NORTH AMERICAN DRÄGER Drager Narkomed 6400 User manual

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Operator’s
Instruction

Manual

Part Number: 4117965-003

Date: 30 May 2004

© 2004 Draeger Medical, Inc.

Rev: -

Narkomed 6400

Anesthesia Syst em

W ARNING: For a full understanding of the performance characteristics of this anesthesia

machine, the user should carefully read this manual before operating.

RETURN TO THIS MANUAL'S TABLE OF CONTENTS

RETURN TO CD-ROM TABLE OF CONTENTS

RETURN TO THIS MANUAL'S TABLE OF CONTENTS

RETURN TO CD-ROM TABLE OF CONTENTS

Contents

Section 1. Introduction

Operator's Responsibility for Patient Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2

Limitation of Liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2

Restriction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3

Copyright. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3

Trademark Notices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3

Disclaimer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3

Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3

Purpose of This Manual. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-4

How This Manual Is Organized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-4

Conventions Used in This Manual. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-5

General Warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-5

Symbols and Abbreviations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-8

Equipment Symbols. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-9

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-10

Section 2. System Description

Narkomed 6400 Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-2

Gas Delivery System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4

Oxygen Gas Supply Special Features. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-9

Vaporizer Mounts and Interlock Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-11

Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-15

Scavenger Systems (CUSTOMER OPTION) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-35

Power Supply System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-37

Monitoring System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-40

Measurement Subsystems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-49

Breathing System Interface Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-51

Communications Interface Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-52

Advanced Communications Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-52

Sheet Printer Interface Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-53

Strip Chart Recorder (SCR) (CUSTOMER OPTION) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-54

Surgeon Display Controller (CUSTOMER OPTION). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-55

Auxiliary Video Output (CUSTOMER OPTION) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-55

Patient Suction System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-56

Section 3. System Configuration

Initial Warm-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-2

System Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-7

Ventilator Information Notebook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-30

Low Flow Wizard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-34

Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-36

Timers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-37

Alarm Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-39

Software Pressure Gauge. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-42

Fresh Gas Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-45

Printing Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-47

Alarm Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-56

Controlling Individual Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-57

Effects of Ventilator Modes on Alarm Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-59

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Rev: -

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Section 4. Configuration and Settings - Gas Analysis

Default Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-2

Configuring Nitrous Oxide and Agent Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-2

Nitrous Oxide and Agent Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5

Configuring Carbon Dioxide Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-12

Carbon Dioxide Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-13

Gas Analysis Pod Zero Calibration and Delay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-18

Section 5. Configuration and Settings - Volume, Pressure, and Oxygen

Default Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-2

Configuring Breathing Pressure Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-2

Breathing Pressure Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-7

Configuring Respiratory Volume Displays. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-14

Respiratory Volume Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-16

Configuring Oxygen Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-18

Oxygen Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-18

Section 6. Configuration and Settings - Ventilator

Default Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-2

Adjusting Ventilator Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-3

Selecting Operating Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-8

Preparation to Ventilate Pediatric Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-14

Section 7. Checkout Procedures

Daily Checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-2

Preuse Checkout. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-14

Section 8. Operation Summary

Typical Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-2

Service Interruptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-22

Putting the System in Ventilator Standby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-23

Replacing Absorbent Between Cases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-24

Ventilator Safe State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-25

Ventilator Override. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-26

Operating during a Power Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-27

Use of Suction with the Narkomed 6400 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-27

Operation during Cardiac Bypass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-28

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Section 9. Messages/Pr oblem Resolution

Alarm Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-2

Pressure Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-3

Volume Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-7

Nitrous Oxide and Agent Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-10

Carbon Dioxide Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-12

Oxygen Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-14

Machine Input Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-17

System Communications Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-17

Miscellaneous Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-17

Ventilator Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-19

Hint Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-29

Negative Pressure Dialog Box. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-33

Breathing Hose Compliance Limit Dialog Box. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-34

Section 10. General Care and Maintenance

Powering Down the Narkomed 6400 for Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-2

General Care Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-2

Inspecting the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-3

Ventilator Cleaning, Disinfection, and Sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-3

Ventilator Routine Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-5

Ventilator Disassembly Instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-6

Ventilator Reassembly Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-10

Removing the Piston Assembly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-15

Replacing the Oxygen Sensor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-17

Clearing Condensation from the Flow Sensor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-17

Disinfecting the Flow Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-19

Cleaning and Disinfecting the Breathing System Pressure Gauge . . . . . . . . . . . . . . . . . . . . . . . . . .10-22

Open Reservoir Scavenger Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-22

Maintenance for Passive Systems Scavenger Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-24

Water Trap Reservoir Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-25

Care of Vaporizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-28

Replacing the Strip Chart Recorder Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-28

Removing the Footrest (Narkomed 6000 machines). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-29

Replacing the Gas Analysis Pod (GAP-2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-30

Section 11. Specifications

Physical Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-2

Environmental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-2

Electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-2

Touch Screen Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-3

Auxiliary Video Output. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-3

Gas Delivery System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-3

Ventilator, Divan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-4

Breathing System Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-5

Ultrasonic Flow Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-5

Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-6

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iii

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Appendix 1: Tables

Self-Diagnostic Tests. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-2

Factory Default Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-3

Alarm Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-6

Alarm Displays. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-10

Summary of Alarm Messages and Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-13

Summary of Ventilator Control Panel Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-17

Flow Sensor Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-17

Allowable Waveform Export Tables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-18

(Surgeon Display Controller). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-18

Printer Drivers/Models Supported by the Narkomed 6400 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1-19

Appendix 2: User-Replaceable Parts
Appendix 3: Optional Accessory Mounting Systems
Appendix 4: Divan Ventilator Self-Test Flow Chart

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1

Introduction

This section describes the operator’s responsibility for patient safety,
limit of liability, and general warnings and cautions relating to the
Narkomed 6400 with Divan ventilator. Abbreviations and terms used
throughout the manual are also described.

Operator's Responsibility for Patient Safety ..................... 1-2

Limitation of Liability ......................................................... 1-2

Restriction ......................................................................... 1-3

Copyright .......................................................................... 1-3

Trademark Notices ........................................................... 1-3

Disclaimer ......................................................................... 1-3

Recommendations ............................................................ 1-3

Purpose of This Manual .................................................... 1-4

How This Manual Is Organized ........................................ 1-4

Conventions Used in This Manual .................................... 1-5

Typefaces ............................................................................ 1-5

Warnings and Cautions ....................................................... 1-5

General Warnings ............................................................. 1-5

Symbols and Abbreviations .............................................. 1-8

Equipment Symbols .......................................................... 1-9

Glossary ........................................................................... 1-10

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1

Introduction

Operator's Responsibility for Patient Safety

Draeger Medical anesthesia products are designed to provide the greatest
degree of patient safety that is practically and technologically feasible. The
equipment design, the accompanying literature, and the labeling on the
equipment take into consideration that the purchase and use of the
equipment are restricted to trained professionals, and that certain inherent
characteristics of the equipment are known to the trained operator.
Instructions, warnings, and caution statements are limited, therefore, to
the specifics of the Draeger Medical design. This publication excludes
references to hazards which are obvious to a medical professional, to the
consequences of product misuse, and to potentially adverse effects in
patients with abnormal conditions. Product modification or misuse can be
dangerous. Draeger Medical disclaims all liability for the consequences of
product alterations or modifications, as well as for the consequences which
might result from the combination of Draeger Medical products with
products supplied by other manufacturers if such a combination is not
endorsed by Draeger Medical.

The operator of the anesthesia system must recognize that the means of
monitoring and discovering hazardous conditions are specific to the
composition of the system and the various components of the system. It is
the operator, and not the various manufacturers or suppliers of components,
who has control over the final composition and arrangement of the
anesthesia system used in the operating room. Therefore, the responsibility
for choosing the appropriate safety monitoring devices rests with the
operator and user of the equipment.

Patient safety may be achieved through a variety of means depending on
the institutional procedures, the preference of the operator, and the
application of the system. These means range from electronic surveillance of
equipment performance and patient condition to simple, direct contact
between operator and patient (direct observation of clinical signs). The
responsibility for the selection of the best level of patient monitoring belongs
solely to the equipment operator. To this extent, the manufacturer, Draeger
Medical, disclaims responsibility for the adequacy of the monitoring
package selected for use with the anesthesia system. However, Draeger
Medical is available for consultation to discuss monitoring options for
different applications.

Limitation of Liability

Draeger Medical’s liability, whether arising from or related to the
manufacture and sale of the products, their installation, demonstration,
sales representation, use, performance, or otherwise, including any liability
based upon Draeger Medical’s product warranty, is subject to and limited to
the exclusive terms of Draeger Medical’s limited warranty, whether based
upon breach of warranty or any other cause of action whatsoever, regardless
of any fault attributable to Draeger Medical and regardless of the form of

1-2

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Restriction

Introduction

action (including, without limitation, breach of warranty, negligence, strict
liability, or otherwise).

Draeger Medical shall in no event be liable for any special,
incidental, or consequential damages (including loss of profits)
whether or not foreseeable and even if Draeger Medical has been
advised of the possibility of such loss or damage. Draeger Medical
disclaims any liability arising from a combination of its product
with products from another manufacturer if the combination has
not been endorsed by Draeger Medical. Buyer understands that the
remedies noted in Draeger Medical’s limited warranty are its sole
and exclusive remedies.

Furthermore, buyer acknowledges that the consideration for the
products, equipment, and parts sold reflects the allocation of risk
and the limitations of liability referenced herein.

Federal law restricts this device to sale by, or on the order of, a physician.

1

Copyright

Copyright 2004 by Draeger Medical, Inc. All rights reserved. No part of this
publication may be reproduced, transmitted, transcribed, or stored in a
retrieval system in any form or by any means, electronic or mechanical,
including photocopying and recording, without written permission of
Draeger Medical, Inc.

Trademark Notices

Datagrip, DrägerService, Narkomed, Narkomed GS, ORM,
Quality Service For Life, Respitone, Vigilance Audit, Vitalert, and Vitalink
are registered trademarks of Draeger Medical, Inc. All other products or
name brands are trademarks of their respective owners.

Disclaimer

The content of this manual is furnished for informational use only and is
subject to change without notice. Draeger Medical, Inc. assumes no
responsibility or liability for any errors or inaccuracies that may appear in
this manual.

Recommendations

In the interest of patient safety, Draeger Medical strongly advocates the use
of an oxygen analyzer, pressure monitor, and either a volume monitor or an
end-tidal CO

Part Number: 4117965-003

monitor in the breathing circuit at all times.

2

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1

Introduction

Because of the sophisticated nature of Draeger Medical anesthesia
equipment and its critical importance in the operating room setting, it is
highly recommended that only appropriately trained and experienced
professionals be permitted to service and maintain this equipment. Please
contact DrägerService at [phone] for service of this equipment.

Draeger Medical also recommends that its anesthesia equipment be
serviced at three-month intervals. Periodic Manufacturer's Service
Agreements are available for equipment manufactured by Draeger Medical.
For further information concerning these agreements, contact
DrägerService at [phone].

Purpose of This Manual

This manual provides operating instructions for the Narkomed 6400
Anesthesia Workstation equipped with the Divan ventilator. It is intended
for use by trained clinical professionals familiar with accepted medical
procedures, practices, and terminology used in delivery of anesthesia and
patient monitoring.

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How This Manual Is Organized

All users of this equipment must read this manual completely before using
the equipment.

To make this document more convenient for future reference, it has been
divided into several independent sections. Each section contains either
general information about the Narkomed 6400 or instructions on how to
use it.

Introduction provides restriction and liability statements, discusses
organization of the manual, and provides system warnings and cautions.

System Description describes the main components of the system and some
theory of operation.

System Configuration describes overall customization of the monitoring
system, including alarm management.

Configuration and Settings - Gas Analysis describes clinical customization
of the analytical data collected by the gas analysis pod.

Configuration and Settings - Volume, Pressure, and Oxygen describes
clinical customization of the analytical data collected by the volume,
pressure, and oxygen (VPO) monitor.

Configuration and Settings - Ventilator describes clinically-determined
adjustments that may be made to the ventilator for each mechanical
breathing mode.

1-4

Checkout Procedures describes the full procedure for daily checkout of the
Narkomed 6400, as well as an abbreviated preuse checkout between cases.

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Operation Summary describes how to start and end a case, as well as
operator response to some irregular situations.

Messages/Problem Resolution describes the system alarm structure and a
summary of warning, caution, and advisory messages that may be
encountered during patient monitoring.

General Care and Maintenance lists general cleaning and maintenance
procedures, including some disassembly and reassembly procedures
required for access.

Specifications lists the technical specifications for all system components.

Appendices include general information about system messages and

components.

An extensive index is provided for ease in learning about and efficiently
using the Narkomed 6400 features.

Conventions Used in This Manual

This manual has been set up with several conventions to help organize the
information contained in it. Please read about these conventions carefully so
that you understand their significance in the manual.

Introduction

1

Typefaces A different typeface is used throughout the manual to differentiate between

narrative information and machine messages and labels.

Examples: [O2 CAL] ventilator or monitor control button

label; tab label in parameter notebook

REVERSE FLOW monitor or ventilator message

System Standby system status description

Warnings and
Cautions

All parts of this manual contain warning and caution statements about the
Narkomed 6400.

• Warni n g statements give important information that, if ignored,
could lead directly to personal injury.

• Caution statements give important information that, if ignored,
could lead directly to equipment damage and indirectly to
personal injury.

General Warnings

The following warnings apply to general operation and maintenance of the
Narkomed 6400 anesthesia machine, equipped with the Divan Ventilator
and Narkomed Ultrasonic Flow Sensor. Warnings specific to subsystems
appear in later sections.

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Introduction

Warning : Any person involved with the setup, installation, operation or

maintenance of the Narkomed 6400 anesthesia system must
be thoroughly familiar with this instruction manual.
However, instructions in this manual in no way supersede
established medical procedures for patient care.

Warning : This anesthesia system will not respond automatically to

certain changes in patient condition, operator error, or failure
of components. The system is designed to be operated under
the constant surveillance and control of a qualified operator.

Warning : No third-party components shall be attached to the

anesthesia machine, ventilator, or breathing system (except
for certain approved exceptions). Contact DrägerService for
further information.

Warning : Do not apply unregulated suction to the patient circuit when

using this device.

Warning : The Narkomed 6400 anesthesia system must be serviced only

by an authorized representative of DrägerService.

Warning : A test for leakage current must be performed by qualified

biomedical engineering personnel before use if the Narkomed
6400 is interfaced with other equipment.

Warning : A preuse checkout procedure must be performed immediately

before each use of the Narkomed 6400. A recommended
procedure is provided in this manual.

Warning : To avoid electrical shock hazard:

• Due to the risk of electric shock, do not remove any
component cover. Refer any servicing to DrägerService.

• Use only hospital-grade grounded electrical outlets and
power cord.

• Make sure the external equipment is hospital-grade
grounded before connecting the equipment.

• Disconnect the power supply from the electrical outlet
before cleaning. Let it dry completely before reconnecting
it to the electrical outlet. Always ensure that the

clamp for the power cord, at the power supply end,
is tight thus preventing an accidental disconnect
from the unit.

1-6

• Do not connect additional external equipment other than
equipment specified by Draeger Medical.

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Warning : To ensure patient safety:

• This device must be used by, or on the order of, a
physician.

• Constant attention by a qualified professional is needed
whenever a patient is under anesthesia or connected to a
ventilator. Some equipment malfunctions may pass
unnoticed in spite of the monitor alarms.

• Always make sure that alarm limits are set and alarms
are active when monitoring a patient. Do not rely
exclusively on the audible alarm system for patient
monitoring. Adjusting the alarm volume to a low level
during patient monitoring can jeopardize the patient.

• If the accuracy of any value display is in doubt, first
determine the patient’s vital signs by alternate means
before verifying that the monitor is working correctly.

• If the display loses patient data, it is possible that active
monitoring is not being performed. Close patient
observation or alternate monitoring devices should be
used until monitor function is restored.

Introduction

1

Warning : If fluids are accidentally spilled on the equipment, take the

Narkomed 6400 out of service. Turn the power switch to
STANDBY and unplug the main power cord from the AC
outlet.

Warning : When moving the anesthesia machine, remove all monitors

and equipment from the top shelf, and use only the machine
handles. The anesthesia machine should only be moved by
people who are physically capable of handling its weight.
Draeger Medical recommends that two people move the
anesthesia machine to aid in its maneuverability. Exercise
special care so that the machine does not tip when moving up
or down inclines, around corners, and across thresholds (for
example, in door frames and elevators). Do not attempt to
pull the machine over any hoses, cords, or other obstacles on
the floor.

Warning : Only configure the Narkomed 6400 for optional accessory

mounting systems using one of the permitted combinations
listed in Appendix 3 of this manual. Use of any other
configuration may create a tip hazard.

Caution: Although designed to minimize the effects of ambient radio-

frequency interference, the Narkomed 6400 may be adversely
affected by the operation of electrosurgical equipment or
shortwave/microwave diathermy equipment in the vicinity.

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1

Introduction

Caution: Do not place more than 100 pounds on top of the Narkomed

6400 top shelf.

Caution: Do not place more than 30 pounds on top of the Divan

ventilator.

Symbols and Abbreviations

The following symbols and abbreviations appear throughout this
manual.

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inspiratory inlet

expiratory outlet

bag symbol

gas return symbol

!

APL adjustable pressure limiter (pop-off) valve

BAG connection for breathing bag

cmH

O centimeters of water pressure

2

CO

2

Cpat patient compliance

Csyst system compliance

DISS diameter-indexed safety system

% I.P. ratio of inspiratory pause time/inspiration time

kPa kilopascals

Manual/Spont. manual ventilation or spontaneous breathing

MAC minimum alveolar concentration

important note symbol

carbon dioxide

1-8

O nitrous oxide

N

2

O

2

OFPD oxygen failure protection device

ON/OFF switched on, activated/switched off, de-activated

ORC oxygen ratio controller

Narkomed 6400 Operator’s Manual

oxygen

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Pmax maximum allowable breathing pressure

PMC Periodic Manufacturer’s Certification

Pset pressure setpoint

PEEP positive end-expiratory pressure

psi pounds per square inch, pressure measurement unit

Rate breath rate in Volume and Pressure Modes

SIMV synchronized intermittent mandatory ventilation

SIMV Rate breath rate in SIMV Mode

I:E ratio of inspiration time to expiration time

VPO Volume, Pressure, Oxygen

Vt tidal volume

Equipment Symbols

Introduction

1

These symbols appear on the label on the back of the Narkomed 6400:

!

CAUTION:

ATT ENTION :

CAUTION:

ATT ENTION :

Refer to accompanying documents before
operating equipment.

Consulter les documents ci-joints avant de faire
fonctionner l’appareil.

Risk of electrical shock. Do not remove cover.
Refer servicing to qualified service personnel.

Danger d'électrocution, ne pas enlever le
couvercle. Aucune réparation ne doit entre
entreprise par une personne nonqualifiée.

This symbol can be seen under the ventilator when the table top is raised
and the compact breathing system removed:

CAUTION:

ATT ENTION :

Surface may be hot. Do not touch.

Peut-être que c’est très chaud. Ne touchez pas la
surface.

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1

Introduction

Glossary

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Alarm
Standby

operator has touched bell icon for an operator-controlled
alarm in parameter box on main screen, or

operator has
selected [STBY] at [Alarm Control] setting in volume,
agent, or carbon dioxide parameter notebook. In both
cases, the bell icon is grayed out.

Interlock a device that automatically prevents or requires a specific

following action.

Example 1: vaporizer interlock prevents the use of
more than one anesthetic by closing one vaporizer
source when the other is opened.

Example 2: oxygen failure protection device (OFPD)
interlock decreases pressure of other gases when
oxygen pressure is restricted, in proportion to the
decreased oxygen pressure.

Key general term for control button; may be ventilator control

button, monitor selection button, or monitor command
button, depending upon context. See associated text.

Mean Breathing Pressure

pressure values recorded during each breath

Agent/Nitrous Oxide/Carbon Dioxide Concentration
derivative of "running averages" of real-time data over a
period of 5 seconds. Although continuously calculated,
mean data is displayed on the monitor only when carbon
dioxide respiration cannot be accurately detected.

Monitor
Control
Buttons

Command
Example: [Threshold Pressure Autoset]

Selection

: initiate an action by pressing them once.

: positioned next to a text box or window, that
indicates the current setting. The setting is selected by
touching the button repeatedly until the preferred value
appears next to it.
Example: [Alarm Control] or [Set GAP Delay Period]

Monitor
Standby

operator has touched [Monitor Standby] control button on
monitor touch screen. The monitor standby screen replaces
the main screen on the monitor.

: an average of all of the instantaneous

:

1-10

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System
Standby

Ventilator
Standby

Introduction

operator has selected STANDBY position for Narkomed
6400 system power switch.

operator has pressed control button [Standby] on Divan
ventilator control panel; VENT STANDBY appears as an
advisory on the monitor.

1

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2

System Description

This section describes and illustrates the Narkomed 6400
components and provides relevant theory of operation.

Narkomed 6400 Overview ................................................ 2-2

Gas Delivery System ........................................................ 2-4

Pipeline Gas Supply to the Narkomed 6400 ....................... 2-5

Cylinder Gas Supply ........................................................... 2-5

Flowmeter Bank .................................................................. 2-6

Electronic Fresh Gas Measurement ................................... 2-7

Fresh Gas Outlet ................................................................. 2-8

Oxygen Gas Supply Special Features .............................. 2-9

Auxiliary Oxygen Flowmeter ............................................... 2-9

Oxygen Flush ...................................................................... 2-9

Oxygen Supply Pressure Failure Protection Device ........... 2-10

Oxygen Low Pressure Alarm .............................................. 2-10

Minimum Oxygen Flow ....................................................... 2-10

Oxygen Ratio Controller ...................................................... 2-10

Vaporizer Mounts and Interlock Systems ......................... 2-11

Ventilator ........................................................................... 2-15

Narkomed 6400 Operator’s Manual

Overview ............................................................................. 2-15

Respitone (Customer Option) ............................................. 2-19

Power-Up Diagnostic Tests ................................................. 2-19

Mechanical Ventilation Modes ............................................ 2-20

Tidal Volume Compensation ............................................... 2-20

Fresh Gas Decoupling ........................................................ 2-20

Low-Flow Technique ........................................................... 2-21

Leak Detection .................................................................... 2-21

Compact Breathing System ................................................ 2-21

Piston Assembly ................................................................. 2-27

Ventilator Control Panel ...................................................... 2-28

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System Description

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Ultrasonic Flow Sensor .................................................... 2-33

Breathing System Pressure Gauge (CUSTOMER OPTION) 2-34

Scavenger Systems (CUSTOMER OPTION) ................ 2-35

Open Reservoir Scavenger .............................................. 2-35

Scavenger Interface for Passive Systems ....................... 2-36

Power Supply System ................................................... 2-37

System Power Switch ...................................................... 2-37

Convenience Outlet ......................................................... 2-38

Circuit Breakers ............................................................... 2-38

Reserve Power System ................................................... 2-38

Machine Functions on Reserve Power ............................ 2-39

Monitoring System ......................................................... 2-40

Main Screen ..................................................................... 2-41

Alarm Window .................................................................. 2-47

Measurement Subsystems ............................................ 2-49

Breathing System Interface Panel ................................. 2-51

Communications Interface Panel ................................... 2-52

Advanced Communications Option ............................... 2-52

Sheet Printer Interface Option ....................................... 2-53

Strip Chart Recorder (SCR) (CUSTOMER OPTION) .... 2-54

Surgeon Display Controller (CUSTOMER OPTION) ..... 2-55

Auxiliary Video Output (CUSTOMER OPTION) ............ 2-55

Patient Suction System ................................................. 2-56

Connections and Switch .................................................. 2-56

Patient Suction System (CUSTOMER OPTION) ............. 2-57

Narkomed 6400 Overview

The Narkomed 6400 anesthesia workstation consolidates a number of
functions formerly executed by several pieces of equipment. As a stand­alone anesthesia workstation, it directs many tasks automatically,
including:

2-2

• anesthetic gas and agent delivery

• automatic ventilation

• ventilation monitoring, including pressure and volume
monitoring

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System Description

• inspired and expired gas monitoring, including concentrations of
anesthetic agent, nitrous oxide (N
oxygen (O

)

2

O), carbon dioxide (CO2) and

2

• anesthetic agent identification in both inspired and expired
gases.

Although the Narkomed 6400 is completely integrated to perform these
anesthesia delivery and monitoring tasks, it is also capable of being
upgraded. Desired enhancements may include additional monitoring
equipment. Likewise, integrated data management modules may be
attached to communicate with the hospital’s patient records system.

VAPORIZER
MOUNT

FLOWMETERS

SYSTEM
DISPLAY

MONITOR

PRESSURE

GAUGES

2

AUXILIARY
O2
FLOWMETER

SCAVENGER
(OPTIONAL)

ULTRASONIC
FLOW
SENSOR

BRAKE

Figure 2-1. Narkomed 6400 Anesthesia Workstation

Narkomed 6400 operating system components include:

• gas delivery system

• vaporizer mount and interlock system

DIVAN

VENTILATOR

ABSORBENT

CANISTER

STORAGE

DRAWER

• Divan ventilator

• Narkomed ultrasonic flow sensor

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System Description

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• power supply system

• monitoring system

• measurement subsystems

• piping

• open reservoir scavenger or
system (CUSTOMER OPTION)

• strip chart recorder (SCR) (CUSTOMER OPTION)

• patient suction system (CUSTOMER OPTION)

• auxiliary video output (CUSTOMER OPTION)

• surgeon display controller (CUSTOMER OPTION)

• sheet printer interface (CUSTOMER OPTION)

A brief description of the capabilities of each system component follows.
Please see Sections 7 and 8 of this manual for details on Narkomed 6400
operation.

The Narkomed 6400 incorporates three interfaces: a gas delivery interface
in a cockpit-style design, a configurable monitoring interface accessed
through a touch screen, and a ventilator interface for adjustment/display of
programmed parameters.

Gas Delivery System

The Narkomed 6400 can simultaneously deliver up to three gases and one
anesthetic agent. Three pipeline gas inlets connect to central gas delivery
systems, and three yokes connect to cylinder gas supplies.

interface for passive scavenger

2-4

Each gas supply has separate controls and flowmeter indicators. Individual
pressure gauges provide pressure readings. All connectors, valves, gauges,
and flowmeters are labeled and color-coded for the appropriate gas as shown
in the following table.

Gas System Color Coding

Gas Marking USA ISO

Air AIR Yellow Black/White

Checkered

Nitrous Oxide N

Oxygen O

Narkomed 6400 Operator’s Manual

OBlueBlue

2

2

Green White

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OP00669

O2
CYLINDER
YOKE

AIR
CYLINDER
YOKE

N2O
CYLINDER
YOKE

System Description

CONNECTION

CONNECTION

CONNECTION

2

O2

PIPELINE

AIR

PIPELINE

N20

PIPELINE

Pipeline Gas
Supply to the
Narkomed
6400

Cylinder Gas
Supply

Figure 2-2. Gas Delivery System Connections

The Narkomed 6400 features a controlled gas hookup that reduces the risk
of delivering the wrong gas to a patient. Pipeline gas inlets are indexed for
air, nitrous oxide, and oxygen fittings to be keyed to corresponding outlets of
hospital pipeline gases. The risk of incorrect connection of gas hoses is
thereby minimized. Pipeline gases should be supplied at 50 to 55 psi.

The system design also protects the patient, clinician, and its own systems
from contamination. Each pipeline gas inlet has a check valve that prevents
backflow leakage into the atmosphere when supply hoses are not connected.
Check valves also prevent pipeline flow into the internal gas lines of the
Narkomed 6400 when reserve cylinders are used. In addition, filters in each
pipeline connection prevent foreign material from entering the
Narkomed 6400.

When centrally-supplied gases are not used, the system runs on cylinder­supplied gases. The Narkomed 6400 has a standard cylinder yoke
configuration of one yoke for each gas: oxygen, air, and nitrous oxide.
(Field-upgraded machines may have a different yoke configuration).

The controlled gas hookup for cylinders reduces the risk of delivering the
wrong gas to a patient. The cylinder yokes are labeled, color-coded, and
keyed for cylinders containing particular gases. A pin-indexed safety system
prevents incorrect cylinders from being connected to the yoke.

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Narkomed 6400 design protects the patient, clinician, and its own systems
from contamination while operating on cylinder gas. A check valve in each
yoke prevents leakage of ambient air into the patient circuit if a cylinder is
not mounted on the yoke. The check valve also prevents movement of gas
from one cylinder to another when two cylinders of the same gas are
attached. In addition, filters in each yoke prevent foreign material from
entering the internal gas system of the Narkomed 6400. Further protection
from contamination is provided by a yoke plug, attached to the yoke.

Flowmeter
Bank

Flowmeters

The Narkomed 6400 provides highly visible, easily scanned controls and
indicators for all gases flowing through its systems. The flowmeter bank
houses flowmeters, flow control valves, and pressure gauges for each gas.
There are separate pressure gauges for each gas source — one for each
pipeline gas supply and one for each cylinder gas supply.

The flowmeters are tapered tubes scaled in milliliters per minute (mL/min)
and liters per minute (L/min). Flowmeter scales are backlighted for ease of
observation. A float indicator shows the flow rate of each gas in the fresh
gas mixture as delivered to the Narkomed 6400. The flowmeters are labeled
and color-coded for gas identification.

FLOWMETERS

2-6

AUXILIARY
O2
FLOWMETER

OP00663

Figure 2-3. Flowmeter Bank

Narkomed 6400 Operator’s Manual

PRESSURE

Part Number: 4117965-003

GAUGE

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Flow Control
Valves

Pipeline
Pressure
Gauges

Cylinder
Pressure
Gauges

System Description

2

Adjustment knobs for the control valves that regulate gas flow are located
below their respective flowmeter tubes. They are labeled and color-coded for
gas lines containing particular gases. The oxygen flow control valve is also
touch-coded with a deeply fluted knob (bezel). Turning the valve adjustment
knob counterclockwise increases gas flow. Turning the knob clockwise
decreases flow. A knob guard prevents accidental adjustments to the gas
flow. A zero-stop prevents damage to the flow control valve seat.

Pipeline pressure gauges are located below their corresponding flow control
valves. The flowmeter panel is labeled and color-coded for pipelines
containing particular gases. Concentric scales in psi and kPa indicate the
pipeline supply pressure.

Below their corresponding pipeline pressure gauges, the cylinder pressure
gauges show remaining cylinder pressure. The flowmeter panel is labeled
and color-coded for cylinder lines containing particular gases. Concentric
scales in psi and kPa indicate the cylinder gas pressure when the cylinder
valve is open.

Electronic
Fresh Gas
Measurement

For nonliquified gases like oxygen and air, the pressure indicates the
proportion of gas in the cylinder. For a liquefied gas like nitrous oxide, the
gauge indicates the vapor pressure of the liquefied gas in the cylinder. This
pressure remains constant until all of the liquid in the cylinder is vaporized.
When the liquid is vaporized, the cylinder pressure decreases proportionally
as gas is removed from the cylinder.

In addition to the flowmeters, the Narkomed 6400 has an electronic flow
measurement system which can display current flow readings for air,
oxygen, and nitrous oxide on the Narkomed 6400 monitor screen. It also has
the capability to export the data via Vitalink to an information management
system. See “Fresh Gas Information” on page 3-45 of this manual for more
information.

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Fresh Gas
Outlet

The fresh gas outlet delivers the fresh gas mixture consisting of the gases
selected and the vapors of a liquid anesthetic agent to the patient breathing
system. It is located below the ventilator on the left front of the machine.
The quick connect fitting used is unique to the Narkomed 6400 and cannot
be replaced by a hose from any other make or model of anesthesia
machine.

UNIQUE
QUICK-CONNECT
FITTING

FRESH GAS
HOSE

Figure 2-4. Fresh Gas Outlet with Quick-Connect Fitting

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Oxygen Gas Supply Special Features

Auxiliary
Oxygen
Flowmeter

Oxygen
Flush

The auxiliary oxygen flowmeter (see Figure 2-3) delivers a metered flow of
pure oxygen, used, for example, in the delivery of oxygen through a nasal
cannula. Auxiliary oxygen can also be used when the system power switch is
in the STANDBY position.

A manually operated, self-closing, oxygen flush valve is located on the front
left corner of the Narkomed 6400. A bezel is mounted around the
pushbutton to prevent accidental engagement. When actuated, the valve
delivers an unmetered oxygen flow of about 55 L/min directly to the fresh
gas common outlet. The power switch does not have to be on to use the
oxygen flush; it remains operative in STANDBY position.

OP00674

System Description

2

OXYGEN FLUSH
BUTTON

Figure 2-5. Oxygen Flush Button

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Oxygen
Supply
Pressure
Failure
Protection
Device

Oxygen Low
Pressure
Alarm

Minimum
Oxygen Flow

The oxygen failure protection device (OFPD) is a pneumatically operated
valve that protects the patient in the event of partial or complete loss of
oxygen pressure. Each gas circuit in the anesthesia machine, except the
oxygen circuit, is controlled by one of these valves. These valves, in turn, are
controlled by the gas pressure in the oxygen supply line. When oxygen
pressure is adequate, the valves remain open for an unrestricted gas flow.
Loss of oxygen pressure causes the valves to close to a degree that is
proportional to the loss. The result is a restriction or shut down of the flow
of all gases except oxygen.

Gas flow reductions are indicated on the flowmeter. When the oxygen
supply from the pipeline or reserve cylinders drops below about 37 psi, a
O2 SUPPLY LOW alarm is activated and, depending on the machine’s
configuration, a 7-second whistle may also sound. However, if only one
source of oxygen supply pressure (either reserve cylinders or pipeline) fails
and the other source maintains proper supply pressure, the OFPD and
oxygen supply low alarm are not activated.

The Narkomed 6400 has an oxygen dispensing system with a calibrated
bypass flow of 150 ±50 mL/min at 50 psi pipeline pressure. This volume of
oxygen is delivered even if the oxygen flow control valve should become fully
closed.

Note: Minimum oxygen flow is disabled in the optional Air-Only Mode. For

more information, see the Operator’s Manual for Air-Only Mode for
the Narkomed 6400 Anesthesia System.

Oxygen Ratio
Controller

The ratio of oxygen to nitrous oxide is controlled by another interlock
system. The oxygen ratio controller (ORC) is designed to maintain a
minimum fresh gas oxygen concentration of 25±4%. It provides independent
control of the oxygen and nitrous oxide flows pneumatically.

The ORC works by proportionally limiting the nitrous oxide flow whenever
the selected oxygen and nitrous oxide flow control valve settings would
otherwise result in a hypoxic fresh gas mixture. For example, if the clinician
opens the nitrous oxide flow control valve wide open without making a
corresponding increase in the oxygen flow control valve setting, the nitrous
oxide flow will not increase. Similarly, if the clinician decreases the oxygen
flow without also decreasing the nitrous oxide flow, the nitrous oxide flow
automatically drops in proportion to the oxygen flow.

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Vaporizer Mounts and Interlock Systems

The Narkomed 6400 provides mounts and an interlock system for either two
vaporizers (standard) or three vaporizers (customer option). With either
configuration, a mounting rack for a spare vaporizer is provided on the back
of the machine as shown in Figure 2-7.

Two
Vaporizer
Mount and
Interlock
System

The two vaporizers are mounted on the left front of the machine and both
are connected to the fresh gas flow. The interlock system allows the clinician
to select which vaporizer can be turned on, which prevents the two
vaporizers from being used simultaneously. To enable the left vaporizer, the
selector lever is moved to the right to lock out the right vaporizer. To enable
the right vaporizer, the selector lever is moved to the left to lock out the left
vaporizer.

VAPORIZER INTERLOCK

System Description

2

OP000179P

Figure 2-6. Two Vaporizer Interlock System

SERIAL
NUMBER
LABEL

Figure 2-7. Narkomed 6400 Rear View

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MOUNTING

RACK FOR

SPARE

VAPORIZER

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System Description

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Warning : On machines equipped with the two vaporizer mount and

interlock system, the D-tec desflurane vaporizer must be
installed in the left-hand position. Installing the D-tec
desflurane vaporizer in the right-hand position can lead to
fresh gas and vapor leaks.

LEFT-HAND
VAPORIZER
POSITION

RIGHT-HAND

VAPORIZER

POSITION

WARNING
LABEL

Figure 2-8. Desflurane Warning Label (Two Vaporizer Mount and Interlock System)

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