Drager Zeus Service Manual
5133.0 Revision 3.0 Because you care Technical Documentation Zeus Anesthetic workstation A l l r i g h t s r e s e r v e d. [download] ebooks drager zeus manual pdf DRAGER ZEUS MANUAL Drager zeus manual - service manual for 1996 chevy impala ssrelated samsung galaxy s3 user manual.
This was the first patient on the schedule. The anesthesia machine passed the daily checks through the electronic system, and the circle breathing circuit had also been manually checked using the thumb-occlusion test by G.H. Before the case. The patient was preoxygenated, during which time the bag was moving appropriately with inspiration and expiration. Anesthesia was induced with propofol and a Laryngeal Mask Airway-Unique ™ (Laryngeal Mask Company Limited, San Diego, CA) was placed without difficulty.
Manual ventilation via the machine through the Laryngeal Mask Airway-Unique ™ was easily accomplished. The patient had good lung compliance, so little pressure was required to generate an adequate tidal volume. The ventilation mode was switched from manual to controlled ventilation because deep anesthesia was required for the procedure. At the end of the procedure, the patient was transferred smoothly to the gurney with the Laryngeal Mask Airway-Unique ™ in situ. Controlled ventilation was switched to manual mode with the adjustable pressure-limiting (APL) valve fully open. The confirm wheel on the machine was pressed to activate the change in ventilation modes.
In the Apollo® model, changing a ventilation mode is a two-step process involving one button to select the mode and a different button to confirm the selection before it is initiated. The patient at that point did not make any spontaneous respiratory effort, so the plan was to manually assist her until she had a regular respiratory pattern.
Once the switch to manual mode was made, it was not possible to ventilate the patient; the bag remained empty despite fully closing the APL valve (which was free of obstructions) using high fresh gas flows and activating the oxygen flush. There was a faint hissing sound at the time of squeezing the reservoir bag while there was still enough pressure in the circuit to try to attempt manual ventilation, but this was short-lived because the system quickly emptied, and no pressure could be generated. The sound of gas appeared to be coming from where the circuit attached to the inspiratory and expiratory limbs, but these connections were tested and intact. Was this a ventilation problem secondary to dislodgment of the Laryngeal Mask Airway-Unique ™ during the transfer to the gurney? This seemed unlikely because the transfer had been very smooth without any strain on the circuit. As a precaution, the Laryngeal Mask Airway-Unique ™ was removed and a Guedel airway placed before attempting ventilation using a backup device.
It still was not possible to mask ventilate the patient via the machine bag because it was completely empty. Therefore, ventilation was changed from the machine to a bag valve mask, and ventilation of the patient was easily accomplished. A few minutes later, she commenced spontaneous respiration. The patient was stable throughout the incident. This was the second patient on the schedule. After case 1, the anesthesia technicians repeated the electronic leak test, and the machine passed. The technicians understood the problem that had been identified, but this was not reproducible during the second electronic test.
A manual check of the machine for a leak was performed with a thumb-occlusion test, and no problems could be identified. Preoxygenation was accomplished with appropriate bag movement and normal end tidal capnography. Intravenous induction of anesthesia was performed as in case 1; an attempt at manual ventilation before insertion of the Laryngeal Mask Airway-Unique ™ was not made. The Laryngeal Mask Airway-Unique ™ was placed without any problems. Manual ventilation via the machine bag was again not possible, as in case 1, with the same hissing sound occurring. Ventilation was successfully obtained using a bag valve mask; anesthesia was maintained with propofol. Thus, there were no problems with the seating of the Laryngeal Mask Airway-Unique ™.
Anesthesia technicians returned to the room with clinical engineers, who checked the machine and still found no faults. They were able to generate positive pressure ventilation. During the bag valve mask and Guedal airway ventilation, clear fluid appeared from the patient's mouth (the patient had no history of gastroesophageal reflux disease), so he was immediately intubated after the administration of succinylcholine. There was no fluid in the inspiratory hose. The patient was stable throughout.
Because the engineers could not find any fault with the machine, anesthesia was continued in a volume-controlled ventilation mode (manual ventilation was not tested on the patient via the machine before continuing in the controlled mode). At the end of the procedure, the controlled mode was switched to manual mode, and the patient immediately resumed spontaneous ventilation, so the reservoir bag did not need to be squeezed to generate positive pressure. The patient was extubated awake. The same machine that was used in cases 1 and 2 passed the electronic test at the start of the day. There was no problem with the first patient on the schedule in either the spontaneous or controlled ventilation modes. Manual check of the circuit was performed before each patient use, and no problems were detected. The clinician did not specifically check on the state of moisture in the breathing manifold/piston diaphragm.
The second patient on the schedule was preoxygenated while the bag inflated and deflated appropriately. After intravenous induction of anesthesia, it again was not possible to manually ventilate the patient via the machine bag, so a muscle relaxant was not given. Correct mask positioning was verified. Once again, the machine bag remained empty despite that the APL valve was closed and high fresh gas flows were used.
A hissing noise appeared to come from the flow sensor area, as occurred in cases 1 and 2. Ventilation was changed to a bag valve mask, and anesthesia was maintained with propofol.
Drager Zeus Service Manual
The patient was stable throughout. Because of a delay in obtaining a replacement anesthesia machine, anesthesia was discontinued and the patient was allowed to wake.
The anesthesia machine was taken out of service for the second time. The problem in case 3 appeared to G.H.
To be the same as that in cases 1 and 2. All of the problems mentioned above occurred during use in the manual mode. Could the APL valve have gotten stuck in the open position internally, despite the control knob having been turned to the closed position externally? The Man-Auto valve (APL bypass valve) was inspected and replaced as a precaution. At a later time, after the second bag failure, the entire valve body (fresh gas decoupling valve, scavenging valve, Man-Auto valve, positive end expiratory pressure valve, expiratory valve, inspiratory valve, heater block) was replaced.