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1. V MT TO FRESH GAS TUBE Note The check valve is not installed on the Canadian machine 144 Fabius Tiro Operator s Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Appendix Daily and Preuse Checkout Form Daily and Preuse Checkout Form Before operating the Fabius Tiro the following checkout verification form must be completed to ensure that the machine is ready for use Do nat insert any additional components into or modify the anesthesia system after the checkout procedure 15 started This is a recommended procedure Follow your institution s policies for specific checkout procedures Caution check can not be carried out satisfactorily the machine must n
2. OP50002 Fabius Tiro Operators Manual 500 8758 LLE Hed RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Connecting the Compact Breathing System Chapter 4 Preparation Con necting the Com pact Breathing Figure 55 Compact Breathing System Installation System The following numbers in boldface refer to Figure 55 and Figure 56 Caution The sealing rings on the threaded and conical connectors 5 and 6 must be undamaged and clean Caution Only hand tighten the threaded connectors Do not use tools 1 Pull and hold plunger 1 out to its full extension on the compact breathing system 2 the compact breathing system onto the compact breathing system mount 2 3 Release the plunger 1 and rotate the compact Figure 56 Hose Connections for Compact Breathing breathing system until the plunger locks into System position 4 Screw the fresh gas hose from the Fabius Tiro 3 to the compact breathing system 4 5 Screw the ventilation hose to the ventilator 5 and a
3. 36 FIRE 5 E RT A 37 Fresh Gas Flow Monitoring Resolutions 1 111 38 Standard Resolution e M 38 aal M 38 APLI Pp E 39 Fabius Tiro Operator s Manual 19 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Overview Chapter 3 Operating Concept Overview This chapter provides an overview of the user interface which enables you to set and view monitoring ventilation and status information using the respective screens windows keys soft keys and the rotary knob See Monitoring on page 71 for more information Standard Function Controls Figure 7 Ventilation Monitor Screen and System Controls Home Key The Home key 1 in Figure 7 displays the main screen the screen in Figure 7 from anywhere in the system 4 2 1 5 elle 7 Support M20 Air 02 Mains Power Applied LED The Mains Power Applied LED 2 in Figure 7 when A illuminated indicates that the machine is connected ee mm to a Mains power source Selecting and Confirming The rotary knob 3 in Figure 7 is used to select and confirm functio
4. 1 4 2 1 131 Gas Supply 132 Chapter 12 Technical Data Contents A75 dada Res 133 Technical Data cio TIE 135 sede A A A E 143 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev Chapter 1 Introduction Contents Introduction Contents 3 3 Not for Use in Areas of Explosion Hazard 3 Safe Connection with Other Electrical Equipment 3 Operators Responsible K 4 SUBE EAS a 4 Copyright Trademark and Limitation of Liability 4 GUSTO arma M 4 DIE INC qe EL EHE 4 cin 4 SIA IO sra opina 5 8 General Warnings and Cautions anbauen 9 Fabius Tiro Manual 1 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Overview Overview Caution For your safety and that of your patient
5. 141 Low Oxygen Supply Pressure Alarm T 141 S ORC Sensitive Oxygen Ratio Controller ecce 142 ee E 142 Diagrams RU 143 Fabius Tiro Operator s Manual 133 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev Technical Data Technical Data Ambient Conditions During operation Temperature Atmospheric pressure Relative humidity During storage Temperature Atmospheric pressure Relative humidity Machine Data RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 12 Technical Data 10 to 35 700 to 1060 cmH O 20 to 80 10 to 60 700 to 1060 cmH O 10 to 90 Gas supply from medical gas pipeline system Pipeline System Pressure Range at Machine Connector O2 N2O Air Gas supply connectors Each inlet is fitted with a non return valve Pipeline Pressure Indicator Accuracy 50 to 55 psi 3 4 to 3 8 bar Note Pipeline system supply pressure variation shall not exceed x 1096 NIST or DISS where required 3 of full scale from 40 to 120 psi 2 7 to 8 bar Gas supply from supplementary O2 and N2O cylinders with pin index connections Cylinder Connections Cylinder Gas Pressure typical full loads at 70 F 21 Cylinder Gauges Cylinder Gauge Range Internal Regulator Safety Relief Valve Pressur
6. UO UR YS 47 Attaching Manual Ambu Ventilation 0 2 47 Preparing the 1 48 Ventilator Safety Features Rh RR RR ERA RR RR N 48 Attaching the CO2 Absorber onto the Compact Breathing 49 Attaching the Inspiratory 1 49 Attaching the Expiratory Valve 49 Attaching the Adjustable Pressure Limiting APL 50 Inserting the Flow Sensor nn eee 50 Attaching the Waste Gas Outlet Port 2 n 50 Connecting the Compact Breathing 51 Connecting the Breathing 71 52 Inserting A New O2 Sensor 52 Accessing the Connector Panel 53 Connecting the O2 Sensor 4 54 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Contents Connecting the Pressure 54 Con
7. ia 117 Dismantling the Absorbent Canister u an nn nn 118 Dismantling Pas or the Year cisne 118 cleaning falle eier 119 Recommendations for Typical Cleaning and Disinfection After Use 120 xis Dp eie ISR T n 121 LS TECH AA tee 121 Every D MOMS cnica lidia 121 FOREN n 121 oi d AAA 121 Checking Readiness for Operation uri ii 121 Fabius Tiro Manual 115 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 9 Routine Maintenance and Cleaning Routine Maintenance Routine Maintenance Routine maintenance must be performed regularly to ensure safe and effective operation Regularly check the condition of the absorbent and the overall condition of the machine power cord hoses and breathing bag Disassembling Preparing the Compact Breathing System Leave the vaporizer s on the machine Remove all breathing hoses Remove the breathing bag Remove the ventilation hose Qv doo m B Remove the fresh gas hose from the breathing system Remove the anesthetic scavenging hose Detach the APL bypass and the Peep Pmax lines from the breathing system and from the side of the machine 8 Remove the flow sensor cable
8. 12 The Alarm window 1 displays up to four of the 540 6 5 highest priority alarms The following numbers in boldface refer to Figure 14 Alarm Window PLAT PEAK Oxygen Monitor Window 7 1 8 The Oxygen Monitor window 2 displays the inspiratory oxygen concentration in units of percent It also displays the oxygen alarm limits in the far right section of this window Respiratory Volume Monitor Window VT Freq TL TE TIP TI PEEP The Respiratory Volume Monitor window 3 displays the patient s frequency breaths per minute or respiratory rate tidal volume minute volume the minute volume high alarm limit and the minute volume low alarm limit Breathing Pressure Monitor Window The Breathing Pressure Monitor window 4 displays the patient s positive end expiratory pressure PEEP mean airway pressure MEAN or plateau airway pressure PLAT and peak airway pressure PEAK Breathing Pressure Trace Window The Breathing Pressure Trace window 5 displays a trace or waveform of the patient s breathing pressure Fabius Tiro Operator s Manual 25 Chapter 3 Operating Concept Selecting Setting Monitoring Functions The following example describes changing alarm limits on the Standby Setup Screen Example 1 Press the Setup key while the Standby Screen Figure 15 is active The Standby Setup screen Figure 16 replaces the Standby Screen 2 The rotary knob enables
9. Standby Screen Figure 117 Leak Compliance Test Vent Prep Message Preparing ventilator for Leak Compl best Figure 118 Leak Compliance Test Instruction Screen 1 Close all fresh gas control valves 2 Place Y piece on plug located on bag mount 3 Seal sanmple line connector if applicable 4 Switch APL valve to and set pressure to 48 58 5 Press 02 flush button build up a pressure of 15 30 Pa cmHzio ress rotary knob ko exit Figure 119 Leak Compliance Test Results Screen Standby 81 54 Leak Tests COMPLETE Compliance Test COMPLETE Ventilator Leak Test PASSED 6 Compliance Test PASSED 2 08 nmL enHza Date Ventilator Leak Compliance nL nin Br 11 B2 Brr11 82 T 78 nL cnHze 2 12 2 12 2 13 Br llz482 Failed Failed Press rotary knob En exit 2 09 Fabius Tiro Manual 500 8758 LLE Hed RETURN THIS MANUAL S TABLE OF CONTENTS Standby Screen Access Alarm Log 1 Press the Access Alarm Log soft key The Alarm Log appears Figure 120 2 Turn the rotary knob to scroll through the Alarm Log When the Clear Alarm Log is selected and confirmed all alarms in the Alarm Log are deleted Restore Site Defaults Press the Restore Site Defaults soft key The pre defined site default settings are restored and the Default settings restored mes
10. T ERUIT dei DATE TREES aes 17 Chapter 3 Operating Concept onc MOM IC ET 19 OVOIVIOW x 000 bo ah dee xa EG a EXE EGO Pda xx CU dee Kee ure qe 21 Standard Function 6 114 40 21 Cross Functional Controls and 22 Monitoring PEE E Vegan a ed 24 Ventilation 28 Fresh Gas Control d 244 00 trad ede ddd oe bet t dob wine bod el od 37 Fresh Gas Flow Monitoring Resolutions 1 38 BAR A v sa ay ee eS 39 Chapter 4 Preparation Contents 2 nee doen behets op Kee A AA e 41 Mounting the Fabius Tiro Onto 43 Activating the Battery sss peer Me REDI orna E TR RR pet Rete 44 Gas Supply sex 0 ERR d am RUE mee RS Pad NUN E EG 45 Medical Gas Pipeline Supply of O2 20 and 45 Tethered Medical Gas Regulator and Gauge 45 Cylinders with Pin index Mounting 46 Electrical Supply 2 chad AS NUR
11. 3 Insert the diaphragm 4 Fit the cover 3 and lock the three clasps Connect the ventilator chamber pressure sensor line 5 to the ventilator chamber pressure sensor line port 6 6 Swing the ventilator unit 1 back into position Ventilator Safety Features e High pressure safety relief valve A Negative pressure safety relief valve B e Ventilator chamber pressure sensor 48 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Preparing the Ventilator Figure 50 Ventilator Assembly Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Attaching the CO2 Absorber onto the Compact Breathing SystemChapter 4 Preparation Attaching the Absorber onto the Compact Breathing System 1 Remove the absorber canister see Replacing 2 Absorbent on page 64 for more information Fill the absorber with fresh CO2 absorbent to the fill line Dr ger Medical Inc recommends the use of Dr gersorb 800 Plus Ensure that no CO2 absorbent dust particles have been deposited between the gaskets and the sealing surfaces Such dust and particles can cause leaks in the system Tighten the absorber by turning it to
12. Checking Readiness for Operation Refer to Daily and Preuse Checkout Form in the Appendix Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 9 Routine Maintenance and Cleaning 121 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 10 Troubleshooting Contents Troubleshooting Contents Table 8 Alarm Message Probable Cause and 125 Fabius Tiro Operator s Manual 123 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev Contents RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Table 7 Alarm Message Probable Cause and Remedy Chapter 10 Troubleshooting Alarm Message Probable Cause Remedy AIRWAY PRESSURE HIGH Upper alarm limit for airway pressure has been exceeded ventilation hose is kinked Alarm limit has been set too low Check hose system on anesthesia machine Check breathing circuit or alarm limit value APNEA FLOW Breathing ventilation stops Leak or disconnect in breathing circuit Check ventilator Check breathing circuit APNEA PRESSURE Inadequate fresh gas supply Breathing ventilation stops Leak or disconnect in breathing circuit Ensure adequ
13. Mounting the Fabius Tiro Onto A Wall Note Complete the Periodic Manufacturer s Service procedure SP00267 after you set up the Fabius Tiro anaesthesia machine Mounting the Fabius Tiro Onto A Wall The following bolded numbers refer to Figure 41 1 Insert the rear of the dovetail plate 1 into the wall mounted dovetail bracket 2 Tighten the retaining screw 3 Place the Fabius Tiro Core Module 4 on top of the two swivel plate pins 5 so that the pins enter into the applicable Fabius Tiro Core Module pin holes 4 Tighten the two set screws 6 with a hex key The following bolded numbers refer to Figure 42 5 Ifthe Fabius Tiro has the optional writing tray 1 pull out the writing tray to expose the swivel plate retention knob 2 Part Number 4118348 003 Rev Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 4 Preparation Figure 41 Mounting Fabius Tiro Onto A Wall 43 Chapter 4 Preparation The following bolded numbers refer to Figure 43 6 Turn the swivel plate retention knob 1 clockwise to loosen the Fabius Tiro module Rotate the Fabius Tiro module counterclockwise Insert and tighten the two screws 2 into the bottom of the swivel plate 3 Activating the Battery The Fabius Tiro anesthesia machine is shipped with the battery fuse disconnected in order to prevent discharge during shipment and storage prior to installation 1 Remove the ba
14. Select and confirm Default Settings SEVERE The Default Settings column is selected Figure 123 Default Settings If the return arrow 1 in Figure 123 is selected and confirmed the Default Settings column is de Volume Settings selected and Default Settings is selected Pressure Settings Figure 122 Alarm Limits Alarm Uo lune The Default Settings Items are Restore Factory Defaults e Volume settings Pressure settings Alarm Limits Alarm Volume Restore Factory Defaults 104 Fabius Tiro Operator s Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Standby Setup Screen Chapter 8 Standby Mode Functions Volume Settings Figure 124 Standby Setup Screen Default Volume Standby Setup Default Settings Exit 1 Select and confirm Volume settings The Default Volume Settings window appears along the bottom of the Standby Setup screen Figure 124 Uo lune Settings Pressure Settings Alarm Limits Alarm Restore Factory Defaults Select a value by pressing corresponding soft key 550 2 Press a soft key ex PMAX Figure 125 Figure 125 Standby Setup Screen Default Volume Change The cursor appears over the setting for the Standby Setup selected soft key Default Settinaz Ext 3 Select and confirm a new setting value ex in Figure 125 the
15. Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Fabius Tiro Operators Manual 500 8758 LLE Hed RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Appendix Daily and Preuse Checkout Form Part Number 4118348 003 Rev Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Fabius Tiro Operator s Manual Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Appendix Daily and Preuse Checkout Form Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date
16. Standby Setup Screen Configure Date Set Select The values that can be selected are numerical values Standby Setup applicable to day month and two digit year Configuration Exit Tine Set Time Format Date Format Acoustic Confirmation Alarm Tone Sequence Waveform Display Select date and press rotary knob Ea confirm Date Format Figure 140 Standby Setup Screen Configure Date Format The values that can be selected are Select MM DD YY or DD MM YY Standby Setup Configuration Exit Tine Set Tine Format Date Set Date Format Acoustic Confirmation Alarm Tone Sequence Waveform Display Select Format and press rotary knob to confirm Acoustic Confirmation Figure 141 Standby Setup Screen Configure Acoustic Confirmation Standby Setup The values that can be selected are On and Off If On is selected an acoustic confirmation is Configuration annunciated every time that the rotary knob is Exit ressed sed Tine Set Time Format Date Set Date Format Acoustic Confirmation Hlarm Tone Sequence Waveform Display Select and press ratary knob to confirm 112 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Standby Setup Screen Chapter 8 Standby Mode Functions Alarm Tone Sequence Figure 142 Standby
17. to a Warning in the Alarm window and a continuously repeating audible alarm sounds During apneic conditions the respiratory volume measurements disappear after 30 seconds When a valid breath is detected alarm annunciation ceases and a tidal volume measurement appears in the display window When the system is in ManSpont Mode Caution condition does not occur until 30 seconds have elapsed without a valid breath Warning condition does not occur until 60 seconds have elapsed without a valid breath During apneic conditions the respiratory volume measurements disappear after 60 seconds When a valid breath is detected alarm annunciation ceases and a tidal volume measurement appears in the display window EXP PORT LEAKAGE Caution Expiratory volume during inspiration is greater than 15 mL MINUTE VOLUME HIGH Caution Whenever the Fabius Tiro measures a minute volume higher than the high minute volume alarm limit the Caution message MINUTE VOLUME HIGH appears in the Alarm window and an intermittent audible alarm sounds Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring 83 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Respiratory Volume Monitoring MINUTE VOLUME LOW Caution Whenever the Fabius Tiro measures a minute volume less than the low minute volume alarm limit the Caution message
18. 12 0 in 8 0 in 30 5cm 20 3 cm Mount Arm Length Right Side 12 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS General Warnings and Cautions Caution Caution Trolley mounted units with right hand COSY Figure 2 on page 12 and Figure 12 the combined weight of the accessories shall not exceed 14 pounds 6 4 kilograms on the side of the Fabius Tiro where the COSY 1 mounted and shall not exceed 40 pounds 18 2 kilograms on the side opposite the COSY Trolley mounted units The total combined weight of all accessories and monitors mounted on the top and sides of the Fabius Tiro shall not exceed 80 pounds 36 kilograms Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 1 Introduction 13 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 2 Configurations and Components Contents Configurations and Components Contents ses cc rro 17 GINS emi hits 17 Vaporizer OPtonal A 17 17 Auxillary Oxygen Flowmeter Optional eu 17 Fabius Tiro Operators Manual 15 RETURN TO
19. 9 Remove the O2 sensor cable 10 Remove the compact breathing system Dismantling the Inspiratory Valve 1 Unscrew the retaining nut 2 Remove the inspection cap 3 Extract the valve disc Dismantling the Expiratory Valve 1 Unscrew the retaining nut 2 Remove the inspection cap 3 Extract the valve disc Dismantling the Flow Sensor 1 Loosen fitting on the expiration port 2 Extract the flow sensor Dismantling the APL Valve 1 Unscrew the retaining nut 2 Remove the APL valve 3 Unscrew the waste gas outlet port Fabius Tiro Operator s Manual 117 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 9 Routine Maintenance and Cleaning Disassembling Dismantling the Absorbent Canister 1 Turn the absorber counter clockwise and remove by pulling down 2 Empty the expired CO2 absorbent from the absorber into an appropriate refuse container Warning Absorbent is caustic and is a strong irritant to the eyes skin and respiratory tract When replacing the absorbent take care not to spill its caustic contents 3 Fill the absorber with fresh CO2 absorbent Ensure that no CO2 absorbent dust particles have been deposited between the gaskets and sealing surfaces Such dust and particles can cause leaks in the system Dr ger recommends the use of Dr gersorb 800 Plus Dismantling Parts of the Ventilator Figure 145 Dismantling the Ventilator The following num
20. 93 Volume Alarms cc e yum a 94 AUO 94 Calibrate O2 94 Activate Desflurane 95 ACCESS Alartm LOG A E AAA A E 96 Access Alarm Volume v eU 96 Window 96 Chapter 8 Standby Mode Functions Contents LA M EA AAA AAA eae Sates dur 97 OVOIVIOW dud da 99 Standby SCIGen A QURE gta eis 99 Standby Setup Screens eseria AA A A A A 104 Chapter 9 Routine Maintenance and Cleaning Content Baan A 115 Routine cocci n 117 Disasseimbling NN 117 Disinfecting Cleaning Autoclaving 119 Maintenance 121 Checking Readiness for Operation 41 121 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Contents Chapter 10 Troubleshooting Contents desirte ra a ah 123 Chapter 11 Components uoc PDC 127 A EPI 129 Compact Breathing System Top View 130 Rear View Connector
21. Access Alarm Log soft key volume Control 1221 DH The alarm log Figure 102 replaces the Setup window Turn the rotary knob to scroll down the list of alarm UT nu 8 0 messages 540 6 5 3 0 Note If Clear Alarm Log is selected and 1 PLAT PERE 35 confirmed all alarm messages in the Alarm T 1 8 10 Log are deleted Clear Hlarm Log 61 68 82 16 49 IHSP 02 LOM I Access Alarm Volume Figure 103 Setup Alarm Volume 1 Press the Access Alarm Volume soft key volume Control mem The Alarm Volume Setting window Figure 103 replaces the Setup window 2 Select and confirm a new alarm volume value Freq pu g UT The new alarm volume value is saved and the 1 2 540 65 2 0 Access Alarm Volume Setting window TIT SEHE disappears 2 f 18 x Adjust Alarm volume and press rotary knob to confirm Note The value 1 is the minimum and the value of 10 is the maximum Alarm Yolume Range 1 10 Window Deactivation Once the Setup window is activated if no rotary knob activity occurs within 15 seconds the Setup window is deactivated and the Waveform window is activated Another way to deactivate the Setup window and activate the Waveform window is to press the Home key 96 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Funct
22. OF CONTENTS Respiratory Volume Monitoring Respiratory Volume Monitor Display Information about the patient s respiratory volume is presented in the Respiratory Volume Monitor window in the middle of the monitor display as shown in Figure 90 From left to right measured values are shown for breathing frequency 1 tidal volume 2 and minute volume 3 At the extreme right in small type is the minute volume high alarm limit 4 and the minute volume low alarm limit 5 The following numbers in boldface refer to Figure 90 Frequency Freq 1 Shows the number of breaths during the previous minute of respiration Readings appear after two breaths The numeric data is displayed in units of Breaths Per Minute bpm The display range is from 2 bpm to 99 bpm e Tidal Volume Measurement VT 2 Displays the expired volume for each breath If the monitor does not detect a valid breath within 30 seconds in an automatic ventilation mode or within 60 seconds in ManSpont mode the display area goes blank The numeric data is displayed in units of milliliters mL The display range is from 0 mL to 1500 mL Minute Volume Measurement MV 3 Continuously displays the volume of exhaled gas accumulated during the previous minute of respiration The numeric data is displayed in units of liters minute L min The display range is from 0 1 L min to 99 0 L min Volume Alarm High Limit 4 Indicates the volume abo
23. OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 4 Preparation Electrical Supply Cylinders attached to the hanger yokes must contain gas at the recommended pressures outlined in Table 1 Indicated pressures are of E size cylinders at 70 F or 21 C Cylinders measuring less than the minimum recommended pressure PSI MIN should be replaced with new full cylinders Electrical Supply Fabius Tiro can be operated at mains voltages from 100 V to 240 V Push power plug into supply mains socket Switch on the machine The system power switch 1 in Figure 48 is on the rear of the machine Attaching Manual Ambu Ventilation Bag Hang the fully prepared and tested bag 1 on a wall rail wall mounted Fabius Tiro or on a trolley rail trolley mounted Fabius Tiro Fabius Tiro Operator s Manual Table 1 Recommended Cylinder Gas Pressures PSl bar FULL GAS typical full load PSl bar MIN Nitrous Oxide 745 51 600 42 Oxygen 1900 131 1000 69 Figure 48 Power Switch Figure 49 Ambu Ventilation Bag 47 Chapter 4 Preparation Preparing the Ventilator Use only disinfected sterilized components The following numbers in boldface refer to Figure 50 1 Swing out the ventilator door 1 2 Unlatch the three clasps 2 to remove the cover 3
24. Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date viii Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Preuse Checkout Signature Name Date Fabius Tiro Manual 500 8758 LLE Hed RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Drager medical A Drager and Siemens Company Drager Medical Inc 3135 Quarry Road Telford PA 18969 USA 215 721 5400 215 721 9561 Sales Fax 215 723 5935 Service Fax http www draegermedical com EC Representative Drager Medical AG amp Co KGaA Germany Moislinger Allee 53 55 D 23542 L beck 451 882 0 FAX 451 882 2080 http www draeger com
25. REMEDY No pressure readout in display area during ventilation Pilot line not connected Make sure pilot line is properly connected Pilot line blocked or kinked Make sure that lumen of pilot line is free of obstructions Erratic readings Condensation accumulation in pilot line Drain and reconnect pilot line Fabius Tiro Operator s Manual 89 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 7 Setup Window Used During Operation Contents Setup Window Used During Operation Contents OVES W een 93 Setup Window 93 Volume Alarms On Off eee 94 Auto 94 Calibrate O2 Sensor ee 94 Activate Desflurane Compensation 95 Access Tai 96 Access Alarm Volume 8 96 Window Deactivation 96 Fabius Tiro Operator s Manual 91 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Overview Overview This chapter describes the monitoring and ventilation functions available in the Setup window which
26. RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Ventilation Figure 21 Ventilation Monitor Screen and System Controls 1 Volume Control 2 Control Fabius Tiro Manual 00 81 8LLp Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Ventilation Ventilation Screens Soft Key Labels The following numbers in boldface refer to Figure 22 Each soft key 1 is associated with a ventilation parameter 2 that is associated with a specific ventilation mode 3 Volume Control Mode The following soft key labels appear from left to right along the bottom of the Volume Control screen See Figure 23 PMAX maximum ventilation pressure The range for PMAX is 15 to 70 cmH O The factory default value is 40 cmH O e tidal volume The range for VT is 20 mL to 1400 mL The factory default value is 600 mL Freq ventilation frequency The range for Frequency is 4 bpm to 60 bpm The factory default value is 12 bpm time ratio between inspiration time and expiration time phases The range for is 4 1 to 1 4 The factory default value is 1 2 Tip Ti relative inspiratory pause The range for is 0 to 50 The factory default value is 10 PEEP positive end expiratory pressure The range for PEEP is to 20 cmH O The factor
27. Serial Port Clock Speaker Main Poner Battery FUNCTIONAL Dr ger AL Fabius Tiro SW 2 18 6764 Figure 109 Calibrate Flow Sensor Instruction Screen 1 Close all Fresh gas control valves Remove expiratory hase From breathing system 3 To start Flow Sensor Calibration press rotary knob Figure 110 Calibrate Flow Sensor in Progress Bar Flow Calibration in progress Run Calibrate Access Restore System Flows Alarm Site Test Sensor Defaults Figure 111 Calibrate Flow Sensor Completed Bar Flow Calibration completed reconnect expiratory hose Calibrate Calibrate Restore Flow o2 Site Sensor Sensor Defaults Figure 112 Calibrate Flow Sensor Failed Bar Flow Calibration Failed Calibrate Calibrate Access Restore Flows oz Alarm Site Sensor Sensor Log Defaults Fabius Tiro Operator s Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Standby Screen Calibrate O2 Sensor 1 Press the Calibrate O2 Sensor soft key The Calibrate O5 Sensor Instruction window replaces the Standby screen soft keys Figure 113 Follow the instructions The Calibrate Sensor in Progress bar replaces the instruction window Figure 114 Upon completion of the calibration the O2 Sensor Calibration completed message Figure 115 or the 02 Sensor Calibration FAILED message Figure 116 appears 02 Sensor Cal
28. TE 1 2 0 Flow 30 PEEP 0 Alarm Default Settings for O High 100 e Low 20 Alarm Default Settings for MV e High 12 0 Low 3 0 Alarm Default Settings for Pressure e High lt 40 Threshold 8 Alarm Audio Volume 5 Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Functions Figure 132 Restore Factory Defaults Standby Setup Default Settings Exit Uo lune Settings Pressure Settinas Alarm Limits Alarm Restore Factory Defaults Select and press rotary knob to confirm 109 Chapter 8 Standby Mode Functions Configuration Select and confirm Configuration The Configuration column is selected Figure 133 If the return arrow is selected and confirmed the Configuration column is de selected and Configuration is selected The Configuration ltems are Time Set Time Format Date Set Date Format e Acoustic Confirmation Alarm Tone Sequence e Waveform Display Time Set 1 Select and confirm Time Set The Time Set window appears to the right of Time Set and the cursor appears over the hour field Figure 134 2 Select and confirm a new hour time value ex in Figure 135 the value is changed from 13 to 20 The cursor moves over the minute field Figure 136 110 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Standby Setu
29. TO CD ROM TABLE OF CONTENTS Chapter 11 Components Contents Components Contents dis n 129 Compact Breathing System Top VIEW pt STE Fol La RR 130 Rear View coda PEN RP MT 131 Gas supply Connections aan ae 132 Fabius Tiro Manual 127 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Front View Chapter 11 Components Front View Figure 146 Compact Breathing System and Front of Machine 1 O2sensor on inspiratory valve 2 Selection knob for MAN and SPONT on APL valve 3 Dr ger Vapor anesthetic agent vaporizer 4 Oxygen flush 5 Total fresh gas flowmeter 6 Ventilator 7 Ventilator control panel settings for ventilation parameters and airway monitoring 8 Ventilator hose Fabius Tiro Operator s Manual 129 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 11 Components Compact Breathing System Top View Compact Breathing System Top View Figure 147 Compact Breathing System 1 Selection knob for MAN and SPONT on APL valve 2 APL Bypass valve connection port 3 PEEP PMAX valve connection port 4 Inspiratory valve 5 Expiratory valve 6 Inspiratory port 7 Connector for breathing bag 8 Expiration port 00 81 8LLp Hed 130 Fabius Tiro Manu
30. The apnea pressure alarm 1 disabled APNEA PRESSURE Warning Caution When the ventilator is on If the measured breathing pressure does not cross the pressure threshold alarm limit for more than 15 seconds the Caution message APNEA PRESSURE appears in the Alarm window and an intermittent audible alarm sounds If the breathing pressure does not cross the pressure threshold for an additional 15 seconds 30 seconds total the Caution message APNEA PRESSURE is upgraded to a Warning in the Alarm window APNEA PRESSURE and a continuously repeating audible alarm sounds When the system is in ManSpont Mode The APNEA PRESSURE alarm is automatically deactivated The APNEA PRESSURE alarm can be activated When it is activated in ManSpont mode the Caution occurs after 30 seconds and the Warning occurs after 60 seconds CONTINUOUS PRESSURE Warning If the measured breathing pressure remains above the pressure threshold alarm limit for more than 15 seconds the breathing pressure display area is cleared the Warning message CONTINUOUS PRESSURE appears in the Alarm window and a continuous audible alarm sounds When the measured breathing pressure drops below the pressure threshold alarm limit alarm annunciation ceases AIRWAY PRESSURE HIGH Warning If the measured breathing pressure exceeds the high pressure limit the Warning message AIRWAY PRESSURE HIGH appears in the Alarm window and a continuously repeating
31. as ether cyclopropane etc Safety Features Monitoring of P V FiO2 e O2 SUPPLY LOW alarm Integrated S ORC Sensitive Oxygen Ratio Controller control device to ensure minimum O2 concentration of 23 Vol Per EN740 burns may occur if antistatic or electrically conductive ventilation tubes are used in combination with high frequency electrical surgery equipment Therefore per EN740 these types of breathing tubes are not recommended Caution Do not use Fabius Tiro in the environment of NMR tomography equipment Malfunctions may result thereby endangering the patient RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Intended Use Caution The use of portable and mobile radio frequency communications equipment can affect medical electrical equipment Do not use mobile phones within a distance of 10 meters from the machine Mobile phones can cause malfunctions in electrical medical equipment thereby endangering the patient and the operator Copyright Trademark and Limitation of Liability Copyright Copyright 2003 by Draeger Medical Inc All rights reserved No part of this publication may be reproduced transmitted transcribed or stored in a retrieval system in any form or by any means electronic or mechanical including photocopying and recording without written permission of Draeger Medical Inc The exceptions to this are Recommendations for Typical Cleaning and Disinfectio
32. audible alarm sounds This alarm condition is cleared when the measured breathing pressure drops below the high pressure alarm limit However the alarm message is extended for 10 seconds to allow for a momentary high pressure condition Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring 87 Chapter 6 Monitoring PRESSURE NEGATIVE Warning If the measured breathing pressure falls below 5 cmH O or mean pressure falls below 2 cmH O the Warning message PRESSURE NEGATIVE appears in the Alarm window and a continuously repeating audible alarm sounds This alarm condition is cleared when the sensed pressure rises above 5 cmH O or above a mean pressure of 2 cmH O However the alarm message is extended for 10 seconds to allow the recognition of a momentary subatmospheric pressure condition EXP PRESSURE HIGH Caution During Volume or Pressure Ventilation Caution Any time that the monitor measures a PEEP of 4 cmH O over the PEEP setting the Caution message EXP PRESSURE HIGH appears in the Alarm window and an intermittent audible alarm sounds PEEP HIGH Advisory During ManSpont Mode Advisory Alarm annunciation occurs when the measured PEEP is greater than 4 cmH O INSP PRES NOT REACH Advisory Any time that PINSP pressure is not reached in Pressure mode the Advisory message INSP PRES NOT REACH appears in the Alarm window PRESSURE SENSOR FAIL Advisory
33. expiratory hose Empty water traps if their water level exceeds the maximum water level limit Nitrogen Wash out When Required During anesthesia induction air containing about 7996 nitrogen N2 remains in the compact breathing system and in the patient s lungs If the unit will be used for a low flow anesthesia case press the O2 Flush to remove this N2 Fabius Tiro Operator s Manual 63 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 5 Operation and Shut down Operation Replacing 2 Absorbent Figure 74 Replacing the Absorber Canister The CO2 absorbent in the compact breathing system should be replaced when two thirds of the CO2 absorbent has changed color Draeger Medical recommends the use of Dr gersorb 800 Plus The color change indicates that the CO2 absorbent can no longer absorb 2 Dr gersorb 800 Plus changes from white to violet Do not flush CO2 absorbent for long periods with dry gas because the CO2 absorbent will dry out When the moisture content falls below a specified minimum level the following undesirable reactions can occur regardless of the type of CO2 absorbent and the anesthetic agent used e g Halothane Enflurane Isoflurane Sevoflurane or Desflurane reduced CO2 absorption e formation of CO absorption and or decomposition of the inhalation anesthetic agen
34. hose barb 1 until it engages Caution Do not squeeze the pressure measuring line hose when pressing it onto the hose barb Connect the pressure measuring line hose to the bacterial filter 2 and plug it firmly onto the port on the connector panel 54 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Connecting the O2 Sensor Figure 62 Connecting the O2 Sensor Capsule Figure 63 Pressure Sensor Connections OP50006 Fabius Tiro Operator s Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Connecting the Breathing Pressure Gauge Chapter 4 Preparation Connecting the Breathing Pressure Figure 64 Breathing Pressure Gauge Gauge 1 Connect the pressure gauge 1 to the compact breathing system mount 2 and secure with the retaining screw 3 and lockwasher 4 Push the pressure measuring line hose onto the hose barb 5 the breathing pressure gauge port 6 and onto the port on the connect
35. mode of operation is confirmed To confirm ManSpont press rotary knob 3 The Waveform window 1 replaced by the ManSpont window 2 in Figure 32 A message appears 3 in Figure 32 that provides instructions to confirm the mode change 2 Confirm the mode change The ManSpont screen is activated Figure 33 After the mode change is confirmed the ManSpont key LED switches from blinking to constantly on and the waveform is restored after a short delay Freq UT MU Note The ManSpont screen enables you to 1 2 540 6 5 turn the Apnea Pressure alarm and PEER PLAT 0 Volume alarms ON or OFF T 1 8 3 Adjust the APL valve knob to the appropriate value for the maximum ventilation pressure see APL Valve on page 39 4 Press the O2 flush button as required to inflate the bag OFF ne Set the fresh gas flow Start manual ventilation Fabius Tiro Manual 35 Chapter 3 Operating Concept Selecting Setting Ventilation Parameters 1 In Volume Control mode press the Volume Control key The Volume Control Ventilation Settings window 1 in Figure 34 replaces the Waveform window In Pressure Control mode press the Pressure Control key The Pressure Control Ventilation Settings Window 1 in Figure 35 replaces the Waveform window The following example continues in Volume Control mode 2 Press the VT tidal volume soft key The Ventilator Setti
36. page 112 Acoustic Confirmation Alarm Tone Sequence Waveform Display Select time and press rotary knob En confirm Time Format Figure 137 Standby Setup Screen Configure Time Format 1 Select and confirm Time Format Standby Setup Configurati The Time Format window appears to the right of EN p il Time Format and the cursor appears over the default time format value Figure 134 Tine Set Tine Format 24 Hour Date Set Date Format Acoustic Confirmation Hlarm Tone Sequence Waveform Display Select Format and press rotary knob to confirm 2 Select and confirm a new time format value Figure 138 Standby Setup Screen Configure Time Hour ex in Figure 135 the value is changed from Standby Setup 24 00 Hour to AM PM aan Exit The new format value is saved the Time Format window disappears and the cursor in the 1 i Time Farnat AMPH Configuration column appears over Time oa E Format Date Format The values that can be selected are Acoustic Confirmation 24 Hour or AM PM Alarm Tone Sequence Waveform Display Note This two step process applies to all other items in the Configuration column except for Time Set and Date Set Select Format and press rotary knob to confirm Fabius Tiro Operator s Manual 111 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Functions Standby Setup Screen Date Set Figure 139
37. psi 1 4 bar The cylinder gauges 13 trolley mount only 14 on pressure reducer wall mount only display the pressure measurement of each gas entering the Fabius Tiro from pin index type cylinders Figure 37 Flowmeter and Pressure Gauge Assemblies e Pipeline 1 197 Fabius Tiro Operator s Manual 37 Chapter 3 Operating Concept Fresh Gas Flow Monitoring Resolutions The Fabius Tiro can be configured by your Local Authorized Service Organization to display fresh gas flow rates either in a standard resolution mode or in a high resolution mode Standard Resolution If standard resolution is configured Figure 38 the numeric displays LEDs for the fresh gas flow rates support 100 ml min increments format xx x l min and the flow meters on the monitor screen indicate a range of 0 to 12 l min High Resolution If high resolution is configured Figure 39 the numeric displays LEDs for the fresh gas flow rates support 10 ml min increments format x xx l min and the flow meters on the monitor screen indicate a range of 0 to 10 l min with an emphasis on resolution at the lower end of the scale High resolution data is displayed when all individual gas flows are below 9 99 l min Switching to standard resolution occurs when the highest flow rate is greater than 9 99 l min Switching to high resolution occurs when the highest flow rate drops below 9 00 l min 38 RETURN TO THIS MANUAL S TABLE OF CONTENT
38. sensor outside B2 C2 AGS housing 1 C 1 D 1 AGS flow tube no filter B1 D 1 AGS buffer vol container 1 C 1 D 1 AGS transfer hose A 1 C 1 D 1 120 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Maintenance Intervals Maintenance Intervals Clean and disinfect the machine and components before each service and also when returning for repair When Required e Replace the O2 sensor when calibration is no longer possible Replace the flow sensor when calibration is no longer possible Replace the pressure measuring line silicone rubber hose and sleeve Replace APL bypass and PEEP and Pmax silicone rubber hoses Replace the ventilator hose if it is discolored or damaged Every 6 Months Inspection and service by trained service personnel Draeger Medical Inc recommends Dr gerService Fabius Tiro Breathing systems e Vaporizer s e Sensors e Ventilator hose Annually e Replace the bacterial filter on the pressure measuring line Replace the diaphragm in the ventilator patient Replace vaporizer O rings After 3 Years By trained service personnel e Replace the lead gel rechargeable battery for the back up power supply Replace the diaphragm and O rings of the ventilator piston Replace breathing system canister assembly and associated seals
39. setting value was changed from 40 to 50 Uo lune Settings Pressure Settings Alarm Limits The Standby Setup screen instructs you to Alarm Volume confirm the new default setting Figure 126 Restore Factory Defaults 4 Repeat steps 2 and 3 for setting other parameter values To confirm new PMAX value press rotary knob 5 Confirm the new default setting Figure 126 Standby Setup Screen Default Volume Change aved The Default Volume Ventilator Settings window disappears and the cursor appears over the Standby Setup return arrow Default Settings Exit Pressure Settings Uo lune Settings Use the process example Volume Settings and replace Volume settings with Pressure settings Alarm Uo lune Restore Factory Defaults To confirm new volume default settings press rotary knob VT 550 Fabius Tiro Operator s Manual 105 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Functions Standby Setup Screen Alarm Limits Figure 127 Standby Setup Screen Default Alarm Limits Standby Setup Default Settings Exit 1 Select and confirm Alarm Limits o The Default Alarm Limits window appears Figure 127 Uo lune Settings Pressure Settings Alarm Limits Alarm Uo lune Restore Factory Defaults Fa Select alarm limit and press rotary knob to confirm 2 Select
40. valve The O2 Low Supply Pressure Alarm LED is blinking N2O does not flow Restore the O2 supply N2O flow is present Set O2 metering valve to 1 5 L min N20 flow 3 L min to 5 L min Close the O2 metering valve No 20 flow Open the AIR flow control valve Air flow of at least 10 L min present Close all metering valves Sensor Calibration I I Remove 2 sensor housing from inspiratory valve dome Calibrate O2 sensor Calibrate flow sensor Replace 2 sensor Checking the Gas Type 7 Set the O2 metering valve to approx 3 L min Verify an O2 concentration indication of approx 100 vol Close O2 metering valve RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Vapor 19 n Vapor 2000 Tec 5 Fastening Latched down firmly and set PII vertically 7 Handwheel In zero position and engaged Filling level between and Key indexed filling system Sealing key or pin inserted and closed tight when present Filler opening locked shut Quik Fil or Funnel filling system Locking screw tight when present Desflurane Vaporizer when present Fastening Latched down firmly and set vertically Handwheel In zero position and engaged Operational light lit Filling level between and max Selectatec Fastening Latched down firmly and set vertically P Handwheel In zero po
41. you to select the Default Settings or Configuration label Select and confirm the Default Settings label The Default Settings column 15 selected Figure 17 Note Selecting and confirming the return arrow 1 in Figure 16 will deactivate the Standby Setup screen and activate the Standby screen Figure 15 Note Selecting and confirming the return arrow 1 in Figure 17 will deselect the Default Settings column and reselect the Default Settings label as in Figure 16 26 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Monitoring Figure 15 Standby Screen Last system test run 69719703 19736 Sleep Mode will activate in 2 min sec To start operation press ane of Ehe keys located to the left of the display SWU 18 6764 Access Restore System Alarm Site Test Log Defaults Figure 16 Standby Setup Screen Standby Setup Configuration Exit Exit Uo lune Settings Time Set Time Format Date Set Date Format Pressure Settings Alarm Limits Alarm Uo lune Restore Factory Defaults Acoustic Confirmation Alarm Tone Sequence Waveform Display Figure 17 Standby Setup Screen Default Settings Selected Standby Setup Default Settings Uo lune Settings Pressure Settinas Alarm Limits Alarm Uo lune Restore Factory Defaults Fabius Tiro Operator s Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RE
42. 0 22 mL cmH 0 in automatic mode Volume Control Absorber volume 1500 mL Resistance of Breathing System 5 L min 30 L min 60 L min Inspiratory 0 5 cmH O 1 3 cmH O 2 8 cmH O Resistance Expiraory 0 7 cmH O 2 4 cmH O 4 8 cmH O Resistance S Compliance exclusive of patient hoses Note Resistance tests in compliance with EN740 107 4 2 1 20 Dry Classification Il b Conforming to Directive 93 42 EEC Appendix IX UMDNS Code 10 134 Universal Medical Device Nomenclature System Control Inputs Ranges APL Valve MAN mode 5 70 cmH O SPONT mode 1 5 cmH O Pressure Required to Open a Wet Unidirectional Valve Moist 1 5 cmH O Tested in accordance with EN740 Pressure Generated by a Wet Unidirectional Valve Moist 3 1 cmH O Tested in accordance with EN740 Low Oxygen Supply Pressure Alarm Alarm limit Warning signal when the pressure drops below 20 4 psi Alarm signal High priority alarm Warning LED indicator The red LED indicator in the O area of the gas flow control interface will flash until the supply is restored Fabius Tiro Operator s Manual Chapter 12 Technical Data 141 Chapter 12 Technical Data S ORC Sensitive Oxygen Ratio Controller S ORC is a control element which guarantees a min imum O2 concentration in the fresh gas flow As from a flow rate of approx 200 mL min the N20 concen tration in the fresh gas can be freely set between 0 and
43. 4 Please refer to the specific Instructions for Use for Dr ger Vapor 62 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Operation Figure 70 Power Up Standby Screen Last system test run 69719703 19 356 Sleep Mode will activate in 2 min sec To start operation press ane of Ehe keys located to the left of the display SWU 18 6764 Access Restore System Alarm Site Test Defaults Volume Control Pressure Control PMAX YT PEEP Figure 72 Setting the Vaporizer 500 8758 LLE Hed Fabius Tiro Manual Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Operation Chapter 5 Operation and Shut down O2Flush Figure 73 O2 Flush Button 1 Press the O2 Flush button 1 in Figure 73 Additional O2 flows into the compact breathing system The flow control elements and the anesthetic agent vaporizer are bypassed Note In Man Spont mode pressure may rise rapidly up to the setting of the APL valve Minimum Flow of Anesthesia When long term flow of anesthesia is below 0 5 L min increased humidity in the ventilator hose is a natural occurrence Disconnect the ventilator hose from the compact breathing system and clean before and after long term procedures Use water traps in the
44. 48 003 Rev Oxygen Monitoring RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Table 2 Unsuccessful Calibration Causes and Solutions Cause Solution Sensor was exposed to an excessively lean or excessively rich oxygen calibration mixture Make sure that the sensor is exposed to room air for the entire calibration period Sensor was exposed to a constantly changing calibration mixture Make sure that the sensor is exposed to room air for the entire calibration period Sensor did not receive the proper waiting period If the sensor capsule was removed from the sensor assembly a waiting period equal to the time that the capsule spent outside the sensor assembly is necessary prior to calibration New sensors require a 15 minute waiting period Sensor is exhausted If the oxygen sensor has decayed beyond its useful service life see the Specifications section of the manual replace the exhausted sensor with a new sensor and allow the proper waiting period Sensor is disconnected When the sensor is disconnected or if there is no cell in the housing the display area is blank and the message O2 SENSOR FAIL appears in the Alarm window If this happens ensure that the sensor is correctly assembled and recalibrate the oxygen sensor Consequences If the oxygen sensor is improperly calibrated it can cause inaccurate measureme
45. 50 50 mixture of and O The accuracy of the flow meter may degrade with other gas mixtures See the Technical Data section for specifications The total flow meter serves two purposes The total flow meter provides a reference of the total fresh gas applied to the breathing circuit Flow rate measurements for each individual gas N O Air and are provided by their respective electronic flow indicator Should a fault develop in the electronic flow sensing digital display or power circuitry the total flow meter is still functional The measurement will indicate the total flow rate prior to the fault condition To adjust the fresh gas ratios while under the fault condition shut off all flows O may be left on and then restore each gas flow individually For example start with 2 L min The total flow meter will read 2 L min If 1 L min of gt is needed open the flow control knob until the total flow meter reads 3 L min 2 L min O plus 1 L min The electronic fresh gas flow indicators N O 5 AIR 6 711 display the flow measurement of each gas Note The electronic fresh gas flow meters are altitude corrected The central supply pressure indicators N O 8 AIR 9 O 10 display the pressure measurement of each gas entering the Fabius Tiro from the facility s pipeline The O2 Low Supply Pressure Alarm LED 12 flashes when the O2 supply is below the factory set minimum pressure nominally 20
46. 68 Switch Off the Anesthetic Agent Vaporizer 2 1 1 68 PWEN ON Me Er ic E 69 Remove ME U2 See ii ae 69 SAN OE rain AA 69 Disconnect the Central Gas Supply 44 27 22 2 9 9 4 72002 00 010000000 70 Fabius Tiro Operator s Manual 59 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Operation Operation Power Up Screen When the SYSTEM POWER switch is turned to the ON position the Fabius Tiro performs extensive self tests on its internal hardware As these diagnostics are performed each test and its result appear on the screen The result Pass or Fail indicates the status of the tested component See Figure 69 Self Diagnostic Conclusions At the end of the self diagnostics one of three possible conclusions to the self tests is posted on the screen Figure 69 FUNCTIONAL Every component of the monitoring system 1 in satisfactory operational order After a brief delay the Standby screen appears CONDITIONALLY FUNCTIONAL A noncritical fault was detected The Fabius Tiro may be used but call your local Authorized Service Organization or see Daily and Preuse Checkout Form for Dr gerService contact information Press the rotary knob to continue operation NON FUNCTIONAL A serious fault wa
47. 75 During O2 shortage S ORC limits the N20 concentration in the fresh gas so that the O2 concentration does not drop below 23 vol N20 metering valve S ORC prevents open and 2 metering N20 flow valve closed or O2 flow less than 0 2 L min During N20 failure 02 may still be administered No alarm Serial Interface Type RS 232 Baud Rates 4800 9600 19 2K Parity Odd Even None Data Bits 7 or 8 Stop Bits 1 or 2 Protocol Vitalink Medibus 142 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Technical Data Fabius Tiro Operator s Manual 00 81 8LLp Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 12 Technical Data Diagrams Diagrams Figure 152 Gas flow diagram Compact Breathing System Fresh Gas Decoupling Fresh gas t Absorber OP50013 setting Pmax Peep APL Bypass E Fabius Tiro Operator s Manual Scavenging 143 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 12 Technical Data Diagrams Figure 153 Schematic Diagram of Internal Gas Flow
48. Flow control valves Shut Off Message window are deactivated and the Waveform window is activated The Ventilator will not be switched to Standby mode 2 Confirm Figure 105 Standby Screen The Standby screen Figure 105 replaces the previous screen Gas still flowing shut off all gas flow control activate Sleep Mode After the Standby status is confirmed e Standby key s LED is switched from blinking to constantly on and the ventilator is switched to Standby mode SUN 2 187 54 6764 To start operation press ane of Ehe keys located to the left of the display gas flow is detected then the flows were not shut off before activating Standby mode and the Gas still flowing alarm message will appear in the alarm window Calibrate Calibrate Access Figure 105 Once all gas flow control valves are shut off the flow detection alarm message disappears Figure 106 Test Sensor Sensor Log System az Alarm Figure 106 Standby Screen Last system test runon 97 91 9 2 1962 Sleep Mode will activate in 2 min sec To start operation press one of Ehe keys located to the left of the display SW 6764 Fabius Tiro Operator s Manual 99 Chapter 8 Standby Mode Functions Sleep Mode If 2 5 minutes elapse in Standby mode with no user input SLEEP mode is activated Figure 107 The Ventilator monitor screen is replaced by the screen saver The Screen Sav
49. If the Fabius Tiro detects a faulty sensor the Advisory message PRESSURE SENSOR FAIL appears in the Alarm window If this happens call your local Authorized Service Organization or Dr gerService see Daily and Preuse Checkout Form for Dr gerService contact information PRESSURE LIMITING Advisory Any time that the monitor detects pressure greater than or equal to the PMAX setting Advisory message PRESSURE LIMITING appears in the Alarm window This advisory can only occur when the ventilator is in Volume Control mode PRES THRESHOLD LOW Advisory The Advisory message PRES THRESHOLD LOW appears in the Alarm window any time the sensed peak pressure exceeds the threshold pressure alarm limit by more than 6 cmH O at threshold pressure alarm limit settings of 5 20 cmH O or by more than 88 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Breathing Pressure Monitoring Fabius Tiro Manual 00 81 8LLp Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Breathing Pressure Monitoring 8 cmH 0 at threshold pressure alarm limit settings of 21 29 cmH O Setting the threshold pressure alarm limit at 30 cmH O disables the PRES THRESHOLD LOW advisory Problem Resolution Table 5 Breathing Pressure Monitoring Problem Resolution PROBLEM POSSIBLE CAUSE
50. LE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Ventilation Figure 24 Pressure Control Ventilation Screen Pressure Control 15 38 100 Freq 12 0 12 540 65 PLAT 2 18 Fea Figure 25 ManSpont Ventilation Screen ManSpont 15 38 _ 90 12 540 65 18 2 H OFF votune Fabius Tiro Manual 500 8758 LLE Hed RETURN THIS MANUAL S TABLE OF CONTENTS Ventilation Standby Mode The following soft key labels appear from left to right along the bottom of the Standby screen See Figure 26 Run System Test Calibrate Flow Sensor e Calibrate O2 Sensor Leak Compl Test Access Alarm Log Restore Site Defaults See Standby Screen on page 99 for details Flow Meter Monitor Window The Flow Meter Monitor window is a graphical display of the flow rates of O5 Air and L min 1 in Figure 27 Note On some non U S units of the Fabius Tiro the O2 and N20 virtual flow tubes have changed positions Part Number 4118348 003 Rev Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 3 Operating Concept Figure 26 Standby Screen Last system test run oan 69719703 19 356 Sleep Mode will activate in 2 min 20 sec To start operation press ane of Ehe keys located to the left of the display SWU 18 6764 Calibrate Cal
51. LOW SENSOR FAIL Flow sensor has not been calibrated Sensor faulty Follow the procedure to calibrate sensor Replace sensor and calibrate Call your local Authorized Service Organization or Dr gerService see Daily and Preuse Checkout Form for Dr gerService contact information FRESH GAS LOW Inadequate fresh gas supply Blocked kinked hose Leak or disconnect in breathing circuit Ensure adequate fresh gas supply Check hoses Check breathing circuit INSP 02 HIGH Inspiratory O2 concentration exceeds the Check flowmeter settings and O2 high alarm limit upper alarm limit INSP O2 LOW Inspiratory O2 concentration is below Check O2 supply Check flowmeter settings and lower alarm limit 02 low alarm limit INSP PRES NOT REACH Set pressure not achieved while ventilating in Pressure Control mode Check ventilator and Pinsp settings MINUTE VOLUME HIGH Minute volume has exceeded upper alarm limit Flow sensor has not been calibrated Sensor faulty Calibrate flow sensor Replace if necessary Fabius Tiro Operator s Manual 125 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 10 Troubleshooting Contents Alarm Message Probable Cause Remedy MINUTE VOLUME LOW Minute volume has fallen below lower alarm limit Blocked kinked hose Leak in breathing system Reduced volume due to pressure limitation Redu
52. MINUTE VOLUME LOW appears in the Alarm window and an intermittent audible alarm sounds FLOW SENSOR CAL DUE Advisory The FLOW SENSOR CAL DUE advisory message appears in the Alarm window if it has been longer than 18 hours since the flow sensor has been calibrated FLOW SENSOR FAIL Advisory The FLOW SENSOR FAIL advisory message appears in the Alarm window if the sensor cable is not properly connected to the interface panel if there is an internal sensor fault VOLUME ALARMS OFF Advisory Volume alarms disabled by the operator when in ManSpont mode Respiratory Volume Monitoring Problem Resolution Table 4 Respiratory Volume Monitoring Problem Resolution PROBLEM POSSIBLE CAUSE REMEDY Blank display area Two breaths have not elapsed for minute volume and respiratory rate since respiration began Wait for two breaths to read display Apnea condition Correct apnea condition Ensure sensor is properly connected to the expiratory valve Blank display area FLOW SENSOR Sensor cable is disconnected FAIL alarm message in Alarm window Reconnect sensor cable to sensor at breathing system Sensor fault Replace sensor assembly Inaccurate data displayed Flow sensor signal drift Calibrate the sensor Desflurane compensation setting not consistent with actual agent delivered Activate or deactivate Des Comp as appropriate External agent analyzer providing inacc
53. N TO CD ROM TABLE OF CONTENTS Oxygen Monitoring Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev Oxygen Monitoring RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Oxygen Monitoring Problem Resolution Table 3 Oxygen Monitoring Problem Resolution Chapter 6 Monitoring PROBLEM POSSIBLE CAUSE REMEDY Alarm Message 02 SENSOR FAIL appears in Alarm window Sensor needs calibration Display area remains blank when a reading is expected Perform proper calibration Remove sensor assembly from breathing circuit Make sure sensor is exposed to room air only Calibrate the sensor Hardware malfunction Contact your local Authorized Service Organization or Dr gerService Faulty sensor housing and cable Replace housing cable assembly Sensor cord is disconnected Insert sensor cord connector into the interface panel Pressing the Calibrate O2 Sensor Soft key does not initiate calibration Sensor is disconnected Insert sensor cord connector into the interface panel Sensor cord is damaged Replace housing cord assembly Pressing Calibrate O2 Sensor soft key initiates calibration but Oxygen Monitor window is blank at end of calibration period Sensor is exposed to incorrect oxygen concentration Sensor exposed to constantly changing calibration mixture Expose sensor t
54. OM TABLE OF CONTENTS Connecting the Flow Sensor Figure 66 Connecting the Flow Sensor OP50008 Figure 67 Installing the Scavenger Transfer Hose 36 OP50004 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 4 Preparation Scavenger System for Fabius Tiro Scavenger System for Fabius Tiro Caution Do not use anesthetic gas scavenging system in combination with extracorporeal oxygenator The following numbers in boldface refer to Figure 68 Output connection 1 from the scavenger system to the hospital waste gas removal system Connection to scavenger system 2 from Fabius Tiro breathing system Flow indicator 3 During use the flow indicator must be between the upper and lower marks on the tube Flow adjustment valve 4 Note Activate hospital vacuum system before using scavenger system For more detailed information on the scavenger system refer to the separate specific Instructions for Use For detailed information regarding mounting the scavenger system to the Fabius Tiro anesthesia worksta
55. RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Drager medical A Drager and Siemens Company Operator s Instruction Manual Part Number 4118348 003 ev Fabius Tiro Software Version 2 1n Date 31 March 2004 2004 Draeger Medical Inc Fabius Tiro Warning For a full understanding of the performance of this anesthesia machine the user should carefully read this manual before operating RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Contents Chapter 1 Introduction Contents 244 nern xu ua aaa A y A A e ds 1 OVOIVIOW cota A A as 3 Operators Responsibility eens 3 Intended Use 4 22 24 04 20022 ee ehe ihre ib ep hie 4 Safety S nee A A A ag 4 Copyright Trademark and Limitation of Liability 4 Symbol Definition Sana ao a EEG A UNDA EUR YORKER ee dd FRA RES 5 Abbrevlatloris tace dete Aad ede eat be da dente abdo dud duet dus 8 General Warnings and 1 0 1 9 Chapter 2 Configurations and Components Contents ander aia A AA AAA os A A da eee Vd 15 Typical Fabius Tiro Configuration 1 9 17 Components 2 33 9 I
56. S RETURN TO CD ROM TABLE OF CONTENTS Fresh Gas Flow Monitoring Resolutions Figure 38 Standard Resolution Fresh Gas Flow Monitoring Last system test run on 8919 03 19 356 Sleep Mode will activate in 2 min sec To start operation press ane of Ehe keys located to the left of the display SWU 18 6764 Calibrate Calibrate Access Restore System Flow oz Alarm Site Test Sensor Sensor Log Defaults Figure 39 High Resolution Fresh Gas Flow Monitoring Last system test runon 19109 Sleep Mode will activate in 2 min sec To start operation press ane of Ehe keys located to the left of the display SWU 18 6764 Calibrate Calibrate Restore Flow az Site Sensor Sensor Defaults Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS APL Valve APL Valve The following numbers in boldface refer to Figure 40 The APL valve 1 has two functions It limits the maximum pressure during manual ventilation It also exhausts excess gas into the scavenger system during manual and spontaneous ventilation The APL valve is connected to the patient airway through the ventilator It functions only when the ventilator is in ManSpont mode or ventilator override condition The APL valve has a labeled knob 2 for selecting between spontaneous and manual modes of ventilation and for indicating appr
57. Setup Screen Alarm Tone Sequence The values that you can select are Dr ger and select EN 740 Standby Setup Configuration Exit Tine Set Time Format Date Set Date Format Acoustic Confirmation Alarm Tone Sequence Waveform Display Select and press rotary knob to confirm Waveform Display Figure 143 Standby Setup Screen Waveform Display The values that you can select are Normal and Standby Setup Filled Configuration Exit Time Set Time Format Date Set Date Format If Normal is selected the waveform is filled with a solid pattern but appears as a line 1 in Figure 144 Acoustic Confirmation Alarm Tone Sequence Waveforn Display Filled Select and press rotary knob to confirm Figure 144 Normal Waveform Display volume Control 15 38 90 E 42 12 0 540 65 PEEP PLAT 2 18 Fabius Tiro Operator s Manual 113 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 9 Routine Maintenance and Cleaning Contents Routine Maintenance and Cleaning Contents pe AAA 117 A o AAA AA TAY Preparing the Compact Breathing System 117 Dismantling the Inspiratory Vale anna 117 Dismantling the Expiratory Valve aba 117 0 fe 117
58. THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Typical Fabius Tiro Configuration Typical Fabius Tiro Configuration The Fabius Tiro Inhalation Anesthesia Machine is a modular system consisting of a basic gas delivery module with a variety of components and configuration designs to meet the requirements of various anesthesia delivery applications 2 gas version O2 and Air e 3 gas version O2 N2O and Air pin index cylinder yokes and pressure gauges Components Vaporizer Optional The Vapor anesthetic agent vaporizer 1 in Figure 5 is used to enrich the fresh gas with a precisely metered quantity of vapor from the liquid anesthetic agent being used i e Isoflurane Halothane Enflurane or Sevoflurane When using a third party Desflurane vaporizer 220 V Mains Devapor 110 V Mains D Tec Devapor and D Tec are available through your local Desflurane representative Selectatec Optional For information on the Selectatec refer to the Selectatec Vaporizer s instruction manual Selectatec is a registered trademark of Datex Ohmeda Auxiliary Oxygen Flowmeter Optional For the delivery of a metered flow of pure oxygen for example delivery of oxygen through a nasal cannula an optional auxiliary oxygen flowmeter 1 in Figure 6 can be mounted on the left side of the flo
59. TURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Monitoring Chapter 3 Operating Concept 3 Select and confirm the Alarm Limits label Figure 18 Standby Setup Screen Default Alarm Limits The Default Alarm Limits window appears Standby Setup TI o 1 in Figure 18 Default Settinas Exit Uo lune Settings Pressure Settings Alarm Limits Alarm Uo lune Restore Factory Defaults Select alarm limit and press rotary knob to confirm 4 Selectthe alarm limit value that needs to change Figure 19 Standby Setup Screen Default Alarm Limits Figure 19 Select Standby Setup Default Settings Exit Uo lune Settings Pressure Settings Alarm Limits Alarm Restore Factory Defaults Select alarm limit and press rotary knob to confirm 5 Confirm the alarm limit value and select a new Figure 20 Standby Setup Screen Default Alarm Limits value for the alarm limit ex in Figure 20 the Confirm value was changed from 30 to 25 Standby Setup 6 Confirm the new value for the alarm limit Default Settinas The new alarm limit value is saved and the cursor Ext gt moves over the return arrow Uolume Settings Pressure Settings Alarm Limits Alarm Uo lune Restore Factory Defaults To confirm new OF alarm limit press rotary knob Fabius Tiro Operator s Manual 27 Chapter 3 Operating Concept Ventilation Note Pressure Control described in th
60. Time 4 PM YT Freq Displays the time Fabius Tiro Operator s Manual 23 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 3 Operating Concept Monitoring Monitoring Figure 12 Ventilation Monitor Screen and System Controls Monitoring Controls LED Indicators LED lamps 1 in Figure 12 in the upper right corner a of the control panel indicate the degree of urgency of currently active alarms Warning Red Blinking Caution Yellow Blinking Advisory Yellow Continuous Silence Alarms Key The Silence Alarms key 2 in Figure 12 silences all active alarm tones for 2 minutes It resets the silence time for two minutes each time the key is pressed Alarm Limit Key Figure 13 Alarm Limit Configure Window The Alarm Limit key 3 in Figure 12 displays the volume Control Alarm Limits window 1 in Figure 13 which appears in the same location on all mode screens Setup Key The Setup key 4 in Figure 12 is a cross functional control See Setup Key on page 22 Kakak n 24 Fabius Tiro Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Monitoring Chapter 3 Operating Concept Monitoring Windows Figure 14 Monitor Screen volume Control A 119 1885 12 48
61. actory default value 12 0 L min Minute Volume Low Limit The Minute Volume Low Limit range is from 0 0 L min to 19 9 L min Factory default value 3 0 L min Procedure See Alarms on page 73 to change the low alarm limit 82 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Respiratory Volume Monitoring Figure 91 Respiratory Volume Monitor Controls Volume Control Volume Control Control n n Man Spont Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Respiratory Volume Monitoring Respiratory Volume Alarm Messages The following list contains all warning caution and advisory alarms associated with respiratory volume monitoring APNEA FLOW Warning Caution The Fabius Tiro continuously monitors the expiratory flow in the patient breathing system By processing the expiratory flow pattern the monitor can determine whether a valid breath has occurred A valid breath has a tidal volume of 20 mL or greater When the ventilator is on If 15 seconds pass and a valid breath is not detected the Caution message APNEA FLOW appears in the Alarm window and an intermittent audible alarm sounds e If an additional 15 seconds pass 30 seconds total and a valid breath is not detected the Caution message APNEA FLOW is upgraded
62. al Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Rear View Connector Panel Chapter 11 Components Rear View Connector Panel Figure 148 Connector Panel at Back of Machine 1 Power cable plug 2 On off switch 3 Fuse Fabius Tiro Operator s Manual 131 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 11 Components Gas Supply Connections Gas Supply Connections Figure 149 Gas Supply Connections 1 Connectors for medical gas pipeline supply central supply 2 Connector for gas cylinder supply reserve supply trolley mount only Figure 150 Tethered Medical Gas Regulator and Gauge 1 Tethered medical gas regulator and gauge 600 8768 Hed 132 Fabius Tiro Manual Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 12 Technical Data Contents Technical Data Contents pa AA P 135 SIE ANIOS esteros abans a 135 ta nennen 135 FUSES ici 137 Electromagnetic Compatibility EMG unse 137 ce E o AA 137 ans pa A 138 Anesthesia Gas Supply Module 139 Anesthetic Agent Vaporizer Interface 140 E AA q
63. and confirm the desired alarm limit Figure 128 Standby Setup Screen Default Alarm Limits Figure 128 Select Standby Setup Default Settings Exit Uo lune Settings Pressure Settings Alarm Limits Alarm Uo lune Restore Factory Defaults Select alarm limit and press rotary knob to confirm 3 Select a new setting value ex in Figure 129 Figure 129 Standby Setup Screen Default Alarm Limits the setting value was changed from 30 to 25 Confirm 4 Confirm the new setting value standby Setup Default Settings The new setting is saved and the cursor appears Exit over the return arrow Volume Settings 5 Repeat steps 2 through 4 for setting other setting Pressure Settings values Alarm Limits Alarm Wo lune Restore Factory Defaults ar 500 8758 LLE Hed To confirm new OF alarm limit press rotary knob 106 Fabius Tiro Operator s Manual Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Standby Setup Screen Setting Alarm Limit Defaults When the anesthesia machine 1 started it uses the default alarm limit values that were established the last time the machine was configured These values can be viewed and changed in the Alarm Limit window The Alarm Limit window is deactivated if the rotary knob 1 not used within 15 seconds ifthe Alarm Limit key is pressed again or if any other key 15 pressed Alarm Variables Oxygen High Limit The Oxyge
64. arm Volume Figure 130 Volume Setti olume Settings Pressure Settings Alarm Limits Alarm Wo lune Restore Factory Defaults Range 1 14 Select alarm volume and press rotary knob to confirm 2 Select and confirm a new alarm volume value Figure 131 Standby Setup Screen Default Alarm Volume ex in Figure 131 the value is changed from Standby Setup 4 to 5 Default Settings The new alarm volume value is saved and the Exit Default Alarm Volume Setting window Volume Settings disappears Pressure Settings wane Alarm Limits Note The value 1 is the minimum and the value Alarm alime of 10 is the maximum Restore Factory Defaults Range 1 14 Select alarm volume and press rotary knob to confirm 108 Fabius Tiro Operator s Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Standby Setup Screen Restore Factory Defaults 1 Select and confirm Restore Factory Defaults The Restore Factory Defaults Setting window appears next to Restore Factory Defaults Figure 132 2 Select and confirm Yes or No When Yes is selected and confirmed the factory defaults are restored and replace the Default Settings The factory default settings Volume Control e PMAX 40 e lt 600 e Freq 12 TI TE 1 2 0 e TIP TI 10 e PEEP 0 Pressure Control e PINSP 15 e Freq 12 Tl
65. as monitoring when P present connected to Luer lock on the Y piece correct anesthetic agent selected P 7 Desflurane vaporizer when being used powered on Checking Reserve Power P 7 Verify that battery is fully charged If the battery does not show full a charge the battery operation time is not guaranteed to be 45 minutes Fabius Tiro Operator s Manual Checking the Medical Gas Connections Visually inspect all gas supplies from the m medical gas pipeline system and cylinders to make sure that they connect properly and fit securely Verify that all medical gas pipeline supplies are within acceptable pressure ranges Open reserve gas cylinders when present O2 pressure more than 1000 psi 70 bar 0 pressure greater than 600 psi 43 bar if present Air pressure greater than 1000 psi 70 bar if present 20 0 OF OF 11 Close reserve gas cylinders O2 Flush Function 71 Press O2 flush A strong flow of gas should be emitted from the patient connection 1 Release O2 flush button flow of gas from patient connection stops Daily and Preuse Checkout Form Checking the Flow Control Metering System I I Activate ManSpont mode Fully open the 2 metering valve O2 flow of at least 10 L min present Fully open the N20 metering valve N20 flow of at least 10 L min present Turn off the O2 supply Remove the O2 connector and close the O2 cylinder
66. ate fresh gas supply Check ventilator Check breathing circuit BATTERY LOW AC failure and battery lt 20 Advisory Restore mains power AC failure and battery lt 10 Caution CHECK APL VALVE APL bypass valve fault Check ventilator diaphragm and close cover Check APL bypass valve connection for disconnect or leak Select Standby Mode and switch back to the previous ventilation mode Check the APL valve setting CHECK BATTERY UPS is not functional Replace fuse Call your local Authorized Service Organization or Dr gerService see Daily and Preuse Checkout Form for Dr gerService contact information CONTINUOUS PRESSURE Breathing pressure above threshold for more than 15 seconds Check breathing circuit If in ManSpont mode check fresh gas flow EXP PORT LEAKAGE Expiratory flow of more that 15 mL measured during inspiration Check expiratory valve and valve disk Check tubing of expiration control line Follow the procedure to calibrate flow sensor Call your local Authorized Service Organization or Dr gerService see Daily and Preuse Checkout Form for Dr gerService contact information EXP PRESSURE HIGH Peep is 4 gt above the Peep setting in an automatic ventilation mode Check PEEP PMAX etc hoses for kinks FLOW SENSOR CAL DUE More than 18 hours passed since last flow sensor calibration Follow the procedure to calibrate flow sensor F
67. attempt to pull the machine over any hoses cords or other obstacles on the floor Warning Apply the caster brakes trolley mount only when the anesthesia machine is in use RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 1 Introduction General Warnings and Cautions Cautions Caution Although the Fabius Tiro is designed to minimize the effects of ambient radio frequency interference machine functions may be adversely affected by the operation of electrosurgical equipment or short wave or microwave diathermy equipment in the vicinity Caution Communications with external equipment may be temporarily affected by electromagnetic interference due to the use of electrosurgical equipment Caution Never allow the battery to completely discharge If the battery does discharge completely recharge immediately Caution Do not place more than 40 pounds 18 kilograms on top of the Fabius Tiro monitor housing Caution Do not place more than 22 pounds 10 kilograms on top of the Fabius Tiro optional pull out writing tray Caution Do not place more than 15 pounds 6 8 kilograms in any drawer Caution Trolley mounted units with left hand COSY the combined weight of the accessories shall not exceed 30 pounds 13 6 kilograms on the side of the Fabius Tiro where the COSY is mounted and shall not exceed 40 pounds 18 2 kilograms on the side opposite the COSY Caution Trolley
68. b 3 to set oxygen concentration alarm limits and calibrate the oxygen sensor Setting Oxygen Alarm Limits At power up the oxygen high and low alarm limits are automatically set to their default settings See Default Settings on page 104 for more information You can adjust these limits within specified ranges Oxygen Alarm Limits Oxygen High Limit The Oxygen High Alarm Limit range is from 19 to 100 The Oxygen High Limit can not be set less than or equal to the Oxygen Low Limit The factory default for Oxygen High Limit is 100 Oxygen Low Limit The Oxygen Low Alarm Limit range is from 18 to 99 The Oxygen Low Alarm Limit can not be set equal to or greater than the Oxygen High Limit The factory default value for Oxygen Low Limit 15 20 Procedure See Alarms on page 73 to change the high or low alarm limit Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Figure 84 Monitor Controls 75 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Oxygen Monitoring Calibrating the Oxygen Sensor Figure 85 Ventilation Monitor Screen and System Controls To calibrate the oxygen sensor correctly make sure it is exposed only to room air during the entire calibration period The oxygen sensor should be calibrated as part of the daily preoperative setup of the anesthesia e
69. bers in boldface refer to Figure 145 1 Swing out the ventilator door 1 2 Disconnect the ventilator chamber pressure sensor line 2 from the ventilator chamber pressure sensor line port 3 3 Unlock the three clasps 4 to remove the cover 5 4 Remove the diaphragm 6 lolofolofolo 118 Fabius Tiro Operator s Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Disinfecting Cleaning Autoclaving Disinfecting Cleaning Autoclaving Clean and autoclave the Fabius Tiro Anesthesia Workstation and its parts according to the guidelines below Follow your institution s policies regarding specific methods and agents for cleaning and sterilization Determination of the need and frequency of sterilization of any particular component is the responsibility of the user institution Autoclaving procedures should be performed according to procedures established by the user institution following the specific instructions provided by the manufacturer of the sterilizing equipment or agent to be used Such policies procedures and instructions should ultimately be consistent with established principles of clinical microbiology and infection control Caution The exterior and certain other components of the anesthesia
70. bius Tiro Operator s Manual 69 Chapter 5 Operation and Shut down Disconnect the Central Gas Supply 1 70 Remove all plug in couplings from the wall terminal units Close gas cylinders Press the O2 Flush to depressurize the entire system RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Preparation for Transport or Storage Figure 80 Central Gas Supply 2 7 2 Z 7 2 2 2 7 7 7 OP50012 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Contents Monitoring Contents v e 73 ETS nic o 73 AS A A 73 Alarm TONGS ci Aaaa a aaia 73 Alam Text Display 6 e csi 73 ME e eu 74 Oxygen A 74 A as A 74 E AA 75 Selling Oxygen Alarm LIS aussi S 75 calibrating the jboo 76 Dygen Alarm Messages 78 Oxygen Monitoring Problem Resolution 79 Respiratory Volume Monitoring aussen 80 Respiratory Volume Monitoring Overview 22 2 2222222 80 Respiratory Volume Monitor Display ias A 81 Respirator
71. can be used in Volume Control Pressure Control and ManSpont mode The Setup window enables you to perform ventilation functions and e view and change monitoring settings for the current operation Note To set default monitoring settings to be used at the power up of each operation see Standby Setup Screen on page 104 Setup Window Access Press the Setup key 1 in Figure 95 while the ventilator is in Volume Control Pressure Control or ManSpont ventilation mode The Setup window 1 in Figure 96 replaces the Waveform area and the soft key labels 2 and 3 in Figure 95 The following soft key labels appear in the Setup window e Volume Alarms On Off e Auto Set Calibrate O2 Sensor Des Comp On Off Access Alarm Log Access Alarm Volume Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 7 Setup Window Used During Operation Figure 95 Ventilation Monitor Screen and System Controls Volume Control Pr C 24 3A Lamp Figure 96 Setup Window volume Control Yolume Calibrate Access Access Alarms oz Alarm Alarm Sensor volume 93 Chapter 7 Setup Window Used During Operation Volume Alarms On Off Press the Volume Alarms On soft key 1 in Figure 97 Volume Alarms On changes to Volume Alarms Off and volume alarms are disabled Note The Volume Alarms On Off soft key label does not a
72. ced lung compliance Flow sensor not calibrated or faulty Check breathing circuit and alarm limit Check breathing circuit Check breathing system Check Pmax setting on ventilator control panel Check ventilator settings Follow the procedure to calibrate flow sensor and replace if necessary NO FRESH GAS Inadequate fresh gas supply Fresh gas control valve closed Ensure adequate fresh gas supply Open fresh gas control valve 02 SENSOR CAL DUE More than 18 hours passed since last oxygen sensor calibration Follow the procedure to calibrate oxygen sensor 02 SENSOR FAIL 02 sensor has not been correctly calibrated O2 sensor replaced and or not calibrated O2 sensor used up O2 sensor disconnected Faulty sensor cable Follow the procedure to calibrate O2 sensor Follow the procedure to calibrate O2 sensor Replace sensor capsule and calibrate Connect O2 sensor assembly Replace 02 sensor housing assembly O2 SUPPLY LOW supply line has less than minimum pressure permitted approximately 20 psi Check supply and cylinder backup PEEP HIGH Peep is higher than 4 gt ManSpont Check APL valve setting and or fresh gas flow mode POWER FAIL Mains not connected Connect mains Facility power failure PRES APNEA ALARM OFF Pressure alarms off in ManSpont PRESSURE LIMITING Measured pressure equals or exceeds Pmax ventilator setting Check ve
73. d Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Symbol Definition endorsed by Draeger Medical Inc Buyer understands that the remedies noted in Draeger Medical Inc s limited warranty are its sole and exclusive remedies Furthermore buyer acknowledges that the consideration for the products equipment and parts sold reflects the allocation of risk and the limitations of liability referenced herein Symbol Definition The following symbols appear on the labels on the back of the Fabius Tiro and are defined below Caution Refer to accompanying documents before operating equipment Caution Risk of electric shock do not remove cover Refer servicing to a Dr gerService representative Degree of protection against electric shock Type B Registration Mark Year Manufactured The following symbols appear on the shipping container of the Fabius Tiro This end up Handle with care Keep dry Fabius Tiro Operator s Manual gt a gt Chapter 1 Introduction RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 1 Introduction Symbol Definition Minimum and maximum storage temperatures 60 C 10 c Do not stack The following symbols are used on other locations of the Fabius Tiro to provide quick and easy recognition of product functions Oxygen Concentration Sensor Port Brea
74. e Equipment Class Ingress of Fluids Fabius Tiro Operator s Manual Pin indexed hanger yokes CGA V 1 1994 O2 1900 psi 131 bar 0 745 psi 51 3 bar Conform to ASME B40 1 Grade B O 0 to 3000 psi 206 8 bar 0 0 to 3000 psi 206 8 bar 70 psi Class 1 IPXO IPXO 135 Chapter 12 Technical Data Dimensions Approximate RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Technical Data Note Width may vary with COSY arm position Trolley Mount without COSY W 22 8 in x H 53 6 in x D 24 7 in W 57 9 cm x H 136 1 cm x D 62 7 cm Trolley Mount with COSY W Wall Mount without COSY 30 4 in x H 53 6 in x D 33 0 in W 77 2 cm x H 136 1 cm x D 83 8 cm W 20 8 in x H 21 9 in x D 17 4 in W 52 8 cm x H 55 6 cm x D 44 2 cm Wall Mount with COSY W 28 4 in x H 21 9 in x D 30 5 in W 72 1 cm x H 55 6 cm x D 77 5 cm Weight Approximate Note The following weights exclude weights of supplementary cylinders and vaporizers Fabius Tiro Wall Mount Fabius Tiro Core Module COSY Wall Mount Bracket Fabius Tiro Wall Mount Total Fabius Tiro Trolley Mount Fabius Tiro Core Module with two pin index cylinder yokes COSY Trolley Fabius Tiro Trolley Mount Total Power supply Rating Non configurable Rechargeable batteries Rating Type Recharging time Operation time with fully charged batter
75. ed operator Warning No third party components shall be attached to the anesthesia machine ventilator or breathing system except for certain approved exceptions For more information contact your local Authorized Service Organization or Dr gerService at Dr gerService Draeger Medical Inc 3122 Commerce Drive Telford PA 18969 Tel 215 721 5402 800 543 5047 Fax 215 721 5784 Warning Each institution and user has a duty to independently assess based on its his or her unique circumstances what components to include in an anesthesia system However Draeger Medical in the interest of patient safety strongly recommends the use of an oxygen analyzer pressure monitor volume monitor and end tidal CO2 monitor in the breathing circuit at all times Warning When moving the anesthesia machine trolley mount only remove all monitors and equipment from the top shelf and work surfaces and use only the machine Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 1 Introduction handles or push pull bars The anesthesia machine should only be moved by people who are physically capable of handling its weight Draeger Medical recommends that two people move the anesthesia machine to aid in maneuverability Exercise special care so that the machine does not tip when moving up or down inclines around corners and across thresholds for example in door frames and elevators Do not
76. ely to the equipment operator To this extent the manufacturer Draeger Medical Inc disclaims responsibility for the adequacy of the monitoring package selected for use with the anesthesia system However Draeger Medical Inc is available for consultation to discuss monitoring options for different applications Chapter 1 Introduction Restriction Caution Federal law and regulations in the United States restrict this device to sale by or on the order of a physician Intended Use Fabius Tiro is an inhalation anesthesia machine for use in operating induction and recovery rooms It may be used with O2 N2O and AIR supplied by a medical gas pipeline system or by externally mounted gas cylinders Fabius Tiro is equipped with a compact breathing system providing fresh gas decoupling PEEP and pressure limitation The following ventilation options are available e Volume Controlled Ventilation Pressure Controlled Ventilation Optional e Manual Ventilation e Spontaneous Breathing Fabius Tiro is equipped with an electrically driven and electronically controlled ventilator and monitors for airway pressure P volume V and inspiratory oxygen concentration FiO2 As per EN740 Anesthetic Workstations and their Modules Particular Requirements additional monitoring of the concentrations of CO2 and anesthetic agent is required when the machine is in use Do not use readily flammable anesthetic agents such
77. endent electrochemical cells or sensor halves When the sensor is exposed to oxygen an electrochemical reaction occurs within each cell The oxygen monitor measures the current produced in each cell computes an average for the two cells and translates the average into an oxygen concentration measurement Caution Never remove an oxygen sensor from its housing except to replace it If a sensor is removed from its housing you must do the following before continuing normal operations Reinstall the sensor in the housing Calibrate the sensor Note When the machine is not in use remove the oxygen sensor assembly from the inspiratory valve dome and insert the valve dome plug into the dome Oxygen Monitor Window Figure 83 Oxygen Monitor Window The following numbers in boldface refer to volume Control 15 38 Figure 83 e 1 the numerical value for inspiratory oxygen concentration in units of percent 96 between T UT 10 and 100 2 high oxygen concentration alarm limit 1 2 540 65 3 0 e 3 the low oxygen concentration alarm limit f FEEF PLAT PEAK 40 18 gt 500 8758 LLE Hed 74 Fabius Tiro Manual Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Oxygen Monitoring Oxygen Monitor Controls The following numbers in boldface refer to Figure 84 You use the Alarm Limits key 1 Setup key 2 and rotary kno
78. er displays a message that provides instructions on how to activate Standby mode Run System Test Press the Run System Test soft key The system diagnostics is performed Figure 108 After successful completion the system switches to the Standby screen Calibrate Flow Sensor 1 Press the Calibrate Flow Sensor soft key The Calibrate Flow Sensor Instruction window replaces the Standby screen soft key labels Figure 109 2 Follow the instructions The Calibrate Flow Sensor in Progress bar replaces the instruction window Figure 110 3 Upon completion of the calibration the Flow Sensor Calibration completed message Figure 111 or the Sensor Calibration FAILED message Figure 112 on page 100 appears Flow Sensor Calibration Failed Troubleshooting If the Flow sensor can not be calibrated retry the calibration If the Flow sensor still can not be calibrated call your local Authorized Service Organization or Dr gerService see Daily and Preuse Checkout Form for Dr gerService contact information 100 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Standby Screen Figure 107 Sleep Mode Screen Dr ger MEDICAL Fabius Tiro Press any key to end sleep mode and activate standby mode Figure 108 Diagnostics Screen SYSTEM DIAGNOSTICS Fabius Tira Watch Dog Timer System RAM Program Memory Video Test Interrupts A D Converter
79. essure setting in Pressure Control mode PLAT Plateau airway pressure Pmax Maximum airway pressure setting SPONT Spontaneous breathing TI TE Ratio of inspiratory to expiratory time Tip Ti Ratio of inspiratory pause time to inspiratory time UPS Uninterruptible power supply VAC Vacuum e g for secretion aspiration VT Tidal volume 8 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS General Warnings and Cautions General Warnings and Cautions The following list of warnings and cautions apply to general operation and maintenance of the Fabius Tiro Warnings and cautions about installing and operating specific parts appear with those topics e Warning statements give important information that if ignored could lead directly to a patient s or operator s injury e Caution statements give important information that if ignored could lead directly to equipment damage and indirectly to a patient s injury Warnings Warning Any person involved with the setup operation or maintenance of the Fabius Tiro anesthesia system must be thoroughly familiar with this instruction manual Warning This anesthesia system will not respond automatically to certain changes in patient condition operator error or failure of components The system is designed to be operated under the constant surveillance and control of a qualifi
80. expose En room air 2 minutes 2 To start Oz Calibration press rotary knob 3 Observe Calibration status Cr data window 4 Reinsert O2 Sensor after successful Calibration Figure 99 Calibrate O Sensor in Progress Bar volume Control 15 38 02 1 100 Freq UT 12 540 6 5 PLAT PERK 40 18 2 H Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Activate Desflurane Compensation Chapter 7 Setup Window Used During Operation Activate Desflurane Compensation Press the Des Comp Off soft key 1 in Figure 100 When the Des Comp Off soft key is pressed its soft key label ch Des Comp anges from Des Comp Off to On 1 in Figure 101 Des on appears at the top of the Setup window 2 in Figure 101 Desflurane compensation is activated The Desflurane compensation state will not change when you restore site defaults or run system diagnostics Note Caution Caution Note Fabius Tiro Desflurane has characteristics that affect the sensitivity of the Fabius GS flow sensor To help assure that the volume measurements from the monitor are accurate activate Desflurane compensation when Desflurane is used in the breathing circuit The Fabius GS will automatically compensate for the change in flow measurement characteristics ca
81. flurane Vapor Dr ger Sevoflurane Vapor Datex Ohmeda Devapor D Tec for Desflurane See specific Instructions for Use manuals for technical data of anesthetic agent vaporizers Monitoring and Measurement Display Range Resolution Accuracy Condition p Airway pressure numeric 20 to 99 cmH O 1 cmH O 4 aw Airway pressure wave to 99 cmH O Ve Expiratory minute volume 0 to 99 9 L min 0 1 L min 15 1 ATPS Expiratory tidal volume 0 to 1500 mL 1 mL 1 5 or ATPS 20 mL whichever is greater Note For end tidal values of Desflurane exceeding 12 tidal and minute volume accuracies may exceed 15 f Breathing frequency 2 to 99 bpm 1 bpm 1 bpm FiO2 02 measurement in the main gas 10 to 100 vol 1 vol 3 vol with reference to flow ambient pressure during calibration Response time Less than 25 seconds Service life of O sensor cell gt 8 months at 25 50 relative humidity 50 O gas mixture or gt 5000 hour O 4 of the measured value or 2 cmH 0 whichever is greater T At standard test conditions per EN740 Annex DD and fresh gas flow 2 times Ambient Temperature Pressure Saturated Gas 140 Fabius Tiro Operator s Manual 00 81 8LLp Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Technical Data Breathing System Compact Breathing System Volume 2 8 L bag Compliance
82. hand RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Connecting the Breathing Hoses Figure 57 Breathing Hose Handling Caution Figure 58 Installing Breathing Hoses OP50003 Figure 59 O2 Sensor Capsule Assembly 500 8758 LLE Hed Fabius Tiro Operators Manual RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Accessing the Connector Panel Chapter 4 Preparation Accessing the Connector Panel Figure 60 Pulling Out Optional Writing Tray The following bolded numbers refer to Figure 60 4 1 Ifthe Fabius Tiro has the optional writing tray 1 pull out the writing tray to expose the swivel plate retention knob 2 The following bolded numbers refer to Figure 61 2 Turnthe swivel plate retention knob 1 clockwise to loosen the Fabius Tiro module 3 Rotate the Fabius Tiro module counterclockwise Part Number 4118348 003 Rev Fabius Tiro Operator s Manual 53 Chapter 4 Preparation Connecting the Sensor The following numbers in boldface refer to Figure 62 Push the O2 sensor into the port opening of the inspiratory port dome 1 and plug the connector into the connector panel Connecting the Pressure Sensor The following numbers in boldface refer to Figure 63 Press the pressure measuring line hose onto the
83. hold Alarm Limit The Pressure Threshold Limit range is from 5 to 30 Factory default value 8 cmH O The pressure threshold alarm limit defines the level below which an apneic alarm condition exists When the patient s breathing pressure falls below the threshold limit for 15 seconds a message appears in the Alarm window and an audible alarm sounds Note The pressure threshold alarm limit should be as close as possible to the sensed peak pressure without exceeding it approximately 6 cmH O below the peak pressure Procedure See Alarms on page 73 to change the pressure high alarm limit 86 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Breathing Pressure Monitoring Figure 94 Breathing Pressure Monitor Controls D Volume Control 15 30 1 4 90 2 mo 12 540 6 5 SA 5 E PEE PLAT PEAK 40 7 18 6 gt vr Freq PEEP Mans Power Man 1 Lamp Pressure Control MET K 5 Surnao Fabius Tiro Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Breathing Pressure Monitoring Breathing Pressure Alarm Messages The following list contains all warning caution and advisory alarms associated with breathing pressure monitoring PRES APNEA ALARM OFF
84. ibrate Flows az Sensor Sensor Figure 27 Flow Meter Monitor Window volume Control 15 38 90 12 540 65 PLAT 40 18 31 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 3 Operating Concept Ventilation Changing Ventilation Modes Figure 28 Ventilator Mode Change Confirmation Volume Control and Pressure Control The following example describes changing Volume Control Volume the present ventilation mode Volume Control E 90 1 in Figure 28 Freq UT MU 12 0 e the desired ventilation mode Pressure 12 540 65 2 in Figure 28 with the desired ventilation ES PEEP PERT PERK settings 3 in Figure 28 2 T 18 1 Press the Pressure Control key inse Flow The LED associated with this key starts blinking Mies 4 in Figure 28 It remains blinking until the selected mode of operation is confirmed A message appears 5 in Figure 28 that provides instructions to confirm the mode change The Waveform window is replaced by the Ventilator Settings window 6 in Figure 28 Volume and Pressure modes only 2 Ifthe ventilation settings are correct confirm the mode change 3 Ifthe ventilation settings are not correct for each parameter that needs to change press the corresponding soft key select the correct value and confirm the change 4 When the parameter changes are completed conf
85. ibration Failed Troubleshooting If the sensor can not be calibrated replace the O capsule in the O sensor housing see Inserting A New O2 Sensor Capsule on page 52 If the O sensor still can not be calibrated call your local Authorized Service Organization or Dr gerService see Daily and Preuse Checkout Form for Dr gerService contact information Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Functions Figure 113 Calibrate O Sensor Instruction Screen 1 Remove O2 sensor and expose to room air For 2 minutes 2 To start 02 Calibration press rotary knob Figure 114 Calibrate O Sensor in Progress Bar O2 Calibration in progress Calibrate Access Flows Alarm Sensor Flows Sensor Figure 116 Calibrate O Sensor FAILED Bar O2 Sensor Calibration Failed Calibrate Calibrate Flows az Sensor Sensor 101 Chapter 8 Standby Mode Functions Leak Compliance Test 1 102 Press the Leak Compl Test soft key The Leak Compl Test Ventilator Preparation message replaces the Standby screen Figure 117 followed by the Leak Compl Test Instruction screen Figure 118 Follow the instructions on the Leak Compl Test Instruction screen Upon completion of the instructions the Leak Compl Test Results screen appears Figure 119 on page 102 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS
86. ies 136 64 0 Ibs 29 0 kg 15 5 Ibs 7 0 kg 26 0 Ibs 11 8 kg 105 5 lbs 47 8 kg 69 5 16 31 5 kg 15 5 165 7 0 kg 160 0 Ibs 72 6 kg 245 0 Ibs 111 1 kg 100 240 Vac 50 60 Hz 2 3 A maximum 24 V 3 5 Ah sealed gelled lead acid lt 16 hours on the mains or full operation time 45 minutes minimum Fabius Tiro Operator s Manual 00 81 8LLp Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Technical Data Chapter 12 Technical Data Fuses Figure 151 Fuse Locations The following numbers in boldface refer to Figure 151 Mains fuses 1 For 100 240V supply voltage 2 T2 5AL 250V 127 111 Fuses located on circuit board 1 T1 6AL 250V 1271 2 1x T4AL 250V IEC 127 1111 3 1 T2 5AL 250V 127 4 Battery fuse 1 T3 15AL 250V IEC 127 111 5 Electromagnetic Compatibility EMC Conforming to EN 60601 1 2 and IEC 60601 1 2 The operation of this anesthetic workstation or module may be adversely affected by electromagnetic interference exceeding the levels specified in EN 60601 1 2 and IEC 60601 1 2 Electrical Safety Conformance Conf
87. ines around corners and across thresholds for example in door frames and elevators Do not attempt to pull the machine over any hoses cords or other obstacles on the floor Switch Off the Anesthetic Agent Figure 77 Closing the Vaporizer Vaporizer Vapor Turn the handwheel 1 in Figure 77 to 0 until the button engages 68 Fabius Tiro Operators Manual 500 8758 LLE Hed RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Preparation for Transport or Storage Chapter 5 Operation and Shut down Switching Off the Ventilator Figure 78 Switching off the Ventilator The following numbers in boldface refer to Figure 78 1 Switch the anesthesia ventilator to standby by pressing the Standby button 1 2 Confirm by pressing the rotary knob 2 Fabius Tiro is now in standby mode Remove the O2 Sensor Remove the O2 sensor from the inspiratory valve and leave exposed to air This precaution prolongs the service life of the O2 sensor Switch Off System Power Figure 79 Control Unit On Off Switch Switch off the unit using the switch at the back 1 and disconnect the power plug UNAM 000000000000000 000000000000000 Part Number 4118348 003 Rev Fa
88. ing 2 in Figure 30 lt remains blinking until the selected mode of operation is confirmed The Waveform window is replaced by the 1 2 540 65 ManSpont window 3 in Figure 30 PLAT PEAK 40 A message appears 4 in Figure 30 that provides instructions to confirm the mode 2 H 1 8 2 Confirm the mode change The ManSpont screen is activated Figure 31 After the mode change is confirmed the ManSpont key LED switches from blinking to x constantly on and the waveform is restored after a short delay 3 Rotate the APL valve knob fully counterclockwise to release pressure for spontaneous ventilation 4 Setthe appropriate fresh gas flow Note The ManSpont screen enables you to turn the Apnea Pressure alarm and Volume alarms ON or OFF 34 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Ventilation Chapter 3 Operating Concept Manual Ventilation Figure 32 Ventilator Mode Change to Man Spont Note In ManSpont mode the apnea volume timer countdown for caution alarms changes from Volume Control 15 seconds to 30 seconds and for warning Control 12 L12 alarms from 30 seconds to 60 seconds 81418 1 Press the ManSpont key Control 12 The LED associated with this key starts blinking 1 in Figure 32 lt remains blinking until the selected
89. ions Contents Standby Mode Functions Contents slc M 99 SO ORE AAA 99 TO MEE 99 dre T aaa 100 A TER 100 Calibrate e 100 Calibrate 27 DONDE sisas aii si 101 KER Ie Te DI A ener 102 Access Alarmi LOG pois 103 A EE 103 o MAA 104 MI ri ia 104 A A A 110 Fabius Tiro Operator s Manual 97 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Overview Chapter 8 Standby Mode Functions Overview This chapter describes the functions that are made available in Standby mode Standby Screen Figure 104 Standby Confirmation Message and Gas Flow Control Valve Shut Off Message Window Access ManSpont 1 Press the Standby key The Standby Confirmation Message and Gas Flow Control Valve Shut Off Message window 1 Freq UT 1 in Figure 104 replaces the Waveform window 1 1 2 540 6 5 The LED associated with the Standby key starts PLAT E 40 blinking It remains blinking until Standby is confirmed by pressing the rotary knob 2 7 1 8 Note If confirmation does not occur within 15 seconds the Standby Confirmation Press rotary knob Eo confirm Standby Message and Gas Flow Control Valve Shut aff all gas
90. irm the ventilation mode change After the mode change is confirmed the Pressure Control key LED switches from blinking to constantly on the ventilator switches to the selected operating mode and the waveform is restored after a short delay 32 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Ventilation Ventilator Setting Selection Selected ventilator settings for the new mode of operation are automatically derived from the settings and performance of the last confirmed automatic ventilation mode Settings affected in the new mode will be highlighted 1 in Figure 29 The settings for Freq TI TE and PEEP are taken directly from the settings used in the former mode as applicable When changing from Volume Control to Pressure Control Pinsp is set to the Plateau pressure developed in Volume Control When changing from Volume Control to Pressure Control the suggested value for Insp Flow is either the last used value or the site default value When changing from Pressure Control to Volume Control VT is set by dividing the last minute volume by the respiratory rate When changing from Pressure Control to Volume Control the suggested value for TIP TI is either the last used value or the site default value When changing from Pressure Control to Volume Control PMAX is set 10 c
91. is manual is optional Ventilation Controls The following numbers in boldface refer to Figure 21 Ventilation Mode Keys Ventilation modes are selected by pressing one of the ventilation mode keys 1 2 3 and are confirmed by pressing the rotary knob If the selection is not confirmed the ventilation mode will not change Standby Key The Standby key 5 switches the ventilator to standby mode Monitoring and alarms are turned off and the ventilator stops Setup Key The Setup key 4 is a cross functional control See Setup Key on page 22 Soft Keys Soft keys 6 select ventilation parameters and functions Ventilator Compliance Compensation Ventilator compliance compensation is continuously applied during Volume Control so that the tidal volume delivered to the patient corresponds to the Vt setting Ventilator compliance is determined during the leak and compliance test performed from the Standby mode To have compliance compensation work accurately it is important that the patient hoses used during the leak compliance test match the type of hoses used during the procedure Note When the ventilator settings for Volume Control cause the ventilator to operate at its limits of performance it is not possible for the Fabius Tiro to apply compliance compensation If the ventilator s performance limit is reached it is not possible to increment the Vt setting via the Volume Control Settings window 28
92. it 02 SUPPLY LOW Warning The Warning message 2 SUPPLY LOW appears in the Alarm window and an alarm sounds if the oxygen supply drops too low to properly pressurize the fresh gas circuit below about 20 psi 1 4 bar The red LED indicator in the O area will flash until the supply is restored Under normal operating conditions the 2 supply channel is pressurized sufficiently to prevent this alarm from occurring If the O2 supply pressure fails and 2 is not being used by the Fabius Tiro the circuit will remain pressurized and the O2 SUPPLY LOW alarm will not annunciate immediately If pressure is reduced in this circuit by the use of O2 O2 flush etc the alarm will annunciate when the internal supply pressure drops below 20 psi 1 4 bar nominal INSP O2 HIGH Caution If the measured inspiratory oxygen concentration exceeds the high alarm limit the Caution message INSP O2 HIGH appears in the Alarm window and an intermittent audible alarm sounds O2 SENSOR FAIL Advisory The Advisory message O2 SENSOR FAIL appears in the Alarm window when any of the following instances occur O2sensor has not been correctly calibrated O2sensor replaced and or not calibrated O2 sensor used O2sensor disconnected Faulty sensor cable O2 SENSOR CAL DUE Advisory More than 18 hours have passed since the last sensor calibration 78 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETUR
93. lat line flip the APL valve to SPONT to release pressure PO Peak pressure display on monitor reads 24 to 36 cmH O Fabius Tiro Operator s Manual Checking Ventilator Operation PO Connect a breathing bag to the Y piece to act as test lung Press the Pressure Control key and confirm o Check that ventilation measurements displayed 7 Check that the ventilator piston is cycling PO Monitor the operation of the inspiratory and expiratory valve discs P Check that the breathing bag test lung on the Y piece is ventilating Press the Standby key and confirm Monitors The alarm function can be tested by setting alarm limits to levels that are certain to trigger an alarm Check the alarm limit settings The monitor alarm limits are automatically set to a default configuration when the SYSTEM POWER switch is turned on Check these settings and adjust them if necessary Alarm limits can be adjusted at the beginning of or during a procedure Also make sure that any external monitors if any are connected properly Test the alarm functions for all monitors Simulate alarm conditions and check for appropriate alarm signals 7 Test the 2 monitor and alarm module 7 Test the volume monitor and alarm module Test the pressure monitor and alarm module 1 Press the Standby key and confirm Daily and Preuse Checkout Form Additional Monitors when present 1 Check
94. mH O higher than the plateau pressure developed during Pressure Control Fabius Tiro Operator s Manual Chapter 3 Operating Concept Figure 29 Ventilator Mode Change Settings Control Control Volume Control 100 _ 90 12 0 12 540 65 PEEP PLRT PERK To confirm Pressure Control press rotary knob InsP L 1 M20 Air 02 2 7 18 Flow nin 0 33 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 3 Operating Concept Ventilation ManSpont Figure 30 Ventilator Mode Change to Man Spont ManSpont Manual Spontaneous is a non automatic mode of ventilation However the ventilation monitor BEEN and alarms are still operational In ManSpont mode 8 8 Freq 12 the ventilator piston is moved to its top most position Pressure Control to minimize system compliance Manual ventilation with APL valve pressure limit can be delivered with the APL valve switch in the MAN position Spontaneous ventilation APL valve wide open can ala occur with the APL valve in the SPONT position NB 3 4 The following examples describe changing from the present ventilation mode Volume 1 in Figure 30 e tothe desired ventilation mode ManSpont 1 in Figure 31 Spontaneous Breathing Figure 31 ManSpont Ventilation Screen 1 Press the ManSpont key The LED associated with this key starts blink
95. me of the breathing bag It may be necessary to press the O2 flush button again to reinflate the breathing bag RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Operation Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Operation Overriding the Ventilator In the unlikely event of a fault in which the ventilator does not recover and the user cannot switch to manual ventilation mode through the use of the ManSpont key and rotary knob manual ventilation is still possible 1 Locate the system power switch on the rear panel Toggle the system power switch to off Figure 75 and then Toggle the system power switch back to Figure 76 The ventilator now performs as in ManSpont mode Set the APL valve to MAN position Adjust the APL pressure limit for the desired inspiratory plateau pressure Press the O2 flush button on the Fabius Tiro as required to sufficiently inflate the breathing bag Manually ventilate the patient by squeezing the breathing bag Note After toggling the main power switch the Fabius Tiro will perform its diagnostic tests During the diagnostic tests manual ventilation is possible If the diagnostic tests result in FUNCTIONAL the Fabius Tiro will automatically switch to ManSpont mode if fresh gas flow is detected Fabius Tiro respiratory mo
96. mounted units with right hand COSY the combined weight of the accessories shall not exceed 14 pounds 6 4 kilograms on the side of the Fabius Tiro where the COSY is mounted and shall not exceed 40 pounds 18 2 kilograms on the side opposite the COSY Caution Trolley mounted units The total combined weight of all accessories and monitors mounted on the top and sides of the Fabius Tiro shall not exceed 80 pounds 36 kilograms Caution Wall mounted units the combined weight of the accessories shall not exceed 60 pounds 27 kilograms on the Fabius Tiro If necessary additional accessories must be mounted onto wall rails 10 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev General Warnings and Cautions Figure 1 Mounting Requirements 1 Caution Caution Caution Fabius Tiro RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 1 Introduction Trolley Mount with Left Hand COSY Wall Mount with COSY on Either Side Side Accessory Option Caution Possible Tip Over Hazard If Mounting Accessories Exceed Approved Limits Option Weight 24 16 10 9 kg 22 lb 10 0 kg 20 15 9 1 kg 18 8 2 kg Approved Mounting Limits 16 0 in 12 0 in 8 0 in 40 6cm 30 5 cm 20 3 cm Mount Arm Length Trolley mounted units with left hand COSY Figure 1 the combined weight of the accessories shall not exceed 30
97. n After Use on page 120 and Daily and Preuse Checkout Form in Appendix A Trademark Notices Dr gerService and Vitalink are registered trademarks of Draeger Medical Inc Fabius and Vapor are registered trademarks of Dr ger All other products or name brands are trademarks of their respective owners Limitation of Liability Draeger Medical Inc s liability whether arising from or related to the manufacture and sale of the products their installation demonstration sales representation use performance or otherwise including any liability based upon Draeger Medical Inc s product warranty is subject to and limited to the exclusive terms of Draeger Medical Inc s limited warranty whether based upon breach of warranty or any other cause of action whatsoever regardless of any fault attributable to Draeger Medical Inc and regardless of the form of action including without limitation breach of warranty negligence strict liability or otherwise Draeger Medical Inc shall in no event be liable for any special incidental or consequential damages including loss of profits whether or not foreseeable and even if Draeger Medical Inc has been advised of the possibility of such loss or damage Draeger Medical Inc disclaims any liability arising from a combination of its product with products from another manufacturer if the combination has not been Fabius Tiro Operators Manual 500 8758 LLE He
98. n High Alarm Limit range is from 19 to 100 lt is not possible to set the Oxygen High Limit setting to less than or equal to the Oxygen Low Limit The factory default value for Oxygen High Limit is 100 e Oxygen Low Limit The Oxygen Low Alarm Limit range is from 18 to 99 It is not possible to set the Oxygen Low Limit setting to equal to or greater than the Oxygen High Limit The factory default value for Oxygen Low Limit is 20 Minute Volume High Limit The Minute Volume High Limit range is from 0 1 L min to 20 0 L min The factory default value is 12 0 L min Minute Volume Low Limit The Minute Volume Low Limit range is from 0 0 L min to 19 9 L min The factory default value is 3 0 L min Pressure High Limit The Pressure High Limit range is from 10 to 70 cmH O The factory default value is 40 cmH O Apnea Pressure Threshold The Apnea Pressure Threshold Limit range is from 5 to 30 The factory default value is 8 cmH O Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Functions 107 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Functions Standby Setup Screen Alarm Volume Figure 130 Standby Setup Screen Default Alarm Volume Standby Setup Default Settings Exit 1 Select and confirm Alarm Volume The Default Alarm Volume Setting window appears next to Al
99. nance and Cleaning 119 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 9 Routine Maintenance and Cleaning Disinfecting Cleaning Autoclaving Recommendations for Typical Cleaning and Disinfection After Use Washing Machine Wet pasteurisation at 70 C 158 F for 30 minutes after detergent cleaning Wiping Glutaraldehyde based formultations of 296 ethyl or isopropyl alcohol at 70 to 9096 sodium hypochlorite 5 296 household bleach 1 500 dilution 100 ppm free chlorine C Immersion Glutaraldehyde based formultations of 2 D Autoclaving Including steam or hot air at 134 C 273 Use your manufacturer s or your facility s recommendations 1 Per patient 2 Daily 3 Weekly 4 Monthly Front daily other surfaces weekly Caution Ensure that subsystems have been thoroughly aerated following cleaning and disinfection activities Table 6 Schedules for Fabius Tiro Anesthesia Workstation Components Processed Schedules A B Workstation outside B Vaporizers B2 Power cable gas supply B4 hoses Breathing bag and hose and 1 1 D 1 Y piece Diaphragm A1 C 1 D 1 Breathing system A1 C 1 D 1 Valve discs 1 C 1 D 1 Ventilator hose D 1 Ventilator cover D 1 APL valve D 1 Exhaust port D 1 Control lines and cables B3 outside Expiratory port A1 C 1 D 1 Absorber and insert A 1 C 1 D 1 Flow
100. necting the Breathing Pressure 55 Connecting APL Bypass and 55 Connecting the Flow 1 56 Installing Anesthetic Gas Scavenging Hose to the Compact Breathing SysteM 56 Scavenger System for Fabius 57 Additional 4 9 57 Daily Preuse Checkout 1 24 0 1 57 Chapter 5 Operation and Shut down 59 Operation rss a 61 Preparation for Transport or 1 68 Chapter 6 Monitoring COM OMS 44844 VE a Er Ra rau ea a men 71 OVA ba A AN ee een A 73 AMS 73 Oxygen Monitoring id ad a A a ta 74 Respiratory Volume 0 80 Breathing Pressure Monitoring 85 Chapter 7 Setup Window Used During Operation 91 OI a H 93 Setup Window
101. ngs window appears with the VT parameter label highlighted 1 in Figure 36 Select a new VT parameter setting Confirm the new VT parameter setting Note Once the Ventilator Settings window is 36 activated it will return to the Waveform window if 15 seconds pass and neither the rotary knob nor a soft key is pressed If the Home key is pressed the Ventilator Settings window will return to the Waveform window In either case the ventilation parameter will remain as it was before it was activated in the Ventilator Settings window RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Ventilation Figure 34 Volume Ventilator Settings Window Yalume Control 02 100 Freq WT B 12 540 65 PEEP PLRT 35 7 18 x 540 65 f 18 v Insp Flow Lenin WT Mu 2 0 540 6 5 35 f 18 x Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Fresh Gas Control Chapter 3 Operating Concept Fresh Gas Control The following numbers in boldface refer to Figure 37 Flow is increased when the flow control knobs 0 1 AIR 2 O 3 are turned counterclockwise The total flow meter 4 displays the flow measurement of all of the applied gases combined Note The total flow meter is calibrated for a
102. nitoring is available If the diagnostic tests result in NON FUNCTIONAL Manual ventilation is still possible but Fabius Tiro respiratory monitoring is not available Note In ventilator override situation the ventilator piston assembly position may not be locked as in ManSpont mode As a result airway pressure may initially push the piston back to its limit stop increasing the volume of the breathing bag It may be necessary to press the O2 flush button again to reinflate the breathing bag 8 Contact your local Authorized Service Organization before using the ventilator Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 5 Operation and Shut down Figure 75 Toggle Power Switch to Off Label Figure 76 Toggle Power Switch to On Label 67 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 5 Operation and Shut down Preparation for Transport or Storage Preparation for Transport or Storage Warning When moving the anesthesia machine remove all monitors and equipment from the top shelf remove the absorber system and use only the machine handles to push or pull the unit The anesthesia machine should only be moved by people who are physically capable of handling its weight Draeger Medical recommends that two people move the anesthesia machine to aid in maneuverability Exercise special care so that the machine does not tip when moving up or down incl
103. nnect the AIR hose 2 to the connector on the Fabius Tiro and to the wall terminal unit 4 of the medical gas pipeline system Connect the O2 hose 3 to the connector on the Fabius Tiro and to the wall terminal unit 4 of the medical gas pipeline system Tethered Medical Gas Regulator and Gauge The following numbers in boldface refer to Figure 46 Attach the tethered medical gas regulator and gauge 1 to the O2 cylinder 2 see Cylinders with Pin index Mounting on page 46 for the procedure Warning Ensure that the O2 cylinder contents gauge faces forward remains unobstructed and is visible from the front of the Fabius Tiro Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 4 Preparation Figure 45 3 Gas Supply Connections E OOOO OP50012 Figure 46 Tethered Medical Gas Regulator and Gauge 45 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 4 Preparation Cylinders with Pin index Mounting Cylinders with Pin index Mounting Warning When attaching a cylinder ensure that only one washer 15 installed between the cylinder and the yoke gas inlet The use of multiple washers will inhibit the pin index safety system Be sure to verify the presence of the index pins each time a cylinder is installed Never attempt to override the pin index safety system Caution Do not oil o
104. ns by e Turning Select Turning the rotary knob moves the cursor over the system operating parameters or changes the value of a parameter that has been confirmed for adjustment Note This function is indicated in the examples and instructions of this manual by select Pressing Confirm Pressing the rotary knob either confirms the system operating parameter to be adjusted or confirms the change to the selected operating parameter Note This function is indicated in the examples and instructions of this manual by confirm Tabletop Light Key The Tabletop Light key 4 in Figure 7 turns on the tabletop light Fabius Tiro Operator s Manual 21 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 3 Operating Concept Cross Functional Controls and Displays Cross Functional Controls and Figure 8 Ventilation Monitor Screen and System Controls Displays Cross functional controls and displays are used for both monitoring and ventilation functions Key LED Indicators LED indicators 1 in Figure 8 within keys Volume Control Pressure Control Man Spont Alarm Silence and Standby illuminate when that mode or function is selected and operating Setup Key The Setup key is 2 in Figure 8 Pressed During A Ventilation Mode The Setup window 1 in Figure 9 replaces the Waveform area 3 in Figure 8 540 65 The Setup
105. ntilator and Pmax settings PRESSURE NEGATIVE Measured breathing pressure is less than 5 20 Check breathing circuit and ventilator settings PRESSURE SENSOR FAIL Faulty sensor or pressure not calibrated Call your local Authorized Service Organization or Dr gerService see Daily and Preuse Checkout Form for Dr gerService contact information PRES THRESHOLD LOW Ventilation parameters were changed without changing alarm settings Breathing pressure leak or partial disconnection occurs when the threshold pressure alarm limit is set significantly lower than the peak pressure Push the Auto Set soft key and check ventilator settings Check breathing circuit RS232 COM FAIL External monitor cable disconnected Check monitor interface cable SPEAKER FAIL Primary speaker failed Call your local Authorized Service Organization or Dr gerService see Daily and Preuse Checkout Form for Dr gerService contact information VENTILATOR FAIL Ventilator not assembled correctly Check diaphragm and close cover Check PEEP PMAX line for disconnect or leak Select Standby Mode and switch back to the previous ventilation mode VOLUME ALARMS OFF Volume alarms turned off by operator in ManSpont mode 126 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN
106. nts When a calibration gas mixture is excessively rich or lean in oxygen the Fabius Tiro will not complete an attempted calibration however if the calibration gas is rich or lean but is within certain limits the Fabius Tiro will complete the calibration As a result when displaying sensor measurements the Fabius Tiro displays an oxygen percentage either higher or lower than the actual oxygen percentage Therefore make sure that the sensor is exposed only to room air during the entire calibration period Figure 89 illustrates the relationship between the calibration mixture and the accuracy of oxygen measurement A 7 Displayed O Percentage B Actual O Percentage 1 At calibration sensor exposed to lt 21 O2 Thus displayed O2 will be higher than actual O2 2 Correct calibration of room air 21 O2 for entire calibration period Displayed O2 actual 96 O2 3 At calibration sensor exposed to gt 21 O2 Figure 89 Measurement Error Due to Incorrect Calibration Thus displayed O2 will be lower than actual O2 Fabius Tiro Operator s Manual 77 Chapter 6 Monitoring Oxygen Alarm Messages The following list contains all warning caution and advisory alarms associated with oxygen monitoring INSP 02 LOW Warning The Warning message INSP 02 LOW appears in the Alarm window and an alarm sounds if the measured inspiratory oxygen concentration falls below the low alarm lim
107. o room air for 2196 calibration Sensor capsule was removed from housing for a prolonged period Allow a waiting period equal to duration of capsule removal New capsule not given proper waiting period Allow 15 minute waiting period Exhausted or faulty sensor capsule Replace sensor capsule Fabius Tiro Operator s Manual 79 Chapter 6 Monitoring Respiratory Volume Monitoring Respiratory Volume Monitoring Overview Respiratory volume 15 measured using thermal anemometry The flow sensor output is converted into meaningful readings for minute volume tidal volume and respiratory rate displays Caution Note 80 Although the Fabius Tiro is designed to minimize the effects of ambient radio frequency interference the functioning of the respiratory volume monitor may be adversely affected by the operation of electrosurgical equipment or short wave or microwave diathermy equipment in the vicinity Sudden irregular expiratory flow may cause erratic tidal volume and respiratory rate displays To avoid such erroneous measurements defer reading the display until a full minute has elapsed after the irregular flow has stopped RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Respiratory Volume Monitoring Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE
108. or panel 7 Connecting the APL Bypass and Figure 65 APL Bypass and Peep Hose Connections Peep Pmax Hoses The following numbers in boldface refer to Figure 65 1 Plug the control hose to the connection port on the PEEP PMAX valve 1 and to the connection port marked on the connection panel 2 2 Plug the control hose to the connection port on the APL Bypass valve 3 and to the connection port marked on the connection panel 4 Note The control hoses are connected together near the end of each hose The APL bypass hose is larger than the PEEP PMAX hose OP50009 Fabius Tiro Operator s Manual 55 Chapter 4 Preparation Connecting the Flow Sensor Push the cable onto the connection port on the flow sensor 1 Installing Anesthetic Gas Scavenging Hose to the Compact Breathing System Connect the transfer hose to the waste gas port of the Compact Breathing System and to the anesthetic gas scavenging line or an anesthetic agent filter A second transfer hose is required for the Semi open compact breathing system 56 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD R
109. orms to UL2601 IEC 60601 1 IEC 60601 2 13 CAN CSA C22 2 No 601 1 M90 CAN CSA C22 2 No 60601 2 13 EN 740 Fabius Tiro Operator s Manual 137 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 12 Technical Data Technical Data Ventilator Control Inputs Ranges PMAX Pressure limiting 15 70 cmH O 1 cmH O resolution VT Tidal volume 20 1400 mL 10 mL resolution f Breathing frequency 4 60 bpm 1 bpm resolution Ti Te Inspiration expiration ratio 4 1to 1 4 Tip Ti Inspiration pause 096 5096 196 resolution PEEP End expiratory pressure 0 20 cmH O 1 cmH O resolution Pinsp Inspiratory pressure 5 60 cmH 0 1 cmH O resolution Insp Flow Inspiratory flow 10 75 L min 1 L min resolution Delivery Accuracy PMAX Pressure limiting 5 cmH5O of setting a volume 2 f Breathing frequency 1 bpm of setting Ti Te Inspiration expiration ratio 5 of setting Tip Ti Inspiration pause 25 of setting PEEP End expiratory pressure 2 cmH O or 20 of setting whichever is greater High Pressure Safety Relief Valve 75 5 cmH O Negative Pressure Safety Relief Valve Ambient Air Inlet Valve 7 5 to 9 cmH O System Compliance Compensation Measurement 0 2 to 6 0 ml cmH O 0 2 ml cmH O or 10 of actual compliance whichever is greater 138 Fabius Tiro Operator s Manual 500 8758 LLE Hed Part Number 4118348 003 Re
110. ot be used Call your local Authorized Service Organization or Dr gerService at Dr gerService Draeger Medical Inc 3122 Commerce Drive Telford PA 18969 Tel 215 721 5402 800 543 5047 Fax 215 721 5784 Fabius Tiro Operator s Manual RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Appendix Daily and Preuse Checkout Form Part Number 4118348 003 Rev Please note that this Daily Pre use check list takes into consideration all possible configurations of the Fabius Tiro The clinician need only use those areas that apply to their specific Fabius Tiro configuration All checks must be carried out daily before equipment is used The person who carries out the checks must be fully conversant with the Instruction for Use Checks marked with a P must be carried out before each patient use These pages should be removed and copied to establish a daily record of machines checks Mark each function when checks have been satisfactorily completed Fabius Tiro Serial Number Pre conditions Inspection intervals for machine and accessories are current P 7 Machine fully assembled and connected Monitors O2 P V CO2 anesthetic agent 1 when present switched on and functioning self test carried out satisfactorily System diagnostics for Fabius Tiro carried out Sampling line for g
111. oximate pressure settings When the APL valve knob is rotated fully counterclockwise pressure is released for spontaneous ventilation Spontaneous ventilation automatically eliminates both resistance to patient exhalation and the need to readjust back pressure In manual mode the APL valve knob can be rotated to change the pressure threshold at which gas will flow through the valve and into the scavenging system Clockwise rotation of the APL valve knob increases the pressure threshold and counterclockwise rotation of the APL valve knob decreases the pressure threshold Lifting the top of the APL valve knob will temporarily relieve pressure Note The APL valve is automatically excluded from the breathing circuit whenever an automatic ventilator mode is selected Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 3 Operating Concept Figure 40 APL Vavle 39 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 4 Preparation Contents Preparation Contents Mounting the Fabius Tiro Onto Wall ee a 43 Activating AMA A 44 Gas SUPPLY PEE 45 Medical Gas Pipeline Supply of O2 20 and AIR _ 45 Tethered Medical Gas Regulator and Gauge 45 Cylinders with Pin index Mo
112. p Screen Figure 133 Standby Setup Screen Configuration Settings Selected Standby Setup Configuration Time Set Time Format Date Set Date Format Acoustic Confirmation Alarm Tone Sequence Waveform Display Figure 134 Standby Setup Screen Configure Time Hour Select Standby Setup Configuration Exit Time Set Time Format Date Set Date Format Acoustic Confirmation Alarm Tone Sequence Waveform Display Select time and press rotary knob En confirm Figure 135 Standby Setup Screen Configure Time Hour Standby Setup Configuration Exit Tine Set Time Format Date Set Date Format Acoustic Confirmation Alarm Tone Sequence Waveform Display Select time and press rotary knob En confirm Fabius Tiro Operators Manual 500 8758 LLE Hed RETURN THIS MANUAL S TABLE OF CONTENTS Standby Setup Screen 3 Select and confirm a new minute time value ex in Figure 136 the value is changed from 15 to 30 RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Functions Figure 136 Standby Setup Screen Configure Time Minute Standby Setup Configuration Part Number 4118348 003 Rev The new time values are saved the Time Set Exit window disappears and the cursor in the Tine Set Configuration column appears over Time Set Tine Format 2 Date Set Note This three step process also applies to Date Format Date Set on
113. plays the Alarm Limits window 1 in Figure 82 Use the select and confirm process outlined in Selecting Setting Monitoring Functions on page 26 to change the alarm limits on the Alarm Limits window Alarm LED Indicators The Alarm LED indicators are shown at 2 in Figure 81 See LED Indicators on page 24 for details Alarm Tones The alarm tones provide an audible alert to the message displays Each message is assigned a tone or sequence of tones to indicate its degree of urgency e Warning continuous Caution every 30 seconds e Advisory single signal or no tone for selected advisories only Alarm Text Display Convention Warnings are followed by three exclamation marks e Cautions are followed by two exclamation marks M Advisories are followed by one exclamation mark Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Figure 81 Ventilation Monitor Screen and System Controls Volume Control Figure 82 Alarm Limit Configure Menu Window Yolume Control 7 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Oxygen Monitoring Oxygen Monitoring Oxygen Monitoring Overview Inspiratory oxygen concentration is measured with a dual galvanic cell sensor which is attached to the inspiratory valve dome The sensor contains two indep
114. pounds 13 6 kilograms on the side of the Fabius Tiro where the COSY is mounted and shall not exceed 40 pounds 18 2 kilograms on the side opposite the COSY Trolley mounted units The total combined weight of all accessories and monitors mounted on the top and sides of the Fabius Tiro shall not exceed 80 pounds 36 kilograms Wall mounted units the combined weight of the accessories shall not exceed 60 pounds 27 kilograms on the Fabius Tiro If necessary additional accessories must be mounted onto wall rails Fabius Tiro Operator s Manual 16 Ib 7 3 kg 14 16 6 4 kg 12 1b 5 4 kg 10 Ib 4 5 kg 11 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 1 Introduction General Warnings and Cautions Figure 2 Mounting Requirements 2 Fabius Tiro Trolley Mount with Right Hand COSY Left Side Accessory Option Option Weight 24 16 10 9 kg 22 16 10 0 kg Caution Possible Tip Over 20 Ib 9 1 kg Hazard If Mounting Accessories Exceed Approved Limits Approved 18 Ib 8 2 kg Mounting Limits 16 lb 7 3 kg 14 Ib 6 4 kg 12 b 5 4 kg 10 Ib 4 5 kg 16 0in 12 0 in 8 0 in 40 6cm 30 5cm 20 3 Mount Arm Length Left Side Figure 3 Mounting Requirements 3 Fabius Tiro Trolley Mount with Right Hand COSY Right Side Accessory Option Caution Possible Tip Over Option Hazard If Mounting Accessories rn Weight Exceed Approved Limits 9 15 Ib 6 8 kg 10 Ib 4 5 kg 5 2 3 kg
115. ppear in ManSpont mode because itis selectable on the ManSpont screen Auto Set Press the Auto Set soft key 2 in Figure 97 The breathing pressure threshold is set to 4 cmH O below the current Peak pressure data value Note The threshold setting may not be less than 5 cmH 0 or greater than 30 cmH O Note In the absence of a current Peak pressure data value pressing the softkey will have no effect Calibrate O2 Sensor 1 Press the Calibrate O2 Sensor soft key 3 in Figure 97 The Calibrate Sensor Instruction window Figure 98 replaces the Setup window 2 Follow the instructions and press the rotary knob The present value is replaced by CAL 1 in Figure 99 Upon completion of the calibration the Oz concentration measurement appears If the O sensor can not be calibrated replace the O capsule in the O sensor housing see Inserting A New O2 Sensor Capsule on page 52 If the O sensor still can not be calibrated call your local Authorized Service Organization or Dr gerService see Daily and Preuse Checkout Form for Dr gerService contact information 94 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Volume Alarms On Off Figure 97 Setup Window volume Control UT MU E 540 6 5 PEAK 40 18 Yolume Calibrate Access Alarms oz Alarm Sensor volume Figure 98 Calibrate O Sensor Instruction Screen 1 Remove 2 sensor and
116. quipment 1 Press the Setup key 1 in Figure 85 The Setup screen appears Figure 86 2 Press the soft key under the Calibrate O2 Sensor soft key label 1 in Figure 86 Freq UT PEAK 40 2 18 volume Calibrate Access Access Alarms oz Alarm Alarm Sensor Log volume The Calibrate O2 Sensor Instruction window Figure 87 Calibrate O Sensor Instruction Screen replaces the Setup screen soft key labels window Figure 87 1 Remove 2 sensor and expose En room air 2 minutes 2 To start Oz Calibration press rotary knob 3 Observe Calibration status Oz data window 4 Reinsert O2 Sensor after successful Calibration Alarm window the calibration was not successful 4 j PLAT PERK 40 An unsuccessful calibration can be caused by i 2 7 1 8 8 several conditions as described in Table 2 on page 77 After the instructions are followed and the rotary Figure 88 Calibrate O Sensor in Progress Bar knob is pressed the present value is replaced by Y vol Control S CAL 1 in Figure 88 eee 15 30 3 02 1 100 Upon successful completion the calibration the O FPOAL 5 concentration measurement is restored N Freq UT 12 0 If at the end of the calibration period the 9 02 SENSOR FAIL Advisory message appears the 1 2 540 6 5 3 0 amp E 2 lt 76 Fabius Tiro Manual Part Number 41183
117. r grease the O2 cylinder valves and O2 pressure regulator There is a risk of explosion If cylinder valves are leaky or difficult to open or close they must be repaired in accordance with the manufacturer s specifications Even if the gas supply is connected to a medical gas pipeline the cylinders should remain on the device in reserve The following numbers in boldface refer to Figure 47 Figure 47 Pin Index Cylinder Mounting To connect a gas cylinder 1 to its yoke 1 Remove the old washer 2 and install a new washer on the seat of the yoke gas inlet connection 2 Verify that the two index pins 3 below the gas inlet 4 are present 3 Insert the head 5 of the gas cylinder into the yoke from below Ensure that the gas outlet and indexing holes on the cylinder head align with the gas inlet and index pins of the yoke assembly 6 4 Engage the indexing holes with the index pins Turn the yoke handle 7 clockwise against the cylinder head so that the point of the yoke handle bolt is aligned with the indent on the back of the cylinder head 6 Verify that the washer is in place the index pins are engaged and the cylinder hangs vertically 7 Tighten the yoke firmly When required the cylinder valve 8 is opened using the cylinder wrench 9 that is provided 46 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE
118. s strictly follow this instruction manual Any use of the Fabius Tiro requires full understanding and strict observation of these instructions The unit is only to be used for purposes specified here Recommendations Because of the sophisticated nature of Draeger Medical anesthesia equipment and its critical importance in the operating room setting it is highly recommended that only appropriately trained and experienced professionals using authentic Draeger Medical spare parts be permitted to service and maintain this equipment Please contact Dr gerService at 800 543 5047 or 215 721 5402 for service of this equipment Draeger Medical anesthesia systems must be serviced every six months Periodic Manufacturer s Certification Agreements are available for equipment manufactured by Draeger Medical For further information concerning these agreements contact Dr gerService at 800 543 5047 or 215 721 5402 Not for Use in Areas of Explosion Hazard The Fabius Tiro is neither approved nor certified for use in areas where combustible or explosive gas mixtures are likely to occur To avoid explosion hazards flammable anaesthetic agents such as ether and cyclopropane or other flammable substances must not be used in this machine Only anaesthetic agents that comply with the requirements on non flammable anaesthetic agents in the IEC Standard Particular requirements for the safety of anaesthetic machine are suitable for u
119. s detected and operation of the monitor and ventilator is inhibited Do not use the machine Immediately call your local Authorized Service Organization or Dr gerService to correct the problem Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 5 Operation and Shut down Figure 69 Power Up Screen SYSTEM DIAGNOSTICS Fabius Tira Watch Dog Timer System RAM Program Henory Video Test Interruptz A D Converter HU Serial Port Clock Speaker Main Power Battery FUNCTIONAL Dr ger MEDICAL Fabius Tiro SW 2 18 6764 61 Chapter 5 Operation and Shut down Power Up Standby Screen Following a successful power up the Standby screen appears Figure 70 and provides instructions on starting the operation of the Fabius Tiro Ventilation Monitor Screen When the Fabius Tiro is in use monitoring information is displayed on the Ventilation Monitor screen See Operating Concept on page 19 for an explanation of the Ventilation Monitor screen controls and windows Setting the Vaporizer The following numbers in boldface refer to Figure 72 1 Ensure that the vaporizer is properly seated and locked 2 Press and hold down the 0 button 1 and turn the handwheel 2 counter clockwise to the desired anesthetic agent concentration 3 Regularly check the filling level on the sight glass When reaching the minimum mark fill the Vapor with anesthetic agent
120. sage appears Figure 121 Site default settings are set in the Standby Setup screen Part Number 4118348 003 Rev Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Functions Figure 120 Standby Screen Alarm Log Last system test run on 1962 Sleep Mode will activate in 2 min sec To start operation press one of Ehe keys located to the left of the display SUU z 18 6764 Clear Hlarm Log 66 19 42 16 28 APNEA PRESSURE 19 42 16 28 APNEA PRESSURE Figure 121 Site Defaults Restored Bar Site Default settings restored Run Calibrate Calibrate Access System Flows az Alarm Test Sensor Sensor Log 103 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 8 Standby Mode Functions Standby Setup Screen Standby Setup Screen Figure 122 Standby Setup Screen In Standby mode press the Setup key Standby Setup The Standby Setup screen Figure 122 replaces the an Exit Exit Standby Screen Volume Settings Time Set The cursor which appears over Default Settings Pressure Settings Tine Format enables you to select Default Settings or Alarm Limita Date Set Configuration Alarm Volume Date Format Restore Factory Defaults Acoustic Confirmation Alarm Tone Sequence Waveform Display Default Settings Figure 123 Standby Setup Screen Default Settings aa n Selected
121. se in this machine Safe Connection with Other Electrical Equipment Electrical connections to equipment which are not listed in these Instructions for Use should only be made following consultations with the respective manufacturers or an expert and shall be in compliance with national medical device regulations Operator s Responsibility The equipment design the accompanying literature and the labeling on the equipment take into consideration that the purchase and use of the equipment are restricted to trained professionals and that certain inherent characteristics of the equipment Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 1 Introduction are known to the trained operator Instructions warnings and caution statements are limited therefore to the specifics of the Draeger Medical Inc design This publication excludes references to hazards which are obvious to a medical professional to the consequences of product misuse and to potentially adverse effects in patients with abnormal conditions Product modification or misuse can be dangerous Draeger Medical Inc disclaims all liability for the consequences of product alterations or modifications as well as for the consequences which might result from the combination of Draeger Medical Inc products with products supplied by other manufacturers if such a combination is not endorsed by Draeger Medical Inc The operator of the anesthesia s
122. sition and engaged P I Filling level between min and max Checking the Condition of CO2 Absorbent 7 Color change is no more than the canister of CO2 absorbent Fabius Tiro Operators Manual 500 8758 LLE Hed RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Appendix Daily and Preuse Checkout Form Part Number 4118348 003 Rev Leak Testing the Fresh Gas Circuit Test once without the vaporizer and once with the Dr ger Vapor with the handwheel set to zero Go to Standby and press the Leak Test soft key Follow the instructions on the screen If the system leaks i e pressure drops e Check that all plug in push fit and screw connectors fit tightly Replace any missing or damaged seals If necessary call your local Authorized Service Organization or DragerService Inspiratory and Expiratory Valves Compact Breathing Systems Press the ManSpont key and confirm Set APL valve to MAN position and adjust to 30 cmH O Press O2 flush Breathing bag for manual ventilation fills Inspiratory and expiratory valve discs move freely when the breathing bag is squeezed and released APL Valve Compact Breathing System PO Set APL valve to MAN and 30 cmH O Set fresh gas flow to 20 L min Press ManSpont key and confirm When the pressure waveform on the m Breathing Pressure Trace window stabilizes e g a f
123. t increased heat generation in the absorber leading to higher breathing gas temperatures These reactions can result in danger to the patient in the form of CO intoxication insufficient depth of anesthesia and airway burns Note Please refer to the specific Instructions for Use for Dr gersorb 800 Plus Draeger Medical recommends that absorbent be changed regardless of color if the anesthesia machine has been idle for 48 hours or more Further Draeger Medical recommends that it be changed at the beginning of the work week Warning Absorbent is caustic and is a strong irritant to the eyes skin and respiratory tract When replacing the absorbent take care not to spill its caustic contents 1 Empty the expired CO2 absorbent from the absorber into an appropriate refuse container 2 Fill the absorber with fresh CO2 absorbent 3 Ensure that no CO2 absorbent dust particles have been deposited between the gaskets and sealing surfaces Such dust and particles can cause leaks in the system Dr ger recommends the use of Dr gersorb 800 Plus 64 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Operation Power Failure Backup When AC power is interrupted from the Fabius Tiro the internal battery backup will provide full operation of the ventilator and internal monitors for up to two hours after the power interrup
124. the CO2 monitor and alarm module Check the anesthetic agent monitor and alarm module Anesthetic Gas Scavenging System Check the hose connections Adjust the flow regulator to place the float P between the Minimum and Maximum marks Press and hold the O2 flush button and verify P that airway pressure is lt 10 cmH O with Y piece occluded Close all flow control valves on the machine P with Y piece occluded and verify that airway pressure is gt 0 5 cmH20 Manual Ventilation Bag for Emergency Ventilation when present m Check that the bag is functioning correctly by pumping manually When the bag is squeezed air must audibly m and tangibly flow out ofthe mask cone when the bag is released it must rapidly recover its original shape Block off the mask connector cone with the ball of your thumb you should only be able to squeeze the bag a little vi RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Before Connecting to Patient Verify that all vaporizers are off handwheels are set to zero the APL Valve is set as desired all flowmeters indicate 0 the patient suction is level adequate and the breathing system is ready to use the bag is in place and all hoses are connected properly If any check can not be carried out satisfactorily the machine must not be used Daily Checkout Signature Name
125. the instantaneous pressure values recorded during each breath The numeric data display range is from 0 to 50 e 3 PEAK Breathing Pressure The highest instantaneous pressure value for each breath The numeric data display range is from 0 to 80 e 4 Pressure High Alarm Limit 5 Pressure Threshold Alarm Limit 6 Breathing Pressure Trace Window This large window displays a breathing pressure trace or waveform e 7 Breathing Pressure Threshold Limit Line 8 Breathing Pressure Minimum and Maximum Trace Scale Limits Indicator Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Figure 92 Breathing Pressure Monitoring Displays Volume Control 15 30 100 Freq 12 0 12 540 65 PLRT PEAK 18 Figure 93 Breathing Pressure Monitor Data Volume Control 15 30 100 Freq 12 0 12 540 65 PLAT PEAK 24 72 248 85 Chapter 6 Monitoring Breathing Pressure Monitor Controls The following numbers in boldface refer to Figure 94 The Alarm Limits key 1 and the rotary knob 2 enable you to set breathing pressure alarm limits Setting the Pressure and Threshold Alarm Limits At power up and when you press the Restore Default Settings key on the Standby screen the breathing pressure high and pressure threshold alarm limits are automatically set to their default settings You can adjust these limits within specified ranges Pressure Thres
126. the right into the compact breathing system Attaching the Inspiratory Valve The following numbers in boldface refer to Figure 52 1 2 3 4 Place the valve disc 3 in the valve seat Place the gasket 4 on top of the valve disc Fit the inspection cap with port 5 Tighten the retaining nut 6 securely Attaching the Expiratory Valve The following numbers in boldface refer to Figure 52 1 2 3 4 Place the valve disc 7 in the valve seat Place the gasket 8 on top of the valve disc Fit the inspection cap 9 Tighten the retaining nut 10 securely Fabius Tiro Operator s Manual Figure 51 CO2 Absorber 49 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 4 Preparation Attaching the Adjustable Pressure Limiting APL Valve Attaching the Adjustable Pressure Limiting APL Valve Tighten the APL valve 9 in Figure 53 securely into place with the retaining nut Inserting the Flow Sensor The following numbers in boldface refer to Figure 54 1 Unscrew and remove the expiration port 1 2 Insert the flow sensor 2 3 Reinstall the expiration port 1 Attaching the Waste Gas Outlet Port Screw the waste gas port into the compact breathing system from underneath 3 in Figure 54 50 Figure 53 APL Valve OP50001 Figure 54 Flow Sensor Assembly
127. thing Pressure Sensor Port Breathing Volume Sensor Port Ventilator Port Pipeline Gauge Pipeline Inlet Breathing Bag Flowmeter Level Indicator Indicates Direction 6 Fabius Tiro Manual 500 8758 LLE Hed Part Number 4118348 003 Rev Symbol Definition Total Power Applied Partial Power Applied Cylinder Gauge Remote Cylinder Inlet Do Nat Oil The following symbols are used on the Fabius Tiro monitoring user interface Table Top Light Upper and Lower Alarm Limits Return to Home Screen Suppress Alarm Tone for Two Minutes Standby Mode Available Operating Capacity of UPS Close Menu Back to Previous Menu Fabius Tiro Operator s Manual RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS EILEEN EC Chapter 1 Introduction RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 1 Introduction Abbreviations Upper Alarm Limit Lower Alarm Limit Mains Applied Mains Power Alarm Off Setup Screen Hei Abbreviations Abbreviation Meaning COSY Compact breathing system FLOW Expiratory flow FiO Inspiratory O concentration MAN Manual ventilation MEAN Mean airway pressure 0 Nitrous Oxide O Oxygen PAW Airway pressure PEAK Peak airway pressure PEEP Positive end expiratory pressure PINSP Pr
128. tion The battery depletion rate depends upon ventilator settings and the condition of the battery age and level of charge but under no circumstances should a fully charged battery provide less than 45 minutes of full functionality The transition to battery powered operation will not interrupt any machine functions At the transition and as the battery is discharged the following information will be displayed The battery symbol 5 appears in the status bar and the Mains Power LED turns off POWER FAIL Advisory alarm message is displayed in the alarm window When the battery is discharged to 20 of its reserve power the BATTERY LOW Advisory alarm message 15 displayed in the alarm window When the battery is discharged to 10 of its reserve power the BATTERY LOW Caution alarm message replaces the Advisory alarm message in the alarm window When the battery is almost fully discharged the ventilator will stop and the Ventilator Fail Warning alarm message VENTILATOR FAIL is displayed in the alarm window If manual ventilation is not provided the Apnea Pressure Warning APNEA PRESSURE Apnea Flow Warning APNEA FLOW and Minute Volume Low Caution MINUTE VOLUME LOW alarm messages are displayed in the alarm window internal monitors continue to operate until the battery is completely discharged and all electronics are shut down Warning When the BATTERY LOW Ca
129. tion refer to specific instructions provided with the scavenger kit Additional Equipment Prepare additional equipment as specified in the specific Instructions for Use Caution If monitors and other equipment placed on top of Fabius Tiro the risk of tipping over the unit is increased especially when rolling over thresholds etc Remove all monitors and other equipment from the top of the Fabius Tiro before moving the unit Daily and Preuse Checkout Form Complete the Daily and Preuse Checkout Form in Appendix A Fabius Tiro Operator s Manual Figure 68 AGS Scavenger Drager AGS 57 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 5 Operation and Shut down Contents Operation and Shut down Contents GUS fce 61 PowerUp SOIBBI arma asin ir tas 61 PowerUp Standby A 62 Ventilation Monitor Scree LT 62 SEINE DE VAPOR is 62 EUSI ro A A 63 Mirour Flow of Anestesia aiii 63 Nitrogen Wash out When Required 44 4 2 63 Riiie LE R ABSORBE e 64 Falle Biel md 65 FA ratas 66 ananas anaa aeia 67 Preparation for Transport or Storage see eee eee eree
130. ttach it to the conical connector ventilator port on the compact breathing system 6 Part Number 4118348 003 Rev Fabius Tiro Operator s Manual 51 Chapter 4 Preparation Connecting the Breathing Hoses Note Take care not to damage the breathing hoses When connecting and disconnecting always hold the breathing hoses by the end sleeve not by the spiral reinforcement Figure 57 Otherwise the spiral reinforcement may be torn loose Breathing hoses with a damaged spiral reinforcement can kink or become occluded Before each use check the breathing hoses for damage The following numbers in boldface refer to Figure 58 1 Push patient breathing hoses 1 onto both the inspiratory and expiratory connectors or onto the microbial filters Connect both patient breathing hoses to the Y piece 2 Connect the bag 3 to the elbow port on the compact breathing system Inserting A New O Sensor Capsule Inserting a new 2 sensor capsule The following numbers in boldface refer to Figure 59 1 2 52 Unscrew the cap 1 from the sensor housing Remove the new sensor capsule from its packaging or use a disinfected sensor capsule Insert the capsule 2 in the housing with the ring shaped conductors against the contacts in the housing Screw the cap 1 on firmly by
131. ttery fuse from its packaging 2 Insert the battery fuse into the battery fuse holder 1 in Figure 44 turn the fuse 1 4 turn clockwise until it is snug 44 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Activating the Battery Figure 43 Loosen The Swivel Plate Retention Knob Figure 44 Battery Fuse OP50010 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Gas Supply Gas Supply Note Medical gases must be dry and free from dust and oil The medical gas pipeline supply connections are shown in Figure 45 Medical Gas Pipeline Supply of N O and AIR Warning Carefully check hoses each time you The following numbers in boldface refer to Figure 45 1 connect a machine to a wall or ceiling outlet to ensure that both ends of the hose are indexed for the same gas Pipeline delivery hoses used between wall outlets and anesthesia machines have caused accidents when during assembly an oxygen fitting was placed on one end of the hose and a nitrous oxide fitting on the other end Connect the N2O hose 1 to the connector on the Fabius Tiro and to the wall terminal unit 4 of the medical gas pipeline system Co
132. unting nennen 46 Electrical Supply 47 Attaching Manual Ambu Ventilation Bag 47 Preparing the Ventilator 48 Ventilator Safety Features DeC EET 48 Attaching the CO2 Absorber onto the Compact Breathing System 49 Attaching the Inspiratory Valve sun ernennt 49 Attaching the Expiratory Valve een benennen hehe 49 Attaching the Adjustable Pressure Limiting APL Valve 50 Inserting the Flow Sensor ee mm 50 Attaching the Waste Gas Outlet Port see 50 Connecting the Compact Breathing System 22222 1 51 Connecting the Breathing Hoses 2 2 1 1 52 Inserting A New O2 Sensor Capsule 52 Accessing the Connector Panel 2 did 53 Connecting the O2 Sensor 54 Connecting the Pressure Sensor eee eee 54 Connecting the Breathing Pressure 55 Connecting the APL Bypass and Hoses 55 Connecting the Flow Sensor Rs 56 Installing Anesthetic Gas Scavenging Hose to the Compact Breathing System 56 Scavenger System for Fabius Tiro sese eee eee 57 Daily and Preuse Checkout Form sese eee eee eee 57 Fabius Tiro Operator s Manual 41 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS RETURN TO THIS MANUAL S TABLE OF CONTENTS
133. urate data through the communications port Check agent analyzer Check communications cable Disconnect analyzer from the Fabius Tiro and set Des Comp appropriately 84 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Breathing Pressure Monitoring Breathing Pressure Monitoring Breathing Pressure Monitoring Displays Information about the patient s breathing pressure 15 presented in the Breathing Pressure Monitor Window 1 in Figure 92 and in the Breathing Pressure Trace Window 2 in Figure 92 The Breathing Pressure Monitor window contains breathing pressure measurements expressed in units of cmH O as as the pressure high and pressure threshold alarm limits The measurement units are selected via the Configuration screen see Configuration on page 110 Note The Fabius Tiro can be configured by your Local Authorized Service Organization to display mean pressure MEAN instead of plateau pressure PLAT The following numbers in boldface refer to Figure 93 1 Positive End Expiratory Pressure The breathing pressure at the end of exhalation The numeric data display range is from 0 to 30 e 2 PLAT Plateau Breathing Pressure The breathing pressure at the end of inspiration The numeric data display range is from 0 to 80 2 MEAN Breathing Pressure The average of all
134. used by the use of Desflurane Ensure that Desflurane compensation is only activated whenever Desflurane is used Failure to activate when Desflurane is used will affect measured volume accuracy Activating when Desflurane is not used will affect measured volume accuracy The Fabius Tiro will automatically compensate for Desflurane when agent concentration data is available through communication with an external agent analyzer Inaccurate data from the analyzer may affect measured volume accuracy If Desflurane concentration data is communicated to the Fabius Tiro by an external agent analyzer the Fabius Tiro will automatically perform the corresponding flow compensation In this case the communicated data always overrides the functionality of the Desflurane compensation softkey Operators Manual Figure 100 Setup Desflurane Compensation Off volume Control 15 38 Freq Mu 12 540 65 PLAT 40 2 18 Yolume Calibrate Access Alarms oz Alarm Sensor volume Figure 101 Setup Desflurane Compensation On volume Control 2 Des on 15 34 Freq 12 540 65 PLAT PEAK 40 18 Access 2 H Calibrate Access Alarms az Alarm Alarm volume Sensor Log volume 95 RETURN THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 7 Setup Window Used During Operation Access Alarm Log Access Alarm Log Figure 102 Setup Alarm Log Press the
135. ution alarm message is first displayed the ventilator will continue to operate for up to an additional 10 minutes Then automatic ventilation is not available until AC power is restored Caution Never allow the battery to completely discharge If the battery does discharge completely recharge immediately When the battery is completely discharged all pneumatic functions of the Fabius Tiro continue to be available APL valve breathing pressure gauge cylinder and pipeline gauges fresh gas and agent delivery S ORC and total flowmeter Manual or spontaneous ventilation can be maintained Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 5 Operation and Shut down 65 Chapter 5 Operation and Shut down Ventilator Fail State If the Fabius Tiro does not recover from a VENTILATOR FAIL condition 1 66 Switch to ManSpont mode by pressing the ManSpont key and confirming the mode change by pressing the rotary knob Set the APL valve to MAN position Adjust the APL pressure limit for the desired inspiratory plateau pressure Press the O2 flush button on the Fabius Tiro as required to sufficiently inflate the breathing bag Manually ventilate the patient by squeezing the breathing bag Note In the ventilator fail situation the ventilator piston assembly position may not be locked As a result airway pressure may initially push the piston back to its limit stop increasing the volu
136. v RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Technical Data Chapter 12 Technical Data Anesthesia Gas Supply Module Fresh Gas Flow Indicators O2 20 Air Range and accuracy 0 0 to 12 0 L min 10 of reading or 0 12 L min into an ambient atmosphere of 14 7 psi 101 3 kPa at 20 C Resolution 0 1 L min Fresh Gas Flow Stability O2 and 20 10 of setting with pipeline pressures between 45 65 psi Air 10 of setting with pipeline pressures between 50 55 psi Air flow rate will vary proportionally with supply pressures outside 50 55 psi Total Fresh Gas Flowmeter Range and accuracy 0 to 10 L min 10 of full scale at STP calibrated with 50 O 50 gas mixture 0 to 10 L min 15 of full scale at STP for all other gas mixtures Resolution 0 5 L min from 0 5 2 L min 1 0 L min from 2 10 L min O2 flush bypass at 55 psi 3 8 bar max 50 L min at 50 psi 3 4 bar min 35 L min Common Gas Outlet Pressure Limit 13 psi 0 9 bar maximum Fabius Tiro Operator s Manual 139 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 12 Technical Data Technical Data Anesthetic Agent Vaporizer Interface Dr ger Vapor quick change plug in system for one anesthetic agent vaporizer The connections are automatically closed and sealed when the vaporizer is removed Dr ger Halothane Vapor Dr ger Enflurane Vapor Dr ger Iso
137. ve which an alarm condition occurs The numeric data is displayed in units of liters minute L min Minute Volume Alarm Low Limit 5 Indicates the volume below which an alarm condition occurs The numeric data 1 displayed in units of liters minute L min Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 6 Monitoring Figure 90 Monitor Display 02 100 90 Freq WT 12 0 12 7 540765 PLAT 40 18 81 Chapter 6 Monitoring Respiratory Volume Monitor Controls The following numbers in boldface refer to Figure 91 You can use the Alarm Limits key 1 the Standby key 2 and the rotary knob 3 to set the high and low respiratory volume alarm limits While the ventilator is on apnea volume alarms are generated at 15 seconds Caution and 30 seconds Warning if the respiratory volume monitor does not sense a valid breath While the ventilator is off and the system is in ManSpont mode these alarms are generated at 30 seconds Caution and 60 seconds Warning The Fabius Tiro s volume alarms are automatically enabled when the ventilator is switched from Standby to a ventilation mode Setting the Minute Volume Alarm Limits If the minute volume falls below the minute volume low alarm limit or above the minute volume high limit an alarm condition occurs Minute Volume High Limit The Minute Volume High Limit range is from 0 1 L min to 20 0 L min F
138. window enables you to PLAT PEAK 40 e perform ventilation functions and 7 1 8 E e view and change monitoring settings Note The Volume Alarms On Off soft key label Valume Calibrate Access does not appear in ManSpont mode because Alarms 02 alarn itis selectable on the ManSpont screen E Figure 25 on page 30 Sensor volume Pressed During Standby Mode Figure 10 Standby Setup Screen The Standby Setup screen Figure 10 appears The Standby Setup Standby Setup screen enables you to define site Configuration defaults and configuration Exit Exit Uo lune Settings Tine Set Pressure Settings Time Format Alarm Limits Date Set Alarm Wo lune Date Format Restore Factory Defaults Acoustic Confirmation Hlarm Tone Sequence Waveform Display 22 Fabius Tiro Operators Manual 500 8758 LLE Hed Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Cross Functional Controls and Displays Chapter 3 Operating Concept Status Bar Figure 11 Status Bar volume Control 24 119 100 41 2 48 100 The following numbers in parenthesis refer to Figure 11 Mode Display 1 30 Displays the active ventilator mode 1 2 540 6 5 Alarm Silence Status 2 E PLAT PERE Displays the time remaining for alarm silence when 7 1 8 the Silence Alarms key 1 pressed Battery Power Level 3 Displays the status of the reserve power
139. wmeter bank This flowmeter can be used when the machine is turned off A zero stop prevents damage to the flow control valve seat Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 2 Configurations and Components Figure 4 Fabius Tiro Anesthesia Machine Figure 5 Dr ger Vapor System Figure 6 Auxiliary Oxygen Flowmeter 17 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Chapter 3 Operating Concept Contents Operating Concept Contents E e O every Mq MM 21 a NAAA pr CN RSV M 2l POET E oea ni al 21 Mains Power Applied LED an 21 A e MEE TT 21 A 21 Gross Fu unctional Controls and Displays esti n 22 O EN P 22 Setup oT M PH 22 e 23 24 AS a ds 24 cedo A 25 Selecting Setting Monitoring ii 26 KOT 28 STH EDD DES risa in 28 Ventilator Compliance Compensation 28 Si 29 Changing Ventilation Modes isis ic 32 Selecting Setting Ventilation
140. workstation consist of materials that are sensitive to certain organic solvents sometimes used for cleaning and disinfecting e g phenols halogen releasing compounds oxygen releasing compounds strong organic acids etc Exposure to such substances may cause damage that is not always immediately apparent Sterilization with ethylene oxide EtO or formaldehyde is also not permitted To prevent any damage we recommend that only detergents and disinfectants are used that are compatible with the device e g surface disinfectants on the basis of aldehydes alcohols or quarternary ammonium compounds for disinfection Ensure that all disinfectants are registered with the U S Environmental Protection Agency or approved by your national authorities for use as intended Always follow the instruction labels specifically with respect to prescribed concentrations and the necessary exposure times Disinfectants often contain besides their main active agents additives that can also damage materials When in doubt ask the supplier manufacturer of the disin fectant cleaning agent Caution The Fabius Tiro and its components must not be treated with formaldehyde vapors or ethylene oxyde Warning Follow all of your accepted hospital procedures for disinfecting parts contaminated with body fluids protective clothing eyewear etc Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 9 Routine Mainte
141. y Volume Monitor COntrolS 82 Setting the Minute Volume Alarm Limits 82 Respiratory Volume Alarm Messages 11222222 21 1 12 2 4 9 83 Respiratory Volume Monitoring Problem Resolution 84 Breathing Pressure een 85 Breathing Pressure Monitoring Displays 222222 2 85 Breathing Pressure Monitor Controls 86 Setting the Pressure and Threshold Alarm Limits sees 86 Breathing Pressure Alarm Messages uices set trap entire puc Rag cias 87 O bn 89 Fabius Tiro Operator s Manual 71 RETURN TO THIS MANUAL S TABLE OF CONTENTS RETURN TO CD ROM TABLE OF CONTENTS Part Number 4118348 003 Rev RETURN TO THIS MANUAL S TABLE OF CONTENTS Overview Overview This chapter describes functions that are specific to oxygen monitoring respiratory volume monitoring and breathing pressure monitoring For information on general monitoring functions see Operating Concept on page 19 Alarms Setting Alarm Limits The Alarm Limits key enables you to set alarm limits for the present procedure To set the default alarm limits that take effect at power up see Setting Alarm Limit Defaults on page 107 Alarm Limits Key The Alarm Limits key is shown at 1 in Figure 81 Dis
142. y default value is 0 cmH O Fabius Tiro Operator s Manual RETURN TO CD ROM TABLE OF CONTENTS Chapter 3 Operating Concept Figure 22 Ventilation Monitor Screen and System Controls 3H Control Volume Control volume Control 15 38 90 12 540 65 18 29 Chapter 3 Operating Concept Pressure Control Mode Optional The following soft key labels appear from left to right along the bottom of the Pressure Control screen See Figure 24 PINSP inspiratory pressure setting The range for PINSP is 5 to 60 cmH O The factory default value is 15 Freq ventilation frequency The range for Frequency is 4 bpm to 60 bpm The factory default value is 12 bpm time ratio between inspiration and expiration phases The range for TI TE is 4 1 to 1 4 The factory default value is 1 2 Insp Flow maximum rate at which the piston travels upward to create the target pressure The range for Insp Flow is 10 L min to 75 L min The factory default value is 30 L min PEEP positive end expiratory pressure The range for Peep is to 20 cmH O The factory default value is 0 cmH O ManSpont Mode The Apnea Pressure and Volume Alarms labels appear to the left of their ON OFF label on the bottom of the ManSpont screen See Figure 25 Pressing the ON OFF soft key turns the applicable alarm s ON or OFF 30 RETURN TO THIS MANUAL S TAB
143. ystem must recognize that the means of monitoring and discovering hazardous conditions are specific to the composition of the system and the various components of the system It is the operator and not the various manufacturers or suppliers of components who has control over the final composition and arrangement of the anesthesia system used in the operating room Therefore the responsibility for choosing the appropriate safety monitoring devices rests with the operator and user of the equipment The Fabius Tiro is equipped to monitor breathing circuit pressure exhaled volume and inspired oxygen and to sound an alarm when any of these parameters violates a preset limit The Fabius Tiro should not be used if any of these monitors are not functioning properly Draeger Medical Inc also recommends that the Fabius Tiro only be used to deliver anesthesia and or mechanical ventilation in accordance with the guidelines for patient monitoring published by the American Society of Anesthesiologists In addition to volume pressure and oxygen monitoring these guidelines require the use of a capnometer to monitor inspired and expired carbon dioxide as well as other patient monitors including continuous electrocardiography pulse oximetry and arterial blood pressure monitoring Anesthetic agent monitoring and temperature monitoring are also strongly recommended The responsibility for the selection of the best level of patient monitoring belongs sol

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