Gradian Universal Anaesthesia Machine User manual

Universal Anaesthesia Machine®
Maintenance Manual
®

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HOW TO GET HELP
GENERAL DESCRIPTION OF THE UNIVERSAL ANAESTHESIA MACHINE®
SPECIFICATIONS
COMPONENTS OF THE UAM®
UNPACKING AND PREPARING FOR USE
RECOMMENDED UAM MAINTENANCE SCHEDULE
FULL FUNCTION TEST
MAINTENANCE PROCEDURES
Cleaning or Replacing the Primary Air Filter
Replacing the Consumable Oxygen Sensor
Removing and Replacing the Draw-Over Vaporizer
Cleaning the Halothane Vaporizer
Replacing the Fenton Balloon
Replacing the Analyzer Screen Circuit Board
Replacing the Concentrator Loss of Power Alarm Battery
Removing the Concentrator
Installing the Concentrator
Replacing the Analyzer Screen Battery
Removing, Inspecting and Cleaning the Pressure Relief Valve
PROBLEM SOLVING
MAIN PARTS
ILLUSTRATED PARTS
APPENDIX I: BREATHING CIRCUIT DIAGRAM
APPENDIX II: OXYGEN CONCENTRATOR FLOW DIAGRAM
APPENDIX III: ELECTRICAL DIAGRAM
APPENDIX IV: UAM SERVICE RECORD
APPENDIX V: UAM INSPECTION LABEL
APPENDIX VI: PRESSURE CONVERSIONS & COLOUR IDENTIFICATION FOR MEDICAL GASES
Copyright © 2020 by Gradian Health Systems. All rights reserved.
Gradian Health Systems, UAM,and the Gradian logo are registered trademarks (®) of Gradian Health Systems, registered
in the United States.
Printed in the United States of America.

HOW TO GET HELP
EMAIL:
WEB:
[e-mail]
www.gradianhealth.org
WHATSAPP: [phone]
ADDRESS: Gradian Health Systems, 40 W 25th St., 6th Floor, New York, NY 10010, USA
NOTE: For the latest UAM specifications and technical materials please visit us online at:
http://www.gradianhealth.org/our-products/uam/
GENERAL DESCRIPTION OF THE UNIVERSAL ANAESTHESIA MACHINE®
The UAM® combines elements from both continuous ow and draw-over designs to provide a workstation that delivers
controlled anaesthesia in all hospital settings.
The breathing system is a low pressure (limited to 5 cm H2O) continuous ow system that defaults to a demand-ow (draw-
over) system when the supply fails. There are three one-way valves and a balloon operated inating valve which provide this
uniquely versatile method of anaesthesia delivery.
Oxygen can be provided from a variety of sources, and if none of those sources is available the machine will automatically
draw in room air without the need for the user to change settings. The vaporizer provides calibrated delivery of anesthetic
agent and the manual bellows ensures that safe assisted respiration can continue without requiring a high pressure gas
source.
The system has been designed to accept standard anaesthesia accessories such as the breathing circuit, oxygen sensor,
and standard connectors for the oxygen and nitrous oxide supplies. The UAM is also designed for simple eld service. Most
components can be removed with standard tools and local technicians can install replacement parts without removing the
UAM from the hospital.
The UAM carries the CE Mark, having passed EU regulatory inspections. It is manufactured in an ISO-certied factory in
England. It is used in a wide variety of hospitals, from internationally recognized academic centers to resource-constrained
district hospitals.
The Universal Anaesthesia Machine ensures that an adequate supply of oxygen and anaesthesia is always available to meet
patient demand, no matter what the environment.
The UAM provides several ways to deliver oxygen, including connections for cylinder and pipeline. Most importantly, the
machine produces its own oxygen using an integrated concentrator that converts room air into 95% oxygen. Air is drawn
into the UAM and is puried by 2 different lters. Ambient air is made up of 78% nitrogen, 21% oxygen and 1% other gases.
The electrically powered oxygen concentrator in the UAM removes nitrogen from room air, creating a mixture that is 95%
oxygen and 5% other gases.
The compressed air passes into a canister lled with a powdered material called Zeolite. Nitrogen sticks to the Zeolite,
while oxygen and other gases ow through it to a reservoir tank. The UAM produces up to 10 liters per minute of up to 95%
oxygen. The oxygen then travels through the rotameter bank into the back bar and reservoir bag.
GAS FLOW IN THE PATIENT SYSTEM
The ow dials control the amount of oxygen entering the back bar and available for the patient. The spinning bobbin in each
rotameter shows the ow rate in liters per minute.
The back bar provides the following functions:
1. The reservoir bag stores up to 2 liters of oxygen.
2. The pressure relief valve limits pressure in the back bar to 5 centimeters of water, protecting the patient from harm.
3. The air inlet valve allows room air to be drawn in whenever the supply of oxygen is less than the demand, as expressed
by the patient’s minute volume.
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The low-resistance draw-over vaporizer adds volatile agent to the carrier gas passing through it. Volatile agent is added by
using the selector wheel to achieve the desired percentage. The resulting anesthetic supply gas is comprised of oxygen,
volatile agent and a variable amount of room air. The anesthetic supply gas ows from the back bar at low pressure to the
breathing block and the bellows.
An oxygen analyzer measures the oxygen concentration of the supply gas passing to the patient. The reading is displayed
on the analyzer screen.
As the supply gas ows past the sampling point for the consumable oxygen sensor, it passes the rst one-way valve, then
enters the bellows chamber. Depending on the conguration, the second one-way valve is immediately after the bellows in
the breathing block, or on the inspiratory Y-piece connection.
During spontaneous breathing both non-return valves open for inspiration and close during expiration. The bellows will not
ll with exhaled gas.
The bellows is used for intermittent positive pressure ventilation, also known as IPPV or controlled ventilation. When the
bellows is raised, supply gas ows through the rst non-return valve into the bellows. The second non-return valve remains
closed.
As the bellows are pushed down, the supply gas ows out through the second non-return valve into the inspiratory limb. The
rst non-return valve is closed.
Another pressure relief valve ensures that excessive manual force on the bellows cannot cause harm to the patient.
The UAM uses a conventional Y-piece patient connection. Exhaled gas returns to the UAM via the expiratory limb of the
Y-piece and then passes by a third one-way valve and the Fenton balloon to the scavenger port. The balloon acts as an
inating valve which enables controlled ventilation of the lungs, the third valve prevents back-ow during spontaneous
breathing.
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UAM CONFIGURATIONS
IF YOUR UAM DOES NOT LOOK LIKE PICTURES PRESENTED ELSEWHERE, DO NOT BE ALARMED. The UAM has two
different designs depending on when it was manufactured: Rev A (for UAMs manufactured before October 2018) and Rev
B for UAMs manufactured after that date. UAMs with a serial number prior to 21501-001 are Rev A. Serials numbers after
this are Rev B. The order and exact location of select components depends on the design. Your institution may or may
not have also purchased a UAMV and/or a patient vital sign monitor, which sit on top of the UAM.
Photos and Diagrams specific to one configuration will be highlighted with a grey border (Rev A: manufactured before
October 2018) or orange border (Rev B: manufactured after October 2018) Photos and diagrams that lack borders apply
to both UAM designs.
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Rev A
Before Oct. 2018
Rev B
After Oct. 2018

SPECIFICATIONS
PHYSICAL AND ELECTRICAL
g Workstation: 146cm x 53cm x 69cm, 130kg; aluminum frame, vertical mounting side rails on both sides, nylon internal tubing
g Top shelf: 54 cm (W) x 37 cm (D), maximum load 35 kg with even load distribution; Epoxy powder coated pressed aluminum;
monitor brackets bolt items to the top of the top shelf
gDrawer: 10cm x 29cm x 32cm in A, 11cm x 29cm x 24cm in B; 35kg weight limit, stainless steel, removable for cleaning.
gWork surface: Stainless Steel, 46 cm (W) x 31 cm (D) x 88 cm (H) above ground (removable) in A, 46 cm (W) x 26 cm
(D) x 88 cm (H) in B
gMains power supply: 220V, 50-60Hz
gPower: 500 Watts/220v = 2.27 amps
gOxygen analyzer power: CE-marked, fused and medical grade. Mains powered with battery backup for ten hours of use.
g Automatic over/under voltage mains power isolator protects oxygen concentrator, and sockets for monitor and accessories
g3.5” TFT touch screen for oxygen percentage display and alarm setting
gMembrane switch for oxygen analyzer power
gCasters: 150 mm diameter single wheel antistatic casters, front lockable casters
OXYGEN SUPPLY AND MONITORING
gOxygen concentrator ow rate: 0.1 to 10.0 liters per minute
g  Maximum oxygen concentration: 95%
NOTE: The oxygen concentration may vary according to ambient humidity and maintenance of the air lter
gAlternative sources: cylinder yoke, pipeline, or other external ow regulated portable oxygen source
gAutomatic room air intake when patient minute volume exceeds supply gas ow
gAccuracy of glass rotameter for O2: +/- 2.5% when using 100% O2
gIntegrated inspiratory oxygen analysis uses a MOX-3 oxygen sensor
gCalibration for room air (21%) and 100% oxygen
gPressure sensitive apnea or high ow alarm
gAdjustable minimum and maximum oxygen alarm settings
gUp to ten hour analyzer battery backup, trickle recharge from mains power
gMembrane keypad and touch screen
OPTIONAL USE OF NITROUS OXIDE
gSources: pipeline or cylinder
gHypoxic cut-off: A solenoid automatically shuts off nitrous oxide delivery if supply gas O2level falls below a minimum of 25%
gFlow of N2O stops if electrical power fails
gSight and touch differentiated ow control dial per ISO standards
gAccuracy of glass rotameter for N2O: +/- 2.5%
VENTILATION
gManual bellows for adult and pediatric use made from durable, long-lasting silicone rubber
g 1600cc capacity
g Inspiratory pressure relief of 55 cmH2O for pressure created during mechanical ventilation
g Aluminum bellows block
g Silicone balloon inating valve at the expiratory port
g 15mm female/22mm male ISO standard taper connection for breathing circuit, 30mm male ISO standard taper connection for AGSS
scavenging equipment
VAPORIZERS
g Stainless steel and plated brass construction
g Draw over ow type
g Pour ller type.
g Separate units for isourane, sevourane, and halothane per ISO standards
g Agent delivery range: 0.5% to 4%
g 120ml capacity
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3LPM 4LPM 5LPM 6LPM 7LPM 8LPM
4.5
4
3.5
3
2.5
1
1.5
1
.5
0
TYPICAL HALOTHANE VAPORIZER PERFORMANCE WITH FLOW
4%
3%
2%
1.5%
1%
.5%
g Performance:
150C 220C 250C 300C 350C
6
5
4
3
2
1
0
4%
3%
2%
1%
TYPICAL HALOTHANE VAPORIZER PERFORMANCE WITH TEMPERATURE
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150C 220C 250C 300C 350C
6
5
4
3
2
1
0
4%
3%
2%
1%
TYPICAL ISOFLURANE VAPORIZER PERFORMANCE WITH TEMPERATURE
3LPM 4LPM 5LPM 6LPM 7LPM 8LPM
4.5
4
3.5
3
2.5
1
1.5
1
.5
0
TYPICAL ISOFLURANE VAPORIZER PERFORMANCE WITH FLOW
4%
3%
2%
1.5%
1%
.5%
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REAR PANEL CONNECTORS
gMains isolator switch, 2 UK style power sockets
gOxygen and nitrous pipeline NIST connectors and cylinder yokes
gMulti-diameter external oxygen hose connector
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COMPONENTS OF THE UAM
SEE INSET PAGE 9
8. Manual Bellows
9. Pressure relief valve
and gauge
10. Fenton Balloon
expiratory valve
11. Y-piece connectors
12. Water trap
13. Oxygen concentrator
status screen
14. Integrated oxygen
concentrator
15. Castors (front lockable)
1. Oxygen analyzer and
control screen
2. Oxygen and Nitrous Oxide
Flowmeter Bank
3. Back bar with air inlet,
pressure relief valve and
2 liter reservoir bag
4. Low resistance vaporizer
5. Oxygen concentrator
on/off switch
6. Oxygen cylinder and
pipeline pressure gauges
7. Nitrous Oxide cylinder
and pipeline gauges
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NOTE A VS B