Medin medinCNO User manual

medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[e-mail]
User manual for
medinCNO®

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
OP_cno Rev 07 - Correct as of: 09.09.2015 2 of 64
The medinCNO®contains batteries and electrical components. Consequently it cannot
be disposed of in domestic waste but must be collected separately and recycled in
accordance with local regulations. (WEEE)
0483
Classification (according to COUNCIL DIRECTIVE 93/42/EEC Annex IX): IIb
medin Medical Innovations GmbH
Adam-Geisler-Str. 1 –82140 Olching –Germany
[phone] –www.medingmbh.com –[e-mail]
Made in Germany
OP_medinCNO®Rev 07 Correct as of 09.09.2015
ETL CLASSIFIED
CONFORMS TO
AAMI STD ES60601-1IEC STD 60601-1-8
CERTIFIED TO
CSA STD C22.2 NO.60601-1
CSA STD C22.2 NO.60601-1-8

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
OP_cno Rev 07 - Correct as of: 09.09.2015 3 of 64
Table of contents
1Introduction.............................................................................................................................. 5
1.1 About the instructions for use............................................................................................ 5
1.2 General liability conditions ................................................................................................ 5
2Description of the Device and Conditions for Use .................................................................. 6
2.1 Intended purpose .............................................................................................................. 6
2.2 Operating staff ................................................................................................................... 6
2.3 Alternative respiration systems ......................................................................................... 6
2.4 Combination with other devices and ancillary equipment................................................. 6
2.5 Technical description of function....................................................................................... 7
2.5.1 Principles of function.............................................................................................. 7
2.5.2 Technical data........................................................................................................ 7
2.5.3 Overview of the general technical description ....................................................... 8
3Installation of the medinCNO®–Conditions ......................................................................... 10
3.1 Mounting.......................................................................................................................... 10
3.2 Power supply ................................................................................................................... 10
3.2.1 Mains operation ................................................................................................... 10
3.2.2 Battery operation.................................................................................................. 11
3.2.3 Power supply unit................................................................................................. 12
3.3 Gas feed .......................................................................................................................... 12
3.4 External alarm interface and data interfaces .................................................................. 13
3.4.1 External alarm ...................................................................................................... 14
3.4.2 USB data interface............................................................................................... 14
3.4.3 RS232 interface ................................................................................................... 15
3.4.4 Output data (live and trend data) ......................................................................... 16
3.5 Environmental conditions (operation / transport / storage)............................................. 19
4First Use ................................................................................................................................ 22
4.1 CPAP system components ............................................................................................. 22
4.2 Connecting the medinCNO®and establishing the CPAP system................................... 23
4.3 Starting up the system..................................................................................................... 25
5Operation............................................................................................................................... 26
5.1 Operator console ............................................................................................................. 27
5.2 Display screen ................................................................................................................. 28
5.3 Basic CPAP settings ....................................................................................................... 29
5.4 Push................................................................................................................................. 30
5.5 O2flush ............................................................................................................................ 32
5.6 Backup function ............................................................................................................... 32
5.7 CPAP mode..................................................................................................................... 33

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
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5.8 APNOEA CPAP mode..................................................................................................... 34
5.9 SNIPPV mode ................................................................................................................. 36
5.10 Oscillation mode ........................................................................................................ 39
5.11 Switching between modes......................................................................................... 41
5.12 Alarm settings ............................................................................................................ 41
5.13 Trend.......................................................................................................................... 43
5.14 Standby...................................................................................................................... 43
6Switching Off ......................................................................................................................... 45
6.1 Software switch-off .......................................................................................................... 45
6.2 Hardware switch-off......................................................................................................... 45
6.3 Disconnection .................................................................................................................. 45
6.4 Disposal........................................................................................................................... 45
7Accessories ........................................................................................................................... 46
7.1 Ancillary equipment ......................................................................................................... 46
7.2 Components of the rest of the CPAP system ................................................................. 46
8Alarms and Error Messages ................................................................................................. 47
8.1 Error messages during system start-up .......................................................................... 47
8.2 Error messages during operation.................................................................................... 48
8.3 Emergency programme................................................................................................... 52
8.4 Indicator lights ................................................................................................................. 53
9Cleaning and Maintenance ................................................................................................... 54
9.1 Cleaning .......................................................................................................................... 54
9.2 Maintenance and exchange of the internal batteries ...................................................... 54
9.3 Repairs ............................................................................................................................ 55
9.4 Device modifications ....................................................................................................... 55
9.5 Power supply unit (cleaning, maintenance, repairs and modifications).......................... 55
9.6 External filter.................................................................................................................... 56
10 Electromagnetic Compatibility............................................................................................... 57
10.1 Electromagnetic transmission ................................................................................... 57
10.2 Electromagnetic immunity ......................................................................................... 58
11 Symbols................................................................................................................................. 62
12 Abbreviations......................................................................................................................... 63
13 History of the Software Versions and Hardware Changes ................................................... 64

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
OP_cno Rev 07 - Correct as of: 09.09.2015 5 of 64
1 Introduction
1.1 About the instructions for use
These instructions for use contain information about starting up, using and maintaining the
medinCNO®(medin-cno). They also contain safety information, describe the device's functions and
give an overview of the ancillary equipment needed.
Users must be very familiar with the information and warnings given in these instructions for use in
order to operate the medinCNO®safely. However, they are no substitute for training.
The instructions and warnings are categorised as follows:
Warning: Warnings must be followed in order to prevent possible serious consequences for the
patient or the operator.
Attention: This indicates hazards that could damage the device or impair its functionality.
Tip: This indicates how the medinCNO®can be used more efficiently.
Keep these instructions for use close to the medinCNO®and easily accessible.
Please contact the dealer or go directly to the manufacturer if you have any questions or
comments about these instructions for use.
Warning:
-Read these instructions for use carefully before using the products, and follow the
instructions, warnings and tips closely.
-The medinCNO®may only be used by individuals with a thorough knowledge of these
instructions for use, in accordance with these instructions for use for the purpose
described under the section headed ‘Intended purpose’.
-The use of the equipment and consumables used in combination with the medinCNO®
(e.g. nCPAP generators and humidifiers) is described in the relevant instructions for
use. Users must also comply with those instructions for use.
1.2 General liability conditions
The general terms of trade of Medin Medical Innovations GmbH (hereinafter referred to as Medin)
are binding.
Medin accepts no responsibility or liability for the safe use of the medinCNO®if the device is
serviced or repaired by individuals who have not received appropriate specialist training or if an
operation that does not comply with correct use is performed. Medin also accepts no responsibility
or liability for the safe use of the medinCNO®if the function tests and maintenance that are
specified are not carried out. The user is responsible for respecting maintenance and function test
intervals.
Medin accepts no liability for damage caused by failure to comply with these instructions.
Warning:
The medinCNO®may not be modified without permission from the manufacturer and subsequent
appropriate examinations and testing to ensure continued safe use.

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
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2 Description of the Device and Conditions for Use
2.1 Intended purpose
The medinCNO®CPAP driver is used in combination with the Medijet®nCPAP generator to
administer CPAP therapy to premature infants and newborns. The medinCNO®must be used
under the supervision of expert, specially trained staff in a clinical setting, and the patient’s oxygen
saturation must be monitored at the same time.
Warning:
-The medinCNO®is intended for clinical use only.
-The medinCNO®may only be used while the patient’s oxygen saturation is being
monitored at the same time.
-The medinCNO®may only be used by and under the supervision of expert staff who
have been trained in the device.
-For use only in combination with the Medijet®nCPAP generator.
-The medinCNO®is a CPAP device. It is suitable only for patients who can breathe
spontaneously and not for patients who are dependent on artificial respiration.
-The medinCNO®may not come into contact with flammable anaesthesia gases or
other flammable materials while in use.
-The medinCNO®may not be operated in an oxygen-enriched environment.
-US legislation stipulates that this device may only be sold to or on the instructions of a
doctor (for USA:. Rx only).
2.2 Operating staff
The medinCNO®must be operated by a doctor or by an individual with the necessary technical
skills acting on a doctor’s instructions. Consequently, all operating staff must have a detailed
knowledge of these instructions for use and have undergone training in the device.
2.3 Alternative respiration systems
An alternative CPAP system or respiration system (e.g. bag valve unit) must always be available
while the medinCNO®is in use.
2.4 Combination with other devices and ancillary equipment
The medinCNO®may only be combined with devices or consumables (e.g. CPAP ancillary
equipment) not mentioned in these instructions for use after consulting the manufacturer.
Use of ancillary equipment that is not approved puts the patient at risk and may impair the proper
functioning of the device.
Warning:
If the medinCNO®is connected to another device or system, the requirements of IEC 60601-
1:2005 chapter 16 and the requirements with regard to EMC according to IEC 60601-1-2 must be
met, otherwise the device function, electrical safety and EMC of the medinCNO®are not
guaranteed.

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
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2.5 Technical description of function
2.5.1 Principles of function
The medinCNO®is a CPAP driver that can be used in combination with the Medijet®nCPAP
generator to administer CPAP therapy. The role of the medinCNO®in this CPAP system is to
provide the necessary, possibly oxygen-enriched drive flow, which is fed to the nCPAP generator
Medijet®via the tubes connected to the patient and is converted into CPAP pressure within the
generator.
An internal electronic blender combines the air and oxygen coming from an external source and
administers the total volume so that the drive flow reaching the patient can be enriched with
oxygen as necessary to any oxygen level between 21% and 100%.
The flow volume of the gas mix within a range of 4 l/min to 15 l/min can be set depending on the
mode selected. According to the flow volume set, the medinCNO®provides a constant drive flow.
This generates a constant CPAP pressure in the Medijet®CPAP generator, or the medinCNO®
assesses the CPAP pressure signal measured in the Medijet®in order to react to the patient's
breathing and trigger a higher flow impulse in the event of apnoea or synchronously with the
patient's inhalation. This triggers a pressure impulse with elevated CPAP pressure in the Medijet®
CPAP generator. The medinCNO®can also trigger oscillation between 5 Hz and 20 Hz in the
CPAP pressure applied by Medijet®by means of an oscillating drive flow.
The monitor which is part of the medinCNO®displays the parameters selected by the user, the
sensors’ readings, the length of time that CPAP pressure has been applied by Medijet®in the form
of a graph, and any alarms.
The medinCNO®can operate for up to two hours without mains power thanks to its rechargeable
batteries.
Warning:
The medinCNO®may not be modified without permission from the manufacturer and subsequent
appropriate examinations and testing to ensure continued safe use.
2.5.2 Technical data
Dimensions (L x W x H)
29 x 23.5 x 18.5 cm
Weight:
4.75 kg
Display
7.0“ – colour, 800 x 480 pixel
Power supply:
100 to 240 V AC / 50 to 60 Hz
Internal battery
14.4 V DC, 2 hours run time, rechargeable
Gas connections:
Air supply: 300 to 600 kPa (=3.0 to 6.0 bar)
Oxygen: 300 to 600 kPa (=3.0 to 6.0 bar)
Connector standard: DISS or NIST (as preferred)
Patient flow outlet
Dimensions M22 (ED) or F15 (ID)
CPAP pressure meter
connection
Luer-type –4.3 mm ID
Flow:
Setting range: 0 l/min to 15 l/min
Working range: 4 l/min to 10 l/min
Accuracy: ±1 L/min (in the working range) ±2 L/min (outside

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
OP_cno Rev 07 - Correct as of: 09.09.2015 8 of 64
of the working range)
Basis of measurement: DIN 1343 at 0°C, 1013.25 mbar and
0% air humidity (0/1013)
Oxygen concentration:
Setting range: 21% to 100% (in flow working range)
Measurement range: 21% to 100%
Accuracy ± 3% (Vol.)
MLF –16 or OOM 102 measurement sensor
Pressure measurement:
Measurement range 0 mbar to 15 mbar - pressure graph
Accuracy ±1.3 mbar
Verification: Redundant measurement by two sensors
Push (inspiration support by the
medinCNO®)
Setting range
additional flow during the inspiration push:
Min: 0 L/min
Max: 17.5 L/min minus set basic flow
Duration 200 ms to 2 seconds
Accuracy
± 1 L/min (if the total flow = basic flow + additional
inspiration flow - is within the flow working range)
± 2 L/min (if the total flow = basic flow + additional
inspiration flow - is outside of the flow working
range)
Basis of measurement: DIN 1343 at 0°C, 1013.25 mbar and
0% air humidity (0/1013)
O2flush
Duration: 1 minute
Level: +10, +20, +30 % (vol.) via set target oxygen
concentration or 100% oxygen.
Electronic shut-off valve
In the event of an error, interrupts the flow supply to the
patient and opens the tubing system to the atmosphere
Mechanical overpressure valve
Opening pressure 4 kPa (= 40 mbar)
Operating Time
The medinCNO®can be used for continuous, long-term
operation up to 4 weeks without a restart in the interim.
IP class
IP20
2.5.3 Overview of the general technical description
Information on these points can be found in the chapters indicated:
Conditions for use, transport and storage: see chapter 3.5
Characteristics and accuracies of the device: see chapter 2.5.2
Information on the installation of the device: see chapter 3
Description of the supply gases required: see chapter 3.3
Description of the power supply: see chapter 3.2
The device is disconnected from the mains by pulling the power supply unit cable
of the medinCNO®out of the electrical outlet. Thus when installing the
medinCNO®, it should be ensured that this plug is always freely accessible and
can be disconnected from the mains without difficulty. The medinCNO®does not
contain any switch which disconnects it from the mains.

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
OP_cno Rev 07 - Correct as of: 09.09.2015 9 of 64
Changes and modifications to the medinCNO®are not permitted without the
permission of the manufacturer: see chapter 9.4
Repairs and an exchange of parts may only be made by trained, professional
service personnel and only in accordance with the instructions in the
Maintenance Manual, observing warnings in the manual and in these instructions
for use.
The medinCNO®and its power supply unit are not suitable for use in the direct
vicinity of the patient. Only the patient tubes, the Medijet®and the masks and
prongs used are used in the direct vicinity of the patient.

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
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3 Installation of the medinCNO®–Conditions
Prior to start-up, the medinCNO®must be securely mounted. In doing so, the following conditions
must be observed:
3.1 Mounting
Figure 3-1: a) Brackets holding the medinCNO®in position; b) Ventilation slits; c) Overpressure
valve; d) Knurled screws
The medinCNO®must always be securely mounted before the device is started up. To do this, the
two fixing brackets on the back of the device (Figure 3-1-a) are inserted into a standard track
(cross-section: 10 x 25 mm) and the brackets are then fixed in place manually using the knurled
screws (Figure 3-1–d). It is important to ensure that the rear and lateral ventilation slits (Figure 3-1
–b) are not covered and that the overpressure valve (Figure 3-1–c) on the base of the device is
not blocked.
The medinCNO®can be transported when it is not in use. When it is in use, it must be securely
mounted, however. However, if the medinCNO®becomes damaged during transport or due to
rough handling, its function must be checked by a service technician. It is not allowed to be used
until then.
Warning:
-The medinCNO®must always be securely mounted in an upright position throughout
the entire time that it is in use.
-The medinCNO®must not be covered while in use, and none of the openings or
ventilation slits must be blocked.
-The overpressure valve must be kept clear whenever the medinCNO®is in use, and it
must always hang free in the air.
-A damaged medinCNO®may not be used.
3.2 Power supply
3.2.1 Mains operation
The power supply unit (REF 39-113) of the medinCNO®may only be connected to a power supply
with the following properties:

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
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Voltage: 100 –240V~ (alternating current)
Frequency: 50 –60Hz
Strength of current: at least 1.1A
The power supply unit of the medinCNO®has a C8 connector for connection to the mains grid. The
power line between the power supply unit of the medinCNO®and the mains grid must therefore
meet these conditions:
Power supply side: plug appropriate for the country
Device side: C7 plug in accordance with EN60320
Minimum rated voltage: the minimum rated voltage of the power line must be at least
as high as the voltage of the local mains supply. (Recommended: 240V)
Minimum rated current: 1.1A
Maximum length 2 metres (in order to achieve EMC in accordance with DIN EN 60601-
1-2:2007)
Spare power lines with EU plugs can be ordered under REF 39-115 (supplied as standard as part
of the power supply unit). Alternative power lines for other countries are available under these
numbers:
with UK plug REF 39-116
with plug for USA/Japan REF 39-117
with Australian plug REF 39-118
Attention:
The medinCNO®may only be run on the local mains grid using the power supply unit provided by
the manufacturer (REF 39-113) and suitable power lines, otherwise the functionality and EMC of
the device cannot be guaranteed.
3.2.2 Battery operation
The medinCNO®contains an internal battery and can work on a fully charged battery for up to two
hours.
Figure 3-2: Battery charge status displayed in the top left-hand area of the screen
The charge status of the internal battery is displayed in the top left-hand area of the medinCNO®
screen (Figure 3-2).

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
[phone] www.medingmbh.com[email protected]om
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A full battery is shown with a symbol with five bars. As soon as only two bars remain, the battery
symbol is shown in red and the medinCNO®should be connected to the mains soon. As soon as
there is only one bar left, the battery alarm is triggered.
Attention:
When the medinCNO®is running on battery power, an alarm is sounded when the internal battery
is low. If this happens it is essential that the device is connected to an external power source
without delay.
Tip:
If the medinCNO®battery is completely depleted, it can only be recharged very slowly which
greatly increases the recharging time (up to 5 hours). In addition, the battery will be damaged by
this exhaustion and will need to be replaced sooner. Since the battery of the medinCNO®also
recharges while switched off, it is recommended that the medinCNO®be regularly charged during
longer periods of storage.
3.2.3 Power supply unit
The power supply unit of the medinCNO®may only be used according to its imprinted input and
output power.
Input power: 100 to 240 V AC / 50 to 60 Hz / 1.1A
Output power: 24 V DC / 2.2A (SELV - Safety Extra Low Voltage).
Disconnect the power supply unit from the mains during thunderstorms.
Warning:
If the medinCNO®is not connected to the mains, the internal battery will also discharge while
switched off. That is, if the medinCNO®is to later be used on rechargeable battery power, it will
need to be charged beforehand.
If the alarm Battery low –Connect power supply unit does not disappear despite connecting the
power supply unit and deleting the alarm text (e.g. by triggering a push notification or a higher-
priority alarm (red)), there may be a defect of the medinCNO®. Contact a service technician and do
not use this medinCNO®for the time being.
3.3 Gas feed
In order to operate the medinCNO®, it must be supplied with air and oxygen from an external
source that meets these conditions:
Medicinal oxygen:
- 300 to 600 kPa (=3.0 to 6.0 bar)
- Oxygen content: ≥ 99.5%
- H2O ≤ 67 ppm (V/V) (free from condensate)
Medicinal air (Aer medicalis):
- 300 to 600 kPa (=3.0 to 6.0 bar)

medinCNO®User Manual
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- Oil ≤ 0.1 mg/m3, ideally oil-free
- H2O ≤ 870 ppm (V/V) and free from condensate. If as a result of the operating
temperature it is possible that condensate may form despite a relatively low
concentration of H2O in the air, then the concentration of H2O must be reduced
accordingly.
Figure 3-3: Water trap in the medinCNO®air inlet; a) Bolt for removing the condensate from the
water trap
The medinCNO®can be fitted with a water trap in the air inlet as an option (Figure 3-3) (REF 39-
800). This allows small amounts of condensate to be removed from the air supply provided to the
medinCNO®if the water trap is checked for condensate and emptied on a regular basis. To empty
the water trap, undo the black bolt (Figure 3-3 –a) on the underside of the water trap and keep it
open until the condensate has run off (this can also be done under pressure).
Attention:
The functionality of the medinCNO®can only be guaranteed if both the oxygen and medicinal air
supplied to it are free from condensate water, oil and contaminants. If this is not guaranteed, the
medinCNO®could be damaged. Even the use of a water trap can only remove small amounts of
condensate from the air.
In order to avoid fires, oxygen must not come into contact with oil or grease. It is therefore
essential to ensure that all parts of the medinCNO®and the CPAP system which come into contact
with oxygen (e.g. gas feed tubes, O2inlet to the medinCNO®, patient outlet, patient tubes and
Medijet®) remain free from oil and grease.
Gas feed connections:
The medinCNO®can be fitted as standard with NIST or DISS gas supply connections as the
customer prefers. The tube kits to connect the device to the external gas source must also meet
the selected standard.
3.4 External alarm interface and data interfaces
Attention:
Only devices and systems which are approved for medical use and which meet the relevant
electrical safety and EMC standards may be connected to the medinCNO®data interface and
alarm interface.

medinCNO®User Manual
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3.4.1 External alarm
The medinCNO®has an interface for connection to an external alarm system. The interface can
open or close an external current circuit in the event of an alarm. The interface thus acts only as a
switch, that is, the power supply must be ensured by the external alarm system.
Time Delay:
The interface to the external alarm system is updated every 100 msec. That is, the alarm in the
external alarm system is activated with a maximum delay of 100 msec in comparison to the alarm
in the device.
The alarm is likewise deactivated with a maximum delay of 100 msec in comparison to the alarm in
the device. The silencing of the alarm sound does not count here, but rather the actual
deactivation of the alarm (that is, correction of the alarm condition and acknowledgement of the
alarm by the user).
The cable supplied by Medin must be used to connect the medinCNO®to an external alarm
system in order to achieve EMC according to DIN EN 60601-1-2:2007 (REF 39-114) and the
connection must be set up initially by an appropriately trained technician.
Attention:
The medinCNO®may only be connected to an external alarm system using the connection cable
provided by the manufacturer (REF 39-114), otherwise the functionality and EMC of the device
cannot be guaranteed.
Warning:
The function of the external alarm interface must be initially activated by a service technician in the
service menu prior to its first use. The medinCNO®s are delivered with a deactivated interface as a
standard feature.
3.4.2 USB data interface
The USB data interface of the medinCNO®can be used to retrieve internal device data and to
install software updates. In addition, there is the option to prompt an expert of the trend data in the
trend by pressing the corresponding buttons. The USB interface thus delivers either live data or
trend data which must be received and saved by a computer or data management system. The
data are serial data which are transformed internally into a USB signal. Their receipt corresponds
to that of normal serial signals (such as RS232) with these settings:
- Data Type: serial
- Baud rate: 115200
- Data bits: 8
- Parity: none
- Stop bits: 1
- Handshaking: none

medinCNO®User Manual
medin Medical Innovations GmbH Adam-Geisler-Str. 1 D-82140 Olching
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To connect the medinCNO®to a system for archiving and processing patient data, a standard USB
cable (USB 2.0 type A to USB 2.0 type B) with double winding through a ferrite of the type: 742-
711-32 from the manufacturer Würth Elektronik can be used (see Figure 3-4: USB and RS232
cable with ferrite). Nonetheless, the function of the medinCNO®must be observed to avoid
disruptions by the entire system with regard to electromagnetic influences.
Attention:
The data interface of the medinCNO®may only be connected with the cable specified above,
including ferrite core of the type: 742-711-32 from the manufacturer Würth Elektronik with double
winding and a computer system that meets the medically relevant requirements in terms of
electrical safety and EMC, otherwise the functionality and EMC of the medinCNO®cannot be
guaranteed.
In doing so, only the following ferrite core may be used: Würth Elektronik - Type: 742-711-32.
The cable used in each case (USB cable or optional RS232 cable) must thus contain a ferrite
(REF 39-125; Würth Elektronik - Type: 742-711-32, gray or black) with a double wound cable in
accordance with Figure 3-4.
Figure 3-4: USB and RS232 cable with ferrite
a) RS232 cable without ferrite b) RS232 cable with a ferrite that is still open whereby the
cable must be carried through the core twice, that is, wrap the ferrite core once. c)
RS232 cable with ferrite d) USB cable with ferrite (the cable must also be carried
through the ferrite core twice as in the case of RS232 cable)
3.4.3 RS232 interface
The RS232 interface can be installed optionally. The function, data and settings are identical to the
USB interface. A ferrite (Würth Elektronik - Type: 742-711-32, gray or black; REF 39-125) with a
double-wound cable must likewise present on the RS232 cable identical to the USB cable (see
chapter 3.4.2).
a) b) c) d)

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Attention:
The medinCNO®data interface must be connected using the cable, including ferrite core (REF 39-
125) specified above (see Figure 3-4) and a computer system that meets the medically relevant
requirements in terms of electrical safety and EMC, otherwise the functionality and EMC of the
medinCNO®cannot be guaranteed.
3.4.4 Output data (live and trend data)
3.4.4.1 Live data
The live data of the medinCNO®contain the patient pressure, the set flow, the measured oxygen
concentration, whether a push is currently being emitted, all alarms, the set additional push flow
and the current mode. In addition, date, time, device name and software version are regularly
indicated. The live data are automatically and constantly indicated in normal operation. However,
they are not saved in the medinCNO®. If the live data are of interest, they must be recorded and
saved by a computer or data system or the data will be lost. The exact structure of the live data is
described below:
Every 10 min., a line with these data is indicated:
-***;
- Date;
- Time;
- Device name (can be set in the service menu);
- VXXX (CPU software version);
In the interim, the following data are provided every 0.1 sec (separated by ; ) via the USB interface:
- The currently measured CPAP pressure (in the CPAP, APNOEA CPAP and SNIPPV
mode) or the CPAP average value (in oscillation mode) in XX.X mbar
- Set target flow in XX.X L/min for the basic CPAP level; in the case of additional
activation of the leak assist, the target flow + correction flow is emitted.
- Measured oxygen concentration FiO2XXX%;
- Current push activity X: 2 = Backup actively running (independent of whether there is
currently a push or not), 1 = push active (without backup), 0 = no push active;
- High-priority alarms (active alarms are indicated by a bit set at the corresponding site).
The sum of all active alarms XXXX is given:
0x0001: Disconnection
0x0002: CPAP pressure high (fixed)
0x0004: Feed pressure high
0x0008: Gas feed oxygen
0x0010: Gas feed air
0x0020: Device error patient pressure measurement
0x0040: Flow stopped, reactivation via alarm reset
0x0100: Device error restart necessary
- Medium-priority alarms XXXX:
0x0001: Battery almost empty –Connect power supply unit
0x0002: CPAP pressure high (adjustable)
0x0004: CPAP pressure low (adjustable)
0x0008: Oxygen concentration high

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0x0010: Oxygen concentration low
0x0020: Internal temperature too high
- Low-priority alarms XXXX:
0x0001: Fan blocked
0x0004: Leak assist
- Additional flow set during the push XX.X l/min
- Mode X:
C = CPAP
A = APNOEA CPAP
S = SNIPPV
O = Oscillation
Example of live data:
***;2014-04-04;14:09:11;medin-cno1004;V1.3;
04.1;06.0;039;0;0000;0008;0000;03.7;O
04.1;06.0;039;0;0000;0008;0000;03.7;O
…
04.2;06.0;039;0;0000;0008;0000;03.7;O
04.2;06.0;039;0;0000;0008;0000;03.7;O
…
07.0;08.7;021;0;0000;0000;0000;03.8;C
07.9;08.7;021;0;0000;0000;0000;03.8;C
07.9;08.7;021;0;0000;0000;0000;03.8;C
07.7;08.7;021;0;0000;0000;0000;03.8;C
07.5;08.7;021;0;0000;0000;0000;03.8;C
06.7;08.7;021;0;0000;0000;0000;03.8;C
3.4.4.2 Trend data
The trend data are divided into two parts: The first part contains logfiles of saved alarms and
device starts. This recording contains the data of the last device uses and will continue to be saved
even if the medinCNO®is switched off. The second part of the trend data is deleted each time the
medinCNO®is switched off. It saves the data since the last device start for a maximum of 28 days.
It contains the CPAP pressure, the set flow, the measured oxygen concentration, the set additional
push flow, the mode, respiratory rate, whether the backup was active, the pushrate Rinsp, the
minimum and maximum possible push rate, the maximum pressure during the pushes, the
oscillation frequency, the set level of the oscillation amplitude, the resultant pressure of the
oscillation amplitude, the set inspiration time and the set apnoea time.
The structure of the trend data is shown below as an example:
###;2014-04-07;14:20:14;medin-cno1004;V1.3;alarm
record;
start;2014-04-04;10:59;
alarm;04;11:07;0000;0008;0000;for 14:48
alarm;04;13:50;0000;0004;0000;for 00:30
alarm;04;14:14;0002;0002;0000;for 00:36
###;2014-04-07;14:20:15;medin-cno1004;V1.3;trend
record;
CPAP;Flow;FiO2;Finsp;Mode;RR;BU;Rinsp;min;max;Pinsp;Fr
eq;AmpS;AmpP;Tinsp;Tapn;

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05.6;07.0;021;00.0;C;018; ; ; ; ; ; ; ; ;
; ;
05.6;07.0;021;00.0;C;018; ; ; ; ; ; ; ; ;
; ;
…
5.5;07.0;024;01.0;A;024;-;000; ; ;00.0; ; ;
;0.3;10.0;
5.9;07.5;024;01.0;A;018;-;000; ; ;00.0; ; ;
;0.3;10.0;
…
05.8;08.0;021;02.6;S; ;B;070;25;120;10.6; ; ;
;0.2;02.2;
07.3;08.0;021;02.6;S; ;B;070;25;120;11.2; ; ;
;0.2;02.2;
…
02.5;06.0;026;02.5;O; ; ; ; ; ; ;07;10;05.4;
; ;
04.1;06.0;036;03.7;O; ; ; ; ; ; ;14;06;04.1;
; ;
04.1;06.0;039;03.7;O; ; ; ; ; ; ;19;06;04.9;
; ;
***;2014-04-07;14:22:51;medin-cno1004;record complete;
Start of alarm recording:
- ###;
- Date: YYYY-MM-DD; (current date, set in the service menu)
- Time: HH:MM:SS; (current time, set in the service menu,
the switch to local time or
summer time must
be performed manually)
- Device name: medin-cnoZZZZZ (set in the service menu)
- SW version: VXXX (installed main software version)
- Alarm record;
Start and alarm recording:
- For each device start, date and time are saved as such:
start; YYYY-MM-DD;HH:MM;
- For each new alarm, day, time, all active alarms of high, medium and low priority and
the duration (min:sec) of the alarms are saved:
alarm; DD; HH:MM;HHHH;MMMM;LLLL;for MM:SS
The alarm coding takes place analogously to the coding in the live data (for detailed information,
see chapter 3.4.4.1). The date is only shown as a day. The month can be determined using the
last prior start entry. The alarm duration is indicated in minutes and seconds from the start of the
alarm until its end.
Recording the set and measured values:
The trend data contain all values saved in the trend and additional values since the last time the
device was switched on. Every 20 seconds, a line is saved. If a value is not available in the current
mode, it is replaced with blank spaces.
The structure is as follows:

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- Average value of the CPAP pressure in XX.X mbar
- Set flow in XX.X L/min + if applicable, correction flow with activated leak assist
- Measured FiO2 in XXX%
- Set, additional push flow in XX.X L/min
- Current mode: C = CPAP, A = APNOEA CPAP, S = SNIPPV, O = Oscillation, - =
Standby
- Measured respiration rate in XXX / min
- Status of backup (B = actively running; -= currently not actively running or generally off
)
- Push frequency Rinsp in XXX / min
- Minimum reachable push frequency Rinsp in XX / min caused by apnoea
- Maximum reachable push frequency Rinsp in XX / min caused by triggering
synchronised with respiration
- Maximum CPAP value during the push in XX.X mbar
- Set oscillation frequency in XX Hz
- Set amplitude level of oscillation in level XX
- Measured amplitude during the oscillation in XX.X mbar
- Set push length Tinsp in X.X sec
- Set apnoea time in XX.X sec
Tip:
When reading the trend data, there may be time delays upon receipt at the computer or data
system. For this reason, when reading the data, wait until the last line (***;2014-04-
07;14:22:51;medin-cno1004;record complete;) has been issued. Only then
have the trend data been fully received.
3.5 Environmental conditions (operation / transport / storage)
The medinCNO®must not be used in rooms at risk of explosion, near to flammable substances or
close to locations exposed to splash water.
Warning:
The medinCNO®is not suitable for use near magnetic resonance imaging equipment (MR-unsafe).
Environmental conditions for the medinCNO®during operation:
Temperature: 15°C to 35°C
Relative air humidity: Air humidity 20% to 80% (not condensing)
Moisture: The device is to be kept dry during operation.
Ambient pressure: 700hPa to 1100hPa
Altitude: ≤ 2000 m above sea level

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Cleanliness: The hygiene regulations valid for the hospital are to be
observed. In addition, the medinCNO®is to be operated in
standard hospital ambient conditions.
Environmental conditions of the power supply unit during operation:
Temperature: - between 0°C and 40°C
- do not use power supply unit in locations exposed to significant
temperature fluctuations.
Moisture: - use only in dry locations
- relative humidity ≤90%, non-condensing
- do not use in locations exposed to significant amounts of
moisture or condensate
- do not use in locations exposed to significant environmental
stress
- do not use outdoors
Vibrations: do not use in locations exposed to constant vibration
Environmental conditions for the medinCNO®during transport/short-term storage:
Temperature: -20°C to 50°C (longer-term storage only at room temperature)
Relative air humidity: 20% to 80% (not condensing)
Moisture: During transport and storage, the medinCNO®must be
protected from wet conditions.
Cleanliness: The medinCNO®must be protected from contamination during
transport and storage.
Attention:
If the medinCNO®is exposed to temperatures of ≤ 15 °C during transport, it must be acclimatised
at room temperature for at least 24 hours at the location where it is to be used before being
switched on and used for the first time. If this is not done, the condensate which has formed could
damage the medinCNO®.
The medinCNO®may only be transported in the original packaging, since it contains internal
lithium batteries which may only be transported under special conditions. If the medinCNO®
contains defective batteries, these may not be transported and must be removed in advance and
disposed of in accordance with local regulations. (See separate instructions on transporting the
medinCNO®and the batteries it contains).
Long-term storage of the medinCNO®:
Temperature: Room temperature (approximately 20°C)
Relative air humidity: 20% to 80% (not condensing)
Moisture: During storage, the medinCNO®must be protected from wet
conditions.
Cleanliness: The medinCNO®must be protected from contamination during
storage.