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Penlon AV900 Ventilator - Frank`s Hospital Workshop

1. Ventilation LE Airway Pressure es Electronic Positive End Expiratory Pressure Alarm Mute Inspiratory Bause d ues cae Sats eee sx dp Ep eee Print A100 Absorber with Bag Ventilator Mode Detection Switch Waveform Displays llle Rear Panel Alarms and Message Displays Back up Battery zio D ex ex re RS Operational Capability do a e eet soars fedet Ventilator Oxygen Monitor iii Page No hp CONTENTS 5 1 5 1 1 5 1 2 5 1 3 5 1 4 5 1 5 5 1 6 5 2 5 3 5 3 1 5 3 2 5 4 5 4 1 5 4 2 5 4 3 5 4 4 6 1 6 2 6 3 6 4 7 1 7 2 7 3 7 4 7 5 7 6 PRE OPERATION PROCEDURES Ventilator Set up Components Supplied with the Ventilator Mounting the Ventilator Electrical Power Gas supply breathing system connections and start up Spirometer Connections Spirometer Calibration Bellows Assemblies Pre use Checklist Daily Weekly Checklist Oxyg
2. FA FIS 2 uL DESCRIPTION STANDBY The parameters listed above ON are active in STANDBY mode to allow system set up The following alarms are functional in STANDBY mode LOW SUPPLY PRESSURE MAINS FAILURE VENT INOP LOW BATTERY HIGH AIRWAY PRESSURE Note In STANDBY mode this alarm is triggered at 80 cmH2O NEGATIVE AIRWAY PRESSURE INCORRECT RATE RATIO O2 High Alarm O2 Monitor option O2 Low Alarm O2 Monitor option Sensor Fault O2 Monitor option 19 DESCRIPTION K Penton 9602 PATIENT WAVE PRINT 25 20 Active Tabs V SET E PEEP LIMIT millilitres BPM RATIO cmH 70 cmH 70 600 10 1 2 0 OFF 38 A touchscreen control Touchscreen Active Tabs Turn the wheel to alter the value of the active parameter 3 5 3 Touchscreen Operation and Press to confirm the Navigator Wheel Push setting Button The functions parameters shown on the screen above can be activated by touching the screen at the appropriate tab area NOTE PATIENT SUPPORT is available in Spotaneous mode only Variable parameters can then be altered by rotating the navigator wheel When the required value is displayed press the active tab or the wheel to confirm the setting 20 AV 900 V 4 Menu Functio MAIN MENU OXYGEN MONITOR SPIROMETRY FRESH GAS COMPENSATION ON GAS MIXTURE air HIGH TIDAL VOLUME ALARM ns TOGGLE
3. point Time LOW AIRWAY PRESSURE APNOEA High priority Alarm point Pressure _3 7 f Base line pressure NEGATIVE AIRWAY PRESSURE High priority Pressure Time 20 cmH20 Alarm point 76 Condition Pressure in the breathing circuit fails to return to base line pressure during exhalation Alarm resets at next in tolerance breath Breathing system pressure fails to reach predetermined level Alarm resets at next in tolerance breath Breathing system pressure reaches preset negative pressure Detected b Patient gas pressure transducer 16 pneumatic system diagram section 3 2 Patient gas pressure transducer 16 pneumatic system diagram section 3 2 Patient gas pressure transducer Item 16 pneumatic system diagram section 3 2 Alarm Specification 30 cmH20 Tidal volume dependant Functional in pressure volume and spontaeneous modes 3 7 cmH20 above base line pressure during inspiratory period Note Base line pressure is not necessarily zero Tidal volume dependant Functional in pressure and volume mode and Spont mode if Spirometry is disabled 20 cmH20 ve Functional in standby pressure volume and spontaneous modes APPENDIX OXYGEN SENSOR FAULT High priority Condition Functional in all modes when Oxygen monitor functional Sensor disconnected Alarm OXY
4. 10 The driving gas is discharged through the opening in the back of the ventilator control unit The discharged gas may contaminate the environment and should therefore be extracted using a gas scavenging system The bellows support approximately 1 kPa 10 cmH20 differential positive pressure above which it may be dislodged from the mounting ring resulting in dangerous malfunction of the ventilator Do not connect a PEEP valve or other restrictive device to the exhaust port on the bellows base This would increase the pressure inside the bellows and the bellows could detach from the base causing serious malfunction The breathing system which conveys gases from the anaesthetic machine to the patient and disposes of expired gases is a vital part of the anaesthetic delivery system Because breathing systems require frequent cleaning and disinfection they are not a permanent part of the anaesthetic ventilator and therefore cannot be directly under the control of the anaesthetic ventilator manufacturer However we strongly recommend that only breathing systems which have been approved and authorised by Penlon for use with AV900 should be employed Do not use conductive breathing system hoses When mechanical ventilation is employed the patient breathing system must be connected directly to a pressure relief valve to prevent the possibility of barotrauma Do not connect a spirometer to the ex
5. Always renew components at the recommended interval The two spirometry flow sensors are mounted within the A100SP Absorber in the inspiratory and expiratory airways Connect the sensor cable assembly between the connector at the rear of the A100SP Absorber A and the the Spiro socket B at the rear of the Ventilator control unit Check that the cable connections are secure NOTE A B If the connections are incorrectly made the ventilator will alarm LOW TIDAL VOLUME or HIGH TIDAL VOLUME To allow the ventilator to be used in the event of damage or non functioning of the spirometer heads turn off the spirometry function see MENU function section 3 5 If the spirometer is switched OFF a Fresh gas compensation is disabled b Fresh gas mixture compensation is disabled c Patient support function is disabled 49 e OL Rear view of A100SP Absorber as fitted to Prima SP Oo PRE OPERATION PROCEDURES 5 1 6 Spirometer Calibration Spirometer system with flow sensors fitted to A100 Absorber for A100SP see next page 1 Remove the spirometer sensors from the breathing system 2 Press the menu switch on the front panel 3 Scroll down the main menu and select SPIROMETRY 4 Scroll down the sub menu and select CALIBRATION 5 Turn the wheel to switch display to CALIBRATION cal 6 Amessage will appear Remove the
6. Insert the cable connector into the new sensor B Screw the new flow diverter C onto the new sensor and fit new O rings Fit the assembly into the absorber or Tee adaptor Calibrate the new sensor see section 5 4 8 Dispose of the used components according to hospital regulations and relevant national legislation 67 gu cos Oxygen Sensor Location 1 Prima SP with A100SP Absorber 2 Mounted on the dome of the absorber inspiratory valve 8 ORDERING INFORMATION Spares Contact your distributor or the Service Department at Penlon Limited for spare parts Service Department Tel Fax 44 1235 547060 44 1235 547061 E mail service penlon co uk 57653 57654 Preventive Maintenance Kit must be fitted by a Penlon trained engineer Overhaul kit Five year must be fitted by a Penlon trained engineer Accessories Contact your distributor or the sales office at Penlon Limited for full details of the range of accessories for the AV900 ventilator Penlon Sales Office UK Tel 01235 547036 Fax 01235 547023 Export Tel 44 1235 547041 Fax 44 1235 547021 Mains electrical power cables 57513 1 5 240 IEC plug 57514 57493 1 5 120 plug 57494 57590 3 0m 240 220V AC IEC wiring code no plug Drive hoses 57510 1 4 m DISS to mini Schraeder O2 57515 57529 1 4 m DISS to reverse DISS O2 CSA 57528 56048 5 0 m DISS to DISS O2
7. AV900 Ventilator V A User Manual AV900 Version 4 Software Partnership for Life IMPORTANT Servicing and Repairs In order to ensure the full operational life of this ventilator servicing by a Penlon trained engineer should be undertaken periodically The ventilator must be serviced to the following schedule a Six monthly service inspection and function testing b Annual service c Five year major service including battery replacement Details of these operations are given in the AV900 Service Manual available only for Penlon trained engineers For any technical enquiry regarding the servicing or repair of this product contact the nearest accredited Penlon agent or communicate directly with Technical Support Penlon Limited Abingdon Science Park Barton Lane Abingdon OX14 3PH UK Tel 44 0 1235 547076 Fax 44 0 1235 547062 E mail technicalsupport penlon co uk Always give as much of the following information as possible Type of equipment Product name Serial number Software revision number Approximate date of purchase Apparent fault gt Et FOREWORD This manual has been produced to provide authorised personnel with information on the function routine performance maintenance checks applicable to the AV900 Anaesthesia Ventilator with version 4 software Information contained in this manual is correct at the date of publication The policy
8. Preferably mount it permanently on the shelf of the anaesthesia machine or on a strong bracket This will protect the ventilator from accidental fall and accidental disconnection of the hoses To mount the ventilator permanently a Penlon bracket 1 Align the four mounting feet over the mating holes in the bracket 2 Use the four M4 screws supplied with the mounting bracket kit inserted through the bracket and rubber feet and screwed into the threaded inserts in the base of the ventilator Only use the screws supplied with the kit Pole mount type mounting brackets and side frame brackets are available see section 8 5 1 3 Electrical power connection Before connecting the ventilator to the mains supply check that the power supply is within the correct rating as stated on the label on the rear of the control unit 44 WARNING Excessive electronic noise caused by other poorly regulated devices such as electrocautery may adversely interfere with the proper functioning of the ventilator To avoid this problem do not connect the ventilator power cord into the same electrical wall outlet or strip into which an electrocautery unit is connected 5 1 4 Ventilator gas supply breathing system connections and start up Before the ventilator can be used the following preparation must be made 5 1 4 1 Gas Supply 1 Verify the drive gas specified for the ventilator oxygen or air 2 Connect the drive gas
9. The exhalation diaphragm valve has 1 5 cmH2O opening pressure to keep the bellows from collapsing The outside of the bellows the space between the bellows and the bellows housing is also connected to the ambient through the de energised discharge valve in the control unit Therefore the only pressure gradient across the bellows is the opening pressure of the exhalation diaphragm valve BELLOWS EXHALATION DIAPHRAGM VALVE EXHAUST VALVE OPEN 7 USER MAINTENANCE 7 1 Service Schedule At 6 months 12 months and 5 years the ventilator must be serviced by a Penlon trained engineer following the schedule given below and the procedures given in the AV900 Service Manual Every day Pre use function check Every week Check the condition of the diaphragm valve and clean as required Test the Mains Failure Alarm and the Low Supply Pressure Alarm see section 5 3 2 If the ventilator is used in conjunction with an A100 or A100SP Absorber check that the condensate is drained from the absorber as specified in absorber User Manual Every 6 months Inspection and Function Check Remove covers internal inspection and clean Check condition of bellows and spirometer sample lines Every 12 months Repeat six month procedure plus Replace O seals and drive gas inlet filter Preventive maintenance kit available Every 5 years Major Service Replace battery Fit service exchange pneumatic as
10. on the rear panel of the control unit Use tubing 57523 to connect to the expiratory limb of the breathing system close to the circle system expiratory valve PrimaSP with inboard A100 Absorber Connect the tubing with adaptor Part No 053049 to the self sealing connector at B PrimaSP with inboard A100SP Absorber Connect the tubing with adaptor Part No 053049 to the self sealing connector C Pole mounted absorber Connect the tubing to the distal sensing tee at D NOTE Use a Penlon distal sensing tee Cat No 53194 Breathing System Tee WARNING The High and Low Airway Pressure Alarms are important for patient care The connection point must be properly located in the expiratory limb of the breathing system 5 1 4 3 Start the Ventilator 1 Press the ventilator ON OFF switch After a test sequence the ventilator will revert to STANDBY mode NOTE special operating system on ventilators interfaced with Prima SP see section 3 5 2 a b Turn the Prima Sp Gas Delivery Switch to ON the ventilator will power up While the Prima SP power is ON the Ventilator can be turned OFF and ON using the ventilator On Off switch Turn the Prima SP Gas Delivery Switch to OFF The ventilator will power down Set the AIRWAY PRESSURE LIMIT to 50 cmH20 47 Self sealing connector Push in the tube as far as possible Do not use excessive force The connector end piece X will also mov
11. If the internal battery is fully discharged the ventilator will not function in the event of mains power failure The battery must be recharged before the ventilator is used clinically otherwise backup cannot be guaranteed See section 9 for battery maintenance See also CAUTION No 7 Used or defective batteries must be disposed of according to hospital local state and federal regulations No oil grease or other flammable lubricant or sealant must be used on any part of the ventilator in close proximity to medical gas distribution components There is a risk of fire or explosion 29 Exterior panels must not be removed by unauthorised personnel and the apparatus must not be operated with such panels missing There is a possible electric shock hazard Bellows Assembly 30 The valve seat on the patient gas exhalation diaphragm valve in the base of the bellows assembly must be cleaned regularly see section 7 2 Failure to keep the valve seat clean could result in the diaphragm sticking thus preventing exhalation Great care must be taken not to damage the precision surface of the valve seat on the patient gas exhalation diaphragm valve in the base of the bellows assembly Never use any hard object or abrasive detergent to clean it use only a soft cloth If the valve seat is damaged the valve will leak and may cause serious ventilator malfunction WARNINGS AND CAUTIONS CAUTIONS 10 NOTE On
12. and cable labelling C The sensors are marked for attachment to the Inspiratory or Expiratory ports of the absorber CAUTION The electrical connectors on the flow sensors must face upwards D This will prevent moisture entering the internal components of the Sensors 3 Connect the sensor cable assembly to the Spiro socket E at the rear of the Ventilator control unit 4 Check that each sensor assembly is correctly connected between the absorber and the breathing circuit tubing Check that the cable connections are secure NOTE A f the connections are incorrectly made the ventilator will alarm LOW TIDAL VOLUME or HIGH TIDAL VOLUME B To allow the ventilator to be used in the event of damage or non functioning of the spirometer heads turn off the spirometry function see MENU function section 3 5 If the spirometer is switched OFF a Fresh gas compensation is disabled b Fresh gas mixture compensation is disabled c Patient support function is disabled C Connection of the spirometer between the patient circuit and the absorber also provides an indication of breathing system disconnect 48 PRE OPERATION PROCEDURES Spirometer Connections Flow sensors fitted to an A100SP Absorber mounted on a Prima SP 1 Use a breathing system bacterial filter See section 5 1 4 operation 7 CAUTION Replacement Disposal always follow the instructions supplied with the filter
13. section 3 5 4 30 DESCRIPTION 3 5 15 Waveform Displays Real time waveforms can be selected via the menu system as follows Pressure 20 v Time sec The pressure scale y axis has three ranges and the correct range is displayed automatically when the user sets a value for airway pressure limit LIMIT cmH2O Pressure LIMIT set value 10 to 40 41 to 60 cmH2O 60 to 80 cmH20 Pressure scale y axis range 10 to 40 2 10 to 60 cmH2O 10 to 80 cmH2O The time scale x axis has three ranges and the correct range is displayed automatically when the user sets a value for rate RATE BPM RATE BPM set value range 4 to 20 21to 40 41 to 100 02 M00 25 2 Vr PATIENT WAVE MEASD SUPPORT FREEZE RINT 31 A Tsecs SET RATE l E PEEP LIMIT millilitre 10 1 20 d E 600 Pressure 2 v Time sec H20 Volume litre v Time sec Time scale x axis range 0 to 15 seconds 0 to 5 seconds 0 to 3 seconds 9902 VT LITRE V PATIENT WAVE 31 SET millilitre 600 Volume litre v Time sec The volume scale y axis has three ranges and the correct range is displayed automatically when the user sets a value for tidal volume MEAS Tidal Volume set value 20 ml to 500 550 ml to 1 0L 1 05 to 1 6L Tidal volume scale y axis range 0 to 500 ml 0to
14. 1 0L 0 to 2 0L The time scale x axis has three ranges and the correct range is displayed automatically when the user sets a value for rate RATE BPM RATE BPM set value 4 to 20 21to 40 41 to 100 31 Time scale x axis range 0 to 15 seconds 0 to 5 seconds 0 to 3 seconds DESCRIPTION SET PATIENT WAVE Spe MEASD SUPPORT FREEZE RINT UTE 30 Prax 1 2 GAS MIXTURE O2 air Volume litre v Pressure 2 compliance loop waveform The pressure scale x axis has three ranges and the correct range is displayed automatically when the user sets a value for airway pressure limit LIMIT cmH2O Pressure LIMIT set value Pressure scale x axis range 10 to 40 cmH20 10 to 40 cmH20 41 to 60 cmH20 10 to 60 cmH20 60 to 80 cmH2O 10 to 80 cmH20 NOTE In Spontaneous Mode the x axis defaults to 10 to 10 cmH20 The volume scale y axis has three ranges and the correct range is displayed automatically when the user sets a value for tidal volume Vr MEAS Tidal Volume set value Tidal volume scale y axis range 20 to 500 mL 0 to 500 ml 550 ml to 1 0L 0 to 1 0L 1 05 to 1 6L 0 2 0L 32 DESCRIPTION 3 6 Rear Panel 3 6 1 Labelling Terminology The term is defined in IEC 601 1 the standard for electrical medical equipment Class 1 equipment has additional protection such that metal parts of the unit that are accessible to the user e g the metal casing of the AV900 control uni
15. 4 Disconnect the drive gas supply hose The LOW SUPPLY PRESSURE alarm should activate NOTE If there is any malfunction the ventilator must NOT be used If the problem cannot be rectified the ventilator must be checked by Penlon trained engineer 54 PRE OPERATION PROCEDURES O2 Monitor 5 4 Oxygen Monitor System Set up if fitted 5 4 1 Installation Fit the probe as illustrated depending on the system installed on your anaesthetic machine 1 Prima SP with A100SP Absorber 2 Mounted on the dome of the absorber inspiratory valve 3 T piece adaptor on CGO block Connect the cable to the input socket A on the back of the AV900 ventilator control unit NOTE The anaesthetic machine gas control switch must be in the ON position for gas delivery WARNING The sensor contains a small quantity of electrolyte classified as a harmful irritant which is potentially hazardous Do not attempt to open a cell ALWAYS check the integrity of the sensor assembly before use Once exhausted the sensor must be disposed of according to hospital local state and federal regulations NOTE To maintain maximum sensor life always remove from breathing circuit after use Bacterial Filter Use a breathing system bacterial filter in the expiratory limb of the breathing circuit to protect the oxygen sensor see section 5 1 4 2 CAUTION Replacement Disposal always follow the instructions supplied with the filter a
16. DATE Thu 84 88 2808 NOTE 2 PRESSURE WAVEFORM 20 VOLUME WAVEFORM wl 88 188 88 688 48 28 6 9 6 9 SECONDS SECONDS SETTINGS CURRENT ALARMS Set Volume 8 88caH20 Rate IE Ratio Peep Pres Limit 2caH20 Mode Volume 71 APPENDIX AV900 V4 Main Board Version 4 19 onwards Front Panel Version 4 25 onwards Ventilator Alarms Theory of Operation The following pages provide information on the function and operation of the alarms fitted to the AV900 V4 Ventilator 72 APPENDIX APPENDIX 2 Ventilator Alarms Theory of Operation Pressure Pressure Pressure 73 Condition Detected by Alarm LOW DRIVE GAS SUPPLY Specification High priority Drive gas Low supply Preset to 35 psi supply pressure pressure Functional in falls below detector standby Alarm point minimum Item 3 pressure and required to pneumatic volume modes maintain system performance diagram specification section 3 2 HIGH DRIVE GAS PRESSURE High priority Pressure in the Bellows drive Preset at 80 modes bellows drive gas over 2 gas circuit pressure Functional in exceeds preset detector standby value Item 14 volume fo Pre set value fixed Alarm resets pneumatic pressure and at EE 80 when pressure System spontaneous returns below diagram modes fixed value section 3 2 Failure of Ventilator Sensor value Time pressure control system out of tolerance
17. MONITOR ON CALIBRATION gt HIGH ALARM SET LOW ALARM SET EXIT MENUS DESCRIPTION Spirometry ON OFF Press the navigator wheel to switch between ON and OFF Scroll to EXIT MENUS and press the wheel to exit If spirometry is switched ON a Measured Volume tab will appear on the screen NOTE If the spirometer is switched OFF a Fresh gas compensation is disabled b Fresh gas mixture compensation is disabled c Patient support function is disabled Fresh Gas Compensation ON OFF Press the navigator wheel to switch between ON and OFF Scroll to EXIT MENUS and press the wheel to exit NOTE Fresh Gas Compensation can be switched on and off but is disabled when the spirometer is switched OFF Gas Mixture Press the navigator wheel to switch between O2 air and 02 3 20 Scroll to EXIT MENUS and press the wheel to exit NOTE Selection of the incorrect gas mixture can affect the accuracy of the Spirometry system If the spirometer is switched OFF fresh gas mixture compensation is disabled High Tidal Volume Alarm Rotate the navigator wheel to scroll down to HIGH TIDAL VOL ALARM Press the navigator wheel to switch between ON and OFF Scroll to EXIT MENUS and press the wheel to exit Spirometry sub menu SPIROMETRY ON CALIBRATION no cal EXIT MENUS Fresh Gas Compensation O2 MONITOR SPIROMETRY FRESH GAS COMPENSATION ON GAS MIXTURE HIGH TIDAL VOLUME ALARM VOLUME TYPE WA
18. Used batteries must be disposed of according to hospital local state and federal regulations 69 APPENDIX APPENDIX 2 Examples of print out capability NAME Penlon DATE OF BIRTH DIAGNOSIS NOTE 1 TIME 21 54 55 DATE Thu 84 88 2888 NOTE 2 AIRWAY PRESSURE 0 cd mires MEAN AIRWAY PRESSURE 0 88 fe minutes 4 5 6 4 5 6 MINUTES MINUTES SET I E RATIO 1 6 1 5 1 4 1 3 1 2 11 1 Se 5 6 MINUTES minutes INSP PAUSE USE YES NO 8 1 2 3 8 9 4 5 6 MINUTES ALARMS KEY HAP High airway pressure Alara Occurrences HCP High continious pressure 105 Low oxygen supply HCP LAP Low airway pressure LOS LTY Low tidal volume LAP IRR Incorrect rate ratio LoB 7 Low battery IRR MF Mains fail Log SPN Spontaneous PRE Pressure cont RUN Normal vent nues VENT DE SPN 70 APPENDIX AVIDO VENTILATOR DATE OF BIRTH DIAGNOSIS NOTE 1 TIME 21 53 44 DATE Thu 84 88 2888 NOTE 2 PRESSURE WAVEFORM 0 VOLUME WAVEFORM ml 88 188 88 68 48 2 8 18 DH 6 9 1 8 3 6 3 SECONDS SECONDS SETTINGS CURRENT ALARMS Set Volume 8 88cwH20 Rate IE Ratio 1 2 8 OFF Pres Limit 2 0 Mode Volume 89900 VENTILATOR DATE OF BIRTH DIAGNOSIS NOTE 1 TIME 21 52 82
19. applicable for adult and paediatric patients The ventilator is intended for use by health care providers i e Physicians Nurses and Technicians with patients during general anaesthesia Oxygen Monitor optional The Oxygen Monitor is intended to continuously measure and display the concentration of oxygen in breathing gas mixtures used in anaesthesia and is intended for adult and paediatric patients The oxygen monitor is a module within an anaesthesia machine and is a mandatory module when the spirometry option for AV900 is specified The oxygen monitor is intended for use by health care providers i e Physicians Nurses and Technicians for use with patients during general anaesthesia 3 DESCRIPTION 3 4 General Description The AV900 is a time cycled volume pressure controlled and pressure limited ventilator for closed circuit ventilation or for use with a Mapleson D circuit The ventilator is compliance compensated and has a user selectable option of an inspiratory pause fixed at 2596 of the inspiratory time In addition models with spirometry are fresh gas compensated and also feature user selectable gas mixture compensation The print function provides a permanent record of function activity for up to eight hours during a procedure or can be used to record waveforms The bellows unit can be easily detached and then refitted to the bellows base assembly to facilitate cleaning Bellows Hous
20. both in Bag mode and Ventilator mode on absorber APPENDIX HIGH TIDAL VOLUME Condition Detected by High priority Pressure mode Measured tidal Spirometer volume exceeds value E expected tidal S o eit volume Yagi Steeg Sg Expected volume Time HIGH TIDAL VOLUME High priority Measured tidal Spirometer Volume mode volume exceeds value set tidal o volume 5 150 SS Set volume Time OXYGEN MONITOR ALARMS Oxygen Oxygen sensor HIGH OXYGEN CONCENTRATION concentration Jer exceeds set High priority vale 02 Set Time OXYGEN MONITOR ALARMS Oxygen Oxygen sensor LOW OXYGEN CONCENTRATION concentration High priority falls below set value O2 Time 75 Alarm If variance is greater than 15096 of expected volume Functional in Pressure mode User can select Alarm Off in Menu The alarm will reset to ON if a The user selects Standby mode b The ventilator is switched OFF If variance is greater than 5096 of set volume Functional in Volume mode User can select Alarm Off in Menu The alarm will reset to ON if a The user selects Standby mode b The ventilator is switched OFF If oxygen concentration is above High O2 Alarm set value Range 19 105 Functional in all modes If oxygen concentration is below Low O2 Alarm set value Range 18 99 Functional in all modes APPENDIX HIGH CONTINUOUS PRESSURE High priority Pressure 30 cmH2O0
21. is missing See section 7 3 for information sterilisation procedures Paediatric Bellows Assembly Exhalation Diaphragm Valve Assembly USER MAINTENANCE Refitting Refit the diaphragm valve assembly to the bellows base and reassemble the bellows assembly see section 5 2 If a paediatric bellows is fitted press the adaptor C into the ventilator bellows assembly base then fit the bellows CAUTION Always check for correct fitment of the bellows see illustration and function test the ventilator before clinical use 7 3 Spirometer Sensors as fitted to A100 Absorber only For information on the sensors fitted to the A100SP Absorber please refer to the user instructions supplied with the A100SP On a regular basis in line with hospital procedures for infection control the spirometer sensors must be removed and sterilised Follow the illustrated remove and refit sequence on the following page a Detach each spirometer sensor from the breathing system b Carefully disconnect the cable from each sensor C Sterilisation see section 7 Do not sterilise the cables d When the components are dry Reconnect the cables check the label on each cable and the flow direction arrow on the sensor Route the cable as shown in illustration 3 before rotating the cover plate to its closed position e the sensors to the breathing system see also section 5 1 5 64 U
22. models with spirometry circuit compliance is not activated until Fresh 1 Do not sterilise the ventilator control unit Gas Compensation is switched OFF The internal components are not compatible with sterilisation techniques and damage may result 2 For ventilator components which require sterilisation peak sterilisation temperatures should not exceed 136 C 275 F to prevent possible damage See sections 7 2 and 7 3 3 Those parts suitable for ethylene oxide sterilisation should following sterilisation be quarantined in a well ventilated area to allow dissipation of residual gas absorbed by the components Follow the steriliser manufacturer s recommendations for any special aeration periods required 4 The exhalation valve located in the bellows base assembly and the paediatric bellows adaptor must be cleaned and sterilised separately See sections 7 2 and 7 3 5 Care must be taken not to let any liquid run into the control unit serious damage may result 6 Always check for correct fitment and carry out a full function test before clinical use if the bellows has been removed and refitted for any reason See sections 5 2 and 7 2 7 Damage may occur to the battery if it is allowed to remain in a discharged state Check the battery frequently if the ventilator is in storage see Appendix 1 8 On models with spirometry fresh gas compensation is disabled if a The spirometry system is turned OFF th
23. power disconnected all functions are unpowered Mains power connected the backup battery recharge circuit is live the yellow LED is illuminated Switch to OFF after use To switch off hold down the switch for at least one second Screen display shows POWERING DOWN 5 4 3 2 1 ON The ventilator automatically initiates a three second internal test sequence During this period the boot up screen is displayed and the audible alarms will activate After the test sequence the ventilator switches to STANDBY mode and the following parameters default to the values shown TIDAL VOLUME 600 ml RATE 10 bpm RATIO 1 2 AIRWAY PRESSURE LIMIT 38 cmH20 PEEP Off Interface to Prima SP The AV900V4 can be interfaced to the Prima SP Anaesthetic Machine and A100SP Absorber through a connection A at the rear of the ventilator control unit The interface cable is plugged into the socket B on the rear panel of the anaesthetic machine Prima SP Interface Function a Turm the Prima Sp Gas Delivery Switch C to ON The ventilator will power up b While the Prima SP power is ON the Ventilator can be turned OFF and ON using the ventilator On Off switch as described above c Turn the Prima SP Gas Delivery Switch to OFF The ventilator will power down lt On Off Switch Mains Power Indicator Alarm Mute Menu Switch Navigator Wheel and Press Button Front Panel Controls
24. spirometry system is turned OFF through the menu system or b The spirometry system is not functioning correctly Fresh Gas Mixture Compensation models with Spirometry The spirometry system compensates for fresh gas mixture the user must access the menu System and select the gas mixture that will be used for each clinical procedure Fresh gas mixture compensation is disabled if a The spirometry system is turned OFF through the menu system or b The spirometry system is not functioning correctly The O2 monitor is switched OFF 3 3 3 User Selectable Inspiratory Pause A user selectable inspiratory pause is provided which when activated holds the inspiratory phase at the end of inspiration for a period of 2596 of the inspiratory time before reverting to the expiratory phase NOTE Inspiratory Pause function is not available in PRESSURE mode and SPONTANEOUS mode 3 3 4 Automatic Altitude Compensation Ambient pressure is monitored the ventilator automatically compensates the delivered volume according to the local atmospheric pressure 3 3 5 Patient Gas Pressure Transducer The Patient Gas Pressure Transducer is connected to the patient breathing system via the rear panel VOLUME CYCLE mode whenever this pressure exceeds the maximum working pressure as set on the front panel an alarm is activated and the following occurs 1 The HIGH AIRWAY PRESSURE visual 14 indicator is ill
25. voltage is less than predetermined value Battery voltage approaching minimum safe operating value Battery voltage below minimum safe operating value Battery voltage too low to maintain function Various internal functions are monitored and if determined to be outside specification will trigger ventilator inoperative condition Detected by Tidal volume rate and I E ratio controls Power supply Power supply Power supply Power Supply Alarm Specification Rate less than 2 L min or greater than 75 L min Functional in volume mode Functional in all modes Battery voltage less than 11 3 volts see Ventilator Inoperative Functional in all modes Less than 10 8 volts or battery disconnected Less than 10 5 volts K 52863 Doc No 9 v 4 020501 2005 Penlon Limited Abingdon Science Park Barton Lane Abingdon OX14 UK Technical Support Tel 44 0 1235 547076 Fax 44 0 1235 547062 E mail technicalsupport penlon co uk Spares Service Department Tel 44 1235 547060 Fax 44 1235 547061 E mail service penlon co uk International Sales Tel 44 1235 547001 Fax 44 1235 547021 E mail export penlon co uk UK Sales Tel 01235 547036 Fax 01235 547023 E mail uksales penlon co uk InterMed Group of Companies Penlon is a member of the InterMed Group
26. 0 11 12 Pull the Absorber On Off lever 1 down to its OFF position The flow will bypass the absorbent Remove the breathing circuit hoses from the inspiratory and expiratory connectors 2 on the absorber This will give a free flow of oxygen through the sensor Switch on the ventilator and the anaesthetic machine gas delivery switch 3 The oxygen monitor automatically switches ON when the ventilator is switched on Ensure that all vaporizers are OFF Apply 10096 oxygen only at 5 L min from the anaesthetic machine flowmeter Allow the oxygen to flow until the oxygen monitor readout stabilises Calibrate the sensor using the AV900 ventilator menu procedure as follows Press the menu switch and select the O2 monitor sub menu Scroll to CALIBRATION If the menu shows 2196 calibration using air press the navigator wheel to switch to 100 calibration using oxygen A message will flash on the screen O2 AT 10096 Press the button to confirm NOTE The message OXYGEN SENSOR LOW OUTPUT will appear on screen if the user attempts to calibrate at 21 in 100 oxygen Repeat operations 8 and 9 twice more Scroll to ESCAPE FROM MENUS and press the wheel to exit Turn off the flow of oxygen 58 On Off Switch Alarm Mute Menu Switch Navigator Wheel and Press Button CALIBRATION O Monitor sub menu calibration O2 MONITO
27. 1 3 5 2 3 5 3 3 5 4 3 5 5 3 5 6 3 5 7 3 5 8 3 5 9 3 5 10 3 5 11 3 5 12 3 5 13 3 5 14 3 5 15 3 6 3 7 3 8 3 9 USER RESPONSIBILITY ee ee we WARNINGS AND 5 PURPOSE DESCRIPTION General Ventilation Pneumatic System Operation e Compliance Compensation and Fresh Gas Mixture Compensation User Selectable Inspiratory Pause Automatic Altitude Compensation Patient Gas Pressure Transducer High Pressure Protection Spirometry Oxygen Monitor System The MOX 3 Oxygen Display Alarms Alarm Mute Control Unit System Controls and Parameters Power Switch including Interface with Prima SP Touchscreen Operation and Navigator Wheel Push Button On screen Mode Selection Tidal Volume Ventilation Rate
28. 2 MONITOR SPIROMETRY FRESH GAS COMPENSATION GAS MIXTURE HIGH TIDAL VOLUME ALARM VOLUME TYPE WAVEFORM SERVICE EXIT MENUS NOTE The ventilator must be in Standby mode to access SERVICE option DESCRIPTION O2 Monitor sub menu if O2 monitor fitted ON OFF Press the navigator wheel to switch between ON and OFF Scroll to EXIT MENUS and press the wheel to exit NOTE The oxygen monitor automatically switches ON and defaults to the previous values for high and low alarm settings when the ventilator is switched on Fresh gas mixture compensation is disabled if the O2 monitor is switched OFF CALIBRATION Press the navigator wheel to initiate the calibration procedure see section 5 4 2 for full procedure To exit the menu scroll to EXIT MENUS and press the wheel HIGH ALARM SET LOW ALARM SET Scroll to the required parameter and press the navigator wheel to activate Rotate the navigator wheel again to change the displayed value see section 5 4 4 for full procedure 19 to 105 18 99 High Alarm range Low Alarm range The displayed figure will flash on and off Press to confirm Scroll to EXIT MENUS and press the wheel to exit 23 O Monitor sub menu O2 MONITOR ON CALIBRATION HIGH ALARM SET LOW ALARM SET EXIT MENUS O Monitor sub menu calibration O2 MONITOR ON CALIBRATION HIGH ALARM SET LOW ALARM SET EXIT MENUS O Monitor sub menu alarms O2
29. 20O 11094 N A N A 80 cmH20 80 cm H20 10 cm H20 Atmospheric None 3 cmH20 None No mixture controls SPECIFICATION 4 22 4 23 4 24 4 25 4 26 4 27 4 28 4 29 4 30 4 31 Flowmeters Manual Changeover Inspiratory Relief Valve Humidifiers and Monitors System Pressure Gauge Airway Pressure Gauge Spirometer Accuracy Range Resolution Maximum Inspiratory Pressure Alarms in priority order Power Source Electrical Input Drive Gas Power Consumption Electrical Gas None None Fixed 80 cmH20 No humidifier Volume monitor optional spirometer Pressure monitor built in None Airway pressure value is displayed on screen Optional 2096 volume range 20 to 300 ml 10 volume range 300 to 1600 ml Note a The Oxygen Monitor must be switched ON b Accuracy is affected by variations in gas composition 20 to 1600 ml 1 ml to 100 cmH O See section 3 for detailed descriptions Vent inop ventilator inoperative not mutable High airway pressure High drive gas pressure High cont continuing airway pressure PEEP Low supply pressure not mutable Low airway pressure Negative airway pressure Low tidal volume High tidal volume Incorrect rate or ratio Low battery Mains failure Interface cable fault 100 VAC 240 VAC 50 60 Hz universal input 0 30A 0 18A Oxygen or air dry and oil free at 38 to 100 psi 262 to 689 kPa 37 watts
30. 3 seconds Sensor Minimum HIGH AIRWAY PRESSURE User set High Priority Volume mode and Spontaneous mode Pressure in Patient gas User set breathing pressure airway pressure system exceeds transducer limit control Alarm point pressure limit Item 16 within range User set value Ventilator pneumatic 10 80 cmH20 DEAD CERE pvc reverts to system Functional in EE exhalation in diagram volume and volume mode section 3 2 spontaneous modes Note Standby mode 15 3 seconds triggered at 80 Minimum cmH20 APPENDIX LOW TIDAL VOLUME High Priority 1 Volume mode Condition Measured tidal volume varies from set volume Detected by Spirometer and set value variance by greater than preset value Alarm resets after next Time in specification breath Alarm point Volume LOW TIDAL VOLUME High Priority 2 Pressure mode Measured tidal volume fails to reach the preset minimum volume Spirometer Value Set tidal volume Alarm Time LOW TIDAL VOLUME High Priority 3 Spontaneous mode Measured tidal Spirometer volume is less value than 20 ml Expected volume Volume 20 ml Time 74 Alarm Specification Variance greater than 50 of set Functional in volume mode If variance is greater than 50 of set tidal volume Functional in Pressure mode Functional in Spontaneous mode but only when spirometry is active Functional
31. 43 Oxygen Monitor Measurement Range Resolution Accuracy and Linearity Response Time Operating Temperature Storage Temperature Relative Humidity Range Battery Back up Sensor Type High Priority Alarm Medium Priority Alarm Low Priority Alarm Alarm Mute Low Alarm Set Range High Alarm Set Range Cable length Sensor Type Life 0 100 1 2 of full scale at constant temperature and pressure 90 of final value in approx 10 seconds air to 100 O2 50 F to 100 F 10 C to 38 23 F to 122 F 5 C to 50 C 5 95 non condensing As per ventilator MOX 3 galvanic fuel cell Flashing 5 audio pulses with 6 seconds repeat time Flashing 3 audio pulses with 24 seconds repeat time Static with single beep sound 30 seconds for high priority alarm 120 seconds for medium priority alarm 18 99 1 19 105 1 2 m 6 ft fully extended Galvanic fuel cell sensor 0 100946 1500000 2 hours One year minimum in typical applications Interference Gases and Vapours in 3096 Oxygen 7096 Nitrous Oxide Interference Nitrous Oxide Carbon Dioxide Halothane Enflurane Isoflurane Sevoflurane Volume Dry Interference in 02 80 lt 1 5 lt 1 5 lt 1 5 lt 1 5 lt 1 5 lt 1 42 SPECIFICATION 2 Monitor Oxygen Monitor continued Humidity Effects Sensor output is relatively unaffected by prolonged operation in either high or very low re
32. Alarm High Drive Gas Pressure The mute button will silence the audible alarm for up to 30 seconds A mute period countdown sequence in seconds is displayed on screen 3 7 2 Alarm Indicators Visual indicators are displayed on screen beneath the waveform display All alarms self cancelling with a minimum activation period of 2 seconds except VENT INOP ventilator inoperative HIGH AIRWAY PRESSURE High priority Standby Spontaneous and Volume Cycle Mode A visual and audible alarm which activate Alarms comply with EN475 NOTE a Visual alarms can not be defeated b Alarms are priority configured c The highest priority alarm will always take precedence when the pressure sensed at the patient tee exceeds the setting of the AIRWAY PRESSURE LIMIT control This alarm will remain on until the pressure falls below the control setting for a minimum of 1 second This alarm can be muted for 30 seconds Normal conditions must be restored or the unit turned off in order to cancel the alarms 35 DESCRIPTION HIGH CONT Continuing PRESSURE High priority A visual and audible alarm which activate when the pressure sensed at the patient tee exceeds 30 cmH2O just prior to the next inspiratory cycle Once activated this alarm remains on until the pressure falls below the required baseline at the beginning of a breath The alarm can be muted for 120 seconds LOW AIRWAY PRESSURE High prio
33. Battery CAUTION Damage may occur if the battery is allowed to remain in a discharged state Never discharge the battery to below 10 2 volts A Battery installed in ventilator The battery must be charged before the machine is released for use with an 14 hour charge from the ventilator s internal power supply ventilator connected to the mains supply but not running Note that the mains power indicator on the front panel will show a yellow light during charging Subsequently the recharge periods for a battery on a ventilator in store are similar to those in B below Batteries in machines in normal use will be kept charged by the internal power supply Note that the Low Battery Alarm indicator may be displayed if automatic rechargong is taking place as the ventilator is in use B Battery care storage requirements During storage batteries will require a periodic recharge the frequency of which is determined by the storage temperature which must not exceed 50 C 120 F Storage Recharge temperature period 38 to 509C 100 to 1229F 1 month 21 to 38 C 70 to 100 C 3 months 7 to 21 F 45 to 70 F 6 months to 79C 32 to 45 F 9 months 5 to 00 23 to 32 F 12 months Duration recharge until the charge current is less than 25 mA typically overnight It is recommended that at each charge an updated label is affixed to each battery to indicate date of the last charge Disposal of used batteries
34. Cleaning and Disinfection CAUTION If you use ethylene oxide for sterilisation use only a low temperature ethylene oxide method Do not immerse the sensor in any cleaning solution Do not autoclave or expose the sensor to high temperatures Bacterial Filter Use a breathing system bacterial filter in the expiratory limb of the breathing circuit to protect the oxygen sensor section 5 1 4 2 CAUTION Replacement Disposal always follow the instructions supplied with the filter and always replace at the recommended interval 7 6 Oxygen Sensor Replacement WARNING The sensor contains A A small quantity of electrolyte classified as a harmful irritant which is potentially hazardous B Lead Do not attempt to open a cell ALWAYS check the integrity of the sensor assembly before use Once exhausted the sensor must be disposed of according to hospital local state and federal regulations 7 6 1 Sensor Expiry Date The approximate expiry date is marked on the sensor label using two boxes which represent the year and month Thus on a sensor marked as below the approximate expiry date is the end of December 2006 YR 012345X 7899 MIHUF SONN 7 6 2 Sensor Unit Remove and Refit Replacement parts 102714 Sensor includes flow diverter and O rings 58779 Tee adaptor Detach the cable connector A from the sensor B Unscrew the sensor from its location Discard the expired sensor and flow diverter C
35. GEN SENSOR FAULT Oxygen concentration greater than 110 Alarm HIGH OXYGEN Oxygen sensor Low Alarm OXYGEN SENSOR LOW OUTPUT SPIROMETER DISCONNECT Alarm Spirometer disconnect HIGH TIDAL VOLUME ALARM INTERFACE CABLE DISCONNECT Alarm Interface cable disconnect ABSORBER INTERFACE CABLE FAULT Oxygen monitor receiving an out of tolerance value Oxygen monitor receiving an out of tolerance value Oxygen monitor receiving a low oxygen cell voltage Spirometer has become disconnected or broken Signal cable between ventilator and absorber has become disconnected Detected b Oxygen monitor system Oxygen monitor system Oxygen monitor system Ventilator monitoring system Ventilator monitoring system Alarm Specification Oxygen cell disconnected Oxygen cell fault or over pressurised Oxygen cell returning a low voltage for specified concentration Spirometer connections read open circuit Functional in all modes Interface connections read open circuit Functional in all modes APPENDIX INCORRECT RATE OR RATIO Low priority MAINS FAILURE Low priority LOW BATTERY Low priority BATTERY POWER FAIL Medium priority VENTILATOR SHUTDOWN FROM LOW BATTERY VENTILATOR INOPERATIVE High priority 78 Condition Flow rate set is greater than or less than predetermined values Ventilator automatically resets flow rate Mains supply
36. Input gas filter Low supply pressure detector Input pressure regulator Test point Inspiratory valve Drive gas flow metering valve Stepper motor and feedback potentiometer for 7 Expiratory valve 11 12 13 14 15 16 17 Exhaust outlets Pressure relief valve Exhaust valve Proportional valve Drive gas over pressure switch Outlet to bellows assembly Pressure transducer Inlet from breathing circuit DESCRIPTION 3 3 Pneumatic System 3 3 1 System Operation Refer to the pneumatic system diagram on the previous page The AV900 Ventilator is designed to operate on a 262 689 kPa 38 100 psi drive gas supply oxygen or air to customer s requirement The gas source is connected to the DRIVE GAS SUPPLY 0168 fitting on the rear of the ventilator control unit The gas supply should be capable of a flow rate of 80 L min while maintaining a minimum pressure in excess of 262 kPa 38 psi The drive gas is filtered with a 40 micron Input Gas Filter which protects the pneumatic components from incoming particulate matter The Low Supply Pressure Detector is a pressure switch set at a predetermined level to detect a loss or reduction of the input gas source pressure When the pressure falls below 243 kPa 35 psi the LOW SUPPLY PRESSURE indicator will be displayed and the high priority audible alarm will activate The Input Pressure Regulator conditions the input drive gas to 221 kPa 21 kPa 32 p
37. OPTION ON OFF OXYGEN MONITOR MEM O2 MONITOR ON TOGGLE OPTION 21 100 INTEGER CALIBRATION 100 ESCAPE FROM MENU 19 105 INTEGER HIGH ALARM SET 77 18 99 TOGGLE OPTION ON OFF SPIROMETRY MENU TOGGLE OPTION SPIROMETER ON CAL NO CAL LOW ALARM SET 21 CALIBRATION cal ESCAPE FROM MENU TOGGLE OPTION TOGGLE OPTION O2 air O2 N20 TOGGLE OPTION ON OFF TOGGLE OPTION VOLUME TYPE TIDAL WAVEFORM pressure v time SERVICE MENU EET E CEN TIDAL MINUTE WAVEFORM PICK LIST EXIT MENU CLOCK MENU YEAR 2 MONTH 4 DATE 21 DOW 3 pressure v time LANGUAGE TOGGLE OPTION volume v time pressure v vol SERVICE MENU ENGLISH ITALIANO TURKCE POLSKI ESPANOL FRANCAIS LANGUAGE ENGLISH SERIAL MODE NONE SERIAL MODE SERVICE 2 Penlon USE SERVICE 3 Penlon USE NONE H P SPACELABS PIN PENLON USE ENGINEERING MODE TOGGLE OPTION ON OFF ABSORBER SWITCH ON __ ESCAPE FROM MENU INTEGER 00 99 INTEGER 1 12 INTEGER 1 31 INTEGER 1 7 INTEGER 0 23 HOUR 11 MINUTE 25 VENTILATOR S WARE VERSION DISPLAY S WARE VERSION DISPLAY ERRORS INTEGER 0 59 ERROR LOG DISPLAY ESCAPE FROM MENU LISTS ERRO
38. Options 57546 Paediatric bellows canister and base 57638 E mail uksales penlon co uk E mail export penlon co uk 3 0m 240 3 pin UK plug 3 0m 120VAC CSA 1 4 m DISS to DISS O2 green 1 0 m DISS to DISS O2 white Air hose kit 1 5 m hose adaptor kit must be fitted by a Penlon trained engineer also available 57496 Mounting Systems 58381 57591 58581 58585 58470 Mounting bracket pole mount 1 2 m hose DISS to quick release Air Mounting Kit use to mount bellows base assembly onto an anaesthetic machine Mounting bracket Prima side mount Mounting bracket Prima pole mount Mounting Kit use to mount a bellows base assembly onto an absorber Miscellaneous 57523 57655 57653 57654 57545 57548 57554 57552 57549 51537 Pressure sensor tube Pressure sensor tee 053049 Tubing adaptor Preventive Maintenance Kit must be fitted by a Penlon trained engineer Overhaul kit Five year must be fitted by a Penlon trained engineer Bellows and Canister 57550 Base assembly 57547 Base adaptor Paediatric bellows 57546 Paediatric bellows 57553 AGSS adaptor 19 mm female to 30 mm male Drive gas hose 16 mm diameter x 210 mm long Oxygen Monitor 102714 Sensor includes flow diverter and O rings 58779 68 Bellows Base assembly and AGSS adaptor Paediatric canister and bellows Paediatric canister Tee adaptor 9 APPENDIX APPENDIX 1 Care of Back up
39. R ON 100 HIGH ALARM SET LOW ALARM SET ESCAPE FROM MENUS PRE OPERATION PROCEDURES O2 Monitor 5 4 3 Sensor Low Indication The unit automatically detects when sensor life is low The message OXYGEN SENSOR LOW OUTPUT will appear on screen to indicate that the sensor must be replaced The sensor output will fall very quickly to zero over a period of two to three weeks from the first time that the alarm is activated Sensor replacement see section 7 5 5 4 4 Setting the O2 Alarms 5 4 4 1 Set High Alarm O2 Monitor sub menu calibration The high alarm value cannot be set below 1996 or above 10596 Note that in certain conditions of excess O2 MONITOR ON pressure the readout may show a value above CALIBRATION 100 100 gt HIGH ALARM SET 1 Press the menu switch on the ventilator front LOW ALARM SET panel select the O2 monitor sub menu ESCAPE FROM MENUS 2 Scroll to HIGH ALARM SET and press the navigator wheel 3 Rotate the wheel to change the displayed alarm figure to the desired value 4 Press the wheel to confirm Qro 5 Scroll to ESCAPE FROM MENUS and press the wheel to exit 5 4 4 2 Set Low Alarm The low alarm value cannot be set lower than 18 or above 99 1 Press the menu switch on the ventilator front panel select the O2 monitor sub menu 2 Scroll to LOW ALARM SET and press the navigator wheel 3 Rotate the wheel to change the displayed alarm figure to the desired value Press th
40. R CODES 21 DESCRIPTION 3 5 4 On Screen Menus To Access Press the menu switch on the front panel to access the following functions and parameters via drop down menus OXYGEN MONITOR SPIROMETRY FRESH GAS COMPENSATION ON GAS MIXTURE HIGH TIDAL VOLUME ALARM VOLUME TYPE TIDAL WAVEFORM pressure v time SERVICE MENU EXIT MENU To Exit Press the menu switch on the front panel or select EXIT MENU and press the wheel NOTE The menu window will not be displayed if A Control parameters Vr MEAS BPM LE PEEP or LIMIT are enabled but not confirmed B A display window is active To Operate 1 Rotate the navigator wheel clockwise to scroll through the menu options the cursor aligns with each parameter in turn 2 Press the wheel to enter the required sub menu 3 Rotate the navigator wheel to change any displayed values and press to confirm 4 Toexit the menu display A Press the menu switch on the front panel B Scroll to EXIT MENUS and press the navigator wheel NOTE A f confirmation does not take place within 8 seconds the parameter reverts to its previous value B f another parameter is selected using the touchscreen the menu is de selected C While any menu is selected the alarms are active the ventilator can be switched off 22 Menu Switch Turn the wheel to scroll through the menus Press to enter sub menu Default menu gt O
41. RNINGS AND CAUTIONS The following WARNINGS and CAUTIONS must be read and understood before using this ventilator WARNINGS General Information 1 Personnel must make themselves familiar with the contents of this manual and the machine s function before using the ventilator Before Using the Ventilator 2 Before the ventilator is used clinically for the first time verify that the hospital engineering department has carried out an earth continuity test Excessive electronic noise caused by other poorly regulated devices such as an electrocautery unit may adversely interfere with the proper functioning of the ventilator To avoid this problem do not connect the ventilator s power cord into the same electrical wall outlet or adaptor strip into which an electrocautery unit is connected If used with a mains extension cord the unit may be subject to electro magnetic interference The driving gas supply must be clean and dry to prevent ventilator malfunction This ventilator is designed to be driven by oxygen or medical air only It is calibrated during manufacture for use with either gas Before the ventilator is used clinically for the first time the commissioning engineer must confirm that the internal Air Oxygen switch is set correctly for the gas that is to be used The use of any other gas will cause inaccurate operation and may damage the ventilator resulting in potential injury to the patient
42. SER MAINTENANCE Spirometer Sensors A100 Absorber Detach each spirometer sensor from Carefully disconnect the cable the breathing system from each sensor Reassembly 65 USER MAINTENANCE 7 4 Sterilisation Recommended guidelines for sterilisation CAUTION To prevent possible damage to components peak sterilisation temperatures must not exceed 540 130 F for gas ethylene oxide or 134 C 275 F for steam autoclave Do not sterilise the ventilator control unit The internal components are not compatible with sterilisation techniques and may be damaged Following sterilisation with ethylene oxide components must be quarantined in a well ventilated area to allow dissipation of any residual gases Follow the recommendations given by the steriliser manufacturer for aeration periods required ITEM METHOD Bellows Gas liquid autoclave 20 cycles max Hoses Gas liquid autoclave O rings Gas liquid autoclave Bellows base Gas liquid autoclave Exhalation valve Gas liquid pasteurise low temperature assembly autoclave Control unit Do not sterilise see section 7 2 Bellows canister Liquid autoclave Spirometer sensor Autoclave Oxygen monitor see section 7 4 NOTE Examples of suitable liquid agents are Nu Cidex Sporicidin and Sonacide The exhalation diaphragm valve must be removed cleaned and sterilised separately 66 USER MAINTENANCE 7 5 Oxygen Monitor Sensor
43. VEFORM SERVICE EXIT MENUS Gas Mixture Oz MONITOR SPIROMETRY FRESH GAS COMPENSATION GAS MIXTURE O2 air HIGH TIDAL VOLUME ALARM VOLUME TYPE WAVEFORM SERVICE EXIT MENUS High Tidal Volume Alarm MONITOR SPIROMETRY FRESH GAS COMPENSATION GAS MIXTURE O2 air HIGH TIDAL VOLUME ALARM VOLUME TYPE WAVEFORM SERVICE EXIT MENUS DESCRIPTION Volume Type Press the navigator wheel to switch between Tidal Volume or Minute Volume NOTE The Set and Measured Volume change depends on the Volume Type setting Waveform Select the required waveform and press the wheel to confirm Scroll to EXIT MENUS and press the wheel to exit Service Select Standby mode Select the required parameter and press the wheel to confirm NOTE a language Select the required language and press the wheel to confirm b Use SERIAL MODE to select HP or Spacelabs monitor types for connection to the COMMS PORT Analogue Alarm outlet on the rear panel 3 6 10 c SERVICE 2 and 3 have no user accessible functions d Access to the PIN menu is restricted to Penlon trained service technicians e Use ENGINEERING MODE to access Date Time configuration Display Errors and ventilator software version f Use ABSORBER SWITCH to disable the function that detects the position of the Absorber Switch e g in the event of a cable fault or other related condition which persistently gives rise to an alarm Scroll to E
44. XIT MENUS and press the wheel to exit 25 Volume Type O2 MONITOR SPIROMETRY FRESH GAS COMPENSATION GAS MIXTURE HIGH TIDAL VOLUME ALARM VOLUME TYPE WAVEFORM SERVICE EXIT MENUS Waveform sub menu gt PRESSURE vs TIME VOLUME vs TIME PRESSURE vs VOLUME EXIT MENUS Service sub menu gt LANGUAGE SERIAL MODE SERVICE 2 SERVICE 3 PIN ENGINEERING MODE ABSORBER SWITCH EXIT MENUS DESCRIPTION PRESSURE MODE SPONT Active Tabs MODE VOLUME CYCLE Turn the wheel to alter the value of the active parameter Press to confirm the setting SET PEEP LIMIT millilitres cmH30 cmH 70 600 2 0 OFF 38 A touchscreen control STANDBY HIE 3 5 5 Mode Selection 3 5 5 2 PATIENT SUPPORT MODE WARNING The patient must be continuously attended and monitored when Patient Support Mode is 3 5 5 1 SPONT spontaneous Select by touching the screen tab in use The screen tab will flash A confirm message will be displayed Patient Support Mode Function Press the screen tab or wheel to confirm 1 The patient breathes spontaneously The tab background will change to orange The ventilator will monitor display the functions listed below 2 The user has the option of setting a target value for tidal volume If this option is not taken the ventilator will default to a target of 25 of the volume set prior to the selection
45. atient gas into the lt DRIVE GAS IN 2 End of Inspiratory Phase The main drive gas valve closes and the bellows stops moving NOTE Inspiratory Pause Volume Mode only user selectable Inspiratory pause holds the inspiratory phase at the end of inspiration for a period of 2596 of the inspiratory time before reverting to expiratory phase See section 3 3 3 MAIN DRIVE GAS VALVE CLOSED DESCRIPTION BELLOWS EXHALATION DIAPHRAGM VALVE EXHAUST VALVE OPEN BELLOWS EXHALATION DIAPHRAGM VALVE CLOSED PEEP VALVE OPEN 11 Beginning of Expiratory Phase The exhaust valve opens allowing the drive gas above the bellows to escape to atmosphere The bellows starts to rise and exhaled gas enters the bellows End of Expiratory Phase The bellows exhalation diaphragm valve in the base of the bellows assembly opens when the bellows reaches the top of the chamber Patient circuit gas exits through the bellows assembly exhaust port and then through the ventilator exhaust valve PEEP Positive End Expiratory Pressure user selectable During PEEP the bellows exhalation diaphragm valve is closed Fresh gas flows in the patient circuit Pressure in the bellows increases The PEEP proportioning valve will maintain the pressure with a controlled bleed flow DESCRIPTION ech bie E E ver 17 PNEUMATIC SYSTEM DIAGRAM 10 Gas supply
46. ay will flash Rotate the navigator wheel to set the required volume A confirm message will be displayed Press the screen tab or wheel to confirm Real time adjustment is only possible when the ventilator is in volume set mode Displayed values NOTE When the ventilator is switched from standby to the required operating mode the spirometer will take 1 2 minutes before stabilising If the set parameters are within normal limits the system will deliver the set volume indicated If during adjustment the required flow rate is less than 2 L min or exceeds 75 L min the set tidal volume will be limited accordingly WARNING The AV900 has compliance compensation and fresh gas compensation on models with spirometry but the actual tidal volume delivered to the patient may be different to the ventilation parameters set by the user This may be due to a an extreme compliance condition b a substantial system leak or C patient circuit pressure effects d extreme fresh gas flow In addition high fresh gas flows will lead to an increased Vt being delivered to the patient Note that on models fitted with spirometry the actual tidal volume exhaled will be displayed The patient must be monitored independently from the ventilator It is the responsibility of the user to monitor patient ventilation 3 5 7 Ventilation Rate Control RATE BPM Select by touching the screen tab RATE BPM The setting display will f
47. ayonet tabs completely engage 5 Function test the ventilator section 5 3 1 NOTE If there is any malfunction the ventilator must NOT be used If the problem cannot be rectified the ventilator must be checked by a Penlon trained engineer 52 Paediatric Bellows Assembly 1 Remove the adult bellows housing 1 twist carefully counterclockwise until the bayonet tabs become free then lift up from the base 2 Remove the bellows 3 Fit the paediatric adaptor 5 press the adaptor into the ventilator bellows assembly base 2 Fit the paediatric bellows 6 to the adaptor Check for correct assembly as illustrated 4 Fit the paediatric bellows housing 7 to the base by pushing down then twisting clockwise until the bayonet tabs completely engage Function test the ventilator section 5 3 1 PRE OPERATION PROCEDURES 5 3 Pre use Checklist 5 3 1 Daily Checklist The following tests must be carried out at the beginning of every working day Alarm System WARNING The operation of each alarm function should be verified daily If the audible alarm or the visual display for any alarm function fails to activate during any alarm condition or fails to reset after the alarm has been cleared refer the unit to an authorised service technician Back up Battery WARNING If the internal battery is fully discharged the ventilator will not function Recharge the battery before the
48. ctitioner is in attendance at all times to react to an alarm or other indication of a problem In compliance with good anaesthesia practice an alternative means of ventilation must be available whenever the ventilator is in use 17 18 19 20 21 22 The basic model AV900 is not equipped with an oxygen analyser It is recommended that the patient oxygen concentration should be monitored continuously at or near the proximal airway with an oxygen monitor that includes high low alarms If the drive gas supply pressure drops below a nominal 241 kPa 35 psi the LOW DRIVE GAS SUPPLY alarm will activate both audibly and visually Patient minute volume may be reduced due to lowered flow rates An audible alarm indicates anomalous condition and should never go unheeded The characteristics of the breathing circuit connected between the ventilator and the patient can modify or change patient ventilation To assist the maintenance of the delivered patient tidal volume the ventilator control system software includes A a compliance compensation algorithm B a fresh gas compensation algorithm However patient ventilation must be monitored independently from the ventilator It is the responsibility of the user to monitor patient ventilation On models with spirometry care must be taken to ensure that the flow sensors are connected correctly to the inspiratory and expiratory ports of the abs
49. d the anaesthetic machine gas control switch The oxygen monitor automatically switches ON when the ventilator is switched on Ensure that all vaporizers are OFF Detach the sensor from the anaesthetic machine and gently move it through the air to allow room air to circulate for 20 seconds Allow the oxygen sensor to stabilise 30 seconds Press the menu switch and select the 2 monitor sub menu Scroll to CALIBRATION and press the navigator wheel to switch to 21 calibration using air if the menu shows 100 calibration using oxygen A message will flash on the screen 2 AT 21 Press the button to confirm Note that the message OXYGEN SENSOR LOW OUTPUT will appear on screen if the user attempts to calibrate at 21 in 100 oxygen Scroll to ESCAPE FROM MENUS and press the wheel to exit Refit the oxygen sensor and check the monitor with the sensor in oxygen Flush 100 oxygen through the CGO and maintain the flow through the total breathing circuit for approximately 20 seconds Allow the oxygen sensor to stabilise 30 seconds Check that the measured O2 concentration display shows 100 1 57 On Off Switch Alarm Mute Menu Switch Navigator Wheel and Press Button PRE OPERATION PROCEDURES O2 Monitor Calibration Using 100 Oxygen AV900 ventilator system mounted on a Prima SP anaesthetic machine fitted with a ATOOSP absorber Calibrate with the sensor in position within the absorber 1 1
50. d to interface with HP Monitors to special order Detailed configuration information can be accessed from H P Vuelink Open Interface Manual The port must only be connected to devices that comply to EN60950 3 6 12 Oxygen Monitor Sensor Connected to the oxygen sensor mounted in the breathing system see section 5 4 1 DESCRIPTION Alarm Mute Countdown Indicator 2 Measured Airway 25 V PATIENT WAVE pp MEAS DJSUPPORT FREEZE MUTE 30 P H50 Alarm Mute Button Alarm SET millilitres 600 Indicator GAS MIXTURE 2 air LOW DRIVE GAS SUPPLY High priority A visual and audible alarm which activate if the input drive gas pressure has dropped below 35 psi This alarm is not silenceable Supply pressure should be monitored by a separate means e g pressure gauge on anaesthetic machine or supply line 3 7 Alarms and Message Displays 3 7 1 Alarm Mute All mutable alarms except High Airway Pressure and High Drive Gas Pressure The mute button will silence the audible alarm for up to 120 seconds HIGH DRIVE GAS PRESSURE High priority A visual and audible alarm which activate when the drive gas supply overpressure switch operates at the maximum pressure limit 80 cmH20 This alarm can be muted for 30 seconds Note that the High Airway Pressure Alarm see below does not activate when the overpressure switch operates High Airway Pressure
51. drive gas outlet labelled DRIVE GAS and the bellows base DRIVE GAS inlet port 4 Attach a printer to the printer port if a printed output of the ventilator function is required see 3 5 12 2 Connect the EXHAUST valve port on S Gene Ee the control unit to a properly breathing system functioning scavenging system use a 30 mm hose 6 a Usea breathing system bacterial Fit a 10 cmH O pressure relief valve filter in the expiratory limb of the between the exhaust valve port and breathing circuit to protect the oxygen the inlet port of the AGSS receiver sensor Note that the diaphragm valve under b Use a heat and moisture the bellows is connected internally to exchanger HME at the patient Y the EXHAUST port to facilitate the discharge of excess breathing gas at E Bi NT oaa always follow the WA EL Ine expiratory phases instructions supplied with the filter or HME Always renew components at the Applying negative or positive pressure to the recommended interval bellows exhaust port results in positive pressure in the patient breathing system 7 Therefore the scavenging system must not generate more than 0 5 20 positive negative pressure when connected to the ventilator Any problem arising from an improperly functioning scavenging system is solely the user s responsibility Connect a 2 litre breathing bag to the patient connection as a test lung 8 Close the anae
52. e DESCRIPTION 3 5 13 Print A printed copy of the ventilator conditions for up to eight hours of the procedure can be provided In addition captured waveforms can also be printed first select WAVE FREEZE on the screen Connect a HPL 2 or greater format printer to the printer output port on the rear of the ventilator the end of the clinical procedure switch the ventilator to standby and press the PRINT tab once To cancel press the PRINT tab again Turn the ventilator to OFF and switch the ventilator back on again to clear the stored print information The printer port must only be connected to devices that comply to EN 60950 For examples see Appendix section 9 3 5 14 A100 SP Absorber with Bag Vent Detection Switch Automatic ventilator mode selection is enabled if the interface socket is connected to an A100 SP Absorber fitted with a sensor that detects the position of the absorber bag vent lever a If the Absorber Bag Vent Lever is moved from Vent to Bag the ventilator will change from Volume Mode or Pressure Mode into Spontaneous Mode b Switching the absorber Bag Vent lever from Bag to Vent will reset the ventilator from Spontaneous Mode to Standby Mode If the ventilator is in any mode other than those detailed above operation of the absorber Bag Vent lever will not affect the ventilator NOTE This function can be enabled disabled through the on screen menus Service Sub menu see
53. e inwards Pull the tube carefully outwards The end piece X will be pulled outwards to the locked position Self sealing connector on inboard A100 Absorber as fitted to Prima SP Self sealing connector on A100SP Absorber as fitted to Prima SP Distal sensing tee on pole mounted absorber Set TIDAL VOLUME to 600 ml Set RATE to 10 bpm Set RATIO to 1 2 0 Use the O2 flush button on the anaesthetic machine to fill the bellows Select VOLUME CYCLE The delivered tidal volume indicated by the scale on the side of the bellows housing should be 600 ml Before using the ventilator clinically a Check all connections and verify that there are no leaks b Spirometry check calibration 5 1 6 C Carry out a function test see 5 3 1 PRE OPERATION PROCEDURES 5 1 5 Spirometer Connections Flow sensors fitted to A100 Absorber for A100SP see next page 1 Use a breathing system bacterial filter see section 5 1 4 operation 7 CAUTION Replacement Disposal always follow the instructions supplied with the filter Always renew components at the recommended interval 2 Connect the two spirometry flow sensors The recommended placement of the flow sensors is between the inspiratory and expiratory connectors on the circle absorber A and the patient s breathing circuit tubing CAUTION Attach the sensors with due regard to the flow direction markings B
54. e wheel to confirm Scroll to ESCAPE FROM MENUS and press the wheel to exit 59 Dee Lal High Alarm 0 Val 25 Set Value Low Alarm Set Value Measured O2 concentration 6 CLINICAL OPERATION 6 1 Before Using the Ventilator 1 Prior to use with a patient check that all connections are correct and verify that there are no leaks 2 Perform the daily checklist detailed in section 5 3 1 WARNING An alternative means of ventilation must be available whenever the ventilator is in use e g manual resuscitation NOTE special operating system on ventilators interfaced with Prima SP see section 3 5 2 a Turn the Prima Sp Gas Delivery Switch to ON the ventilator will power up b While the Prima SP power is ON the Ventilator can be turned OFF and ON using the ventilator On Off switch c Turn the Prima SP Gas Delivery Switch to OFF The ventilator will power down 6 2 Setting the Parameters Select STANDBY mode and set the appropriate parameters for the patient Set the TIDAL VOLUME Set the RATE Set the ratio If the parameter being adjusted will not increase and the INCORRECT RATE or RATIO alarm is activated the flow demanded has reached the allowable maximum of 75 L min or minimum of 2 L min Adjust the other two parameters to allow a further increase or decrease of the desired parameter 5 Set the maximum airway pressure Note that all displayed parameters are always deliv
55. ed The ventilator then reverts to the exhalation phase In Pressure Control mode a The inspiration valve is closed when the set pressure is achieved The ventilator holds the set pressure until DESCRIPTION the end of the calculated inspiratory time before reverting to the exhalation phase b The variable pressure LIMIT control tab is replaced by the TARGET tab see 3 5 5 PRESSURE CONTROL MODE C If the user sets a target pressure in Pressure Mode the set value will be retained if an alternative mode is selected Measured airway pressure is displayed on Screen 3 5 10 Electronic PEEP Select by touching the screen tab PEEP cmH20 The setting will flash Rotate the navigator wheel to set the required PEEP pressure NOTE In Pressure Control Mode a PEEP must be set at least 10 below the target pressure set value b If the target pressure is subsequently reduced the ventilator will automatically reduce PEEP to maintain the 10 cmH2O pressure gap A confirm message will be displayed Press the Screen Tab or Wheel to confirm Note that Electronic PEEP does not function in Spontaneous Mode PEEP on off sequence Using the A100SP Absorber Interface Ventilator Mode Selection 1 Ventilator is in Volume Ventilation Mode 2 PEEP selected pressure set to required level PEEP display indicates pressure 3 1005 Absorber Bag Vent lever is moved to Bag position Ventilator a
56. ements detailed in this manual Additionally the user must accept responsibility for any malfunction which may result from misuse of any kind or non compliance with other requirements detailed in this manual Worn broken distorted contaminated or missing components must be replaced immediately Should such a repair become necessary it is recommended that a request for service advice be made to the nearest Penlon accredited agent This device and any of its constituent parts must be repaired only in accordance with written instructions issued by Penlon Limited and must not be altered or modified in any way without the written approval of Penlon Limited The user of this equipment shall have the sole responsibility for any malfunction which results from improper use maintenance repair damage alteration by anyone other than Penlon or its appointed agents USA and Canadian Federal Law restricts the sale and use of this device to or on the order of a licensed practitioner Statements this manual preceded by the following words are of special significance WARNING means there is possibility of injury to the user or others CAUTION means there is a possibility of damage to the apparatus or other property NOTE indicates points of particular interest for more efficient and convenient operation Always take particular notice of the warnings cautions and notes provided throughout this manual T WA
57. en Monitor Set up Installation Calibration E d as Sensor Low Indication Setting the High and Low Alarms CLINICAL OPERATION Before Using the Ventilator Setting the Parameters Positive End Expiratory Pressure PEEP Bellows PresSure USER MAINTENANCE Service Schedule Spirometer Sensors Sterilisation Oxygen Monitor Cleaning and Sterilisation Oxygen Sensor Replacement ORDERING INFORMATION APPENDIX Back up Battery Print out Examples __ Ventilator Alarms Theory of Operation iv 60 60 61 61 62 62 64 66 67 67 68 USER RESPONSIBILITY This anaesthesia ventilator has been built to conform with the specification and operating procedures stated in this manual and or accompanying labels and notices when checked assembled operated maintained and serviced in accordance with these instructions To ensure the safety of this device it must be checked and serviced to at least the minimum standards laid out in this manual A defective or suspected defective product must not under any circumstances be used The user must accept responsibility for any malfunction which results from non compliance with the servicing requir
58. ered unless the LOW DRIVE GAS SUPPLY alarm is on Roo must CAUTION The specifications and displayed values apply only to the ventilator and may have no direct relationship to the ventilation of the patient The characteristics of the breathing system connected between the patient and the ventilator can change or modify patient ventilation 60 Compliance Compensation WARNING The ventilator has circuit compliance compensation and fresh gas gas mixture compensation However the actual tidal volume delivered to the patient may be different to the ventilation parameters set by the user due to A an extreme compliance condition B a substantial system leak C patient circuit pressure effects or D extreme fresh gas flows In addition high fresh gas flows will lead to an increased Vt being delivered to the patient Note that on models fitted with spirometry the actual tidal volume exhaled will be displayed The patient must be monitored independently from the ventilator It is the responsibility of the user to monitor the patient for adequate ventilation Circuit compliance NOTE On models with spirometry circuit compliance is not activated until Fresh Gas Compensation is switched OFF Fresh Gas Compensation models with Spirometry Fresh gas compensation is disabled if a The spirometry system is turned OFF through the menu system or b The spirometry system is not functioning correctly Fre
59. falls below the set value minimum value is 20 ml HIGH TIDAL VOLUME The High Tidal Volume Alarm can be switched ON or OFF in Volume Mode Pressure Mode and Spontaneous mode using the Menu display see section 3 5 4 NOTE The alarm will reset to ON if a Standby mode is selected b The ventilator is switched OFF NOTE In Pressure Mode the High Tidal Volume Alarm is activated when the measured volume rises above 150 of the tidal volume achieved by the ventilator see 3 5 5 4 The alarm can be muted for 120 seconds Spirometer Disconnect Disconnection of a spirometer cable is indicated by a activation of the Low Tidal Volume Alarm and b a change to the Vr MEASD display Check the Vr MEASD display Indicates disconnection at ES the back of the control unit Or disconnection at the back of the A100SP absorber at the inspiratory spirometer sensor A low value decreasing to approximately 20 ml indicates disconnection at the expiratory spiro sensor 20 Interface Cable Disconnect Prima SP and A100 SP Absorber Cable Low Priority If an interface cable is fitted and is disconnected during use a visual indicator and audible alarm are activated DESCRIPTION INCORRECT RATE OR RATIO Low priority A visual indicator and audible alarm which indicates that the required inspiratory flow rate a is below 2 L min or b has reached the upper limit of 75 L min as dete
60. function is disabled DESCRIPTION O2 Monitor 3 4 Oxygen Monitor Optional The oxygen monitor continuously measures and indicates the concentration of oxygen in the breathing system and triggers an alarm when the concentration varies from the set levels 3 4 4 System Description The Oxygen Monitor uses a fast responding oxygen specific self powered sensor that achieves 9096 of final value in less than 10 seconds An external probe is supplied with a 2 m 6 ft extendable cable and diverter fitting The probe has a safety lock The system has user adjustable high level and low level alarms with visual and audible indication of alarm conditions 3 4 2 The MOX 3 Oxygen Sensor The MOX 3 oxygen sensor offers quick response linear output over the entire 0 10096 oxygen range and long service life The MOX 3 is a self powered galvanic cell that generates a current proportional to oxygen concentration The cell has a highly stable output over its operating life Significant output loss is only shown at the very end of its life Typical sensor drift rates are less than 196 per month when the sensor is exposed to gas in typical applications Sensor life approximately 1 500 000 O2 percent hours at 20 minimum one year in most normal applications Sensor lifetime is governed by the mass of lead available to react with the oxygen and its rate of consumption High oxygen partial pressure and high temperature w
61. gen sensor to stabilise 30 seconds 5 Press the menu switch and select the O2 monitor sub menu 6 Scroll to CALIBRATION and press the navigator wheel to switch to 10096 calibration using oxygen if the menu shows 21 calibration using air ES message will flash on the screen O2 100 Press the button to confirm NOTE The message OXYGEN SENSOR LOW OUTPUT will appear on screen if the user attempts to calibrate at 21 in 10096 oxygen 8 Scroll to ESCAPE FROM MENUS and press the wheel to exit 9 Check the monitor with the sensor in Air Detach the sensor from the anaesthetic machine and gently move it through the air to allow room air to circulate for 20 seconds Allow the oxygen sensor to stabilise 30 seconds Check that the measured 02 concentration display shows 2196 11956 ev On Off Switch Alarm Mute Menu Switch Navigator Wheel and Press Button O Monitor sub menu calibration O2 MONITOR ON CALIBRATION 100 HIGH ALARM SET LOW ALARM SET ESCAPE FROM MENUS Penlon 9602 21 Measured O2 concentration 56 PRE OPERATION PROCEDURES O2 Monitor 5 4 2 2 Calibration Using Room Air NOTE If the AV900 ventilator is used on a Prima SP anaesthetic machine fitted with a A100SP absorber please see page 58 NOTE Calibration in room air may not provide as great an accuracy as calibration carried out in 10096 oxygen 1 Switch on the ventilator an
62. haust port on the bellows base The device will not measure exhaled volumes in that position WARNINGS AND CAUTIONS 11 12 The operation of each alarm function should be verified daily Periodically check the alarms at clinically suitable intervals If the audible alarm or the visual indicator of any alarm function fails to activate during any alarm condition or fails to reset after the alarm has been cleared refer the unit to an authorised service technician Before using the ventilator check that all connections are correct and verify that there are no leaks Patient circuit disconnects are a hazard to the patient Extreme care should be taken to prevent such occurrences It is recommended that Safelock fittings are used throughout the breathing circuit Using the Ventilator 13 14 15 16 This apparatus must not be used with or in close proximity to flammable anaesthetic agents There is a possible fire or explosion hazard Anaesthesia apparatus must connected to an anaesthetic gas scavenging system to dispose of waste gas and prevent possible health hazards to operating room staff This requirement must be observed during test procedures as well as during use with a patient Any problem arising from an improperly functioning scavenging system is solely the user s responsibility When the ventilator is connected to a patient it is recommended that a qualified pra
63. he ventilation parameters set by the user due to A an extreme compliance condition B a substantial system leak C patient circuit pressure effects or D extreme fresh gas flows In addition high fresh gas flows will lead to an increased Vt being delivered to the patient Note that on models fitted with spirometry the actual tidal volume exhaled will be displayed The patient must be independently from the ventilator It is the responsibility of the user to monitor the patient for adequate ventilation monitored Circuit Compliance Compensation A compliance compensation algorithm is built into the control software which monitors the volume of gas delivered and the rate of pressure rise It calculates an additional volume to deliver into the breathing system to compensate for the reduced volume delivered to the patient as a result of the increased breathing system pressure As a Safety feature this additional volume is restricted to a maximum of 15 of the set tidal volume irrespective of the maximum pressure rise NOTE On models with spirometry circuit compliance compensation is not activated until Fresh Gas Compensation is switched OFF DESCRIPTION Fresh Gas Compensation models with Spirometry A fresh gas compensation algorithm is built into the control software Delivered volume will be altered by up to 4596 to allow compensation for fresh gas Fresh gas compensation is disabled if The
64. ill increase the sensor output current thus shortening the operation life At the point where all lead has been consumed the output will fall very quickly to zero over a period of two to three weeks 15 Sensor Location 1 Prima SP with A100SP Absorber Please refer to the datasheet Doc No A100SP 103DS U supplied with the absorber Sensor 2 Mounted on the dome of the absorber inspiratory valve DESCRIPTION O2 Monitor 3 4 3 Display High set low set and oxygen concentration percentage readings are displayed on screen Oxygen Concentration The display provides a direct readout of measured oxygen concentrations in the range 0 100956 Low Alarm Set limited within 18 9996 The oxygen percentage set by the user at which the low alarm will be activated To set the low oxygen alarm see section 5 4 4 High Alarm Set limited within 19 105 The oxygen percentage set by the user which the high alarm will be activated Note that in certain conditions of excess pressure the readout may show a value above 100 To set the high alarm see section 5 4 4 3 4 4 Oxygen Monitor Alarms HIGH O2 ALARM The high O2 alarm is triggered when the oxygen concentration is 196 above the set value a The High O2 Alarm visual indicator will illuminate b A high priority audible alarm will sound To cancel this alarm the high alarm setting must be equal to or above the o
65. ing AV900 Ventilator Drive gas supply The ventilator drive gas supply can be oxygen or air The supply must be at 262 to 689 kPa 38 to 100 psi Note that the drive gas is specified by the customer prior to delivery Conversion from one drive gas to another must be carried out by a Penlon trained service engineer Options a Spirometry and an integral oxygen monitor to measure oxygen concentration in the breathing circuit Note that on models without spirometry the patient support function is disabled b Paediatric bellows assembly c Mounting options the AV900 can be mounted on the anaesthetic machine as a single complete unit or the bellows unit and the control unit can be mounted separately DESCRIPTION Breathing System Port Bellows Drive Gas Inlet Port Spirometer Do NOT connect connector spirometer Prima SP Interface Pressure Monitor Port connector Input socket Oxygen monitor sensor RS232 Port Data Output Outlet Exhaust Valve Electrical mains input Printer Port and fuse unit Connect to cylinder or pipeline supply Connect to Bellows Drive Gas Inlet Port Rear Panel and Gas Ports DESCRIPTION 3 2 Ventilation Cycle This section provides a simplified description of the ventilation cycle Ce 1 Inspiratory ES Phase y Drive gas pressure builds up above PATIENT GAS OUT E WC s BREATHIN gt CIRCUIT down forcing p
66. inlet port on the rear of the control unit to a dry oil free supply Supply pressure range 38 to 100 psi 2 6 6 9 bar 262 689 kPa The drive gas inlet port is labelled OXYGEN AIR 38 100 PSI OXYGEN SUPPLY a O2 cylinder b Anaesthetic machine O2 auxiliary gas outlet O2 pipeline supply from a wall outlet AIR SUPPLY a Air cylinder b Anaesthetic machine Air auxiliary gas outlet C Air pipeline supply from a wall outlet Supply pressure should be monitored by a separate means e g pressure gauge on anaesthetic machine or supply line NOTE It is possible to reconfigure the ventilator for use with a different drive gas to the gas originally specified This work must be carried out by a Penlon trained engineer at your hospital or a Penlon distributor PRE OPERATION PROCEDURES Breathing System Port Bellows Drive Gas Inlet Port Do NOT connect spirometer Spirometer connector Prima SP Interface connector see section 3 5 2 Pressure Monitor Port Input socket Oxygen monitor sensor RS232 Port Data Output Outlet Exhaust Valve Electrical mains input Printer Port Connect to cylinder or pipeline supply Connect to Bellows Drive Gas Inlet Port 5 1 4 2 Breathing System and Cable 3 Connect the spirometer sensors if Connections spirometry option is fitted see 1 Connect the 16 diameter Section 5 1 5 corrugated hose provided between the control unit
67. irm The tab background will change to orange Ventilator cycling will commence all the alarms will be activated except high airway pressure NOTE In Pressure Control Mode the flow is automatically set by the ventilator to the optimum value The ventilator will then achieve the target inspiratory pressure as quickly as possible The ventilator will continue to deliver gas until the pressure target is reached At this point the ventilator will stop delivering gas and pause in this condition until the calculated end of inspiration time has been reached The ventilator will exhalation phase then return to the The inspiratory pause function does not operate in this mode NOTE If a high fresh gas flow has been set a small increase above the target pressure may be observed during the inspiratory phase Note also that the ventilator will not compensate for any increase in pressure during the pause phase while the exhaust valve is closed NOTE a If PEEP is selected it must be set at least 10 cmH2O below the target pressure set value b If the target pressure is subsequently reduced the ventilator will automatically reduce PEEP to maintain the 10 cmH2O pressure 3 5 5 5 STANDBY MODE Allows values for Tidal Volume Rate Ratio and Pressure Limit to be set by the user See also section 3 5 2 DESCRIPTION 3 5 6 Tidal Volume Control Select by touching the screen tab Vr SET The setting displ
68. irometer via the ventilator menu procedure NOTE Do NOT remove the spirometer heads Press the menu switch on the front panel Main menu select SPIROMETRY Sub menu select CALIBRATION Turn the wheel to switch display to CALIBRATION cal A message will appear Remove the spirometer head Do NOT remove the spirometer heads Press the wheel to initiate calibration Repeat operations 8 to 12 twice more Calibration is completed Scroll to ESCAPE FROM MENUS Press the wheel to confirm 51 On Off Switch Alarm Mute Menu Switch Navigator Wheel and Press Button Main menu O2 MONITOR SPIROMETRY FRESH GAS COMPENSATION ON GAS MIXTURE VOLUME TYPE WAVEFORM SERVICE ESCAPE FROM MENUS Spirometry sub menu SPIROMETRY ON gt CALIBRATION cal ESCAPE FROM MENUS PRE OPERATION PROCEDURES 5 2 Bellows Assemblies CAUTION Always ensure correct fitment of bellows see illustration above and carry out a full function test before clinical use if a bellows is removed and refitted 1 Remove the bellows housing 1 Twist carefully counterclockwise until the bayonet tabs become free then lift up from the base 2 2 Remove the bellows 3 3 Refit the bellows and check for correct assembly as illustrated 4 4 Fit the bellows housing to the base by pushing down then twisting clockwise until the b
69. kground will turn to orange In Patient Support Mode the user can reset Set Tidal Volume Rate Ratio Pressure Limit Patient Support Function If the measured volume is less than the set target tidal volume averaged over a period of 15 seconds a The Low Tidal Volume Alarm will sound for three seconds b The ventilator will then switch to Volume Cycle Mode To reinstate Patient Support Mode the user must repeat the procedure given above see Selecting Patient Support Mode 3 5 5 3 VOLUME CYCLE MODE Select by touching the screen tab The screen tab will flash A confirm message will be displayed Press the screen tab or wheel to confirm The tab background will change to orange Ventilator cycling will commence and all the alarms will be activated The inspiratory pause function is available in this mode Maximum breathing system pressure will be monitored If maximum breathing system pressure is reached a The alarm HIGH AIRWAY PRESSURE alarm will be triggered 27 b The ventilator will immediately revert to the expiratory phase inspiratory pause function will be overidden 3 5 5 4 PRESSURE CONTROL MODE Select by touching the screen tab The screen tab will flash The TARGET pressure display will flash and show the default setting 10 cmH20 Rotate the navigator wheel to set the required target pressure A confirm message will be displayed Press the screen tab or wheel to conf
70. lash Rotate the navigator wheel to set the required rate A confirm message will be displayed 28 Press the screen tab or wheel to confirm The system will accept the setting as long as the value is within normal limits The display indicates the requested RATE If during adjustment the required flow rate is less than 2 L min or exceeds 75 L min the set rate will be limited accordingly 3 5 8 Ventilator I E Ratio WARNING The ventilator settings can allow for an inverse LE ratio up to 1 0 3 The clinician must always ensure that sufficient time is allowed for the patient to adequately exhale Select by touching the screen tab RATIO The setting display will flash Rotate the navigator wheel to set the required ratio A confirm message will be displayed Press the screen tab or wheel to confirm If during adjustment the required flow rate is less than 2 L min or exceeds 75 L min the set ratio will be limited accordingly 3 5 9 Airway Pressure Limit cmH20 Select by touching the screen tab LIMIT cmH20 The setting display will flash Rotate the navigator wheel to set the required pressure A confirm message will be displayed Press the screen tab or wheel to confirm This control sets a maximum breathing System pressure as sensed by the pressure transducer in the patient breathing circuit In Volume Cycle mode The inspiratory cycle is terminated whenever this set pressure is achiev
71. lative humidity If the sensor shows signs of being affected by condensation dry the sensor with soft tissue CAUTION DO NOT use heat to dry the sensor Temperature Effects The sensor has a built in temperature compensation circuit and is relatively unaffected by temperature changes within the operating temperature range given above Pressure Effects The sensor measures O2 partial pressure and its output will rise and fall due to pressure change e g changes in barometric pressure or breathing system pressure An increase in pressure of 10 at the sensor inlet will produce a 10 increase in sensor output 43 5 PRE OPERATION PROCEDURES 5 1 Ventilator Set up 5 1 1 Components supplied with the ventilator The ventilator is supplied with various additional components depending specification and configuration a A 210 mm long 16 mm diameter corrugated hose to connect the control unit to the bellows assembly Drive gas hose to customer specification Electrical mains supply cable to customer specification Pressure sampling line and T piece Spirometer sensors and leads spirometer option only f Oxygen sensor system oxygen monitor option only wa Qa 5 1 2 Mounting the ventilator The AV900 can be mounted on the anaesthetic machine as a single complete unit or the bellows unit and the control unit can be mounted separately Locate the ventilator in a safe place
72. maximum 75 L min intermittent maximum inspiratory flow SPECIFICATION 4 32 4 33 4 34 4 35 4 36 4 37 4 38 4 39 4 40 4 41 4 42 Dimensions Height Height of control unit only Width Depth Weight Weight with adult bellows Weight with paediatric bellows Weight of control unit only Method of Disinfection or Sterilisation Bacterial Filter Fail Safe Mechanism Reliability Waveform Tests Volume Tests A Mobility B Mounting Fuse mains supply Environmental Ambient Temperature Storage Operating Humidity Altitude Ingress protection 41 385 mm 150 mm 240 mm 300 mm 9 0 kg 8 7 kg 7 6 kg Bellows base assembly and inside of bellows require sterilisation section 7 3 None see section 5 1 4 for recommendations for breathing system Battery back up in case of mains electricity failure MTBF 5x106 to 50 106 cycles Not applicable Not applicable Secure mounting on anaesthesia machine required Mounting bracket available as optional extra The bellows assembly can be separated from the control unit for remote mounting Two fuses Type T 2AH 2A 250 V rating 20 mm anti surge ceramic 5 to 50 23 to 1220F Refer to Appendix 1 for battery care during storage 10 to 389C 50 to 100 F 10 9595 RH relative humidity non condensing Up to 2775 m 9000 feet Conforms to EN 794 1 Clause 44 spillage test SPECIFICATION O2 Monitor 4
73. meter taper connector and delivers the drive gas from the control unit to the ventilator bellows assembly The drive gas over pressure relief valve is set at a non adjustable 80 cmH2O 3 6 5 Exhaust Valve Gas from the bellows assembly drive gas either air or oxygen is exhausted through this outlet The port must not be blocked 3 6 6 Pressure Transducer Connected to a pressure transducer in the breathing system 3 6 7 RS 232 Port Configuration details for this port are available by special order from Penlon Limited The port must only be connected to devices that comply to EN 60950 3 6 8 Printer Port This standard Centronics 36 way parallel port is configured to output to any HPL 2 or equivalent compatible parallel printer The port must only be connected to devices that comply to EN 60950 34 3 6 9 Spirometer Connection An electrical DIN connector is provided for the cable carrying the signals from the Inspiration and Expiration flow sensors Each sensor is identified with INSP or EXP and the direction of flow Care must be taken to ensure that each sensor is connected correctly to the Absorber components to ensure that breathing cycle flow and direction is detected 3 6 10 Prima SP Interface The connector is provided for connection to a Prima SP with an interface socket that links to the SP Master ON OFF switch and A100 SP Absorber BAG VENT lever 3 6 11 Data Outputs This port can be configure
74. mponents must be carefully inspected and damaged parts must be replaced Bellows As with all elastomers the bellows material deteriorates with aging and should be inspected at least every six months or after 1200 hours of use whichever comes first The bellows must be replaced if it shows signs of aging The bellows B can be removed by carefully pulling it off the base If a paediatric bellows is fitted the bellows adaptor C must also be removed Do not dismantle the bellows Exhalation Diaphragm Valve The exhalation diaphragm valve is under the bellows and can be removed by loosening the three thumbscrews The valve seat is now visible WARNING Great care must be taken Do not damage the precision surface of the valve seat D Never use any hard object or abrasive agent to clean it use only a soft cloth If the valve seat is damaged the diaphragm valve will leak and may cause serious malfunction Clean the seat and the metal disk E attached to the base of the diaphragm valve thoroughly and remove all contamination from the surfaces of both components NOTE If excessive contamination is discovered check that a bacterial filter is used in the expiratory limb of the breathing circuit or an HME at the patient tee piece See section 5 1 4 After cleaning check that the small O ring F located in the bellows base under the diaphragm valve is in place The ventilator will not function if the O ring
75. nd always replace at the recommended interval 5 4 2 Calibration The new unit must be calibrated before clinical use Thereafter as a safety precaution we recommend calibration of the unit every time the system is switched on Calibration must also be performed A when the sensor is replaced B when point of use elevation changes by more than 160 m 500 ft We recommend calibration with a 10096 oxygen standard source at a pressure and flow similar to your application Calibration at 2196 i e using air is possible but less desirable 55 Sensor Location and Cable Connections 1 Prima SP with A100SP Absorber Please refer to the user instructions supplied with the absorber 2 Mounted on the dome of the absorber inspiratory valve Cable connection on AV900 control unit rear panel Oo PRE OPERATION PROCEDURES O2 Monitor 5 4 2 1 Calibration Using 100 Oxygen NOTE If the AV900 ventilator is used on a Prima SP anaesthetic machine fitted with a A100SP absorber please refer to the User Instructions supplied with the A100SP 1 Switch on the ventilator and the anaesthetic machine gas control switch The oxygen monitor automatically switches ON when the ventilator is switched on Ensure that all vaporizers are OFF Flush 10096 oxygen through the CGO and maintain the flow through the total breathing circuit for approximately 20 seconds 4 Allow the oxy
76. of Patient Support Mode VENT INOP HIGH AIRWAY PRESSURE LOW SUPPLY PRESSURE NEGATIVE AIRWAY PRESSURE 3 the patient fails to achieve the target LOW BATTERY volume the Low Tidal Volume alarm MAINS FAILURE will trigger and the ventilator will O2 HIGH LOW SENSOR FAULT automatically revert to Volume Cycle LOW TIDAL VOLUME moos Spirometer ON simulates Apnoea Patient Support Mode must then be manually reinstated if required alarm LOW AIRWAY PRESSURE Apnoea NOTE Spirometry OFF or not fitted a Patient Support Mode will not function i if Spirometry is OFF ii if Spirometry is not fitted Models with Spirometry i ilator Spirometry ON the vent SR b When selecting Patient Support Mode ensure will also display values for the Absorber BAG VENT Switch is set to Vent Tidal Volume Rate Position ratio Maximum Pressure Pmax 26 DESCRIPTION Selecting Patient Support Mode Select by touching the Screen Tab a The VT SET tab will flash and display 25 of the previously set tidal volume b On anaesthetic machines not fitted with a sensor that detects the position of the absorber bag vent lever the ventilator will display Absorber in Vent Mode Aconfirm message will be displayed The user has 8 seconds to i confirm that Patient Support Mode is required ii Set a target value for tidal volume Press the screen tab or wheel to confirm The tab bac
77. of Penlon Limited is one of continued improvement to its products Because of this policy Penlon Limited reserves the right to make any changes which may affect instructions in this manual without giving prior notice Personnel must make themselves familiar with the contents of this manual and the machine s function before using the apparatus Copyright Penlon Limited 2005 All rights reserved THE IMPORTANCE OF PATIENT MONITORING WARNING Anaesthetic systems have the capability to deliver mixtures of gases and vapours to the patient which could cause injury or death unless controlled by a qualified anaesthetist There can be considerable variation in the effect of anaesthetic drugs on individual patients so that the setting and observation of control levels on the anaesthesia systems does not in itself ensure total patient safety Anaesthesia system monitors and patient monitors are very desirable aids for the anaesthetist but are not true clinical monitors as the condition of the patient is also dependent on his respiration and the functioning of his cardio vascular system IT IS ESSENTIAL THAT THESE ELEMENTS ARE MONITORED FREQUENTLY AND REGULARLY AND THAT ANY OBSERVATIONS ARE GIVEN PRECEDENCE OVER MACHINE CONTROL PARAMETERS IN JUDGING THE STATE OF CLINICAL PROCEDURE CONTENTS 3 1 3 2 3 3 3 3 1 3 3 2 3 3 3 3 3 4 3 3 5 3 3 6 3 3 7 3 4 3 4 1 3 4 2 3 4 3 3 4 4 3 4 5 3 5 3 5
78. of being affected by condensation dry the sensor with soft tissue Do not use heat to dry the sensor NOTES 1 The O2 SENSOR FAULT alarm indicates that one of the following conditions has occurred a Internal electrical fault b Software electronics fault Oxygen sensor fault The concentration read out may in certain conditions of excess pressure show a value above 100 To accommodate these conditions it is possible to set the high alarm value up to 105 see section 5 4 4 To maintain maximum sensor life always remove the unit from the breathing circuit after use The accuracy of flow and volume measurements may be reduced if the oxygen monitor is not in use Fresh gas mixture compensation is disabled if the oxygen monitor is switched OFF 2 PURPOSE The AV900 Ventilator is a software controlled multi mode ventilator designed for mechanical ventilation of adult and paediatric patients under general anaesthesia In addition in spontaneous mode it can be used to monitor spontaneously breathing patients It is designed for use in closed circuit anaesthesia and also to drive a Mapleson D circuit Indications for use of the device The AV900 Ventilator is intended to provide continuous mechanical ventilatory support during anaesthesia The ventilator is a restricted medical device intended for use by qualified trained personnel under the direction of a physician Specifically the ventilator is
79. orber The Vent Inop ventilator inoperative alarm indicates that one of the following conditions has occurred A The drive gas solenoid has failed B The flow control valve has failed C Internal electronic fault D Internal electrical fault E Software error Note that if a ventilator error is detected an error code will be displayed on the front control panel display WARNINGS AND CAUTIONS 23 24 The High and Low Airway Pressure Alarms are important for patient care The ventilator is designed to be used with a distal sensing tee only Catalogue 53194 Breathing System Tee Assembly see section 8 It is important that the distal sensing tee is properly located in the expiratory limb of the circuit between the patient and the expiratory one way valve See section 5 1 4 The patient must be continuously attended and monitored when Patient Support Mode is in use User Maintenance Control Unit 25 26 27 28 Opening the control unit by unauthorised personnel automatically voids all warranties and specifications Prevention of tampering with the control unit is exclusively the user s responsibility If the control unit seal is broken the manufacturer assumes no liability for any malfunction or failure of the ventilator For continued protection against fire hazards replace the two fuses only with the identical type and rating of fuse See section 4 41 for fuse rating
80. rity Disconnect Alarm A visual and audible alarm which activate if the pressure sensed at the patient tee piece in the expiratory limb of the breathing circuit does not increase by at least 4 14 cmH20 during a ventilator inspiratory cycle depending on tidal volume setting This alarm remains on until the required pressure differential is reached The alarm can be muted for 120 seconds NOTE Spirometry fitted and switched ON the Low Airway Pressure Alarm does not function in Spontaneous Mode NEGATIVE AIRWAY PRESSURE High priority Disconnect Alarm A visual and audible alarm which activate if the pressure sensed at the patient tee piece in the expiratory limb of the breathing circuit falls below 20 cmH2O during a ventilator inspiratory cycle depending on tidal volume setting This alarm remains on until the pressure rises above 20 cmH2O The alarm can be muted for 120 seconds LOW TIDAL HIGH TIDAL VOLUME High priority The AV900 can be fitted with an optional external volume spirometer which provides signals to the volume display LOW TIDAL VOLUME A visual indicator and an audible alarm are activated if the apparent tidal volume as measured by the spirometer falls below 50 of the set tidal volume The alarm can be muted for 120 seconds 36 NOTE In Spontaneous and Patient Support modes the Low Tidal Volume Alarm acts as an Apnoea alarm The alarm will activate if the measured tidal volume
81. rm is not silenceable In the event of a ventilator error being detected a ventilator inoperative message will be displayed beneath the waveform display area In addition code will be stored in volatile memory which can be accessed by the service engineer to assist with fault finding WARNING To reset a VENT INOP alarm Turn the ventilator OFF for a minimum of one second and then turn the ventilator back ON If the VENT INOP alarm occurs again do not use the ventilator and refer the unit to an authorised service technician Oxygen Monitor Alarms See section 3 4 4 3 8 Back up Battery In the event of mains electrical failure the back up battery cuts in automatically A fully charged battery will power the ventilator for approximately 60 minutes See Appendix 1 for battery care procedures Tidal Volume litres Vt DESCRIPTION 3 9 Operational Capability 1 E Ratio 1 6 15 1 4 1 3 1 2 1 1 1 0 3 KER OW d 1 6 1 5 1 4 1 3 1 2 1 1 1 0 0 9 0 8 0 7 0 6 0 5 0 4 0 3 0 2 0 1 0 10 20 30 40 50 60 70 80 90 100 Rate bpm The ventilator is capable of operating at the volumes and rates below each ratio curve Note The minimum tidal volume setting is 20 ml b The minimum rate setting is 4 bpm Example 1 Select required volume e g 0 8 litres 2 Select rate e g 10 bpm 3 Select ratio of 1 2 The point X on the graph lies beneath the 1 2 ratio c
82. rmined by the settings for TIDAL VOLUME RATE RATIO and INSP PAUSE This alarm can be muted for 120 seconds MAINS FAILURE Low priority A visual and audible alarm low priority which activates when mains electrical power is disconnected when the ventilator is operating Note that the battery must be ina charged state for this alarm to operate LOW BATTERY Low priority Medium priority A visual and audible alarm which activates if the internal battery is low In this condition the 60 minute backup period is significantly reduced A low battery alarm does not indicate that the ventilator is faulty When mains is connected the alarm is merely an indication that the battery is not fully charged and is being charged by the ventilator WARNING Do not leave the Ventilator on if the device is not connected to the mains this will severely drain the battery Medium Priority Status When approximately ten minutes of battery backup time remains the alarm will change from low to medium priority To prevent damage to the battery the ventilator will shut down before the battery is fully discharged VENT INOP High priority The VENT INOP ventilator inoperative alarm indicates that one of the following conditions has occurred a Asolenoid has failed b The flow control valve has failed c Internal electrical fault d Internal Communications error e Battery disconnected f Software error This ala
83. rough the menu system or b The spirometry system is not functioning correctly 9 models with spirometry fresh gas mixture compensation is disabled if a The spirometry system is turned OFF through the menu system or b The spirometry system is not functioning correctly The monitor is switched OFF WARNINGS AND CAUTIONS Oxygen Monitor Oxygen Monitor WARNINGS 1 We recommend calibration of the oxygen monitor every time the system is turned on as a safety precaution Do not attempt to open the fuel cell The sensor contains small quantities of a electrolyte classified as a harmful irritant which is potentially hazardous and b lead Used or defective cells must be disposed of according to hospital local state and federal regulations ALWAYS check the integrity of the sensor assembly before use See section 3 4 Once exhausted the sensor must be disposed of according to hospital local state and federal regulations The sensor measures oxygen partial pressure and its output will rise and fall due to pressure change An increase in pressure of 10 at the sensor inlet will produce a 10 increase in sensor output CAUTIONS 1 Do not sterilise the oxygen sensor control unit components These components are not compatible with sterilisation techniques and damage may result Do not autoclave or expose the sensor to high temperatures If the sensor shows signs
84. sembly Replace the spirometer sensor and sample lines Details of these service operations are given in the Service Manual Always ensure that a record is kept of any service or repair work 7 2 Cleaning Outside surfaces and bellows housing CAUTION Care must be taken not to allow liquids to run into the control unit serious damage may result Check that the unit is disconnected from the electrical supply before cleaning Do not use cleaning solutions containing alcohol the bellows housing may be damaged To clean the outside surface of the ventilator use a damp cloth If necessary use a warm mild detergent solution to remove resistant grime Make sure that all detergent residues are fully removed after cleaning Never use any harsh abrasive cleaning agent The transparent acrylic bellows housing and in general the surfaces of the control unit are not scratch resistant The inside of the bellows housing under normal conditions is not in contact with the breathing gas and therefore only needs cleaning as described above Remove the bellows housing A by slightly twisting it counter clockwise until the tabs at the bottom clear the bayonet locks then lift it straight up from the base Touchscreen Use a soft cloth only Never use any harsh abrasive cleaning agent USER MAINTENANCE Bellows and exhalation diaphragm valve Each time the bellows assemblies are opened for cleaning all visible co
85. sh Gas Mixture Compensation models with Spirometry Fresh gas mixture compensation is disabled if a The spirometry system is turned OFF through the menu system or b The spirometry system is not functioning correctly c The O2 monitor is switched OFF Ventilating the Patient To start ventilating the patient 1 Switch the breathing system from the breathing bag to the ventilator 2 Select VOLUME CYCLE or PRESSURE mode on the ventilator 3 Select gas mixture see section 3 5 4 CLINICAL OPERATION 6 3 Positive End Expiratory Pressure PEEP Select PEEP on the touchscreen display 8 5 10 Pressure can be set between 4 and 30 cmH20O The only pressurised part of the breathing system should be the patient and the connecting hoses between the inspiratory and expiratory valves Note that the use of PEEP alters the compliance of the breathing system 6 4 Bellows Pressure WARNING The bellows can support only 10 cmH20 differential pressure Normally the pressure on the inside and outside of the bellows are approximately the same During the expiratory phase the exhalation diaphragm valve under the bellows is de energised so that the inside of the bellows is connected to the ambient through the drive gas circuit to the ventilator exhaust The bellows can support only 10 cmH20 across it Above this pressure it may be dislodged from the mounting ring resulting in a dangerous malfunction of the ventilator
86. si 3 psi which will operate the internal pneumatic system The Inspiratory Valve is an electro pneumatically driven valve with a large orifice The valve supplies the drive gas to the Drive Gas Flow Metering Valve The Expiratory Valve operates as a pilot valve for the exhaust valve The Drive Gas Flow Metering Valve is a variable orifice needle valve which determines the drive gas flow rate to the bellows during inspiration The Valve Position Feedback Potentiometer and the Flow Control Motor function together to set a flow rate as required by the front panel controls The flow from the Drive Gas Flow Metering Valve goes to the Bellows Assembly via the drive connector The flow then closes the exhalation diaphragm valve and pushes the bellows downward As the bellows moves downwards the gas 13 inside the bellows is forced into the Breathing System At the end of inspiration the exhaust valve opens and allows the drive gas in the top of the bellows housing to exhaust out through the Exhaust Outlet As the pressure in the top of the bellows housing is reduced to zero the patient exhales into the breathing system and the bellows rises 3 3 2 Compliance Compensation and Fresh Gas Fresh Gas Mixture Compensation WARNING The AV900 has circuit compliance compensation and fresh gas compensation on models fitted with spirometry However the actual tidal volume delivered to the patient may be different to t
87. spirometer head 7 Press the wheel to initiate calibration 8 Calibration is completed 9 Scroll to ESCAPE FROM MENUS 10 Press the wheel to confirm 11 Refit the spirometer sensors see section 5 1 5 Menu Switch Turn the wheel to scroll through the menus Press to enter sub menu Press to confirm settings Main menu Oz MONITOR SPIROMETRY FRESH GAS COMPENSATION ON GAS MIXTURE VOLUME TYPE WAVEFORM SERVICE ESCAPE FROM MENUS Spirometry sub menu SPIROMETRY ON gt CALIBRATION cal ESCAPE FROM MENUS PRE OPERATION PROCEDURES Spirometer Calibration system fitted to an A100SP Absorber mounted on a Prima SP The Spirometry heads must be calibrated with zero flow going through them 1 10 11 12 13 14 15 16 17 Turn the Prima SP gas flow off at the Gas Delivery switch 1 This will stop all gas flows including the AHD basal flow This will also turn the AV900 off Turn the AV900 on at the ventilator Do not use the Prima SP Gas Delivery switch Remove the breathing circuit hoses from the inspiratory and expiratory connectors 2 on the absorber Disconnect the fresh gas hose from the CGO block on the anaesthetic machine Disconnect the hose from the APL valve outlet 3 at the rear of the manifold block a Ensure that the ventilator bellows is empty Or b Remove the bag and set the Bag Vent lever 4 to Bag position Calibrate the sp
88. sthetic machine APL or PRV valve in the breathing system 45 9 gra PRE OPERATION PROCEDURES mra L Bellows Control Unit Outlets to Anaesthetic Gas Scavenging System AGSS Bacterial Filter Absorber valve block Heat and moisture exchanger Patient CGO Block on anaesthetic machine Fresh Gas Supply Auxiliary Outlet on anaesthetic machine Drive Gas Supply Flow sensor expiratory Flow sensor inspiratory Sensor pressure monitor Expiratory Valve Absorber Inspiratory Valve Absorber Inlet from Ventilator Connector Reservoir Bag Inlet Absorber Fresh Gas Supply Drive Gas Inlet Ventilator Drive gas Outlet control unit to bellows Outlet Exhaust Valve Inlet Bellows Drive Gas 46 26 Breathing System Connections Note 1 2 3 This Schematic shows an AV900 with spirometry and oxygen monitor Prima SP interface cabling is shown The absorber is fitted with a Bag Vent 26 27 28 29 Outlet to breathing system Input socket Oxygen monitor sensor Input socket spirometer Input socket Prima SP interface SP on off switch and A100SP Absorber Bag Vent lever position Interface connection on Prima SP if fitted See section 3 5 2 Connector pressure monitor APL Valve Oxygen sensor for alternative locations see section 3 4 PRE OPERATION PROCEDURES PRESSURE TRANSDUCER port A
89. t cannot become live in the event of failure of the basic insulation of the electrical components within the unit This symbol denotes Type B equipment Type B equipment calls for a particular degree of protection against electric shock This symbol denotes Refer to the User Manual N Breathing System Port Bellows Drive Gas Inlet Port Spirometer Do NOT connect connector spirometer Prima SP Interface Pressure Monitor Port connector Input socket Oxygen monitor sensor RS232 Port Data Output Outlet Exhaust Valve Electrical mains input Printer Port and fuse unit Connect to cylinder or pipeline supply Connect to Bellows Drive Gas Inlet Port 33 DESCRIPTION 3 6 2 Electrical Mains Supply The mains supply inlet is designed for connection to any mains voltage from 100 to 240 VAC and a frequency of 50 to 60 Hz without any adjustment The connector is a standard IEC type 3 6 3 Oxygen Air inlet Ventilator driving gas is attached to this connector at a pressure of 38 100 psi 262 to 689 kPa and capable of supplying gas ata flow rate of not less than 80 L min at the minimum pressure Air or Oxygen must be used as the drive gas and the supply must be clean and dry Note that the drive gas is specified by the original customer To change the drive gas refer to a Penlon trained service engineer 3 6 4 Drive Gas outlet to bellows The drive gas outlet is a special 17 mm dia
90. uminated alarm 2 The audible alarm is activated high priority alarm 3 The Inspiratory Valve is closed the exhaust valve is opened and the inspiration cycle is ended Note The rate of breaths per minute will be affected in this condition as the ventilator will cease to deliver flow above the maximum working pressure high priority WARNING If this alarm is ignored the patient may receive an insufficient minute volume In PRESSURE controlled mode when the set pressure is reached the following occurs 1 The Inspiratory valve is closed 2 The ventilator maintains the set pressure until the end of the inspiration cycle 3 3 6 High Pressure Protection High pressure in the ventilator is limited by three independent protective systems 1 The Pressure Transducer has already been described 2 The Driving Gas Over pressure Switch is set at 80 cmH20O and will shut off drive gas flow at this value 3 The Pressure Relief Valve is a mechanical over pressure relief which will open at 80 cmH2O diverting the driving gas to atmosphere through the exhaust port The Exhaust Outlet on the back of the control unit accepts the drive gas exhaust from all internal pneumatic components 3 3 7 Spirometry System Spirometry if fitted can be enabled or disabled via the on screen menu system NOTE If the spirometry system is turned OFF a Fresh gas fresh gas mixture compensation is disabled b Patient support
91. urve and is therefore within the ventilator s capability 38 4 4 1 4 2 4 3 4 4 4 5 4 6 4 7 4 8 4 9 4 10 4 11 4 12 4 13 4 14 4 15 4 16 4 17 4 18 4 19 4 20 4 21 SPECIFICATION Application Internal Compliance Adult bellows Paediatric bellows Minute Volume Range Tidal Volume Range Adult bellows Paediatric bellows At ambient temperature of 209C 10 and ambient atmosphere of 101 3 kPa 10 Frequency Rate Range Inspiratory Phase Time Range Expiratory Phase Time Range Inspiratory Expiratory Phase Time Ratio Range I E ratio Pressure Control Range pressure ventilation mode Inspiratory Flow Range Airway Pressure Limit volume ventilation mode Inspiratory Triggering Inspiratory Triggering Response Time Maximum Safety Pressure Maximum Working Pressure Minimum Safety Pressure Minimum Working Pressure Sub atmospheric Pressure Range SE Resistance 80 L min Sigh Characteristics Inspiratory Mixture Ventilation for use in anaesthesia 3 ml cmH2O nominal 2 ml cmH2O nominal N A this parameter cannot be set 20 to 1600 ml 10 20 to 350 ml 10 4 to 100 bpm limited by tidal volume setting 0 07 to 11 54 seconds 100 bpm 1 8 0 14 to 13 33 seconds 100 bpm TE 1 0 3 and 4 bpm TE 1 8 1 0 3 1 8 0 limited by tidal volume and rate settings 10 to 70 2 41096 2 to 75 L min 10 to 80 cmH
92. ute can not be operated a Until the mute time is over or the alarm condition has been rectified b When concentration drops below 18 High Alarm Set Low Alarm Set DESCRIPTION Alarm Mute Countdown Indicator Vy ps W i MUTE 30 MEASD PAUSE FREEZE On Off Switch Alarm Mute Menu Switch Navigator Wheel Vr SET PEEP LIMIT and millilitres cmH20 cmH20 GAS MIXTURE Press Button 600 OFF 38 O2 air A touchsereen control 3 5 Control Unit 3 5 1 System Controls and Parameters Ventilator parameters VENTILATION MODE TIDAL VOLUME RATE RATIO AIRWAY PRESSURE CONTROL ELECTRONIC PEEP MENU FUNCTION WAVEFORM DISPLAY INSPIRATORY PAUSE volume cycle mode only The parameters default to factory set values when the ventilator is switched on see 3 5 2 The parameters be activated and new values assigned by using the touchscreen and navigator wheel see 3 5 3 Based on the control settings the system 1 Calculates INSPIRATORY FLOW and the INSPIRATORY and EXPIRATORY times see section 3 7 2 Controls the flow metering valve 3 Displays values for tidal volume or minute volume rate and I E Ratio on the front panel 4 Generates the appropriate messages and alarms Oxygen Monitor parameters O2 High Alarm O2 Low Alarm The parameters are set via the menu system see 3 5 4 17 DESCRIPTION 3 5 2 Power Switch OFF Electrical Circuit Condition Mains
93. utomatically switches to Spontaneous Mode PEEP is automatically switched off does not function in Spontaneous Mode PEEP display is blank 4 Bag Vent lever reset to Vent position 29 Ventilator automatically switches to Standby Mode PEEP is Off PEEP display indicates Off 5 Set ventilator to Volume Ventilation Mode PEEP remains Off Select PEEP if required 3 5 11 Alarm Mute When the alarm mute push button is depressed during an alarm condition the audible alarm will be muted as follows All mutable alarms except High Airway Pressure The mute button will silence the audible alarm for up to 120 seconds High Airway Pressure Alarm High Drive Gas Pressure Alarm The mute button will silence the audible alarm for up to 30 seconds A mute period countdown sequence in seconds is displayed on screen Mutable alarms will be immediately reinstated upon fresh alarm conditions Note that the alarms for Vent Inop ventilator inoperable and Low Supply Pressure are not mutable 3 5 12 Inspiratory Pause In volume ventilation mode depressing the INSP PAUSE button will allow a 25 inspiratory pause to be included at the end of the inspiratory phase The I E ratio will be maintained To compensate for the reduced inspiratory flow time period the inspiratory flow rate is increased up to a maximum flow rate of 75 litres per minute The inspiratory pause does not function in Pressure Ventilation mod
94. valve in the breathing system Adult bellows only Set the tidal VOLUME to 600 ml RATE to 10 bpm and RATIO to 1 2 0 Use the O2 flush button on the anaesthetic machine to fill the bellows Select VOLUME CYCLE mode The delivered tidal volume indicated on the scale printed on the bellows housing should be 600 ml If the delivered tidal volume is less than 500 ml or greater than 700 ml refer the ventilator to a Penlon trained engineer Occlude the patient Y piece The HIGH AIRWAY PRESSURE alarm should be activated The peak pressure read on the breathing system pressure gauge is the maximum working airway pressure limit and should agree with the setting Open the patient Y piece to ambient pressure At the second cycle the LOW AIRWAY PRESSURE alarm should be activated PRE OPERATION PROCEDURES 12 Select STANDBY mode Before using the ventilator clinically check that all connections are correct and verify that there are no leaks NOTE If there is any malfunction the ventilator must NOT be used If the problem cannot be rectified the ventilator must be checked by Penlon trained engineer 5 3 2 Weekly Checklist At least every week in addition to the daily function test 1 Select STANDBY MODE 2 Unplug the mains power cable from the AC outlet The MAINS FAILURE alarm should activate 3 Reconnect the mains power cable to the AC outlet The alarm should turn off
95. ventilator is used clinically Charging the battery for 14 hours from a discharged state will allow a minimum of 60 minutes of continuous operation Connect the ventilator to a mains power supply The mains power indicator will illuminate to show that the battery is being charged it is not necessary to turn on the ventilator Ventilator internal test Press the ON OFF switch A three second internal test is initiated 1 The power up screen is displayed 2 The audible alarm sounds one high tone one low tone 3 The ventilator reverts to STANDBY mode NOTE special operating system on ventilators interfaced with Prima SP see section 3 5 2 a Turn the Prima Sp Gas Delivery Switch to ON the ventilator will power up b While the Prima SP power is ON the Ventilator can be turned OFF and ON using the ventilator On Off switch c Turn the Prima SP Gas Delivery Switch to OFF The ventilator will power down 53 Function Test 1 10 11 Set the AIRWAY PRESSURE LIMIT to 50 cmH2O Check that the PRESSURE TRANSDUCER port on the rear of the control unit is correctly connected to the expiratory limb of the breathing circuit close to the circle system expiratory valve see operation 10 section 5 1 4 Connect the ventilator bellows base BREATHING SYSTEM port to the breathing system Connect a 2 litre breathing bag to the patient connection as a test lung Close the anaesthetic machine APL or PRV
96. xygen concentration The alarm can be muted for 120 seconds LOW O2 ALARM The low alarm is triggered when the oxygen concentration is 196 below the set value a The Low O2 Alarm visual indicator will illuminate b Ahigh priority audible alarm will sound To cancel this alarm the low alarm setting must be equal to or below the oxygen concentration The alarm can be muted for 120 seconds O2 SENSOR FAULT The alarm is triggered 1 when either the oxygen sensor is disconnected or approaching the end of its life ii if the O2 concentration exceeds 110 a The legend O2 SENSOR FAULT will illuminate 16 SOEN X Measured O2 concentration Value Oxygen Monitor Display b Ahigh priority audible alarm will sound To cancel this alarm check the sensor connection or replace the sensor The alarm can be muted for 120 seconds O2 SENSOR LOW This alarm indicates the sensor has approached the end of its life The legend O2 SENSOR LOW will be displayed and a low priority alarm single note will sound The sensor must be replaced as the output will fall very quickly to zero within two to three weeks of normal usage See section 7 5 for sensor replacement 3 4 5 Oxygen Monitor Alarm Mute In an alarm condition pressing the ALARM MUTE button will deactivate the audible alarm but the alarm message display will remain on screen The switch will illuminate and a single note will sound The alarm m

Penlon AV900 Ventilator - Frank`s Hospital Workshop

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