Aisys CS² User's Reference Manual Software Revision 10.X User responsibility Datex-Ohmeda, Inc. a General Electric Company, doing business as GE Healthcare. This product will perform in conformity with the description thereof contained in this User’s Reference manual and accompanying labels and/or inserts, when assembled, operated, maintained, and repaired in accordance with the instruction provided. This Product must be checked periodically. A defective Product should not be used. Parts that are broken, missing, plainly worn, distorted, or contaminated should be replaced immediately. Should repair or replacement become necessary, Datex-Ohmeda recommends that a telephonic or written request for service advice be made to the nearest Datex- Ohmeda Customer Service Center. This Product or any of its parts should not be repaired other than in accordance with written instructions provided by Datex-Ohmeda and by Datex-Ohmeda trained personnel. The Product must not be altered without the prior written approval of Datex-Ohmeda. The user of this Product shall have the sole responsibility for any malfunction which results from improper use, faulty maintenance, improper repair, damage, or alteration by anyone other than Datex-Ohmeda. CAUTION U.S. Federal law restricts this device to sale by or on the order of a licensed medical practitioner.Outside the U.S.A., check the local laws for any restriction that may apply. Table of Contents 1 Introduction Intended use .....................................1-2 Indications for use ..............................1-2 General information .............................1-2 Serial numbers .................................1-4 Trademarks ...................................1-5 Symbols used in the manual or on the equipment ........1-6 Symbols used on the equipment ...................1-6 Symbols used on the user interface ................1-9 Typeface conventions used ........................ 1-10 Abbreviations ....................................1-11 System information ...............................1-14 System classification ...........................1-14 Device standards IEC 60601-1:2005 .............. 1-14 Device standards IEC 60601-1:1988 .............. 1-14 Integral system components .....................1-15 Not integral system components ..................1-15 System accessories ............................1-15 System safety ................................... 1-16 Preparing for use ..............................1-16 Inspecting the system ..........................1-17 Electrical safety ...............................1-18 2 System controls and menus System overview ..................................2-2 Using the brake ................................2-4 Using the O2 flush button ........................2-4 Positioning the display ...........................2-4 Advanced breathing system components ...............2-6 Using the bag support arm .......................2-7 2067226-001 i Aisys CS² Aladin cassette controls ............................ 2-8 Display controls ...................................2-9 Touch points ................................. 2-10 Measured value touch points .................... 2-10 Active alarm touch points ....................... 2-11 Anesthesia system display .........................2-12 Digit fields ................................... 2-13 Waveform fields ...............................2-13 Split screen field .............................. 2-13 Display navigation ................................2-15 Using menus .................................2-15 Using the ComWheel .......................... 2-16 Using quick keys ..............................2-16 3 Operation System operation safety ............................3-2 Turning on the system ..............................3-3 Start a case ......................................3-4 Minimum Alveolar Concentration .................. 3-4 Starting a case using default settings ...............3-5 Starting a case using custom settings .............. 3-5 End a case ....................................3-6 Turning off the system ..............................3-7 Ventilator setup ...................................3-8 Changing ventilator mode ........................3-8 Changing ventilator settings ......................3-8 Optional ventilator procedures .................... 3-8 Auto limits ....................................... 3-9 Setting auto limits .............................. 3-9 Gas setup ...................................... 3-10 Changing gas settings ..........................3-10 Changing balance gas ..........................3-10 Changing circuit type ...........................3-10 ii 2067226-001 Table of Contents System setup ....................................3-13 Patient demographics ..........................3-13 Screen setup menu ............................3-13 Fresh gas usage ..............................3-16 Alarm setup .....................................3-17 Setting CO2 alarms ............................3-17 Setting MV TV alarms ..........................3-18 Setting alarm limits ............................ 3-18 Viewing alarm history .......................... 3-19 Setting alarm volume ...........................3-19 Setting apnea delay ............................3-19 Silencing leak audio alarms ..................... 3-19 Setting auto MV limits ..........................3-20 Setting to default limits ......................... 3-20 Alarms On Off ...................................3-21 Disable alarm limits ............................3-21 Next page ...................................... 3-22 Trends .........................................3-23 Setting trends ................................ 3-23 Spirometry ......................................3-24 Setting loop type ..............................3-24 Setting loop graph scaling .......................3-25 Setting patient and sensor type ...................3-25 Setting the data source .........................3-25 Setting spirometry volume type ...................3-26 Saving, viewing, and deleting spirometry loops ......3-26 Procedures ..................................... 3-27 Pause gas flow ............................... 3-27 Cardiac bypass ...............................3-27 Vital capacity .................................3-28 Cycling ......................................3-29 Timer function ...................................3-31 Using the timer ............................... 3-31 ecoFLOW .......................................3-32 2067226-001 iii Aisys CS² Using ecoFLOW .............................. 3-33 Alternate O2 control ...............................3-34 Using Alternate O2 control ...................... 3-34 EZchange canister mode .......................... 3-36 Using EZchange canister mode .................. 3-37 Condenser ......................................3-38 Draining the condenser .........................3-38 Auxiliary Common Gas Outlet .......................3-40 Using the ACGO ..............................3-40 4 Preoperative checkout Every day before your first patient .................... 4-2 Before every patient ............................... 4-3 5 Preoperative tests Aladin cassette installation ..........................5-2 Flow and pressure calibration ........................5-3 Circuit compliance compensation .....................5-4 Checkout menu ...................................5-5 Full test ......................................... 5-6 Vent and gas ..................................5-6 Circuit leak ....................................5-6 Circuit O2 cell ................................. 5-7 External gas monitor ............................5-7 Individual tests ....................................5-8 Vent and gas ..................................5-8 Circuit leak ....................................5-8 Circuit O2 cell ................................. 5-8 Low P leak ....................................5-8 Low P leak (machines with ACGO) .................5-9 Agent delivery .................................5-9 Positive low pressure leak test (ACGO systems only) ....5-10 iv 2067226-001 Table of Contents 6 Airway modules Airway modules ...................................6-2 E and M series airway modules ................... 6-3 CARESCAPE airway modules .................... 6-4 Connecting the airway module .......................6-5 Parameters setup ................................. 6-6 Data source ...................................6-6 Automatic agent identification ........................6-7 Calibrating the airway module ........................6-8 7 Alarms and troubleshooting Alarms ..........................................7-2 Alarm priorities .................................7-2 Pausing alarms ................................7-2 Cancelling audio pause ..........................7-3 Display changes during alarms ....................7-3 De-escalating alarms ............................7-3 Battery indicator ................................7-3 Internal failure .................................7-4 Informational tones ............................. 7-4 List of alarms .....................................7-5 Sustained pressure threshold ....................7-12 Alarm ranges ....................................7-13 Alarm tests ......................................7-15 Breathing system problems .........................7-17 Electrical problems ............................... 7-18 Pneumatic problems ..............................7-19 8 Setup and connections Setup safety ......................................8-2 Moving and transporting