Mindray WATO EX-65 User manual

WATO EX-65
Anesthesia Machine Quick Guide
Shenzhen Mindray Bio-Medical Electronics Co., Ltd.

©Copyright 2008-2009 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. All
rights reserved. Contents of this guide are subject to change without prior notice.
This guide contains the basics necessary to operate the product safely and quickly.
For details, refer to the Operator's Manual.
Notes:
Observance of this guide is a prerequisite for proper product performance and
correct operation and ensures patient and operator safety.
This guide is based on the maximum configuration and therefore some contents
may not apply to your product. If you have any question, please contact us.
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The product bears CE mark indicating its conformity with the
provisions of the Council Directive 93/42/EEC concerning medical
devices.

1
Product Introduction
1.Brake
2. Pipeline pressure gauge
3.Total flowmeter
4.Flow control
5.Electronic flowmeter
6.Ventilator control panel
7.Control knob
8. Display
9.Vaporizer
10.Gas supply connector
11.System switch
12.Cylinder pressure gauge
13.O2 flush button
14. Auxiliary electrical outlet
15.Drawer lock
16.Worktable (with drawer)

2
Product Introduction
1.O2 sensor connector
2. Inspiration connector
3.Expiration connector
4.Inspiratory check valve
5.Expiratory check valve
6.Bellows housing
7.Sample gas return port
8.Manual bag port
9.Bag/mechanical
ventilation switch
10.APL (Airway Pressure
Limit) valve
11.O2 sensor connector
12.Rotary handle
13.Sodalime canister

3
Product Introduction
1.Cylinder connector
2.Equipotential stud
3.Fan
4.Mains inlet
5.Network connector
6.
CIS 12 V power supply
connector
7.Speaker
8.Auxiliary O2 supply
9.ACGO (Auxiliary Common
Gas Outlet) switch
10.Module slot
11.AGSS outlet
12.AGSS Transfer and
Receiving System

4
Control Panel
The control panel is located beneath the ventilator display, as shown below:
1. Battery LED
2. AC power LED
3. Operating state LED
4. Alarm silence key
To set alarm silence state, push this key to enter 120 s alarm silenced
status. The alarm silence symbol and 120 s countdown time appear in
the upper right corner of the screen.
To clear alarm silence, push this key again.
5. Standby key
Push to enter or exit standby mode.
6. Normal screen key
Push to clear all menus popping up on the screen and return to the normal
screen.
7. MV&TVe alarm key
In case of manual ventilation mode: Push the key to switch off MV and TVe
overrange alarms and apnea alarm. Push the key again to switch on MV
and TVe overrange alarms and apnea alarm.
In case of mechanical ventilation mode: Push the key to switch off MV
and TVe overrange alarms. Push the key again to switch on MV and TVe
overrange alarms.
8. Control knob
Push the control knob to select a menu option or confirm your setting. Turn
the control knob clockwise or counterclockwise to scroll through the menu
options or change your settings.
123 4 5 6 7 8

5
12 345 6 78 9
10
11
12
13
14
15
16
17
18
Display Screen
This anesthesia machine adopts a high-resolution color TFT LCD to display
various parameters, spirometry loops and waveforms (airway pressure, flow,
volume, EtCO2, etc).
The following is a standard display screen. For descriptions of other screens,
refer to Operator's Manual.
1. Ventilation mode prompt area
Displays the current ventilation mode. If manual ventilation is selected for the
bag/mechanical ventilation switch, is displayed in this area. Otherwise,
the currently selected mechanical ventilation mode is displayed.
2. Lung icon
The icon is displayed when SIMV-VC or SIMV-PC mode is selected and
inspiration triggering action is done currently.

6
3. MV&TVe alarm off icon
4. Physiological alarm area
5. Apnea alarm off icon
6. Alarm silence icon area
7. System time
8. Technical alarm area
9. Power supply state icon area
Displays power source or battery icon. The icon is displayed when
the anesthesia machine is powered by AC power source. The battery icon
is displayed when the anesthesia machine is battery powered to indicate
battery capacity.
10.[Vent Mode] shortcut key
Used to select mechanical ventilation mode.
11.[Alarm Setup] shortcut key
Used to change the alarm settings for the anesthetic ventilator, gas module
or BIS module.
12.[Screens] shortcut key
Used to set user screen.
13.[User Setup] shortcut key
Used to change the settings for TV compensation, O2 monitoring source,
gas module, BIS module, screen, sound etc.
14.[Maintenance] shortcut key
Used to perform leak test, calibrate O2 sensor and flow sensor, view trend
graph, trend table and alarm logbook, and set language, system time,
pressure unit, IP address etc.
15. Timer Setup shortcut key
16. Parameter Setup shortcut keys area
Used to set the parameters related to mechanical ventilation mode. Shortcut
keys arrangement is subject to specific mechanical ventilation mode.
17. System prompt message area
18. Parameter & graph area
Displays the parameters, waveforms, spirometry loops, or electronic
flowmeter graphs which the anesthetic ventilator, gas module, or BIS module
monitors. Different types of screens are displayed based on the actual
system configuration or screen layout settings.
Display Screen

7
Inspect the System
Make sure that:
The anesthesia machine is undamaged.
All components are correctly attached.
The breathing system is correctly connected, and the breathing tubes are
undamaged.
The vaporizers are locked in position and contain sufficient agent.
The gas supplies are connected and the pressures are correct.
Cylinder valves are closed on models with cylinder supplies.
The necessary emergency equipment is available and in good condition.
Equipment for airway maintenance and tracheal intubation is available and
in good condition.
Applicable anesthetic and emergency drugs are available.
The casters are not damaged or loose and the brake is set and prevents
movement.
The breathing system is locked (in the position).
The AC mains indicator and the battery indicator come on when the power
cord is connected to the AC power source. If the indicators are not on, the
system does not have electrical power.
The anesthesia machine is switched on or off normally.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Make sure that the breathing system is correctly connected and not
damaged.
The top shelf weight limit is 30 kg.
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NOTE:

8
Preoperative Test
Perform the preoperative tests listed below at these events:
1.Before each patient.
2.When required after a maintenance or service procedure.
The following table indicates when a test must be done.
Test Item Test Intervals
Pipeline tests
Every day before the first patientCylinder tests
Flow control system tests
Inspect the system
Before each patient
Alarm tests
Power failure alarm test
Breathing system tests
O2 Flush Test
Preoperative preparations
NOTE:
Read and understand the operation and maintenance of each component
before using the anesthesia machine.
Do not use the anesthesia machine if a test failure occurs. Contact us
immediately.
Within the warranty period, check the sealing condition only. When a great
deviation occurs to the pressure value or the flow value that is measured,
contact the authorized engineer for calibration service.
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Test Intervals

9
Turn on the System
Connect the power cord to the AC power source.Make sure that the AC power
LED is illuminated.
Set the system switch to ON.Make sure that both the operating state LED and
battery LED are illuminated (the battery is being charged or fully charged).
The alarm lamp flashes yellow and red once in turn and then a beep is given.
The display shows the start-up screen and then enters the standby screen
after half a minute.
1.
2.
3.
4.
WARNING：
Do not use the anesthesia machine if it generates alarms when turned on, or
can not operate normally. Contact your service personnel or us.
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Input Fresh Gas
Connect the gas supplies correctly and ensure adequate gas pressure.
You can control the O2, N2O and AIR flows in the fresh gas through the O2,
N2O and AIR flow controls. Readings of the gas flows can be seen on the
respective flowmeters.
If inspiratory anesthetic agent is used, ensure that the vaporizer is correctly
mounted onto the anesthesia machine and the vaporizer conforms to the
the anesthetic agent to be used. Fill the vaporizer with the anesthetic agent
properly.
Push and turn the concentration control on the vaporizer to set the
appropriate concentration of anesthetic agent.
1.
2.
3.
4.
NOTE:
This anesthesia machine can be mounted with vaporizers corresponding with
halothane, enflurane, isoflurane, sevoflurane and desflurane. Only one of the
five vaporizers can be opened at a time because the vaporizers are featured
with interlock.
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10
Mechanical Ventilation Mode
Make sure that the system is Standby.
Set the appropriate Plimit value in the parameter setup shortcut keys area.
Check the ACGO switch to make sure that it is OFF .
Set the bag/mechanical ventilation switch to the position.
Push the O2 flush button to inflate the bag if it collapses.
Select the [Vent Mode] shortcut key to open the [Vent Mode Setup] menu.
Select ventilation mode.
1.
2.
3.
4.
5.
6.
Select the parameter setup shortcut key to set the parameters related to
mechanical ventilation mode.
Set Alarm Limits
Select the [Alarm Setup] shortcut key and then [Ventilator >>].
Set [High Limit] and [Low Limit] respectively for each parameter.
Select the [Alarm Setup] shortcut key and then [Gas Module >>].
Set [High Limit] and [Low Limit] respectively for each parameter.
1.
2.
3.
4.
Set Ventilator Parameters
Ventilation Mode
Start Mechanical Ventilation
After settings of the related parameters are already made, you can enter
mechanical ventilation mode by pushing the Standby key and then selecting
[Ok] from the pop-up menu to exit the standby status. The system will work in the
selected mechanical ventilation mode.
NOTE:
Before starting a new mechanical ventilation mode, make sure that all related
parameters are set to the appropriate values.
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11
To turn off the system, do as follows:
Confirm that system use is finished.
Set the system switch to OFF.
1.
2.
Turn off the System
Manual Ventilation Mode
Turn the APL valve control to adjust the pressure in the breathing system
within the appropriate range.
Set the bag/mechanical ventilation switch to the position. The ventilation
mode prompt area displays the icon for manual ventilation mode. Besides,
the system prompt message area displays [Manual Vent.].
Press the O2 flush button to inflate the bag if necessary.
1.
2.
3.
Start Manual Ventilation
Stop Mechanical Ventilation
Make sure that the APL valve is set properly before stopping mechanical
ventilation. The APL valve adjusts the breathing system pressure limit during
manual ventilation. Its scale shows approximate pressure.
Set the bag/mechanical ventilation switch to the position. This selects
manual ventilation and stops mechanical ventilation (ventilator).
1.
2.
NOTE:
Before applying mechanical ventilation, check the sodalime in the canister. If
sodalime color changes significantly, replace the sodalime promptly.
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Mechanical Ventilation Mode
Set Alarm Limits
Select the [Alarm Setup] shortcut key and then [Ventilator >>].
Set [High Limit] and [Low Limit] respectively for each parameter.
Select the [Alarm Setup] shortcut key and then [Gas Module >>].
Set [High Limit] and [Low Limit] respectively for each parameter.
1.
2.
3.
4.

12
Cleaning and Disinfection
NOTE：
Obey applicable safety precautions.
Read the material safety data sheet for each cleaning agent.
Read the operation and service manual for all disinfection equipment.
Wear gloves and safety glasses. A damaged O2 sensor can leak and cause
burns (contains potassium hydroxide).
Reuse of undisinfected breathing system or reusable accessories may cause
cross-contamination.
Preoperative tests must be performed before patient use every time the
anesthesia machine has been disassembled for cleaning and disinfection, or
has been reassembled.
To prevent leaks, avoid damaging any component in case of disassembling
and reassembling the breathing system. Ensure the correct installation of the
system, especially of the seal. Make sure of the applicability and correctness of
the cleaning and disinfection methods.
Disassemble and reassemble the breathing system as described in this guide.
For further disassembly and reassembly, contact us. Improper disassembling
and reassembling may cause breathing system leak and compromise normal
system use.
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WARNING：
To help prevent damage, refer to the manufacturer’s data if you have questions
about a cleaning agent.
Do not use organic, halogenated, or petroleum based solvents, anesthetic agents,
glass cleaners, acetone, or other harsh cleaning agents.
Do not use abrasive cleaning agents (such as steel wool, silver polish or cleaner).
Keep all liquids away from electronic parts.
Do not permit liquid to go into the equipment housings.
Do not soak synthetic rubber parts for more than 15 minutes. Otherwise swelling
or faster aging may occur.
Only autoclave parts marked 134ºC.
Cleaning solutions must have a pH of 7.0 to 10.5.
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13
All parts of the breathing system can be cleaned and disinfected. The cleaning
and disinfection methods are different for different parts. You need to select
the appropriate method to clean and disinfect the parts based on the actual
situations to avoid cross-contamination.
This table is our recommended cleaning and disinfection methods for all parts of
the breathing system.
Parts
Intermediate level
disinfection
High level
disinfection
A* B* C*
Breathing tubes and Y piece ★★
Breathing mask ★★
Flow sensor ★
Bellows assembly ★★
Inspiratory and expiratory check valves
assembly ★★
O2 sensor ★
Canister assembly ★★
Canister connection block assembly ★★
Water collection cup ★★
Bag arm ★★
BYPASS assembly ★★
Breathing System ★★
Manual bag ★★
AGSS assembly ★
★Indicates that this disinfection method is applicable.
A* Clean with a damp cloth soaked in mild detergent and then wipe off the
remaining detergent with a dry lint free cloth.
B* Flush with water first; then soak in water and cleaning solution (water
temperature 40ºC recommended) for approximately three minutes and wipe
with 70% ethanol.
C* Steam autoclave at maximum 134ºC.
Cleaning and Disinfection

14
Clean and Disinfect the Anesthesia Machine Housing
Clean the surface of the anesthesia machine housing with a damp cloth soaked in
mild detergent (such as 70% ethanol).
After cleaning the housing, remove the remaining detergent by wiping with a dry lint
free cloth.
1.
2.
WARNING：
Seeping liquid into the control assembly can damage the equipment or cause
personal injury. When cleaning the housing, make sure that no liquid flows into
the control assembly and always disconnect the equipment from the AC mains.
Reconnect the AC mains after the cleaned parts are fully dry.
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NOTE：
Use only soft dry and lint free cloth to clean the display. Do not use any liquid
for display cleaning.
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Disassemble the Breathing System Cleanable Parts
You need to disassemble the breathing system cleanable parts first before
cleaning the system.
O2 Sensor
1.Remove one end of the O2 sensor cable
from the connector on the anesthesia
machine. Unplug the other end of the cable
from the O2 sensor.
2. Turn the O2 sensor counterclockwise to
take it out.
Cleaning and Disinfection

15
Flow Sensor
1.Turn the locking nuts counterclockwise. 2.
Pull out the inspiration/expiration connectors
and their locking nuts.
Remove the filter from the Y piece. Disconnect the breathing tubes from the
inspiration/expiration connectors on the breathing system.
Breathing Tubes and Y Piece
WARNING：
When installing the breathing tube, hold the tube connector at both ends of the
tube to prevent damage of the tube.
Do not reuse the filter to prevent cross-contamination. Follow local regulations
regarding disposal of hospital waste when the filter is discarded.
Install the filter as described in this guide to prevent dust and particles from
entering the patient’s lungs and prevent cross-contamination.
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WARNING：
Tighten the locking nuts when installing the flow sensor. Failure to do so may
result in invalid measurement.
The end of inspiration/expiration connectors which connect the breathing tube
shall be kept downward to prevent condensed water from entering the breathing
system.
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Cleaning and Disinfection

16
3.Pull out the flow sensors horizontally.
Cleaning and Disinfection
Check Valve Assembly
1. Turn the check valve
cover counterclockwise to remove it.
2.Pull out the check valve.
WARNING：
Do not separate the check valve diaphragm from the valve cover.
When installing the check valve, depress the valve forcibly to make sure that it
is installed in position.
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Water Collection Cup
1. Hold the water
collection cup and turn it clockwise.
2. Remove the water collection cup.