Heyer Narkomat + Operator's Manual
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Heyer Narkomat + Operator's Manual

Anesthesia system
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N a r k o m a t
+
A n e s t h e s i a S y s t e m
Operator's Manual
Rev. 3.1 – 05/09
M
S
A
I
ODERN
OLUTIONS FOR
NESTHETICS AND
NHALATION

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  • Page 1 N a r k o m a t A n e s t h e s i a S y s t e m Operator’s Manual Rev. 3.1 – 05/09 ODERN OLUTIONS FOR NESTHETICS AND NHALATION...

  • Page 3: Table Of Contents

    Alarm messages during normal operation................40 5.5.1 Alarm messages during normal operation with the integrated Gas Module * ..... 45 5.5.2 Alarm messages during normal operation with the optional ventilation mode PCV..47 Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 3 / 150...
  • Page 4 Connecting and disconnecting of the vaporizers..............137 Cleaning ........................... 138 Cleaning and sterilizing the apparatus ................. 138 9.1.1 Cleaning the housing ....................138 Patient module........................138 9.2.1 Sterilizing the patient module..................138 4 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...
  • Page 5 12 Month Service Interval ................. 140 10.1.1.3 36 Month Service Interval ................. 141 10.2 Servicing the Vaporizer ....................141 10.3 Other Servicing....................... 141 Specifications........................142 Warranty ..........................146 Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 5 / 150...

  • Page 6: Table Of Figures

    Fig. 63 Alarm limits 1 in the Manual/spontaneous ventilation mode ..............94 Fig. 64 Display “Alarm limits 2 in the Manual/spontaneous ventilation mode” ............95 Fig. 65 Alarm limits in manual/spontaneous mode ....................96 6 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...
  • Page 7 Fig. 94 Dismantling of the patient module, front view ..................132 Fig. 95 Dismantling of the patient module, top view .................... 134 Fig. 96 Dismantling of the valve bodies ....................... 136 Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 7 / 150...

  • Page 8: Details Of The Manufacturer / Apparatus

    H E Y E R N a r k o m a t 1 Details of the Manufacturer / Apparatus +® ® ® ® Apparatus: Anesthesia system HEYER NARKOMAT Manufacturer: HEYER Medical AG Carl-Heyer-Strasse 1-3 56130 Bad Ems Germany Tel: ++49 2603 / 791-3 Fax: ++49 2603 / 70424 E-Mail: info@heyermedical.de...

  • Page 9: Description And Utilization Of The Apparatus

    2 Description and Utilization of the Apparatus 2.1 General Introduction The HEYER NARKOMAT + anesthesia system represents a flexible anesthesia workplace for implementing and monitoring inhalation anesthesia in the half-closed system and the nearly closed system for low-flow techniques with minimum gas- and anesthetic agent utilization.

  • Page 10: Product Improvements

    Alveolar concentration of the Anesthetic agent for MAC =1 at 100% O patient age of 40 years. 2.1.1 Product improvements HEYER MEDICAL AG retains the right to carry out modifications or to update the apparatus and/or operating instructions without prior notification. These Operating Instructions explain all features of the HEYER NARKOMAT anesthesia system and are correct at going to print.

  • Page 11: Responsibilities Of Operators

    2.1.3 Liability of the manufacturer HEYER MEDICAL AG shall only be liable for the safety, reliability and functionality of the apparatus, if: - the apparatus was operated in accordance with the information issued by the manufacturer;...

  • Page 12: General Precautions

    The connection of apparatus via the additional socket may, in case of a failure of the protective conductor, lead to a discharge current exceeding the permissible values. Electromagnetic radiation disturbances exceeding the values of EN 60601-1-2, can affect the function of the machine. 12 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 13: Caution Notes

    * The gas measurement tube system at the monitor must be connected before putting the apparatus into use or changing the flow rate. Otherwise the apparatus might falsely detect a tube blockage. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 13 / 150...

  • Page 14: Functional Description

    The inspiratory flow of the ventilation gas is automatically adapted to the respective settings of the tidal volume VT, the ventilation frequency RATE and the ventilation time ratio I/E. 14 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 15: Compliance Compensation

    O flow, the required O flow is also automatically increased. The thus set fresh gas is then fed over a vaporizer, where it is mixed with anesthetic agent. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 15 / 150...

  • Page 16: Vaporizer Mounting Device And Vaporizers

    For further information see: Instructions of the respective anesthetic agent vaporizer. 16 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 17: Patient Module

    *not valid with the apparatus option with integrated gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 17 / 150...

  • Page 18: Patient Module Heating

    * only valid with the apparatus option with integrated gas module 18 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 19: Operating Elements / Connections For Appliances

    (rotary switch). 5 Patient module Absorber circuit system with integrated bag-in- bottle system, active and passive valves, such as APL-valve. Fig. 1 Front view of the apparatus Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 19 / 150...

  • Page 20: Rear Of Apparatus

    8 Pipeline supply connections Connections for O2, AIR and N2O from central gas supply. Three pipeline pressure gauges inform Fig. 2 Rear of the apparatus about supply pressure. 20 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 21: Left Side Of Apparatus

    5 Water trap with gas measurement inlet** * Only valid without the option gas module **Only valid with the option gas module Fig. 3 Left side view on the apparatus Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 21 / 150...

  • Page 22: Right Side Of Apparatus

    During the operation, the switch remains in the ON position. 3 Rail mount 25 x 10 Fig. 4 Right side view on the apparatus 22 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 23: Ventilator Unit

    0 to 315 kPa x 100 (315 bar). Fig. 5 Ventilator display and airway pressure gauge Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 23 / 150...

  • Page 24: Operating Panel, Ventilator Keyboard

    In this position, the ventilator is switched to the mode for the controlled ventilation of children. Adult (300-1400 ml): In this position the ventilator is switched to the mode for the controlled ventilation of adults. 24 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 25: Push To Enter" - Encoder Button To Change And Confirm Settings

    * In the standby mode the patient module can be unlocked and the gas measurement can be verified. * *Only valid with option gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 25 / 150...

  • Page 26: Alarms" - Panel Keys And Displays For Alarms

    I:E from inspiration to expiration time. PEEP: This key opens a PEEP display window in the CMV ventilation mode allowing a PEEP setting. 26 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 27: Flow Meter Tube Block Including Fresh Gas Dosing

    O or AIR, which can then be dosed with the respective valve spindles. The previously set volume flow is retained after switching back to the same gas type. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 27 / 150...

  • Page 28: Vaporizer Mounting Device

    H E Y E R N a r k o m a t 4.4 Vaporizer mounting device Fig. 8 Vaporizer mounting device Fixing knob for patient arm Valve cartridge of vaporizer mount Locking device Stopping face 28 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 29: Patient Module (Circuit System)

    Hose connection for inspiration branch Hose connection for reservoir/manual ventilation bag 10 Bellows including bellows dome 11 CO absorber canister *only the apparatus option without the gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 29 / 150...

  • Page 30: Sample Gas Recirculation

    "Sample gas recirculation" adapter at the rear side. The sample gas is putted back to the reservoir bag by this adapter. * only the apparatus option without the gas module 30 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 31: Vacuum Source For Bronchial Suction (Optional)

    Tube clamp for suction tube/finger tip Quick coupling AIR for vacuum source Vacuum source (injector) with vacuum gauge and control knob Connection for tube to suction glass "vacuum" connector Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 31 / 150...

  • Page 32: Symbols On The Unit

    H E Y E R N a r k o m a t 4.8 Symbols on the Unit Attention, check the accompanying documents On/Off (connection to the power supply) 32 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 33: Alarm Messages And Safety Devices

    In the following, all alarm situations that may arise during the different operating conditions are explained. There are three priority levels of the alarms: No. Alarm LEDs Acoustic Continues red Continues tone Red blinking Intermitting tone Yellow blinking Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 33 / 150...

  • Page 34: Alarm Messages Direct After The System Start

    The operating conditions can be checked and, if necessary, errors can be corrected. Fig. 12 Example of an alarm message during the booting procedure 34 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 35: Alarm Messages In Standby

    Fig. 13 Example of an alarm message during the booting procedure Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 35 / 150...

  • Page 36: Compliance Test Alarm Messages

    600 ml/min at 40 cm H2O. If necessary use the Check breathing circuit Compliance test in Standby / Press OK to continue OPTIONS to retest after tightening the breathing circuit and valve rings. 36 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...
  • Page 37 Service. Patient module unlocked The Patient module is not adapted Check if the Patient module is correctly in the docking station. adapted correctly. If else fails, call service Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 37 / 150...

  • Page 38: System Test Alarm Messages

    Fig. 15 Example of a system test alarm message 38 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...
  • Page 39 Expose cell to 21% oxygen or Expose Sensor to room air. of oxygen that is higher than 21% replace the cell. Press OK to start. or cell is faulty. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 39 / 150...

  • Page 40: Alarm Messages During Normal Operation

    After each activation of the CMV mode, the following alarm message is, for instance, displayed because the selected minimum airway pressure has not been reached and the anesthesia gas concentration is not sufficient for identification. Alarm messages during normal operation (continued) 40 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...
  • Page 41 During the test, the hotwire sensor Retry function. Reboot machine. available did not pass its test. Sensor may If all else fails call Service. Replace Flow Sensor - Call be faulty. Service Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 41 / 150...
  • Page 42 Temp Sensor readings not The temperature sensor of the Perform the Compliance test in available breathing circuit has failed. Standby / OPTIONS. If all else Call Service fails call Service. 42 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...
  • Page 43 Check for Leaks. the fresh-gas setting and increase Check if patient is breathing the fresh gas flow, if necessary. Spontaneously. call Service at next opportunity. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 43 / 150...
  • Page 44 The Startup Compliance test has Perform the Compliance test in been bypassed Standby / OPTIONS as soon as time allows to ensure the safe function of the system 44 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 45: Alarm Messages During Normal Operation With The Integrated Gas Module

    The water trap is full, nearly full or Check if the water trap is soon or connection faulty the water trap is not connected connected correctly or, if full, correctly exchange it Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 45 / 150...
  • Page 46 Wait up to 4 min for the sensor to Measurement in Startup Mode and cannot deliver the warm up. If all else fails call measurements within the ISO Service. specifications *Only valid with option gas module 46 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 47: Alarm Messages During Normal Operation With The Optional Ventilation Mode Pcv

    Expiratory time too short The set expiration time does not Check that I:E ratio and allow the below to refill completely breathing frequency setting are appropriate. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 47 / 150...

  • Page 48: Technical Failure Alarm Message

    Ensure that the connectors are not in the park position. 4. Plug the mains cable into a grounded socket. Switch on the power supply using the mains switch at the right side of the apparatus. 48 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 49: Pre-Operation Tests

    "Sample gas recirculation". 6. Ensure via a manual test that the APL valve does not allow a pressure greater than 100 Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 49 / 150...

  • Page 50: Sample Tube Connection (Optional Integrated Gas Module)

    Condensed water can also damage the internal sensors. WARNING Ensure the sample tube is going direct upward from the y-piece to avoid condense water going into the system. 50 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 51: System Start

    The system then asks the operator to carry out the sensor test Fig. 18 First display message during system start Fig. 19 Second display message during system start Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 51 / 150...

  • Page 52: Battery Control

    The breathing circuit, patient connection hoses, the Y-piece etc. are also tested for leaks. Furthermore the system compliance to which in particular also the patient hoses contribute is detected during the compliance test. 52 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 53: Fig. 21 Display After The Sensor Test

    Y-piece, etc. The compliance test should be carried out, if the patient tubes were exchanged against others, with a relevant difference in the tube compliance. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 53 / 150...

  • Page 54: Compliance Test

    H E Y E R N a r k o m a t 6.6.1 Compliance Test Fig. 22 Display prior to the compliance test Follow the instructions of the ventilator display and activate by pressing the “START” button. 54 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 55: Fig. 23 Display After The Compliance Test As Extended Information

    As extended information to the test result of a compliance test, the leakage of the patient module at 40 cmH O and the detected system compliance is displayed. Fig. 24 Display after the compliance test as pass/fail information Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 55 / 150...

  • Page 56: System Test

    The system test involves a calibration of the oxygen sensor and a fresh-gas system leak test and should be carried out during a correct system start. * Only valid with option gas module 56 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 57: Fig. 26 Display Of System Test Selection Sub-Menu

    Confirm the selection by pressing the encoder on the “Run” display key. * The oxygen calibration is not valid with the apparatus option with integrated gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 57 / 150...

  • Page 58: O2 Sensor Calibration

    O sensor cable. * The oxygen calibration is not valid with the apparatus option with integrated gas module 58 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 59: Fig. 28 Second Display Message Of O Sensor Calibration

    15 second countdown is displayed in a calibration start window. * The oxygen calibration is not valid with the apparatus option with integrated gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 59 / 150...

  • Page 60: Fig. 29 Third Display Message Of O Sensor Calibration

    Fig. 29 Third display message of O sensor calibration * The oxygen calibration is not valid with the apparatus option with integrated gas module 60 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 61: Fig. 30 Fourth Display Message Of O

    This completes the calibration of the O sensor. * The oxygen calibration is not valid with the apparatus option with integrated gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 61 / 150...

  • Page 62: Leak Test Fresh Gas Delivery System

    , absorber canister, manual ventilation hose and ventilation pressure valve (APL) for any leaks. 62 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 63: Fig. 32 Display After The Leak Test Fresh Gas Delivery System

    The Standby window of the normal operating mode is displayed. In the following section 7 “Operation in the individual functions” this window is described under section 7.1 “Standby mode”. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 63 / 150...

  • Page 64: Gas Module Verification

    A calibration of the gas module is not necessary because it is maintenance free. Should a value of the gas measurement be outside of the tolerance, call an authorized service technician. *only for apparatus option with integrated gas module 64 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 65: Fig. 34 Connection Of The Tube System To The Verification Gas Bottle

    Fig. 34 Connection of the tube system to the verification gas bottle Fig. 35 Display No. 1 for gas measurement verification *only for apparatus option with integrated gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 65 / 150...

  • Page 66: Fig. 36 Display No. 2 For Gas Measurement Verification

    Connect the gas measurement tube to the verification gas bottle Open the Valve of the verification gas bottle Confirm “start” through turning and pressing the encoder button. *only for apparatus option with integrated gas module 66 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 67: Fig. 37 Display No. 3 For Gas Measurement Verification

    To ensure the correct display of the values, a zeroing of the gas module is performed first. The maximum time for a zeroing is 1 min. Do not press the „Quit“ button during this time. *only for apparatus option with integrated gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 67 / 150...

  • Page 68: Fig. 38 Display No. 4 For Gas Measurement Verification

    Gas module verification (continued)* After the zeroing is completed, open the gas cylinder valve. Fig. 38 Display No. 4 for gas measurement verification *only for apparatus option with integrated gas module 68 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 69: Fig. 39 Display No. 5 For Gas Measurement Verification

    If continues values are being displayed, activate the button quit and close the valve of the verification gas bottle. Fig. 39 Display No. 5 for gas measurement verification *only for apparatus option with integrated gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 69 / 150...

  • Page 70: Fig. 40 Display No. 6 For Gas Measurement Verification

    Fig. 40 Display No. 6 for gas measurement verification Activate the button “finalize verification“ to return to the options menu. *only for apparatus option with integrated gas module 70 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 71: Operation In The Individual Functions

    “Start-up and functional test” and its sub-sections. The following sections describe how to operate the system for the various ventilation modes in the standby mode and the operating modes. Fig. 41 Control panel Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 71 / 150...

  • Page 72: Standby Mode

    The display shows the following window: Fig. 42 Standby mode display The ventilator display shows the current time, the total number of system operating hours and the status of the system tests. 72 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 73: Standby Mode Menu Window

    Manual/spontaneous mode, the alarm acoustic is automatically set to the previous set value. The display keys "Clock Set", "Load/save" and "System Test Options" open further sub- menus determining further basic settings. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 73 / 150...

  • Page 74: Fig. 44 "Set Time" Within The Menu Window

    The new date or time settings are confirmed with “OK” and will then be stored in the system. To quit the "Set date and time" window, the display key "Cancel" is pressed. 74 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 75: Fig. 45 "Load/Save Personal Alarm Limits" Within The Menu Window

    4. You can leave the menu "Load and Save private Alarm Limits” slots through turning and pressing the encoder button in the panel “Quit”. Note: Due to safety reasons, the system will activate the default settings after every new start Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 75 / 150...

  • Page 76: Fig. 46 "System Test Options" Within The Menu Window

    This window can be closed and the settings saved through the button “Quit”. 76 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 77: Standby Mode Graphics Window

    The desired time axis representation for the real time curves can be chosen by selecting the respective screen key. By pressing the "Graphics" key for the second time, the window is closed again and the selected setting is stored. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 77 / 150...

  • Page 78: Standby Mode Options Window

    In the field “Gas Measurement“ the date of the last verification is displayed. Activating the button “verify“ opens the menu fort the Gas verification. 78 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 79: Standby Mode Screen Saver Function

    The text line "Press ENTER for Standby screen" is displayed on different positions of the display. To deactivate this screen saver function just press or turn the encoder button. Fig. 49 Screen saver Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 79 / 150...

  • Page 80: Control Panel Keys In The Ventilation Modes Cmv / (S)Cmv / Pcv * Adult / Child

    1 to 10. This setting will remain stored until the next system start. The display keys "Clock Set", "Load/save" and "System Test Options" open further sub- menus determining further basic settings. * The ventilation modes (S)CMV / PCV are optional. 80 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 81: Graphic Window In The Ventilation Modes Cmv / (S)Cmv / Pcv * Adult / Child

    By pressing the "Graphics" key for the second time, the window is closed again and the selected setting is stored. * The ventilation modes (S)CMV / PCV are optional. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 81 / 150...

  • Page 82: Options Window In The Ventilation Modes Cmv / (S)Cmv / Pcv * Adult / Child

    The display of the CO unit can be changed to mmHg or %. * The ventilation modes (S)CMV / PCV are optional. 82 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 83: Automatic Anesthetic Agent And Agent Mixture Identification

    Agent : +/-0,15% : +/- 2% **** The minimum concentration for the identification of anesthetic agents is approx. 0,3 Vol%. * only for apparatus option with integrated gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 83 / 150...
  • Page 84 Zeroing required accuracy accuracy 04:00 00:00 Zeroing in progress 04:30 00:30 ISO accuracy ISO accuracy ISO accuracy Zeroing completed 124:00 120:00 ISO accuracy ISO accuracy ISO accuracy Zeroing required 84 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 85: Panel Key Vt/V In The Ventilation Modes Cmv / (S)Cmv Adult / Child

    The Menu window shows the screen adjustment Vt for the setting of the tidal volume in ml during the controlled ventilation. This adjustment is stored until the unit is switched off. The window closes after pressing the encoder button or automatically after 10 s. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 85 / 150...

  • Page 86: Panel Key Vt/V In The Ventilation Mode Pcv Adult / Child

    This adjustment is stored until the unit is switched off. The window closes after pressing the encoder button or automatically after 10 s. 86 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 87: Panel Key F In The Ventilation Modes Cmv / (S)Cmv / Pcv Adult / Child

    The Menu window shows the screen adjustment f for the setting of the ventilation rate in 1/min. This adjustment is stored until the unit is switched off. The window closes after pressing the encoder button or automatically after 10 s. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 87 / 150...

  • Page 88: Panel Key I:e In The Ventilation Modes Cmv / (S)Cmv / Pcv Adult / Child

    The Menu window shows the screen adjustment I:E for the setting of the inspiration- exspiration time ratio This adjustment is stored until the unit is switched off. The window closes after pressing the encoder button or automatically after 10 s. 88 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 89: Panel Key Peep In The Ventilation Modes Cmv / (S)Cmv / Pcv Adult / Child

    The Menu window shows the screen adjustment PEEP for the setting of the PEEP in cmH2O. This adjustment is stored until the unit is switched off. The window closes after pressing the encoder button or automatically after 10 s. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 89 / 150...

  • Page 90: Manual/Spontaneous" Ventilation Mode

    PEEP Positive end expiratory pressure in cmH2O T. Vol. Tidal volume in ml Rate Ventilation or spontaneous breath rate in 1/min M. Vol. Respiratory minute volume in l (1/min) minimal alveolar Concentration 90 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 91: Fig. 59 "Manual/Spontaneous Settings" Display 2

    Iso. Exspiratory Anesthetic agent concentration in %. Here for concentration in %. Here for example Isoflurane. example Isoflurane. Inspiratory N O concentration in Expiratory N O concentration in Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 91 / 150...

  • Page 92: Fig. 60 "Manual/Spontaneous Settings" Display 3

    N2O: Off The N2O alarms N2O high, N2O low are Rate: Off The frequency alarms f switched off min and f max are switched off 92 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 93: Fig. 61 Ventilation Pressure Valve (Apl) In Cmv/Sp Setting

    For a manual ventilation, the ventilation pressure valve (APL) must be set to a respective pressure limiting value, for example 20 cmH2O. The patient will be ventilated with the manual ventilation bag. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 93 / 150...

  • Page 94: Alarm Limit Setting In "Manual/Spontaneous" Mode

    Minimum pressure limit (low pressure limit) in cmH2O pressure limit) in cmH2O High FiO Limit for maximum oxygen Low FiO Limit for minimum oxygen concentration in % concentration in % 94 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 95: Fig. 64 Display "Alarm Limits 2 In The Manual/Spontaneous Ventilation Mode

    RB CO re-breathing alarm. Low N Limit for the maximum The maximum inspiratory inspiratory N concentration concentration High Iso. Limit for the maximum inspiratory anesthesia gas concentration Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 95 / 150...

  • Page 96: Fig. 65 Alarm Limits In Manual/Spontaneous Mode

    The acoustic alarm suppression can be switched off by changing the alarm volume in the menu window. * The default setting for the Desflurane high alarm is 8 % 96 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 97: Fig. 66 Graphics Window In Manual/Spontaneous Ventilation Mode

    By pressing the "Graphics" key for the second time, the window is closed again and the selected setting is stored. *only for apparatus option with integrated gas module Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 97 / 150...

  • Page 98: Controlled Ventilation Mode

    Different bellows are not required for the ventilation of adults and children. The used tube and filter systems should be fitted to the patient. Described is only the ventilation mode CMV-Adult. Differences in the ventilation CMV-Child will be explained specifically. 98 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 99: Cmv Adult Ventilation Mode

    The ventilation modes (S)CMV and PCV are options. The appearance of this window depends on the apparatus configuration. Fig. 67 Display “ventilation mode adult” Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 99 / 150...

  • Page 100: Fig. 68 "Cmv-Settings / Adult" Display

    Setting for a sigh ventilation. Every 100 breathing cycles an inspiration with 1.5 times the volume and 1.5 times the duration is carried out, the display key shows "ON". 100 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...
  • Page 101 (20) EIN, AUS EIN, AUS Sigh (OFF) (OFF) Trigger -2, -4, -6 2, -4, -6 [cmH2O] (-2) (-2) () The values inside the brackets are the default values Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 101 / 150...

  • Page 102: Fig. 69"Start In Cmv Adult" Ventilation Mode Display

    Peak airway pressure value in cmH2O PEEP Positive end expiratory pressure in cmH2O T. Vol. Tidal volume in ml Rate Ventilation rate in 1/min M. Vol. Minute volume in l Minimum alveolar concentration 102 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 103: Fig. 70" Cmv Adult" Ventilation Mode Display

    Expiratory Agent concentration of breathing gas in % breathing gas in % Exspiratory Nitrous oxide Inspiratory Nitrous oxide concentration of breathing gas in % concentration of breathing gas in % Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 103 / 150...

  • Page 104: Parameter Settings In Cmv Adult Mode

    The parameters are set as at the start of the ventilation mode with the aid of the operating panel encoder button. Additionally you have the possibility to change the ventilation mode in this window. Fig. 71 "Parameter setting during the CMV adult" ventilation mode display 104 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 105: Alarm Limits Setting In Cmv Adult Mode

    High FiO Limit for max. FiO value in % Automatic Pmin/Pmax setting Special function to adapt the Pmin and Pmax limits automatically to the current airway peak pressure. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 105 / 150...

  • Page 106: Fig. 73 Display "Alarm Limits 2 In The Cmv Adult Ventilation Mode

    RB CO Maximum difference High N Limit for the maximum between the inspiratory inspiratory N and expiratory value of concentration Low N Limit for the maximum inspiratory N concentration 106 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 107: Fig. 74 Alarm Limits In The Cmv Adult Ventilation Mode

    0 [%] 2 [%] 0-82 [%] Fig. 74 Alarm limits in the CMV Adult ventilation mode * The default setting for the Desflurane high alarm is 8 % Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 107 / 150...

  • Page 108: Alarm Limits Setting In Cmv Child Mode

    0 [%] 1 [%] 0-82 [%] Fig. 75 Alarm limits in the CMV Child ventilation mode * The default setting for the Desflurane high alarm is 8 % 108 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 109: Ventilation Mode (S)Cmv

    The assisted ventilation therefore is nothing else than a controlled ventilation which is controlled by the patient, which determines the ventilation rate and therefore also the minute volume. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 109 / 150...

  • Page 110: Ventilation Mode (S)Cmv

    The assisted ventilation therefore is nothing else than a controlled ventilation which is controlled by the patient, which determines the ventilation rate and therefore also the minute volume. Fig. 76 Display “ventilation mode adult” 110 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 111: Fig. 77 "(S)Cmv-Settings / Adult" Display

    Trigger Trigger level of the respiratory Rate Ventilation rate in 1/min effort. Plateau A plateau for the inspiratory pressure curve expressed in % to the overall inspiration period. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 111 / 150...
  • Page 112 (20) EIN, AUS EIN, AUS Sigh (OFF) (OFF) Trigger -2, -4, -6 2, -4, -6 [cmH2O] (-2) (-2) () The values inside the brackets are the default values 112 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 113: Fig. 78 "(S)Cmv Adult" Ventilation Mode Display 1

    Peak airway pressure value in cmH2O PEEP Positive end expiratory pressure in cmH2O T. Vol. Tidal volume in ml Rate Ventilation rate in 1/min M. Vol. Minute volume in l Minimum alveolar concentration Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 113 / 150...

  • Page 114: Fig. 79 "(S)Cmv Adult" Ventilation Mode Display 2

    Expiratory Agent concentration of breathing gas in % of breathing gas in % Exspiratory Nitrous oxide Inspiratory Nitrous oxide concentration of breathing gas in concentration of breathing gas in % 114 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 115: Changing Parameter Settings In (S)Cmv Adult Mode

    The parameters are set as at the start of the ventilation mode with the aid of the operating panel encoder button. Additionally you have the possibility to change the ventilation mode in this window. Fig. 80"Parameter setting during the (S)CMV adult" ventilation mode display Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 115 / 150...

  • Page 116: Alarm Limits Setting In (S)Cmv Adult Mode

    % Limit for min. FiO value in % Automatic Pmin/Pmax setting Special function to adapt the Pmin and Pmax limits automatically to the current airway peak pressure. 116 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 117: Fig. 82 Display "Alarm Limits 2 In The (S)Cmv Adult Ventilation Mode

    RB CO Maximum difference High N Limit for the maximum between the inspiratory inspiratory N and expiratory value of concentration Low N Limit for the maximum inspiratory N concentration Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 117 / 150...

  • Page 118: Fig. 83 Alarm Limits In The (S)Cmv Child Ventilation Mode

    0 [%] 2 [%] 0-82 [%] Fig. 83 Alarm limits in the (S)CMV Child ventilation mode * The default setting for the Desflurane high alarm is 8 % 118 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 119: Alarm Limits Setting In (S)Cmv Child Mode

    0 [%] 1 [%] 0-82 [%] Fig. 84 Alarm limits in the (S)CMV Child ventilation mode * The default setting for the Desflurane high alarm is 8 % Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 119 / 150...

  • Page 120: Ventilation Mode Pcv

    The advantage is the avoiding of pressure peaks, so that it is mainly used in the pediatric, but also increasingly used to ventilate adults e.g. severe lung failure or lung leakage. 120 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 121: Pcv Adult Ventilation Mode

    The ventilation modes (S)CMV and PCV are options. The appearance of this window depends on the apparatus configuration. Fig. 85 Display “ventilation mode adult” Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 121 / 150...

  • Page 122: Fig. 86 "Pcv -Settings / Adult" Display

    Plateau The pre-set maximum l/min inspiratory pressure in cmH2O Rate Ventilation rate in 1/min Ventilation time ratio of inspiration and expiration PEEP Setting of a PEEP in cmH2O 122 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...
  • Page 123 (20) ON, OFF ON, OFF Sigh (OFF) (OFF) Trigger -2, -4, -6 2, -4, -6 [cmH2O] (-2) (-2) () The values inside the brackets are the default values Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 123 / 150...

  • Page 124: Fig. 87 "Start In Pcv Adult" Ventilation Mode Display

    PEEP Positive end expiratory pressure in Plat plateau pressure in cmH2O cmH2O T. Vol. Tidal volume in ml Rate Ventilation rate in 1/min M. Vol. Minute volume in l Minimum alveolar concentration 124 / 150 HEYER Narkomat , Operator’s manual Rev. 3.1 - 05/09...

  • Page 125: Fig. 88 "Pcv Adult" Ventilation Mode Display

    % or mmHg Expiratory oxygen concentration of breathing gas in % Expiratory Agent concentration of breathing gas in % Inspiratory Nitrous oxide concentration of breathing gas in % Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 125 / 150...

  • Page 126: Changing Graphic Settings In Pcv Adult Mode

    The parameters are set as at the start of the ventilation mode with the aid of the operating panel encoder button. Additionally you have the possibility to change the ventilation mode in this window. Fig. 89 "Parameter setting during the PCV adult" ventilation mode display Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 126 / 150...

  • Page 127: Alarm Limits Setting In Pcv Adult Mode

    % MVol. min Limit for min. minute volume in l P min Minimum pressure limit (lowest pressure limit)) in cmH2O Limit for min. FiO value in % Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 127 / 150...

  • Page 128: Fig. 91 Display "Alarm Limits 2 In The Pcv Adult Ventilation Mode

    Limit for the minimum inspiratory anesthesia gas concentration High N Limit for the maximum inspiratory N O concentration Low N Limit for the maximum inspiratory N O concentration Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 128 / 150...

  • Page 129: Fig. 92 Alarm Limits In The Pcv Adult Ventilation Mode

    0 [%] 2 [%] 0-82 [%] Fig. 92 Alarm limits in the PCV adult ventilation mode * The default setting for the Desflurane high alarm is 8 % Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 129 / 150...

  • Page 130: Alarm Limits Setting In Pcv Child Mode

    2 minutes. The muting is cancelled by pressing the key again before the expiration of the period and in the case that another alarm occurs. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 130 / 150...

  • Page 131: Dismantling And Reassembling

    Unscrew the patient dome from the bayonet fitting by turning it anti-clockwise. The dome can be pulled out from below. Now the bellows can be pulled off the connection cone. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 131 / 150...

  • Page 132: Fig. 94 Dismantling Of The Patient Module, Front View

    H E Y E R N a r k o m a t Dismantling and reassembling (continued) Fig. 94 Dismantling of the patient module, front view Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 132 / 150...

  • Page 133: Replacing The Expiratory Flow Sensor

    CAUTION: The spring in the top of the ventilation pressure valve may not be stressed. After removal from the bottom section place the top section to one side, taking care that the spring is not unduly loaded. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 133 / 150...

  • Page 134: Fig. 95 Dismantling Of The Patient Module, Top View

    H E Y E R N a r k o m a t Dismantling and reassembling (continued) Fig. 95 Dismantling of the patient module, top view Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 134 / 150...

  • Page 135: Replacing The Diaphragm Valves

    When attaching the valves to the patient module the additional membrane (7) at the expiration diaphragm valves must be inserted in the valve seat. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 135 / 150...

  • Page 136: Fig. 96 Dismantling Of The Valve Bodies

    H E Y E R N a r k o m a t Dismantling and reassembling (continued) Fig. 96 Dismantling of the valve bodies Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 136 / 150...

  • Page 137: Valves (Emergency Air, Inspiration, And Expiration Valve)

    After each exchange of a vaporizer, carry out a fresh-gas system leak test. CAUTION: To drain and fill the vaporizer remove it from the unit and place it for example on a table. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 137 / 150...

  • Page 138: Cleaning

    The upper part of the ventilation pressure valve (APL) should be dismantled before autoclaving. Please autoclave the APL upper part and the membrane as separated parts with the patient module. Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 138 / 150...

  • Page 139: Preventive Maintenance And Servicing

    HEYER is not responsible for component failure or loss resulting from the use of stated consumables beyond their recommended replacement interval. These are noted in the Preventive Maintenance Checklist on the following pages.

  • Page 140: Month Service Interval

    Check the 200 Pa x 100 (200 cmH2O; 3 PSI) pressure reducers for the solenoid valve block □ Check the electrical and pneumatic function of the solenoid valves MV1 to MV4 Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 140 / 150...

  • Page 141: Month Service Interval

    10.3 Other Servicing Other service work on the gas processing unit, fresh gas dosing etc. are carried out by the service department. Please see the HEYER NARKOMAT + service instructions for further information and a detailed description of the work.

  • Page 142: Specifications

    Standard measuring tubes: 0.05 - 1 / 1.5 - 10 l/min (Illuminated) 0.1 - 1 / 1.5 - 10 l/min AIR: 0.1 - 1 / 1.5 - 10 l/min Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 142 / 150...
  • Page 143 CMV child, CMV adult, PCV child *, PCV adult *, S(CMV) Tidal volume: 20 - 1400 ml (+/- 10%), CMV child: 20 - 400 ml, CMV adult: 300 - 1400 ml Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 143 / 150...
  • Page 144 <500 ms 150ml/min Display: 0-100% Accuracy: ± 2% or + 8% rel. reaction time: <500 ms 150ml/min Display: 0-100% Accuracy: ± 3.0% reaction time: <500 ms 150ml/min * Option Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 144 / 150...
  • Page 145 Child mode ±10% of the measured value, at least 10 ml* Flow tubes ±3% of the scale value* Rate ±1 / min* *ATPD Subject to alterations, issued May 2009 Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 145 / 150...

  • Page 146: Warranty

    6. The warranty is also void if changes, alterations or repairs are made to the device by persons not authorized to do this. 7. The warranty claim only applies to customers of HEYER MEDICAL AG; it cannot be transferred to third parties.
  • Page 147 H E Y E R N a r k o m a t Notes: Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 147 / 150...
  • Page 148 H E Y E R N a r k o m a t Rev. 3.1 – 05/09 HEYER Narkomat , Operator’s manual 148 / 150...
  • Page 150 C a r l - H e y e r - S t r . 1 / 3 D - 5 6 1 3 0 B a d E m s T e l . : + 4 9 ( 0 ) 2 6 0 3 / 7 9 1 - 3 F a x : + 4 9 ( 0 ) 2 6 0 3 / 7 0 4 2 4 E - M a i l : i n f o @ h e y e r m e d i c a l .

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