Draft Copy

July 2005
No update will be given

AV-S Ventilator
Remote Display Module and Interface
for use with A200SP Absorber
Service Manual

Partnership for Life

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 THE IMPORTANCE OF PATIENT MONITORING

WARNING Anaesthesia system monitors and patient

monitors are very desirable aids for the
anaesthetist but are not true clinical
Anaesthetic systems have the capability monitors as the condition of the patient is
to deliver mixtures of gases and vapours also dependent on his respiration and the
to the patient which could cause injury or
functioning of his cardio-vascular system.
death unless controlled by a qualified
anaesthetist.
IT IS ESSENTIAL THAT THESE ELEMENTS
There can be considerable variation in ARE MONITORED FREQUENTLY AND
the effect of anaesthetic drugs on REGULARLY AND THAT ANY
individual patients so that the setting and OBSERVATIONS ARE GIVEN
observation of control levels on the PRECEDENCE OVER MACHINE CONTROL
anaesthesia systems does not in itself PARAMETERS IN JUDGING THE STATE OF
ensure total patient safety. A CLINICAL PROCEDURE.

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 IMPORTANT

Servicing and Repairs

In order to ensure the full operational life of this

ventilator, servicing by a Penlon-trained
engineer should be undertaken periodically.

The ventilator must be serviced to the following

schedule:

(a) Six monthly service - inspection and

function testing.
(b) Annual / 2 Year / four year service
including component replacement.

Details of these operations are given in this

Manual for the AV-S, available only for Penlon
trained engineers.

For any enquiry regarding the servicing or

repair of this product, contact the nearest
accredited Penlon agent:

or communicate directly with:

Technical Support
Penlon Limited
Abingdon Science Park
Barton Lane
Abingdon
OX14 3PH
UK

Tel: 44 (0) 1235 547076

Fax: 44 (0) 1235 547062
E-mail: [email protected]

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)

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 FOREWORD

This manual has been produced to provide

authorised personnel with information on the
function, routine performance, service and
maintenance applicable to the AV-S
Anaesthesia Ventilator.

Information contained in this manual is correct

at the date of publication.
The policy of Penlon Limited is one of continued
improvement to its products.
Because of this policy, Penlon Limited 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 servicing the apparatus.

Copyright © Penlon Limited, 2005.

All rights reserved.

(ii)

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 CONTENTS
Page No.
USER RESPONSIBILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1. WARNINGS AND CAUTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2. PURPOSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

3. DESCRIPTION
3.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
3.2 Ventilation Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

3.3 Pneumatic System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

3.3.1 System Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.4 Electrical System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

3.5 Control Panel ............................................. 16

3.5.1 Touchscreen Operation and Navigator wheel / push-button ............ 16
3.5.2 User Adjustable Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.5.3 Operational capability ........................................ 17
3.5.4 Output Compensation Functions ............................... 18
3.6 Interface with Prima SP and A200SP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

3.7 Ventilation Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

3.7.1 Standby Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.7.2 Volume Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.7.3 Pressure Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
3.7.4 Spontaneous Mode ......................................... 23
3.7.5 Advanced Spontaneous Breathing Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.7.5.1 SIMV (Synchronised Intermittent Mandatory Ventilation) . . . . . . . . . . . . . 24
3.7.5.2 SMMV (Synchronised Mandatory Minute Ventilation) ............ 25
3.7.5.3 PSV (Pressure Supported Ventilation) ...................... 26
3.7.5.4 PEEP ( Positive End Expiratory Pressure) . . . . . . . . . . . . . . . . . . . . . . 27

3.8 On-screen Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

3.9 Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.10 Display Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.11 Alarms ...... .............................................. 30

3.12 Oxygen Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

3.13.1 System Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
3.12.2 The MOX-3 Oxygen Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
3.12.3 Menus .................................................. 32
3.12.4 Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.12.5 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.12.6 Alarm Mute. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

4. SPECIFICATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Ventilator .................................................. 34
Oxygen Monitor . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

(iii)

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 CONTENTS

5. PRE-OPERATION PROCEDURES
5.1 Ventilator Set-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
5.1.1 Mounting the Ventilator ....................................... 39
5.1.2 Electrical Power Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
5.1.3 Ventilator Gas Supply .................................. 39
5.1.4 Breathing System Schematic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
5.1.5 Bellows Drive Gas ........................................... 43
5.1.6 Anaesthetic Gas Scavenging System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
5.1.7 Printer .................................................... 43
5.1.8 Breathing System ........................................... 43
5.1.9 Spirometer Connections ....................................... 44
5.1.10 Pressure Monitor Connections .................................. 46
5.1.11 Bellows Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

5.2 Pre-use Checklists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

5.2.1 Daily Checklist ........................................... 48
5.2.2 Function Test .............................................. 49
5.2.3 Weekly Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

5.3 Oxygen Monitor Set-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

5.3.1 Installation . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
5.3.2 Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
5.3.3 Sensor Low Indication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
5.3.4 Setting the High and Low O2 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

6. SERVICE PROCEDURES
6.1 Service Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
6.2 Control Unit Patient Block Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

7. SERVICE SCHEDULE
Service Schedule ..................................... 56

8. PARTS LISTS
Preventive Maintenance Kits .............................. 64
Assemblies 65

9. APPENDIX
1. Back-up Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
2. Menu System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
3. Ventilator Spirometry System .......................... .... 82
4. Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Outside Surfaces ................................... .. 85
Bellows and Diaphragm Exhalation Valve . . . . . . . . . . . . . . . . . . . . . 86
Spirometer Sensors ................................... 86
Patient Connector Block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Sterilisation ........................................... 87
Oxygen Monitor - Cleaning and Sterilisation . . . . . . . . . . . . . . . . . . 88
Oxygen Sensor Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

(iv)

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 USER RESPONSIBILITY

This anaesthesia ventilator has been built to Statements in this manual preceded by the
conform with the specification and operating following words are of special significance:
procedures stated in this manual and/or
accompanying labels and notices when WARNING means there is a
checked, assembled, operated, maintained possibility of injury to the
and serviced in accordance with these user or others.
instructions.
CAUTION means there is a possibility
To ensure the safety of this device it must be of damage to the apparatus
checked and serviced to at least the or other property.
minimum standards laid out in this manual.
A defective, or suspected defective, product NOTE indicates points of
must not under any circumstances be used. particular interest for more
efficient and convenient
The user must accept responsibility for any
operation.
malfunction which results from non-
compliance with the servicing requirements
detailed in this manual. Always take particular notice of the
warnings, cautions and notes provided
Additionally, the user must accept throughout this manual.
responsibility for any malfunction which may
result from misuse of any kind or non-
compliance with other requirements detailed
in 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 the nearest
Penlon accredited agent.

This device and any of its constituent parts

must be repaired only in accordance with
written instructions issued by Penlon
Limited and must not be altered or modified
in any way without the written approval of
Penlon Limited. 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 Penlon or its
appointed agents.

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 7. The driving gas is discharged through
must be read and understood before using the opening in the back of the ventilator
control unit.
this ventilator.
The discharged gas may contaminate
the environment, and should therefore
be extracted using a gas scavenging
WARNINGS system.
General Information
8. The bellows can only support
1. Personnel must make themselves approximately 1 kPa (10 cmH2O)
familiar with the contents of this differential positive pressure, above
manual and the machine’s function which it may be dislodged from the
before using the ventilator. mounting ring, resulting in dangerous
malfunction of the ventilator.
Do not connect a positive end
Before Using the Ventilator expiratory pressure (PEEP) valve or
2. Before the ventilator is used clinically other restrictive device to the exhaust
for the first time, verify that the hospital port on the bellows base.
engineering department has carried out This would increase the pressure inside
an earth continuity test. the bellows and the bellows could
detach from the base, causing serious
3. Excessive electronic noise caused by malfunction.
other poorly regulated devices, such as
an electrocautery unit, may adversely 9. Breathing System
interfere with the proper functioning of The breathing system which conveys
the ventilator. gases from the anaesthetic machine to
the patient, and disposes of expired
To avoid this problem, do not connect gases, must conform to the
the ventilator’s power cord into the requirements of ISO 8835-2.
same electrical wall outlet or adaptor Because breathing systems require
strip into which an electrocautery unit frequent cleaning and disinfection they
is connected. are not a permanent part of the
anaesthetic ventilator and therefore
4. If used with a mains extension cord, the cannot be directly under the control of
unit may be subject to electro-magnetic the anaesthetic ventilator manufacturer.
interference. However, we strongly recommend that
only breathing systems which have
5. The driving gas supply must be clean been approved and authorised by
and dry to prevent ventilator Penlon for use with AV-S should be
malfunction. employed.

6. This ventilator is designed to be driven Do not use conductive breathing

by oxygen or medical air only. It is system hoses.
calibrated during manufacture for use
with either gas. When mechanical ventilation is
Before the ventilator is used clinically employed the patient breathing system
for the first time, the commissioning must be connected directly to a
engineer must confirm that the internal pressure relief valve to prevent the
Air/Oxygen switch is set correctly for possibility of barotrauma.
the gas that is to be used.
The use of any other gas will cause
inaccurate operation and may damage 10. Do not connect a spirometer to the
the ventilator, resulting in potential exhaust port on the bellows base.
injury to the patient. The device will not measure exhaled
volumes in that position.

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 WARNINGS AND CAUTIONS

11. The operation of each alarm function 17. In compliance with good anaesthesia
should be verified daily. practice, an alternative means of
ventilation must be available whenever
Periodically check the alarms at the ventilator is in use.
clinically suitable intervals. If the
audible alarm or the visual indicator of 18. It is recommended that the patient
any alarm function fails to activate oxygen concentration should be
during any alarm condition or fails to monitored continuously.
reset after the alarm has been cleared,
refer the unit to an authorised service 19. If the drive gas supply pressure drops
technician. below a nominal 241 kPa (35 psi), the
LOW DRIVE GAS SUPPLY alarm will
12. Before using the ventilator check that activate both audibly and visually.
all connections are correct, and verify Patient minute volume may be reduced
that there are no leaks. due to lowered flow rates

Patient circuit disconnects are a hazard 20. An audible alarm indicates an

to the patient. Extreme care should be anomalous condition and should never
taken to prevent such occurrences. go unheeded.

It is recommended that Penlon 21. The characteristics of the breathing

Safelock fittings are used throughout circuit connected between the
the breathing circuit. ventilator and the patient can modify or
change patient ventilation.
To assist the maintenance of the
Using the Ventilator delivered patient tidal volume, the
ventilator control system software
13. The AV-S ventilator is not intended for includes:
use in intensive care applications. A) a compliance compensation
algorithm,
14. This apparatus must not be used with, B) a fresh gas compensation
or in close proximity to, flammable algorithm.
anaesthetic agents.
There is a possible fire or explosion However, patient ventilation must be
hazard. monitored independently from the
ventilator.
15. Anaesthesia apparatus must be It is the responsibility of the user to
connected to an anaesthetic gas monitor patient ventilation.
scavenging system (AGSS) to dispose
of waste gas and prevent possible 22. Care must be taken to ensure that the
health hazards to operating room staff. flow sensors are connected correctly
This requirement must be observed to the inspiratory and expiratory ports
during test procedures as well as of the absorber.
during use with a patient.
The scavenging transfer and receiver 23. The Vent Inop (ventilator inoperative)
system must conform to ISO 8835-3. alarm indicates that one of the
Any problem arising from an following conditions has occurred:
improperly functioning scavenging a) The drive gas solenoid has failed.
system is solely the user’s
responsibility. b) The flow control valve has failed.
Do not use a scavenging system that c) Internal electronic fault.
restricts drive gas flow when negative
d) Internal electrical fault.
pressure is exerted on it.
e) Software error.
16. When the ventilator is connected to a
patient, it is recommended that a Note that if a ventilator error is
qualified practitioner is in attendance detected, ‘Ventilator Inoperative’ will be
at all times to react to an alarm or other displayed on the front control panel
indication of a problem. display.

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 WARNINGS AND CAUTIONS

24. The High and Low Airway Pressure 31. Check that the cable between the
Alarms are important for patient care. control unit and remote display screen
It is important that the sensor is unit is connected before use.
properly located in the expiratory limb Always use a cable type recommended
of the circuit - refer to section 5.1.10. by the manufacturer.

25. The patient must be continuously Bellows Assembly

attended and monitored when 32. The valve seat on the patient gas
Advanced Breathing Modes are in use. exhalation diaphragm valve in the base
of the bellows assembly must be
cleaned regularly - see section 6.2.
User Maintenance
Failure to keep the valve seat clean
could result in the diaphragm sticking,
Control Unit
thus preventing exhalation.
26. Opening the control unit by
unauthorised personnel automatically
Great care must be taken not to
voids all warranties and specifications.
damage the precision surface of the
valve seat on the patient gas exhalation
Prevention of tampering with the
diaphragm valve in the base of the
control unit is exclusively the user’s
bellows assembly.
responsibility. If the control unit seal is
broken, the manufacturer assumes no
Never use any hard object or abrasive
liability for any malfunction or failure of
detergent to clean it; use only a soft
the ventilator.
cloth.
If the valve seat is damaged, the valve
27. For continued protection against fire
will leak and may cause serious
hazards, replace the two fuses only
ventilator malfunction.
with the identical type and rating of
fuse.
See section 4 for fuse rating.

28. If the internal battery is fully

discharged, the ventilator will not
function in the event of mains power
failure. The battery must be recharged
before the ventilator is used clinically,
otherwise backup cannot be
guaranteed.
See Appendix for battery maintenance.
See also CAUTION No. 7.

Used or defective batteries must be

disposed of according to hospital,
local, state, and federal regulations.

29. No oil, grease or other flammable

lubricant or sealant must be used on
any part of the ventilator in close
proximity to medical gas distribution
components.
There is a risk of fire or explosion.

30. Exterior panels must not be removed

by unauthorised personnel and the
apparatus must not be operated with
such panels missing.
There is a possible electric shock
hazard.

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 WARNINGS AND CAUTIONS

CAUTIONS 10. Circuit compliance is not activated until

Fresh Gas Compensation is switched
1. Do not sterilise the ventilator control unit. OFF.
The patient block assembly must be
removed from the control unit before
sterilisation ( see section 6.2.4).
All other internal components are not NOTES
compatible with sterilisation techniques
and damage may result. 1. The term ‘cycle’ is used to designate the
transition to the exhalation phase.
2. For ventilator components which require
2. The term ‘trigger’ is used to indicate the
sterilisation, peak sterilisation
transition to the inhalation phase.
temperatures should not exceed 136oC
(275oF) to prevent possible damage.
(See section 6).

3. Those parts suitable for ethylene oxide

sterilisation should, following sterilisation,
be quarantined in a well ventilated area to
allow dissipation of residual gas absorbed
by the components.
Follow the steriliser manufacturer’s
recommendations for any special aeration
periods required.

4. The exhalation valve located in the

bellows base assembly and the paediatric
bellows adaptor must be cleaned and
sterilised separately. See section 6.

5. Care must be taken not to let any liquid

run into the control unit; serious damage
may result.

6. Always check for correct fitment, and carry

out a full function test before clinical use, if
the bellows has been removed and
refitted for any reason. See section 6.

7. Damage may occur to the battery if it is

allowed to remain in a discharged state.
Check the battery frequently if the
ventilator is in storage (see Appendix 1).

8. Fresh gas compensation is disabled if :

a) The spirometry system is turned OFF
through the menu system, or
b) The spirometry system is not functioning
correctly.

9. Fresh gas mixture compensation is disabled

if :
a) The spirometry system is turned OFF
through the menu system, or
b) The spirometry system is not functioning
correctly.
c) The O2 monitor is switched OFF.

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 WARNINGS AND CAUTIONS - Oxygen Monitor

Oxygen Monitor
NOTES
1. The O2 SENSOR FAULT alarm indicates
WARNINGS
that one of the following conditions has
1. We recommend calibration of the
occurred.
oxygen monitor every time the system
a) Internal electrical fault
is turned on, as a safety precaution.
b) Software/electronics fault
c) Oxygen sensor fault.
2. Do not attempt to open the fuel cell.
The sensor contains small quantities
2. The concentration read-out may, in
of :
certain conditions of excess pressure,
a) electrolyte, classified as a harmful
show a value above 100%.
irritant which is potentially hazardous,
To accommodate these conditions it is
and
possible to set the high alarm value up to
b) lead.
105% (see section 5).
Used or defective cells must be
3. To maintain maximum sensor life:
disposed of according to hospital,
i) always switch off the anaesthetic
local, state, and federal regulations.
machine after use, to ensure that the basal
flow ceases.
3. ALWAYS check the integrity of the
ii) disconnect the breathing circuit after
sensor assembly before use.
use.
4. Once exhausted, the sensor must be
4. The accuracy of flow and volume
disposed of according to hospital,
measurements may be reduced if the
local, state and federal regulations.
oxygen monitor is not in use.
5. The sensor measures oxygen partial
5. Fresh gas mixture compensation is disabled
pressure, and its output will rise and
fall due to pressure change. if the oxygen monitor is switched OFF.
An increase in pressure of 10% at the
sensor inlet will produce a 10%
increase in sensor output.

CAUTIONS
1. Only use low temperature ethylene oxide
sterilisation for the oxygen sensor.
The sensor is not compatible with other
sterilisation techniques - damage may
result.
Do not sterilise any other components.

2. Do not autoclave or expose the sensor to

high temperatures.

3. If the sensor shows signs of being affected

by condensation, dry the sensor with soft
tissue.
Do not use heat to dry the sensor.

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 2. PURPOSE

The AV-S Ventilator is a software controlled,

multi-mode ventilator, designed for
mechanical ventilation of adult and
paediatric patients under general
anaesthesia.
In addition, in spontaneous mode, it can be
used to monitor spontaneously breathing
patients
It is designed for use in closed-circuit
anaesthesia and also to drive a Mapleson D
circuit.

Indications for use of the device:

The AV-S Ventilator is intended to provide

continuous mechanical ventilatory support
during anaesthesia. The ventilator is a
restricted medical device intended for use by
qualified trained personnel under the
direction of a physician. Specifically the
ventilator is applicable for adult and
paediatric patients.
The ventilator is intended for use by health
care providers, i.e. Physicians, Nurses and
Technicians with patients during general
anaesthesia.
The AV-S ventilator is not intended for use in
intensive care applications.

Oxygen Monitor
The Oxygen Monitor is intended to
continuously measure and display the
concentration of oxygen in breathing gas
mixtures used in anaesthesia, and is
intended for adult and paediatric patients.
The oxygen monitor is an integral part of the
ventilator.
The oxygen monitor is intended for use by
health care providers, i.e. Physicians,
Nurses and Technicians for use with patients
during general anaesthesia.

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 3. DESCRIPTION

AV-S Ventilator

3.1 General Description Patient Monitoring

Airway pressure, measured from the
The AV-S Ventilator is a pneumatically expiratory limb of the breathing circuit.
driven, software controlled, multi-mode
ventilator. Tidal volume and Minute Volume
measurement is provided by a dual
The ventilator is a time-cycled, spirometry system
volume/pressure controlled, and pressure
limited. An integral oxygen monitor system
measures oxygen concentration in the
The ventilator has compliance compensation breathing circuit inspiratory limb.
and a user selectable option of an inspiratory
pause fixed at 25% of the inspiratory time. The print function provides a permanent
In addition, fresh gas compensation and record of function activity for up to eight
user selectable gas mixture compensation is hours during a procedure, or can be used to
a standard feature. record waveforms.

Ventilation Modes Screen

Volume Mode - continuous mandatory 210 mm (8.4 inch) high definition, colour TFT
ventilation screen, with single/dual waveform display.
Pressure Mode - pressure controlled
ventilation
Spontaneous, with advanced features -
SIMV, SMMV, PSV
PEEP

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 DESCRIPTION

Bellows unit
The bellows unit (1) is built into the A200SP 1
absorber.
A paediatric bellows assembly is available as
an option

Mounting options
The AV-S integral screen and control unit can
be mounted securely on the anaesthetic
machine shelf or side bracket.

Drive gas supply

The supply must be at 310 to 689 kPa (45 to
100 psi ).
The ventilator drive gas supply can be oxygen
or air.
Note that the drive gas is specified by the
customer prior to delivery. Conversion from
one drive gas to another must be carried out by
a Penlon-trained service engineer.

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 DESCRIPTION

5 8 9 10 11 12 13 14 15
6

3 2 1
7
4

Interface and Parameter inputs

Control Unit 5. A200SP Absorber Bag/Vent
Rear Panel switch interface
Spirometer connector
6. Prima SP Interface connector
7. Pressure Monitor Port
Gas Connections
8. Input socket - Oxygen monitor
1. Ventilator drive gas inlet
sensor
- connect to anaesthetic machine
auxiliary gas outlet
Data and Printer Ports
2. Bellows Drive Gas Output
9. Data Output
- connect to bellows
( on Prima SP with A200SP absorber, 10. Output to remote screen
connect to absorber - see section 5.1.5) 11. Ethernet
3. Outlet - Exhaust Valve 12. USB
13. VGA
Electrical Connection 14. Printer port
4. Electrical mains input and fuse unit 15. RS232

NOTE
USB port is for use by Penlon-trained
engineers only.
All other data ports are read only.
For further information, please contact
Penlon Technical Support.

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 DESCRIPTION

3.2 Ventilation Cycle

This section provides a simplified description of the ventilation cycle.

1. Inspiratory Phase

The inspiratory proportional

1 valve (1) in the control unit
opens, and bellows drive
4 gas is delivered to the
bellows housing (2).
The expiratory proportional
valve (3) opens and gas
3 flows through the bleed
valve. The back pressure
ensures that the exhaust
2 valve (4) is kept closed
5
Drive gas pressure builds
6 up above the bellows, which
starts to move down.
The diaphragm (5) in the
bellows assembly base is
held closed, and patient gas
is forced out of the bellows
base (6) into the breathing
system.

2. Beginning of
Expiratory Phase
1
The Inspiratory (1) and
Expiratory (3) proportional
valves close and the exhaust
valve (4) opens. Patient gas
4 returns to the bellows. As
3
the bellows rises, redundant
drive gas is pushed out
through the exhaust valve.

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 DESCRIPTION

3. End of
Expiratory Phase
4
With the bellows at the top
of its housing fresh gas
continues to flow. To
prevent a high pressure
build up the exhalation
5 diaphragm (5) lifts and
allows gas to exit through
the exhaust valve (4).

4. PEEP
Positive End
Expiratory
1 Pressure
(user selectable)

4
During PEEP the Exhalation
Proportional valve (3)
applies PEEP pressure plus
3
20 cmH2O to the exhaust
valve, which remains closed
at this stage.
As fresh gas flows in the
patient circuit, any pressure
increase above PEEP
pressure in the bellows will
cause gas to bleed past the
exhaust valve (4).
A continuous flow from the
Inspiratory proportional
valve (1) ensures that any
fall in pressure is
compensated by driving the
bellows as required.

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 DESCRIPTION

A Pneumatic Flow
Diagram
1 3 to 7 bar

2
3 241 kPa (35 psi)

5 6
0 - 80 cmH2O

B 7 8 14
C

10 12

11 15

0 - 90 cmH2O
13

16
100 cmH2O

17 18

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 DESCRIPTION

3.3 Pneumatic System

3.3.1 System Operation
Refer to the pneumatic system diagram on the
previous page.

A) Gas inlet manifold block B) Pneumatic Control Manifold Block

The AV-S Ventilator is designed to operate on a 7. Inspiratory Proportional Valve

310 - 689 kPa (45 -100 psi) drive gas supply
(oxygen or air - to customer’s requirement). 8. Flow Sensor

1. DISS Connector 9. Drive Gas pressure Sensor

The gas source is connected to the
DRIVE GAS SUPPLY fitting on the rear of 10. Low Pressure Regulator
the ventilator control unit.
The gas supply should be capable of a 11. Expiratory Proportional Valve
flow rate of 80 L/min while maintaining a
minimum pressure in excess of 310 kPa 12. PEEP pressure sensor
(45 psi).

2. Filter 13. Restrictor

The drive gas is filtered with a 40-micron The restrictor allows a flow of up to 2 L/min
Input Gas Filter which protects the (<2 L/min bleeding)
pneumatic components from incoming
particulate matter.
C) Exhaust Manifold Block
3. The Low Supply Pressure Detector
The pressure switch is set at a 14. Check Valve
predetermined level to detect a loss or
reduction of the input gas source 15. Diaphragm Valve
pressure.
When the pressure falls below 235 kPa 16. Pressure Relief valve
(35 psi ± 1 psi), the LOW SUPPLY Set to 100 cmH2O
PRESSURE indicator will be displayed
and the high priority audible alarm will 17. Exhaust Port ( to AGSS)
activate.
18. Bellows drive gas outlet (to bellows
4. Input Pressure Regulator assembly)
Regulates the input drive gas to 260 kPa
± 21 kPa (38 psi ± 3 psi).

5. Cut-off Valve
The valve isolates the the gas supply :
a) when the ventilator is switched off
b) when a fault condition occurs.

6. Airway Pressure Sensor

Connected to expiratory limb of breathing
circuit.

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 DESCRIPTION

3.4 Electrical System

Mains Supply
The mains supply inlet is designed for
connection to any mains voltage from 100 to
240 VAC and a frequency of 50 to 60 Hz,
without any adjustment.
The connector is a standard IEC type.

Back-up Battery
In the event of mains electrical failure, the back-
up battery cuts in automatically.
A fully charged battery will power the ventilator
for approximately 30 minutes.

See Appendix 1 for battery care procedures.

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 DESCRIPTION

2
AV-S
cm H2O Gas Mixture 1
IO
O2 + air o
o . .
%O2 100
SMMV
33 20
4
Trigger
Freeze
cmH2O
Waveform
-1.0

Pmax Pmean
3
cmH2O cmH2O
24 10 5

Spont
secs Mode

Vm SET V MEAS SET Insp Time PEEP LIMIT

m
Litres Litres BPM Sec cmH2O cmH2O Standby

3.6 3.6 6 2 5 38
Touchscreen control

3.5 Control Panel 5. Navigator Wheel and Press Button

Turn the wheel to select a function or
3.5.1 Touchscreen and Navigator parameter, or to alter the value of an
Wheel / Push Button active parameter.
Press to confirm the setting.
3.5.1.1 Control Panel
1. On/Off control
Switch On: 3.5.1.2 Selecting Functions and
Short internal test sequence Parameters
Switch Off: The functions/parameters shown on the
5 second power down sequence with screen can be activated as follows:
audible tones a) touch the screen at the appropriate tab
area.
2. Status indicators for electrical power b) rotate the navigator wheel and press it
(mains/battery supply) when the indicator arrow is on the required
Yellow indicator parameter tab
- illuminated whenever power is Note that parameters default to factory-set
applied to the unit and internal battery values when the ventilator is switched on
is being charged and no further user selection is made.
Green indicator
- illuminates when the unit is switched 3.5.1.3 User Adjustable Parameters
on, . Variable parameters can be altered by
rotating the navigator wheel.
3. Menu switch
When the required value is displayed, press
The menu function provides access to
the active tab or the wheel to confirm the
user and service pages
setting.
4. Alarm mute switch
30 second or 120 second Alarm
silence, depending on alarm status.
Note also that some alarms are not
mutable (see 3.11).
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3.5.2 User Adjustable Parameters

Tidal Volume Range 20 - 1600 ml

Rate 4 - 100 bpm
I:E Ratio 1:0.3 to 1:8
PEEP 4 - 30 cmH2O
Can be set to OFF
Pressure Limit
Volume mode: 10 - 80 cmH2O
Pressure mode: 10 - 70 cmH2O

3.5.3 Operational Capability

Tidal Volume, Rate, and I:E ratio settings are all limited by a
maximum inspiratory flow of 75 L/min.

I:E Ratio
1:6 1:5 1:4 1:3 1:2 1:1 1:0.3

1.6
1.5
1.4
1.3
1.2
1.1
1.0
Tidal
Volume 0.9

(litres) 0.8 X
(Vt) 0.7
0.6
0.5
0.4
0.3
0.2
0.1

0 10 20 30 40 50 60 70 80

Rate (bpm)

The ventilator is capable of operating at the volumes and rates below each I:E ratio curve.

Example
1. Select required volume (Vt) (e.g. 0.8 L)
2. Select rate (e.g. 10 bpm).
3. Select I:E ratio of 1:2.
The point X on the graph lies beneath the 1:2 ratio curve, and is therefore within the
ventilator’s capability.

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 DESCRIPTION

3.5.4 Output Compensation

Functions

WARNING
The AV-S automatically compensates for fresh
gas (spirometry On), fresh gas mixture
(spirometry and oxygen monitor On), and
altitude.
However, the actual tidal volume delivered to the
patient may be different to the ventilation
parameters set by the user, due to:
A) an extreme compliance condition,
B) a substantial system leak,
C) patient circuit pressure effects, or
D) extreme fresh gas flows

In addition, high fresh gas flows will lead to an

increased Vt being delivered to the patient.
The patient must be monitored independently
from the ventilator.
It is the responsibility of the user to monitor the
patient for adequate ventilation.

Fresh Gas Compensation

Adjusts delivered volume up to 60%
Alarms if measured volume is 50% different
than set volume
User adjustable

NOTE
Fresh gas compensation is disabled if :
a) The spirometry system is turned OFF through the
menu system, or
b) The spirometry system is not functioning correctly.

Fresh Gas Mixture Compensation

- models with Spirometry
The spirometry system compensates for fresh gas
mixture - the user must access the menu system and
select the gas mixture that will be used for each
clinical procedure.

NOTE
Fresh gas mixture compensation is disabled if :
a) The spirometry system is turned OFF through the
menu system, or
b) The spirometry system is not functioning correctly.

If the O2 monitor is switched OFF, a 40%/60%

mixture of O2/N2O is assumed.

Altitude Compensation
Monitors ambient pressure
Adjusts delivered volume accordingly

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 DESCRIPTION

3.6 Interface to Prima SP2/3 and A200SP

The AV-S is designed to interface with the Prima
SP Anaesthetic Machine and the A200SP
Absorber.
B A
3.6.1 Prima SP Interface

The interface cable links the socket (A) on the

control panel to a socket on the rear panel of the
anaesthetic machine.

a) Turn the Prima Sp Gas Delivery Switch to

ON.
The ventilator will power-up.
b) While the Prima SP power is ON, the
Ventilator can be turned OFF and ON, using
the ventilator On/Off switch, as described in
section 3.5.1.
c) Turn the Prima SP Gas Delivery Switch to
OFF. The ventilator will power-down.

3.6.2 A200SP Absorber Interface D

The interface cable links the socket (B) on the
control panel to a socket (C) at the rear of the
absorber.

a) The A200SP is fitted with fitted with a sensor

that detects the position of the absorber
bag/vent control (D).
The sensor signal cabling is routed internally
to connector (C) and a second cable runs to
the the rear of the AV-S control unit.

b) Operation of the Bag/Vent control will trigger

automatic Mode switching on the AV-S
ventilator, as follows:
i) If the Absorber Bag/Vent control is moved
from Vent to Bag, the ventilator will change
from Volume Mode, or Pressure Mode, into
Spontaneous Mode.
ii) Switching the absorber Bag/Vent control
from Bag to Vent:
The ventilator will reset from Spontaneous C
Mode to the previously set active mode.
iii) If the ventilator is in any mode other than
those detailed above, operation of the
absorber Bag/Vent control will not affect the
ventilator.
NOTE This function can be enabled/disabled
through the AV-S on-screen menus (Service Sub-
menu, see appendix).

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 DESCRIPTION

3.7 Ventilation Modes

3.7.1 Standby Mode

Allows parameters to be set.

Some patient alarms are active:

High airway pressure (at 80 cmH2O)
High/Low O2
Negative pressure
Incorrect Rate/Ratio

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 DESCRIPTION

3.7.2 Volume Mode

Volume Mode Parameters
The ventilator delivers a mandatory set
volume of gas at preset, fixed breath Tidal volume 20 – 1600 mL
intervals. Rate 4 – 100 bpm
The Patient is making no respiratory effort. I:E ratio 1:0.3 – 1:8
PEEP 'Off' or adjustable 4 – 30 cmH2O
3.7.2.1 Fresh Gas Compensation Inspiratory pressure limit 10 to 80 cmH2O
Adjusts delivered volume up to 60% Inspiratory pause 25%
This delivered volume will consist of the (does not affect I:E ratio)
volume delivered from the ventilator bellows Sigh 1.5 x Set Vt is
plus the fresh gas flow from the anaesthetic delivered once, twice,
machine fresh gas supply, minus any three times or four
compliance loss and minus any leak. times every 50
This gives a total actual inspired tidal breaths (user selects
volume. frequency)
An alarm is triggered if measured volume is
50% different than set volume
User adjustable

Altitude Compensation
Monitors ambient pressure
Adjusts delivered volume accordingly

3.7.2.2 Operating Functions

Inspiratory Pause function: Creates
25% plateau

Sigh function:
When the ventilator is in Volume Cycle
mode the "sigh" option is available. When
selected, this option provides extra volume
for 1 to 4 breaths in 50 (frequency is user
selectable).
The extra volume will be 50% above the
tidal volume set by the user.

Volumes measured if Spirometry function

selected
Auto High and Low volume alarms if
measured volume different by 50% of set
volume
User adjustable option
If max pressure limit achieved, ventilator
cycles to expiratory phase

3.7.2.3 Volume Type Selection

Use the menu to switch between Tidal
Volume and Minute Volume.
NOTE Minute Volume is derived from a rolling
average during a 30 second period.

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 DESCRIPTION

3.7.3 Pressure Mode

3.7.3.1 Parameters
The ventilator delivers a volume of gas to
achieve a set pressure at fixed breath
intervals.
The Patient is making no respiratory effort.
This is a common mode for the ventilation of
small paediatric patients.

Inspiratory pressure 10 - 70 cmH2O

Rate 4 – 100 bpm
I:E ratio 1:0.3 – 1:8
PEEP 'Off' or adjustable: 4 – 30 cmH2O

Inspiratory decelerating flow controlled by the

ventilator according to pressure setting
No Inspiratory pause function

3.7.3.2 Pressure Mode Operating Functions

Defaults to 10 cmH2O
Maximum Inspiratory Flow to achieve target
pressure
Sustaining flow maintains circuit pressure
Control achieved using exhaust valve

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 DESCRIPTION

3.7.4 Spontaneous Mode

3.7.4.1 Parameters
The ventilator monitors the following patient parameters:

Rate
I:E ratio
Pressure
Tidal volume

Provides waveform displays

Inspiratory oxygen is measured

3.7.4.2 Spontaneous mode operating functions

No mechanical ventilation
No Inspiratory Pause function

Patient Monitoring (Bag mode and Ventilator mode):

Airway pressures
FiO2,
Vt,
Rate
I:E ratio,
Supply pressures
Ventilation conditions

Advanced Spontaneous Breathing modes are selectable from

this mode - see below, and section 3.7.5.

3.7.4.3 Advanced Spontaneous Breathing Modes

Support modes available from 'Special Modes' (select from

main menu):
SIMV
SMMV
PSV

The A200SP Absorber Bag/Vent control must be in 'Vent'

position for these modes to be selected.

Note that if the system fails to detect an absorber bag/vent

switch, a confirm message will be displayed.

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 DESCRIPTION

3.7.5 Advanced Spontaneous

Breathing Modes
C E

3.7.5.1 SIMV D

Synchronised Intermittent
Pmax
Mandatory Ventilation
Guarantees a minimum level of volume.
SIMV allows spontaneous breaths and a
set mandatory breath PEEP
0 cmH2O
SIMV - Spontaneously Breathing A A

Patient B B

Inspiratory flow in the Trigger Window

(generated by the patient’s spontaneous SIMV - Spontaneously Breathing Patient
breath) results in a synchronised A = Cycle Time (set from BPM)
B = Trigger Window
mandatory breath at a preset volume and C = Spontaneous Breath
rate D = Trigger
E = Mandatory breath at the set Vt

SIMV - No breathing effort by Patient

D
If the patient makes no effort to breathe C
during a cycle, a mandatory breath, at the
end of the trigger window, will still be Pmax
delivered at the preset volume and rate

SIMV - Selection
Select Standby PEEP
Select Menu 0 cmH2O
A A
Select Special Modes
B B
Select SIMV

SIMV is now on the main screen in

Spontaneous mode. SIMV - No breathing effort by Patient
A = Cycle Time (set from BPM)
B = Trigger Window
NOTE C = Flat Pressure Trace (no breathing effort)
D = Mandatory breath at the end of the Trigger Window at the set Vt
1. SIMV is triggered by flow when
Spirometry is active.
SIMV is triggered by pressure If
Spirometry is disabled.
2. The trigger window is pre-set to
60% of the BPM cycle time.
3. The trigger pressure is PEEP
referenced
4. If the pressure limit and alarm are
activated the inspiratory phase is
terminated

Default Settings - SIMV

SIMV Default Settings
Adult Paediatric Overall range
The ventilator will default to the settings
shown in the table, after selecting 'SIMV'. Vt 600 ml 200 ml As Volume Mode
Note that Vt can be adjusted before SIMV BPM 6 10 As Volume Mode
is confirmed.
Insp. (Ti) 2 1 I:E display box
Trigger setting defaults to 0.4 L/min, and is Trigger level 0.4 L/min 0.4 L/min 0.2 to 1.0 L/min
adjustable between 0.2 and 1.0 L/min.

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 DESCRIPTION

C E
3.7.5.2 SMMV D
Synchronised Mandatory
Minute Ventilation Pmax

Guarantees a set level of minute

volume ventilation. SMMV allows
spontaneous breaths, combined with a
synchronised mandatory breath, to PEEP
achieve the set minute volume 0 cmH2O
A A
B B
SMMV -
Spontaneously Breathing Patient
SMMV - Spontaneously Breathing Patient
Inspiratory flow in the Trigger Window A = Cycle Time (set from BPM)
(generated by the patient’s B = Trigger Window
C = Spontaneous Breath
spontaneous breath) results in a D = Trigger
synchronised mandatory breath, E = Vt of Mandatory Breath is equal to Vm / BPM minus the volume
spontaneously breathed during the cycle (maintaining the set Vm)
ensuring that the set minute volume is
achieved

SMMV -
No breathing effort by Patient
D
If the patient makes no effort to breathe
C
during a cycle, a mandatory breath, at
the end of the trigger window, will still Pmax
be delivered at the preset volume and
rate

SMMV - Selection
Select Standby Mode PEEP
Select Menu 0 cmH2O
A A
Select Special Modes
B B
Select SMMV

SMMV is now on the main screen in SMMV - No breathing effort by Patient

A = Cycle Time (set from BPM)
Spontaneous mode. B = Trigger Window
C = Flat Pressure Trace (no breathing effort)
D = Mandatory breath at the end of the Trigger Window at the set Vm
NOTE
1. SMMV is triggered by flow when
Spirometry is active.
SMMV is triggered by pressure
If Spirometry is disabled.
2. The trigger window is pre-set to
60% of the BPM cycle time.
3. The trigger pressure is PEEP
referenced
4. If the pressure limit and alarm are
activated the inspiratory phase is
terminated.
Default Settings - SMMV
SMMV Default Settings
Adult Paediatric Overall range
The ventilator will default to the settings Vm 3.6 L 2L As Volume Mode
shown in the table, after selecting BPM 6 10 As Volume Mode
'SMMV'. Insp. (Ti) 2 1 I:E display box
Note that Vm can be adjusted before
Trigger level 0.4 L/min 0.4 L/min 0.2 to 1.0 L/min
SMMV is confirmed.

Trigger setting defaults to 0.4 litres/min,

and is adjustable between 0.2 and 1.0
litres/min.
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3.7.5.3 PSV
Pressure Supported B
Ventilation
PSV assists each spontaneous breath to
achieve
a preset pressure, thus reducing the
effort required to breathe
Inspiratory flow (generated by the
patient’s spontaneous breath) results in PEEP
synchronised 0 cmH2O
A A
pressure support

C C
PSV is used to support
spontaneously breathing patients
ONLY
If the patient makes no attempt to PSV Pressure Supported Ventilation
A = Set Inspiratory Time
breathe, the ventilator will not provide B = Pressure Support Level
C = Spontaneous Breath results in a synchronised pressure supported breath
support and the apnoea alarm will be
activated

PSV - Selection
Select Standby Mode
Select Menu
Select Special Modes
Select PSV

PSV is now on the main screen in

Spontaneous mode.

NOTE
1. The trigger window is pre-set to
60% of the BPM cycle time.
2. The trigger pressure is PEEP
referenced.
3. If the Spirometry is disabled then
PSV is not available.
4. If the pressure limit and alarm are
activated the inspiratory phase is
terminated.

PSV Default Settings

Default Settings - PSV
The ventilator will default to the settings
shown in the table, after selecting 'PSV' Adult Paediatric Overall range
from Spontaneous Mode.
P. Supp 10 cmH2O 10 cmH2O 3-20 cmH2O
Note that Support Pressure can be Insp. (Ti) 2 sec 1 sec I:E display box
adjusted before PSV is confirmed. Trigger level 0.4 L/min 0.4 L/min 0.2 to 1.0 L/min

Trigger setting defaults to 0.4 litres/min,

and is adjustable between 0.2 and 1.0
litres/min.

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 DESCRIPTION

3.7.5.4 PEEP ( Positive End Expiratory Pressure)

The AV-S ventilator includes a microprocessor-

controlled, electronically integrated PEEP system,
regulated using secondary pressure on exhaust
diaphragm.
The ventilator controls PEEP by allowing flow from, or
delivering flow into the bellows drive circuit, maintaining
pressure

PEEP is electronically controlled

Variable from 4-30 cmH2O in increments of 1 cmH2O
Clear “OFF” indication when not in use
Switch off the ventilator - PEEP is switched off.
PEEP is switched off during 'Spont' mode to minimise patient’s
breathing effort.

Selecting PEEP
Select by touching the screen tab PEEP, or using the
navigator wheel
The setting will flash.

Rotate the navigator wheel to set the required PEEP

pressure.
A confirm message will be displayed.
Press the Screen Tab, or Wheel to confirm.

Note that Electronic PEEP does not function in

Spontaneous Mode.

PEEP on/off sequence

Using the A200SP Absorber Interface - Ventilator
Mode Selection
1. Ventilator is in Volume Ventilation Mode
2. PEEP selected, pressure set to required level.
PEEP display indicates pressure
3. A200SP Absorber Bag/Vent control (A) is moved
to ‘Bag’ position. A
Ventilator automatically switches to Spontaneous
Mode.
PEEP is automatically switched off (does not
function in Spontaneous Mode)
PEEP display is blank.
4. Bag/Vent control reset to ‘Vent’ position.
Ventilator automatically switches to the mode
previously set by the user.
PEEP is Off.
PEEP display indicates Off.
5. Set ventilator to Volume Ventilation Mode.
PEEP remains Off.
Select PEEP if required.

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 DESCRIPTION

3.8 On-Screen Menus

To Access:
Press the menu switch on the front panel to
access the following functions and parameters
via drop-down menus:

EXIT MENUS
O2 MONITOR & SPIROMETRY
FRESH GAS COMPENSATION: ON
SPECIAL MODES Menu Switch
WAVEFORM
ALARM SETTINGS
GAS MIXTURE: O2+AIR
USER SETTINGS
SERVICE MENU
Turn the wheel
To Exit: to scroll through
Press the menu switch on the front panel, or, the menus.
select EXIT MENUS and press the wheel. Press to enter
sub-menu
NOTE
The menu window will not be displayed if:
A) Control parameters (VT MEAS, BPM, I:E, PEEP,
or LIMIT) are enabled but not confirmed.
B) A display window is active

To Operate:
1. Rotate the navigator wheel clockwise to
scroll through the menu options - the
cursor ( > ) aligns with each parameter in
turn.
2. Press the wheel to enter the required sub-
menu.
3. Rotate the navigator wheel to change any
displayed values, and press to confirm.
4. To exit the menu display:
A) Press the menu switch on the front
panel .
B) Scroll to EXIT MENUS
and press the navigator wheel.

NOTE
A) If confirmation does not take place within 8
seconds, the parameter reverts to its previous
value.
B) If another parameter is selected using the
touchscreen, the menu is de-selected.
C) While any menu is selected:
- the alarms are active,
- the ventilator can be switched off.

See Appendix 2 for a full description of the

Menu system.

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3.9 Spirometry

Spirometry can be enabled, or disabled via the

on-screen menu system.
NOTE
If the spirometry system is turned OFF:
a) Fresh gas / fresh gas mixture compensation
is disabled.
b) Special Modes are disabled.

See Appendix 3, for a detailed description of the

spirometry system.

3.10 Display Waveforms

Default waveform is always Pressure v Time
(cmH2O v seconds)

Wave Freeze is available when ventilation is in

progress.

Second waveform
A second waveform can be displayed by using
menu control or touch waveform on screen.

The second waveform is selectable:

Volume v Time (litres v seconds)
Volume v Pressure (litres v cmH2O)
Compliance loop waveform
- First loop can be frozen
- Subsequent loops overlaid

Display Functions

Automatic Scale adjustment

Y axis
a) Scale adjusts as Plimit is changed
(-20 to 40, 60, 80 cmH2O)
b) In Vol. v Time mode as Vt is changed
(0 to 0.5L, 1.0 L, 2.0 L)

X axis
a) Scale adjusts as Rate is changed
0 to 15sec, 5 sec, 3sec
b) In Vol. v Pres. mode as Plimit is changed
(-20 to 40, 60, 80 cmH2O)

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 Alarm Priority Trigger Mute Set by:
time

Ventilator Inoperative High Internal failure or Battery failure zero Automatic

3.11
Power About to Fail High Ventilator is on battery, and the battery voltage is less than 10.2 v zero Automatic
Low Drive Gas Supply Pressure High Less than 235 kPa (35 psi +/-1 psi) zero Automatic
Alarms

Low Bellows Drive Gas Pressure High Fails to reach target level 30 s Automatic
High Bellows Drive Gas Pressure High Exceeds calculated target level 30 s
Automatic

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High Continuous Airway Pressure High Breathing system pressure fails to return to below 30 cmH2O 120 s Auto
by the start of the next inspiratory phase
DESCRIPTION

High Airway Pressure High Pressure reaches set limit (10 to 80 cmH2O adjustable) 30 s User / Default

Low Airway Pressure High Breathing system pressure fails to reach minimum level 120 s Default

Negative Airway Pressure High Breathing system pressure exceeds 10 cmH2O 120 s Automatic

Low Tidal Volume High a) Measured Vt less than 50% of volume set 120 s User / Default
b) Spirometer disconnected

30
Low Minute Volume High Calculated volume lower than 50% of volume set 120 s User / Default

Apnoea High In Spontaneous mode, no breath detected within 15 seconds 120 s Auto

High Tidal Volume High Measured value exceeds 150% of set value 120 s User / Default

High Minute Volume High Calculated value exceeds 150% of set value 120 s User / Default

High O2 Concentration High Measured O2 % exceeds set value 120 s User / Default
Low O2 Concentration High Measured O2 % lower than set value 120 s User / Default
O2 Sensor low output Low Sensor life exhausted zero Auto
O2 sensor fault High Sensor disconnected 120 s Auto

Incorrect Rate or Ratio Medium Settings outside 75 L/min 120 s Auto

Mains Failure Low Mains power fails zero Auto

30 minutes use available (if battery is fully charged)

Battery Power Fail Medium Battery disconnected, or missing, or totally discharged 120 s
Low Battery Low Battery voltage has dropped below 11.2 v zero
Absorber cable fault (A100SP) Medium Disconnection or short circuit 120 s Auto
Printer not available Low Printer disconnected, or has no power, or has no paper zero

Priority identification:
High Priority: 5 ascending tones - repeated Medium Priority: 3 ascending tones - repeated Low Priority: Single Tone - repeated
 DESCRIPTION - O2 Monitor

3.12 Oxygen Monitor

The oxygen monitor continuously measures and indicates

the concentration of oxygen in the breathing system, and
triggers an alarm when the concentration varies from the
set levels.
3.12.1 System Description
The Oxygen Monitor uses a fast-responding, oxygen-
specific, self powered sensor that achieves 90% of final O2 Sensor Location
value in less than 10 seconds. Prima SP with A200SP Absorber

An external probe (1) is supplied with a 2 m (6 ft)

extendable cable.
The system has user-adjustable high-level and low-level
alarms with visual and audible indication of alarm
conditions.

Bacterial Filter
Use a breathing system bacterial filter in the
expiratory limb of the breathing circuit to protect the
oxygen sensor (see section 5 in the AV900 or AV-S
user manual).
CAUTION
Replacement/Disposal - always follow the instructions
supplied with the filter, and always replace at the
recommended interval.
1
3.12.2 The MOX-3 Oxygen Sensor
The MOX-3 oxygen sensor offers quick response, linear
output over the entire 0-100% oxygen range, and long
service life.

The MOX-3 is a self-powered galvanic cell that generates

a current proportional to oxygen concentration.

The cell has a highly stable output over its operating life.
Significant output loss is only shown at the very end of its
life.
Typical sensor drift rates are less than 1% per month when
the sensor is exposed to gas in typical applications.

Sensor life:
approximately 1500 000 O2 percent hours at 20oC
(minimum one year in most normal applications).

Sensor lifetime is governed by the mass of lead available

to react with the oxygen and its rate of consumption. High
oxygen partial pressure and high temperature will increase
the sensor output current, thus shortening the operation
life.

At the point where all lead has been consumed, the output
will fall very quickly to zero over a period of two to three
weeks.

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 DESCRIPTION

3.12.3 O2 Monitor sub-menu

O2 Monitor sub-menu
ON/OFF
Turn the navigator wheel to switch between
O2 Monitor & Spiro
ON and OFF.
Press to confirm.
ESCAPE FROM MENU
Scroll to EXIT MENUS and press the wheel
> O2 MONITOR: on
to exit.
CALIBRATION: 100%
NOTE
HIGH ALARM SET: 105
The oxygen monitor automatically switches ON LOW ALARM SET: 18
and defaults to the previous values for high and SPIROMETER: on
low alarm settings when the ventilator is SPIRO CALIBRATION: 0 L/min
switched on.
Fresh gas mixture compensation is disabled if the
O2 monitor is switched OFF.

O2 Monitor sub-menu - calibration

CALIBRATION
Press the navigator wheel to initiate the O2 Monitor & Spiro
calibration procedure (see section 5.3.2 for
full procedure). ESCAPE FROM MENU
To exit the menu, scroll to EXIT MENUS O2 MONITOR: on
and press the wheel. > CALIBRATION: 100%
HIGH ALARM SET: 105
LOW ALARM SET: 18
SPIROMETER: on
SPIRO CALIBRATION: 0 L/min

HIGH ALARM SET

O2 Monitor sub-menu - alarms
LOW ALARM SET
Scroll to the required parameter and press
O2 Monitor & Spiro
the navigator wheel to activate.
Rotate the navigator wheel again to change
ESCAPE FROM MENU
the displayed value.
(see section 5.3.4 for full procedure). O2 MONITOR: on
CALIBRATION: 100%
High Alarm range: 19% to 105% > HIGH ALARM SET: 105
Low Alarm range 18% to 99% LOW ALARM SET: 18
SPIROMETER: on
The displayed figure will flash on and off. SPIRO CALIBRATION: 0 L/min
Press to confirm.
Scroll to EXIT MENUS and press the wheel
to exit.

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 DESCRIPTION - O2 Monitor

3.12.4 Display High Alarm Set

High-set, low-set, and oxygen concentration Value
percentage readings are displayed on screen.
Touch the tab to activate O2 menu

Oxygen Concentration
IO
The display provides a direct readout of
measured oxygen concentrations in the range
o
o . .
0-100%. %O2 100
33 20
Low Alarm Set - limited within 18-99%
The oxygen percentage, set by the user, at
which the low alarm will be activated.
Measured O2 Low Alarm Set
To set the low oxygen alarm, see section 5.3.4.
concentration Value
High Alarm Set - limited within 19-105%
The oxygen percentage, set by the user, which
the high alarm will be activated.
Note that in certain conditions of excess
pressure, the readout may show a value above
100%.
To set the high alarm, see section 5.3.4.

3.12.5 Display

HIGH O2 ALARM b) A high priority audible alarm will sound.

The high O2 alarm is triggered when the oxygen
concentration is 1% above the set value. To cancel this alarm, check the sensor
connection or replace the sensor.
a) The High O2 Alarm visual indicator will The alarm can be muted for 120 seconds.
illuminate.
b) A high priority audible alarm will sound. O2 SENSOR LOW
This alarm indicates the sensor has approached
To cancel this alarm, the high alarm setting must the end of its life.
be equal to, or above the oxygen concentration. The legend O2 SENSOR LOW will be displayed,
The alarm can be muted for 120 seconds. and a low priority alarm (single note) will sound.
LOW O2 ALARM The sensor must be replaced as the output will
The low alarm is triggered when the oxygen
concentration is 1% below the set value. fall very quickly to zero within two to three weeks
of normal usage.
a) The Low O2 Alarm visual indicator will See section 6.5 for sensor replacement.
illuminate.
b) A high priority audible alarm will sound. 3.12.6 Oxygen Monitor Alarm Mute
In an alarm condition, pressing the ALARM
To cancel this alarm, the low alarm setting must
MUTE button will deactivate the audible alarm,
be equal to, or below the oxygen concentration.
but the alarm message display will remain on
The alarm can be muted for 120 seconds.
screen.
The switch will illuminate, and a single note will
O2 SENSOR FAULT sound.
The alarm is triggered:
The alarm mute can not be operated:
i) when either the oxygen sensor is
disconnected or approaching the end of its life. a) Until the mute time is over, or the alarm
condition has been rectified.
ii) if the O2 concentration exceeds 110%.
b) When O2 concentration drops below 18%.
a) The message O2 SENSOR FAULT will be
displayed.
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 4. SPECIFICATION

4.1 Application Ventilation for use in anaesthesia.

4.2 Internal Compliance

Adult bellows 3 ml/cmH2O (nominal)
Paediatric bellows 2 ml/cmH2O (nominal)

4.3 Physical
Size (mm)
- control unit only 290 wide x 300 deep x 185 high
- with adult bellows 290 wide x 300 deep x 385 high
Screen Size 210 mm (8.4") TFT
Weight - control unit only 7.6 kg
- with adult bellows 9 kg
Bellows
Adult (Latex free): 20 ml - 1600 ml
Paediatric : 20 - 350 ml
(Note - latex free paediatric available as option)

Power 90 - 264 VAC, 47 - 63 Hz

Battery Back-up: 30 minutes (assumes fully charged battery)
Drive Gas Oxygen or Air
(dry, and oil free) at 45 to 100 psi (310 to 689 kPa).

4.4 Alarms
Alarm Mute 30 or 120 seconds (see 3.11)
Low Drive Gas Pressure Less than 235 kPa (35 psi)
High Continuous Airway Pressure Above 30 cmH2O at start of cycle
Low Pressure 4 - 14 cmH2O PEEP referenced
Low Tidal Volume 50% of Volume set (Spirometry)
Incorrect Rate or Ratio
Mains Failure 30 minutes (nominal) Battery Backup
Low Battery 5 minutes Use
Ventilator Inoperative Internal or Battery Failure
Alarms - User Set
Vt (Tidal)
Min 0 - 1600 ml
Max 20 - 1600 ml
Vm (Minute)
Min 0 - 10 L
Max 0 - 30 L

Apnoea Adjustable Re-set Pressure (PEEP referenced)

Low and High O2 Concentration 18% - 105%
High Airway Pressure 10 - 80 cmH2O adjustable

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 SPECIFICATION

4.5 Functional

Tidal Volume
Adult bellows 20 to 1600 ml (±10%)
Paediatric bellows 20 to 350 ml (±10%)
At ambient temperature of 20oC (+/-10%) and ambient atmosphere of 101.3 kPa (+/-10%).

Minute Volume 0 to 30 L
Rate 4 - 100 bpm
I:E Ratio 1:0.3 - 1:8
Pressure Limit 10 - 80 cmH2O
Fresh Gas Compensation Automatic Tidal Volume adjustment

Modes Off
Standby
Volume Cycle
Pressure Controlled
Spontaneous (includes advanced breathing modes)

Pressure Control 10 - 70 cmH2O

Inspiratory Flow 2 - 75 L/min

Spontaneous Mode Active Volume and Pressure Alarms,

Advanced Breathing Modes selectable (see section 4.6)

Electronic PEEP 4 - 30 cmH2O

Oxygen Monitor Fuel Cell type

For full specification, see section 4.15.

Spirometry - Resolution ±1 ml

Ventilator Performance - accuracy of delivered volumes

>300 ml ± 10%
>100 ml <300 ml ± 20%
<100 ml ± 50%.

NOTE
The ventilator is designed for use with Spirometry ON.
Accuracy of delivered volumes with Spirometry OFF may vary from the figures given above.

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 SPECIFICATION

4.6 Advanced Spontaneous Breathing Modes (SIMV, SMMV, PSV)

Trigger (PEEP Referenced) 0.2 to 4 L/min
Trigger Window Set 60% of Expiratory Time
Vt and Vm As Volume Mode
Insp Time (Ti) 0.5 to 5 secs
Support Pressure 3 to 20 cmH2O
Default settings

Volume Vt BPM I:E Pmax

Adult 600 ml 10 1:2 38 cmH2O
Paediatric 150 ml 15 1:2 38 cmH2O

Pressure Vt BPM I:E P-target

Adult 600 ml 10 1:2 10 cmH2O
Paediatric 150 ml 15 1:2 10 cmH2O

SIMV Vt BPM Insp time Trigger

Adult 600 ml 6 2 sec 0.4 L/min
Paediatric 200 ml 10 1 sec 0.4 L/min
SMMV Vm BPM Insp time Trigger
Adult 3.6 L 6 2 sec 0.4 L/min
Paediatric 2L 10 1 sec 0.4 L/min
PSV Support Pressure Insp time
Adult 10 cmH2O 0.4 L/min
Paediatric 10 cmH2O 0.4 L/min

4.7 Disinfection and Sterilisation Bellows base assembly, Patient Block

assembly and inside of bellows can be
sterilised if necessary - section 6.

4.8 Bacterial Filter None (see section 5.1.4, use a bacterial filter in
the breathing system to protect components
that are not autoclavable, e.g. oxygen sensor)

4.9 Fail Safe Mechanism Battery back-up in case of mains electricity

failure
Gas shut-off in the event of electronic failure

4.10 Reliability MTBF: 5x106 to 50x106 cycles

4.11 Waveform Tests Not applicable
4.12 Volume Tests Not applicable

4.13 Mobility and Mounting

(A) Mobility Secure mounting on anaesthesia machine shelf

or side bracket required.
(B) Mounting Mounting bracket available as optional extra.
The bellows assembly is built into the A200SP
Absorber.

4.14 Fuse (mains supply) Two fuses, Type T 2AH

2 A, 250 V rating, 20 mm, anti surge, ceramic.

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 SPECIFICATION - O2 Monitor

4.15 Oxygen Monitor

Measurement Range: 0-l00%

Resolution: ±1%

Accuracy and Linearity: ±2% of full scale (at constant temperature and pressure)
Response Time: 90% of final value in approx. 10 seconds (air to
100% O2)

Operating Temperature: 50°F to 100°F (10°C to 38°C)

Storage Temperature: 23°F to 122°F (-5°C to 50°C)
Relative Humidity Range: 5%-95% (non-condensing)

Battery Back-up: As per ventilator

Sensor Type: MOX-3 galvanic fuel cell

High Priority Alarm: Flashing, 5 audio pulses with 6 seconds repeat

time.
Medium Priority Alarm: Flashing, 3 audio pulses with 24 seconds repeat time
Low Priority Alarm: Static with single beep sound
Alarm Mute: 30 seconds for high priority alarm
120 seconds for medium priority alarm

Low Alarm Set Range: 18%-99% (± 1%)

High Alarm Set Range: 19%-105% (± 1%)

Cable length: 2 m (6 ft), fully extended

Sensor
Type: Galvanic fuel cell sensor (0-100%)
Life: 1500000 O2% hours
(One year minimum in typical applications)

Interference Gases and Vapours (in 30% Oxygen, 70% Nitrous Oxide)

Interference Volume % Dry Interference in O2%

Nitrous Oxide 80% <1%

Carbon Dioxide 5% <1%
Halothane 5% <1%
Enflurane 5% <1%
lsoflurane 5% <1%
Sevoflurane 5% <1%

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 SPECIFICATION - O2 Monitor

Oxygen Monitor - continued

Humidity Effects
Sensor output is relatively unaffected by prolonged operation in either high or very low relative
humidity.
If the sensor shows signs of being affected by condensation, dry the sensor with soft tissue.
CAUTION DO NOT use heat to dry the sensor.

Temperature Effects
The sensor has a built-in temperature compensation circuit, and is relatively unaffected by
temperature changes within the operating temperature range given above.

Pressure Effects
The sensor measures O2 partial pressure, and its output will rise and fall due to pressure change
(e.g. changes in barometric pressure, or breathing system pressure).
An increase in pressure of 10% at the sensor inlet will produce a 10% increase in sensor output.

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 5. PRE-OPERATION PROCEDURES

5.1 Ventilator Set-up 5.1.3 Ventilator Gas Supply

1. Verify the drive gas specified for the

5.1.1 Mounting the Ventilator
ventilator (oxygen or air).
Always use the correct drive gas.
Mounting
The display screen is mounted on an
2. Connect the drive gas inlet port on the
adjustable arm, with the control unit
rear of the control unit to a dry, oil free
mounted at the rear or side of the
supply.
anaesthetic machine.
Supply pressure range:
Optional Mounting System
45 to 100 psi
Locate the ventilator control unit in a safe
(3.1-6.9 bar, 310-689 kPa)
place.
Preferably, mount it permanently on the shelf
OXYGEN SUPPLY:
of the anaesthesia machine or on a strong
a) O2 cylinder,
bracket. This will protect the ventilator from b) Anaesthetic machine O2 auxiliary gas
accidental fall and disconnection of the outlet,
hoses. c) O2 pipeline supply from a wall outlet.
To mount the ventilator control unit
permanently on a Penlon bracket: AIR SUPPLY:
1. Align the four mounting feet over the a) Air cylinder,
mating holes in the bracket. b) Anaesthetic machine Air auxiliary gas
2. Use the four M4 screws supplied with outlet
the mounting bracket kit, inserted c) Air pipeline supply from a wall outlet.
through the bracket and rubber feet
Supply pressure should be monitored
and screwed into the threaded inserts
by a separate means, e.g. pressure
in the base of the ventilator. gauge on anaesthetic machine or
Only use the screws supplied with supply line.
the kit.
NOTE: It is possible to reconfigure the
Pole-mount type mounting brackets and side ventilator for use with a different drive gas
frame brackets are available from Penlon to the gas originally specified. This work
Limited. must be carried out by a Penlon-trained
engineer at your hospital, or a Penlon
Bellows unit distributor.
The bellows unit is built into the A200SP
absorber. 5.1.4 Breathing System Schematic

The following page contains a schematic

5.1.2 Electrical Power Connection diagram showing the cables and tubing for an
AV-S ventilator mounted on a Prima SP
Before connecting the ventilator to the mains
anaesthetic machine with an integral A200SP
supply, check that the power supply is within
Absorber.
the correct rating as stated on the label on
the rear of the control unit.
WARNING
Excessive electronic noise caused by other,
poorly regulated devices, such as
electrocautery, may adversely interfere with
the proper functioning of the ventilator.
To avoid this problem, do not connect the
ventilator power cord into the same electrical
wall outlet or strip into which an
electrocautery unit is connected.

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 PRE-OPERATION PROCEDURES

Hoses and Cables Schematic

AV-S and A200SP Absorber

3 25 31
23
2 26
24
20 19 30

18

12

4 1

11 10
21
16 27 13
14
28 5 22
26
29
15 17 12
6

9
7
8

Note
1. AV-S has spirometry and oxygen monitor.
2. Interface cabling is shown for Prima SP2
On/Off switch and A200SP Bag/Vent
switch.

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 PRE-OPERATION PROCEDURES

1. Bellows
2. Ventilator Control Unit
3. Outlets to Anaesthetic Gas Scavenging System (AGSS)
4. Bacterial Filter
5. Absorber valve block
6. Heat and moisture exchanger
7. Patient
8. CGO Block on anaesthetic machine (Fresh Gas Supply)
9. Auxiliary Outlet on anaesthetic machine (Drive Gas Supply)
10. Flow sensor - expiratory
11. Flow sensor - inspiratory
12 Connectors - sensor - pressure monitor
13. Expiratory Valve - Absorber
14. Inspiratory Valve - Absorber
15. Inlet - from Ventilator Bellows
16. Connector - Reservoir Bag
17. Inlet - Absorber - Fresh Gas Supply
18. Drive Gas Inlet - Ventilator
19. Drive gas Outlet - ventilator control unit to bellows
20. Outlet - Exhaust Valve
21. Inlet - Bellows Drive Gas
22. Outlet - to breathing system
23. Input socket - Oxygen monitor sensor
24. Input socket - Prima SP interface
(SP on/off switch)
25. Input socket:
(i) A200SP Absorber Bag/Vent control position
(ii) Spirometer sensor signal
26. Interface connections on Prima SP2 and A200SP
27. APL Valve
28. Outlet from APL Valve to AGSS
29. Oxygen sensor
30. Ventilator remote screen
31. Cable - control unit to screen

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 PRE-OPERATION PROCEDURES

5 8 9 10 11 12 13 14 15
6

3 2 1
7
4

Interface and Parameter inputs

Control Unit 5. A200SP Absorber Bag/Vent
Rear Panel switch interface
Spirometer connector
6. Prima SP Interface connector
7. Pressure Monitor Port
Gas Connections
8. Input socket - Oxygen monitor
1. Ventilator drive gas inlet
sensor
- connect to anaesthetic machine
auxiliary gas outlet
Data and Printer Ports
2. Bellows Drive Gas Output
9. Data Output
- connect to bellows
( on Prima SP2 with A200SP absorber, 10. Output toremote display
connect to absorber - see section 5.1.5) 11. Ethernet
3. Outlet - Exhaust Valve 12. USB
13. VGA
Electrical Connection 14. Printer port
4. Electrical mains input and fuse unit 15. RS232

NOTE
USB port is for use by Penlon-trained
engineers only.
All other data ports are read only.
For further information, please contact
Penlon Technical Support.

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 PRE-OPERATION PROCEDURES

5.1.5 Bellows drive gas hose

1. Prima SP2 with A200SP absorber: Connect
a 16 mm diameter corrugated hose between
the ventilator control unit drive gas outlet
(labelled: DRIVE GAS) and the outlet (1) at
the rear of the A200SP absorber.
2. All other AV-S configurations:
Connect a 16 mm diameter corrugated hose
between the control unit drive gas outlet
(labelled: DRIVE GAS) and the bellows
base DRIVE GAS inlet port. 1

5.1.6 Anaesthetic Gas Scavenging

System
1. Connect the EXHAUST valve port on the
control unit to a properly functioning
scavenging system
Use a 19 mm hose (30 mm in non-USA).
2. Fit a 10 cmH2O pressure relief valve
between the exhaust valve port and the inlet
port of the AGSS receiver.
Note that the diaphragm valve under the
bellows is connected internally to the
EXHAUST port to facilitate the discharge of
excess breathing gas at the end the
expiratory phase.
WARNING
Do not use a scavenging system that restricts
drive gas flow when negative pressure is exerted
on it.
Applying negative or positive pressure to the
bellows exhaust port results in positive pressure in
the patient breathing system.
Therefore, the scavenging system must not
generate more than 0.5 cmH2O positive or negative
pressure when connected to the ventilator.
Any problem arising from an improperly
functioning scavenging system is solely the user`s
responsibility. 1

5.1.7 Remote Screen 2

Attach the DVI cable supplied with the screen
between the interface connectors (1) on the rear
of the control unit and screen.
WARNING
Check that the cable between the control unit and
remote display screen unit is securely connected
before use.
Always use a cable type recommended by the
manufacturer.

5.1.8 Printer
Attach a printer to the printer port (2) if a
printed output of the ventilator function is
required.
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 PRE-OPERATION PROCEDURES

5.1.9 Breathing System

1. Connect the ventilator bellows base
BREATHING SYSTEM port to the breathing
system.
2. a) Use a breathing system bacterial filter in
the expiratory limb of the breathing circuit to
protect the oxygen sensor.
b) Use a heat and moisture exchanger
(HME) at the patient Y piece.
CAUTION
Replacement/Disposal - always follow the
instructions supplied with the filter or HME.
Fit new components at the recommended interval.

3. Connect a 2-litre breathing bag to the patient

connection as a test lung.
4. Close the anaesthetic machine APL.

5.1.10 Spirometer
5.1.10.1 Flow sensors fitted to an A200SP
Absorber mounted on a PrimaSP2

1. Use a breathing system bacterial filter - see

section 5.1.8, operation 2.
CAUTION
Replacement/Disposal - always follow the
instructions supplied with the filter.
Always renew components at the recommended
interval.

2. The two spirometry flow sensors are

mounted within the A200SP Absorber in the
inspiratory and expiratory airways.
3. Connect the cable assembly between the
connector at the rear of the A200SP
Absorber (A) and the the socket (B) at the A
rear of the Ventilator control unit.
4. Check that the cable connections are
secure.
NOTE
A) If the connections are incorrectly made, the
ventilator will alarm LOW TIDAL VOLUME or B
HIGH TIDAL VOLUME.

B) To allow the ventilator to be used in the event of

damage, or non-functioning of the spirometer
heads, turn off the spirometry function - see MENU
function, section 3.5.

If the spirometer is switched OFF:

a) Fresh gas compensation is disabled
b) Fresh gas mixture compensation is disabled.
c) Patient support function is disabled.

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 PRE-OPERATION PROCEDURES

5.1.10.2 Spirometer Calibration

Flow sensors fitted to an A200SP
Absorber mounted on a Prima SP 3

The Spirometry heads must be calibrated with zero flow

going through them.

1. Turn the Prima SP gas flow off at the Gas

1
Delivery on/off switch. This will stop all gas flows
(including the AHD basal flow).
This will also turn the AV-S off.

2. Turn the AV-S on at the ventilator (Do not use the

Prima SP Gas Delivery switch).
or,
Disconnect the fresh gas hose from the CGO
block on the anaesthetic machine.

3. Remove the breathing circuit hoses from the 2

inspiratory and expiratory connectors (1) on the
absorber.

4. Disconnect the hose that connects the APL valve

outlet (2) at the rear of the manifold block to the
AGSS receiver (or disconnect at receiver).

5. a) Remove the bag, and set the Bag/Vent

o IO
o . . On/Off Switch
control (3) to Bag position.
or,
b) Ensure that the ventilator bellows is empty, Alarm Mute

6. Calibrate the spirometer via the ventilator menu Menu Switch

procedure.

7. Press the menu switch on the front panel.

8. Scroll down the main menu and select O2
MONITOR & SPIROMETRY.
Navigator
9. Select SPIRO CALIBRATION.
Wheel and
Press Button
10. Press the wheel to initiate calibration.

11. Calibration is completed.

12. Scroll to ESCAPE FROM MENUS.

O2 Monitor & Spiro
13. Press the wheel to confirm.
ESCAPE FROM MENU
O2 MONITOR: on
CALIBRATION: 100%
HIGH ALARM SET: 105
LOW ALARM SET: 18
SPIROMETER: on
> SPIRO CALIBRATION: 0 L/min
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 PRE-OPERATION PROCEDURES

5.1.11 Pressure Monitor Connections

WARNING
The High and Low Airway Pressure Alarms are
important for patient care.
The connection point must be properly
located in the expiratory limb of the breathing
system.

1. PATIENT PRESSURE port (A) on the

rear panel of the control unit:
Use the appropriate Penlon tubing A
assembly to connect to the expiratory
limb of the breathing system, close to
the circle system expiratory valve.
B
2. Push-fit, self sealing connectors (B)
Push in the tube as far as possible
Do not use excessive force.
X
The connector end piece ‘X’ will also
move inwards.

Pull the tube carefully outwards.

The end piece ‘X’ will be pulled
outwards to the ‘locked’ position.

3. Connect the tubing (with adaptor, Part

No 053049) to the push-fit, self-sealing
connector (C) at the rear of the
A200SP Absorber.

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7
4

6
2

5.1.12 Bellows Assemblies Paediatric Bellows Assembly

CAUTION 1. Remove the adult bellows housing

Always ensure correct fitment of bellows (see
(1) - twist carefully counterclockwise
illustration above), and carry out a full function
test before clinical use, if a bellows is removed until the bayonet tabs become free,
and refitted. then lift up from the base (2).
Remove the bellows (3).
1. Remove the bellows housing (1). 2. Fit the paediatric adaptor (5) - press
the adaptor into the ventilator bellows
Twist carefully counterclockwise until
assembly base (2).
the bayonet tabs become free, then lift
3. Fit the paediatric bellows (6) to the
up from the base (2). adaptor.
2. Remove the bellows (3). Check for correct assembly, as
3. Refit the bellows and check for illustrated (4).
correct assembly, as illustrated (4). 4. Fit the paediatric bellows housing (7)
4. Fit the bellows housing by pushing to the base by pushing down, then
down, then twisting clockwise until the twisting clockwise until the bayonet
bayonet tabs completely engage. tabs completely engage.
5. Function test the ventilator - section 5. Function test the ventilator - section
5.3.1. 5.3.1.
NOTE
If there is any malfunction, the ventilator must
NOT be used.
If the problem cannot be rectified, the ventilator
must be checked by a Penlon trained engineer.

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5.2 Pre-use Checklist

5.2.1 Daily Checklist
The following tests must be carried out at the
beginning of every working day:

Alarm System
WARNING
The operation of each alarm function should be verified
daily.
If the audible alarm or the visual display for any alarm
function fails to activate during any alarm condition or
fails to reset after the alarm has been cleared, refer the
unit to an authorised service technician.

Back-up Battery
WARNING
If the internal battery is fully discharged, the ventilator
will not function.

Recharge the battery before the ventilator is used

clinically.
Charging the battery for 14 hours from a discharged
state will allow a minimum of 30 minutes of
continuous operation.
Connect the ventilator to a mains power supply. The
mains power indicator will illuminate to show that the
battery is being charged (it is not necessary to turn on
the ventilator).

Ventilator internal test

Press the ON/OFF switch (1).
o IO
o . . 1
A three-second internal test is initiated:
1. The ‘power -up’ screen is displayed.
2. The audible alarm sounds.
3. The ventilator reverts to STANDBY mode if no
selection is made.

NOTE special operating system on ventilators interfaced

with Prima SP (see section 3.5.2).
a) Turn the Prima Sp Gas Delivery Switch to ON - the
ventilator will power-up.
b) While the Prima SP power is ON, the Ventilator can be
turned OFF and ON, using the ventilator On/Off switch.
c) Turn the Prima SP Gas Delivery Switch to OFF. The
ventilator will power-down.

Calibrate the Spirometer - 5.1.9.2

Calibrate the O2 Monitor - 5.3.2

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5.2.2 Function Test 10. Open the patient ‘Y’ -piece to ambient
pressure.
1. Set the AIRWAY PRESSURE LIMIT At the second cycle, the LOW
to 50 cmH2O. AIRWAY PRESSURE alarm should
be activated.
2. Connection for PRESSURE
TRANSDUCER: 11. Select STANDBY mode
Check that the port on the rear of the Before using the ventilator clinically,
control unit is correctly connected to check that all connections are correct,
the port on the rear of the absorber and verify that there are no leaks.
assembly (see section 5.1.10).
NOTE
3. Connect a 2-litre breathing bag to the If there is any malfunction, the ventilator must
patient connection as a test lung. NOT be used.
If the problem cannot be rectified, the ventilator
must be checked by a Penlon trained engineer.
4. Adult bellows only:
Set the tidal VOLUME to 600 ml;
RATE to 10 bpm, and I:E RATIO to
1:2.0.

5. Use the O2 flush button on the

anaesthetic machine to fill the
bellows.
6. Select VOLUME CYCLE mode.
7. The delivered tidal volume indicated
on the scale printed on the bellows
housing should be approximately 600
ml.
If the delivered tidal volume is less
than 500 ml or greater than 700 ml,
refer the ventilator to a Penlon-trained
engineer.

8. Set a basal flow only on the

anaesthetic machine.
Check the bellows after 10 breaths -
the bellows should return to the top of
the housing.
Failure to return to the top of the
housing indicates a leak in the
breathing circuit.
Rectify the leak before clinical use.

9. Occlude the patient ‘Y’ -piece.

The HIGH AIRWAY PRESSURE
alarm should be activated.
The peak pressure read on the
breathing system pressure gauge is
the maximum working airway
pressure limit and should agree with
the setting.

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5.2.3 Weekly Checklist

At least every week, in addition to the daily
function test, the following checks must be
carried out:

Alarms
1. Select STANDBY MODE.

2. Unplug the mains power cable from

the AC outlet.
The MAINS FAILURE alarm should
activate.

3. Reconnect the mains power cable to

the AC outlet. The alarm should turn
off.

4. Disconnect the drive gas supply hose.

The LOW SUPPLY PRESSURE
alarm should activate.

NOTE
If there is any malfunction, the ventilator must
NOT be used.
If the problem cannot be rectified, the ventilator
must be checked by a Penlon trained engineer.

Bellows
Check the condition of the bellows and
exhalation diaphragm valve - see section
6.2.2.

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5.3 O2 Monitor System Set-up

5.3.1 Installation
Fit the probe (A) to the A200SP absorber.
Connect the cable to the input socket (B) on
the back of the AV-S ventilator control unit

NOTE The anaesthetic machine gas control

switch must be in the ON position for gas delivery.

WARNING
The sensor contains a small quantity of
electrolyte, classified as a harmful irritant
which is potentially hazardous.
Do not attempt to open a cell.
ALWAYS check the integrity of the sensor
assembly before use.
Once exhausted, the sensor must be A
disposed of according to hospital, local, state
and federal regulations. B
NOTE
To maintain maximum sensor life:
i) always disconnect the breathing circuit after
use.
ii) Switch off the anaesthetic machine to cut-off
the basal flow through the system.

Bacterial Filter
Use a breathing system bacterial filter in the
expiratory limb of the breathing circuit to
protect the oxygen sensor (see section
5.1.8).
CAUTION
Replacement/Disposal - always follow the
instructions supplied with the filter, and always
replace at the recommended interval.

5.3.2 Calibration
The new unit must be calibrated before
clinical use.
Thereafter, as a safety precaution, we
recommend calibration of the unit every
time the system is switched on.

Calibration must also be performed:

A) when the sensor is replaced
B) when point-of-use elevation changes by
more than 160 m (500 ft).

We recommend calibration with a 100%

oxygen standard source, at a pressure and
flow similar to your application.

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5.3.2.1 Calibration - Using 100% Oxygen

AV-S ventilator mounted on a Prima SP

anaesthetic machine fitted with a A200SP
absorber

Calibrate with the sensor in position within the absorber.

1. Detach the absorbent canister (1).

2. Remove the breathing circuit hoses from the
inspiratory and expiratory connectors (2) on 2
the absorber.
This will give a free flow of oxygen through the
sensor.
1
3. Switch on the ventilator (3) and the
anaesthetic machine gas delivery switch.
The oxygen monitor automatically switches
ON when the ventilator is switched on.
Ensure that all vaporizers are OFF.
o IO
o . .
4. Apply 100% oxygen only, at 5 L/min, from the %O2 100 3
anaesthetic machine flowmeter.
21 20

5. Allow the oxygen to flow until the oxygen 5

monitor readout (4) stabilises.

6. Calibrate the sensor, using the AV-S ventilator 4

menu procedure, as follows.

7. Press the menu switch (5) and select the O2

monitor sub-menu. 6

8. Scroll to CALIBRATION.
If the menu shows 21% (which indicates
calibration using air), press the navigator
wheel / button (6) to switch to 100%
(calibration using oxygen).

9. A message will flash on the screen:

O2 AT 100% ?
Press the button (5) to confirm
NOTE O2 Monitor & Spiro
The message:
OXYGEN SENSOR LOW OUTPUT ESCAPE FROM MENU
will appear on screen if the user attempts to O2 MONITOR: on
calibrate at 21% in 100% oxygen. > CALIBRATION: 100%
HIGH ALARM SET: 105
10. Scroll to ESCAPE FROM MENUS and press
the button (6) to exit. LOW ALARM SET: 18
SPIROMETER: on
11. Turn off the flow of oxygen. SPIRO CALIBRATION: 0 L/min
12. Refit the canister.

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5.3.3 Sensor Low Indication

The unit automatically detects when sensor
life is low. O2 Monitor & Spiro
The message:
OXYGEN SENSOR LOW OUTPUT ESCAPE FROM MENU
will appear on screen to indicate that the O2 MONITOR: on
sensor must be replaced. CALIBRATION: 100%
The sensor output will fall very quickly to > HIGH ALARM SET: 105
zero over a period of two to three weeks LOW ALARM SET: 18
from the first time that the alarm is SPIROMETER: on
activated. SPIRO CALIBRATION: 0 L/min

Sensor replacement - see section 6.5.

5.3.4 Setting the O2 Alarms

5.3.4.1 Set High Alarm

The high alarm value cannot be set below
19% or above 105% (Note that in certain High Alarm
conditions of excess pressure, the readout Set Value
may show a value above 100%.).
1. Touch the O2 concentration display, or
o IO
o . . On/Off Switch
Press the menu switch on the
ventilator front panel and select the O2 %O2 100
Alarm Mute
monitor sub-menu. 21 20
2. Scroll to HIGH ALARM SET and
press the navigator wheel. Menu Switch
3. Rotate the wheel to change the
displayed alarm figure to the desired
value. Low Alarm
Set Value
4. Press the wheel to confirm.
5. Scroll to ESCAPE FROM MENUS
and press the wheel to exit.
Navigator
Wheel and
5.3.4.2 Set Low Alarm Press Button
The low alarm value cannot be set lower
than 18%, or above 99%.
1. Touch the O2 concentration display, or
Press the menu switch on the
ventilator front panel and select the O2
monitor sub-menu.
2. Scroll to LOW ALARM SET and
press the navigator wheel.
3. Rotate the wheel to change the
displayed alarm figure to the desired
value.
4. Press the wheel to confirm.
5. Scroll to ESCAPE FROM MENUS
and press the wheel to exit.

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6.1 Service Intervals

At 6 months, 12 months, 2 years and 4

years, the ventilator must be serviced by a
Penlon-trained engineer, following the
schedule given below, and the procedures
given in section 7 in this Service Manual.

Every day:
Pre-use function check

Every week:
Check the condition of the diaphragm valve,
and clean as required.

Test the Mains Failure Alarm and the Low

Supply Pressure Alarm

Every 6 months:
Inspection and Function Check.
Remove patient block assembly and clean.
Check condition of bellows.

Every 12 months:
Repeat six month procedure, plus:
Replace components, including O-seals,
drive gas inlet filter, exhaust diaphragm,
one way valve.
Preventive maintenance kit available.

Every 2 years:
Repeat 12 month service, plus:
Replace battery.

Every 2 years:
Repeat 12 month service, plus:
Replace PCB battery and bellows
diaphragm valve.

Details of these service operations are given

in this manual.

Always ensure that a record is kept of any

service or repair work.

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6.2 Control Unit Patient Block

Assembly - Removal

On a regular basis (in line with hospital

procedures for infection control), the
patient block (1) must be removed,
1
cleaned and sterilised.

1. Detach the hoses from the outlets 3

(2).
Note different diameters for correct
refitment.
3 2 2
2. Undo the securing knobs (3).
3. Carefully detach the assembly (1)
from the control unit.
Note that resistance will be felt until
the metal tubes (4) disengage.
4
4. Wash thoroughly, then sterilise, as
recommended in section 6.3.
Do not disassemble.

Refitting
5. Position the patient block and push
fully into the control unit, ensuring
that the metal tubes (4) are engaged 4
in their unions.
6. Fit the securing knobs (3).
7. Function test the ventilator.

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1 Initial Checks (every six months)

1.1 Check serial number to determine service required.
1.2 Check general condition of ventilator.
1.3 Check configuration of attachments, tubing, cables and connectors.
Note, or replace as necessary.

2 Power On and Display Checks (every six months)

2.1 Check mains indicator illuminates amber when unit is switched off and connected to
the mains.
2.2 Turn ventilator to 'Standby'.

2.3 Check audible alarm activates

2.4 Default selection screen appears and automatically defaults to adult mode after
approximately eight seconds.
2.5 Mains indicator illuminates green

2.6 Check screen is undamaged, display is clear and that the touch sensitive screen
functions are operating correctly.

2.7 Check operation of on-screen indicator control using navigator wheel

3 Menu Selection Tests (every six months)

3.1 Press 'Menu' button.
Check menu screen appears.

3.2 Rotate Navigator wheel and check menu scrolls.

Check sub-menus can be selected by pressing the Navigator wheel.
Note some menu selections will time out after approximately 8 seconds of inactivity.

3.3 Restore any changed settings during above tests.

4 Engineers Mode (Available in Standby only) (every six months)

4.1 Press Menu button and select 'Service Menu'

4.2 Select 'Clock Menu' check date and time are correct.
Year = 2005 - 2099
Month = 1-12 (Jan - Dec)
Date = 1- 31
DOW = 1-7 =(Day of week, Mon - Sun)
Hour = 1-23
Minute = 1-59

4.3 Select 'Upgrade Menu' check software revisions

I/O Firmware for the main board
Main Firmware for CPU core
Select 'Ambient Pressure'
Check reading is correct adjust as necessary by selecting
'Engineer Menu' - 'Penlon Options Menu' - 'Cal Pressure'
Adjust to correct value.

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5 Engineer Error Codes (every six months)

5.1 Select 'Service Menu' - 'Engineer Menu' - 'Diagnosis Menu'- 'Display Error Log'

5.2 Check and investigate errors. Up to 30 Error Codes can be stored. Format is:
Date - Time - Fault
Example: 08/05/01 - 09:12:40 - On/Off Valve

5.3 Reset Error log.

6 Bellows Assembly (every six months)
6.1 Remove and clean canister.
6.2 Remove bellows from base and inspect bellows.

6.3 Discard old bellows and replace with new. (every 12 months)

6.4 Remove diaphragm valve (3 x thumbscrew)

6.5 Inspect valve seat for damage

6.6 Check valve disc hangs level.

6.7 Replace diaphragm valve

If necessary clean valve seat and valve disc using alcohol wipe.
Do not attempt to dismantle diaphragm assembly.

6.8 Replace large orange o-ring from bellows canister (not absorbent canister)
(every 12 months)
Replace small o-ring from diaphragm valve. (every 12 months)
Apply oxygen approved grease

6.9 Refit diaphragm valve and secure. (3 x thumb screws)

6.10 Refit bellows and canister.

6.11 With hand occlude the Inspiratory connector of the absorber and inflate bellows
assembly using flush button until bellows is at top of housing.
With no flow from anaesthesia machine bellows should not drop.

6.12 Move hand from Inspiratory connector and occlude drive gas hose at rear of absorber.
Bellows will fall momentarily but then should stop falling.

Failure of either 6.11 or 6.12 indicates a bellows leak, diaphragm valve leak, drive gas
hose leak or canister leak.

7 Pneumatic System Tests (every six months)

7.1 With unit switched off, disconnect mains supply.

Unscrew thumbscrews at rear of unit and withdraw Patient Valve Block.

7.2 Remove Diaphragm valve, spring and spring cap.

Remove the Non-Return Valve.
Clean and examine for damage or discolouration.
Replace as necessary.
Refit the Non-Return Valve.
With the spring, spring cap, and the diaphragm still removed, occlude the spring orifice.

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Use an inflation bulb to apply pressure to the drive gas connector.

Pressure should relieve at 100 cmH2O ± 10%

7.3 Replace diaphragm valve and Non-return valve (every 12 months)

7.4 Replace 5 mm, 7 mm, and 12 mm probe O-rings (every 12 months)

7.5 Remove the 5mm hexagonal fitting at the rear of the control unit.
Replace Gas Supply Filter. (every 12 months)

7.6 Leak test gas inlet to unit On/Off -valve.

Ensure less than 7 kPa/min

7.7 With patient valve still removed, connect ventilator to power supply.
Reconnect gas supply.
Switch on the unit.
In 'Standby Mode', set inspiratory flow of 5l/min using front panel settings: 500, 5, 1:1,
OFF, 38.
Switch ventilator to 'Volume Mode'

7.8 Connect test gauge to primary regulator test point.

Check regulator set to 262kPa +/- 21 kPa (38 psi +/- 3 psi) during inspiratory phase.
If adjustment is necessary unit cover will need to be removed.

7.9 Connect manometer to output of patient proportional valve (small probe) .

Check for 90 cmH2O +/- 10% during the inspiratory phase and zero during the
expiratory phase.
Adjust secondary regulator as necessary

7.10 During expiratory phase ensure that there is no gas flow from the Drive Gas connector.
If necessary carry out Drive Gas Valve Offset calibration.

8 Control Unit (every 6 months)

8.1 From 'Diagnosis Menu' check supply voltages and battery current as follows, with the
mains lead connected:
'V IN' = 1096 mV±10% (mV x 13 = input voltage)
'V SUPP' = 1060 mV±10% (mV x 13 = input voltage)
'I BATT' 0 - 450 mV (mV x 1.333 = mA)

8.2 Check all electrical connections and components for security. (every 12 months)

8.3 Replace back up battery. (every 2 years)

8.4 Replace Real Time battery. (every 4 years)

9 Set Up (every 6 months)

9.1 Select drive hose 02 or Air.

Attach to the 'Driving Gas Input' connection to the rear panel.
9.2 Connect the long corrugated hose to the 'Drive Gas Output' connector of vent and the
vent drive gas connector at rear of absorber.

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9.3 Connect the pressure tube to 'Patient Pressure' connection on the rear panel of the
control module to the Pressure Sensing port on the rear of the absorber.

9.4 Connect the cable from the 'Interface' connector on the rear panel of the control
module and to the Spirometer connection on the rear of the absorber and the rear of
the Prima SP anaesthesia.

9.5 Attach the 'Fresh Gas Supply' hose from the absorber to the CGO of the PrimaSP

9.6 Connect a patient breathing circuit to the CO2 absorber and attach the patient
connector to a test lung.

9.7 Connect the Gas Scavenging System to the "Exhaust' connector on the rear of the
vent. (If no scavenge system is attached to the rear of the ventilator, a continuous
bleed during the inspiratory phase will be audible)

10 Standby (every 6 months)

10.1 Power On the Anaesthesia machine. Ventilator should switch 'ON'

10.2 Power Off the Anaesthesia machine. Ventilator should switch 'OFF'

10.3 Press the Power button on the ventilator.

10.4 Default selection screen appears and automatically defaults to adult mode after
approximately eight seconds

10.5 Note: standby mode is highlighted white in the bottom right of screen.

10.6 Set incorrect rate, i.e. increase Vt, and/or Rate controls.
Check 'Incorrect Rate Or Ratio' displayed on screen and 3 alarm tones sound. Do not
confirm settings, wait for default values to return.

11 Oxygen Analyser Function and Calibration Tests (every 6 months)

11.1 Connect a calibrated O2 Analyser into inspiratory connector.

11.2 Check Vent O2 sensor is inserted into the absorber O2 sampling point.

11.3 Remove canister.

Attach a short hose to inspiratory limb.
Use O2 flush for 20 seconds the set a 5 l/min flow of oxygen and allow reading to
stabilise.
Ensure 100% indicated on test device and ventilator display is stable.

11.4 Calibrate Vent in 100% Oxygen.

11.5 From menu select 'Oxygen Monitor & Spirometry'-'Calibration'.

Adjust until 100% is indicated then press navigator wheel to confirm.

11.6 Exit menu and set fresh gas flow to minimum

11.7 Expose both sensors to air and check reading is 21% +/- 2

11.8 On ventilator, adjust high and low O2 alarms and check alarms trigger when values

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lower or higher than reading on ventilator O2 display respectively.

Return alarm levels to original settings.

11.9 Restore ventilator O2 sensor to correct location.

Remove test O2 analyser.
Refit canister.

12 Spirometer Calibration (every 6 months)

12.1 Check condition of external Spirometer cables and connections.

12.2 Disconnect fresh gas hose from anaesthesia machine Common Gas Outlet. Switch
Bag/Vent switch to 'Bag' and remove bag from bag arm.
Remove test lung from patient connector if fitted, or remove patient circuit. Ensure
scavenging circuit is not connected.

12.3 Check Spirometer is enabled in menu.

12.4 From menu select 'Oxygen Monitor & Spirometry'- 'Spiro Calibration'.

12.5 Rotate dial until '0 L/min' is displayed.

12.6 Press Navigator wheel to calibrate Spiro.

12.7 Display will flash 'Calibrating Zero'

12.8 If successful 'Calibration complete' will be displayed.

12.14 Reconnect fresh gas hose, patient circuit and manual bag and re-set bag/vent switch
to 'Vent' position.

13 Spontaneous Mode (every 6 months)

13.1 Select 'Spont Mode' on touch screen.

13.2 Check absorber is in vent mode.

13.3 Operate Test Lung (by hand)

Check 'Vt meas.', 'BPM' and 'I:E' readings at bottom of the display .
Observe waveform displayed.

13.4 Stop operation of test lung.

Ensure pressure reading falls to zero and after 15 sec delay check 'Apnoea' alarm
triggered and 'Vt meas.' shows '= = ='.

13.5 Press 'Mute' verify audible alarm is muted for 120 seconds.
(Note, alarm mute countdown is displayed at bottom right of touch screen.)

13.6 Switch absorber to bag mode, close APL valve. Inflate bag with O2 flush and repeat
tests 3 - 5 above using re-breathing bag.

13.7 Switch absorber to vent mode.

From the 'Special Modes' menu select SIMV.

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Re-select 'Spont Mode' and select 'SIMV'

NB: If absorber switch is not enabled in service menu, message will read 'Absorber in
vent mode?' Press 'SIMV' once again.

13.8 Operate Test Lung very gently (by hand)

Check that occasional ventilator assistance is given.

13.9 Stop operation of test lung.

Ensure test lung is ventilated at the default settings. 600 ml; 6 bpm; 2 sec Ti

13.10 Switch ventilator to 'Standby'

From the 'Special Modes' menu select SMMV.
Re-select 'Spont Mode' and select 'SMMV'

NB: If absorber switch is not enabled in service menu message will read 'Absorber in
vent mode?' Press 'SMMV' once again.

13.11 Operate Test Lung very gently (by hand)

Check that occasional ventilator assistance is given.
Check that the measured Minute Volume is 3.6 litres

13.12 Stop operation of test lung

Ensure test lung is ventilated at the default settings. 3.6 litres; 6 bpm; 2 sec Ti

13.13 Switch ventilator to 'Standby'

From the 'Special Modes' menu select Pressure.
Re-select 'Spont Mode' and select 'PSV'

NB: If absorber switch is not enabled in service menu message will read 'Absorber in
vent mode?'
Press 'PSV' once again.

13.14 Operate Test Lung (by hand) and check that occasional ventilator assistance is given
with a pressure of 10 cmH2O.

13.15 Stop operation of test lung and ensure pressure reading falls to zero and after 30 sec
delay check 'Low Tidal Volume' alarm triggered and 'Vt meas.' shows '= = ='.

14 Volume Cycle & Flow Compensation Tests (every 6 months)

14.1 Switch Ventilator to 'Volume ' Mode

14.2 Set 'Vt' to 600 ml, 'BPM' to 10, 'I:E' to 1:2 and 'Pressure Limit' to 80.

14.3 Verify approximately 600 ml is delivered as indicated on bellows canister.

14.4 Press 'Insp Pause' check 25% pause during the inspiratory phase.

14.5 Check measured display indicates 600 ml +/- 50ml on 'Vt Meas'

14.6 From Menu select Fresh Gas compensation OFF.

14.7 The bellows still delivers 600 ml +/- 50 ml but the measured volume will reduce to
approximately 500 ml with a standard test lung

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14.8 Apply a flow of Oxygen from Anaesthetic Machine of 8 L/min.

Check displayed 'Vt Meas' Rises.

14.9 From Menus select Fresh Gas compensation ON.

Allow 2 minutes for reading to stabilise.
Check displayed 'Vt Meas.' = 600 ml +/- 50 ml.
Observe that the bellows delivers less gas than before

14.10 Press 'Wave Freeze'

Check waveform freezes on display.
Press again to clear.

14.11 Set PEEP to 10cm H2O

Check waveform to see that it displays 10cm H2O of PEEP. (Straight line is good.
Decline of line indicates leak.)
Turn off PEEP.

14.12 Adjust Airway Pressure

Observe changing scale on waveform.
Reset to max.

14.13 Touch waveform screen

Check the following second waveforms are selectable and waveform is displayed.
1. Volume v Time.
2. Pressure v Volume (Compliance Loop).
Reset back to 'None'.

14.14 Check the ventilator is operating smoothly, test lung is inflating, and system pressure is
displayed on both vent and absorber manometer.

15 Airway alarm Tests (every 6 months)

15.1 Set ventilator to default settings and ventilate test lung in 'Volume' mode.

15.2 Disconnect test lung and occlude patient connector.

Ensure 'High Airway Pressure' occurs.
Re-connect test lung and ensure alarm clears.

15.3 Disconnect test lung and open patient connector.

Ensure 'Low Airway Pressure' occurs.
Re-connect test lung
Re-fill bellows and ensure alarm clears.

15.4 Volume cycle vent, adjust Vt Set to achieve a peak airway pressure of greater than 30
cm H2O of water.

15.5 At peak pressure clamp pressure sensing tube.

Displayed waveform should show pressure greater than 30 cm H2O continuously.
Check that 'High Continuous Pressure' alarm is activated.
Unclamp pressure-sensing tube and allow the vent to cycle.
Reset ventilator to default settings.

15.6 Disconnect power supply.

Verify ventilator continues to operate on battery.

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Check that the 'AC Power Fail' alarm is displayed.

Reconnect Mains lead to ventilator.

15.7 Remove drive gas line from gas supply pressure.

Check 'Low Supply Pressure' alarm activates.

15.8 Re-connect drive gas line and ensure alarm clears.

16 Pressure Ventilation (every 6 months)

16.1 Switch Ventilator to 'Pressure'

16.2 Vent will automatically Set 'Airway Pressure Limit' to 10 cm H2O.

Verify pressure is held at this setting.

16.3 Carry out leak test.

Set 'Rate' to 5 BPM, I:E 1:1, and 'Pressure Target' to 50 cm H2O.
Ensure flowmeter on anaesthesia machine is set to minimum.
Fill bellows using O2 flush.
Allow bellows to cycle and verify bellows remain full.
If necessary adjust flow from anaesthesia machine to maintain full bellows.
Max permissible flow (leak) 200ml.

16.4 Check waveform holds the airway pressure values. (Level display)
A falling display indicates a leak either in the driving circuit, the patient circuit or the
absorber system.

17 Electrical Safety Checks (i.a.w. MDA DB 9801 supp. 1) (every 6 months)

17.1 Earth Continuity (Max 0.2 ohms) at 1 Amp or less

17.2 Insulation Resistance (not less than 20 Meg Ohms) at 340-500Vdc

17.3 Earth Leakage (Max 500 micro amps)

17.4 Enclosure Leakage (Max 100 micro amps)

18 Paperwork (every 6 months)

18.1 Fill out appropriate service report.

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 8. PARTS LIST

Preventive Maintenance Kits

One year Kit Part No 57298

Exhaust diaphragm 300580
One-way valve 300581
O-rings (x 5) 5 mm - 041204
7 mm - 041245
12 mm - 041222
Inlet filter 300560
Bellows 57550

2 year Kit Part No 57299

As One year kit, plus:
12v battery 103996

4 year Kit Part No 57300

As 2 year kit, plus:
3v PCB battery 104019
Bellows diaphragm valve 406020

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 PARTS LIST

5000492
Arm Assembly

Control Unit and Remote Display Screen Assemblies

Item Part No. Description Quantity
1 01056 M5 x 12 SKT HD Cap Screw 4
2 300529 Screen Display Assembly (Remote) 1
3 5000543 Chassis Assembly (Remote) 1
4 01130 M5 X 16 SKT Cap Head Screw ST STL 4
5 300549 Interface Cable - screen to control unit 1
(not shown)

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Display Screen Assembly

Item Part No. Description Quantity

1* 300540 Front Moulding 1
2* 300541 Rear Cover 1
3 300575 Spinner Ø38 mm 1
4 300573 Gasket 2
5* 01253 M4 X 25 SKT HD Cap 4
6 300550 Membrane Switch + LED’s 1
7 019122 M3 X 6 LG Button HD 4
8 300516 LVDS Encoder Assembly 1
9 01013 M4 X 10 SKT HD Cap 4
10 300547 ‘O’ Ring Cord 1
11 300524 TFT Sub Assembly 1
12 01059 M2.5 X 6 CH HD 2
13 025606 M3 Fibre Washer 6
14 15056 Product Label 1
15 15446 Warranty Label 1

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Screen Assembly (300524)

Item Part No. Description Quantity

1 300565 8.4” TFT Screen (NEC) 1
2 300531 TFT Mounting Plate 1
3 300567 Inverter 5V 1
4 300599 M2.5 X 16 Butt HD SS 4
5 5000544 M2.5 Nyloc Nut ST STL 4
6 300536 Tape (Touch Screen To TFT) 1
7 300537 Tape (TFT To Plate) 1
8 300566 8.4” Touch Screen 1

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Control Unit Assembly (5000453)

Item Part No. Description Quantity

1 01056 M5 x 12 SKT HD Cap Screw 4
2 300534 SP Mounting Plate 1
3 019171 M4 x 10 But Flanged HD 10
4 300564 Short Form Instructions 1

5 019049 M3 X 10 LG Pan HD 3
7 5000489 Chassis Assembly 1
8 5000499 Tray Assembly (Remote) 1

9 15446 Warranty Label 1

10 15056 Product Label 1
11 034072 M5 Cover Plug 4
12 5000460 Cover - AVS 1

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 PARTS LIST

Control Unit Chassis Assembly (5000489)

Item Part No. Description Quantity

1 5000459 Chassis - AVS 1

2 5000156 Regulator & Control Assembly 1
4 300595 DISS Con’ Nut 1
5 011240 Rubber Foot 4
6 01235 M8 Internal Star 1
7 01149 M8 Locknut 1

8 103996 Battery 1
9 104715 LEC Mains Connector / Filter 1
10 2220-099 LEC Mains Plug Retainer Assembly 1

11 5000449 Patient Valve Block Assembly 1

12 35150 Hose - Hose Panel Connector 1
13 019122 M3 X 6 LG Button HD 4
14 5000505 External Circlip Ø10 mm Shaft 2

15 5000498 Power Supply Bracket 1

16 5000504 External Circlip Ø8 mm Shaft 2
17 5000472 Chassis Label - AVS 1
18 300569 Power Supply 1
19 300634 Straight Connector 5 O/D Tube - M5 1
20* 5000540 Bostik Silicone Sealant A/R

21 5000488 Pressure Connector 1

22 041204 5.1 I/D X 1.6 CSØ Viton 1
23 500506 Tray Gasket 1

24 5000487 Bleed Adaptor 1

26 054541 Tube Conn’ 1
27 041245 O Seal Ø7.0 X 1.5 1

29 300609 Sensor Assembly 1

30 019067 M4 X 12 SKT HD Cap 2
31 011241 D/S Tape 3M’s X 105 mm Long 2
32 019087 M3 X 16 Cap HD Screw 2
33* 057002 Loctite 222 A/R
34 011169 M4 Skiffy Cap 2
36 019121 M4 X 8 Button HD 1
37* 300638 Tube Ø4.0 O/D A/R
38* 300637 Tube Ø5.0 O/D A/R
39* 011092 Silicon Tube O/D 6 mm X I/D 3 mm A/R

40 104038 Fuse, 2 Amp T HRC - 20 mm, UL 2

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Regulator Assembly and Control Block Assembly

Item Part No. Description Quantity

1 300526 Regulator Assembly 1
2 5000482 Control Block Assembly 1
3 019037 M3 X 35 Cap HD 4
4 041221 ‘O’ Ring Ø8.1 X Ø1.6 1

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Patient Block Assembly

Item Part No. Description Quantity

1 300580 Diaphragm 1
2 300581 One-way valve 1
3 300583 Inline Relief Valve 1
4 5000478 Check Valve Cap 1
5 300593 Taper Adaptor 1
6 300594 Tapered Conn 1
7 5000448 Spring Guide 1
8 5000450 Valve Body 1
9 5000451 Seat Insert 1
10 5000452 Drive Gas Block 1
11 5000453 Valve Base 1

12 0501 ‘O’ Ring 1

13 01014 M4 X 16 SKT HD Cap Screw Ss 4
14 011169 M4 Skiffy Cap 4
15 019028 M3 X 6 Grub Ss Cup 1
16 019087 M3 X 16 Cap HD Screw 4
17 019128 M4 X 8 Butt HD CHEM BLK 4
18 019153 M4 X 50 Cap Head SS 4

19 041214 ‘O’ Ring RM 0221-16 Viton 1

20 041217 ‘O’ Ring 1
21 041250 ‘O’ Ring Ø27.6 X 2.4 1

22 300561 Compression Spring 1

23 5000444 M4 Tappex Trisert 8
24 5000445 M3 Tappex Trisert 4
25 5000475 Mounting Plate 1
26 5000476 Mounting Plate Label 1

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 7. APPENDIX

APPENDIX 1
Care of Back-up Battery
CAUTION
Damage may occur if the battery is allowed to remain in a discharged
state.
Never discharge the battery to below 10.2 volts.

A. Battery installed in ventilator

The battery must be charged before the machine is released for use
with an 14 hour charge from the ventilator’s internal power supply
(ventilator connected to the mains supply, but not running).
Note that the mains power indicator on the front panel will show a
yellow light during charging.
Subsequently the recharge periods for a battery on a ventilator in
store are similar to those in B, below.
Batteries in machines in normal use will be kept charged by the
internal power supply.
Note that the Low Battery Alarm indicator may be displayed if
automatic recharging is taking place as the ventilator is in use.

B. Battery care/storage requirements.

During storage, batteries will require a periodic recharge, the
frequency of which is determined by the storage temperature,
which must not exceed 50oC (120oF).

Storage Recharge
temperature period

38 to 50oC (100 to 122oF) 1 month

21 to 38oC (70 to 100oC) 3 months

7 to 21oF (45 to 70oF) 6 months

0 to 7oC (32 to 45oF) 9 months

-5 to 0oC (23 to 32oF) 12 months

Duration - recharge until the charge current is less than 25 mA

(typically overnight).
It is recommended that at each charge an updated label is affixed
to the unit to indicate date of the last charge.

C. Disposal of used batteries

Follow all hospital, local, state and federal regulations.

Note
Removal/replacement of battery must only be undertaken by a trained
technician

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APPENDIX 2
On-screen Menus
NOTE:

1. All selection or changes in the menu are

followed by a "CONFIRM" message
prompt on the screen, and accompanied
by a "BEEP" (user volume set)

2. The selected text or option will invert in

colour

3. User settings menus only activate in

Standby mode.

4. Clock menu, Upgrade menu, Diagnostic

menu only activate in Standby mode.

5. Special Modes on-screen tab only

activates in Spontaneous mode

6. Adult default settings

VT=600 mL
RATE=10 bpm
IE RATIO=1:2
Plimit=38 cmH2O
Ptarget=10 cmH2O

7. Paediatric default settings

VT=150 ml
RATE=15 BPM
IE RATIO=1:2
Plimit=38 cmH2O
Ptarget=10 cmH2O

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 Menu Structure
O2 Monitor & Spirometry

ESCAPE FROM MENU

O2 MONITOR: on off / on (Toggle option
CALIBRATION: 100% 21 / 100% (Toggle option)
HIGH ALARM SET: 105 19 -105 (Integer)
LOW ALARM SET: 18 18 - 99 (Integer)
SPIROMETER: on off / on (Toggle option)
SPIRO CALIBRATION: 0 L/min 0 L/min / 10 L/min (Toggle option)

Fresh Gas Compensation

Main Menu
ON / OFF off/on (Toggle option)
EXIT MENUS
O2 MONITOR & SPIROMETRY
FRESH GAS COMPENSATION: ON Support Mode pick list
SPECIAL MODES Special Modes none
WAVEFORM pressure
ALARM SETTINGS ESCAPE FROM MENU simv
GAS MIXTURE: O2+AIR SUPPORT MODE: none smmv
TRIGGER: 5 L/min Trigger pick list
USER SETTINGS 0.2 L/min
SIGH TO BREATH RATIO: 1:50
SERVICE MENU 0.3 L/min
Sigh to Breath 0.4 L/min
Ratio pick list 0.5 L/min
1:50 1.0 L/min
2:50 1.5 L/min
3:50 2.0 L/min
4:50 2.5 L/min
3.0 L/min
4.0 L/min

Waveform

ESCAPE FROM MENU

SECOND WAVEFORM: off Second waveform pick list
off
vol. vs time
vol. vs press.

Alarm settings

ALARM MENU
ESCAPE FROM MENU
ALARM MODE : default default / user (Toggle option)
HIGH TIDAL VOLUME: off off / on (Toggle option)
VM MIN: 0.3 L 0.0 - 7.4 (Integer)
VM MAX: 0.9 L 0.1 - 7.5 (Integer)
VT MIN: 300 mL 10 - 1600 (Integer)
VT MAX: 900 mL 20 - 2400 (Integer)
APNOEA ALARM LIMIT: 0.3 cmH2O 0.3 - 3.5 (Integer)
ALARM VOLUME: 50% 50 - 100% (Integer)

Gas mixture: O2+Air

O2+AIR
O2+N2O
O2+Xe
O2+He

Select settings
User Settings ESCAPE FROM MENU
USER1: CCT1
ESCAPE FROM MENU USER2: CCT2
SELECT SETTINGS USER3: CCT3
SAVE SETTINGS USER4: CCT4
BACK LIGHT LEVEL: 50% USER5: CCT5
VOLUME TYPE: tidal ADULT DEFAULT
PAEDIATRIC DEFAULT

Save settings
ESCAPE FROM MENU
USER1: CCT1 CONFIRM: CCT1
USER2: CCT2 CONFIRM: CCT2
USER3: CCT3 CONFIRM: CCT3
USER4: CCT4 CONFIRM: CCT4
USER5: CCT5 CONFIRM: CCT5

Backlight level
0 - 100% (integer)

Volume type
tidal/minute (toggle)
Service
See next page

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 Service
ESCAPE FROM MENU
LANGUAGE: ENGLISH Language pick list
PRINT PATIENT DATA ENGLISH
SERIAL MODE: none ITALIANO
CLOCK MENU TURKCE
UPGRADE MENU POLSKI
AMBIENT PRESSURE: 988 mBar ESPANOL
DISPLAY HISTORY
*SERVICE PIN: 0 Serial mode pick list
*ENGINEER MENU NONE
Philips
SPACELABS

Clock
ESCAPE FROM MENU Clock pick list (integer)
YEAR: 2005 2005 - 2099 (integer)
MONTH: 3 1 - 12 (integer)
DATE: 16 1 -31 (integer)
DOW: 3 1 - 7 (1 = Monday) (integer)
HOUR: 9 0 - 23 (integer)
MINUTE: 57 0 - 59 (integer)
UPDATE CLOCK
DAYLIGHT SAVING: off off / on (toggle option)

Upgrade
ESCAPE FROM MENU
I/O HARDWARE: 2
I/O FIRMWARE: v0.47 [Build 68]
MAIN FIRMWARE: v0.92 [Build 32]
REGISTRATION KEY: unknown
UPGRADE FIRMWARE: unavailable
ADD NEW FEATURE: unavailable

History Display
ESCAPE FROM MENU
MANUFACTURER DATE : 03/03/05
TOTAL HOURS RUN: 100
LAST SERVICE DATE: 13/08/04
HOURS SINCE SERVICE : 100
DRIVE VALVE CYCLES: 1253
PATIENT VALVE CYCLES: 822
CUTOFF VALVE CYCLES: 72

*NOTE
Service PIN
Engineer Menu

Sub-menus are not accessible by users.

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 APPENDIX

APPENDIX 3 The flow sensor output is read at least

every 2 msec and then five sets of readings
AV-S Ventilator Spirometry System
are averaged and the averaged value is
sent every 10 ms to the processor for
Ventilator Spirometry Measurement calculation of the volume delivered to the
The AV-S ventilator drive gas and patient.
spirometry system uses a total of three This delivered volume will consist of the
mass flow gas sensors to monitor and then volume delivered from the ventilator bellows
independently measure the gas flows within plus the fresh gas flow from the anaesthetic
the ventilator and breathing system. machine fresh gas supply, minus any
This ensures that correct volumes are compliance loss and minus any leak.
delivered to the patient. This gives a total actual inspired tidal
These monitors are measuring firstly in the volume.
ventilator delivery control system, and
secondly in the patient breathing system. A similar measurement method is used for
the exhaled volume. During the exhalation
During use of the ventilator the user will set period the measured exhaled volume is
a required tidal volume and at the first subtracted from the inspired volume, and at
breath the ventilator will use its pre- the end of exhalation.
calibrated delivery flow rate valve settings A negative (more gas coming out) volume
to set the proportional delivery valve indicates that fresh gas has increased the
position to deliver the requested tidal delivered volume.
volume. A positive volume (less gas coming out)
To confirm that the correct flow rate (tidal indicates a leak in the circuit.
volume) is being delivered by the ventilator The ventilator control system will then
delivery system an internal flow sensor (a adjust the next delivered tidal volume, up to
Honeywell AWM43300V mass flow sensor), a maximum of 100 ml. This will bring the
monitors the delivered flow rate and makes delivered volume to exactly as set.
adjustments every 30 ms using proportional If the variation between set and delivered is
regulation. greater than the maximum rate of change
As this sensor is always measuring the allowed, the adjustment will occur gradually
known drive gas rather than breathing over several breaths.
system gas the volumes measured will The displayed volume is the average of the
always be independent of breathing system inspiratory and expiratory volumes. If this
gas composition. This system ensures value is less or more than 50% of set
accurate delivery volume from the ventilator volume, a low or high volume alarm is
control unit. given.

To monitor for correct delivery volumes in Breathing System Gas Composition

the breathing system there are two Gas flow measurements are affected by the
breathing system mass flow sensors breathing system gas composition. To
(Honeywell AWM 720P1 spirometers). compensate for these effects the ventilator
One sensor is located in the inspiratory has
limb, and one in the expiratory limb. a) a gas composition setting whereby the
Measurements are taken from these user is able to select the gasses being
sensors to determine the actual delivered delivered, i.e. oxygen/air, oxygen/nitrous
and exhaled gas volumes in the breathing oxide etc,
system. This enable measurements to be b) an oxygen monitor;
made to compensate for fresh gas flow,
compliance losses and possible breathing Thus the ventilator knows the overall
system leaks. oxygen concentration and the majority of
During the inspiratory cycle the inspiratory the remaining gas composition.
flow sensor measures the gas volume
delivered to the patient.

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 APPENDIX

near as possible, under the circumstances.

Altitude Effects Accuracies for spirometry measurement are
Gas flow measurements are also affected >300 ml ± 10%
by atmospheric pressure, in a linear >100 ml <300 ml ± 20%
relationship. <100 ml ± 50%.
To compensate for altitude effects an
ambient pressure sensor is available. When
the spirometers are calibrated for zero flow Flow sensor description
the ambient pressure is recorded so that The microbridge mass airflow sensor
the measured volume may be adjusted. operates on the theory of heat transfer.
The measured volume is multiplied by the Mass airflow is directed across the surface
ratio of Pamb to Pcal; where Pamb is the of the sensing elements.
latest ambient pressure and Pcal is the Output voltage varies in proportion to the
ambient pressure recorded when the mass air or other gas flow through the inlet
spirometers were calibrated at zero flow. and outlet ports of the package.

Carrier Gas Effects The specially designed housing precisely

The effect of air as the dilutent gas is directs and controls the airflow across the
different to that of nitrous oxide and as the microstructure sense element.
ventilator includes only an oxygen monitor, The microbridge mass airflow sensor has a
the additional information of gas being unique silicon chip based on advanced
ventilated is included to increase available microstructure technology. It consists of a
accuracy. In the event of the wrong gas thin-film, thermally isolated bridge structure
selection being made by the user, the error containing heater and temperature sensing
in delivered volume could reach up to elements. The bridge structure provides a
approximately 7%. This possible variation is sensitive and fast response to the flow of
of no known clinical disadvantage. air or other gas over the chip.

Anaesthetic Agent Effects Dual sensing elements positioned on both

The addition of anaesthetic agent is known sides of a central heating element indicate
also to increase the spirometry readings flow direction as well as flow rate.
depending on the agent and its Laser trimmed thick film and thin film
concentration by up to approximately 2%. resistors provide consistent
Again this minor volume measurement interchangeability from one device to the
variation is of no known clinical next.
disadvantage and is therefore not
compensated for other than that due to The microbridge mass airflow sensor uses
oxygen variation due to the percentage temperature-sensitive resistors deposited
change. within a thin film of silicon nitride. They are
suspended in the form of two +bridges over
Water Vapour Effects an etched cavity in the silicon.
Water vapour volumes in the breathing gas The chip is located in a precisely
are not detectable in normal breathing dimensioned airflow channel to provide a
system dynamics. repeatable flow response.

Additional Features Highly effective thermal isolation for the

Additional spirometry features available for heater and sensing resistors is attained by
selection by the user are the ability to turn etching the cavity space beneath the flow
off the automatic compliance and fresh gas sensor bridges. The small size and thermal
compensation and also the feedback isolation of the microbridge mass airflow
provided by the oxygen monitor. sensor are responsible for the extremely
In this event, the ventilator relies on the fast response and high sensitivity to flows.
basic delivery look up table and the internal
flow sensor to confirm delivery volumes as

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 APPENDIX

Dual Wheatstone bridges control airflow

measurement - one provides closed loop
heater control, the other contains the dual
sensing elements.
The heater circuit minimizes shift due to
ambient temperature changes by providing
an output proportional to mass flow. The
circuit keeps the heater temperature at a
constant differential (160°C) above ambient
air temperature which is sensed by a heat-
sunk resistor on the chip.
The ratiometric voltage output of the device
corresponds to the differential voltage
across the Wheatstone bridge circuit.

Sensor flow characteristics

The graph shown below is a typical flow
versus resistance graph for the Honeywell
spirometer head units for the flow range
showing typical hysteresis between up and
down flow measurements (and
repeatability).

5
4.5
4
3.5
Resistance 3
(cmH2O) 2.5
2
1.5
1
0.5
0
0 20 40 60 80 100 120 140

Flow
(L/min)

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APPENDIX 4
Cleaning A
Outside surfaces and bellows housing

CAUTION
Care must be taken not to allow liquids to run into the control
unit; serious damage
may result.

Check that the unit is disconnected from the electrical supply

before cleaning.

Do not use cleaning solutions containing alcohol; the bellows

housing may be damaged.

To clean the outside surface of the ventilator, use a damp

B
cloth.
If necessary use a warm, mild detergent
solution to remove resistant grime. Make sure that all F
detergent residues are fully removed after cleaning.

Never use any harsh abrasive cleaning agent. The

transparent acrylic bellows housing and, in general, the
surfaces of the control unit are not scratch resistant.

The inside of the bellows housing, under normal

conditions, is not in contact with the breathing gas and
therefore only needs cleaning as described above.

Remove the bellows housing (A) by slightly twisting it

counter-clockwise until the tabs at the bottom clear the
bayonet locks, then lift it straight up from the base. Paediatric
Bellows
Touchscreen Assembly
Use a soft cloth only.
Never use any harsh abrasive cleaning agent.

Bellows and exhalation diaphragm valve

Each time the bellows assemblies are opened for C
cleaning, all visible components must be carefully
inspected and damaged parts must be replaced.

Bellows
As with all elastomers, the bellows material deteriorates
with aging and should be inspected at least every six
months or after 1200 hours of use, whichever comes first.
The bellows must be replaced if it shows signs of aging.

The bellows (B) can be removed by carefully pulling it off

the base.
If a paediatric bellows is fitted, the bellows adaptor (C)
must also be removed.

Do not dismantle the bellows.

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Exhalation Diaphragm Valve
The exhalation diaphragm valve is under the bellows and
can be removed by loosening the three thumbscrews.
The valve seat is now visible. E
WARNING
Great care must be taken. Do not damage the precision
surface of the valve seat (D).
Never use any hard object or abrasive agent to clean it;
use only a soft cloth.
If the valve seat is damaged, the diaphragm valve will leak
D
and may cause serious malfunction.

Clean the seat, and the metal disk (E) attached to the
base of the diaphragm valve, thoroughly and remove all
Exhalation Diaphragm Valve
contamination from the surfaces of both components. Assembly

NOTE
If excessive contamination is discovered, check that a bacterial
filter is used in the expiratory limb of the breathing circuit (or an
HME at the patient tee-piece).

After cleaning, check that the small O-ring (F) located in

the bellows base under the diaphragm valve is in place.
The ventilator will not function if the O-ring is missing.

See next page for information on sterilisation procedures.

Refitting
Refit the diaphragm valve assembly to the bellows base
and reassemble the bellows assembly
If a paediatric bellows is fitted, press the adaptor (C) into
the ventilator bellows assembly base, then fit the bellows.

CAUTION
Always check for correct fitment of the bellows (see illustration),
and function test the ventilator before clinical use.

Spirometer Sensors
The sensors are built into the A200SP absorber, and
cleaning and sterilisation can only be carried out when the
absorber assembly is removed for cleaning.
For further information please refer to the user
instructions supplied with the A200SP.

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Sterilisation

Recommended guidelines for sterilisation

CAUTION
To prevent possible damage to components, peak sterilisation
temperatures must not exceed :
54oC (130oF) for gas (ethylene oxide) or,
134oC (275oF) for steam autoclave.
Low temperature autoclave is 121oC

Do not sterilise the ventilator control unit. The internal

components are not compatible with sterilisation techniques and
may be damaged.
Following sterilisation with ethylene oxide, components must be
quarantined in a well ventilated area to allow dissipation of any
residual gases.

Follow the recommendations given by the steriliser

manufacturer for aeration periods required.

ITEM METHOD

Bellows Gas, liquid, autoclave (20 cycles max.)

Hoses Gas, liquid, autoclave

O rings Gas, liquid, autoclave

Bellows base Gas, liquid, autoclave
Exhalation valve Gas, liquid, pasteurise, low temperature
assembly autoclave

Control unit Do not sterilise - remove patient block

Patient Block Autoclave

Bellows canister Liquid, autoclave

Oxygen monitor (including sensor) - see section 6.4

NOTE
1. Liquid method indicates the use of a high level
disinfectant.
2. Examples of suitable high level disinfection liquid agents
are: Nu-Cidex, Sporicidin, and Sonacide.
3. The exhalation diaphragm valve must be removed,
cleaned and sterilised separately.

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Oxygen Monitor Sensor

- Cleaning / Disinfection / Sterilisation
In case of contamination the sensor may be cleaned with distilled
water and allowed to dry naturally.
CAUTION
The sensor is not suitable for sterilisation by steam or exposure to
chemicals such as ethylene oxide or hydrogen peroxide.
Do not immerse the sensor in any cleaning solution.
Do not autoclave or expose the sensor to high temperatures.

Bacterial Filter
Use a breathing system bacterial filter in the expiratory limb of the
breathing circuit to protect the oxygen sensor (see section 5.1.8).
CAUTION 1
Replacement/Disposal - always follow the instructions supplied with the
filter, and always replace at the recommended interval.

Oxygen Sensor Replacement

WARNING
The sensor (1) contains:
A) A small quantity of electrolyte, classified as a harmful irritant which is
potentially hazardous.
B) Lead
Do not attempt to open a cell.
ALWAYS check the integrity of the sensor assembly before use.
Once exhausted, the sensor must be disposed of according to hospital,
local, state and federal regulations.

Sensor Expiry Date

The approximate expiry date is marked on the sensor label, using
two boxes which represent the year and month.
Thus, on a sensor marked as below the approximate expiry date is
the end of December 2006.
YR 0 1 2 3 4 5 6 7 8 9 x
MTH J F M A M J J A S O N D x
Sensor Unit - Remove and Refit
Replacement parts
102714 Sensor (includes flow diverter and O rings)

1. Detach the cable connector (A) from the sensor (B). A

2. Unscrew the sensor from its location.
3. Discard the expired sensor and flow diverter (C).
4. Insert the cable connector into the new sensor (B). B
5. Screw the new flow diverter (C) onto the new sensor, and fit
new O rings.
6. Fit the assembly into the absorber. C
7. Calibrate the new sensor, see section 5.
8. Dispose of the used components according to hospital
regulations and relevant national legislation.

88

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 Doc No AV-S (USA) 0105U SM
July 2005

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