Air Liquide MONNAL T75, User Manual

Page 1: ... MONNAL T75 User Manual English Software version V3 6 x www device airliquidehealthcare com YL072800 Revision 9A 2021 06 EN YL072800 V3 6 xI9A ...

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Page 3: ...tion and commissioning 19 Unpacking 19 Connections and commissioning 19 Power supply 19 Oxygen supply 19 Assembly of patient circuit and accessories 19 CO2 Measurement Probe 20 Humidifier 20 Nebulization 21 Applying power 22 Automatic tests 22 Transport on the rolling stand 23 Use 26 Screen description 27 Stand by mode 27 Ventilation mode 28 Start stop ventilation 28 Shutting down the unit 29 New ...

Page 4: ...esuscitation 40 Oxygen therapy 41 CO2 Option 43 Introduction 43 Installing the CO2 software option 43 Display of pressure and flow rate curves 43 Setting up the CO2 measurement probe 44 Adjusting the CO2 unit 45 Monitored CO2 parameters 45 Activation or deactivation of CO2 monitoring 47 Calibrating the CO2 probe 48 Recommendations for the use of the MASIMO IRMA CO2 measurement probe 48 Display of ...

Page 5: ...etting 66 77 Enabling Options 67 77 Saving the ventilation set points 68 77 Pressure Support Setting 69 78 Setting the ventilation set points 70 78 Selecting ventilation modes 71 78 Alarms 80 Parameters 80 Acknowledgement of alarms 81 Inhibition of alarms 81 List of alarms 81 Maintenance 92 Definitions 92 Routine maintenance 92 Expiratory assembly flow sensor expiratory valve Monnal EVA 93 Monnal ...

Page 6: ...wer supply management 106 Mains supply 106 Internal battery 106 External battery 107 Inputs and outputs 107 Alarm transfer 107 RS232 link 108 Connectivity to hospital networks 108 Video output 110 Performances and characteristics 110 Regulatory requirements 110 Recovery of the components of the medical device 110 Technical characteristics 111 Settings tables 126 Testing the alarms 133 Bibliography...

Page 7: ...onnel doctors nurses etc In the intensive care unit In the post operative recovery room When transporting patients in the hospital area Medical electrical system Monnal T75 is part of the medical electrical system along with the CO2 measuring probe IRMA Ref KB033600 It can also be operated with various accessories such as a Monnal Clean in HEPA filter a nebulizer a humidifier oxygen from a supply ...

Page 8: ...he safety and the expected performance of the device Patient environment Under normal use the patient is in a hospital bed and the Monnal T75 equipment is placed nearby All parts of the medical electrical system are suitable for use in the patient environment User s position The equipment is positioned with the display facing towards the user allowing them to make the nec essary adjustments with t...

Page 9: ...f the ventilator practice on a test lung adapted to the type of hospital service This training can be repeated or covered in more depth at the request of the users by contacting the usual Air Liquide Medical Systems representative Training in routine maintenance Training in the routine maintenance of the ventilator takes around thirty minutes It is carried out dur ing delivery to the biomedical de...

Page 10: ...itting Do not push O2 0 150 kPa 0 85 L min Low pressure oxygen inlet fitting Complies with European Direc tive 93 42 CEE Notified Body No 0459 Patient circuit inspiratory fitting Device catalog number Patient circuit expiratory fitting Serial Number of the device IRMA CO2 probe connector Date of manufacture YYYY MM Nebulizer fitting Caution refer to the user manual O2 cell cover locked Protective ...

Page 11: ...232 connectors Alarm transfer outlet External power supply connector AC power supply indicator light Specific symbols for IRMA CO2 measurement probe ref KB033600 IP44 Protection Index according to the EN 60529 standard 4 protection from the penetration of solid bodies of diameter 1 mm 4 protection from water splash ing from any direction Type BF device 1 6 General safety instructions Oxygen use Pr...

Page 12: ...er to keep the internal battery sufficiently charged In the event of any doubt about the condition of the mains power supply cable use the device on its in ternal battery Do not use antistatic or electrically conductive tubing The user must not touch the patient and the equipment enclosures at the same time Modifications to the EM system require an assessment of their compliance with the requireme...

Page 13: ... of an alternative means of ventilation may result in patient death should the ventilator fail If the accessories used are not compliant with the manufacturer s recommendations the manufactur er accepts no responsibility in the event of an incident Do not expose the device to direct sunlight Do not use the Monnal T75 in a hyperbaric chamber It is not reccommended to push the pulmonary ventilator b...

Page 14: ...ed personnel carry out assembly operations extensions readjustments modifi cations or repairs the electrical installation of the relevant room complies with the appropriate requirements the ME equipment or ME system is used in accordance with the instructions for use The qualified technician must use only Air Liquide Medical Systems spare parts when carrying out routine maintenance on the device D...

Page 15: ... silicone disc 2 2 Front panel 1 Alarm indicator light It turns red to inform the user that an ultra or high alarm has been activated 2 Color touch screen 10 4 inches This is the user interface and it enables to adjust all the ventilation parameters 3 Control wheel This is used to adjust and validate the parameters 4 AC power supply indicator light It illuminates when the device is connected to th...

Page 16: ...ory assembly eject button 8 Ambiant air intake 9 Pneumatic nebulizer supply connection 10 Inspiratory limb connection 2 3 Right hand side Oxygen Cell 11 O2 sensor access cover Oxygen access closed 11 12 O2 sensor position Oxygen access closed 12 2 4 Left hand side Expiratory assembly 16 ...

Page 17: ...2 Description of the device 13 14 13 Expiratory assembly built into the device 14 Electrical connection with the hot wire flow sensor expiratory assembly withdrawn 2 5 Rear panel 15 16 17 ...

Page 18: ...on 17 Low pressure oxygen inlet 18 Cooling wings 19 High pressure oxygen inlet 20 Access to internal battery 21 AC power supply connector 22 AC power supply connector 23 Alarm transfer connector 24 On Off button 25 Patient air intake filter 26 Monnal Clean in filter 18 ...

Page 19: ...r plug it into a grounded AC power outlet CAUTION Always check that the electrical network is compatible with the specifications in this manual Check that the device preventing the mains plug from being pulled out is operative 3 2 2 Oxygen supply To supply FiO2 above 21 connect the low or high pressure inlet of the ventilator oxygen to an avail able source via an appropriate connection If this oxy...

Page 20: ...rcuit CAUTION Empty the water traps regularly during ventilation When using the equipment on a patient for the first time make sure that you follow the hospital s hy giene protocol for new single use equipment or adequately sterilized reusable equipment The acces sories and consumables patient circuit masks expiratory valves adapters nebulizer etc are gener ally available in single use and autocla...

Page 21: ...ified by the following symbol To set up a nebulizer 2 1 3 4 5 1 Install a connector 5 upstream from the Y piece in the inspiratory limb of the patient circuit 1 2 Connect the body of the nebulizer 3 to this connector 5 3 Connect the nebulizer pipe 4 to the nebulizer output of the ventilator CAUTION The nebulization output front panel and the low pressure inlet rear panel are similar Beware of not ...

Page 22: ... Checklist on page 135 Note Monnal T75 is equipped with an absolute pressure sensor to compensate the effects of altitude In case of an installation in a high altitude area an alarm tells the user to start the automatic tests the atmospheric pressure is therefore measured and the device compensat ed CAUTION Do not obstruct the openings under and behind the ventilator as this may com promise patien...

Page 23: ...e start to resume the last step of the automatic tests If the automatic tests fail with the message Circuit resistance not evaluated check the consistency between the patient category selected and the patient circuit used check that the patient circuit is properly connected to the device check that the filters and other accessories used do not cause too high a resistance CAUTION Make sure that the...

Page 24: ...e wheels CAUTION When the floor is sloping you must place both foot brakes on the same side ei ther on the side sloping upwards or on the side sloping downwards Placing one foot brake on side sloping upwards and one brake on the side sloping downwards may imbalance Mon nal T75 24 ...

Page 25: ...3 Installation and commissioning 25 ...

Page 26: ...mode allows the user to select the ventilation mode to configure set points and alarm thresholds for the selected mode to start ventilation green to choose a patient category to start automatic tests to shut down the device red In the stand by mode screen the following information is displayed the current software version the ventilation time counter the power on time counter the current time and ...

Page 27: ...matic tests key Oxygen therapy function key 33 Symbol status of external battery indica tion of mains connection status internal battery 34 Ventilation mode and access to mode change 35 Patient category 36 Software alarm indicator 37 Audible alarm silence button 38 Alarm display zone 39 Screen lock key 40 Alarm history access key 41 Menu access key 42 Nebulization access key 43 Curves access key 2...

Page 28: ... Access to other monitored parameters 49 Monitored respiratory parameters and ac cess to alarm settings 50 Ventilation set points 51 Pressure and flow rate curves 52 Access key to the rest of the set points a ventilation mode in progress 4 2 Start stop ventilation Note Adjust the parameters before starting ventilation To restore the standard settings press the New Patient key To start ventilation ...

Page 29: ...el key 4 4 New patient Category selection Press the New patient button to reinitialize all of the ventilation and alarm settings The choice of a patient category enables the prescriber to adapt each of the following elements to the condition of the patient Initial values of ventilation parameters and alarms Ventilation parameter and alarm adjustment ranges Each of these values or ranges is given i...

Page 30: ...ation Users may access the configurations at any time by pressing the Menu and Ventilator Configura tion keys The following parameters can be accessed 4 5 1 Language Monnal T75 offers several languages To change the language press the Language keys Press the key for the desired language then press Back twice and Exit 4 5 2 Date and time To change the date or time Click on the display key use the c...

Page 31: ...The second alarm Custom can be customized with another tone and its volume can be modified Note This adjustment must be performed by a technician contact your representative if you want the alarm volume to be modified The alarm volume adjustment is for the convenience of the doctor The maximum distance and the volume of the alarm must therefore be determined by the user according to the surroundin...

Page 32: ...desired ventilation mode 2 and press Validate 4 6 2 Ventilation set points There are several series of set points for each ventilation mode These ventilation set points can be adjusted either in Stand by mode or in ventilation mode They are displayed on one or two pages using the arrow according to the selected ventilation mode To adjust a set point touch it to select set the desired value by turn...

Page 33: ...every x cycles VTsigh enabling the sigh function if OFF sigh amplitude unit x VT e g VT sigh 1 5 VT Sigh Period sigh period 1 sigh every sigh period cycles Note If the patient tries to inhale at a greater flow rate than the flow rate set point the venti lator will deliver the desired flow rate to the patient but will switch to expiration when the vol ume has been delivered TI will not be observed ...

Page 34: ...e value of PI corresponds to the pressure added to the current PEEP value The PEEP value is incorporated in the PI In PCV mode unlike VCV the pressure delivered to the patient is controlled but the tidal and minute volumes are not 4 7 3 PCV Pressure Controlled Ventilation Principle A constant positive pressure is maintained above PEEP level in the patient circuit each time the patient makes an ins...

Page 35: ...ilation Principle SIMV mode combines mandatory assisted controlled ventilation and pressure supports spontaneous patient ventilation between the controlled cycles Ventilation set points FiO2 inspired oxygen fraction VT tidal volume mL RR SIMV determines the frequency of the mandatory cycles c min PEEP positive end of expiration pressure cmH2O Tins determines the inspiration time of the mandatory c...

Page 36: ... parameters should be suited to the con dition and requirements of the patient 4 7 5 PSIMV Synchronized Intermittent Mandatory Pressure Monitored Ventilation Principle PSIMV Mode combines mandatory assisted pressure controlled ventilation and spontaneous patient ventilation between the assisted controlled cycles Ventilation set points FiO2 inspired oxygen fraction PI inspiratory pressure cmH2O RR ...

Page 37: ...key PSV NIV mode enables the prescriber to ventilate a patient via a non airtight interface facial or nasal mask NIV headset Likewise the ventilation setting ranges and the alarm thresholds and ranges are suited to NIV the PEEP setting is limited to 15 cmH2O the PS setting is limited to 25 cmH2O the E Trig set point is set at 50 by default the high and low VTi alarms are disabled the low MVe thres...

Page 38: ...rnation of two CPAP levels Principle The Duo Levels mode is characterized by controlled pressure ventilation combined with the patient having the option of breathing spontaneously throughout the entire cycle Duo Levels mode enables the prescriber to maintain a constant level of pressure PI for a period of time T high then a lower level of pressure PEEP for a period of time T low The duration of th...

Page 39: ...e An absence of inspiratory demand during the apnea time Tapnea activates apnea ventilation Note The value of Phigh is absolute meaning that the pressure on the high level will be equal to Phigh independent of the PEEP setting 4 7 10 PRVC Pressure Regulated Volume Controlled PRVC Pressure Regulated Volume Controlled Principle PRVC mode is a pressure regulated ventilation mode that guarantees the v...

Page 40: ...cmH2O PI max maximum inspiratory pressure cmH2O I Trig inspiratory trigger L min or cmH2O Slope inspiratory pressure slope cmH2O s CAUTION The Vt Target should not be used in NIV If there is a leak the tidal volume moni tored by the ventilator no longer represents the tidal volume inhaled by the patient Any adap tation of the pressure is therefore inappropriate 4 7 11 PS PRO interlocked barometric...

Page 41: ...he frequency is no longer adapted until the patient is recon nected Safety features of the Vt target function are applied when the function is activated Ventilation set points FiO2 inspired oxygen fraction PS inspiratory assistance cmH2O RR support maintenance frequency at which the patient is ventilated when he or she no longer breathes spontaneously c min PEEP positive end of expiration pressure...

Page 42: ...he required patient circuit on the inspiratory limb of the ventilator 52 and on the humidifier 52 4 Connect the patient machine interface between the humidifier and the patient 5 Check that the humidifier is in working order before switching it on 6 Enable the Oxygen therapy function and set the desired flow rate Note Humidify the flow generated by the device CAUTION Oxygen therapy is not a ventil...

Page 43: ...ovides clinical support and can be used to assess the integrity of the patient s air ways as well as to check that accurate intubation has been successful 4 9 2 Installing the CO2 software option CO2 monitoring requires installation of the software option with a code If you would like this option contact your Air Liquide Medical Systems representative 1 Go to the Administrator configuration menu 2...

Page 44: ...y or the key 4 9 4 Setting up the CO2 measurement probe 1 Connect the IRMA probe to the etCO2 connection socket 1 1 2 Apply power to the ventilator 3 Connect the probe to its patient adapter a The probe is correctly connected to its adapter when you hear it click into position 4 The LED flashes and then goes green This means that the IRMA probe is ready for use b 5 Connect the IRMA probe equipped ...

Page 45: ...measurement 1 Go to the Administrator configuration menu 2 Press the EtCO2 Monitoring key 3 Choose between mmHg kPa and 4 Validate with the control wheel This configuration will be saved when you press the Exit Administrator config key 4 9 6 Monitored CO2 parameters The following CO2 parameters result from the interpretation of the temporal or volumetric capnogra phy curve The volumetric capnograp...

Page 46: ... of CO2 exhaled during expiration and the volume of CO2 inhaled during inspiration Measuring VMCO2 enables medical staff to evaluate the level of gaseous exchange in the lung It also indicates how the patient is responding to treatment Dead space VDaw The physiological dead space is the part of the air volume inhaled by the patient that is not part of the gaseous exchanges in the lung The physiolo...

Page 47: ...tomical dead space Not all of the alveolar volume is involved in gaseous exchanges because some alveoli are only partial ly perfused The volume not involved in gas exchange is called the alveolar dead space To evaluate it the blood gas must be measured This is used to calculate the CO2 arterial partial pressure PaCO2 Alveolar plateau slope CO2 slope The alveolar plateau slope is the slope of the p...

Page 48: ...probe is intended to be connected to a patient circuit to monitor the gases inhaled exhaled by adult or pediatric patients in emergency or intensive care situations The probe must not be the sole patient monitoring device It must always be used with other de vices to monitor vital signs and or in addition to medical advice given by a qualified person The IRMA probe must be used by qualified author...

Page 49: ...ration is not done properly the measurement values will be skewed Never sterilize the IRMA probe or immerse it in liquid Do not pull on the cable of the IRMA probe Do not use the IRMA probe at a temperature below 0 C or above 40 C During use ensure that the IRMA probe is connected to the ventilator before you connect it to the patient The probe can be cleaned using a cloth dipped in alcohol maximu...

Page 50: ...r the cmH2O key 3 To adjust the flow rate scale press the ordinate axis of the flow rate curve or the L min key 2 To adjust the volume scale press the y axis of the volume curve or the mL key To adjust the CO2 scale press the y axis of the CO2 curve the mmHg key the kPa key or the key Freezing the curves Pressing the Freeze key immediately freezes the curves 4 Two cursors vertical lines are then a...

Page 51: ...urrent value 56 Upper alarm threshold 57 Lower alarm threshold 4 11 1 Display of measurements The display of measurements varies according to the chosen ventilation mode The respiratory parameters are displayed over 2 or 3 pages If the CO2 software option is present an additional page specifically for CO2 monitoring is displayed Press on the arrow to access the different pages 51 ...

Page 52: ... Auto PEEP Rdyn WOB P0 1 RR VTe Cdyn RR spont NIF Auto PEEP etCO2 VMalv Vdaw Vt CO2 slope VMCO2 MVe Vdaw FiO2 Page 4 etCO2 VMalv Vdaw Vt CO2 slope VMCO2 MVe Vdaw FiO2 etCO2 VMalv Vdaw Vt CO2 slope VMCO2 MVe Vdaw FiO2 TI Ttot or I E ratio according to monitoring configuration selected If the CO2 monitoring option is present Static values displayed during an RC stat measurement Dynamic values otherw...

Page 53: ...ory frequency Spont Percentage of spontaneous respiratory cycles FiO2 Insufflated oxygen fraction TI Ttot Ratio of inspiration time to total cycle time I E Ratio of inspiratory time to expiratory time peak insp Peak insufflated flow peak exp Peak exhaled flow f VTe Ratio of frequency to exhaled tidal volume Pmean Average cycle pressure P0 1 Obstruction pressure Rstat Calculated static resistance C...

Page 54: ...pdated After an inspiratory pause In the event of an inspiratory plateau lasting longer than 0 3 s in VCV and SIMV When the inspiratory plateau is not activated the Pplat measurement is displayed as follows The static and dynamic resistance and compliance values are displayed in the same monitoring pan els and in the context of invasive ventilation only When the RC stat function see R C stat key o...

Page 55: ... mains red 59 this indicates that the alarm took place CAUTION After a new patient selection the alarm thresholds are automatically reset to their standard value These threshold settings must be systematically re assessed in order to ensure that they suit the pa tient and his ventilation The upper pressure threshold is especially important to protect the patient from excessive airway pressure The ...

Page 56: ... event of non invasive ventilation with major leaks 4 11 3 Automatic thresholds The Auto set button automatically configures the alarm thresholds according to the values measured at the time when it is pressed To adjust the automatic thresholds press on a monitoring pad and the Auto threshold button will ap pear on the right of the screen Press the Auto setting of alarm thresholds button then conf...

Page 57: ... list To exit the alarm history press the control wheel Note When a complete power cut occurs mains external and internal batteries the histo ry is preserved and can be displayed after the power supply has been restored These data are preserved thanks to a back up battery with a working life of approximately two years An alarm is triggered when this battery runs low The battery should then be repl...

Page 58: ...long as the user holds down the button As soon as the user stops pressing the button the ven tilator resumes normal ventilation Note A curve freeze can be applied in order to measure the Pplat pressure value via the cur sors See CO2 Option on page 43 5 3 R C stat key Calculated patient resistance and compliance values consist of selectively or periodically evaluating resistance in cmH2O L s of the...

Page 59: ...wing is displayed in the alarm banner R and C stat measurement enabled Note Pressing on the R C stat button again disables the function Measurement principle The ventilator generates end expiratory occlusion inspiration consistent with the current mode delivering a Vt end inspiratory occlusion Note Inspiration between the two occlusions can be shortened to ensure that the flow rate at end of inspi...

Page 60: ...n be performed automatically when required or according to the following frequencies min 1 2 3 4 5 10 20 and 30 1 Press on the P0 1 set point on the bottom line 2 Select the required value with the control wheel and press on the control wheel to validate To enable the function press on the P0 1 button The indicator light comes on and the measurement begins The following is displayed in the alarm b...

Page 61: ...ocedure takes place the circuit is blocked and the pressure drop generated by the patient is measured When the key is released ventilation is resumed Note The maximum measurement duration is 30 s Note NIF measurement is accessible in all ventilation modes except CPAP Duo Levels and APRV It is not available in non invasive ventilation where the risk of leaks does not guarantee reliable measurement ...

Page 62: ...l T75 can calculate the work contributed by the patient to overcome the resistance of the circuit and the intubation probe and obtain a sufficient flow rate generated by the machine after the trigger is started The value displayed on the monitoring unit equates to the Work Of Breathing Imposed WOBi Note Monitoring is not available for modes CPAP Duo Levels APRV and PSV VNI 62 ...

Page 63: ...mands via a two level structure The menu is accessible via the start up stand by and ventilation screens The menu items give access to the oxygenation aspiration function apnea ventilation adjustment tube Compensation settings machine configuration sensor settings Press the Exit key to return to the previous screen 63 ...

Page 64: ...racheostomy Language Battery test Date hour Transfer Brightness Alarm Ventilator config uration Low pressure O2 Low pressure O2 ON OFF CO2 monitoring Sensors Calibration 6 2 1 Apnea ventilation adjustment Apnea ventilation uses an assisted volume controlled mode with a frequency and tidal volume to be adjusted It keeps the PEEP and inspiratory trigger set in the current mode Ti Ttot of 33 and a de...

Page 65: ... set tings 6 2 2 TC Tube Compensation Patient circuit compensation In invasive ventilation the tube compensation function is used to estimate tube end pressure at the tip of the tube by making up for pressure loss in the intubation tube tube resistance according to flow rate By therefore applying the pressure level set not at the pressure measured in the Y piece but at bottom pressure the patient ...

Page 66: ... that attached to the patient CAUTION Compensation is limited to 10 cmH2O CAUTION For tubes of a diameter smaller than 3 mm compensation is deliberately un der estimated to avoid barotrauma Bottom pressure is actually lower than the value dis played CAUTION Ensure there are no leaks in order to prevent barotrauma 6 2 3 O2 low pressure This function allows the device to enrich the O2 mix from a low...

Page 67: ...fied CAUTION To have efficient operation on a low O2 pressure source the high pressure O2 connection hose must be disconnected from the device To prevent the low pressure O2 fitting becoming detached ensure the pressure applied to the low pressure oxygen inlet is less than 150 kPa 1 5 bar 6 2 4 Sensors CO2 monitoring The CO2Monitoring key activates and deactivates CO2 monitoring See CO2 Option on ...

Page 68: ...nction is organized into three steps 1 Oxygenation Once you press the xx O2 key the FiO2 that is delivered increases to the value set for oxygena tion A countdown indicates the time remaining for oxygenation If the patient circuit is disconnected or opened to carry out pulmonary aspiration during this oxygena tion step 1 the Suction step 2 is activated Otherwise the oxygenation turns off and the x...

Page 69: ...genation aspiration function nebulization is suspended It automatically resumes at the end of the function Settings The different oxygenation settings can be adjusted via a window of the O2 Settings Menu This menu is used to set Target O2 FiO2 applied to the whole oxygenation suction period Duration of oxygenation before suction step 1 Oxygenation Duration of oxygenation after suction step 3 End o...

Page 70: ...ation of the nebulization flow rate by reducing its own outlet flow rate by an equivalent amount and by prioritizing the reduction of its oxygen flow rate The FiO2 reading is displayed on screen the value shown represents the concentration in the Y piece i e it includes the nebulization flow Note The display of the FiO2 value is an estimation of the gas concentration and cannot substitute external...

Page 71: ...s flow rate automatic adjustment or manual adjustment Automatic adjustment This is the preferred mode When the automatic test is launched the user is asked to integrate the nebulizer in the inspiratory limb see Nebulization on page 21 and to connect the device to the oxygen network or cylinder The flow rate from the nebulizer can then be measured and the flow rate parameter can be adjusted automat...

Page 72: ... to NONE To go back to the previous screen press Back 6 3 5 Loop curves The following types of loop curves can be displayed Volume Pressure Flow rate Pressure Volume Flow rate CO2 Volume if the CO software option is present To access the loop curves 1 Press the Curves key in the right hand bar 2 Press the Loops key To access these various types of loop curve touch the curves zone until the desired...

Page 73: ...ours RR VTi Vte MVe Pplat Ppeak Pmean PEEP Ti Ttot Leak Auto PEEP spont MVe spont RR spont peak ins peak exp P0 1 Rstat Cstat Rdyn Cdyn NIF WOB leak I E FiO2 etCO2 To access the trends press the Curves key in the right hand bar press the Trends key This screen can display two trend curves 2 1 To change the top trend and display another parameter press the current parameter button top left of the g...

Page 74: ...uttons 1 To scroll the trends curves from left to right use the arrows 2 The user can display the precise values at a given moment date and time of the selected ventilation parameters using the vertical line The user can thus move the line along the trends curve and read off the values of the two previously defined parameters 74 ...

Page 75: ...ess the Administrator config button in the right hand bar to display the Administrator config screen To close the Administrator config menu press the Exit Administrator config button 60 61 62 68 69 70 63 64 65 66 67 7 2 Presentation The Administrator config menu enables the prescriber to customize the configuration of default ven tilation parameters set points alarms etc The new parameters are app...

Page 76: ... Ti Configurations are saved when you press the Exit Administrator config key 7 5 Inspiratory time monitoring 62 Several types of measures are available to measure inspiratory time I E ratio measurement TI Ttot ratio measurement 7 6 Monitoring etCO2 63 See CO2 Option on page 43 7 7 Disabling the RRmini set point 64 It is possible to deactivate the RRmini set point for the following modes PSV PSV N...

Page 77: ...l alarms Depending on oxygen concentration the algorithms monitoring technical failures of the mixer may be less sensitive Note Depending on network concentration certain set points may not be available Note The estimated FiO2 for nebulisation may be subject to error up to the natural varia tions in network purity 7 9 Volume setting 66 It is possible to customize the alarm sound level Press the Vo...

Page 78: ...dure for saving ventilation and alarm set point 1 In standby mode choose a category of patient adult child or infant 2 Configure the chosen mode with the desired settings and alarm 3 Go to the Administrator Configuration menu and press the save button s 4 Exit the Administrator Configuration menu 5 Change the patient category and repeat the same operation 7 14 Selecting ventilation modes 71 The av...

Page 79: ...7 Administrator configuration To restore default configuration mode press the Retrieve default settings key 79 ...

Page 80: ...LOW Low Cyan Cyan INFO None Green None Note The software alarm signal flashes when an ULTRA HIGH or MEDIUM alarm is raised The arrow means that there are several alarms at the same time 8 1 Parameters Alarms are ranked according to 3 priority levels with different sounds and colors Alarms Background color Text color Sound ULTRA Red White Intermittent HIGH Red Black Intermittent MEDIUM Yellow Black...

Page 81: ... The user must validate using the control wheel the dialogue box then disappears 8 3 Inhibition of alarms Press to interrupt the audible signal for two minutes This greys out the inhibit button Press to cancel the alarm inhibition The alarm message remains on the screen If this alarm is replaced by another audible alarm with a higher priority the inhibit function is automati cally disabled and the...

Page 82: ...ck the suitability of alarm levels with ventilation settings 12 Error detected Contact the tech department HIGH Electronics failure Immediate triggering Use a different unit and contact the tech nical department 13 14 Screen fault Ventilation Effective HIGH Electronics failure Immediate triggering Use a different unit and contact the tech nical department 15 Incorrect Settings HIGH Electronics fai...

Page 83: ...sure alarm is activated The frequency mea sured by the ventila tor is above the set threshold Triggered after 5 s Check the suitability of alarm levels with ventilation settings 26 High respiratory rate MEDIUM Self triggering of in spiratory trigger Triggered after 5 s Lower the inpiratory trigger sensitivity 27 High minute volume MEDIUM MVe set threshold Immediate triggering Check the suitability...

Page 84: ...partment 40 Apnea ventilation HIGH No respiratory activ ity for a time T ap nea T apnea Immediate triggering Switch to back up ventilation associat ed alarm 41 Delivered gases too hot HIGH Temperature of gas es supplied to pa tient is approaching 41 C Immediate triggering Check that the unit is being used accord ing to specifications If problem persists use a different unit and contact the tech ni...

Page 85: ... Electronics failure Immediate triggering Use a different unit and contact the tech nical department 58 Safety Ventilation recommend switching ventilator HIGH Electronics failure Immediate triggering Use a different unit and contact the tech nical department 59 Low VTe MEDIUM Exsufflated volume set threshold Triggered after 6 consecutive ventila tion cycles Check the suitability of alarm levels wi...

Page 86: ...partment 73 High pressure LOW Ppeak threshold Immediate triggering When the high pres sure threshold is reached the ma chine goes into expi ration mode Check the suitability of alarm levels with ventilation settings 74 O2 supply pressure low LOW O2 supply pressure is too low Immediate triggering Check remaining supply in cylinder or pressure in wall net work In case of opera tion on low pressure s...

Page 87: ...es sary 88 Ventilator operates from external bat tery LOW acknowledge able Loss of mains power supply Immediate triggering Monitor the remain ing charge in the ex ternal battery and connect the unit to the mains if the bat tery is low 89 FiO2 sensor to be soon replaced LOW Voltage below a threshold Immediate triggering Replace the O2 sen sor the next time you put the unit in ser vice 90 Perform a ...

Page 88: ...tor INFO Disable the hot wire sensor Immediate triggering Use an external mon itor 106 Low minute volume alarm disabled LOW Immediate triggering Set a low MVe alarm threshold different from OFF 107 Press detected on nthe touch screen LOW Electronic fault Immediate triggering Change the ventila tion and contact the tech department Exhaled volume Vt target and Delivered pressure Ppeak Immediate trig...

Page 89: ...n the probe Immediate triggering Check the UU adapter 121 Replace IRMA probe CO2 adapter LOW CO2 sensor UU adapter is obstruct ed or blocked Immediate triggering Change the adapter 122 CO2 concentration is outside toler ance LOW CO2 measured 15 Immediate triggering If CO2 is correctly 15 calibrate the probe 123 Calibrate the IRMA probe CO2 LOW CO2 sensor Probe drift Immediate triggering Calibrate ...

Page 90: ...ng Check the suitability of the alarm levels with the ventilation settings 133 VMCO2 high MEDIUM VMCO2 value is above the set thresh old Immediate triggering Check the suitability of the alarm levels with the ventilation settings 134 VMCO2 low MEDIUM VMCO2 value is be low the set threshold Immediate triggering Check the suitability of the alarm levels with the ventilation settings 135 Perform Prev...

Page 91: ... The Tapnea set point switches to a value other than OFF dur ing CPAP Ventilator or ventilation other than CPAP 139 Reduced battery power for transfer MEDIUM acknowledgeable Battery capacity 50 Immediate triggering See battery see Bat tery life check on page 99 140 Insufficient battery power for transfer HIGH acknowledgeable Battery capacity 25 Immediate triggering The battery has reached its oper...

Page 92: ...tests CAUTION Never use abrasive powders acetone or other powerful solvents Note The following instructions have been approved by the manufacturer of the medical equipment as ENABLING a medical device to be prepared for re use It is always the responsibility of the department concerned to ensure that the sterilization procedure actually implemented via the equipment materials and personnel of the ...

Page 93: ...s on hospital infection control protocols the presence of secretions and the nebulization of drugs Reusing single use accessories or consumables carries the risk of patient cross contamination Autoclavable version The expiratory assembly is intended to undergo at least 50 sterilization cycles To help track the number of cycles the sensor and valve are marked with a unit serial number SN The expira...

Page 94: ...G R obey product manufacturer instructions 2 Shake the pre disinfected components thoroughly in a cleaning solution 3 Rinse under running water 4 Dry the components fully except the expiratory flow sensor Sterilization If necessary sterilize the following parts of the expiratory assembly compatible with sterilization for 18 min at 134 C and 1 bar above atmospheric pressure expiratory flow sensor v...

Page 95: ... the rear panel Two cleaning methods are recommended Remove the filter from its housing and wash it using warm soapy water Rinse under running wa ter Make sure that the filter is fully dry before reinstalling it Remove the filter from its housing and use an air jet to remove any particles trapped in it and then reinstall the filter 9 6 Bacteriological filter Apply manufacturer recommendations conc...

Page 96: ... EVA expiratory valve 1 expiratory flow sensor 1 power cable 1 specific gas connector 10 2 List of consumables Consumables Reference Expiratory assembly Autoclavable expiratory flow sensor KY632200 Autoclavable expiratory valve Monnal EVA per unit KY694500 Group of 5 single use expiratory valves Monnal EVA KY694800 Group of 20 single use expiratory valves Monnal EVA KY694900 Group of 5 single use ...

Page 97: ...iratory water trap KG019300 Group of 12 single use child patient circuits 1 6 meter with inspiratory expirato ry water trap Can be connected to a pneumatic nebulizer KG019400 Group of 15 single use adult patient circuits 1 6 meter with a water trap on the inspiratory circuit and a corrugated surface expiratory circuit Cannot be connected to a pneumatic nebulizer VD315100 Group of 10 single use chi...

Page 98: ...30V EU FR ES EN VD324500 Heating humidifier MR850 115V US PT ES EN VD324600 Heating humidifier MR850 230V EU IT ES PT VD324700 CO2 monitoring option Reference Monnal T75 IRMA CO2 probe KB020400 Monnal T75 CO2 monitoring software option KB034000 UU adult pediatric adapters for the IRMA CO2 probe x25 KB020300 UU infant adapters for the IRMA CO2 probe x10 KB032800 10 4 List of available documents Use...

Page 99: ...ncy Particulate Air on page 94 Replace the air intake filter see Air intake filter on page 95 Check the remaining battery capacity approximately every six months start ventilation and check that battery capacity is adequate see below The battery must be replaced after 500 charge discharge cycles Replace lip seal every three months Go through a checklist before each use see Checklist on page 135 11...

Page 100: ... and test date Note This test resizes the battery charge indicator displayed on screen for example if the battery is down to 50 of its initial charge no more than three of the five pictogram cells can be lit This function keeps the user aware of the overall state of the battery 11 2 By the technician Servicing once a year and checking the operation and performance of the unit The ventilator counts...

Page 101: ...sor referring to the instructions on the packaging of the new sensor if necessary 4 Tighten the sensor properly in order to prevent leakage and then connect it 5 To close the cover press it down slightly with the arrow pointing to and turn it until the arrow points to 6 Run the sensor calibration automatic test Note It is recommended that you calibrate the O2 sensor frequently via the automatic te...

Page 102: ...sor C2 Non return valve PS3 Balloon pressure sensor C3 Non return valve F1 Air intake filter microfilter PS4 Airway inspiratory pressure sensor F2 O2 inlet filter oxygen concentrator PS5 Airway inspiratory pressure sensor redun dancy F3 O2 inlet filter compressed gas T Turbine F4 Air intake filter TS1 Patient gas temperature sensor FS1 O2 flow sensor V1 Oxygen regulating proportional solenoid valv...

Page 103: ...ia the pressure sensor PS4 At the same time the inspiratory electromagnet regulates the flow via the flow sensor FS3 for a rinse flow of 3 L min This flow limits reinhalation and allows quick detection of an inspiratory demand Note During ventilation with leakage such as NIV the solenoid valve V6 is liable to in crease the rinse flow it then enters an on demand valve mode The purpose of this funct...

Page 104: ...unit A distinction is made between O2 network operation and concentrator operation Operation on an O2 network For proper operation the pressure at the O2 inlet terminals O2 HP must be between 2 8 and 6 bar The O2 is then filtered via F3 The proportional solenoid valve V1 enriches the mixture in oxygen by regulating the flow via the flow sensor FS1 where the set point is proportional to the upstrea...

Page 105: ...sures monitoring of the FiO2 concentration in the circuit This sensor is a chemical cell where an electrolytic reaction occurs The current produced is propor tional to the partial pressure of oxygen However a compensation of this pressure is applied each time the automatic tests are lauched Am bient humidity also affects the oxygen measurement at the rate of 0 03 per Hr at 25 C see Mea sured param...

Page 106: ... upper left hand part of the screen ex ample based on a new battery Full battery charge Comfortable battery charge Medium battery charge Battery low connect the unit to the mains power supply Associated with a medium priority acknowledgeable alarm Internal battery nearly dis charged Battery dangerously low imminent shutdown Associated with high priority acknowledgeable alarms Internal battery disc...

Page 107: ...te a medical electrical system Two icons indicates the absence or presence of an external source Presence of an external battery Presence of an external battery In case of a power supply disconnection the changeover to the external battery is indicated with a low priority acknowledgeable alarm Ventilator operates from external battery 12 3 Inputs and outputs 12 3 1 Alarm transfer Description of th...

Page 108: ...k No Note With regard to the RS232 link the use of an accessory that is not compliant with the safety requirements of this ventilator can bring about a reduction in the safety level of the re sulting system The following factors should be considered when choosing the accessory Its use near the patient Certainty that its safety certification was carried out in compliance with the local standards in...

Page 109: ...transmitted The information transmitted is as follows ventilation set points alarms alarm thresholds all measurements apart from time curves Compatible communication modules Capsuletech Datacaptor OTP protocol Philips monitors VueLink Intellibridge Protocol EC10 Mindray OTP protocol To obtain a full list of the communication modules compatible with the Monnal T75 contact the manu facturer A hospit...

Page 110: ... on the fol lowing standards EN ISO 14971 Application of risk management to medical devices EN ISO 60601 1 Medical electrical equipment Part 1 General requirements for basic safety and es sential performance EN ISO 80601 2 12 Medical electrical equipment Part 2 12 Particular requirements for basic safety and essential performance of critical care ventilators EN ISO 80601 2 55 Medical electrical eq...

Page 111: ...teral standards Accessories from the Air Liquide Medical Systems catalog or included in the accessories kit delivered with the ventilator comply with these requirements The use of accessories not recommended by Air Liquide Medical Systems releases Air Liquide Medical Systems from all liability in the event of an inci dent The user is responsible for ensuring that the use of accessories does not af...

Page 112: ...espiratory system of the Monnal T75 ventilator is a type B ap plied part The CO2 probe of the Monnal T75 is a type BF applied part CAUTION Ambient temperature warning the temperature of the Monnal T75 delivery flow can exceed that of the room Exercise extreme caution when using the Monnal T75 at ambi ent temperatures above 38 C 100 4 F At an ambient temperature of 38 C or higher gas temperature ca...

Page 113: ...ic compatibility standards in force neverthe less the user shall ensure that any electromagnetic interference does not create an additional risk such as radio frequency transmitters or other electronic devices In this section you will find the information required to ensure that the installation and putting into op eration of your medical device is carried out under the best possible conditions in...

Page 114: ...ng Max imal length Test type in compliance with RF Emission CISPR 11 Class B Emission of harmonic currents IEC 61000 3 2 Voltage fluctuation and voltage flickers IEC 61000 3 3 Electrostatic discharge immunity IEC 61000 4 2 Radiated immunity Electromagnetic fields IEC 61000 4 3 Electrical fast transient burst immunity IEC 61000 4 4 Surge immunity IEC 61000 4 5 Immunity to conducted disturbances ind...

Page 115: ...ker IEC 61000 3 3 Compliant Home health care environment and a professional health care establishment environment Magnetic and electromagnetic immunity The medical device is intended for use in a magnetic and electromagnetic environment described in the table below The user and installer must ensure compliance of the electromagnetic environment Immunity test Test level according to IEC 60601 Compl...

Page 116: ...ment If use of the system re quires continued oper ation during power sup ply cuts the use of a separate power source to power the medical device is recommend ed UPS etc Electromagnetic immunity portable radio frequency equipment The medical device is intended for use in a magnetic and electromagnetic environment as described in the table below The user and installer must ensure compliance of the ...

Page 117: ...g amateur ra dio bandwidths 80 MA to 1 KHz The electromagnetic field strengths of fixed radio frequency transmitters as determined by a sur vey of the electromagnetic environment a must be below the compliance level for each frequency range Interference may occur close to equipment identified by the following symbol Comment These specifications may not apply in all situations Electromagnetic propa...

Page 118: ...flow rate at atmospheric pressure 105 L min at 2 8 bar 130 L min at 6 bar HP 85 L min at 1 5 bar LP Standalone mode Cylinder HP Concentrator LP Mixer Electronic electrochemical O2 sensor Precision of set value 3 Gas consumption 1 Patient ventilation 4 L min flow by internal consumption Connectors Inspiratory hose connector ISO 22 mm male Expiratory hose connector ISO 22 mm male Inspiratory and exp...

Page 119: ...ntermediate accessory For accessories other than those mentioned in this manual please contact us The test method is also available on request Compatibility of accessories parts of the respiration system which can be removed and assem bled by the operator Inspiratory resistance Adult max 5 5 cmH2O 30 L min Child max 5 5 cmH2O 15 L min Infant max 5 5 cmH2O 7 5 L min Expiratory resistance Adult max ...

Page 120: ...er an inspiratory cycle Expiratory trigger system During any spontaneous cycle the switch to expiration occurs as soon as one of the following crite ria is encountered expiratory flow trigger Trig E Expiration as soon as the inspiratory flow rate reaches x of peak inspiratory flow rate expiratory pressure trigger not adjustable expiration as soon as an overpressure of 3 cmH2O is detected on the in...

Page 121: ...te L min Adjustable on successive scales 10 to 10 20 to 20 40 to 40 80 to 80 160 to 160 Pressure cmH2O Adjustable on successive scales 0 to 20 0 to 40 0 to 60 0 to 100 Volume mL Adjustable on successive scales 0 to 80 0 to 100 0 to 500 0 to 1000 PCO2 in mmHg or kPa or FCO2 in Adjustable on successive scales In mmHg in kPa in 0 to 50 0 to 7 0 to 7 0 to 150 0 to 15 0 to 15 Time s Adjustable on succe...

Page 122: ...or an alarm threshold when an adjustment is made and an alarm if triggered Because the alarm log reports only alarm related events the maximum number of events recorded can be below 4000 12 4 3 7 Measured parameters Measured para meters Measurement range Resolution Precision Filtering Peak airway pres sure Ppeak cmH2O 0 100 1 2 cmH2O 4 15 ms Positive end of ex piratory pressure PEEP cmH2O 0 99 1 2...

Page 123: ... RR bpm 0 120 1 1 bpm 4 cycles spon tanés Percentage of spontaneous cy cles spont 0 100 1 5 Peak insufflated flow rate max ins L min 0 120 0 1 1 L min 10 125 ms Peak exhaled flow rate max exp L min 0 150 0 1 2 L min 15 125 ms Ratio of frequen cy to exhaled tidal volume RR VTe bpm L 0 5000 1 20 Mean cycle pres sure Pmean cmH2O 0 99 1 2 cmH2O 4 Occlusion pres sure 1 P0 1 cmH2O 0 20 1 2 cmH2O 4 Estim...

Page 124: ...ion time to expi ration time I E 1 20 1 0 3 1 0 1 1 0 3 Leak rate leak L min 0 120 1 2 L min 15 Measured parameters related to the IRMA CO2 measurement probe Fraction of CO2 at the end of expira tion etCO2 0 15 0 1 0 43 abs 8 rel CO2 pressure at the end of expira tion etCO2 mmHg 0 100 1 3 mmHg abs 8 rel CO2 minute vol ume VMCO2 mL min 0 9999 1 30s Alveolar minute volume Vmalv L min 0 99 0 1 30s Ra...

Page 125: ...tomatically conducted during in teractive testing Precision is guaranteed only when there is fre quent calibration at least weekly Minimum flow rate to guarantee precision 5 L min Drift of measurement accuracy over 6 hours 3 Vol Response time at 90 extreme conditions 45s Response time at 90 according to the EN ISO 80601 2 55 standard 10 s Start time Immediate Sampling rate of the O2 cell data 5 ms...

Page 126: ...ntilation Adult Child Infant Set points Unit Min Max Incr Default Min Max Incr Default Min Max Incr Default VT mL 100 2000 10 450 50 500 5 200 20 75 1 35 RR bpm 4 80 1 15 5 120 1 25 10 120 1 40 TI Ttot 5 80 1 33 5 60 1 33 5 60 1 33 I E 1 19 1 0 3 1 0 1 1 2t 1 19 1 0 7 1 0 1 1 2 1 19 1 0 7 1 0 1 1 2 Flow L min 2 150 1 20 2 150 1 15 2 150 1 4 Tplat 0 60 5 20 0 60 5 0 0 40 5 0 RR SIMV bpm 1 80 1 10 1...

Page 127: ...w cmH2O 0 50 1 0 0 50 1 0 0 50 1 0 according to ventilation mode Adult Child Infant Alarms Unit Min Max Incr Default Min Max Incr Default Min Max Incr Default Ppeak high cmH2O 10 100 1 45 10 100 1 45 10 100 1 45 Pplat high cmH2O OFF 1 50 1 OFF OFF 1 50 1 OFF OFF 1 50 1 OFF Pplat high cmH2O OFF 1 50 1 30 OFF 1 50 1 OFF OFF 1 50 1 OFF RR low bpm 1 70 1 6 1 110 1 10 1 110 1 20 RR high bpm 11 80 1 45 ...

Page 128: ...FF OFF 39 0 5 OFF OFF 39 0 5 OFF VMalv high L min 1 40 0 5 40 1 40 0 5 40 1 40 0 5 40 Settings PRVC and PS PRO Invasive ventilation Adult Child Infant De scrip tion Min Max Incr De fault Min Max Incr De fault Min Max Incr De fault Maxi Pas Incr Expi ratory pres sure PRVC PS PRO PEP cmH2O 0 50 1 0 0 50 1 0 0 50 1 0 FIO2 PRVC PS PRO FiO2 21 100 1 50 21 100 1 50 21 100 1 35 Fre quen cy PRVC f c min 4...

Page 129: ...00 OFF 20 75 1 35 PRVC 2 99 2 99 2 99 PI max PS PRO PI max cmH2O 2 99 1 20 2 99 1 20 2 99 1 20 Non invasive ventilation Adult Child Infant Set points Unit Min Max Incr Default Min Max Incr Default Min Max Incr Default PS cmH2O 2 25 1 15 2 25 1 15 2 25 1 15 PEP cmH2O 0 15 1 5 0 15 1 5 0 15 1 5 RR mi ni c min 1 80 1 8 1 100 1 15 1 100 1 20 Timax s 0 3 5 0 0 1 1 3 0 3 5 0 0 1 1 2 0 2 2 5 0 1 0 5 L mi...

Page 130: ...VTe mL 100 3000 10 3000 100 3000 10 1000 10 800 10 100 Low MVe L min OFF 0 5 59 0 0 1 2 0 OFF 0 1 59 0 0 1 1 5 OFF 0 1 39 0 1 1 High MVe L min 1 0 60 0 0 1 30 0 1 0 60 0 0 1 10 0 0 9 40 0 1 5 FiO2 low 18 95 1 55 18 95 1 45 18 95 1 30 FiO2 high 23 100 1 65 23 100 1 55 23 100 1 40 T ap nea s 15 60 1 20 4 60 1 20 2 30 1 10 If FiO2 set point 35 CO2 ALARMS IF THE CO2 MONITORING SOFTWARE OPTION IS ENABL...

Page 131: ...tion time s 30 300 5 120 30 300 5 120 30 300 5 120 Nebulization settings Adult Nebu lization Unit Min Max Incr Default Child Infant Flow L min 1 0 20 0 0 5 6 0 Nebu lization dura tion min 1 60 1 10 Fre quency h 1 24 none 1 none Inactive function Inactive function Oxygen therapy settings Adult Child Infant Oxygen Unit Min Max Incr Default Min Max Incr Default Min Max Incr Default FiO2 21 100 1 50 2...

Page 132: ...lat cmH2O cmH2O P plat mea sured 5 OFF OFF OFF VTi low mL mL VTi measured 75 OFF VTi measured 75 VTi measured 75 VTi high mL mL VTi measured 50 2000 mL VTi measured 50 VTi measured 50 MVe low L min L min MVe measured 50 MVe high L min L min MVe measured 50 MVe measured 75 MVe mea sured 50 MVe mea sured 75 RR low c min c min RR measured 50 RR high c min c min RR measured 50 VMCO2 low mL min VMCO2 m...

Page 133: ...nge the threshold to activate the corresponding alarm Obstruction alarm Use a suitable device to simulate obstruction of the expiratory branch during ventilation e g by clamping the expiratory branch O2 supply failure alarm Disconnect the oxygen supply Means of testing an alarm in each category LOW ALARM Adjust a min VTe threshold to below the mea sured value MEDIUM ALARM Adjust a min VTe threshol...

Page 134: ...on artificielle http www infirmiers com etudiants en if si cours cours reanimation la ventilation artificielle html Laurent Brochard Alain Mercat Jean Christophe M Richard Ventilation artificielle De la physiolo gie à la pratique Collection Manuel d anesthésie de réanimation et d urgences Elsevier Masson 2008 J Roeseler J B Michotte A F De Ranter S Delaere P F Laterre M Reynaert Différentes techni...

Page 135: ...er supply During ventilation on a test lung disconnect the electrical connection Check that the ventilator ventilates on its internal battery and announces this fact on screen Check the battery is charged enough 3 squares at least if an intra hospital trans port is programmed Reconnect the AC power supply See also Testing the alarms on page 133 Alarm level tone Press the Stand by key a dialog box ...

Page 136: ...ts or dropping it Pre disinfection cleaning Immerse the expiratory assembly components in a pre disinfectant solution Air Liquide Medical Sys tems recommends the use of ANIOS products ANIOSYME DD1 SALVANIOS PH7 HEXANIOS G R obey the instructions of the product manufacturer Rinse the parts under running water except for the expiratory flow sensor 1 which should only be dipped in water Leave the com...

Page 137: ...in the membrane reposition the membrane in the valve body CAUTION Before any further use of the expiratory assembly check that it was correctly re assembled by connecting it to the ventilator and performing the automatic tests Monnal EVA autoclavable expiratory assembly Monnal EVA single use expiratory assembly 137 ...

Page 138: ...se 92182 ANTONY CEDEX FRANCE Tel 33 0 1 40 96 66 00 Fax 33 0 1 40 96 67 00 Hotline hors France métropolitaine 33 0 1 79 51 70 01 Hotline France 0820 146 359 0 12 min TTC depuis un poste fixe www device airliquidehealthcare com YL072800 Revision 9A 2021 06 EN UM000103 V3 6 xI9A ...