Gradian UAM Service manual
®
Universal Anaesthesia Machine®
Maintenance Manual
HOW TO GET HELP 1
GENERAL DESCRIPTION OF THE UNIVERSAL ANAESTHESIA MACHINE® 1-2
SPECIFICATIONS 2-5
COMPONENTS OF THE UAM® 6-10
UNPACKING AND PREPARING FOR USE 11-15
RECOMMENDED UAM MAINTENANCE SCHEDULE 15
FULL FUNCTION TEST 16-17
MAINTENANCE PROCEDURES 17
Cleaning or Replacing the Oxygen Concentrator Filter 17-18
Replacing the Oxygen Sensor 18
Removing and Replacing the Draw-Over Vaporizer 18-19
Cleaning the Halothane Vaporizer 19
Replacing the Fenton Balloon 20
Replacing the Control Screen Circuit Board 21
Replacing the Concentrator Loss of Power Alarm Battery 22
Removing the Concentrator 23-24
Installing the Concentrator 25
Replacing the Control Screen Battery 26
Removing, Inspecting and Cleaning the Pressure Relief Valve 27-30
PROBLEM SOLVING 31
MAIN PARTS 32-33
ILLUSTRATED PARTS 33-37
APPENDIX I: BREATHING CIRCUIT DIAGRAM 38
APPENDIX II: OXYGEN CONCENTRATOR FLOW DIAGRAM 39
APPENDIX III: ELECTRICAL DIAGRAM 40
APPENDIX IV: UAM SERVICE RECORD 41
APPENDIX V: UAM INSPECTION LABEL 42
APPENDIX VI: PRESSURE CONVERSIONS & COLOUR IDENTIFICATION FOR MEDICAL GASES 42-43
Copyright © 2013 by Gradian Health Systems, LLC. All rights reserved.
Gradian Health Systems, UAM and the Gradian logo are registered trademarks (®)
of Gradian Health Systems, LLC, registered in the United States.
Printed in the United States of America. Rev 1.0, P/N: 1974-005, December 2013 CE 0120.
The UAM is manufactured by OES Medical Ltd., Witney, Oxon, UK.
HOW TO GET HELP
HELP
AIL
A
EMAIL: service@gradianhealth.org
WEB: www.gradianhealth.org
PHONE: +1.212.537.0340
ADDRESS: Gradian Health Systems, 160 Fifth Avenue, 7th Floor, New York, NY 10010, USA
NOTE: For the latest UAM specifications and technical materials please visit us online at:
http://ww.gradianhealth.org/universal-anaesthesia-machine/
DESCRIPTION OF THE UNIVERSAL ANAESTHESIA MACHINE
The UAM® combines elements from both continuous flow and draw-over designs to provide a workstation that delivers
controlled anaesthesia in all hospital settings.
The breathing system is a low pressure (limited to 5 cm H2O) continuous flow system that defaults to a demand-flow (drawover) system when the supply fails. There are three one-way valves and a balloon operated inflating valve which provide this
uniquely versatile method of anaesthesia delivery.
Oxygen can be provided from a variety of sources, and if none of those sources is available the machine will automatically
draw in room air without the need for the user to change settings. The vaporizer provides calibrated delivery of anaesthetic
agent and the manual bellows ensures that safe assisted respiration can continue without requiring a high pressure gas
source.
The system has been designed to accept standard anaesthesia accessories such as the breathing circuit, oxygen sensor,
and standard connectors for the oxygen and nitrous oxide supplies. The UAM is also designed for simple field service. Most
components can be removed with standard tools and local technicians can install replacement parts without removing the
workstation from the hospital.
The UAM carries the CE Mark, having passed EU regulatory inspections. It is manufactured in an ISO-certified factory in
England. It is used in a wide variety of hospitals, from internationally recognized academic centres to resource-constrained
district hospitals.
The Universal Anaesthesia Machine ensures that an adequate supply of oxygen and anaesthesia is always available to meet
patient demand, no matter what the environment.
®
The UAM provides several ways to deliver oxygen, including connections for cylinder and pipeline. Most importantly, the
machine produces its own oxygen using an integrated concentrator that converts room air into 95% oxygen. Air is drawn
into the UAM and is purified by 2 dierent filters. Ambient air is made up of 78% nitrogen, 21% oxygen and 1% other gases.
The electrically powered oxygen concentrator in the UAM removes nitrogen from room air, creating a mixture that is 95%
oxygen and 5% other gases.
The compressed air passes into a canister filled with a powdered material called Zeolite. Nitrogen sticks to the Zeolite,
while oxygen and other gases flow through it to a reservoir tank. The UAM produces up to 10 liters per minute of up to 95%
oxygen. The oxygen then travels through the flow meter into the back bar and reservoir bag.
GAS FLOW IN THE PATIENT SYSTEM
The flow meter controls the amount of oxygen entering the back bar and available for the patient. The spinning bobbin
shows the flow rate in liters per minute.
The back bar provides the following functions:
1. The reservoir bag stores up to 2 liters of oxygen.
2. The pressure relief valve limits pressure in the back bar to 5 centimetres of water, protecting the patient from harm.
3. The air inlet valve allows room air to be drawn in whenever the supply of oxygen is less than the demand, as expressed
by the patient’s minute volume.
1
The low-resistance draw-over vaporizer adds volatile agent to the carrier gas passing through it. Volatile agent is added by
using the selector wheel to achieve the desired percentage. The resulting anaesthetic supply gas is comprised of oxygen,
volatile agent and a variable amount of room air. The anaesthetic supply gas flows from the back bar at low pressure to the
breathing block and the bellows.
An oxygen monitor measures the oxygen concentration of the supply gas passing to the patient. The reading is displayed on
the control screen.
As the supply gas flows from the oxygen sensor it passes the first one-way valve, then the bellows chamber, followed by the
second one-way valve.
During spontaneous breathing both non-return valves open for inspiration and close during expiration. The bellows will not
fill with exhaled gas.
The bellows is used for intermittent positive pressure ventilation, also known as IPPV or controlled ventilation. When the
bellows is raised, supply gas flows through the first non-return valve into the bellows. The second non-return valve remains
closed.
As the bellows are pushed down, the supply gas flows out through the second non-return valve into the inspiratory limb. The
first non-return valve is closed.
Another pressure relief valve ensures that excessive manual force on the bellows cannot cause harm to the patient.
The UAM uses a conventional Y-piece patient connection. Exhaled gas returns to the UAM via the expiratory limb of the
Y-piece and then passes by the Fenton balloon and a third one-way valve to the scavenger port. The balloon acts as an
inflating valve which enables controlled ventilation of the lungs, the third valve prevents back-flow during spontaneous
breathing.
SPECIFICATIONS
PHYSICAL AND ELECTRICAL
gWorkstation: 146cm x 53cm x 69cm, 130kg, aluminium frame, vertical dove mount side rails on both sides, nylon internal
tubing
gTop Shelf: 46cm x 31cm, 88cm above floor, 35kg weight limit
gDrawer: 10cm x 29cm x 32cm, 35kg weight limit, stainless steel, removable for cleaning.
gTop shelf: Epoxy powder coated pressed aluminium; side slots for nylon strap to secure equipment; optional monitor
brackets are available to bolt items to the top of the top shelf, 54 cm (W) x 37 cm (D), Load maximum: 35 kg with even
load distribution.
gWork surface: Stainless steel, removable for cleaning, 46 cm (W) x 31 cm (D) x 88 cm (H) above ground
gMains power supply: 220V, 50-60Hz
gPower: 500 Watts/220v = 2.27 amps
gControl screen power: CE-marked, fused and medical grade. Mains powered with battery backup for one day of use.
gAutomatic over/under voltage mains power isolator protects oxygen concentrator, and sockets for monitor and
accessories
g3.5” TFT touch screen for oxygen display and alarm setting
gMembrane switch for oxygen and alarm settings
gCasters: 150 mm diameter single wheel antistatic casters, front lockable casters
OXYGEN SUPPLY AND MONITORING
gOxygen concentrator flow rate: 0.1 to 10.0 liters per minute
gMaximum oxygen concentration: 95%
NOTE: The oxygen concentration may vary according to ambient humidity and maintenance of the air filter
gAlternative sources: cylinder yoke, pipeline, or other external flow regulated portable oxygen source
gAutomatic room air intake when patient minute volume exceeds supply gas flow
gAccuracy of glass rotameters: +/- 2.5% when using 100% O
gIntegrated inspiratory oxygen monitoring uses MOX-3 oxygen sensor
gCalibration for room air (21%) and 100% oxygen
gPressure sensitive apnea or high flow alarm
gAdjustable minimum and maximum oxygen alarm settings
2
2
gUp to ten hour battery backup, trickle recharge from mains power
gMembrane keypad and touch screen
OPTIONAL USE OF NITROUS OXIDE
gSources: pipeline or cylinder
gHypoxic cut-o: A solenoid automatically shuts o nitrous oxide delivery if supply gas O2 level falls below a minimum of 25%
gFlow of N2O stops if electrical power fails
gSight and touch dierentiated flow control knob per ISO standards
gAccuracy of glass rotameter for N2O: +/- 2.5%
VENTILATION
gBellows for adult and paediatric use made from durable, long-lasting silicone rubber
g1600cc capacity
gInspiratory pressure relief of 55 cmH2O for pressure created during mechanical ventilation
gAluminium bellows block
gSilicone balloon inflating valve at the expiratory port
g15mm female/22mm male ISO standard taper connection for breathing circuit 30mm male ISO standard taper
connection for AGSS scavenging equipment
VAPORIZERS
gStainless steel and plated brass construction
gDraw over flow type
gPour filler type.
gSeparate units for isoflurane and halothane per ISO standards
gAgent delivery range: 0.5% to 4%
g120ml capacity
gPerformance:
4.5
3.5
2.5
1.5
.5
4
3
4%
3%
1
2%
1.5%
1%
1
.5%
0
3LPM 4LPM 5LPM 6LPM 7LPM 8LPM
TYPICAL HALOTHANE VAPORIZER PERFORMANCE WITH FLOW
3
6
5
4
3
2
1
0
4.5
3.5
4%
3%
2%
1%
15C 22C 25C 30C 35C
TYPICAL HALOTHANE VAPORIZER PERFORMANCE WITH TEMPERATURE
4
3
2.5
1
1.5
1
.5
4%
3%
2%
1.5%
1%
.5%
0
3LPM 4LPM 5LPM 6LPM 7LPM 8LPM
TYPICAL ISOFLURANE VAPORIZER PERFORMANCE WITH FLOW
4
6
5
4
3
2
1
0
15C 22C 25C 30C 35C
TYPICAL ISOFLURANE VAPORIZER PERFORMANCE WITH TEMPERATURE
REAR PANEL CONNECTORS
gMains isolator switch, 2 UK style power sockets
gOxygen and nitrous pipeline NIST connectors and cylinder yokes
gMulti-diameter external oxygen hose connector
4%
3%
2%
1%
5
COMPONENTS OF THE UAM
1. Patient Vital Signs Monitor
2. Oxygen monitor and
control screen
3. Oxygen and Nitrous Oxide
Flow Meters
4. Back bar with air inlet,
pressure relief valve and
2 liter reservoir bag
5. Low resistance vaporizer
6. Oxygen concentrator
on/o switch
7. Oxygen cylinder and
pipeline pressure gauges
8. Nitrous Oxide cylinder
and pipeline gauges
SEE INSET PAGE 7
9. Bellows
10. Pressure relief valve
and gauge
11. Fenton Balloon
expiratory valve
12. Y-piece connectors
13. Water trap
14. Oxygen concentrator
status screen
15. Integrated oxygen
concentrator
16. Castors (front lockable)
6
2. Oxygen monitor
and control screen
3. Oxygen and Nitrous
Oxide Flow Meters
4. Back bar
a. Air inlet valve
b. Pressure relief valve
c. Reservoir bag
5. Low resistance vaporizer
6. Oxygen concentrator
on/o switch
7. Oxygen cylinder and pipeline
pressure gauges
8. Nitrous Oxide cylinder
and pipeline gauges
INSET
7
Oxygen sensor
Bellows
Pressure relief gauge
Y-piece connectors
Fenton Balloon
inflating valve
Pressure relief valve
Y-piece connectors
Fenton Balloon
inflating valve
Water trap
8
THE CONTROL SCREEN
Calibration settings (to
calibrate oxygen sensor
and apnea alarm)
Fenton Balloon
Inflating Valve
One Way Valve and
scavenging 30mm
taper connection
Percent Oxygen (shows the
oxygen percentage of the
anaesthetic gas measured
before inspiration)
Battery charge status
High oxygen percentage
alarm (user adjusted)
Mode (opens screen for
system settings)
Low oxygen percentage
alarm (user adjusted)
Message Area
Apnoea alarm on/o
Mains power indicator
(machine is on mains power supply)
9
Pin-indexed connectors for E-size
oxygen and nitrous oxide cylinders
Oxygen inlet
Pipeline connections for
oxygen and nitrous oxide
Mains isolator (Power On/O)
Fuses for oxygen monitor,
oxygen concentrator
British style fused 3-pin plugs
10
UNPACKING THE UAM AND PREPARING FOR USE
Use only 1 liter/min flow to conserve the oxygen in the external cylinder. This will provide 30-35% oxygen to the
1. Remove front panel from the crate and remove the internal wooden crossbeam. If applicable remove the vital signs
monitor box and set it aside.
2. Remove accessories from underneath and along the sides of the UAM and set aside.
3. Unlock the front wheels and carefully roll the machine out of the packing case, supporting the weight as you lower the
machine to the floor. Remove all packing material.
4. Unpack work tray from its cardboard packaging. Remove film from work tray and place on top of the drawer.
5. Connect pipeline hoses and cylinders.
6. Screw in oxygen sensor and connect telephone-style cable. Some oxygen sensors come with an extra piece: this may be
discarded. (See photo on next page.)
USING OXYGEN
The UAM accepts an E-size pin-index oxygen cylinder. The cylinder connects via a yoke and Bodok seal and the pressure is
displayed on the pressure gauge on the front of the machine.
Bull-nose cylinders may be attached to the pipeline inlet using an approved 4 Bar medical regulator.
USING A PIPELINE CONNECTOR
The UAM accepts pipeline connections for oxygen. Each machine is supplied with an oxygen hose connecting to the UAM’s
NIST inlet. The other end is typically shipped with a BS 5682 probe, which is the British standard. Probes for other connector
types can be arranged. Pipeline pressure is displayed on the gauge on the front of the machine.
USING THE EMERGENCY OXYGEN INLET
An emergency oxygen supply connection is mounted on the back of the machine. It accommodates diering tube sizes
from ward-style flow-meters.
CAUTION: Oxygen from this source is not controlled by the glass flow meter on the front of the UAM. Rather, it must be
controlled with an external flow meter attached to the cylinder providing the emergency oxygen. The user can confirm that
oxygen is being given by observing the oxygen monitor.
NOTE: Use only 1 liter/min flow to conserve the oxygen in the external cylinder. This will provide 30-35% oxygen to the
patient.
USING NITROUS OXIDE
The UAM supports cylinder and pipeline sources of nitrous oxide. The flow of N2O is controlled by the right hand side flow
meter. The N
The UAM automatically cuts o nitrous oxide if the percent of oxygen in the anaesthetic mix falls to 25% and below. The
oxygen monitor must be powered on and working correctly for nitrous oxide delivery to occur. An exhausted oxygen sensor
or battery will shut o N
The cut o mechanism is electrical, unlike older style mechanical interlocks. The N2O valve is closed in its resting position
and must receive a current from the oxygen monitor to open. Any interruption of that current, including a decrease in
oxygen below 25%, will shut o the flow of nitrous oxide.
O flow knob has a dierent size and shape to distinguish it from the oxygen flow meter control knob.
2
O supply.
2
11
NOTE: Do not open the package of the spare oxygen sensor until it is needed. The oxygen sensor will start to deplete as
Do not open the package of the spare oxygen sensor until it is needed. The oxygen sensor will start to deplete as
soon as it comes into contact with air.
Screw in oxygen sensor and connect telephone-style cable. Some oxygen sensors come with an extra piece: this may be discarded.
6.
7. Attach bellows assembly to UAM by placing it on top of the connector and firmly pushing down. Then tighten knurled nut fully.
12
8. Attach airway pressure gauge by pushing down collar and inserting gauge into the port. Press firmly until collar springs up.
9. Attach green reservoir bag to back bar as shown in photo.
13
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