Penlon Prima SP3 User manual

Prima SP3 Anaesthetic Machine Range
User Manual
Partnership for Life
IMPORTANT
Servicing and Repairs
In order to ensure the full operational life of this anaesthetic machine, servicing by an engineer trained by the manufacturer should be undertaken periodically.
The machine must be serviced to the schedule detailed in section 6.4.
Details of these service operations are given in the Prima SP3 Service Manual, available only for engineers trained by the manufacturer.
For any enquiry regarding the servicing or repair of this machine, contact
Penlon Inc. 11515 K-Tel Drive Minnetonka MN 55434
Penlon Inc.:
Always give as much of the following information as possible:
1. Type of equipment
2. Product name
3. Serial number
4. Approximate date of purchase
5. Apparent fault
(i)
FOREWORD
This manual has been produced to provide authorised personnel with information on the function, routine performance and maintenance checks applicable to the Prima SP3 anaesthetic machine range.
Information contained in this manual is correct at the date of publication. The policy of the manufacturer is one of continued improvement to its products. Because of this policy, the manufacturer reserves the right to make any changes which may affect instructions in this manual, without giving prior notice.
Personnel must make themselves familiar with the contents of this manual and the machine’s function before using the apparatus.
The Importance of Patient Monitoring
WARNING Anaesthetic systems have the capability to deliver mixtures of gases and vapours to the patient which could cause injury or death unless controlled by a qualified anaesthetist.
There can be considerable variation in the effect of anaesthetic drugs on individual patients so that the setting and observation of control levels on the anaesthesia systems does not in itself ensure total patient safety. Anaesthesia system monitors and patient monitors are very desirable aids for the anaesthetist but are not true clinical monitors as the condition of the patient is also dependent on his respiration and the functioning of his cardio-vascular system.
IT IS ESSENTIAL THAT THESE ELEMENTS ARE MONITORED FREQUENTLY AND REGULARLY AND THAT ANY OBSERVATIONS ARE GIVEN PRECEDENCE OVER MACHINE CONTROL PARAMETERS IN JUDGING THE STATE OF A CLINICAL PROCEDURE.
Before using any monitoring system or device with the anaesthetic machine, the user must check that it conforms to the relevant standard, as listed in the table below.
Parameter / Device Relevant Standard
Pressure Measuring ISO 8835-2 Pressure Limitation Device EN 60601-2-13:2006 - 51.101.1 Exhaled Volume Monitor EN 60601-2-13:2006 - 51.101.4 Breathing System Integrity Alarm System EN 60601-2-13:2006 - 51.101.5 Continuing Pressure Alarm EN 60601-2-13:2006 - 51.101.6 Oxygen Monitor ISO 7767 Carbon Dioxide Monitor ISO 9918 Breathing Circuit ISO 8835-2 Gas Scavenging ISO 8835-3 Vaporizers ISO 8835-4 Ventilators ISO 8835-5 Agent Monitor ISO 11196
For information on installing and connection of any of these systems or devices, please refer to the relevant manufacturer’s instructions.
(ii)
CONTENTS
Page No.
USER RESPONSIBILITY 1
1. WARNINGS AND CAUTIONS 2
2. PURPOSE 4
3.
3.1 Framework and General Construction 5
3.2 Gas Circuit 5
3.3 Gas Supply Safety Devices 7
3.4 Mechanical Anti Hypoxic Device (AHD) 8
3.5 Pressure Gauges 8
3.6 Flowmeters and Controls 9
3.7 Vaporizers 10
3.8 Common Gas Outlet (CGO) 10
3.9 Electrical Power Supply 11
3.10 Auxiliary Gas Outlets 13
3.11 A200SP Absorber 13
3.12 AV-S Ventilator 13
4.
4.1 Physical Dimensions 14
4.2 Gas Supplies 15
4.3 Flowmeters 15
4.4 Gas Pressures 16
4.5 Auxiliary Gas Outlets 16
4.6 Oxygen Failure Warning Devices 16
4.7 Oxygen Flush 16
4.8 Mechanical AHD System 17
4.9 Environmental 17
4.10 Electrical Supply 17
4.11 Device Classification and Labelling 18
DESCRIPTION 5
Gas Circuit Schematic 6
SPECIFICATION 14
5.
5.1 Pre-use Check List 19
5.2 Pre-use Checks - Gas Supply 21
5.2.1 Gas Pipeline Supplies 21
5.2.2 Gas Cylinder Supplies 21
5.2.3 Flowmeters 22
5.3 Vaporizers 23
5.4 Electrical Supply 24
PRE-USE CHECKS 19
(iii)
CONTENTS
5.5 Patient Breathing System 25
5.6 Leak Rate Check - Low pressure gas System 28
5.7 Oxygen Flush 28
5.8 Anaesthetic Gas Scavenge System (AGSS) 28
5.9 Ventilator 29
5.10 Alarm System Testing 30
6.
6.1 Cleaning and Sterilisation 31
6.2 A200SP Absorber 32
6.3 Service Schedule 33
APPENDIX
Disposal at end of useful life: risk assessment 34 Accessories 35
USER MAINTENANCE
(iv)
USER RESPONSIBILITY
This anaesthetic machine has been built to conform with the specification and operating procedures stated in this manual and/or accompanying labels and notices when checked, assembled, operated, maintained and serviced in accordance with these instructions.
To ensure the safety of this device it must be checked and serviced to at least the minimum standards laid out in this manual. A defective, or suspected defective, product must not under any circumstances be used.
The user must accept responsibility for any malfunction which results from non­compliance with the servicing requirements detailed in this manual.
Additionally, the user must accept responsibility for any malfunction which may result from misuse of any kind or non­compliance with other requirements detailed in this manual.
Statements in this manual preceded by the following words are of special significance:
WARNING means there is a
possibility of injury to yourself or others.
CAUTION means there is a possibility
of damage to the apparatus
or other property.
NOTE indicates points of
particular interest for more efficient and convenient
operation.
Always take particular notice of the warnings, cautions and notes provided throughout this manual.
Worn, broken, distorted, contaminated or missing components must be replaced immediately. Should such a repair become
necessary it is recommended that a request for service advice be made to Penlon Inc.
This device and any of its constituent parts must be repaired only in accordance with written instructions issued by the manufacturer and must not be altered or modified in any way without the written approval of the manufacturer. The user of this equipment shall have the sole responsibility for any malfunction which results from improper use, maintenance, repair, damage or alteration by anyone other than the manufacturer or Penlon Inc.
USA and Canadian Federal Law restricts the sale and use of this device to, or on the order of, a licensed practitioner.
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1. WARNINGS AND CAUTIONS
The following WARNINGS and CAUTIONS must be read and
understood before using this anaesthetic apparatus.
WARNINGS
1. This apparatus is designed for use only with non flammable anaesthetic agents. It must not be used with or in close proximity to flammable anaesthetic agents, due to a possible fire or explosion hazard.
2. Exterior panels must not be removed by unauthorised personnel and the apparatus must not be operated with such panels missing.
On machines with an electrical power supply, unauthorised personnel must not attempt to access fuses or other electrical components. There is a possible electric shock hazard.
3. No oil, grease or other flammable lubricant or sealant must be used on any part of the machine in close proximity to medical gas distribution components. There is a risk of fire or explosion.
4. When attaching cylinders of medical gases ensure that the machine yoke and cylinder faces are dust free and clean and that the sealing washer provided is in position between the cylinder valve and the yoke.
Tighten the yoke securely before opening the cylinder valve. Dust and dirt presents a fire hazard in the presence of high pressure gas.
Leakage of high pressure gas can cause serious injury.
5. Anaesthesia apparatus must be connected to an anaesthetic gas scavenging system (AGSS) to dispose of waste gas and prevent possible health hazards to operating room staff.
This requirement must be observed during test procedures as well as during use with a patient.
6. Prima SP series machines must only be used with Delta vaporizers (or other vaporizers approved by the manufacturer) installed by means of the Cagemount or Selectatec system.
Free-standing vaporizers may be accidentally tipped, resulting in excessive and uncalibrated volumes of anaesthetic drug entering the breathing system
Do not install or connect any vaporizers of any description between the Common Gas Outlet (CGO) and the breathing system unless they are specifically designed for such use. (If this is done, the oxygen flush flow will pass through the vaporizer and may result in gross overdosage when the flush valve is operated.)
7. The breathing system which conveys gases from the anaesthetic machine to the patient and disposes of expired gases is a vital part of the anaesthetic delivery system.
Because breathing systems require frequent cleaning and disinfection they are not a permanent part of the anaesthetic machine and therefore cannot be directly under the control of the anaesthetic machine manufacturer.
However, we strongly recommend that only breathing systems which have been approved and authorised by Penlon for use with the Prima SP range should be employed.
This is particularly important when mechanical ventilation is employed.
8. When mechanical ventilation is employed the patient breathing system must be connected directly to an over­pressure relief valve to prevent the possibility of barotrauma.
9. Always perform a pre-use check of the machine, including vaporizers, ventilator, circle absorber and monitors before clinical use. Follow the pre-use checklist (see section 5) as a minimum requirement. Many clinical incidents occur because of a failure to check for correct function.
10. The machine must not be used if any of the alarm, monitoring or protection system devices are not functioning correctly.
11. The gas supply failure systems within the anaesthetic machine will not necessarily operate as indicated in the user manual during any procedures that are outside the scope of the indications for use of the machine:
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WARNINGS AND CAUTIONS
(A) Machine set to deliver Air only
When the machine is operated with an Air flow only, note that there may still be retained oxygen in the system, and that the visual O2 alarm will continue to indicate green, even though oxygen is not being delivered.
(B) Machine set to deliver Oxygen only through Auxiliary Outlets
The oxygen failure alarm is designed to operate during normal use of the machine, i.e. when providing controlled concentrations and flows of gases to a patient breathing system, as described in Section 2 (Purpose).
Do not use the machine solely to provide large flows of oxygen, via the anaesthetic machine auxiliary outlets, to external devices which may not be equipped with a supply failure alarm.
12. The machine must not be fitted with more than four operator accessible mains socket outlets. There is a risk of an excessive leakage current.
13. The use of antistatic or electrically conductive breathing hoses is not recommended when using high frequency electrical surgery equipment (e.g. Diathermy). Burns may be caused.
14. Before any electrically powered machine is used clinically for the first time, check that the hospital engineering department has carried out an earth continuity test.
15. Before using any additional electrical equipment powered by the auxiliary sockets on the machine, check that the additional equipment is correctly wired and is earthed through its plug. A missing or defective protective earth conductor may increase earth leakage currents to the patient to values exceeding the allowable limits, resulting in ventricular fibrillation, or interference with the pumping action of the heart.
16. Additional equipment placed on the top shelf must be securely attached. Take care when moving a fully loaded machine, particularly when negotiating ramps. Check that hoses or power leads are not trailing on the floor.
17. Prima SP2/3 series anaesthetic machines are not MRI compatible.
CAUTIONS
1. Flowmeter needle valves are designed to seal with light torque and may be damaged if tightened excessively. Do not force the control knob past either the fully open or fully closed positions.
2. Open cylinder valves slowly to avoid damage to pressure reducing valves. Ensure that cylinder valves are at least one full turn open when in use.
3. Under no circumstances should anaesthetic agents be used for cleaning purposes.
4. After use, always disconnect the machine from the piped gas supply and/or close the gas cylinder valves.
5. Mechanical AHD system - The oxygen flow control is restricted to prevent the needle valve from fully closing. This ensures a minimum basal flow of oxygen. DO NOT attempt to close the flow to zero. Do not overtighten.
6. Compressed gas supplies must be clean and dry.
7. When the auxiliary gas outlets are in use on a machine with cylinder supply only, or if the pipeline supply is not in use, check flow rate requirements, and ensure that adequate back-up cylinders are available.
8. The requirements of IEC 60601-1-1 apply to any device connected to the auxillary sockets. Users must be aware of the risks of increased leakage currents when equipment is connected to the auxillary power sockets
9. In the event of malfunction of any device powered by the auxiliary sockets, check if the circuit breaker has tripped.
10. On machines with pipeline connections, note that a malfunction of the central gas supply within your facility may cause immediate cessation of gas delivery and total anaesthesia system failure.
3
2. PURPOSE
The Prima SP3 anaesthesia workstation range is intended to provide controlled concentrations and flows of anaesthesia gases into a patient breathing system, from where the anaesthesia ventilator and breathing circuit will then deliver this fresh gas mixture to the patient
Use the Prima SP3 in conjunction with anaesthetic vaporizers, breathing hoses and patient connection fittings which comply with the relevant ISO standard or equivalent.
Depending upon the patient circuit selected, the machines can be used in open, semi­open, semi-closed or closed circuit configurations.
The range has been designed to give a wide choice of configurations and accessories, including:
Gas supplies
Up to four gases - oxygen, nitrous oxide, and air, with optional fourth gas (see section 4).
Pin-index cylinder yokes, and provision for up to three pipeline supply inlets.
Vaporizer mounting systems
Backbar manifold for Selectatec Compatible, or Cagemount type vaporizers.
Anti-hypoxic Device (AHD)
The mechanical AHD system is designed to minimise the risk of a hypoxic mixture reaching the patient (see section 3).
4
3. DESCRIPTION
3.1 General Construction
Frame
The machine has a cast aluminium base, extruded aluminium uprights, with aluminium and plastic panels.
Mobility
Four castors are fitted, with a brake on each of the front castors. The castors are five inches diameter. A footrest is built into the front of the machine and, to aid manoeuvrability, two handles are provided.
Mounting posts and brackets
A mounting system is built into each side upright, to allow the use of pole-mount brackets, V-brackets, and ventilator
mounting brackets. The pole mount upright can be used to mount an A200SP Absorber assembly.
Work surfaces
The work surface has raised edges to retain instruments, vials etc. A pull-out writing tablet is mounted under the work surface.
1
Pipeline Inlets (1)
Up to three, rear mounted pipeline gas inlets can be fitted. Pipeline supply hoses are connected by non-interchangeable, screw threaded unions.
CAUTION
A malfunction of the central gas supply within your facility may cause immediate cessation of gas delivery and total anaesthesia system failure.
Filters
To prevent dirt entering the gas system, cylinder yokes and pipeline inlets are fitted
with filters.
3.2 Gas Circuit
Gas Circuit Schematic
A gas circuit schematic is shown on the following page.
Gas Supplies
A variety of cylinder and pipeline combinations can be added to the basic specification of oxygen and nitrous oxide cylinder and pipeline supply. For example, two extra gas cylinders (choose from one additional oxygen, one additional nitrous oxide, one air), and one extra pipeline supply - Air.
Cylinder Yokes
The yokes are rear mounted and conform with ISO standards for pin-index fitting. To ensure that only cylinders of the appropriate gas may be installed the yokes are designed so that the retaining latch cannot be closed unless the index pins are fully engaged.
Gas Inlet Block
Each individual cylinder or pipeline supply, is routed through a separate gas block. Each gas block has an integral high
pressure gauge tapping for direct mounting of a pressure gauge, and a non-return valve to prevent back flow of gas. In addition, cylinder gas blocks have a diaphragm pressure regulator to reduce the pressure of the compressed gas supply, and a pressure relief valve, factory set to 517 kPa (75 psi). This prevents pressure build up under the diaphragm should any leakage develop across the reducing valve seat.
Secondary Pressure Regulator
A second stage regulator reduces the pressure supplied to each flowmeter control (see section 4). The fitment of a secondary regulator for oxygen and nitrous oxide enhances the performance of the mechanical AHD system. Secondary regulation of the air supply aids the stabilisation of the output at the flowmeter.
5
USA specification three-
gas machine with dual cascade oxygen and nitrous oxide flowmeters.
2 Air N2O
O
Flowmeter Assembly
Pneumatic pressure source
Pressure gauge
O2 N2O Air
Gas cut-off valve (normally open)
Reservoir
Gas Tray
Flowmeter
Vaporizer
Pressure regulator
Pressure relief valve
Audible alarm
Restrictor
Pneumatic on/off switch
Flow control valve (variable)
Filter
6
Oxygen flush valve
Non-return valve
Power take-off point (or test point)
Visual indicator
DESCRIPTION
3.3 Gas Supply Safety Devices
3.3.1 Gas Supply Cut-off Device
A gas cut-off device, triggered by low oxygen supply pressure, cuts the supply of nitrous oxide, and carbon dioxide or other fourth gas (if fitted).
The cut-off operates when the oxygen pressure falls to 200 ± 14 kPa (29 ± 2 psig).
Gas supplies are reinstated only when the oxygen supply pressure rises above 227 kPa (33 psig).
3.3.2 Oxygen Supply Failure Warning Whistle
WARNING: Refer to WARNING 11 (section 1).
A whistle gives an audible warning when there is a reduction of oxygen supply pressure. Operated solely by the remaining oxygen in the machine system, the warning whistle is prolonged by an oxygen reservoir built into the gas circuit, allowing a minimum warning whistle of 7 seconds duration.
The whistle will start to sound when the pressure falls to 200 ± 21 kPa (29 ± 3 psig), and will continue to sound until the pressure falls to approximately 70 kPa (10 psig).
Oxygen consumption of the whistle is approximately 2 L/min when sounding and nil at other times.
1
3.3.4 Oxygen Supply Visual Indicator
WARNING: Refer to WARNING 11 (section 1).
The indicator (1) is mounted on the front of the machine and is operated from the oxygen supply and shows GREEN when the supply is at working pressure, and RED if the pressure falls.
3.3.5 Mechanical AHD
A mechanical link between the oxygen control valve and a needle valve in the nitrous oxide flow ensures that the machine delivers a fresh gas mixture with a minimum 30% (±3%) oxygen, irrespective of the flow of nitrous oxide set by the anaesthetist. With the nitrous oxide control valve fully open, the oxygen and nitrous oxide flows are then both controlled by the oxygen control valve.
See section 3.4 for a full description
3.3.3 Fresh Gas Pressure Relief Valve
A pressure relief valve is mounted between the vaporizer back bar and the common gas outlet (CGO) on the inside face of the machine right hand upright.
It is designed to prevent fresh gas being delivered to the breathing system at pressures exceeding 41 kPa (6 psi). This valve also protects machine components against excessive pressure in the event of a total blockage of the CGO.
3.3.6 Low Pressure Gas Tubing
Diameter-indexed tubing is used for the low pressure gas system - see section 4.
7
DESCRIPTION
3.4 Mechanical AHD
(Anti Hypoxic Device)
3.4.1 Introduction
The Mechanical AHD is housed within the flowmeter module and comprises a gear linkage between the oxygen control valve and a needle valve in the nitrous oxide flow.
The system controls the relative flow rates of oxygen and nitrous oxide. A predetermined minimum oxygen concentration of 30% nitrous oxide mixture is maintained over the flow range to prevent delivery of a hypoxic mixture.
±3% in the oxygen /
1
limits the flow of nitrous oxide relative to the flow of oxygen set by the user. Note that this needle valve acts as the primary nitrous oxide valve, and is actuated only by movement of the oxygen control.
The nitrous oxide control knob on the flowmeter module operates a secondary needle valve in the nitrous oxide flow. It is positioned downstream of the primary valve and therefore is used only to restrict the flow already set by the primary valve, which itself has been determined by the position of the oxygen control knob. Therefore, for any oxygen flow set by the user, the mixture delivered will still contain a minimum 30% nitrous oxide control knob fully open. As the nitrous oxide knob is progressively closed, the oxygen content of the mixture increases to 100%.
3.4.4 Oxygen Basal Flow
To allow the system to function correctly, an oxygen basal flow is continuously supplied.
±3% oxygen even with the
3.4.2 Gas Delivery Switch (1)
The Gas Delivery Switch (1) operates on the oxygen supply and must be in the ‘On’ position for normal operation of the anaesthetic machine.
Switch labelling: 1 Indicates On
0 Indicates Off
The switch consequently controls the supply of all gases provided with a gas cut-off triggered by a predetermined pressure level within the oxygen supply (see section 3.3.1).
A whistle (oxygen failure warning whistle) will sound briefly whenever the gas delivery switch is turned on or off. Note that the whistle functions continuously if the oxygen supply fails (see section 3.3.2).
NOTE The switch also controls the electrical supply to the optional flowmeter lighting unit.
3.4.3 Gear Linkage and Nitrous Oxide Control Valves
A gear linkage connects the oxygen control knob on the flowmeter module and a needle valve in the nitrous oxide flow. This linkage
Single Flow Tubes: 100 - 200 ml/min
Dual Cascade System Flow Tubes:
50 - 75 ml/min
This basal flow can only be turned on and off by using the Gas Delivery Switch.
CAUTION
The oxygen control is restricted to prevent the needle valve from fully closing. This ensures a minimum oxygen basal flow. DO NOT attempt to close the flow to zero. Do not overtighten the knob.
3.5 Pressure Gauges
Pressure gauges (50 mm diameter) are located on the front panel below the flowmeter bank. The gauge for Air is positioned between oxygen and nitrous oxide. Unused gauge positions are blanked out.
All pressure gauges are colour coded and labelled for the gases whose pressures they are indicating. Cylinder gauges are marked: CYLINDER.
Pipeline gauges are marked: PIPELINE.
The gauges are calibrated in kPa x 100.
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