning the ComWheel. The current setting is displayed
above the adjustment value.

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13 Brief instructions

Volume/
Rate I:E PEEP
Pressure

Another way of accessing the ventilator menu is by pushing the Ventilator key. Values within
brackets and/or cyan colored are not valid for the current mode. Adjusting the settings in the
Ventilator menu is convenient when setting up the ADU for the next patient.
A third way of accessing the ventilator menu is by pushing the ComWheel to display the Menu
Functions menu and select Ventilator.
Confirmation of a selected change of setting, can be achieved by either:
Pushing the ComWheel
Pushing the corresponding quick key
Pushing any of the keys grouped around the display screen
This is also valid if Normal screen is pushed.
WARNING Pressing any of the keys grouped around the display directly after adjustment of a
parameter by means of the ComWheel, may result in an unintentional
confirmation of a setting.
To ensure adequate ventilation, be sure to have EtCO2 monitored. The quality of ventilation may be
estimated with the help of spirometry.

Monitor integration
The ADU measures the circuit pressure (= Pcirc) under the bellows block. The delivery unit also
transmits and displays numerical pressure values and corresponding curve.
The Anesthesia Monitor measures the airway pressure with the D-Lite, D-Lite+ or Pedi-Lite close to
the patients airway.
The different measurement sites result in different measured values. With the Anesthesia Monitor,
peak pressures are 2 to 3 cmH2O lower.
The Anesthesia Monitor keeps a check on all patient values for gases, spirometry and
hemodynamics.
The gas and spirometry values may be displayed on the ADU, showing set and measured values side
by side.

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Figure 125 Displaying set and measured gas and spirometry values
(1) Pressure data for delivery unit circuit
(2) Patient gas monitor CO2 waveform and numeric value
(3) Ventilator settings
(4) Spirometry data
(5) Patient gas monitoring data

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Brief instructions

Disinfection methods table


Concerning the level and frequency of disinfection, always follow the hospital routines.
Intermediate level disinfection High level disinfection

Equipment Washer-disinfector with a Wash by hand using water and mild Steam autoclave at maximum 134 C/273 F
decontaminating program (min. 10 detergent AND wipe with 70% alcohol
minutes at 85 C/185 F)
Reusable patient circuit
tubing, manual bag tubing and
connectors, Y-piece, D-lite
Compact patient circuit:
Compact block II
Compact canister reusable
Ventilator bellows assembly:
Bellows *
Bellows block incl. APL valve and
overflow valve
Bellows chamber **
Overflow valve rubber *
membrane
Manual bag
* NOTE: May change shape and has to be replaced after repeated autoclaving. The bellows should be hung so that the lower folds can hang freely during the autoclaving cycle.
** NOTE: Does not normally have to be autoclaved since it is not in direct contact with patient gases. May develop small cracks on the surface after repeated autoclaving.

201
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202 Document No. 8502304-2


Index

Index Oxygen failure 116


PEEP High 116
Pmax Release 116
Ppeak High 116
Numerics Ppeak High limit 118
3 year maintenance 151 Ppeak Low 116
Ppeak Low limit 118
Priority 115, 121
A Sequence 115
Abbreviations 181 Setting 195
Absorbent 88 Silencing 121
Absorber 22, 38, 88 Status 117
Canister 22, 38 Timer 121
Compact patient circuit 22, 38 Volume 117, 119
Adjustable pressure limiting valve (APL) 79 Anesthetic agent 84, 87
Adjusting Concentration 197
Agent 87 APL valve 66, 79, 89, 90, 158, 193
Alarms 196 View 17
Fresh gas 196 Assembly 33
ADU Atmospheric pressure 164
Front perspective 10 ATPD 85
Rear perspective 11 Audible alarms silencing 121
Adult Audio On/Off 120
Sensor 55 Auditory alarms silencing 121
Agent 84 Auto / Manual selector 17, 79
Adjustment 87 Auxiliary electrical outlets 25
Flow 15
Identification 87 B
Selection 87
Agent cassette 15, 79, 87, 88 Backup 26
Agent wheel 79, 87 Backup supply 27
Air 84, 85 Bacteria 133
Flow 79 Bag 22, 38, 158
Airway pressure Checking the functionality 66
Limits 195 Cleaning 149
Aladin 15 Bain 46
Cleaning 150 Battery 25, 30, 82, 88
Alarm 166 Backup system 26
Activate 120, 121 Capacity 26
Adjusting 117 Charging 26
Audio On/Off 120, 121 Bellows
Battery supply 88 Base 36
Cancel changes 118 View 17
Colors 115 Block
Current limits 117 Assembling 34
Default limits 118 Cleaning 133, 137
History 120 Gasket 158
Limits 116 View 17
Adjusting 196 Chamber 156
Messages 159 Insertion and locking 37
Negative pressure 116 View 17
Cleaning 149

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Problem-solving tool 155 Serial input/output 13


View 17 Ventilator 42
Bottom plate gasket 158 Controlled mechanical ventilation (Auto) 79, 91
Breathing Controls 80
Phases 19 Cursor 127
System 22, 46 Cut off 86
Bypass 73, 193 Cylinder 33

C D
Cancel 118 Daily System Checkout 193
Cassette Declaration form 152
Agent 15 Default
Caustic 136 Limits 118
Chamber locking handle 17 Settings
Charging battery 26 Save changes 110
Checking system Diagram
Daily 193 Gas flow during expiration 20
Circuit Gas flow during inspiration 20
Block cleaning 132 Dimensions 163
Boom 22, 38 Disinfecting 133
Pressure 199 Display 79, 82, 165
Classification 5 10.4" 80
Cleaning 132 12.1" 80
Aladin cassette 150 D-lite 55, 133
Bellows 149 Driving gas 17, 18
Compact patient circuit 136 Backup 28
Hytrel tube 135 Dust 133
Sampling line 150
Ventilation bag 149 E
Compact Block 22, 38, 155
Cleaning 137 Electrical
Compact patient circuit 22 Connections 164
Assembly 38 Supply 88
Block Endotracheal tube 133
Cleaning 132 Engstrm 133
Cleaning 136 Environmental conditions 164
View 192 Erasing trends 129
Compatibility 25 Expiration phase 20
Compensation 21
Compliance 21 F
Compressed volume 21 Filling mechanism
ComWheel 79, 83, 127 of Aladin 48
Concentration Flow
Setting for anesthetic agents 197 Controls 84
Connector O2 85
Expiratory 42 Flowmeter height
Fresh gas inlet 42 Adjust 107
Fresh gas outlet 42 Fresh gas 27, 82
Inspiratory 42 Adjusting delivery 196
Manual bag 17 Compensation 21
Patient circuit 17, 42

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Index

Controls 84, 168 Interfacing 25, 199


Display 84
Hose 22, 38 J
Function keys 79
Fuse 30, 164 Jackson Rees 46

G K
Gas Keyed Filler System 51
Cylinder 33
Monitoring 25, 55, 82 L
Sample 57 LCD 79
Schematics 14 Leak correction 153
Supply 167 Leak test
Backup 27 Bellows chamber positioning 156
Pressure 33 Bottom plate gasket 158
Gasket 158 Compact Block 155
Gauges 33 Hoses 154
Graphical trends 124 Leak limits 153
Manual bag and hose 158
H Overflow valve 157
Handle for locking chamber 17 Leaks 76
Health and Safety Declaration Form 152 LED 88
History, alarms 120 List of alarms 120
Hose 154 Low flow 153, 197
Fresh gas 22, 38
Manual bag 158 M
Ventilator 22, 38 Mains 25, 26
Humidity 164 Maintenance 151
Hytrel tubes MAN leak 158
Cleaning 135 Manual
Bag connector 17
I Ventilation 90
I/E ratio Ventilation bag 22, 38, 158
Settings 97 Measuring techniques 199
I/E time sec Mechanical ventilation 198
Settings 98 Medical Device Directive 5
IEC 601 5 Membrane 35, 157
Insp. time Menu 83
Settings 98 Graphs 107
Inspiration phase 19 Messages 82
Inspiratory Alarm 159
Pause settings 100 MAN leak 158
Rise time settings 101 Others 162
Inspiratory/expiratory valve 22, 38, 155 Status 160
Install Vaporizer 161
Change settings 110 Ventilator 160
Installation 129 Middle field
of interfaced monitors 25 Adjust 108
Integration Minimal flow 197
of monitors 199

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Minute volume Pressure 193


Settings 97 Circuit 89
Module frame rack 24 Curve 89
Monitoring 25, 55, 103 Gas supply 33
Gauges 33
N in standing bellows 18
Limits in airway 195
N2O 85 Relief valve 90
N2O/Air selector 79 Settings 97
Nitrous oxide 84 Problem-solving
Numeric trends 125 Bellows 155
Proportional regulator 86
O Purpose 3
O2 85
Flow 79 Q
Flush 67, 86 Quik Fil 48
O2 and N2O ratio 86
ON/STBY switch 79
Overfill R
Protection mechanism of vaporizer cassette 51 Ratio control 86
Overflow valve 157 Rebreathing system 197
Assembling 35 Reserve gas cylinders 27
View 17 Reserve, inspiratory 89
Oxygen failure alarm 116 Reset case 84, 118, 129
Respiration rate
P Settings 97
Rotameter 85
Password 129 Rubber
Patient circuit Gasket 156
Assembly 38 Membrane 157
Compact 22 Sealing 156
Compact, assembly 38
Connector 17
Hoses 154 S
Jackson Rees 47 Safety 3
Patient weight 96 Agent cassette 88
Peak pressure 90 Battery 7
Pediatric Compact circuit 7
Sensor 55 Features 7
Pedi-lite 56 Gas mixer 7
Cleaning 150 Gas supply 7
PEEP Standards 6
Settings 98 Symbols 29
Periodic maintenance 151 Vaporizer 7
Pmax Release 195 Ventilator 7
Power Sampling gas 57
Cord 26 Returning gas 197
Supply 164 Sampling line
Ppeak High 118 Cleaning 150
Limits 195 Scale 127, 128
Ppeak Low 118 Scavenging 57, 197

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Index

Screen layout 105 Total flow data 85


Select N2O/Air 85 Trends 117, 165
Selector Changing setups 126
Auto/Manual 17, 79 Cursor 127
N2O/Air 79 Erasing 129
Self-check 193 Graphical 124
Sensor Length 128
Adult 55 Numeric 125
Pediatric 55 Scales 128
Service 151 Setup 129
Personnel 151 Trigger sensitivity
Set time and date 109 Settings 99
Settings Trigger window
Ventilator 82 Settings 100
Setup 105 Tube
Trend pages 129 Electrically conductive 45
Sevoflurane 49 Hytrel, cleaning 135
Short instructions 191 TV 21
Show total flow 108
Shunt valve 189 U
Sigh
Settings 102 Ultraviolet light 135
Silence alarms 121 Units
Soda-lime 136 Change settings 111
Spirometry 197
tube 56 V
Spontaneous ventilation 89 Values
Standard patient circuit Set and measured 199
Cleaning 135 Valve 15
Starting 192 APL 79, 89, 90, 158, 193
Ventilation 198 Assembling overflow valve 35
Startup 192 Compact block 22, 38
Status messages 160 Membrane 35
Storage 164 Vaporizer 15, 79, 169
Storing Messages 161
Bellows 149 Ventilation
Ventilation bag 149 Bag 22, 38
Supply pressure 86 Cleaning 149
Symbols 29 Manual 90
System Checkout Mode 91
Leak test 76 Spontaneous 89
Starting 198
T Ventilator 16, 17, 171
Temperature 50 Assembling 34
Tidal volume 21 Hose 22, 38
Compensation 21 Setting field
Settings 96 Adjust settings 109
Time 127 Settings 82
Timer 82 Viruses 133
Alarm silence 121 Vocabulary 183
Tone, alarm 119 Volume Controlled Ventilation, VCV 92

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Volume, alarm 117, 119

W
Wall
Outlets 33
Pressure 28
Waveforms 106
Words 183

Y
Yokes 27

208 Document No. 8502304-2