Page 1: Operating Instructions
Operating Instructions ™ ™ Anesthesia System A N E S T H E S I A S YS T E M A N E S T H E S I A S YS T E M...
Page 2 Operating Instructions ™ ™ Anesthesia System A N E S T H E S I A S YS T E M A N E S T H E S I A S YS T E M...
Page 3 A5™ and A3™ are U.S. trademarks of Mindray DS USA, Inc. SELECTATEC® is a registered trademark of Datex-Ohmeda, Inc. Copyright © Mindray DS USA, Inc., 2010 to 2017. All rights reserved. Contents of this publication may not be reproduced in any form without permission of Mindray DS USA, Inc.
Page 5: Table Of Contents
Install the Vaporizer........................................2 - 5 Filling and Draining the Vaporizer ................................2 - 7 Install the DGSS..........................................2 - 8 System Interface ..............................3 - 1 Main Screen Components......................................3 - 2 System Information Header .....................................3 - 6 Elapsed / Countdown Timer..................................3 - 6 A5/A3™ Operating Instructions 046-003777-00...
Page 6 Waveforms Tab .......................................... 3 - 12 Waveforms Autoscaling ....................................3 - 12 Waveforms Manual Scaling ..................................3 - 13 Spirometry Tab (A5 Only) ....................................... 3 - 14 Loop Type.......................................... 3 - 16 Show Reference ......................................3 - 17 Save Loop .......................................... 3 - 17 Review Loops Button ....................................
Page 7 Change Ventilation Mode ....................................5 - 8 Set Manual Ventilation Mode..................................5 - 9 Setting Monitor Mode (A5 with AG Module connected) ......................... 5 - 11 Make Settings before Starting Mechanical Ventilation Mode ....................... 5 - 14 Volume Control Ventilation (VCV) ................................5 - 14 Pressure Control Ventilation (PCV)................................
Page 8 Volume Waveform ......................................5 - 23 Gas Waveform (available with the AG module) ..........................5 - 23 Waveform Autoscaling ....................................5 - 25 Parameter Monitoring (Spirometry, A5 Only) ..............................5 - 26 Alarms and Messages ............................6 - 1 Introduction ...........................................6 - 2 Alarm System Self-Test....................................6 - 2...
Page 9 Anesthetic Gas Scavenging System (AGSS)..............................9 - 14 Monitor Module ......................................... 9 - 14 AG Module ........................................9 - 14 Alarms..........................................9 - 17 Effect of Interfering Gas on AG Measured Value..........................9 - 18 Ventilator Specifications ......................................9 - 19 A5/A3™ Operating Instructions 046-003777-00...
Page 10 Linked Ventilation Parameter ....................................C - 13 Ventilation Parameter Relationships..................................C - 15 Pneumatic Diagram ............................D - 1 Pneumatic Diagram of the A5/A3 System................................D - 2 Abbreviations, Symbols, and Units of Measure ....................E - 1 Abbreviations ..........................................E - 2 Symbols............................................E - 4 Units of Measure...........................................E - 4...
Page 11 Table of Contents Malignant Hyperthermia Washout ..................................F - 2 Washout Procedure for Malignant Hyperthermia Susceptible Patients with A5 Anesthesia Delivery Systems......F - 2 References............................................F - 4 A5/A3™ Operating Instructions 046-003777-00...
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Page 13: Foreword
The A5/A3 is not suitable for use in an MRI environment. Responsibilities of Operators The proper function of the A5/A3 System can only be guaranteed if it is operated and serviced in accordance with the information provided in this manual and by an authorized Mindray service representative.
Page 14: Warnings
Each outlet is rated 3 A; the total current that may be drawn through all outlets is 10 A on the A5 System and 9 A on the A3 System; do not attempt to exceed these load ratings.
Page 15 Use only non-flammable anesthetic agents that meet the requirements specified in ISO 80601-2-13. The A5/A3 Anesthesia System can be used with halothane, enflurane, isoflurane, sevoflurane, and desflurane. Only one anesthetic agent can be used at a time.
Page 16 A hazard can exist if different alarm presets are used for the same or similar equipment in any single area. WARNING: Due to the size and weight of the A5/A3, it should only be moved by qualified personnel. WARNING: Overloading machine may cause tipping. Equipment attached to the side of the machine should fall within the rated weights to prevent tipping of the machine.
Page 17 WARNING: If the A5/A3 is damaged in any way that compromises the safety of the patient or user, discontinue use and attach a visible tag that marks the A5/A3 as unusable. Call Mindray Technical Support.
Page 18: Cautions
CAUTION: The A5/A3 Anesthesia System may become unstable if the unit is tilted beyond 10 degrees. Use extreme caution when moving or resting the unit on surfaces exceeding a 10 degree slope. Do not hang articles on the sides of the unit that would cause an excessive imbalance.
Page 19 CAUTION: Use cleaning agent sparingly. Excess fluid could enter the machine, causing damage. CAUTION: Do not autoclave any parts of the A5/A3 unless specifically identified as autoclavable in this manual. Clean the A5/A3 only as specified in this manual. CAUTION: To prevent system damage: •...
Page 20 CAUTION: Do not use any flow outlets as handles for moving the A5/A3. The flow outlets may become damaged. Use the metal side bars on the main body when moving the A5/A3.
Page 21: Notes
The A5/A3 is intended to be operated with its integral Breathing Pressure limitation devices in use. NOTE: The A5/A3 is intended to be operated with its integral Exhaled Volume monitoring in use. NOTE: The A5/A3 is intended to be operated with its integral Breathing System integrity Alarm System in use.
Page 22 For the method of connecting A5 to external monitor or other devices, please see Anesthesia Machine Bracket Installation Instructions. NOTE: The A5 can be equipped with one scavenger system to provide the best match with the hospital’s waste-gas disposal system. The scavenger system shall comply with ISO 80601-2-13.
Page 23: Intellectual Property Statement
Recommended preventative maintenance, as prescribed in the Maintenance section of this manual, is the responsibility of the user, and is not covered by this warranty. Except as otherwise provided herein, the terms, conditions, and limitations of Mindray DS USA, Inc. ’ s standard warranty will remain in effect.
Page 24: Disclaimers
A condition of this warranty is that this equipment or any accessories which are claimed to be defective be returned when authorized, freight prepaid to Mindray DS USA, Inc., Mahwah, New Jersey 07430. Mindray DS USA, Inc. shall not have any responsibility in the event of loss or damage in transit. Disclaimers Product Improvements —...
Page 25: Symbols
Gas Flow: Minimum Power On Electrical: Gas Flow Total Power Standby Electrical: Gas: Protective Earth Flush (Ground) Electrical: WEEE (Waste of Electrical and Electronic Sensor Connector Equipment) Marking. Separate treatment from general waste at end of life. A5/A3™ Operating Instructions 046-003777-00...
Page 26 IEC Std.60601- 1-8, ISO Std. 80601-2- subject to magnetic 13, ISO Std. 80601-2-55. resonance imaging Certified to CSA Std. C22.2 No. 60601- (MRI) 1, CSA Std. C22.2 No.60601-1-8, ISO Std. 80601-2-13, ISO Std. 80601-2-55. Canister opened Canister closed xxii 046-003777-00 A5/A3™ Operating Instructions...
Page 27 Medium priority message AC power not connected. Battery supply low charged and powering system. High priority message Recharging recommended. AC power not connected. Battery supply not installed. Breathing System Warmer Off A5/A3™ Operating Instructions 046-003777-00 xxiii...
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Page 29: Product Description
Product Description General System Overview ...................................1-2 Physical Views ......................................1-9 A5/A3™ Operating Instructions 046-003777-00 1 - 1...
Page 30: General System Overview
The A5/A3 Anesthesia System is a device intended to administer, continuously or intermittently, a general inhalation anesthetic to a patient, and to maintain a patient's ventilation. The A5/A3 also provides for ventilatory monitoring of the patient. The anesthesia system is intended to be used in the patient environment.
Page 31: Key Features
The cursor disappears if the user touches the screen or after 15 seconds of mouse inactivity. A3: The USB mouse can serve as a backup to the touchscreen. A5: The USB mouse can serve as a backup to both the touchscreen and touchpad. 1.1.3...
Page 32: Flow Control
O flow is limited by the flow of O so that a safe ratio of no less than 21% oxygen can be maintained. The A5/A3 is designed to maintain oxygen flow at its previously set level when N O is decreased.
Page 33: Anesthesia Ventilator
Synchronized Intermittent Mandatory Ventilation-Volume Control (SIMV-VC), Pressure Control Ventilation (PCV), Pressure Support (PS) ventilation, and Manual ventilation. The A5 offers additional ventilation modes, which include Pressure Control Ventilation (PCV) with and without Volume Guarantee (VG), and Synchronized Intermittent Mandatory Ventilation-Pressure Control (SIMV-PC).
Page 34: Active Anesthetic Gas Scavenging System
Anesthetic Gas Scavenging System (AGSS) The A5/A3 includes a waste gas scavenger that attaches to the side rail mount on the system. The A5/ A3 provides a port for the connection of the waste line from an anesthetic gas monitor.
Page 35 When the A5/A3 is connected to an AC power source, the battery supply is charged whether or not the A5/A3 is turned on. In case of power failure, the A5/A3 will automatically switch to run from the internal battery supply. When AC power source is restored within the specified time, the battery supply begins recharging, and power is switched from battery to AC automatically to ensure continuous system use.
Page 36: Workplace Ergonomics
For the A5, a non-slip footrest and central brake are provided. For the A3, a non-slip footrest and individual caster brakes are provided. The top shelf can be used to mount additional equipment.
Page 37: Physical Views
Yellow = medium priority, cyan = low priority, off = no alarm condition. LCD Touchscreen Display / See section ‘‘System Interface’’ on page 3-1 System Interface Auxiliary O /Air Flowmeters Auxiliary O /Air Flowmeters for auxiliary O /Air output A5/A3™ Operating Instructions 046-003777-00 1 - 9...
Page 38 Wheels Casters to enable the A5/A3 System to be moved. Casters on the A5 lock via a central brake. Casters on the A3 lock via individual locking levers on each caster. Work Light...
Page 39: Main Unit (Rear View)
FIGURE 1-3 Main Unit (Rear View) PART(S) DESCRIPTION Circuit Breakers Breakers for each auxiliary outlet A5: 3 A each (quantity 4), 10 A total (quantity 1) A3: 3 A each (quantity 3) Mains Inlet Connects the mains power cord A5/A3™ Operating Instructions...
Page 40 A3: Additional devices up to a total maximum power of 9 amps can be connected to three (3) outlets. The A5 outlets are covered with two (2) metal plates, the A3 outlets are covered with one (1) metal plate, and require a tool to access.
Page 41: Main Unit (Left View)
Enables mounting of patient monitors and most standard attachment arms for other devices. Rail mounts are on both left and right sides of the A5/A3. Module slot AG module can be inserted into the slot and identified. A5/A3™ Operating Instructions 046-003777-00 1 - 13...
Page 42: Main Unit (Right View)
Storage Drawers Drawers (3) for storage (lockable) Rail Mount Enables mounting of patient monitors and most standard attachment arms for other devices. Rail mounts are on both left and right sides of the A5/A3. 1 - 14 046-003777-00 A5/A3™ Operating Instructions...
Page 43: Main Unit (Top View)
Top level surface Work Level Shelf Work Level surface (stainless steel) Handle Wrap-around metal bar used to assist moving the A5/A3 device Mounting Holes Allows mounting of optional equipment to the top shelf (i.e., DPM6 and DPM7 mounting plates and kits (see section A.7 (page A-3) "Mounting Accessories").
Page 44: Breathing System (Top View)
Tidal volume (Vt) should be read exclusively from the display of the user interface. Delivered Vt is a combination of bellows displacement and fresh gas flow. The APL valve and PAW gauge numerics are for reference only. Calibrated patient airway pressure is dis- played on the user interface. 1 - 16 046-003777-00 A5/A3™ Operating Instructions...
Page 45: Breathing System (Left View)
The APL valve and PAW gauge numerics are for reference only. Calibrated patient airway pressure is dis- played on the user interface. 1.2.7 Breathing System (Left View) FIGURE 1-8 Breathing System (Left View, the Flexible Bag Arm (optional)) A5/A3™ Operating Instructions 046-003777-00 1 - 17...
Page 46 To remove, turn clockwise (looking from top). Absorber Bypass Assembly Maintains pressure in the breathing circuit when changing the soda lime contents in the CO absorber canister. Hook Hang the tubes of the breathing system. 1 - 18 046-003777-00 A5/A3™ Operating Instructions...
Page 47: Active Anesthetic Gas Scavenging System
1.2.8 Active Anesthetic Gas Scavenging System 1.2.8.1 Anesthetic Gas Scavenging System (AGSS) (Top, Right, and Rear Views) Top View Rear View Right View FIGURE 1-10 Active AGSS (Top, Right, and Rear Views) A5/A3™ Operating Instructions 046-003777-00 1 - 19...
Page 48 Knob (H2) until the float is between the Min and Max marks. 1.2.8.2 Dynamic Gas Scavenging System (DGSS) (Top, Right, and Rear Views) Rear View Right View Top View FIGURE 1-11 DGSS (Top, Right, and Rear Views) 1 - 20 046-003777-00 A5/A3™ Operating Instructions...
Page 49 (see FIGURE 1-3) to transfer the exhaust gases. Exhaust Port Exhaust port to the hospital’s waste gas disposal system. A5/A3™ Operating Instructions 046-003777-00 1 - 21...
Page 50: Passive Anesthetic Gas Scavenging System (Agss) (Right View)
Intake for exhaust gases from the breathing system connecting with the AGSS ports. Exhaust Port Exhaust port to the hospital’s waste gas scavenging system. Manual Bag When the manual bag is inflated, it indicates that the passive AGSS is blocked. 1 - 22 046-003777-00 A5/A3™ Operating Instructions...
Page 51: Installation
Installation Unpacking........................................2-3 Initial Setup........................................2-4 Install the Vaporizer ....................................2-5 A5/A3™ Operating Instructions 046-003777-00 2 - 1...
Page 52 CAUTION: The operational environment and the power source of the equipment must comply with the requirements as specified in the A5/A3 ‘‘Product Specifications’’ on page 9-1 . 2 - 2 046-003777-00...
Page 53: Unpacking
If there is NO damage and ALL tip indicators on the box exterior are intact, then sign and date the bill of lading or airway bill to indicate safe receipt of the A5/A3. b. If there is DAMAGE or ANY of the tip indicators on the box exterior have been activated, then conditionally accept the delivery and clearly describe the damages on the bill of lading or airway bill.
Page 54: Initial Setup
Initial Setup Installation Initial Setup The initial setup of the A5/A3 Anesthesia System must be performed by an authorized Mindray service representative. Please contact Mindray Technical Support for any additional assistance. NOTE: The A5/A3 is intended to be operated with an external CO2 monitor complying with ISO 80601-2-55.
Page 55: Install The Vaporizer
Vaporizer mounts for two/three (optional) inline vaporizers A5 only: Additional vaporizer mount for one inactive vaporizer FIGURE 2-1 Location of Vaporizer Mounting System 1. If replacing and removing the vaporizer, lift each vaporizer straight up off the manifold. Do not pull the vaporizer forward.
Page 56 WARNING: For the A5/A3 Anesthesia System, using or turning on more than one vaporizer simultaneously is prohibited and prevented by a mechanical interlock. Do not attempt to override this safety mechanism.
Page 57: Filling And Draining The Vaporizer
Install the vaporizers with a Selectatec interlock system that are compliant to ISO 80601-2-13 on the A5 unit. See section A.9 (page A-4) "Vaporizers". Refer to the vaporizer manufacturer’s Instructions For Use for filling or draining the vaporizer and other information.
Page 58: Install The Dgss
Screws DGSS Mounting Adapter FIGURE 2-4 Install the DGSS Mounting Adapter 2. Slide the DGSS mounting block into the rail from the top. DGSS Mounting Block FIGURE 2-5 Install the DGSS mounting Block 2 - 8 046-003777-00 A5/A3™ Operating Instructions...
Page 59 Lastly, install the reservoir bag and connect the DC power supply. Waste Gas Scavenging Connector DC Power Supply Waste Gas Transfer Hose DGSS Outlet Port DGSS Inlet Port Reservoir Bag FIGURE 2-7 Connect the Hoses A5/A3™ Operating Instructions 046-003777-00 2 - 9...
Page 60 Install the DGSS Installation This page intentionally left blank. 2 - 10 046-003777-00 A5/A3™ Operating Instructions...
Page 61: System Interface
System Interface Main Screen Components ..................................3-2 System Information Header ................................3-6 Fresh Gas Flow Display ..................................3-11 Waveforms Tab ......................................3-12 Spirometry Tab (A5 Only).................................. 3-14 Demographics Tab....................................3-20 Ventilation Mode Tabs ..................................3-21 Measured Values Area..................................3-24 System Softkeys...................................... 3-25 Setup ..........................................
Page 62: Main Screen Components
Main Screen Components System Interface Main Screen Components FIGURE 3-1 A5 Main Screen Components 3 - 2 046-003777-00 A5/A3™ Operating Instructions...
Page 63 Patient Size Displays the currently selected patient size (Adult, Pediatric, or Infant). Select to change the patient size when the A5/A3 is in Standby mode, Manual mode or Monitor* mode Current Ventilation Mode Displays the current ventilation mode (VCV, SIMV-VC, PCV, SIMV-PC*, PS, Manual, Bypass**,Monitor or Standby.
Page 64 Select a parameter button to change the parameter setting. See ‘‘Ventilation Modes’’ on page 5-8. * Monitor mode is only available with the AG module. **SIMV-PC and Bypass are only available on A5. 3 - 4 046-003777-00 A5/A3™ Operating Instructions...
Page 65 Waveforms/Spirometry Area Displays waveforms or spirometry. Monitored Parameter Area Displays monitored parameters. * Monitor mode is only available with the AG module. **SIMV-PC and Bypass are only available on A5. A5/A3™ Operating Instructions 046-003777-00 3 - 5...
Page 66: System Information Header
When the countdown timer is expired, the system will pop-up a warning dialog (see FIGURE 3-6) and provide a notification sound at the same time, The sound will repeat until the Done button is pressed. 3 - 6 046-003777-00 A5/A3™ Operating Instructions...
Page 67: Patient Size
3.2.2 Patient Size Displays the currently selected patient size (Adult, Pediatric, or Infant). Select to change the patient size when the A5/A3 is in Standby mode, Manual mode or Monitor mode (available with the AG module). (FIGURE 3-8) Patient Size FIGURE 3-8 Patient Size Menu (with AG module connected) 3.2.3...
Page 68: Alarm Silence Icon
The Alarm Silence icon and Alarm Silence countdown timer are displayed after selecting the Silence softkey is selected, which indicates that all currently sounding alarms are silenced for 120 seconds (see FIGURE 3-10). Alarm Silence Icon FIGURE 3-10 Alarm Silence Icon (with AG module connected) 3 - 8 046-003777-00 A5/A3™ Operating Instructions...
Page 69: Date And Time
Daylight Savings setting has been set to Auto in the System settings (see TABLE 3-10, “System Tab Settings,” on page 39). 3. Select the “Accept” to finalize your changes. FIGURE 3-12 Date and Time Menu A5/A3™ Operating Instructions 046-003777-00 3 - 9...
Page 70: Battery Status
Battery Status Displays the main power supply and battery state (see FIGURE 3-14). For more information on the advanced A5/A3 power management system, see “Power Management / Battery Supply” on page 1- Battery Status Icon FIGURE 3-13 Battery Status Icon (with AG module connected)
Page 71: Fresh Gas Flow Display
The flowmeter numerics display a precision to two decimal digits for flows < 1 L/min and one decimal digit for flows ≥ 1 L/min. For the A5, the size (height) of the fresh gas flow tubes changes depending on whether the AG module is connected as shown in FIGURE 3-15.
Page 72: Waveforms Tab
If the measured value of Paw or Flow is less than the boundary minus a margin at the end of two continuous breath cycles, the A5/A3 System will auto scale the Paw or Flow at the beginning of the next breath cycle.
Page 73: Waveforms Manual Scaling
O Scale 0-35 0-50 0-100 Des Scale 0.0-6.0 0.0-9.0 0.0-18.0 Sev Scale 0.0-2.0 0.0-4.0 0.0-8.0 Iso Scale 0.0-1.2 0.0-2.5 0.0-5.0 0.0-5.0 Hal Scale 0.0-1.2 0.0-2.5 Enf Scale 0.0-1.2 0.0-2.5 0.0-5.0 TABLE 3-1 Gas Scales A5/A3™ Operating Instructions 046-003777-00 3 - 13...
Page 74: Spirometry Tab (A5 Only)
Spirometry Tab (A5 Only) System Interface Spirometry Tab (A5 Only) Displays separate looped graphs and waveforms (see FIGURE 3-17). NOTE: Displaying spirometry and waveforms simultaneously is available for software bundle version 02.06.00 and later. You can press the button (see FIGURE 3-17) to only view the spirometry loop (see FIGURE 3-18).
Page 75 System Interface Spirometry Tab (A5 Only) You can press the button (see FIGURE 3-18) to see the spirometry loop and waveforms (see FIGURE 3-17). FIGURE 3-18 Spirometry: Pressure-Volume Loop FIGURE 3-19 Spirometry: Flow-Volume Loop A5/A3™ Operating Instructions 046-003777-00 3 - 15...
Page 76: Loop Type
Spirometry Tab (A5 Only) System Interface FIGURE 3-20 Spirometry: Pressure-Flow Loop (only for software bundle version 02.06.00 and later) Spirometry loops reflect patient lung function and ventilation. They also indicate other related parameters such as compliance, over-inflation, breathing system leak, and airway blockage.
Page 77: Show Reference
NOTE: A reference loop cannot be saved without first saving a baseline loop. The A5 System will always makes the first saved loop as the baseline loop if no previous loops have been saved. Afterward, additional loops can be saved either as a baseline replacement or as a new reference loop.
Page 78 Spirometry Tab (A5 Only) System Interface Small Loop Window: These small graphic windows show the baseline and reference loops. The baseline loop (only one) is always located on the left and has a white border around its graph. The reference loops (up to four) are located to the right of the baseline loop. The reference loops are displayed from oldest (left) to newest (right).
Page 79 System Interface Spirometry Tab (A5 Only) • Time • Expiratory Minute Volume (Mv Exp) • Inspiratory Minute Volume (Mv Insp) • Expiratory Tidal Volume (Vt Exp) • Inspiratory Tidal Volume (Vt Insp) • Ratio of Inspiratory time to Expiratory time (I:E) •...
Page 80: Demographics Tab
The Demographics tab is located on the main screen next to the Waveforms tab on the A3 system, and next to the Spirometry tab on the A5 system (see FIGURE 3-23). The Demographics tab contains editable fields to enter patient and hospital data (see TABLE 3-2).
Page 81: Ventilation Mode Tabs
Pressure Control Ventilation (PCV) • Pressure Support ventilation (PS) • Manual (only A5 can have the AG module) Ventilation Mode Tabs FIGURE 3-24 Ventilation Mode Tabs (with AG module installed) To change the ventilation mode: 1. Select a desired ventilation mode tab. The Set Mode softkey begins to blink green.
Page 82 Ventilation Mode Tabs System Interface FIGURE 3-25 Ventilation Mode: VCV FIGURE 3-26 Ventilation Mode: SIMV-VC FIGURE 3-27 Ventilation Mode: PCV (A5 unit) FIGURE 3-28 Ventilation Mode: PCV (A3 unit) FIGURE 3-29 Ventilation Mode: SIMV-PC (A5 only) FIGURE 3-30 Ventilation Mode: PS...
Page 83 System Interface Ventilation Mode Tabs FIGURE 3-31 Ventilation Mode: Manual NOTE: Bypass function is available only on the A5. FIGURE 3-32 Ventilation Mode: Manual (with AG module installed) NOTE: Bypass function is available only on the A5. NOTE: Monitor mode available when external AG module connected.
Page 84: Measured Values Area
Expiratory Tidal Volume (Vt), Expiratory Minute Volume (MV),and Breath Rate (Rate), and Inspiratory % (FiO ). (FIGURE 3-33) Measured Values Area FIGURE 3-33 Measured Values Area (no AG module connected) FIGURE 3-34 Measured Values Area (without AG module connected) 3 - 24 046-003777-00 A5/A3™ Operating Instructions...
Page 85: System Softkeys
System Softkeys System Softkeys The A5/A3 System provides system softkeys at the bottom right of the main screen for direct access to the history menu, system setup, and alarms menu, and for capturing events and silencing alarms (see FIGURE 3-35).
Page 86 BUTTON FUNCTION Moves the cursor to the oldest record from its current position. Moves the cursor one page back from its current position. 3 - 26 046-003777-00 A5/A3™ Operating Instructions...
Page 87 Every point on the curve corresponds to the parameter value at a specific time point. Graphic Trends tab displays end case event, captured event and parameter alarm event. Graphic trend data automatically displays in one minute intervals unless the zoom is selected. A5/A3™ Operating Instructions 046-003777-00 3 - 27...
Page 88 An end case event occurred during this period. The parameter data of the time indicated by cursor. TABLE 3-4 NOTE: The Graphic Trends will be cleared after the anesthesia machine undergoes power failure or is turned off. 3 - 28 046-003777-00 A5/A3™ Operating Instructions...
Page 89 Moves the cursor to the next event from its current position. Moves the cursor up one parameter from its current position. Moves the cursor down one parameter from its current position. TABLE 3-5 A5/A3™ Operating Instructions 046-003777-00 3 - 29...
Page 90 Events can be physiological indicating that a patients physiological alarm thresholds have been violated or technical indicating that a specific technical issue has occurred. 3 - 30 046-003777-00 A5/A3™ Operating Instructions...
Page 91 Event Log Filter The Filter button allows for the Event Log Entries trends to be displayed in a similar Event type. Set Filter to High, Medium, Low, Informational or All. The A5 will display the corresponding event based on your setting.
Page 92: Setup
NOTE: The Service tab is for use only by Mindray Technical Service. Please contact Mindray Technical Support for details. Many of these functions are only available if the A5/A3 is in Standby mode. 3.11 General Tab The General tab provides access to calibrate the O sensor and flow sensor, perform system leak and compliance tests, activate the breathing system warmer, and zero flow meters.
Page 93 General Tab Leak Test / Compliance The Test Leak / Compliance button enables the A5/A3 system to perform a manual leak test and automatic leak test, and calculates the compliance for the A5/A3. To perform a leak test, select the Test Leak/Compliance button. Follow the on-screen instructions and prompts.
Page 94: Display Tab
3. Select the Accept button to confirm the change, or select Cancel button to discard the change. Select the +/- buttons to adjust screen brightness. FIGURE 3-41 A5/A3 Display Tab> Screen Brightness Area 3 - 34 046-003777-00 A5/A3™ Operating Instructions...
Page 95 3. Select the Accept button to confirm the change, or select Cancel button to discard the change. Select the +/- buttons to adjust the key click volume. FIGURE 3-42 A5/A3 Display Tab > Key Click Volume Area Clean Screen To clean the LCD touch screen: 1. Select Setup softkey > Display tab.
Page 96 The table below shows the CO scale options. To set the CO scale: 1. Select Setup softkey > Display tab. 2. Select the CO Scale button. 3 - 36 046-003777-00 A5/A3™ Operating Instructions...
Page 97 FACTORY DEFAULT SCALE Scale 0-60 mmHg 0.0-8.0 kPa 0.0-8.0 % Scale 0-100 % O Scale 0-100 % Des Scale 0-9.0 % Sev Scale 0-4.0 % Iso Scale 0-2.5 % TABLE 3-9 Factory default scale A5/A3™ Operating Instructions 046-003777-00 3 - 37...
Page 98: System Tab
System tab. The password can be maximum of 6 digits in length containing numerals 0 to 9. FIGURE 3-44 A5/A3 Setup Menu > System Tab 3 - 38 046-003777-00...
Page 99 Select “Import Defaults” to import a copy of the defaults from the USB mass storage device if one has been inserted into an SB port at the rear of the A5/A3 unit. Export Defaults Select “Export Defaults” to export a...
Page 100 Daylight Savings (Default Select to set the Daylight Savings Time =Manual, Auto) (DST) to be adjusted automatically by the A5 system, or manually by the authorized administrator. If the region or country of installation does not observe DST, change this setting to Manual.
Page 101: Network Configuration
TABLE 3-10 System Tab Settings 3.13.1 Network Configuration Network configuration settings can be set via the Network button (see FIGURE 3-45). Select main screen > Setup button > System tab > Network button. A5/A3™ Operating Instructions 046-003777-00 3 - 41...
Page 102 Screen is available in software bundle version 02.06.00 and later. SETTINGS PARAMETERS This Machine Configure Ethernet Enter: • IP Address (default = 192.168.23.250) • Subnet (default = 255.255.255.0) • Default Gateway (default = [blank]) TABLE 3-11 Network Configuration Settings and Parameters 3 - 42 046-003777-00 A5/A3™ Operating Instructions...
Page 103 NOTE: MR-Link renamed to HL7 on software bundle version 02.02.00 and later. NOTE: When Protocol is set to MR-WATO, the A5 can communicate with the patient monitor of Mindray through Benelink module of Mindray. NOTE: When Protocol is set to Philips, the...
Page 104: Service Tab
Secondary Server IP Enter: Secondary Server IP (default = 210.72.145.44) TABLE 3-11 Network Configuration Settings and Parameters 3.14 Service Tab Accessible only by Mindray-authorized service personnel. Please contact Mindray Technical Support for assistance. 3 - 44 046-003777-00 A5/A3™ Operating Instructions...
Page 105 Cylinder Tests......................................4-20 Flow Control System Test.................................. 4-21 Vaporizer Tests ......................................4-22 Breathing System Tests..................................4-24 Alarm Tests ......................................... 4-26 Preoperative Preparations ................................4-28 Inspect the Active/Passive Anesthetic Gas Scavenging System ................4-29 A5/A3™ Operating Instructions 046-003777-00 4 - 1...
Page 106: Preoperative Tests
Preoperative Test Schedules Preoperative Tests Preoperative Test Schedules Preoperative tests on the A5/A3 follow the ASA guidelines and should be performed according to the test intervals listed below. Refer to special procedures or precautions in this manual. NOTE: This is a guideline which can be modified to accommodate variations in local clinical practice.
Page 107: Inspect The System
14. The AC mains indicator and the battery indicator are displayed when the power cord is connected to the AC power source. If the indicators are not displayed, the system does not have electrical power. 15. The A5/A3 anesthesia machine is switched on or off normally. A5/A3™ Operating Instructions 046-003777-00...
Page 108: Pre-Operative Checkout List
This test should be performed before starting each case. By verifying that a test lung (breathing bag) can be manually and mechanically ventilated, this indicates that the A5/A3 is capable of ventilating a patient with the attached breathing circuit.
Page 109 O manual leak test. Set the vaporizer to OFF. Repeat for the right vaporizer if installed (see “Manual Leak Test” on page 4-22). 6. Perform a vaporizer leak test for each vaporizer installed on the A5/A3 system (see “Vaporizer Leak Test” on page 4-22).
Page 110: System Self-Test
Perform a vaporizer leak test (see “Vaporizer Leak Test” on page 4-22). System Self-Test When the A5/A3 is powered on, it performs a self-test to ensure its alarm system (alarm LED, speaker, and buzzer) and hardware (flowmeter board, ventilator board, assistant ventilator board, power board, and CPU board) are properly functioning.
Page 111 Preoperative Tests System Self-Test RESULT COMMENTS/OPTIONS Pass condition The Pass condition indicates that the A5/A3 has passed the System Self-Test. No errors have been detected. Alarms Example: and hardware are functioning properly. Select Continue to enter the Automatic Circuit Leak and Compliance Test screen.
Page 112 Bundle Version – The Bundle Version is displayed in all System Self-Test results. The Bundle Version is the version number of the package of software that is installed in the A5/A3. If the Bundle Version displays a fail status, contact Mindray Technical Support.
Page 113: Leak And Compliance Tests
1. From power up: If the A5/A3 System is being powered on, the system automatically initiates a self-test and enters the Preoperative Check List screen. Select Continue to enter the Automatic Circuit Leak Test screen, followed by the Manual Circuit Leak Test screen.
Page 114 Auto position and when no fresh gas is detected. 3. Compare the test results with the information in TABLE 4-3, “Automatic Circuit Leak and Compliance Test Results, ” on page 4-11, and proceed accordingly. 4 - 10 046-003777-00 A5/A3™ Operating Instructions...
Page 115 Select Accept to proceed to the Manual Circuit Leak Test screen and use the previous compliance values. Select Retry to repeat the Automatic Circuit Leak Test & Compliance Test. TABLE 4-3 Automatic Circuit Leak and Compliance Test Results A5/A3™ Operating Instructions 046-003777-00 4 - 11...
Page 116 Auto Ventilation Disabled – Leak Test Failed: WARNING: Selecting the “Manual Only” button will disable automatic ventilation. TABLE 4-3 Automatic Circuit Leak and Compliance Test Results 4 - 12 046-003777-00 A5/A3™ Operating Instructions...
Page 117 Test result cannot be shown due to an internal Example: communication error. Select Retry to repeat the Automatic Circuit Leak Test & Compliance Test. Select Override to skip the test. TABLE 4-3 Automatic Circuit Leak and Compliance Test Results A5/A3™ Operating Instructions 046-003777-00 4 - 13...
Page 118: Manual Circuit Leak Test
1. From power up: If the A5/A3 System is being powered on, the system automatically initiates a self-test and enters the Preoperative Check List screen. Select Continue to enter the Automatic Circuit Leak and Compliance Test and the Manual Circuit Leak Test. If the Skip button is selected, the system bypasses these tests and enters the Standby screen.
Page 119 Fail: Fresh gas flow detected Manual Circuit Leak Test failed. Example: Fresh gas is detected. Adjust all flowmeters to zero. Select Retry to repeat the test. TABLE 4-4 Manual Circuit Leak Test Results A5/A3™ Operating Instructions 046-003777-00 4 - 15...
Page 120 If this anomaly occurs, press the Cancel button on the screen to continue. Select Accept to proceed. TABLE 4-4 Manual Circuit Leak Test Results 4 - 16 046-003777-00 A5/A3™ Operating Instructions...
Page 121: Preoperative Check List (Software Bundle Version 02.09.00 And Later)
Preoperative Check List (software bundle version 02.09.00 and later) While powering on the A5, the system automatically initiates a self-test and enters the Preoperative Check List screen. Select Continue to proceed to Standby mode. The Preoperative Check List screen is displayed in FIGURE 4-3.
Page 122: Power Failure Alarm Test
1. Connect the O pipeline supply. 2. Close all cylinder valves if the A5/A3 anesthesia machine is equipped with cylinders. 3. Set the system switch to the ON position. 4. Set the flow controls approximately to mid-range (approximately 6 L/min).
Page 123: Air Pipeline Test
1. Connect the Air pipeline supply. 2. Close all cylinder valves if the A5/A3 anesthesia machine is equipped with cylinders. 3. Set the system switch to the ON position. 4. Set the flow controls approximately to mid-range (approximately 6 L/min).
Page 124: Cylinder Tests
Preoperative Tests 4.10 Cylinder Tests NOTE: You do not need to perform cylinder tests if the A5/A3 anesthesia machine is not equipped with cylinders. 4.10.1 Check the Cylinder Pressure 1. Set the system switch to the OFF position and connect the cylinders to be checked.
Page 125: Flow Control System Test
FLOW SETTING (L/MIN) O FLOW (L/MIN) ≤ 1.0 ≥ 2.0 and ≤ 2.5 ≥ 2.5 and ≤ 3.2 ≥ 4.90 and ≤ 6.3 ≥ 7.4 and ≤ 9.5 ≤ 12.7 ≤ 15.8 ≤ 19.0 A5/A3™ Operating Instructions 046-003777-00 4 - 21...
Page 126: Vaporizer Tests
6. Verify that circuit holds pressure for greater than 10 seconds. 7. Set the APL valve to SP. 4.12.3 Vaporizer Leak Test 1. Set the Auto/Manual ventilation switch to Manual. 2. Set the APL valve to the SP position. 4 - 22 046-003777-00 A5/A3™ Operating Instructions...
Page 127 6. Set the APL valve to 75 and verify that the pressure on the airway pressure gauge increases above 30 cmH O within 2 minutes. 7. Turn off the vaporizer. 8. Repeat Steps 4, 5, 6, and 7 for the other vaporizer. A5/A3™ Operating Instructions 046-003777-00 4 - 23...
Page 128: Breathing System Tests
30 cmH O on the airway pressure gauge. 10. Release the flush button. A pressure decrease on the airway pressure gauge indicates a leak. Contact your service personnel. 4 - 24 046-003777-00 A5/A3™ Operating Instructions...
Page 129: Apl Valve Test
Ensure that the reading on the airway pressure gauge does not exceed 10 cmH 13. Turn the O flow control to Off. Ensure that the reading on the airway pressure gauge does not decrease below 0 cmH A5/A3™ Operating Instructions 046-003777-00 4 - 25...
Page 130: Alarm Tests
Alarm Tests Preoperative Tests 4.14 Alarm Tests Alarms also can be verified by creating an alarm condition on the A5/A3 and verifying the corresponding alarm indicators are present on the monitor. 4.14.1 Prepare for Alarm Tests 1. Connect a test lung or manual bag to the Y-piece of the breathing circuit.
Page 131: Test The Low Minute Volume (Mv) Alarm
5. Push the O flush button for approximately 15 seconds. Ensure that the Continuous Airway Pressure alarm occurs. 6. Disconnect the breathing circuit and ensure that the alarm cancels. 7. Reconnect the breathing circuit. A5/A3™ Operating Instructions 046-003777-00 4 - 27...
Page 132: Test The High Paw Alarm
8. Turn all flow controls to set all gas flows to Off. 9. Ensure that the breathing system is correctly connected and not damaged. WARNING: Before connecting a patient, flush the A5/A3 anesthesia machine with 8 L/min of O for at least two minutes. This removes unwanted mixtures and by-products from the system.
Page 133: Inspect The Active/Passive Anesthetic Gas Scavenging System
2. Close the breathing system at the patient connection by connecting the Y-piece on the breathing circuit to the leak test port. 3. Connect the passive AGSS assembly. 4. Set the O flow to 10 L/min. A5/A3™ Operating Instructions 046-003777-00 4 - 29...
Page 134 6. Block up the exhaust port of the passive AGSS assembly. Ensure that the manual bag expands slowly and reaches the inflated status after approximately 15 seconds. 4 - 30 046-003777-00 A5/A3™ Operating Instructions...
Page 135: Operations
Operations Powering On the A5/A3 Anesthesia System ...........................5-2 Powering Off the A5/A3 Anesthesia System ...........................5-2 Patient Setup .......................................5-3 Oxygen Sensor Calibration .................................5-5 Input Fresh Gas ......................................5-6 Ventilation Modes ....................................5-8 Start Mechanical Ventilation ................................5-19 Stop Mechanical Ventilation ................................5-19 Relationships of Ventilation Parameters ..........................5-19 Parameter Monitoring (Numerics) ..............................
Page 136: Powering On The A5/A3 Anesthesia System
The A5/A3 system provides a powering off function with the following features: • A prompt sound is given when user turns off the A5/A3. If the system switch is turned off in Standby mode, the A5/A3 will immediately power off.
Page 137: Patient Setup
If the Restore Default settings checkbox is not selected, all the settings are retained. FIGURE 5-3 End Case Checkbox In Standby, all system functions are on idle. It is the default system startup mode and is used after ending the case. A5/A3™ Operating Instructions 046-003777-00 5 - 3...
Page 138 0.0 L/min (i.e., flow < 0.05 L/min). NOTE: The A5/A3 system will not allow the End Case button to be selected until the Auto/Manual ventilation switch is set to Manual, and system detects the individual fresh gas flows are effectively turned off (i.e., flow <...
Page 139: Select The Patient Size (Adult, Pediatric, Infant)
NOTE: The A5/A3 saves the latest patient parameter settings (VCV, PCV, PCV- VG (A5 only), PS, SIMV-VC, SIMV-PC (A5 only), and Alarms) for each patient type: Adult, Pediatric, and Infant. Changing to another patient type does not erase the parameter settings from the previous patient type.
Page 140: Input Fresh Gas
• Safety systems within the A5/A3 work to prevent hypoxic mixtures from being delivered to the patient. Nitrous oxide will not be delivered unless oxygen flow is present. A mechanical safety system assures that at least 21% O...
Page 141: Set Anesthetic Agent
The concentration of the anesthetic agent actually output will vary if the vaporizer is filled with the wrong agent. 2. Mount the vaporizer filled with anesthetic agent onto the A5/A3 Anesthesia System. See “Install the Vaporizer” on page 2-5. 5.5.2.2...
Page 142: Ventilation Modes
Δ Min Rate, P, Trigger, PEEP, Tslope, Apnea Ti Manual Bypass (A5 only), Alarms, Monitor (available with AG module) 5.6.3 Change Ventilation Mode To change ventilation mode to Manual 1. Use the Auto/Manual Bag switch on the breathing system block to enter and exit Manual ventilation mode.
Page 143: Set Manual Ventilation Mode
Operations Ventilation Modes To change ventilation mode to VCV, SIMV-VC, PCV, SIMV-PC (A5 only), or PS: 1. Select the tab of the desired ventilation mode. The “Set Mode” button (or “Preset Mode” button in manual) will flash (see FIGURE 5-6).
Page 144 The APL valve adjusts the breathing system pressure limit during manual ventilation. Its scale shows approximate pressure. Cardiac Bypass Mode (A5 Only) Cardiac Bypass mode is only available in Manual ventilation mode. This mode turns off pressure volume and apnea alarms when they are not appropriate (e.g., during heart/lung bypass).
Page 145: Setting Monitor Mode (A5 With Ag Module Connected)
Setting Monitor Mode (A5 with AG Module connected) Monitor mode is only available in the Manual ventilation mode when there is an AG module connected to the A5. This mode turns off all ventilation related alarms. NOTE: When Monitor mode is On, the Alarms button is disabled and set to Off.
Page 146 Off. Pressure, volume and apnea alarms can be turned on by setting the Alarms softkey to On, which returns the related alarm limits to their original settings. FIGURE 5-10 Set Alarms to Off 5 - 12 046-003777-00 A5/A3™ Operating Instructions...
Page 147 Risk of inadequate monitoring. National standards require a minimum monitoring with some alarm functions. These standards may not be met if the alarm function of the CO2 monitoring parameter is disabled. Only disable this monitoring parameter after consulting national standards. A5/A3™ Operating Instructions 046-003777-00 5 - 13...
Page 148: Make Settings Before Starting Mechanical Ventilation Mode
This is called tidal volume compensation. In the VCV mode, if tidal volume compensation has failed, the A5/A3 Anesthesia System can continue delivering gas stably but cannot compensate for the effects of fresh gas flow and breathing system compliance losses.
Page 149: Pressure Control Ventilation (Pcv)
For the A5, in PCV mode, Tidal Volume Guarantee (VtG) can be enabled with the VtG setting. When VtG is a value, then Pinsp is disabled. The ventilator attempts to deliver the set VtG while maintaining the PAW at or below PlimVG.
Page 150: Synchronized Intermittent Mandatory Ventilation (Simv)
Pressure Support in Synchronized Intermittent Mandatory Ventilation (SIMV) In SIMV-VC and SIMV-PC (A5 only) Ventilation modes, PS Ventilation can be turned on and off by changing the PS setting to On and Off, respectively. When PS Ventilation is Off, the ΔP and Tslope settings are disabled in SIMV-VC mode, and the ΔP setting is disabled in SIMV-PC mode.
Page 151 Control (SIMV-PC) - A5 Only FIGURE 5-15 Synchronized Intermittent Mandatory Ventilation–Pressure Control (SIMV-PC) SIMV-PC is available on the A5 only. SIMV-PC means to deliver synchronized intermittent mandatory pressure controlled ventilation to the patient. In the SIMV-PC mode, the ventilator waits for patient’s next inspiration based on the specified time interval. The sensitivity depends on Trigger.
Page 152: Pressure Support Ventilation (Ps)
5.6.10 Pressure Support Ventilation (PS) In Pressure Support (PS) mode, the patient’s effort is supported by the A5/A3 at a preset level of inspiratory pressure. Inspiration is triggered and cycled by patient effort. The user can set the Trigger flow, ΔP, PEEP, minimum allowed breathing frequency, and Slope Time.
Page 153: Start Mechanical Ventilation
1. Set the Auto/Manual ventilation switch to Manual. 2. Exit Standby by touching the main screen or by turning on the fresh gas flow to more than 0.2 L/min. 3. Set the Auto/Manual ventilation switch to Auto. The A5/A3 system will begin mechanical ventilation. Stop Mechanical Ventilation To stop mechanical ventilation: 1.
Page 154: Parameter Monitoring (Numerics)
The high alarm limit for Minute Volume (MV) is displayed to the top right of the reading. The low alarm limit for Minute Volume (MV) is displayed to the bottom right of the reading. FIGURE 5-18 Volume Parameter Group 5 - 20 046-003777-00 A5/A3™ Operating Instructions...
Page 155: Gas (Available With The Ag Module)
100 %, although not realistic, are possible due to errors in calibration. NOTE: The high alarm limit is displayed to the top right of the reading. The low alarm limit is displayed to the bottom right of the reading. FIGURE 5-20 FiO Parameter A5/A3™ Operating Instructions 046-003777-00 5 - 21...
Page 156: Parameter Monitoring (Waveforms)
5.11.1.1 Auto-zeroing the Pressure Sensors The A5/A3 auto-zeros the pressure sensors at regular intervals to compensate for changes in temperature and/or barometric pressure that could affect both pressure and flow measurements. This may affect the waveforms on the screen, but does not affect the volume/pressure delivered to the patient.
Page 157: Volume Waveform
The Y-axis can automatically adjust the scales. Though the X-axis is not labeled, it represents a time scale of 0 to 15 seconds. NOTE: O, O , and AA waveforms are available for software bundle version 02.06.00 and later. A5/A3™ Operating Instructions 046-003777-00 5 - 23...
Page 158 0 to 15 seconds. If no agent is detected, the system displays AA vs. Time waveform (see FIGURE 5- 27). If an anesthetic agent such as sevoflurane is detected, the system displays Sev vs. Time waveform (see FIGURE 5-28). 5 - 24 046-003777-00 A5/A3™ Operating Instructions...
Page 159: Waveform Autoscaling
10 L/min if Flow ≤ 30 L/min 15 L/min if Flow > 30 L/min Volume 25 ml if volume ≤ 100 ml 100 ml if volume > 100 ml TABLE 5-1Autoscaling Margins of Paw, Flow, and Volume A5/A3™ Operating Instructions 046-003777-00 5 - 25...
Page 160: Parameter Monitoring (Spirometry, A5 Only)
Parameter Monitoring (Spirometry, A5 Only) Operations 5.12 Parameter Monitoring (Spirometry, A5 Only) Spirometry is a respiratory monitoring technology that provides continuous (breath-by-breath) measurement of patient lung mechanics. The resultant pressure, volume, flow, compliance, and resistance data enables quick assessment of the patient’s pulmonary status.
Page 161 Operations Parameter Monitoring (Spirometry, A5 Only) Flow - Volume Spirometry Loop FIGURE 5-30 is an example of the Flow - Volume loop. FIGURE 5-30 Flow - Volume Loop The Y-axis of the Flow - Volume Spirometry loop represents Flow. The X-axis represents Volume.
Page 162 Parameter Monitoring (Spirometry, A5 Only) Operations This page intentionally left blank. 5 - 28 046-003777-00 A5/A3™ Operating Instructions...
Page 163 Alarms and Messages Introduction .........................................6-2 Displaying Alarms.....................................6-5 Setting Alarm Volume....................................6-7 Silencing Alarms......................................6-8 Alarm Limits .........................................6-9 Alarm and Prompt Messages ................................. 6-15 A5/A3™ Operating Instructions 046-003777-00 6 - 1...
Page 164: Alarms And Messages
Alarms and Messages Introduction The A5/A3 System provides alarms and messages that are indicated to the user by visual and audible alerts. Alarms and messages appear at the top of the Main Screen and in the Alarms window (see FIGURE 6-1). Users can adjust alarm properties, which include setting alarm limits to trigger alarm conditions, adjusting alarm volume, and silencing alarms.
Page 165: Types Of Alarms And Messages
Alarms and Messages Introduction 6.1.2 Types of Alarms and Messages The A5/A3 provides the following types of alarms and messages below. See section 6.6 (page 6-15) "Alarm and Prompt Messages" for the list of alarms and messages: • Physiological Alarm: This is an alarm caused by a patient-related variable.
Page 166: Alarm Indicators
Introduction Alarms and Messages 6.1.3 Alarm Indicators The A5/A3 provides the following alarm indicators: • An alarm LED located on top of the LCD monitor. The LED can illuminate red, yellow, cyan, or OFF depending on the alarm condition. TABLE 6-1 describes the alarm behavior of different alarm types and different alarm priority labels.
Page 167: Displaying Alarms
Alarms are displayed in order of priority and time. See section 6.2.1 (page 6-6) "Displayed Order of Alarm Messages" for more information. FIGURE 6-2 Active Alarms list in the Alarms window A5/A3™ Operating Instructions 046-003777-00 6 - 5...
Page 168: Displayed Order Of Alarm Messages
In each group, the most recent alarm is displayed first. • If the alarm in Area A is removed, then the most recent and highest priority alarm from Area B is moved to Area A. 6 - 6 046-003777-00 A5/A3™ Operating Instructions...
Page 169: Setting Alarm Volume
FIGURE 6-4 Audio Tab WARNING: Do not rely exclusively on the audible alarm system when using the A5/ A3 Anesthesia System. Adjustment of alarm volume to a low level may result in a hazard to the patient. Always keep the patient under close surveillance.
Page 170: Silencing Alarms
Silence softkey again to turn off the new alarm audio. If the new alarm is medium or high level alarm, you can select the Silence softkey again to silence the new alarm for 120 seconds. Alarm audio-off icon FIGURE 6-6 Alarm Audio-off 6 - 8 046-003777-00 A5/A3™ Operating Instructions...
Page 171: Alarm Limits
The alarm is then triggered when the parameter value is greater than the High Limit or lesser than the Low Limit. NOTE: When using the A5/A3 Anesthesia System, ensure that the alarm limits of each parameter are set to the appropriate values for the patient. There are two ways to set alarm limits: 1.
Page 172 Alarm Limits Alarms and Messages FIGURE 6-7 Limits tab in the Alarms Window (without AG module connected) FIGURE 6-8 Limits tab in the Alarms Window (with AG module connected) 6 - 10 046-003777-00 A5/A3™ Operating Instructions...
Page 173 Alarms and Messages Alarm Limits FIGURE 6-9 Agents tab in the Alarms Window (with AG module connected) A5/A3™ Operating Instructions 046-003777-00 6 - 11...
Page 174: Loading Alarm Defaults
Load Alarm Defaults button FIGURE 6-10 Load Alarm Defaults button in the Alarms window (without AG module connected) Load Alarm Defaults button FIGURE 6-11 Load Alarm Defaults button in the Alarms window (with AG module connected) 6 - 12 046-003777-00 A5/A3™ Operating Instructions...
Page 175 Alarms and Messages Alarm Limits Load Alarm Defaults button FIGURE 6-12 Load Alarm Defaults button in the Agents window (with AG module connected) A5/A3™ Operating Instructions 046-003777-00 6 - 13...
Page 176: Auto Alarm Limits
The Auto Alarm Limits function uses an algorithm based on measured values. The relationship is shown in the TABLE 6-2. The Auto Alarm Limits button is disabled when the A5/A3 is in Standby mode, Manual mode or Monitor mode (with AG module). The Auto Alarm Limits button is also disabled when the current mode is PS, SIMV-VC, or SIMV-PC.
Page 177: Alarm And Prompt Messages
MV < low alarm limit Medium N/A * setting N/A - Not Applicable. This alarm message does not exist within this mode and therefore cannot be disabled or enabled. TABLE 6-3 Physiological Alarm Messages A5/A3™ Operating Instructions 046-003777-00 6 - 15...
Page 178 EtSEV Too High EtSEV > high alarm limit Medium setting N/A - Not Applicable. This alarm message does not exist within this mode and therefore cannot be disabled or enabled. TABLE 6-3 Physiological Alarm Messages 6 - 16 046-003777-00 A5/A3™ Operating Instructions...
Page 179 CO waveform screen. The time displayed is the time since the last breath and the time will reset once the CO Apnea alarm has cleared (software bundle version 02.06.00 and later). A5/A3™ Operating Instructions 046-003777-00 6 - 17...
Page 180: Technical Alarm Messages
“All” indicates that all Automatic Ventilation, Manual Ventilation, and Cardiac Bypass modes are enabled. “Only Manual” indicates that only Manual Ventilation and Cardiac Bypass modes are enabled. “Non-Functional” indicates that the A5/A3 Anesthesia System cannot be used. MACHINE MODE STARTUP...
Page 181 Ventilator After powering on, CPU High Startup Non- CPU Board Initialization board cannot send the Functional Error / parameter settings to Ventilator the ventilator board. Initialization: Fail TABLE 6-4 Startup Alarm Messages A5/A3™ Operating Instructions 046-003777-00 6 - 19...
Page 182 Fan Failure Speed of the fan ≤ 20% of Medium Runtime normal speed Fan Failure O Speed of Module Rack Medium Runtime fan < 3640 TABLE 6-5 CPU Board Runtime Alarm Messages 6 - 20 046-003777-00 A5/A3™ Operating Instructions...
Page 183 25 L/ Runtime min for 1 second. Air Flow Too High Air flow is greater than 20 L/ Runtime min for 1 second. TABLE 6-7 Electronic Flowmeter Board Runtime Alarm Messages A5/A3™ Operating Instructions 046-003777-00 6 - 21...
Page 184 2. Expiratory flow is out of range. N/A - Not Applicable. This alarm message does not exist within this mode and therefore cannot be disabled or enabled. TABLE 6-8 Ventilator Control Board Runtime Alarm Messages 6 - 22 046-003777-00 A5/A3™ Operating Instructions...
Page 185 N/A - Not Applicable. This alarm message does not exist within this mode and therefore cannot be disabled or enabled. TABLE 6-8 Ventilator Control Board Runtime Alarm Messages A5/A3™ Operating Instructions 046-003777-00 6 - 23...
Page 186 MAC < 3 anesthetic gas and MAC < 3 Mixed anesthetic More than one Medium Runtime gas and MAC >= 3 anesthetic gas and MAC >= 3 TABLE 6-9 AG Module Alarm Messages 6 - 24 046-003777-00 A5/A3™ Operating Instructions...
Page 187 Des Over Range Over Range Rate Over Range The monitoring value of Runtime Rate exceeds the measurable range. when this type of alarm is triggered, “--” will be displayed. TABLE 6-9 AG Module Alarm Messages A5/A3™ Operating Instructions 046-003777-00 6 - 25...
Page 188: Prompt Messages
AG Unloaded. ” will not display at the same time. Only the latest one will be shown when both of External AG Unloaded them exist. Successfully TABLE 6-10 Prompt Messages Displayed in Alarm Area 6 - 26 046-003777-00 A5/A3™ Operating Instructions...
Page 189 Check lever on Standby mode while the Auto/Manual breathing system. switch is in Auto position and system is in the Automatic Ventilation disabled state. TABLE 6-11 Prompt Messages Displayed in Pop-up Area A5/A3™ Operating Instructions 046-003777-00 6 - 27...
Page 190 This message displays when the Auto/ Manual Mode! Manual switch is in Auto position and the system is in non-Standby, then if the user presses the disabled End Case button. TABLE 6-11 Prompt Messages Displayed in Pop-up Area 6 - 28 046-003777-00 A5/A3™ Operating Instructions...
Page 191: Maintenance
Breathing System Maintenance...............................7-4 Flow Sensor Calibration ..................................7-5 Sensor Calibration.....................................7-6 Water Build-up in the Flow Sensor ..............................7-9 AGSSWaste Gas Transfer Tube Maintenance..........................7-9 Electrical Safety Inspection.................................7-9 Cleaning and Disinfection................................7-11 DGSS and Waste Gas Transfer Hose............................7-29 A5/A3™ Operating Instructions 046-003777-00 7 - 1...
Page 192 Maintenance WARNING: Do not use a malfunctioning A5/A3 Anesthesia System. Have all repairs and service done by an authorized service representative. WARNING: Use a cleaning and disinfection schedule that conforms to your institution's disinfection and risk-management policies. • Refer to the material safety data sheet as applicable.
Page 193: Theory Of Operation
Maintenance Theory of Operation Theory of Operation The A5/A3 System is a pneumatically-driven and electronically-controlled anesthesia machine. Three types of supply gases are available: N O, O , and Air. The user adjusts supply gas flows through the flowmeters. The mixed gas outputted from the flowmeters is further mixed with the anesthetic agent inside the anesthetic vaporizer to form the fresh gas.
Page 194: Maintenance Schedule
Clean the external surfaces. Every 72 hours Perform 21% O calibration (O sensor in breathing system). The A5/A3 will prompt the user for 21% O calibration (only for units with an galvanic O2 cell). Monthly Water trap on AG module.
Page 195: Flow Sensor Calibration
11. Select Done to close the Calibration window (see FIGURE 7-3). 12. Select the Accept or Cancel softkey to close the Setup window. NOTE: In case of repeated calibration failure, contact Mindray Technical Support. FIGURE 7-2 Flow Sensor Calibration FIGURE 7-3 Flow Sensor Calibration...
Page 196: Sensor Calibration
A5/A3 checks for 21 % O calibration approximately every 72 hours. The A5/A3 prompts the user for 21 % O calibration as follows: • When the machine is powered on, if more than 72 hours have elapsed since the last successful calibration, the prompt message "Calibrate O...
Page 197: Calibrate The O2 Sensor
Setup > General tab. When calibrating from the Setup > System tab, the A5/A3 must be placed in Standby mode and a system password is required. See ‘‘System Tab’’ on page 3-38 for password information.
Page 198 11. After calibration, select Done to close the calibration window. NOTE: In case of repeated calibration failures, replace the O sensor and repeat the calibration. If calibration still fails, contact Mindray Technical Support. ERROR CODE DESCRIPTION RECOMMENDED ACTION...
Page 199: Water Build-Up In The Flow Sensor
NOTE: The electrical safety inspection should be performed once a year. 7.9.1 Auxiliary Electrical Outlet Test Verify the mains voltage is present at each auxiliary outlet when the A5/A3 is connected with power. A5/A3™ Operating Instructions 046-003777-00 7 - 9...
Page 200: Electrical Safety Inspection Test
While for the last two tests, verify that the maximum leakage current does not exceed 1000 μA (1 mA). NOTE: Make sure the safety analyzer is authorized by certificate organizations (UL, CSA, or AAMI etc.). Follow the instructions of the analyzer manufacturer. 7 - 10 046-003777-00 A5/A3™ Operating Instructions...
Page 201: Cleaning And Disinfection
7.10.2 Cleaning and Disinfecting Agents / Autoclaving The A5/A3 should be cleaned and disinfected before its first use, then daily and as often as needed. (see TABLE 7-1, “Maintenance Schedule, ” on page 7-4.) TABLE 7-3 lists the cleaning and disinfecting agents and autoclaving process that may be used on the A5/A3 Anesthesia System.
Page 202: External Surfaces
1. The bellows dome is a transparent cover with graduation marks from 300 to 1500 ml. Remove the bellows dome by turning it counterclockwise and lifting it away from the breathing system. (see FIGURE 7-5) 7 - 12 046-003777-00 A5/A3™ Operating Instructions...
Page 203 2. Detach the bellows from the base plate (see FIGURE 7-6). FIGURE 7-6 Detaching the Bellows 3. Detach the top plate from the bellows (see FIGURE 7-7). FIGURE 7-7 Detaching the Bellows Top Plate A5/A3™ Operating Instructions 046-003777-00 7 - 13...
Page 204 CAUTION: Do not autoclave the following components: Paw gauge, oxygen sensor, flow sensor, and bellows. These components cannot withstand immersion or the heat and pressure of autoclaving. 7 - 14 046-003777-00 A5/A3™ Operating Instructions...
Page 205: Inspiration And Expiration Valves
The following procedure is written generically for a single, unspecified valve. It should be performed on both the inspiration and expiration valves. Expiration Valve Inspiration Valve FIGURE 7-10 Location of Expiration and Inspiration Valves 1. Remove the valve dome (see FIGURE 7-11), turning it counterclockwise. A5/A3™ Operating Instructions 046-003777-00 7 - 15...
Page 206 The valve disc in each of the inhalation and exhalation valve assemblies on the breathing system is fragile and must be handled with care while removing the valve cage from the valve assembly. 7 - 16 046-003777-00 A5/A3™ Operating Instructions...
Page 207 TION. Prior to use after cleaning or disinfecting, power up the system and follow the on- screen prompts to perform the leak test and the compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests").. A5/A3™ Operating Instructions 046-003777-00 7 - 17...
Page 208: Oxygen Sensor
(see section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving"). Allow to dry thoroughly. 3. Inspect the oxygen sensor for damage and replace as necessary. 4. Re-insert the oxygen sensor if it had been removed. 7 - 18 046-003777-00 A5/A3™ Operating Instructions...
Page 209: Apl Valve
Prior to use after cleaning or disinfecting, power up the system and follow the on-screen prompts to perform the leak test and the compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests").. A5/A3™ Operating Instructions 046-003777-00 7 - 19...
Page 210: Paw Gauge
3. Re-insert the PAW gauge if it was removed. Prior to use after cleaning or disinfecting, power up the system and follow the on-screen prompts to perform the leak test and the compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests").. 7 - 20 046-003777-00 A5/A3™ Operating Instructions...
Page 211: Bag Arm
4. Reassemble the bag arm to the breathing system. Prior to use after cleaning or disinfecting, power up the system and follow the on-screen prompts to perform the leak test and the compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests").. A5/A3™ Operating Instructions 046-003777-00 7 - 21...
Page 212: Absorber Canister
19). This separates the absorber canister from the top of the assembly. While noting the previous WARNING, remove the absorber canister. Then remove the Pre-Pak or loose fill absorbent from the canisters. Dispose of the absorbent as per the local regulations. 7 - 22 046-003777-00 A5/A3™ Operating Instructions...
Page 213 6. Make sure that the gasket is correctly installed. The comparison between correct installation and incorrect installation is shown below. A5/A3™ Operating Instructions 046-003777-00 7 - 23...
Page 214 (see FIGURE 7-20). Prior to use after cleaning or disinfecting, power up the system and follow the on-screen prompts to perform the leak test and the compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests"). 7 - 24 046-003777-00 A5/A3™ Operating Instructions...
Page 215: Breathing System Block
3. Press and hold the buckle on the bypass assembly to take out the bypass assembly downward. Buckle Bypass Assembly FIGURE 7-22 Remove Bypass Assembly 4. Pull out the canister bottom plate upward. Canister Bottom Plate FIGURE 7-23 Remove Canister Bottom Plate A5/A3™ Operating Instructions 046-003777-00 7 - 25...
Page 216 5. While holding the sides of the breathing system block, firmly separate and slide it away from its mounting arm. FIGURE 7-24 Breathing System Block Removal, Top View FIGURE 7-25 Breathing System Block Removal, Bottom View 7 - 26 046-003777-00 A5/A3™ Operating Instructions...
Page 217 To ensure patient safety, use only parts and accessories specified in this manual. CAUTION: To ensure measurement accuracy and to avoid possible damage to the A5/A3, use only Mindray-approved cables and accessories. CAUTION: Inspiratory and expiratory flow sensors are flow-direction-sensitive. A5/A3™ Operating Instructions...
Page 218: Active Anesthetic Gas Scavenging System
7.10.12.1 AGSS and Waste Gas Transfer Hose 1. Disconnect the EVAC hose from the AGSS (see FIGURE 7-26). 2. Remove the AGSS and Transfer Hose from the A5/A3. Transfer Hose EVAC Hose Port FIGURE 7-26 AGSS and Transfer Hose Removal 3.
Page 219: Dgss And Waste Gas Transfer Hose
Maintenance Cleaning and Disinfection AGSS Filter FIGURE 7-27 Removal of AGSS Top / AGSS Filter Inspection 5. Reassemble the AGSS and Transfer Hose and reconnect them to the A5/A3 in the reverse order. 7.10.12.2 DGSS and Waste Gas Transfer Hose 1.
Page 220: Regular Maintenance
2. Perform an overall visual inspection of the system. 3. Power up the system and follow the on-screen prompts to perform the leak test and the compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests"). 7 - 30 046-003777-00 A5/A3™ Operating Instructions...
Page 221 Concentration Monitoring (Optional) Introduction .........................................8-2 Understand MAC Values..................................8-3 Identify External AG Modules................................8-4 Prepare to Measure AG ..................................8-6 Make AG Settings......................................8-6 Measurement Limitations ...................................8-8 Troubleshooting......................................8-8 Scavenge the Sample Gas...................................8-9 Calibrate the AG Module .................................. 8-10 046-003777-00 8 - 1 A5/A3™ Operating Instructions...
Page 222: Introduction
, EtCO , FiCO , EtN O, FiN O, EtAA, FiAA and MAC, where, AA stands for any of the five anesthetic agents: Des (desflurane), Iso (isoflurane), Enf (enflurane), Sev (sevoflurane), or Hal (halothane). 8 - 2 046-003777-00 A5/A3™ Operating Instructions...
Page 223: Ag And O2 Concentration Monitoring (Optional)
U.S. Food and Drug Administration for a healthy 40- year-old male patient. NOTE: In actual applications, although the A5 accounts for patient age, the effects of weight and other factors on the inhaled anesthetic agent should be considered.
Page 224: Identify External Ag Modules
Gas outlet FIGURE 8-1External AG Module NOTE: The AG module (see FIGURE 8-1) is configured with the function of compensating barometric pressure automatically. NOTE: The hardkey on the AG module has been disabled. 8 - 4 046-003777-00 A5/A3™ Operating Instructions...
Page 225: Prepare To Measure Ag
Do not use high volume watertraps with Infant patients. Otherwise, patient injury could result. WARNING: Make sure that all connections are reliable. Any leak in the system can result in erroneous readings due to patient breathing gas mixed with ambient air. A5/A3™ Operating Instructions 046-003777-00 8 - 5...
Page 226: Make Ag Settings
Med: 150 ml/min for high volume watertrap; 90 ml/min for low volume watertrap Low: 120 ml/min for high volume watertrap; 70 ml/min for low volume watertrap 4. Select the Accept button to confirm the change. 8 - 6 046-003777-00 A5/A3™ Operating Instructions...
Page 227: Set Alarm Limits
The alarm is then triggered when the parameter value is greater than the High Limit or lesser than the Low Limit. NOTE: When using the A5 Anesthesia System, ensure that the alarm limits of each parameter are set to the appropriate values for the patient. To set the Alarm Limits: 1.
Page 228: Measurement Limitations
If that does not resolve it, internal occlusions may exist. Contact your service personnel. If the expired concentration is higher than the inspired concentration, it is possible that the pump rate is too low. Setting Gas Bench Flow Rate to High is recommended. 8 - 8 046-003777-00 A5/A3™ Operating Instructions...
Page 229: Scavenge The Sample Gas
When using the AG module to perform AG measurements on the patients who are receiving or have recently received anesthetic agents, connect the outlet to the sample gas return port to prevent the medical staff from breathing in the anesthetic agents. A5/A3™ Operating Instructions 046-003777-00 8 - 9...
Page 230: Calibrate The Ag Module
9. Select the Calibrate button to start to calibrate the AG Module. The system will display the results of the calibration status when the process is completed. 10. After calibration, select Done to close the Calibration window. 11. Select Accept to close the Setup window. 8 - 10 046-003777-00 A5/A3™ Operating Instructions...
Page 231 Ventilator Specifications ..................................9-19 Displays and Controls Specifications............................9-21 Alarms ........................................... 9-23 Safety Specifications .................................... 9-24 ASTM F 1208 – 89 (2005) Disclosures............................9-25 Data Storage (Non-Volatile) and Recording.......................... 9-26 Electromagnetic Compatibility ..............................9-27 A5/A3™ Operating Instructions 046-003777-00 9 - 1...
Page 232: Product Specifications
Standards Compliance Product Specifications Standards Compliance The A5/A3 Anesthesia System is in compliance with the following industry standards. ISO 10993-1: 2009 Biological Evaluation of Medical Devices - Part 1: Evaluation and Testing ISO 15223-1: 2012 Medical Devices - Symbols to be used with Medical...
Page 233 The pressure restriction device, expiratory volume monitor and breathing system with alarm system also comply with ISO 80601-2-13. • AG monitor in compliance with ISO 80601-2-55. • monitor in compliance with ISO 80601-2-55. A5/A3™ Operating Instructions 046-003777-00 9 - 3...
Page 234: Safety Designations
9.2.2 Wiring and PC Board Materials The A5/A3 complies with NRTL standards for wiring and PC board materials. Primary wiring is double insulated (jacketed). All wires are UL recognized. 9 - 4 046-003777-00...
Page 235: Physical Specifications
Stability Configurations and Conditions Maintains stability when tilted 10 degrees, as required by IEC 60601-1, clause 9.4. WARNING: Due to the size and weight of the A5/A3, it should only be moved by qualified personnel. WARNING: To avoid tip hazards, use care when moving the A5/A3 up or down inclines, around corners and across thresholds.
Page 236: Environmental Specifications
Resistance to Ingress of Water: Complies with the requirements of clause 11.6.3 in IEC 60601-1 and also the requirements in IEC 60529 for protection against vertically falling water drops (IPX1) Environmental Specifications TABLE 9-4 9 - 6 046-003777-00 A5/A3™ Operating Instructions...
Page 237: Electrical Specifications
Power Supply Input Voltage: 100 to 120 VAC @ 60 Hz Power Supply Input Current: 12 A maximum (2A maximum for A5 unit. 10 A maximum for A5 auxiliary outlets) 12 A maximum (3A maximum for A3 unit. 9 A maximum for...
Page 238: Communication Ports
Electrical Specifications Product Specifications 9.6.4 Communication Ports Communication Port (SP1): One DB9 male connector on the rear of the A5/A3. Provides a non-isolated output serial RS232C interface. CAUTION: Do not connect any non- isolated devices to the DB9/RS232C interface of the A5/A3.
Page 239: Pneumatic Specifications
Cylinder Supply TABLE 9-10 9.7.3 Vaporizer Connections Vaporizer Positions: Two vaporizer mount or three vaporizer mount. Vaporizer Parking Mount: Inactive, for storage only (A5 only) Mounting Mode: ® ® SELECTATEC , with interlocking function (SELECTATEC registered trademark of Datex-Ohmeda Inc.)
Page 240: O 2 Controls
Adjustable Range of Motion: 330 ± 10 degrees Tactile Knob Indication: 30 cmH O and above Minimum pressure to open the APL Dry: 0.15 kPa valve: Wet: 0.15 kPa APL Valve TABLE 9-16 9 - 10 046-003777-00 A5/A3™ Operating Instructions...
Page 241 Product Specifications Breathing System Specifications Resistance of APL valve in dry gas: Flow (L/min) Resistance of APL valve in wet gas: Flow(L/min) APL Valve TABLE 9-16 A5/A3™ Operating Instructions 046-003777-00 9 - 11...
Page 242: Resistance
Resistance of APL valve in dry gas (Lift the APL Valve): Flow (L/min) Resistance of APL valve in wet gas (Lift the APL Valve): Flow(L/min) APL Valve TABLE 9-16 9.8.6 Resistance Expiratory resistance: Flow(L/min) Resistance TABLE 9-17 9 - 12 046-003777-00 A5/A3™ Operating Instructions...
Page 243: Breathing System Temperature Controller
All materials in contact with the patient’s exhaled gas are autoclavable, except the flow sensors, pressure gauge, bellows, and O cell. All materials in contact with the patient's gas comply with ISO 10993-1, ISO 10993-5, ISO 10993-10. A5/A3™ Operating Instructions 046-003777-00 9 - 13...
Page 244: Anesthetic Gas Scavenging System (Agss)
1): 10 % to 90 %. Sample gas flow: 200 ml/min. DRYLINE watertrap. Adult DRYLINE sampling line (2.5 m). 2): 10 % to 90 %. Sample gas flow: 120 ml/min. DRYLINE watertrap. Pediatric DRYLINE sampling line (2.5 m). AG Module TABLE 9-21 9 - 14 046-003777-00 A5/A3™ Operating Instructions...
Page 245 1): 10 % to 90 %. Sample gas flow: 200 ml/min. DRYLINE watertrap. Adult DRYLINE sampling line (2.5 m). 2): 10 % to 90 %. Sample gas flow: 120 ml/min. DRYLINE watertrap. Pediatric DRYLINE sampling line (2.5 m). AG Module TABLE 9-21 A5/A3™ Operating Instructions 046-003777-00 9 - 15...
Page 246 Record the EtCO value at each frequency. By drawing the coordinate diagram which indicates the corresponding relationship between end-tidal value and breathing frequency, the range of breathing frequency can be obtained. 9 - 16 046-003777-00 A5/A3™ Operating Instructions...
Page 247: Alarms
Off, 0.0 to 17.8 FiDes High Limit Off, 0.2 to 18.0 FiDes Low Limit Off, 0.0 to 17.8 Mixed Agent Low priority Multiple halogenated Anesthesia agents value > 3 MAC Medium priority Alarms TABLE 9-22 A5/A3™ Operating Instructions 046-003777-00 9 - 17...
Page 248: Effect Of Interfering Gas On Ag Measured Value
The total interference of all gases is never larger than 5 % 4) Interference for one of the five agents with secondary agent. Effect of Interfering Gas on AG Measured Value TABLE 9-23 9 - 18 046-003777-00 A5/A3™ Operating Instructions...
Page 249: Ventilator Specifications
Fresh Gas Flow Compensation: Volume-compensated ventilation Inspiratory Flow (Min/Max): The A5/A3 does not allow combinations of ventilation parameters (e.g., I: E, Vt and Freq.) to be set if the resultant inspiratory flow is greater than 110 L/m maximum or less than 2.4 L/min minimum.
Page 250 VtG* Off, 20 to 1500 ml (PCV), Step: 1 PlimVG* 5 to 100 cmH O (PCV), Step: 1 cmH * SIMV-PC, VtG, and PlimVG available on A5 only Ventilator Parameter Settings Range TABLE 9-25 Ventilator Performance Drive Pressure: 280 to 600 kPa Inspiratory flow range: 2.4 to 110 L/min...
Page 251: Displays And Controls Specifications
Touchpad (A5 only): Allows alternate control of the touch screen Mouse: SB port on rear of A5/A3 allows connection of a mouse for alternate control of the touch screen. Electronic Controls TABLE 9-29 A5/A3™...
Page 252: Pneumatic Controls
Auxiliary O and Air Flow Meter: Flow range for each meter: 0 to 15 L/min Auxiliary O Gas Power Outlet (A5 Only): Pressure range: 280 to 600 kPa Maximum flow: ≥ 90 L/min Flush Pushbutton (green): Flow rate: 35 to 50 L/min...
Page 253: Alarms
9.13 Alarms Self-test: Self-testing of alarm system functions (alarm light, speaker, and buzzer) is performed when A5/A3 System is powered Alarm Indicators: Audible: speaker / buzzer Visual: alarm light and on-screen alarm messages (Audible and visual alarms comply with the requirements of IEC 60601-1-8.)
Page 254: Safety Specifications
Mains supply to earth (A-a1): 1500 VRMS, 1 min Mains supply to applied part (B-a): 4000 VRMS, 1 min Applied part to earth (B-d): 1500 VRMS, 1 min Isolation at network port: 1500 VRMS, 1 min Safety Specifications TABLE 9-32 9 - 24 046-003777-00 A5/A3™ Operating Instructions...
Page 255: Astm F 1208 - 89 (2005) Disclosures
Safety Specifications TABLE 9-32 9.15 ASTM F 1208 – 89 (2005) Disclosures Based on the following disclosures, the A5/A3 meets ASTM Standard Specification F1208 for Anesthesia Breathing Systems. 9.15.1 Leakage of Breathing System Mode...
Page 256: Unidirectional Valve Opening Pressure
Wet: 0.05 kPa opening pressure. 9.16 Data Storage (Non-Volatile) and Recording Configuration Storage: A5/A3 supports one factory configuration group and one user configuration group. Each configuration has three patient size types: Adult, Pediatric, and Infant. Log Storage: 500 entries of event log...
Page 257: Electromagnetic Compatibility
GUIDANCE AND DECLARATION - ELECTROMAGNETIC EMISSION The A5/A3 is intended for use in the specified electromagnetic environment. The customer or the user of the A5/A3 should assure that it is used in such an environment as described below.
Page 258 Product Specifications GUIDANCE AND DECLARATION - ELECTROMAGNETIC IMMUNITY The A5/A3 is intended for use in the specified electromagnetic environment. The customer or the user of the A5/A3 should assure that it is used in such an environment as described below.
Page 259 If the measured field strength in the location in which the A5/A3 is used exceeds the applicable RF compliance level above, the A5/A3 should be observed to ver- ify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting or relocating A5/A3.
Page 260 RECOMMENDED SEPARATION DISTANCES BETWEEN PORTABLE AND MOBILE RF COMMUNICATIONS EQUIPMENT AND THE A5/A3 The A5/A3 is suitable for use in an electromagnetic environment in which radiated RF disturbance are controlled. The customer or the user of the A5/A3 can help prevent electromagnetic interference by...
Page 261 O: 45 ± 3 volatile anesthetic DES: 5 ± 0.2 agent or generation of : 45 ± 2 a technical alarm condition Anesthesia system's EMC essential performance TABLE 9-39 A5/A3™ Operating Instructions 046-003777-00 9 - 31...
Page 262 Electromagnetic Compatibility Product Specifications This page intentionally left blank. 9 - 32 046-003777-00 A5/A3™ Operating Instructions...
Page 263 AG Accessories ......................................A-2 Absorbent Canister ..................................A-2 Gas Cylinder Accessories..................................A-2 Gas Supply Hoses ....................................A-3 Manuals and Reference Cards................................A-3 Mounting Accessories ..................................A-3 Networking and USB Storage ................................A-4 Vaporizers ........................................A-4 A5/A3™ Operating Instructions 046-003777-00 A - 1...
Page 264: Accessories
The following accessories are designed for the A5/A3 Anesthesia System. The use of other accessories is not recommended. To place an order for these or other accessories, contact Customer Service at 877.913.9663 or order accessories online at www.mindray.com.
Page 265: Gas Supply Hoses
EVAC DISS to VAC Puritan Bennett Gas Supply Hose, 15 ft 0004-00-0081-34 EVAC DISS to VAC DISS Female Gas Supply Hose, 15 ft Manuals and Reference Cards PART NUMBER DESCRIPTION 046-003777-01 A5/A3 Operations Manual (Hardcopy, English) 046-009638-00 Disinfection / Cleaning Card 801-0631-00081-00 A5/A3 Pre-Operation Checklist (English) 801-0631-00082-00 A5/A3 Auxiliary O...
Page 266: Networking And Usb Storage
PART NUMBER DESCRIPTION 0040-00-0452 Mounting Kit, Passport 12M / 17M, DPM6/7, T5 & T8 to GCX Mount Adapter Plate 115-009637-00 Kit for SMR to A5/A3 without Hooks 0436-00-0198 Monitor Mounting Arm, Pivot, 16" 0436-00-0258 Utility Tray, Two Pivot, 24" 045-000250-00...
Page 267: Scavenging Accessories
PART NUMBER DESCRIPTION 115-037548-00 Passive scavenging kit The Dynamic Gas Scavenging System (DGSS) from Anesthetic Gas Reclamation is approved for use on the A5/A3. NOTE: The Active AGSS comes standard with the A5 system. A5/A3™ Operating Instructions 046-003777-00 A - 5...
Page 268 Scavenging Accessories Accessories This page intentionally left blank. A - 6 046-003777-00 A5/A3™ Operating Instructions...
Page 269: User Accessible Spare Parts
User Accessible Spare Parts Active AGSS ........................................B-2 Breathing System......................................B-2 Absorbent Canister ..................................B-2 Flow Sensor ........................................B-2 Gas Cylinder Accessories..................................B-3 Sensor ........................................B-3 Battery..........................................B-3 A5/A3™ Operating Instructions 046-003777-00 B - 1...
Page 270: Active Agss
Active AGSS User Accessible Spare Parts The following spare parts are designed for the A5/A3 Anesthesia System. The use of other spare parts is not recommended. To place an order for these or other spare parts, contact Customer Service at 877.913.9663 or order spare parts online at www.mindray.com.
Page 271: Gas Cylinder Accessories
PART NUMBER DESCRIPTION 115-033063-00 Gas Cylinder Wrench Sensor PART NUMBER DESCRIPTION 040-001270-00 Sensor, A Series 801-0631-00102-00 Sensor Cable and Housing, A Series 801-0631-00091-00 Sensor Cable, A Series Battery PART NUMBER DESCRIPTION 115-018012-00 Lithium-ion Battery A5/A3™ Operating Instructions 046-003777-00 B - 3...
Page 272 Battery User Accessible Spare Parts This page intentionally left blank. B - 4 046-003777-00 A5/A3™ Operating Instructions...
Page 273 Parameters and Factory Defaults Waveform/Spirometry Tabs (A5 Only) ............................C-2 Alarm Limits .........................................C-3 Setup Menu........................................C-5 Alarm Volume and History..................................C-8 Date and Time......................................C-8 Demographics ......................................C-9 Ventilation Modes ....................................C-9 Linked Ventilation Parameter .................................C-13 Ventilation Parameter Relationships ............................C-15 A5/A3™ Operating Instructions 046-003777-00 C - 1...
Page 274: Parameters And Factory Defaults
Waveform/Spirometry Tabs (A5 Only) Parameters and Factory Defaults Waveform/Spirometry Tabs (A5 Only) Current selection saved when OBJECT RANGE DEFAULT powered off Waveform/Spirometry Waveform tab, Spirometry Waveform tab Spirometry Tab: Loop Pressure - Volume, Flow - Pressure - Volume Type Volume, Pressure- Flow...
Page 275: Alarm Limits
Step: 0.1 EtHal Low Off, 0.0 to (High-0.2) Step: 0.1 FiHal High Off, (Low+0.2) to 5.0 Step: 0.1 FiHal Low Off, 0.0 to (High-0.2) Step: 0.1 EtEnf High Off, (Low+0.2) to 5.0 Step: 0.1 A5/A3™ Operating Instructions 046-003777-00 C - 3...
Page 276 Off, (Low+0.2) to 100 Step: 1 EtO2 Low Off, 10 to (High-2) Step: 1 CO2 Apnea 10 sec, 15 sec, 20 sec, sec, Delay Time 25 sec, 30 sec, 35 sec, 40 sec C - 4 046-003777-00 A5/A3™ Operating Instructions...
Page 277: Setup Menu
Hal Scale 0-2.5%, 0-5.0% Display Tab: Gas Scales: 0-1.2%, 0-2.5% Enf Scale 0-2.5%, 0-5.0% Display Tab: Gas Scales: 0-35%, 0-100% Scale 0-50%, 0-100% Display Tab: Gas Scales: 0-35%, 0-100% O Scale 0-50%, 0-100% A5/A3™ Operating Instructions 046-003777-00 C - 5...
Page 278 9600 This Machine: Configure 115200 Serial: Baud Rate System Tab: Network: Odd, Even, None None This Machine: Configure Serial: Parity System Tab: Network: 8, 7, 6, 5 This Machine: Configure Serial: Data Bits C - 6 046-003777-00 A5/A3™ Operating Instructions...
Page 279 — 6678 Network Protocol: Configure MD2: Port System Tab: Network: 10 sec, 30 sec, 1 min, 5 SNTP Protocol: Interval min, 30 min, 1 hr, 2 hr, 6 hr, 12 hr, 24 hr A5/A3™ Operating Instructions 046-003777-00 C - 7...
Page 280: Alarm Volume And History
1-31 Month 1-12 Year 1900-2099 2009 Hour — 00 (24 hr) 12 AM(12 hr) Minute 00-60 AM/PM AM/PM 12/24 hour 12, 24 Date format YYYY/MM/DD, MM/DD/YYYY, YYYY/MM/DD DD/MM/YYYY Daylight Savings On, Off Time C - 8 046-003777-00 A5/A3™ Operating Instructions...
Page 281: Demographics
VtG**, PlimVG**, Pinsp, Rate, I:E, PEEP, Tslope Δ SIMV-PC** Pinsp, Rate, Tinsp, PS (On/Off ), P, Trigger, PEEP, Tslope Δ Min Rate, P, Trigger, PEEP, Tslope, Apnea Ti ** SIMV-PC, VtG, PlimVG, and Bypass are available only on A5. A5/A3™ Operating Instructions 046-003777-00 C - 9...
Page 282 Step: 1 Step: 1 Defaults: Defaults: Adult: 600 ml Adult: 600 ml Pediatric: 120 ml Pediatric: 120 ml Infant: 20 ml Infant: 20 ml VtG (A5 only) — — Range: — — — 20 to 1500 ml Step: 1 Default: VG (A5 only) —...
Page 283 Step: 1 cmH Step: 1 cmH Defaults: Defaults: Adult: 50 cmH Adult: 50 cmH Pediatric: 40 cmH Pediatric: 40 cmH Infant: 20 cmH Infant: 20 cmH PlimVG (A5 — — Range: 5 - 100 — — — only) Step: 1 cmH Default:...
Page 284 Default: 0.2 sec Default: 0.2 sec — Range: On, Off — Range: On, Off — — Step: — Step: — Default: Off Default: Off Bypass (A5 — — — — — Range: On, Off only) Step: — Default: Off Alarm —...
Page 285: Linked Ventilation Parameter
PlimVG. PlimVG. of PlimVG. PlimVG. Tslope — The parameter value is shared between the previous and current ventilation modes. *** Available on A5 only. A5/A3™ Operating Instructions 046-003777-00 C - 13...
Page 286 Tslope — Min Rate — ΔP — Trigger — Peep — Tslope — Apnea Ti — The parameter value is shared between the previous and current ventilation modes. *** Available on A5 only. C - 14 046-003777-00 A5/A3™ Operating Instructions...
Page 287: Ventilation Parameter Relationships
10 ≤ Plimit ≤ 100 SIMV-VC Rate 4 ≤ Rate≤ 100 20 ≤ Vt ≤1500 ΔP ΔP ≤ Plimit-PEEP 3 ≤ ΔP ≤ 50 Plimit Plimit ≥ PEEP+5 Plimit ≥ ΔP+PEEP 10 ≤ Plimit ≤ 100 A5/A3™ Operating Instructions 046-003777-00 C - 15...
Page 288 4 ≤ Rate ≤ 100 Pinsp Pinsp ≥ PEEP+5 5 ≤ Pinsp ≤ 70 NOTE: Even when the PlimVG, Pinsp, or ΔP parameters are inactive, they are restricted to the parameter relationship equations. C - 16 046-003777-00 A5/A3™ Operating Instructions...
Page 289: Pneumatic Diagram
Pneumatic Diagram Pneumatic Diagram of the A5/A3 System ..........................D-2 A5/A3™ Operating Instructions 046-003777-00 D - 1...
Page 290: Pneumatic Diagram Of The A5/A3 System
Pneumatic Diagram of the A5/A3 System Pneumatic Diagram Pneumatic Diagram of the A5/A3 System FIGURE D-1 Pneumatic Diagram of the A5/A3 System D - 2 046-003777-00 A5/A3™ Operating Instructions...
Page 291 Pneumatic Diagram Pneumatic Diagram of the A5/A3 System DESCRIPTION DESCRIPTION Gas Pipeline Connection Bypass Valve Gas Cylinder Connection Sensor O Gas Pipeline Connection Airway Pressure Gauge O Gas Cylinder Connection Inspiratory Flow Sensor Air Gas Pipeline Connection Patient Connector Air Gas Cylinder Connection...
Page 292 Pneumatic Diagram of the A5/A3 System Pneumatic Diagram This page intentionally left blank. D - 4 046-003777-00 A5/A3™ Operating Instructions...
Page 293: Abbreviations, Symbols, And Units Of Measure
Abbreviations, Symbols, and Units of Measure Abbreviations, Symbols, and Units of Measure........................E-2 Symbols .......................................... E-4 Units of Measure ....................................... E-4 Attention Symbols ....................................E-5 A5/A3™ Operating Instructions 046-003777-00 E - 1...
Page 294: Abbreviations
Flow flow halothane ratio of inspiration time to expiration time isoflurane mean alveolar concentration MEAN mean pressure Min Rate minimum breath rate minute volume nitrous oxide oxygen E - 2 046-003777-00 A5/A3™ Operating Instructions...
Page 295 Trigger trigger sensitivity tidal volume tidal volume guarantee volume control ventilation volume guarantee control A5/A3™ Operating Instructions 046-003777-00 E - 3...
Page 296: Symbols
Volt kilo Volt Amp kilogram Volts alternating current kiloPascal Ω pound-force per square inch μA microAmp L, l liter μV microVolt pound Watt nanometer E - 4 046-003777-00 A5/A3™ Operating Instructions...
Page 297: Attention Symbols
Abbreviations, Symbols, and Units of Measure Attention Symbols Attention Symbols The following figures provide descriptions of symbols of Attention that are used on the device and/or within this manual. FIGURE E-1 Main Unit (Front View) A5/A3™ Operating Instructions 046-003777-00 E - 5...
Page 298 Only vaporizers with Selectatec Interlock-Systems may be used with the A5/A3 unit. Use vaporizers compliant to ISO 80601-2-13. See section A.9 (page A-4) "Vaporizers". Refer to the vaporizer manufacturer’s Instructions For Use for filling or draining the vaporizer and other information.
Page 299 Individual outlet current is limited to 3 A. Total mains output current is limited to 10 A. Sample Line Exhaust Gas Inlet: Inlet for waste gas from an optionally attached gas module. Merges with the AGSS connector that connects to the AGSS. A5/A3™ Operating Instructions 046-003777-00 E - 7...
Page 300 /Air Gas Outlet: Nozzle (barbed connector) for auxiliary O /Air output. Combines the auxiliary O /Air flowmeters into a single output. Maximum supporting weight: 25 kg at a maximum distance of 0.31 m. Warning: Hot E - 8 046-003777-00 A5/A3™ Operating Instructions...
Page 301 Maximum supporting weight: 25 kg at a maximum distance of 0.31 m. Maximum supporting weight: 25 kg at a maximum distance of 0.31 m. Maximum supporting weight: 25 kg at a maximum distance of 0.31 m. A5/A3™ Operating Instructions 046-003777-00 E - 9...
Page 302 Attention Symbols Abbreviations, Symbols, and Units of Measure Rear Front FIGURE E-5 Main Unit (Top View) ATTENTION! NUMBER DESCRIPTION Top Shelf: 40 kg MAX. 88 lbs MAX. E - 10 046-003777-00 A5/A3™ Operating Instructions...
Page 303 Autoclavable up to 134°C. Polyphenylsulfone (PPSU). APL Valve: The APL valve and PAW gauge numerics are for reference only. Calibrated patient airway pressure is displayed on the user interface. A5/A3™ Operating Instructions 046-003777-00 E - 11...
Page 304 NUMBER DESCRIPTION 134°C >PPSU<. Autoclavable up to 134°C. Operating the A5/A3 with a full water trap in the breathing system block does not allow the water to condense appropriately. The trap should be removed and emptied when filled with water.
Page 305: Preparation For Malignant Hyperthermia Susceptible Patients
Preparation for Malignant Hyperthermia Susceptible Patients Malignant Hyperthermia Causes, Effects and Treatment ....................F-2 Malignant Hyperthermia Washout ..............................F-2 Washout Procedure for Malignant Hyperthermia Susceptible Patients with A5 Anesthesia Delivery Systems ........................................... F-2 References........................................F-4 A5/A3™ Operating Instructions 046-003777-00 F - 1...
Page 306: Malignant Hyperthermia Causes, Effects And Treatment
5 ppm to be safe. the following steps are recommended to prepare a A5 anesthesia system for an MH-susceptible patient. 1. Turn off and remove all the vaporizers from the anesthesia system to prevent their inadvertent use.
Page 307 5. Maintain the oxygen fresh gas flow rate of 15 L/min throughout the case to functionally create a non-rebreathing system and minimize rebound of volatile concentration at low fresh gas flow rates. Agent washout time with A5 Anesthesia Systems (Data on file) FIGURE F-1 Washout Procedure for Malignant Hyperthermia Susceptible Patients A5/A3™ Operating Instructions...
Page 308: References
: Guidelines are excerpted from the MHAUS website and do not replace the indicated instructions for preparation of the A5. : This method has not been tested with A5. References 1. Hopkins PM. Malignant hyperthermia: pharmacology of triggering. Br J Anaesth. 2011 Jul;...
Page 310 046-003777-00 (16.0) August 15, 2017...

Mindray A5 Operating Instructions Manual

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