Baldus Touch 50 User manual

0483
MADE
IN
GERMANY
Instructions for use
02N20 MIXER FOR ANALGESIA
BALDUS® TOUCH 50/60/70
BALDUS® BAG T

– 2 –
Specialist in nitrous oxide sedation
and medical gases
WELCOME
to Baldus Medizintechnik GmbH
Baldus Medizintechnik GmbH
Auf dem Schafstall 5 · 56182 Urbar – Germany
& +49 (0) 261 / 96 38 926 - 0
+49 (0) 261 / 96 38 926 - 21
o[email protected]
www.baldus-medical.com

– 3 –
CONTENTS
1. Important information and intended use 5
2. Indications, contraindications and side eects 7
3. Nitrous oxide system components and technical specications 8
3.1 Front view and icons 8
3.2 Main menu 9
3.3 Sedation menu 10
3.4 Bag T 11
3.5 Back and side views 11
3.6 Technical specications 13
4. Scope of delivery and accessories 14
5. Assembly instructions 15
6. Safety and regular controls 18
6.1 General safety instructions 18
6.2 Safety features 19
6.3 Information signals and error codes 20
6.4 Regular checks 21
6.5 Ambient air contamination 23
7. Handling and hygiene 25
8. Eective troubleshooting 26
9. Frequently asked questions 26
10. Declaration of Conformity 27

– 4 –
Dated: 01/06/2017 0483
Inhalt nIcht sterIl /
Contents not sterile
Physicians using nitrous oxide have given our service a
1 (1.4) rating
You can trust the specialist in
MEDICAL GASES AND
INHALATION SEDATION SYSTEMS

– 5 –
1. IMPORTANT INFORMATION
AND INTENDED USE
Please read the entire instruction manual carefully prior
to initial operation to protect yourself and your patients
from operating errors! This instruction manual contains
instructions on checks which must be performed by the
practitioner before initial operation and periodically
thereafter. The checks are needed to ensure the unit and
its safety features are fully operational. Please keep this
instruction manual so that it can be consulted whenever
necessary.
Intended use
Specic percentages of medical nitrous oxide are added
to medical oxygen using the mixer. The patient remains
conscious, but is more relaxed and is no longer afraid of
the treatment. Various journals and studies have indi-
cated that nitrous oxide sedation up to a maximum of
70% nitrous oxide constitutes minimal sedation aimed
at achieving an anxiolytic eect (alleviating anxiety) in
patients. It is not an anaesthetic. The patient is awake
and breathing independently and can respond to exter-
nal stimuli. Some patients are not suciently sedated
with a level of 50% nitrous oxide. Accordingly, besides
the Baldus® Touch 50, which can administer maximum
50% nitrous oxide, there are also the Baldus® Touch 60
and 70 units, which are limited to maximum 60% and
70% nitrous oxide. Trained practitioners can therefore
decide for themselves the maximum nitrous oxide dose
they would like to administer. The nitrous oxide concen-
tration is tailored to the individual patient. The Baldus®
Touch 50, 60 and 70 units are designed for installation
in the Baldus® All-in-One-Cart, for example, or in plas-
terboard. The Baldus® Bag T is also compatible with ni-
trous oxide mixers from other manufacturers designed
for installation. Breathing bags and mask systems are
attached to the Bag T.
Important information
The oxygen-nitrous oxide mixer must not be combined
with anaesthetic equipment or used as anaesthetic
equipment. Adjusting the settings or system and open-
ing the mixer or Bag T are strictly forbidden, as this could
cause your patient serious harm. Any alterations to the
mixer or Bag T will invalidate all guarantees and warran-
ties.
Only accessories approved by Baldus® for the system
may be used. In case of faults or problems discontinue
the treatment with nitrous oxide immediately and con-
sult your instruction manual and/or contact your ser-
vice partner or the manufacturer Baldus Medizintechnik
GmbH (0049 261/ 96 38 926-0). Do not attempt to per-
form any repairs yourself or adjust the mixer. Never use
the unit without rst taking an advanced training course
on how to handle and use these units. Ensure to careful-
ly observe the content of the advanced training course
from which you obtained your certication and instruc-
tions from your service partner. The unit is only intended
for use in the medical eld and may only be used by a
physician to sedate patients with nitrous oxide and ox-
ygen where necessary. The oxygen-nitrous oxide mixer
must not be used for any other purpose.
Please take the medical history correctly, as conveyed
during the advanced training course. At the start of the
treatment, apply the pulse oximeter and increase the
concentration of N2O slowly, according to the individual
patient, until the patient is sedated. Never leave a sedat-
ed patient unattended! The breathing bag can be used
to monitor the sedation and should always be lled dur-
ing the sedation (can be ordered as an accessory, refer to
Section 4. Accessories and 7. Handling).
CAUTION! Any sedation must always be monitored
using a pulse oximeter with individual alarm limits
(refer to Section 4. Accessories)! Always keep spare
batteries ready for the pulse oximeter!
Pulse oximeter (can be ordered as an accessory, refer
to Section 4. Accessories): The pulse and oxygen satura-
tion level are vital parameters which indicate whether
the patient is doing well and the sedation is having an
eect. Sedation usually increases the oxygen saturation
level, lowers the pulse and relaxes the patient. If the ox-
ygen saturation level drops below an individually ad-
justable value, an alarm sounds on the pulse oximeter.
If a patient is being sedated with 20% nitrous oxide, for
example, 80% oxygen is being delivered. In other words,
the patient has a healthy oversupply of oxygen. If the
oxygen saturation level still falls below 85%, for exam-
ple, the nitrous oxide sedation must be stopped imme-
diately in case the nitrous oxide and oxygen have been
mixed up and 80% nitrous oxide is being delivered, for
instance. Ensure the oxygen and nitrous oxide have not
been mixed up (refer to Section 6.1 General safety infor-
mation: gas type check).
Delivering 100% nitrous oxide would harm your patient.
However, there is very little probability of this happening
as the manufacturer performs a gas type check. If the pa-

– 6 –
tient’s pulse is too high, this may indicate oversedation
(refer to Section 2). An alarm sounds to alert the practi-
tioner. In case of oversedation, reduce the nitrous oxide
immediately or set it to 0 and administer 100% oxygen
to the patient. If the oxygen saturation level indicated on
the pulse oximeter falls while 100% oxygen is being ad-
ministered, switch the unit o immediately and contact
your service partner. If the pulse is too low and the pa-
tient is too deeply sedated, an alarm signal also sounds
and the nitrous oxide must be reduced. It is essential
that information learned during the advanced training
course be adhered to!
Information on ambient air pollution
with nitrous oxide
The practising physician is responsible for ensuring the
rooms used are suciently ventilated and for complying
with the limit values for nitrous oxide concentration in
rooms. Observe the current Technical Rules for Hazard-
ous Substances TRGS 900 (occupational exposure limit
values) and TRGS 525 (Hazardous substances in health
care facilities). Take the table under Section 6 on reduc-
ing ambient air pollution through nitrous oxide into ac-
count.
A suction unit is compulsory and should have a
suction power of at least 45 l/min.! It must be moni-
tored using a vacuum control block (refer to Section
4. Accessories)!
Vacuum control block (can be ordered as an accessory,
refer to Section 4. Baldus® scavenger system accesso-
ries and instruction manual): The vacuum control block
is equipped with an inspection glass with indicator and
ball and a controller. The controller is used to adjust the
suction power. The suction unit is at the ideal setting
when the ball is in the indicated range.
Environment and disposal
The mixer and Bag T must be positioned in a splash-
proof area. If moisture or other contaminants enter the
unit a malfunction may occur. The unit must be stored at
a temperature between -5°C and 48°C (stabilise to room
temperature before operation). Return the unit to us for
disposal or observe the usual disposal methods.
CAUTION! It may be dicult to read the display
in bright environments, e.g. if a lamp or the sun is
shining directly on it. Ensure that the percentages are
set correctly, as incorrect settings may lead to overse-
dation, for example.

– 7 –
Contraindications:

(rhinitis, sinusitis)


personality disorders



bubble



- Consequence: neither employees of the dental
practice nor patients in the
rst or second trimesters may be exposed to nitrous
oxide
- Third trimester of pregnancy: Use following
careful indication
- Please note: in Sweden, 90% of mothers use nitrous
oxide during labour.
Nitrous oxide diuses into hollow spaces. Accordingly, it
should not be inhaled following a middle ear infection,
an intestinal obstruction, an eye operation with intraoc-
ular gas bubble, etc. In the last instance, for example, this
could lead to loss of sight or, at least, an unpleasant feel-
ing of pressure. Always take a medical history and observe
the content conveyed in the advanced training course.
Indications:



gag/swallowing reex

problems and asthma


Side eects:
The general side eects of nitrous oxide are very minor,
e.g. vitamin B12 deciency In case of continuous admin-
istration over two days.
Cardiovascular side eects:



Respiratory eects:


consider other forms of anaesthesia
No eect on:






the body
Complications of overdose
Precisely because of the risk of oversedation (e.g. light-
headedness, increase in pulse rate, discomfort), the prac-
titioner must be precisely trained on how to individually
titrate the nitrous oxide. In case of oversedation, either
reduce the nitrous oxide or press the O
2
ush button to
deliver 40-55 litres/minute of oxygen into the breathing
bag. Nitrous oxide is easy to control and has a rapid o-
set, i.e. oversedation passes quickly.
Nausea and vomiting:

combination with other anaesthetics/analgesics

therefore only administer more than 50% nitrous ox-
ide in exceptional cases. The average patient is already
optimally sedated at approx. 30-40% nitrous oxide.

important to turn his head to the side so there is no
risk of aspiration.
2. INDICATIONS, CONTRAINDICATIONS
AND SIDE EFFECTS

– 8 –
Psychomotor side eects

cause psychosomatic changes.

Psychiatric side eects

no data proving or indicating a teratogenic, mutagen-
ic or carcinogenic eect or changes to reproductive
health from nitrous oxide. Of course, it is still recom-
mended to take all measures to minimise the concen-
tration of nitrous oxide in the workplace.
Nitrous oxide sedation has already been used millions of
times and is routine in dental practices in places such as
-
atric dentists in the USA use nitrous oxide for sedation.
In Sweden, for example, 90% of mothers use nitrous ox-
ide during labour, although oxygen-nitrous oxide mixers
with a demand valve are used for this.
Baldus Medizintechnik GmbH does not guarantee that
the information is up to date, correct or complete. When
creating a medical history, please follow the content of
the advanced training course.
Oxygen-nitrous oxide mixer:
Controls and regulates the ow (gas ow rate) and per-
centage nitrous gas and oxygen concentrations. Con-
nector complies with the DISS standard (Diameter Index
Safety System).
3.1 Front view and icons
1. O2ush button: 100% pure oxygen immediately
ows into the breathing bag once the ush button is
pressed.
2. I/O button with LED:

the I/O button pressed for three seconds to switch the
unit to standby mode. If you press the I/O button during
sedation (sedation menu active), you will be asked if you
-
ton pressed for ve seconds to power down the Baldus®
Touch nitrous oxide mixer.




use
3. NITROUS OXIDE SYSTEM COMPONENTS

O2Flush
I/O button
Icon for
instruction manual
Icon
for manufacturer’s information
Icon
for dangerous voltage
Fig. 1: Baldus® Touch front view

– 9 –
NOTE: Baldus Medizintechnik GmbH is not liable for
any data loss. The operator/owner of the unit is re-
sponsible for data privacy and backups in relation to
patient data/sedation logs. We expressly recommend
that data be regularly exported to a USB stick and
stored in a secure data storage system.
The sedation logs are always saved in the unit language.
4. Settings: The Settings menu appears. There are
seven options.
4.1. Time/date: Any time and date can be set.
4.2. Volume: The information signal volume can be reg-
ulated and key sounds can be turned on and o.
4.3. Service: The dates of the last and next services, the
hardware and software versions, the max. N2O delivery
and the unit serial number are displayed. The service
hotline number is also shown.
4.4. Display % N2O: As delivered, the mixer is set up as
standard to display the percentage nitrous oxide being
delivered on the sedation display. If the user now presses
“Display % N2O”, the heading changes to “Display % O
2
”
and the percentage oxygen concentration is shown on
the sedation display. Summary: The nitrous oxide con-
centration is shown if “Display % N2O” is set and the oxy-
gen concentration if “Display % O
2
” is set. These settings
can be switched at any time.
4.5. 5% concentration increments: As delivered, the
mixer is set up as standard to add nitrous oxide to the
oxygen in 5% increments. If the user presses “5% con-
centration increments”, the heading changes to“1% con-
centration increments”and the nitrous oxide is increased
and reduced in 1% increments. Summary: The nitrous
oxide is increased/reduced in 5% increments if “5% con-
centration increments”is set and in 1% increments if“1%
concentration increments” is set. These settings can be
switched at any time.
3.2 Main menu
1. Start sedation with patient ID: A menu with letters
and numbers appears for adding a patient by name or
patient number. After clicking Enter, the sedation starts
immediately with a 5 l/min. total ow and 0% N2 
100% O
2
).
2. Start sedation with anonymous patient: The seda-
tion display is shown without having entered a patient
ID. Sedation starts immediately with 5 l/min. and 0% N2O

2
).
3. Recent patients: Shows the most recently treated pa-
tients, either anonymously or with the name/patient ID.
The treatment time, start of sedation, date, average total
ow, average N2O delivery in % and max. N2O delivery
are displayed. Sedation logs can also be deleted. Arrows
are used to click through the recent patients.
Sedation data can be saved to a USB stick, which can
be inserted on the left of the unit. For this, the operator
should click on the “Export data” button in the “Recent
patients” menu item. All data is saved to a directory on
the Baldus Touch. A .txt le is created for each patient.
During the export, all available data is copied to the USB
stick. The last 50 entries are displayed in the Recent Pa-
tients directory and can be individually deleted if nec-
essary.
If the unit is not powered down correctly (by keeping the
I/O button held for ve seconds), the le system may be-
come corrupted. This can happen even if the unit is only
ever powered down incorrectly once. Therefore, always
power down the unit before unplugging it. The sedation
log is only saved if the nitrous oxide sedation is ended
correctly. Accordingly, the last sedation log is not saved
if the unit is unplugged.
Main menuMain menu
Start
sedation with
patient ID
Start
sedation with
patient ID
Start
sedation
with anony-
mous patient
Start
sedation
with anony-
mous patient
Recent
patients
Recent
patients
SettingsSettings
Monday, 3 April 2017 11:03:02Monday, 3 April 2017 11:03:02

– 10 –
on the concentrations.
5. Recovery: Use the “Recovery” button to discontinue
sedation and start the recovery phase. When the but-
ton is pressed, you are asked to conrm if you really
wish to discontinue the sedation and start the recov-
         
user remains in the sedation display and the sedation
 
of the window, showing “Recovery phase: 5 min. 00
sec.”, and “Cancel countdown” now appears where pre-
viously there was “Recovery”. While the countdown
runs for 5 minutes (factory setting, can be changed in the
menu), 100% O
2
is delivered. However, if “Cancel count-
down” is pressed during this, you are asked in a pop-up
to conrm if you really wish to discontinue the recovery
-
covery phase is discontinued and the user remains in
 
The unit can be switched o after the countdown has
nished, otherwise the sedation display remains on.
6. Menu: When the Menu button is pressed, a window
appears asking: “Go back to the main menu?”
Options: Yes/No
No: The user remains in the Sedation menu.
Yes: The user is taken to the main menu and the se-
dation is discontinued.
4.6. Error memory: The last 20 error messages of the
unit can be viewed and saved. The memory can also be
deleted.
All errors are displayed in the maintenance menu.
4.7. Recovery time: The recovery time can be set here
individually as learned during the advanced training
course.
3.3. Sedation menu
1. Concentration controller 4. Concentration monitor
2. Flow regulator 5. Recovery
3. Mute button 6. Menu
1. Concentration controller: The ratio (mixture) of ox-
ygen to nitrous oxide can be set quickly and precisely
with one nger using the arrow keys on the left of the
display. There is a menu setting for dening whether the
percentage nitrous oxide or oxygen values should be
displayed. If N2O appears below the percentage beside
the arrow keys, the percentage relates to nitrous oxide. If
O
2
appears below the percentage beside the arrow keys,
the percentage relates to oxygen.
2. Flow regulator: The total ow (gas ow) in litres
per minute is set using the arrow keys on the right. The
breathing bag is lled using the upward arrow key, while
the ll volume is reduced using the downward arrow key.
3. Mute button: The check N2O information signal of
the unit is muted using the mute button. The check O
2
information signal cannot be muted. However, the O
2
signal sounds in greater intervals when the mute button
is pressed.
4. Concentration monitor: Graphical display of the ni-
trous oxide and oxygen ows, so that an eye can be kept
1
5
6
3
2
4
Fig. 2: Sedation menu display

– 11 –
3.4. Bag T
Connection to the gas supply hose (spiral hose):
A non-rebreathing valve prevents the patient from
breathing back into the breathing bag.
Bag connector: The breathing bag is attached here.
Ambient air valve: When the breathing bag is com-
pletely empty, the safety valve opens and the patient
breathes ambient air.
Nozzle: The hose linking the Bag T with the mixer is con-
nected here.
3. O
2
outlet: oxygen mask connector: The connector
for the O
2
demand mask is located at the back of the unit.
A non-return valve prevents oxygen escaping when no
mask is inserted. Optional: O
2
demand mask for general
emergencies in the practice. If a patient becomes dizzy,
for example, he can breathe in pure oxygen using the
full-face mask. The demand valve of the mask opens
on inhalation. If a patient is unconscious and no longer
breathing independently, he can be actively ventilated
by pressing the button. An oxygen mask is not manda-
tory with nitrous oxide sedation, but it is useful in the
practice in case of emergency. Use only the Baldus® De-
mand Mask in combination with the Baldus® Touch (refer
to Section 4. Accessories).
Fig. 3: Bag T
Connection to the
gas supply hose
Bag
connector
Ambient air
valve
Fig. 4: Baldus® Touch back view
3.5 Back and side views
1. Mixed gas outlet: outlet for the mixed gas
2. O
2
inlet/ O
2
/inlet: The white oxygen pressure hose is
attached here.
Fig. 5: Baldus® demand mask
Fig. 6: Baldus® Touch, view of the right side
4. N2O inlet: The blue nitrous oxide pressure hose is at-
tached here.
There is a connector for the power supply cable on the
right side.

– 12 –
The USB port is on the left. Sedation data can be saved
to a USB stick. For this, the operator should click on the
“Export data”button in the “Recent patients”menu item.
NOTE FOR THE OPERATOR:
USB stick le format: FAT32.
Possible sizes of up to 64 GB.
Fig. 7: Baldus® Touch, view of the left side
Fig. 8: The full Baldus® Touch system in the Baldus® All-in-One-Cart
BACK FRONT
All-in-One-Cart
N2O pressure hose
O2pressure reducer N2O pressure reducer
O2pressure hose
N2O compressed
gas cylinder
O2compressed
gas cylinder
Oxygen-nitrous oxide mixer
Breathing bag
Scavenger
system
Gas supply hose
(spiral hose)
Vacuum
hose

– 13 –
3.6 Technical data
PHYSICAL FEATURES
Mixer:
Dimensions: 135 x 300 x 120 mm (H x W x D)
Weight: 2.5 kg
Nitrous oxide/N2O inlet: DISS connector
oxygen-O2inlet: DISS connector
Bag T:
Diameter of the bag and
scavenger system connectors:

Back of the Bag T:
Gas administration
Maximum ow: 18 l/min.
Demand mask connector: 100 to 250 l/min.
PRODUCT VARIANT 1:
Baldus® Touch 70 (for installation)
Minimum O
2
concentration: 30%
Maximum O
2
concentration: 100%
Minimum N2O concentration: 0%
Maximum N2O concentration: 70%
PRODUCT VARIANT 2:
Baldus® Touch 60 (for installation)
Minimum O
2
concentration: 40%
Maximum O
2
concentration: 100%
Minimum N2O concentration: 0%
Maximum N2O concentration: 60%
PRODUCT VARIANT 3:
Baldus® Touch 50 (for installation)
Minimum O
2
concentration: 50%
Maximum O
2
concentration: 100%
Minimum N2O concentration: 0%
Maximum N2O concentration: 50%
PRODUCT VARIANT 4:
Baldus® Bag T
Compatible with Baldus® Touch 50/60/70, Matrx MDM-D
Cabinet Mount Digital Flowmeter, Porter Digital MDM,
Porter MXR-1 Cabinet-Mounted Flowmeter, Porter
MXR-D Digital Flowmeter and Accutron Digital Ultra™
Flushmount nitrous oxide unit
Fig. 10: Product variant 4: Baldus® Bag T
Fig. 9: Product variant 1-3: Baldus® Touch
(for installation)
Electrics
Input voltage: 110/230V AC
Input frequency: 50 – 60 Hz
Fuses: 2 x 1A, inert
Max. ambient temperature: 50°C
Power pack:
Protection class: I
Ampere: 1.0-0.55A
Inlet pressure
Inlet pressure: min. 3.5, max. 5 bar
The outlet pressure is less than 0.3 bar.
NOTE: All specications are subject to tolerances
during manufacture.
Non-continuous operation

– 14 –
Baldus Medizintechnik GmbH recommends the double
nasal mask scavenger system for the following rea-
sons:
Benets of double masks:


than with single masks

than a single mask system
-
ygen-nitrous oxide, the membranes in the inner mask
open and the mixed gas is suctioned via the outer
mask, double hose and vacuum hose and released
into the atmosphere.

sta from nitrous oxide.
Besides the oxygen-nitrous oxide mixer and Bag T in-
cluded in the scope of delivery, the following accesso-
ries, available from Baldus Medizintechnik GmbH, are
absolutely necessary for safety reasons during dental
sedation:
Item no. Product
16024-1
or
16030-1
Baldus® Double Nasal Mask
Scavenger System For Adults
or
Baldus® Double Nasal Mask
Scavenger System For Children
16002 Baldus® Vacuum Control Block
15021
Ultraslim N2O Cylinder Pressure Reducer
15020 Ultraslim O
2
Cylinder Pressure Reducer
16038-1 O
2
Pressure Hose
16038-2 N2O Pressure Hose

or


or

15016 Baldus® Holder for Cylinders
(e.g. cylinder trolley)
15018 
(e.g. OxyTrueA)
15030 Suction Unit (e.g. mobile
nitrous evacuator suction pump,
dental chair suction unit, etc.)
Item no. Product
51516160 
in the nitrous oxide system
15012 O2Breathing Mask: universal oxygen
breathing mask which can be connect-
ed to the nitrous oxide system. Option
of active and passive ventilation in
case of emergencies in the practice
The following accessories are not essential:

Item no. Aroma Item
16029-AA Apple
Baldus® Inner Masks, Adults
16029-PA Baldus® Inner Masks, Children
16029-ABlue Blueberry Baldus® Inner Masks, Adults
16029-PBlue Baldus® Inner Masks, Children
16029-ABub Chewing
gum
Baldus® Inner Masks, Adults
16029-PBub Baldus® Inner Masks, Children
16029-AE Strawberry Baldus® Inner Masks, Adults
16029-PE Baldus® Inner Masks, Children
16029-AV Vanilla Baldus® Inner Masks, Adults
16029-PV Baldus® Inner Masks, Children
16029-AG No
aroma
Baldus® Inner Masks, Adults
16029-PG Baldus® Inner Masks, Children
Baldus® Single-Use Inner Masks | contents: 25 units | delivered in acrylic glass

– 15 –
Risks of single masks:
Single masks are still approved for nitrous oxide treat-
ments, but the following risks should be considered:

oxide occupational exposure limit values (refer to
Section 6. Safety and regular checks, (e.g. 100 ppm in
Germany, refer to TRGS 900) are dicult with single
masks. That is why Baldus® does not oer single masks.

-
wendung in der Zahnheilkunde [Use of Nitrous Oxide
in Dentistry], 2014).
Delivery of gas cylinders
Gas cylinders can be obtained from Baldus Medizintech-
nik GmbH.
To place a gas order:
Tel.: [phone]
Fax: [phone]-21
Email: [email protected]
Use tested compressed gas cylinders only! For a decen-
tralised nitrous oxide system, order at least two 10-litre
oxygen cylinders and one 10-litre nitrous oxide cylinder
for safety reasons. The nitrous oxide cylinder must be
stored upright.
Always keep a spare oxygen cylinder on hand!
For a centralised gas supply, the gas cylinders and equip-
ment are located in a separate room and the gas ows to
the treatment rooms through medical copper pipes. Bal-
dus Medizintechnik GmbH, which is ISO 13485 certied,
can also install a centralised gas supply; 50-litre cylinders
are usually used.
The cylinders must stand securely and be protected from
tipping over using straps, for example (e.g. on a cylinder
trolley with straps, see photo).
Connecting pressure reducers
to the gas cylinders
It is not possible to mix up the nitrous oxide and oxy-
gen pressure reducers to the cylinders when connecting
them, as the connectors have dierent kinds of threads.

grease and NEVER use tools to tighten them. Tightening
by hand is sucient.
Do not open the cylinders too quickly, as otherwise the
pressure exerted on the pressure reducers and O-rings
may be too strong and these may have to be replaced
sooner. Spray the pressure ports with a leak detection
spray (solution of soap and water, see Accessories) to
identify any leaks.

INSTRUCTIONS
Fig. 11: Cylinder trolley
Fig. 12: Pressure reducer (left: N2O, right: O2)

– 16 –
Materials required (included in the scope of delivery):
Baldus® Touch, 4 Allen screws (size M5) and 4 washers
for the Baldus® Touch, connecting hose between the Bal-
dus® Touch and Baldus® Bag T, Baldus® Bag T, 4 screws
(size M3) and 4 washers for the Baldus® BagT, power sup-
ply cable
Baldus® Touch assembly:
Caution! Soiling can penetrate into the housing (e.g.
when installing in a wall), with the risk of an electric
shock or unit damage/destruction!
Connecting the pressure reducers
to the mixer
Use the blue pressure hose to connect the N2O pressure
reducer to the mixer. The white hose is therefore used
to connect the O
2
pressure reducer to the mixer. The
pressure hoses are mounted to the back of the mixer;
DISS connections with O-rings are used for this. As the
connectors are dierent sizes, there is no possibility of
confusion.
Assembling the Baldus® Touch mixer
and Baldus® Bag T
The Baldus® Touch oxygen-nitrous oxide mixer is in-
stalled in the Baldus® All-in-One-Cart or plasterboard
(at least 12.5 mm), see photos. The units must not be in-
stalled in carts which are not approved by Baldus®.
Fig. 13: Pressure reducers connected to gas cylinders
Fig. 14: Baldus®
All-in-One-Cart for
Baldus® Touch
designed for
installation
Fig. 15: Baldus® Touch dimensions in mm
1. Attach at a height at which the practitioner is ideally
looking straight on at the monitor.
2. Draw a mounting cut-out of 253 mm in width and
122 mm in height.
3. Now mark the holes for the 4 screws (size M5):
3.1. Go 8.5 mm from the top left and top right cor-
ners of the mounting cut-out to the respective
side and 11 mm downwards. In each case, draw
a point there for the centre of the rst two holes
(see illustration).

– 17 –
3.2. Go 8.5 mm from the bottom left and bottom
right corners of the mounting cut-out to the re-
spective side and 11 mm upwards. In each case,
draw a point there for the centre of the third and
fourth holes (see illustration).
4. Cut out the mounting cut-out using the right tool for
the material and use a 6-mm drill suitable for the ma-
terial to drill the 4 marked holes. The holes are each
8.5 mm in diameter.
5. Now attach the Baldus® Touch with the 4 screws (size
M5) and 4 washers included.


15 15
15
22
Baldus® Bag T assembly:
Fig. 15: 5 holes for the Baldus® Bag T, dimensions in mm
1. From the centre of the Baldus® Touch, go 180 mm
downwards and draw a point there. A hole for the
Bag T brass nozzle, to which the hose is connected,
will be bored there later.
2. Now mark the holes for the 4 screws (size M3):
2.1 From the point for the nozzle outwards, go 15
mm to the left and 15 mm upwards and draw
the rst point for the screws there.
2.2 Now go from the point for the nozzle out 15 mm
to the right and 15 mm upwards and draw the
second point for the screws there.
2.3 Now go from the point for the nozzle out 15 mm
to the right and 22 mm downwards and draw
the third point for the screws there.
2.4 Now go from the point for the nozzle out 15 mm
to the left and 22 mm downwards and draw the
fourth point for the screws there.
3. Then drill the holes: The hole for the Bag T nozzle is
22 mm in diameter. The four holes for the screws are
each 4.5 mm in diameter.
4. Now attach the Bag T with the 4 screws (size M3) and
4 washers.
Connecting the Baldus® Touch
to the Baldus® Bag T:
    
      
hot air blower to warm the hose so that it softens. When
it cools down, the hose contracts again, becoming hard
and absolutely gas tight. Also use a hot air blower to
help attach the other end of the hose to the mixed gas
outlet connector on the Baldus® Touch (see illustration).
Fig. 16:
Bag T with LW9 nozzle
Fig. 17: Connecting the Bag T to the Baldus® Touch
Mixed gas outlet
Connecting
hose
4 screws
of the Bag T

– 18 –
Connecting to the suction unit
When using a dental chair suction unit, insert the end of
the mask system vacuum hose into the large suction cup
without an adapter or to the saliva ejector of the small
suction cup using the white adapter. If you need both
suction cups for the treatment, please contact your chair
manufacturer and order an additional suction cup/T-
piece or order a nitrous evacuator from Baldus Medizin-
technik GmbH (see Accessories).
Now insert the included power supply cable into a 230
V socket.
Before operating the unit for the rst time, perform a
gas type check, inspect the safety mechanisms (refer to
Section 6) and use a leak detection spray to ensure gas
tightness!
Fig. 18: Connecting the hose
to the mixed gas outlet
Suction unit
White adapter
for saliva ejector of the
small suction cup

6.1 General safety information
By using double masks, you minimise the risk of ambient
air contamination.
Before the rst sedation, carry out
a gas type check and inspect the
safety mechanisms!
The operator is responsible for storing the gas cylin-
ders and units safely. Use with certified medical gases
only. Observe the fire safety regulations and the Or-
dinance on Hazardous Substances (Gefahrstoffverord-
nung). The gas types must be checked after installing
the mixer and accessories to rule out any mix up in the
gas types. To check the gas types, open just the oxy-
gen cylinder and set a total flow (e.g. 5 l/min.), ensur-
ing that the N2O concentration is 0%; the N2O cylinder
must be kept closed. Only oxygen should now flow if
everything has been connected correctly. If no gas is
flowing, do not use the nitrous oxide sedation under
any circumstances and contact the Service team im-
mediately.
Caution: The control valves are hot; the
service partner must let them cool down before
maintenance/replacement.
Ensure that the high-pressure valves of the gas cylinders
are always opened slowly. Quick opening may cause the
pressure reducers to malfunction or lead to defects in
the mixer. Before any treatment, ensure there is su-
cient pressure in the gas cylinders to complete the pa-
tient’s treatment without a gas running out (refer to the
ll level calculation below). If the pressure gauges on the
pressure reducers show less than 50 bar of oxygen (O2)
or 30 bar of nitrous oxide (N2O) (with 10-litre cylinders),
do not perform any further treatments with nitrous ox-
ide. Also observe the cylinder pressure during the treat-
ment. For a decentralised nitrous oxide system, order at
least two 10-litre oxygen cylinders and one 10-litre ni-

– 19 –
trous oxide cylinder for safety reasons. The nitrous oxide
cylinder must be stored upright.
Caution! Before any sedation, always check the
residual pressure in the O
2
cylinder (at least 50 bar
with 10-litre cylinders)! Always keep a spare oxygen
cylinder on hand!
Oxygen ll level calculation:
200 bar gaseous/10-litre O
2
cylinder
Example: The oxygen cylinder pressure gauge
indicates 200 bar (full cylinder)
200 bar working pressure x 10 l (gas cylinder volume)

by 5 l/min. ventilation

If the oxygen cylinder indicates 200 bar, a
treatment of approx. 400 minutes is still possible.
Nitrous oxide ll level calculation:
Nitrous oxide is initially in a liquid state. Pressure drops
are only discernible on
the pressure gauge when it becomes gaseous.
With nitrous oxide, it is dicult to estimate how long
a cylinder will last (10 l cylinder approx. 650 minutes).
~50 bar liquid/10-litre N2O cylinder
Example: Pressure drops to 40 bar
 -
ume)

Ventilation (50% nitrous oxide)
If the nitrous oxide cylinder indicates 40 bar, a
treatment of approx. 114 minutes is still possible.
To identify the gases, the cylinders are colour-coded
white for O
2
and blue for N2O. Alternatively, colour-neu-
tral labelling can also be used.
NOTE: Nitrous oxide: blue, oxygen: white
Both nitrous oxide and oxygen are re accelerants.
CAUTION! -
ly cylinders and pressure reducers, free of oil and
grease to prevent the risk of explosion!
If there is a power outage, administer 100% oxygen to
your patient to discontinue the nitrous oxide sedation
and start the recovery phase. If you do not have any ox-
ygen supply due to the power outage, remove the mask
from the sedated patient and let him exhale the nitrous
oxide through the ambient air. Depending on the nitrous
oxide concentration administered, the patient should
only leave the practice after approx. 30-60 minutes.
6.2 Safety features
Baldus® Touch has the following
safety features:
•Self-test:For the self-test, one gas is sent at a time
across the measurement section. The unit then rec-
ognises whether one or both kinds of gases are not
owing. If one of the two gases is not owing, the unit
immediately indicates this and it indicates visually and
acoustically that the relevant gas is not owing. The
self-test is performed every time the unit is switched
on (from standby mode as well).
•O2ush button: 100% oxygen is delivered as long as
the red button is kept pressed.
•Acousticandvisualinformationsignals:Acoustic and
visual information signals
•Recoveryatthepressofabutton:Recovery at the
press of a button
•One-ngertipcontrol:The ow set at the beginning is
not changed by the addition of particular percentages
of N2O to the mix. Therefore, the depth of sedation can
be adjusted in just a few steps.
if the breathing bag is empty
to prevent rebreathing
if there is a lack of oxygen
•ConnectorfortheO
2
emergency mask
•Gastypecoding:You can quickly tell which gas is
which from the dierent colour-coding for the gas
types on the pressure hoses and gas cylinders. Please
note that in case of medical gases used in Germany,
nitrous oxide is coded blue and oxygen white. The
connectors are dierent sizes to prevent confusion.

– 20 –
2. Check N2O: If no nitrous oxide is being supplied,
the unit emits visual and acoustic information signals.
This also happens if the pressure is too low or there is a
measurement section failure. The visual “Check N2O” sig-
nal appears in the top right of the sedation display and
the N2O bar on the bottom right is shaded red. A “Check
N2O gas supply” pop-up window appears and must be
acknowledged. In addition, an acoustic information sig-
nal is audible. This event is recorded in the error memory
log. Pure oxygen can still be administered to the patient,
however the sedative eect will wear o without the ni-
trous oxide. The settings in the Sedation menu can still
be changed. The alert disappears once N2O ows across
the measurement section again. The check N2O informa-
tion signal of the unit is muted using the mute button. If
the cause is an empty nitrous oxide cylinder, replace the
cylinder. If the alert has been caused by something else,
please contact the Service team.
6.3 Information signals and error codes
Information signals
The information signals are shown in the top right of the
display.
1. Check O
2
:If no oxygen is being supplied, the unit
emits visual and acoustic information signals. This also
happens if the pressure is too low or there is a measure-
ment section failure. The visual“Check O2”signal appears
in the top right of the sedation display and the O
2
bar on
the bottom right is shaded red. A “Check O2gas supply”
pop-up window appears and must be acknowledged. In
addition, an acoustic information signal is audible. This
event is recorded in the error memory log. The sedation
continues, but without N2O and therefore without gas
ow. Accordingly, the unit has a nitrous oxide lock: The
unit switches o the nitrous oxide ow immediately if
there is a lack of O
2
. The patient will not suocate if the
oxygen cylinder is empty and the practitioner forgets to
remove the mask. Instead, the emergency valve on the
Bag T opens and the patient breathes in the ambient
air. The alert disappears once O
2
ows across the meas-
urement section again. The check O
2
information signal
cannot be muted. The O
2
signal sounds in greater inter-
vals when the mute button is pressed. If the cause is an
empty oxygen cylinder, replace the cylinder. If the alert
has been caused by something else, please contact the
Service team.
Fig. 19: Sedation display, check O
2
Fig. 20: Sedation display, check N2O
3. O
2
minimum ow 1l/min.: Visual and acoustic sig-
nals: The O2minimum ow is 1 l/min. The mixture ad-
ministered can never contain less than 1 litre of O
2
. This
is displayed visually in the top right. The total mixture
volume is never less than 3 l/min.
Fig. 21: Sedation display, O2minimum ow 1l/min.