Dräger Medical Narkomed 6400 Operator's Manual
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Dräger Medical Narkomed 6400 Operator's Manual

Anesthesia system
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Operator's
Instruction
Manual
Part Number: 4117965-001
Rev: A
Date: 7 February 2003
© 2003 Draeger Medical, Inc.
Narkomed 6400
Anesthesia System

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  • Page 1 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Operator’s Instruction Manual Part Number: 4117965-001 Rev: A Date: 7 February 2003 © 2003 Draeger Medical, Inc. Narkomed 6400 Anesthesia System...
  • Page 2 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...

  • Page 3: Table Of Contents

    Narkomed 6400 Overview ........
  • Page 4 Use of Suction with the Narkomed 6400 ........
  • Page 5 Powering Down the Narkomed 6400 for Cleaning ........
  • Page 6 Flow Sensor Failure............. . . A-1-17 Appendix 2: User-Replaceable Parts Appendix 3: Optional Accessory Mounting Systems Appendix 4: Divan Ventilator Self-Test Flow Chart Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 7 This section describes the operator’s responsibility for patient safety, limit of liability, and general warnings and cautions relating to the Narkomed 6400 with Divan ventilator. Abbreviations and terms used throughout the manual are also described. Operator's Responsibility for Patient Safety ..... 1-2 Limitation of Liability ............

  • Page 8: Section 1. Introduction

    Draeger Medical’s limited warranty, whether based upon breach of warranty or any other cause of action whatsoever, regardless of any fault attributable to Draeger Medical and regardless of the form of Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 9: Restriction

    In the interest of patient safety, Draeger Medical strongly advocates the use of an oxygen analyzer, pressure monitor, and either a volume monitor or an end-tidal CO monitor in the breathing circuit at all times. Narkomed 6400 Operator’s Manual Rev: A Part Number: 4117965-001...

  • Page 10: Purpose Of This Manual

    To make this document more convenient for future reference, it has been divided into several independent sections. Each section contains either general information about the Narkomed 6400 or instructions on how to use it. Introduction provides restriction and liability statements, discusses organization of the manual, and provides system warnings and cautions.

  • Page 11: Conventions Used In This Manual

    General Warnings The following warnings apply to general operation and maintenance of the Narkomed 6400 anesthesia machine, equipped with the Divan Ventilator and Narkomed Ultrasonic Flow Sensor. Warnings specific to subsystems appear in later sections. Narkomed 6400 Operator’s Manual...
  • Page 12 Warning: Do not apply unregulated suction to the patient circuit when using this device. Warning: The Narkomed 6400 anesthesia system must be serviced only by an authorized representative of DrägerService. Warning: A test for leakage current must be performed by qualified biomedical engineering personnel before use if the Narkomed 6400 is interfaced with other equipment.
  • Page 13 Warning: If fluids are accidentally spilled on the equipment, take the Narkomed 6400 out of service. Turn the power switch to STANDBY and unplug the main power cord from the AC outlet.

  • Page 14: Symbols And Abbreviations

    Manual/Spont. manual ventilation or spontaneous breathing minimum alveolar concentration nitrous oxide oxygen OFPD oxygen failure protection device ON/OFF switched on, activated/switched off, de-activated oxygen ratio controller Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 15: Equipment Symbols

    SIMV Mode ratio of inspiration time to expiration time Volume, Pressure, Oxygen tidal volume Equipment Symbols These symbols appear on the label on the back of the Narkomed 6400: CAUTION: Refer to accompanying documents before operating equipment. ATTENTION: Consulter les documents ci-joints avant de faire fonctionner l’appareil.

  • Page 16: Glossary

    Example: [Alarm Control] or [Set GAP Delay Period] operator has touched [Monitor Standby] control button on Monitor Standby monitor touch screen. The monitor standby screen replaces the main screen on the monitor. Narkomed 6400 Operator’s Manual 1-10 Part Number: 4117965-001 Rev: A...
  • Page 17 STANDBY position for Narkomed Standby 6400 system power switch. operator has pressed control button [Standby] on Divan Ventilator ventilator control panel; VENT STANDBY appears as an Standby advisory on the monitor. Narkomed 6400 Operator’s Manual 1-11 Rev: A Part Number: 4117965-001...
  • Page 18 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 19 Narkomed 6400 Overview ..........2-2 Gas Delivery System ............2-4 Pipeline Gas Supply to the Narkomed 6400 ....... 2-5 Cylinder Gas Supply ............2-5 Flowmeter Bank ..............2-6 Electronic Fresh Gas Measurement ........2-7 Fresh Gas Outlet ..............

  • Page 20: Narkomed 6400 Overview

    Connections and Switch ..........2-52 Patient Suction System (CUSTOMER OPTION) ..... 2-53 Narkomed 6400 Overview The Narkomed 6400 anesthesia workstation consolidates a number of functions formerly executed by several pieces of equipment. As a stand- alone anesthesia workstation, it directs many tasks automatically, including: •...
  • Page 21 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS System Description Although the Narkomed 6400 is completely integrated to perform these anesthesia delivery and monitoring tasks, it is also capable of being upgraded. Desired enhancements may include additional monitoring equipment.

  • Page 22: Gas Delivery System

    (CUSTOMER OPTION). A brief description of the capabilities of each system component follows. Please see Sections 7 and 8 of this manual for details on Narkomed 6400 operation. The Narkomed 6400 incorporates three interfaces: a gas delivery interface...

  • Page 23: Cylinder Gas Supply

    PIPELINE CONNECTION Figure 2-2. Gas Delivery System Connections Pipeline Gas The Narkomed 6400 features a controlled gas hookup that reduces the risk Supply to the of delivering the wrong gas to a patient. Pipeline gas inlets are indexed for Narkomed...

  • Page 24: Flowmeter Bank

    (L/min). Flowmeter scales are backlighted for ease of observation. A float indicator shows the flow rate of each gas in the fresh gas mixture as delivered to the Narkomed 6400. The flowmeters are labeled and color-coded for gas identification.

  • Page 25: Electronic Fresh Gas Measurement

    Measurement oxygen, and nitrous oxide on the Narkomed 6400 monitor screen. It also has the capability to export the data via Vitalink to an information management system. See “Fresh Gas Information” on page 3-45 of this manual for more information.

  • Page 26: Fresh Gas Outlet

    It is located below the ventilator on the left front of the machine. The quick connect fitting used is unique to the Narkomed 6400 and cannot be replaced by a hose from any other make or model of anesthesia machine.

  • Page 27: Oxygen Gas Supply Special Features

    A manually operated, self-closing, oxygen flush valve is located on the front Flush left corner of the Narkomed 6400. A bezel is mounted around the pushbutton to prevent accidental engagement. When actuated, the valve delivers an unmetered oxygen flow of about 55 L/min directly to the fresh gas common outlet.

  • Page 28: Oxygen Supply Pressure Failure Protection Device

    OFPD and oxygen supply low alarm are not activated. Minimum The Narkomed 6400 has an oxygen dispensing system with a calibrated Oxygen Flow bypass flow of 150 ±50 mL/min at 50 psi pipeline pressure. This volume of oxygen is delivered even if the oxygen flow control valve should become fully closed.

  • Page 29: Vaporizer Mounts And Interlock Systems

    System Description Vaporizer Mounts and Interlock Systems The Narkomed 6400 provides mounts and an interlock system for either two vaporizers (standard) or three vaporizers (customer option). With either configuration, a mounting rack for a spare vaporizer is provided on the back of the machine as shown in Figure 2-7.
  • Page 30 LEFT-HAND RIGHT-HAND VAPORIZER VAPORIZER POSITION POSITION WARNING LABEL OP00643 Figure 2-8. Location of Desflurane Warning Label Narkomed 6400 Operator’s Manual 2-12 Part Number: 4117965-001 Rev: A...
  • Page 31 To enable the third (top) Option) vaporizer, move the selector lever completely up; this locks out the two bottom vaporizers. VAPORIZER INTERLOCK Figure 2-9. Three Vaporizer Interlock System Narkomed 6400 Operator’s Manual 2-13 Part Number: 4117965-001 Rev: A...
  • Page 32 D-tec desflurane vaporizer in the lower mounting positions. UPPER MOUNTING POSITION RIGHT-HAND VAPORIZER LEFT-HAND POSITION VAPORIZER POSITION LABEL WARNING LABEL OP00700 Figure 2-10. Desflurane Labels (Three Vaporizer Mount and Interlock System) Narkomed 6400 Operator’s Manual 2-14 Part Number: 4117965-001 Rev: A...

  • Page 33: Ventilator

    The ventilator supports three mechanical modes of ventilation: • Volume Mode (time cycled and volume-controlled) • Pressure Mode (time-cycled and pressure-controlled) • Synchronized Intermittent Mandatory Ventilation (SIMV) Mode (synchronized, time-cycled, and volume-controlled). Narkomed 6400 Operator’s Manual 2-15 Part Number: 4117965-001 Rev: A...
  • Page 34 The ventilator is intended for use as an integrated part of the Narkomed 6400. It is suitable for adults, children, and neonates. Integration of the SIMV Mode facilitates weaning of the patient from mechanical ventilation.
  • Page 35 (APL) with breathing bag connection pressure setting (turn) and MAN/SPONT changeover (2-way toggle switch) Figure 2-12. Ventilator Component Details Narkomed 6400 Operator’s Manual 2-17 Part Number: 4117965-001 Rev: A...
  • Page 36 APL valve (pop-off valve) • breathing bag with re-usable and sterilizable hose. Gas control is provided by a mechanically driven piston assembly. Details may be found on page 26 of this section. Narkomed 6400 Operator’s Manual 2-18 Part Number: 4117965-001 Rev: A...

  • Page 37: Respitone (Customer Option)

    Power-Up Power is supplied to the ventilator when the system power switch on the Diagnostic Narkomed 6400 is turned on. A self-diagnostic test is performed during Tests power-up to check the ventilator and breathing system status, including leakage and system compliance. The self-diagnostic test results are displayed on the operator control panel display.

  • Page 38: Mechanical Ventilation Modes

    During expiration, the fresh gas flow and breathing bag are connected to the patient circuit and mix with breathing gas as the piston retracts and excess gas is discharged to the scavenger. Narkomed 6400 Operator’s Manual 2-20 Part Number: 4117965-001 Rev: A...

  • Page 39: Low-Flow Technique

    It System contains the remainder of the Narkomed 6400 pneumatic interfaces and a re-usable absorbent canister. Figure 2-15 presents a simplified diagram of the ventilator pneumatic component systems and their relationship with each other.
  • Page 40 Legend Sensor Pilot-operated diaphragm valve Variable-resistance valve Directional valve Spring-loaded directional valve Manually actuated two-way valve OP00051 If applicable Figure 2-15. Simplified Schematic of Breathing System Pneumatic Subsystems Narkomed 6400 Operator’s Manual 2-22 Part Number: 4117965-001 Rev: A...
  • Page 41 PATIENT HOSE BAG CONNECTIONS CONNECTION AIRWAY PRESSURE MEASUREMENT CONNECTION SECONDARY VACUUM RELIEF VALVE (IF APPLICABLE) FRESH GAS HOSE CONNECTIONS OP00649 SCAVENGER PATIENT HOSE CONNECTION CONNECTION Figure 2-17. Compact Breathing System Connections Narkomed 6400 Operator’s Manual 2-23 Part Number: 4117965-001 Rev: A...
  • Page 42 The absorber is a single canister system for absorbing exhaled carbon dioxide in the rebreathing circuit. The re-usable absorber canister uses loose, granular soda lime absorbent. Design of the Narkomed 6400 permits easy access for inspection or service of the canister from the front of the machine.
  • Page 43 During spontaneous ventilation resistance to patient exhalation is automatically eliminated by toggling to the SPONT position, which eliminates the need to re-adjust backpressure. MAN/SPONT TOGGLE SWITCH APL VALVE ADJUSTMENT APL VALVE Figure 2-19. Ventilator APL Valve Narkomed 6400 Operator’s Manual 2-25 Part Number: 4117965-001 Rev: A...

  • Page 44: Piston Assembly

    This feature allows for more accurate control of tidal volume delivery while minimizing compressible volume and waste of drive gas. Mechanical integrity is maintained with rolling seal diaphragms. Narkomed 6400 Operator’s Manual 2-26 Part Number: 4117965-001 Rev: A...

  • Page 45: Ventilator Control Panel

    The ventilator does not display any measured patient parameters, which are available on the Narkomed 6400 monitor screen. Bar Graph The bar graph, located in the top left corner of the panel, is a indicator of Display piston movement during inspiration and expiration.
  • Page 46 • preset airway pressure (Pset) will always be displayed in Pressure Mode • breathing rate in breaths per minute (Rate) will always be displayed in Pressure Mode or Volume Mode. Narkomed 6400 Operator’s Manual 2-28 Part Number: 4117965-001 Rev: A...
  • Page 47 Pressing the selector/confirmation knob confirms changes in mode or parameter settings and confirms and/or clears prompts. After the clinician presses the selector/confirmation knob, an audible tone is sounded (if enabled) to acknowledge the change in settings. Narkomed 6400 Operator’s Manual 2-29 Part Number: 4117965-001 Rev: A...
  • Page 48 [Volume Mode] sets time-cycled, volume-controlled mechanical ventilation [SIMV] synchronizes mechanical ventilation with patient’s breathing efforts through Synchronized Intermittent Mandatory Ventilation (SIMV) [Pres. Mode] sets time-cycled, pressure-controlled mechanical ventilation Narkomed 6400 Operator’s Manual 2-30 Part Number: 4117965-001 Rev: A...
  • Page 49 This test can only be initiated when the ventilator is in Ventilator Standby status. The Y-piece must be occluded to successfully complete the test. Fresh gas flow should be adjusted to minimum. Narkomed 6400 Operator’s Manual 2-31 Part Number: 4117965-001 Rev: A...

  • Page 50: Ultrasonic Flow Sensor

    Two transducers (sensors) sense the differential time of flight. The electronics assembly controls the transducers, processes the data, and provides output to the Narkomed 6400 through a sensor cable that connects through the breathing system interface panel. A lever secures and releases the electronics assembly from the flow housing and transducers.

  • Page 51: Breathing System Pressure Gauge (Customer Option)

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS System Description Breathing The Narkomed 6400 can be equipped with a mechanical pressure gauge to System enable quick visual determination of breathing circuit pressure. The gauge Pressure...

  • Page 52: Scavenger Systems (Customer Option)

    RETURN TO CD-ROM TABLE OF CONTENTS System Description Scavenger Systems (CUSTOMER OPTION) The Narkomed 6400 can be equipped with one of two kinds of scavenger systems for the best match with the facility’s waste gas disposal system. Open The open reservoir scavenger is used with suction (vacuum) waste gas Reservoir disposal systems.

  • Page 53: Scavenger Interface For Passive Systems

    WASTE GAS INPUT PORT, INPUT PORT, 19MM HOSE 19MM HOSE TERMINAL TERMINAL INPUT PORT CAP WASTE GAS EXHAUST PORT, 19MM HOSE TERMINAL OP76131 Figure 2-29. Scavenger Interface for a Passive System Narkomed 6400 Operator’s Manual 2-35 Part Number: 4117965-001 Rev: A...

  • Page 54: Power Supply System

    RETURN TO CD-ROM TABLE OF CONTENTS System Description Power Supply System The Narkomed 6400 has a central power supply for the ventilator, alarm system, and monitoring system. This design permits operation with only one AC power cord, a safety feature. No subsystem, including the monitor, has a separate ON/OFF switch.

  • Page 55: Convenience Outlet

    (except oxygen) energized Convenience The Narkomed 6400 has one convenience outlet, located on the rear of the Outlet machine. The outlet is active when the Narkomed 6400 is plugged into an outlet, whether or not the system power switch is turned on. A circuit breaker protects the outlet.

  • Page 56: Machine Functions On Reserve Power

    Power An AC POWER FAIL advisory will be displayed when the reserve power system is activated. In addition, at any time that the Narkomed 6400 detects an AC power loss, the following dialog box is displayed on the screen, an audible alarm is sounded, and the system exits Monitor Standby (if the system was in Monitor Standby at the time of the power loss).

  • Page 57: Monitoring System

    Volume blue Agent/N O (no agent peach identified) - Halothane/N - Isoflurane/N purple - Desflurane/N blue - Enflurane/N orange - Sevoflurane/N yellow Carbon Dioxide (CO white Oxygen (O green bottom Narkomed 6400 Operator’s Manual 2-39 Part Number: 4117965-001 Rev: A...

  • Page 58: Main Screen

    PARAMETER DISPLAYS BOXES OP00004 Figure 2-32. Main Screen Display Areas and Controls Monitoring the operation of the Narkomed 6400 takes place on the main screen, which consists of the following display areas: Display Monitoring Function Waveforms show four real-time physiological waveforms, or traces, next to their...
  • Page 59 Waveform The waveform displays are real-time data gathered from the measurement Displays subsystems and processed by the Narkomed 6400 processor. Scale labels and reference lines appear with all waveforms. The agent waveform also has a parameter label. The waveform channel is the area in which a waveform is used. Four channels appear on-screen.
  • Page 60 Parameter Parameter boxes are the means through which the clinician communicates Boxes with the Narkomed 6400 monitoring systems. They are aligned and to the right of their respective waveforms. Communication includes: • identity of the waveform that appears to its left •...
  • Page 61 [Print] or available with a future release displays Minimum Alveolar Concentration (MAC) information [MAC Info] (agent notebook only) [Volume] sets audible alarm volume adjustments [Calc] available with a future release Narkomed 6400 Operator’s Manual 2-43 Part Number: 4117965-001 Rev: A...
  • Page 62 Pressure, SIMV, or Man/Spont Mode, a hint message will be displayed stating the following: “DIVAN Ventilator must be in the Standby Mode to enter Monitor Standby”. If the Narkomed 6400 is in Monitor Standby and the DIVAN Ventilator is switched from standby to Volume, Pressure, SIMV, or Man/Spont, the NM6400 will resume the current case.
  • Page 63 RETURN TO CD-ROM TABLE OF CONTENTS System Description Trend Window The Narkomed 6400 provides automatic data recording by compressing real-time data gathered from the waveforms and graphically displaying the resulting trend in the trend window. Data is sampled every 30 seconds, and a maximum of 24 hours of data is collected for display.

  • Page 64: Alarm Window

    I:E ratio settings for the ventilator. Alarm The Narkomed 6400 displays messages concerning all active alarms in the Window alarm window. This window appears automatically in the waveform area of the screen when an alarm condition occurs. The alarm window itself can never be blocked by dialog boxes.
  • Page 65 The system will display all advisories again if any new advisories occur. When the window is at full size, all alarm categories are displayed and a minus sign overlays the icon. Narkomed 6400 Operator’s Manual 2-47 Part Number: 4117965-001 Rev: A...

  • Page 66: Auxiliary Video Output (Customer Option)

    Auxiliary Video Output (CUSTOMER OPTION) The auxiliary video output option allows the use of an additional display mounted either on top of the Narkomed 6400 or in other remote locations. The information presented on the auxiliary display is identical to the information on the main Narkomed 6400 screen but has no interactive capability.
  • Page 67 Measurement The GAP-2 pod and the optional IPM module can be replaced while the Narkomed 6400 system is operating. The system will be fully functional Replacement within 60 seconds after the module is installed without any further intervention by the clinician.

  • Page 68: Breathing System Interface Panel

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS System Description Breathing System Interface Panel An interface panel, located on the left side of the Narkomed 6400 below the ventilator, contains the following hoses and connections: • fresh gas outlet hose •...

  • Page 69: Strip Chart Recorder (Scr) (Customer Option)

    Pressing the [PAPER ADVANCE] key advances the recorder paper as long as PAPER the key is pressed. ADVAVCE LATCH KEYPAD RECORD PRINT WAVE DATA LOG PAPER STOP ADVANCE PAPER OP00286 COMPARTMENT Narkomed 6400 Operator’s Manual 2-51 Part Number: 4117965-001 Rev: A...

  • Page 70: Patient Suction System

    Standard Diameter-Indexed Safety System (DISS) vacuum fittings are and Switch provided on the rear and left side of the Narkomed 6400, for mounting and connecting a patient suction system. A toggle switch is provided on the front of the Narkomed 6400 to turn patient suction on and off.

  • Page 71: Patient Suction System (Customer Option)

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS System Description Patient The suction system option on the Narkomed 6400 is designed for aspirating Suction mucus, blood, and other patient drainage fluids. It consists of a fluid System...
  • Page 72 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 73 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS System Configuration The Narkomed 6400 monitoring system can be configured to meet the specific needs of an individual clinician or hospital. This section begins with initial warm-up of the Narkomed 6400. Following subsections describe system-wide adjustments to main screen displays and alarms.

  • Page 74: Initial Warm-Up

    Effects of Ventilator Modes on Alarm Management ..3-56 Initial Warm-up When the Narkomed 6400 is turned ON at the power switch on the front panel below the vaporizer mounts, a number of actions occur automatically. The monitor displays a start-up screen; the processor begins a checkout of all the component systems;...
  • Page 75 PMC is due. The machine can be used, but an authorized representative of DrägerService should be notified to correct the problem. The clinician must acknowledge the indicated failure by pressing [Continue]. The Narkomed 6400 will not automatically proceed to the main screen. Figure 3-2. SYSTEM CONDITIONALLY FUNCTIONAL Screen Narkomed 6400 Operator’s Manual...

  • Page 76: Ventilator Self-Test

    Figure 3-3. SYSTEM NON-FUNCTIONAL Screen Ventilator The ventilator initiates a self-test each time the Narkomed 6400 is powered Self-Test on. The clinician does not need to take the time for a complete self-test before each case and may place the ventilator in Ventilator Standby status after its self-test has begun.
  • Page 77 Allow the full diagnostic sequence to cycle. Do not attempt to bypass the ventilator self-test. See “Start-up Screen” on page 2 and “Ventilator Self- Test” on page 4 of this section for a complete description. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 78: Emergency Quick-Start

    2. The ventilator will go into Ventilator Standby status after a bypassed self-test. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 79: System Setup

    Standby. Pressing the [Setup Notebook] button displays the system setup notebook Setup for the Narkomed 6400. It is used in configuring the system for individual Notebook preferences for a case. See “System Setup Notebook” on page 10 later in this section for details of use.
  • Page 80 Pressing the [To Secondary Keys] button toggles the taskbar to provide additional main control buttons to be used for a second set of tasks. Secondary Keys Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 81 Each of these pages is described in detail later in this section of the manual, beginning on page 3-36. Pressing the [To Primary Keys] button toggles all control buttons back to their primary function. Primary Keys Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 82: Slider Bar

    The system setup notebook is the clinician’s main interface for configuring the Narkomed 6400 system for routine and custom operation. The notebook allows the clinician to perform the following actions: •...
  • Page 83 - Sevoflurane/N yellow white Oxygen green Note: For display colors of parameters monitored by the Integrated Patient Monitor, see the Operator’s Instruction Manual for the Integrated Patient Monitor Option. Narkomed 6400 Operator’s Manual 3-11 Part Number: 4117965-001 Rev: A...

  • Page 84: System Setup

    The associated window switches from Off to On. The label for appropriate unit of measure, for example cmH O, appears in each parameter box. To remove units of measure, touch the control button to toggle from On to Off. Narkomed 6400 Operator’s Manual 3-12 Part Number: 4117965-001 Rev: A...
  • Page 85 Note: A battery test is automatically performed during the initial warm-up period when the Narkomed 6400 is first turned on. The start-up screen indicates In Progress. The load test is audible when testing takes place in the background during the ventilator self-test.
  • Page 86 The message window displays results from both the battery test and the speaker tests. If a test is performed while a message is in the message window, the new test results will overwrite the old message. Narkomed 6400 Operator’s Manual 3-14 Part Number: 4117965-001 Rev: A...

  • Page 87: System Alarm Limits

    The alarm limit setup page lists each parameter with configurable alarm limits. To view alarm limits for parameters that are not currently displayed on the screen, press the [Next Table] or [Previous Table] buttons. Narkomed 6400 Operator’s Manual 3-15 Part Number: 4117965-001 Rev: A...
  • Page 88 ± 10 cmH ± 1 cmH PEEP ± 2 cmH ± 1 cmH Min Vol ± 1 liter ± 0.1 liter Hal, Iso, Enf, Des, or Sev ± 1% ± 0.1% Narkomed 6400 Operator’s Manual 3-16 Part Number: 4117965-001 Rev: A...
  • Page 89 A confirmation dialog box is displayed: Figure 3-10. Limits Autoset Confirmation Dialog Box Touch [No] to clear the dialog box from the screen without • adjusting the limits. Touch [Yes] to adjust the limits. • Narkomed 6400 Operator’s Manual 3-17 Part Number: 4117965-001 Rev: A...
  • Page 90 When the parameter alarm autoset has been set to Off, the [Autoset Single Param] button is grayed out. Narkomed 6400 Operator’s Manual 3-18 Part Number: 4117965-001 Rev: A...

  • Page 91: Template

    The clinician can change the Site template settings but cannot change the template name. Each folder can hold a maximum of 100 templates. Narkomed 6400 Operator’s Manual 3-19 Part Number: 4117965-001 Rev: A...
  • Page 92 1. Touch the control button of the folder where the new template is to be stored. 2. Touch [New]. The New Template dialog box is displayed: Figure 3-12. New Template Dialog Box Narkomed 6400 Operator’s Manual 3-20 Part Number: 4117965-001 Rev: A...
  • Page 93 Touch [No] to remove the dialog box from the screen without saving the settings • Touch [Yes] to continue; the keyboard window will be displayed to allow the clinician to enter a template name Narkomed 6400 Operator’s Manual 3-21 Part Number: 4117965-001 Rev: A...
  • Page 94 The clinician will then have to repeat the process. Narkomed 6400 Operator’s Manual 3-22 Part Number: 4117965-001 Rev: A...
  • Page 95 2. In the template list window, find the desired template, using the up and down arrow keys if needed. Touch the name of the template where the current settings are to be saved. Narkomed 6400 Operator’s Manual 3-23 Part Number: 4117965-001 Rev: A...
  • Page 96 Touch [No] to remove the dialog box from the screen without saving the settings • Touch [Yes] to continue; the current settings are saved to the selected template, replacing the previous contents Narkomed 6400 Operator’s Manual 3-24 Part Number: 4117965-001 Rev: A...
  • Page 97 (i.e., one name is lowercase and the other is uppercase) is considered a duplicate and will not be accepted. • Use the [CAPS LOCK] control button to toggle between uppercase and lowercase Narkomed 6400 Operator’s Manual 3-25 Part Number: 4117965-001 Rev: A...
  • Page 98 The clinician will then have to repeat the process. Narkomed 6400 Operator’s Manual 3-26 Part Number: 4117965-001 Rev: A...

  • Page 99: Traces

    (default) and 25 mm/sec. All waveforms have the same trace speed. The [Cardiovascular Waveforms] button and the Screen Config window are enabled only if the Narkomed 6400 is configured with the Integrated Patient Monitor (IPM). For complete information, see the Operator’s Manual for the Integrated Patient Monitor Option.

  • Page 100: System Alarm Volume

    To change the alarm volume for all alarms, use the fine adjust, coarse adjust, or rapid adjustment bar. The monitor produces a representative tone to assist in selecting the proper level. Narkomed 6400 Operator’s Manual 3-28 Part Number: 4117965-001 Rev: A...

  • Page 101: About System

    RETURN TO CD-ROM TABLE OF CONTENTS System Configuration About Touch the [About] tab to view the Narkomed 6400 system software page. System Figure 3-21. About Narkomed 6400 System Software Page The about page contains information about the specific hardware installed and the corresponding software version, including the version number.

  • Page 102: Ventilator Information Notebook

    On or Off. Confirm Tone To change the volume of the ventilator confirmation tone, use the fine, Volume coarse, or rapid adjustment on the Confirm Tone Volume slider bar. Narkomed 6400 Operator’s Manual 3-30 Part Number: 4117965-001 Rev: A...
  • Page 103 Divan ventilator. It also displays a trend of the results from the last 50 leak tests to enable the clinician to spot potential problems. Figure 3-23. Leak and Compliance Page in Ventilator Information Notebook Narkomed 6400 Operator’s Manual 3-31 Part Number: 4117965-001 Rev: A...
  • Page 104 Sounds 5 through 7 should be used with breathing rates below 14 BPM or the sounds may overlap. Sound Volume To change the volume of the Respitone, use the fine, coarse, or rapid adjustment on the Sound Volume slider bar. Narkomed 6400 Operator’s Manual 3-32 Part Number: 4117965-001 Rev: A...
  • Page 105 [Help] tab. This page contains a table with recommended bag sizes based on the selected tidal volume and a table of compliance compensation values used by the Divan ventilator. Figure 3-25. Help Page in Ventilator Information Notebook Narkomed 6400 Operator’s Manual 3-33 Part Number: 4117965-001 Rev: A...

  • Page 106: Low Flow Wizard

    Spontaneous or Standby, or when any condition occurs where the wizard is not able to accurately assess the fresh gas surplus. A message appears in the Message Report area when data cannot be displayed (see “Message Report Area” below). Narkomed 6400 Operator’s Manual 3-34 Part Number: 4117965-001 Rev: A...
  • Page 107 WIZARD INDICATION RECOMMENDED ACTION Too Little Increase gas flow to avoid depletion of oxygen in the circuit. Too Much Decrease gas flow to minimize waste. Narkomed 6400 Operator’s Manual 3-35 Part Number: 4117965-001 Rev: A...

  • Page 108: Calculations

    Whenever calculations are required to configure parameter displays or annotate patient records, the clinician can use the calculator available on the Narkomed 6400. The calculator is part of the utilities notebook. To access the calculator: 1. Press [To Secondary Keys] on the main screen taskbar.

  • Page 109: Timers

    Timers Whenever a countdown timer or an elapsed time measurement is needed, the clinician can use the timers available on the Narkomed 6400. These timers are available from the Timers page of the utilities notebook. To use a countdown timer: 1.
  • Page 110 Stop Timer. Pressing this button will stop the timer. Both the countdown timer (remaining time) and elapsed time will continue to be displayed on the title bar when the Utilities Notebook is closed. Narkomed 6400 Operator’s Manual 3-38 Part Number: 4117965-001 Rev: A...

  • Page 111: Alarm Log

    2. Press [Utilities Notebook] on the new taskbar. The utilities notebook appears. 3. Press the [Alarm Log] tab to access the alarm log page. Figure 3-30. Alarm Log Page in Utilities Notebook Narkomed 6400 Operator’s Manual 3-39 Part Number: 4117965-001 Rev: A...
  • Page 112 To clear all entries in the alarm log, touch the [Clear Alarm Log] button. A Alarm Log confirmation dialog box is displayed: Figure 3-32. Alarm Log Clear Confirmation Dialog Box Narkomed 6400 Operator’s Manual 3-40 Part Number: 4117965-001 Rev: A...
  • Page 113 [Display Advisories]. Touching the button a second time will Log Display cause the advisories to be displayed again and the button label to change back to [Filter Out Advisories]. Narkomed 6400 Operator’s Manual 3-41 Part Number: 4117965-001 Rev: A...

  • Page 114: Software Pressure Gauge

    2. Press [Utilities Notebook] on the new taskbar. The utilities notebook appears. 3. Press the [Press Gauge] tab to access the pressure gauge page. Figure 3-33. Software Pressure Gauge Page in Utilities Notebook Narkomed 6400 Operator’s Manual 3-42 Part Number: 4117965-001 Rev: A...
  • Page 115 The circular gauge is removed from the page and replaced with control buttons that allow the clinician to set the audio tone’s properties. Figure 3-34. Software Pressure Gauge Page in Utilities Notebook - Alternate Display Narkomed 6400 Operator’s Manual 3-43 Part Number: 4117965-001 Rev: A...
  • Page 116 [Enable Audio]. Displaying Touch the [Display Gauge] button to return the notebook page to the Gauge software pressure gauge display. Narkomed 6400 Operator’s Manual 3-44 Part Number: 4117965-001 Rev: A...

  • Page 117: Fresh Gas Information

    Several control buttons change to choose additional tasks. 2. Press [Utilities Notebook] on the new taskbar. The utilities notebook appears. 3. Press the [Fresh Gas Info] tab to access the fresh gas information page. Narkomed 6400 Operator’s Manual 3-45 Part Number: 4117965-001 Rev: A...
  • Page 118 To set the threshold within the range of 0.5 to 10 L/min, use the up and down arrow buttons. The threshold is shown in the text box next to the arrow buttons. The factory default is 4 L/min. Narkomed 6400 Operator’s Manual 3-46 Part Number: 4117965-001 Rev: A...

  • Page 119: Printing Patient Data

    System Configuration Printing Patient Data If the Narkomed 6400 is configured with a strip chart recorder, the clinician can use it to print waveforms, vital signs reports, and the data log. Various print options are available from the Print notebook which is accessed by pressing the [Print] button on the main screen taskbar.
  • Page 120 The date and time reflect the time of the oldest waveform sample. The waveform printouts have various annotations specific to the parameter printed above and below the waveforms. OP00283 OP00282 SINGLE WAVEFORM DOULE WAVEFORM Figure 3-37. Examples of Waveform Prints Narkomed 6400 Operator’s Manual 3-48 Part Number: 4117965-001 Rev: A...
  • Page 121 If monitoring information for a particular parameter is invalid or not available, dashes appear for that parameter on the printed report. OP00652 Figure 3-38. Example of a Vital Signs Report Narkomed 6400 Operator’s Manual 3-49 Part Number: 4117965-001 Rev: A...
  • Page 122 If there are more than ten entries, a vertical divider appears between the pages. If monitoring information for a particular parameter is invalid or not available, dashes appear for that parameter on the printed data log. Narkomed 6400 Operator’s Manual 3-50 Part Number: 4117965-001 Rev: A...
  • Page 123 Note: The [NIBP/SPO2 Datalog] control button is enabled only if the Narkomed 6400 is configured with an Integrated Patient Monitor. For complete information, see the Operator’s Manual for the Integrated Patient Monitor (IPM) Option. Narkomed 6400 Operator’s Manual...
  • Page 124 Repeat this procedure for the second waveform. The selection list for Waveform 2 contains only selections that have not been chosen for the Waveform 1 to prevent printing the same waveform more than once in a single printout. Narkomed 6400 Operator’s Manual 3-52 Part Number: 4117965-001 Rev: A...

  • Page 125: Alarm Window

    (default) ALARMS SUSPEND advisory. If any new advisory occurs, all advisories will reappear. The alarm window will expand to Minimized Window Touch icon include all active alarms and advisories. Narkomed 6400 Operator’s Manual 3-53 Part Number: 4117965-001 Rev: A...

  • Page 126: Controlling Individual Alarms

    6400. Note: During automatic ventilation, CO alarms can be set to OFF only when Full CO Control is enabled. See “Carbon Dioxide Alarm Management” on page 4-14 for complete information. Narkomed 6400 Operator’s Manual 3-54 Part Number: 4117965-001 Rev: A...

  • Page 127: Turning The Alarm Off Or On

    When the cable is reconnected, the volume alarms automatically change to Alarm Standby status. However, when the oxygen sensor is reconnected, the Narkomed 6400 automatically prompts the clinician to calibrate the sensor, and oxygen alarms remain off until the calibration is successfully completed.

  • Page 128: Effects Of Ventilator Modes On Alarm Management

    Standby; may also be set to OFF in Full Control CO mode) Manual/Spontaneous Mode all parameter alarms (except O ) can be turned OFF Narkomed 6400 Operator’s Manual 3-56 Part Number: 4117965-001 Rev: A...
  • Page 129 RETURN TO CD-ROM TABLE OF CONTENTS Configuration and Settings - Gas Analysis The Narkomed 6400 monitoring system can be configured to meet the specific needs of an individual clinician or hospital for receiving data collected by the gas analysis pod.

  • Page 130: Section 4. Configuration And Settings - Gas Analysis

    The default setting is the anesthetic agent. Potential labels include: Label Agent Label Agent Agent No agent is detected Sevoflurane Halothane Desflurane Isoflurane Enflurane Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 131 (MAC) level based on the detected agent type and concentration. The display of MAC values can be turned on or off in the agent parameter notebook. See “Agent Setup” on page 4-6 and “MAC Info” on page 4-11 for more information. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 132: Agent Alarm Annunciation

    When the AGENT MIX condition clears, the reported agent label(s) will be be accurate. Agent Alarm When the Narkomed 6400 warms up, the default in Ventilator Standby Annunciation status has alarms silenced (bell has through it).

  • Page 133: Nitrous Oxide And Agent Settings

    The clinician can choose whether the system traces an anesthetic agent or Trace nitrous oxide. Touch [Displayed Trace] until the preferred setting is displayed: Agent the system traces the anesthetic agent (DEFAULT) the system traces nitrous oxide. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 134: Agent Setup

    17 in this section. Note: Because the gas analysis pod monitors both agent/N O and CO O [Setup] tab will simultaneously, any changes made on the agent/N [Setup] tab. be reflected on the CO Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 135 Use this parameter to set the sample flow rate to the gas analysis Select Flow pod. Touch the [Select Flow Rate] button to toggle between a low flow rate Rate of 60 mL/min and a normal flow rate of 200 mL/min (default). Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 136: Agent Alarms

    Agent alarms will be disabled automatically when the ventilator mode is changed to Ventilator Standby status, since no ventilation is possible in Ventilator Standby. Turning the ventilator back on will automatically enable these alarms. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 137 2. Move the slider control until the preferred setting is displayed next to the [Set Lo] control button. • Use the fine adjustment to change the alarm levels by 0.1% • Use the coarse adjustment to change the alarm levels by 1.0%. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 138 [Set Hi] and [Set Lo] control buttons. Note: The autoset function has no effect if no agent is present or if only mean values are displayed. Narkomed 6400 Operator’s Manual 4-10 Part Number: 4117965-001 Rev: A...
  • Page 139 MAC calculation and a table of unit MAC values for all agents and N It also references the applicable MAC standard and source of MAC constants. Figure 4-6. MAC Info Page Narkomed 6400 Operator’s Manual 4-11 Part Number: 4117965-001 Rev: A...

  • Page 140: Configuring Carbon Dioxide Displays

    A reference line is fixed at 5%, 5 kPa, or 38 mmHg, depending on the selected units. Carbon When the Narkomed 6400 warms up, the default in Ventilator Standby Dioxide status has alarms silenced (bell has through it).

  • Page 141: Carbon Dioxide Settings

    Use this parameter to set the sample flow rate to the gas analysis Select Flow pod. Touch the [Select Flow Rate] button to toggle between a low flow rate Rate of 60 mL/min and a normal flow rate of 200 mL/min (default). Narkomed 6400 Operator’s Manual 4-13 Part Number: 4117965-001 Rev: A...

  • Page 142: Carbon Dioxide Alarms

    STBY to ON. Note: alarms will be automatically turned to OFF when the ventilator mode is changed to Ventilator Standby status, since no ventilation Narkomed 6400 Operator’s Manual 4-14 Part Number: 4117965-001 Rev: A...
  • Page 143 2. Move the slider control until the preferred setting is displayed next to the [Set Hi] control button. • Use the fine adjustment to change the alarm levels by 0.1% • Use the coarse adjustment to change the alarm levels by 1.0%. Narkomed 6400 Operator’s Manual 4-15 Part Number: 4117965-001 Rev: A...
  • Page 144 +0.5% from the current inspiratory reading, but not less than 0 nor more than 9.9%. Touch [AUTOSET Wide]. The change is automatic. The new range values appear next to the [Set Hi] and [Set Lo] control buttons. Narkomed 6400 Operator’s Manual 4-16 Part Number: 4117965-001 Rev: A...

  • Page 145: Gas Analysis Pod Zero Calibration And Delay

    To assure availability of data during a clinically significant period, the clinician may calibrate the gas analysis pod manually beforehand or delay an automatic calibration to a more convenient time. Manual Calibration Figure 4-10. Agent Monitoring Setup Page Narkomed 6400 Operator’s Manual 4-17 Part Number: 4117965-001 Rev: A...
  • Page 146 The zero calibration begins automatically. The readings in the parameter boxes and waveform channels clear, and alarms are turned OFF. When calibration is complete, the Narkomed 6400 automatically resets the parameter box values and waveforms. Alarms are reset to their previously programmed status.
  • Page 147 RETURN TO CD-ROM TABLE OF CONTENTS Configuration and Settings - Volume, Pressure, and Oxygen The Narkomed 6400 monitoring system can be configured to meet the specific needs of an individual clinician or hospital for receiving data collected by the volume, pressure, and oxygen (VPO) monitor.

  • Page 148: Section 5. Configuration And Settings - Volume, Pressure, And Oxygen

    Oxygen Alarm Management ..........5-24 Default Values Programmed settings return to their default values after power up or selecting [New Case]. A summary of Narkomed 6400 volume, pressure, and oxygen monitoring parameter default settings appears in the following table. Parameter...
  • Page 149 100 cmH O. The default high setting is 50 cmH O. The low scale always remains at zero. Autoscaling The Narkomed 6400 automatically adjusts the high scale for the pressure the Pressure waveform according to the following rules. High Scale •...
  • Page 150 Limit Line down in the pressure waveform area or by making the correct setting in the pressure parameter notebook. The acceptable range is 5 to 30 cmH Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 151: Threshold Pressure Limit

    Operator is not alerted of apnea condition. OP00660 Figure 5-3. Waveforms Produced by Correct or Incorrect Threshold Pressure Limits Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 152: Pressure Alarm Annunciation

    RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Configuration and Settings - Volume, Pressure, and Oxygen Pressure When the Narkomed 6400 warms up, the default in Ventilator Standby Alarm status has alarms silenced (bell has through it). Only the oxygen alarms Annunciation remain enabled.

  • Page 153: Breathing Pressure Settings

    RETURN TO CD-ROM TABLE OF CONTENTS Configuration and Settings - Volume, Pressure, and Oxygen Breathing Pressure Settings Whenever the Narkomed 6400 is operating, the breathing pressure monitor will measure and display valid breathing pressure data. Setting Up Touch the pressure parameter box anywhere except the alarm bell to Pressure display the pressure notebook.
  • Page 154 2. Touch the slider control until the preferred setting is displayed. • Use the fine adjustment to change the threshold by 1 cmH • Use the coarse adjustment to change the threshold by 2 cmH Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 155: Pressure Alarms

    To remove the displays, touch the control button to toggle from On to Off. Pressure Touch the [Alarms] tab in the pressure notebook to display the alarms page. Alarms Figure 5-6. Airway Pressure Alarms Page Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 156: Pressure Alarm Management

    On to Off; an appears on the alarm bell in the pressure parameter box. When the Narkomed 6400 warms up, the default in Ventilator Standby has pressure alarms silenced (bell has through it). Only the oxygen alarms remain enabled at all times.
  • Page 157 Use the coarse adjustment to change the setting by 10 cmH The precise value for the pressure alarm limit appears in the notebook window next to the [Set Hi] button. Narkomed 6400 Operator’s Manual 5-11 Part Number: 4117965-001 Rev: A...
  • Page 158 [Set PEEP Hi] button. Display The clinician may display alarm limits in the pressure parameter box by Pressure touching the [Disp Limits] button until the preferred selection is Limits displayed. Narkomed 6400 Operator’s Manual 5-12 Part Number: 4117965-001 Rev: A...
  • Page 159 PEEP measurement, but not more than 20 cmH Touch [AUTOSET Wide]. The change is automatic. The new range values appear next to the [Set Hi] and [Set PEEP Hi] control buttons. Narkomed 6400 Operator’s Manual 5-13 Part Number: 4117965-001 Rev: A...

  • Page 160: Configuring Respiratory Volume Displays

    Configuration and Settings - Volume, Pressure, and Oxygen Configuring Respiratory Volume Displays The Narkomed 6400 monitors respiratory volume using the flow sensor. The assembly has two transducers that measure the time of flight of ultrasonic pulses transmitted upstream and downstream in the airway flow path. The difference in time of flight is used to determine the velocity and the flow rate of gas through the patient circuit.

  • Page 161: Tidal Volume

    The low minute volume alarm limit is adjusted in the volume notebook. When the Narkomed 6400 warms up, the default in Ventilator Standby status has alarms silenced (bell has through it). Only the oxygen alarms remain enabled at all times. Both the visual and audible respiratory volume alarms are disabled.

  • Page 162: Respiratory Volume Settings

    Touch the volume parameter box anywhere except the alarm bell to display Volume the volume notebook. Parameters Minute The alarms page is the only page currently available in the volume Volume notebook. Alarms vol_alrm.bmp Figure 5-10. Minute Volume Alarms Page Narkomed 6400 Operator’s Manual 5-16 Part Number: 4117965-001 Rev: A...

  • Page 163: Volume Alarm Management

    Wide Minute volume reading, but not less than 0.2 liter. Volume Alarm Touch [AUTOSET Wide]. The change is automatic. The new value appears Limits next to the [Set Lo] control button. Narkomed 6400 Operator’s Manual 5-17 Part Number: 4117965-001 Rev: A...

  • Page 164: Configuring Oxygen Displays

    Figure 5-12. Oxygen Sensor Calibration Dialog Box Note: An alternative procedure is to initiate calibration from the oxygen parameter notebook. See “Oxygen Setup” on page 22 of this section. Narkomed 6400 Operator’s Manual 5-18 Part Number: 4117965-001 Rev: A...
  • Page 165 If, at the end of the calibration period, the oxygen parameter box remains blank, the calibration was not successful. (This condition is also indicated by the advisory message O2 CAL ERROR. The O2 CAL DUE advisory remains posted.) Narkomed 6400 Operator’s Manual 5-19 Part Number: 4117965-001 Rev: A...
  • Page 166 Narkomed 6400 will not complete an attempted calibration; however, if the calibration gas is rich or lean but is within certain limits, the Narkomed 6400 will complete the calibration. As a result, when displaying sensor measurements, the Narkomed 6400 displays an oxygen percentage either greater or less than the actual oxygen percentage.
  • Page 167 > 21% O2. Thus, displayed % O2 will be lower than actual % O2. O P 1 0 0 9 8 ACTUAL O2 PERCENTAGE Figure 5-14. Relationship Between Calibration and Precise Delivery of Oxygen Narkomed 6400 Operator’s Manual 5-21 Part Number: 4117965-001 Rev: A...

  • Page 168: Setting Up Oxygen Parameters

    This field displays the date and time of the last oxygen monitoring system Calibration calibration. This information is maintained in the system even if the Narkomed 6400 is powered off. Note: The system monitors the time since the last oxygen monitoring system calibration.
  • Page 169 Note: The [Calibrate] button is disabled when the oxygen zero calibration values are invalid. Oxygen Touch the [Alarms] tab in the oxygen notebook to display the alarms page. Alarms o2_alarm.bmp Figure 5-16. Oxygen Alarms Page Narkomed 6400 Operator’s Manual 5-23 Part Number: 4117965-001 Rev: A...
  • Page 170 18% nor more than 100%. Touch [AUTOSET Wide]. The change is automatic. The new range values appear next to the [Set Hi] and [Set Lo] control buttons. Narkomed 6400 Operator’s Manual 5-24 Part Number: 4117965-001 Rev: A...
  • Page 171 Spontaneous Breathing ............6-8 Manual Ventilation ............... 6-8 Mechanical Ventilation ............6-9 Volume Mode ..............6-9 SIMV Mode ................. 6-10 Pressure Mode ..............6-13 Preparation to Ventilate Pediatric Patients ....... 6-14 Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 172: Section 6. Configuration And Settings - Ventilator

    (Flow) in Pressure mode 50L/min [PEEP] Positive end-expiratory pressure 0 cmH [SIMV Rate] Breathing rate in SIMV mode 12 bpm The default settings can be changed by an authorized representative of DrägerService, if requested. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 173: Adjusting Ventilator Parameters

    1. Press a parameter setting button. (For example, press the [Vt] button.) 2. Note that the current setting, the parameter and its unit of measure, and the adjusted value appear in the alphanumeric display in sequential order. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 174: Pmax/Pset

    Tidal volume cannot be set to values resulting in the following conditions: • tidal volume > 1400 mL • tidal volume < 10 mL • inspiratory flow > 75 L/min • minute volume > 25 L/min. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 175: Breathing Rate (Rate)

    75 L/min inspiratory flow at the last preset % Insp Pause and Vt Note: The tidal volume setting may need to be lowered to achieve the desired rate while in Pressure mode. • expiratory time < 400 milliseconds. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 176: I:e Ratio

    Limitations on % Inspiratory Pause Settings % I.P. cannot be set to values resulting in the following conditions: • % I.P. > 60% • % I.P. < 0% • inspiratory flow > 75 L/min. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 177: Peep

    Limitations on SIMV Rate Settings SIMV Rate cannot be set to values resulting in the following conditions: • SIMV Rate > 80 bpm • SIMV Rate < 3 bpm • SIMV Rate > Rate Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 178: Selecting Operating Mode

    3. Press the selector knob to confirm. 4. Manual/Spont. will be displayed. 5. Set the toggle on the APL valve (pop-off valve) to SPONT position. 6. Set the appropriate fresh gas flow on the Narkomed 6400. Note: Adjusting parameter button settings has no effect on ventilation during spontaneous breathing.

  • Page 179: Mechanical Ventilation

    Ventilation the appropriate ventilation parameter settings for the case. Previously set parameter values remain active if the Narkomed 6400 is not switched to System Standby, even if the ventilator has previously been set to Ventilator Standby status or another ventilation mode, except as noted below.

  • Page 180: Simv Mode

    Trigger window Spont Spont Expectation Insp Insp window Trigger RATE RATE SIMV RATE OP00065 SIMV RATE Figure 6-7. Waveform Showing SIMV Breathing Narkomed 6400 Operator’s Manual 6-10 Part Number: 4117965-001 Rev: A...
  • Page 181 = 6 s + 3.5 s = 9.5 s Spont RATE This corresponds to a frequency of approximately 6 per minute and the applied minute volume increases to 6 per minute Narkomed 6400 Operator’s Manual 6-11 Part Number: 4117965-001 Rev: A...
  • Page 182 30 seconds for cautions and 60 seconds for warnings, respectively, until the ventilation mode is changed or the ventilation frequency is set to at least 6 breaths per minute. Narkomed 6400 Operator’s Manual 6-12 Part Number: 4117965-001 Rev: A...

  • Page 183: Pressure Mode

    15 seconds for caution alarms and 30 seconds for warning alarms. Summary of See “Summary of Ventilator Control Panel Information” on page A-1-17. Ventilator Modes Narkomed 6400 Operator’s Manual 6-13 Part Number: 4117965-001 Rev: A...

  • Page 184: Preparation To Ventilate Pediatric Patients

    Pediatric hoses? message to prompt the clinician to change hoses. Note: The Narkomed 6400 supports tidal volumes set as low as 10 mL. 2. Fit the infant hoses. 3. Press the selector knob to confirm.
  • Page 185 Checkout Procedures This section outlines recommended procedures that should be performed daily and before each case to ensure that the Narkomed 6400 is ready for use. Daily Checkout ..............7-2 Preparation for Checkout ............ 7-2 Emergency Ventilation Equipment Verification ....7-2 Oxygen Cylinder - High Pressure System ......

  • Page 186: Section 7. Checkout Procedures

    Preparation 1. Enter the Narkomed 6400 serial number, located on the side wall to the for Checkout left of the cylinder yokes, into the anesthesia record. See “Narkomed 6400 Rear View” on page 2-11.

  • Page 187: Oxygen Cylinder - High Pressure System

    Verify that the ultrasonic flow sensor electronics housing is securely latched to the flow housing. Check for moisture accumulation in the 22 mm hose between the bag connection on the ventilator and the short bag arm connection. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 188 If the Narkomed 6400 has been out of use or in storage or if it is suspected that the fresh gas has been left running at a high rate with no patient attached for an extended period of time, then replace the absorbent before using it.

  • Page 189: Oxygen Pipeline - High Pressure System

    Connect the oxygen supply hose from the wall outlet fitting to the System DISS inlet connectors. c. Turn the Narkomed 6400 system switch to the ON position. d. Check for sufficient oxygen pipeline pressure. The pressure, indicated on the oxygen pipeline pressure gauge below the flow control valve, should be between 50-55 psi.

  • Page 190: Component System Diagnostics

    See “Start-up Screen” on page 3-2 for details. The reserve power verification test is part of the power-up diagnostics of the Narkomed 6400. A low battery will cause the system to be CONDITIONALLY FUNCTIONAL and will require operator acknowledgment.

  • Page 191: Calibrating The Oxygen Monitoring System

    1000 psi. To check for a high pressure leak, close the cylinder and observe the cylinder pressure gauge for a prominent decrease in the pressure. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 192: Nitrous Oxide And Air Pipelines - High Pressure System

    50-55 psi. Open the flow control valve to a moderate value; the pressure indicated at the pipeline pressure gauge must not decrease more than 5 psi. d. Verify that the correct gases are supplied to all Narkomed 6400 pipeline inlets. Vaporizer -...

  • Page 193: Oxygen Ratio Controller - Low Pressure System

    30 cmH Note: This level can be determined by displaying the Software Pressure Gauge on the Narkomed 6400 monitor screen. Switch the APL toggle to the SPONT position. g. Observe the pressure waveform on the monitor drops. The pressure now must not exceed 5 cmH O, the minimum apnea pressure threshold limit.

  • Page 194: Open Reservoir Scavenger System

    Observe that the breathing bag becomes fully collapsed. h. Open and close the patient Y-piece. Observe the breathing pressure on the monitor. The value on the waveform display should not change. Narkomed 6400 Operator’s Manual 7-10 Part Number: 4117965-001 Rev: A...

  • Page 195: Scavenger Interface For Passive Systems

    33. Flush the system with 100% oxygen by pressing the oxygen flush button. 34. If the Narkomed 6400 is configured with Air-Only Mode, use the following procedure to verify proper operation: a. Enable Air-Only Mode by pressing the [Air-Only Mode] control button and then pressing the [Continue] button in the dialog box.

  • Page 196: Final Position

    Checkout Procedures Final Position 35. At the completion of the daily checkout procedure, verify that the final status of the Narkomed 6400 is as follows: a. All vaporizers off (handwheels set to zero) b. APL valve control set to 5 cmH c.

  • Page 197: Preuse Checkout

    Checkout Procedures Preuse Checkout The following abbreviated checkout procedure applies to the Narkomed 6400 when used in successive cases. It may be performed only after the Narkomed 6400 has undergone the initial daily checkout procedure. This is a recommended procedure. Follow the institution's policies regarding specific checkout procedures.
  • Page 198 If the Narkomed 6400 has been out of use or in storage or if it is suspected that the fresh gas has been left running at a high rate with no patient attached for an extended period of time, then replace the absorbent before using it.

  • Page 199: Apl Valve

    30 cmH Note: This level can be determined by displaying the Software Pressure Gauge on the Narkomed 6400 monitor screen. Switch the APL toggle to the SPONT position. g. Observe the pressure waveform on the monitor drops. The pressure now must not exceed 5 cmH O, the minimum apnea pressure threshold limit.
  • Page 200 Attach a breathing bag to the patient Y-piece to simulate a lung. b. Verify that the ventilator is set to Manual/Spontaneous Mode. c. Set the fresh gas flow to 2 L/min of oxygen on the Narkomed 6400. d. Set the APL valve toggle to the MAN position.
  • Page 201 This test can only be initiated in Ventilator Standby status. A manual leak and compliance test should be performed each time the breathing hoses are changed or whenever system components are disassembled and reassembled, or changed. Narkomed 6400 Operator’s Manual 7-17 Part Number: 4117965-001 Rev: A...
  • Page 202 Ventilator Leak and Compliance Test. If it is necessary to abort a Ventilator Leak and Compliance Test, the clinician should press and hold the [STANDBY] button until STANDBY appears on the Divan control panel. Narkomed 6400 Operator’s Manual 7-18 Part Number: 4117965-001 Rev: A...
  • Page 203 Set the APL valve toggle to MAN and the value to 50 cmH d. Set the Divan ventilator to Manual/Spontaneous mode. e. On the main screen task bar on the Narkomed 6400 monitor screen, press [Press Gauge]. Use the oxygen flush button to pressurize the system to approximately 30 cmH O.
  • Page 204 Final Position 18. At the completion of the Daily Checkout procedure, verify that the final status of the Narkomed 6400 is as follows: a. All vaporizers off (handwheels set to zero) b. APL valve open control set to 5 cmH c.
  • Page 205 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Operation Summary This section summarizes basic operation of the Narkomed 6400: how to start a new case, put a case in monitoring standby, resume a case, and continue when operation is interrupted.

  • Page 206: Section 8. Operation Summary

    See “Daily Checkout” on page 7-2 and “Preuse Checkout” on page 7-13. This is a recommended procedure. Follow institutional policies for specific checkout procedures. After the Narkomed 6400 is powered on and diagnostic tests are successfully completed, the machine is ready for use immediately. Putting the...

  • Page 207: Beginning A Case

    Operation Summary When the clinician confirms the selection of Monitor Standby status, the Narkomed 6400 immediately stops all monitoring functions. All alarms are suspended. Standby messages are posted. Data collection stops; no waveforms and no numeric data are displayed. No trend, data log, or alarm log data is collected.
  • Page 208 3. Check the alarm limit settings. The monitor automatically sets alarm limits and other monitor parameters to a default configuration when starting a new case. Check the settings in the following table of Narkomed 6400 monitoring parameter default settings and adjust them if necessary. Note: For information on setting alarm limits for parameters monitored by the Integrated Patient Monitor, see the Operator’s...

  • Page 209: Resuming A Case

    To use the oxygen flush, press the oxygen flush button, located on the front Oxygen of the Narkomed 6400, for a few seconds. This introduces an unmetered flow Flush of pure oxygen into the breathing circuit at a rate of about 55 L/min.

  • Page 210: Automatic Data Recording

    There are two pages of trend data available for viewing as well as a third page where the clinician can configure a custom trend display of up to four parameters. See “Creating a Custom Trend Page” on page 8-9 for complete information. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 211 0/10 L/min Fresh Gas Flow - O 0/10 L/min Fresh Gas Flow - N 0/10 L/min Fresh Gas Flow - Total 0/20 L/min Inspired N 0/100% Page 3 - Custom Trend Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 212 Use the [Previous] and [Next] buttons to view preceding or succeeding pages of trend data. Note: The last page of the trend display is the custom trend page. See “Creating a Custom Trend Page” on page 8-9 for more information. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 213 2. Touch the [Config] button to enter a configuration mode. Four selection buttons appear on the screen: [Trend 1], [Trend 2], [Trend 3], and [Trend 4]. See Figure 8-9. Figure 8-8. Custom Trend Page Figure 8-9. Trend Selection Controls Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 214 Touch the [Cancel] button to cancel the selection 5. Repeat the procedure for the remaining custom trends. When all trends have been configured, touch the [Exit Config] button to exit the trend configuration mode. Narkomed 6400 Operator’s Manual 8-10 Part Number: 4117965-001 Rev: A...
  • Page 215 Touch [Clear Trends, Data Log, and Alarm Log] to remove all trend data immediately from these sources. Cleared data cannot be recovered. Touch [Cancel] to resume trend recording without deleting the accumulated data. Narkomed 6400 Operator’s Manual 8-11 Part Number: 4117965-001 Rev: A...
  • Page 216 Data Log Entry Monitoring Measure Time time readings were taken Resp Rate respiratory rate (BPM) (from volume) Min Vol minute volume (liters) Tid Vol tidal volume (liters) Peak Pres peak pressure (cmH Narkomed 6400 Operator’s Manual 8-12 Part Number: 4117965-001 Rev: A...
  • Page 217 Insp Flow ventilator inspiratory flow rate setting (L/min) (logged in Pressure mode only) FG Flow Air fresh gas flow for air (L/min) FG Flow fresh gas flow for nitrous oxide (L/min) Narkomed 6400 Operator’s Manual 8-13 Part Number: 4117965-001 Rev: A...
  • Page 218 [Clear Trends, Data Log, and Alarm Log] in the confirmation dialog box that follows. To close the data log, the clinician touches [Data Log] or [Main Screen] while the data log spreadsheet is displayed. Narkomed 6400 Operator’s Manual 8-14 Part Number: 4117965-001 Rev: A...
  • Page 219 [Vertical] to display the data log vertically over the right side of the waveform display (see Figure 8-14.) • touch [Horizontal] to display the data log horizontally across the bottom of the waveform display (see Figure 8-12.) Narkomed 6400 Operator’s Manual 8-15 Part Number: 4117965-001 Rev: A...
  • Page 220 Note: The [NIBP] and [Cardiac Output] control buttons are enabled only if the Narkomed 6400 is configured with an Integrated Patient Monitor. For complete information, see the Operator’s Manual for the Integrated Patient Monitor (IPM) Option. Narkomed 6400 Operator’s Manual...

  • Page 221: Ending A Case

    Monitor Standby cannot be entered unless the ventilator is in Ventilator Standby. Warning: Once the patient is disconnected from the Narkomed 6400, be sure that the fresh gas is adjusted to minimum O flow.

  • Page 222: Service Interruptions

    (monitors, recorders, third party equipment etc.) must be removed from the top shelf of the NM6400. Powering If it becomes necessary to move the Narkomed 6400 or to take it out of Down the service, the following procedure is recommended. System for 1.

  • Page 223: Putting The System In Ventilator Standby

    Ventilator Standby status is recommended for the most efficient and cost effective use of the ventilator. The ventilator is powered through the Narkomed 6400 and cannot be powered off independently. Warning: Assisted ventilation is not possible while in Ventilator Standby status. Never change to Ventilator Standby with a patient attached.

  • Page 224: Replacing Absorbent Between Cases

    Warning: Change the absorbent if fresh gas has flowed continuously without the use of the Narkomed 6400 on patients (e.g., if machine has been left on over a weekend). Additionally, it has been observed that excessively dry...

  • Page 225: Ventilator Safe State

    2. Adjust the APL pressure limit for the desired inspiratory plateau pressure. 3. Press the O flush button on the Narkomed 6400 as required to sufficiently inflate the breathing bag. 4. Manually ventilate the patient by squeezing the breathing bag.

  • Page 226: Operating During A Power Failure

    Operating during a Power Failure During a power failure, the Narkomed 6400 battery backup will ensure continued operation for a minimum of 30 minutes. Even after the Narkomed 6400 batteries are depleted, the ventilator can continue to be used to ventilate the patient in Manual/Spontaneous Mode.

  • Page 227: Operation During Cardiac Bypass

    The Narkomed 6400 has help screens to assist the clinician in the case where negative pressure has been applied to the airway. For more information, see “Negative Pressure Dialog Box” on page 9-32 and corrective action for Breath Sys.
  • Page 228 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 229 RETURN TO CD-ROM TABLE OF CONTENTS Messages/Problem Resolution This section describes the alarm notification structure and lists all potential Narkomed 6400 monitoring alarms and ventilator control panel messages, including status messages, operator prompts, and alarms. Descriptions of problem resolution follow the appropriate monitoring alarms.

  • Page 230: Alarm Structure

    5 seconds 2/3 volume 4 seconds 4th, etc. full volume 3 seconds; alarm sounds full volume in 3-tone bursts until condition is resolved or [ALARM SILENCE] control button is activated, when possible. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 231: Pressure Monitoring

    The following tables contain all warning, caution, and advisory alarms Pressure associated with breathing pressure monitoring. Alarms Note: This summary assumes that the patient’s condition is checked before attempting to change any system settings when patient condition alarms occur. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 232 This alarm condition is cleared as soon as the measured breathing pressure drops below the high pressure alarm limit. However, the alarm message remains displayed for 5 seconds. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 233 The monitor has sensed a PEEP of 26 cmH O or greater. Alarm annunciation ceases as soon as the measured PEEP drops below 26 cmH Also, a pressure apnea warning or continuing pressure alarm condition clears this alarm condition. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 234: Pressure Monitoring Problem Resolution

    Ensure flow sensor is displayed while installed in expiratory properly installed to ventilator is in limb the expiratory valve. Manual/ Flow sensor cable is Ensure flow sensor Spontaneous Mode disconnected cable is connected. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 235: Volume Monitoring

    The expiratory flow in the patient breathing system is continuously monitored. By processing the expiratory flow pattern, the monitor can determine if a “valid” breath has occurred. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 236 15% below the ventilator setting. The measured tidal volume used for comparison is compensated for hose compliance. Note: This alarm is available only in Volume mode and SIMV mode. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 237: Volume Monitoring Problem Resolution

    An error has occurred with the flow sensor. VOL SENSOR DISC The flow sensor cord is not properly connected to the respiratory volume input receptacle on the Narkomed 6400 (or the cord is damaged enough to cause an open circuit). Volume Monitoring...

  • Page 238: Nitrous Oxide And Agent Monitoring

    The gas analysis pod is warming up LINE BLOCK Air samples are not getting through the sample line to the gas analysis pod. SERVICE GAP The gas monitoring system needs service Narkomed 6400 Operator’s Manual 9-10 Part Number: 4117965-001 Rev: A...

  • Page 239: Carbon Dioxide Monitoring

    30 seconds. When the ventilator is in Manual/ Spontaneous or SIMV (SIMV rate<6) Mode: The warning condition does not occur until 60 seconds have elapsed. Narkomed 6400 Operator’s Manual 9-11 Part Number: 4117965-001 Rev: A...
  • Page 240 The CO alarm state is OFF. LINE BLOCK Air samples are not getting through the sample line to the gas analysis pod. SERVICE GAP The gas monitoring system needs service Narkomed 6400 Operator’s Manual 9-12 Part Number: 4117965-001 Rev: A...

  • Page 241: Oxygen Monitoring

    The measured inspiratory oxygen concentration has fallen below the low alarm limit. Oxygen Monitoring Cautions Message Condition O2 SUPPLY LOW Oxygen supply to the Narkomed 6400 has fallen below 37 psi (± 3 psi). Narkomed 6400 Operator’s Manual 9-13 Part Number: 4117965-001 Rev: A...
  • Page 242 O2 SENSOR DISC The oxygen sensor cord has become disconnected (or is damaged enough to cause an open circuit). SERVICE O2 MON Oxygen zero calibration values are invalid. Narkomed 6400 Operator’s Manual 9-14 Part Number: 4117965-001 Rev: A...

  • Page 243: Oxygen Monitoring Problem Resolution

    O2 CAL DUE housing and cable housing/cable messages appear on assembly. central alarm display Sensor cord is Reconnect oxygen during monitoring. disconnected sensor cord to input receptacle on Narkomed 6400. Narkomed 6400 Operator’s Manual 9-15 Part Number: 4117965-001 Rev: A...

  • Page 244: Machine Input Alarms

    GAP COMM LOST Communications lost with gas analysis pod Miscellaneous Alarms Warnings Message Condition VENT FAILURE Ventilator failure Cautions Message Condition FRESH GAS LOW Fresh gas low condition reported by ventilator Narkomed 6400 Operator’s Manual 9-16 Part Number: 4117965-001 Rev: A...
  • Page 245 VENT FAN ERR Ventilator Fan Failure VENT STANDBY Ventilator in Ventilator Standby status VENT TEST DUE No ventilator self-test for more than 10 days. WPU TEMP HIGH Temperature high in WPU Narkomed 6400 Operator’s Manual 9-17 Part Number: 4117965-001 Rev: A...

  • Page 246: Ventilator Messages

    Inspect inspiratory valve disk > 175 ml/min, to prompt clinician and seat for possible cause of to verify that inspiratory valve leak. Resume operation by disk is good pressing selector/confirmation knob. Narkomed 6400 Operator’s Manual 9-18 Part Number: 4117965-001 Rev: A...
  • Page 247 Reassemble piston assembly and reinstall. Resume operation by pressing selector/confirmation knob. piston test displayed during piston test, No operator response required. which occurs periodically during mechanical ventilation Narkomed 6400 Operator’s Manual 9-19 Part Number: 4117965-001 Rev: A...
  • Page 248 Subsystem 3 leak displayed under certain leak Inspect breathing bag, fresh gas conditions hose, and vaporizers for insecure connections or damage. Resume operation by pressing selector/ confirmation knob. Narkomed 6400 Operator’s Manual 9-20 Part Number: 4117965-001 Rev: A...
  • Page 249 Y-piece Verify that Y-piece is open. Confirm change by pressing selector/confirmation knob. Ventilator The following messages are provided to the Narkomed 6400 operator for Status information only. Ventilator status messages rarely require any response Messages from the operator.
  • Page 250 Volume or Pressure Mode; digits in the spaces indicate the current set PEEP value Power off displayed momentarily when Narkomed 6400 is switched to standby Resetting/ displayed during an internal reset Resetting piston...
  • Page 251 Spontaneous Mode of operation and contact an authorized representative of Messages DrägerService. If ventilation is not possible in Manual/Spontaneous Mode selection, the ventilator override switch can be activated to bypass the ventilator. Narkomed 6400 Operator’s Manual 9-23 Part Number: 4117965-001 Rev: A...
  • Page 252 To prevent this situation from occurring, follow the guidelines given in “Use of Suction with the Narkomed 6400” on page 8-22. Narkomed 6400 Operator’s Manual 9-24 Part Number: 4117965-001 Rev: A...
  • Page 253 Equipment fault See Fault Nr. message below. displayed momentarily when an equipment fault is detected; replaced by a fault number Narkomed 6400 Operator’s Manual 9-25 Part Number: 4117965-001 Rev: A...
  • Page 254 DrägerService. Pressure limit displayed when operating in Increase Pmax or decrease tidal Volume Mode or SIMV Mode volume. but limited by Pmax Narkomed 6400 Operator’s Manual 9-26 Part Number: 4117965-001 Rev: A...
  • Page 255 Verify that the airway pressure hose is sensor fault is detected undamaged and properly connected to the compact breathing system. If the Narkomed 6400 is equipped with the optional breathing system pressure gauge, verify secure connections at the T-fitting and the breathing system interface panel.

  • Page 256: Hint Messages

    Hint messages that are not associated with alarms should be removed sooner than 3.5 or five seconds if another hint message is displayed. Hint messages can be removed immediately by touching the hint message. Narkomed 6400 Operator’s Manual 9-28 Part Number: 4117965-001 Rev: A...
  • Page 257 To the left of the bell icon for Agent. Warmup. Warmup. CO2 Alarm Bell during GAP COMM Alarm remains Off when there is a To the left of the bell icon for CO2. LOST. GAP communications error. Narkomed 6400 Operator’s Manual 9-29 Part Number: 4117965-001 Rev: A...
  • Page 258 Stop the Time Remaining timer to On the “Hours Minutes Seconds” on Timers page of the Utility select new time. row of the selection table. Notebook when the timer remaining timer is active. Narkomed 6400 Operator’s Manual 9-30 Part Number: 4117965-001 Rev: A...
  • Page 259 (with concurrent delivered. Consider checking for PRESSURE LIMIT and FRESH adequate fresh gas flow rate and GAS LOW alarms) possible leak in airway or fresh gas delivery system. Narkomed 6400 Operator’s Manual 9-31 Part Number: 4117965-001 Rev: A...

  • Page 260: Negative Pressure Dialog Box

    Figure 9-1. Negative Pressure Dialog Box Note: To prevent this situation from occurring, follow the guidelines given in “Use of Suction with the Narkomed 6400” on page 8-22. Narkomed 6400 Operator’s Manual 9-32 Part Number: 4117965-001 Rev: A...

  • Page 261: Breathing Hose Compliance Limit Dialog Box

    Messages/Problem Resolution Breathing Hose Compliance Limit Dialog Box When the Narkomed 6400 determines that the Divan ventilator can no longer compensate for the breathing hose compliance, a dialog box is displayed to alert the clinician. The dialog box also shows the numerical values for both the preset and the delivered tidal volumes.
  • Page 262 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 263 RETURN TO CD-ROM TABLE OF CONTENTS General Care and Maintenance This section provides instructions for clearing condensation, cleaning, and disinfecting, and basic maintenance of the Narkomed 6400 and its component systems. Powering Down the Narkomed 6400 for Cleaning ..10-2 General Care Instructions ..........

  • Page 264: Powering Down The Narkomed 6400 For Cleaning

    Replacing the Gas Analysis Pod (GAP-2) ....10-30 Powering Down the Narkomed 6400 for Cleaning When moving the Narkomed 6400 for service or to clean up a fluid spill, the following procedure is recommended. 1. Turn the main switch to STANDBY position.

  • Page 265: Inspecting The System

    Such policies, procedures, and instructions should ultimately be consistent with established principles of clinical microbiology and infection control. Narkomed 6400 Operator’s Manual 10-3 Part Number: 4117965-001 Rev: A...
  • Page 266 All parts must be dry before the steam sterilization process. Minimum exposure is 20 minutes at 121°C (250° F) and 10 minutes at 134°C (273° F). Processing plastic and rubber parts at temperatures over 121°C accelerates deterioration. Narkomed 6400 Operator’s Manual 10-4 Part Number: 4117965-001 Rev: A...

  • Page 267: Ventilator Routine Maintenance

    In the event that patient circuit filters nation are not used, or there are cases involving infected patients, more frequent cleaning and decontamination may be required. Narkomed 6400 Operator’s Manual 10-5 Part Number: 4117965-001 Rev: A...

  • Page 268: Ventilator Disassembly Instructions

    Warning: The temperature of the breathing system heater may be as much as 65°C. BREATHING SYSTEM HANDLE BREATHING SYSTEM LOCKING LEVER OP00035B Figure 10-2. Location of Breathing System Locking Lever Narkomed 6400 Operator’s Manual 10-6 Part Number: 4117965-001 Rev: A...
  • Page 269 7. Unscrew the APL valve and remove it from the ventilator. 8. Unscrew the inspiratory and expiratory valve caps and remove the sealing rings and valve disks. Narkomed 6400 Operator’s Manual 10-7 Part Number: 4117965-001 Rev: A...
  • Page 270 (counterclockwise). 2. Lift the top housing away from the bottom housing. 3. If the two valves inside are soiled, unscrew them to release them from the bottom housing. Narkomed 6400 Operator’s Manual 10-8 Part Number: 4117965-001 Rev: A...
  • Page 271 3. Completely unscrew the central captive screw on the piston using 6 mm hexagon key. 4. Remove the piston and front roller diaphragm. The remainder of the piston assembly does not contact breathing gas, therefore does not need to be sterilized. Narkomed 6400 Operator’s Manual 10-9 Part Number: 4117965-001 Rev: A...

  • Page 272: Ventilator Reassembly Instructions

    4. Insert the piston by carefully placing the lipped edge of the diaphragm around the edge of the piston. 5. Tighten the piston into position with the center captive screw. Note: Tighten firmly. This is not a quick-release screw. Narkomed 6400 Operator’s Manual 10-10 Part Number: 4117965-001 Rev: A...
  • Page 273 6. Tighten the five quick-release screws with a 6 mm hex key. 7. Press the button on the secondary vacuum relief valve, and verify that it operates freely (see Figure 10-8). Narkomed 6400 Operator’s Manual 10-11 Part Number: 4117965-001 Rev: A...
  • Page 274 Caution: Be careful not to damage the lip seals when replacing the piston. 4. Swing the piston assembly handle to the left and down as far as possible. See Figure 10-9. Narkomed 6400 Operator’s Manual 10-12 Part Number: 4117965-001 Rev: A...
  • Page 275 2. Fit the sealing rings. Expiratory and APL 3. Screw on the valve caps. Valves 4. Screw on the APL valve. The graduations should face the front of the Narkomed 6400. Narkomed 6400 Operator’s Manual 10-13 Part Number: 4117965-001 Rev: A...
  • Page 276 . Refer to the manufacturer’s instructions for the specific signs to expect when the absorbent is saturated. If the Narkomed 6400 has been out of use or in storage, replace the absorbent before using the machine. Draeger Medical recommends establishing a routine schedule with a sufficient safety margin for replacing absorbent.

  • Page 277: Removing The Piston Assembly

    Caution: If the piston assembly handle cannot be lifted to its full up position, DO NOT force the handle up as this will damage the piston coupling assembly. Narkomed 6400 Operator’s Manual 10-15 Part Number: 4117965-001 Rev: A...
  • Page 278 Do not operate the ventilator with the piston assembly handle in the up position. 4. Turn the breathing system locking lever to its locked position. Narkomed 6400 Operator’s Manual 10-16 Part Number: 4117965-001 Rev: A...

  • Page 279: Replacing The Oxygen Sensor

    3. Press down on the black lever under the flow housing and remove the flow housing and transducer assembly from the electronics housing. Narkomed 6400 Operator’s Manual 10-17 Part Number: 4117965-001...
  • Page 280 If the flow housing is properly aligned, try gently shifting the flow housing left and right until the assembly fits easily into the electronics housing and the lever clicks into place. Narkomed 6400 Operator’s Manual 10-18 Part Number: 4117965-001 Rev: A...

  • Page 281: Disinfecting The Flow Sensor

    4. Press down on the black lever under the flow housing and remove the flow housing and transducer assembly from the electronics housing. 5. Pull both transducers out of the flow housing. Narkomed 6400 Operator’s Manual 10-19 Part Number: 4117965-001...

  • Page 282: Care And Cleaning

    Tighten the retaining ring (hand-tighten only). See Figure 10-14. 4. Connect the 22 mm corrugated hose to the flow sensor assembly. Narkomed 6400 Operator’s Manual 10-20 Part Number: 4117965-001 Rev: A...
  • Page 283 Perform the preuse checkout procedure provided in this manual, Section 7. OP00642 FLOW SENSOR ASSEMBLY 22MM HOSE TO Y-PIECE SENSOR CABLE SENSOR CABLE ATTACHED TO RESPIRATORY VOLUME SENSOR INTERFACE Figure 10-14. Installing the Flow Sensor Narkomed 6400 Operator’s Manual 10-21 Part Number: 4117965-001 Rev: A...

  • Page 284: Cleaning And Disinfecting The Breathing System Pressure Gauge

    7. Perform the open reservoir scavenger portion of the daily checkout procedure. See “Open Reservoir Scavenger System” on page 7-10 of this manual. Narkomed 6400 Operator’s Manual 10-22 Part Number: 4117965-001 Rev: A...
  • Page 285 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS General Care and Maintenance BLOCK VACUUM SOURCE TERMINAL ADAPTER NEEDLE VALVE ASSEMBLY INPUT PORT CAP FLOWMETER OP00146 Figure 10-15. Open Reservoir Scavenger Maintenance Narkomed 6400 Operator’s Manual 10-23 Part Number: 4117965-001 Rev: A...

  • Page 286: Maintenance For Passive Systems Scavenger Interface

    5. Remove the relief valve by twisting it counterclockwise out of the housing. Use the tips of a needle-nose pliers to turn the valve, taking care not to damage the fragile valve disk. Narkomed 6400 Operator’s Manual 10-24 Part Number: 4117965-001 Rev: A...

  • Page 287: Water Trap Reservoir Maintenance

    1. To avoid damage, grip the water trap only by its ribbed surface as shown in Figure 10-17, and pull it out of its holder. RIBBED SURFACE Figure 10-17. Removing the Water Trap Narkomed 6400 Operator’s Manual 10-25 Part Number: 4117965-001 Rev: A...
  • Page 288 Figure 10-17, and pull it out of its holder. Dispose of it in an appropriate manner. 2. Push a new water trap into the holder until it clicks into place. Narkomed 6400 Operator’s Manual 10-26 Part Number: 4117965-001 Rev: A...
  • Page 289 Luer-lock fitting on the water trap, and twist until secure. SAMPLE LINE ANALYSIS TO Y-PIECE ADAPTER WATER TRAP SEMI-PERMEABLE OP00667 TUBE Figure 10-19. Semi-Permeable Tube Replacement Narkomed 6400 Operator’s Manual 10-27 Part Number: 4117965-001 Rev: A...

  • Page 290: Care Of Vaporizer

    4. Close the paper compartment. LATCH OP00613 PAPER HOLDER Figure 10-20. Replacing the Strip Chart Recorder Paper Narkomed 6400 Operator’s Manual 10-28 Part Number: 4117965-001 Rev: A...

  • Page 291: Removing The Footrest (Narkomed 6000 Machines)

    Figure 10-21 when following this procedure. Note: This information on the optional footrest applies only to Narkomed 6000 machines. Narkomed 6400 machines have an integrated footrest which is standard equipment and is not removable. To remove the footrest from the machine: 1.

  • Page 292: Replacing The Gas Analysis Pod (Gap-2)

    Figure 10-21. Removing/Replacing the Footrest (Narkomed 6000 only) Replacing the Gas Analysis Pod (GAP-2) The GAP-2 pod can be replaced while the Narkomed 6400 system is operating. This allows the anesthesia machine to remain functional in the event of a GAP-2 failure during a case.
  • Page 293 10. Verify that the GAP-2 pod is functional within 60 seconds of installation. 11. When practical, perform a complete system self-test in order to allow full diagnostics to be run on the GAP-2 pod. Narkomed 6400 Operator’s Manual 10-31 Part Number: 4117965-001...
  • Page 294 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 295 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Specifications This section lists important specifications for the Narkomed 6400. Physical Dimensions ............11-2 Environmental ..............11-2 Operating ................11-2 Storage ................11-2 Electrical ................. 11-2 Touch Screen Display ............. 11-3 Auxiliary Video Output ............

  • Page 296: Physical Dimensions

    Backup battery charging time ......≤ 12 hours Backup battery reserve power time (from full charge) . ≥ 30 minutes Narkomed 6400 Operator’s Manual 11-2...

  • Page 297: Touch Screen Display

    Fresh gas oxygen concentration (ORC)....25 ± 4% Oxygen flush flow rate......55 (±10) L/min Narkomed 6400 Operator’s Manual 11-3...

  • Page 298: Ventilator, Divan

    PEEP ......2.0 to 20 cmH O ± 2 cmH Narkomed 6400 Operator’s Manual 11-4...

  • Page 299: Breathing System Specifications

    Flow Resistance ......<2 cmH 0 at 60 L/min Operating Media ..All normal anesthetic gases except Heliox Narkomed 6400 Operator’s Manual 11-5 Part Number: 4117965-001 Rev: A...

  • Page 300: Monitoring

    Noise ......... . . < 0.1% abs Narkomed 6400 Operator’s Manual...
  • Page 301 Sensor service life ......≥ 8 months at 25° C, 50% relative humidity, 50% O gas mixture (or ≥ 5000% hour CO Narkomed 6400 Operator’s Manual 11-7 Part Number: 4117965-001 Rev: A...
  • Page 302 Waveform resolution ......1 L/minute Waveform display scales ....0-20, 0-50, 0-100 L/minute Narkomed 6400 Operator’s Manual 11-8...
  • Page 303 Protocols ......... . Vitalink Narkomed 6400 Operator’s Manual...
  • Page 304 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 305 Factory Default Settings ..........A-1-3 Alarm Management ........... A-1-6 Alarm Displays ............A-1-10 Summary of Alarm Messages and Indicators .... A-1-13 Summary of Ventilator Control Panel Information ..A-1-17 Flow Sensor Failure ........... A-1-17 Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...

  • Page 306: Self-Diagnostic Tests

    Tables Self-Diagnostic Tests The following self-diagnostic tests are conducted by the Narkomed 6400 when the main switch is powered on or when the main switch is changed from STANDBY to ON position. Power is cycled by the processor to the appropriate ports;...

  • Page 307: Factory Default Settings

    200 ml/ Breathing Pressure Peak PEEP Apnea Threshold 8 cmH Plateau Display Mean Display Minute Volume Agent Note: the Halothane agent scale Isoflurane changes to Enflurane 20% for Desflurane Desflurane Sevoflurane Narkomed 6400 Operator’s Manual A-1-3 Part Number: 4117965-001 Rev: A...
  • Page 308 Monitor Standby via [New Case]. Vent Confirm Tone Volume Level MAC Display Ventilation Sound Selection None Volume O Waveform Display Narkomed 6400 Operator’s Manual A-1-4 Part Number: 4117965-001 Rev: A...
  • Page 309 Window #4 no trend configured Tidal Volume Alarm Enabled The Tidal Volume alarm setting cannot be stored within a template. The setting listed here will be restored with each machine power-up. Narkomed 6400 Operator’s Manual A-1-5 Part Number: 4117965-001 Rev: A...

  • Page 310: Alarm Management

    • ventilator in Ventilator reset by Standby Mode clinician; • monitor error enabled during • flow sensor ventilator disconnected communica- • VPO monitor tions error communications error Same as Agent/N2O Narkomed 6400 Operator’s Manual A-1-6 Part Number: 4117965-001 Rev: A...
  • Page 311 Standby Mode clinician; • monitor error enabled during • flow sensor ventilator disconnected communica- • calibration in progress tions error • calibration failure • VPO monitor communications error Same as Agent/N2O Narkomed 6400 Operator’s Manual A-1-7 Part Number: 4117965-001 Rev: A...
  • Page 312 Standby Mode enabled during • monitor error ventilator • flow sensor communica-tions disconnected error • calibration in progress • calibration failure • VPO monitor communications error Same as Agent/N2O Narkomed 6400 Operator’s Manual A-1-8 Part Number: 4117965-001 Rev: A...
  • Page 313 • gas analysis pod communications error Oxygen clinician cannot change oxygen alarms Pressure • ventilator not in Manual/Spontaneous Mode • monitor error • VPO monitor communications error Same as Agent/N2O Narkomed 6400 Operator’s Manual A-1-9 Part Number: 4117965-001 Rev: A...

  • Page 314: Alarm Displays

    Active alarm or Pre-existing condition Alarm window erases resolved alarm silenced alarm is resolved condition and contracts to fit remaining alarms. Alarm window closes if no alarms. Narkomed 6400 Operator’s Manual A-1-10 Part Number: 4117965-001 Rev: A...
  • Page 315 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Tables Advisories Pre-Existing Alarm Narkomed 6400 Response when no New Condition Window Condition ALARM SUSPEND Alarm window New advisory Alarm window expands to show all alarms minimized...
  • Page 316 OFF annunciators ON Pressure Volume annunciators OFF annunciators OFF annunciators OFF annunciators OFF no change no change no change no change Agent annunciators OFF annunciators OFF annunciators OFF annunciators OFF Narkomed 6400 Operator’s Manual A-1-12 Part Number: 4117965-001 Rev: A...

  • Page 317: Summary Of Alarm Messages And Indicators

    PEEP greater than high limit Patient none - bell icon Pressure alarms disabled NM 6400 changes APNEA - VOLUME Warning Volume apnea detected, over 30/60 seconds Patient (longer when ventilator is in Manual/Spontaneous Mode) Narkomed 6400 Operator’s Manual A-1-13 Part Number: 4117965-001 Rev: A...
  • Page 318 Ventilator communications failure NM 6400 VOL SENS ERR Advisory Volume sensor error NM 6400 + single audible tone VENT FAN ERR Advisory Ventilator fan problem NM 6400 + single audible tone Narkomed 6400 Operator’s Manual A-1-14 Part Number: 4117965-001 Rev: A...
  • Page 319 Agent low - Isoflurane Patient % SEVO LOW Caution Agent low - Sevoflurane Patient % DES LOW Caution Agent low - Desflurane Patient MAC HIGH Caution Total MAC value exceeds 3.0 NM 6400 Narkomed 6400 Operator’s Manual A-1-15 Part Number: 4117965-001 Rev: A...
  • Page 320 NM 6400 + single audible tone FRESH GAS LOW Caution Fresh gas low condition reported by ventilator NM 6400 SERVICE O2 MON Advisory Oxygen zero calibration values are invalid NM 6400 Narkomed 6400 Operator’s Manual A-1-16 Part Number: 4117965-001 Rev: A...

  • Page 321: Summary Of Ventilator Control Panel Information

    Occurrence Alarm Message Displayed 12 V Failure SERVICE VOL NVRAM Failure SERVICE VOL Healthcheck Failure SERVICE VOL Ultrasonic Failure VOL SENS ERR Volume Sensor Cable VOL SENSOR DISC Disconnect Narkomed 6400 Operator’s Manual A-1-17 Part Number: 4117965-001 Rev: A...
  • Page 322 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 323 Gas Evacuation Accessories ........A-2-3 Respiratory Gas Monitoring ........A-2-3 Interface Cables ............A-2-3 Auxiliary Video Output Accessories ......A-2-4 Side-Mount Accessories ..........A-2-4 Printer Paper ............. A-2-4 Drawer Storage ............A-2-4 Training ..............A-2-4 Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 324 Suction Assembly with Reusable Glass Canister..4106328-001 Suction Suction Assembly with Disposable Plastic Canister ..4112647-002 Systems Power Outlet strip (6 additional outlets with 15 ft. power cord) . . . 4112267 Management Narkomed 6400 Operator’s Manual A-2-2 Part Number: 4117965-001 Rev: A...
  • Page 325 Narkomed 6400 Binder and Instruction Manual Assembly (includes Narkomed 6400 Operator’s Manual) ... 4118068 Narkomed 6000 Series Service Manual ....4114846-001 Narkomed 6000 Series Service Binder Assembly (includes Narkomed 6000 Series Service Manual) .
  • Page 326 Removable drawer divider trays (set of 2) ....4115001 Training Biomed training seminar, (Telford PA) ....SV00400 Narkomed 6400 Operator’s Manual A-2-4 Part Number: 4117965-001 Rev: A...
  • Page 327 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Optional Accessory Mounting Systems This section specifies the permitted configurations for optional accessory mounting systems for the Narkomed 6400. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 328 Optional Accessory Mounting Systems Narkomed 6400 Permitted Configurations for Optional Accessory Mounting Systems Optional mounting systems are available for the Narkomed 6400 anesthesia system allowing the user convenient positioning of monitors and accessories. Each line in the following table lists the permitted configurations of weight distribution for components installed on the Narkomed 6400.
  • Page 329 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Optional Accessory Mounting Systems 5 IN. MAX 15 IN. MAX MOUNT FLUSH ONLY WITH NO EXTENSION OP00121 Figure A-3-1. Locations of Mounting Options Narkomed 6400 Operator’s Manual A-3-3 Part Number: 4117965-001 Rev: A...
  • Page 330 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 331 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Divan Ventilator Self-Test Flow Chart This section contains a flow chart for the Narkomed 6400 Divan ventilator self-test. Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 332 APL = 30 CM H2O? Y-PIECE OPEN? PISTON SEAL LEAK TEST OPERATING CONTROL PRESSURE SUPPLY PRESSURE? CONT. PRESS. LOW? SERVICE 120 SUBSYSTEM 2 LEAK? CHECK PISTON REMOVE PISTON INSERT PISTON CONTINUED CONTINUED Narkomed 6400 Operator’s Manual A-4-2 Part Number: 4117965-001 Rev: A...
  • Page 333 CONT. PRESS. LOW PISTON SEAL LEAK CONTROL PRESSURE TEST BREATH SYS LOCK? SERVICE 118 SERVICE 119 SERVICE 115 VALVE AND ROLLER VALVE DISK FAIL DIAPHRAGM TEST PISTON SEAL LEAK CONTINUED CONTINUED Narkomed 6400 Operator’s Manual A-4-3 Part Number: 4117965-001 Rev: A...
  • Page 334 SUBSYSTEM 2 LEAK FRESH GAS OFF? LEAKAGE >10 L/MIN INSP. VALVE? SUBSYS. 1 LEAK LEAK = [ ] ML/MIN RERUN LEAK TEST? LEAK ACCEPTED? <175 >175 SUBSYS 2 LEAK CONTINUED CONTINUED Narkomed 6400 Operator’s Manual A-4-4 Part Number: 4117965-001 Rev: A...
  • Page 335 FRESH GAS OFF? TEST VALVE FUNCTION BREATH SYS. FAIL INSP. VALVE? APL = 30 CM H2O? APL = è MAN? SUBSYS 1 / 2 LEAK END OF SELF TEST STANDBY Narkomed 6400 Operator’s Manual A-4-5 Part Number: 4117965-001 Rev: A...
  • Page 336 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 337 ......9-10 airway pressure ......7-16 7-17 8-22 9-26 greatly exceeds high alarm limit ....9-10 connection ..........9-21 9-27 annunciators ..........4-4 continuous ............9-27 autoset ............4-10 high ..............9-26 Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 338 9-14 oxygen monitoring system calibration ..5-18 5-20 PEEP pressure ..........5-12 anesthesia record ............7-2 pressure ............5-13 anesthesia workstation, Narkomed 6400 ....2-3 set by clinician ........2-40 3-15 anesthetic agent supply ..........7-8 setup page ............3-15 anesthetic agent trace ..........4-5 system-wide autoset ........
  • Page 339 ............9-14 main control button ........2-41 incomplete ..........7-7 parameter box during operation .......2-42 mixture too lean ........9-14 parameter box in configuration ......2-42 mixture too rich ........9-14 checkout procedure Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 340 ......2-5 Respitone ............3-9 cylinder yokes keyed ........2-5 Resume ............. 8-5 cylinder yokes labeled ........2-5 Setup ............... 3-10 cylinder pressure gauge ..........2-7 Setup Notebook ..........3-7 cylinder wrench ............7-2 Narkomed 6400 Operator’s Manual Rev: A Part Number: 4117965-001...
  • Page 341 ........5-15 pressure measuring hose ........10-6 default setting, ventilator .......... 6-9 flow control valve ..........2-6 breathing rate ............ 6-2 adjustment ..........2-7 inspiratory flow rate ........... 6-2 color-coded ..........2-4 Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 342 ..........2-5 sample compensation ........8-4 humidification fresh gas use, minimal ........2-20 2-31 inspiratory gas ..........2-21 Full Control mode ........... 4-15 hypoxic mixture, fresh gas ........2-10 functions, Narkomed 6400 Narkomed 6400 Operator’s Manual Rev: A Part Number: 4117965-001...
  • Page 343 ....9-19 9-21 9-25 Backup Speaker Test Passed ......3-14 internal reset ........... 9-22 Battery Fully Charged ........3-13 manual ............2-31 BATTERY LOW ..........2-37 manual in Ventilator Standby ......2-19 Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 344 ......... 1-5 SIMV Rate ............9-23 message, ventilator SIMV Rate = __/min .........9-22 % Insp Pause ..........9-22 Standby ..........8-19 9-22 ___I to E___ ............ 9-22 Standby ? ..........8-19 9-23 viii Narkomed 6400 Operator’s Manual Rev: A Part Number: 4117965-001...
  • Page 345 Subsystem 2 leak ..........9-20 log time of day ........2-46 8-12 Subsystem 3 leak ..........9-20 respiratory volume ...........5-16 Supply pressure? ..........9-21 moving the Narkomed 6400 ....1-7 8-18 10-2 Testpress. error ..........9-21 US.Version ............9-22 Valve disk fail ..........9-21 Narkomed 6400 ............1-4...
  • Page 346 Reduce Volume, ventilator ......9-23 reserve cylinder ..........2-10 override, ventilator fault ..2-16 2-25 8-21 9-23 9-28 to Narkomed 6400 ...........9-21 oxygen alarms ..........5-23 5-24 oxygen, bypass flow ..........2-10 advisories ............9-14 autoset ............5-24 cannot place on Alarm Standby ...... 3-54 page, agent/N2O monitoring parameter notebook cannot suspend ........3-54...
  • Page 347 ..........2-24 in SIMV Mode ..........2-31 pop-off valve .........1-8 2-17 2-25 7-15 in Volume Mode ..........2-31 adjustment ..........2-25 increase setting ..........2-29 pressure limit ........8-21 8-22 Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 348 ..........8-22 parameter box ..........2-45 operating systems on ........3-2 peak ............5-2 pneumatic ............3-2 PEEP ............5-2 power switch, Narkomed 6400 ....... 2-19 plateau ...............5-2 ON ............2-36 2-37 problem resolution ..........9-6 initiates diagnostic tests ......2-32 setup ..............5-7...
  • Page 349 ......2-25 2-34 7-15 Volume ........ 2-43 3-11 3-27 3-28 adjustment ............9-27 setup notebook, Narkomed 6400 system ....3-7 exhaust connection, ventilator ......2-24 setup, preoperative ..........5-18 exhaust gas ..........7-11 7-16 SIMV Mode, ventilator ..1-9 2-15 2-20 2-30 6-10 pressure restriction ..........
  • Page 350 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS Narkomed 6400 ..........3-2 display colors ...........2-45 sterilization ............. 10-4 display scale, minimum and maximum ....8-7 storage drawer ............2-3 display two-hour trend ........8-6 strip chart recorder .....2-51...
  • Page 351 .......... 8-19 agent/N2O monitoring ........9-10 no gas used ............. 8-19 carbon dioxide monitoring ........9-11 piston can be removed ........8-19 Heliox incompatible with flow sensor ....2-32 ventilator tone volume ..........3-30 Narkomed 6400 Operator’s Manual Part Number: 4117965-001 Rev: A...
  • Page 352 ........1-6 trend ..............2-45 patient safety ............. 1-7 volume ........... 2-41 5-14 physician supervision of Narkomed 6400 operation width of viewing area ....... 2-42 waveform, printing ......... 3-48 3-51 preuse checkout ..........1-6 weight limits, top shelf ..........1-8 qualifications for operation of anesthesia machine .
  • Page 353 RETURN TO THIS MANUAL'S TABLE OF CONTENTS RETURN TO CD-ROM TABLE OF CONTENTS...
  • Page 354 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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