OES_Carina Anes_Ventilator
Contents
1. 14 Rear illustration Simca e OWO c ZI S 1 Mains inlet socket 2 Mains Fuses 3 Pressure relief valve exhaust 4 Drive gas exhaust 5 Ventilator bellows driving gas connecter 17 mm taper 6 High pressure oxygen inlet 7 Manometer connector 8 Solenoid and spool valve exhaust port 9 Bellows 22 mm Patient connection 10 Bellows 30 mm scavenging connection 11 Bellows unit drive gas connector 15 Adult bellows assembly Bellows base assembly The bellows base assembly is attached to the top of the ventilator case and incorporates an o seal for the bellows housing to seal against and an o seal to seal between the bellows base and the exhaust gas diaphragm assembly An exhaust valve seat which allows the escape of exhaust gas to the bellows exhaust port on the rear of the assembly at the end of the expiratory phase is situated in the centre of the assembly WARNING care must be taken not to damage the exhaust valve seat Bellows base screws Thumb screws which hold the bellows base to the top of the ventilator case 4 off Exhaust diaphragm assembly This assembly contains a diaphragm and a sealing disc which seals on the exhaust valve seat in the bellows base during the expiratory phase Exhaust diaphragm assembly screws Thumb screws which hold the diaphragm assembly onto the bellows base assembly 3 off Adult bellows The bellows are attached to t2. 7 Ventilator to bellows connection 17 mm taper 8 Bellows to patient taper 22 mm taper to BS 3049 9 Bellows exhaust gas taper 19 mm taper 10 Inspiratory time range 0 25 to 3 0 seconds 11 Expiratory time range 0 5 to 6 0 seconds 12 Frequency range 6 6 to 80 breaths per minute derived from inspiratory and expiratory times 13 Inspiratory gas flow rate 0 1 to 1 0 litre per second of oxygen 14 Tidal volume range 0 025 to 3 0 litres per breath derived from inspiratory time and inspiratory flow rate Note the maximum tidal volume which can be achieved is 1 6 litres due to the capacity of the bellows 15 Minute volume range derived from tidal volume and frequency 16 Maximum relief pressure 80 CM H20 17 LE ratio variable between 1 1 and 1 24 22 18 Weight 8 0 Kg 19 Dimensions height of complete ventilator 340 mm width 300 mm depth 260 mm 20 Sterilisation for details on bellows assembly sterilisation see appropriate section 22 Adjustable low pressure alarm 0 30 cm H20 23 Adjustable high pressure alarm 10 70 cm H20 24 Mute button 15 seconds 25 Patient audible and visual alarms for disconnect low airway pressure high airway pressure high continuous pressure and sub ambient pressure 26 Ventilator alarms for mains failure low battery and low drive gas pressure 27 External power supply 90 264 volts A C 28 Batter
3. User notes Service and repairs In order to achieve the full operational life of the CARINA ANAESTHESIA VENTILATOR the following service schedule must be adhered to Three monthly inspection and service check Six monthly bellows replacement Two yearly replacement of exhaust diaphragm and battery Five yearly overhaul a b C d nn ra re Service reguirements are detailed in the service manual that is available to factory trained personnel Further details are available from The Service department OES MEDICAL LTD UNIT 10 AREA D RADLEY ROAD INDUSTRIAL ESTATE ABINGDON OXFORDSHIRE OX14 3RY ENGLAND Phone 01235 539618 Fax 01235 539619 Always provide the following information with any communication Type of product and part number Product name Warnings and cautions Throughout this manual warnings and cautions relating to various aspects of use of this ventilator are given It is the responsibility of the user to read this manual and fully understand the functions of this ventilator prior to use No clinical advise on the use of this ventilator is given or implied within this manual the various technical functions are described and it s use by the anaesthetist must be based on safe best clinical practice using all necessary additional patient monitoring considered necessary for patient safety The use of patient monitoring during the use of this anaesthesia ventilator is essent
4. base thumb screws 4 off Pole mount bracket ASTRA anaesthesia machine dovetail bracket 33 User notes 34
5. certain alarm conditions such as disconnect high airway alarm apnea and continuous positive airway pressure Low drive gas pressure cannot be muted Trigger point alarm adjustment The minimum patient airway circuit pressure is adjustable between 0 and 30 cm H20 The value set on the trigger point is the pressure that the patient circuit must reach or exceed during the inspiratory phase failure to reach this pressure will result in an instant disconnect alarm During the expiratory phase the patient circuit pressure must drop below the trigger point setting failure to do so will result in a continuous positive airway pressure alarm C P A P High pressure alarm adjustment The maximum patient airway pressure is adjustable between 30 and 70 cm H20 The value set on the high airway pressure alarm must be set just above the maximum required airway pressure to prevent an alarm during normal use During the inspiratory phase if the patient circuit pressure reaches the maximum airway pressure there is an instant high pressure alarm and the inspiratory flow is stopped with the ventilator going into expiratory mode for the balance of the inspiratory time Bellows unit assembly The bellows canister is marked with a scale which allows the tidal volume to the patient to be determined with bellows movement Further information on the bellows unit assembly is given on page 16 17 and 18 10 Front illustration 1 On off switc
6. balance of the inspiratory time If the trigger point setting is not reached during the inspiratory phase the disconnect alarm will sound Failure to drop below the trigger point during the expiratory phase will cause the continuous positive airway pressure alarm to sound Note the LED alarms latch to indicate what the alarm was these are reset by pressing the mute button 20 Calculations for breaths per minute 1 E ratio minute and tidal volume Breathes per minute is determined in the following way B P M 60 Inspiratory time Expiratory time The I E ratio is determined in the following way Inspiratory time I E Ratio Expiratory time Note the electronics of the ventilator prevents inverse I E ratios from being selected the minimum expiratory time is the same as the set inspiratory time The tidal volume is determined in the following way Tidal volume Inspiratory time x flow rate The tidal volume is determined in the following way Minute volume Tidal volume x breathes per minute 21 Specification 1 Application adult and paediatric ventilation during anaesthesia 2 Gas supply oxygen 3 Gas supply pressure 275 to 840 KPA 4 Gas supply hose 1 5 metres of white anti static hose fitted with a DISS fitting 5 Hose end mini Schrader or special order as required 6 Patient airway pressure gauge 63 mm diameter aneroid pressure gauge with 20 to 100 cm of water
7. g gently at the front Warning ensure that the cover is not levered off on one of the location lugs on the bellows housing 2 Pull the bellows gently off the bellows base 3 Unscrew the exhaust diaphragm from the bellows base Warning Do not lose the o seal which seals between the bellows base and the expiratory diaphragm Warning Do not damage the exhaust seat or the seat on the exhaust diaphragm ITEM Bellows housing Bellows Exhaust diaphragm assembly Bellows base assembly STERILISATION METHOD Warm mild detergent solution no abrasive cleaner or alcohol Gas or liquid Such as cidex Sporicidin and Sonacide Gas or liquid Gas liquid or low temperature autoclave 32 Ordering information 9050 200 9060 001 9060 010 9060 011 9060 012 9060 020 9060 015 9070 001 9070 002 9070 003 9070 004 9070 005 9070 006 9070 007 9050 005 0000 000 OES CARINA anaesthesia ventilator 1 5 metre oxygen drive hose DISS to open end Corrugated drive gas hose 265 mm Corrugated drive gas hose 1500 mm for remote mounting of the bellows Patient breathing system drive hose 1800 mm Breathing system pressure tee piece 22 mm male female taper Pressure sensing tube silicone 2 5 metres Adult bellows assembly Adult bellows housing Adult bellows Exhaust diaphragm assembly Exhaust diaphragm assembly screws 3 off Bellows base assembly Bellows
8. h 2 Expiratory time adjustment 3 Flow adjustment 4 Inspiratory time adjustment 5 Airway pressure gauge 6 Mute button 7 LED alarm displays 8 Trigger point adjustment 9 High pressure alarm adjustment 10 Bellows assembly 11 Rear panel description Mains inlet socket The ventilator mains inlet supply is provided by a IEC style socket Mains fuses Fuses are provided on both live and neutral and are 360 mA The fuses are mounted in a holder which is an integral part of the mains inlet socket Pressure relief valve exhaust port The ventilator incorporates an over pressure relief valve which acts as a fail safe should the electronic high pressure alarm fail to activate This exhaust port allows the drive gas to exhaust to atmosphere when the set pressure on the high pressure alarm is exceeded WARNING do not attempt to block the exhaust port Drive gas exhaust port The exhaust port which allows the drive gas to be exhausted from within the bellows canister the outside of the bellows as the bellows rise during the expiratory phase This function is controlled by a silicone diaphragm which is inflated during the inspiratory phase and deflates to allow gas flow during the expiratory phase WARNING do not attempt to block the exhaust port Ventilator bellows driving gas connector A 17 mm male taper which connects to the bellows drive gas connector with a flexible corrugated tube 12 High pressu
9. he bellows base assembly by the lower convolution on the shoulder of the bellows base assembly Warning care must be taken to ensure that the bellows is attached by it s bottom convolution onto the bellows base shoulder Failure to attach the bellows properly will result in the bellows drive gas diluting the patient circuit gas with potentially serious consequences 16 Adult bellows housing The adult bellows housing is located on the bellows base assembly by the location ring on the bellows base assembly it is then locked in position by twisting clockwise until the lugs are located in the bellows base assembly 17 Bellows assembly illustration 1 Bellows base 2 Bellows base screw 3 Exhaust diaphragm assembly 4 Exhaust diaphragm assembly screws 5 Bellows 6 Bellows cover 18 Ventilator cycle description 1 The bellows prior to the start of the inspiratory phase is fully inflated by the fresh gas flow from the anaesthetic machine and retains this position due to the weight of the exhaust diaphragm valve giving a slight back pressure within the bellows 2 Atthe start of the inspiratory phase drive gas from the ventilator enters the inside of the bellows housing and forces the bellows down driving the patient gas within the bellows into the breathing circuit During the inspiratory phase the ventilator exhaust diaphragm inflates blocking the exhaust port and the bellows exhaust diaphragm is held shut b
10. ial for patient safety Purpose The OES ORION VENTILATOR is an electronically controlled anaesthesia ventilator with bellows unit designed for mechanical ventilation during anaesthesia It can be used in closed circuit anaesthesia and to drive a Bain circuit Description The OES CARINA VENTILATOR is a time cycled flow generator type ventilator that is provided with an ascending bellows unit which is easily detachable for cleaning Controls are provided for inspiratory time expiratory time flow rate and basic patient and ventilator alarm functions Front panel description On Off switch The on off switch is located on the top right hand side of the front panel Expiratory time control knob Calibrated between 0 5 and 6 0 seconds Rotation of the knob in a clockwise direction increases the expiratory time The expiratory time is electronically controlled Flow control knob Calibrated between 0 1 and 1 0 litres per second Rotation of the grooved knob in an anti clockwise direction increases the flow rate The tidal volume delivered to the patient is determined in the following way Tidal volume inspiratory time x flow rate litres seconds litres per second Inspiratory time control knob Calibrated between 0 25 and 3 0 seconds Rotation of the knurled knob clockwise increases the inspiratory time The inspiratory time is electronically controlled Airway pressure gauge Calibrated between 20 to 100 c
11. ircuit 6 Patient breathing system drive hose connect the 22 mm female taper to the bellows breathing system taper connect the other end to the patient circuit 7 Scavenging system connect the exhaust port on the bellows unit to a scavenging system Warning the anaesthetic gas scavenging system must not generate more than 0 5 cm H2O of negative or positive pressure Failure to comply with this requirement will result in positive or negative pressure within the breathing circuit 25 Pre use function test 1 Ensure that the ventilator is correctly connected refer to the ventilator set up procedure 2 Set the adjustable pressure relief valve to the required setting 3 Set the desired inspiratory time 4 Set the desired expiratory time 5 Set the desired flow rate 6 Set the trigger point alarm 7 Set the high pressure alarm 8 Attach a 2 litre breathing bag to the patient connection as a breathing bag 9 Fill the bellows by using the anaesthetic machine oxygen flush 10 Turn the ventilator on and ensure that the ventilator delivers the correct tidal volume this can be checked by the scale on the adult bellows housing or by using a flow sensor 11 Adjust the flow rate and or the Inspiratory time to achieve a circuit pressure low than the trigger setting and ensure that a disconnect alarm occurs Check the mute button function 12 Prevent the circuit pressure dropping bellow the trigger
12. m of water the gauge must be connected to the inspiratory limb of the breathing circuit via the connector on the rear panel The manometer is also connected internally to the pressure transducer on the electronic patient monitoring board Mute button The mute button gives 15 second of alarm silence The mute only applies to disconnect alarms LED alarm displays Displays are provided to show the following ventilator conditions Mains supply indicates that the ventilator is running from mains power Low battery indicates that the battery reguires charging normally due to use for to long without the mains power connected Low drive gas pressure indicates a low oxygen drive gas pressure below 40 psi High airway pressure alarm indicates that the patient airway pressure has exceeded that set on the adjustable high airway pressure alarm Disconnect alarm indicates that the patient circuit pressure has not exceeded the trigger point setting which would suggest that the tidal volume is to low or that the patient connection has become disconnected Continuous positive airway pressure alarm indicates that the patient circuit pressure has not dropped below the set trigger point during the expiratory phase Apnea alarm indicates a negative pressure within the patient circuit of at least 5 cm H20 Mute indicates that the alarm has been muted for 30 seconds Note that this function is only available for
13. point and ensure that a continuous high pressure alarm occurs 11 Remove the breathing bag and occlude the end of the patient connector 12 Refill the bellows with the oxygen flush 26 13 Turn the ventilator back on and check that the patient circuit relieves at the set level on the high pressure alarm 14 Turn off the mains power supply and ensure that the mains failure LED comes on 15 Disconnect the high pressure oxygen supply and ensure that the low drive gas pressure LED comes on accompanied by the audible alarm 27 Clinical operation 1 Prior to use with a patient check that all connections are correct and that there are no leaks 2 Perform the pre use function test 3 Set the desired ventilator parameters Warning The actual ventilation of the patient may vary from the set ventilator parameters due to compliance and circuit leaks The patient ventilation must be monitored independently from the ventilator It is the responsibility of the user to monitor patient ventilation The use ofthis ventilator is recommended with anaesthetic agent and oxygen analysers 28 Fault finding Fault condition When the ventilator is turned on it does not cycle Bellows will not fill or it collapses Bellows collapses progressively during use with normal fresh gas flow Tidal volume is incorrect Possible cause 1 The oxygen high pressure hose is not connected 2 The oxygen supply is no
14. re oxygen inlet A 1 5 metre long high pressure hose is supplied for connection to the DISS oxygen inlet connector with the other end suitable for connection to a mini Schrader style connector on the anaesthesia machine Manometer connection This connects to the 2 5 metres of silicone tube and the 22 mm taper male female sensing tee which must be placed in the inspiratory limb of the patient breathing circuit Solenoid and spool valve exhaust port The ventilator cycle is controlled by a solenoid driven by the electronic circuit this solenoids function is to activate a pneumatic spool valve Both the solenoid and spool valve reguire high pressure oxygen to be exhausted at the start of the expiratory phase or when the high pressure alarm setting is reached this gas is exhausted through this port Bellows unit patient connection A 22 mm male taper connection which connects to the patient circuit via 1 8 metre length of disposable corrugated tubing 13 Bellows unit exhaust port A 30 mm taper to which the anaesthetic gas scavenge system must be connected WARNING the anaesthetic gas scavenging system must not generate more than 0 5 cm H20 of negative or positive pressure Failure to comply with this requirement will result in positive or negative pressure within the breathing circuit Bellows unit driving gas connector A 17 mm taper which connects to the ventilator bellows drive gas connector via a flexible corrugated tube
15. t turned on 1 No fresh gas flow 2 Breathing system hose disconnected 3 Detached or damaged bellows 4 Damaged exhaust diaphragm assembly 5 Missing or damaged o seals 6 Damaged bellows base assembly 1 Anaesthesia machine APL valve may be open 2 Breathing system leak 3 Damaged exhaust diaphragm assembly 4 Missing or damaged o seal at exhaust diaphragm assembly 1 Missing or damaged o seals 2 Damaged exhaust diaphragm assembly 3 Partially detached bellows 4 High compliance 5 low oxygen inlet pressure User maintenance Service schedule The ventilator must be serviced by a factory trained engineer to the following schedule a 3 monthly inspection and function check b 6 monthly bellows replacement c 2 yearly replacement of exhaust diaphragm and battery d 5 yearly major service 30 Cleaning of the ventilator control unit The ventilator control unit must only be cleaned with a damp cloth and if necessary with warm mild detergent to remove persistent grime Warning do not allow the cleaning liquid to enter the control unit Warning do not use harsh or abrasive cleaning agents on any parts of the ventilator 31 Cleaning and sterilisation of the bellows unit To disassemble the bellows assembly for cleaning and sterilisation 1 Twist the bellows housing anticlockwise until the location lugs clear the bellows base then lift it off by pushin
16. www ardusmedical com OES MEDICAL USER MANUAL CARINA ELECTRONIC ANAESTHESIA VENTILATOR Index Index Service and repairs Warnings and cautions Purpose Ventilator description Front panel description On off switch Expiratory time adjustment Flow adjustment Inspiratory time adjustment Airway pressure gauge Mute button LED alarm displays Trigger point adjustment High pressure alarm adjustment Bellows assembly Front illustration Rear panel description Mains inlet socket Mains fuse Pressure relief valve exhaust Drive gas exhaust Ventilator driving gas connector High pressure oxygen inlet Manometer connector Solenoid and spool valve exhaust Bellows patient connection Bellows unit exhaust port Bellows unit drive gas connector Rear panel illustration Adult bellows description Bellows base assembly Bellows base screws Exhaust diaphragm assembly Exhaust diaphragm screws Adult bellows Adult bellow housing Adult bellows assembly illustration Ventilation cycle description Electronic pneumatic circuit description 2 WO OOOOOOOSODO RN Breath per min tidal volume and I E ratio calculations Specification Ventilator standard parts Ventilator set up procedure Pre use function test Clinical operation Fault finding User maintenance service schedule Cleaning of the control unit Cleaning and sterilisation of the bellows unit Ordering information
17. y back up 12 hours minimum 23 Ventilator standard parts The ventilator is supplied with the following standard parts 1 High pressure drive hose specification as per order 2 Ventilator to bellows drive hose 3 Manometer tube 4 Pressure sensing tee piece 22 mm male female taper 5 Patient breathing system drive hose with male and female 22 mm taper connectors 1 8 metre long 6 Mains cable 7 User manual 24 Ventilator set up procedure 1 Mounting the ventilator the ventilator can be mounted either on the anaesthetic machine shelf on the ASTRA anaesthesia machine dove tail bracket or on to a pole mount bracket plate to suit diameter 25 0 25 4 mm poles It is attached by removing the feet from the ventilator and attaching the bracket in its place This plate is an optional extra see the spares section for details 2 High pressure hose assembly attach the hose to the ventilator care must be taken to attain a leak free seal without over tightening the fitting Attach the other end of the hose assembly to the high pressure oxygen supply 3 Ventilator to bellows drive hose attach the corrugated hose to both the ventilator drive gas taper and the bellows drive gas taper 4 Mains power supply cable 5 Manometer tube attach the silicone tube to the manometer connection on the rear panel place the pressure sensing tee piece in the inspiratory limb of the patient breathing c
18. y the pressure of the drive gas flow from the ventilator 3 At the start of the expiratory phase the flow of drive gas from the ventilator ceases and the ventilator exhaust diaphragm deflates This allows the drive gas within the bellows housing to exhaust through the ventilator drive gas exhaust port as the bellows rise with the exhaled gas Excess exhaled gas exhausts through the bellows exhaust port into the scavenging system 19 Pneumatic and electronic circuit description The pneumatic circuit consists of a spool valve and an electrical solenoid valve which control the flow of high pressure gas to the flow control valve and low pressure oxygen to the exhaust diaphragm The spool valve is controlled by the electronic circuit which during the inspiratory phase opens the solenoid This in turn opens the spool valve to give a flow of oxygen to the flow control needle and also pressure from the low pressure regulator to inflate the ventilator exhaust diaphragm At the expiratory phase the electronic circuit shuts the solenoid and the spool valve closes the pressure in the exhaust diaphragm is exhausted through the exhaust port on the rear of the ventilator and the diaphragm deflates allowing the bellows to rise as the expired gas is driven back into the bellows from the patient During use the inspiratory flow rate is stopped if the high pressure alarm setting is exceeded the ventilator then goes into expiratory mode for the
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