Dräger Apollo Quick reference guide

Supplement Paper Apollo SW 3.2n, SW 4.n 1
Supplement Paper
Inhalation Anesthesia Machine
Apollo, Software 3.2n, Software 4.n
This document only applies for anesthesia
machines equipped with a CO2module and a
manual with part number
9038237 (6th Edition – June 2006) or
9039994 (2nd edition – November 2008).
For the combination of the anesthesia machine
Apollo with a module which can supply a con-
trolled flow of carbon dioxide (CO2) as a fourth
gas into the fresh-gas flow from the anesthesia
machine's mixer.
Anesthesia machines running Software 3.2 or
higher may be combined with this module.
Such anesthesia machines will differ from pre-
vious models and their respective Instructions
for Use as follows.
001

2Supplement Paper Apollo SW 3.2n, SW 4.n
Chapter – Introduction
Intended Use
The Apollo is an inhalation anesthesia machine for
use in operating, induction, and recovery rooms. It
can be used with rebreathing systems, semi-closed
to virtually closed systems with low flow and mini-
mal flow techniques, and non-rebreathing systems
(with the Auxiliary Common Gas Outlet).
It may be used with O2, N2O, CO2(in combination
with the CO2module), and Air supplied by a medi-
cal gas pipeline system (not available for CO2) or
by externally mounted gas cylinders. Anesthetic
agent can be delivered by vaporizers mounted to
the machine.
Chapter 2 – System Components
The CO2Module
1Flow meter
2CO2Flow Control
3CO2cylinder connection
002
1
2
3

Supplement Paper Apollo SW 3.2n, SW 4.n 3
Chapter 3 – User Interface
CO2Flow Control
The CO2flow control is located on the right side on
the Apollo, not adjacent to the other flow controls
for O2, N2O, and Air. The module can only be oper-
ated by the flow meter and the flow control knob
depicted in "The CO2Module" on page 2.
Turn the control knob counterclockwise to increase
the CO2flow and clockwise to decrease the flow.
The current flow is shown on the CO2flow tube and
as part of the total flow on the total flow meter.
Connecting the Gas Cylinders for O2,
N2O, CO2, and Air
The Apollo is equipped with ANSI standard pin-
indexed hanger yokes for E-size cylinders to con-
nect backup gas cylinders to the anesthesia
machine. The yoke for O2is standard, the yokes for
N2O and Air are optional. All cylinder yokes are
located on the back of the machine as shown in Fig-
ure 25 of the Instructions for Use.
The CO2module requires an externally mounted
fourth gas cylinder. As shown in Figure 25a, the
position for the CO2cylinder is on the right hand
side of the machine (as you face the machine). The
CO2cylinder mount is compatible with pin-indexed
E-size cylinders and the gas inlet is equipped with
a NIST gas-specific connection for the cylinder.
NOTE
The user must position the gas cylinder and the
pressure regulator in such a way that the gauge of
the pressure regulator can be read from the front
of the anesthesia machine.
CAUTION
Risk of device failure.
Compressed gas supply (central supply or cylin-
der): To avoid damaging the device(s) attached to
a gas supply, use only medical gases. Pay partic-
ular attention to national and international stan-
dards regulating the use of medical gases.
Figure 25a. CO2cylinder location

4Supplement Paper Apollo SW 3.2n, SW 4.n
Chapter 5 – Pre-use Checkout
Checking the Workstation According
to the Check List
Check the cylinder gas supply:
3.1 Checking the cylinder gas supply of the CO2
gas cylinder
a. Using the provided cylinder wrench,
slowly open the cylinder valve of the
CO2cylinder.
b. Open the control valves for O2to acti-
vate SORC and CO2.
c. Check if the cylinder pressure is suffi-
cient for the operation planned.
Adjust the flow control knob for CO2and verify that
the float moves freely on the flow meter.
d. Close the CO2control valve.
e. Close the control valve for O2and push
the O2+ button to flush the breathing
system in order to remove CO2.
WARNING
Risk of patient injury.
When initializing operation, the pressure indi-
cated on the pressure regulator may be resid-
ual pressure from the cylinder supply of a
previous case.
To avoid injuring the patient, make sure the
cylinder valve is open before delivering CO2.

Supplement Paper Apollo SW 3.2n, SW 4.n 5
Chapter 6 – Operation Summary
Setting Fresh-gas Flow
WARNING
Risk of patient injury.
Because of high inspiratory CO2levels,
derived numerical expiratory CO2measure-
ment values will fluctuate greatly (up to 1 or
2 Vol.%) as compared to "normal" values
when the CO2Module is not in use.
The user must exercise increased attentive-
ness by monitoring the CO2waveform.
CAUTION
Risk of elevated levels of CO2doses.
If a fully filled absorber or a CLIC absorber is
used, the inspiratory CO2concentration may
automatically rise during a case as increasingly
more soda lime becomes inactive in the upper
area of the absorber canister. Inactive soda lime
will remove less CO2from the fresh-gas flow.
When administering CO2, Dräger recommends
using a refillable absorber (not a CLIC absorber)
only filled halfway. In this way:
– The inspiratory CO2concentration can more
easily be kept constant;
– CO2gas will be saved;
– Soda lime will be saved.
CAUTION
Risk of patient injury.
If applying inspiratory CO2concentrations, the
soda lime will be exhausted more quickly; inspira-
tory CO2concentrations may increase drastically.
Pay special attention to the state of the soda lime
when operating with inspiratory CO2concentra-
tions.

6Supplement Paper Apollo SW 3.2n, SW 4.n
Operating the CO2Module
WARNING
Risk of inadequate monitoring.
When operating the CO2module within an
inspiratory CO2concentration range higher
than 3.5 Vol.%, situations may occur in which
breathing phase-derived gas measurement
values cannot be calculated. If this is the case,
the related alarm monitoring will not be active.
In order to guarantee gas monitoring, it is nec-
essary to activate the bypass mode for
inspiratory CO2concentration settings above
3.5 Vol.%.
WARNING
Risk of inadequate monitoring.
Apnea monitoring for CO2and pressure mea-
suring is not active when the bypass mode is
used (as described above). Flow apnea alarm
monitoring is not active in the Man/Spont
mode and therefore must be replaced by a
continuously active lower minute volume (MV)
limit.
To achieve this, activate the MV alarm limits
for Man/Spont on the configuration screen by
setting them to "on" and make sure that the
MV lower alarm limit is active whenever venti-
lating the patient.
WARNING
Risk of inadequate monitoring.
CO2concentration monitoring alarms are not
active when the bypass mode is used (as
described above). The user must exercise
increased attentiveness. The user must manu-
ally monitor measured CO2concentrations,
which will not be based on breathing phases
in the bypass mode, by observing the dis-
played CO2waveform. In addition, gas mea-
surement availability must be constantly
supervised because CO2apnea alarm moni-
toring is unavailable.

Supplement Paper Apollo SW 3.2n, SW 4.n 7
Standard operation is possible with the CO2mod-
ule even if the inspiratory carbon dioxide values
reach 3.5 Vol.%. If, however, the CO2concentra-
tion exceeds this level, breathing phase-derived
gas measurement values may not be available. For
this reason, inspiratory and expiratory gas mea-
surement values and the respective alarm trigger-
ing (based on a breathing phase) can no longer be
ascertained. In such cases, real-time values are
displayed at a rate of 1/s. To monitor the CO2con-
centration, the user must correlate the displayed
real-time values to the CO2waveform display.
To ensure adequate gas monitoring, the bypass
mode is mandatory when the Apollo is intended for
operation with inspiratory CO2levels above
3.5 Vol.%. When running in bypass mode, absolute
inspiratory and expiratory CO2measurements, as
well as apnea detection for CO2and pressure, are
deactivated. The only apnea alarm function remain-
ing is then based upon flow measurement; this is,
however, deactivated in the Man/Spont mode. To
provide adequate monitoring during Man/Spont,
the lower minute volume limit must be appropriately
set.
The upper inspiratory CO2alarm limit is adjustable
and can be disabled, to prevent nuisance alarms.
The CO2module is equipped with an SORC. This
safety feature limits the CO2concentration in the
fresh gas so that the O2concentration does not fall
below 21 Vol.%. When the CO2flow control is open
and the O2flow control is closed (or the O2flow is
less than 500 mL/min), the SORC prevents a CO2
flow. If the CO2flow fails, oxygen can still be admin-
istered.
WARNING
Risk of patient injury.
To ensure proper CO2monitoring and prevent
a risk to the patient, only set the CO2alarm
default value to a higher limit if the device is
being used solely for CO2applications.

8Supplement Paper Apollo SW 3.2n, SW 4.n
Chapter 9 - Alarms
Adjustment Range of the Alarm Limits
during Operation
With Software 3.2n:
With Software 4.n:
Chapter 11 – Cleaning and Maintenance
Maintenance intervals
Refer to the Apollo Instructions for Use.
Chapter 13 – Specifications
CO2Module
FiCO2
[Vol.%]
0.1 to 1.4 Vol.%, – –
FiCO2
[Vol.%]
0.1 to 3.5 1), – –
1) DrägerService can change the upper limit to 1.4.
WARNING
Risk of patient injury.
To prevent the CO2module from malfunction-
ing, only the Dräger pressure reducer CO2Pin
index (part no. 8607429) should be used. Only
use a CO2cylinder with this pressure reducer
to supply the CO2module.
Inlet connection: Pin-Index coded pressure regulator
Inlet pressure 5 kPa x 100 ±20 %
(72.5psi±20%)
CO2flow dosing: 0 to 0.6 L/min ±10 %
with an inlet pressure of 5 kPa x 100
(72.5 psi)
CO2flow meter 100 to 1000 mL/min
Accuracy ±50 mL/min
Resolution 50 mL/min

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