Dräger Medical Narkomed GS Operator's Instruction Manual
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Dräger Medical Narkomed GS Operator's Instruction Manual

Anesthesia system
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Operator's
Instruction
Manual
Part Number: 4113801-007
Rev: G
Date: 30 January 2004
© 2004 Draeger Medical, Inc.
Narkomed GS
Anesthesia System
WARNING: For a full understanding of the performance characteristics of this anesthesia
machine, the user should carefully read this manual before operating.

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  • Page 1 Part Number: 4113801-007 Rev: G Date: 30 January 2004 © 2004 Draeger Medical, Inc. Narkomed GS Anesthesia System WARNING: For a full understanding of the performance characteristics of this anesthesia machine, the user should carefully read this manual before operating.
  • Page 2 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...

  • Page 3: Table Of Contents

    Preuse Checkout Procedure............4-2 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 4 Problem Resolution ..............10-7 Narkomed GS Operator’s Instruction Manual...
  • Page 5 Placing the Cuff ..............15-4 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 6 Respiratory Volume Monitoring Accessories ..........A-3 INDEX Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 7 Figure 2-1 . Narkomed GS Anesthesia System, Front View ....... .
  • Page 8 Figure 15-2 . Placing the Cuff ............15-4 Narkomed GS Operator’s Instruction Manual...
  • Page 9 Figure 16-10 . Passive System Scavenger Connections ........16-25 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 10 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 11 Table 16-1 . Recommended Disinfection Methods........16-16 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 12 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 13 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Introduction This section introduces you to the Narkomed GS anesthesia machine. Operator's Responsibility for Patient Safety ....... 1-2 Limitation of Liability ............1-3 Restriction ................1-3 Copyright ................1-3 Trademark Notices .............

  • Page 14: Section 1. Introduction

    Draeger Medical, disclaims responsibility for the adequacy of the monitoring package selected for use with the anesthesia system. However, Draeger Medical is available for consultation to discuss monitoring options for different applications. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 15: Limitation Of Liability

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

  • Page 16: Disclaimer

    Agreements are available for equipment manufactured by Draeger Medical. For further information concerning these agreements, contact DrägerService at (800) 543-5047. Symbol Definition The following symbols appear on the label on the back of the Narkomed GS and are defined below. CAUTION: Refer to accompanying documents before operating equipment.

  • Page 17: Purpose Of This Manual

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Introduction These additional symbols are used on other locations of the Narkomed GS to provide quick and easy recognition of product functions: OXYGEN CONCENTRATION BREATHING PRESSURE BREATHING VOLUME...

  • Page 18: Conventions Used In This Manual

    General Warnings and Cautions The following list of warnings and cautions apply to general operation and maintenance of the Narkomed GS. Warnings and cautions about installing and operating specific parts appear with those topics. WARNING: Any person involved with the setup, operation, or maintenance of the Narkomed GS anesthesia system must be thoroughly familiar with this instruction manual.
  • Page 19 Do not attempt to pull the machine over any hoses, cords, or other obstacles on the floor. CAUTION: Although the Narkomed GS is designed to minimize the effects of ambient radio-frequency interference, machine functions may be adversely affected by the operation of electrosurgical equipment or short wave or microwave diathermy equipment in the vicinity.
  • Page 20 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 21 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS General Description This section introduces you to the Narkomed GS anesthesia machine. Overview ................2-2 Gas Delivery System ............2-2 Vaporizers ................ 2-12 Absorber ................2-13 Bain Circuit Adapters ............2-16 Scavenger Systems ............

  • Page 22: Overview

    The pneumatic system can simultaneously deliver up to four gases and one anesthetic agent (from a selection of up to three). Oxygen and nitrous oxide are standard on all Narkomed GS machines. Optional gases are air and carbon dioxide. Gas is supplied to the system through pipelines and cylinders.

  • Page 23: Section 2. General Description

    (when supply hoses are not connected) or into the attached supply hoses (when reserve cylinders are in use). Each pipeline connection is equipped with a filter to prevent foreign material from entering the internal gas piping of the Narkomed GS. Pipeline gases should be supplied at 50–55 psi. Pipeline...
  • Page 24 50–55 psi. A deviation from within this range indicates that the pipeline gas supply system is improperly adjusted and may adversely affect the operation of the Narkomed GS. A fluctuating pipeline supply pressure, for example, would cause a corresponding fluctuation of the flow of gas delivered from that pipeline.

  • Page 25: Table 2-2. Recommended Cylinder Gas Pressures

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS General Description Gas Entry Via The Narkomed GS can be equipped with a maximum of two oxygen and Cylinder two nitrous oxide cylinder hanger yokes. An additional yoke for an Yokes optional third gas is also available.
  • Page 26 NOTE: When one source of oxygen pressure (either pipeline or reserve cylinders) fails, but the other source is able to maintain proper pressure within the machine's oxygen supply lines, the oxygen supply pressure alarm is not activated. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 27 Each flowmeter has a float indicator. To determine the flow rate, read the flowmeter scale at the center of the float. Low-Flow For low-flow anesthesia, the Narkomed GS can be configured with low- Flowmeters flow, dual-tube flowmeters for oxygen and nitrous oxide. These flowmeters...
  • Page 28 WARNING: The ORC interlocks only the flows of oxygen and nitrous oxide. Hypoxic fresh gas concentrations are possible if carbon dioxide is used as an additional gas. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 29 Figure 2-3. Fresh Gas Outlet O2 FLUSH TABLETOP CONTROL FRESH GAS OUTLET FRESH HANDLE HOSE FRESH GAS LOCKING BAR RELEASE TO OP10011 (EXTENDED POSITION) LOCK Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 30 Figure 2-4. Fresh Gas Outlet (Canada) O2 FLUSH CONTROL TABLETOP HANDLE FRESH GAS LOCKING BAR FRESH GAS RELEASE TO HOSE LOCK OP10012 2-10 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 31: Figure 2-5. Fresh Gas Oxygen Sensor Adapter

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS General Description Fresh Gas The optional fresh gas adapter allows the Narkomed GS to monitor the Oxygen fresh gas oxygen concentration when using a non-rebreathing circuit Sensor (other than a Bain Circuit).

  • Page 32: Vaporizers

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS General Description Vaporizers The Narkomed GS can be equipped with up to three fixed-mount vaporizers (Vapor 19.1) or up to two removable vaporizers (Vapor 19.3) for administering liquid anesthetics. Exclusion...

  • Page 33: Absorber

    PEEP BYPASS CONTROL INSPIRATORY APL VALVE VALVE PEEP VALVE (OPTIONAL) MANUAL/ AUTOMATIC ABSORBENT SELECTOR CANISTER VALVE BREATHING FRESH GAS SYSTEM HOSE PRESSURE GAUGE DUST CUP BREATHING BAG MOUNT OP98103A CANISTER RELEASE LEVER Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 2-13...
  • Page 34 Dust Cup A removable, transparent plastic cup below the bottom assembly collects absorbent dust and excess moisture which could cause increased flow resistance in the system. 2-14 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 35 O in increments of 2 cm H Gauge WARNING: Frequent observation of the breathing system pressure gauge is mandatory to ensure adequate pressure buildup and relief, regardless of the mode of operation. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 2-15...

  • Page 36: Bain Circuit Adapters

    SENSOR 22MM M/15MM F EXPIRATION TERMINAL BREATHING PRESSURE GAUGE MANUAL/AUTOMATIC SELECTOR VALVE OXYGEN SENSOR BAIN PORT CAP CIRCUIT BAIN CIRCUIT HOSE BARB FOR FRESH GAS HOSE BREATHING FRESH GAS HOSE OP21036 2-16 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 37: Figure 2-9. Pole Mount Bain Circuit Adapter

    CIRCUIT MANUAL/AUTOMATIC SELECTOR VALVE BAIN APL VALVE CIRCUIT HOSE SET SCREW BARB FOR FRESH GAS HOSE PEEP CONTROL KNOB (OPTIONAL) MOUNTING STUD ABSORBER POLE BREATHING BAG MOUNT OP00200A FRESH GAS HOSE Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 2-17...

  • Page 38: Scavenger Systems

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS General Description Scavenger Systems The Narkomed GS can be equipped with one of two kinds of scavenger systems, permitting the best match with the hospital's waste gas disposal system. Open...

  • Page 39: Figure 2-11. Scavenger Interface For Passive Systems

    Figure 2-11. Scavenger Interface for Passive Systems SAFETY RELIEF VALVE, SHOWN CLOSED WASTE GAS WASTE GAS INPUT PORT, INPUT PORT, 19MM HOSE 19MM HOSE TERMINAL TERMINAL INPUT PORT CAP WASTE GAS EXHAUST PORT, 19MM HOSE TERMINAL OP76131 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 2-19...

  • Page 40: Av2+ Ventilator

    The pressure of the supply gas must be between 40 and 60 psi. The ventilator will not function properly if this pressure drops below 32 psi. Electrical power is supplied by the Narkomed GS's AC power source, or, in event of AC power failure, by the backup battery. A fully charged battery can power the ventilator for approximately 30 minutes.

  • Page 41: Figure 2-12. Av2+ Ventilator

    INSPIRATORY PRESSURE LIMIT TIDAL VOLUME cmH2O PUSH TO TURN PRESET TIDAL VOLUME (ml) TIDAL VOLUME 1400 CONTROL 1200 1000 PRESSURE LIMIT CONTROL BELLOWS CANISTER TIDAL VOLUME SETTING INDICATOR BREATHING CIRCUIT OP91018c CONNECTOR Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 2-21...

  • Page 42: Main Switch Panel

    INDICATOR OP20050 System The SYSTEM POWER switch on the Narkomed GS has two positions: ON Power Switch and STANDBY . In the ON position, the gas (pneumatic) and electric power circuits are actuated, and the green LED indicator adjacent to the switch illuminates.

  • Page 43: Power Supply System

    Power Supply System The Narkomed GS is equipped with a central power supply for the ventilator, alarm system, and monitoring system. When in use, the Narkomed GS must be plugged into an AC outlet.

  • Page 44: Figure 2-14. Power Supply System

    The backup battery system automatically provides power between the time that line power fails and the emergency power system is activated. The backup battery also provides power if the anesthesia machine's power cord is accidentally unplugged during a case. 2-24 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 45 The machine cannot provide monitoring or alarm functions until AC power is restored. NOTE: If the Narkomed GS's power cord is not plugged into an active AC outlet for a period of 30 days or more, the backup battery may become depleted.

  • Page 46: Sensor Interfaces

    An AUTO/BAG SELECTOR interface for the manual/automatic selector valve interface cable Figure 2-15. Sensor Interfaces REAR PANEL OF VENTILATOR BOX OP00208 UNDERNEATH VENTILATOR BOX VOLUME AUTO/BAG SELECTOR SENSOR INTERFACE INTERFACE OXYGEN BREATHING PRESSURE INTERFACE SENSOR INTERFACE 2-26 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 47: Monitoring System

    The anesthesia machine's monitoring system integrates the functions of the electronic monitors and organizes information from these monitors onto the screen, which is located on the front panel of the machine. The Narkomed GS monitors the following measurements: • oxygen concentration •...

  • Page 48: Alarm System

    Cautions - second priority alarms requiring a prompt response. Advisories - the lowest priority alarms requiring the operator’s • awareness The Narkomed GS provides both visual and audible notification of the most urgent conditions. The Narkomed GS presents messages for active alarm conditions in the Alarm Display Alarm window at the top of the monitor screen as shown in Figure 2-17.
  • Page 49 Tones for lower-priority alarm conditions are temporarily suppressed to minimize the confusion caused by simultaneous alarms. If the primary speaker on the Narkomed GS fails, a backup speaker is activated. The backup speaker has a tinny sound to distinguish it from the primary speaker.

  • Page 50: Manual Sphygmomanometer (Optional)

    RETURN TO CD-ROM TABLE OF CONTENTS General Description Manual Sphygmomanometer (optional) Noninvasive blood pressure can be measured with the manual sphygmomanometer. Several cuff sizes are available to accommodate varying patient requirements. 2-30 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 51: Section 3. Daily Checkout Procedure

    RETURN TO CD-ROM TABLE OF CONTENTS Daily Checkout Procedure This section describes the daily checkout procedure that you are to perform on the Narkomed GS anesthesia machine. Daily Checkout Procedure ..........3-2 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 52: Section 3. Daily Checkout Procedure

    RETURN TO CD-ROM TABLE OF CONTENTS Daily Checkout Procedure Daily Checkout Procedure Before operating the Narkomed GS, the following checkout procedure must be performed to make sure the machine is ready for use. This is a recommended procedure. Follow your institution's policies for specific checkout procedures.
  • Page 53 Close the cylinder valve and remove the cylinder from the yoke. Verify that there is one cylinder gasket and there are two index pins. Verify that the cylinder matches the associated yoke label. Place the cylinder back in its yoke. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 54: Table 3-1. Full And Minimum Cylinder Pressures

    12. * Vaporizer Verification System a. Check for sufficient supply of liquid anesthetic in the vaporizer(s). Verification The liquid level indicated in the vaporizer sight glass must be between the minimum and maximum markings. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 55 17. * Check the oxygen flush: Flush a. Press the oxygen flush button and listen for an audible gas flow Verification sound, accompanied by a marked increase in oxygen concentration in the breathing system. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 56 BREATHING PRESSURE interface and either the absorber quick-connect fitting or the appropriate fitting at or near the patient Y-piece. g. Make sure the oxygen sensor and flow sensor are properly installed. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 57 3 cm H Breathing 24. Perform a breathing and fresh gas delivery system pressure test. This System Leak test detects leaks from the patient breathing system and fresh gas Test delivery system. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 58 (or attach a wall suction hose onto the adapter's hose-barb fitting). Short-circuit the inspiratory valve and the expiratory hose terminal on the ultrasonic flow sensor with a 22 mm breathing hose. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 59 If the system is equipped with a PEEP valve, turn the PEEP valve control knob fully counterclockwise to its lowest setting. g. Open the oxygen flow control valve to a flow of 10 l/min and occlude the 19 mm scavenger terminal labeled EXHAUST . Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 60 Check these settings and adjust them if necessary. Alarm limits can be adjusted at the beginning of or during a procedure. Also, make sure that any external monitors (if any) are connected properly. 3-10 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 61 0 (or minimum) e. the patient suction is level adequate the breathing system is ready to use (the bag is in place and all hoses are connected properly) Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 3-11...
  • Page 62 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...

  • Page 63: Section 4. Preuse Checkout

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Preuse Checkout This section describes the daily checkout procedure that you are to perform on the Narkomed GS anesthesia machine. Preuse Checkout Procedure ..........4-2 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 64: Preuse Checkout Procedure

    Preuse Checkout Procedure Perform the following abbreviated checkout procedure when the Narkomed GS is used in successive cases. It may be performed only after the initial daily checkout procedure given in Section 3 was performed. This is a recommended procedure. Follow your institution's policies regarding specific checkout procedures.
  • Page 65 To check the APL valve's flow resistance: a. Set the manual/automatic selector valve to BAG . b. Remove the bag from the swivel arm bag mount. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 66 8. * Verify the performance of the scavenger system. System To test the open reservoir scavenger system: a. Make sure a 19 mm scavenger hose is connected between the ventilator relief valve and the scavenger interface. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 67 The absorber system's breathing pressure gauge must indicate a pressure less than 5 cm H r. After the test, adjust the scavenger needle valve to a flowmeter indication halfway between the two white lines. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 68 The pressure gauge must indicate a pressure over 30 cm H O when the bellows completes its downward travel. The pressure should not exceed 3 cm H O at the end of the expiratory phase when the bellows completes its upward travel. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 69 0 (or minimum) e. the patient suction is level adequate the breathing system is ready to use (the bag is in place and all hoses are connected properly) Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 70 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 71 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Gas Delivery System This section describes the gas delivery system of the Narkomed GS anesthesia machine. Overview ................5-2 Connecting the Pipeline Gas Supply ......... 5-2 Connecting the Gas Cylinders ........... 5-3 Connecting the Fresh Gas Hose ........

  • Page 72: Section 5. Gas Delivery System

    2. Connect the other end of the supply hose to the appropriate functioning hospital pipeline supplies. 3. Check the pipeline pressure gauge on the front of the Narkomed GS for sufficient pipeline pressure (50-55 psi). Narkomed GS Operator’s Instruction Manual...

  • Page 73: Connecting The Gas Cylinders

    WARNING: Use only one cylinder washer per yoke. Using more than one washer could cause leakage of the cylinder gas and compromise the pin indexing system. 2. Verify the presence and integrity of the two index pins below the gas inlet. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 74: Figure 5-2. Connecting The Gas Cylinders

    Tighten the handle securely. Figure 5-2. Connecting the Gas Cylinders YOKE YOKE INDEX OP20035A HANDLE ASSEMBLY PINS GAS INLET YOKE PLUG CYLINDER VALVE SEALING WASHER CYLINDER HEAD GAS CYLINDER (COLOR CODED) CYLINDER WRENCH Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 75: Connecting The Fresh Gas Hose

    To connect the fresh gas hose, pull out the fresh gas locking bar located on the front of the Narkomed GS to its extended position. Insert the 15 mm male fitting on the fresh gas hose into the 15 mm female terminal. Release the spring-loaded locking bar over the fitting, allowing it to “lock”...
  • Page 76 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 77 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Vaporizer This section describes the vaporizer of the Narkomed GS anesthesia machine. Overview ................6-2 Filling Systems ..............6-2 Exclusion Systems ............6-3 Fixed-Mount Exclusion System ......... 6-4 Removable Vaporizer Exclusion System ......

  • Page 78: Section 6. Vaporizer

    RETURN TO CD-ROM TABLE OF CONTENTS Vaporizer Overview The Narkomed GS can be equipped with up to three fixed-mount vaporizers (Vapor 19.1) or up to two removable vaporizers (Vapor 19.3). These vaporizers add an anesthetic gas to the fresh gas stream by producing a precisely metered amount of the vapor of a particular liquid anesthetic.

  • Page 79: Exclusion Systems

    OP10603 KEY INDEXED SAFETY SYSTEM OPEN FUNNEL FILLER Exclusion Systems The Narkomed GS is equipped with one of two vaporizer exclusion systems corresponding to the vaporizer model: • fixed-mount vaporizer exclusion system (for the Vapor 19.1) • removable vaporizer exclusion system (for the Vapor 19.3) The purpose of the exclusion system is to prevent more than one vaporizer from being activated at a time.

  • Page 80: Figure 6-2. Fixed-Mount Exclusion System

    This selector Exclusion lever provides an interlock function which ensures that only one vaporizer System can be turned on at a time. Figure 6-3. Removable Vaporizer Exclusion System OP00161 SELECTOR LEVER Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 81: Installing/Removing The Vapor 19.3 Vaporizer

    2. Move the locking lever 90 ° counterclockwise to the open position (over the handwheel). 3. Lift the vaporizer off the mounting block. Figure 6-4. Installing/Removing the Vapor 19.3 at the Mounting Block LOCKING LEVER VAPORIZER MOUNTING BLOCK OP00160 PORTS Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 82: Selecting A Vapor 19.3 Vaporizer

    (0.3% volume with Enflurane Vapor). This part of the handwheel actuates the on/off switch and cannot be calibrated. NOTE: After you turn on the vaporizer, activate the scavenger system to collect and remove vented gas from the operating room. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 83: Filling The Vaporizer

    The Sevoflurane vaporizer must be filled with Sevoflurane only (trade name: Ultane). Do not use a vaporizer that has been inadvertently filled with the wrong anesthetic. Drain the vaporizer and return the device to Draeger Medical's Technical Service Department. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 84: Filling The Vaporizer During A Case

    For information on draining the vaporizer, refer to “Draining Vaporizer With Open Funnel Spout” on page 6-13 later in this section. 8. Place the cap back on the bottle. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 85: Figure 6-5. Filling The Vaporizer (Open Funnel System)

    Teflon seal surface of the filler port. Bend the filler tube so that the liquid level in the bottle is below the filler port. Adjust the plastic tubing to avoid kinks. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 86 “Draining Vaporizer With Key Indexed Safety System” on page 6-13 later in this section. 14. Remove the adapter from the bottle. 15. Place the cap back on the bottle. 6-10 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 87: Figure 6-6. Filling The Vaporizer (Key Indexed Safety System)

    FILLER PORT LOCKSCREW KEYED FILLER PORT FILLER PORT PLUG KEYED BOTTLE SIGHT GLASS ADAPTER OVERFLOW LINE FULL LINE REFILL LINE DRAIN VALVE KNOB DRAIN PORT LOCKSCREW KEYED BOTTLE KEYED DRAIN PORT ADAPTER Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 6-11...

  • Page 88: Figure 6-7. Keyed Bottle Adapters

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Vaporizer Figure 6-7. Keyed Bottle Adapters HALOTHANE (RED) ENFLURANE (ORANGE) ISOFLURANE (PURPLE) SEVOFLURANE (YELLOW) OP10620 6-12 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 89: Draining The Vaporizer

    3. Insert the bottle adapter fitting into the drain port of the vaporizer. The two holes in the adapter fitting must face the Teflon seal surface in the drain port. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 6-13...
  • Page 90 6. Close the drain valve and remove the adapter from the drain port. WARNING: Do not re-use drained agent. 7. Place the cap back on the bottle and dispose of the bottle in accordance with approved hospital procedures. 6-14 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 91: Section 7. Open Reservoir Scavenger

    This section describes the open reservoir scavenger of the Narkomed GS anesthesia machine. Overview ................7-2 Connecting the Open Reservoir Scavenger System ..7-3 Operating the Open Reservoir Scavenger System .... 7-4 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 92: Overview

    Figure 7-1. Open Reservoir Scavenger LOCK NUT VACUUM DISS HOSE TERMINAL NEEDLE VALVE KNOB 19MM SCAVENGER HOSE TERMINAL THREADED INPUT PORT CAP 19MM FLOWMETER SCAVENGER HOSE TERMINAL RESERVOIR CANISTER RELIEF PORT OP75121 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 93: Connecting The Open Reservoir Scavenger System

    Open Reservoir Scavenger Connecting the Open Reservoir Scavenger System The open reservoir scavenger system is installed on the Narkomed GS before shipping. The only thing you need to do before operating the scavenger is to make the hose connections. Refer to Figure 7-2 on page 7-4.

  • Page 94: Operating The Open Reservoir Scavenger System

    If the disposal system's flow rate (suction) exceeds the waste gas flow rate from the patient breathing system, the disposal system draws room air through the relief ports. Thus, the disposal system does not apply a negative pressure to the patient breathing system. Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 95 You may have to readjust the needle valve setting during a case. For example, a shared suction disposal system may provide a varying suction flow rate, depending on the number of users at any given time. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 96 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...

  • Page 97: Section 8. Scavenger Interface For Passive Systems

    RETURN TO CD-ROM TABLE OF CONTENTS Scavenger Interface for Passive Systems This section describes the scavenger interface for passive systems of the Narkomed GS anesthesia machine. Overview .................. 8-2 Operating the Scavenger Interface for Passive Systems ..8-3 Draeger Medical, Inc.

  • Page 98: Overview

    Figure 8-1. Scavenger Interface for Passive Systems SAFETY RELIEF VALVE, SHOWN CLOSED WASTE GAS WASTE GAS INPUT PORT, INPUT PORT, 19MM HOSE 19MM HOSE TERMINAL TERMINAL INPUT PORT CAP WASTE GAS EXHAUST PORT, 19MM HOSE TERMINAL OP76131 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 99: Operating The Scavenger Interface For Passive Systems

    Figure 8-2. Scavenger Interface for Passive Systems Hose Connections VENTILATOR APL VALVE RELIEF VALVE 19MM SCAVENGER HOSE TERMINAL 19MM SCAVENGER HOSE ABSORBER POLE SCAVENGER INTERFACE FOR NON-ACTIVE SYSTEMS 19MM SCAVENGER TO HOSPITAL HOSE OP00170B EXHAUST SYSTEM Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 100 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...

  • Page 101: Section 9. Main Switch Panel

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Main Switch Panel This section describes the main switch panel of the Narkomed GS anesthesia machine. Overview ................9-2 System Power Switch ............9-3 Testing the Battery ............. 9-3 Draeger Medical, Inc.

  • Page 102: Overview

    Figure 9-1. Main Switch Panel RED O2 SUPPLY PRESSURE LOW INDICATOR BATTERY TEST PUSH BUTTON YELLOW AC POWER LOW INDICATOR SYSTEM POWER YELLOW SWITCH BATTERY LOW INDICATOR GREEN BATTERY TEST INDICATOR OP20050 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 103: System Power Switch

    Main Switch Panel System Power Switch The SYSTEM POWER switch on the Narkomed GS has two positions: ON and STANDBY . In the ON position the gas (pneumatic) and electric power circuits are activated and the green LED indicator adjacent to the switch is illuminated.
  • Page 104 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 105 Setting the Respiratory Frequency ........10-5 Setting the Inspiratory/Expiratory (I:E) Phase Time Ratio 10-6 Setting the Inspiratory Flow Rate ........10-6 Setting the Inspiratory Pressure Limit ......10-6 Problem Resolution ............10-7 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 106: Section 10. Av2+ Anesthesia Ventilator

    The pressure of the supply gas must be between 40 and 60 psi. The ventilator will not function if this pressure drops below 32 psi. Electrical power is supplied by the Narkomed GS's AC power source, or, in event of AC power failure, by the backup battery. A fully charged battery can power the ventilator for approximately 20 minutes.

  • Page 107: Activating The Ventilator

    AUTO/BAG SELECTOR interface, as shown in Figure 10-2. When the interface cable is disconnected, the position of the selector lever has no effect on the ventilator. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 10-3...

  • Page 108: Figure 10-2. Auto/Bag Selector Interface Cable Connection

    • To shut down the ventilator, turn the switch counterclockwise; the green ON indicator is then turned off and the switch returns to its center position. 10-4 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 109: Adjusting The Tidal Volume

    Use the frequency control knob to set the respiratory frequency from 1 to 99 breaths per minute (BPM) in 1 BPM increments. Clockwise rotation of the control knob increases the frequency setting, while counterclockwise rotation decreases the frequency setting. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 10-5...

  • Page 110: Setting The Inspiratory/Expiratory (I:e) Phase Time Ratio

    15 cm H O. When the control is turned fully clockwise, the peak inspiratory pressure will be less than or equal to 120 cm H 10-6 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 111: Problem Resolution

    Ventilator does not Selector switch on the Turn the selector switch operate; yellow FAULT absorber is in the BAG on the absorber to the LED on ventilator lights position AUTO position Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 10-7...
  • Page 112 BAG position Inspiratory flow control Increase inspiratory flow setting on ventilator too control setting. Frequency too high Decrease frequency. Inspiratory pressure limit Increase inspiratory setting on ventilator too pressure limit setting. 10-8 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 113 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Monitoring System This section describes the monitoring system of the Narkomed GS anesthesia machine. Overview ................11-2 Power-On Screen ............11-2 Monitor Screen and Controls ........... 11-3 Configuring the Anesthesia Machine .......

  • Page 114: Section 11. Monitoring System

    RETURN TO CD-ROM TABLE OF CONTENTS Monitoring System Overview In addition to monitoring clinical parameters, the Narkomed GS performs diagnostic self-tests every time the machine is turned on. After the initial power-on screen appears, the Monitor screen is displayed. This section of the manual describes these screens, and explains how to establish general monitoring settings.

  • Page 115: Monitor Screen And Controls

    Breathing Volume (Liters) PORT A ERROR TID VOL MIN VOL 0.35 Limit Breathing Pressure (cm H O) Alarms High PEAK Limit Stby MEAN Auto PEEP LEFT MONITOR RIGHT KEYPAD SCREEN KEYPAD Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 11-3...

  • Page 116: Figure 11-3. Monitor Screen

    (PEEP). • Breathing Pressure Trace Window— Displays a trace, or waveform, of the patient's breathing pressure, and the anesthesia machine's breathing pressure alarm limits (to the left of the waveform). 11-4 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 117: Figure 11-4. Left Keypad

    You also enter the Alarm Log by way of the Configure screen. These functions are described in detail later in this section. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 11-5...

  • Page 118: Figure 11-5. Right Keypad

    12, ”Oxygen Monitoring” , Section 13, ”Respiratory Volume Monitoring”, and Section 14, ”Breathing Pressure Monitoring”. Figure 11-5. Right Keypad Oxygen (%) High Limit Limit Breathing Volume (Liters) Limit Breathing Pressure (cm H O) High Limit Auto OP87008 11-6 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 119: Configuring The Anesthesia Machine

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Monitoring System Configuring the Anesthesia Machine You can configure the following parameters on the Narkomed GS: • Trace Speed— Speed of the breathing pressure waveform trace: either FAST or SLOW •...

  • Page 120: Table 11-1. Control Key Functions In The Configure Screen

    Displaying the Follow this procedure to display the Alarm Log. Alarm Log 1. From the Monitor screen, press the Config key. Config The Configure screen is displayed. 11-8 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 121 NOTE: The monitoring system automatically exits the Alarm Log if a minute passes and no keys are pressed. When you exit the Alarm Log, you are returned to the Monitor screen. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 11-9...

  • Page 122: Setting Alarms To Standby

    NOTE: All continuous audible alarms are automatically silenced for 2 minutes following power-up. During this period, the occurrence of a new alarm produces a non-repeating tone pattern appropriate for that alarm's level of urgency. 11-10 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 123 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Oxygen Monitoring This section describes the oxygen monitoring of the Narkomed GS anesthesia machine. Overview ................12-2 Monitor Display ..............12-2 Monitor Controls .............. 12-3 Setting Alarm Limits ............12-3 Calibrating the Oxygen Sensor ........

  • Page 124: Section 12. Oxygen Monitoring

    AC / BATTERY FAIL O2 SUPPLY LOW HIGH OXYGEN ADVISORY: SERVICE VENT MON PORT A ERROR CONCENTRATION TID VOL MIN VOL ALARM LIMIT 0.35 LOW OXYGEN PEAK CONCENTRATION ALARM LIMIT MEAN PEEP 12-2 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 125: Monitor Controls

    Valid settings for the alarm limits, and their system defaults, are shown in Table 12-1. Limit Table 12-1. Alarm Limits Alarm Limit Default Valid Settings High 100% 19%–100%; must be greater than low alarm limit 18%–99%; must be less than high alarm limit Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 12-3...

  • Page 126: Calibrating The Oxygen Sensor

    Typically, calibration lasts less than 30 seconds. However, the time may vary depending on the amount of oxygen the sensor was exposed to before calibration. Oxygen Exposure Typical Calibration Time 10 seconds > 21% up to 50 seconds 12-4 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 127: Figure 12-3. Calibrating The Oxygen Sensor

    EXPIRATORY VALVE DOME INSPIRATORY VALVE DOME INSPIRATORY VALVE DOME PLUG OP00202A 5. When the Narkomed GS successfully completes the calibration, pull the inspiratory valve dome plug and reinsert the sensor assembly. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 12-5...

  • Page 128: Unsuccessful Calibration

    DISC appears in the Alarm window. If this happens, reconnect the sensor cord to the OXYGEN SENSOR interface beneath the rear panel of the ventilator box and try to calibrate the oxygen sensor again. 12-6 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 129: Figure 12-4. Measurement Error Due To Incorrect Calibration

    When a calibration gas mixture is excessively rich or lean in oxygen, the Narkomed GS will not complete an attempted calibration; however, if the calibration gas is rich or lean but is within certain limits, the Narkomed GS will complete the calibration. As a result, when displaying sensor measurements, the Narkomed GS displays an oxygen percentage either greater or less than the actual oxygen percentage.

  • Page 130: Oxygen Alarm Messages

    Advisory message REPLACE O2 CELL appears in the Alarm window. During oxygen sensor calibration, the Narkomed GS also checks the sensor's output against a range of acceptable output voltages. There are three possible causes for deviation from within this range.

  • Page 131: Low Oxygen Supply Whistle

    Low Oxygen Supply Whistle If the Narkomed GS is configured to do so, it sounds a 7-second whistle when the oxygen supply drops too low to properly pressurize the fresh gas circuit (below about 37 psi). If this alarm sounds, it cannot be silenced.
  • Page 132 Defective sensor housing Replace housing/cable message appears in and cable. assembly. alarm window during Sensor cord is Insert sensor cord monitoring. disconnected. connector into OXYGEN SENSOR interface underneath rear panel of ventilator box. 12-10 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 133 Setting the Minute Volume Low Alarm Limit ....13-5 Turning Respiratory Volume Alarms Off ......13-5 Turning Respiratory Volume Alarms On ......13-5 Respiratory Volume Alarm Messages ......13-6 Problem Resolution ............13-8 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 134: Section 13. Respiratory Volume Monitoring

    (ULTRASONIC CONNECTOR HOSE FLOW SENSOR) OP00225 WARNING: The ultrasonic flow sensor can be used with all normal anesthetic gases except oxygen-helium (heliox). Incorrect flow measurements will result if heliox is used. 13-2 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 135: Monitor Display

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Respiratory Volume Monitoring CAUTION: Although the Narkomed GS is designed to minimize the effects of ambient radio-frequency interference, the functioning of the respiratory volume monitor may be...

  • Page 136: Monitor Controls

    While the ventilator is off, these alarms are generated at 30 seconds (Caution) and 60 seconds (Warning). The Narkomed GS's volume alarms are automatically enabled when the ventilator power switch is turned to the ON position. A disconnected or damaged sensor causes a sensor failure alarm.

  • Page 137: Setting The Minute Volume Low Alarm Limit

    To turn on the respiratory volume alarms, press the Breathing Volume On key. The LED next to the Breathing Volume On key lights to indicate that the volume alarms are enabled. NOTE: After power-up, the volume alarms are in standby. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 13-5...

  • Page 138: Respiratory Volume Alarm Messages

    MINUTE Whenever the Narkomed GS measures a minute volume less than the low VOLUME minute volume alarm limit, the Caution message MINUTE VOLUME LOW appears in the Alarm window, and an intermittent audible alarm sounds.
  • Page 139 When the volume alarms have been set to Standby, the Advisory message STBY VOL ALARMS STBY appears in the Alarm window. (Advisory) If the Narkomed GS detects an internal electronic failure that would SERVICE VENT MON prevent proper operation, the Advisory message SERVICE VENT MON (Advisory) appears in the Alarm window.

  • Page 140: Problem Resolution

    REVERSE FLOW Expiratory valve not Check expiratory valve alarm message in closing completely during disc and pins. Clean, Alarm window inspiration repair, or replace expiratory valve. Defective sensor Replace sensor assembly. 13-8 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 141 Setting the Threshold Pressure Alarm Limit ....14-11 Turning the Apnea Pressure Alarm Off ......14-14 Turning the Apnea Pressure Alarm On ......14-14 Breathing Pressure Alarm Messages ......14-14 Problem Resolution ............14-16 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 142: Overview

    Draeger Medical pressure monitors are therefore not promoted for detection of blocked breathing paths. 14-2 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 143 Draeger Medical has no control, must be included in this decision. Draeger Medical is available to discuss with you in detail the positive and negative aspects of each pressure monitoring approach. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 14-3...

  • Page 144: Installing The Breathing Pressure Pilot Line

    Figure 14-1. Absorber Monitoring REAR PANEL OF VENTILATOR BOX VOLUME OXYGEN BREATHING AUTO/BAG SENSOR SENSOR PRESSURE SELECTOR QUICK-CONNECT FITTINGS SHORT PILOT LINE OP00204A ABSORBER TOP ASSEMBLY 14-4 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 145: Figure 14-2. Y-Piece Monitoring

    Y-piece. Figure 14-2. Y-piece Monitoring MALE LUER-LOCK FITTING LONG PLASTIC PILOT LINE HOSE CLIPS VOLUME OXYGEN BREATHING AUTO/BAG SENSOR SENSOR PRESSURE SELECTOR QUICK-CONNECT FITTING REAR PANEL OF OP00205A VENTILATOR BOX Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 14-5...

  • Page 146: Monitor Displays

    To the left of the waveform, in small type, are the pressure high and threshold pressure alarm limits. • Breathing Pressure Monitor Window— This small window on the right contains numerical breathing pressure measurements. 14-6 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 147: Figure 14-4. Breathing Pressure Monitor Window

    10 cm H greater than PEEP pressure. When this pressure difference drops below 10 cm H O, the numeric information remains 1 minute longer and then disappears. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 14-7...

  • Page 148: Figure 14-5. Breathing Pressure Trace Window

    (PEEP). • The length of the plateau from peak pressure to the decrease in pressure corresponding to expiration is equivalent to the length of the inspiratory pause (if present). 14-8 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 149: Figure 14-6. Breathing Pressure Trace Window With Examples Of High Alarm Limit Markers

    Figure 14-6. Breathing Pressure Trace Window with Examples of High Alarm Limit Markers HORIZONTAL MARKER STEP-LIKE MARKER PRESSURE HIGH ALARM PRESSURE HIGH ALARM LIMIT < TOP OF SCALE LIMIT = TOP OF SCALE SCALE = 0-50 cm H OP87020 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 14-9...

  • Page 150: Monitor Controls

    The new value is saved and displayed as the pressure high alarm limit. If the alarm limit is on or below the upper limit of the scale, a marker appears next to the alarm limit. 14-10 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 151: Setting The Threshold Pressure Alarm Limit

    The threshold pressure limit is automatically set 4 cm H O below the current peak pressure measurement, to a minimum of 5 cm H O and a maximum of 30 cm H Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 14-11...
  • Page 152 O. (If the threshold is set lower than 15 cm H O when the ventilator is turned off, the threshold retains its setting.) When the ventilator is turned back on, the threshold is restored to its previous set value. 14-12 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 153: Figure 14-8. Sample Threshold Limit Settings

    > 6 cm disconnection or leak, small pressure H2O below peak pressure. fluctuation in system satisfies incorrectly set threshold pressure alarm limit. Operator is not alerted of apnea condition. PEAK MEAN PEEP OP87018 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 14-13...

  • Page 154: Turning The Apnea Pressure Alarm Off

    O for more than 60 seconds, the numeric data is cleared. When the ventilator is off: The Caution condition does not occur until 30 seconds have elapsed; the Warning condition does not occur until 60 seconds have elapsed. 14-14 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 155 APNEA-P Any time that the apnea pressure alarm (threshold pressure alarm limit) ALM STBY has been set to Standby, the Advisory message APNEA-P ALM STBY (Advisory) appears in the Alarm window. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 14-15...

  • Page 156: Problem Resolution

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Breathing Pressure Monitoring SERVICE If the Narkomed GS detects an internal electronic failure that would VENT MON prevent proper operation, the Advisory message SERVICE VENT MON (Advisory) appears in the Alarm window.
  • Page 157 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Manual Sphygmomanometer This section describes the sphygmomanometer of the Narkomed GS anesthesia machine. Overview ................15-2 Selecting a Blood Pressure Cuff ........15-3 Connecting the Cuff ............15-3 Placing the Cuff ...............

  • Page 158: Section 15. Manual Sphygmomanometer

    FOR GAUGE AND CUFF BP CUFF SPHYGMOMANOMETER GAUGE INTERNAL PIPING CONNECTS BULB FITTING FEMALE LUER FITTING TO GAUGE AND CUFF FITTING (SLIP-FIT) FOR CUFF INFLATION BULB FLUSH HANDLE FRONT OF FRAME 15-2 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 159: Selecting A Blood Pressure Cuff

    After connecting the manual sphygmomanometer, check the gauge's pressure indication. With zero pressure applied to the gauge and cuff, the gauge pointer should remain within the band marked on the face plate. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 15-3...

  • Page 160: Placing The Cuff

    Can be used on either right or left arm. CENTER OF INFLATION BAG MARKS (BOTH SIDES) CENTER OF INFLATION BAG OP30005 POSITIONED PROPERLY OVER BRACHIAL ARTERY 15-4 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 161 RETURN TO CD-ROM TABLE OF CONTENTS Routine Maintenance and Cleaning This section describes the routine cleaning and maintenance required for the Narkomed GS anesthesia machine. Overview ................16-2 Routine Maintenance ............16-2 Scavenger Interface for Passive Systems Maintenance .. 16-8 Removing Parts for Cleaning and Disinfection ....

  • Page 162: Overview

    2. Remove the canisters from the absorber system. 3. Empty the contents of the canisters into an appropriate refuse container. 4. Check the canisters to make sure they are not chipped or cracked. 16-2 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 163: Figure 16-1. Replacing The Absorbent

    6. Stack one canister on top of the other and center the stack on the gasket of the bottom dome. 7. Raise the bottom dome, remove and empty the dust cup if loose absorbent is present, and replace the dust cup. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-3...

  • Page 164: Figure 16-2. Replacing The Oxygen Sensor

    SENSOR HOUSING OP00206 REAR PANEL OF VENTILATOR BOX SENSOR CAPSULE SENSOR VOLUME OXYGEN BREATHING AUTO/BAG HOUSING COVER SENSOR SENSOR PRESSURE SELECTOR INSPIRATORY VALVE DOME INSPIRATORY VALVE DOME PLUG SENSOR CORD CONNECTOR 16-4 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 165: Figure 16-3. Clearing Condensation In The Ultrasonic Flow Sensor

    6. Tip and shake the flow housing to release fluid trapped in the housing. 7. Make sure that all large droplets are cleared from the transducer ports. 8. Pat the transducers dry with a soft, lint-free cloth. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-5...
  • Page 166 12. Connect the patient hose to the expiratory hose terminal on the flow sensor. 13. Install the connector hose assembly between the flow sensor and the expiratory valve, and secure it by turning the ring nut clockwise. 16-6 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 167: Figure 16-4. Open Reservoir Scavenger Maintenance

    Inspect the needle valve and seat for lint or dust accumulation. Clean with compressed air, if necessary. Figure 16-4. Open Reservoir Scavenger Maintenance BLOCK VACUUM SOURCE TERMINAL ADAPTER NEEDLE VALVE ASSEMBLY INPUT PORT CAP FLOWMETER OP00146 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-7...

  • Page 168: Scavenger Interface For Passive Systems Maintenance

    O-ring is properly seated. 9. Perform the scavenger interface for passive systems portion of the daily checkout procedure provided in Section 3, ”Daily Checkout Procedure”. 16-8 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 169: Figure 16-5. Scavenger Interface For Passive Systems Maintenance

    (cold cycle), followed by appropriate aeration according to the sterilizer manufacturer's instructions. NOTE: Do not autoclave the gauge assembly; it cannot withstand the heat of autoclaving. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-9...

  • Page 170: Removing Parts For Cleaning And Disinfection

    When removing the absorbent, take care not to spill its caustic contents. 11. Remove the inspiratory and expiratory valves by turning their ring nuts counterclockwise until the valves are free of the system. 16-10 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 171: Figure 16-6. Removing The Pressure Gauge

    13. Remove the absorber using a 3/16-inch hex screwdriver to loosen the hex screw securing the absorber assembly to the absorber pole. Do not remove the screw. Lift the absorber off the absorber pole. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-11...

  • Page 172: Figure 16-7. Removing The Bellows Assembly

    See Figure 16-7. Figure 16-7. Removing the Bellows Assembly OP00260A BELLOWS CANISTER BELLOWS PILOT LINE RELIEF VALVE BODY WINGNUT (2X) 16-12 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 173: Disassembling Parts For Cleaning And Disinfection

    1. Unscrew and remove the ring nut around the plastic valve dome. bling the 2. Separate the plastic dome, dome gasket, and valve disk from the valve Inspiratory body. See Figure 16-8. Expiratory Valves Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-13...

  • Page 174: Figure 16-8. Disassembling The Inspiratory And Expiratory Valves

    INSPIRATORY VALVE DOME EXPIRATORY VALVE DOME DOME GASKET VALVE DISK VALVE PINS EXPIRATORY VALVE BODY CAPTIVE RING NUT INSPIRATORY VALVE BODY VALVE MOUNT GASKET EXPIRATORY VALVE MOUNT INSPIRATORY VALVE MOUNT OP00642 16-14 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 175: General Guidelines For Cleaning And Disinfection

    Routine Maintenance and Cleaning General Guidelines for Cleaning and Disinfection The frequency, level, and need for disinfection of the Narkomed GS is determined by the user facility based on the conditions of use and hospital infection control policy. Draeger Medical recommends using disposable patient breathing circuits that can be replaced after single use.

  • Page 176: Figure 2-7 . Absorber

    D Wet pasteurization at 70° C for 30 minutes after detergent cleaning E Sodium hypochlorite (5.2% household bleach) 1:500 dilution (100 ppm free chlorine) F Ethyl or isopropyl alcohol (70% to 90%) 16-16 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 177 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Routine Maintenance and Cleaning CAUTION: To avoid damaging the Narkomed GS: • Do not use Betadine®, Povodine®, Sagrotan®, Mucocit®, acetone, ketone, xylene, or anesthetic agents for cleaning.
  • Page 178 Allow the assembly to drip dry. Ventilator After cleaning, use an EtO process for disinfection. Follow manufacturer's Bellows guidelines. Bottom Assembly 16-18 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 179 121 ° C. Follow the manufacturer's instructions for the process. Flow Sensor Allow the transducers to normalize for 30 minutes under room ambient Housing and Transducers conditions before using them. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-19...
  • Page 180 Turn the APL valve control knob fully counterclockwise before cleaning or Cleaning and Disinfecting disinfecting the absorber system. the Absorber After cleaning, an EtO procedure can be used. Follow manufacturer's Assembly guidelines. CAUTION: Do not autoclave the absorber assembly. 16-20 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 181 Refer back to the cleaning instructions provided in “Open Reservoir Reservoir Scavenger Maintenance” on page 16-7. Scavenger CAUTION: Do not autoclave the open reservoir scavenger. The scavenger's flowmeter cannot withstand the heat of autoclaving. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-21...

  • Page 182: Reassembly Instructions

    6. Reassemble the inspiratory and expiratory valves. Place the valve disk and dome gasket in the valve body, then replace the dome and ring nut. Turn the ring nut clockwise to tighten. 16-22 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 183 19. Turn the SYSTEM POWER switch to ON . 20. Perform the daily checkout procedure provided in this manual before operating the machine. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-23...

  • Page 184: Figure 16-9. Open Reservoir Scavenger Connections

    Figure 16-9. Open Reservoir Scavenger Connections VENTILATOR APL VALVE RELIEF VALVE 19MM SCAVENGER HOSE TERMINAL ABSORBER POLE OP00143C 19MM SCAVENGER HOSE VACUUM TERMINAL 19MM SCAVENGER HOSE 19MM SCAVENGER OPEN RESERVOIR HOSE TERMINAL SCAVENGER 16-24 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 185: Figure 16-10. Passive System Scavenger Connections

    Figure 16-10. Passive System Scavenger Connections VENTILATOR APL VALVE RELIEF VALVE 19MM SCAVENGER HOSE TERMINAL 19MM SCAVENGER HOSE ABSORBER POLE SCAVENGER INTERFACE 19MM SCAVENGER FOR NON-ACTIVE SYSTEMS HOSE TO HOSPITAL OP00141B EXHAUST SYSTEM Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 16-25...
  • Page 186 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 187 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Specifications This section describes the specifications of the Narkomed GS anesthesia machine. General ................17-2 Environmental ..............17-2 Gas Delivery System ............17-3 Vaporizers (Vapor 19.1 and 19.3) ........17-4 Ventilator ................

  • Page 188: General

    Reserve power time (from full charge) ......≥ 30 min 17-2 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 189: Gas Delivery System

    ± 15% of reading @ <1 l/min Oxygen (Auxiliary Oxygen) ..... . .1–10 l/min ±5% FS Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 17-3...

  • Page 190: Vaporizers (Vapor 19.1 And 19.3)

    Tidal volume ....... . . 20–1500 ml, ±100 ml Pressure limit control adjustment range....15–120 cm H 17-4 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.

  • Page 191: Absorber System

    Sensor service life ....... . . ≥ 8 months at 25 ° C, 50% relative humidity, 50% O gas mixture (or ≥ 5000% hour CO Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual 17-5...

  • Page 192: Breathing Pressure Monitoring

    Protocols ..........Vitalink 17-6 Narkomed GS Operator’s Instruction Manual Draeger Medical, Inc.
  • Page 193 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Appendix - Spare and Replacement Parts This section describes the spare and replacement parts for the Narkomed GS anesthesia machine along with their part numbers. Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...

  • Page 194: Appendix - Spare And Replacement Parts

    Narkomed GS Operator's Instruction Manual ....4113853 Narkomed GS Technical Service Manual ....4112817-010 Absorber System Gasket - Canister Top .

  • Page 195: Vaporizers (19.1

    O-ring Set ..........4115147 Draeger Medical, Inc. Narkomed GS Operator’s Instruction Manual...
  • Page 196 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...

  • Page 197: Index

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Index Absorbent replacement .............16-2 Absorber system .
  • Page 198 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS power failure ..............2-25 respiratory volume .
  • Page 199 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS monitoring ............. . . 11-5, 11-6 oxygen alarms .
  • Page 200 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS supply ............... .2-23 switch .
  • Page 201 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Ultrasonic flow sensor description ..............13-2 maintenance .
  • Page 202 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 203 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 204 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Draeger Medical, Inc. 3135 Quarry Road Telford, PA 18969 Tel: (215) 721-5404 (800) 462-7566 Fax: (215) 721-9561 Web: www.draegermedical.com Printed in the U.S.A.

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