Dräger Apollo Guide de référence rapide

Supplement Paper Apollo SW 3.2n, SW 4.n 1

Supplement Paper

Inhalation Anesthesia Machine

Apollo, Software 3.2n, Software 4.n

This document only applies for anesthesia

machines equipped with a CO2module and a

manual with part number

9038237 (6th Edition – June 2006) or

9039994 (2nd edition – November 2008).

For the combination of the anesthesia machine

Apollo with a module which can supply a con-

trolled flow of carbon dioxide (CO2) as a fourth

gas into the fresh-gas flow from the anesthesia

machine's mixer.

Anesthesia machines running Software 3.2 or

higher may be combined with this module.

Such anesthesia machines will differ from pre-

vious models and their respective Instructions

for Use as follows.

001

2Supplement Paper Apollo SW 3.2n, SW 4.n

Chapter – Introduction

Intended Use

The Apollo is an inhalation anesthesia machine for

use in operating, induction, and recovery rooms. It

can be used with rebreathing systems, semi-closed

to virtually closed systems with low flow and mini-

mal flow techniques, and non-rebreathing systems

(with the Auxiliary Common Gas Outlet).

It may be used with O2, N2O, CO2(in combination

with the CO2module), and Air supplied by a medi-

cal gas pipeline system (not available for CO2) or

by externally mounted gas cylinders. Anesthetic

agent can be delivered by vaporizers mounted to

the machine.

Chapter 2 – System Components

The CO2Module

1Flow meter

2CO2Flow Control

3CO2cylinder connection

002

Supplement Paper Apollo SW 3.2n, SW 4.n 3

Chapter 3 – User Interface

CO2Flow Control

The CO2flow control is located on the right side on

the Apollo, not adjacent to the other flow controls

for O2, N2O, and Air. The module can only be oper-

ated by the flow meter and the flow control knob

depicted in "The CO2Module" on page 2.

Turn the control knob counterclockwise to increase

the CO2flow and clockwise to decrease the flow.

The current flow is shown on the CO2flow tube and

as part of the total flow on the total flow meter.

Connecting the Gas Cylinders for O2,

N2O, CO2, and Air

The Apollo is equipped with ANSI standard pin-

indexed hanger yokes for E-size cylinders to con-

nect backup gas cylinders to the anesthesia

machine. The yoke for O2is standard, the yokes for

N2O and Air are optional. All cylinder yokes are

located on the back of the machine as shown in Fig-

ure 25 of the Instructions for Use.

The CO2module requires an externally mounted

fourth gas cylinder. As shown in Figure 25a, the

position for the CO2cylinder is on the right hand

side of the machine (as you face the machine). The

CO2cylinder mount is compatible with pin-indexed

E-size cylinders and the gas inlet is equipped with

a NIST gas-specific connection for the cylinder.

NOTE

The user must position the gas cylinder and the

pressure regulator in such a way that the gauge of

the pressure regulator can be read from the front

of the anesthesia machine.

CAUTION

Risk of device failure.

Compressed gas supply (central supply or cylin-

der): To avoid damaging the device(s) attached to

a gas supply, use only medical gases. Pay partic-

ular attention to national and international stan-

dards regulating the use of medical gases.

Figure 25a. CO2cylinder location

4Supplement Paper Apollo SW 3.2n, SW 4.n

Chapter 5 – Pre-use Checkout

Checking the Workstation According

to the Check List

Check the cylinder gas supply:

3.1 Checking the cylinder gas supply of the CO2

gas cylinder

a. Using the provided cylinder wrench,

slowly open the cylinder valve of the

CO2cylinder.

b. Open the control valves for O2to acti-

vate SORC and CO2.

c. Check if the cylinder pressure is suffi-

cient for the operation planned.

Adjust the flow control knob for CO2and verify that

the float moves freely on the flow meter.

d. Close the CO2control valve.

e. Close the control valve for O2and push

the O2+ button to flush the breathing

system in order to remove CO2.

WARNING

Risk of patient injury.

When initializing operation, the pressure indi-

cated on the pressure regulator may be resid-

ual pressure from the cylinder supply of a

previous case.

To avoid injuring the patient, make sure the

cylinder valve is open before delivering CO2.

Supplement Paper Apollo SW 3.2n, SW 4.n 5

Chapter 6 – Operation Summary

Setting Fresh-gas Flow

WARNING

Risk of patient injury.

Because of high inspiratory CO2levels,

derived numerical expiratory CO2measure-

ment values will fluctuate greatly (up to 1 or

2 Vol.%) as compared to "normal" values

when the CO2Module is not in use.

The user must exercise increased attentive-

ness by monitoring the CO2waveform.

CAUTION

Risk of elevated levels of CO2doses.

If a fully filled absorber or a CLIC absorber is

used, the inspiratory CO2concentration may

automatically rise during a case as increasingly

more soda lime becomes inactive in the upper

area of the absorber canister. Inactive soda lime

will remove less CO2from the fresh-gas flow.

When administering CO2, Dräger recommends

using a refillable absorber (not a CLIC absorber)

only filled halfway. In this way:

– The inspiratory CO2concentration can more

easily be kept constant;

– CO2gas will be saved;

– Soda lime will be saved.

CAUTION

Risk of patient injury.

If applying inspiratory CO2concentrations, the

soda lime will be exhausted more quickly; inspira-

tory CO2concentrations may increase drastically.

Pay special attention to the state of the soda lime

when operating with inspiratory CO2concentra-

tions.

6Supplement Paper Apollo SW 3.2n, SW 4.n

Operating the CO2Module

WARNING

Risk of inadequate monitoring.

When operating the CO2module within an

inspiratory CO2concentration range higher

than 3.5 Vol.%, situations may occur in which

breathing phase-derived gas measurement

values cannot be calculated. If this is the case,

the related alarm monitoring will not be active.

In order to guarantee gas monitoring, it is nec-

essary to activate the bypass mode for

inspiratory CO2concentration settings above

3.5 Vol.%.

WARNING

Risk of inadequate monitoring.

Apnea monitoring for CO2and pressure mea-

suring is not active when the bypass mode is

used (as described above). Flow apnea alarm

monitoring is not active in the Man/Spont

mode and therefore must be replaced by a

continuously active lower minute volume (MV)

limit.

To achieve this, activate the MV alarm limits

for Man/Spont on the configuration screen by

setting them to "on" and make sure that the

MV lower alarm limit is active whenever venti-

lating the patient.

WARNING

Risk of inadequate monitoring.

CO2concentration monitoring alarms are not

active when the bypass mode is used (as

described above). The user must exercise

increased attentiveness. The user must manu-

ally monitor measured CO2concentrations,

which will not be based on breathing phases

in the bypass mode, by observing the dis-

played CO2waveform. In addition, gas mea-

surement availability must be constantly

supervised because CO2apnea alarm moni-

toring is unavailable.

Supplement Paper Apollo SW 3.2n, SW 4.n 7

Standard operation is possible with the CO2mod-

ule even if the inspiratory carbon dioxide values

reach 3.5 Vol.%. If, however, the CO2concentra-

tion exceeds this level, breathing phase-derived

gas measurement values may not be available. For

this reason, inspiratory and expiratory gas mea-

surement values and the respective alarm trigger-

ing (based on a breathing phase) can no longer be

ascertained. In such cases, real-time values are

displayed at a rate of 1/s. To monitor the CO2con-

centration, the user must correlate the displayed

real-time values to the CO2waveform display.

To ensure adequate gas monitoring, the bypass

mode is mandatory when the Apollo is intended for

operation with inspiratory CO2levels above

3.5 Vol.%. When running in bypass mode, absolute

inspiratory and expiratory CO2measurements, as

well as apnea detection for CO2and pressure, are

deactivated. The only apnea alarm function remain-

ing is then based upon flow measurement; this is,

however, deactivated in the Man/Spont mode. To

provide adequate monitoring during Man/Spont,

the lower minute volume limit must be appropriately

set.

The upper inspiratory CO2alarm limit is adjustable

and can be disabled, to prevent nuisance alarms.

The CO2module is equipped with an SORC. This

safety feature limits the CO2concentration in the

fresh gas so that the O2concentration does not fall

below 21 Vol.%. When the CO2flow control is open

and the O2flow control is closed (or the O2flow is

less than 500 mL/min), the SORC prevents a CO2

flow. If the CO2flow fails, oxygen can still be admin-

istered.

WARNING

Risk of patient injury.

To ensure proper CO2monitoring and prevent

a risk to the patient, only set the CO2alarm

default value to a higher limit if the device is

being used solely for CO2applications.

8Supplement Paper Apollo SW 3.2n, SW 4.n

Chapter 9 - Alarms

Adjustment Range of the Alarm Limits

during Operation

With Software 3.2n:

With Software 4.n:

Chapter 11 – Cleaning and Maintenance

Maintenance intervals

Refer to the Apollo Instructions for Use.

Chapter 13 – Specifications

CO2Module

FiCO2

[Vol.%]

0.1 to 1.4 Vol.%, – –

FiCO2

[Vol.%]

0.1 to 3.5 1), – –

1) DrägerService can change the upper limit to 1.4.

WARNING

Risk of patient injury.

To prevent the CO2module from malfunction-

ing, only the Dräger pressure reducer CO2Pin

index (part no. 8607429) should be used. Only

use a CO2cylinder with this pressure reducer

to supply the CO2module.

Inlet connection: Pin-Index coded pressure regulator

Inlet pressure 5 kPa x 100 ±20 %

(72.5psi±20%)

CO2flow dosing: 0 to 0.6 L/min ±10 %

with an inlet pressure of 5 kPa x 100

(72.5 psi)

CO2flow meter 100 to 1000 mL/min

Accuracy ±50 mL/min

Resolution 50 mL/min

Supplement Paper Apollo SW 3.2n, SW 4.n 9

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10 Supplement Paper Apollo SW 3.2n, SW 4.n

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