Siemens Drager medical Carina User manual

WARNING
For a full understanding of the per-
formance characteristics of this
medical device, the user should
carefully read these Instructions for
Use before use of the medical
device.
Instructions for Use
Carina
Sub-Acute Care Ventilator
Software 3.n

2Instructions for Use Carina SW 3.n
Working with these
Instructions for Use
In the header – the subject of the main chapter
To help you find your way around quickly.
On each page – the instructions for use
Combining text with illustrations. The information is
translated directly into actions to enable the user to
learn "hands-on" how to use the Carina ventilator.
Left-hand column – the text
Provides explanations and guides the user clearly
and ergonomically with brief directions for using the
product.
Dots indicate the steps to be followed whilst num-
bers refer to the illustration and indicate the
sequence.
Font style, e.g. »Start/Standby«, »MVi«, indicates
buttons, device labels and messages on the
screen.
Right-hand column – the illustration
Provides a link with the text and serves as a guide
to the ventilator. Points mentioned in the text are
emphasized and non-essential information is omit-
ted.
Screen displays guide the user and confirm the
steps to be followed.
107
Operation
54 Instructions for Use Carina SW 3.n
Setting ventilation modes
Switching on, Carina shows the ventilation mode
last set along with the set parameters.
Calling up the ventilation settings menu
1Press »Select Menu« button.
2Press the »Settings« button and the ventilation
mode last set is indicated.
Changing the ventilation mode
3Press button for the ventilation mode.
zSelect and confirm the ventilation mode using
the rotary knob.
Carina can use the following ventilation modes:
–VC-SIMV
–PC-BIPAP
–PC-AC
– SPN-PS (VG)
– SPN-CPAP
035
1
507
2
506
3

Instructions for Use Carina SW 3.n 3
Trademarks
– AutoFlow®
–Carina
®
– SyncPlus®
are registered trademarks of Dräger.
–BIPAP*
–Virex
®
is a registred trademark of JohnsonDiversery.
Definitions
* Trademark Used Under Licence
WARNING
A WARNING statement provides important
information about a potentially hazardous
situation which, if not avoided, could result in
death or serious injury.
CAUTION
A CAUTION statement provides important infor-
mation about a potentially hazardous situation
which, if not avoided, may result in minor or mode-
rate injury to the user or patient or in damage to
the medical device or other property.
NOTE
A NOTE provides additional information intended
to avoid inconvenience during operation.

4Instructions for Use Carina SW 3.n
This page intentionally left blank

Instructions for Use Carina SW 3.n 5
Contents
Contents
Working with these Instructions for Use . . . . . 2
Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
For Your Safety and That of Your
Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
General WARNINGS and CAUTIONS . . . . . . . . 10
Intended Use. . . . . . . . . . . . . . . . . . . . . . . . . . . 13
System Overview . . . . . . . . . . . . . . . . . . . . . . . 15
Main functions . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Control panel, top . . . . . . . . . . . . . . . . . . . . . . . . 18
Carina underside . . . . . . . . . . . . . . . . . . . . . . . . 18
Front connection block . . . . . . . . . . . . . . . . . . . . 19
Rear connection block . . . . . . . . . . . . . . . . . . . . 19
Trolley 1-63 cm, Trolley 1-78 cm . . . . . . . . . . . . 20
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Operating concept . . . . . . . . . . . . . . . . . . . . . . 25
Control panel . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Setting ventilation mode . . . . . . . . . . . . . . . . . . . 28
Setting ventilation parameters . . . . . . . . . . . . . . 28
Calling up menus . . . . . . . . . . . . . . . . . . . . . . . . 29
Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Information on preparation . . . . . . . . . . . . . . . . . 32
Fitting the inlet filter . . . . . . . . . . . . . . . . . . . . . . 32
Positioning Carina . . . . . . . . . . . . . . . . . . . . . . . 32
Carina with trolley . . . . . . . . . . . . . . . . . . . . . . . . 33
Information on using bacterial filters, HME
systems and hose systems . . . . . . . . . . . . . . . . 39
Connecting a hose system . . . . . . . . . . . . . . . . . 40
Connecting a respiratory gas humidifier . . . . . . . 43
Preparing the Aeroneb Pro nebuliser . . . . . . . . . 46
Connecting to the power supply . . . . . . . . . . . . . 47
O2supply, connect . . . . . . . . . . . . . . . . . . . . . . . 50
Connecting to the nurse call system. . . . . . . . . . 52
MEDIBUS interface . . . . . . . . . . . . . . . . . . . . . . 53
Position of the user. . . . . . . . . . . . . . . . . . . . . . . 53
Start-up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Information on start-up . . . . . . . . . . . . . . . . . . . 56
Switching on Carina . . . . . . . . . . . . . . . . . . . . . 56
Checking readiness for operation . . . . . . . . . . . 57
Selecting an application method . . . . . . . . . . . . 59
Setting the O2supply . . . . . . . . . . . . . . . . . . . . 60
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Setting ventilation modes . . . . . . . . . . . . . . . . . 62
Setting ventilation parameters. . . . . . . . . . . . . . 63
Starting ventilation . . . . . . . . . . . . . . . . . . . . . . . 63
VC-SIMV AF . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
PC-BIPAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
PC-AC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
SPN-PS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
SPN-CPAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Apnoea ventilation. . . . . . . . . . . . . . . . . . . . . . . 73
Volume guarantee . . . . . . . . . . . . . . . . . . . . . . 74
NIV – Non-invasive Ventilation . . . . . . . . . . . . . 75
LPO – Low Pressure Oxygen mode . . . . . . . . . 77
Locking buttons . . . . . . . . . . . . . . . . . . . . . . . . . 80
Terminating ventilation. . . . . . . . . . . . . . . . . . . . 81
Switching off the device . . . . . . . . . . . . . . . . . . 81
Improve displayed accuracy of the charging
capacity of the internal battery . . . . . . . . . . . . . 82
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Setting alarm limits . . . . . . . . . . . . . . . . . . . . . . 84
In the event of an alarm. . . . . . . . . . . . . . . . . . . 85
Troubleshooting. . . . . . . . . . . . . . . . . . . . . . . . . 86
Suppressing the alarm tone . . . . . . . . . . . . . . . 86
Alarm after battery discharge . . . . . . . . . . . . . . 86
Configuration. . . . . . . . . . . . . . . . . . . . . . . . . . 87
Carina Configuration . . . . . . . . . . . . . . . . . . . . . 88
Service menu . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Setting volume of the alarm tone. . . . . . . . . . . . 91
Setting the alarm tone . . . . . . . . . . . . . . . . . . . . 91
Selecting screen display . . . . . . . . . . . . . . . . . . 92
Selecting display for 2 measured values. . . . . . 93
Selecting an application method . . . . . . . . . . . . 93
Switching LPO mode on/off. . . . . . . . . . . . . . . . 93
Selecting Ti or I:E . . . . . . . . . . . . . . . . . . . . . . . 94
Setting the night screen. . . . . . . . . . . . . . . . . . . 94

6Instructions for Use Carina SW 3.n
Contents
Fault – Cause – Remedy . . . . . . . . . . . . . . . . . 95
Fault – Cause – Remedy . . . . . . . . . . . . . . . . . . 96
Displaying technical alarm causes . . . . . . . . . . 101
Rescue Ventilation . . . . . . . . . . . . . . . . . . . . . . 101
Cleaning, Disinfection and Sterilisation. . . . 103
General information on cleaning,
disinfection and sterilisation . . . . . . . . . . . . . . . 104
Care list . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Dismantling the components . . . . . . . . . . . . . . 105
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Wipe disinfection . . . . . . . . . . . . . . . . . . . . . . . 106
Wipe disinfection with Virex Tb. . . . . . . . . . . . . 106
Damp heat disinfection. . . . . . . . . . . . . . . . . . . 106
Autoclave sterilisation at 134 °C. . . . . . . . . . . . 106
Reprocessing of accessories . . . . . . . . . . . . . . 106
Before reusing on patient . . . . . . . . . . . . . . . . . 106
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Maintenance intervals . . . . . . . . . . . . . . . . . . . 108
Replacing the inlet filter . . . . . . . . . . . . . . . . . . 109
Taking the device out of operation for
a lengthy period . . . . . . . . . . . . . . . . . . . . . . . . 109
Visual inspection of accessories. . . . . . . . . . . . 110
Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Disposing of the internal battery. . . . . . . . . . . . 112
Disposing of the inlet filter . . . . . . . . . . . . . . . . 112
Disposing of the device . . . . . . . . . . . . . . . . . . 112
Technical Data . . . . . . . . . . . . . . . . . . . . . . . . 113
Ambient conditions . . . . . . . . . . . . . . . . . . . . . . 114
Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Performance data. . . . . . . . . . . . . . . . . . . . . . . 115
Measurement displays . . . . . . . . . . . . . . . . . . . 115
Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Operating data . . . . . . . . . . . . . . . . . . . . . . . . . 117
Classification . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Trolley. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Hose systems. . . . . . . . . . . . . . . . . . . . . . . . . . 119
EMC Declaration . . . . . . . . . . . . . . . . . . . . . . . 120
Description . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Mode of operation . . . . . . . . . . . . . . . . . . . . . . 126
VC-SIMV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
PC-BIPAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
PC-AC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
SPN-PS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
SPN-CPAP . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Tube (Invasive ventilation) . . . . . . . . . . . . . . . 135
Mask ventilation (Non-invasive ventilation) . . . 136
SyncPlus . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Volume Guarantee (VG) . . . . . . . . . . . . . . . . . 138
Volume measurement . . . . . . . . . . . . . . . . . . 139
AutoRamp . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

Instructions for Use Carina SW 3.n 7
For Your Safety and That of Your Patients
For Your Safety and That of Your Patients
Strictly follow these Instructions for Use . . . . . . . . 8
Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Safe connection with other electrical
equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Patient safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Patient monitoring. . . . . . . . . . . . . . . . . . . . . . . . . 8
Functional safety . . . . . . . . . . . . . . . . . . . . . . . . . 9
General WARNINGS and CAUTIONS . . . . . . . 10
Note on EMC/ESD risk for the device
function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Adequate monitoring of ventilation . . . . . . . . . . . 11
Back-up ventilation with an independent
manual ventilation device . . . . . . . . . . . . . . . . . . 12

8Instructions for Use Carina SW 3.n
For Your Safety and That of Your Patients
Strictly follow these Instructions for Use
Maintenance
Accessories
Safe connection with other electrical equipment
Patient safety
The design of the medical device, the accompany-
ing literature, and the labeling on the medical
device take into consideration that the purchase
and use of the medical device are restricted to
trained professionals, and that certain inherent
characteristics of the medical device are known to
the trained operator. Instructions, warnings, and
caution statements are limited, therefore, largely to
the specifics of the Dräger design.
This publication excludes references to various
hazards which are obvious to a medical profes-
sional and operator of this medical device, to the
consequences of medical device misuse, and to
potentially adverse effects in patients with abnor-
mal conditions. Medical device modification or mis-
use can be dangerous.
Patient monitoring
The operators of the medical device are responsi-
ble for choosing appropriate safety monitoring that
supplies adequate information on medical device
performance and patient condition. Patient safety
may be achieved through a wide variety of means
ranging from electronic surveillance of medical
device performance and patient condition, to sim-
ple, direct observation of clinical signs.
The responsibility for the selection of the best level
of patient monitoring lies solely with the medical
device operator.
WARNING
Any use of the medical device requires full
understanding and strict observation of all
portions of these instructions. The medical
device is only to be used for the purpose spec-
ified under "Intended Use" on page 14 and in
conjunction with appropriate patient monitor-
ing (see page 11). Strictly observe all WARN-
ING and CAUTION statements throughout
these instructions for Use and all statements
on medical device labels.
WARNING
The medical device must be inspected and
serviced regularly by properly trained service
personnel.
Repair of the medical device may also only be
carried out by properly trained service per-
sonnel.
Dräger Medical recommends that a service
contract be obtained with DrägerService and
that all repairs also be carried out by them.
Dräger Medical recommends that only authen-
tic Dräger Medical repair parts be used for
maintenance. Otherwise the correct function-
ing of the medical device may be compro-
mised.
See chapter "Maintenance".
WARNING
Only the accessories indicated on the list of
accessories 90 38 969 (1st edition or higher)
have been tested and approved to be used
with the medical device. Accordingly it is
strongly recommended that only these acces-
sories be used in conjunction with the specific
medical device. Otherwise the correct func-
tioning of the medical device may be compro-
mised.
WARNING
Electrical connections to equipment which is
not listed in these Instructions for Use should
only be made following consultation with the
respective manufacturers. Equipment mal-
function may result with the risk of patient
injury.

Instructions for Use Carina SW 3.n 9
For Your Safety and That of Your Patients
Functional safety
The essential performance consists in controlled
and monitored patient ventilation with user-defined
settings for the monitoring functions
– minimum inspiratory breathing gas flow,
– maximum airway pressure,
or, if one of the limits set is exceeded, by an appro-
priate alarm. The medical device is equipped with
basic safety features to reduce the possibility of
patient injury while the cause of an alarm is reme-
died.

10 Instructions for Use Carina SW 3.n
For Your Safety and That of Your Patients
General WARNINGS and CAUTIONS
The following WARNINGS and CAUTIONS apply to
general operation of the device. WARNINGS and
CAUTIONS specific to subsystems or particular
features appear with those topics in later sections
of these Instructions for Use or in the Instructions
for Use of any product being used with this device.
WARNING
It is the medical user's responsibility to select
the appropriate ventilation mode for the
patient's underlying disorder. Despite all the
ventilator adjustments to ensure that the ven-
tilation setting is optimally suited to the condi-
tion of the patient, the user must take the
patient's respiratory status and general state
of health into account.
WARNING
Only use the device under the supervision of
qualified medical personnel so that in the
event of a malfunction assistance is on hand
immediately.
WARNING
Operation prohibited in potentially explosive
atmospheres! The device is not approved for
operation in potentially explosive atmos-
pheres.
WARNING
Do not use the device in conjunction with
flammable gases or anaesthetic agents – fire
hazard!
WARNING
Medications or other substances based on
flammable solvents such as alcohol must not
be introduced into the hose system. Fire haz-
ard!
If highly flammable substances are used for
disinfection, adequate ventilation must be
ensured.
WARNING
Do not use the device during magnetic reso-
nance (MRI, NMR, NMI)! Device operation may
be affected, thus placing the patient at risk.
WARNING
Do not use the device in hyperbaric cham-
bers!
Device operation may be affected, thus plac-
ing the patient at risk.
WARNING
Operation of the device can be impaired by the
use of high-frequency electrosurgical units,
defibrillators and shortwave therapy devices,
thus endangering the patient.
WARNING
Do not use any antistatic or conductive Venti-
lation hoses. Risk of electric shock and fire
hazard due to oxygen.
CAUTION
To prevent the device from tipping over, only use
Carina up to a maximum inclination of 15°!
CAUTION
To combine Carina with other products the opera-
tor must secure the equipment appropriately in
accordance with the relevant basic requirements
of Directive 93/42/EEC.
CAUTION
Observe the following for ventilation when moving
through the hospital: Do not place Carina on the
bed. Prevent Carina from dropping. Secure
accessories.
WARNING
Do not use the device in rooms at tempera-
tures above 35 °C (95 °F) or below 5 °C (41 °F).
Risk of lung damage, especially in the case of
tracheotomized patients.

Instructions for Use Carina SW 3.n 11
For Your Safety and That of Your Patients
Note on EMC/ESD risk for the device function
General information on electromagnetic compatibil-
ity (EMC) pursuant to international EMC standard
IEC 60601-1-2:
Electromedical devices are subject to special pre-
cautionary measures concerning electromagnetic
compatibility (EMC) and must be installed and put
into operation in accordance with the EMC informa-
tion provided on page 120.
Portable, mobile RF communications equipment
can affect medical electrical equipment.
Adequate monitoring of ventilation
The patient monitoring system integrated into
Carina monitors the following parameters:
– Airway pressure Paw
– Inspiratory minute volume MVi
– Delivered minute volume MV (without leakage
compensation)
– Apnoea time Tapn
– Inspiratory tidal volume VTi (not in SPN-CPAP)
– Delivered tidal volume VT (without leakage
compensation) (not in SPN-CPAP)
– PEEP
– Mean pressure Pmean
– Frequency f
–I:E
Changes in these parameters can be caused by:
– acute change in the condition of the patient
– adjusting and handling errors
– device errors
– failure of power and gas supplies
If there is a fault in the integrated patient monitoring
system use separate measuring equipment.
CAUTION
Only use the device in well ventilated rooms to
prevent over heating of the device.
CAUTION
Do not expose the device to direct sunlight to pre-
vent over heating of the device.
WARNING
Only operate Carina with an inlet filter (HEPA)
to prevent infection and dusting patient.
WARNING
If inspiratory oxygen concentration differs
from ambient air concentration, monitoring of
inspiratory oxygen concentration with adjust-
able high and low alarm limits is needed. Con-
nect external monitor to hose system in
accordance with ISO 21647.
Otherwise no alarm will be activated if actual
inspiratory oxygen concentration differs from
set oxygen concentration.
WARNING
Patients depending on ventilation need either
monitoring of expiratory tidal volume, or mon-
itoring of expiratory minute volume, or moni-
toring of endtidal expiratory CO2
concentration. Connect appropriate external
monitor to hose system.
Otherwise no alarm will be activated, if
patient's ventilation deteriorates.
CAUTION
Due to Carina's limited monitoring functionality
(no internal monitoring of expiratory minute vol-
ume), Carina is not always able to detect a dis-
connection of the hose system or pilot line!
Especially in cases when low PEEP values and
filters with high resistance are used. Use only fil-
ters listed in the separate accessories list, or con-
nect appropriate external monitor!
WARNING
In the case of patients who require a high O2
concentration ensure that there is an emer-
gency supply of oxygen available, e.g. in O2
cylinders.
WARNING
Do not operate a defibrillator while supplying
oxygen. Fire hazard!

For Your Safety and That of Your Patients
12 Instructions for Use Carina SW 3.n
Back-up ventilation with an independent
manual ventilation device
WARNING
If a fault is detected in Carina so that its life-
support functions are no longer assured, ven-
tilation using an independent ventilation
device must be started without delay – if nec-
essary with PEEP and/or an increased inspir-
atory O2concentration (e.g. with the
Resutator MR 100).

Instructions for Use Carina SW 3.n 13
Intended Use
Intended Use
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Sub-acute care definition . . . . . . . . . . . . . . . . . . 14

Intended Use
14 Instructions for Use Carina SW 3.n
Intended Use
Carina – long-term ventilator for ventilator-depend-
ent patients or ventilator-assisted patients.
– For treatment of sub-acute care patients in hos-
pital or medical rooms.
– For invasive ventilation or non-invasive ventila-
tion.
– For patients with a tidal volume of at least
100 mL.
– For use by qualified medical personnel.
Sub-acute care definition*
Sub-acute care is comprehensive, inpatient care
for patients who:
– Have had an acute event resulting from injury,
illness or exacerbation of a desease process;
– Have a determined course of treatment;
– Though stable, require diagnostics or invasive
procedures, but not intensive procedures
requiring an acute level of care.
The severity of the patient’s condition requires:
– Active physician direction with frequent on-site
visits;
– Professional nurse care;
– Complex medical and/or rehabilitative care.
Typically sub-acute care is designed to return
patients to the community or transition them to a
lower level of care.
WARNING
Not intended for acute inpatient care of non-
stabilized patients who require ventilation
with comprehensive continuous monitoring
according to IEC 60601-2-12 or EN 794-1.
* References:
National Association of Subacute and Post Acute Care
(NASPAC)
The American Health Care Association (AHCA)
The Joint Commission on Accreditation of Healthcare
Organizations (JCAHO)
FDA Consumer magazine September-October 1999

Instructions for Use Carina SW 3.n 15
System Overview
System Overview
Main functions . . . . . . . . . . . . . . . . . . . . . . . . . 16
Ventilation modes . . . . . . . . . . . . . . . . . . . . . . . . 16
Supplements. . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Hose systems. . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Gas supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Interfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
MEDIBUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Trolley. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Control panel, top. . . . . . . . . . . . . . . . . . . . . . . 18
Carina underside . . . . . . . . . . . . . . . . . . . . . . . 18
Front connection block . . . . . . . . . . . . . . . . . . 19
Rear connection block . . . . . . . . . . . . . . . . . . . 19
Trolley1-63cm,Trolley1-78cm. . . . . . . . . . . 20
Symbols. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . 22

16 Instructions for Use Carina SW 3.n
System Overview
Main functions
Ventilation modes
VC-SIMV AF
Volume Control – Synchronized Intermittent Man-
datory Ventilation – AutoFlow
Intermittent triggered mechanical ventilation (vol-
ume-controlled) in conjunction with spontaneous
breathing. With AutoFlow function for optimisation
of inspiration flow.
PC-AC
Pressure Control – Assist Control
Pressure-assisted spontaneous breathing with
fixed inspiration time.
PC-BIPAP
Pressure Control – Biphasic Positive Airway Pres-
sure
Pressure-controlled ventilation in conjunction with
free spontaneous breathing during the entire
breathing cycle.
SPN-PS (VG)
Spontaneous – Pressure Support
(Volume Guarantee)
Pressure-assisted spontaneous breathing with
selectable volume guarantee function
SPN-CPAP
Spontaneous Continuous Positive Airway Pressure
Spontaneous breathing with continuous positive
airway pressure
Supplements
Apnoea ventilation
For automatically switching to volume-controlled,
mandatory ventilation in the event of apnoea. If
apnoea occurs, Carina gives an alarm after the set
alarm time and starts ventilation at the predeter-
mined volume.
Trigger
For the ventilation of spontaneously breathing
patients, synchronising ventilation with spontane-
ous breathing.
SyncPlus
For leak compensation.
Ramp
Variable rise in pressure from the lower pressure
level to the upper pressure level.
VG
Volume Guarantee
VG ensures that patients receive a defined tidal vol-
ume even during pressure-assisted ventilation
(SPN-PS).
Hose systems
Hose system with leak valve (LeakV) for mask or
tube application method
– Automatic leakage compensation
– MVi and VTi represents the calculated inspira-
tory patient volume
– VC-SIMV AF and SPN-PS (VG) control the cal-
culated inspiratory patient volume
Hose system with expiratory valve (ExpV) for tube
application method
– No leakage compensation
– MV and VT represents the delivered volume
– VC-SIMV AF and SPN-PS (VG) control the
delivered volume
Monitoring
The following parameters are monitored:
– Airway pressure Paw
– Inspiratory minute volume MVi, MV
– Breathing frequency f
The following are indicated as measured values:
– Airway pressure PIP
– Airway pressure Pmean
– Airway pressure PEEP
– Inspiratory minute volume MVi, MV
– Inspiratory tidal volume VTi, VT (not in
SPN-CPAP)
– Breathing frequency f
– Leak minute volume MVleak
The following are represented as curves:
–Flow(t)
–P
aw (t)

Instructions for Use Carina SW 3.n 17
System Overview
The following are displayed as a bar graph:
– Airway pressure
Display of:
– Log book for technical alarms
– List of measured values
– List of set values
Monitoring of the patient is assisted by adjustment
of the alarm limits:
– Airway pressure Paw high
– Pressure limitation Pmax
– Minute volume MV high, MV low
– Breathing frequency f high
–T
disconn (disconnect alarm for mask ventilation)
– Apnoea time Tapn
Gas supply
HPO – High Pressure Oxygen mode
For O2supply to Carina from the central gas supply
or from a O2gas cylinder.
LPO – Low Pressure Oxygen mode
For O2supply to Carina from a mobile oxygen
source, separate from a central high-pressure O2
supply.
Power supply
– Mains voltage 100 to 240 V, 50/60 Hz
– Internal battery
– External battery (optional)
Active power supply is indicated on the screen.
Interfaces
– RS 232 serial port for data communication
– Nurse call system
MEDIBUS
Software protocol for the transfer of data between
Carina and an external medical or non-medical
device (e. g. patient monitors or computers for data
management systems) via an RS 232 interface,
see "MEDIBUS for Dräger Intensive Care Devices"
(90 28 329) and "MEDIBUS for Carina"
(90 39 037).
All transferred data are for information only and
should not be used as basis for diagnostic or ther-
apeutic decisions.
To protect the patient and the user against electrical
hazards, it is essential that all systems consisting of
medical devices as well as other electrical devices
which are not restricted to computers, printers etc.,
are only assembled by trained personnel.
The system must meet the requirements of the
IEC/EN 60601-1-1 and IEC/EN 60601-1-2
standards.
Trolley
Carina can be positioned on a trolley.

System Overview
18 Instructions for Use Carina SW 3.n
Control panel, top
1Carrying handle
2Screen for application-specific information on
ventilation
3Buttons for selecting functions and ventilation
parameters
4Centre rotary knob for setting and confirming
functions and parameters
5»Audio paused 2 min.« button for suppressing
the alarm tone for 2 minutes and
for visual indication of alarm status:
red = warning, yellow = caution
6LED for indicating power supply:
LED lit = External power supply (mains/external
battery), internal battery is charged
LED flashes = External power supply
(mains/external battery), internal battery is
being charged
LED off = battery operation
7»Start/Standby« button to switch between
standby and ventilation
8»Select Menu« button to open the menus for
ventilation settings, alarms, measured values,
configuration, interlock
Carina underside
9Switch for hose system with leak valve or hose
system with expiratory valve masked by sliding
cover (not illustrated)
10 Base humidifier (accessory, currently not fitted)
11 Holes for positioning on the trolley (4 off)
CAUTION
Switching between a hose system with leak valve
and a hose system with expiratory valve must be
carried out by properly trained personnel only!
Risk of malfunction!
000
1
4
5
2
3
8
7
6
001
9
10
11

Instructions for Use Carina SW 3.n 19
System Overview
Front connection block
1Ventilation hose connection
2Emergency air inlet and oxygen overflow
3Connection for control hose (for hose system
with expiratory valve)
Rear connection block
4Not assigned
5Connection for nurse call system
6RS 232 serial port for data communication
(MEDIBUS)
7Not assigned
8Inlet filter (HEPA filter)
9Connection for HPO oxygen supply
10 Connection for LPO oxygen supply
11 Mains switch
12 Connection for external battery
13 Power cable connection
002
1
2
3
003
456 7
8
9
10
111213

System Overview
20 Instructions for Use Carina SW 3.n
Trolley 1-63 cm, Trolley 1-78 cm
1Carina bracket
2Standard rail grip
3Universal bracket with standard rail, optional
4Trolley column
5Pedastal
6Red locking lever of the column mount closed
(under pedestal)
7Dual rollers with locking brakes, 4 each
8Battery holder, optional
077
1
2
3
4
7
6
5
8