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Julian
User Manual
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Drager Julian User Manual

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Julian
Anaesthetic Workstation
Instructions for Use Software 2.n
1-36-96
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
How to use these Instructions for Use
In the header is the subject… of the main chapter.
Underneath is the title of the subchapter, to help you find your way around quickly.
On each page… the instructions for use
combining text with illustrations. The information is translated directly into actions to enable the user to learn „hands-on“ how to use the workstation.
Left-hand column: the text…
provides explanations and guides the user clearly and ergonomically with brief directions on the use of the product. Bullet points indicate the steps to be followed, and where there are several steps, numbers refer to the illustration and indicate the sequence.
Right-hand column: the illustration…
provides the link with the text and serves as a guide to the workstation. Points mentioned in the text are emphasised and non-essential information is omitted.
Screen displays guide the user and confirm the steps to be followed.
How to use these Instructions for Use
2
1 Press the »MAN/SPONT« key, 2 and confirm with the rotary knob.
Display (example):
O2 flush
– For flushing and rapidly filling the breathing
system and breathing bag with O2 while bypassing the Vapor unit.
3 Press the »O2 +« button.
O2 flows into the breathing system without anaesthetic gas as long as the button is held down.
Julian
1
2
Operation Selecting the ventilation mode MAN/SPONT
Julian
D
3
MAN/SPONT
Pleth
40
0
CO
2
40 36
0.8 0.6 58 56
38
98 67
5.2 8
4.0030
Volumeter starten: Bestätigen!
O
2
SpO
2
N2O
Hal.
Fi
Fet
et CO
2
AMV
Freq
Grenzen CO
2
-Al.
aus/ein Alarm
Info Liste
Kurven
Konfig.
Frischgas O
2
+ N2O
O
2
%
L/min
VT
0.35
0
Volumeter
--s
--
05
10
0.5
1
Frischgas
intern extern
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Contents
3
Contents
Index 142
For Your Safety and that of Your Patients 5
Intended Use 7
Operating Concept 11
Before Using for the First Time 19
Preparation 21
Starting Up 25
Operation 35
Monitoring 55
Configuring in Standby Mode 81
Care 95
Julian as Wall-mounted Unit 113
Maintenance Intervals 115
What's what 125
Technical Data 131
Fault – Cause – Remedy 119
Abbreviations / Symbols 139
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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4
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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For Your Safety and that of Your Patients
Strictly follow the Instructions for Use
Any use of the apparatus requires full understanding and strict observation of these instructions. The apparatus is only to be used for purposes specified here.
Maintenance
The apparatus must be inspected and serviced regularly by trained service personnel at six monthly intervals (and a record kept). Repair and general overhaul of the apparatus may only be carried out by trained service personnel. We recommend that a service contract be obtained with DrägerService and that all repairs also be carried out by them. Only authentic Dräger spare parts may be used for maintenance. Observe chapter "Maintenance Intervals".
Accessories
Do not use accessory parts other than those in the order list.
Not for use in areas of explosion hazard
This apparatus is neither approved nor certified for use in areas where combustible or explosive gas mixtures are likely to occur.
Safe connection with other electrical equipment
Electrical connections to equipment which is not listed in these Instructions for Use should only be made following consultations with the respective manufacturers or an expert.
Liability for proper function or damage
The liability for the proper function of the apparatus is irrevocably transferred to the owner or operator to the extent that the apparatus is serviced or repaired by personnel not employed or authorized by DrägerService or if the apparatus is used in a manner not conforming to its intended use.
Dräger cannot be held responsible for damage caused by non-compliance with the recommendations given above. The warranty and liability provisions of the terms of sale and delivery of Dräger are likewise not modified by the recommendations given above.
Dräger Medizintechnik GmbH
For Your Safety and that of Your Patients
5
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Contents
Intended Use............................................................................................. 9
7
Intended Use
Contents
Intended Use
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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8
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Intended Use
Julian Anaesthetic Workstation for patients with a body weight of 5 kg and over with the use of IPPV ventilation.
For the use of:
– Inhalation anaesthesia in rebreathing systems – Inhalation anaesthesia in semi-closed to virtually
closed systems with "low flow" and "minimal flow" techniques (for minimal gas and anaesthetic agent consumption).
– Inhalation anaesthesia in non-rebreathing systems,
with separate fresh gas outlet for the connection of e.g. the Bain system or Magill system
with a fresh gas flow of 0.5 to 12 L/min.
Ventilation modes:
– Automatic ventilation (IPPV)
and
pressure-controlled ventilation (PCV). – Manual ventilation (MAN). – Spontaneous ventilation (SPONT).
The following measured values are displayed:
– Peak pressure, mean pressure, plateau pressure and
PEEP – Expiratory minute ventilation
Tidal volume VT
Breathing rate
Patient compliance – Inspiratory and expiratory concentration of O2, N2O,
anaesthetic gas and CO2 optional: – Functional oxygen saturation (SpO2) and pulse rate.
The following parameters are displayed as curves:
– Airway pressure – Expiratory flow – Inspiratory and expiratory concentration of O2, CO2
and anaesthetic gas optional: – Plethysmogram Trend curves and measured value lists are also available.
Monitoring
by means of adjustable alarm limits that are automatically adapted to the ventilation mode.
The workstation may only be used under the supervision of qualified medical personnel, so that assistance can be provided immediately in the event of any malfunctions.
Explosive anaesthetics, such as ether or cyclo- propane, must not be used due to the risk of fire.
Mobile radio telephones must not be used within 10 metres of the workstation!
Mobile telephones may interfere with the operation of electrical and electronic medical equipment.
Julian must not be used with nuclear spin tomography (MRT, NMR, NMI)!
Operation of the apparatus may be impaired.
Intended Use
9
Intended Use
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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10
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Contents
Screen ergonomics.................................................................................12
Selecting / setting ventilation parameters..................................................14
Selecting / setting monitoring functions.....................................................15
Screen layout..........................................................................................16
Three basic screens for monitoring...........................................................17
The standard screen.................................................................................17
The data screen....................................................................................... 17
The trend screen......................................................................................18
Operating Concept
Contents
11
Operating Concept
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Operating Concept
Screen ergonomics
All the settings required for – Fresh gas delivery – Ventilation – Monitoring are entered on the system screen using the appropriate
keys and the rotary knob. The keys are grouped in function fields:
Left-hand field Fresh gas delivery
Right-hand field Ventilation
Middle field Monitoring
The main functions for anaesthesia, e.g. selection of N2O or AIR, or selection of ventilation modes, can be selected directly by keys with permanently defined functions ("hardkeys"):
1 Left-hand block
The »N2O« or »AIR« keys are used to select the gas to be mixed with O2 for the fresh gas mix.
2 Right-hand block
The »MAN SPONT«, »IPPV« oder »PCV« keys select the ventilation mode.
These function keys are located in the bottom row on the control panel. Left-hand block for fresh gas setting Right-hand block for ventilation
Operating Concept Screen ergonomics
12
.
12...
.
NO
2
AIR
MAN
SPONT
IPPV PCV
Monitoring
Ventilation
Fresh gas delivery
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
_
CO
2
Ve
.
12...
.
NO
2
AIR
MAN
SPONT
IPPV PCV
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
1
2
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Complementary "softkeys" with variable functions are provided at the bottom edge of the screen, above each group of hardkeys. These softkeys are used to set the fresh gas delivery parameters and ventilation parameters.
1 Left-hand block:
The keys for setting the O2 concentration and fresh gas flow.
2 Right-hand block:
The keys for setting the parameters for the relevant ventilation mode. The example shows the parameters for IPPV controlled ventilation.
These softkeys have different functions, depending on the operating status or ventilation mode.
The current parameter values are displayed in the softkey field.
In a prominent position at the bottom right-hand side: The "turn-and-push" rotary knob
is the main operating control of the apparatus and has the following functions in all setting operations:
3 select = turn 4 confirm = press
– to confirm the selected carrier gas or a ventilation
mode,
– to set and confirm the parameters for fresh gas and
ventilation modes,
– to set and confirm the monitoring functions.
Beside the rotary knob: The standby key E for switching over to standby mode. 5 Press standby key E and confirm by pressing the
rotary knob.
13
Operating Concept Screen ergonomics
.
12...
.
NO
2
AIR
MAN
SPONT
IPPV PCV
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
1 2
_
CO
2
Ve
.
12...
.
NO
2
AIR
MAN
SPONT
IPPV PCV
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
3
5
4
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Operating Concept Screen ergonomics
14
Selecting / setting ventilation parameters
Example: PEEP ventilation parameter
1 Press the softkey »PEEP«. 2 Select the PEEP value = turn the rotary knob. 3 Confirm the PEEP value = press the rotary knob.
The keys for the various monitoring functions are located on the right-hand side of the screen.
These keys also have different functions = softkeys, depending on the monitoring screen required.
Julian
1
2
3
.
12...
.
NO
2
AIR
MAN
SPONT
IPPV PCV
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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15
Operating Concept Screen ergonomics
Selecting / setting monitoring functions
For example, to change the lower alarm limit of the end- tidal CO2 concentration.
1 Press the »alarm limits« softkey. The alarm limits
menu is displayed on the screen.
● Select the alarm limit value = turn the rotary knob.
Confirm the selection = press the rotary knob. The limit value is highlighted.
Example: lower alarm limit etCO2: <30
● Set the alarm limit value = turn the rotary knob.
● Confirm the new alarm limit = press the rotary knob.
The cursor returns to the zsymbol.
Julian
1
Pleth
IPPV
CO2
40
0
PAW
600 10
1:2
10 0251.0050
98 67 38
6.0 29
0.8
--
95
3.0
--
20
1.0
0.0 40
8
120
50
--
Select limit: Turn and confirm ! !
42 30
0
20
FiO
2
FiHal.
PAW
SpO
2
etCO
2
MV
alarm limits
auto set limits
alarm info
list
curves
config.
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N2O
Pleth
IPPV
CO
2
40
0
600 10
1:2
10 0251.0050
98 67 38
6.0 29
0.8
--
95
3.0
--
20
1.0
0.0 40
8
120
50
--
Adjust limit value: Turn and confirm !
42
30
PAW
0
20
FiO
2
FiHal.
PAW
SpO
2
etCO
2
MV
alarm limits
auto set limits
alarm info
list
curves
config.
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O2 + N2O
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Operating Concept Screen ergonomics Screen layout
16
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
_
CO
2
Ve
➀ ➁ ➂ ➃
➄ ➅ ➆ ➇
Exit the alarm limits menu: 1 Press the rotary knob
or
2 Press the Q key.
The function keys for standard functions are located on the right-hand side of the control panel.
G Suppress the acoustic alarm for 2 minutes. S Select the screen page. Q Back to standard page.
Screen layout
➀ Status field:
Displays information on the current operating mode
➁ Graphics field:
For curves and bargraphs
➂ Alarm field:
Displays information on the alarms, warnings, etc. and their priority
➃ Numerical value field:
For numerical values
➄ Lower softkeys – for fresh gas parameters ➅ Prompt field:
For user guidance
➆ Lower softkeys – for ventilation parameters ➇ Right-hand softkeys – for monitoring:
For rapid selection of the desired monitoring function
.
12...
.
NO
2
AIR
MAN
SPONT
IPPV PCV
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
_
CO
2
Ve
Julian
2
1
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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17
Operating Concept
Screen layout
Three basic screens for monitoring To call up the standard screen, data screen and trend
screen in succession: 1 Briefly press the S key until the desired screen is
displayed.
Back to the standard screen: 2 Press the Q key.
The fresh gas and ventilation parameters can be set by means of the softkeys in each of the three basic screens.
The standard screen
with three selectable curves. The most important numerical values are displayed in groups on the right-hand side of the screen.
The data screen
contains all the numerical values with their units of measure.
Julian
2 1
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
_
CO
2
Ve
IPPV
PAW
40
20
0
600 10
1:2
10 0251.0050
O
2
%
N
2
O
%
Hal. %
036
40 33
0.8 0.6 58 56
Fi
Fet
CO
2
mmHg
98 67
6.0
0.60 10
27 20
5 15 65
MV V
T
freq
peak plat. PEEP mean compliance
mbar
mL/mbar
L/min
L
34
AW-temp.
°C
1/min
01. Nov. 98
sys. comp. 6.40 mL/mbar leckage 10 mL/min
01-10
8 : 00
12 : 00
SpO
2
%
1/min
alarm limits
auto se
t
limits
alarm info
list
config.
Freshgas O
2
+ N2O
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Operating Concept Screen layout
18
The trend screen
displays the recorded progress of the numerical values over time since measurement started. The current measured values are displayed on the right-hand side.
Display (example): Trends for CO2 and minute ventilation MV
IPPV
40 36
0.8 0.6 58 56
38
98 67
6.0 10
600 10
1:2
10 0251.0050
PAW
40
20
0
11:00 12:00 13:00
60
30
0
15
10
5
0
Select zoom area:
Turn !
Zoom in: Press !
CO
2
MV
O
2
SpO
2
N2O
Iso.
Fi
Fet
etCO
2
MV
freq
alarm limits
AGas N
2
O
CO
2
MV
O
2
compl. SpO
2
pulse full
trend
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N2O
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Contents
Charging the battery for emergency operation......................................20
When Julian is not in use........................................................................ 20
19
Before Using for the First Time
Contents
Before Using for the First Time
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Before Using for the First Time
Fit the enclosed O2 sensor, page 117 "Replacing O2 sensor" Fit the flow sensor, page 106
Charging the battery for emergency operation
Julian has a built-in uninterruptible power supply UPS which maintains the power supply for 30 minutes in the event of a mains failure, provided that the battery is charged. The switch-over to the battery-powered UPS is automatic and is indicated on the screen by the message: POWER FAIL!
The battery recharges automatically when the workstation is plugged into the mains.
The battery must be charged for 10 hours before using the Workstation for the first time.
● Plug the mains plug of the Julian workstation into the
mains socket. The mains voltage must correspond to the voltage specified on the nameplate.
1 The green LED
NN
NN
lights up.
● Leave Julian connected to the mains for 10 hours.
The workstation does not have to be switched on.
The devices connected to auxiliary power sockets will not be powered by the UPS in the event of a power failure.
When Julian is not in use
● Charge battery at least every 4 weeks.
Allowing it to run down can lead to damage.
If Julian is out of use for an extended period:
● Leave the workstation connected to the mains at all
times.
1 The green LED
NN
NN
is lit.
20
Before Using for the First Time Charging the battery for emergency operation When Julian is not in use
1
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Contents
Connecting the gas supply.....................................................................22
Connecting the backup gas cylinders for O2 and N2O .............................23
Caution when handling O2 cylinders.........................................................23
Connecting the anaesthetic gas scavenging system.............................23
Connecting the power supply.................................................................24
Connecting auxiliary systems....................................................................24
Equipotential bonding...............................................................................24
Connecting the power supply...................................................................24
21
Preparation
Contents
Preparation
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Preparation
Use only cleaned and disinfected parts!
Connecting the gas supply
1 Screw the central gas supply pressure hoses for O2,
AIR and N2O into the ports on the back of the gas supply block. The two ports at the front are reserved for the backup gas cylinders.
2 The vacuum supply block (VAC) is available as option
for secretion aspiration. Plug the other end of the pressure hoses into the wall
supply points.
● Make sure the gas pressures of the central gas
supply are between 2.7 and 5.5 bar:
3 All three pressure gauges in the green zone.
22
Preparation Connecting the gas supply
N2O AIR O2 VAC
12
Julian
D
3
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Connecting the backup gas cylinders for O2 and N2O
Even if the workstation is connected to a central gas supply, the cylinders must remain on the apparatus as backup supply.
● On the back of the workstation:
place full cylinders in the cylinder holders and secure in position.
1 Screw the pressure reducing adapters onto the
cylinder valves.
2 Screw the gas hoses into the ports on the front of the
gas supply block.
Switch over immediately to cylinder supply if the central gas supply fails:
● Open the cylinder valves.
Caution when handling O2 cylinders
● Do not oil or grease the O2 cylinder valves or O2
pressure reducing adapters, and do not handle with greasy fingers.
Danger of explosion!
● The cylinder valves must be opened / closed by hand.
Do not use tools.
● If a cylinder valve is leaky or difficult to operate, it
must be repaired by an expert.
Connecting the anaesthetic gas scavenging system
3 Connect the transfer hose to the waste gas port and
to the port of the scavenging system.
4 Connect the scavenging hose to the port of the
scavenging system.
5 Connect the anaesthetic waste gas probe to the
aspirating hose.
6 Ensure that the second connection to the scavenging
system is sealed by a screw plug.
● Follow the Instructions for Use of the anaesthetic gas
scavenging system.
23
Preparation
Connecting the gas supply
Connecting the anaesthetic gas scavenging system
N2O
1
1
O2
22
6
3
3
5
4
3
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Connecting the power supply
Connecting auxiliary systems 1 connect to auxiliary sockets on the back of the
workstation.
The auxiliary sockets are not powered by the uninterruptible power supply UPS in the event of a power failure!
Do not connect HF surgical devices to the auxiliary sockets!
Connecting equipment to the auxiliary sockets may cause the patient leakage current to rise above the permitted values in the event of failure of a protective earth conductor. The risk of electric shock cannot be excluded in such cases. Additional power adapter sockets must not be connected to the auxiliary sockets.
Equipotential bonding
e.g. for intracardial or intracranial operations. 2 Connect one end of the earth cable to one of the
connecting pins on the back of the workstation.
● Connect the other end of the earth cable to the
specified equipotential bonding point, e.g. on the operating table or ceiling lamp.
Connecting the power supply
The mains voltage must be the same as specified on the nameplate on the back of the workstation. Voltage range: 90 to 265 V
● Plug the mains plug into the wall socket.
24
Preparation Connecting the power supply
1
2
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Contents
Checking the workstation against the checklist.................................... 26
Switching on............................................................................................26
Gas pressures.........................................................................................29
Central gas supply................................................................................... 29
Backup gas cylinders............................................................................... 29
Suction system.........................................................................................30
O2 flush .................................................................................................. 30
O2 emergency metering........................................................................... 30
Preparing Julian for the self-test................................................................31
Self-test...................................................................................................31
Electronics...............................................................................................31
Fresh gas mixer........................................................................................31
Ventilator and breathing system ...............................................................31
System compliance................................................................................ 32
Leakage...................................................................................................32
Emergency start......................................................................................33
25
Starting Up
Contents
Starting Up
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Starting Up
Checking the workstation against the checklist
Preconditions: The workstation must be prepared as described on pages 95 to 105 and assembled ready for operation as described on pages 106 to 111. The gas supply and power supply must be connected.
Switching on 1 Switch on Julian: press the power switch » «.
Version without rotary knob for O2 emergency metering:
After switching on, Julian delivers an O2 flow of 4 L/min for manual ventilation. This O2 flow is switched off automatically by Julian as soon as the »cancel test« key appears after acknowledging the checklist.
The opening screen appears with the current software version after about 10 seconds. Julian now loads its software and tests its internal memory.
The checklist is displayed after about 40 seconds.
● Check the components as instructed in the checklist
on the screen.
If the self-test has to be interrupted, e.g. for a quick start in an emergency:
● Acknowledge the checklist:
Press the rotary knob. After a few seconds, the »cancel test« softkey appears on the right-hand edge of the screen.
● Press the »cancel test« key. See "Emergency start"
on page 33 to continue.
Starting Up Checking the workstation against the checklist
26
Julian
D
1
Technology for life
SW-version 2.0
01. Nov. 98
Please wait !
Julian
Check-list Julian
Vapor Safety fill Vapor Mont Interlock system
Handwheel set to zero, fill level o.k. Stopper inserted and locked into position Vaporiser present and locked into position non used vapor blocked
Watertrap Gas scavenging system Breathing system Soda lime Emergency breathing bag
level ok ? connected and ready fir use complete and fixed in place no colour change present and functional
Central gas supply Back up cylinders Suction unit O
2
-Flush
O
2
pressure, AIR, N2O pressure, 2,7 bar
O
2
pressure > 50 bar, N2O pressure > 30 bar functional audible flow, breathing bag fills
Julian o.k. according to check-list? Please confirm !
Examine machine according to check-list prior to operation
Before commencing test, close y-piece, connect gas sample-line
and set APL valve to 30 mbar and "Man"
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
"Vapor" anaesthetic vaporizer (example: Vapor 19.3) Only use Vapor 19.3, Vapor 2000 or Devapor.
Follow the Instructions for Use for the particular vaporizer used.
1 Handwheel to "0" and engaged. 2 Filled to sufficient level. 3 Sealing slide valve inserted and screwed tight.
● The plug-in adapter must fit evenly on the connection
block.
4 The locking lever must point to the left = locked. 5 The unused Vapor unit must be locked by the
interlock slider (example: left-hand Vapor locked).
Water trap
● Remove water trap container by pulling downwards
and empty if necessary.
● Observe the hygiene regulations of the hospital.
● Replace container from below.
When using the "Waterlock" water trap
● See separate Instructions for Use
27
Starting Up
Checking the workstation against the checklist
33
4
5
4
1
2 2
1
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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AGS anaesthetic gas scavenging system 1 The transfer hose from the waste gas port must be
connected.
2 The scavenging hose must be connected;
the anaesthetic waste gas probe must be plugged into the Dräger wall socket and the indicator must be green.
3 The float must be between the two marks.
Breathing system
● Complete and engaged, with both valve discs
inserted, bellows fitted and hoses securely connected.
● Soda lime renewed, no violet discoloration.
28
Starting Up Checking the workstation against the checklist
3
21
2
1
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Emergency ventilating bag
Example: Dräger Resutator 2000
● Ready for operation.
Central gas supply Gas pressures: 1 All pressure gauges in the green zone.
Backup gas cylinders 2 Slowly open the cylinder valves.
Check the cylinder pressure gauges:
3 O2 pressure greater than 50 bar, 4 N2O pressure greater than 30 bar.
2 Reclose the cylinder valves.
29
Starting Up
Checking the workstation against the checklist
2
2
4
3
N2O O2
Julian
D
3
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Suction system 1 Switch to I. 2 Set suction pressure with rotary knob »Vac.«. 3 Block the secretion viewing window or kink the
suction hose.
4 Measure the suction pressure on the pressure gauge. 1 Switch to 0.
O2 flush 5 Press »O2 +« button. 6 The breathing bag inflates. 7 O2 flows from the Y-piece.
Version with rotary knob for O2 emergency metering 8 Turn on rotary knob »Safety O2« for O2 emergency
metering.
6 The breathing bag inflates. 7 O2 flows from the Y-piece. 8 Turn off rotary knob »Safety O2« for O2 emergency
metering again.
30
Starting Up Checking the workstation against the checklist
7
Julian
D
6
5
8
Julian
D
4
1
3
2
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Preparing Julian for the self-test
● Make sure that the breathing system is securely
connected.
1 Close the Y-piece = plug firmly on to the cone. 2 Ensure that the sample line is connected to the
Y-piece and to the water trap on the back of the workstation.
Self-test
If all points on the checklist are OK:
● Confirm = press the rotary knob.
The self-test is started. The self-test is run automatically and takes 3 to 4 minutes.
Julian carries out the following automatic tests and actions:
Electronics
– Testing and calibration of gas metering bench – Testing and calibration of O2 sensor – Testing of pressure sensor for airway pressure
measurement – Testing the flow sensor – Testing the battery – Activating the default settings for alarm limits,
monitoring parameters and the default settings of
the ventilator and fresh gas settings
Fresh gas mixer
– Testing of gas supply O2, N2O, AIR – Testing of gas inlet valves – Calibration of pressures sensors in the compressed
air supply – Testing of O2 emergency metering – Testing of fresh gas failure monitoring (optional)
Ventilator and breathing system
– Testing and calibration of PEEP/Pmax valves – Testing of safety valve – Testing of MAN/AUTO switch-over valve – Calibration of flow monitoring valve – Testing of time monitoring valve – Testing of bellows
31
Starting Up
Checking the workstation against the checklist
2
2
1
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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System compliance
Julian determines the current system compliance. Depending on the breathing hoses used, the system compliance is 5 to 6 mL/bar.
Leakage
Julian determines the current leakage of the breathing system and breathing hoses. The system tolerates leaks of up to 150 mL/min.
For leaks of more than 150 mL/min:
● Check the breathing system and repeat the leak test.
Display (example): A tick (✓) indicates that the relevant test point has been
completed successfully. The clock symbol uuuu indicates the test stage is currently in progress.
Malfunctions detected in the self-test and any gas failures are displayed on the screen. Some malfunctions can be accepted by confirming = pressing the rotary knob, for example no AIR supply (AIR FAILURE!!!). Other malfunctions need to be corrected before starting up the workstation, for example no O2 supply (O2 FAILURE!!!).
Julian switches to standby after the self-test. Display:
Starting Up Checking the workstation against the checklist
32
Self-test
electronics
freshgas mixer
ventilator and breathing system
system compliance
leakage
✓
✓ ✓
3.40 mL/mbar
20 mL/mbar
cancel test
delete trend
leakage test
config.
Julian
SW-version 2.0
01. Nov. 98
Standby
4.00
L/min
30
Operation with , or
MAN
SPONT
IPPV
PCV
O
2
%
Freshgas O2+N2O
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Emergency start
This procedure should only be used when there is no time for the self-test!
1 Switch on the workstation.
Version without rotary knob for O2 emergency
metering:
After switching on, Julian delivers an O2 flow of
4 L/min for manual ventilation.
Version with rotary knob for O2 emergency
metering: 2 Set rotary knob »Safety-O2« for O2 emergency
metering to the desired O2 flow.
Range 0 to 12 L/min.
● Wait for the software to be internally loaded and for
the electronics to be self-tested.
The checklist appears after about 40 seconds.
● Confirm the checklist: press the rotary knob.
After a few seconds, the »Cancel test« softkey is
displayed on the right-hand edge of the screen.
Display:
● Press the softkey »Cancel test«.
The apparatus only runs through a minimal test.
Julian is ready for operation about 1 minute after switching on. Calibration of the O2 sensor is complete after about 2 minutes.
The leakage and compliance test is not performed. The accuracy levels specified in the "Technical Data" cannot be guaranteed.
To prevent abuse of this facility, the self-test can only be cancelled 10 times in succession.
The self-test cannot be cancelled the next time that Julian is started and a complete self-test must be run through.
33
Starting Up
Emergency start
Julian
D
1
2
Self-test
electronics
freshgas mixer
ventilator and breathing system
✓
cancel test
39
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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The workstation switches to standby mode after completing the minimal test.
Display (example):
If no key is pressed in standby mode for two minutes, the standby screen is switched off and a screen saver with the Dräger logo is displayed instead.
To switch the standby screen on again:
● Press the rotary knob or any other key.
To start Julian:
Version with rotary knob for O2 emergency metering:
● Turn rotary knob for O2 emergency metering to 0.
● Select fresh gas setting and ventilation mode.
See »Operation«, page 36 onwards.
34
Starting Up Emergency start
delete trend
leakage test
config.
Julian
SW version 2.0
01. Nov. 98
Standby
2.00
L/min
100
Operation with , or
MAN
SPONT
IPPV
PCV
Freshgas O
2
O
2
%
First interruption of self-test
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Contents
Setting the fresh gas concentrations..................................................... 36
Adjustment ranges................................................................................... 36
Selecting the carrier gas...........................................................................36
Setting the O2 concentration....................................................................36
Setting the fresh gas flow.........................................................................37
Selecting the ventilation mode...............................................................37
MAN/SPONT ventilation mode.................................................................37
Manual ventilation.....................................................................................37
Spontaneous breathing.............................................................................37
IPPV ventilation mode...............................................................................40
Starting IPPV............................................................................................41
PCV ventilation mode...............................................................................43
Starting PCV............................................................................................44
Setting the Vapor unit.............................................................................46
Aspirating secretion................................................................................46
Changing patients...................................................................................47
Changing soda lime................................................................................47
Leakage test........................................................................................... 48
Ventilating children.................................................................................49
Connecting the breathing hoses...............................................................49
Using non-rebreathing systems..............................................................50
In the event of a power failure................................................................52
In the event of a gas failure....................................................................53
In the event of a Major Hardware Fault.................................................. 53
End of Operation.....................................................................................54
35
Operation
Contents
Operation
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Operation
Setting the fresh gas concentrations
The fresh gas settings are displayed in the Standby screen:
–»Fresh gas O2 + N2O«
or
»Fresh gas O2 + AIR« –O2 concentration »O2 %« – Fresh gas flow »L/min« The settings correspond to the configurable default
values after switching on and after entering standby mode. The fresh gas settings can be modified before selecting the ventilation mode. Fresh gas does not flow in standby mode. The fresh gas flow is not enabled until a ventilation mode has been started.
Adjustment ranges and default settings on delivery
Selecting the carrier gas 1 Press the »N2O« or »AIR« hardkey.
The yellow LED in the selected key flashes.
● Press the rotary knob to confirm. The yellow LED
lights up constantly.
The selected fresh gas components are displayed on the screen.
Setting the O2 concentration 2 Press the softkey »O2%«.
The key field is highlighted against a white background.
● Set and confirm the O2 concentration by means of the
rotary knob.
* Only in MAN/SPONT mode
Operation Setting the fresh gas concentrations
36
Julian
1
2
delete trend
leakage test
config.
Julian
SW-version 2.0
01. Nov. 98
Standby
4.00
L/min
30
Operation with , or
MAN
SPONT
IPPV
PCV
O
2
%
Freshgas O2+N2O
Fresh gas parameters
Adjustment range
Default setting
on delivery Carrier gas AIR or N2ON2O O2 % 25 to 100 100 Fresh gas flow
L/min
0* ; 0,5 to 12 2
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Setting the fresh gas flow 1 Press the softkey »L/min«.
The key field is highlighted against a light background.
● Set and confirm the fresh gas flow by means of the
rotary knob.
Julian is fitted with an electronic O2 minimum dosing system to avoid hypoxic gas mixtures. For fresh gas flow settings below 1 L/min, the O2 concentration is automatically increased to a value corresponding to an O2 flow of 250 mL/min. If this control system is activated, the O2 value is highlighted in addition to the active softkey »L/min«.
Version with fresh gas failure detection (optional): During operation, Julian checks that the bellows are sufficiently full.
If the message „Fresh gas ? !!“ appears:
● Increase the fresh gas flow
The default settings valid whenever Julian is switched on can also be modified; see "Setting default values" on page 82.
Selecting the ventilation mode
MAN/SPONT ventilation mode
Choose between manual ventilation MAN and sponta- neous breathing SPONT on the APL pressure-limiting valve.
Manual ventilation 2 Set the lever of the APL pressure-limiting valve to
MAN.
3 Set the pressure limit = rotate lever.
Spontaneous breathing 4 Set the lever of the APL pressure-limiting valve to
SPONT.
The valve is open for a free spontaneous breathing stroke regardless of the set pressure limit.
37
Operation
Setting the fresh gas flow
Selecting the ventilation mode
MAN/SPONT
Julian
1
MAN
MAN
3
2
SPONT
SPONT
4
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
1 Press the »MAN/SPONT« key, 2 and confirm with the rotary knob.
Display (example):
O2 flush
– For flushing and rapidly filling the breathing system
and breathing bag with O2 while bypassing the Vapor unit.
3 Press the »O2 +« button.
O2 flows into the breathing system without anaesthetic gas as long as the button is held down.
Operation Selecting the ventilation mode MAN/SPONT
38
Julian
1
2
Julian
D
3
MAN/SPONT
Pleth
40
0
CO
2
40 36
0.8 0.6 58 56
38
98 67
5.2 8
Start volumeter: Confirm !
O
2
SpO
2
N2O
Hal.
Fi
Fet
etCO
2
MV
freq
alarm limits
CO
2
-al.
on/off alarm
info list
curves
config.
Freshgas O
2
+ N2O
fresh gas
O
2
%
L/min
VT
0.35
0
Volumeter
--s
--
0510
0.5
1
_
CO
2
Ve
internal external
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
39
Operation
Selecting the ventilation mode
MAN/SPONT
Certain alarms are automatically switched off in MAN/SPONT ventilation mode in order to avoid artefacts. The deactivated alarms are identified by the grey back- ground in the table.
– – : The default setting on delivery is outside the
monitoring range and the corresponding alarm limit is switched off.
To set the values of the alarm limits during operation see page 60.
To set the default alarm limits see page 86.
Alarm limits in MAN/SPONT
mode
Default setting on delivery
SpO2 ON
ON
– –
92
Pulse
H
ON ON
120
50
etCO2 ON
ON
50 (mmHg)
– –
FiCO2 OFF
MV OFF
OFF
– – – –
FiO2 OFF
ON
– –
20
Fi Hal. ON
OFF
1.5 – –
Fi Iso. ON
OFF
2.3 – –
Fi Enf. ON
OFF
3.4 – –
Fi Des. ON
OFF
12.0 – –
Fi Sev. ON
OFF
3.4 – –
PAW ON
OFF
40
– – Apnoea pressure OFF Apnoea flow OFF Apnoea CO2
ON
activated after
60 seconds
_
_
_
_
_
_
_
_
_
_
_
>
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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IPPV ventilation mode IPPV = Intermittent Positive Pressure Ventilation
Volume-controlled ventilation with fixed mandatory minute volume (MV), set with the tidal volume (VT), breathing rate (Freq.) and the ratio of inspiration time to expiration (TI:TE ).
Presetting the ventilation parameters for IPPV 1 Press the »IPPV« hardkey; its LED flashes.
● The six ventilation parameters for IPPV are displayed
on the screen with their default settings.
2 Press the softkey for the desired ventilation
parameter.
3 Set and confirm the ventilation parameter with the
rotary knob.
Display (example):
Adjustment ranges and default settings on delivery
For tidal volumes VT of less than 200 mL:
● Use the paediatric hose set,
see "Ventilating children", page 49.
In IPPV ventilation mode, automatic system compliance compensation takes place, and the applied tidal volume therefore corresponds to the set volume.
* The default values can be set specifically for each hospital,
see page 82.
40
Operation Selecting the ventilation mode IPPV
Julian
2
3
1
Ventilation parameters Adjustment
range
Default setting on delivery *
Pressure limit Pmax [mbar]
10 to 70 25
Tidal volume VT [mL]
50 to 1400 600
Frequency Freq. [1/min]
6 to 60 12
Insp/Exp ratio TI : TE
2 : 1, 1 : 1, 1 : 2, 1 : 3, 1 : 4
1 : 2
Insp. pause time : Insp. time TIP : TI [%]
0 to 50 10
PEEP [mbar] 0 to 20 0
delete trend
leakage test
config.
Julian
SW- version 2.0
01. Nov. 98
Standby
To Start IPPV: Confirm !
4.00 30
600 12
1:2
10 0
25
O2 %
L/min
V
T
mL
PEEP
mbar
Freq.
1/min
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O2+N2O
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Starting IPPV 1 Press the »IPPV« hardkey 2 and confirm with the rotary knob.
Display (example):
The preset ventilation parameters are displayed on the screen.
The symbol rotates in the softkey »L/min« to indicate that fresh gas is flowing.
If a change in ventilation parameters is required:
● Press the corresponding softkey. Set and confirm the
ventilation parameter with the rotary knob.
41
Operation
Selecting the ventilation mode
IPPV
Julian
1
2
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Operation Selecting the ventilation mode IPPV
42
Alarms effective in IPPV mode
– – : The default setting on delivery is outside the
monitoring range and the corresponding alarm limit is switched off.
To set the values of the alarm limits during operation see page 60.
To set the default alarm limits see page 86.
Alarm limits In IPPV mode Default setting
on delivery
SpO2 ON
ON
– –
92
Pulse
H
ON ON
120
50
etCO2 ON
ON
50 (mmHg)
– –
FiCO2 ON Fixed upper alarm
limit 5 mmHg
MV ON
ON
– –
3.0
FiO2 ON
ON
– –
20
Fi Hal. ON
ON
1.5 – –
Fi Iso. ON
ON
2.3 – –
Fi Enf. ON
ON
3.4 – –
Fi Des. ON
ON
12.0 – –
Fi Sev. ON
ON
3.4 – –
PAW ON
ON
40
8
Apnoea pressure ON Active after
15 seconds
Apnoea flow ON Active after
15 seconds
Apnoea CO2 ON Active after
30 seconds
_
_
_
_
_
_
_
_
_
_
>
_
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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PCV ventilation mode PCV = Pressure Controlled Ventilation
In pressure controlled ventilation mode, the applied tidal volume depends on the ventilation parameters Pmax, insp. Flow, insp. Time, PEEP and the lung compliance. Changes in ventilation parameters or lung compliance influence the tidal volume and the MV minute volume must therefore be monitored constantly.
Presetting ventilation parameters for PCV 1 Press »PCV« its LED flashes.
● The five ventilation parameters for PCV appear on the
screen with the default settings.
2 Press the softkey of the relevant ventilation parameter. 3 Set and confirm the ventilation parameter with the
rotary knob.
Display (example):
Adjustment ranges and default settings on delivery
When ventilating infants weighing less than 20 kg:
● Use the paediatric hose set;
see page 49 "Ventilating children".
––––––––––– * The default settings can be set specifically for each hospital,
see page 82.
** Can be set by DrägerService.
43
Operation
Selecting the ventilation mode
PCV
1
Julian
2
1
3
Ventilation parameter Adjustment
range
Default setting on delivery*
Pressure limit Pmax [mbar]
(PEEP+1)
to 70
15
Frequency Freq. [1/min]
6 to 60 12
Insp./Exp. ratio [TI : TE]
2: 1, 1: 1, 1: 2,
1: 3, 1: 4
1 : 2
Insp. flow [L/min] 5 to 50 (75**) 30 PEEP [mbar] 0 to 20 0
Julian
SW version 2.0
01. Nov. 98
Standby
4.00
30
12
1:2
30 0
15
delete trend
leakage test
config.
To Start PCV : Confirm !
O2 % L/min
PEEP
mbar
Freq.
1/min
TI:TEInsp.Flow
L/min
Pmax
mbar
Freshgas O2+N2O
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
44
Operation Selecting the ventilation mode PCV
Starting PCV 1 Press »PCV«. 2 Confirm by pressing the rotary knob.
Display (example):
The preset ventilation parameters appear on the screen. Fresh gas flows, as indicated by the rotating symbol
in the softkey »L/min«. If a change in ventilation parameters is required:
● Press the relevant softkey. Set and confirm the
ventilation parameter with the rotary knob.
Julian
1
2
Pleth
PCV
CO
2
40
0
PAW
0
20
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
4.3 10
MV
freq
10
1:2
30 0184.0030
alarm limits
alarm info
list
curves
config.
PEEP
mbar
Freq.
1/min
TI:TEInsp. flow
L/min
Pmax
mbar
Freshgas O
2
+ N2O
O
2
%
L/min
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
45
Operation
Selecting the ventilation mode
PCV
Alarms effective in PCV mode
– – : The default setting on delivery is outside the
monitoring range and the corresponding alarm limit is switched off.
To set the values of the alarm limits during operation see page 60.
To set the default alarm limits see page 86.
Alarm limits In PCV mode Default setting on
delivery
SpO
2 ON
ON
– –
92
Pulse
H
ON ON
120
50
etCO2 ON
ON
50 (mmHg)
– –
FiCO2 ON Fixed upper alarm
limit 5 mmHg
MV ON
ON
– –
3.0
FiO2 ON
ON
– –
20
Fi Hal. ON
ON
1.5 – –
Fi Iso. ON
ON
2.3 – –
Fi Enf. ON
ON
3.4 – –
Fi Des. ON
ON
12.0 – –
Fi Sev. ON
ON
3.4 – –
PAW ON
ON
40
8
Apnoea pressure ON Active after
15 seconds
Apnoea flow ON Active after
15 seconds
Apnoea CO2 ON Active after
30 seconds
_
_
_
_
_
_
_
_
_
_
>
_
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Setting the Vapor unit
1 Lock the unused Vapor unit
= push lever fully in the direction of the unused Vapor (example: left-hand Vapor locked).
2 Press the O button and 3 set the handwheel to the required anaesthetic agent
concentration.
Aspirating secretion
● Swing the bottles forwards.
1 Set the switch to I. 2 Seal the "fingertip" or kink the suction hose and 3 Set the appropriate suction pressure for the patient
with the rotary knob »Vac.« and
4 check on the pressure gauge.
Observe the hygiene regulations of the hospital!
After aspirating
● Rinse the suction hose with the water purifier.
1 Set the switch to 0.
Julian
D
2
4
1
3
46
Operation Setting the Vapor unit Aspirating secretion
2
1
3
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Changing patients
To switch Julian to standby:
● Press the Standby key E and confirm with the
rotary knob.
The functions of the workstation are switched off. The set alarm limits are cancelled and the default alarm settings are valid again.
The default settings are loaded for dosing anaesthetic gas and for the ventilation parameters.
If the ventilation hoses have been changed:
● Perform a leakage test, page 48.
Changing soda lime
– If 2/3 of the absorber charge has turned violet. – If the inspiratory CO2 concentration FiCO2 equals
5 mmHg or more.
● Press the Standby key E and confirm by pressing
the rotary knob.
1 Raise the writing top. 2 Pull the catch and draw out the breathing system at
the same time.
3 Turn the absorber counterclockwise and pull it out
downwards.
● Drain the used soda lime and dispose of with
domestic waste.
● Fill the absorber with fresh soda lime up to the MAX
mark.
● Fit the absorber to the breathing system from below
and turn it clockwise as far as it will go.
● Push the breathing system inwards until it clicks into
place.
● Fold down the writing top.
47
Operation
Changing patients
Changing soda lime
1
2
MAX
3
delete trend
leakage test
config.
Julian
SW-version 2.0
01. Nov. 98
Standby
4.00
L/min
30
Operation with , or
MAN
SPONT
IPPV
PCV
O
2
%
Freshgas O2+N2O
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Leakage test
Must not be performed when a patient is connected to the workstation!
– When the soda lime has been changed
or
– when the breathing hoses have been changed.
1 Close the Y-piece = place firmly on the cone. 2 Ensure that the sample line is connected to the
Y-piece and to the water trap at the back of the workstation.
● Press the softkey »leakage«.
Julian performs the leakage test for IPPV/PCV, duration approx. 30 seconds. The breathing bag and its hose are not included in the test.
Display: After the test has been successfully completed, the clock
symbol disappears and Julian displays the values for leakage and system compliance for a few seconds. The results of the leakage test are continually displayed on the data screen.
To return to the standby screen:
● Press the rotary knob.
48
Operation Leakage test
2
2
1
Leakage test
System- compliance
Leakage
Please wait.
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Ventilating children
For tidal volumes VT of less than 200 mL:
● Use paediatric hoses.
Connecting the breathing hoses 1 Use Y-piece with connection for sample line.
● The inspiratory and expiratory
microbial filter 654 St should not be used – this reduces the system compliance.
2 Connect 0.5 L breathing bag with socket to the
breathing hose with the large connection sleeves. Slip the breathing hose over the angled socket. Hang the 0.5 L breathing bag onto the hook.
3 Slip the breathing hoses with the large sleeves onto
the inspiratory and expiratory sockets and connect the small sleeves to the Y-piece.
4 Connect the sample line to the Y-piece and water
trap.
● Set the sample rate to 200 mL/min, page 84.
If the measured gas is not recirculated:
● Increase the tidal volume VT in accordance with the
sample rate.
Volumeter function:
● Select »Child« scale, page 67.
To determine system compliance and leakage: 5 Firmly connect the Y-piece to the cone.
● Determine the system compliance and leakage,
see „Leakage test“ on page 48. Set a correspondingly higher tidal volume VT in accordance with the airway pressure PAW.
● Use PCV or IPPV ventilation mode.
49
Operation
Ventilating children
3
2
1
4
5
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Using non-rebreathing systems
Example: Bain system
● Prepare the Bain system in accordance with the
separate Instructions for Use.
For the specified monitoring of O2, CO2 and anaesthetic agents:
1 Screw the sample line to the Luer lock connection of
the mask manifold pipe and to the water trap on the back of the workstation.
For mask pipes without sample line connector:
● Place a T-piece with filter between the mask pipe and
fresh gas connection port.
or:
● where applicable, use the Luer lock connection of a
filter.
2 Connect the fresh gas hose of the Bain system to the
fresh gas outlet.
3 Connect the anaesthetic gas scavenging system AGS
to the Bain system.
● Note the Instructions for Use of the Bain system.
Display (example):
In MAN/SPONT ventilation mode:
● Press the softkey »Fresh gas internal/external«,
select »Fresh gas external« and confirm by pressing the rotary knob.
50
Operation Using non-rebreathing systems
3
2
1
MAN/SPONT
Pleth
40
0
CO
2
40 36
0.8 0.6 58 56
38
98 67
5.2 8
4.0030
Start volumeter: Confirm !
O
2
SpO
2
N2O
Hal.
Fi
Fet
etCO
2
MV
freq
alarm limits
CO
2
-al.
on/off alarm
info list
curves
config.
Freshgas O
2
+ N2O
fresh gas
O
2
%
L/min
VT
0.35
0
Volumeter
--s
--
0510
0.5
1
_
CO
2
Ve
internal external
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
51
Operation
Using non-rebreathing systems
Display (example): The airway pressure (PAW), minute volume (MV) and
frequency are not measured.
● Set the fresh gas flow. The fresh gas supply must be
at least twice the minute volume in order to prevent rebreathing.
Certain alarms are automatically switched off in order to avoid artefacts. The inactive alarm limits are highlighted by the grey background in the following table.
FRESHGAS EXTERNAL
CO
2
40
0
30 28
0.8 0.8 58 57
38
98 67
--
--
6.0030
Pleth
O
2
SpO
2
N2O
Hal.
Fi
Fet
etCO
2
MV
freq
CO
2 al.
on/off
alarm limit
alarm info
list
curves
config.
Freshgas O
2
+ N
2
O
O
2
%
L/min
fresh gas
_
CO
2
Ve
internal external
Alarm limits In external fresh
gas mode
Default setting on delivery
SpO2 ON
ON
– –
92
Pulse
H
ON ON
120
50
etCO2 ON
ON
50 (mmHg)
– –
FiCO2 ON Fixed upper alarm
limit 5 mmHg
MV OFF
OFF
– – – –
FiO2 OFF
ON
– – 20
Fi Hal. ON
OFF
1.5 – –
Fi Iso. ON
OFF
2.3 – –
Fi Enf. ON
OFF
3.4 – –
Fi Des. ON
OFF
12.0 – –
Fi Sev. ON
AUS
3.4 – –
PAW ON
OFF
40
– – Apnoea pressure OFF Apnoea flow OFF Apnoea CO2 ON
_
_
_
>
_
_
_
_
_
_
_
_
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Switch off the external fresh gas output:
● Press the softkey »Fresh gas internal/external« and
confirm by pressing the rotary knob. Julian switches over to MAN/SPONT ventilation mode or
● Press the »IPPV« or »PCV« key and confirm with
the rotary knob. Julian then switches over directly to controlled
ventilation via the original rebreathing system.
When changing from the external non-rebreathing system to the rebreathing system of the Julian:
● Reconnect the sample line to the Y-piece.
In the event of a power failure
Julian automatically switches over to the integrated uninterruptible power supply (UPS). If the battery is charged, operation will be maintained for an average of 30 minutes.
The message
POWER FAIL!
appears on the screen together with the remaining available battery capacity in
percent. Example:
JJ
JJ
95 %
If the battery is almost completely discharged, the message BATTERY LOW !!! appears on the screen.
In the event of a power failure if the battery is discharged, Julian switches over automatically to MAN/SPONT ventilation mode. The fresh gas mixer is deactivated.
Version without rotary knob for O2 emergency metering:
Julian automatically delivers an O2 flow of 4 L/min. This O2 flow bypasses the Vapor unit, and so the patient no longer receives any anaesthetic agent.
Version with rotary knob for O2 emergency metering:
● Set rotary knob »Safety-O2« for O2 emergency
metering to the desired O2 flow. Range 0 to 12 L/min. This O2 flow flows through the Vapor unit.
● Check Vapor unit setting.
● Ventilate patient manually!
Operation Using non-rebreathing systems In the event of a power failure
52
Julian
D
Pleth
IPPV
POWER FAIL !
alarm limits
95 %
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
J
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:T
I
%
25
Pmax
mbar
Freshgas O2+N2O
1.00
O
2
%
L/min
50
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
In the event of a gas failure
Julian activates an alarm if the O2 or AIR or N2O supply fails.
● Open the valve on the corresponding backup gas
cylinder on the rear of the workstation.
● Reconnect the central gas supply.
If there is no backup supply of gas available, Julian replaces the set gas mixture with AIR or O2:
Julian delivers 100 % AIR if the O2 supply fails. Julian delivers 100 % O2 if the N2O supply fails. Julian delivers 100 % O2 if the AIR supply fails.
The amount of fresh gas flow (L/min) remains constant. Fresh gas metering is still possible even in the event of
failure of one of the gases. For example, if the N2O supply fails, AIR can be selected as the carrier gas.
In the event of a Major Hardware Fault
such as the failure of the fresh gas mixer, the message:
SYSTEM FAULT!!!
will be displayed. In the event of total system failure including the screen,
an alarm will sound for about 30 seconds. In such cases Julian switches to MAN/SPONT ventilation mode.
Version without rotary knob for O2 emergency metering:
Julian automatically delivers an O2 flow of 4 L/min*. This O2 flow bypasses the Vapor unit, and so the patient no longer receives any anaesthetic agent.
Version with rotary knob for O2 emergency metering:
● Set rotary knob for O2 emergency metering to the
desired O2 flow. Range 0 to 12 L/min. This O2 flow flows through the Vapor unit.
● Check the Vapor unit setting.
● Ventilate the patient manually!
* Can be adjusted to up to 8 L/min O2 by DrägerService.
N2O O2
53
Operation
In the event of a gas failure
In the Event of a Major Hardware Fault
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
End of Operation
To switch Julian to Standby:
● Press the standby key E and confirm by pressing
the rotary knob. The workstation is now on standby. The fresh gas flow is switched off.
Manual ventilation is not possible!
The following default values are activated in standby mode: Fresh gas default values Ventilation parameters Alarm limits
To switch Julian off:
● Press the power switch » « down completely.
The apparatus is switched off after 10 seconds.
● Remove the gas supply probes from the wall sockets.
● Leave Julian plugged into the power supply in order to
charge the uninterruptible power supply (UPS).
To switch off the anaesthetic gas scavenging system AGS:
● Pull back the black sleeve on the connector of the
suction hose to release the connector.
Julian is equipped with a switch-off time-lag. The message "System will be closed down and switched off" appears for 10 seconds after pressing the main power switch. Julian can immediately be restarted by pressing the main power switch again during this time. The switch-off time-lag is not active during the self-test.
54
End of Operation
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Contents
Selecting the standard screen................................................................56
Selecting the data screen.......................................................................57
Selecting the trend screen..................................................................... 58
Zoom function..........................................................................................59
To delete the trend memory......................................................................59
Alarms.....................................................................................................60
Displaying and setting alarm limits............................................................ 60
Adapting limits – AutoSet......................................................................... 62
If an alarm occurs...................................................................................63
Alarm info................................................................................................64
CO2 alarms on /off................................................................................. 64
List display.............................................................................................. 65
Delete list.................................................................................................65
Selecting curves..................................................................................... 66
Using the volumeter function................................................................. 67
Starting the volumeter...............................................................................67
Configuring in operation.........................................................................68
Setting the monitoring functions................................................................69
Setting the pulse tone...............................................................................69
Setting the alarm sound............................................................................69
Selecting the scale...................................................................................69
Setting the measuring parameters............................................................ 70
Record.....................................................................................................71
Time.........................................................................................................71
Activating monitor defaults........................................................................71
Selecting alarms.....................................................................................72
Default..................................................................................................... 72
Alarm mode for the heart-lung machine HLM............................................73
Selecting the anaesthetic agent.............................................................74
Manual calibration...................................................................................75
SpO2 Measurement (optional).................................................................76
Sensor selection.......................................................................................76
C-lock-ECG synchronization (optional).....................................................77
Tips to prevent artefacts...........................................................................78
Applying the Durasensor DS-100 A..........................................................79
Airway temperature measurement (optional)..........................................80
55
Monitoring
Contents
Monitoring
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
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Monitoring
Selecting the standard screen
The standard screen is automatically displayed on the screen whenever a ventilation mode is selected (MAN/SPONT or IPPV or PCV). This page can always be selected during operation:
1 Press the Q key
or
2 Press the S key several times.
Display (example): The most important parameters are grouped together on
the right-hand side of the screen. Three curves are displayed on the left-hand side
(to select other curves, see page 66).
Measured values shown in grey
Calibration is performed automatically by Julian. The measured values are shown in grey until sufficient data are available and until the sensors have reached their operating temperature. In this way, Julian indicates that the accuracy of these data is still reduced in comparison with the "Technical data". For maximum accuracy the sensors can be calibrated manually – see page 75.
When measuring CO2, anaesthetic agent and N2O, their numerical values are shown in grey during the warm-up phase whenever the workstation is switched on.
The display CAL appears instead of the numerical value during automatic calibration of the O2 sensor (every 24 hours).
The flow sensor is automatically calibrated as soon as a CO2 signal is detected by the gas measuring system. Julian takes account of the relevant gas mixture when calculating the volumetric concentrations.
Monitoring Selecting the standard screen
56
Julian
2 1
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Selecting the data screen
● Press the S key several times until the data page
appears. Display (example): All numerical values are displayed on the data screen
with their units of measure. The bar display on the left of the screen shows the change in airway pressure PAW over time. The lines cutting across the bar graph mark the upper and lower alarm limits. To set the alarm limits for PAW, see page 60.
The system compliance (Sys.-Compl.) and leakage are displayed in the right-hand field, together with the time of the last test.
57
Monitoring
Selecting the data screen
IPPV
PAW
40
20
0
600 10
1:2
10 0251.0050
O
2
%
N
2
O
%
Hal. %
036
40 33
0.8 0.6 58 56
Fi
Fet
CO
2
mmHg
98 67
6.0
0.60 10
27 20
5 15 65
MV V
T
freq
peak plat. PEEP mean compliance
mbar
mL/mbar
L/min L
34
AW-temp.
°C
1/min
01. Nov. 98
sys. comp. 6.40 mL/mbar leckage 10 mL/min
01-10
8 : 00
12 : 00
SpO
2
%
1/min
alarm limits
auto set limits
alarm info
list
config.
Freshgas O
2
+ N2O
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Selecting the trend screen
Displays the measured values over time since the start of measurement.
Maximum storable time: 8 hours. The following display combinations can be selected:
– CO2/MV – AGas/N2O –O2/compliance* – SpO2/pulse rate
● Press the S key several times until the trend screen
appears.
AMV and compliance trends are scaled in accordance with the setting in the configuration menu for adults or children.
AMV trend scale: 0 to 3 L/min for children
0 to 15 L/min for adults Compliance trend scale: 0 to 20 mL/mbar for children
0 to 100 mL/mbar for adults
Display (example): Trend CO2 and MV
Selecting other display combinations
● Press the appropriate softkey:
»AGas N2O« or »O2 compl.« or »SpO2 pulse«
The softkey disappears if a measuring function is not available.
____________ * Lung properties can be monitored continuously with the compliance
trend display so that ventilation can be adjusted accordingly. Patient compliance is not measured in MAN/SPONT ventilation mode.
58
Monitoring Selecting the trend screen
IPPV
40 36
0.8 0.6 58 56
38
98 67
6.0 10
600 10
1:2
10 0251.0050
PAW
40
20
0
11:00 12:00 13:00
60
30
0
15
10
5
0
Select zoom area:
Turn !
Zoom in: Press !
CO
2
MV
O
2
SpO
2
N2O
Iso.
Fi
Fet
etCO
2
MV
freq
alarm limits
AGas N
2
O
CO
2
MV
O
2
compl. SpO
2
pulse full
trend
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N2O
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Zoom function
The trend display can be magnified with the zoom function after half-an-hour of operation.
To select the range:
● Turn the rotary knob = the dashed frames move.
To enlarge the selected area to the full width of the display:
● Press the rotary knob.
A new dashed frame appears after a corresponding period of operation and can also be enlarged.
To return to the overall trend:
● Press the softkey »full trend« and the complete trend
is displayed again.
To delete the trend memory Only possible in standby mode.
The trend memory and list are deleted together!
In standby mode:
● Press the softkey »delete trend«.
The system asks you to confirm that the trend is really to be deleted.
To delete:
● Press the softkey »delete«.
The stored trend for the anaesthetic gas concentration is deleted automatically when a new anaesthetic gas is selected.
59
Monitoring
Selecting the trend screen
IPPV
40 36
0.8 0.6 58 56
38
98 67
6.0 10
600 10
1:2
10 0251.0050
PAW
40
20
0
11:00 12:00 13:00
60
30
0
15
10
5
0
Select zoom area:
Turn !
Zoom in: Press !
CO
2
MV
O
2
SpO
2
N2O
Iso.
Fi
Fet
etCO
2
MV
freq
alarm limits
AGas N
2
O
CO
2
MV
O
2
compl. SpO
2
pulse full
trend
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N2O
_
CO
2
Ve
delete trend
leakage test
config.
Julian
SW-version 2.0
01. Nov. 98
Standby
4.00
L/min
30
Operation with , or
MAN
SPONT
IPPV
PCV
O
2
%
Freshgas O2+N2O
do not delete
config.
Julian
SW-version 2.0
01. Nov. 98
Standby
4.00
L/min
30
Operation with , or
MAN
SPONT
IPPV
PCV
O
2
%
Freshgas O2+N2O
delete
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Alarms
Displaying and setting alarm limits
Alarms can be displayed and set from all three basic screens (standard, data and trend screen) during operation.
The default alarm limits for the ventilation mode are activated automatically when changing from standby to a ventilation mode.
These default alarm limits can be used unchanged or they can be set individually for the patient.
The individual settings are deleted on changing from ventilation mode to standby and the default alarm limits are reactivated.
To call up alarm limits:
● Press the softkey »alarm limits«.
Display (example): The measured values and their alarm limits are shown on
the right-hand side. The curves with the alarm limits represented by dashed lines are shown on the left.
Example etCO2: The upper alarm limit (42 mmHg) and the lower alarm limit (30 mmHg) are shown alongside the measured value (38 mmHg).
A deactivated alarm limit is indicated by two dashes (– –).
To set an alarm limit:
● Place the cursor bar on the alarm limit by turning the
rotary knob and press to confirm. The alarm limit is highlighted.
● Set the new value by turning the rotary knob and
press to confirm. The new alarm limit is now effective. The cursor bar returns to the zzzz symbol.
Monitoring Alarms
60
Pleth
IPPV
CO
2
40
0
600 10
1:2
10 0251.0050
98 67 38
6.0 29
0.8
--
95
3.0
--
20
1.0
0.0 40
8
120
50
--
Adjust limit value: Turn and confirm !
42
30
PAW
0
20
FiO
2
FiHal.
PAW
SpO
2
etCO
2
MV
alarm limits
auto set limits
alarm info
list
curves
config.
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O2 + N2O
38
42
30
etCO
2
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Adjustment range of the alarm limits
To quit the alarm limits menu:
● Press the rotary knob
or
● Press the Q key.
61
Monitoring
Alarms
Alarm limit Adjustment range SpO2
[%]
51 to 100
50 to 99
Pulse
H
[1/min]
21 to 250 20 to 249
etCO2 [mmHg]
1 to 75 0 to 74
MV [L/min]
0.1 to 39 0 to 38.9
FiO2 [Vol.%]
19 to 100
18 to 99
Fi Hal. [Vol.%]
0.1 to 7 0 to 6.9
Fi Iso. [Vol.%]
0.1 to 7 0 to 6.9
Fi Enf. [Vol.%]
0.1 to 7 0 to 6.9
Fi Des. [Vol.%]
0.1 to 21.9 0 to 21.8
Fi Sev. [Vol.%]
0.1 to 9.9 0 to 9.8
PAW [mbar]
5 to 98 0 to 35
_
_
_
_
_
_
_
_
_
_
_
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Adapting limits – AutoSet
When the ventilation settings have been made, Julian can automatically adapt the alarm limits for the minute volume (MV) and airway pressure (PAW) to the current ventilation settings in IPPV mode.
● Press the softkey »auto set limits«.
The new alarm limits for the set MV and PAW are calculated by Julian as follows:
To reset individual alarm limits for MV and PAW:
● See "Displaying and setting alarm limits"
on page 60.
To reuse all default alarm limits:
● See "Configuring in standby mode,
setting default alarm limits" on page 72.
62
Monitoring Alarms
Upper alarm limit Lower alarm limit
MV [L/min]
VT x f x 1.4 At least 2.0
VT x f x 0.6 At least 0.5
PAW [mbar]
(Pmax + 10) PEEP +
Pmax – PEEP
4
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
If an alarm occurs
Alarm messages are assigned to three priority classes by Julian, depending on their urgency, and identified by exclamation marks:
Warning !!! = message with top priority A warning message requires immediate action
Caution !! = message with medium priority A caution message requires prompt action
Advisory ! = message with lowest priority An advisory message requires to be noted and action taken if necessary
If several alarms occur simultaneously, Julian displays the alarm with the highest priority. The others are not displayed.
All warning, caution and advisory messages that have been emitted can be displayed by pressing the »alarm Info« softkey.
Each time an alarm message is displayed, the alarm lamp either flashes or lights up continuously and an audible tone sequence is emitted to indicate the alarm priority class:
Warning: 1 Red lamp flashes, accompanied by a continuous tone. Caution: 1 Yellow lamp flashes, accompanied by an intermittent
tone every 30 seconds.
Advisory: 1 Yellow lamp lights up continuously, accompanied by a
single tone.
The alarm tone can be suppressed for two minutes: 2 Press the G key and its yellow LED lights up. To reactivate the alarm tone: 2 Press the G key and its yellow LED goes out. A list of alarm messages can be found on page 120,
"Message – Cause – Remedy".
63
Monitoring
If an alarm occurs
Julian
2
1
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Alarm info
This function is used to list all active alarms / warnings in order of priority.
● Press and hold the softkey »alarm info«.
Display (example): Active alarms:
FIO2 <<
<<
!!!
Active warning: ETCO2 <<<< !!
The display only remains visible as long as the softkey is pressed.
CO2 alarms on /off
The alarm limits for etCO2, insp. CO2 and CO2 apnoea monitoring can be switched off with the softkey »CO2-al. on/off« in MAN/SPONT mode.
In this case, the symbol CO2 g appears alongside the measured end-expiratory CO2 concentration.
The CO2 alarm limits are reactivated by pressing the softkey again. The deactivated CO2 alarm limits are reactivated automatically when changing to a different ventilation mode.
The CO2 alarm limits can also be activated and deactivated under "Alarm limits" in the configuration screen in all ventilation modes, see page 72.
National and European standards require a minimum monitoring with alarm function. These standards may not be met if the alarm function of the etCO2 monitoring parameter is deactivated.
Monitoring CO2 alarms on/off Alarm info
64
Pleth
IPPV
CO
2
40
0
PAW
0
20
600 10
1:2
10 0251.0050
ETCO2 !!
FIO2 !!!
FIO2 !!!
alarm limits
auto set limits
alarm info
list
curves
config.
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N
2
O
MAN/SPONT
CO
2
40
0
40 36
0.8 0.6 58 56
38
98 67
5.2 8
4.0030
VT
0.35
0
Volumeter
--s
Start volumeter:
Confirm !
--
05
10
0.5
1
Pleth
SpO
2
etCO
2
freq
MV
O
2
Hal.
N
2
O
Fi Fet
alarm limits
CO
2-al.
on /off
alarm Info
list
curves
config.
O
2
%
L/min
Freshgas O
2
+ N
2
O
fresh gas
_
CO
2
Ve
internal external
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
List display
Record of measured values, alarms and ventilation modes to facilitate compilation of the anaesthetic record. The control criteria for entries can be configured, see "Record" on page 71.
● Press the softkey »list«.
Display (example):
"Open" the previous page:
● Select »previous page« by turning the rotary knob
and press to confirm.
"Open" the next page:
● Select »next page« by turning the rotary knob and
press to confirm.
Return to the standard page:
● Place cursor on the zz
zz
symbol by turning the rotary
knob and press to confirm.
or
● Press the Q key.
Delete list The list and trend memory are deleted together!
Only possible in standby!
In standby:
● Press the softkey »delete trend«.
Delete trends and list:
● Press the softkey »delete«.
65
Monitoring List display
IPPV
next page previous page
alarmtime HR/Puls NiBP/mmHg
Sys/M/Dia
SpO2 etCO2 MV O2
Fi/Fet
AGAS Fi/Fet
PAW Peak/Peep
99 98 99
40 38 40
6.0
5.9
6.1
30/26 25/20 30/26
1.6/0.6
0.8/0.7
0.8/0.7
33/10 30/10 30/10
FI HAL FI O2
12:13 12:15 12:20
65 65 66
!!! !!!
600 10
1:2
10 0251.0050
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N2O
PAW
40
20
0
delete trend
leakage test
config.
Julian
SW-version 2.0
01. Nov. 98
Standby
4.00
L/min
30
Operation with , or
MAN
SPONT
IPPV
PCV
O
2
%
Freshgas O2+N2O
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Selecting curves
Only possible from the standard screen! Three curves can be selected and positioned for the
momentary ventilation mode in this menu. The following curves can be selected: AGas Curve of anaesthetic agent concentration at
the Y-piece
CO2 Curve of CO2 concentration at the Y-piece Flow Expiration flow O2 Curve of O2 concentration at the Y-piece PAW Airway pressure Pleth The plethysmogram derived from SpO2
measurement (optional)
Volumeter A display mode showing the minute volume
and tidal volume VT as bar graphs
Pressures Digital indication of the measured value for
PPEAK, PPLAT, PMEAN and PEEP
blank Blank field
● Press the softkey »curves«.
Display (example): The names of the curves in each curve field are displayed
together with the choice of possible parameters. The current curves are highlighted by a grey background.
In the example, the PAW curve is to be replaced by the volumeter display.
● Turn the rotary knob to select the required
parameter (»volumeter« ) and press to confirm.
The cursor jumps to the zzzzsymbol of the positioning menu.
● Select the desired position with the rotary knob and
press to confirm. Display (example): The curve is replaced and the cursor returns to the zz
zz
symbol in the selection menu. To return to the standard page:
● Press the rotary knob.
If a curve field is to remain blank:
● Select »blank« with the rotary knob and
press to confirm.
66
Monitoring Selecting curves
Pleth
IPPV
40 36
0.8 0.6 58 56
38
98 67
6.0 10
600 10
1:2
10 0251.0050
Select curve: Turn and confirm !
SpO
2
etCO
2
freq
MV
O
2
Hal.
N
2
O
Fi Fet
alarm limits
auto set limits
alarm info
list
curves
config.
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N2O
CO
2
PAW
Flow
Volumeter
Pleth
O
2
AGas
blank
CO
2
PAW
Pleth
Pressures
_
CO
2
Ve
Pleth
IPPV
40 36
0.8 0.6 58 56
38
98 67
6.0 10
600 10
1:2
10 0251.0050
Select curve position: Turn and confirm !
SpO
2
etCO
2
freq
MV
O
2
Hal.
N
2
O
Fi Fet
alarm limits
auto set limits
alarm info
list
curves
config.
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N2O
CO
2
Volumeter
Pleth
CO
2
PAW
Flow
Volumeter
Pleth
O
2
AGas
blank
Pressures
_
CO
2
Ve
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Using the volumeter function
To observe and assess ventilation in manual and pressure controlled ventilation modes and during spontaneous breathing.
➀ Upper bar:
Current tidal volume VT, preceded by the numerical value.
➁ Lower bar:
Volumeter (minute volume measurement), preceded by the numerical value.
The scale of the bar display depends on the default setting, see "Configuring in operation, selecting the scale" on page 69 and "Configuring in standby mode, selecting the scale" on page 83.
Starting the volumeter
● Press the rotary knob.
The values are deleted and volumeter restarted if the rotary knob is pressed again before 60 seconds have elapsed.
The elapsed time in seconds is displayed above the bar with the summed volume on the left. The individual breaths are separated by segments in the bar. The volumeter stops automatically with an acoustic signal after 60 seconds. The measured values are displayed for 4 minutes and then erased.
67
Monitoring
Using the volumeter function
Setting Tidal volume VT
in L
Minute
volume MV
in L/min
Scale for children
0.2 2
Scale for adults
1.0 10
MAN/SPONT
Pleth
40
0
CO
2
40 36
0.8 0.6 58 56
38
98 67
5.2 8
4.0030
VT
0.35
0
Volumeter started. To re-start:
Confirm !
0.5
1
O
2
SpO
2
N2O
Hal.
Fi
Fet
etCO
2
MV
freq
alarm limits
CO
2
-al.
on / off alarm
info list
curves
config.
Freshgas O
2
+ N2O
O
2
%
L/min
Volumeter 46 s
4.1
05
10
fresh gas
_
CO
2
Ve
internal external
➀
➁
VT
0.35
0
0.5
1
Volumeter 46 s
4.1
05
10
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Configuring in operation
The configuration menus are used to select or modify individual monitoring functions for the measurements in progress. The settings entered here are only valid while measu- rement is in progress and are deleted on switching to standby mode.
In the standard screen (example) or data screen:
● Press the softkey »config.«.
Display (example): The softkeys for fresh gas and ventilation parameters
remain active. The values highlighted in grey represent the current
settings.
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
_
CO
2
Ve
Monitoring Configuring in operation
68
O2-Sensor 21 Vol.%
gas sensor
IPPV
anesth. agent
calibration
pulse tone alarm sound scale parameters record activate monitor defaults
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
alarms
600 10
1:2
10 0251.0050
settings
✓
✓
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N
2
O
selection auto man
default
CO
2
on off
SpO
2
on off
HLM on off
Isoflurane
PAW
40
20
0
The anesthetic agent is automati- cally selected by gas identification
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Setting the monitoring functions
● Select the »settings« column by turning the rotary
knob and press to confirm.
Display (example):
Setting the pulse tone 0 = OFF
9 = Maximum volume
● Select the line »pulse tone« by turning the rotary knob
and press to confirm. The cursor automatically jumps to the last value selected (in the example: setting 5).
● Set the value with the rotary knob and press to
confirm.
Setting the alarm sound 1 = Minimum volume
9 = Maximum volume
● Select the line »alarm sound« by turning the rotary
knob and press to confirm. The cursor automatically jumps to the last value selected (in the example: setting 4).
● Set the value with the rotary knob and press to
confirm.
Set a sufficiently loud alarm sound!
The audible »NO O2« and »NO FRESH GAS« alarms are always sounded at maximum volume.
Julian complies with national regulations in certain countries that stipulate a minimum volume of 45 dB (A). Settings 1 to 4 are programmed at 45 dB (A) for these countries.
Selecting the scale
To adapt the scale for the volumeter function and trend curve.
● Select the line »scale« with the rotary knob and press
to confirm.
● Select »adult« or »child« with the rotary knob and
press to confirm.
69
Monitoring
Configuring in operation
Setting the monitoring functions
O2-Sensor 21 Vol.%
gas sensor
IPPV
anesth. agent
calibration
pulse tone alarm sound scale parameters record activate monitor defaults
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult. child
alarms
600 10
1:2
10 0251.0050
✓
✓
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N
2
O
selection auto man
Standard
CO
2
on off
SpO
2
on off
HLM on off
Isoflurane
PAW
40
20
0
The anesthetic agent is automati- cally selected by gas identification
settings
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Setting the measuring parameters
● Select the line »parameters« with the rotary knob and
press to confirm. The »parameters« menu appears in the left-hand field.
Display (example):
Switch SpO2 measurement (optional) on/off:
● Select the line »SpO2 measurement« with the rotary
knob and press to confirm.
● Select »on« or »off« with the rotary knob and press to
confirm.
Select the sample rate for gas measurement:
● Select the line »sample rate« with the rotary knob and
press to confirm.
● Select »60« or »200 mL/min« with the rotary knob
and press to confirm.
For paediatric use:
● Select a sample rate of 200 mL/min in order to obtain
more accurate values on account of the high frequen- cies and time constant of the measuring system.
● Recirculate the measured gas, see page 109.
If the measured gas is not recirculated:
● Increase the minute volume accordingly in order to
maintain the volume balance.
For adult use:
● Select a sample rate of 60 or 200 mL/min.
Recommendation: select 200 mL/min and recirculate the measured gas, see page 109.
Set CO2 unit:
● Select the line »CO2 unit« with the rotary knob and
press to confirm. The last value selected is highlighted by a grey background.
● Select the required unit of measure by turning the
rotary knob and press to confirm.
IPPV
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
600 10
1:2
10 0251.0050
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N
2
O
PAW
40
20
0
settings
puls tone alarm sound Scale
parameter
record activate monitor defaults
SpO2-measure. sample rate CO
2
unit
on off
60 200 mL/min
mmHg kPa vol%
Menu for configuration of measurement parameters.
anesth. agent
calibration
alarms
70
Monitoring Configuring in operation Setting the monitoring functions
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Record
This function is used to determine the type of event that triggers an entry in the record list or a printout on the connected logging printer.
● Select the line »record« with the rotary knob and
press to confirm. The »record« menu appears on the left-hand side.
Display (example):
Time interval-started (min)
A list entry is activated after a fixed time interval in minutes.
NiBP-started An entry is made after every NiBP measurement with new measured values. This entry can be read by an external Dräger monitor via the MEDIBUS interface.
warning-started An entry is made whenever an alarm is triggered.
caution-started An entry is made whenever a caution message is triggered.
● Turn the rotary knob to select the event triggering the
entry and press to confirm.
Activating monitor defaults
This function is used to activate the default monitoring settings configured in standby mode and active whenever the apparatus is switched on.
● Select the line »activate monitor defaults« with the
rotary knob and press to confirm.
IPPV
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
600 10
1:2
10 0251.0050
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N
2
O
PAW
40
20
0
settings
puls tone alarm sound Scale parameter
record
activate monitor defaults
Menu for configuration of measurement parameters.
list entry: time intervall (min) NiBP started warning started caution started
printer entry: time intervall (min) NiBP started warning started caution started
12510 off
on off on off
on
off
12510 off
on
off
on off
on
off
anesth. agent
calibration
alarms
71
Monitoring
Configuring in operation
Setting the monitoring functions
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Selecting alarms
● Turn the rotary knob to select the column »alarms«
and press to confirm.
Default
This function is used to activate the default alarm limits set in the standby configuration which are effective whenever the apparatus is switched to standby.
Setting default alarm limits:
● Select the »default settings« menu by turning the
rotary knob and press to confirm. See page 86 for the further procedure.
CO2 alarms on/off
To activate / deactivate all CO2 alarms, including the
apnoea alarm.
● Turn the rotary knob to select »CO2 on« or »CO2 off«
and press to confirm.
SpO2 alarms on/off
To activate/deactivate all SpO2 alarms.
● Turn the rotary knob to select »SpO2 on« or »SpO2
off« and press to confirm.
Deactivated alarms are indicated by the symbol _ in the measurement field.
National and European standards require minimum monitoring with alarm function. These standards may not be met when the alarm function of the monitoring parameter etCO2 or SpO2 is deactivated.
72
Monitoring Configuring in operation Selecting alarms
O2-Sensor 21 Vol.%
gas sensor
IPPV
anesth. agent
calibration
pulse tone alarm sound scale parameters record activate monitor defaults
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult. child
600 10
1:2
10 0251.0050
✓
✓
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N
2
O
selection auto man
Standard
on off
SpO
2
on off
HLM on off
Isoflurane
PAW
40
20
0
The anesthetic agent is automati- cally selected by gas identification
settings
alarms
CO
2
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Alarm mode for the heart-lung machine HLM
HLM alarm mode can be used independently of the active ventilation mode for patient monitoring when using the heart-lung machine.
In HLM alarm mode, – all apnoea alarms are deactivated. – the gas concentrations are measured continuously
regardless of the respiratory phase.
– the SpO2 alarms are deactivated.
They are reactivated automatically when pulsations are detected by the apparatus again after switching off the HLM alarm mode.
Selecting HLM alarm mode
● Press the softkey »config«.
● Turn the rotary knob to select the column »alarms«
and press to confirm.
● Turn the rotary knob to select the line »HLM on« and
press to confirm.
● Display (example):
The lung is kept open with constant airway pressure.
HLM alarm mode can be switched off at any time:
● Press the softkey »HLM off«.
In standby mode, the HLM alarm mode is automatically deactivated.
73
Monitoring
Configuring in operation
Selecting alarms
MAN/SPONT HLM
CO
2
40
0
30 30
0.8 0.8
0.0 0.0
5
--
--
-.- --
6.0030
SpO
2
etCO
2
freq
MV
O
2
Hal.
N
2
O
Fi Fet
alarm limit
HLM off
alarm info
list
curves
config.
O
2
%
L/min
Freshgas O
2
+ AIR
PAW
0
20
fresh gas
_
internal external
_
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Selecting the anaesthetic agent
Julian automatically recognizes the anaesthetic gas used and switches measurement and monitoring of the anaesthetic gas concentration to the identified gas.
If a mixture of two anaesthetic agents is detected,
the system generates a caution message:
AGAS MIXTURE !!
The anaesthetic agent with the higher concentration is monitored and displayed. As long as a mixture of two anaesthetic agents is present (e.g. after changing the anaesthetic agent), the values of the anaesthetic agent concentration are displayed in grey = reduced accuracy.
Displays Fi and Fet give information about the anaesthetic agent mixture situation:
Fi display Fet display Situation grey light AGAS mixture
inspiratory only
grey grey AGAS mixture
inspiratory and expiratory
light grey AGAS mixture
expiratory only
light light No more AGAS mixture
The anaesthetic agent can also be selected manually:
● Turn the rotary knob to select the column »anasth.
agent« and press to confirm.
● Turn the rotary knob to select the line »man« and
press to confirm.
● Turn the rotary knob to select the column »gas« and
press to confirm.
● Turn the rotary knob until the required gas appears in
the display window. Press the rotary knob to confirm the selection.
The user is responsible for manual selection of the anaesthetic agent and for correctly filling of the anaesthetic vaporizer!
74
Monitoring Configuring in operation Selecting the anaesthetic agent
Pleth
IPPV
alarm limits
auto set limits
alarm info
list
curves
CO
2
40
0
PAW
0
20
config.
O
2
SpO
2
N2O
Hal.
40 36
0.8 0.6 58 56
Fi
Fet
etCO
2
38
98 67
6.0 10
MV
freq
600
V
T
mL
10
1:2
10 0
PEEP
mbar
Freq.
1/min
TI:TETIP:TI
%
25
Pmax
mbar
Freshgas O2+N2O
4.00
O
2
%
L/min
30
_
CO
2
Ve
O2-Sensor 21 Vol.%
gas sensor
IPPV
calibration
pulse tone alarm sound scale parameters record activate monitor defaults
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult. child
alarms
600 10
1:2
10 0251.0050
settings
✓
✓
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N
2
O
selection auto man
Standard
CO
2
on off
SpO
2
on off
HLM on off
Isoflurane
PAW
40
20
0
Confirm to select Isoflurane.
anesth. agent
gas
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Manual calibration
Julian calibrates its sensors automatically during operation. The message CAL appears instead of the current measured value during a calibration process. Calibration of the O2 sensor and zero calibration of the other gas sensors can be repeated manually, for instance if automatic calibration was unsuccessful.
● Turn the rotary knob to select the »calibration«
column and press to confirm.
● Select and confirm the appropriate line with the rotary
knob, for example: »O2-Sensor 21 vol.%«
The calibration process is started when the selection is confirmed. The clock symbol UUUU appears after the relevant line, i.e. calibration is in progress.
When calibration is complete, a tick (✓) appears instead of the clock symbol. A question mark (?) indicates that calibration must be repeated because the previous calibration was defective.
Other settings can already be made during the calibration process.
O2-Sensor 21 Vol.%
gas sensor
IPPV
anesth. agent
calibration
pulse tone alarm sound scale parameters record activate monitor defaults
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
alarms
600 10
1:2
10 0251.0050
settings
✓
✓
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N
2
O
selection auto man
default
CO
2
on off
SpO
2
on off
HLM on off
Isoflurane
PAW
40
20
0
The anesthetic agent is automati- cally selected by gas identification
75
Monitoring
Configuring in operation
Manual calibration
O2-sensor 21 Vol.%
gas sensor
IPPV
600 10
1:2
10 0251.0050
✓
O
2
%
L/min
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
Freshgas O
2
+ N
2
O
PAW
40
20
0
calibration
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Monitoring SpO2 Measurement
76
SpO2 Measurement (optional)
Sensor selection
Only use Nellcor sensors. Note the Instructions for Use of the sensors – incorrect positioning or use can cause tissue damage.
Select the sensor according to the following criteria: – Patient weight – Patient mobility – Possible application site – Patient perfusion – Duration of use
The following table listing the specific sensor types available and their characteristics is intended as an aid for selection.
OXISENSOR I-20, OXISENSOR D-20, DURASENSOR DS-100 A, OXISENSOR D-25 and OXISENSOR R-15 are registered trademarks.
–––––––––––––
1)
in unopened, undamaged packaging
Sensor type OXISENSOR OXISENSOR DURASENSOR OXISENSOR OXISENSOR
I-20 D-20 DS-100 A D-25 R-15
Age group Infants Children Adults Adults Adults
Patient 1 to 20 kg 10 to 50 kg >40 kg >30 kg >50 kg weight
Duration Short and long-term Short and long-term Short-term Short and long-term Short and long-term of use monitoring monitoring monitoring zeitüberwachung monitoring
Patient Limited Limited Immobile Limited Immobile mobility mobility mobility patients only mobility patients only
Preferred Toe Finger Finger Finger Nose measuring site
Sterility
1)
Sterile packaging Sterile packaging ____ Sterile packaging Sterile packaging
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● Select the appropriate sensor.
On the back of the Julian: 1 Swing the flap over the socket »SpO2« to the left and
insert the sensor plug.
C-lock-ECG synchronization (optional) If the patient is highly agitated or the arterial flow is very
low, the measurement signals of the SpO2 measurement can be improved with the C-Lock-ECG synchronization. In this case, Julian receives two separate signals that transmit the heart activity:
– An optical signal from the SpO2 sensor and – An electrical signal from the separate ECG monitor.
Julian uses the R-wave of the ECG signal to identify the pulse and to synchronize with the SpO2 measurement.
2 Channel the ECG signal of the ECG monitor with the
cable andyesck-plug to the back of the Julian (»Sync.« socket). See the "Technical data" on page 131 for the requirements for the electrical signal and plug layout.
In the event of a delayed ECG signal
Synchronization may be impaired if the ECG signal is delayed by more than 40 milliseconds to the QRS complex.
If you suspect a fault of this kind:
● Use the Julian without C-Lock-ECG synchronization.
1
77
Monitoring
SpO2 Measurement
2
EKG Monitor
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Monitoring SpO2 Measurement
78
Tips to prevent artefacts
Only use Nellcor sensors in the recommended positions, otherwise incorrect measurements and tissue damage may result.
Damaged sensors with exposed electrical contacts must not be used – danger of electric shock.
Used adhesive strips of the Oxiband-OXI-A/N and OXI-P/I sensor must not be reused, as they may not adhere properly. The strips must not be stretched unduly. Never use two strips together, as this may lead to venous pulsation and failure of the pulse signal.
High intrathoracic pressure, pressure on the thorax and other consecutive impairments of the venous flow can lead to venous pulsation with failure of the pulse signal.
The pulse signal may fail in the presence of shock, low blood pressure, severe vasoconstriction, major anaemia, hypothermia, arterial occlusion proximal to the sensor and asystolia.
The sensor must be protected from exposure to bright light (e.g. surgical lamps and direct sunlight), otherwise the pulse signal may fail or inaccurate results may be obtained.
The sensor should not be positioned on limbs together with an arterial catheter, sphygmomanometer cuff or intravascular venous infusion, otherwise the pulse signal may fail and measurement become inaccurate.
Measurement accuracy may be reduced in the presence of significant concentrations of dyshaemoglobins, such as carboxyhaemoglobin or methaemoglobin.
Intravascular dyes, such as methylene blue, may also impair measurement accuracy.
Electrocautery can impair the measuring accuracy; the leads and sensor should therefore be positioned as far away as possible from the electrocautery and its neutral electrode.
Sensor performance may be impaired and lead to inaccurate results if the patient moves violently. The sensor should be applied to a different site in such cases in order to reduce the risk of artefacts due to movement.
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Applying the Durasensor DS-100 A
Reusable sensor for short-term monitoring of relatively quiet patients weighing over 40 kg.
The sensor is preferably positioned on the index finger, although other fingers can also be used. The little finger should be used if the patient is particularly large or obese.
● Open the clip slightly and slide the sensor onto the
finger. The tip of the finger must touch the end and the soft padding should rest on the nail and tip of the finger. The lead should be on top of the finger.
● Ensure that the finger is not compressed or hurt by
the clip.
● Change the application site after not more than
4 hours in order to avoid a build-up of blood pressure (blocked circulation).
Follow the specific Instructions for Use when using other Nellcor sensors!
79
Monitoring
SpO2 Measurement
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Airway temperature measurement (optional)
Parts required: – Temperature sensor 84 05 371
– Y-piece with connection
for temperature sensor M 30 543 – T-piece 86 00 224 – Filter 86 00 225
1 Connect Y-piece to respiratory hoses. 2 Insert T-piece into Y-piece. 3 Insert filter into T-piece. 4 Insert temperature sensor into Y-piece.
5 Connect temperature sensor plug to »Temp.« socket
at the back of the workstation.
● The airway temperature is displayed in the data
section of the screen:
AW temp. XX °C
The upper alarm limit is fixed. If the airway temperature exceeds 40°C, the »AW Temp > !!!« alarm will be activated.
80
Monitoring Airway temperature measurement
4
3
2
1
5
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Contents
Setting default values.............................................................................82
Setting the pulse tone...............................................................................83
Setting the alarm sound............................................................................83
Selecting the scale...................................................................................83
Setting the measuring parameters............................................................ 84
Record.....................................................................................................85
Time.........................................................................................................85
Configuring the interfaces........................................................................ 85
Interface...................................................................................................86
Setting default alarm limits........................................................................86
Setting default alarm limits for anaesthetic agents.....................................86
Adjustment range for default alarm limits...................................................87
Configuring curves...................................................................................88
Setting basic configurations......................................................................88
IPPV default settings................................................................................ 90
PCV default settings.................................................................................90
Setting the fresh gas default settings........................................................91
Manual calibration...................................................................................92
100 Vol.% O2 calibration..........................................................................92
O2 linearity test........................................................................................ 93
Selecting anaesthetic agent...................................................................93
81
Configuring in Standby Mode
Contents
Configuring in Standby Mode
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82
Configuring in Standby Mode Setting default values
Configuring in Standby Mode
The default settings for the monitoring functions and the fresh gas and ventilation parameters can be configured in standby mode. The default settings for the monitoring functions and the choice of anaesthetic gas are valid whenever the apparatus is switched on. The default values for the alarm limits, fresh gas parameters and ventilation parameters are valid after each standby.
● Switch Julian to standby mode.
● Press the softkey »config.«.
Display (example):
The following settings can be made in the menu: – Default settings – Calibration – Anaesth. agent Fields highlighted by a grey background contain the
currently valid settings. The symbol zzzzindicates a return to the previous
menu level.
● Select, set and confirm the new settings with the
rotary knob.
Setting default values
Default values are valid whenever the apparatus is switched on. The default monitoring settings can be activated during operation with activate monitor defaults, see "Activating monitor defaults" on page 71.
● Select and confirm the default settings with the
rotary knob.
Display (example):
Standby / Configuration anesth. agent
calibration
default settings
O2-sensor 21 vol.%
gas sensor more
✓
✓
selection auto man
pulse tone alarm sound scale parameters record interfaces alarm limits curves basic configurations IPPV default settings PCV default settings fresh gas delivery
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
The anesthetic agent is automati- cally selected by gas identification
Isoflurane
These default settings are password protected. The default settings are active on start-up.
To change the default settings enter the password:
0123456789
Turn and confirm .
Standby / Configuration
default settings
* * *
anesth. agent
calibration
O2-sensor 21 vol.%
gas sensor more
✓
✓
selection auto man
The anesthetic agent is automati- cally selected by gas identification
Isoflurane
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The menu requests the user to enter a 4-digit password in order to prevent unauthorized tampering with the basic settings. This password is notified during system training. The function can be disabled by DrägerService if required.
● Turn the rotary knob to select the digits con-secutively
from the line provided and press to confirm. The pass- word is indicated underneath with asterisks (
* * * *
). The menu for selecting the default settings appears when the password has been entered correctly.
Display (example):
Setting the pulse tone (optional) 0 = OFF
9 = Maximum volume
● Select the line »pulse tone« by turning the rotary knob
and press to confirm. The cursor automatically jumps to the last value selected (example 5).
● Set the value with the rotary knob and press to
confirm.
Setting the alarm sound 1 = Minimum volume
9 = Maximum volume
● Select the line »alarm sound« by turning the rotary
knob and press to confirm. The cursor automatically jumps to the last value selected (example 4).
● Set the value with the rotary knob and press to
confirm.
Set a sufficiently loud alarm sound!
The audible »NO O2« and »NO FRESH GAS« alarms are always sounded at maximum volume.
Julian complies with national regulations in certain countries that stipulate a minimum volume of 45 dB (A). Settings 1 to 4 are programmed at 45 dB (A) for these countries.
Selecting the scale
To adapt the scale for the volumeter function and trend curve.
● Select the line »scale« with the rotary knob and press
to confirm.
● Select »adult« or »child« with the rotary knob and
press to confirm.
83
Configuring in Standby Mode
Setting default values
Standby / Configuration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
pulse tone alarm sound scale parameters record interfaces alarm limits curves basic configurations IPPV default settings PCV default settings fresh gas delivery
anesth. agent
calibration
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84
Configuring in Standby Mode Setting default values
Setting the measuring parameters
● Select the line »parameters« with the rotary knob and
press to confirm. The »parameters« menu appears in the left-hand field.
Display (example):
Switch SpO2 measurement (optional) on/off:
● Select the line »SpO2 measurement« with the rotary
knob and press to confirm.
● Select »on« or »off« with the rotary knob and press
to confirm.
Select the sample rate for gas measurement:
● Select the line »sample rate« with the rotary knob
and press to confirm.
● Select »60« or »200 mL/min« with the rotary knob
and press to confirm.
For paediatric use:
● Select a sample rate of 200 mL/min in order to obtain
more accurate values on account of the high frequen- cies and time constant of the measuring system.
● Recirculate the measured gas, see page 109.
If the measured gas is not recirculated:
● Increase the minute volume accordingly in order to
maintain the volume balance.
For adult use:
● Select a sample rate of 60 or 200 mL/min.
Recommendation: select 200 mL/min and recirculate the measured gas, see page 109.
Set CO2 unit:
● Select the line »CO2 unit« with the rotary knob and
press to confirm. The last value selected is highlighted by a grey background.
● Select the required unit of measure by turning the
rotary knob and press to confirm.
Standby / Configuration anesth. agent
calibration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
SpO2-measure. sample rate CO
2
unit
on off
60 200 mL/min
mmHg kPa vol%
default settings
Menu for configuration of measurement parameters.
pulse tone alarm sound scale
parameters
record interfaces alarm limits curves basic configurations IPPV default settings PCV default settings fresh gas delivery
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85
Configuring in Standby Mode
Setting default values
Record
This function is used to determine the type of event that triggers an entry in the record list or a printout on the connected record printer.
● Select the line »record« with the rotary knob and
press to confirm. The »record« menu appears on the left-hand side.
Display (example):
Time interval-started (min)
A list entry is activated after a fixed time interval in minutes.
NiBP-started An entry is made after every NiBP measurement with new measured values. This entry can be read by an external Dräger monitor via the MEDIBUS interface.
Warning-started An entry is made whenever an alarm is triggered.
Caution-started An entry is made whenever a caution message is triggered.
● Turn the rotary knob to select the event triggering the
entry and press to confirm.
Configuring the interfaces
Julian has three serial interfaces: COM1, COM2, COM3. COM2 and COM3 are configured as MEDIBUS* interfaces and COM1 as printer interface. The interfaces can be adapted to the connected equipment.
● Turn the rotary knob to select the line »interfaces«
and press to confirm.
The »interfaces« menu appears in the left-hand field. Display (example): COM2 is configured in the upper half of the menu and
COM1 and COM3 in the bottom half.
_____________ * MEDIBUS: Dräger communications protocol for medical equipment.
Standby / Configuration anesth. agent
calibration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
list entry: time intervall (min) NiBP started warning started caution started
printer entry: time intervall (min) NiBP started warning started caution started
12510 off
on off on off
on
off
12510 off
on
off
on off
on
off
Menu for configuration of list and printer entries.
pulse tone alarm sound scale parameters
record
interfaces alarm limits curves basic configurations IPPV default settings PCV default settings fresh gas delivery
Standby / Configuration anesth. agent
calibration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
Menu for configuration of Medibus and printer ports.
pulse tone alarm sound scale parameters record
interfaces
alarm limits curves basic configurations IPPV default settings PCV default settings fresh gas delivery
COM 2 (Medibus): baud rate parity data bits stop bits
COM 1 (printer), COM 3 (Medibus): config. of: baude rate parity data bits stop bits
1.2
9.6
even 8 1
COM 1 COM 3
1.2 2.4 4.8 9.6 19.2
even none
odd
7 8
1 2
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Configuring in Standby Mode Setting default values
86
Interface
Choice between configuration of COM2 or COM3.
Baud rate
Transmission speed (variable, see Instructions for Use of the equipment to be connected).
Parity
This display is invariable for MEDIBUS and is shown only for information.
Data bits
This display is invariable for MEDIBUS and is shown only for information.
Stop bits
This display is invariable for MEDIBUS and is shown only for information.
Setting default alarm limits
● Turn the rotary knob to select the line »alarm limits«
and press to confirm. The »alarm limits« menu appears in the left-hand field.
Display (example):
● Select and confirm the required alarm limit with the
rotary knob. The default alarm limit is highlighted against a white background.
● Set and confirm the value with the rotary knob. The
value is then displayed in normal mode. The cursor bar jumps to the next default alarm limit.
● Set the next default alarm limit as described above.
Setting default alarm limits for anaesthetic agents
● Turn the rotary knob to select the line
»anaesth. agent« and press to confirm. The corresponding menu is displayed.
Standby / Configuration anesth. agent
calibration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
Menu for configuration of default alarm limits.
pulse tone alarm sound scale parameters record interfaces
alarm limits
curves basic configurations IPPV default settings PCV default settings fresh gas delivery
--
95
40 30
120
50
3.0
--
--
20 40
8
SpO
2
etCO
2
MV Fi O
2
PAW
anaesth. agent
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87
Configuring in Standby Mode
Setting default values
Adjustment range for default alarm limits
Fixed alarm limits / times: FiCO2 Fixed upper alarm limit 5 mmHg
(deactivated in MAN/SPONT). Apnoea pressure after 15 seconds Apnoea flow after 15 seconds Apnoea CO2 after 15 seconds
(after 60 seconds in MAN/SPONT)
– – : The default value set on delivery is outside the
monitoring range and the corresponding alarm limit is therefore switched off.
The newly set default alarm limits are valid whenever the apparatus is switched on or started up from standby mode.
Certain alarm limits are switched off automatically in MAN/SPONT ventilation mode and when using the external fresh gas outlet: see tables, alarm limits for MAN/SPONT, page 39 and alarm limits for non-rebreathing systems, page 51.
Alarm limit Adjustment range Default value
set on delivery
SpO
2
[%]
51 to 100
50 to 99
– –
92
Pulse
H
[1/min]
31 to 300 30 to 299
120
50
etCO2 [mmHg]
1 to 75 0 to 74
50 (mmHg)
– –
MV [L/min]
0.1 to 39 0 to 38.9
12
3.0
FiO2 [Vol.%]
19 to 100
18 to 99
– –
20
Fi Hal. [Vol.%]
0.1 to 7 0 to 6.9
1.5 – –
Fi Iso. [Vol.%]
0.1 to 7 0 to 6.9
2.3 – –
Fi Enf. [Vol.%]
0.1 to 7 0 to 6.9
3.4 – –
Fi Des. [Vol.%]
0.1 to 21.9 0 to 21.8
12.0 – –
Fi Sev. [Vol.%]
0.1 to 9.9 0 to 9.8
3.4 – –
PAW [mbar]
5 to 98 0 to 35
40
8
_
_
_
_
_
_
_
_
_
_
_
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Configuring in Standby Mode Setting default values
88
Configuring curves
Three standard curves can be configured for each of the ventilation modes: MAN/SPONT, IPPV, PCV and Fresh gas external.
● Turn the rotary knob to select the line »curves« and
press to confirm. The selection menu appears in the left-hand field.
Display (example):
● Select the required ventilation mode with the rotary
knob:
The »Standard IPPV screen« has been selected in the example:
The currently selected parameters appear in the left-hand field, followed by the selection menu with the curves which can be selected.
● Select the required parameter in the selection menu
with the aid of the rotary knob and press to confirm. The parameter appears against a white background.
● Select and confirm the position of the new parameter
with the rotary knob. The corresponding position remains unused if »blank« is selected.
Setting basic configurations
for time, date, language and tone sequence.
● Turn the rotary knob to select the line
»basic configurations« and press to confirm. The selection menu appears in the left-hand field.
Display (example):
Standby / Configuration anesth. agent
calibration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
Screen configuration menu.
pulse tone alarm sound scale parameters record interfaces alarm limits
curves
basic configurations IPPV default settings PCV default settings fresh gas delivery
default curves Man./Spont. default curves IPPV default curves PCV default curves freshgas external
Standby / Configuration anesth. agent
calibration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
To select curve position: turn and confirm .
pulse tone alarm sound scale parameters record interfaces alarm limits
curves
basic configurations IPPV default settings PCV default settings fresh gas delivery
CO2
PAW
Pleth
default curves IPPV
CO
2
PAW
Flow
Volumeter
Pleth
O
2
AGas
blank
Pressures
Standby / configuration anesth. agent
Calibration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
Menu for setting time, date, language and tone sequence.
pulse tone alarm sound scale parameters record interfaces alarm limits curves
basic configurations
IPPV default settings PCV default settings fresh gas delivery
time
date language tone sequence
08 : 15 day month year 27 - 10 - 98
English (GB)
Dräger Euro-stand.
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Setting the date/time:
● Select and confirm the »time« line with the rotary
knob. The cursor bar marks the hours.
● Press the rotary knob to confirm and the value is
highlighted against a white background. It can now be adjusted and confirmed with the rotary knob. The minutes are adjusted and confirmed in the same way.
● Set and confirm the date as described above.
Setting the language of the display texts: The last language selected is highlighted by a grey
background. The following alternatives can be selected: English (GB) Swedish (SW)
French (F) Norwegian (N) German (D) Portuguese (P) Dutch (NL) Polish (PL) Italian (I) English (USA) Spanish (E) Japanese (Kanji) (JP) Danish (DK)
To change the language setting:
● Turn the rotary knob to select the line »language« and
press to confirm.
● Select and confirm the relevant country code with the
rotary knob. The texts in the menu now appear in the language selected.
Setting the tone sequence:
● Turn the rotary knob to select the line
»tone sequence« and press to confirm.
● Select and confirm either the Dräger alarm tone
sequence or the standard European alarm tone sequence.
89
Configuring in Standby Mode
Setting default values
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Configuring in Standby Mode Setting default values
90
IPPV default settings
● Select and confirm the line »IPPV default settings«
with the rotary knob. The softkeys for IPPV are displayed:
Display (example):
To modify the settings:
● Press the relevant softkey.
● Set and confirm with the rotary knob.
To return to the »default settings«:
● Press the rotary knob.
PCV default settings
● Select and confirm the line »PCV default settings«
with the rotary knob. The softkeys for PCV are displayed:
Display (example):
To modify the settings*:
● Press the relevant softkey.
● Set and confirm with the rotary knob.
To return to the »default settings« menu:
● Press the rotary knob.
_____________ * Maximum setting for Pmax: 30 mbar.
Standby / Configuration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
pulse tone alarm sound scale parameters record interfaces alarm limits curves basic configurations
IPPV default settings
PCV default settings fresh gas delivery
Modify default settings or confirm .
600 12
1:2
10 025
PEEP
mbar
Freq.
1/min
V
T
mL
TI:TETIP:T
I
%
Pmax
mbar
anesth. agent
calibration
O2-sensor 21 vol.%
gas sensor more
✓
✓
selection auto man
The anesthetic agent is automati- cally selected by gas identification
Isoflurane
Standby / Configuration
anesth. agent
calibration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
pulse tone alarm sound scale parameters record interfaces alarm limits curves basic configurations IPPV default settings
PCV default settings
fresh gas delivery
Modify default settings or confirm .
12
1:2
10 015
PEEP
mbar
freq.
1/min
TI:TEInsp. flow
L/min
Pmax
mbar
O2-sensor 21 vol.%
gas sensor more
✓
✓
selection auto man
The anesthetic agent is automati- cally selected by gas identification
Isoflurane
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Setting the fresh gas default settings
● Select and confirm the line
»fresh gas default settings« with the rotary knob. The softkeys for the fresh gas settings are displayed:
Display (example):
To modify the settings: 1 Press the keys »N2O« or »Air« to select the default
carrier gas and press the rotary knob to confirm.
2 Press the softkey »O2 %«.
Set the default O2 concentration with the rotary knob and press to confirm.
3 Press the softkey »L/min«.
Set and confirm the default fresh gas flow with the rotary knob.
To return to the »fresh gas default settings« menu:
● Press the rotary knob.
91
Configuring in Standby Mode
Setting default values
Julian
1
23
Standby / Configuration
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
default settings
pulse tone alarm sound scale parameters record interfaces alarm limits curves basic configurations IPPV default settings PCV default settings
fresh gas delivery
Modify default settings or confirm ! Carrier gas selection via hardkey.
2.00100
O
2
%
L/min
Freshgas O
2
anesth. agent
calibration
O2-sensor 21 vol.%
gas sensor more
✓
✓
selection auto man
The anesthetic agent is automati- cally selected by gas identification
Isoflurane
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Configuring in Standby Mode Manual calibration
92
Manual calibration
Julian calibrates its sensors automatically during opera- tion. The message CAL appears instead of the current measured value during a calibration process. Calibration of the O2 sensor and zero calibration of the other gas sensors can be repeated manually, for instance if automatic calibration was unsuccessful.
In standby / configuration mode:
● Turn the rotary knob to select the »calibration«
column and press to confirm.
● Select and confirm the appropriate line with the rotary
knob, for example: »O2-sensor 21 vol.%«
The calibration process is started when the selection is confirmed. The clock symbol Uappears after the relevant line, i.e. calibration is in progress.
When calibration is complete, a tick (✓) appears instead of the clock symbol. A question mark (?) indicates that calibration must be repeated because the previous calibration was defective.
To improve the measuring accuracy of high O2 concen- trations, an additional 100 vol% O2 calibration and a linearity test of the O2 sensor can be performed under the menu option »more«.
Other settings can already be made during the calibration process.
100 Vol.% O2 calibration
● Use a separate O2 source, e.g. O2 flowmeter.
O2 from the Julian breathing system is not suitable, as it still contains traces of anaesthetic gas.
● Unscrew the sample line from the Y-piece and place it
in the continuous flow of the O2 source.
● Turn the rotary knob to select the line
»O2-sensor 100 vol.%«
and press to confirm.
● Allow the O2 flow to continue flowing into the sample
line.
A tick (✓) appears after the field when calibration is complete.
● Screw the sample line back on to the Y-piece.
Standby / Configuration anesth. agent
calibration
default settings
O2-sensor 21 vol.%
gas sensor more
✓
✓
selection auto man
pulse tone alarm sound scale parameters record interfaces alarm limits curves basic configurations IPPV default settings PCV default settings fresh gas delivery
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
The anesthetic agent is automati- cally selected by gas identification
Isoflurane
✓
✓
Standby / Configuration
O2-sensor 21 Vol.%
gas sensor
more
O2-sensor 100 Vol.%
linearity test O
2
calibration
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O2 linearity test
● First perform the "100 vol.% O2 calibration".
Then:
● Turn the rotary knob to select the line
»linearity test O2«
and press to confirm.
After approx. 20 seconds:
● Display (example):
O2 21 vol.%
A display in the range between 18 and 24 vol.% is correct. If the display is outside this range, the O2 sensor is defective or spent (replace O2 sensor, see page 117).
Selecting anaesthetic agent
Julian automatically recognizes the anaesthetic agent used and switches measurement and monitoring of the anaesthetic agent concentration to the identified gas.
If »auto« is selected in the menu »anesth. agent«, the anaesthetic agent is selected automatically.
The anaesthetic agent can also be selected manually:
● Turn the rotary knob to select the column
»anaesth. agent« and press to confirm.
Under the »selection« line:
● Turn the rotary knob to select »man« and press to
confirm.
● Turn the rotary knob to select the line »gas« and press
to confirm.
● Turn the rotary knob until the required gas appears in
the display window. Press the rotary knob to confirm the selection.
● Check that the manually selected anaesthetic agent is
compatible with the Vapor unit.
The user is responsible for manual selection of the anaesthetic agent and for correctly filling the anaesthetic vaporizer!
93
Configuring in Standby Mode
Manual calibration
Selecting anaesthetic agent
Standby / Configuration
calibration
default settings
O2-sensor 21 vol.%
gas sensor more
✓
✓
pulse tone alarm sound scale parameters record interfaces alarm limits curves basic configurations IPPV default settings PCV default settings fresh gas delivery
0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9
adult child
selection auto man
Isoflurane
Confirm to select Isoflurane.
gas
anesth. agent
✓
✓
Standby / Configuration
O2-sensor 21 Vol.%
gas sensor
more
O2-sensor 100 Vol.%
linearity test O
2
calibration
First calibrate with 100 vol.% O
2
then expose sample-line to to ambient air for about 2 minutes !
O
2
21 Vol. %
If the displayed value is outside the range 18 to 24 vol.% O
2
the sensor is defective.
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
94
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Contents
Dismantling components........................................................................96
Dismantling sample line............................................................................96
Removing water trap container................................................................. 96
Removing breathing hoses........................................................................96
Removing microbial filters.........................................................................97
Dismantling the suction system.................................................................98
Dismantling the breathing system..............................................................99
Removing the flow sensor.........................................................................99
Removing the absorber and bellows.........................................................99
Opening the breathing system................................................................100
Dismantle the anaesthetic gas scavenging system AGS..........................100
Removing waste gas connector..............................................................101
Dismantling emergency ventilation bag................................................... 101
Disinfecting / cleaning / sterilizing...................................................... 102
Breathing system................................................................................... 102
Surfaces................................................................................................ 102
Flow-Sensor.......................................................................................... 102
Microbial filter 654 St.............................................................................103
Care list for Julian anaesthetic workstation......................................... 104
Assembling...........................................................................................106
Installing the breathing system................................................................106
Inserting the flow sensor........................................................................ 106
Installing the bellows..............................................................................107
Filling and installing the absorber............................................................107
Installing the breathing hoses................................................................. 108
Preparing the suction system..................................................................108
Connecting the measured gas recirculation system................................ 109
Fitting waste gas connector....................................................................110
Sample gas scavenging..........................................................................110
Fitting emergency ventilation bag............................................................111
Connecting the anaesthetic gas scavenging system AGS.......................111
95
Care
Contents
Care
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Care
Dismantling components
Dismantling sample line
● Unscrew the sample line from the Y-piece and water
trap on the back of the unit. The sample line is not reusable and can be disposed of with ordinary domestic waste.
Removing water trap container
● Pull the container of the water trap down and off, and
empty it.
Note the hygiene regulations of the hospital!
● Prepare the container of the water trap for disinfection
and cleaning in a washing machine.
When using the "Waterlock" water trap
● See separate Instructions for Use.
Removing breathing hoses
● Remove the breathing hoses and breathing bag.
● Dismantle Y-piece and connector.
● Prepare the breathing hoses, breathing bag and
Y-piece for disinfection and cleaning in a washing machine.
96
Care Dismantling components
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
● Do not damage the breathing hoses!
Always hold the hoses by the connection sleeve and not by the spiral ribbing when removing and connecting the breathing hoses, otherwise the spiral ribbing may be torn off the sleeve. Breathing hoses with damaged spiral ribbing can easily be kinked and interrupt ventilation! Always check the breathing hoses for damage prior to use. Damaged breathing hoses must not be used.
Removing microbial filters
On the sleeve of the microbial filter:
● Press together the surfaces marked »PRESS« and
pull the filter off the connection at the same time. Do not use force, otherwise the sleeve may be damaged.
● Prepare the microbial filter for conditioning in
accordance with the separate Instructions for Use.
97
Care
Dismantling components
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Dismantling the suction system 1 Remove the suction hose and vacuum hose. 2 Grip the silicone sleeve of the bottle cap and pull it
off.
3 Remove the secretion collecting bottle and flushing
bottle from the bracket and empty them.
Note the hygiene regulations of the hospital.
4 Remove the silicone sleeve from the lid of the
secretion collecting bottle.
5 Remove the overflow protection float from the rising
pipe. Store the parts together for disinfection and cleaning in a washing machine.
6 Replace the bacterial filter in the back panel of the
Julian – if soaked through or if contamination is suspected. The filter must be replaced at the latest every two weeks.
● The bacterial filter must be disposed of as infectious
special waste. It can be incinerated with little pollution at temperatures of more than 800 °C.
2
33
1
1
98
Care Dismantling components
4
5
6
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Dismantling the breathing system 7 Fold up the writing top. 8 Pull the catch and at the same time pull out the slot-in
module.
9 Hold breathing system by the handle and pull
upwards to remove.
Removing the flow sensor 1 Unscrew the expiration port. 2 Remove the flow sensor. The flow sensor cannot be disinfected / cleaned in a
washing machine, nor can it be sterilized in high- temperature steam.
● The flow sensor must be disinfected in 70 % ethanol
solution for approx. 1 hour. Leave the sensor to dry in air for at least 30 minutes, otherwise the remaining alcohol can damage the sensor when calibrated.
● The flow sensor can be reused as long as it can be
calibrated successfully.
Removing the absorber and bellows 3 Turn the absorber counterclockwise and pull it
downwards.
● Empty the soda lime; it can be disposed of with
ordinary domestic waste.
4 Remove the insert from the absorber. 5 Turn the container of the bellows counterclockwise
and pull it downwards.
6 Remove the bellows.
● Prepare the absorber, container of the bellows and
the bellows for disinfection and cleaning in a washing machine.
99
Care
Dismantling components
4
MAX
3
6
5
1
2
7
8
9
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
Opening the breathing system
– Weekly 1 Loosen the five sealing screws a quarter-turn with the
key supplied.
● Remove the cover.
2 Remove the two valve discs.
● Lift off the metal valve plate.
● Keep the valve discs in a cassette to protect them
against damage and prepare them for disinfection and cleaning in a washing machine.
● Prepare the housing parts for disinfection and
cleaning in a washing machine.
Dismantle the anaesthetic gas scavenging system AGS
3 Remove the scavenging hose. 4 Remove the transfer hose. 5 Remove the anaesthetic gas scavenging system.
● Prepare the individual parts for disinfection and
cleaning in a washing machine.
11
11
1
100
Care Dismantling components
2
2
5
4
4
3
"Only for internal use by Draeger. Not applicable as Instructions for Use!"
All manuals and user guides at all-guides.com
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