Lowenstein Medical LM Flow Parts list manual

1
LM Flow / LM Flow 100
Instructions for Use and Technical
Description
High-flow device with heatable
humidifier
HOME CARE
HOSPITAL
HUMID BM / BH
HOSPITAL HOME CARE DIAGNOSTICS

02
Table of Contents
Table of Contents.............................................................................02
Symbols...............................................................................................03
Warnings.............................................................................................03
Foreword ...........................................................................................06
Intended use ...................................................................................06
Device description...........................................................................06
System preparation.........................................................................07
Notes to the reader / Warnings..................................................10
Control panel.....................................................................................12
Use ........................................................................................................14
Alarms..................................................................................................19
Cleaning and maintenance...........................................................22
LM Flow disinfection instructions ..............................................23
Service and repair ...........................................................................24
Troubleshooting...............................................................................25
Technical data ...................................................................................26
Electrical block diagram ...............................................................28
Flow Block Diagram .......................................................................28
Packing list .........................................................................................29
Appendix A Electromagnetic Compatibility ...........................29
Appendix B Order numbers .........................................................34

03
Symbols
Warnings
• Before using this high- ow
device, please read this user
manual carefully.
• Do not use this high- ow device
for life support.
• The high- ow device generates
a positive airway pressure during
operation. If the high- ow shows
side e󰀨 ects in patients, please
discontinue therapy immediately
and call a physician.
• This high- ow device may only
be used and adjusted on the
instructions of a physician.
• Do not replace the advice of the
physician with recommendations
in the user manual.
• This high- ow device may only
be used with humidi ers, heated
breathing tubes, nasal cannulas
and other accessories approved
by Löwenstein Medical. The use
of unapproved accessories can
impair the functionality of the
high- ow device or cause danger.
• In the event of a power failure or
malfunction of the high- ow de-
vice, remove the nasal cannulas
and shut o󰀨 the oxygen supply.
• To ensure electromagnetic
compatibility, this high- ow
Degrees Celsius Litre per minute
Protection class II against electric shock Protection class against vertical
water drips (dripping water)
Alarm condition Electrical level of protection, BF
Acoustic alarm switched OFF Serial number
According to RoHS Pay attention to the User Manual
According to EC directive 93/42 / EEC Pay attentiion to the safety
information
Caution – hot surfaces Menu open; parameter changes
possible
Heated tube Menu blocked; Parameter-
changes not possible
°C L/min
IPX1

04
device must be installed, tested
and used in accordance with the
provisions in the accompanying
documents.
• Portable and mobile RF commu-
nications equipment can impair
the electromagnetic compatibility
of this high-ow device. Should
this happen, please contact
Löwenstein Medical to resolve
the problem.
• This high-ow device can only be
connected with the power cords
specied in this document. The
use of unapproved accessories
and power cords to connect
the high-ow device can lead
to increased electromagnetic
emissions or reduce immunity to
electromagnetic radiation.
• Do not place this high-ow device
near other devices.
If this high-ow device is to be
installed in the vicinity of other
devices, inspections and obser-
vations must be made to ensure
that this high-ow device can
function normally in such a loca-
tion. The high-ow device should
be placed in a well-ventilated
area and not on a soft surface.
• Do not use the high-ow device
if it is surrounded by ammable
and / or narcotic gases.
• Do not continue to use the high-
ow device if there is obvious
damage, liquid has penetrated
the high-ow device, the therapy
gas is too hot, or if unusual nois-
es can be heard.
• If the high-ow device is used in
accordance with the specied
ambient and humidity conditions,
the therapy gas temperature is
below 43°C.
• The temperature and humidity of
the therapy gas will be a󰀨ected if
the high-ow device is operated
outside of the specied ambi-
ent temperature and humidity
conditions.
• If the high-ow device is used
outside the specied environ-
mental conditions (temperature,
humidity, etc.), the performance
of the high-ow device may be
a󰀨ected.
• The AC input voltage should be
within ± 10% of the rated voltage.
AC input voltages outside of this
range can damage the high-ow
device.
• The high-ow device can be
disturbed if it is operated in the
vicinity of electrocautery, elec-
trosurgery, debrillation, X-rays
(y-rays), infrared radiation and
transient electromagnetic elds
including magnetic resonance
(MRI) and radio interference.
• If the high-ow device is blocked
by closing the therapy tube or the

05
air inlet, the high-ow device may
overheat or be damaged.
• If the high-ow device is connect-
ed to oxygen and the therapy
tube is blocked, this can lead to
an increased oxygen concentra-
tion.
• The ventilation openings are in
the bottom of the humidication
chamber. To avoid burns, do not
touch the underside when moving
the device.
• Do not carry the high-ow device
during operation, do not turn it
upside down or tilt it when there
is water in the water chamber.
This will prevent water from ow-
ing back into the high-ow device
and damaging it.
• When the high-ow device is not
in use, remove the plug from the
socket.
• Do not open the inside of the
high-ow device. Repairs may
only be carried out by authorised
maintenance personnel.
• For proper disposal of the
high-ow device, please contact
Löwenstein Medical.
• Note: Above are general warn-
ings and precautions. Refer
to this User Manual for more
detailed warnings, notes to the
reader, and remarks.

06
Foreword
The high-ow devices of the LM Flow series are heatable high-ow devic-
es with an integrated respiratory humidier. In order to use this high-ow
device safely and e󰀨ectively, please read this user manual carefully before
use.
Intended use
LCD display
Breathing gas
outlet
Reference point of the
target dew point
temperature
LM Flow
Water chamberButtons
Power connection
cover
Air inlet
lter
Oxygen inlet
Low pressure
Components and functions
Encoder
This high-ow device is suitable for patients with spontaneous breathing.
For treatment, heated and humidied breathing gas with a specic ow is
provided. This high-ow device is suitable for humidication treatment and
oxygen therapy via nasal cannula, endotracheal intubation and tracheos-
tomy. This product is not for life support.
Device description
Device components
The LM Flow series high-ow devices consist of the following
components:
Data port

07
System preparation
Oxygen inlet, Low-/ High
pressure
Parameter display, parameter setting (only LMFlow100)
Start/stop, parameter setting
Connection to an external oxygen source
Connection to the power supply
Inlet and ltering of the therapy air
Extends the functions of the device; please contact Löwen-
stein Medical for details
Connection to the heated therapy tube
Water supply and heating
Reference point of the target dew point temperature
Auto FiO2 control
Warning: Only connect storage media approved by Löwenstein Medical
to the data port.
Warning: If the water chamber and heated therapy tube are not properly
installed, please do not start the high-ow device. To avoid burns, do not
touch the underside of the water chamber.
O2control module
LM Flow 100
LCD display
Buttons / encoders
Oxygen inlet
Power connection
Cover, air inlet, lter
Data port
Breathing gas outlet
Water chamber
Reference point of the
target dew point temperature
O2-control module

08
Installation LM Flow
Connect the nozzle
tting to the water
chamber.
To insert the water
chamber, press the
lock with the bottom
of the water chamber
and slide the water
chamber onto the
heating plate until the
lock engages.
Connect the water bag
/ water bottle (only
when using the auto-ll
water chamber).
Check the water level
in the water chamber.
Connect the heated
tube system.
Connect the oxygen
source to the oxygen
tank (not necessary if
no additional oxygen is
required).
Connect the oxygen
source to the high-ow
device (not necessary
if no additional oxygen
is required).
Connect
the LM ow to power.

09
Installation LM Flow 100
Connect the nozzle
tting to the water
chamber.
To insert the water
chamber, press the
lock with the bottom
of the water chamber
and slide the water
chamber onto the
heating plate until the
lock engages.
Connect the water bag
/ water bottle.
Connect
the LM ow 100 to
power.
Check the water level
in the water chamber.
Connect the heated
tube system.
Connect
the oxygen source
(not necessary if no
additional oxygen is
required).

10
→Home care water chamber
When using the Home care water chamber, ll clean water or medical
sterile water (e.g. ALLEGRA sterile water) into the water chamber. By
heating the water to 100°C before use, you reduce limescale deposits
in the water chamber. Do not ll the water chamber above the mark for
the maximum water level.
Note to the reader: The water chamber is heated during operation.
Please avoid touching the metal base of the water chamber and the
heating plate of the high-ow device.
→ Clinic water chamber (Auto-Fill)
When using the Clinic AutoFill water chamber, hang a sterile water
bag in a high position. Insert the inlet needle into the rubber stopper of
the water bag and open the ventilation opening of the bag. The Clinic
AutoFill water chamber is automatically lled with water to the intended
level.
Please use sterilised water suitable for medical purposes and not more
than 2000 ml.
After connecting the water bag, check that the water ows into the
Clinic AutoFill water chamber and is below the marking line. Replace
the clinic AutoFill water chamber in the event of problems.
Make sure that water does not leak from the Clinic AutoFill water
chamber and water bag during use. Otherwise the Clinic AutoFill water
chamber will run dry and impair the humidication e󰀨ect.
To avoid damage to the Clinic AutoFill water chamber, avoid running
empty.
→ Therapy tube
Check the therapy tube and nasal cannula before connecting them and
replace them if a breakage or other damage is visible.
Do not expose uncovered skin to the heated therapy tube for a long
time to avoid skin irritation caused by the heat.
Do not run the therapy tube near a heat source (e.g. heater). Do not
cover large areas of the therapy tube. Otherwise the temperature may
rise.
Notes to the reader / Warnings

11
To avoid interference, the therapy tube should be kept away from all
objects with electronic radiation and from electrical wires and conduc-
tors.
→ Connecting the oxygen source
LM Flow (Fig.III a)
The LM Flow high-ow device can be con-
nected to a low-pressure oxygen source
(e.g. oxygen concentrator). To do this, plug
the oxygen supply hose onto the oxygen
connector on the high-ow device (see
Figure IIIa).
LM Flow 100 (Fig.III b)
The LM Flow 100 high-ow device can be
connected to both a low-pressure oxygen
source (e.g. oxygen concentrator) and a
high-pressure oxygen source.
For connection to a low-pressure oxygen
source, please proceed as described under
LM Flow and Figure IIIa.
To connect to a high-pressure oxygen
source, screw the connecting nut of the
oxygen supply hose onto the thread of the
oxygen connection of the high-ow device
(see Fig. IIIb) and tighten the connecting nut
rmly (hand-tight).
→ How to connect to the power supply
Connect the power cord to the power connector on the back of the
high-ow device and insert the power plug into the socket. The high-
ow device screen will light up indicating that the high-ow device is
being properly supplied with power.
III a) Oxygen connection
(Low pressure)
III b) Oxygen connection
(Low pressure)
Oxygen connection
(High pressure)

12
Control panel
LCD display
Start/stop button
Mute button
Menu button
Encoder
Start/Stop
Mute
Menu
Encoder
*
*
*
The control panel consists of buttons and an LCD display.
→ Buttons
→ LCD display
The LCD display can be operated in Monitoring mode or Setup Menu
Mode.
Monitoring mode : Displays the operating mode and monitors the oxy-
gen concentration, ow rate and temperature.
If no input is made for approx. 5 minutes during therapy, the high-ow
device darkens the LCD display. When you press any button, the LCD
display lights up again.
• Press this button in standby mode to start therapy. Press this
button during the therapy to end therapy.
• Press this button to enable or disable the acoustic alarm.
• Press this button to enter the setup menu or to exit and conrm the
set menu parameters.
• The encoder has three basic functions: conrm (press), turn left,
turn right.
• In the setup menu, press the encoder to select or exit the displayed
function.
By turning left or right you select the dierent functions and can
then change the values or data. The data or values are applied by
pressing the encoder again.

13
30
L/min
Flow
°C
Temp
Standby
Standby
30
L/min
Flow
°C
Temp
55
%
Concentration
Working time
Operating status of the high-
ow device, prompts, alarm
information
Setting the ow value
Operating status of
the high-ow device
Display of the oxygen
concentration
Display of the oxygen
concentration
Set value of the dew
point temperature
Prompts,
alarm information
Setting the ow value
LM Flow
LM Flow 100
* Setup menu: Mode setting, Alarm setting, System conguration
55
%
Concentration
Set value of the
dew point
temperature

14
Use
→ How to connect the high- ow device
Connect the high- ow device to the mains.
→ Set parameters
Do not change the parameters without the doctor's instruction and
supervision. You can skip this chapter if the high- ow device is to
continue to operate with the last settings.
You cannot change the parameters if is displayed in the upper right
corner of the settings interface.
Only if is displayed, can you change the parameters and make
changes to the system con guration.
Parameter setting LM Flow
Press the menu button to select
the  ow and temperature via the
encoder.
Set the parameters with the
encoder.
Set the desired oxygen concen-
tration at the oxygen source. (Not
applicable if no additional oxygen
is required)
Press the Start/Stop button for 3
seconds to start therapy.
Adjust the nasal cannula.

15
Parameter setting LM Flow 100
Select the parameters using the
touchscreen.
Set the required parameters(O2,
ow, temperature) using the
touchscreen / encoder.
Press the Start/Stop button for 3
seconds to start therapy.
Adjust the nasal cannula.
End of therapy
LM Flow:
Disconnect/shut o the
oxygen source.
Press the Start/Stop button
for 3 seconds to end the
therapy and start or end
the drying mode.
LM Flow 100:
Disconnect/shut o the
oxygen source.
Remove the tube system and disconnect the power.

16
Parameter settings mode
Children
Adults
• Flow: 2-25 L/min;
• Temperature: 34 °C
• O2: 21-100%
• Flow: 10-80 L/min
• Temperature : 31 °C, 34°C, 37°C
• O2: 21-100%
Operating mode:
Alarm settings:
System conguration:
Alarm Parameter settings Default value
O2 too high! OFF, 30% - 100% 90%
O2 too low! OFF, 21% - 25% 21%
System alarm! OFF, ON OFF
System blocked!! OFF, ON OFF
Reset alarms Resets the default values of the alarm
parameters
Clinical menu OFF: High-ow device can only be switched
ON and OFF. All other settings are blocked
On: All settings can be changed.
Language German/English

17
Caution:
If the high-ow device sends an alarm because the set ow value is
not reached, this may be because the nasal cannula model is not suit-
able. In this case, it must be replaced with a larger nasal cannula. It is
recommended that the NAS-1 S model be used when the ow is less
than 50 L / min or the NAC-1 M model when the ow is less than 60 L /
min.
Do not set the parameters without the instruction of your attending
physician and use this high-ow device only under the supervision of a
physician.
Incorrect alarm threshold settings can lead to false alarms.
→ Preheating
Press the Start/Stop button for 3 seconds to start the high-ow device.
The screen shows “Preheating” and the high-ow device begins to
warm up. Immediately afterwards
the displayed ow and dew point
values increase. When the set
values are reached, the display
value remains unchanged.
The word "Active" then appears
after warm up.
Warning:
Make sure that the high-ow device is already started when you con-
nect oxygen.
Oxygen may only be connected to the oxygen inlet of the high-ow
device itself. Make sure that the oxygen hose, air inlet cover, lter,
and power plug are properly installed. Before ending the therapy, rst
shut o󰀨 the oxygen source, then disconnect the oxygen hose and only
switch the high-ow device to standby mode when the oxygen con-
centration in the high-ow device has returned to the ambient level
(21 vol%).
When the high-ow device is not in use, make sure that the oxygen
source is shut o󰀨 to prevent oxygen accumulation in the device.
To avoid the risk of re, special precautions must be taken during oxy-
gen therapy. The high-ow device must not be located near sources of
re or smoke.
The high-ow device should be installed in a well-ventilated place.
For safety reasons all ignition materials should be kept away from
oxygen and should not be stored in the same room with oxygen. “No
Preheating Active

18
smoking, no re”, signs should be visibly hung.
Near medical oxygen equipment and accessories avoid sparks gener-
ated by static electricity (through friction).
→ Adjust the oxygen ow
Adjust the ow of the oxygen source and ensure that the oxygen
concentration shown on the display of the high-ow device corresponds
to the required values. The FiO2 can be controlled automatically when
using the LM Flow 100.
The oxygen concentration must be within the preset range of the alarm
parameters for the oxygen concentration, otherwise an alarm will
sound.
Note to the reader:
The gas inhaled by the patient may be below the monitored value due
to dilution by air.
→ Use
Put on the nasal cannula correctly and start the treatment.
If the external power supply is interrupted during treatment, an alarm
sounds (press the mute button to switch o󰀨 the alarm). In this case, the
user must immediately shut o󰀨 the oxygen source, remove the nasal
cannula, check the power supply, and do not continue to use the high-
ow device until the fault has been rectied.
→ Transport-Mode
Press and hold the mute button for 3 seconds in standby, warm up or
active mode so that the high-ow device switches to transport mode
and the hoses and water chamber are no longer in warm up mode. The
high-ow device switches back to warm up mode 20 minutes later. The
device ow remains unchanged during transport mode.
→ End of therapy
When you end therapy with the high-ow device, remove the nasal can-
nula, shut o󰀨 the oxygen source rst, then disconnect the oxygen hose
from the high-ow device. Press the Start/Stop button for 3 seconds.
The high-ow unit then switches to the drying mode, in which the hoses
are dried. The drying mode runs for 99 minutes. The high-ow device
then switches to standby mode. If the drying mode is to be switched o󰀨
earlier, press the Start/Stop button for at least 3 seconds.

19
Warning:
If drying phases are too short, the tubes can be dam-
aged by the remaining moisture, which can prevent
reuse.
Caution:
At the end of the therapy, the oxygen must always
be switched o󰀨 in order to avoid an accumulation of
oxygen in the high- ow device.
Warning:
To avoid possible damage to health, do not wear a
nasal cannula during the drying mode.
The high- ow devices of the LM Flow series are
equipped with visual and acoustic alarm signals. The
visual alarm signal appears if an alarm is triggered
while using the high- ow device. The causes of alarm
signals should be eliminated as soon as possible in
order to avoid risks.
The visual alarm signal is shown in the  gure on the
right. The alarm type is explained under the symbol.
The mute button can mute the acoustic alarm for 2
minutes.
The acoustic alarm is reactivated by pressing the mute
button again.
Alarms
Close oxygen
99
Drying Tube
99
!! Error !
!! Error !

20
The following alarms are arranged according to internal priority:
Alarm
Internal alarm
Check tube
Check for leakage
System blocked
Oxygen too low
Oxygen too high
Target ow
Problem description
Problem description
After commissioning, an error alarm
displays errors in internal parts such
as the engine, and after 5 seconds
an acoustic alarm sounds.
The alarm appears if the high-ow
device does not detect a heatable
respiratory tube after starting thera-
py. An acoustic alarm tone sounds
after 5 seconds.
If the high-ow device detects a
leak, a leak alarm is displayed and
an acoustic alarm tone sounds after
5 seconds.
If the device detects a blockage, an
alarm is displayed and after 10 sec-
onds an acoustic alarm tone sounds.
If it is detected that the oxygen con-
centration is below the limit value, an
alarm is displayed and an acoustic
alarm tone sounds after 20s. The
alarm setting range of the low FiO2
is between 21 to 25 vol% and OFF
(setting levels: 1 vol%). The default
setting is 21 vol%.
If it is recognised that the oxygen
concentration has exceeded the limit
value of the high FiO2 alarm, an
alarm is displayed and an acoustic
alarm sounds after 20s. The range is
adjustable from 30 to 100 vol% and
OFF. The default setting is 100vol%
(setting levels: 1vol%).
If the high-ow device does not reach
the preset ow within 10 minutes
(± 1 minute), an alarm is displayed.
In addition, an acoustic alarm tone
sounds.
Modus operandi
Turn o󰀨 and turn on again. If
this does not solve the problem,
please contact Löwenstein
Medical.
Make sure the respiratory tube
is not damaged and has been
connected properly. If this does
not solve the problem, replace
the tube.
Verify that the water chamber
is installed. Check whether
the therapy tube is intact and
properly connected.
Check to see if the water cham-
ber, therapy tube, or nasal can-
nula are blocked. Check whether
the air inlet of the device or the
lter are clogged.
Check that the device's oxygen
inlet is properly connected to the
oxygen source. Adjust the ow
of the oxygen source as needed.
Adjust the ow of the oxygen
source as needed.
Check whether the water cham-
ber, the therapy tube
or the nasal cannula are
clogged. Check if the fan air
inlet cover or lter are clogged.