Dräger Primus SW 4.5n User manual

Instructions for use
Primus
Anesthesia workstation
SW 4.5n
WARNING
To properly use this medical device,
read and comply with these instruc-
tions for use.
Status: 27. January 2014, 18:46

2Instructions for use Primus SW 4.5n
Typographical conventions
Any text shown on the screen and any labeling on
the device are printed in bold and italics, e.g.,
PEEP, Air, or Alarm Settings.
The greater than symbol >is used in menu se-
quences. The main menu is indicated first, then the
menu option for selection, and if applicable further
submenus, e.g., System Setup > Ventilation >
Basic Settings.
Use of terms
Dräger uses the term "Accessory" not only for ac-
cessories in the sense of IEC 60601-1, but also for
consumable parts, removable parts, and ttached
parts.
Screen layouts and illustrations of the
device
Schematic renderings of screen layouts and illus-
trations of the device are used, which may differ in
appearance or in configuration from the actual
screen images.
Trademarks
1Consecutive numbers indicate steps of action,
with the numbering restarting with "1" for each
new sequence of actions.
zBullet points indicate individual actions or differ-
ent 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
DrägerService®
Dräger
Drägersorb®
D-Vapor®
Spirolog®
SpiroLife®
Vapor®
VacuSmart®
WaterLock®
Durasensor®Nellcor
OxiMax™Covidien
Neodisher®
Medizym
Dr. Weigert
Trademark Trademark owner

Instructions for use Primus SW 4.5n 3
Safety information definitions
Definition of target groups
For this product, users, service personnel, and ex-
perts are defined as target groups.
These target groups must have received instruction
in the use of the product and must have the neces-
sary training and knowledge to use, install, reproc-
ess, maintain, or repair the product.
The product must be used, installed, reprocessed,
maintained, or repaired exclusively by defined tar-
get groups.
Users
Users are persons who use the product in accord-
ance 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 mainte-
nance 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 in-
formation about a potentially hazardous situa-
tion which, if not avoided, could result in
death or serious injury.
CAUTION
A CAUTION statement provides important infor-
mation about a potentially hazardous situation
which, if not avoided, may result in minor or mod-
erate 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.

4Instructions for use Primus SW 4.5n
Abbreviations and symbols
Explanations are listed in chapter "Overview" in the
sections "Abbreviations" and "Symbols".

Instructions for use Primus SW 4.5n 5
Contents
Contents
For your safety and that of your patients. . . 7
General safety information . . . . . . . . . . . . . . . . 8
Product-specific safety information. . . . . . . . . . 12
Application . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Intended use. . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Indications and contraindications . . . . . . . . . . . 18
Further information on application . . . . . . . . . . 18
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Components . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Additional functions . . . . . . . . . . . . . . . . . . . . . 28
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Operating concept . . . . . . . . . . . . . . . . . . . . . 35
Screen ergonomics. . . . . . . . . . . . . . . . . . . . . . 36
Keys with permanent functions (hard keys) . . . 37
Keys with variable functions (soft keys) . . . . . . 38
Selecting and setting . . . . . . . . . . . . . . . . . . . . 38
Color concept . . . . . . . . . . . . . . . . . . . . . . . . . . 41
LED indicators of the device. . . . . . . . . . . . . . . 42
Menu structure overview . . . . . . . . . . . . . . . . . 43
Assembly and preparation . . . . . . . . . . . . . . 49
Before first use . . . . . . . . . . . . . . . . . . . . . . . . . 50
Information about transport within the clinic . . . 51
Accessory weight limits . . . . . . . . . . . . . . . . . . 53
Primus as a wall/ceiling device (optional). . . . . 55
Connecting the gas supply . . . . . . . . . . . . . . . . 57
Connecting the anesthetic gas scavenging
system AGS . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Connecting the endotracheal aspiration
system (optional) . . . . . . . . . . . . . . . . . . . . . . . 60
Connecting the patient system . . . . . . . . . . . . . 61
Connecting the flexible arm for the
breathing bag (optional) . . . . . . . . . . . . . . . . . . 67
Park holder for vaporizer units (optional) . . . . . 67
Connecting the electrical connections . . . . . . . 68
Getting started . . . . . . . . . . . . . . . . . . . . . . . . 71
Device check . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Self test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Emergency start . . . . . . . . . . . . . . . . . . . . . . . 87
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Operation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Setting fresh-gas concentrations. . . . . . . . . . . 91
Setting the Vapor . . . . . . . . . . . . . . . . . . . . . . . 94
Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Using non-rebreathing systems. . . . . . . . . . . . 115
Changing patients . . . . . . . . . . . . . . . . . . . . . . 117
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Alarm displays . . . . . . . . . . . . . . . . . . . . . . . . . 124
Alarm priorities and alarm signals . . . . . . . . . . 125
Suppressing alarms. . . . . . . . . . . . . . . . . . . . . 126
Limit-based alarms activated in respective
ventilation modes . . . . . . . . . . . . . . . . . . . . . . 128
Enabling/disabling CO2alarms . . . . . . . . . . . . 130
HLM mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Enabling/disabling SpO2alarms (optional) . . . 132
Displaying and setting alarm limits . . . . . . . . . 133
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Selecting the standard screen. . . . . . . . . . . . . 138
Monitoring mode . . . . . . . . . . . . . . . . . . . . . . . 139
Screen layout . . . . . . . . . . . . . . . . . . . . . . . . . 139
Displayed parameters . . . . . . . . . . . . . . . . . . . 140
Gas measurement. . . . . . . . . . . . . . . . . . . . . . 143
Using the volumeter function. . . . . . . . . . . . . . 147
Econometer (optional) . . . . . . . . . . . . . . . . . . . 148
Loops (optional). . . . . . . . . . . . . . . . . . . . . . . . 149
Mini trends (optional). . . . . . . . . . . . . . . . . . . . 150
Selecting the data screen . . . . . . . . . . . . . . . . 152
Selecting the trend screen. . . . . . . . . . . . . . . . 153
Selecting the logbook . . . . . . . . . . . . . . . . . . . 155
Using the timer function. . . . . . . . . . . . . . . . . . 156
SpO2measurement (optional). . . . . . . . . . . . . 156
Configuration. . . . . . . . . . . . . . . . . . . . . . . . . 161
Configuring the default settings. . . . . . . . . . . . 162
Basic settings and audible signals . . . . . . . . . 163
Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
Interfaces/logbook . . . . . . . . . . . . . . . . . . . . . . 165
Screen layout . . . . . . . . . . . . . . . . . . . . . . . . . 166

Contents
6Instructions for use Primus SW 4.5n
Setting alarm limits . . . . . . . . . . . . . . . . . . . . . . 167
Ventilator and gas delivery . . . . . . . . . . . . . . . . 170
System information. . . . . . . . . . . . . . . . . . . . . . 173
Configuration during operation . . . . . . . . . . . . . 175
Setting the patient's age and weight during
operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Remedying faults . . . . . . . . . . . . . . . . . . . . . . 179
Power failure . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Gas failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Ventilator failure . . . . . . . . . . . . . . . . . . . . . . . . 183
Fresh gas delivery failure . . . . . . . . . . . . . . . . . 184
Ventilator and fresh gas delivery failure . . . . . . 185
Gas measurement failure . . . . . . . . . . . . . . . . . 186
Screen error . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
User interface failure . . . . . . . . . . . . . . . . . . . . 186
System failure. . . . . . . . . . . . . . . . . . . . . . . . . . 187
Alarm – Cause – Remedy . . . . . . . . . . . . . . . . 188
Cleaning, Disinfection and Sterilization . . . . 207
Disassembly . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
Reprocessing Procedure . . . . . . . . . . . . . . . . . 216
Reprocessing List. . . . . . . . . . . . . . . . . . . . . . . 219
Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Before using on patients on again . . . . . . . . . . 228
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Preventive maintenance. . . . . . . . . . . . . . . . . . 232
Repair. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Emptying or replacing the water trap . . . . . . . . 235
Replacing the O2sensor . . . . . . . . . . . . . . . . . 236
Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Disposing of the medical device. . . . . . . . . . . . 238
Disposal of Non-Rechargeable Batteries . . . . . 238
Technical Data . . . . . . . . . . . . . . . . . . . . . . . . 239
Technical Data . . . . . . . . . . . . . . . . . . . . . . . . . 240
EMC Declaration . . . . . . . . . . . . . . . . . . . . . . . 262
Device combinations . . . . . . . . . . . . . . . . . . . . 267
Connections to IT-networks . . . . . . . . . . . . . . . 267
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269

Instructions for use Primus SW 4.5n 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
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Not for use in areas of explosion hazard . . . . . 9
Connection with other electrical equipment . . . 9
Patient safety . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Patient monitoring. . . . . . . . . . . . . . . . . . . . . . . 10
Information on electromagnetic compatibility . . 10
Sterile accessories . . . . . . . . . . . . . . . . . . . . . . 11
Storing the instructions for use . . . . . . . . . . . . . 11
Training. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Product-specific safety information . . . . . . . 12
Functional safety . . . . . . . . . . . . . . . . . . . . . . . 14

For your safety and that of your patients
8Instructions for use Primus SW 4.5n
General safety information
The following WARNING and CAUTION state-
ments apply to general operation of the medical de-
vice.
WARNING and CAUTION statements specific to
subsystems or particular features of the medical
device appear in the respective sections of these
instructions for use or in the instructions for use of
another product being used with this device.
Strictly follow these instructions for use
Maintenance
Accessories
WARNING
Risk of incorrect operation and of incorrect
use
Any use of the medical device requires full un-
derstanding and strict observation of all sec-
tions of these instructions for use. The medi-
cal device must only be used for the purpose
specified under "Intended use" on page 16
and in conjunction with appropriate patient
monitoring (see page 17).
Strictly observe all WARNING and CAUTION
statements throughout these instructions for
use and the information on medical device la-
bels. Failure to observe these safety informa-
tion statements constitutes a use of the medi-
cal 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. Re-
pair and complex maintenance carried out on
the medical device must be performed by ex-
perts.
If the above is not complied with, medical de-
vice failure and patient injury may occur. Ob-
serve chapter "Maintenance".
Dräger recommends that a service contract is
obtained with DrägerService and that all re-
pairs are performed by DrägerService. For
maintenance Dräger recommends the use of
authentic Dräger repair parts.
WARNING
Risk due to incompatible accessories
Dräger has tested only the compatibility of ac-
cessories listed in the current list of accesso-
ries. If other, incompatible accessories are
used, there is a risk of patient injury due to
medical device failure.
Dräger recommends that the medical device is
only used together with accessories listed in
the current list of accessories.

Instructions for use Primus SW 4.5n 9
For your safety and that of your patients
Not for use in areas of explosion hazard
Connection with other electrical equip-
ment
For further information, see "Device combinations"
on page 267.
NOTE
Strictly observe the instructions for use of all ac-
cessories such as:
– Water traps
– Flow sensors
– CLIC adapter
– CLIC absorber
– Soda lime
– Breathing hoses
–Masks
– Filters
– Endotracheal suction
– Vaporizer
– Manual resuscitator
– AGSS terminal unit
WARNING
Risk of explosion and fire
The medical device is not approved for use in
areas where oxygen concentrations greater
than 25 Vol%, or combustible or explosive gas
mixtures are likely to occur.
WARNING
Risk of electric shock or device malfunction
Any connected devices or device combina-
tions not complying with the requirements
mentioned in these instructions for use can
compromise the correct functioning of the
medical device and lead to an electric shock.
– Electrical connections to equipment not
listed in these instructions for use or these
assembly instructions must only be made
when approved by each respective manu-
facturer.
– Before operating the medical device,
strictly comply with the instructions for
use of all connected devices or device
combinations.

For your safety and that of your patients
10 Instructions for use Primus SW 4.5n
Patient safety
The design of the medical device, the accompany-
ing documentation, and the labeling on the medical
device are based on the assumption that the pur-
chase and the use of the medical device are re-
stricted to persons familiar with the most important
inherent characteristics of the medical device.
Instructions and WARNING and CAUTION state-
ments are therefore largely limited to the specifics
of the Dräger medical device.
The instructions for use do not contain any informa-
tion on the following points:
– Risks that are obvious to users
– Consequences of obvious improper use of the
medical device
– Potentially negative effects on patients with dif-
ferent underlying diseases
Medical device modification or misuse can be dan-
gerous.
Patient monitoring
The user of the medical device is responsible for
choosing a suitable patient monitoring system that
provides appropriate information on medical device
performance and patient condition.
Patient safety can be achieved by a wide variety of
means ranging from electronic surveillance of med-
ical device performance and patient condition to di-
rect observation of clinical signs.
The responsibility for selecting the best level of pa-
tient monitoring lies solely with the user of the med-
ical device.
Information on electromagnetic compat-
ibility
General information on electromagnetic compatibil-
ity (EMC) according to international EMC standard
IEC 60601-1-2:
Medical electrical equipment is subject to special
precautionary measures concerning electromag-
netic compatibility (EMC) and must be installed and
put into operation in accordance with the EMC in-
formation provided (see page 262).
Portable and mobile radio frequency communica-
tion equipment can affect medical electrical equip-
ment.
CAUTION
Risk of patient injury
Do not make therapeutic decisions based solely
on individual measured values and monitoring pa-
rameters.
WARNING
Risk of electric shock
Do not connect connectors with an
ESD warning symbol and do not touch
their pins without implementing ESD
protective measures. Such protective meas-
ures can 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 users concerned must be instructed in
these ESD protective measures.

Instructions for use Primus SW 4.5n 11
For your safety and that of your patients
Sterile accessories
Storing the instructions for use
Training
Training for users is available from the Dräger or-
ganization responsible, see www.draeger.com.
WARNING
Risk of electric shock
Connecting devices to the aux-
iliary outlets of the anesthesia
machine can cause an increase
in leakage current beyond per-
missible values if the protective conductor of
a device fails.
Check the leakage current when connecting
devices to the auxiliary outlets. If connecting
a device (or devices) increases the leakage
current to a value which exceeds the permis-
sible value, do not use the auxiliary outlets of
the anesthesia machine: use a separate wall
socket.
The system must fulfill the requirements for
medical electrical equipment in accordance
with the relevant standards, see "Technical
Data", page 261.
CAUTION
Risk of medical device failure and of patient injury
Do not use sterile-packaged accessories if the
packaging has been opened, is damaged, or if
there are other signs of non-sterility.
Disposable articles must not be reprocessed and
resterilized.
CAUTION
Risk of incorrect use
Instructions for use must be kept accessible to the
user.

For your safety and that of your patients
12 Instructions for use Primus SW 4.5n
Product-specific safety information
WARNING
Risk of malfunctions
Unapproved modifications to the medical de-
vice can cause malfunctions.
No modifications must be made to this medi-
cal device without the permission of Dräger.
Dräger does not accept responsibility for
modifications to the device made without the
permission of Dräger.
WARNING
Risk due to barely audible alarms
The user must remain within the hearing
range of the acoustic alarm signal. This per-
mits quick recognition and handling of the
alarm.
Adjust the volume of the alarm signal to the
distance from the medical device.
WARNING
Risk due to a noisy environment
When operating in a noisy environment, the
volume of the alarm signals must be adjusted
to suit.
Always set the volume of the alarm signal suf-
ficiently high.
WARNING
Risk of use error
Various potentially dangerous situations may
occur which demand the attention of trained
personnel.
The workstation may only be used under the
permanent supervision of qualified medical
personnel so that assistance can be provided
immediately in the event of any malfunctions.
WARNING
Risk of fire
In order to prevent a fire hazard, explosive an-
esthetics, such as ether or cyclopropane,
must not be used.
WARNING
Risk of device failure and/or danger to patient
Magnetic fields may negatively influence the
proper function of the medical device, thus
endangering the patient or user.
The medical device must not be used in the vi-
cinity of magnetic resonance imagers (MRI,
NMR, NMI).
WARNING
Risk of explosion, fire
If an oxygen leak is suspected within or near
the anesthesia machine, do not initiate opera-
tion.
Disconnect all oxygen supplies and contact a
trained service technician.
WARNING
Risk of fire
To prevent a fire hazard, drugs or other sub-
stances based on inflammable solvents, such
as alcohol, must not be introduced into the
medical device, particularly into the breathing
circuit and the breathing system.
Adequate ventilation must be ensured if
highly inflammable substances are used for
disinfection.

Instructions for use Primus SW 4.5n 13
For your safety and that of your patients
CAUTION
Risk of patient injury
An incorrect diagnosis or misinterpretation of
measured values, or other parameters, may en-
danger the patient.
Do not base therapy decisions on individual
measured values or monitoring parameters only.
WARNING
Risk of patient injury
If ventilation of the patient is no longer en-
sured due to an obvious fault in the equip-
ment, the patient must immediately be venti-
lated with a manual resuscitator.
Always keep an emergency manual breathing
bag at hand.
WARNING
Risk of burns
Conductive breathing hoses or face masks
may cause burns during HF surgery.
Do not use these types of hoses and masks in
combination with HF surgery.
CAUTION
Risk of mechanical failure
The shock and vibrations caused by transporta-
tion may lead to a mechanical failure. The appli-
cation of a wall or ceiling mount is designated for
buildings.
Do not use the anesthesia machine for mobile fa-
cilities such as ambulances, helicopters or ships.
CAUTION
Risk of crushing
Movable parts and attached parts can lead to
crushing injuries. Pay special attention to edges,
movable parts, and corners when working with the
following parts:
– Drawers
– Ventilator module
–Doors
– Writing table
– Swivel arms for mounted devices
– Accessories such as gas cylinders, vaporiz-
ers, CLIC absorbers, and CLIC adapters
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 stand-
ards regulating the use of medical gases.

For your safety and that of your patients
14 Instructions for use Primus SW 4.5n
Functional safety
The essential performance consists in:
– Supplying the anesthesia workstation with O2
If the O2supply (central supply or gas cylinder)
fails, an alarm is issued.
– Supply of the patient with adequately
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 concentra-
tions are delivered, an alarm is issued.
– Monitoring the airway pressure and the expira-
tory minute volume
Alarms are issued depending on the set alarm
limits.

Instructions for use Primus SW 4.5n 15
Application
Application
Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Ventilation modes . . . . . . . . . . . . . . . . . . . . . . . 16
The following measured values are
displayed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
The following parameters can be displayed
as mini trends . . . . . . . . . . . . . . . . . . . . . . . . . . 17
The following parameters are displayed as
curves. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
The following are displayed as bar graphs. . . . 17
Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Indications and contraindications . . . . . . . . 18
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Contraindications . . . . . . . . . . . . . . . . . . . . . . . 18
Further information on application. . . . . . . . 18
Environment of use. . . . . . . . . . . . . . . . . . . . . . 18

Application
16 Instructions for use Primus SW 4.5n
Intended use
Primus – Anesthesia workstation for adults, chil-
dren, and neonates with automatic and manual
ventilation, as well as spontaneous breathing with
or without pressure support.
Utilization
– Inhalation anesthesia in rebreathing systems
– Inhalation anesthesia in semi-closed to virtually
closed systems with "low flow" and "minimal
flow" techniques (for minimal gas and anes-
thetic agent consumption)
– Inhalation anesthesia in non-rebreathing sys-
tems, with a separate fresh-gas outlet for con-
necting, e.g., a Bain system or Magill system,
with a fresh-gas flow of 0.2 to 18 L/min (op-
tional).
Optional:
– Operation without nitrous oxide: The device
may only be operated with O2and air.
Ventilation modes
– Volume-controlled ventilation in Volume Mode.
Optional activation of: Synchronization, Press.
Support (Pressure support) (optional)
– Pressure-controlled ventilation in Pressure
Mode.
Optional activation of: Synchronization, Press.
Support (Pressure support) (optional)
– Manual ventilation (Man.)
– Spontaneous breathing (Spont.)
– Pressure-supported spontaneous breathing
Press. Support CPAP (optional)
–Volume AF (Volume Mode AutoFlow) (op-
tional).
Optional activation of: Synchronization, Press.
Support (Pressure support) (optional)
The following measured values are
displayed
– Peak pressure PEAK, mean pressure PMEAN,
plateau pressure PLAT, and PEEP
– Expiratory minute volume MV, difference be-
tween insp. and exp. minute volume MVLEAK,
– Patient compliance CPAT,
Tidal volume VT,
Breathing rate Freq.
– Inspiratory and expiratory concentration of O2,
N2O, anesthetic gas, and CO2
– Δ O2:
Difference between inspiratory and expiratory
O2concentration
Optional:
– Functional oxygen saturation (SpO2) and pulse
rate
WARNING
Risk of device failure and/or danger to patient
If the intended use of this anesthesia machine
is not adhered to, it may fail and/or the patient
may be endangered.
Use the anesthesia machine only as specified
in the intended use of these instructions for
use.

Instructions for use Primus SW 4.5n 17
Application
The following parameters can be
displayed as mini trends*
– Minute volume CO2MV*CO2
–O2Uptake
–PEEP, patient compliance CPAT
The following parameters are displayed
as curves
– Airway pressure PAW
– Inspiratory and expiratory flow
– Inspiratory and expiratory concentration of O2,
CO2, and anesthetic gas
Optional:
– Plethysmogram
–PAW-V loops and V-Flow loops
The following are displayed as bar
graphs
– Inspiratory tidal volume, expiratory tidal volume,
and leakage tidal volume
– Volumeter
–Pressure
– Econometer for indicating fresh-gas utilization
(optional)
Trends showing the measured values over time
and a logbook are also available.
Monitoring
by means of adjustable alarm limits which can au-
tomatically be adapted to the momentary ventila-
tion situation.
With monitoring for
– Airway pressure PAW
– Expiratory minute volume MV
– Apnea
– Inspiratory and expiratory anesthetic gas con-
centration
– Detection of anesthetic gas mixtures (simulta-
neous detection of up to two anesthetic agents)
– Inspiratory O2and N2O concentrations
– Inspiratory and expiratory CO2concentrations
– Special alarm behavior in HLM mode
– Automatic agent alarm activation for multiples
of MAC (xMAC)
Optional:
– Oxygen saturation
–Pulserate
*optional

Application
18 Instructions for use Primus SW 4.5n
Indications and contraindications
Indications
Primus is intended for inhalational anesthesia and/
or patient ventilation in accordance with its intended
use during surgical or diagnostic procedures.
Contraindications
For patients with suspected malignant hyperther-
mia: Do not use any volatile anesthetic agents or
Primus with residual concentrations of these gases
above 5 ppm.
Do not perform long term low-flow anesthesia on
patients with ketoacidosis or patients under the in-
fluence of alcohol. Otherwise, there is a risk of ac-
etone accumulation in the patient.
Further information on application
Environment of use
Primus is designed for use in areas in which thera-
peutic or diagnostic procedures can be performed.
Do not use Primus in the following environments:
– Outside buildings
– On intensive care units
– During patient transport
– In vehicles, airplanes, or helicopters
WARNING
Risk of explosion and fire
The medical device is not approved for use in
areas where oxygen concentrations greater
than 25 Vol%, or combustible or explosive gas
mixtures are likely to occur.
WARNING
Risk of device failure and/or danger to patient
Magnetic fields may negatively influence the
proper function of the medical device, thus
endangering the patient or user.
The medical device must not be used in the vi-
cinity of magnetic resonance imagers (MRI,
NMR, NMI).

Instructions for use Primus SW 4.5n 19
Overview
Overview
Components . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Front . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Rear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Gas inlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Screen with user interface . . . . . . . . . . . . . . . . 23
Interface panel . . . . . . . . . . . . . . . . . . . . . . . . . 24
Flexible arm for breathing bag (optional) . . . . . 25
Auxiliary O2flow tube (optional) . . . . . . . . . . . . 26
Gas flow diagram . . . . . . . . . . . . . . . . . . . . . . . 27
Additional functions. . . . . . . . . . . . . . . . . . . . 28
MEDIBUS/MEDIBUS.X Protocol . . . . . . . . . . . 28
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . 29
List of abbreviations used in the software
and on the device . . . . . . . . . . . . . . . . . . . . . . . 29
List of general abbreviations. . . . . . . . . . . . . . . 31
Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Symbols. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Overview
20 Instructions for use Primus SW 4.5n
Components
Front
AScreen with user interface
BRotary knob
CSystem power switch
DO2emergency delivery
EO2flush button O2+
FWriting table
GBreathing system
HRelease button for ventilator module*
IAbsorber
(optional: disposable Dräger absorber
Drägersorb CLIC)
JDrawer
KCastors with locking brake
LEndotracheal aspiration system (optional)
MWater trap with sample line connection
NVapor units with Interlock system
OExt. fresh-gas outlet (optional)
PTop shelf (for external monitors)
001
A
B
C
D
E
F
G
H
I
P
O
N
M
L
K
J
* available since November 2004