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ICU Anaesthesia Ventilator Machine

FOB Price: US $2,000 / Piece
Min. Order: 1 Piece
Min. Order FOB Price
1 Piece US $2,000/ Piece
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Production Capacity: 3000PCS/Year
Payment Terms: L/C, T/T

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Basic Info
  • Model NO.: MF-M-01D
  • Ptr: -10-10hpa
  • Tidal Volum: 50-1500ml
  • Specification: CE & ISO
  • Vaporizer: 1 Vaporizer(Enflurane/Isoflurane/Sevoflurane)
  • Peep: 1-10hpa
  • Trademark: MEDFAR
  • Origin: Shandong
Product Description

ICU  anaesthesia ventilator machine:

ICU Anaesthesia Ventilator Machine

Intro:This paragraph anesthesia machine uses bright digital tube, directly knob to adjust the parameters double digit evaporator tank, integration of integrated breathing circuit, four meter, set the volume limit pressure synchronous anesthesia ventilator, and has power-off delay, machine through the CE certification, for many years won the first sales of private hospitals, high cost


Specifications:  
Pneumatically drivenelectronicallycontrolled system
Built-in ventilator, LED display screen
With 1 patient circuit for adult (Option:patient circuit for children).
2-tube flowmeters, O2 & N2O;0.1 L/Min ~10 L/Min;
Double vaporizer, Enflurane/Isoflurane/Sevoflurane;(Option: Halothane)
Oxygen Flush: 25~75 L/Min;
Respiration Mode:  IPPV, SIPPV,Manu
Tidal Volume: 50~1500 mL;
I:E: 1:1.5; 1:2.0; 1:2.5; 1:3
Respiration Frequency:  4~40 bpm
Ptr: -10~10 hPa;
CO2 absorber capacity: 1.5 kg
Alarm parameter: upper/lower limit ofventilation volume, upper /lower limit ofairway pressure, tidal volume exceedlimitation, no tidal volume output, apnea,AC power malfunction, battery lowpower 

Loop part:
Integrated design, integrated breathing circuits

Evaporator:
High-precision single evaporator configuration, enflurane or isoflurane or Sevflurane or Haloflurane
Concentration adjustment range: 0.5 ~ 5%VOL
Evaporator flow, pressure, andautomatictemperature compensation function
Self-locking feature

Configuration:
Vaporizer: Two vaporizers,Enflurane/Isoflurane/Sevoflurane(Option: Halothane)
Anesthesia gas concentration range:0.5~5%
Soda lime absorption system: resistant to high temperature of 176 degrees Celsius.
CE & ISO certificates approved

2.Structural Characteristics and Operating Principles
This anesthesia machine consists of a main unit, an anesthetic vaporizer, a flow meter, an anesthesia respirator and a respiratory circuit system.
2.1 Anesthesia Machine Main Unit
The structure and operating principles of the main unit are as shown in Figure 1.

Figure 1
 
The anesthesia machine uses compressed oxygen and compressed laughing gas (nitrous oxide gas) from a gas cylinder or central gas supply system at the hospital. The compressed oxygen and laughing gas from the central gas supply system are both at a pressure of 0.4MPa. After oxygen and backup oxygen are combined by a one-way valve and then split into two flows, one is connected to an oxygen flush valve, and the other flow is depressurized to 0.3 to 0.35MPa by a pressure regulator and then enters a flow meter and is connected with an oxygen fault alarm. The laughing gas is depressurized to 0.25 to 0.30MPa by a pressure regulator and then enters the flow meter. The pressure of the gas from the gas cylinder or central oxygen supply system may vary with the temperature and air storage. The purpose of the pressure regulator (also called reducing valve) is to stabilize the gas pressure and meet the need of the anesthesia machine.
For the gas supply with a gas cylinder, a pressure regulator must be used and the output pressure should be adjusted to 0.4MPa. The variation in the pressure at the output pressure port of the pressure regulator is less than 8kPa when the inlet pressure varies by 1MPa to ensure the stability of output pressure. The output of the pressure regulator is equipped with a safety valve. If a fault occurs to the pressure regulator or the output pressure is caused to be too high due to human errors, the safety valve automatically exhausts gas to ensure that the output gas pressure reaches the rated operating pressure. The exhaust pressure of safety valve ranges from 0.5 to 0.6MPa.
The flow meter not only can indicate but also can adjust the flow rates of the oxygen and laughing gas. A "oxygen-laughing gas linkage device" and "laughing gas cut-off equipment" are installed between the oxygen flow regulator valve and laughing gas flow regulator valve. Their functions: when only the oxygen flow regulator valve is opened, laughing gas flow may be closed; but if the laughing gas flow regulator valve is opened, the oxygen flow regulator valve will inevitably be opened by the link mechanism to ensure the oxygen concentration required by the patient. After the oxygen and laughing flows are opened, the oxygen flow rate will decrease if the oxygen flow rate is decreased gradually. When the pressure of the oxygen entering the flow meter is lower than 0.20MPa±0.05MPa, the flow meter will automatically close the laughing gas flow. At the flow meter outlet, oxygen and laughing gas are mixed with each other and then enter the anesthetic vaporizer.
If the anesthesia machine is equipped with two vaporizers and such two vaporizers are connected in series, when one vaporizer is activated the other one cannot be activated and this can ensure that only one vaporizer can work at any time to ensure patient safety. The mixed gas flowing out from the anesthetic vaporizer flows through a one-way valve to the gas outlet. Then it passes through a transition interface to enter the recirculation circuit to be described later in this manual.
When the anesthesia machine is in operation, the pressure at the gas output port will be caused to be always at a fluctuating level by turning on the rapid switch. The one-way valve isolates the adverse impacts that such fluctuating pressure has on the vaporizer.
The anesthesia machine is equipped with a rapid oxygen supply valve. By pressing this valve, the oxygen supplied into the anesthesia machine can be enabled to bypass such a series of components as pressure regulator, flow meter, vaporizer, etc and then directly enter the recirculation circuit and thus rapidly supply a great amount of oxygen.
For safety consideration, a laughing gas shutoff valve is arranged in the flow meter of the anesthesia machine. When the pressure of the inlet oxygen of the anesthesia machine is lower than 0.20MPa±0.05MPa, such valve automatically shuts off the laughing gas. Almost at the same time, oxygen supply fault alarm buzzes.
 


Figure 2
 
The compressed oxygen input in the anesthesia machine should be split for another flow which will be used as power gas source for the anesthetic respirator. The operating pressure gauge for the respirator should be used for monitoring the pressure of the respirator.
2.2 Anesthetic Recirculation Circuit
The anesthetic recirculation circuit, also called patient circuit, is a combination gas circuit device connected with the patient. Its main function is to transmit mixed anesthetic gases to the patient and allow the patient to normally inhale oxygen and exhale carbon dioxide through such system. It can operate in the "Maneuvering" or "Manual" mode. The so-called "Maneuvering Mode" refers to the mode in which the patient's respiratory function is managed by using the anesthetic respirator. The so-called "Manual" mode refers to the mode in which an anesthetist controls the respiration of  the patient by pressing the air storage bag connected on the recirculation circuit.
An integrated anesthetic recirculation circuit is used on the JINLING-01 I  Anesthesia Machine.

Figure 3

1.Manual/Maneuvering changeover valve
2.Common gas inlet
3.Gas storage bag connection port
4.Carbon dioxide absorber
5.Exhalation valve
6.Exhalation screwed pipe port
7.Inhalation screwed pipe port
8.Inhalation valve
9.Pressure gauge
10.APL safety valve
11.Air bellow
12.Driving gas inlet
13.Pressure signal  
14.Oxygen concentration sensor interface
15.Waste gas exhaust port
16.Connection with 17 through screwed pipe
17.Connection with 16 through screwed pipe
 
 

When the Manual/Maneuvering changeover valve is put to the Manual position, the recirculation circuit is in the "Manual" operating mode. By pressing the rapid oxygen supply valve on the main unit, the oxygen is enabled to directly enter the gas storage bag connected with the recirculation circuit through the common gas inlet.

Figure 4
After the gas storage bag is pressed, the gas in the gas bag which is accompanied with mixed gases from the main unit of the anesthesia machine enters the body of the patient through the carbon dioxide absorber, inhalation valve and screwed tube connected with the valve. The inhalation valve is a one-way valve. It only allows the gas to flow to the screwed tube from the recirculation circuit rather than flow back. The gas expired by the patient enters the recirculation circuit through the screwed tube (not shown in the figure) connected on the inhalation valve and expiration valve and returns to the gas storage bag. The expiration valve is also a one-way valve. In contrast to the inhalation valve, it only allows the gas to flow from the screwed tube to the interior of the recirculation circuit rather than flow back and recirculation is achieved like this.
As the gas needs to pass through the carbon dioxide absorber where the carbon dioxide in the gas expired by the patient will chemically react with the soda lime in the absorber to be absorbed before flowing to the inhalation valve, the main unit of the anesthesia machine delivers the oxygen and anesthetic gas required in the respiration by the patient into the recirculation circuit.
Each time when the gas storage bag is pressed, the airway pressure in the recirculation circuit can be read from the pressure gauge. The maximum airway pressure should be set by adjusting the APL safety valve. Once the airway pressure is higher than the set value, excessive gas will be discharged.
When the Manual/Maneuvering changeover valve is put to the Maneuvering mode, the recirculation circuit is in the "Maneuvering" operating mode. At this time, the air bellow replaces the gas storage bag in the "Manual" mode. The driving gas from the anesthetic respirator enters the air bellow through the driving gas inlet on the recirculation circuit and forms a driving force on the exterior of the folded bag of  the air bellow to replace the "Manual" mode.

Figure 5
As the gases inhaled by the patient not only contain the gas from the air bellow bag but also are accompanied with fresh mixed gases from the main unit of the anesthesia machine, the gas expired by the patient is more than the gas in the air bellow bag in the amount. An automatic adjustment device is installed in the air bellow bag and it will discharge the excessive gas.
During the operation, the flow rate of the gas output by the anesthetic respirator can be obtained from the RPM of the flow rate sensing impeller between the expiration valve and expiration screwed tube. When the oxygen concentration needs to be monitored, the oxygen concentration can be sampled at the oxygen concentration transducer connector.
The carbon dioxide monitor is connected at the expiration screwed tube connector of the anesthetic recirculation circuit. The anesthetic gas monitor is connected at the common gas inlet of the anesthetic recirculation circuit.
Attention: latex components within this system include the screwed tube, k. gas storage bag and mas. When washing and disinfecting them, the user should note that the screwed tube consists of disposable components and reusable components. The gas storage bag is a reusable component. When washing and disinfecting latex components, special attention should be paid to that cleaning agent or disinfectant may have corrosive and damaging effects on the components. These several latex components are mainly in the anesthetic ventilation system. The reusable gas storage bag should be reused to the extent that it is not damaged.
2.3 Anesthetic Respirator

The JINLING-01 I anesthetic respirator uses a pneumatic electric controlled anesthetic respirator.
The medical compressed oxygen from a power gas output passes through a gas jetter with venture effect to form a gas in which medical oxygen is mixed with atmosphere at a certain pressure. Such mixed gas is delivered into the ventilation circuit of the anesthesia machine to drive the motion of the air bellow bag  and thus perform the mechanical ventilation of the patient.
In the anesthetic respirator, a fast solenoid valve, a high sensitivity flow sensor and pressure sensor and single-chip computer control system are used to set, measure and adjust the ventilation pressure, ventilation duration, ventilation volume, etc ,applied to the patient. When the anesthetic agent takes effect and the patient loses spontaneous breathing, the anesthetic respirator will perform mechanical ventilation at the set frequency, respiratory rate and tidal volume. When the operation is completed and spontaneous breathing of the patient is resumed somewhat, the anesthetic respirator will automatically synchronize with the spontaneous breathing of the patient.
If the anesthetic circuit is in the "Manual" mode, the anesthetic respirator can display the tidal volume, ventilation frequency and airway pressure in real time although it does not participate in the ventilation control.
2.4 Anesthetic Vaporizer
Attention: when the vaporizer does not match the anesthesia machine, the performance of the vaporizer will be deteriorated.
A bypass variable, outside-circuit dedicated vaporizer is used on the Jinling-01 I anesthesia machine. This vaporizer has good pressure compensation and temperature compensation functions. When it is in the off mode, its inlet is directly communicated with its outlet so that the fresh gas does not pass through the vaporizer chamber at all to avoid the leakage of the anesthetic agent. After the vaporizer is opened by turning the concentration adjustment disk, the fresh gas passes through the switching valve to be split by a bypass temperature control needle valve; one flow carries the anesthetic agent vapor to pass through the control needle valve and arrive at the vaporizer outlet after being compensated by the pressure compensator and entering the vaporizer chamber; then it merges with the other gas flow directly from the fresh gas inlet. Turning the concentration adjustment disk can adjust the caliber of the control needle valve and this results in the adjustment of the concentration of the anesthetic gas in the mixed gas. The pressure compensator here is intended for preventing the impacts that the pressure fluctuation between the upstream and downstream of the vaporizer. The ventilation interval of the bypass needle valve automatically changes with the temperature to play the role of temperature compensation.
3. Technical
3.1 Operating mode: circulatory closed, semi-closed and semi-open.
3.2 Gas requirement: medical oxygen and nitrous oxide with a pressure ranging from 0.3 MPa to 0.5 MPa.
3.3 The maximum error of the pressure testing device should not exceed ± (4% of the full scale reading + 8% of the actual reading).
3.4 For oxygen and nitrous oxide, a special pressure regulator with a safety valve will be provided. The exhaust pressure of the safety valve should not be higher than 6 kPa.
3.5 Indication range of the oxygen and nitrous oxide flow meter: 0.1 L/min ~ 10 L/min.
When the flow rate ranges from 10% of the full scale value to 100%, the scale accuracy should be within ±10% of the indicated value.
3.6 The flow meter is equipped with an oxygen-nitrous oxide proportional control device.
When the oxygen concentration in the mixed gas N2O/O2 conveyed by the anesthesia
machine is no lower than 20% (V/V) or the FiO2 is lower than 20%, the machine will emit an
alarm.
3.7 When the oxygen pressure of the anesthesia machine is 0.20MPa±0.05MPa, the machine raises a low gas source pressure alarm which is a high priority alarm, and shuts off  the nitrous oxide conveyed to the common gas outlet.
3.8 Oxygen Flush:25~75 L/Min;
3.9 Anesthetic gas concentration adjustment range of vaporizer: 0~5%, relative error ±20 %.
3.10 The exhaust pressure of the safety valve of the respiratory circuit is no higher than 6 kPa.
3.11 Anesthesia ventilator
3.11.1 Respiration Mode:IPPV,SIPPV,Manu
3.11.2 Respiration Frequency:4~40bpm
3.11.3 I/E Ratio:1:1.5~1:4
3.11.4 Tidal Volume:50~1500mL
3.11.5 Ptr:-10~10hPa
3.11.6 Controlled ventilation and assisted ventilation switching time: 6s
3.11.7 Maximum safety pressure:  ≤ 12.5 kPa.
3.11.8 Pressure limit range: 1~6 kPa
3.11.9 Airway pressure alarm: adjustment range of upper alarm limit: 0.3kPa ~ 6 kPa, permissible error ±0.2 kPa, or ±15% (whichever is greater), the machine should immediately raise a high level alarm when the airway pressure rises to the alarm value; the lower alarm limit ranges from 0.2 to 5 kPa and the permissible error is ±0.2 kPa or ±15% (whichever is greater). The machine should immediately raise a medium level alarm when the airway pressure drops to the alarm value and such condition lasts 4 to 15s.
3.11.10 Tidal volume alarm: the upper alarm limit ranges from 50 to 2000ml, the permissible error is ±20%, the adjustment range of the lower alarm limit is 0~1800ml, the permissible error is ±20% and the machine should raise a medium level alarm.
3.11.11 Ventilation volume lower alarm limit: the adjustment range is  0~12 L/min , and the permissible error is ±20%. The ventilation volume upper alarm limit is fixed to be 25 L/min, the permissible error is ±20% and the machine should raise a medium level alarm.
3.11.12 Power supply fault alarm: the machine should give audible alarm in case of power outage and the alarm should last more than 120s.
3.11.13 The silencing time of the audible alarm signal should be less than 120s. The alarm status should not be deactivated and visual alarm signal should not be intermittent.
3.11.14 The emergency battery should be a lead acid battery with a rated output voltage of DC 12V. The duration of the operation of the anesthetic respirator driven by the battery should be more than 60min.

5.2 Installation of Anesthesia Machine
1)Install four casters on the frame of the anesthesia machine. The two casters installed on the front of the anesthesia machine should be equipped with a locking device. The two casters without a locking device should be installed on the back of the anesthesia machine.
2)Push the frame of the anesthesia machine to the pre-determined position and then depress the locking device for the front caster to disable the anesthesia machine to freely move.
3)Install the anesthetic agent vaporizer onto the special frame of the vaporizer on the anesthesia machine and tighten the fastening screw rod on the connection base by using an Allen tool.
4) Fix the anesthetic recirculation circuit on the support frame on the left side of the anesthesia machine through a branch arm and then connect the respiratory bellow and gas bag on the recirculation circuit.
5) Installing carbon dioxide absorber;
A)Prior to the use of the anesthesia machine, an appropriate amount of soda lime needs to be loaded into the cup. Make sure not to exceed the max scale line. Then seal the cup and cup cap following the method as below; first pay attention to the engagement position between the cup cap and cup and the cup cap has been fixed on the circuit body.

Figure 6
 
 
B) Observe the buckle position of the cup cap (a total of 4 buckle positions)

Figure  7
 
 
C) Observe the snap position of the cup (a total of 4 snaps)





Figure 8
D) Align the snap of the cup with the buckle position of the cup cap, turn the cup right by  grasping the cup with two hands (pay attention to the locking direction) until the snap is in the inner most position of the buckle when you can hear a clicking sound. This indicates that the soda lime cup is sealed.
E) If soda lime needs to be replaced, turn the cup left when removing the cup (pay attention to the lock loosening direction). When you hear a clicking sound and then observe that the snap is completely separated from the buckle, you can remove the cup and then dump soda lime out from the cup. Perform operations again following the above mentioned steps.

Figure 9
F) Connect the emergency battery and connect the anesthetic respirator to the anesthetic recirculation circuit by using a screwed tube.
G) Connect two screwed tubes on a Y-shaped tee tube. Connect one tube to the inspiration valve screwed tube connector of the recirculation circuit and connect the other tube to the expiration valve screwed tube connector of the recirculation circuit.
H) Connect the Y-shaped tee tube with the test lung or leather bag.
I) Connect the anesthesia machine to the compressed oxygen source and compressed laughing gas source by using a high pressure gas tube.
 Attention: the oxygen tube is blue 5×8 mm and the laughing gas tube is orange 5×8 mm.
J) Insert the power plug of the anesthesia machine into a single-phase AC 220V power outlet which is well grounded.
Attention: the equipment should not be imbalanced when it is inclined by 10 DEG under horizontal condition and normal configuration, but addition of other device on the equipment decrease the equipment stability.
5.3 Pre-adjustment of Anesthesia Machine
1) Check the indication zero points on the pressure gauge on the recirculation circuit of the anesthesia machine and airway pressure gauge of the anesthesia machine. In case of any deviation, the zeroing screw of the pressure gauge needs to be adjusted by using a screwdriver.
2)Observe the output pressure gauge on the compressed gas cylinder or central gas supply system; its indication should range from 0.3 to 0.50MPa. After compressed oxygen and compressed laughing gas are connected, observe the indication of the power gas output pressure gauge; the indication should be consistent with the input pressure of the compressed oxygen; observe the oxygen pressure gauge and laughing gas pressure gauge on the anesthesia machine panel; their indications should be around 0.30 MPa (the pressure of the laughing gas should be 0.25 MPa and the oxygen pressure should be 0.30MPa).
3) Turn the knob of the flow regulation valve on the flow meter and you should be able to see that: during the regulation the flow meter buoyant moves flexibly and the flow meter buoyant is stabilized and does no move upon completion of regulation. 
4) Put the Manual/Maneuvering changeover switch to the manual position, plug the outlet of the Y-shaped Tee tube, press the rapid oxygen supply valve, the respiratory bag with a capacity of 3L should be filled full within 3 to 5s and the pressure gauge on the recirculation circuit should correspondingly indicate the pressure of the gas circuit.
5) Switch the anesthesia machine to the Maneuvering mode, connect the power of the respirator and set its operating parameters to the following values: tidal volume 0.70 L, ventilation frequency 20t/min, and respiratory ratio 12. You should observe that the test lung or gas storage bag inflates and deflates at the ventilation frequency of the respirator and the inhalation valve and expiration valve on the recirculation circuit operate freely.
5.4 Acceptance Test After Installation and Adjustment
1) Sealing Performance Test of High-pressure Circuit of Anesthesia Machine
Close the flow regulation valve on the flow meter, connect the compressed gas source and you can see on the anesthesia machine that the indications on the oxygen pressure gauge and laughing gas pressure gauge are around 0.3MPa. Then shut off the compressed gas source and you should observe that the indication from the pressure gauge on the anesthesia machine does not fluctuate obviously within five minutes.
2)Sealing Performance Test of Low-pressure Circuit of Anesthesia Machine
Put the Manual/Maneuvering changeover switch on the anesthetic recirculation circuit to the manual position. Plug the outlet of the Tee tube communicated with the anesthesia machine, supply gas with a rapid oxygen supply valve and you should observe that the gas bag inflates due to the charge; stop gas supply when the indication on the airway pressure gauge reaches 3kPa, and you should observe that the drop in the indication on the airway pressure gauge should be less than 0.4kPa within one minute.
3)Oxygen-Laughing Gas Linkage Function Test of Flow Meter
Connect the compressed gas source and connect the outlet of the anesthesia machine with the atmosphere. Turn the flow regulation valve on the flow meter. You should be able to observe that: when you just open the oxygen flow regulation valve the laughing gas flow is off; when you just open the laughing gas flow regulation valve the oxygen flow will be also turned on through a linkage mechanism; after the oxygen and laughing gas flows are fully opened, gradually reduce the oxygen flow rate and the laughing flow rate also decreases to the closed status gradually. Under normal ventilation condition, the flow rate should be stable and the flow rate of oxygen to laughing gas should be 1:1.5.
4)Test on Automatic Laughing Gas Throttling and Oxygen Supply Fault Alarm
Connect the compressed gas source, connect the outlet of the anesthesia machine with the atmosphere, open the oxygen flow regulation valve and laughing gas flow regulation valve, gradually decrease the pressure of the compressed oxygen conveyed into the anesthesia machine, observe the oxygen pressure gauge of the anesthesia machine, the laughing gas flow rate decreases with the drop in the pressure of the oxygen; when the oxygen pressure is lower than 0.20MPa±0.05MPa, the laughing gas flow is completely shut off and the anesthesia machine emits alarm buzz lasting no shorter than 7s.
5)Tidal Volume Test
Close the oxygen flow regulation valve and laughing gas flow regulation valve on the flow meter of the anesthesia machine, set the ventilation frequency of the anesthetic respirator to 20t/min and respiratory ratio to 1:2, turn the tidal volume regulation valve of the anesthetic respirator and you should be able to observe that the indicated value of the tidal volume after three to four ventilations tends to be stable and its adjustment range is no less than 50mL to 1500mL. If a test lung is used, you should also observe that the maximum error of the indicated value of the tidal volume of the anesthetic respirator compared to that of the test lung after stabilization does not exceed 20%.
6)Alarm Function Test
Test condition: close the oxygen flow regulation valve and laughing gas flow regulation valve on the flow meter of the anesthesia machine and set the operating parameters of the anesthetic respirator to the following values: ventilation frequency 20t/min and respiratory ratio 1:2.
Attention: the ventilator alarm system is started up 120s after the startup of the ventilator.
7)Extension Function Test Upon Power Failure
Remove the AC power plug of the anesthesia machine (not open the power switch) and the anesthesia machine should continue to operate on the emergency battery.
6. Use and Operation
6.1Preparation and Inspection Before Use
1.Gas source check: check whether the oxygen and laughing gas in the cylinder are sufficient, whether the output pressure of the cylinder or hospital central gas supply system ranges from 0.3MPa to 0.5MPa and whether the connection circuit from the compressed gas source to the anesthesia machine is correct in good and completion condition.
2.Power check: check whether the grid voltage ranges from AC220 to AC240V, whether protective grounding is in good and complete condition and whether the power plug of the anesthesia machine is securely connected.
3.Check the use records and cleaning and disinfection records of the anesthesia machine (including the anesthetic respirator) and confirm that the performance of the machine is good.
     Warning: never allow the anesthesia machine which is not thoroughly washed and disinfected or has potential safety threat to operate.
4.Carbon dioxide absorber check: remove old soda lime in the absorber, wipe clean the interior of the absorber and fully charge the absorber with fresh soda lime.
5.Fill the anesthetic vaporizer with anesthetic agent.
6.Simulate the method for ventilation of the patient to repeatedly charge the recirculation circuit with gas by using the rapid oxygen supply valve and rinse the recirculation circuit and ventilation circuit to remove the waste gases by using pure oxygen.
7.Adjust and set the parameters of the anesthetic respirator.
6.2 Use of Anesthesia Machine
1) The most critical operation to use the anesthesia machine is the feeding of the anesthetic concentration and ventilation management and control. The anesthesia machine can manage the breathing in the patient in the manual mode or automatically control the breathing in the patient following the set parameters. During the use, you should pay close attention to the condition whether the indications on all instruments on the anesthesia machine and anesthetic respirator meet the needs of the patient. Generally, indications from the instruments can only be used as reference even though they are very accurate and the patient's condition is the most fundamental basis.
2) Method for opening the anesthetic vaporizer: press the concentration adjustment disk and turn it counterclockwise to increase the concentration of the output anesthetic agent. After the adjustment disk turns, you do not need to press it with pressure.
Attention: only under the condition that the flow through the vaporizer ranges from 0.5 to 10 L/min and the output anesthetic agent concentration ranges from 0.5 to 5 vol% can the output concentration of the vaporizer be ensured to be within the permissible error range. It is prohibited to use the vaporizer within the range from the "OFF"(or "0") graduation to the first graduation line because it cannot be ensured that the output concentration of the vaporizer is within the permissible error range.
3) Estimation of anesthetic agent dosage:
Anesthetic agent dosage (mL)≈anesthetic agent concentration output by the vaporizer (Vol%) ×fresh gas flow (L/min)×anesthesia time (hour)× 3
This formula is an empirical formula. For example, assuming that the set output concentration of the vaporizer is 1.5 Vol%, the sum of  the oxygen flow rate and laughing gas flow rate read from the flow meter of the anesthesia machine is 2 L/min and the operation duration is estimated to be 8 hours, then the dosage of the anesthetic agent to be prepared in the vaporizer must not be less than: 1.5×2×8×3 = 72(mL).
Of course, for safety and reliability, the dosage of the anesthetic agent to be actually prepared will be more than the estimation.
 4)The anesthetic agent should be dosed to the 135mL between the highest and lowest graduation lines.
5)Due to the impact of the on-off actions, the vaporizer cannot be calibrated within the range from the "OFF" position to the "0" position, and so the concentration value cannot be set within such range.
6) During weaning, you should turn off the vaporizer by using the this method: press the concentration adjustment disk, clockwise turn the concentration adjustment disk to the zero point, you must see that the concentration adjustment disk snaps out and at this time you should determine that the concentration adjustment disk is locked.
7) During the ventilation with the anesthetic respirator, a flow rate higher than 2L/min is recommended. During manual recirculation closed anesthesia, an oxygen flow rate ranging from 0.7 to 1L/min is recommended to ensure the oxygen inhalation and life supporting needs of the patient.
8) The main role of the low oxygen alarm device and laughing gas shut-off device is to automatically raise an alarm and shut off the laughing gas flow when the medical oxygen pressure drops and medical oxygen cannot be normally used.
6.3 Use of Anesthetic Respirator
6.3.1Anesthetic Respirator
The control panel of the anesthetic respirator that the Jinling-01 I anesthesia machine is equipped is as follows:

Figure 10
The front panel of the respirator consists of the following components:
Digital window: the digital window consists of three units which respectively indicate the respiration ratio, frequency and tidal volume from left to right on the operation interface. After entering the Setup Interface, you can see the L1 tidal volume upper limit, L2 tidal volume lower limit, P1 peak pressure upper limit and P2 peak pressure lower limit.
Alarm lamp: a red lamp indicates a high level alarm and a yellow lamp indicates a medium level alarm.
Inspiration triggering lamp: when the respirator is triggered by the spontaneous breathing of the patient, the indicator lamp will flicker once indicating that the current breathing cycle is generated by the patient spontaneously.
Pressure limitation lamp: when the current airway pressure of the respirator reaches this value, the airway pressure limitation lamp goes on and the anesthetic respirator automatically switches from the inspiration phase to the expiration phase.
Airway pressure gauge: it instantaneously displays the airway pressure of the current anesthesia machine.
Five knobs: a red indicator indicates a high level alarm and a yellow indicator indicates a medium level alarm.
1) Frequency adjustment knob: this knob is used for adjusting the current operating frequency of the respirator from 4t/min to 40t/min;
2) Ventilation volume low limit alarm knob: the adjustment range is 0~12 L/min. When the accumulative ventilation volume within 1 minute is lower than this adjusted value, the respirator will generate a medium level alarm.
3) Inspiration triggering pressure knob: adjustment range: -1.0kPa~+1.0kPa, you should adjust the sensitivity of the value according to the breathing intensity of the patient. If the value is set to be greater, the inspiration will be more sensitively triggered.
4) Airway pressure limitation knob: adjustment range: 1.0kPa~6.0kPa. You can set this value to be bigger a little bit and then adjust it to be slightly higher than the actual maximum airway pressure in the patient.
5) Tidal volume adjustment knob: you can adjust the tidal volume increasingly from 50 to 1500mL.
  Switch: this switch is used for turning on and off the power of the respirator.
  3 functional keys:
Mode key: this key has double functions. If you press this key, the respirator switches between the assisted/controlled mode and manual mode; if you press and hold this key for more than 2s, then you enter the Setup Interface to set the L1 tidal volume upper limit, L2 tidal volume lower limit, P1 peak pressure upper limit and P2 peak pressure lower limit.
Ratio key: by pressing this key on the operating interface you can change the setting of the respiration ratio.
Silence key: when an alarm occurs, you can silence the alarm sound for 120s by pressing this key. If after the time is up the alarm is not deactivated, then the respirator continues to raise the alarm sound. You can enter the alarm query interface by pressing and holding this key for more than 2s.
Operation and use methods for anesthetic respirator:
After you turn on the power switch, the respirator enters the self-inspection status, all digital tubes flicker three times and the software version number is displayed. After this status lasts 4s, the respirator enters the startup interface and starts the ventilation following the parameters stored in the memory. The operator can directly adjust all parameters through the knobs and keys on the panel to achieve the status suitable for the patient.
Alarm Setup Interface:
When the alarm upper and lower limits need to be changed, you can press and hold Mode key for more than 2s to enter the Setup Interface to set the L1 tidal volume upper limit. At this time, the digital window shows that L1 is flickering followed by the currently set value. Pressing the Ratio key represents an increment of 1, pressing the Silence key once represents an decrement of 1, pressing and holding the Ratio key represents continuous increment of 1and pressing and holding the  Silence key represents continuous decrement of 1 to modify the tidal volume upper limit and adjustment range from 50mL to 2000mL.
Upon completion of setting, after pressing the Mode key you can enter the L2 tidal volume lower limit Setup Interface to set the lower limit. The setting method is the same as the above and the adjustment range is from 0 to 1800mL.
Upon completion of setting, after pressing the Mode key you can enter the P1 peak pressure upper limit Setup Interface to set the upper limit. The setting method is the same as the above and the adjustment range is from 0.3 to 6.0kPa.
Upon completion of setting, after pressing the Mode key you can enter the P2 peak pressure lower limit Setup Interface to set the lower limit. The setting method is the same as the above and the adjustment range is from 0.2 to 5.0kPa.
Upon completion of setting, after pressing the Mode key you can return to the operating interface (as shown in Figure 12), store alarm parameters and complete the setting.
Alarm Query Interface:
After the respirator raises an alarm during operation, the alarm lamp will emit medium and high level alarm indications according to different alarms. At this time, you can enter the alarm query interface by pressing and holding the Silence key for more than 2s. The corresponding code displayed on the tidal volume window indicates what alarm occurs. The code designations are as follows:
P upper limit , this indicates a high level upper pressure limit alarm and the red lamp flickers.
P lower limit ,this indicates a medium level lower pressure limit alarm and the yellow lamp flickers.
L upper limit ,this indicates a medium level upper pressure limit alarm and the yellow lamp flickers.
L lower limit ,this indicates a medium level lower tidal volume limit alarm and the yellow lamp flickers.
U upper limit ,this indicates a medium level upper ventilation volume limit alarm and the yellow lamp flickers.
U lower limit, this indicates a medium level ventilation lower limit alarm and the yellow lamp flickers.
Po , This indicates a high level low gas source pressure alarm and the red lamp flickers.
CP, This indicates a high level continuous positive pressure alarm and the red lamp flickers.
12.0 ,This indicates the battery power capacity.
If multiple alarms occur simultaneously, you can query all current alarm codes by pressing the Silence key once on the alarm query interface.
On the front panel of the anesthetic respirator, obvious note words are shown nearby all indicator lamps. When the indicator lamp goes on, this indicates that the anesthetic respirator is in the operating status as described by the note words.
The power input outlet, fuse box, emergency battery input outlet, power gas input connector, pressure signal connector, and flow sensor input socket of the anesthetic respirator are on the rear panel and provided with obvious Chinese labeling.
In the manual ventilation mode, the anesthetic respirator can still display the frequency, tidal volume and airway pressure of the manual ventilation and still provide the airway pressure alarm, ventilation volume alarm, etc.
6.3.2 AC and DC Operation
If AC power supply fails during the use of the anesthesia machine, the machine will automatically switch to the DC power supply and operate based on the originally set parameters. If DC power supply is also interrupted, the anesthetic respirator will stop gas supply and the anesthesia machine is switched to the Manual mode to provide fresh gas to the patient.
6.3.3 Pressure Maintenance
When the anesthesia system stops gas supply, the pressure of the medical gas pipeline will be maintained.


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