Dräger Perseus A500 User manual

Instructions for use
Perseus A500
WARNING
To properly use this medical device,
read and comply with these
instructions for use.
Anesthesia workstation
Software 1.1n

2 Instructions for use Perseus A500 SW 1.1n
Typographical conventions
Any text shown on the screen and any labeling on
the device are printed in bold and italics, for
example, PEEP, etCO2, or Screen layout.
The "greater than" symbol >indicates the
navigation path in a dialog window, for example,
System setup > Alarms > Alarm limits. In this
example, System setup represents the dialog
window title, Alarms represents a horizontally
aligned tab, and Alarm limits a vertically aligned
tab.
Use of terms
Dräger uses the term "Accessory" not only for
accessories in the sense of IEC 60601-1, but also
for consumable parts, removable parts, and
attached parts.
The product "Perseus A500" is also referred to as
"Perseus".
Screen layouts and illustrations of the
device
The actual screen layout or the device may differ in
appearance or in configuration from the
illustrations.
Trademarks
1Consecutive numbers indicate steps of action,
with the numbering restarting with "1" for each
new sequence of actions.
Bullet points indicate individual actions or dif-
ferent options for action.
– Dashes indicate the listing of data, options, or
objects.
(A) Letters in parentheses refer to elements in the
related illustration.
ALetters in illustrations denote elements
referred to in the text.
Trademark Trademark owner
Perseus®
Dräger
Infinity®
DrägerService®
Dräger-Vapor®
D-Vapor®
Drägersorb®
MEDIBUS.X®
WaterLock®
Selectatec®Datex-Ohmeda
Dismozon®
BODE ChemieMikrobac®
Korsolex®
Neodisher Medi-
clean®Dr. Weigert
Buraton®Schülke & Mayr
Trademark
BIPAP1)
1) Trademark used under license
Trademark Trademark owner

Instructions for use Perseus A500 SW 1.1n 3
Safety information definitions
Definition of target groups
For this product, users, service personnel, and
experts are defined as target groups.
These target groups must have received
instruction in the use of the product and must have
the necessary training and knowledge to use,
install, reprocess, maintain, or repair the product.
The target groups must understand the language
of the present document.
The product must be used, installed, reprocessed,
maintained, or repaired exclusively by defined
target groups.
Users
Users are persons who use the product in
accordance with its intended use.
Service personnel
Service personnel are persons who are
responsible for the maintenance of the product.
Service personnel must be trained in the
maintenance of medical devices and install,
reprocess, and maintain the product.
Experts
Experts are persons who perform repair or
complex maintenance work on the product.
Experts must have the necessary knowledge and
experience with complex maintenance work on the
product.
WARNING
A WARNING statement provides important
information about a potentially hazardous
situation which, if not avoided, could result in
death or serious injury.
CAUTION
A CAUTION statement provides important
information about a potentially hazardous
situation which, if not avoided, may result in
minor or moderate injury to the user or patient or
in damage to the medical device or other
property.
NOTE
A NOTE provides additional information intended
to avoid inconvenience during operation.

4 Instructions for use Perseus A500 SW 1.1n
Abbreviations, symbols, and product labels
Explanations are listed in Chapter ''Annex'' in
sections ''Abbreviations'', ''Symbols'', and ''Product
labels''.

Instructions for use Perseus A500 SW 1.1n 5
Contents
Contents
For your safety and that of your patients.... 7
General safety information .............................. 8
Product-specific safety information.................. 10
Application..................................................... 12
Intended use.................................................... 13
Indications/Contraindications........................... 13
Further information on application ................... 14
Overview......................................................... 15
Hardware......................................................... 16
Functional scope ............................................. 29
Gas flow plan................................................... 32
Operating concept......................................... 35
Screen ............................................................. 36
Color concept .................................................. 38
Selecting and setting ....................................... 39
Assembly and preparation ........................... 41
Mounting of accessories.................................. 42
Before first operation ....................................... 43
Transport within the hospital............................ 47
Connecting the gas supply .............................. 48
Ensuring the gas supply .................................. 53
Preparation for an operation day / after
cleaning and sterilization ................................. 54
Selecting and connecting patient-specific
accessories...................................................... 58
Connecting or exchanging consumables......... 65
Getting started............................................... 68
Switching on Perseus...................................... 69
Checking for the readiness of operation.......... 70
Operation in case of emergency...................... 71
Operation........................................................ 72
Safety information............................................ 73
Starting the therapy ......................................... 74
Adjusting the therapy....................................... 77
Special forms of therapy.................................. 80
Using fields with special functions ................... 82
Organizing the screen display ......................... 87
Displaying additional data................................ 90
Setting the sound volume................................ 92
Adjusting the alarms........................................ 93
Changing the patient data ............................... 96
Exporting data ................................................. 96
Other settings .................................................. 97
Ending the therapy .......................................... 99
Patient change ................................................ 100
System test .................................................... 102
Information on the availability of individual
device functions............................................... 103
Testing the system .......................................... 103
Performing the tests ........................................ 105
Processing the checklist.................................. 106
Ending operation........................................... 111
Switching off the device................................... 112
Alarms ............................................................ 114
Display of alarms............................................. 115
Response to alarms ........................................ 116
Adopting alarm settings when changing the
ventilation mode .............................................. 120
Alarm delay and alarm escalation ................... 121
Activation of alarms after breath detection ...... 124
Intelligent alarm behavior ................................ 124
Configuration................................................. 125
Device settings ................................................ 126
Defining start settings...................................... 126
Transferring device configurations .................. 144
Activating applications..................................... 145
Overview of the configurable screen contents 146
Troubleshooting ............................................ 153
Leakages......................................................... 154
Power supply failure ........................................ 155
Failure of the gas supply ................................. 157
Failure of fresh-gas delivery (electronically
controlled gas mixture) .................................... 158
Ventilator failure .............................................. 159
Failure of the gas measurement...................... 159
Failure of flow measurement ........................... 159
Screen fault/user interface failure.................... 160
Complete failure .............................................. 160

Contents
6 Instructions for use Perseus A500 SW 1.1n
Problems with the anesthetic gas receiving
system (AGS) .................................................. 161
Problems with the pressure reducers.............. 162
Problems with the Vapor View option.............. 162
Alarm – Cause – Remedy ............................... 162
Cleaning, disinfection and sterilization....... 184
Disassembly .................................................... 185
Reprocessing procedures ............................... 187
Reprocessing list ............................................. 191
Assembling the parts....................................... 194
Before using on patients again........................ 194
Maintenance................................................... 195
Overview ......................................................... 196
Inspection ........................................................ 196
Preventive maintenance.................................. 198
Repairs ............................................................ 199
Disposal ......................................................... 200
Disposing of the medical device...................... 201
Disposing of accessories................................. 201
Technical data ............................................... 202
General information......................................... 203
Ambient conditions .......................................... 203
Fresh-gas delivery........................................... 204
Fresh-gas delivery (electronically controlled
gas mixer)........................................................ 204
Fresh-gas delivery (mechanically controlled
gas mixer)........................................................ 205
Ventilator ......................................................... 205
Breathing system............................................. 207
External fresh-gas outlet ................................. 209
Anesthetic gas receiving system ..................... 209
Measurement systems and displays ............... 210
Display of calculated values ............................ 215
Operation characteristic values ....................... 217
Device outlets.................................................. 221
Relevant standards ......................................... 223
Diagrams ......................................................... 226
EMC declaration.............................................. 229
Device combinations ....................................... 233
Connections to IT networks............................. 234
Software license compliance (optional)........... 236
Principles of operation ................................. 237
Description of the ventilation modes ............... 238
Minimum O2delivery ....................................... 247
Influence of patient category, weight, and age
on device behavior .......................................... 248
Infinity ID accessory support ........................... 248
Schematic diagram of alarm tones.................. 250
Combination lock on the drawer (optional)...... 251
Annex ............................................................. 253
Abbreviations................................................... 254
Symbols........................................................... 256
Product labels.................................................. 259
Overview of the menu structure ...................... 261
Password ....................................................... 265
Configuration password for Perseus
A500 Software 1.1n......................................... 265

Instructions for use Perseus A500 SW 1.1n 7
For your safety and that of your patients
For your safety and that of your patients
General safety information........................... 8
Strictly follow these instructions for use........... 8
Maintenance.................................................... 8
Safety checks .................................................. 8
Accessories ..................................................... 8
Patient safety................................................... 9
Patient monitoring............................................ 9
Information on electromagnetic compatibility .. 9
Training............................................................ 10
Keeping the instructions for use ...................... 10
Product-specific safety information ............ 10
Functional safety ............................................. 11
Handling Infinity ID components...................... 11

For your safety and that of your patients
8 Instructions for use Perseus A500 SW 1.1n
General safety information
The following WARNING and CAUTION
statements apply to general operation of the
medical device.
WARNING and CAUTION statements specific to
its subsystems or particular features appear in the
respective sections of these instructions for use or
in the instructions for use of any other product
being used with this device.
Strictly follow these instructions for use
Maintenance
Safety checks
The medical device must be subject to regular
safety checks. See chapter ''Maintenance''.
Accessories
WARNING
Risk of incorrect operation and incorrect use
Any use of the medical device requires full
understanding and strict observation of all
sections of these instructions for use. The
medical device must only be used for the
purpose specified under ''Intended use'' (see
page 13) and in conjunction with appropriate
patient monitoring (see page 9). Strictly
observe all WARNING and CAUTION
statements throughout these instructions for
use and all statements on medical device
labels.
Failure to observe these safety information
statements constitutes a use of the medical
device that is inconsistent with its intended
use.
WARNING
Risk of medical device failure and of patient
injury
The medical device must be inspected and
serviced regularly by service personnel.
Repair and complex maintenance carried out
on the medical device must be performed by
experts. Dräger recommends DrägerService
for a service contract and for repairs. Dräger
also recommends using original Dräger parts
for maintenance.
If the above is not complied with, medical
device failure and patient injury may occur.
Observe chapter ''Maintenance''.
WARNING
Risk due to incompatible accessories
Dräger has only tested the compatibility of
accessories that appear in the current list of
accessories or in separate declarations by
Dräger. If other, incompatible accessories are
used, there is a risk of patient injury due to
medical device failure.
Dräger recommends using the medical device
only with accessories from the current list of
accessories.

Instructions for use Perseus A500 SW 1.1n 9
For your safety and that of your patients
Patient safety
The design of the medical device, the
accompanying documentation, and the labeling on
the medical device are based on the assumption
that the purchase and the use of the medical
device are restricted to persons familiar with the
inherent characteristics of the medical device.
Instructions and WARNING and CAUTION
statements are therefore largely limited to the
specifics of the Dräger medical device.
These instructions for use do not provide any
information on the following:
– Dangers that are obvious to the user
– Consequences of intentional misuse of the
medical device
– Possible negative impacts on patients with
various underlying diseases
Medical device modification or misuse can be
dangerous.
Patient monitoring
The user of the medical device is responsible for
choosing suitable monitoring that provides
appropriate information about medical device
performance and the patient's condition.
Patient safety may be achieved by a wide variety
of means ranging from electronic surveillance of
medical device performance and patient condition
to simple, direct observation of clinical signs.
The responsibility for selecting the best level of
patient monitoring lies solely with the user of the
medical device.
Information on electromagnetic
compatibility
General information on electromagnetic
compatibility (EMC) according to the international
EMC standard IEC 60601-1-2:
Medical electrical equipment is subject to special
precautionary measures concerning
electromagnetic compatibility (EMC) and must be
installed and put into operation in accordance with
the EMC information provided (see page 229).
Portable and mobile RF communications
equipment can affect medical electrical equipment.
WARNING
Risk of operating errors and incorrect use
Strictly observe the instructions for use of all
accessory parts, e.g.:
– Water traps
– Flow sensors
–CLICadapter
– CLIC absorber
– Soda lime
– Breathing hoses
– Masks
–Filter
– Endotracheal suction
–Vaporizer
– Manual resuscitator
– AGSS terminal unit
WARNING
Risk of electric shock
Do not connect connectors with an
ESD warning symbol and do not
touch the pins of such connectors
without implementing ESD protective
measures. Such protective measures may
include antistatic clothing and shoes,
touching a potential equalization pin before
and during connection of the pins, or using
electrically insulating and antistatic gloves.
All relevant users must be instructed in these
ESD protective measures.

For your safety and that of your patients
10 Instructions for use Perseus A500 SW 1.1n
Training
User training is offered by the responsible Dräger
organization, see www.draeger.com.
Keeping the instructions for use
Product-specific safety information
WARNING
Risk of device failure
Electromagnetic fields, e.g., those generated
by radio frequency communication
equipment such as mobile phones, high-
frequency electrical surgery equipment,
defibrillators or shortwave therapy devices
can disrupt the function of the medical
device.
Only operate radio frequency devices at a
sufficient safety clearance of at least 20
cm (7.9 in).
CAUTION
Risk of incorrect use
The instructions for use must be kept in an
accessible location for users.
WARNING
Risk due to device failure
Device failure can compromise the correct
therapy functionality of the device.
To ensure immediate remedial action in case
of device failure, the device may only be
operated under permanent supervision of
users. Always have a manual resuscitator
ready.
WARNING
Dräger recommends that the user remains in
the vicinity of the anesthesia machine, i.e.
within a distance of up to 4 meters (12 feet).
This facilitates fast recognition and response
in the event of an alarm.
WARNING
Risk of malfunction
Unallowed modifications to the medical
device can lead to malfunctions.
This medical device must not be modified
without permission from Dräger.
WARNING
Risk of fire
To avoid a fire hazard, do not introduce drugs
or other substances based on flammable
solvents, such as alcohol, into the breathing
system and do not use explosive anesthetic
agents such as ether or cyclopropane or
spray them into the device.
If highly flammable substances are used for
disinfection, adequate ventilation is required.
CAUTION
Risk of crushing
Movable device parts or attached components
may cause crushing due to clamping. Pay special
attention to edges, movable parts, and corners
when working with the following components:
– Column cover
– Breathing system cover
–Drawers
– Extensible writing tray
– Swivel arms for mounted devices
– Accessories such as gas cylinders,
vaporizers, CLIC absorber, and CLIC adapter

Instructions for use Perseus A500 SW 1.1n 11
For your safety and that of your patients
Functional safety
The essential performance features comprise:
– Supplying the anesthesia workstation with O2
If the O2supply (central gas supply or gas
cylinder) fails, an alarm is issued.
– Supply of the patient with adequately
oxygenated breathing gas
If the breathing gas contains insufficient levels
of O2, an alarm is issued.
– Patients are not supplied with excessively high
anesthetic gas concentrations
If excessively high anesthetic gas
concentrations are delivered, an alarm is
issued.
– Monitoring of the airway pressure and the
expiratory minute volume
Alarms are issued depending on the set alarm
limits.
Handling Infinity ID components
Ownership or purchase of this medical device with
RFID technology only includes the right to use the
medical device and RFID technology in
conjunction with products approved by Dräger and
in strict compliance with these instructions for use.
No intellectual property rights or any rights to the
use of the medical device or RFID technology are
hereby granted, either explicitly or implicitly, which
are contrary to the above-mentioned conditions.
WARNING
Risk due to electromagnetic fields
Although the medical device does not exceed
the applicable limiting values for
electromagnetic fields, such radiation can
interfere with the functioning of pacemakers.
All wearers of pacemakers should maintain a
distance of at least 25 cm (10 in) between
pacemaker and medical device.

Application
12 Instructions for use Perseus A500 SW 1.1n
Application
Intended use .................................................. 13
Indications/Contraindications...................... 13
Indications ....................................................... 13
Contraindications............................................. 13
Further information on application.............. 14
Environment of use ......................................... 14

Instructions for use Perseus A500 SW 1.1n 13
Application
Intended use
The Perseus anesthesia workstation is intended
for use in anesthetizing adults, children, and
neonates and can be used for automatic and
manual ventilation, pressure-supported
spontaneous breathing, and spontaneous
breathing.
Perseus is equipped with airway monitoring, gas
measurement and device monitoring, O2
insufflation, and an anesthetic gas receiving
system.
Anesthesia is achieved through a mixture of pure
oxygen and Air (medical compressed air) or pure
oxygen and nitrous oxide, with the addition of
volatile anesthetic agents.
Ventilation is accomplished on the patient through
a laryngeal mask airway, a full-face mask, or an
endotracheal tube.
The integrated breathing system can be used with
partial rebreathing (low-flow or minimum-flow).
A non-rebreathing system such as the Kuhn or
Medec Water System may be used at the external
fresh-gas outlet (optional).
Indications/Contraindications
Indications
Perseus is specified for inhalational anesthesia
and/or patient ventilation in accordance with the
intended use during surgical or diagnostic
interventions.
Contraindications
– Perseus applies medications such as oxygen,
nitrous oxide, or volatile anesthetic agents,
among others. For contraindications to the
applied medications, strictly follow the
instructions for use of the medication.
– Do not use soda lime based on potassium
hydroxide. Otherwise, there is a risk of CO
formation.
– Only use pelletized soda lime. Otherwise, there
is a risk of faulty measurement or faulty
delivery as well as progressive damage to the
breathing system due to dust.
– For patients with suspected malignant
hyperthermia: Do not use any volatile
anesthetic agents or Perseus with residual
concentrations of these gases above 5 ppm.
– Do not perform low-flow anesthesia on patients
with ketoacidosis or patients under the
influence of alcohol. This will raise the risk of
acetone accumulation in the patient.
The user is responsible for setting the gas delivery
and ventilation according to the individual patient
status. Patient status must be continually
monitored for any potential changes.

Application
14 Instructions for use Perseus A500 SW 1.1n
Further information on application
Environment of use
Perseus is designed for use in rooms in which
therapeutic or diagnostic interventions can be
performed.
In addition, do not use Perseus in the following
environments:
– Outside buildings
– On intensive care units
– During patient transport
– In vehicles, airplanes, or helicopters
WARNING
Risk of explosion and fire
This medical device is neither approved nor
certified for use in areas where oxygen
concentrations greater than 25 Vol%,
combustible or explosive gas mixtures are
likely to occur.
WARNING
Risk of device malfunctions and/or patient
injury and user injury
Magnetic fields can negatively influence the
correct functioning of the medical device and
therefore endanger the patient or user.
Do not use the medical device in rooms
where devices for magnetic field applications
are used (e.g., magnetic resonance imaging).

Instructions for use Perseus A500 SW 1.1n 15
Overview
Overview
Hardware ........................................................ 16
Front ................................................................ 16
Screen ............................................................. 17
Plug-in connection with Vapor View option for
up to 3 vaporizers............................................ 17
Breathing system............................................. 18
Side view from left ........................................... 19
Device column................................................. 20
Rear................................................................. 21
Interfaces......................................................... 23
Gas inlets......................................................... 24
Hanger yokes (optional) for gas cylinders with
pin-index connections...................................... 25
Auxiliary power sockets ................................... 26
Gas mixing unit (electronically controlled) ....... 27
Gas mixing unit (mechanically controlled) ....... 28
Functional scope ........................................... 29
Device versions, options, and accessories...... 29
Gas delivery..................................................... 29
Ventilation modes............................................ 29
Additional operation modes ............................. 29
Monitoring........................................................ 29
Display on the screen...................................... 30
Protocoling....................................................... 30
Gas supply....................................................... 30
Gas scavenging............................................... 30
Data exchange, interfaces............................... 30
Gas flow plan ................................................. 32
Breathing system............................................. 32
Gas supply (electronically controlled gas
mixer)............................................................... 33
Gas supply (mechanically controlled gas
mixer)............................................................... 34

Overview
16 Instructions for use Perseus A500 SW 1.1n
Hardware
Front
AScreen with integrated workplace illumination
BGas mixing unit (electronically controlled gas
mixer shown here)
CWork surface
DExtensible writing tray with compartment for
instructions for use (optional)
ECentral brake
FCastors with central brake
GFootrest
HTrolley
IAnesthetic gas receiving system with flow
indicator
JCO2absorber
KAPL valve
LExternal fresh-gas outlet (optional)
MPlug-in connection with Vapor View option for
up to 3 vaporizers
10335
A
B
C
D
E
F
G
I
J
K
L
M
H

Instructions for use Perseus A500 SW 1.1n 17
Overview
Screen
ATouch screen to call up functions or dialog
windows
BAudio paused key to suppress the alarm
tones of all active alarms for 2 minutes
CRotary knob with background illumination to
select and confirm settings
Dkey for switching the workplace illumination
on and off and dimming the illumination intesity
in 3 steps (dark, medium, and bright)
Ekey for switching the device on or off
Plug-in connection with Vapor View option for up to 3 vaporizers
ASensor unit
BIllumination unit
10340
A
C
DE B
10397
A
B

Overview
18 Instructions for use Perseus A500 SW 1.1n
Breathing system
AWater trap with connection for sample line
BPressure gauge (optional) for indicating the
pressure in the internal breathing system, see
also (G) on page 27 and (H) on page 28
CInspiratory port
DBag elbow with circuit plug, e.g., to occlude the
Y-piece during an automatic test
EAPL valve
FExpiratory port
GHolder, e.g., for breathing bag hose
HCO2absorber
IAnesthetic gas receiving system
10370
ACDE
G
HI
FB
CAUTION
Pressure gauge indication possibly inaccurate
Always compare the pressures indicated on the
pressure gauge with those on the status display.
Only use the pressure gauge as the primary
source of information if the pressure indicator on
the status display has failed.

Instructions for use Perseus A500 SW 1.1n 19
Overview
Side view from left
AGCX rail for mounting additional workstation
components
BStrain relief for AGS hose, adjustable height
CExternal fresh-gas outlet (optional)
10337
A
C
B

Overview
20 Instructions for use Perseus A500 SW 1.1n
Device column
The following illustration shows the left side of the
device:
AColumn cover
BGCX rail
CRecesses for cables which lead e.g., into the
device arms
DScrew for closing the cable conduit lid
ETabs to hold the cable
FCable conduit
10369
B
A
C
E
F
D