JYOTI DHAMAN-III User manual

DHAMAN-III Ventilator System
Operators Manual Version No: V.02.02.06.2021

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Copyright Information
Copyright 2020 Jyoti CNC Automation Limited Dhaman, Dhaman with logo. The information
contained in this manual is the sole property of Jyoti and may not be reproduced or
duplicated in full or in parts, without the express consent or permission of Jyoti. This manual
may be revised or replaced by Jyoti at any time and without notice. You should ensure that
you have the most current applicable version of this manual; if in doubt, reach us on the
‘contact detail’ given in this manual. While the information set forth herein is believed to be
accurate, it is not a substitute for the exercise of professional judgement. The ventilator
should be operated and serviced only by trained professionals. Nothing in this manual shall
limit or restrict in any way Jyoti’s right to revise or otherwise change or modify the equipment
(including its software) described herein, without notice. In the absence of an express,
written agreement to the contrary, Jyoti has no obligation to furnish any such revisions,
changes, or modifications to the owner or user of the equipment (including its software)
described herein.

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Contents
Chapter 1 - Introduction .................................................................................. 5
1.1 Device Outline ..................................................................................................................... 5
1.2
Operator’s Safety Information ........................................................................................ 7
1.3 General Warnings & Cautions ........................................................................................ 8
Chapter 2 – System Overview ...................................................................... 14
2.1 User Interface .................................................................................................................... 15
2.2 Patient Unit ........................................................................................................................ 18
2.3 Symbols & Labels ............................................................................................................ 19
2.4 Transportation and Storage .......................................................................................... 20
2.5 Information/Assistance .................................................................................................. 21
Chapter 3 – Setting up the Ventilator .......................................................... 22
3.1 Installing Ventilator ......................................................................................................... 22
3.2 Connecting Electrical Supply ....................................................................................... 23
3.3 Connecting Oxygen/ Air Supply ................................................................................... 24
3.4 Connecting Patient Breathing Circuit with Flow Sensor ....................................... 25
3.5 Connecting High Flow Nasal Therapy circuit ........................................................... 27
3.6 Connecting Nebulizer...................................................................................................... 28
3.7 Communication Ports ..................................................................................................... 29
Chapter 4 – Operating Procedure ................................................................ 30
4.1 Operating Flow Summary .............................................................................................. 30
4.2 Turning On Ventilator ..................................................................................................... 30
4.3 Performing Functional Checks .................................................................................... 31
4.4 Attaching Patient Breathing Circuit ............................................................................ 31
4.5 Selecting Patients ............................................................................................................ 31
4.7 Selecting Ventilation Mode & Control Parameters .................................................. 33
4.8 Setting Alarm Limits ........................................................................................................ 35
4.9 Start Ventilation ................................................................................................................ 37
4.10 Stop Ventilation ................................................................................................................ 38
4.11 Turn Off Ventilator ........................................................................................................... 38
Chapter 5 – Ventilator Modes & Controls ................................................... 41
5.1 VCVs (Volume Control Ventilation with Assist Control) ........................................ 42
5.2 VCV-SIMV (Volume Control with Synchronized Intermittent-Mandatory
Ventilation) ..................................................................................................................................... 43
5.3 PRVC (Pressure Regulated Volume Control) ........................................................... 44
5.4 PCVs (Pressure controlled Ventilation with Assist Control) ................................ 47
5.5 PCV-SIMV (Pressure Control with Synchronized Intermittent Mandatory
Ventilation) ..................................................................................................................................... 48
5.6 CPAP-PSV (Continuous Positive Airway Pressure with Pressure Support) .... 49

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5.7 HFNT (High Flow Nasal Therapy) ................................................................................. 51
5.8 BiPAP ST (Biphasic Positive Airway Pressure – Spontaneous Time) ............... 52
5.9 Special Functions ............................................................................................................ 61
Chapter 6 – Monitoring ................................................................................. 63
6.1 Numerical Patient Data ................................................................................................... 63
6.2 Graphics ............................................................................................................................. 64
Chapter 7 – Alarm Handling ......................................................................... 66
7.1 Introduction ....................................................................................................................... 66
7.2 Alarm Setting ..................................................................................................................... 66
7.3 Alarm Messages ............................................................................................................... 68
7.4 Alarm Removal ................................................................................................................. 71
Chapter 8 –Technical Specification ............................................................. 72
8.1 System technical Specification .................................................................................... 72
8.2 Setting parameter ............................................................................................................. 73
8.3 Alarms ................................................................................................................................. 74
8.4 Service ................................................................................................................................ 75
8.5 Accessories ....................................................................................................................... 75
Chapter 9 – Maintenance .............................................................................. 78
9.1 Cleaning, disinfection, and sterilization..................................................................... 79
9.2 Disassembling & Assembling of Exhalation Valve for Disinfection and
Cleaning .......................................................................................................................................... 80
9.3 Disassembling & Disposal of Flow sensor circuit .................................................. 80
9.4 Preventive Maintenance ................................................................................................. 80
Chapter 10 – Definitions ............................................................................... 81
10.1 Definitions of Control Parameters with Range ......................................................... 81
10.2 Definitions of Alarm Parameters with Range ........................................................... 82
10.3 Definitions of Display Parameters with unit ............................................................ 83
Chapter 11 – Accessing Utility ..................................................................... 85
11.1 About Machine .................................................................................................................. 85
11.2 Calibration .......................................................................................................................... 85
11.3 System/ Alarm logs ......................................................................................................... 88
11.4 Special key ......................................................................................................................... 89
11.5 Sound .................................................................................................................................. 89
11.6 Display configuration ...................................................................................................... 90
Chapter 12 – Warranty .................................................................................. 92
12.1 Warranty details & Instructions .................................................................................... 92
12.2 Contact Details: ................................................................................................................ 93
12.3 Summary ............................................................................................................................ 93

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This Operator’s Manual contains detailed information and instructions which, when
adhered to, ensure the safe and effective set up, use and simple maintenance of the
DHAMAN-III ventilator.
This manual is designed for use by Respiratory Therapists and / or other qualified and
trained medical personnel under the direction of a physician in accordance with
applicable state laws and regulations.
1.1 Device Outline
DHAMAN-III Ventilator System is intended to provide invasive or noninvasive ventilator support
and monitoring for pediatric and adult patients with respiratory failure or respiratory
insufficiency.
It is a respiration assistant equipment with various alarm function and safety features for
safe respiration management. It should be used together with other clinical information
for patients’ safety and diagnosis.
Figure 1. Device Outline view
Chapter 1 - Introduction

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1.1.1
Device Configuration:
DHAMAN-III ventilator is composed of the following:
1) User Interface:
• Configures ventilation mode and displays patient measurement data with alarms.
2) Internal System:
• Mixes supplied gas.
• Delivers and exchange gases.
1.1.2
Who can Use the device:
DHAMAN-III ventilator must be used by the following users:
• Medical professionals familiar with Ventilators and have familiarized themselves with this
device.
• Individuals who have received training on the use of this device.
• Individuals who have experience in treatment of respiratory diseases and have gone
through the user manual of this device, under supervision.
1.1.3
Usage Environment:
DHAMAN-III ventilator must be used in the following environments:
• Hospitals
• Facilities and institutions with the purpose of providing medical services, including
respiratory related services.
• Inter and Intra Hospital transportation of patients - within hospitals or medical institutions.
1.1.4
Device Inspection and Service Guidelines:
CAUTION
Regular inspection and servicing:
Detailed Inspection and service of DHAMAN-III ventilator must be done at regular
intervals by a trained professional.
Maintenance of Inspection and Service Records:
All matters related to the inspection and servicing of DHAMAN-III ventilator sha
ll be
recorded in accordance to regulations prescribed by hospital, state government,
and central government.
Service Contract is strongly recommended:
We strongly recommend that all service on the DHAMAN-
III ventilator system be
performed as part of a service contract with Dhaman / Jyoti.

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1.1.5
Exceptions for Legal Responsibilities:
• Inappropriate environment
Our company has no responsibility for the safe operation of DHAMAN-III Ventilator System if
the ‘Intended Use Environment’ requirements specified in this manual are not followed.
• Improper use
Our company has no responsibility for the safe operation of DHAMAN-III ventilator if the
Intended Use described in this Manual is not followed.
• Improper user
Our company has no responsibility for the safe operation of DHAMAN-III ventilator if the
requirement/s of ‘Intended User’ described in this Manual is/are not met with.
• Service by a non-professional
Our company will not be responsible for the safe operation of DHAMAN-III if this product is
serviced or repaired by an individual who does not have or did not complete relevant training
required for maintenance and service of this product.
1.2
Operator’s Safety Information
All Operators should read and understand the following information about
General Warning and Caution before operating the DHAMAN-III ventilator.
Symbols are indicated on the interior and exterior of the product and in this User
Manual. The symbols represent important cautions and advice to the user.
Please read the following symbols carefully and be well informed of them for the
use and storage of the product.
ATTENTION
This Symbol represents “ATTENTION”
It is associated with safety issues that the user should give attention to and be
well informed of before using the product. The operating procedures of the
product are well described in this manual.
WARNING
This Symbol represents “WARNING”
It is associated with possible matters that may harm or cause irreversible damage
to the product or the patient.
CAUTION
This Symbol represents “CAUTION”
It is associated with possible matters that may damage the product or harm the
patient.

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1.3 General Warnings & Cautions
WARNING
DHAMAN-III ventilator is a critical care medical equipment and must be operated by
a trained medical or healthcare worker/professionals in accordance to the
guidelines given in this booklet.
Always perform Functional Check prior to connecting the ventilator to a patient.
To ensure that the internal battery remains functional, fully recharge the battery at
least every 2 months when the ventilator is not in use.
Always keep alternative means of ventilation ready for use in case of equipment
failure in order to avoid possibility of patient death or serious deterioration of health.
Breathing system filters and heat & moisture exchanger require frequent
replacements to prevent build-up of resistance and blockage.
In case of the following, stop the use of ventilator and contact service assistant:
If abnormal screen shows up
If an alarm cannot be settled
If the device creates any abnormal sound
If the device is operating abnormally or shows unexpected failure
The ventilator must always be kept in the vertical position during use.
If the ventilator is connected to a patient,
Carefully monitor the patient.
Prepare/keep a reserve ventilator for back-up, should the device fail
unexpectedly.
Do not raise or separate the expiratory part.
Always check the setting and measurement values displayed on the screen.
Do not cover the ventilator in any way. This will lead to errors in its functions.
Do not block or obstruct the vent (brass mesh filter for mixer damping - sintered
disc) on right side of ventilator as it may affect oxygen concentration delivery.
Continuously check the Expiratory part of the ventilator for contamination.
Do not use the system with worn or frayed hoses or hoses that have been
contaminated, or that may have come in contact / contaminated by combustible
materials such as grease or oil.
Oxygen enriched gas is extremely flammable: if you detect a burning odour, then
disconnect the oxygen supply to the ventilator and turn off the system.
The gases used in the system must be free from particles.
The system is not intended to be used with any anaesthetic agent.
NOTE
This Symbol represents “NOTE”
This symbol is associated with issues you should note regarding the surrounding
environment or additional references to the descriptions in this manual. It does not
pertain to possible damages to the product or the patient.

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CAUTION
Always use a humidifier or disposable humidifies for prevention of dry lung tissues.
When separating or transporting the ventilator or its parts, refer to User Manual or
contact us for any kind of assistance. Always take care while transporting the
ventilator against damages, contamination and missing of loose parts.
Be careful when handling tube, connector, and patient tube parts. Use of support
arm can reduce the weight of tube exerted on the patient and improve the comfort
for the patient.
Do not remove or renovate any part of the ventilator.
Under no circumstances should you attempt to service or repair the device
yourself, if you do so our company is not responsible for safe operation of
ventilator.
While using nebulisation breathing system, filters and heat and moisture
exchangers could require more frequent replacements to prevent build-up of
resistance and blockage.
Please turn off the power to recharge the battery when it is not used.
DHAMAN-III ventilator system is a product conforming to Class II.

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1.3.1 Warnings Regarding Storage of the Device:
WARNING
Do not store the product in a place exposed to extremely low / or extremely high
humidity.
Do not store the product in a place exposed to direct sunlight.
Do not store the product in a place near to a heating device.
Do not store the product in a place with extreme thermal variation. (Proper
Temperature range and humidity range is mentioned in chapter 8).
Do not store the product in a place with poor ventilation.
Do not install or place the product where it may fall or cause any kind of harm to
the patient.
Do not store the product in a place where the product could be exposed to extreme
impact or vibration.
Do not store the product in a place where the product could be exposed to
chemicals or explosive gases.
Do not touch accessible parts of the ventilator and patient simultaneously.
Be careful to prevent dirt, including metals and metal particles, from getting inside
the product.
If the product dysfunctions, do not disassemble the product yourself. Only
DHAMAN’s Service personnel and designated service technicians are authorized
to disassemble the product. If you disassemble the product yourself, you will not
receive any service for the product and the company will no longer be responsible
for the performance of the device including safety aspects.
Turn off the product & disconnect gas sources when not in use.

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1.3.2 Before starting the device:
WARNING
This product is extremely dangerous when used or stored in places exposed to
chemical substances or explosive gases.
Check the settings of various sensors & sub- devices before use.
Do not disassemble or dismantle the product.
Do not touch patient, table or any other equipment if defibrillator used.
All reusable items used for patient shall be sterilized before use.
Do not correct the calibration while device in use. In case of any doubt,
disconnect the device from the patient, correct it and then reconnect to the
patient. Never carry out connections to the device while it is in operation for a
patient.
If the equipment is wet in any case, insulate the power source or call technical
engineer for further inspection.
Please connect earth cable to earth connection port to protect patient & product.
Our company will not take any responsibility on disassembled products.
This product should only be used by an authorized individual with sufficient
knowledge about patient monitoring devices.
The product must be verified regularly to check for accurate operation.
Do not use one device on two patients simultaneously.
Do not use in places exposed to high humidity.
Do not use the product with wet hands.
Do not use product under direct sunlight or any other radiation.
Do not use the product in places with large temperature fluctuations.
Do not use the product nearby electric heating devices.
Do not use the product under high humidity or in areas having ventilation
problem.
Do not use the product in places with excessive impact or vibrations.
Exercise extreme caution while using this product in environments that have
vapours of flammable materials (like spirit / solvents etc) since it increases fire
hazards.
Accessories are aseptic products, so the package shall not be torn before use &
products shall be free from any defects or cracks.
Do not handle the equipment with wet hands.
Take care to prevent dusts, especially metal substances from entering into the
product.

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1.3.3 Precautions for Electronic Safety:
WARNING
A strong electromagnetic wave may affect the performance of the product.
Basically, the product is designed to not suffer functional disorders by surrounding
electromagnetic waves. Notwithstanding this, strong electromagnetic waves may
cause the product to malfunction. This may include displaying incorrect calculation
values, disappearance of measurements and noises affecting the wave pattern. If
such errors continue, contact the DHAMAN-III Technical Service Centre or Service
Engineer for assistance.
If used by a patient with pacemaker, a professional individual with all required expert
knowledge must operate the product.
Electromagnetic waves generated from an MRI device may influence the
measurement values of the product.
CAUTION
This product is used to determine patient status. Other clinical information must
be used together for accurate diagnosis.
If measurement values displayed on the screen is considered inaccurate,
perform EST (Extended Self Test) or Call Dhaman Service.
Use the equipment within the limits of temperature 10 ~ 40 deg centigrade and
humidity 30 ~ 75%.
Pull out power chord by holding the plug firmly, instead of pulling the cable.
Check out the main equipment and sensor at the same time after cleaning the
equipment. Do not use if there is any damage in the equipment.
Do not use the device beyond standard certified one. This product shall be used
under standard certification. Manufacturer does not take responsibility for the
problem occurred while using the product beyond standard certification.
Do not move the equipment when power chord or high pressure hose cage is
connected, it will harm the patient or equipment.
Connect the equipment isolated from other devices electronically for patients’
electrical safety.
Move the equipment with fastened to avoid any possible damage to other
products or people by the monitor or cable.

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1.3.4 Precautions for Electrical Safety:
WARNING
Connect the power plug to an AC power outlet with an earth terminal. Never
connect more devices than the rated capacity of the power outlet to prevent
electrical hazards. Minimum requirement is 220 Volts and 6.5 Amps power supply,
with no additional load on the same power outlet.
Note that neither the company nor any representative of the company will be
responsible for any issues arising from the use of any power source not meeting the
required rated power input.
Only authorized personnel who are trained to service the product will disassemble
the product. Note that neither the company nor any representative of the company
will be responsible for any electric shock, short circuit or product damage caused by
unauthorized disassembly. In such cases, the company will cancel the warranty and
make the product ineligible for service.
If the power chord is damaged, immediately stop using the product and replace the
power cord. Using the product when the power cord is damaged may cause an
electric shock, short circuit, current leakage or product damage.
Do not bump or move the product while the power chord is connected to it. This
may cause patient injuries or product malfunctions.
When using the product with other devices, use a separate AC power source for
other devices to ensure patient’s safety.
Do not use an anti-electrostatic or conductive tube for the product.
Auxiliary equipment and accessories provided by DHAMAN-III have been
specifically qualified and approved by the company to ensure that these items meet
the electrical safety standards. The use of other companies’ products or unproven
items may cause injury to the patient or may damage the device.
In order to avoid unacceptable risk associated with supply failure, the ventilator
should be connected to appropriate power source (UPS/ Battery/ Generator).
All power sources (UPS/ Battery/ Generator) used must be periodically checked
and monitored for safety and their efficient functioning.
If the power supply to the ventilator is from a multiple socket-outlet, then the current
in the protective earth conductor of the multiple socket-outlet shall not exceed 5mA.

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The DHAMAN-III Ventilator System Comprise of the following Main Components as
described in fig.
Figure 2. System Components
Chapter 2 – System Overview
1
2
3
4

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Item No. Description
1 Ventilator System
2 Trolley
3 Humidifier
4 Compressor
2.1 User Interface
The DHAMAN-III Ventilator Control Panel is made up of a Graphical User Interface touch
screen, membrane buttons and indicator LEDs/lights as shown in figure 3.
Figure 3. User Interface View

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2.1.1 Display:
Figure 4. Main Screen Display Area
DHAMAN-III has Touch screen display in which operator can easily access and review all
functions of ventilator.
Item No. Description
1 Status Bar- Alarm description, Mains Supply Status, Battery status, Ventilator
On/Off , Screen Lock, Alarm Silent functions, Nebulizer Alarm logs Shortcut
etc.
2 Main Display Area – Pressure, Flow, Volume Graphs with
Expand view & Pause Feature.
3 Control Shortcuts - Shortcuts for Basic Control Parameters of Active Mode.
4 Main Monitoring Parameters – Patient’s Main Monitoring
Parameters, User Configurable.
5 Settings Window- Operator can select and Change Modes,
Control Parameters, Alarm Limits and Can Access Utility.
6 Start / Stop- Operator can start and stop ventilation process.
7 View All Parameters- Operator can view all detailed
parameters delivered to patient.
1
2
5
3
6
4
7

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2.1.2 Fixed Keys & LED Indications:
Figure 5. User Interface Functions
No Description Function
1 On/Off This button is used to On or Off the ventilator.
2 Alarm Silent This button is used to silent the active alarm sound for 2 Seconds.
3 Manual Breath This button is used to provide manual breath to patient
4 Nebulizer This button is used to turn On/Off the Nebulizer.
5 Select This button used to select/Activate any function on the screen.
6 + Plus button used to increase the parameter values & settings.
7 - Minus button used to decrease the parameter values & settings.
8 Right Right button used to move curser in right-side direction.
9 Left Left button used to move curser in left-side direction.
10 Power (LED) The Power LED will turn On(Green) when the ventilator is
supplied with AC power. When the ventilator recharges the
internal battery whenever AC power is connected the green light
will blink continuously until the battery fully charged.
1
2
3
4
6
8
10
5
7
9

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2.2 Patient Unit
Patient unit (main body of the ventilator) is composed of the following parts.
 Gas supply and connection part
 Power supply and connection part
 Accessory connection part & communication ports
2.2.1 Patient Unit Configuration:
Refer to the patient unit diagram on the next page to check for location of the
following parts.
A B C D
A1. To Patient Port B1. Battery C1. Body Handle D1. Body Handle
A2. Nebulizer Port B2. RS485 Port C2. Sintered Disk
A3. Flow Sensor B3. USB Port
A4. From Patient Port B4. Main Input Power
B5. O2 Gas Inlet
B6. Air Gas Inlet
A B
C D
A
1
A3
A4
A2
B1
B2
C1
D1
C2
Figure 6. Patient Unit vie
w
B3
B4
B5
B6

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2.3 Symbols & Labels
No Name Symbol Explanation
1 Power ON/OFF
Provision of power by switching on and off the
system.
2 Screen lock Provision to lock & unlock the touch screen.
3
Attention, Consult
accompanying
documents
Indicates the necessity to refer to the operational
manual prior to equipment operation.
4
Nebulizer
Neb. Indicate NEBULIZER mode is On. This mode can
be ON / OFF by Nebulizer key.
5
Alarm
Indicate that an Alarm occurred along with its
description.
6
Power Plug
Connected
Indicates the AC plug is connected with machine.
7
Alarm Audible
Alarm audible function will be always On in the
default mode.
8
Alarm Sound OFF
Or Mute
Indicate Alarm Sound OFF or Mute. This function
will be activated by pressing Alarm Silent key also.
9
Alarm Log
It shows Alarm log history with date & time.
10
Battery Charging
indicator
FULL Charge 50% Charge
25% Charge 0% Charge
Battery
Charging

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2.4 Transportation and Storage
2.4.1 Prior to Transportation:
Check the following before intra hospital transportation of the ventilator:
 Be sure the ventilator has been securely attached and fixed by screws with the trolley.
 Be sure that all accessories such as humidifier are securely attached and
locked.
 Check whether the ventilator operates properly.
 Do not leave the ventilator unattended when stationed on an incline
surface.
 If medical portable compressor & oxygen cylinders are used, make sure
they are firmly fixed to prevent movement during transportation.
 Before moving the system, be sure that the batteries are fully charged.
 Before moving the system, check for damages in the Trolley & unlock the
locker on the caster.
 Check and secure all cables, tubes are correctly placed, secured to the
ventilator properly and ready to use when needed, during transportation.
2.4.2 During Transportation:
Follow below given instructions during intra hospital transportation of the
ventilator:
 Make sure it is connected to the movable gas sources.
 Make sure that the required power outlet is functioning and safe, delivering the required
power, in case it is not operating on the battery power alone!
 To move the ventilator, use the handle on the main body only.
 Slowly move the bed and ventilator during transportation, be careful about
pulling or movement of tubes connected to the patient.
 While moving or changing location of the support arm, be careful about
pulling or movement of tubes connected to the patient.
 When passing through obstacles such as door threshold, be careful not to
tilt the Trolley.
2.4.3 Storage:
 When storing ventilator, always disconnect the supply from the main
power source.
 Do not expose the ventilator to a temperature below -15℃ (-5℉) or above
+50℃ (+122℉).
2.4.4 Repacking:
If it is necessary to ship the ventilator for any reason, use the original packing
materials if possible. In case of non-availability of original packing materials,
arrange for appropriate packing and ensure that all components are securely
placed inside the package with adequate protection against transit damages.