STANDARD FLOWMETER USER`S MANUAL
Contents
1. Scavenging Breathing Circuit 0 0 0 0 ee eee Automatic Vacuum Switch AVS 0 ee eee In Line Vacuum Control Kit 2 0 ee eee misi CalUleS thatthe TIT TQ CO aretha ew T DT TL IT Bee eet Safety Feature Checks 2 2 0 2 26664644 cede ben dle lr em n ERR p x E Rod Minimum Oxygen Flow Test 0 0000 cece eee ns Nitrous Oxide Failsafe System Check Before Each Use Power Oxygen Flush Check Monthly llle Quick Test to Check 3 Liter Bag Rubber Goods for Leaks Bag WCC 4254 0 oid beatae ea Mee he bee hae ee ok eee da ee ed eat ed E Non Rebreathing Valve Check Monthly 0 0 0 0 ce eee ee eee Emergency Air Valve Check Monthly 0 0 0 0 0 cece eee ene DIFECHONSAOR USC oc kasd rar eee ee eas ol oes oe ee See wee eae ee E Basic Delivery Technique llli Maintenance and Service 0 ee eee ee ee eee cleaning MCIhOdS ierit ard o EIS See tae eee abdo wa dee d Troubleshooting Chart Partial Listing of Reference Materials llle Warranty and Returns IMPORTANT READ MANUAL COMPLETELY BEFORE OPERATING THIS DEVICE Basic delivery technique is described Also this manual contains instructions on periodically required checks to be performed by the user These checks are necessary to insure the proper performance of this device and its safety features Retain this manual for future reference AN WARNINGS AND PRECAUTIONS These warnings and2. outside of the flowmeter and accessories Do not spray disinfectant directly onto meter Spray disinfectant into disposable towel and wipe unit thoroughly removing excess disinfectant to eliminate buildup Control knobs can be autoclaved Remove knobs from flowmeter Clean using an appropriate disinfectant Rinse with water then autoclave Do not exceed 275 F for 15 minutes maximum TROUBLESHOOTING CHART FOR STANDARD FLOWMETERS SYMPTOM No flow of O2 or N20 when ON OFF switch is ON and the right O2 knob is rotated to give flow Can get O2 flow but cannot get N20 flow O2 minimum flow is less than 3 liters minute or over 3 1 2 liters minute Meter will flow N20 without any O2 flow in the O2 tube Ballooning of the gas bag Gas is leaking from the ON OFF switch Patient not feeling effects of gases Bag is going flat during procedure POSSIBLE CAUSE 1 O2 supply not turned ON 2 Machine not connected to pipeline system 3 Empty O2 cylinders 1 N20 supply not turned ON 2 N20 cylinder empty 1 O2 regulator is pipeline pressure varying 2 Oil or dirt accumulation in tubes Failsafe failure 90 Elbow connected onto bag tee is pushed on too far blocking movement of the non rebreathing valve Nick or cut in o rings on the ON OFF stem 1 Outer mask is not fit properly to patient s face 2 Gas flows do not meet patient s requirement 1 Gas flows do not meet patient s requir
3. tube This feature provides a minimum percentage of Oz flow nominally 30 and therefore does not allow more than a 70 N5O flow If the minimum Os flow is lower than 3 liters minute more than 7096 N5O flow can be delivered For example 2 1 2 liters of O and 7 liters of N O the maximum flow of N2O able to be delivered is a 74 mix A low minimum Os flow indicates a need for servicing 11 NITROUS OXIDE FAILSAFE SYSTEM CHECK BEFORE EACH USE Turn both the NO and Os control valves ON until both flow tubes indicate 5 liters minute of flow Interrupt the flow of Os This will check the dynamic status of the Nitrous Oxide Failsafe System valve This can be done by either disconnecting the Oxygen hose from the wall or shutting off the Oxygen at the tank The Nitrous Oxide flow should drop as the Oxygen flow decreases stopping completely before the Oxygen float drops to zero Failsafe Block AN WARNING If the Nitrous Oxide Failsafe System fails to perform as indicated do not use this product prior to repair Improper function of this safety feature may permit Nitrous Oxide to flow to the patient without Oxygen Please call Porter Instrument at 1 215 723 4000 with any observation or suspicion of improper function 5 he bag should stay inflated If so the test has been successful and there are no excessive leaks If the bag does not stay inflated the 3 liter bag or rubber goods have an excessive leak Repl
4. ALWAYS ASSURE THAT LINES ARE NOT CROSSED WARNING New or modified installations properly connected gas pipelines are absolutely essential to patient safety The dealer or contractor should provide written documentation that all gas pipelines are connected properly and that the system has been pressure tested prior to use While this is a good business practice it is important that the user verify by their own test independent of the dealer or contractor that all gas pipelines are connected correctly prior to using the system The ultimate responsibility of assuring that lines are not crossed rests with the user Do not allow crossed lines to defeat the safety features of the dental flowmeter and or central gas supply manifold systems Crossed lines will create a dangerous and hazardous condition where 100 nitrous oxide will be delivered through the oxygen dental flowmeter tube and subsequently to the patient In addition the resuscitator quick connect would deliver 100 nitrous oxide to an oxygen demand valve Maintain patient observation during procedures Prevent over sedation If a patient becomes over sedated when being delivered 10096 oxygen it is a definite indication of crossed lines If crossed lines are suspected remove the nasal mask immediately and encourage mouth breathing Deliver pure oxygen from an oxygen demand valve only if the oxygen source is independent from the suspected crossed lines area To check for crossed lin
5. E OR OTHERWISE Under no circumstances shall Parker Hannifin Corporation be liable for incidental or consequential damages as those terms are defined in the uniform commercial code Parker Hannifin Corporation Porter Instrument Division warrants that each product or part shall be free from defects in workmanship and materials under normal use and with appropriate maintenance for one 1 year from the date of delivery to customer unless otherwise specified in writing All rubber and plastic parts and accessories are warranted under the same conditions for a period of ninety 90 days from date of purchase No statement or claim about the product by any employee agent representative or dealer of Parker Hannifin Corporation shall constitute a warranty by Parker Hannifin Corporation or give to rise to any liability or obligation of Parker Hannifin Corporation Parker Hannifin Corporation shall not be liable for any damage injury or loss arising out of the use of the product whether as a result of a defect in the product or otherwise if prior to such damage injury or loss the product was 1 damaged or misused 2 repaired altered or modified by persons other than Parker Hannifin Corporation 3 not installed in strict compliance with applicable codes and ordinances or 4 not installed by an authorized Parker Hannifin Corporation dealer Parker Hannifin Corporation s obligation for breach of this warranty or for negligence or otherwise sh
6. STANDARD FLOWMETER USER S MANUAL Instructions and Safety Considerations MXR Models of Porter Conscious Sedation Flowmeters and Bag Tee Accessory Flowmeter Models 1000 1100 Bag Tee Model P1407A k ol PUSH ON Parker Hannifin Corporation Porter Instrument Division PORTER 245 Township Line Rd P O Box 907 Hatfield PA 19440 0907 USA Porter Flowmeter Model No Serial Number Table of Contents Warnings and Precautions 0 cc ee rre Crossed Lines Warnllg eae te se ele oe eee eee ee be Se ee E Wt A Do not Allow Crossed Lines to Defeat Equipment Safety Features Illustration Safety ADA Guidelines NFPA Codes 0 00 eee eens Intended Use Flowmeter for Analgesia Delivery System 0 20005 Use SCaVeNnGiINGs 2 23 ee eicere E X ER eder Eat Dee sates Gas SUPPIY CONNECCION s dtc die dee EC S o acd c b eu d e xd MOMAY Leak ChCCK xu 6440 34 24 00 tate Ramee Soul eee eee x d eee a RPM E Flowmeter Mounting Options 0 0 0 A a A rns Wall MOUM esr ete ec ue Sn ara od tnd Soh en ee a eet hee ee ee eee Sabine lr MOLDE uobis d ete are iren he bats a RS PRCA We Y aet wee ea eo Slide AWAY v Raa bak dcs en dat ae ee Soc hae ees oka eh dod ae tree in Mobile Stand and E S 38 uu acr EC Ro Oe CR SCR Id ESE e FIOWMeter ACCeSSOFIeS c evEPV einen iw tee hole ke eee PING ER dee een Maree LIE BAG Me Positive Pressure Demand Valve 0 0 ee ees Gas
7. ace any parts that leak and retest until results are successful POWER OXYGEN FLUSH CHECK MONTHLY O2 SUPPLY PRESSURE AT 50 PSIG Disconnect the corrugated rubber tubing from the bag tee outlet Figure 1 Item 11 With both control knob valves OFF depress the power O flush button while blocking the flow from the front of the bag 6 Disconnect one of the duplex hoses tee For proper operation the gas from the plastic connector and re install reservoir bag should fill within about 5 the nosepiece seconds NOTE There will be 3 si s liters min of O flowing when the O control valve is in the OFF position Also test for bag rubber goods leak Remove one connector following Steps 1 through 6 and join hoses together Power O Flush Button S Figure 2 Quick Test to Check 3 Liter Bag Rubber Goods for Leaks 1 With the flowmeter bag tee and Porter rubber goods in place remove the nosepiece and one of the two plastic connectors from the Porter rubber goods Refer to Figure 2 2 With the other plastic connector join the two duplex hoses together making a closed system 3 Taking care not to fill the bag too much bag could burst open the oxygen control valve until the 3 liter bag starts to over inflate or balloon then close the valve 4 Observe the 3 liter bag for five minutes BAG TEE The Bag Tee assembly features a Non rebreathing Valve and an Emergency Air Intake located
8. all be strictly and exclusively limited to the repair or replacement of the product or part This warranty shall be void on any product on which the serial number has been altered defaced or removed ORDERS All orders are to be made through authorized Parker Hannifin Corporation distributors All billing will be done through said distributors Direct orders will be handled through the authorized local dealer as determined by Parker Hannifin Corporation RETURNS No returns will be accepted unless authorized in writing by Porter Instrument Division and accompanied by a properly completed return goods authorization All returns are subject to a re stocking and possible rework charges to be determined by Porter Instrument Division Policies subject to change without notice ADA rn PF ACCEPTED American Dental Association 2 The ADA Council on Scientific Affairs Acceptance of Porter Conscious Sedation Flowmeter STD 1100 is based on its findings that the product is effective for use in delivering nitrous oxide oxygen conscious sedation in the dental operatory The Quality System for Porter Instrument is Certified to ISO 13485 The scope of our registration is The design manufacture distribution and servicing of Dental Flowmeters Gas Scavenging Systems Gas Distribution Systems and Office Communication Systems for use in the Dental Profession FM 351 Rev H 9 06 16
9. ceed the guidelines established by the National Fire Protection Association for Nonflammable Medical Gas Systems NFPA 99 Copies of NFPA 99 or portions thereof may be obtained by writing to National Fire Protection Association Batterymarch Park Quincy MA 02269 9904 USA or call 1 800 344 3555 INTENDED USE Flowmeter for Analgesia Delivery System This device is intended for patient use by an attending physician or dentist properly trained in its use Porter Instrument recommends the user be thoroughly familiar with the use of Nitrous Oxide Oxygen Conscious Sedation for patient analgesia and be properly trained in its administration prior to using this product For training requirements on the administration of Nitrous Oxide Oxygen Conscious Sedation contact the appropriate regulatory authority in your country state or province Training is recommended to provide a practical hands on capability and an understanding of the behavioral aspects of Nitrous Oxide Sedation and will complement the safety features of this device USE SCAVENGING Monitor for N20 in the operatory to insure that controls are effective in achieving low levels of ppm parts per million exposure Contact your Porter dealer for details on monitors and testing GAS SUPPLY CONNECTION After installation of the flowmeter connect the nitrous oxide and oxide supply lines to the Diameter Indexed Safety System DISS fittings located on the back of the f
10. d gases during a dental analgesia conscious sedation procedure in a dental operatory The breathing circuit consists of a 22mm 90 elbow connector fresh gas coaxial tubing a corrugated hose and hood assembly Attach the nasal inhaler to the coaxial tubing assembly using the diameter indexed connectors Attach one end of the fresh gas corrugated tubing to the coaxial tubing assembly at the fresh gas Y connector and the other end to the 22mm right angle adapter Press fit the 22mm right angle adapter onto the bag tee Attach the 3L bag to the bottom downspout of the bag tee Attach the vacuum hoses to the vacuum control source AVS or In line Vacuum Control Block Refer to FM 809 for User Instructions Assembly Installation and Cleaning 5061 Connector Installation Do not install 2 connectors together Sig vm Q b J Vacuum y imm 3mm ID ID Automatic Vacuum Switch AVS Option The AVS is used to control the vacuum flow in the gas scavenger breathing circuit and assure that the scavenging system is activated as soon as N5O O is turned ON Adjust the vacuum flow using the control knob Vacuum flow is most effective when the ball float is set within the green bar area Installation of AVS to Flowmeter Screw AVS 5000 knurled seal nut down tight onto flowmeter making sure the rubber washer is inside the seal nut When tight the AVS should not rotate Then screw the bag tee seal nut onto the AVS Bag tee should no
11. e 4 O2 Control Valve controls flow from 3 to 10 liters minute 5 N20 Control Valve controls flow from 0 to 7 liters minute 6 Emergency Air Valve automatically provides the patient with ambient air if gas flow is interrupted check monthly a m al PUSH ON FLOWMETER FEATURES 7 Non Rebreathing Valve guards against CO build up and rebreathing of used gases check monthly 0 Positive On Off Switch in the ON position O flow is pre set at 3 liters a minimum of 30 O is established at all flows 9 Power Flush provides extra delivery of O2 to the breathing bag check monthly 10 0 Quick Connect left side of machine facilitates connection of positive pressure demand valve for emergency Oxygen 11 Bag Tee Outlet connects to fresh gas tubing 12 3 Liter Bag Connection SAFETY FEATURE CHECKS IMPORTANT These are safety features which you should routinely check to assure proper function If any of these safety features are not functioning properly contact your Dental Dealer or Porter Instrument and arrange for the necessary repairs Porter Instrument recommends the repairs be made before reusing the device MINIMUM OXYGEN FLOW FEATURE MINIMUM O2 FLOW TEST Connect gas supply tubing Open the Oe tank valve Os line pressure must be at 50 PSIG Push the ON OFF button to the ON position A flow of 3 liters minute of Oe should be indicated by the ball float position in the Os
12. e flowmeter when mounted on the slide assembly There should be adequate space at the rear of the flowmeter for O2 and N2O gas delivery hoses Contact your local dental dealer for mounting options Solid Wall Mount Telescoping Model 2020 1 Remove cap from the mounting post assembly 2 Insert mounting post through mounting bracket on back of flowmeter 3 Replace cap on top of mounting post a Position small diameter cap down to allow for swivel mounting Figure A b Position small diameter cap up to fix direction of flowmeter Figure B 4 Tighten screw securely Figure A Cap Position Swivel Wall Mount Figure B i Cap Position Up Fixed Position Mobile Stand Cabinet Mount Slide Model 2036 Figure C 1 Loosen knob on side of mounting block 2 Remove mounting post from block 3 Insert post through mounting bracket on back of flowmeter 4 Replace post with flowmeter attached into mounting block 5 Tighten knob on side of mounting block Figure C I Ht a Lal eu E o LL o FRONT Slide Away Mount Model 2035 1 For ease of accomplishing the dual sliding motion hold the meter toward the top half and lift slightly while sliding the arm in and out This will reduce the load on the slide and promote a smoother action Figure D Figure D Loosen thumb screw knob 2 Slide shaft up 3 Insert flowmeter hole in bottom of black failsafe block onto t
13. ement 2 Outer mask is not fit properly to patient s face PARTIAL LISTING OF REFERENCE MATERIAL REMEDY 1 Turn O2 regulator in tank room ON 2 Connect to wall outlet 3 Replace with full cylinder l Turn ON N20 cylinder 2 Replace with full cylinder 1 Check O2 regulator Be sure O2 manifold pressure is 50 PSI 2 PSI f not call Dealer for service 2 Call Dealer for service Take out of service and return to Porter Remove rubber goods and 90 elbow from bag tee Reconnect elbow and rubber goods Call Dealer for service 1 Fit so inner mask is secure to face but outer mask is just off face 2 Re adjust gas flows to obtain acceptable bag action 1 Re adjust gas flows to obtain acceptable bag action 2 Fit so inner mask is secure to face but outer mask is just off face Handbook of Nitrous Oxide and Oxygen Sedation Morris Clark e Ann Brunick Dentists Desk Reference Materials Instruments amp Equipment American Dental Association Helative Analgesia in Dental Inhalation Analgesia and Sedation with Nitrous Oxide Harry Langa D D S Conscious Sedation in Dental Practice C Richard Bennett sedation A Guide to Patient Management Stanley F Malamed The Practical Use Nitrous Oxide Oxygen Conscious Sedation Robert E Hamric D M D WARRANTY THIS WARRANTY IS GIVEN IN PLACE OF ALL OTHER WARRANTIES EXPRESS OR IMPLIED OF MERCHANTABILITY FITNESS FOR A PARTICULAR PURPOS
14. es of an installed Porter Vanguard or Sentinel Manifold System 1 At the manifold system in the tank room start the check from an operating system with 50 psi showing on both gauges and the indicator lights turned on electrical operation and alarms needed for the Vanguard test Then turn off both oxygen tanks and leave both nitrous oxide tanks on For the Sentinel only one tank of each gas is on at a time Turn off the one open oxygen tank leave on the one nitrous oxide tank turn off the indicator lights eliminates alarms during the Sentinel test 2 n the operatory where the flowmeter is installed flow 5 to 6 liters per minute of O only Verify that the N5O flowmeter valve is in the off position and that there is no indicated flow of N20 by observing the ball float resting at the bottom of the glass N5O flow tube This action will bleed the oxygen copper tubing lines 1 2 OD from the manifold through the office walls to the flowmeter Note this action does not cause a quick bleed down as there is a fair sized volume in the lines Os flow would be observed by the position of the ball float in the Os flow tube for several minutes 3 Rather than waiting for the Os flow to decrease go back to the manifold tank room and observe the Oz pressure gauge on the manifold normally showing approximately 50 PSIG pressure The line pressure should start to decrease indicating bleeding of the Os that is no longer being replenished b
15. ient has reached a comfortable relaxed state of sedation The ability to titrate NO is a significant advantage because it limits the amount of drug to that which is required by the patient If titration is done properly the patient does not receive any more of the drug than is necessary The amount of N2O required by a patient on any given day or time varies For information on titration a most valuable resource for the practitioner is the Handbook of Nitrous Oxide and Oxygen Sedation written by Clark and Brunswick and published by Mosby www mosby com This text is a concise and contemporary guide for nitrous oxide oxygen administration Handbook of Nitrous Oxide and Oxygen Sedation Morris Clark e Ann Brunick 14 MAINTENANCE AND SERVICE It is advisable on a two 2 year cycle to have the Standard Flowmeter factory checked and serviced The Nitrous Oxide Failsafe System is made of moving parts Between servicing intervals it is advisable to safeguard against potential malfunctions by performing the failsafe check before each and every use of the unit Safe operating techniques learned during your N2O Os Conscious Sedation training should always be used Inspect and maintain the analgesia delivery system to prevent N20 leaks in all hoses connections and fittings Repair all leaks immediately CLEANING METHODS We recommend the use of an approved disinfectant for the dental environment for cleaning the
16. ith unit turned OFF disconnect the corrugated rubber tubing from the Rubber Goods and draw air with your mouth through the corrugated tubing connected to the bag tee You should be able to draw ambient air through the Emergency Air Valve the gas bag may have to fully collapse first Air going through the valve sounds different than normal gas flow DIRECTIONS FOR USE NOTE These directions detail a basic delivery technique However this is not a comprehensive description and not a substitute for a training course that emphasizes a practical hands on approach together with instruction on safe administration techniques Topics covered in such a course will include experiences of practitioners in specific dental clinical settings the pharmacokinetic properties of nitrous oxide strategies to avoid over sedation and allow for biological variability and strategies to maximize patient satisfaction When the shut off Maintain patient procedure observation during Open N20 O tank valves Push the ON OFF button to ON position 3 Liters minute of O will automatically flow Set Os valve to desired level usually between 5 to 7 liters minute Breathing should be maintained at 34 s full level oet N2O valve to desired level by rotating N2O Control Valve See Figure 1 Item 5 upwards counterclockwise to increase concentration Rotate slowly until desired level is achieved Practice titration with 10 nit
17. lowmeter unit It is important that the regulators for both gases be set to give pressures in the range of 50 PSIG 2 PSIG Confirm the absence of leaks at pressure connections on the unit Bubbles will appear at leaking locations when a soap water solution is used This procedure is recommended each time a cylinder is changed MONTHLY LEAK CHECK or if connections to flowmeter are disconnected and then reconnected such as after a flowmeter service at the factory or if the DISS DISS hose is replaced Leak test the flowmeter system for working pressure leaks After all hose connections are tightened turn the flow control knobs to the off position and the on off switch to the off position Confirm that the DISS Shut Off Valves are in the open position Pressurize the sedation gas supply lines with 50 PSI Observe any pressure decay after an overnight time period 5 PSI drop allowed Monitor Os gas pressures at the beginning of each procedure to assure sufficient gas remains in the tank to complete the procedure FLOWMETER MOUNTING OPTIONS The Dental Flowmeter may be mounted to a telescoping wall mount using the existing hanger on the back of the flowmeter or to a mobile stand using the threaded hole at the bottom of the failsafe block There are various options for mounting the flowmeter within cabinets The location selected for mounting of the slide assembly should provide easy access to reach and unobstructed view of th
18. on the Bag Tee which comply with American Dental Association guidelines The non rebreathing valve has a back flow check valve which prevents exhaled gases from entering the breathing bag no carbon dioxide buildup The emergency air intake has a valve that allows room air to be inhaled into the breathing circuit by the patient A breathing bag is attached to the metal portion of the Bag Tee and is a reservoir bag for the delivered analgesia gases which when taken together with the two valves above becomes the visual barometer for monitoring the patient s respiration rate The bag moves in and out with each inhalation and exhalation Bag Tee Installation to Flowmeter Screw knurled seal down tight onto flowmeter making sure the rubber washer is inside the seal nut When tight the bag tee should not rotate NOTE Fit mask to patient so inner mask is pulled down tight secure to the face Outer mask should not be against the face Vacuum needs to be drawn into outer mask during inhalation NON REBREATHING VALVE CHECK MONTHLY With unit turned OFF disconnect the corrugated rubber tubing from the Rubber Goods and breathe into the corrugated tubing connected to the bag tee You should not be able to fill the bag with exhalation gas If the bag fills the system s Non Rebreathing Valve is not functioning properly and should be replaced Emergency Air Valve Non Rebreathing Valve EMERGENCY AIR VALVE CHECK MONTHLY W
19. op of mobile stand pole Figure E 4 While holding the flowmeter still screw shaft into bottom of the flowmeter 5 To telescope meter Figure E loosen thumb screw knob on side of mobile stand position flowmeter then retighten knob Threaded Stud Pole gt Knob to Adjust Telescoping of Meter Mobile E Stand Figure F Hefer to installation and instructions FM 916 for mounting flowmeter to Mobile E Tank Stand Figure F FLOWMETER ACCESSORIES Three Liter Bag Install the 3 L Reservoir Bag by sliding the opening over the outside of the bag tee downspout The bag moves in and out with each inhalation and exhalation and becomes a visual barometer for monitoring the patient s respiration rate Refer to FM 809 for User Instructions Assembly Installation and Cleaning Positive Pressure Demand Valve The Porter flowmeter is equipped with a Resuscitator Quick Connect which allows for the attachment of an oxygen demand valve The Demand Valve Resuscitator provides a fast simple and effective means to ventilate non breathing patients and provide 100 oxygen on demand The Resuscitator Flow rate is limited up to 40 LPM in line with the 1992 American Heart Association Recommendations and Guidelines for Resuscitation Refer to the User Instructions supplied with this product for complete details Gas Scavenger Breathing Circuit Gas scavenger system is used to remove exhale
20. precautions are to help you to understand how to safely operate the MXR Flowmeter A WARNING alerts you to a possible hazard to people A CAUTION alerts you to the possibility of equipment damage WARNING Do not use this device for the administration of general anesthesia or as a part of or in conjunction with a general anesthesia administration system WARNING Dental workers are exposed to N20 during administration of N20 Os conscious sedation analgesia NIOSH has recommended that exposures should be minimized Contact NIOSH 1 800 35 NIOSH to receive NIOSH Publications on Control of Nitrous Oxide in Dental Operatories Exposure can be minimized by effective controls National Institute for Occupational Safety and Health NIOSH publications state that controls including System Maintenance Ventilation and Work Practices can effectively reduce N concentrations in dental operations Your flowmeter accessory Porter scavenger system is an important part of the system of controls WARNING Porter Instrument equipment utilizes the cross protection system The flexible hose and connectors that connect to the flowmeter are diameter indexed 3 8 O D for Nitrous Oxide and 7 for Oxygen The cross protection system is designed to prevent misconnection of Oxygen and Nitrous Oxide piping DO NOT ATTEMPT TO CHANGE THE DIAMETERS OR CONNECTORS OF THE FLOWMETER Tampering with the cross protection system constitutes acceptance of liabilit
21. rous upward movements every 60 seconds until endpoint achieved Patients may typically experience relief of anxiety tingling in extremities and euphoria Patients typically require less than 50 nitrous procedure is nearing completion amounts of N O should be decreased Terminate the flow of NO and deliver 100 Os to begin a minimum postoxygenation period of 3 to 5 minutes Assess the patient for appropriate recovery Administer additional Os if necessary Titration and post procedure 100 O will minimize nitrous exposure to the operatory potential patient side effects of lethargy headache or nausea and any potential adverse effects of nitrous diffusion into air filled cavities Use Power Flush button Figure 1 Item 9 to evacuate N20 from bag Place the ON OFF switch primary mechanism in the OFF position Figure 1 Item 8 Push from back of ON OFF switch NOTE f control valves are still open gas flows should stop at this point Turn OFF the gas supply at the tank at the end of the day NOTE If your unit does not operate as described in Steps 1 through 9 under Directions for Use please contact your Dental Dealer or Porter Instrument BASIC DELIVERY TECHNIQUE Practice titration Titration is a method of administering a substance by adding definitive amounts of a drug until an endpoint is reached For nitrous oxide oxygen N20 O2 sedation N20 is given in incremental doses until a pat
22. sal mask and Oxygen demand valve when Flowmeter is set for 100 Oxygen resulting in over sedation ersed At gas outlet station the common run of 1 2 inch pipe for Nitrous Oxide is incorrectly allowed to remain at the 1 2 inch size and is then falsely connected to the DISS 1 2 inch outlet station Nitrous Oxide is fed into the Oxygen lines Dental flowmeter valve is set for 100 Oxygen only but will deliver 100 Nitrous Oxide because of the crossed lines A patient will become over sedated and may appear to fall asleep when the flowmeter is set for 100 Oxygen An Oxygen demand valve connected to the resuscitator quick connect of the Flowmeter will also deliver 100 Nitrous Oxide because of the crossed lines SAFETY ADA Guidelines In addition to the fail safe and other safety features found on most sedation machines effective August 1976 the following specifications were added to those required for acceptance by the ADA Council on Dental Materials and Devices 1 Emergency Air Valve 2 Non rebreathing Check Valve and 3 Resuscitator Quick Connect In addition the ADA Council requires that 1 The gas storage and delivery system meet the recommendations of the National Fire Protection Association NFPA 2 The system be installed by a competent supplier of gases and equipment NFPA Codes To assure safe operation and conformation to local fire codes Porter Instrument Nitrous Oxide Sedation Systems meet or ex
23. t rotate Connecting AVS to Vacuum Hoses Attach one end of the vacuum hose to the vacuum hose Y connector and the other end to the MASK port of the AVS Attach a second vacuum hose to the VAC port of the AVS and the other end to the vacuum source Porter recommends that effective scavenging can be achieved with the ball float in the green bar area of the acrylic sight glass however NIOSH publications conclude that higher vacuum flows of up to 45 L min are most effective To meet the NIOSH recommendation of 45 L min adjust the ball above the green bar area In line Vacuum Control Kit Option The kit includes a vacuum control block with sight glass vacuum tube holder adapter T and straight fitting The vacuum control block can be inserted directly into the High Volume Evacuation HVE line or may be placed in line by cutting the vacuum hose and attaching the cut ends of the tubing to both ends of the vacuum control block Adjust the vacuum flow using the control knob Vacuum flow is most effective when the ball float is set within the green bar area Refer to FM 809 for User Instructions Assembly Installation and Cleaning FIGURE 1 LT 4 1 Oxygen Flowmeter Tube indicates the flow of O in liters minute 5 2 Nitrous Oxide Flowmeter Tube indicates flow of N20 in liters minute X596 3 Nitrous Oxide Failsafe System N20 flow is proportionately reduced if O2 is shut off or the pressure is reduced check before each us
24. y WARNING New or modified installations properly connected gas pipelines are absolutely essential to patient safety The dealer or contractor should provide written documentation that all gas pipelines are connected properly and that the system has been pressure tested prior to use While this is a good business practice it is important that the user verify by their own test independent of the dealer or contractor that all gas pipelines are connected correctly prior to using the system The ultimate responsibility of assuring that lines are not crossed rests with the user WARNING During any power outage remember to turn OFF the flowmeter and manually turn OFF the tank valves With centralized electrically powered gas systems if gas was flowing when the power went out and the flowmeter is left ON gas will be flowing when the power is restored CAUTION Federal law requires this device for use by or on the order of a physician or dentist CAUTION Always use clean dry medical grade gases Introduction of moisture or other contaminants into this device may result in defective operation CAUTION Do not attempt to repair alter or calibrate this device Unauthorized repair alteration or misuse of this device is likely to adversely affect the performance and will void the warranty CAUTION Never oil or grease any part of this system minimize fire or explosion potential WARNING NEW OR MODIFIED INSTALLATIONS
25. y the tanks On Vanguard systems the alarm will beep at 40 PSIG a switch will occur from one tank to the second tank at 30 PSIG increasing the gauge back to 40 PSIG The gauge then should eventually go down to zero If the Os pressure does not go down as described above and remains at about 50 PSIG it indicates a crossed lines condition 4 f Oo pressure does not go down proceed to the next crossed line determination check Turn N2O tanks off in the manifold tank room and watch the N O gauge Given a crossed line condition the N2O gauge will now go down the Vanguard system will show a switching similar to step 2 above this shows the O valve of the flowmeter is bleeding the crossed N5O lines The N2O gauge will go down to zero 2 The initial installation potential problem DISS Diameter Index Safety System is modified at tank room wall when 3 8 inch Nitrous Oxide pipe is increased to 1 2 inch pipe size Oxygen pipe remains at the normal 1 2 inch size Both Nitrous Oxide and Oxygen piping is maintained at a common 1 2 inch size throughout the building walls leading to operatories At gas outlet station the Oxygen 1 2 inch pipe is incorrectly decreased down to the DISS 3 8 inch size reserved for Nitrous Oxide lines Oxygen is fed into the Nitrous Oxide lines Do Not Allow Crossed Lines to Defeat Equipment Safety Features Crossed lines in wall structure piping creates hazard of 100 Nitrous Oxide delivery to na
Download Pdf Manuals
Related Search