EHE8-B5 Anesthesia Machine Users Manual

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EHE8-B5 Anesthesia Machine

Users Manual

PLEASE READ THIS OPERATION MANUAL CAREFULLY

BEFORE OPERATING THE ANESTHESIA MACHINE

Im port ant Saf et y I ndic at ion

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1 Thank you for your choosing EHE8-B5 Anesthesia Machine, please carefully read and keep this
Users Manual for future use.
Terms declaration in this manual:
Warning: You should know how to protect the patient or doctor from hurt.
Caution: You should know how to protect the machine from being broken.
Notice: Emphasizing important information.

Please make the storage battery well connected to avoid bad influence to the patient caused by
sudden blackout.

The AC power connected to the machine should have good protection grounded.

4 This machine is not explosion-proof equipment, so please DO NOT operate the machine in any
place with explosive or flammable gases. Also it is not a liquid-proof equipment, if there is liquid
on the surface, please wipe it off immediately. DO NOT let any liquid enter into the machine.
5

The ventilation pipe and spile should be thoroughly cleaned and disinfected before using.

6 Please make sure the machine is in good condition, NEVER operate the machine if there is
malfunction.
7 In order to avoid explosion, NO flammable anesthetic like aether or cyclopropane can be used. This
machine only meets the rules of GB 9706.29-2006(IEC 60601.2.13-2003), and applies only non
flammable anesthetic.

8 This machine does not use flammable anesthetic like aether or cyclopropane, so it is not necessary
to use antistatic ventilation pipes or masks, which may cause burning when using high frequency
electric surgical equipment, so we DO NOT suggest this kind of pipes or masks.

9 The performance of this machine may be influenced by nearby high frequency surgical instruments or
short-wave equipment.

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There should be independent ventilation mode, such as simple respirator with mask, no matter what
kind of anesthesia system is being used.

Explanation to Words and Figures

DANGER: Alert to high danger
WARNING: Alert to moderate danger
NOTICE: Attention to low dander

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B type equipment

Please refer to attached documents

Im por t ant An nounc em ent

The assorted pressure testing instrument should accord with
ISO8835-21999
The assorted O2 monitor should accord with ISO77671997
The assorted CO2 monitor should accord with ISO99181993
The assorted adult anesthesia ventilation system should accord with
ISO8835-21999
Expiratory volume monitor together used with the anesthesia system
should accord with 51.101.4 of GB9706.29-2006(IEC 60601.2.132003)
Pressure restrict equipment together used with the anesthesia system
should accord with 51.101.1 of GB9706.29-2006(IEC 60601.2.132003)
Ventilation system with alarm function together used with the anesthesia
system should accord with 51.101.5 of GB9706.29-2006(IEC
60601.2.13-2003)
The assorted anesthesia gas transportation device should accord with
ISO8835-4
The assorted anesthesia gas monitor should accord with ISO11196
1996
The assorted anesthetic gas cleaning, transportation and receiving
system should accord with ISO 8835-3:1997
This machine is equipped with anesthesia ventilator, the ventilator
should accord with ISO 8835-5
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This anesthesia system or any independent devices is not suitable for

MRI environment
No flammable anesthetic like aether or cyclopropane can be used in this
system. Only anesthetic according with the nonflammable anesthetic
requirements in appendix DD of GB 9706.292006(IEC 60601.2.132003)
The operator should be aware of the danger of high current
caused by creepage when the equipment is connected to
assistant power socket.
The malfunction of central gas supply system may cause one or
more, or even all the related devices stop working
This system does not include anesthetic gas monitor, if you want
to use the monitor, please take sample at the patient end of the
inspiration valve in the ventilation system
This anesthesia system or any independent devices is not
suitable for environment with strong radiation or electromagnetic
interruption, like MRI, Otherwise, the performance of the
equipment may be influenced
As standard GB 9706.15-1999(IEC 60601.1.1-2000) is applicable
to all medical electrical equipments connection, or at least one
medical electrical equipment connect with one or more nonmedical electrical equipment, each independent part of this
system connects together could engender a medical electrical
system when connecting with an assistant mesh power supply.
If anybody who wants to use any independent devices,
inspection devices, alarm devices, protection devices, or
assemble a complete anesthesia system, he should provide the
inspection list of the system.
Before use, the system should be equipped with a device which
can limit the pressure of the patient connection part. This
pressure should not be more than 12.5kPa, if the machine is in
good condition or single malfunction.

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List
1 Summary..................................................................................................................................................................
2 Structure Feature and Working Principle............................................................................................................
2.1 Main Unit........................................................................................................................................................
2.2 The anesthesia circle.......................................................................................................................................
2.3 Ventilator.........................................................................................................................................................
2.4 Vaporizer.........................................................................................................................................................
3 Technical Specifications.........................................................................................................................................
4 SizeWeight..........................................................................................................................................................
5 Assembly and debug..............................................................................................................................................
5.1 Preparation before assembly...........................................................................................................................
5.2. Installation of Anesthesia machine................................................................................................................
5.3 Pre-adjustment................................................................................................................................................
5.4 Receiving test after installation and adjustment.............................................................................................
6 Operation................................................................................................................................................................
6.1 Preparation and checking before use............................................................................................................
6.2 Operation of Anesthesia machine.................................................................................................................
6.3 Operation of Anesthesia ventilator...............................................................................................................
6.4 Operation of Stop using...............................................................................................................................
7 Daily maintenance of anesthesia machine.......................................................................................................
7.1 cleaning.........................................................................................................................................................
7.2 cleaning and disinfection..............................................................................................................................
7.3 Daily maintenance.........................................................................................................................................
8. Malfunction analysis and removal.....................................................................................................................
9 Safe guard and accident settlement..................................................................................................................
10 PackagingTransportationStorage............................................................................................................
10.1 Packaging....................................................................................................................................................
10.2 Transportation.............................................................................................................................................
10.3 Storage.........................................................................................................................................................
11 Others....................................................................................................................................................................

1 Summary
EHE8-B5 Anesthesia machine is necessary anesthesia equipment in the surgical
room, the main function is to provide O 2 to the patients, help them to inhale anesthetic
and manage the respiration.
EHE8-B5 Anesthesia machine is equipped with precise vaporizer, safety device
which can avoid anoxic, and also necessary alarm system. During the process of
anesthesia, the computerized gas-driven electric-control anesthesia ventilator can
manage the patients respiration. All the joints are standard joints. The big CO 2
absorber can reduce the repeated inspiratory of CO2.
Normal working condition:
Environment Temp18 30
Relative Humidity80 %
Atmospheric Pressure86 kPa 106 kPa;
Power Supply AC 220 V10% 501 Hz 100 VA , Single phase
alteration current power with protective ground.
Gas SupplyMedical O2, N2O and air source at rated pressure of 300Pa
500 kPa.
Note AC power connected to the anesthesia machine
must be grounding protection.
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EHE8-B5 Anesthesia machine is belong to Class I, type B general medical

equipment according to GB 9706.12007[Medical Electrical Device: Part one: General
requirements for safety]
:this is the symbol to represent Type B
The machine is normal equipment which is not waterproof, but It can work
continuously.
The machine is not explosion-proof equipment, so please DO NOT operate the
machine in the circumstance with explosive or flammable gases.

2 Structure Feature and Working Principle

The whole system is composed with main unit, circle cycle, anesthesia ventilator,
vaporizer and flow system.

2.1 Main Unit

The anesthesia machine uses compressed O 2, N2O and compressed air which
come from cylinder or central gas system in the hospital. In order to ensure the safe
use of the machine, the machine is also equipped with backup O 2 connection. Pressure
of all the gases should be 300kPa500 kPa. There are filters at all the connections in
order to stop grain bigger than100m entering into the working system of the machine.
After entering to the machine, O2 and N2O mixed into one gas which will be divided
into four gases. The first one enters the pressure-reducing valve, becomes 300KPa,
and enters the flow meter. The pressure of gas from cylinder or central gas system
may change along with the temperature or stored gas volume. Pressure-reducing valve
can make the gas pressure stable and meet the requirement of the anesthesia
machine. The pressure value after being decompressed can show on the O 2 pressure
meter and N2O pressure meter. The second gas goes to the pressure inspection
device, the machine will alarm if the gas pressure is lower than 200KPa+50KPa. The
third gas goes to the common gas exit through the quick O 2 supply valve, so as to
quickly supply O2 to the patients in emergency. The fourth gas will be connected to the
anesthesia ventilator, and will become the driving gas of the ventilator. Both the
compressed N2O and air will go through the pressure-reducing valve and enter into the
flow meter after pressure being reduced to 250KPa and 300KPa.
The flow meter adjusts all the gases and transports the mixed gas to the vaporizer,
and then the mixed gases, together with anesthetic will be sent to the anesthesia cycle
by outlet of common gas.
A pressure adjuster must be used when using cylinder. The output pressure
should be 400KPa. The variety of pressure from the output port should be not more
than 8KPa if the input pressure variety is about 1000 KPa. There is safety valve on the
output end of the adjuster, if there is malfunction or if the output pressure is too high
because of manmade reason, the safety valve will exhaust gas automatically to make
the output pressure become rating value. The exhausting pressure of the safety valve
is 500 KPa~600KPa.
The structural working principle is as in Figure 1

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Figure 1: Working principle figure of anesthesia machine

The flow meter can not display the flow, but also adjust the flow of air, O 2, and N2O
linkage device and N2O closure device in the flow meter. So that, if only turn on the O 2
valve, the N2O may be closed. However, if turns on the N 2O valve, there will be no N2O,
if the O2 valve is closed, this can ensure the O 2 concentration. If turn on O2 and N2O,
N2O flow will decrease along with the reduction of O2 flow. If O2 pressure entering into
the flow meter is less than 200KPa+50KPa, the flow meter will automatically cut down
N2O.
If the machine is equipped with two vaporizers, there must be mutual lock device,
so as to ensure that only one vaporizer can work at any time. So the mixture of two
different anesthetics can be avoided. There is a selecting switch of vaporizer to make
sure only one vaporizer in use to prevent two drugs mixing. The mixed gas from
vaporizer respectively goes through check valve to outlet of mixed gas and tehn goes
into the anesthetic circle stated in the next text.
Since the unlocking switch will make the pressure at the outlet of driving gas
fluctuate, when the machine is under working, the application of check valve isolates is
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adverse effects to vaporizer.

2.2 The anesthesia circle

Anesthesia circle, also called patient circle, is a liaison airway device to the
patients. The main purpose is to deliver the mixed gas to the patients, and meanwhile,
the patients complete regular respiration like breathing in oxygen and breathing out
CO2 via this circle. It has two modes: Auto and Manual. Under auto mode, the patients
respiration is controlled by the machine; while under the manual mode, the patients
respiration is controlled by doctor through the way pressing leather bag that connected
to the circle.
The Integrated anesthetic circulation circuit is as in Figure 2

Figure 2: Integrated anesthetic circulation circuit

1. Bellows
2. Positive and negative pressure table, monitoring airway pressure in circuit.
3.Inlet for new fresh air.
4. Anesthesia ventilator pressurized gas input port, which is connected to the
anesthetic ventilator pressurized gas output
5. Pressure signal output port, which is connected to the anesthesia ventilator
pressure signal input port via a dedicated hose
6. Mounting bracket mainly used to lock screw
7. AGSS exhaust port, which need to be connected to YY0635.2-2009 anesthetic
gas purification, transmission and receiving system.
8.Expiration valve
9.Sodium lime tank
10.Expiration mouth. Connector of breathing tube 22.
11.Connected to gas storage bag
12.Interface of Oxygen concentration sensor
13. Inspiration port, Connector of breathing tube 22..
14.APL safety valve
15.Respiration valve
16.Manual/machine controlled change-over switch
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The anesthesia circuit works at Manual mode when switch the Manual/
Auto valve to Manual. Firstly, press the Flush valve, O2 will go to leather bag
through interface of mixed gas. When squeezing the leather bag, gas in the leather
bag will go to the patient with mixed gas from anesthesia machine through Sodium
lime tank, inspiration valve and interface of inspiration corrugated tube. Inspiration
valve is a check valve which allows gas flow from cycle circuit to corrugated tube
only while inverse current not. The expired gas from the patient comes to cycle
circuit and back to the leather bag through expiration valve and expiration corrugated
tube. The expiratory valve is also a check valve which allows gas flow from
corrugated tube to cycle circuit only. Back flow is not allowed. Repeat this again and
again.
CO2 in expired gas from the patient will be absorbed by sodium lime when it
comes to CO2 absorber before flowing to expiration valve. While the anesthesia
machine sending oxygen and anesthetic gas that patient needs to the cycle circuit
continuously through input of mixed gas.
You can read the airway pressure from pressure gauge each time you press
the leather bag. Adjust APL valve to setup the maximum of airway pressure. Spare
gas will be discharged when airway pressure exceed the setup value.
When Manual/auto valve switch to auto, bellows works instead of leather bag
in manual. Driving gas flows into bellow through inlet of driving gas and forms driving
pressure at the outside of folded leather of bellow to instead of manual mode.
The expiratory gas from patients is more than that from bellows leather bag
because the inspiratory gas to patients is not only the gas in bellows leather bag, but
also from the new mixing gas in anesthesia main unit. Theres a automatically adjusting
equipment in the inner part of bellows, which could remove the useless gas, we can
connect anesthetic gas purification and receiving system with the useless gas outlet.
During the working process, the output gas flow rate value from anesthesia
machine could get sample from the flow sensor of expiratory air valve and expiratory
corrugated tubewhen needing to monitor the Oxygen concentration, you can put the
Oxygen concentration sensor to the joint part. CO2 monitoring system is connected to
the expiratory end of ventilation system, and anesthetic gas monitor sample can be
obtained from the inlet of mixing gas.
Note Silicon rubber parts in this system cover corrugated tube and
leather bag. The users should notice that corrugated tubes are separated to
disposable one and re-useable ones when cleaning and disinfection. Leather
bags are re-useable parts, and also you should take special attention to the
silicone rubber parts when cleaning and disinfection because the cleaning
solution or disinfection liquid may damage the equipment. Theres no
expired date or using times for leather bag if it is not broken.
Note Air valve in inspiratory loop and expiratory loop may stop
working sometimes, which will lead to the accumulation of CO 2. if it monitors
that the Oxygen saturation decreases or the patients face become black in
operation, you can check whether the air valve has problem. Solution to this
problem: open the valve cap, and fasten the air valve tightly.

2.3 Ventilator
The ventilator that EHE8-B5 Anesthesia machine uses is gas driving and Electrical
control.
Oxygen output by driving gas forms certain volume of gas through the flow rate
adjustment valve. Then it passes ventilation loop of the anesthesia machine to drive
movement of bellows and ventilate mechanically to the patients.
The anesthesia machine adopts high-speed electromagnetic valve, high sensitivity
flow sensor, pressure sensor and single chip-control system for setting, monitoring and
adjusting the parameters of ventilation pressure, ventilation time and ventilation
volume, etc. The ventilator could ventilate to patient mechanically according to the
setup frequency, I/E ratio and tidal volume when the anesthetic takes efficiency and
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patients lose conscience to breathe himself; the ventilator could inhale and exhale with
patient synchronously when the patient has conscience to breath himself after
operation.
If anesthetic circulation circuit stays in manual status, the ventilator could also
monitor and show the tidal volume, ventilation frequency and airway pressure etc.
although it doesnt take part in the role of breath control.

2.4 Vaporizer
Note when vaporizer is not applied to the anesthesia machine, the
performance of vaporizer could be degraded.
The anesthesia vaporizer could match imported or domestic manufactured ones.
The working principle and instruction for use of the vaporizer should be attached to the
Users Manual.

3 Technical Specifications
3.1 Working modeCirculation close, half-close, half-open
3.2 Gas requirementPressure is Medical O2 and N2O of 300kPa 500kPa
3.3 Pressure value error does not exceeds 2% of full calibration+ 4 actual
value
3.4 O2 and N2O are both equipped with special pressure regulators with safety valve. The
relieving pressure of safety valve is not more than 600kPa.
3.5 The flow meter range of O2 , N2O and air is0.1 Lmin 10 Lmin
3.6 Flow meter is equipped with O 2--- N2O ratio controlling device to make sure the
Oxygen concentration is no less than 20 %
3.7 Rapid Oxygen-supply flow rate25 Lmin 75 Lmin
3.8 Anesthetic gas concentration adjustment range of vaporizer 0 5relative
error 20
3.9 Anesthesia ventilator
Basic parameters:
Tidal volume adjustment range 20 mL 2000mL adjustable acceptable error
range:below 100mL 20mLabove 100mL 15%
Maximum ventilation/ min18 L/minacceptable error range15%
I/E ratio4118acceptable error range211:415%
Ventilator applicable environment 30 mLkPa
IPPV ventilation frequency adjustment range 199 bpm adjustableacceptable
error range1bpmother values is the setup value 2%
Maximum safety pressure12.5 kPa
Inspiration trigger sensitivity pressure trigger 10 cmH2O 10 cmH2O
adjustableacceptable error range1 cm H2O or setup value 10% (choose the
big one)flux trigger120 L/min adjustable
Frequency adjustment range of SIMV 1 20bpm adjustable acceptable error
range1bpm
Lasting time of EIPPB S 0~50% of inspiratory time, adjustable acceptable
error range15%
PEEP range 01 cmH2O 20cmH2Oadjustable acceptable error range 1 cm
H2O or setup value10% (choose the big one)00: close PEEP
Sigh deep breath one deep breath should be make per 60 120 common
breathing and ventilate by 1.5 times of the inspiration time acceptable error
range15%off: close the function of Sigh
Pressure control 03 60 cmH2O adjustable acceptable error range 10%
under PCV status
Pressure restrict05 60 cmH2O adjustableacceptable error range10%
Pressure slope0110under PCV status
Alarm System
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Alarm from continuous overhigh pressure VBS pressure keeps and overhigh of
25cmH2Ostarts alarm, the maximum delaying time is not longer than 17s
upper alarm of ventilation per min130L/minacceptable error range15%
lower alarm of ventilation per min029L/minacceptable error range15%
Airway pressure upper limit alarm range 05 60 cmH2O acceptable error
range15%
Airway pressure lower limit alarm range 00 50 cmH2O acceptable error
range15%
Breathing frequency upper limit alarm range 10 99 time/minacceptable error
range15%
Breathing frequency lower limit alarm range 1 50 time/min acceptable error
range15%
Tidal volume upper limit alarm range 10 2000 ml acceptable error range
15%
Tidal volume lower limit alarm range 0 1800 ml acceptable error range
15%
Oxygen concentration upper limit alarm range 21% 99% acceptable error
range15%
Oxygen concentration lower limit alarm range 15% 80% acceptable error
range15%
low battery alarmalarm when battery is lower to 10V0.5V
there should be indication when power supply is workingwhen AC works, it shows
power supply pin symbol, when DC works, It shows storage battery symbol
Choke alarm it alarms when theres no humidity but pressure during 10~20S,
acceptable error range 2 S
pipeline taking off alarm it alarms when theres no humidity and pressure during
10~20S, acceptable error range2s
Intelligent alarm system alarms in order by Senior and Junior PRI
Senior PRI: airway pressure upper limit, continuous overhigh pressure, choke,
pipeline taking off
Junior PRI: humidity lower limit, humidity upper limit, airway pressure lower limit,
ventilation upper limit per min, ventilation lower limit per min, Oxygen concentration
upper limit, Oxygen concentration lower limit, frequency upper limit, frequency lower
limit

4 SizeWeight
4.1 Size 1460 mm650 mm690 mm
4.2 Weight 88 kg

5 Assembly and debug

Note Installation, adjustment, checking and use all
should be operated by professional persons. When
delivering the Anesthesia machine to client, it has been
adjusted, theres no need to adjust it again for the
users in order not to lead to unexpected malfunction or
damage.
5.1 Preparation before assembly
1 Confirm the Anesthesia machine and its attachments are intact, the products in
packaging carton are the same as the shipping list. Youd better keep the
packaging carton and cushion packing well for next transportation.
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Note if any damage is found of Anesthesia machine

during transportation, you should connect with
transportation station immediately and claim for
compensation; if you find the content of products is
not the same as shipping list, you should inform
manufacturer or designated agency for answer.
2Become familiar to the working principle, structure features and control panel of
anesthesia machine and ventilator based on the Users Manual.
3 Check the source of medical compressed O 2 and N2O to confirm the pressure
meets the requirement of 300 500kPa. If it supplies with cylinder, you should
also check whether the inner gas is sufficient, the pressure-reducing valve is
good or not, installation performance etc.
4 Check single-phase AC power supply of anesthesia machine to confirm the
voltage has met the requirements of AC 220 V10% and have good grounded
protection. Also you should confirm that the emergency storage battery has been
connected.
5.2. Installation of Anesthesia machine
1 Installation of trucklestwo truckles with brake should be installed in the front of
machine, and two without brake installed in the back.
2 Push the machine to expected position and lock the brakes on trucles to make it
stable.
3 Install the vaporizer to its own bracket on the anesthesia machine and fasten the
hexagon screw. If it is equipped with two vaporizers (the interlock device has
been installed and fixed in the machine, you dont need to install again), you
need to dial the interlock to the right and set vaporizer on the left side, then dial
the interlock to the left, and set the right side of vaporizer
4 Fix the integrated anesthesia breathing circuit on the bracket which lies in the left
side under the anesthesia machine, and connect the air storage bag.
5 Connect two corrugated tubes to the Y shaped tube, the other side of the two
tubes connects with inspiratory air valve joint of circulation circuit and expiratory
air valve joint of circulation circuit by flow sensor. The Y shaped tube connects to
simulated lung or leather bag.
6 Install flow sensor to the Y shaped tube, please pay attention to the direction of
sensor, the blue tube should connect with corrugated tube, and high flow rate
signal in the backboard of anesthesia machine. The white tube connects with
expiratory mouth of integrated loop and low flow rate signal in the backboard of
anesthesia machine.
NoteConnection of sampling tube of flow sensor
7 Connect anesthesia machine to compressed O2 and N2O source by high
pressure windpipe.
Note: Oxygen tube is blue, N2O tube is gray, two tubes
can not be interchanged since the tie-in are different.

8 Insert the power supply pin to AC 220V.

Note If the machine slopes 10 degree in the horizontal
condition, it will not lose balance with common collocation;
however, if you add other equipment to the machine, which will
degrade the machines stability.

5.3 Pre-adjustment
1 Check the pressure meters all show 0
2 Check the pressure meter of monitoring system, their values are 300 500kPa
when connecting O2 and N2O.

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Note O2(N2O) pressure-reducing valve should be

used correctly
A connect pressure-reducing valve with cylinder and make them
fixed
B ensure the pressure-reducing valve is closed adjust the button
counter-clockwise to loose direction till end.
Copen the cylinder gas valve
The pressure-reducing valve we supply is for monitoring of O2 volume,
and we have adjust it to the best condition, users could use it when
connection. If you want to adjust the pressure, you only need to turn on
the hexagon screw cap between pressure-reducing valves, and adjust the
output of pressure. Clockwise direction is for increasing, and counterclockwise direction is for decreasing. Note: the working pressure of
anesthesia machine should be kept 300500kPa.
3 Turning the button of adjusting flow valve on the flow meter, you can see the
buoyage moves quickly when adjusting the flow meter, and the buoyage keeps
stable after adjusting the flow meter.
4 Turn manual-auto switch to manual, and block the outlet of Y-type three-way
tube. Press rapid Oxygen supply valve, the 3 L volume respiratory air chamber
could be full within 3~5 second, and there will be reading of airway pressure from
pressure meter in the circulation loop.
5 Turn it to auto, turn on the power supply of ventilator, and setup the working
parameters as follows tidal volume 0.50 L ventilation frequency 10 times
min I/E ratio 12 you can observe that the simulated lung or bladder
fluctuates according to the ventilation frequency of ventilatorand inspiratory air
valve and expiratory air valve in the circulation loop act well.

5.4 Receiving test after installation and adjustment

1 High pressure pipeline sealing performance test of anesthesia machine
Turn off the flow adjustment valve on the flow meter, and connect with
compressed gas source, you can observe the reading of output pressure of
compressed O2 source from driving gas output pressure meter. The reading of O 2
pressure meter and N2O pressure meter is around 300kPa, cut off the
compressed gas source, there should be no obvious drop of reading from three
pressure meters within 5 min.
2 Low pressure pipeline sealing performance test of anesthesia machine
Turn manual-auto switch to manual, block the outlet of three-way tube, and press
rapid Oxygen supply valve, you can see the air chamber swells because of full of
air stop gas supplying when the airway pressure reaches 3kPa you can
observe that the reading from airway pressure meter within 1 min could not drop
lower than 0.4kPa.
3 O2 & N2O flow meter linkage function test
Turn on compressed gas source, the output of machine connects with air. Turn the
flow adjustment valve on the flow meter, you can observethe N2O flow is closed
when turning on the O2 flow adjustment valve separately the O2 flow will be
opened through linkage equipment when turning on the N 2O flow adjustment valve
separately when turning on O2 and N2O together, and decreasing the O2 flow
generally, the flow of N2O will be decreased at the same until closed. The flow
should be stable in common condition, and the flow ratio between O 2 and N2O is
11.5
4 N2O automatically cut off and O2 supply malfunction alarm test
Turn on compressed gas source, the output of machine connects with air. Turn on
both flow adjustment valve of O2 and N2O, and gradually reduce the input
compressed O2 pressure, then observe the O 2 pressure meter, the reading of N 2O
is descending as that O2 descends ( 0.2MPa), until N 2O flow volume is totally cut
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off and the anesthesia machine alarms no less than 7s.

5 Tidal volume of anesthesia machine test
Turn off the flow adjustment valve of O2 and N2O, setup the anesthesia machine
parameters as followsventilation frequency 10 timesmin, I/E ratio 12 . Setup
the tidal volume, you can observe that the reading keeps table after ventilation for
3 or 4 times, and the range is no less than 50
m L 1200m L . If using the simulated lung, also can observe the error between
tidal volume (when keeps stable) and simulated lung is no more than 20%
6 Alarm function test
Test frequency each time after turning on the machine and before take into use.
Test condition Turn off the flow adjustment valve of O 2 and N2O, setup the
anesthesia machine parameters as follows ventilation frequency 10 timesmin,
I/E ratio 12.
a Setup the airway pressure upper limit alarm around 4cmH 2O. Before the
machine working, block outlet of three-way tube, increasing tidal volume. You
can observe the airway pressure value, when it reaches the expect reading,
the machine emits sound and light alarm signal, and turns to exhalation
phase.
b Deceasing tidal volume, and observe the airway pressure value, the machine
shall emit alarm signal when it reaches expected value.
c Adjust the tidal volume, the machine emits sound and light alarm signal when
ventilation goes up or down to the setup alarm value.
d Power supply malfunction alarm pull off the AC power supply pin and
emergent storage battery link (note: it is not to cut off power supply switch),
the machine will alarm, and last for at least 30s.
e Sound alarm signal disappearing time no longer than 120sif alarm condition
continues, the light alarm signal is continuous.

6 Operation
6.1 Preparation and checking before use
1 air source checking to check O2, N2O in the cylinder is sufficient or not,
whether the output from cylinder or hospital center could meet the requirement of
300 500kPa and connected pipeline between compressed air source and
anesthesia machine is good or not.
2power supply checkingto check whether network voltage is in the range of AC
220V10%, 501Hz, protection grounded is good or not, the power supply pin is
inserted well or not.
3 checking the using record, cleaning and disinfection record of anesthesia
machine (including ventilator) to confirm the performance.
Warning Compulsory working is prohibited if anesthesia
machine is not cleaned & disinfected totally or bearing
safety hidden trouble
4 CO2 absorber checking clean out the sodium lime in the absorber, wipe the
inner part clean and fill in new sodium lime.
5 add anesthetic to vaporizer, the steps are as follows
a Check the dial of anesthetic concentration first, you should notice that the dial
should be on 0 which means the vaporizer is in the closed condition when you
add anesthetic to the vaporizer.
Warning The volatility of anesthetic is very strong. It will
form a big and disordered vapor tension caused by
impact and vibration when flowing to vaporizer. If the
concentration dial is not on 0, the anesthetic vapor will
be sprayed out wrapped with liquid anesthetic, which
will lead to unexpected consequences.
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b Check whether the anesthetic name and vaporizer need to be added is

consistent with anesthetic and check the validity period of it, also cleaning the
disinfected dosing container.
Danger Different anesthetic mixed together will cause
chemical reaction, which is harmful to the patient. So it
is forbidden to mix some kinds of anesthetic and take
into use.

Warning As different anesthetic has different

evaporation features, and the concentration mark
made by vaporizer is according to specific
anesthetic. If it is not the specific anesthetic
designated in the vaporizer, which can not promise
the concentration of output vapor.
cTurn on the button to open mouth of anesthetic adding, and inject anesthetic to
the mouth, you can see the anesthetic flow to the vaporizer slowly. Observe the
anesthetic liquid level from glass observing window of vaporizer; the level can not
be higher than the highest reticle on the window.
Note Anesthetic injection must be slow to prevent the
volatility of anesthetic because of vibration.
d After the process of c, button of anesthetic adding should be screwed down to
avoid the volatilization from the mouth.
e After adding the anesthetic and you can use the vaporizer after keeping it stay
still more than 10min to make stable homeostasis of anesthetic volatilization and
coacervation.
Note Although the machine has taken certain measures,
it is also forbidden to open even the vaporizer is not
taken into use.
6 Simulate the way to do ventilation to the patient. You can use rapid Oxygensupply valve to fill in gas to anesthesia circulation circuit repeatedly, and flush
useless gas in the anesthesia circulation circuit and breath ventilation pipeline
with pure O2.
7 Adjust and setup ventilator parameters.

6.2 Operation of Anesthesia machine

1 The most critical operation to anesthesia machine is the control of anesthesia
concentration and management of breath. The ways to manage patient breath
can be manual and automatically control the patient breath by setup
parameters. You should pay special attention to the reading of each meter on
anesthesia machine and ventilator and judge whether they are applicable to the
patient requirement. Generally speaking, even the readings of meters are very
accurate, we can only take is as reference, and the patient actual condition is
the key point.
2 The way opening vaporizer is like this take hold of the concentration
adjustment plate, turn it to add the concentration of output anesthetic, and stop
turning when it reaches the expected concentration.
NoteIf only gas flow through vaporizer between 0.5 10
Lminoutput anesthetic concentration is between 0.5 5
vol , the vaporizer output concentration could be ensured
in the acceptable error range. Vaporizer is forbidden to use
from the scale OFFor 0to the first scale, because the
vaporizer output concentration can not be ensured in the
acceptable error range during this scale.
3Calculation of anesthetic
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Use dosage of anesthetic mL output concentration of vaporizer Vol

fresh gas flow volumeL/min timehour
3
This is a formula from experience. For example, we suppose the output
concentration is 1.5 Vol, the reading sum of O2 and N2O from flow meter is 2
L/min, operation time is 8 hours, then the anesthetic dosage in the vaporizer can
not be less than 1.5283 = 72mL.
For the sake of safety, the actual prepared anesthetic dosage is more than the
value we calculated.
4Before the removal of anesthesia, the vaporizer should be turned off first. Take
hold of the concentration adjustment plate to 0, and confirm the 0 position lock
switch has been locked tightly.
5) Installation method of vaporizer fix it onto the seat block on the back of the
ventilator by M10 hexagon screw, and make the vaporizer erects on the bracket,
slope is no more than 45o.
6Checking the O2 used to the vaporizer is carry gas, and the ventilator is closed
now.
7Vaporizer can not calibrate at OFF offand 0 the first scale because of
the reaction from turning on and off and switch, so you can setup the
concentration value within this range.
8Noteif the vaporizer and anesthesia machine does not match, it will lead to
the actual leaking or change of concentration, and make the anesthesia machine
performance degraded or can not be used.
9) When adding anesthetic to the vaporizer, the distance between maximum liquid
level and minimum level is 135ml.
10Under the condition that pipeline outlet pressure is 0.35 Mpaflow is less than
60Lminthe recommended gas flow should be bigger than 2 L min when
ventilation; and recommended O2 flow volume is 0.71 Lmin during manual
circulation close anesthesia to confirm the requirement from patient.
11 After using for 2 years, the machine should receive whole parts inspection,
including vaporizer
12The main role of low Oxygen malfunction alarm and N2O cut off equipment is
to cut off the flow of N2O when medical O2 pressure decreases until can not be
used normally.

6.3 Operation of Anesthesia ventilator

6.3.1 Turn on the machineswitch on the gas source and power supply of the ventilator,
then it will enter the self-checking mode lasting about 10S. if any abnormal condition
checked by the system, the machine can not enter system, and you will see the
interface as follows

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it shows as follows
1Press-sensor
2Flow-sensor
3FiO2-sensor
4Vt-adjust
If self-checking passes, it shows YES, if it does not pass, NO will be shown,
and the ventilator cannot enter system. after passing self-checking, ventilator works
well according to the last parameter, the working interface is as follows

1Breathing mode directionVCVPCVSIMVMAN.

2Inhalation and exhalation working directionwhen in Auto status, the symbol will
fluctuate with inspiratory and expiratory of breath, compress means inhalation, and
stretch means exhalation.
When in Manual status, there will be a symbol like Hand beside the bellows, which
represents the tidal volume is adjusted manually.
3 Alarm direction it show Senior PRI alarm content or the current new alarm
content.
4 Alarm bell when alarming the bell will be twinkling, it stops when the alarm
disappears. If theres no alarm, no bell shows.
5Time displayit shows the ventilator working time.
6 Working power supply direction when AC works, it shows power supply pin
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symbol, when DC works, It shows storage battery symbol.

7Tidal volume monitoring areathe prior number is the tidal volume monitored, the
two numbers behind has two lines, the upper one shows setup value of tidal volume
upper limit alarmlower one is the setup value of tidal volume lower limit alarm.
8 Airway pressure peak monitoring area the prior number is the airway pressure
peak value monitored, the two numbers behind has two lines, the upper one is the
setup value of airway pressure upper limit alarm, and the lower one is the setup
value of airway pressure lower limit alarm.
9 Ventilation volume monitoring area the prior number is the ventilation volume
monitored. The two numbers behind has two line, the upper one is the setup value
of ventilation volume upper alarm, and the lower one is the setup value of
ventilation lower limit alarm.
10 Oxygen concentration monitoring area the prior number is the Oxygen
concentration monitored, the two numbers behind has two lines, the upper one is
the setup value of Oxygen concentration upper limit alarm, and the lower one is the
setup value of Oxygen concentration lower limit alarm.
11I/E I/E ratio
12blank
13PEEPpositive end expiratory pressure
14Plimtpressure limit
15 Trigger trigger sensibility. If system setup as pressure, it will show pressure
trigger sensor Vtr ; if it setups as flow rate, it shows flow rate trigger
sensitivityFtr.
16Volume or pressure Volume shows as Vtunder VCV status, pressure shows
as Psuppunder PCV status.
17 f it shows auto-controlled frequency under VCV PCV status. And it shows
SIMV frequency under SIMV status.
18Flow wavein the system setupup, if we setup it as P-T F-T, it shows the wave of
flow - time; it we setup it as P-V F-V, it shows the wave of flow- volume loop and
pressure-volume loop.
19Pressure waveit shows the wave of Pressure-time.
20pressure limitthis is a line of pressure limit.
6.3.2 Instruction for use of Key press and shuttle
1Muteif you press this key, it will close the voice of alarm 120Sbut it
can not eliminate alarm; when inquiring alarm, this key can refurbish
the alarm information.
2Mode setupupif you press this key, it will enter mode setupup interface.
3Alarm setupuppress this key one time, you will enter the setupup interface; if you
press it for a long time, it will enter alarm inquiring interface.
4system setupupyou can enter system setupup interface by pressing this key.
5 Monitoring parameter you can enter monitoring parameter interface by pressing
this key.
6key of standbypress this key for a long time it will enter standby condition. This
status is generally used to the stop of breath, for example, if you want
to absorb sputum, you can use this key for realizing that action. Press
this key for a long time you can resume breathing.
7 Shuttle this key is used to the data choosing, adjusting and confirming. If the
system control is MANUAL, this shuttle can be used
to adjust the flow rate. Press one time can enter the
status. Turn left is to decrease tidal volume, and turn
right is to increase tidal volume. Press again to confirm
the current condition.
6.3.4 Operation Interface
6.3.4.1Mode interface
When pressing mode setupup, ventilator will display the interface below
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modes

VCV
(volume
control)

PCV

pressure
controlSIMVsynchronized intermittent mandatory ventilationMAN(manual)
Press , you can enter the parameters can be setup of corresponding mode

1frequencyrange: 199bpm
2Tidal volumerange 202000ml
3I/E ratiorange 4:1.01:8.0
4 PEEPpositive end expiratory pressurerange 0120cmH2OPEEP could
make the corrugated small airway and alveolus dilated, improving the fade away of
interstitial lung and alveolus dropsy to advance the lung conformability, enhance
alveolus ventilation volume, depress the breath and Oxygen consumption. PEEP
could also improve the ventilation funciton of acute respiratory distress
syndromeand advance the arterial partial pressure of oxygen. The value of PEEP
is generally setup between 35 cmH2Oit is better not to setup it too high for not
leading to emphysema for using a long time.
5Triggerpressure trigger sensitivity: -1010 cmH2O ; flow rate trigger sensitivity:
0120L/min
6 Plateau EIPPB range 0 50% the advantage is to extend the inspiratory
time, which is god to gas distribution and dispersion. It is applicable to the breathing
crock up out of gas distribution uneven. But the time of EIPPB could not be too
long, or it will lead to the increase of even airway pressure which enhances the
heart burden, influences blood stream dynamics so experts advocate the time
should not be exceeded 20% of breathing circulation, or 15% of the inspiratory time.
It also can be used to the chest X-ray photographed in the condition of patient fully
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inspiratory compulsively.
7Sighdeep breathrange 60120; off shows sigh is closedsigh could make
the alveolus swell timely, improve the alveolus ventilation of these parts. It has good
value for the patients who have stay on bed for a long time or receiving the
mechanical ventilation for healing.
8 Control pressure support pressure range 03 60 cmH2O this setupup is
used for controlling airway pressure, it only takes effect under PCV mode
9Pressure sloperange 0110It is used to control the rising speed of pressure,
which takes effect only under PCF mode; 01 represents it reaches pressure setup
value as common inspiratory time,; 10 represents it reaches pressure setup value by
1/10 inspiratory time.
10Pressure restrictrange 0360 cmH2O. it is used to control the airway pressure
peak value is under the setup value to prevent the lung damage out of over-high
pressure
11SIMV frequencyrange 0120bpm
6.3.4.2 Alarm setupup interface
Press one time of alarm setupupit displays

The setup parameters are as follows

VTHhumidity upper limit 102000 ml
VTLhumidity lower limit 001800 ml
MVHventilation upper limit 0130 L/min
MVLventilation lower limit 0029 L/min
PpeakHairway pressure peak upper limit 0560 cmH2O
PpeakLairway pressure peak lower limit 0050 cmH2O
O2%H (Oxygen concentration upper limit) 2199%
O2%L(Oxygen concentration lower limit) 1580%
FH (frequency upper limit) 1099 bpm
FL (frequency lower limit) 150 bpm
Note the frequency alarm refers to frequency alarm by independent
inspiratory
6.3.4.3 Alarm Inquiry interface
Press alarm setupup for a long time it enters alarm inquiry interface. This
interface displays the current alarm content and content of history alarm. If you press
Sound Disappearing key, it refurbish es the alarm inquiry interface, and displays the
current alarm content. You can check below

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The content of alarm is

Vt-up-alarmtidal volume upper limit alarm
Vt-down-alarmtidal volume lower limit alarm
MV-up-alarmventilation upper alarm
MV-down-alarmventilation lower limit alarm
Ppeak-up-alarmairway pressure upper limit alarm
Ppeak-down-alarmairway pressure lower limit alarm
O2%-up-alarm Oxygen concentration upper limit alarm
O2%-down-alarm Oxygen concentration lower limit alarm
F-up-alarmfrequency upper limit alarm
F-down-alarmfrequency lower limit alarm
P-continuous Continuous high pressure alarm
disengagepipeline taking off alarm
chokeChoke alarm
Battery-L-alarm (Battery voltage low alarm)
6.3.4.4 System setupup interface
Press the key of system setupupyou can enter system setupup interface

The content displays as follows

1 Independent checking on/off on: start independent checking, that is to say the
ventilator enters this mode after turning on the switch, it will show independent
checking in the screen, and will last 10 second. It the system has something
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abnormal, it can not enter the system. Off: close independent checking. That is to
say the ventilator will work according to the parameters setup by last time after
turning on the switch.
2 Trigger Press/Flow: it shows the trigger method. Press: pressure trigger; Flow:
flux trigger.
3 Inspiratory correction 0 200. it is the accuracy correction of inspiratory tidal
volume. If you find the inspiratory tidal volume is different from the actual one, you
can use this key to rectify, and you should amend it according to standard
stimulated lung. The experts are accepted to do this action to prevent any accident.
However, it has been setupup before the product sold, it is not need to be rectified
in this general case.
4Expiratory correction0200. the function is same as above.
5Pressure correction01-99. it is used to the accuracy correction of pressure peak.
6Oxygen concentration Lcorrection of 21% of Oxygen concentration. The method
is as follows: After put it in the air for 1 min, it will enter system setupup interface,
put the cursor stay on L (Oxygen concentration), and you can check the reading.
When the reading doesn't descend, you can press Shuttle twice, and the cursor
becomes to red. At the same time, if no ?? appear, it indicates that the value we
measured is in the acceptable range, otherwise it indicates the value is beyond the
range. Press again for exit. The reason why ?? appears is bad connection, time
stays in air is too short or theres something wrong of the signal circuit.
Note In the case that no appears, it indicates the
Oxygen probe stays short time in the air and leads to
the 21% of Oxygen concentration is not accurate. So
you should save the value until it doesn't descend.
7Oxygen concentration H100% correctionput the Oxygen probe into the pure O2
for 1min, it will enter system setupup interface, put the cursor on Oxygen
concentration H and you can check the reading. When the reading doesn't
descend, you can press Shuttle twice, and the cursor becomes to red. At the same
time, if no ?? appear, it indicates that the value we measured is in the acceptable
range, otherwise it indicates the value is beyond the range. Press again for exit.
The reason why ?? appears is bad connection, time stays in pure O 2 is too short
or theres something wrong of the signal circuit.
Note In the case that no appears, it indicates the
Oxygen probe stays short time in the air and leads to the
100% of Oxygen concentration is not accurate. So you
should save the value until it doesn't descend.
8Wave choiceP-T F-T / P-V F-V, this is the choice for monitoring wave. P-T F-T
indicates pressure-time, and flow -time. P-V F-V indicates pressure-volume loop
and flow-volume loop except P-T wave.
9 Control Auto/Manual. Auto: the machine control automatically, which means the
ventilation is performed according to setup parameter of ventilator. Manual: control
manually, this can be used to the time of malfunction of VCV and PCV, for example,
the flow volume sensor has something wrong under VCV condition, which can not
ensure the volume control or the pressure sensor has something wrong under
PCV condition, which can not ensure the pressure control.
The way is to enter system control, and open system setupup, choose
Control and setup it as Manual. Pressure shuttle when exit the system. The
interface will show VT-down xx when turning left, indicates to decrease the tidal
volume; it shows VT-up xx when turning right, indicates to increase the tidal
volume. You can press shuttle to confirm it when the expected value appears.
10 System default Load: press it twice for choosing, and Load will become red,
the system will work according to system default after exit. The default status and
parameters are as follows
frequency15
I/E ratio11.5
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pressure limit35cmH2O
pressure upper limit alarm30 cm H2O
pressure lower limit alarm5 cm H2O
Oxygen concentration upper limit alarm60%
Oxygen concentration lower limit alarm20%
tidal volume upper limit alarm1000mL
tidal volume lower limit alarm100m
ventilation upper limit alarm18L/min
ventilation lower limit alarm2L/min
frequency upper limit alarm40 bpm
frequency lower limit alarm8 bpm
respiratory trigger pressure-5 cm H2O
modeVCV
PEEP0 cm H2O
Sigh120 bpm
Plateau0
SIMV frequency8 bpm
Inspiratory correction factor50
Expiratory correction factor50
Pressure correction factor25
Setup tidal volume500mL
Independent checking after boot-strappingon
Control pressure15 cm H2O
Pressure slope5
Trigger methodpress
Wave chooseP-T F-T
Flux trigger value5L/min
System setupupoff
11system setupupon/off on: turn on, off: turn off.
Note In order to prevent the value of system setupup is
changed arbitrarily, we will use on/off of system
setupup for control. Each time you want to change the
parameter of system setupup you have to open
system setupup first, after the setupting, system
setupup will be closed automatically. If you have other
requirements, you should turn on it again.
6.3.4.5 Monitoring parameter interface
Press monitoring parameter you can enter the interface of monitoring parameter

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The contents it monitors include

1 VTeexpiratory tidal volume, the expiratory gas volume from patient.
2 MV ventilation volume per min, total volume of expiratory gas per minute from
patient.
3 Ppeak airway pressure peak value, the maximum value of airway pressure per
breath.
4 Pmeanmean pressure, mean value of airway pressure per breath.
5 FiO2inspiratory Oxygen concentration, Oxygen concentration of the gas supplied
to patient.
6 Clung conformabilitythe change of lung volume by the lung pressure per unit.
7 Rairway resistance, pressure difference required by gas flux per unit time.
8 Fpt independent inspiratory frequency times for patient inhales independently
and cause trigger within one minute.
9 Battery remained capacity of battery, it monitors the current capacity of storage
battery.
10VTiinspiratory tidal volume, the gas volume supplied by machine to patient
6.3.5 Explanation of breathing mode
6.3.5.1 VCVvolume control
Pressing the key of mode setupup, it enters the mode setupup interface, theres a
finger like symbol appears, please turn the shuttle to VCV and press the shuttle. The
finger symbol will change from white to red, which indicates the setupup is successful.
Press the red finger again; it will turn to white which indicates exit. Choose
and press twice, you will enter the interface to setup parameters. And choose back to
exit

VCV is the basic ventilation method. Positive pressure will be generated when
inspiratory, in this process, patient will press the gas into lung, and exhale gas by his
own pressure. If the patient can not breath independently, he should breath according
to the pre-setup parameter of frequency tidal volume I/E ratio Oxygen
concentration; if the patient can breath by himself, the ventilator could be triggered by
independent breath and be synchronized with it.
Parameters setup under VCV mode are frequency tidal volume I/E
ratioPEEPtriggerinspiratory plateausighpressure limit.
Frequency setupupcommon breath frequency is setup as1220 /min
Tidal volume setupup it has some relationship with breath frequency, the first
tidal volume setupup should be done according to rule. Generally, we setup it as 810
mL/kg at first then adjust according to the analysis of Arterial blood gas. In special
cases like bullae, suspected pneumothorax, hypovolemia has not been yet corrected
or blood pressure decrease, etc. you should setup tidal volume in the lower level, and
increase the breath frequency in order to prevent the insufficient ventilation if
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independent breath frequency is over rapid you should setup the breath frequency
near to independent frequencyand decrease the tidal volume appropriately.
I/E ratio inspiratory time helps to inhaled O 2 distribution, and expiratory time
helps to CO2 discharging. The common person I/E ratio is 1 1.5 Obstructive
ventilatory dysfunction 1 2 2.5 restrictive ventilatory dysfunction 1 1
1.5 . Furthermore, it can also refer to hypoxia and the degree of CO 2 retention and
hemodynamics. If hypoxia is the main reason, extending the inspiratory time when
circulation permits if CO2 retention is the main reason, extending expiratory time
and in later time you can adjust it according to the analysis of arterial blood gas and
cardiac function.
PEEPwe don't not advocate setup PEEP when first ventilation. You can look at
P16 of the Users Manual when it is necessary to setup it.
Triggerwhen the patients independent breath becomes to resume, inspiratory
trigger sensitivity will send synchronizing ventilation signal to ventilator. Usually, the
minimum airway pressure value of inspiratory trigger sensitivity is lower 2 cmH 2O10
cmH2O than case without independent breath. If PEEP turns on, the trigger pressure is
triggered based on PEEP pressure. And the trigger pressure setup value is lower -2
cmH2O-10 cmH2O than PEEP pressure.
Inspiratory plateau its setup could refer to explanation in P14 of the Users
Manual.
Sighits setup could refer to explanation in P14 of the Users Manual.
Pressure limit pressure limit parameter setupup is higher 10cmH 2O than
common airway pressure peek value.
Under this mode, you can setupup the parameters like frequency, tidal volume,
I/E ratio, etc. according to the value above if the patient can not breath independently.
If the patient could breath independently, the ventilator could automatically be triggered
and be synchronized breathe with patient.
Note Under VCV mode tidal volume may not be setup
according to the rangeof it. It is normal condition
because that tidal volume and frequency has mutual
restricted, which can be understood by: tidal volume *
frequency 20L.
6.3.5.2 PCVpressure control
Pressing the key of mode setupup, it enters the mode setupup interface, theres
a finger like symbol appears, please turn the shuttle to PCV and press the shuttle. The
finger symbol will changed from white to red, which indicates the setupup is successful.
Press the red finger again, it will turn to white which indicates exit. Choose
and press twice, you will enter the interface to setup parameters. And choose back to
exit

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PCV mode could pre-setup airway pressure and inspiratory time. When
inspiratory starts, air current rises up quickly, and become slow through the control of
feedback system after reaching the expected value. Keep this value to the end of
inspiratory, and expiratory begins. It is in low value of airway pressure, no peak
pressure, and low air pressure damage occurs, it can also improve the ventilation/
blood flow ratio under PCV mode. This mode is generally used to the new-borne,
infants and acute respiratory distress syndrome or breath crock up. You should also
have to choose this mode when the pipeline leaks.
Parameters setup under PCV mode are frequency tidal volume I/E
ratioPEEPtriggersighcontrol pressurepressure slopepressure limit.
It has little difference to VCVVCV is to control tidal volume, PCV is to control
inspiratory pressure.
The setup parameters, PCV adds control pressure and pressure slope than
VCV.
Control pressurecontrol the airway positive pressure formed in lung.
Pressure sloperising speed control pressure. 01 is slow, 10 is rapid.
Note Under PCV mode, if the tidal volume monitored is
lower than the setup value, it can works well.
If PCV value setups over-high, and leads to tidal volume
monitored is higher than the setup value, and PCV can not
reach the setup value, you should increase the tidal volume
appropriately.
The function of tidal volume under PCV mode is to prevent the
over-high pressure when pressure sensor does not work well,
and to prevent the airway damage from over-high pressure.
6.3.5.3 SIMVsynchronized intermittent mandatory ventilation
Pressing the key of mode setupup, it enters the mode setupup interface, theres a
finger like symbol appears, please turn the shuttle to SIMV and press the shuttle. The
finger symbol will changed from white to red, which indicates the setupup is successful.
Press the red finger again; it will turn to white which indicates exit. Choose
and press twice, you will enter the interface to setup parameters. And choose back to
exit

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SIMV mode is applicable to the patient who can independently breathe but not that
stable. If they are not breathing independently during the period of wait for triggering
(called synchronous trigger window)the ventilator will supply mechanical breath
when trigger window finishes. If the patient has independent breath inner trigger
window, I/E ratio is relatively weak, and no trigger occurs, the breath frequency and
tidal volume will be controlled by the patient himself. If trigger occurs during inner
trigger window, the ventilator realizes synchronized breath, in this way machine and
human confront can be eliminated. This mode could help patient to become less
depend on the ventilator. When preparing offline, you should evaluate how much
ventilation volume the patient need, and supply higher frequency Mandatory ventilation
support, and generally decrease until totally remove.
Parameters setup under SIMV mode are frequency tidal volume I/E
ratioPEEPtriggerinspiratory plateausighpressure limitSIMV frequency.
In this mode, the setup of frequency and I/E ratio controls inspiratory time the
cycle of Mandatory ventilation depends on the setup of SIMV frequency.

Note SIMV frequency must be lower than mechanical

control
frequency.
While
setupting
SIMV
frequency the setup SIMV frequency is higher than
mechanical frequency then the mechanical
frequency will automatically adjust one time higher
than SIMV frequency.
6.3.5.4 Manual modeMAN
Pressing the key of mode setup, it enters the mode setup interface, theres a finger
like symbol appears, please turn the shuttle to MAN and press the shuttle. The finger
symbol will changed from white to red, which indicates the setup is successful. Press
the red finger again, it will turn to white which indicates exit. Choose and press
twice, you will enter the interface to setup parameters. And choose back to exit

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This mode is used to anesthesia induction and recovery from anesthesia.

When using this breathing mode, you should pay attention that that the working
mode of respiratory circuit should be consistent to that of the ventilator. After entering this
mode, you should turn the switch to hand bladder condition. Rapid Oxygen supply will
make the bladder sufficient, and then you can help the patient to breath by pinching the
bladder. Parameters setup under this mode are tidal volume monitored by
ventilatorventilation volumebreath frequencyairway pressure etc.

Note: Under this mode, you should put the air out of
bladder and complement new fresh O2 for continuous
working after pinching it for a period of time.
6.3.6 If the AC power cuts during operation of anesthesia machine, the ventilator will stop
delivering O2, however, there will be fresh air supply and the patient could breath
independently. In this case, you should converse the working condition to Manual
condition.
6.3.7 The pressure supplied from medical gas pipeline will be kept even anesthesia
system stops delivering gas.
6.4 Operation of Stop using
After operation, the machine can be take away after the patient could breathe by
himself and all of his life sign has been reach to the requirement to stop machine help.
First please take away the three-way tube connected with patient, observe the patient
independent breath condition, if you can find he has resumed to normal condition, you
can take away the face mask or tracheal tube. Then
1 Clear the useless gas in the anesthesia circuit by rapid Oxygen-supply valve;
2 Close O2 and N2O cylinder, or put off the gas supply joint from center gas
supply system;
3 Turn on O2 flow control valve and N2O flow control valve, discharge the
remained compressed gas. Turn off the flow control valve when O2 and N2O
pressure meter reach 0.
4 Turn off the power supply switch; pull out the power supply pin.
5 Clean and disinfect the parts needed.
6 Fill in the anesthesia machine using record.

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7 Daily maintenance of anesthesia machine

7.1 cleaning
Soaked the cotton cloth with soak water, wiped the dust on the outside of
anesthesia machine, and use the dry cloth to clean it again. During the cleaning
process, no any liquid is permitted to enter the machine (including ventilator), or it will
lead to the damage of machine or creepage which is very dangerous.
7.2 cleaning and disinfection
First disinfection part and method of anesthesia machine includes whole bracket
touchable parts except the contents below.
Parts connect with patient like respiratory pipeline bladder inspiratory air
valve expiratory air valve flow sensor paddlewheel etc, dismentle them and put
into water for washing and soak for disinfection. First wash the dirty things may
attach to inner part of the pipeline with neutral washing solution, you should take
special attention to the phlegm scab, blood, oil dirt and other remained dunghill. After
that, flush them with clean water. The parts connect with patient should also be
soaked in 70% concentration of medical alcohol for 1 hour, and disinfect after airing.
1st method of disinfection soak the cleaned respiratory pipeline veil etc in
disinfectant solution for 30 60min Note: the silicone product is easy to be
damaged from long time soak . The common use disinfectant is: Benzalkonium
bromide solution, peracetic acid and 84 disinfectant. After soaking, you can use
sterilized brine or distilled water to flush the inner and outer part of the pipeline, and
hang for dry.
2nd method of disinfectionput the cleaned respiratory pipeline mask etc into
EO sterilizer for conventional disinfection.
If the patient has infectious disease, you should also soak the parts in 70%
concentration of medical alcohol for more than 1.5 hours. After that, you can disinfect
the parts according to the method above.
NoteThe waste water, waste solution and waste dirty things used
to wash the machine may be infected, or contaminate environment, so it
should be dealt with according to related national regulation or rule.
Warning The disposable articles can not be reused. The reuseable articles could be used until effect working efficiency. (For
example, it is forbidden to use the silicone product which is gas
leaking.
Latex parts areveilcorrugated pipesignal sampling pipeO-ring gas line
connector

7.3 Daily maintenance

The parts should be installed into the anesthesia machine immediately after
disinfection, and examine the basic performance of machine according to Chapter 4
Installation and Adjustment to confirm each function keeps good.
8. Malfunction analysis and removal
Malfunction
phenomenon

Leaking
circuit

of

circulation

Cause of the analyses

Elimination method

CO2 absorber is not installed

closed.

Re-installation

Tie-in of corrugated tube is loose

or has cracking

Connect it well or change another

corrugated tube

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Switch does not wok

well

It is used for a long time, the inner

part doesn't work well

Put little vaseline in the inner part of

switch.

Tidal volume of ventilator

is insufficient

Driving gas output pressure is not

enough to 0.35MPa

Enhance the pressure to compressed O2

source.

flow sensor is loose

Insert tightly of flow sensor

flow sensors pin is loose

Re-connection or change the pin

flow sensor is damaged

Change flow sensor

flow sensor has remained vapor

Change flow sensor or take off the flow

sensor and make it naturally air-dry.

flow sensors photoelectricity card

was illuminated by strong sunlight

Prevent from strong sunlight or use

something to be sheltered from strong
sunlight

Inspiratory valve does not work

normally.

Re-install of inspiratory valve.

Respiratory circuit is leaking or

connection
of
expiratory
monitoring sensor has something
wrong.

Check the closeness of respiratory

circuit or insert tightly of sensor or
change the sensor

The button of anesthetic adding is

not opened.

Open the button of anesthetic adding

The speed of adding anesthetic is

too fast.

Slow down to add anesthetic

The input anesthesia machine

compressed gas source is overlow.

Adjust gas source pressure

Leaking of machine pipeline

Check the air tube joint, and change the

leaking pipe

Pressure
adjuster
(pressurereducing valve) malfunction

Adjust or change the pressure adjuster

After AC power supply cuts off,

the storage battery is not
sufficient.

Change a sufficient storage battery

Pressure is not enough inner O2

cylinder, the pressure of O2
source is over-low

Check the inner pressure inside of the O2

cylinder, and change the O2 cylinder.

Malfunction
of
O2 cylinder
pressure-reducing
gauge
or
circuit of O2 transportation.

Adjust
gauge

The adjustment of tidal volume of

I/E ratio is not appropriate.

Adjust I/E ratio and tidal volume

Confront of patient independent

breath and mechanical ventilation
from anesthesia machine

Re-adjust the synchronized trigger valve

value

Tidal volume of
ventilator is unstable

Expiratory
wave
is
smaller than inspiratory
wave.

Difficult to add medicine

to vaporizer.

O2 or N2O pressure
meter shows unprecise
value

Airway pressure lower

limit
of
ventilator
continually alarms

Airway pressure alarm,

airway pressure limit or
airway pressure upper
limit continually alarms

Setup of pressure upper limit is

not proper.

30

or

change

pressure-reducing

Adjust pressure upper limit setup value

EHE8-B5 Anesthesia Machine Users Manual

Patient pipeline convulses
rising up because of secretion

Continuous
alarms

sound

Storage battery works

when the network is in
normal
working
condition.

or

version A

Use sputum removal product

Over-low of tidal volume from

leaking of airway or respiratory
tract block up.

Check respiratory
absorb sputum

flow sensor has error

Repair flow sensor

The drainage tube of flow sensor

fallen off.

Connect sensor drainage tube well.

When AC power supply cut off, no

storage
battery
connected
immediately

Connect with sufficient storage battery.

Storage battery has been used up

or it has been damaged.

Change storage battery

AC power supply pin is fallen off.

Insert well of the power supply pin

Fuse is broken

Change the fuse

airway

pipeline,

9 Safe guard and accident settlement

1 In order to prevent connection error of input O 2 N2O air, we adopt different
colors of high pressure pipelines pipeline of O2 is blue, N2O is gray and air is
black.
2 Inner pipeline gas color distinguish pipeline color of O2 is blue, N2O is
transparent, air is black and the mixed gas is orange.
3 When adding anesthetic to the vaporizer, the anesthetic added level can not
exceed the upper scale of observe window.
4The slope of vaporizer can not exceed 45, and you should press 0 to lock the
switch before turning concentration adjustment plate. You should not give overpressure to the vaporizer, or it will damage the inner parts. It is not good to
disassemble or knock down the product because it has been passed the
inspection before taking into use. The product can not be disinfected, you can only
make it dry by medical compressed air, or send back to our company for correction
if any problem you can not solve.
5When transportation, the vaporizer must be disassembly from the machine and
packaged separately. You should also make the vaporizer inner part dry by
medical compressed O2 before package, it costs 3~5 min.
6 The O2 pressure meter and O2 flow adjustment valve should not be close to
grease to prevent the oxidation burning from pure O2.
7 Protection grounded should be reliable when using this machine to ensure the
safety of users.
8 Oxygen concentration in the air of the working environment restricted of this
machine is not beyond 24 %.
9 Theres no relationship between the driving gas of ventilator and the composition
of patient inhaling gas, so the anesthesia machine O2 flow switch should be
turned on when ventilation, which could supply continuous fresh O 2.
10 If the breath bursa can not be totally compressed when patient inhales, it will
lead to the insufficient tidal volume supplied to the patient. In this case, you
should check the smooth of airway, and increase driving pressure properly, also
turn the button of tidal volume to big direction and decrease the compensation
of O2 supply flow. If the breath bursa can not be back to the original condition
when patient exhales, it indicates that respiratory circuit leaks a lot, you should
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check and correct immediately, and increase the compensation of O2 supply

flow to ensure the sufficient ventilation, or open PEEP.
11Charge fully of the storage battery after use, the interval time can not be longer
than 12 hours. You should read the storage battery instruction for use before
charging. If you dont use it frequently, please ensure one time charging per
month. When changing the battery, you should pay special attention to the
polarityred line is connected to the anode, and black line to cathode. The
pole connection should be connection fastened to prevent from open circuit,
heat or strike a light.
When transportation and use processes, the storage battery must be erected,
and prevent from furious vibration.
Storage battery is 12V4.5Ah, or it will effect the time in use.
Warning You can not discard the useless storage battery as you
wish since it will contaminate environment. Please send it to the
callback body. You can not break the rule regulated by national
institute.
Note If theres something uncertain of protection grounded lead,
the machine should be run by the inner power supply.
12 The size of ventilator is glass hull: RT 2A250V type fuse tube. When you
change the fuse, you should first turn off the power supply, then open fuse and
install it well using expert tool.
13Any gas impetus outlet pressure and flow features have no changing within the
rating inlet pressure range and two times of maximum rating inlet pressure.

10 PackagingTransportationStorage
10.1 Packaging
1 The packaging should meet the requirement of GB T 15464. Each machine
should be put to the specific position inner the carton. Soft material is needed
between connection of packaging carton and product to prevent the loose and
mutual friction. There should be damp-proof and rainproof measures inner the
carton.
10.2 Transportation
1using original packaging carton and quakeproof pad according to regulation.
2transportation according to the symbol and labeling on packaging carton
fragile
up
far from rain
3Covers to prevent from sunshine, rain or furious vibration when transportation in
the open air. No conversion or throw is permitted during load and unload period.
10.3 Storage
environment temperature10 55 .
relative humiditynot bigger than 93 %.
atmospheric pressure50 kPa 106 kPa.
storage in the room no caustic gas but good ventilation.
11 Others
Except cleaning, disinfection and daily maintenance after every use, the
anesthesia machine circulation circuit needs to dismantle for cleaning of the water
and sodium lime powder. The ventilator needs total disinfection and maintenance
half a year and vaporizer need to be examined half a year too; flow sensor need to
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be inspected once two years, related maintenance action should be recorded and
kept in the archives by responsible persons for later check up.
If the machine is stopped using more than half a year, whole setup of
performance inspection is needed when starting to use again.
Malfunction analysis and removal in this Users Manual is the basic method to
solve problems, if you can not solve the problems or the malfunction repeats after
adopting the method, please connect with us or authorized service body.
If the machine has quality problems within one year of the sale date, we will supply
service for free. However, if the problems are out of misuse, dismantling without
permission, damage from clients own idea, we will service with payment according to
condition.

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