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
character indicating the year
the product was manufactured;
H = 2004, J = 2005, etc. I and
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.
The XX represents a number
indicating the year the product
was manufactured; 04 = 2004,
05 = 2005, etc.
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
Table of Contents
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
ii M1145956
4 Preoperative Checkout
Table of Contents
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
5 Preoperative Tests
Every day before your first patient . . . . . . . . . . . . . . . . . . . . 4-2
Before every patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
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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6 Airway Modules
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
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
List of alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
Alarm ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-12
Alarm tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-14
Breathing system problems . . . . . . . . . . . . . . . . . . . . . . . . 7-16
Electrical problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-17
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
Pneumatic problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-18
iv M1145956
8 Setup and Connections
Table of Contents
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
9 User Maintenance
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
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 O
cell calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6
2
21% O
calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6
2
Airway gas calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6
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10 Parts
Backlight test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-7
How to help prevent water buildup . . . . . . . . . . . . . . . . . . . . 9-7
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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Table of Contents
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
Index
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
Warranty
viii M1145956
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.
w Before using the system:
• Complete all of the tests in the “Preoperative Tests”
section.
• Test all other system components.
w If 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
M1145956 1-1
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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.
1-2 M1145956
1 Introduction
AB.91.108
Figure 1-1 • Front view
M1145956 1-3
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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
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
O2+
O2 Flush button
Electrical input Electrical output
Electrical input/output Sample gas inlet to scavenging
1-4 M1145956
Pneumatic inlet Pneumatic outlet
1 Introduction
SN
+
Serial number
Equipotential Lamp, lighting, illumination
Variability Variability in steps
Suction bottle outlet Vacuum inlet
Maximum Vacuum
Exhaust Bellows volumes are approximate
Plus, positive polarity
Bag position/manual ventilation Mechanical ventilation
Inspiratory flow Expiratory flow
REF
-
Stock number
Minus, negative polarity
134°C
Movement in one direction Movement in two directions
Lock Unlock
Isolation transformer Low pressure leak test
Autoclavable Not autoclavable
This way up
APL settings are approximate Anesthetic Gas Scavenging System
O2%
O2 cell connection
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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 Submenu
No battery/battery failure Battery in use. Bar indicates amount of
Read to center of float EZchange canister (CO2 bypass)
Open drain (remove liquid) Close drain
Pipeline Cylinder
Alarm silence touch key (Tec 6 Plus)
Gas indicator. Color associated with gas
settings.
battery power remaining.
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 Manufacturer
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.
Authorized representative in the
European Community
GOST R Russian certification
1-6 M1145956
Typeface conventions used
Names of hard keys on the display and modules are written in bold
typeface; for example,
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
1 Introduction
Normal Screen.
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
1-8 M1145956
1 Introduction
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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1-10 M1145956
2 System Controls and Menus
WARNING Do not use antistatic or electrically-conductive breathing
tubes or masks. They can cause burns if used near highfrequency surgical equipment.
w Explosion 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
M1145956 2-1
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AB.91.111
1
2
3
4
5
6
7
8
9
10
12
11
System overview
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
2-2 M1145956
2 System Controls and Menus
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
(optional)
Turn the switch to MAX for full vacuum. Turn the switch to Off (0) for no vacuum. Turn
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
control (optional)
Turn the knob counterclockwise to increase the flow. Turn the knob clockwise to
decrease the flow.
M1145956 2-3
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AB.91.029
1
2
3
4
5
6
7
8
9
10
11
1. Outlet circuit breaker 7. AGSS (Anesthesia Gas Scavenging System)
2. Isolated electrical outlet (optional) 8. Equipotential stud
3. Cable access door 9. Mains inlet
4. Vacuum connection 10. System circuit breaker
5. Collection bottle connection 11. Pipeline connections
6. Cylinder yoke
Figure 2-2 • Rear view
2-4 M1145956
2 System Controls and Menus
AB.91.110
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Advanced breathing system (ABS) components
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
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20
30
70
M
I
N
Item, Figure 2-3 Description
3, 4 Inspiratory flow sensor
Expiratory flow sensor
6 Absorber canister release Push to remove the canister. This causes the breathing system to vent to
Flow sensors provide volume measurements for some monitoring
functions and tidal volume delivery.
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
(APL) valve
Adjusts breathing system pressure limit during manual ventilation. The
scale shows approximate pressures. Above 30 cmH2O, the knob will click
as it turns.
11 Bag/Vent switch Selects between manual ventilation (bag) or mechanical ventilation
(ventilator).
2-6 M1145956
Optional ABS
AB.91.109
AB.82.043
1
2
3
4
5
6
7
components
2 System Controls and Menus
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
Item, Figure 2-4 Description
1 Bag support arm Squeeze the button to raise or lower the arm.
2 Auxiliary Common Gas
Outlet (ACGO) switch
5 EZchange canister
release
6 Condenser drain button Push to drain water out of the condenser.
Set switch to ACGO position for fresh gas to flow through the ACGO port. The
ACGO may be used to provide fresh gas to an auxiliary manual breathing circuit.
Push to drop the canister to EZchange position. This seals the breathing circuit,
permitting continued ventilation and rebreathing of exhaled gases. Be sure to
hold the canister by the handle before releasing the canister.
M1145956 2-7
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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.
2-8 M1145956
2 System Controls and Menus
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 The maximum pressure at the ACGO can be up to 55 kPa
Scavenging the
ACGO sample flow
(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.
M1145956 2-9
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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.
2-10 M1145956
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