Dräger Medical Narkomed GS Assembly instructions

Narkomed GS
Anesthesia System
Date: 30 January 2004
© 2004 Draeger Medical, Inc.
Instruction
Manual
Operator’s
Part Number: 4113801-007
Rev: G
WARNING: For a full understanding of the performance characteristics of this anesthesia
machine, the user should carefully read this manual before operating.
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Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual
Contents
Section 1. Introduction
Operator's Responsibility for Patient Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Limitation of Liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Restriction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Copyright . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Trademark Notices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Disclaimer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Symbol Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Purpose of This Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5
How This Manual Is Organized. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5
Conventions Used in This Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
General Warnings and Cautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
Section 2. General Description
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Gas Delivery System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Vaporizers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
Absorber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
Bain Circuit Adapters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
Scavenger Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
AV2+ Ventilator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-20
Main Switch Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-22
Power Supply System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-23
Sensor Interfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-26
Monitoring System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-27
Monitor Screen and Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-27
Alarm System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-28
Manual Sphygmomanometer (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-30
Section 3. Daily Checkout Procedure
Daily Checkout Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Section 4. Preuse Checkout
Preuse Checkout Procedure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
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ii Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
Section 5. Gas Delivery System
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-2
Connecting the Pipeline Gas Supply. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-2
Connecting the Gas Cylinders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-3
Connecting the Fresh Gas Hose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-5
Adjusting the Gas Flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-5
Using the Oxygen Flush . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-5
Section 6. Vaporizer
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-2
Filling Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-2
Exclusion Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-3
Installing/Removing the Vapor 19.3 Vaporizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-5
Selecting a Vapor 19.3 Vaporizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-6
Operating the Vaporizers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-6
Filling the Vaporizer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-7
Filling the Vaporizer During a Case. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-8
Draining the Vaporizer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-13
Section 7. Open Reservoir Scavenger
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-2
Connecting the Open Reservoir Scavenger System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-3
Operating the Open Reservoir Scavenger System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-4
Section 8. Scavenger Interface for Passive Systems
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-2
Operating the Scavenger Interface for Passive Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-3
Section 9. Main Switch Panel
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-2
System Power Switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-3
Testing the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-3
Section 10. AV2+ Anesthesia Ventilator
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-2
Activating the Ventilator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-3
Adjusting the Tidal Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-5
Setting the Respiratory Frequency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-5
Setting the Inspiratory/Expiratory (I:E) Phase Time Ratio. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-6
Setting the Inspiratory Flow Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-6
Setting the Inspiratory Pressure Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-6
Problem Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-7
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Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual iii
Section 11. Monitoring System
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-2
Power-On Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-2
Monitor Screen and Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-3
Configuring the Anesthesia Machine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-7
Setting Alarms to Standby. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-10
Silencing Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-10
Section 12. Oxygen Monitoring
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-2
Monitor Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-2
Monitor Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-3
Setting Alarm Limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-3
Calibrating the Oxygen Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-4
Unsuccessful Calibration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-6
Oxygen Alarm Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-8
Low Oxygen Supply Whistle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-9
Problem Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-9
Section 13. Respiratory Volume Monitoring
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-2
Monitor Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-3
Monitor Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-4
Setting the Minute Volume Low Alarm Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-5
Turning Respiratory Volume Alarms Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-5
Turning Respiratory Volume Alarms On . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-5
Respiratory Volume Alarm Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-6
Problem Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-8
Section 14. Breathing Pressure Monitoring
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-2
Choice of Breathing Pressure Monitoring Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-2
Installing the Breathing Pressure Pilot Line. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-4
Monitor Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-6
Monitor Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-10
Setting the Pressure High Alarm Limit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-10
Setting the Threshold Pressure Alarm Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-11
Turning the Apnea Pressure Alarm Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-14
Turning the Apnea Pressure Alarm On . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-14
Breathing Pressure Alarm Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-14
Problem Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-16
Section 15. Manual Sphygmomanometer
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-2
Selecting a Blood Pressure Cuff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-3
Connecting the Cuff. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-3
Placing the Cuff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-4
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iv Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
Section 16. Routine Maintenance and Cleaning
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-2
Routine Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-2
Removing Parts for Cleaning and Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-10
Disassembling Parts for Cleaning and Disinfection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-13
General Guidelines for Cleaning and Disinfection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-15
Reassembly Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-22
Section 17. Specifications
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-2
Environmental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-2
Gas Delivery System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-3
Vaporizers (Vapor 19.1 and 19.3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-4
Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-4
Absorber System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-5
Oxygen Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-5
Breathing Pressure Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-6
Respiratory Volume Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-6
Serial Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17-6
Appendix - Spare and Replacement Parts
Manuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2
Absorber System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2
Vaporizers (19.1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
Bellows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
Oxygen Monitoring Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
Breathing Pressure Monitoring Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
Respiratory Volume Monitoring Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
INDEX
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Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual v
Figures
Section 2. General Description
Figure 2-1 . Narkomed GS Anesthesia System, Front View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-2
Figure 2-2 . Three-Gas Flowmeter and Pressure Gauge Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4
Figure 2-3 . Fresh Gas Outlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-9
Figure 2-4 . Fresh Gas Outlet (Canada) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-10
Figure 2-5 . Fresh Gas Oxygen Sensor Adapter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-11
Figure 2-6 . Filling Systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-12
Figure 2-7 . Absorber. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-13
Figure 2-8 . Absorber Mount Bain Circuit Adapter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-16
Figure 2-9 . Pole Mount Bain Circuit Adapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-17
Figure 2-10 . Open Reservoir Scavenger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-18
Figure 2-11 . Scavenger Interface for Passive Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-19
Figure 2-12 . AV2+ Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-21
Figure 2-13 . Main Switch Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-22
Figure 2-14 . Power Supply System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-24
Figure 2-15 . Sensor Interfaces. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-26
Figure 2-16 . Monitor Screen and Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-27
Figure 2-17 . Alarm Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-28
Section 5. Gas Delivery System
Figure 5-1 . Pipeline Gas Supply Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-3
Figure 5-2 . Connecting the Gas Cylinders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-4
Figure 5-3 . Oxygen Flush Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-5
Section 6. Vaporizer
Figure 6-1 . Vaporizer Filling Systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-3
Figure 6-2 . Fixed-Mount Exclusion System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-4
Figure 6-3 . Removable Vaporizer Exclusion System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-4
Figure 6-4 . Installing/Removing the Vapor 19.3 at the Mounting Block . . . . . . . . . . . . . . . . . . . . . . . . .6-5
Figure 6-5 . Filling the Vaporizer (Open Funnel System) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-9
Figure 6-6 . Filling the Vaporizer (Key Indexed Safety System) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-11
Figure 6-7 . Keyed Bottle Adapters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-12
Section 7. Open Reservoir Scavenger
Figure 7-1 . Open Reservoir Scavenger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-2
Figure 7-2 . Connecting the Open Reservoir Scavenger System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-4
Section 8. Scavenger Interface for Passive Systems
Figure 8-1 . Scavenger Interface for Passive Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-2
Figure 8-2 . Scavenger Interface for Passive Systems Hose Connections. . . . . . . . . . . . . . . . . . . . . . .8-3
Section 9. Main Switch Panel
Figure 9-1 . Main Switch Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-2
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vi Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
Section 10. AV2+ Anesthesia Ventilator
Figure 10-1 . AV2+ Anesthesia Ventilator (Front View). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-3
Figure 10-2 . Auto/Bag Selector Interface Cable Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-4
Section 11. Monitoring System
Figure 11-1 . Power-On Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-2
Figure 11-2 . Monitor Screen and System Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-3
Figure 11-3 . Monitor Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-4
Figure 11-4 . Left Keypad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-5
Figure 11-5 . Right Keypad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-6
Figure 11-6 . Configure Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-7
Figure 11-7 . Alarm Log. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-9
Section 12. Oxygen Monitoring
Figure 12-1 . Monitor Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-2
Figure 12-2 . Monitor Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-3
Figure 12-3 . Calibrating the Oxygen Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-5
Figure 12-4 . Measurement Error Due to Incorrect Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-7
Section 13. Respiratory Volume Monitoring
Figure 13-1 . Respiratory Volume System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-2
Figure 13-2 . Monitor Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-3
Figure 13-3 . Monitor Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-4
Section 14. Breathing Pressure Monitoring
Figure 14-1 . Absorber Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-4
Figure 14-2 . Y-piece Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-5
Figure 14-3 . Monitor Displays. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-6
Figure 14-4 . Breathing Pressure Monitor Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-7
Figure 14-5 . Breathing Pressure Trace Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-8
Figure 14-6 . Breathing Pressure Trace Window with Examples of High Alarm Limit Markers. . . . . . .14-9
Figure 14-7 . Monitor Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-10
Figure 14-8 . Sample Threshold Limit Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-13
Section 15. Manual Sphygmomanometer
Figure 15-1 . Manual Sphygmomanometer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-2
Figure 15-2 . Placing the Cuff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-4
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Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual vii
Section 16. Routine Maintenance and Cleaning
Figure 16-1 . Replacing the Absorbent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-3
Figure 16-2 . Replacing the Oxygen Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-4
Figure 16-3 . Clearing Condensation in the Ultrasonic Flow Sensor. . . . . . . . . . . . . . . . . . . . . . . . . . .16-5
Figure 16-4 . Open Reservoir Scavenger Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-7
Figure 16-5 . Scavenger Interface for Passive Systems Maintenance . . . . . . . . . . . . . . . . . . . . . . . . .16-9
Figure 16-6 . Removing the Pressure Gauge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-11
Figure 16-7 . Removing the Bellows Assembly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-12
Figure 16-8 . Disassembling the Inspiratory and Expiratory Valves . . . . . . . . . . . . . . . . . . . . . . . . . .16-14
Figure 16-9 . Open Reservoir Scavenger Connections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-24
Figure 16-10 . Passive System Scavenger Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-25
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Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual ix
Tables
Section 2. General Description
Table 2-1 . Gas System Color Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-3
Table 2-2 . Recommended Cylinder Gas Pressures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-5
Section 3. Daily Checkout Procedure
Table 3-1 . Full and Minimum Cylinder Pressures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-4
Section 10. AV2+ Anesthesia Ventilator
Table 10-1 . Problem Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-7
Section 11. Monitoring System
Table 11-1 . Control Key Functions in the Configure Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-8
Section 12. Oxygen Monitoring
Table 12-1 . Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-3
Table 12-2 . Unsuccessful Calibration - Causes and Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-6
Table 12-3 . Oxygen Monitoring Problem Resolution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-9
Section 13. Respiratory Volume Monitoring
Table 13-1 . Respiratory Volume Monitoring Problem Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-8
Section 14. Breathing Pressure Monitoring
Table 14-1 . Breathing Pressure Monitoring Problem Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . .14-16
Section 15. Manual Sphygmomanometer
Table 15-1 . Selecting a Blood Pressure Cuff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15-3
Section 16. Routine Maintenance and Cleaning
Table 16-1 . Recommended Disinfection Methods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-16
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Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual
1Introduction
This section introduces you to the Narkomed GS anesthesia
machine.
Operator's Responsibility for Patient Safety ....................... 1-2
Limitation of Liability .......................................................... 1-3
Restriction .......................................................................... 1-3
Copyright ........................................................................... 1-3
Trademark Notices ............................................................. 1-3
Disclaimer .......................................................................... 1-4
Recommendations ............................................................. 1-4
Symbol Definition ............................................................... 1-4
Purpose of This Manual ..................................................... 1-5
How This Manual Is Organized .......................................... 1-5
Conventions Used in This Manual ..................................... 1-6
General Warnings and Cautions ........................................ 1-6
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1-2 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
1Introduction
Operator's Responsibility for Patient Safety
Draeger Medical anesthesia products are designed to provide the greatest
degree of patient safety that is practically and technologically feasible. The
design of the equipment, the accompanying literature, and the labeling on
the equipment take into consideration that the purchase and use of the
equipment are restricted to trained professionals, and that certain
inherent characteristics of the equipment are known to the trained
operator. Instructions, warnings, and caution statements are limited,
therefore, to the specifics of the Draeger Medical design. This publication
excludes references to hazards which are obvious to a medical professional,
to the consequences of product misuse, and to potentially adverse effects in
patients with abnormal conditions. Product modification or misuse can be
dangerous. Draeger Medical disclaims all liability for the consequences of
product alterations or modifications, as well as for the consequences which
might result from the combination of Draeger Medical products with
products supplied by other manufacturers if such a combination is not
endorsed by Draeger Medical.
The operator of the anesthesia system must recognize that the means of
monitoring and discovering hazardous conditions are specific to the
composition of the system and the various components of the system. It is
the operator, and not the various manufacturers or suppliers of
components, who has control over the final composition and arrangement
of the anesthesia system used in the operating room. Therefore, the
responsibility for choosing the appropriate safety monitoring devices rests
with the operator and user of the equipment.
Patient safety may be achieved through a variety of different means
depending on the institutional procedures, the preference of the operator,
and the application of the system. These means range from electronic
surveillance of equipment performance and patient condition to simple,
direct contact between operator and patient (direct observation of clinical
signs). The responsibility for the selection of the best level of patient
monitoring belongs solely to the equipment operator. To this extent, the
manufacturer, Draeger Medical, disclaims responsibility for the adequacy
of the monitoring package selected for use with the anesthesia system.
However, Draeger Medical is available for consultation to discuss
monitoring options for different applications.
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Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 1-3
Introduction 1
Limitation of Liability
Draeger Medical's liability, whether arising from or related to the
manufacture and sale of the products, their installation, demonstration,
sales representation, use, performance, or otherwise, including any
liability based upon Draeger Medical's product warranty, is subject to and
limited to the exclusive terms of Draeger Medical's limited warranty,
whether based upon breach of warranty or any other cause of action
whatsoever, regardless of any fault attributable to Draeger Medical and
regardless of the form of action (including, without limitation, breach of
warranty, negligence, strict liability, or otherwise).
Draeger Medical shall in no event be liable for any special,
incidental, or consequential damages (including loss of profits)
whether or not foreseeable and even if Draeger Medical has been
advised of the possibility of such loss or damage. Draeger Medical
disclaims any liability arising from a combination of its product
with products from another manufacturer if the combination has
not been endorsed by Draeger Medical. Buyer understands that
the remedies noted in Draeger Medical's limited warranty are its
sole and exclusive remedies.
Furthermore, buyer acknowledges that the consideration for the
products, equipment, and parts sold reflects the allocation of risk
and the limitations of liability referenced herein.
Restriction
Federal law restricts this device to sale by, or on the order of, a physician.
Copyright
Copyright 2004 by Draeger Medical, Inc. All rights reserved. No part of this
publication may be reproduced, transmitted, transcribed, or stored in a
retrieval system in any form or by any means, electronic or mechanical,
including photocopying and recording, without written permission of
Draeger Medical, Inc.
Trademark Notices
Datagrip, DrägerService, Narkomed, Narkomed GS, ORM,
Quality Service For Life, Vigilance Audit, Vitalert, and Vitalink are
registered trademarks of Draeger Medical, Inc. All other products or name
brands are trademarks of their respective owners.
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1-4 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
1Introduction
Disclaimer
The content of this manual is furnished for informational use only and is
subject to change without notice. Draeger Medical, Inc. assumes no
responsibility or liability for any errors or inaccuracies that may appear in
this manual.
Recommendations
In the interest of patient safety, Draeger Medical strongly advocates the use
of an oxygen analyzer, pressure monitor, and either a volume monitor or an
end-tidal CO2monitor in the breathing circuit at all times.
Because of the sophisticated nature of Draeger Medical anesthesia
equipment and its critical importance in the operating room setting, it is
highly recommended that only appropriately trained and experienced
professionals be permitted to service and maintain this equipment. Please
contact DrägerService at [phone] for service of this equipment.
Draeger Medical also recommends that its anesthesia equipment be
serviced at three-month intervals. Periodic Manufacturer's Service
Agreements are available for equipment manufactured by Draeger Medical.
For further information concerning these agreements, contact
DrägerService at [phone].
Symbol Definition
The following symbols appear on the label on the back of the Narkomed GS
and are defined below.
CAUTION: Refer to accompanying documents before operating
equipment.
ATTENTION: Consulter les documents ci-joints avant de faire
fonctionner l'apparail.
CAUTION: Risk of electric shock, do not remove cover. Refer
servicing to an authorized representative of
DrägerService.
ATTENTION: Risque de choc electrique, ne pas enlever le couvercle. Ne
faire reparer que par un representant technique autorise
de Draeger Medical.
Degree of protection against electric shock: Type B.
Protection contre le risque de choc electrique: Type B.
!
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Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 1-5
Introduction 1
These additional symbols are used on other locations of the Narkomed GS
to provide quick and easy recognition of product functions:
OXYGEN CONCENTRATION
BREATHING PRESSURE
BREATHING VOLUME
AUDIBLE ALARM DISABLE
THRESHOLD PRESSURE ALARM LIMIT
Purpose of This Manual
This manual provides operating instructions for the Narkomed GS
Anesthesia System. It is intended for use by trained clinical professionals
familiar with accepted medical procedures, practices, and terminology used
in delivery of anesthesia and patient monitoring.
How This Manual Is Organized
All users of the Narkomed GS must read this manual completely before
using the machine. In order to make this document more convenient for
future reference, it has been divided into several independent sections.
“Section 2 - General Description” provides a summary of Narkomed GS
features and functions.
“Section 3 - Daily Checkout” contains the checkout procedures that must
done on a daily basis.
“Section 4 - Preuse Checkout” contains the checkout procedures to be
performed between successive cases.
Sections 5 through 15 provide detailed instructions on the use and
operation of each functional component of the system.
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1-6 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
1Introduction
“Section 16 - Routine Maintenance and Cleaning” provides cleaning,
maintenance, and replacement procedures.
“Section 17 - Specifications” contains the specifications for all system
components.
The Appendix lists spare and replacements parts for the machine.
Conventions Used in This Manual
This manual has been set up with several conventions to help organize the
information contained in it. Please read about these conventions carefully
so that you understand their significance in the manual.
Typefaces Different typefaces are used throughout the manual to differentiate
between narrative information and machine messages and labels.
Warningsand
Cautions All parts of this manual contain warning and caution statements about the
Narkomed GS.
•Warning statements give important information that, if ignored, could
lead directly to personal injury.
•Caution statements give important information that, if ignored, could
lead directly to equipment damage and indirectly to personal injury.
General Warnings and Cautions
The following list of warnings and cautions apply to general operation and
maintenance of the Narkomed GS. Warnings and cautions about installing
and operating specific parts appear with those topics.
WARNING: Any person involved with the setup, operation, or
maintenance of the Narkomed GS anesthesia system must
be thoroughly familiar with this instruction manual.
WARNING: This anesthesia system will not respond automatically to
certain changes in patient condition, operator error, or
failure of components. The system is designed to be operated
under the constant surveillance and control of a qualified
operator.
WARNING: No third-party components shall be attached to the
anesthesia machine, ventilator, or breathing system (except
for certain approved exceptions). Contact DrägerService for
further information.
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Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 1-7
Introduction 1
WARNING: When moving the anesthesia machine, remove all monitors
and equipment from the top shelf, remove the absorber
system, and use only the machine handles or push/pull bars.
The anesthesia machine should only be moved by people who
are physically capable of handling its weight. Draeger
Medical recommends that two people move the anesthesia
machine to aid in maneuverability. Exercise special care so
that the machine does not tip when moving up or down
inclines, around corners, and across thresholds (for example,
in door frames and elevators). Do not attempt to pull the
machine over any hoses, cords, or other obstacles on the floor.
CAUTION: Although the Narkomed GS is designed to minimize the
effects of ambient radio-frequency interference, machine
functions may be adversely affected by the operation of
electrosurgical equipment or short wave or microwave
diathermy equipment in the vicinity.
CAUTION: Communications with external equipment may be
temporarily affected by electromagnetic interference due to
the use of electrosurgical equipment.
CAUTION: Do not place more than 100 pounds on top of the Narkomed
GS monitor housing.
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