Datex-Ohmeda Avance User Reference Manual

Avance

User’s Reference Manual

Software Revision 6.X

Datex-Ohmeda, Inc., a General Electric Company, doing business as GE Healthcare.

User Responsibility

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 instructions 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 local laws for any restriction that may apply.

Datex-Ohmeda products have unit serial numbers with coded logic which indicates a product group code, the year of manufacture, and a sequential unit number for identification. The serial number can be in one of two formats.

AAAX11111	AAAXX111111AA
The X represents an alpha	The XX represents a number
character indicating the year	indicating the year the product
the product was manufactured;	was manufactured; 04 = 2004,
H = 2004, J = 2005, etc. I and	05 = 2005, etc.
O are not used.

Avance, Advanced Breathing System, ComWheel, D-fend, EZchange, Disposable Multi Absorber, Reusable Multi Absorber, PSVPro, SmartVent, Tec 6 Plus, and Tec 7 are registered trademarks of Datex-Ohmeda, Inc.

Other brand names or product names used in this manual are trademarks or registered trademarks of their respective holders.

Table of Contents

1 Introduction

Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 Symbols used in the manual or on the equipment . . . . . . . . 1-4 Typeface conventions used . . . . . . . . . . . . . . . . . . . . . . . . . 1-7 Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7

2 System Controls and Menus

System overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

Advanced breathing system (ABS) components . . . . . . . . . 2-5

Optional ABS components . . . . . . . . . . . . . . . . . . . . . . . 2-7

Non-circle circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8

ACGO (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9

Scavenging the ACGO sample flow . . . . . . . . . . . . . . . . 2-9

Scavenging from an auxiliary manual breathing circuit 2-10

Scavenging a gas monitor sample flow . . . . . . . . . . . . 2-10

Vaporizer controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11

Display controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13

Anesthesia system display . . . . . . . . . . . . . . . . . . . . . . . . . 2-14

Waveform fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16

Digit field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16

Using menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-17

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3 Operation

Turning on the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2

Start case (start gas flow) . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3

Using default settings . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4

Using customized settings . . . . . . . . . . . . . . . . . . . . . . . 3-4

Minimum Alveolar Concentration (MAC) . . . . . . . . . . . . 3-5

End case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6

Ventilator setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7

Using quick keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7

Using Vent Setup menu . . . . . . . . . . . . . . . . . . . . . . . . . 3-8

Changing ventilator modes and settings . . . . . . . . . . . . 3-8

Gas setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9

Using quick keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9

Using Gas Setup menu . . . . . . . . . . . . . . . . . . . . . . . . . 3-9

Changing gas and settings . . . . . . . . . . . . . . . . . . . . . . 3-9

Changing circuit type . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10

Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11

Setting loop type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-12

Scaling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13

Spirometry setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14

Setting patient and sensor type . . . . . . . . . . . . . . . . . . 3-14

Selecting a data source . . . . . . . . . . . . . . . . . . . . . . . . 3-15

Setting spirometry split screen . . . . . . . . . . . . . . . . . . . 3-15

Main Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16

Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17

Cardiac bypass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-18

Fresh gas usage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-19

Screen configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-20

Select page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-20

Screen setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-21

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Alarm setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-23 Setting alarm limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-23 Volume apnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-24 MV/TV alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-24 CO2 alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-24 Auto MV limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-25

Alternate O2 control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-26 EZchange canister (optional) . . . . . . . . . . . . . . . . . . . . . . . 3-27 Condenser (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-28 Passive AGSS (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . 3-29 Active AGSS (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-30

Connecting active AGSS with a flow indicator . . . . . . . 3-31 Connecting active adjustable AGSS . . . . . . . . . . . . . . 3-31

4 Preoperative Checkout

Every day before your first patient . . . . . . . . . . . . . . . . . . . . 4-2 Before every patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

5 Preoperative Tests

Inspect the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2

Vaporizer installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3

Flow and pressure calibration . . . . . . . . . . . . . . . . . . . . . . . 5-4

Circuit compliance compensation . . . . . . . . . . . . . . . . . . . . 5-4

Checkout menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5

Leak < 250 ml . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5

Machine check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6

Machine check - system . . . . . . . . . . . . . . . . . . . . . . . . 5-6

Machine check - circuit . . . . . . . . . . . . . . . . . . . . . . . . . 5-7

Machine check -circuit O2 . . . . . . . . . . . . . . . . . . . . . . . 5-7

Machine check - monitor . . . . . . . . . . . . . . . . . . . . . . . . 5-7

Individual checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

Circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

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Circuit O2 cell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9 Low P leak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9 Low P leak (machines with ACGO) . . . . . . . . . . . . . . . . 5-9 Positive low pressure leak test (ACGO systems only) . . . . 5-10 Vaporizer back pressure test . . . . . . . . . . . . . . . . . . . . . . . 5-11

6 Airway Modules

Airway modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2 Connection to a patient . . . . . . . . . . . . . . . . . . . . . . . . . 6-4 Parameters setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5 Data source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5 CO2 setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5 O2 setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5 Agent setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5 Spirometry setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5 Automatic agent identification . . . . . . . . . . . . . . . . . . . . . . . 6-6 Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-6

7 Alarms and Troubleshooting

Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2

Alarm priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2

Silencing alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2

Display changes during alarms . . . . . . . . . . . . . . . . . . . 7-2

De-escalating alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3

Battery indicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3

Internal failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3

List of alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4

Alarm ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-12

Alarm tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-14

Breathing system problems . . . . . . . . . . . . . . . . . . . . . . . . 7-16

Electrical problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-17

Pneumatic problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-18

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8 Setup and Connections

Setup warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2 Canister setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4 When to change the absorbent . . . . . . . . . . . . . . . . . . . 8-5 Removing a canister . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-6 Removing an EZchange canister . . . . . . . . . . . . . . . . . . 8-6 Reusable Multi Absorber canister filling . . . . . . . . . . . . . 8-7 Electrical connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9 Mains inlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9 Outlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9 Serial port . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-10 Pneumatic connections . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11 Pipeline inlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11 Scavenging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11 Sample gas return port . . . . . . . . . . . . . . . . . . . . . . . . 8-12 Vacuum suction regulator (optional) . . . . . . . . . . . . . . 8-12 Venturi suction regulator (optional) . . . . . . . . . . . . . . . 8-13 Auxiliary O2 flowmeter (optional) . . . . . . . . . . . . . . . . . 8-13 How to install gas cylinders . . . . . . . . . . . . . . . . . . . . . . . . 8-14 Pin indexed cylinder yokes . . . . . . . . . . . . . . . . . . . . . 8-14 DIN cylinder connections . . . . . . . . . . . . . . . . . . . . . . . 8-14 High-pressure leak test . . . . . . . . . . . . . . . . . . . . . . . . 8-15 How to attach equipment to the top of the machine . . . . . . 8-16

9 User Maintenance

Repair policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2 Maintenance summary and schedule . . . . . . . . . . . . . . . . . 9-2 Datex-Ohmeda approved service . . . . . . . . . . . . . . . . . 9-3 Circuit O2 cell replacement . . . . . . . . . . . . . . . . . . . . . . . . . 9-4 Calibration menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-5 Flow and pressure calibration . . . . . . . . . . . . . . . . . . . . . . . 9-5 Circuit O2 cell calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6 21% O2 calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6 Airway gas calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6

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Backlight test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-7 How to help prevent water buildup . . . . . . . . . . . . . . . . . . . . 9-7

10 Parts

Flow sensor module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2 Breathing circuit module . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3 Bellows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4 Complete Advanced Breathing System . . . . . . . . . . . . . . . 10-5 Absorber canister . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-6 Exhalation valve assembly . . . . . . . . . . . . . . . . . . . . . . . . . 10-7 AGSS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-8 EZchange canister system . . . . . . . . . . . . . . . . . . . . . . . . . 10-9 Condenser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-10 Test tools and system parts . . . . . . . . . . . . . . . . . . . . . . . 10-11

11 Specifications and Theory of Operation

System pneumatic circuits . . . . . . . . . . . . . . . . . . . . . . . . . 11-2

Gas supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4

O2 flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4

Air and N2O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4

Mixed gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4

EZchange canister . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4

Condenser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

Gas supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

ACGO Port relief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

Non-circle circuit relief . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

Electrical block diagram . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6

Electrical power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-8

Power cord . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-8

Battery information . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9

Flow specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9

Breathing system specifications . . . . . . . . . . . . . . . . . . . . 11-10

Gas scavenging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-11

Physical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-12

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Environmental requirements . . . . . . . . . . . . . . . . . . . . . . 11-12 Airway module specifications . . . . . . . . . . . . . . . . . . . . . . 11-13 Gas specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-13 Typical performance . . . . . . . . . . . . . . . . . . . . . . . . . 11-14 Suction regulators (optional) . . . . . . . . . . . . . . . . . . . . . . 11-15 Ventilator theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-16 O2 monitoring theory of operation . . . . . . . . . . . . . . . 11-17 Ventilation modes . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-17 Ventilator operating specifications . . . . . . . . . . . . . . . . . . 11-25 Pneumatics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-25 Fresh gas compensation . . . . . . . . . . . . . . . . . . . . . . 11-25 Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-25 Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-25 Oxygen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-25 Ventilator accuracy data . . . . . . . . . . . . . . . . . . . . . . . . . 11-26 Electromagnetic compatibility (EMC) . . . . . . . . . . . . . . . . 11-27

Guidance and manufacturer’s declaration - electromagnetic emissions . . . . . . . . . . . . . . . . . . . . . 11-27

Guidance and manufacturer’s declaration - electromagnetic immunity . . . . . . . . . . . . . . . . . . . . . 11-28

Power immunity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-28 Radiated immunity . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-29 Recommended separation distances . . . . . . . . . . . . . 11-30 Electrical safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-31 IEC 60601-1 Classification . . . . . . . . . . . . . . . . . . . . . . . . 11-32 Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-32 System components . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-33 Integral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-33 Not integral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-33

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12 Super User Mode

Install/Service menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-2 Using super user mode . . . . . . . . . . . . . . . . . . . . . . . . 12-3 Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4 Cumulative gas usage . . . . . . . . . . . . . . . . . . . . . . . . . 12-4 Volume apnea setup . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5 Setting time and date . . . . . . . . . . . . . . . . . . . . . . . . . . 12-6 Trends setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7 Setting colors and units . . . . . . . . . . . . . . . . . . . . . . . . 12-9 Parameter settings . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-10 Page Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-10 Configuring case defaults . . . . . . . . . . . . . . . . . . . . . 12-12

Index

Warranty

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1 Introduction

WARNING Read each component’s User’s Reference manual and understand the following before using this system:

•All system connections.

•All warnings and cautions.

•How to use each system component.

•How to test each system component.

wBefore using the system:

•Complete all of the tests in the “Preoperative Tests” section.

•Test all other system components.

wIf a test fails, do not use the equipment. Have a

Datex-Ohmeda trained service representative repair the equipment.

In this section Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 Symbols used in the manual or on the equipment . . . . . . . . 1-4 Typeface conventions used . . . . . . . . . . . . . . . . . . . . . . . . . 1-7 Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7

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Intended use

The Avance anesthesia system combines our highly advanced anesthesia delivery, the very best in patient monitoring, and care information management. The contemporary, compact design addresses many ergonomic considerations including an efficient cable management solution and storage system and an extra large work surface area. Optional, integrated features include auxiliary O2 and suction control. The Avance system offers improved usability through integration of ventilation, gas delivery and gas monitoring (E and M-Series respiratory gas module capable) on a full-color 12-inch display. This system also features electronic gas mixing of up to three gases.

The Avance system uses SmartVent ventilation technology offering Volume Control Ventilation with tidal volume compensation and electronic PEEP. The proven SmartVent technology also features optional Pressure Control Ventilation, Pressure Support Ventilation with an Apnea Backup (PSVPro) that is used for spontaneously breathing patients, Synchronized Intermittent Mandatory Ventilation (SIMV) modes, Pressure Control Ventilation-Volume Guarantee (PCV-VG), and VCV cardiac bypass. These advanced features allow for the ventilation of a broad patient range: from neonates and compromised patients to routine cases.

The Avance system uses the Advanced Breathing System (ABS). This integrated breathing system is easy to remove and disassemble, is made of highly durable polymers, and is fully autoclavable. Its fully integrated design enhances the system’s elegance while minimizing tube connections, minimizing circuit volume, and increasing the work surface area.

The anesthesia system is designed for expansion and upgrades, so it is easy to add new technologies and ventilation capabilities without investing in a new system.

This anesthesia system is not suitable for use in an MRI environment.

This system must only be operated by authorized medical personnel well trained in the use of this product. It must be operated according to the instructions in this User’s Reference manual.

WARNING Explosion Hazard. Do not use this system with flammable anesthetic agents.

Note Configurations available for this product depend on local market and standards requirements. Illustrations in this manual may not represent all configurations of the product. This manual does not cover the operation of every accessory. Refer to the accessory documentation for further information.

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AB.91.108

Figure 1-1 • Front view

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Symbols used in the manual or on the equipment

Symbols replace words on the equipment, on the display, or in Datex-Ohmeda manuals.

Warnings and Cautions tell you about dangerous conditions that can occur if you do not follow all instructions in this manual.

Warnings tell about a condition that can cause injury to the operator or the patient.

Cautions tell about a condition that can cause damage to the equipment. Read and follow all warnings and cautions.

On (power) Off (power)

Standby	O2+	O2 Flush button
Type BF equipment		Type B equipment
Airway module indicator		ACGO active
Dangerous voltage		Frame or chassis ground
Protective earth ground		Earth ground
Direct current		Alternating current
Caution/Warning		Attention, refer to product instructions
Refer to product instructions		Pinch hazard
Electrical input		Electrical output
Electrical input/output		Sample gas inlet to scavenging

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+

134°C

Pneumatic inlet

Serial number

Equipotential

Variability

Suction bottle outlet

Maximum

Exhaust

Plus, positive polarity

Bag position/manual ventilation

Inspiratory flow

Movement in one direction

Lock

Isolation transformer

Autoclavable

This way up

APL settings are approximate

REF

-

O2%

1 Introduction

Pneumatic outlet

Stock number

Lamp, lighting, illumination

Variability in steps

Vacuum inlet

Vacuum

Bellows volumes are approximate

Minus, negative polarity

Mechanical ventilation

Expiratory flow

Movement in two directions

Unlock

Low pressure leak test

Not autoclavable

O2 cell connection

Anesthetic Gas Scavenging System

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Caution: federal law prohibits dispensing without prescription.

O2% indicator on left and balance gas indictor on right. Colors associated with gas settings.

Alarm silence

No battery/battery failure

Read to center of float

Open drain (remove liquid)

Pipeline

Systems with this mark agree with the European Council Directive (93/42/ EEC) for Medical Devices when they are used as specified in their User’s Reference manuals. The xxxx is the certification number of the Notified Body used by Datex-Ohmeda’s Quality Systems.

Date of manufacture

Indicates that the waste of electrical and electronic equipment must not be disposed as unsorted municipal waste and must be collected separately. Please contact an authorized representative of the manufacturer for information concerning the decommissioning of equipment.

This product consists of devices that may contain mercury, which must be recycled or disposed of in accordance with local, state, or country laws. (Within this system, the backlight lamps in the monitor display contain mercury.

Alarm silence touch key (Tec 6 Plus)

Gas indicator. Color associated with gas settings.

Submenu

Battery in use. Bar indicates amount of battery power remaining.

EZchange canister (CO2 bypass)

Close drain

Cylinder

Authorized representative in the European Community

Manufacturer

GOST R Russian certification

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Typeface conventions used

Names of hard keys on the display and modules are written in bold typeface; for example, Normal Screen.

Menu items are written in bold italic typeface; for example, Vent Setup.

Messages that are displayed on the screen are enclosed in single quotes; for example, ‘Check sample gas out.’

When referring to different sections and other documents, the names are written in italic typeface and enclosed in double quotes; for example, “System Controls and Menus.”

Abbreviations

Abbreviation	Definition
A
AA	Anesthetic agent
ABS	Advanced breathing system
ACGO	Auxiliary Common Gas Outlet
AGSS	Anesthesia Gas Scavenging System
Alt O2	Alternate O2
APL	Adjustable pressure-limiting
APN	Apnea
C
CGO	Common Gas Outlet
CO2	Carbon dioxide
Compl	Compliance
E
ET	End-tidal concentration
EtCO2	End-tidal carbon dioxide
EtO2	End-tidal oxygen
Exp	Expiratory
F
FI	Fraction of inspired gas
FiCO2	Fraction of inspired carbon dioxide
FI-ET	Difference between inspiratory and expiratory
	concentrations
FiO2	Fraction of inspired oxygen
F-V	Flow-volume loop

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Abbreviation	Definition
I
I:E	Inspiratory-expiratory ratio
Insp	Inspiratory
Insp Pause	Inspriatory pause time
M
MAC	Minimum Alveolar Concentration
MV	Minute volume
MVexp	Expired minute volume
MVinsp	Inspired minute volume
N
N2O	Nitrous oxide
O
O2	Oxygen
P
Pair	Air supply pressure
Paux	Auxiliary pressure
Paw	Airway pressure
PCV	Pressure controlled ventilation
PCV-VG	Pressure controlled ventilation - volume guaranteed
PEEP	Positive end expiratory pressure
PEEPe	Extrinsic positive end expiratory pressure
Pexp	Expiratory pressure
P-F	Pressure-flow loop
Pinsp	Inspiratory pressure
Plimit	High pressure limit
Pmax	Maximum pressure
Pmean	Mean pressure
PO2	Oxygen supply pressure
Ppeak	Peak pressure
Pplat	Plateau pressure
Psupp	Support pressure
PSV	Pressure supported ventilation
PSVPro	Pressure supported ventilation with apnea backup
P-V	Pressure-volume loop
R
Rate	Respiratory rate
Raw	Airway resistance
RR	Respiratory rate

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Abbreviation	Definition
S
SIMV/PSV	Synchronized intermittent mandatory ventilation with
	pressure supported ventilation
SIMV-PC	Synchronized intermittent mandatory ventilation -
	pressure controlled
T
TV	Tidal volume
TVexp	Expired tidal volume
TVinsp	Inspired tidal volume
V
VCO2	Carbon dioxide production
VCV	Volume controlled ventilation
Vol	Volume

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WARNING Do not use antistatic or electrically-conductive breathing tubes or masks. They can cause burns if used near highfrequency surgical equipment.

wExplosion Hazard. Do not use this system with flammable anesthetic agents.

In this section System overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2 Advanced breathing system (ABS) components . . . . . . . . . 2-5 Vaporizer controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11 Display controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13 Anesthesia system display . . . . . . . . . . . . . . . . . . . . . . . . . 2-14 Using menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-17

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System overview

12

11

		1
		2
	10	3
		4
		5
		6
		7

9

8

1.	Light switch	7.	Integrated suction (optional)
2.	Dovetail	8.	Brake
3.	Vaporizer	9.	O2 flush button
4.	Alternate O2 control	10. Advanced breathing system
5.	System switch	11. Auxiliary O2 flow control (optional)
6.	Mains indicator	12. Anesthesia display

Figure 2-1 • Front view

AB.91.111

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Item, Figure 2-1		Description
4	Alternate O2 control	Alternate O2 control activates automatically in the case of certain failures or errors. It
		can also be activated manually by pushing the Alternate O2 control button if the display
		fails. Turn the knob counterclockwise to increase the flow. Turn the knob clockwise to
		decrease the flow. See “Alternate O2 control” in the Operation section.

5

System switch

Set the switch to the On (|) position to permit gas flow and to turn on the system.

6	Mains indicator	The mains indicator will come on when AC power is connected.
7	Integrated suction	Turn the switch to MAX for full vacuum. Turn the switch to Off (0) for no vacuum. Turn
	(optional)	the switch to On (|) for adjustable vacuum. When in adjustable vacuum, turn the knob
		clockwise to increase the vacuum and counterclockwise to decrease the vacuum.

8	Brake	Push down to lock. Lift to release.

9

O2 flush button

Push the O2 flush button to supply high flows of O2 to the breathing system.

11	Auxiliary O2 flow	Turn the knob counterclockwise to increase the flow. Turn the knob clockwise to
	control (optional)	decrease the flow.

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11

10

9

8

1.Outlet circuit breaker

2.Isolated electrical outlet (optional)

3.Cable access door

4.Vacuum connection

5.Collection bottle connection

6.Cylinder yoke

Figure 2-2 • Rear view

1

2

3

4

5

6

7

AB.91.029

7.AGSS (Anesthesia Gas Scavenging System)

8.Equipotential stud

9.Mains inlet

10.System circuit breaker

11.Pipeline connections

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Advanced breathing system (ABS) components

15

14

13

12

11

10

1

2

9

8

7

3 4

		6	5
1.	Expiratory check valve	9. Manual bag port
2.	Inspiratory check valve	10. Adjustable pressure-limiting (APL) valve
3.	Inspiratory flow sensor	11. Bag/Vent switch
4.	Expiratory flow sensor	12. Bellows assembly
5.	Absorber canister	13. Sample gas return port
6.	Absorber canister release	14. AGSS indicator (only on some AGSS versions)
7.	Leak test plug	15. Airway module (optional)
8.	Breathing system release

Figure 2-3 • Advanced breathing system

AB.91.110

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Item, Figure 2-3		Description
3, 4	Inspiratory flow sensor	Flow sensors provide volume measurements for some monitoring
	Expiratory flow sensor	functions and tidal volume delivery.
6	Absorber canister release	Push to remove the canister. This causes the breathing system to vent to
		the room (unless the EZchange canister option is installed). Be sure to hold
		the canister by the handle before releasing the canister.

10	Adjustable pressure-limiting	Adjusts breathing system pressure limit during manual ventilation. The
	(APL) valve	scale shows approximate pressures. Above 30 cmH2O, the knob will click
		as it turns.
		M	70
		N
		I
			30
			20
11	Bag/Vent switch	Selects between manual ventilation (bag) or mechanical ventilation
		(ventilator).

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Optional ABS

components

1

7

2

3

6

1.Bag support arm

2.Auxiliary Common Gas Outlet (ACGO) switch

3.ACGO port

4.EZchange canister module (CO2 bypass)

5.EZchange canister release

6.Condenser drain button

7.Condenser

Figure 2-4 • Breathing system options

4

	5
AB.91.109	AB.82.043

Item, Figure 2-4		Description
1	Bag support arm	Squeeze the button to raise or lower the arm.

2	Auxiliary Common Gas	Set switch to ACGO position for fresh gas to flow through the ACGO port. The
	Outlet (ACGO) switch	ACGO may be used to provide fresh gas to an auxiliary manual breathing circuit.
5	EZchange canister	Push to drop the canister to EZchange position. This seals the breathing circuit,
	release	permitting continued ventilation and rebreathing of exhaled gases. Be sure to
		hold the canister by the handle before releasing the canister.
6	Condenser drain button	Push to drain water out of the condenser.

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Non-circle circuit

Fresh gas flow is diverted around the inspiratory check valve and out through the inspiratory port when non-circle ventilation is selected. This fresh gas source may be used with circuits without CO2 absorbent capability (for example, Mapleson variants). Mechanical ventilation is not available when using the non-circle circuit. Tidal volume monitoring is not available.

O2 monitoring of fresh gas is available automatically when using the non-circle circuit if the system has the airway module option or the O2 cell monitoring option.

Fresh gas oxygen concentration is displayed on the screen. Set the alarm limits appropriately. Note that fresh gas oxygen concentration may not reflect FiO2 when using these types of circuits. Use an external O2 monitor when using a rebreathing circuit with the noncircle circuit.

Systems with both an airway module and an O2 cell will display the circuit O2 value obtained from the airway module.

Do not use an external ventilator when using the non-circle circuit. Do not use the non-circle circuit to drive external ventilators or for jet ventilation.

WARNING The maximum pressure at the non-circle circuit can be up to 27 kPa (4 psi). Use a breathing circuit with pressure relief.

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ACGO (optional) Fresh gas flow is directed through the Auxiliary Common Gas Outlet (ACGO) on the front of the machine when the ACGO switch is in the ACGO position. Mechanical ventilation is not available when operating an auxiliary manual breathing circuit with fresh gas from the ACGO. The Bag/Vent switch, APL valve, and bag arm are not part of the external circuit. Volume and pressure monitoring are not available.

O2 monitoring of fresh gas is available automatically when the ACGO is selected if the system has the airway module option or the O2 cell monitoring option. A sample of the fresh gas is diverted to the O2 cell in the breathing system. The sample flow to the O2 cell is dependent on the pressure in the external circuit. The sample flow reduces the fresh gas flow rate to the auxiliary breathing circuit equal to the amount diverted to the O2 cell.

Fresh gas oxygen concentration is displayed on the screen. Set the alarm limits appropriately. Note that fresh gas oxygen concentration may not reflect FiO2 during spontaneous breathing or in rebreathing circuits. Use an external O2 monitor if using a rebreathing circuit on ACGO.

Systems with both an airway module and an O2 cell will display the circuit O2 value obtained from the airway module.

Do not use an external ventilator on the ACGO. Do not use the ACGO to drive external ventilators or for jet ventilation.

WARNING

Scavenging the ACGO sample flow

The maximum pressure at the ACGO can be up to 55 kPa (8 psi). Use a breathing circuit with pressure relief.

A sample of the fresh gas is diverted to the airway module or the O2 cell in the breathing system to show the O2 numerics on the screen. This sample flow should be scavenged when an auxiliary manual breathing circuit is used with N2O or volatile anesthetics. If scavenging is not connected, the sample flow is emptied into the room. To connect the scavenging:

1.Attach a circle breathing circuit to the inspiratory and expiratory ports.

2.Occlude the breathing circuit by connecting the Y-piece to the leak test plug located behind the expiratory port.

3.Check for clinically correct settings.

4.Check the position of the Bag/Vent switch.

•If the Bag/Vent switch is set to mechanical ventilation mode, the bellows fills slowly with the sample flow. When the bellows is full, the sample flow goes to the AGSS. (Mechanical ventilation does not start when the ACGO switch is set to ACGO.)

•If the Bag/Vent switch is set to the bag mode, set the APL valve to MIN, and attach a bag. The bag fills slowly with the sample flow. When the bag is full, the sample flow goes to the AGSS.

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Scavenging from an auxiliary manual breathing circuit

Scavenging a gas monitor sample flow

Scavenge the exhaust if an auxiliary manual breathing circuit is used with N2O or volatile anesthetics.

An auxiliary inlet is available for active and passive AGSS units. It provides a female connection with 30 mm - 30 mm male connector (or a 30 mm -19 mm male connector) into the auxiliary port under the breathing system. Do not use these connectors as an outlet for exhaust flow.

The auxiliary inlet is a convenience inlet to the air brake of active AGSS units. There is a reservoir to capture exhaust flows higher than the extract flow.

A separate exhaust hose is needed from the auxiliary manual breathing circuit to the disposal point for all AGSS units.

Sample gas from a gas monitor can be scavenged using the sample gas return port or the AGSS.

•To scavenge from a gas monitor using the sample gas return port, connect the tubing from the monitor to the sample gas return port.

•To scavenge from a gas monitor using the AGSS, connect tubing from the monitor to the male luer inlet on the bottom of the AGSS underneath the breathing system.

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