Pro-Nox™ User Manual
Contents
1. Page 14 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintli co m Nitrous Oxide Delivery System NOTE N20 audible alarm and visual indicator will cycle at 48 beats min They will continue to cycle until the N2O pressure is restored or the Oxygen supply is turned off or depleted Turning off the PRO NOX will not silence the alarm To assess the specific PSI at which the low supply pressure alarms and shut offs are activated you need adjustable supply pressure regulators Slowly decrease supply pressure until the feature is activated You may need to activate the demand valve to depressurize the PRO NOX internals as you decrease the supply pressure setting If using a rolling stand ensure both gas supplies are connected and functioning tanks are turned off at the yoke and a new patient circuit is connected Store in a clean dry environment until next patient use If PRO NOX is wall mounted ensure both gas supply hoses are connected and functioning and a new patient circuit is connected 3 OPERATING INSTRUCTIONS 3 1 ON OFF SELECTOR In the ON position a patient inspiratory effort will activate the demand valve and deliver the Nitrous Oxide Oxygen gas mixture In the OFF position patient efforts will draw ambient air via the port on the back of the machine EK DEMAND VALVE The device is equipped with a demand system providing a 50 nitrous oxide 50 oxygen mixture to sp2. with 2 5 inch x 5 8 inch post CMI 0113 PNX Stainless steel mounting plate to mount PRO NOX unit on Matrx Nitronox rolling stand with 15 inch x 5 8 inch post requires Nitronox post collar Active Scavenger GD 1925 Active Scavenger with 19mm exhaled gas inlet 3 8 barb for suction hose attachment flow control knob and pressure relief ports Basket mount 6 0 MANUFACTURER ul Carestream Medical International Ltd 20133 102 Avenue Unit 1 Langley British Columbia VIM 4B4 CANADA d 0086 Under the Supervision of BSI Group Kitemark Court Davy Avenue Knowlhill Milton Keynes MK5 8PP United Kingdom www bsigroup co uk Page 20 of 22 Tel 1 604 888 6275 Toll Free 1 877 522 1614 Web www cmedintl com WwWww pro nox com Email info cmedintl com Matthew Baxter BSc MRes Regional Manager CAREstream Medical International 93 Gloucester Court Kew Road Richmond TW9 3DZ UK 44 0 7719816326 mbaxter carestreammedical com www cmedintl com CMI FORM O100MAN PNX US V 5 Carestream Medical International www cmedintl com Nitrous Oxide Delivery System 7 0 WARRANTY PF RPA REA ELLE ALE ALE ALE LE OE LE LE LLLP ELE ELLE FLEE IEE ILE L LLL LE LLL LEI IEE IEE L LLB LLL ELLE EE IPI IPE 1 AEE A ILE LLB A LPB EEL EBL IEE IPE ILE IEE EA N WARRANTY SSRN RRS f f f f Carestream Medical International Ltd CMI warrants to the original purchaser of this PRO NO
3. 3 9 LOW SUPPLY PRESSURE SHUT OFF The demand valve will no longer activate if either nitrous oxide or oxygen source pressure falls below 35 37 PSI This indicates that the source gas is exhausted to the point where the device will no longer function as indicated As the oxygen source pressure drops below 35 37 PSI the demand valve shuts down and the O2 supply indicator will go from flashing to off The audible alarm ceases The N2O supply indicator will remain on As the nitrous oxide source pressure drops below 35 37 psi the demand valve shuts down and the N20 pressure indicator and audible alarm continue to cycle at 48 bpm The O2 supply indicator will remain on The low N20 alarm will continue until the O2 supply is depleted or disconnected Page 16 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintli co m Nitrous Oxide Delivery System It is recommended that the patient remove the mouthpiece or mask if the demand valve is shut off If they do not the patient will still be able to draw ambient air via the rear port of the device 4 MAINTENANCE 4 1 ROUTINE CHECKS Inspection of the PRO NOX Nitrous Oxide Delivery System and checking of the device to ensure functioning Low Supply Pressure Alarms and Shut offs should be performed on a regular basis minimally every 6 months see Section 2 2 PRE USE FUNCTIONAL CHECKS and it is recommended that a record of these
4. PRO NOX Nitrous Oxide Delivery System CMI 0100 PNX Made for Carestream Medical International Ltd USER MANUAL CMI FORM O100MAN PNX V 4 Carestream Medical International www cmedintl com Nitrous Oxide Delivery System T Le k C naaa J CA D 4 gt L 4 NATI 4 mr oni J er LA own f i his page leit intentionally blank Page 2 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintl com Nitrous Oxide Delivery System TABLE OF CONTENTS 1 WELCOME TO THE PRO NOX NITROUS OXIDE DELIVERY SYSTEM siscissssiesicncncoosectesamenssves 5 1 1 INTRODUCTION arco ccerycsesctanser lt omansins eta peas ipa ecsaaecancusdconacsieacuanpeedornecdanncammundcsmacsmeasaapaator secs 5 1 2 UNPACKING AND TIN ea EE 5 1 3 ABREVIATIONS AND SYMBOLS USED IN THIS MANUALE 6 1 4 READALL INSTRUCTIONS PRIOR E een 6 1 5 WARNINGS AND CAUTION EE 7 1 6 INDICATIONS FOR USE rorci eee ee eee ae EEE S 9 1 7 ENEE Eege 9 1 8 PRODUCT DESCRIP ION caarcectaaunreonsaqoraseatconieseaagaacesannanncsdaraapataovanaasariaeseiwennnesaoraneaiians 10 1 9 PERFORMANCE E Der er Me CC cron nia A arson 12 Z PREPARATION FOR E 13 2 1 PRELU EN EMBL E 13 2 2 PRE USE FUNCTIONAL TES E 13 2 DPERATINGIN TRUCTFION KEE 15 3 1 ON deen a eO E E EA AE EE EEE 15 3 2 CERTAN EE 15 3 3 GAS SUPPLY VISUAL INDICATORS n sssnsssssenessssseerssssserressssereesssssrresssseeresssseeresssseereesss 16 3 4 LOW CUPPLY PRESSURE eege 16 3 5 LOW SUP
5. and In hospital use ER Labour and Delivery etc Physician s offices Birthing centers Clinics Esthetics centers 1 7 CONTRAINDICATIONS Hypersensitivity to nitrous oxide mixtures Head injuries with impaired consciousness Maxillofacial injuries Artificial traumatic or spontaneous pneumothorax Air embolism Middle ear occlusion ear infection Decompression sickness Severe abdominal distension secondary to intra abdominal air intestinal obstruction Inability of patient to follow directions Inability of patient to hold own delivery device mouthpiece or mask Nitrous Oxide Oxygen N20 O2 mixtures must never be used in any condition where air is trapped in the body and expansion up to 3x original size would be dangerous For example it will exacerbate pneumothorax and increase pressure from any intracranial air Air in any other cavities such as the sinuses middle ear and gut may also expand Page 9 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintli co m j Nitrous Oxide Delivery System 1 8 PRODUCT DESCRIPTION The PRO NOX System is designed to operate on medical nitrous oxide and medical oxygen from cylinders and or medical gas piping systems Supply gas shall be 50 70 PSI and able to supply 100 LPM flow at these pressures 2 4 1 3 1 ON OFF switch With switch turned to ON and sourc
6. US V 5 Carestream Medical International www cmedintl com Nitrous Oxide Delivery System All other components should be wiped clean with a mild soap solution or hard surface disinfectant suitable for polycarbonates Under no circumstances should the complete unit be allowed to be soaked or immersed in cleaning solutions Detailed cleaning procedures are as follows 1 Ensure that the device is disconnected from the gas supply source 2 Remove the single patient use circuit from the device and dispose of safely in accordance with local protocols 3 Remove N20 and O input hoses and wipe clean with a mild soap or hard surface disinfectant Ensure no cleaning solution enters the hoses 4 The PRO NOX enclosure can be wiped over with a soft cloth and mild soap solution or hard surface disinfectant 5 If there is ingrained contamination a soft bristled brush may be used 6 Dry all components thoroughly 7 Surface disinfection may be performed using disinfectant wipes compatible with polycarbonate materials Ex CaviWipes or Accel products with 0 5 accelerated hydrogen peroxide Disinfect as per disinfection product instructions 8 Attach a new patient circuit and connect the unit to the gas supply Check function prior to packaging for emergency use Do not attempt to clean or sterilize any components that are designated as disposable or single patient use as immersion of these items into a sterilizi
7. OT CONSIDER ALTERNATIVE FORMS OF ANALGESIA Page 7 of 22 CMI FORM 0100MAN PNX US V 5 Carestream i International www cmedintl c Medical Turn off compressed gas source prior to storage of PRO NOX device Store PRO NOX in a clean dry area when not in use NOT MRI COMPATIBLE Ensure all gas fittings are tight and leak free Adding components filters circuit extensions to circuit may increase inspiratory resistance If patient complains of difficulty in breathing through device remove additional components Instruct patient to breathe out into mask or mouthpiece and to maintain seal throughout respiratory cycle Always open cylinder valves slowly and completely After use always ensure that all components are cleaned or replaced in accordance with the instructions provided in this manual Use this device in areas with appropriate ventilation to minimize atmospheric exposure to inhaled analgesic Page 8 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintli co m Nitrous Oxide Delivery System 1 6 INDICATIONS FOR USE The PRO NOX Nitrous Oxide Delivery System is intended to provide a mixture of 50 nitrous oxide and 50 oxygen on demand to a conscious spontaneously breathing patient for the relief of pain due to trauma or other conditions where inhalation analgesia is clinically indicated The device is suitable for Pre hospital use ambulance
8. PLY PRESSURE SHUT OFF E 16 Ek EE Sarno E E A NARR 17 4 1 POUTINE CHECI ee SE E E SE N A EAA O EA 17 4 2 CLEANING PROCEDIR eege 17 5 ACCESSORIES S CONSUMABLE EE 19 o AANU CTION E EE 20 e WARANT EE 21 Appendix A PRO NOX checkout kk RRE ENNER NENNEN ENER NENNEN ENER RENE 22 Page 3 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintl com Nitrous Oxide Delivery System Page 4 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedinti co m j Nitrous Oxide Delivery System 1 WELCOME TO THE PRO NOX NITROUS OXIDE DELIVERY SYSTEM 1 1 INTRODUCTION The PRO NOX Nitrous Oxide Delivery System is a pneumatically driven gas mixer designed to deliver a 50 Oxygen and 50 Nitrous Oxide gas mixture to adult and pediatric patients for the relief of pain in a medical setting The demand valve integrated into the main device housing minimizes risk of patient to patient cross contamination Minimal user controls and enhanced safety features make this the safest nitrous oxide mixer available 1 2 UNPACKING AND INSPECTION Inspect packaging for damage document any damage seen Remove all contents from the PRO NOX packaging and ensure all of the following are included PRO NOX Nitrous Oxide Delivery Device 6 foot nitrous oxide high pressure hose 6 foot oxygen high pressure hose Single use patient circuit including mouthpiece and nose clip Product registration ca
9. X Nitrous Oxide Delivery System that it is free from defects in material and workmanship for a period of two years from the date of purchase This warranty 1s extended only to the original purchaser of this product from CMI or an authorized PRO NOX distributor SRN In the event of a defect malfunction or failure of this PRO NOX unit within the two year period and upon notification of the defect in writing by the purchaser CMI will repair or replace the product at the sole discretion of CMI at no cost to the purchaser All shipping costs shall be borne by the purchaser 5 This warranty shall be void if the equipment is damaged as a result of abuse neglect accident or failure to follow operating or maintenance instructions This warranty shall become void 1f any repairs or alterations to the warranted product beyond that described in the user manual are undertaken without the prior authorization of CMI EE RAA EN RR EE NRA ARRA A NRAN E EEN EE EE E E NARA A AAAA E EE E EE PN PN RN NN Aa Under no circumstances will CMI be liable for consequential damage loss or expense arising Wi f directly or indirectly from the use of this device EANNA NARAN MANAA ANRA A RA A E A NRA SNRA A NAA S S AA S AS ARA S RA A ARA NH KEE _ This warranty is given in lieu of all other warranties expressed or implied and Carestream Medical International Ltd neither assumes nor authorizes any person to assume on CMI s behal
10. activate a continuous audible alarm and disable the demand valve should internal malfunction occur in the mixer or any internal hoses rupture or kink THE PRO NOX NITROUS OXIDE DELIVERY SYSTEM IS CONSIDERED A CRITICAL DEVICE AND ITS COMPONENTS CONSIDERED CRITICAL COMPONENTS ONLY THOSE MEDICAL PERSONNEL TRAINED IN THE OPERATION OF NITROUS OXIDE OXYGEN ANALGESIC GAS DELIVERY SYSTEMS SHOULD USE THIS EQUIPMENT THOROUGHLY REVIEW THE INSTRUCTION MANUAL BEFORE USE Page 11 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedinti co m j Nitrous Oxide Delivery System l PERFORMANCE SPECIFICATIONS 9 Minimum Peak Flow rate 120 LPM Inhalation Resistance 0 to 6 cmH2O o 60 LPM Exhalation Resistance 0 to 6 cmH2O 60 LPM Oxygen Concentration 42 5 to 57 5 Operating Temperature 41 F to 104 F 5 C to 40 C 40 C to 60 C Patient Circuit Single Use Patient Circuit c w Scavenging port and filter Patient Valve Dead Space 8 ml meas Dimensions Wx Dx H 8 9 x 6 6 x 3 9 inches 226 x 168 x 99 mm Page 12 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintli co m Nitrous Oxide Delivery System Zz PREPARATION FOR USE 2 1 PRE USE ASSEMBLY If the PRO NOX is being mounted on a wall arm or rolling stand attach mounting plate to the PRO NOX unit as described in the instructions that come with the mount Attach high pressure hose
11. checks be maintained for each unit A sample PRO NOX checkout sheet is included at the end of this manual Beyond this analysis of the patient gas mixture should be done once year to ensure delivered gases are within specified range More in depth testing of the alarm and shut off thresholds should be performed with the use of adjustable pressure regulators whenever proper function of the safety mechanisms is questioned Slowly decrease the source pressure while activating the demand valve until each safety feature is activated Units with test pressures or gas delivery outside of the ranges listed in the product specifications should not be used This PRO NOX device is not designed for field service beyond that indicated in this manual Any attempt to modify or repair this unit will make void the product warranty If you have a unit that requires servicing contact your local distributor prior to returning the unit 4 2 CLEANING PROCEDURES Routine cleaning of the device shall be undertaken to maintain the device in a useable and sanitary condition Patient circuit is intended for single use and shall be discarded after each patient use in accordance with local protocols and replaced with a new circuit The patient interface mouthpiece or mask shall be disposed of or cleaned between patients as indicated Mouthpieces provided with the patient circuits are to be disposed of between patients Page 17 of 22 CMI FORM 0100MAN PNX
12. device is restricted to sale by or on the order of a licenced healthcare practitioner e Only trained qualified medical personnel should operate this device e Use this device only for its intended purpose as indicated in this manual e Ensure absence of contra indications before administering nitrous oxide e Monitor patient closely while delivering nitrous oxide and afterward until effects are cleared e DO NOT obstruct patient ambient air inlet on back of machine e If audible alarm sounds continuously DISCONTINUE USE AND SHUT OFF SOURCE GAS e DO NOT use this device or handle compressed gas near any open flame e ALWAYS follow ANSI and CGA standards when handling compressed medical gases e Servicing of this device should only be done by a qualified and authorized service technician ANY UNAUTHORIZED DISASSEMBLY WILL INVALIDATE THE WARRANTY e The nitrous oxide cylinder should be operated in an upright position If it is in a valve down position while the cylinder valve is open liquid may be expelled through the vent passages This liquid nitrous oxide can cause burns by freezing exposed skin e Never allow oil or grease to come into contact with any part of the cylinders regulators or PRO NOX device e Where scavenging is being used ensure the patient is maintaining a seal with the mouthpiece or mask during exhalation e NEVER HOLD THE MOUTHPIECE OR MASK IN PLACE FOR THE PATIENT THE PATIENT MUST DO THIS ON THEIR OWN IF THE PATIENT CANN
13. e gases connected the demand valve will activate with 2 5 cmH2O inspiratory pressure With switch in OFF position the demand valve is inactive and patient will breathe ambient air via opening at rear of device 7 2 Nitrous oxide and 3 Oxygen supply pressure indicators Light up green when pressurized with the indicated gas These also serve as visual flashing indicators if low source gas pressure alarm is activated NOTE the visual indicator will remain lit with tank turned off if internals remain pressurized 4 Outlet of mixed PRO NOX 50 50 gas to patient 22mm OD connection for attachment of patient circuit 5 DISS gas inlet connection for nitrous oxide source gas 6 DISS gas inlet connection for oxygen source gas The delivered gas mixture is pre set at 50 nitrous oxide 50 oxygen Neither the patient nor medical personnel are able to adjust this ratio eliminating the risk of delivering a hypoxic mixture Page 10 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintli co m Nitrous Oxide Delivery System The gas specific built in alarm systems will generate both visual and audible alarms should either the nitrous oxide or oxygen source pressure fall below 40 PSI and the demand valve will no longer activate should either the nitrous oxide or oxygen source pressure fall below 35 PSI The device is also equipped with a secondary fail safe circuit that will
14. f any liability beyond that stated herein This warranty gives no specific legal rights You i may also have other rights which may vary according to local regulations Ree LLL EL LEE ELE ELLE LLG LEE ELE EE LEAL AREE 1 LEE LEE EE LE LLLP LLL EL LEE ELE LLLP AEE A EL LEE ELE ERE LEAL ELLE ELE EE LEAL ELLE LEE ELE LLL EEL LEE LEE EERE LE AEE A ARE A EL LEE ELE ERE A ARE 1 AREE 1 ARE A AERE A LEE EE LE Ca a TERANA A AAAA NAAS RRR Page 21 of 22 CMI FORM 0100MAN PNX US V 5 Nitrous Oxide Delivery System ESTE SOc TEF geb Q E ke ke ul gS amp Appendix A Sample PRO NOX Checkout Procedure PRO NOX Connect scavenging Attach PRO NOX to source gas cylinders Attach syringe min 500 ml and slowly pull back Demand valve activates Both inlet pressure indicators should be on easily Date circuit Turn PRO NOX on Slowly decrease source pressure while activating demand valve Audible and visual indicators noted when pressure drops below inlet pressure drops 35 37 PSI and PRO NOX attached below 40 PSI to full cylinders or wall source Demand valve meets 30 O2side N20 side O2side N2Oside lpm flow demand and 180bpm 48 bpm closes when insp ends Initials Continue to decrease source pressure Demand valve shuts off when inlet Pull back syringe approximating 30 lpm demand flow Device is clean New pt circuit attached O100MAN PNX US V 5 CMI FORM Page 22 of 22
15. ng solution can cause degeneration of the materials Page 18 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedinti co m Nitrous Oxide Delivery System 5 ACCESSORIES amp CONSUMABLES PRO NOX Nitrous Oxide Delivery System Unit CMI O100 PNX US PRO NOX unit with 6 ft high pressure hoses one single patient use circuit manual 2 year warranty Circuit Components WES9303 Disposable 6 ft 1 8 m Patient Circuit c w filter mouthpiece and nose clips Case of 20 CMI 0160 PNX Scavenging tubing 100 ft roll magenta 19mm cuffs every 12 inches PRO NOX Mounting Solutions CMI 0110A PNX Rolling stand includes 1 rolling stand with handle basket and cylinder holder to mount one oxygen and one nitrous oxide e cylinder to rolling stand 1 stainless steel mounting plate to secure PRO NOX unit onto rolling stand c w circuit holder CMI 0120A PNX Wall mount includes 1 aluminum wall mounted 8 inch swing arm 1 stainless steel mounting plate to attach PRO NOX unit to wall mount NW Page 19 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedinti co m Nitrous Oxide Delivery System For Mounting PRO NOX with Pre existing 5 8 Post Mounts Mounting solutions when replacing older generation mixers CMI 0122 PNX Stainless steel mounting plate to mount PRO NOX unit on Matrx Nitronox wall mount
16. ns to circuit may increase inspiratory resistance If patient complains of difficulty in breathing through device remove additional components Ensure all fittings are secure and that any scavenging attachments are in place and functioning Demand Valve Function 5 Simulate pt inspiration with ON OFF control in the OFF position Demand valve should not activate You will be able to draw ambient air via rear port on PRO NOX 6 Turn PRO NOX ON OFF control to ON 7 Simulate inspiration draw approx 30 Lpm for minimum 1 second You should hear gas flow as the demand valve is activated The demand valve should close when inspiration 1s stopped Low Source Pressure Alarms and Safety Shut offs 8 Disconnect O from gas supply turn tank off at yoke or disconnect high pressure supply hose at wall outlet NOTE Audible and visual alarms are activated as pressure within the PRO NOX unit falls below 40 PSI O visual indicator and alarm cycle at 180 beats min Demand valve ceases to function as O2 supply pressure drop below 35 PSI You may need to simulate several patient inspirations to get drop in gas pressure and alarm activation NOTE Audible alarm will cease once OU pressure within the PRO NOX unit drops below a threshold level Visual indicator will cease to flash and will remain in the unlit state 9 Reconnect oxygen supply gas to unit 10 Repeat steps 8 through 10 with the N O supply
17. ontaneously breathing patients via the patient mouthpiece or mask An inspiratory effort by the patient will open the demand valve and the gas mixture will flow to the patient matching the patient s inspiratory flow demands up to 120 Lpm Page 15 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedinti co m j Nitrous Oxide Delivery System 3 3 GAS SUPPLY VISUAL INDICATORS Located on the front panel the O2 visual indicator shows green when oxygen is supplied to the unit at a sufficient pressure and the N O visual indicator shows green when nitrous oxide is supplied to the unit at a sufficient pressure Used in conjunction with the low supply pressure alarms these indicators provide additional reference for the operator as to the gas supply status OFF 3 4 LOW SUPPLY PRESSURE ALARMS The alarm system will generate a 48 beat per minute visual the N2O indicator will flash green and audible alarm should nitrous oxide supply pressure fall below 40 PSI and generate a 180 beat per minute visual the O2 indicator will flash green and audible alarm should oxygen supply pressure fall below 40 PSI Deep fast inspiration may cause the low pressure alarm to chirp as the internal pressures drop due to high patient flow demand This will cease as inspiratory flow demand slows The patient should be encouraged to take slow deep breaths to maximize analgesic effect while minimizing hyperventilation
18. rd This User Manual NOTE If any components are missing from the shipping carton immediately call the supplier with the packing slip number your original purchase order number and the description of the item which is missing Page 5 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintli co m 1 3 ABREVIATIONS AND SYMBOLS USED IN THIS MANUAL N O O2 DISS PSI LPM cmH20 SE PR mm mL Ib kg Nitrous Oxide Delivery System Nitrous Oxide Oxygen Diameter Index Safety System Pounds per Square Inch pressure equivalent to PSIG gas for the purposes of this manual Litres per minute flow Centimetres of water pressure Degrees Celsius Degrees Fahrenheit Millimeter Millilitre Pound Kilogram Indicates a potentially hazardous situation which if not avoided could result in death or serious injury Indicates a potentially hazardous situation which if not avoided could result in minor or moderate injury or damage to equipment 1 4 READ ALL INSTRUCTIONS PRIOR TO USE Federal USA Law restricts this device to sale by or on the order of a physician or properly licensed practitioner who has appropriate training and experience Page 6 of 22 CMI FORM 0100MAN PNX US V 5 A g Carestream d Medical E International e S www cmedintl co m KA N vc SCH Nitrous Oxide Delivery System 1 5 WARNINGS AND CAUTIONS WARNING e This
19. s to the appropriate inlet DISS connections on the PRO NOX xxx HA ND TIGHT ONLY Using a wrench or excessive force in tightening the supply hose may damage the seal or the thread of the connection Connect hoses to gas source wall outlets or cylinder regulators Attach patient circuit to the patient outlet on the front of the PRO NOX If scavenging exhaled gases attach scavenging tubing to exhalation port of patient valve and connect distal end of tubing to anesthetic gas scavenging system or optional PRO NOX active scavenging system 2 2 PRE USE FUNCTIONAL TESTS Perform these tests before putting PRO NOX unit into service and then every 6 months after Where you are directed to simulate inspiration you can use a large syringe ex 500 cc calibration syringe or a vacuum source set to approx 30 Lpm connected to patient valve 1 Turn PRO NOX ON OFF control to OFF 2 If using cylinder s open cylinder yoke fully NOTE a whistling may be heard when the source gas is first turned on This is an internal oxygen bleed that will last less than 15 seconds until internal components are properly pressurized 3 Note that visual indicators light up 4 Attach machine end of patient circuit to TO PATIENT port Page 13 of 22 CMI FORM 0100MAN PNX US V 5 Carestream Medical International www cmedintli co m Nitrous Oxide Delivery System Adding components filters circuit extensio
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