ZOLL M Series Manual

9650-0223-01 Rev. D
TM
End Tidal Carbon
Dioxide (EtCO2)

The issue date or revision level for this operation guide is shown on the front cover.
ZOLL is a registered trademark, and M Series is a trademark of ZOLL Medical Corporation.
CAPNOSTAT is a registered trademark and LoFlo is a trademark of Respironics Novametrix LLC.
Cidex is a registered trademark of Advanced Sterilization Products, a Johnson and Johnson Company.
Nafion is a registered trademark of DuPont.
System 1 is a registered trademark of the Steris Corporation.
© 2005 by ZOLL Medical Corporation. All rights reserved.

EtCO2- 1
END-TIDAL CARBON DIOXIDE (EtCO2)
General Information
Product Description
MSeries™ units, equipped with software revision 38.25 or higher, and M Series CCT units, equipped with software
revision 57.50 or higher, support two End Tidal Carbon Dioxide (EtCO2) monitoring options for the continuous
measurement of respiratory carbon dioxide (CO2) and respiration rate. These options use the same connector on the
M Series unit and may be used interchangeably.
The first option uses a unique mainstream, solid-state infrared sensor called the CAPNOSTAT® 3 Mainstream CO2
sensor. The CAPNOSTAT 3 sensor is attached to an airway adapter that connects to an endotracheal (ET) tube or
other airway and measures gases flowing through these breathing circuit components. A disposable mouthpiece may
be connected to the adapter for monitoring non-intubated patients. A Capno2mask is also available for use with non-
intubated patients. This option provides for O2delivery while monitoring expired CO2.
The second option is a sidestream sampling system called the LoFlo™ Sidestream CO2Module. The LoFlo module
contains a gas sampling pump, which draws small samples of gas from the patient’s airway via a nasal/oral cannula or
airway adapter, and passes these gases through a solid state infrared sensor (located away from the patient’s airway)
that measures CO2. While the sidestream system is typically used on non-intubated patients, it can also be used for
EtCO2measurement on intubated infant, pediatric, and adult patients. The sidestream system should not be used,
however, on intubated patients who cannot tolerate the 50ml/min removal of the sample gases from their breathing
circuit. The sidestream module uses specially designed sampling cannulae and airway adapters for sampling airway
gases and passing them through an integrated sample cell, which connects to the LoFlo Module’s CO2sensor. These
cannulae incorporate a filter and sample cell, providing maximum filtration of fluids and contaminants, and protecting
the system from aspiration of these fluids.
In both systems, the CO2 sensor generates infrared light and beams it through the airway adapter or sample cell to a
detector on the opposite side. CO2from the patient, flowing through the mainstream airway adapter or aspirated into
the sample cell, absorbs some of this infrared energy. The M Series unit determines CO2concentration in the breathing
gases by measuring the amount of light absorbed by gases flowing through the airway or sample cell.
The M Series unit displays EtCO2(the concentration of carbon dioxide detected at the end of each exhalation) as a
numerical value in millimeters of mercury (mmHg), percent (%), or kilopascals (kPa). In addition, the unit can display a
capnogram waveform. This waveform is a valuable clinical tool that can be used to assess patient airway integrity and
proper endotracheal (ET) tube placement. The unit calculates respiration rate by measuring the time interval between
detected peaks of the CO2waveform. The technology differentiates between waveforms caused by breathing and
those caused by cardiogenic oscillations and artifact.
How to Use This Manual
This section explains how to set up and use the M Series End-Tidal Carbon Dioxide option. Important safety
information relating to general use of the M Series End Tidal Carbon Dioxide monitor appears in the “Safety
Considerations” section of this manual.
The M Series Operator’s Guide provides information operators need for the safe and effective use and care of the
MSeriesunit. It is important that persons using this device read and understand all the information contained therein.
Please thoroughly read both safety considerations and warnings sections before operating your M Series unit.
All CAPNOSTAT 3, LoFlo, airway adapter and cannula questions with regards to the Declaration of Conformity with
European Union Directives should be directed to the authorized representative for Respironics Novametrix LLC:
Respironics Novametrix LLC
Authorized European Contact
Respironics Deutschland
Gewerbestrasse 17
82211 Herrsching
Germany
[phone]

EtCO2- 2
Safety Considerations
WARNINGS
General
• Carefully read the M Series Operator’s Guide and
these operating instructions before operating the
EtCO2monitoring option.
• Ensure that the M Series EtCO2option is operated
by qualified personnel only.
• Do NOT use the M Series EtCO2option as an apnea
monitor.
• Do NOT immerse the M Series unit, patient cables or
sensors in water, solvents, or cleaning solutions.
• If the accuracy of any reading is suspect, first check
the patient’s vial signs by alternate means and then
check the M Series EtCO2option for proper
operation.
• If an alarm condition occurs while the alarms are
suspended, the suspended alarm indications will
only be visual displays and symbols. No audio alarm
indications will occur.
• To ensure patient safety, ensure that the ECG-out
jack and modem (if available) are only connected to
other equipment with galvanically isolated circuits.
• Elevated oxygen levels, nitrous oxide or halogenated
agents contained in the breathing gases may
degrade the accuracy of measurements made with
the M Series EtCO2option. Activate oxygen
compensation if O2levels in excess of 60% are
introduced. Activate N2O compensation if nitrous
oxide is introduced into the airway circuit. The
presence of Desflurane beyond 5% may positively
bias the carbon dioxide reading by up to 3 mmHg.
• Do NOT use the LoFlo module on patients who
cannot tolerate the removal of 50ml/min from the
airway.
• Carefully route patient cabling and gas sampling
tubes to reduce the possibility of patient
entanglement or strangulation.
• Do not touch the bed, patient, or any equipment
connected to the patient during defibrillation. A
severe shock can result. Do not allow exposed
portions of the patient’s body to come in contact with
metal objects, such as a bed frame, as unwanted
pathways for defibrillation current may result.
CAPNOSTAT 3 and LoFlo Sensor and Accessories
• Always ensure the integrity of the patient breathing
circuit after insertion of the mainstream or
sidestream airway adapter by verifying a proper CO2
waveform (capnogram) on the monitor display.
• Do NOT use CAPNOSTAT 3 or LoFlo sensors in the
presence of flammable anesthetics or other
flammable gases.
• Do not attempt to open the sensor. An electrical
shock hazard exists internally. Refer servicing to
qualified personnel.

End Tidal Carbon Dioxide (EtCO2)
EtCO2- 3
CAUTIONS
• CAUTION: Federal (U.S.A.) law restricts this device
to sale, or use by or on the order of a licensed
medical practitioner.
• Use only ZOLL/Respironics Novametrix
CAPNOSTAT 3 sensors and LoFlo modules, airway
adapters, nasal and nasal/oral cannulae with the
M Series EtCO2option.
•The device is protected against interference from
radio frequency emissions typical of two-way radios
and cellular phones (digital and analog) used in
emergency service/public safety activities. Users
should assess the device’s performance in their
typical environment of use for the possibility of radio
frequency interference from high-power sources.
Radio Frequency Interference (RFI) may be
observed as shifts in monitor baseline, trace
compression, display brightness changes or transient
spikes on the display.
• Do NOT sterilize or immerse the CAPNOSTAT 3
sensor or LoFlo module.
• Do NOT reuse or sterilize the disposable airway
adapter, airway adapter with mouthpiece,
Capno2mask, nasal or nasal/oral sampling
cannulae, or airway adapters, as system
performance will be compromised. These items are
intended for single patient use only.
• Do NOT use a damaged sensor or airway adapter.
• Do NOT use the device if it fails to operate properly.
• Do NOT place the mainstream or sidestream airway
adapters between the ET tube and the breathing
circuit elbow, as this may allow patient secretions to
accumulate in the adapter.
• Position mainstream airway adapters with windows
in a vertical, NOT a horizontal, position. This helps
keep patient secretions from pooling on the
windows.
• Do NOT insert any object other than the sample cell
into the sample cell receptacle on the LoFlo module.
• ZOLL Medical Corporation recommends that the
CAPNOSTAT 3 airway adapter be removed from the
circuit whenever aerosolized medication is delivered.
The increased viscosity of the medications may
contaminate the adapter windows, requiring
premature cleaning or replacement of the adapter.
• In order to eliminate the potential buildup of CO2
inside the storage bag, ensure that the LoFlo module
exhaust tube vents gasses away from the module
environment.
• To avoid injury to the patient, remove the nasal/oral
cannula from the patient before cutting the oral
cannula tip.
• Do NOT apply tension to the sensor or module
cable.
• Periodically inspect the sampling tubing for kinks.
• Monitor the capnogram for an elevated baseline. If
an elevated baseline is observed, verify patient
condition first. If the care giver determines that the
patient condition is not contributing to the elevated
baseline, follow the instructions for zeroing the
sensor or module detailed in this manual.
• Do NOT store sensors, modules, airway adapters, or
cannulae at temperatures less than -10° C or greater
than 55° C.
• Do not operate sensors or modules at temperatures
less than 10° C or greater than 40° C.
• Refer servicing to qualified personnel.
• Do not use the LoFlo module with M Series units that
have a software version lower than 38.25, or with
M Series CCT units that have a software version
lower than 57.50.
• Make sure to insert the protective cap into the LoFlo
module when it is not in use.

MSERIES OPERATOR’SGUIDE - OPTION INSERT
EtCO2- 4
Warranty (U.S. Only)
(a) ZOLL Medical Corporation warrants to the original
equipment purchaser that beginning on the date of
installation, or thirty (30) days after the date of shipment
from ZOLL Medical Corporation's facility, whichever first
occurs, the equipment (other than accessories and
electrodes) will be free from defects in material and
workmanship under normal use and service for the
period of one (1) year. During such period ZOLL Medical
Corporation will, at no charge to the customer, either
repair or replace (at ZOLL Medical Corporation's sole
option) any part of the equipment found by ZOLL
Medical Corporation to be defective in material or
workmanship. If ZOLL Medical Corporation's inspection
detects no defects in material or workmanship, ZOLL
Medical Corporation's regular service charges shall
apply. (b) ZOLL Medical Corporation shall not be
responsible for any equipment defect, the failure of the
equipment to perform any function, or any other
nonconformance of the equipment, caused by or
attributable to: (i) any modification of the equipment by
the customer, unless such modification is made with the
prior written approval of ZOLL Medical Corporation; (ii)
the use of the equipment with any associated or
complementary equipment, (iii) installation or wiring of
the equipment other than in accordance with ZOLL
Medical Corporation's instructions, (iv) abuse, misuse,
neglect or accident. (c) This warranty does not cover
items subject to normal wear and burnout during use,
including but not limited to lamps, fuses, batteries,
patient cables and accessories. (d) The foregoing
warranty constitutes the exclusive remedy of the
customer and the exclusive liability of ZOLL Medical
Corporation for any breach of any warranty related to the
equipment supplied hereunder. (e) Limitation of Liability:
ZOLL shall not in any event be liable to Purchaser, nor
shall Purchaser recover, for special, incidental or
consequential damages resulting from any breach of
warranty, failure of essential purpose, or under any other
legal theory including but not limited to lost profits, lost
savings, downtime, goodwill, damage to or replacement
of equipment and property, even if ZOLL has been
advised of the possibility of such damages.
THE WARRANTY SET FORTH HEREIN IS EXCLUSIVE
AND ZOLL MEDICAL CORPORATION EXPRESSLY
DISCLAIMS ALL OTHER WARRANTIES WHETHER
WRITTEN, ORAL, IMPLIED, OR STATUTORY,
INCLUDING BUT NOT LIMITED TO ANY
WARRANTIES OF MERCHANTABILITY OR FITNESS
FOR A PARTICULAR PURPOSE.
For additional information, please call ZOLL Medical
Corporation at 1-800-348-9011. International customers
should call the nearest authorized ZOLL Medical
Corporation service center.
Software License
Read this Operator's Manual and License agreement
carefully before operating any of the M Series products.
Software incorporated into the system is protected by
copyright laws and international copyright treaties as
well as other intellectual property laws and treaties. This
software is licensed, not sold. By taking delivery of and
using this system, the Purchaser signifies agreement to
and acceptance of the following terms and conditions:
1. Grant of License: In consideration of payment of the
software license fee which is part of the price paid for
this product ZOLL Medical Corporation grants the
Purchaser a non-exclusive license, without right to
sublicense, to use the system software in object-code
form only.
2. Ownership of Software/Firmware: Title to,
ownership of and all rights and interests in the
system software and all copies thereof remain at all
times vested in the manufacturer, and Licensors to
ZOLL Medical Corporation and they do not pass to
Purchaser.
3. Assignment: Purchaser agrees not to assign, sub-
license or otherwise transfer or share its rights under
the license without the express written permission of
ZOLL Medical Corporation.
4. Use Restrictions: As the Purchaser, you may
physically transfer the products from one location to
another provided that the software/firmware is not
copied. You may not disclose, publish, translate,
release or distribute copies of the software/firmware
to others. You may not modify, adapt, translate,
reverse engineer, decompile, crosscompile,
disassemble or create derivative works based on the
software/firmware.
NO IMPLIED LICENSE
Possession or purchase of this device does not convey
any express or implied license to use the device with
replacement parts which would, alone, or in combination
with this device, fall within the scope of one or more of
the patents relating to this device.

End TIdal Carbon Dioxide (EtCO2)
EtCO2- 5
EtCO2Indications for Use
The ZOLL M Series EtCO2 option is indicated for the
continuous noninvasive monitoring of end tidal carbon
dioxide (EtCO2) and respiration rate in patients requiring
ventilator support, transport, or anesthesia. The M Series
EtCO2option with Respironics Novametrix technology
supports two methods for continuous measurement of
end tidal carbon dioxide (EtCO2) and respiration rate.
The first method uses the CAPNOSTAT 3 Mainstream
CO2 Sensor attached to an airway adapter that connects
to an endotracheal tube, mask or disposable
mouthpiece.
The second method uses the LoFlo Sidestream CO2
Module to monitor both non-intubated and intubated
patients using specially designed sampling cannulae and
airway adapters.
The M Series EtCO2option is designed to monitor adult,
pediatric, and neonatal patients.
The following substances can influence CO2
measurements made with the CAPNOSTAT 3 Sensor:
•elevated oxygen levels
•nitrous oxide
•halogenated agents
The M Series EtCO2option allows the user to enable
high oxygen and/or nitrous oxide compensation.
Halogenated anesthetic agents alter CO2 readings, but
the M Series unit will monitor CO2 within specifications
when these agents are present at normal clinical levels.
The presence of Desflurane in the exhaled breath
beyond normal values (5-6%) may positively bias
measured carbon dioxide values by up to an additional
2-3 mmHg.
The M Series EtCO2option is intended for use only with
the ZOLL/Respironics Novametrix CAPNOSTAT 3
Mainstream CO2 sensor and the LoFlo Sidestream CO2
Module, mainstream airway adapters, nasal and nasal/
oral sampling cannulae, and sidestream on-airway
adapters.
Mainstream EtCO2Setup
There are several steps involved with mainstream
EtCO2 setup, as follows:
•Attaching the CAPNOSTAT 3 sensor cable.
•Selecting a mainstream airway adapter.
•Attaching the airway adapter to the CAPNOSTAT 3
sensor.
•Zeroing the mainstream sensor/airway adapter.
•Attaching the airway adapter to the airway circuit.
•Applying an airway adapter with mouthpiece.
Attaching the CAPNOSTAT 3 Sensor Cable
To attach the CAPNOSTAT 3 sensor cable, plug the
cable into the CO2connector at the back of the M Series
unit.
Note Effective with M Series software revision 38.35 and
M Series CCT software revision 57.50, the “0” and
“REF” cells on the sensor cable are no longer used.
However, they remain on the sensor cable for
backwards compatibility with earlier versions of the
software.
Selecting a Mainstream Airway Adapter
Select an airway adapter based on the patient's size, ET
tube diameter and monitoring situation. For more
information refer to the following table or contact ZOLL
Medical Corporation.
*SPU = Single Patient Use
Attaching the Airway Adapter to the
CAPNOSTAT 3 Sensor
Before attaching the airway adapter to the
CAPNOSTAT 3 sensor, verify that the airway adapter
windows are clean and dry. Clean or replace the adapter
if necessary.
CAUTION! The disposable (SPU) Pediatric/Adult and
the Neonatal/Pediatric airway adapters are
intended for single patient use. Do NOT
reuse or sterilize these adapters as system
performance will be compromised.
1. Attach the airway adapter to the CAPNOSTAT 3
sensor, as follows:
a. Align the arrow on the bottom of the airway adapter
with the arrow on the bottom of the CAPNOSTAT 3.
b. Press the sensor and airway adapter together until
they click.
2. If the unit displays the “CHECK CO2 ADAPTER”
message, follow steps a through c, or else go to
step 3.
a. Verify proper connection of the adapter to the
sensor.
b. Verify that the airway adapter windows are clean
and dry.
Airway Adapter Type ET Tube Diameter
SPU Pediatric/Adult > 4.0 mm
Adult Reusable > 4.0 mm
SPU Neonatal/Pediatric ≤4.0 mm
Neonatal Reusable ≤4.0 mm

MSERIES OPERATOR’SGUIDE - OPTION INSERT
EtCO2- 6
c. If the adapter is properly connected, and the
windows are clean and dry, then zero the adapter
as described in the next section, "Zeroing the
Mainstream Sensor/Airway Adapter".
3. Turn the Selector switch on the M Series unit to
MONITOR (ON for AED units).
4. Wait for the airway adapter and sensor to warm up.
The unit will display a “WARM UP” message for
approximately one minute while the sensor and
adapter warm to operating temperature. The
message disappears when the sensor is ready to
use.
Note Warm-up time varies with ambient temperature of
the sensor.
Zeroing the Mainstream Sensor/Airway Adapter
Adapter zeroing compensates for the optical differences
between airway adapters and should be performed after
switching between different airway adapter types, in
order to obtain accurate readings.
Zeroing is also necessary the first time a particular
CAPNOSTAT 3 sensor is connected to the unit.
The M Series unit retains the CAPNOSTAT 3 sensor's
zero settings during and after its use. When a previously
used sensor is reconnected to the M Series unit, sensor
zeroing does not need to be repeated, as long as no
other CAPNOSTAT 3 sensor or adapter type has been
connected and zeroed during the interim period.
1. Place the sensor with the adapter installed away from
all sources of CO2 (including the patient's – and your
own – exhaled breath and ventilator exhaust valves).
2. Press the Param. softkey and select the EtCO2
menu item, then press Enter.
3. Press the Zero softkey until the Start menu item is
highlighted, then press Enter.
The unit zeroes the adapter and displays the
"ZEROING CO2 ADAPTER" message for
approximately 15 seconds.
The unit displays the message “ZERO DONE” upon
completion of the zeroing.
Note Do not attempt zeroing for 20 seconds after
removing the adapter from the patient’s airway.
This time allows any CO2 remaining in the adapter
to dissipate before zeroing. Do not attempt to zero
the adapter while it is in the patient’s airway.
Zeroing with CO2 in the adapter can lead to
inaccurate measurement and/or other error
conditions. If you attempt zeroing while CO2
remains in the adapter, the time required to zero
the adapter may be increased. If zeroing cannot be
completed, the message “ZERO FAILED” will be
displayed. If this occurs, clear any occlusion in the
adapter, remove the source of CO2, wait 20
seconds, and try zeroing again.
Attaching the Airway Adapter to the Airway
Circuit
If you have not yet done so, you must attach the airway
adapter to the CAPNOSTAT 3 sensor before attaching
the airway adapter to the airway circuit. Refer to
"Attaching the Airway Adapter to the CAPNOSTAT 3
Sensor" on page 5 if necessary.
Attach the airway adapter to the airway circuit as follows:
1. Place the CAPNOSTAT 3/airway adapter assembly
at the proximal end of the airway circuit between the
elbow and the ventilator circuit wye. Do NOT place
the airway adapter between the ET tube and the
elbow, as this may allow patient secretions to
accumulate in the adapter.
Position the airway adapter with its windows in a
vertical, NOT a horizontal, position. This helps keep
patient secretions from pooling on the windows. If
pooling does occur, the airway adapter may be
removed from the circuit, rinsed with water and
reinserted into the circuit. To prevent moisture from
draining into the airway adapter, do NOT place the
airway adapter in a gravity dependent position. See
Figures 1 and 2.
#!0./34!4#/
2EUSABLE!DULT!IRWAY!DAPTER
4O0ATIENT
6ENTILATOR
%LBOW 7YE
3ENSOR
4O
Figure 1

End TIdal Carbon Dioxide (EtCO2)
EtCO2- 7
2. Check that connections have been made correctly by
verifying the presence of a proper CO2 waveform on
the M Series display.
3. The sensor cable should face away from the patient.
To secure the sensor cable safely out of the way,
attach Sensor Cable Holding Clips to the airway
tubing, then connect the sensor cable to the clips.
Applying an Airway Adapter with Mouthpiece
The disposable Pediatric/Adult airway adapter with
mouthpiece can be used for spot checking CO2 on
non-intubated adult or pediatric patients.
CAUTION! The disposable Pediatric/Adult Airway
Adapter with mouthpiece is intended for
single patient use. Do NOT reuse or sterilize
the adapter, as system performance will be
compromised.
1. Remove adapter with mouthpiece from the package.
Verify that the adapter and mouthpiece are intact and
securely fastened to each other.
2. Attach the airway adapter to the CAPNOSTAT 3
sensor, as follows:
a. Align the arrow on the bottom of the airway adapter
with the arrow on the bottom of the
CAPNOSTAT 3.
b. Press the sensor and airway adapter together until
they click (see Figure 3).
3. If the unit displays the “CHECK CO2 ADAPTER”
message, follow steps a through c, else go to step 4.
a. Verify proper connection of the adapter to the
sensor.
b. Verify that the airway adapter windows are clean
and dry.
c. If the adapter is properly connected, and the
windows are clean and dry, then zero the adapter
as described in "Zeroing the Mainstream Sensor/
Airway Adapter" on page 6.
4. Ensure the patient seals his or her mouth completely
around the mouthpiece and breathes normally.
Note A nose clip may be needed if the patient is exhaling
through the nose. It is important that all, or most, of
the exhalation be routed through the airway
adapter.
Sidestream EtCO2Setup
There are several steps involved with sidestream EtCO2
setup, as follows:
•Selecting a Sidestream Airway Adapter Kit or Cannula
•Attaching the LoFlo Module Cable and Inserting the
Sample Cell
•Zeroing the LoFlo CO2 Module
•Applying a Sidestream Airway Adapter Kit
•Applying a Nasal or Nasal/Oral Cannula
Selecting a Sidestream Airway Adapter Kit
Select an airway adapter kit based on the patient's size,
ET tube diameter, and monitoring situation. Airway
adapter kits are disposable and single patient use.
$ISPOSABLE.EONATAL!IRWAY!DAPTER
#!0./34!4#/3ENSOR
4O0ATIENT
6ENTILATOR7YE
Figure 2
Airway Adapter Kit ET Tube Diameter
Adult/Pediatric Airway Adapter Kit > 4.0 mm
Adult/Pediatric Airway Adapter Kit
with Nafion® tubing
4O0ATIENT
#!0./34!4#/3ENSOR
-OUTHPIECE
!IRWAY!DAPTER
Figure 3

MSERIES OPERATOR’SGUIDE - OPTION INSERT
EtCO2- 8
Note For monitoring times exceeding 6 hours, Nafion
tubing is recommended.
Selecting a Sidestream Cannula
Select a sidestream cannula based on the patient's size
and monitoring situation. Nasal and nasal/oral cannulae
are disposable and single patient use.
Attaching the LoFlo Module Cable and
Inserting the Sample Cell
Follow these steps:
1. Attach the LoFlo module cable to the CO2 connector
at the back of the M Series unit.
2. Remove the LoFlo sampling cannula or airway
adapter kit from the package.
3. Insert the LoFlo sample cell into the LoFlo sample
cell receptacle and ensure that it clicks into place.
4. Ensure that the LoFlo module exhaust tube vents
gasses away from the module environment.
5. Turn the selector switch on the M Series to
MONITOR (ON for AED units).
6. Wait for the CO2 module to warm up.
The unit will display the "WARM UP" message for
approximately one minute while the module and
accessory warm to operating temperature. The
message disappears when the module is ready for
use.
Note Warm up time varies with ambient temperature of
the module.
Zeroing the LoFlo CO2Module
The first time a particular LoFlo module is connected to
the M Series, the unit displays the message “ZERO CO2
MODULE” following the warm up period.
The unit retains the LoFlo module zero settings during
and after its use. When the previously used module is
reconnected to the M Series unit, module zeroing does
not have to be repeated, as long as no other LoFlo
module has been connected and zeroed during the
interim period.
Note After the initial zero procedure, the LoFlo module
may be used during the warm up period. The
capnogram, EtCO2, and respiratory rate will be
displayed; however, full product specifications are
not achieved until the warm up period has
completed.
CAUTION! Always ensure that the sample cell is
properly connected to the LoFlo module
before zeroing.
1. Ensure that the nasal cannula or on-airway adapter is
not connected to the patient or close to any source of
CO2 (including the patient's -- and your own --
exhaled breath and ventilator exhaust valves).
Pediatric/Infant Airway Adapter Kit ≤4.0 mm
Pediatric/Infant Airway Adapter Kit
with Nafion tubing
Cannula Application
Nasal CO2Sampling Cannula, Adult Nasal CO2
sampling only
Nasal CO2Sampling Cannula,
Pediatric
Nasal CO2Sampling Cannula, Infant
Oral/Nasal CO2Sampling Cannula,
Adult
Oral/Nasal CO2
sampling only
Oral/Nasal CO2Sampling Cannula,
Pediatric
Nasal CO2Sampling with O2Delivery
Cannula, Adult
Nasal CO2
sampling with
oxygen delivery
Nasal CO2Sampling with O2Delivery
Cannula, Pediatric
Oral/Nasal CO2Sampling with O2
Delivery Cannula, Adult
Oral/Nasal CO2
sampling with
oxygen delivery
Oral/Nasal CO2Sampling with O2
Delivery Cannula, Pediatric
Airway Adapter Kit ET Tube Diameter
Figure 4
Module Cable
Exhaust Tube
Sample Cell
Sample Cell
Receptacle
LoFlo Module

End TIdal Carbon Dioxide (EtCO2)
EtCO2- 9
2. Press the Param. softkey and select the EtCO2
menu item, then press Enter.
3. Press the Zero softkey until the Start menu item is
highlighted, then press Enter.
The unit zeros the module and displays the
"ZEROING CO2 MODULE" message for
approximately 15 seconds.
The units displays the message “ZERO DONE” upon
completion of the zeroing.
Note Do not attempt zeroing for 20 seconds after
removing the adapter or cannula from the patient’s
airway. This time allows any CO2remaining in the
adapter or cannula to dissipate before zeroing. Do
not attempt to zero the module while the adapter or
cannula is in the patient’s airway. Zeroing with CO2
in the adapter or cannula can lead to inaccurate
measurements and/or other error conditions. If you
attempt zeroing while CO2 remains in the adapter
or cannula, the time required to zero the module
may be increased. If zeroing cannot be completed,
the message “ZERO FAILED” will be displayed. If
this occurs, clear any occlusion in the adapter or
cannula, remove the source of CO2, wait 20
seconds, and try zeroing again.
Applying a Sidestream Airway Adapter Kit
The sidestream airway adapter kit is intended for
monitoring the EtCO2of intubated patients.
Before attaching the airway adapter to the breathing
circuit, verify that the adapter is clean, dry, and
undamaged. Replace if necessary.
CAUTION! The disposable (SPU) Adult/Pediatric and
Pediatric/Infant airway adapter kits are
intended for single patient use. Do NOT
reuse or sterilize these adapters as system
performance will be compromised.
1. Attach the airway adapter kit’s sample cell to the
sample cell receptacle on the LoFlo module, and
ensure that it clicks into place.
2. If the unit displays either of the following messages
take the appropriate action.
3. Place the airway adapter assembly at the proximal
end of the airway circuit between the elbow and the
ventilator circuit wye. Do NOT place the airway
adapter between the ET tube and the elbow as this
may allow patient secretions to accumulate in the
adapter.
If pooling does occur, the airway adapter may be
removed from the circuit, rinsed with water and
reinserted into the circuit. To prevent moisture from
draining into the sample tubing, ensure that the
sampling tube exits from the top of the airway
adapter, not its bottom or sides. See Figure 5.
4. Check that connections have been made correctly by
verifying the presence of a proper capnogram on the
M Series display.
Applying a Nasal or Nasal/Oral Cannula
The nasal and nasal/oral cannulae are intended for
monitoring EtCO2in non-intubated patients.
Oral/nasal sampling cannulae should be used on
patients who are prone to mouth breathing, since most (if
not all) of the CO2 is exhaled through the mouth. If a
If you see this
message:
Take this action:
CHECK CO2
LINE
Verify that the sample cell is plugged
into the module and seated properly.
Verify that neither the sample line nor
the exhaust tube are blocked, kinked,
or pinched. Verify that the airway
adapter is not blocked. If the sample
line, exhaust tube, or the airway
adapter is blocked or otherwise
compromised, the pump shuts off in
approximately 15 seconds. To restart
the pump, correct the blockage, then
remove and reinsert the sample cell
into the sample cell receptacle.
If the problem persists, replace the
sample line.
CHECK CO2
MODULE
Check that module cable is plugged in
and seated properly.
Check that module is not exposed to
excessive heat.
If problem persists, replace module.
Figure 5
Sampling Tube

MSERIES OPERATOR’SGUIDE - OPTION INSERT
EtCO2- 10
standard nasal CO2 sampling cannula is used on such
patients, the EtCO2values and capnogram waveform
displayed will be substantially lower than the actual CO2
levels present in the patient’s expired breath.
CAUTION! The disposable Nasal and Nasal/Oral
Cannulae are intended for single patient
use. Do NOT reuse or sterilize the cannula,
as system performance will be
compromised.
1. Remove the cannula from the package. Verify that
the cannula is clean, dry, and undamaged. Replace if
necessary.
2. Attach the cannula’s sample cell to the sample cell
receptacle on the LoFlo module, and ensure that it
clicks into place.
3. If the unit displays either of the following messages
take the appropriate user action.
4. Place the nasal cannula onto the patient as shown in
Figure 6.
5. If necessary, cut the oral portion of the oral/nasal
cannula (if you are using an the oral/nasal cannula)
to an appropriate length to adequately fit the patient,
as follows:
a. Place the cannula onto the patient as shown in
Figure 7.
b. Observe the length of the oral cannula tip. It should
extend down past the teeth and be positioned in
the mouth opening (see Figure 7).
CAUTION! To avoid injury to the patient, remove the
cannula from the patient before you cut the
oral cannula tip.
c. Trim to the appropriate length.
Cleaning the CAPNOSTAT 3 Sensor
and LoFlo Module
The CAPNOSTAT 3 sensor and LoFlo module (and
rubber protective covering) can be cleaned and
disinfected by wiping with one or more of the following
solutions:
•70% isopropyl alcohol
•2% gluteraldehyde
•10% bleach solution
Use a soft cloth dampened with one of the above listed
solutions to clean the sensor or module. After cleaning,
wipe with a clean, water-dampened cloth to rinse. Dry
before use.
Note Do not immerse or attempt to sterilize the
CAPNOSTAT 3 sensor or LoFlo module.
Cleaning Reusable Airway Adapters
Reusable airway adapters may be cleaned by rinsing in
a warm soapy solution, followed by soaking in a liquid
disinfectant such as Cidex® or System 1® (refer to the
disinfectant manufacturer's instructions for use).
Adapters should then be rinsed with sterile water and
dried.
Reusable airway adapters may also be pasteurized or
autoclaved. Autoclave at 121° C (250° F) for 20 minutes,
unwrapped.
If you see this
message:
Take this action:
CHECK CO2
LINE
Verify that the sample cell is plugged
into the module and seated properly.
Verify that neither the sample line nor
the exhaust tube are blocked, kinked,
or pinched. Verify that the airway
adapter is not blocked. If the sample
line, exhaust tube, or the airway
adapter is blocked or otherwise
compromised, the pump shuts off in
approximately 15 seconds. To restart
the pump, correct the blockage, then
remove and reinsert the sample cell
into the sample cell receptacle.
If the problem persists, replace the
sample line.
CHECK CO2
MODULE
Check that module cable is plugged in
and seated properly.
Check that module is not exposed to
excessive heat.
If problem persists, replace module.
Figure 6
Figure 7

End TIdal Carbon Dioxide (EtCO2)
EtCO2- 11
Before reusing the adapter, ensure the windows are dry
and residue-free, and that the adapter has not been
damaged during handling or by the cleaning process.
How EtCO2is Displayed
The M Series unit displays the numeric EtCO2value in
units of mmHg, unless configured for percent or kPa.
Refer to the M Series Configuration Guide (Part No.
9650-0201-01) for instructions on how to configure
alternate units of measure. The unit also displays the
number of breaths per minute, labeled "RR" for
respiration rate. In addition, a capnogram waveform may
be displayed using the Wave2 softkey.
Monitor the capnogram for an elevated baseline. If an
elevated baseline is observed, verify patient condition
first. If you determine that the patient’s condition is not
contributing to the elevated baseline, follow the
instructions for zeroing the CAPNOSTAT 3 sensor or
LoFlo module, as described in this insert.
Displaying the Capnogram Waveform
The M Series unit can display one or two waveforms in
Monitor, Defib, or Manual (AED) mode, as long as the
defibrillator is not charging or ECG analysis is not in
progress. The unit displays only one waveform in Pacer
mode.
With EtCO2monitoring, the unit can display a capnogram
waveform below the ECG trace for a visual indicator of
the moment-by-moment CO2 values. The unit displays
the capnogram waveform at half the speed of the ECG
display, and provides 8 seconds of data.
The unit temporarily removes the second waveform from
the display when the user presses the CHARGE,
ANALYZE, or ENERGY SELECT buttons, or the Sync
On/Off softkey. The unit restores the second waveform
to the display:
• 3 seconds after a shock is delivered
• 3 seconds after an analysis is completed, unless the
defibrillator is charging
• 4 seconds after the last Energy Select button press
• 3 seconds after Sync mode is turned off
Pressing the Wave2 softkey from the physiological
monitoring menu cycles the display from the capnogram
waveform, to the plethysmograph waveform (if SpO2is
installed), to no second waveform displayed.
Use the Zoom softkey from the EtCO2submenu to
adjust the waveform display size. Numbers shown on the
left side of the capnogram display indicate the scaling.
Physiological Monitoring
The physiological monitoring menu includes the following
softkeys: Param, Wave2, ID#, Alarms, and 12 Lead.
Param Softkey
When the Param softkey is pressed, the following
softkeys will be displayed: Select, Enter, and Return.
Pressing the Select softkey scrolls the highlighted area
among the different available physiological parameters.
Pressing the Enter softkey allows the user to select the
parameter that is highlighted. Pressing the Return
softkey allows the user to return to the physiological
monitoring menu.
Selecting the EtCO2parameter causes the following
softkeys to appear: Zero, Average, Comp., Zoom, and
Return. Note that the Zoom softkey is only displayed if
the capnograph waveform is also displayed.
Pressing “Return” softkey returns the user to the
physiological monitoring menu.
Zero Softkey
Adapter zeroing should be performed whenever the
airway adapter type has been changed. Adapter zeroing
may also be necessary if the unit displays "CHECK CO2
ADAPTER." Module zeroing may be necessary if the unit
displays the message “ZERO CO2 MODULE.”
Note Do not attempt zeroing for 20 seconds after
removing the adapter or cannula from the patient’s
airway. This time allows any CO2remaining in the
adapter or cannula to dissipate before zeroing. Do
not attempt to zero while the adapter or cannula is
in the patient’s airway. Zeroing with CO2 in the
adapter or cannula can lead to inaccurate
measurements and/or other error conditions. If you
attempt zeroing while CO2 remains in the adapter
or cannula, the time required to zero may be
increased. If zeroing cannot be completed, the
message “ZERO FAILED” will be displayed. If this
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MSERIES OPERATOR’SGUIDE - OPTION INSERT
EtCO2- 12
occurs, clear any occlusion in the adapter or
cannula, remove the source of CO2, wait 20
seconds, and try zeroing again.
Pressing the Zero softkey causes the start/cancel menu
to appear. Pressing the Zero softkey again toggles the
highlight between Start and Cancel.
Pressing the Enter softkey with Start highlighted initiates
zeroing of the adapter or module. The unit displays the
"ZEROING CO2 ADAPTER" or "ZEROING CO2
MODULE" message during the zeroing process, which is
typically finished in 15 seconds.
The unit displays the “ZERO DONE” message when the
zeroing process is complete.
The unit displays the “ZERO FAILED” message if the
zeroing process did not complete successfully. If this
occurs, clear any occlusion in the adapter or sample line,
remove the source of CO2, and try zeroing again.
The Cancel selection halts the adapter zeroing process.
Pressing Enter allows the user to enter the highlighted
selection. Pressing Return returns the user to the EtCO2
submenu.
Average Softkey
The M Series unit provides three (3) different time
periods over which EtCO2values are averaged: 1 breath,
10 seconds (default), and 20 seconds.
The user can select the averaging period by pressing the
Average softkey. When the Average softkey is pressed,
the unit displays the Average, Enter, and Return
softkeys.
Pressing the Average softkey scrolls the highlighted
area among the different averaging periods of 1 breath,
10 seconds, and 20 seconds.
Pressing the Enter softkey allows the user to select the
highlighted averaging period. Pressing the Return
softkey returns the user to the EtCO2submenu.
Comp Softkey
The M Series unit can compensate for elevated levels of
oxygen and/or the presence of nitrous oxide. Oxygen
compensation should be activated when oxygen levels in
excess of 60% are present in the airway circuit. Nitrous
oxide compensation should be activated when nitrous
oxide is present in the airway circuit. If the concentration
of oxygen in the breathing circuit exceeds 60% and
nitrous oxide is in use, both O2and N2O should be
activated.
When the Comp softkey is pressed, the unit displays the
Comp., Enter, and Return softkeys.
Pressing the Comp. softkey scrolls the highlight among
the different types of compensation available (either
NONE, O2, N2O, or O2 & N2O).
The O2&N2O selection turns oxygen and nitrous oxide
compensation on. The unit displays two asterisks (*) on
the left side of the CO2 field to indicate compensation for
both oxygen and nitrous oxide. The left asterisk indicates
oxygen compensation is active and the right asterisk
indicates nitrous oxide compensation is active.
The O2 selection turns oxygen compensation on and
displays an asterisk in the far left of the CO2 field. The
N2O selection turns nitrous oxide compensation on and
displays an asterisk to the right of the O2 asterisk. The
NONE selection turns all compensations off and
eliminates the asterisks from the display.
After selecting the appropriate compensation press
Enter to activate the selected function. Pressing the
Return softkey returns the user to the EtCO2submenu.
Zoom Softkey
The user can select the zoom level for capnogram
waveforms by pressing the Zoom softkey. When the
Zoom softkey is pressed, the scale for the displayed
capnogram waveform scrolls among zoom levels:
•0-12.5 mmHg
•0-25 mmHg
•0-50 mmHg
•0-75 mmHg
•0-100 mmHg
The scales are 0-1.7, 0-3.3, 0-6.6, 0-10, and 0-13.3 if
units of kPa or % have been configured. (Refer to the
M Series Configuration Guide for instructions on how to
configure alternate units of measure.)
Alarms
The M Series EtCO2 option provides user programmable
"out of range" alarms for both EtCO2and respiration rate.
See "Default Settings" on page 15 for low and high alarm
limit default values and ranges.
The EtCO2and respiration rate alarms share the same
State field in the Alarms Menu and cannot be enabled or
disabled separately. Enabling the EtCO2alarms enables
both EtCO2and respiration rate alarm functions;
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End TIdal Carbon Dioxide (EtCO2)
EtCO2- 13
disabling EtCO2or respiration rate alarms disables the
other alarm function. See the M Series Operator’s Guide
for details on enabling, disabling, and suspending alarm
functions on the M Series unit.
When the EtCO2and respiration rate alarm states are set
to AUTO, the unit automatically sets the lower and upper
limits for EtCO2and respiration rate.
For EtCO2, the limits will be set to +/- 25% of the patient's
currently measured EtCO2value. If the EtCO2value is
greater than 40 mmHg (which is equivalent to 5.3kPa or
5.3% at a barometric pressure of 760 mmHg), then
10 mmHg (1.3 for kPa or %) will be added and
subtracted from the current reading to set the upper and
lower limits. The auto alarm limits are set only if valid
measurements are present for the vital sign.
For the automatic respiration rate alarm limits, the unit
sets the upper and lower limits for respiration by adding
and subtracting the values shown in the following table
to/from the patient's current breath rate.
Recorder Operation
If EtCO2measurements have been taken, press the
RECORDER button to print a stripchart that includes the
following values across the top part of the paper:
•date and time
•ECG lead and size
•heart rate
•EtCO2value
•respiration rate
The recorder runs continuously until the button is
pressed again. If displayed on the screen, the
capnogram waveform will also be printed under the ECG
trace. All waveforms printed by the recorder are delayed
by six seconds relative to their occurrence.
Automated External Defibrillator (AED)
Operation
M Series AED units equipped with the EtCO2option
operate in a slightly different way than Manual and
Advisory models equipped with EtCO2, as outlined
below.
Semi-Automatic Operation
The EtCO2monitoring parameters can be changed by
pressing the Param softkey, as outlined in "Physiological
Monitoring" on page 11. The capnogram waveform
cannot be displayed in semi-automatic mode.
Although EtCO2alarm functions are operational in
semi-automatic mode, heart rate alarm functions are
disabled. Background ECG analysis functions continue
to operate as described in the “AED” section of the
M Series Operator’s Guide.
The ALARM SUSPEND button can be used to activate,
deactivate, or audibly disable the EtCO2alarms (as
described in the M Series Operator’s Guide). The alarm
limit settings cannot, however, be changed in
semi-automatic mode; only the default alarm limits are
available. See the M Series Configuration Guide for
information on setting alarm limit defaults.
Manual Mode Operation
When the AED unit is in manual mode, the unit can
display the capnogram waveform as described in
"Displaying the Capnogram Waveform" on page 11.
Both heart rate and EtCO2alarms are operational. The
alarm limits can be changed by pressing the Alarms
softkey. The EtCO2monitoring parameters can be
changed by pressing the Param softkey, as outlined in
"Physiological Monitoring" on page 11.
Check Out Procedures
The following procedures verify that the EtCO2option is
functioning properly.
Mainstream EtCO2(CAPNOSTAT 3 Sensor)
1. Connect the CAPNOSTAT 3 sensor cable to the
EtCO2connector at the back of the M Series unit.
2. Connect an airway adapter to the sensor.
3. Turn the selector switch to MONITOR mode (ON for
AED units and select Manual Mode).
4. Wait for the CO2 sensor to warm up. The message
"WARM UP" is displayed for approximately one
minute.
5. Perform a zero procedure if necessary (see "Zeroing
the Mainstream Sensor/Airway Adapter" on page 6).
6. Breath normally into the adapter.
7. Verify that the unit displays EtCO2readings in the
EtCO2display area of the monitor.
8. Verify the capnogram waveform is displayed by
pressing the Wave2 softkey.
Sidestream EtCO2(LoFlo Module)
Use an Adult/Pediatric Airway Adapter when performing
this procedure.
1. Connect the LoFlo module cable to the EtCO2
connector at the back of the M Series unit.
2. Insert the adapter sample cell into the LoFlo module
sample cell receptacle.
3. Turn the selector switch to MONITOR mode (ON for
AED units and select Manual Mode), and wait
Respiration Limits (Auto)
Respiration Rate
Average
High Limit Low Limit
1-15 breaths/min. +7 breaths/min. -50% value
16-40 breaths/min. +10 breaths/min. -7 breaths/min.
> 40 breaths/min. +15 breaths/min. -10 breaths/min.

MSERIES OPERATOR’SGUIDE - OPTION INSERT
EtCO2- 14
approximately one minute while the module warms to
operating temperature (unit displays “WARM UP”
message).
4. Perform a zero procedure if necessary (see "Zeroing
the LoFlo CO2 Module" on page 8).
5. Breath normally into the adapter.
6. Verify that the unit displays EtCO2readings in the
EtCO2display area of the monitor.
7. Verify the capnogram waveform is displayed by
pressing the Wave2 softkey.

End Tidal Carbon Dioxide (EtCO2)
EtCO2- 15
Default Settings
When the unit is turned on, the following default EtCO2settings are automatically selected and remain in operation until
changed.
Note The power on default settings for the capnogram waveform scale and CO2 compensation are set in System
Configuration, as are the power-on default settings for alarm limits. See the M Series Configuration Guide for
more information.
EtCO2Accessories
The following tables list the accessories available for the M Series Mainstream and Sidestream EtCO2monitoring
options.
Table 1: CAPNOSTAT 3 Mainstream CO2Accessories
* SPU = Single Patient Use
Parameter Default Setting Range
Averaging Mode 10 seconds 1 breath
10 seconds
20 seconds
High EtCO2Alarm Limit 55 mmHg
7.2%
7.3 kPa
5 - 100 mmHg, OFF
0.6 - 13.1%, OFF
0.6-13.3kPa,OFF
Low EtCO2Alarm Limit 25 mmHg
3.2%
3.3 kPa
0 - 95 mmHg, OFF
0 - 12.5%, OFF
0 -12.6 kPa, OFF
High Respiration Rate Alarm Limit 120 respirations per min. 5 - 150 respirations per min., OFF
Low Respiration Rate Alarm Limit 5 respirations per min. 0 - 100 respirations per min., OFF
Accessory (ZOLL Reorder Part Number) Application
CAPNOSTAT 3 CO2Sensor and Cable (8000-0264-01)
Sensor Cable Holding Clips, bag of 5 (8000-0266-01)
SPU Pediatric/Adult Airway Adapter (8000-0260-01) Single patient use, for ET tube sizes > 4.0 mm
SPU Neonatal/Pediatric Airway Adapter (8000-0261-01) Single patient use, for ET tube sizes ≤4.0 mm
Reusable Adult Airway Adapter (8000-0262-01) Reusable, for ET tube sizes > 4.0 mm
Reusable Neonatal/Pediatric Airway Adapter (8000-0263-01) Reusable, for ET tube sizes ≤4.0 mm
SPU Pediatric/Adult Airway Adapter with Mouthpiece
(8000-0265-01)
Single patient use, for non-intubated patients
Capno2mask, Large Adult (8000-0761) SPU, for non-intubated large adults
Capno2mask, Standard Adult (8000-0760) SPU, for non-intubated adults
Capno2mask, Pediatric (8000-0762) SPU, for non-intubated adults pediatric patients

EtCO2- 16
Table 2: LoFlo Sidestream CO2Accessories
* SPU = Single Patient Use
Note Components of this product and its associated EtCO2accessories that make patient contact are free of latex.
Note: The CAPNOSTAT 3, LoFlo and its accessories are covered by the following US patents:
Other patents pending.
Accessory (ZOLL Reorder Part Number) Application
LoFlo Module and Cable (8000-0365)
Nasal CO2Sampling Cannula, Adult (8000-0351) SPU, Nasal CO2sampling only (adult)
Nasal CO2Sampling Cannula, Pediatric (8000-0352) SPU, Nasal CO2sampling only (pediatric)
Nasal CO2Sampling Cannula, Infant (8000-0353) SPU, Nasal CO2sampling only (neonate)
Oral/Nasal CO2Sampling Cannula, Adult (8000-0354) SPU, Oral/Nasal CO2sampling only (adult)
Oral/ Nasal CO2Sampling Cannula, Pediatric (8000-0355) SPU, Oral/Nasal CO2sampling only (pediatric)
Nasal CO2Sampling with O2Delivery Cannula, Adult
(8000-0356)
SPU, Nasal CO2sampling with O2delivery (adult)
Nasal CO2Sampling with O2Delivery Cannula, Pediatric
(8000-0357)
SPU, Nasal CO2sampling with O2delivery (pediatric)
Oral/Nasal CO2Sampling with O2Delivery Cannula, Adult
(8000-0358)
SPU, Oral/Nasal CO2sampling with O2delivery (adult)
Oral/Nasal CO2Sampling with O2Delivery Cannula, Pediatric
(8000-0359)
SPU, Oral/Nasal CO2sampling with O2delivery (pediatric)
Adult/Pediatric Airway Adapter Kit (8000-0362) SPU, for ET tube sizes > 4.0 mm
Adult/Pediatric Airway Adapter Kit with Nafion tubing
(8000-0363)
SPU, for ET tube sizes > 4.0 mm
Pediatric/Infant Airway Adapter Kit (8000-0361) SPU, for ET tube sizes ≤4.0 mm
Pediatric/Infant Airway Adapter Kit with Nafion tubing
(8000-0364)
SPU, for ET tube sizes ≤4.0 mm
• 4,859,858
• 4,859,859
• 4,914,720
• 4,958,075
• 5,146,092
• 5,153,436
• 5,206,511
• 5,251,121
• 5,369,277
• 5,616,923
• 5,693,944
• 5,793,044

End Tidal Carbon Dioxide (EtCO2)
EtCO2- 17
Messages and Troubleshooting
The following three tables list the common (occur for both mainstream and sidestream), mainstream, and sidestream
messages that may appear on the M Series unit, possible causes, and the action(s) to take if the message indicates a
problem. You should become thoroughly familiar with this information before monitoring patients.
COMMON MESSAGES
Message/Symptom Possible Cause(s) Recommended Action(s)
----- (dashed lines in EtCO2field) After a defibrillation discharge, the numeric
value displays as “----” for approximately
10 seconds.
When the respiration rate is zero, the
numeric CO2value will display “---”. When
the respiration rate is greater than zero, the
actual CO2numeric value will be displayed.
None, normal operation.
----- (dashed lines at top of
capnogram waveform)
Scale value setting incorrect. Measured
CO2higher than scale limits.
Adjust to higher scale setting using the
Zoom key.
CO2 COMM ERROR No communication from the EtCO2module
or sensor.
Turn M Series unit off, then on again to
reset.
If problem persists, return for service.
CO2 DEVICE NOT READY The zero operation cannot be initiated
because:
• The sensor or module is still warming
up.
• No sensor or module is attached to the
unit.
Wait for sensor or module to warm up.
Attach sensor or module to the unit.
CO2 OUT OF RANGE (dashed
lines for CO2)
Calculated CO2value is greater than
100 mmHg.
If error persists, perform an adapter or
module zero
CO2 UNIT ERROR Defective EtCO2module or sensor. Turn M Series unit off, then on again to
reset.
If problem persists, contact Technical
Support.
INVALID CO2 DEVICE CAPNOSTAT 3 sensor or LoFlo Module is
not responding to the M Series unit.
Turn M Series unit off, then on again to
reset.
Try another sensor/module.
If problem persists, contact Technical
Support.
WARM UP Mainstream sensor or LoFlo sidestream
module is warming up. This may take up to
5 minutes.
Wait for sensor or module to warm up (max
5 minutes).
If message persists more than 5 minutes,
replace the sensor, or module.
ZERO DONE The mainstream sensor or adapter zero, or
the LoFlo module zero, is finished.
No action required.
ZERO FAILED The zero operation did not complete
successfully.
Clear occlusion, remove source of CO2, and
try zeroing again. If problem persists,
contact Technical Support.

EtCO2- 18
MAINSTREAM MESSAGES
Message/Symptom Possible Cause(s) Recommended Action(s)
Sensor not responding to
breaths. CO2waveform always
at 0 mmHg with no messages
displayed.
or
CO2waveform baseline
> 25 mmHg with no messages
displayed.
Sensor/Adapter was zeroed with a low level
of residual CO2in the adapter. CO2
baseline is set below 0 mmHg.
Airway adapter type was changed with unit
powered off. New sensor/adapter
combination has not been zeroed.
Perform a mainstream airway adapter zero
as described in "Zeroing the Mainstream
Sensor/Airway Adapter" on page 6.
CHECK CO2 ADAPTER
displayed during each
inhalation. Message disappears
during exhalation.
CHECK CO2 ADAPTER
alternates with ZERO CO2
ADAPTER shortly after
breathing stops.
Sensor/Adapter was zeroed with a low level
of residual CO2in the adapter. CO2
baseline is set below 0 mmHg.
Perform a mainstream airway adapter zero
as described in "Zeroing the Mainstream
Sensor/Airway Adapter" on page 6.
CHECK CO2 ADAPTER Usually caused when the airway adapter is
removed from the CAPNOSTAT 3, or when
there is an optical blockage on the windows
of the airway adapter.
May also be caused by not having
performed an adapter zero after changing
the adapter type.
Clean airway adapter and reattach it. If the
problem persists or the adapter type was
changed, perform a mainstream airway
adapter zero as described in "Zeroing the
Mainstream Sensor/Airway Adapter" on
page 6.
CHECK CO2 SENSOR Sensor cable not properly plugged in or
over temperature.
Check that sensor cable is plugged in and
properly seated in the connector.
Check that sensor is not exposed to
excessive heat.
If problem persists, replace sensor.
CO2 IN ADAPTER: WAIT There is CO2in the adapter when
attempting to zero.
Zeroing was attempted within 20 seconds
of previous zero operation.
Remove adapter from CO2source including
the patient’s - and your own - exhaled
breaths, and ventilator exhaust valves.
Wait up to 20 seconds before retrying
adapter zero.
REPLACE CO2 SENSOR Sensor is defective or incompatible
(message appears when “WARM UP’
message is displayed for more than 5
minutes).
Replace sensor.
USE AIRWAY ADAPTER CO2sensor is on the “REF” or “0” cell when
zeroing is started.
Remove CO2sensor from the “REF” or “0”
cell and attach airway adapter to CO2
sensor.
ZERO CO2 ADAPTER Sensor cable connected to M Series unit for
the first time. Zeroing error or probe drift
error detected.
Perform a mainstream airway adapter zero
as described in "Zeroing the Mainstream
Sensor/Airway Adapter" on page 6.
ZEROING CO2 ADAPTER Adapter zeroing in progress. Wait for adapter zeroing to finish.