USER/OWNER RESPONSIBILITY
PLEASE READ THIS MANUAL BEFORE OPERATING THE VENTILATOR.
This Hallowell EMC equipment is designed to function, as
specified in this manual, when operated and maintained in accordance with
supplied instructions. This equipment
must be periodically checked, calibrated, maintained and components repaired
and replaced when necessary for equipment to operate reliably. Parts that have failed, in whole or in part,
exhibit excessive wear, are contaminated, or are otherwise at the end of their
useful life, should not be used and should be replaced immediately with parts
supplied by Hallowell EMC or parts which
are approved by Hallowell EMC. Equipment that is not functioning correctly
should not be used. This equipment and
any of its accessories or component parts should not be modified.
The user/owner of this equipment
shall have the sole responsibility and liability for any damage or injury to
patients or property (including the equipment itself) resulting from operation
not in accordance with the authorized maintenance instructions, unauthorized
repair or modification of the equipment or accessories, or from the use of
components or accessories that have either been damaged or not authorized for
use with this equipment by
Hallowell
EMC.
WARNINGS AND CAUTIONS
Personnel operating the ventilator must
become thoroughly familiar with the instruction manual prior to using the Hallowell
EMC Model 2000 or Model 2002TMAnesthesia
Ventilator with patients.
-
ELECTRIC SHOCK
HAZARD - DO NOT remove any of the ventilator covers or panels. Refer all servicing to an authorized service
technician.
-
DANGER - Possible
explosion hazard if the unit is used in the presence of flammable anesthetics.
-
Before using the ventilator, check that all connections are
correct, and verify that there is no leak, per instructions on side plate of
the controller.
-
Any problems arising from an improperly functioning
scavenging system is solely the user's responsibility.
-
OPENING THE
CONTROL UNIT BY UNAUTHORIZED
PERSONNEL AUTOMATICALLY VOIDS ALL
WARRANTIES AND
SPECIFICATIONS. THE PREVENTION OF TAMPERING
WITH THE CONTROL UNIT IS
EXCLUSIVELY THE USER'S RESPONSIBILITY:
THE MANUFACTURER ASSUMES NO LIABILITY FOR ANY MALFUNCTION OR FAILURE OF
THE VENTILATOR IF THE CONTROL UNIT'S
SEAL IS BROKEN.
-
Compressed Supply Gas must be clean and dry to prevent ventilator
malfunction.
WARRANTY
The Hallowell EMC Model 2000 and Model 200TM Veterinary
Anesthesia Ventilator is covered under the warranty expressed on the warranty
card attached to the unit at the time of sale to the end user, which reads as
follows:
HALLOWELL
EMC
ONE YEAR LIMITED WARRANTY
This unit is warranted by HALLOWELL
EMC to be free of
defects in material and workmanship for a period of 1 full year from invoice
date of original purchase.
This warranty does not cover unit
damaged by abuse or where unit is operated outside the normal operating
conditions. The defective part will be
repaired or replaced at our option when sent postage prepaid, insured to HALLOWELL
EMC accompanied by a
copy of original invoice. HALLOWELL
EMC shall not be
responsible for any other incidental, contingent or consequential charges or
damages.
All conditions of this warranty
become null and void should the VOID seal
(located under the Instruction Plate) be broken.
THE
WARRANTY STATED HEREIN (INCLUDING ITS LIMITATIONS) IS THE ONLY WARRANTY MADE BY
HALLOWELL EMC AND IS IN LIEU OF ALL
OTHER WARRANTIES, WHETHER EXPRESSED OR IMPLIED, INCLUDING ANY WARRANTY OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. HALLOWELL EMC SHALL NOT BE LIABLE FOR CONSEQUENTIAL OR INCIDENTAL
DAMAGES OF ANY KIND.
Prices, terms, and product specifications are subject to change
without notice.
INTRODUCTION
The Hallowell EMC Model
2000 and Model 2002TM Veterinary Anesthesia
Ventilator was designed specifically for veterinary anesthesia use. It is volume cycled with a choice of three
bellows sizes, providing consistent IPPV for patients from rabbits to foals.
The Hallowell EMC Model 2000 and Model 2002TMincorporates
experience resulting from over twenty years of ventilator design and
manufacture. The device is small,
portable, and quiet in operation. It has
been designed to be economical in its consumption of supply gas.
The ventilator consists of two main
assemblies: the controller assembly,
comprising all electronics, regulatory and control electronics and pneumatics;
and the bellows assembly, comprising the bellows base with pop-off valve, the
bellows and the bellows housing. The
bellows assembly is easily removed to facilitate cleaning and
sterilization. Equally as easily, the
different size bellows and bellows housings may be interchanged on the same
bellows base to minimize the ventilator's contribution to the compliance of the
breathing system, and to provide increased resolution on the tidal volume scale
in the 0-300 ml tidal volume range.
The bellows base is of injection molded
ULTEMTM a product of
General Electric Plastics. ULTEMā is a high
temperature, high-impact resistant material that is unaffected by water or the
presence of all state-of-the-art anesthetics.
In addition, the high temperature properties of ULTEMTM make it fully
compatible with stand
ard steam sterilization techniques.
The Hallowell EMC Model 2000 and Model 2002TM is shipped as a
free standing unit with the bellows assembly mounted on top of the
controller. For custom installations
such as for use in conjunction with MRI
units, the bellows assembly may be separated from the controller and mounted in
a location closer to the patient. As
supplied, the ventilator may be located on the anesthesia machine shelf or
cart, or on a table top. The rubber feet
can be removed for installation on an optional heavy-duty stand with
casters. The stand increases the mobility
of the unit permitting convenient use in multiple operating rooms. Optionally, Hallowell EMC provides mounting hardware for the
Matrx VMC and Spartan, VMS and VML
anesthesia machines. Mounting hardware
is also available for anesthesia machines manufactured by A.M. Bickford,
Anesco, Delmarva Labs, Dispo-Med, SDI, and VetEquip (formally Omni Medical).
Important
Before attempting to use this
ventilator, it is important that you first thoroughly familiarize yourself with
this manual. After your review, you
should complete the receiving and setup procedures, then perform the verification
check with a test lung, as described herein.
Become familiar with the ventilator's controls during the verification
check, and observe the effect of control adjustments on the breathing system.
If at any time you should have any questions, please do not
hesitate to contact us at the address listed on the front page or visit our Web
site at http://www.hallowell.com for the latest revisions to this manual as
well other information posted there.
RECEIVING PROCEDURES
1.
Remove all components from the shipping carton. Retain and store both original shipping
cartons for use in the event that the unit has to be shipped. (See "Returning For Service").
2.
Inspect the ventilator and accessories for any signs of damage that may
have occurred during shipping. If damage
has occurred, immediately file a damage claim with the carrier.
Packed by _______________ Date
____/____/____ Controller SN_______________
Received by ________________ Date
____/____/____ Serial Number verified ________
3.
Check the items against the packing slip and report discrepancies
immediately.
All ventilator models include and are
shipped with the following:
-
Hallowell EMC Model 2000 and Model 2002TMController
-
Bellows Base Assembly (PN 000A0484)
-
Tube, Driving Gas (7½" black rubber) (PN 000A0495)
-
Airway Pressure Sampling Tee (PN 000A2420A )
-
36" x 22 mm Breathing System Tube (PN 201A1615 )
-
Power Cord (not included for export) (PN 110A1118 )
-
Warranty Card (DOCB0015)
-
Operating Manual (DOCA0074)
The standard Model - our 300 - 1600 ml
version - (PN 000A0090 ) also includes one each of:
-
Bellows, 300 - 1600 ml (PN 000A0488 )
-
Bellows Housing, 300 - 1600 ml (PN 200A2289 )
The 0 - 300 ml version (PN 000A0089 )
also includes one each of
-
Bellows, 0 - 300 ml (PN 000A0487 )
-
Adapter, Bellows, 0 - 300 ml (PN 000A0486 )
-
Bellows Housing, 0 - 300 ml (PN 200A2288 )
The 1600 - 3000 ml version (PN 000A0088 )
also includes one each of:
-
Bellows, 1600 - 3000 ml (PN 000A1866 )
-
Bellows Housing, 1600 - 3000 ml (PN 200A1867 )
Numerous other optional parts may have
been shipped with your order also.
Please refer to the packing slip for details.
NOTE: If you
ordered the optional LO 50 psi Supply Gas Alarm, (PN 000A2425) it is built into
the ventilator and NOT a separate item.
4.
Complete and return the enclosed Warranty Registration card.
SET-UP PROCEDURE
1. Inspect
the control unit for debris from shipping.
Inspect all three ports, the 50 psi Supply
Gas, Exhaust, and Driving Gas
ports on the back of the ventilator and remove any obstructions that may have
become lodged inside during shipping and unpacking.
2. Inspect
the bellows assembly for debris from shipping. Tilt the top of the bellows housing toward
you and lift it off. Remove the
accessories from within the bellows housing.
3. Ensure
that all passages, ports, and chambers are free, clear and unobstructed. Note that even a hair across the pop-off
valve seat will produce an unacceptable leak in the breathing system.
Caution:
If removal of the pop-off valve
becomes necessary, remove the bellows by gently lifting it off to the
side. Unscrew the three red thumb
screws. Gently lift the pop-off valve
off the bellows base assembly to reveal the pop-off valve seat and red silicone
o-ring. Do not damage the valve
seat. Do not touch the seat with any
type of hard object--even a fingernail scratch--could permanently damage the
seat. Be sure the red o-ring remains in
its gland in the bellows base.
4. Reassemble
the bellow assembly. If removed,
first install the pop-off valve with the three red thumbscrews. Next install the bellows with its first
convolution over the bellows-mounting ring.
Carefully hold the outer edge of the bellows disk (top of bellows): lift and lower it quickly several times to
puff out and remove any folds in the convolutions. Place the bellows housing over the bellows,
positioning the housing so that the tabs are to the immediate right of the
bayonet locks. Gently press the housing
down, twisting the housing clockwise at the same time until the tabs engage
with the bayonet locks. The bellows
assembly is now reassembled.
5. Connect
the drive gas tube. Locate the
7½" long corrugated black rubber drive gas tube, with 15 mm diameter
cuffed ends. Connect the tube between
the bellows assembly DRIVING GAS
port and the DRIVING GAS port of
the control unit. If the bellows
assembly is being mounted remotely from the control unit, a longer 15 mm tube
will be needed. (A ½" garden hose
works well for the long runs to MRI
units, but the shorter this tube can be, the better.)
6. Position
the ventilator. Place the ventilator
in an accessible location, close to the area where it will be used, both for
convenience, and in an effort to keep the breathing system tubing as short as
possible.
7. Connect the
ventilator to the breathing system.
Remove the breathing bag from the bag connector of the Anesthesia
machine. Connect the 22 mm x 36" corrugated tube (PN 201A1615 ) to the BREATHING
SYSTEM port of the bellows assembly and to the bag connector. Use of the clear breathing circuit tubing is
recommended so the user can see an excessive accumulation of condensation that
may interfere with gas flows within the breathing system.
8.
Insert the Airway Pressure Sampling Tee into the breathing
system. Disconnect the patient breathing hose from the INHALE VALVE of the
anesthesia machine. Connect the Airway Pressure Sampling Tee (PN 000A2420A ) to
the INHALE VALVE and reconnect the patient breathing hose to the Airway
Pressure Sampling Tee. Route the sampling tube as desired to the ventilator
Pressure Transducer port on the rear panel. Trim sampling tube to length
leaving enough slack for movement. Install Luer Lock fitting such that the hose
barb is fully set into the tube. Attach fitting to ventilator Pressure
Transducer port.
9. Connect the ventilator to the scavenger. Use a 19 mm corrugated tube (not provided) to
connect the EXHAUST port of the bellows assembly to a properly functioning
scavenger system.
Warning:
Applying any negative or positive
pressure to the EXHAUST port of the bellows base assembly will result in a more
positive pressure in the patient breathing system and improper operation of the
ventilator.
10. Connect
the supply gas. Connect the supply
gas hose to the 50 psi Supply Gas port of the control unit, and to the
supply gas source. The unit is provided
with a DISS 1240 male oxygen
bulkhead fitting. Gas consumption of the
ventilator is very economical, therefore, the use of oxygen as a drive gas is
recommended. Oxygen use reduces the risk
of unit malfunction due to contamination of the pneumatics. Compressed air may be used, but it must be
CLEAN and DRY.
The 50-psi
source for the ventilator may be provided from a separate tank, wall or ceiling
drop, or from a PTO (Power-Take Off) on the anesthesia machine. Should none of the above be available, a
common practice, for machines with DISS
1240 male O2 inlets, is to remove the O2 supply line to
the anesthesia machine from the anesthesia machine, connect a demand wye (HEMC
PN 150A1691 (GRN) or 150A1692 (WHITE)) to the inlet of the anesthesia machine
and then reconnect the O2 supply line to the anesthesia machine
via one of the two remaining connections to the wye. This leaves one leg of the wye available to
source the ventilator with O2, connect HEMC PN 000A0489 (GRN) or
000A0490 (WHITE) between the demand wye and the ventilator 50-psi inlet.
11.
Connect the electrical
power. PRIOR to connecting the
electrical power, confirm that the power inlet module voltage selector switch
is set appropriately for your location.
Export Customers
Beware
Warning:
Turning the ventilator on with
the Power Inlet Module Voltage Selector switch set for 110 volts while the unit
is plugged into a 208 - 240 volt source WILL damage the unit and void the
warranty.
Special order
100Vac Japanese versions require no voltage selector setting and will work ONLY
on 100Vac.
Plug the
ventilator into a properly grounded power source.
CONTROLS
Two controls, the
RATE and VOLUME on the Hallowell EMC Model 2000 are used to
directly set the amount of ventilation.
VOLUME Control
(Model 2000) - A needle valve regulating inspiratory flow. Use to adjust the minute ventilation of the
patient. Since the I:E ratio is held
constant at 1:2, this is the only control that will effect minute ventilation.
Three controls, the RATE and VOLUME (COARSE and FINE) on the Hallowell
EMC Model 2002TM, are used to
directly set the amount of ventilation.
VOLUME Controls
(Model 2002) - Two needle valves (coarse and fine) further regulating inspiratory
flow. Use to adjust the minute
ventilation of the patient. The I:E
ratio is also held constant at 1:2.
On both units:
RATE Control - A
potentiometer. Use to set the
respiratory rate in breaths per minute.
(BPM).
The MWPL is used to set a safety limit and the INSP HOLD is used to pause cycling. All models with the exception of special
order 100v ventilators for use in Japan have one additional control
located on back panel. Each control is described in detail below.
I/O Power Switch - a toggle switch
used to turn the ventilator on. The
green LED indicates the power is on when illuminated.
INSPiratory HOLD
Control - A momentary
pushbutton. Use to pause the breathing
cycle at the end of the current or next inspiration for as long as the button is
held unless the set MWPL is exceeded.
Maximum Working
Pressure Limit Control (MWPL) - A potentiometer. Use to adjust an upper limit above which you
wish the airway pressure never to exceed.
Voltage Selector
-
A switch adjacent to the power inlet module on the back panel. Use to select either 105-125v or 208-240v
operation.
Caution:
Be absolutely sure the voltage selector switch
is set to the appropriate setting BEFORE the ventilator is turned on. Turning on a ventilator connected to at
208-240V source while the voltage selector switch is in the 110v position WILL
damage the unit and VOID the warranty.
ALARMS
Maximum
Working Pressure Limit (MWPL):
The MWPL feature allows the operator to set an upper limit above which
the airway pressure will not exceed. The
ventilator will terminate the inspiratory phase of the breathing cycle and
begin an expiratory phase when the pressure transducer senses a pressure above
the MWPL setting. The MWPL is settable
over a range from 10 to 60 cm H2O.
When the airway pressure reaches the set limit, the yellow light on the
front panel blinks and a short tone is heard.
If the excessive pressure is not immediately relieved, cycling is paused
and the alarm sounds continuously. Note
that the INSPiratory HOLD feature is designed to not function when the MWPL
setting is exceeded. Therefore, a
holding inspiration will be released when the MWPL setting is exceeded.
Low
Breathing System Pressure Alarm (LO BSP):
The LO BSP alarm is activated at the end of inspiration if there is not
at least 5 cm H2O pressure sensed by the pressure transducer. This alarm is sometimes commonly referred to
as a "disconnect" alarm; however, it should be understood that a
patient disconnect is not always nor the only cause of low breathing system
pressure. During the alarm condition a
yellow light is illuminated on the front panel and the sound of a raspy siren
is heard. The alarm is automatically
reset at the end of the next inspiratory phase in which there is a minimum of 5 cm H2O
pressure sensed by the pressure transducer.
Low
50 psi Supply Gas Alarm (Optional Feature):
The Low Supply Gas alarm is activated when the supply gas pressure drops
below 35 psi (2.4 bar). The sensor for
this alarm is located downstream of the internal 40 micron filter and may also
indicate a clogged filter condition.
During an Alarm condition, the yellow light on the front panel is
illuminated and a steady, continuous tone is heard. This alarm automatically resets when the
pressure increases above 40 psi (2.7 bar).
VERIFICATION OF PROPER FUNCTION
A
Note on Test Lungs
The most readily available test
lung will probably be the breathing bag you removed to connect the
ventilator. A breathing bag is a very
poor model of a lung. It can be used if
one understands how poor a model of the lung it is and how to avoid using it in
such a way that it creates problems that will not occur with a real patient.
A far better test lung is a
ridged walled container such as a gas can, water fountain bottle, or beer
keg. The compliance of these containers
is equal to their volume in liters and will be linear as is that of a real lung
over normal operating ranges. Most
importantly they will maintain a functional residual capacity (FRC) that is hard to maintain in a breathing bag.
The breathing bag has an
unpredictable FRC from breath to
breath if bumped or squeezed beyond the point of relaxation, more gas than
would normally be popped off at the end of exhalation escapes from the
breathing system. The bellows then
abnormally fails to remain at the top of the bellows housing at the end of
exhalation. To use the bag successfully,
connect it to the patient wye, hang it vertically, and do not disturb it.
Verification of proper ventilator operation
requires that you first complete the system setup, as described on page 6 and
connect a test lung to the patient wye piece.
During verification, you will be observing the operation of the entire
system configuration, checking for leaks, and monitoring the ventilator for
consistent cycling.
-
Install appropriate bellows assembly. Use the 0-300 ml bellows, bellows adapter,
and bellows housing for tidal volume requirements below 300 ml.
-
Connect a test lung to the patient wye and close the
pop-off of the anesthesia machine.
-
Fill the breathing system with the O2 flush
until the bellows reaches the top of the bellows housing.
-
Turn the VOLUME controls fully clockwise to the minimum
setting, set the rate as desired and turn the ventilator on.
-
Increase the VOLUME controls until the peak pressure of
each breath is approximately 30 cm H2O.
-
Depress the INSPiratory HOLD button long enough to verify
that the breathing system is not leaking.
The pressure should remain constant.
-
Release the INSPiratory HOLD button. Observe that the
ventilator is continuing to cycle, and that over time, ~ten cycles, the bellows
is not falling significantly.
-
Turn the VOLUME controls fully clockwise to the minimum
setting and turn the ventilator off.
Note that this verification procedure is
printed on each instruction plate on the ventilator sides.
STOP HERE.
IF THE VENTILATOR IS NOT PERFORMING IN ACCORDANCE
WITH THESE EXPECTED OBSERVATIONS, DO NOT USE THE VENTILATOR. REFER TO THE "TROUBLESHOOTING"
SECTION.
Note that in the above procedure no
fresh gas flow was used. During actual
operation of the system, the anesthesia machine will be set to deliver enough
fresh gas to compensate for minor leaks in the entire breathing system and variations
in patient uptake. This fresh gas will
keep bellows full between each Inspiratory cycle.
GETTING STARTED
A TYPICAL USAGE SCENARIO
The Hallowell
EMC Model 2000 and Model 2002TM is a time cycled volume ventilator with
an adjustable pressure limit. The more
you understand of the ventilator, how it works, and what it does in response to
your settings, the more comfortable you will be with it. It will feel "right" to change a
setting and get what you want from the ventilator.
Making the initial settings:
What are you
going to do first? If this is your first
ventilator, you've probably spent many an hour bagging patients that required
IPPV. You are, by now, comfortable doing
that. Let's setup the ventilator to
"bag" a patient as you would bag one yourself. If you are convinced the ventilator is
bagging the patient, as you would be, you can feel comfortable with what the
machine is doing.
When you bag a
patient, you're careful not to over inflate the lungs. You have a feeling as to how hard to squeeze
the bag. Your feelings have grown out of
experience: checking the chest wall
excursion and correlating that with a reading from the airway pressure
manometer on the anesthesia machine. In
general, for a healthy patient, the peek inspiratory pressure (PIP) should be
kept in the range of 15-20 cm H2O.
Patients with more compliant lungs may even require less pressure for
adequate ventilation and visa versa.
After induction
and intubations, when it is time to start IPPV, set the VOLUME controls fully
clockwise to the minimum setting. These
controls are needle valves regulating inspiratory flow, with no or very little
flow you will deliver no or a very small tidal volume (TV). Set the maximum working pressure limit (MWPL)
control to about 20 cm H2O.
The airway pressure will not exceed this setting regardless of what you
do with the other controls. Connect the
ventilator to the breathing system (BS) as discussed in the Set-up Procedure,
fill the bellows by turning up the fresh gas flow until the bellows reaches the
top of the bellows housing. Turn the
ventilator on. Set the RATE control to an appropriate rate for the
patient.
There will be a
pause before the first inspiration.
Watch the chest wall excursion and the airway manometer as you would
when you bag. Since we have started with
the inspiratory flow very low, the first TV delivered will be too small to
generate sufficient airway pressure.
Consequently, the Low Breathing System (LO BSP) alarm will sound --
don't be alarmed. Now, increase the
VOLUME controls breath by breath, a little at a time, until the chest wall
excursions and PIP reach levels that you would seek to achieve while
bagging. At this point you can be
comfortable that the ventilator "is squeezing the bag" as you would
be.
Trimming the settings as the case
proceeds:
At this point the ventilator is delivering an inspiratory flow,
determined by your setting of the VOLUME controls, for a time as calculated
from your setting of the RATE
control. This flow for a time results in
a volume delivered to the bellows assembly that "squeezes the bag", I
mean bellows, displacing the mixed gas within to the patient.
This delivery to
the patient, these TVs at the set rate, results in the overall minute
ventilation (MV). It is the proper MV
that must be delivered to the patient in order to maintain proper blood gas and
pH levels.
This MV can be
delivered in many ways from a few large TVs to a lot of small TVs. The most
optimum combination is up to you to determine just as you would while bagging.
Our ventilator,
for those of you familiar with the term, is considered a MV divider. For those
unfamiliar with the term, the ventilator delivers a consistent MV to the
patient and that MV is divided into different size TVs by the RATE control.
You can change the RATE
control all you want without changing the total ventilation delivered to the
patient. Let me repeat that. You can change the RATE
control all you want and it will not effect the total ventilation delivered to
the patient.** In order to change the MV
delivered you need only, in fact you must, change the VOLUME controls. This point will be quite important when you
go to wean the patient from the ventilator.
Remember, when
you change the VOLUME controls it is the inspiratory flow that you are changing
directly. The rate and, therefore, the
time that flow is delivered has not changed, thus the delivered TV will be
either larger or smaller than before.
Stop and think about it, you are now delivering a different volume of
gas to the same compliance of the patient; it follows that the PIP will be
different. This different PIP may be
fine or it may be unnecessarily high or low.
In the high extreme the MWPL alarm will sound, a short steady tone, and
the PIP will be limited to the set value or in the low extreme, the LO BSP
alarm will sound, a warbling tone.
Back to the
change being implemented, you have changed the MV as desired now, If needed,
trim the delivered TV size with the RATE
control to obtain a new TV that results in a more appropriate PIP, and no
alarms.
Now do it and get comfortable with it. Don't just put this document away -
setup the ventilator and a test lung.
Read this again trying what is discussed as you read.
Note that no
discussion has been made of I-time and E-time and the need to keep them in a
proper relation to each other. This
relation is automatically held constant by the ventilator. The I:E ratio is a consistent 1:2, no need to
think about it - there will be enough time for exhalation. For those of you that want to think about it,
we offer the model 2KIE with an adjustable ratio from 1:1.5 to 1:4. Even when the I:E ratio is adjustable that
ratio is still held constant over the full range of rate settings.
**This statement is somewhat of a
simplification as you deviate greatly from the current RATE
setting. There is a difference in MV
delivered by the ventilator and the alveolar ventilation received by the
patient. This difference is related to
the dead space and BS compliance. With
each TV delivered, a portion ventilates the dead space and BS, the more TVs per
minute the greater the portion of the delivered MV that is not seen by the
alveoli and, thus, is of no use to the patient. The significance of this
difference is small unless the BS being used is severely mismatched with the
patient or the deviation from the current setting is great. Similarly the amount of variation is minimal
with the small changes needed to trim the TV after adjusting the MV.
OPERATING INSTRUCTIONS
Output of the Hallowell
EMC Model 2002TM is adjusted by
only two controls; a linearly calibrated RATE
control (breaths per minute), and a metering VOLUME (Coarse and Fine) control.
Follow the setup and verification
procedures and be certain the pop-off valve on the anesthesia machine is
completely closed.
DETAILED OPERATING INSTRUCTIONS:
1. When the patient
is ready, reconnect the ventilator to breathing system.
2. ALWAYS set the
VOLUME controls to its minimum setting before turning on the ventilator. The VOLUME controls must be fully clockwise to
be set to the minimum setting.
3. Set the maximum
working pressure limit (MWPL).
4. Turn on the
ventilator. Set the RATE before
any adjustment is made to the VOLUME.
Adjust the RATE to the
desired breaths per minute setting.
NOTE: As you
proceed, continually observe the anesthesia system's breathing system pressure
(BSP) gauge to ensure that excessive pressures are not being attained.
5. The volume
controls, as noted above, are initially set after the appropriate RATE has been selected. Turn the VOLUME controls counterclockwise to
increase the tidal volume delivered, or clockwise, to decrease the tidal volume
delivered. Read the approximate tidal
volume by noting the displacement of the bellows in ml as indicated on the
bellows housing scale. At a given RATE setting, the tidal volume can be increased or
decreased in this manner.
6. Slight changes
in he RATE and VOLUME controls can
be made as the procedure continues but never make any gross adjustments to
these controls with the patient connected.
Warning:
Under no circumstances
should the flush button on the anesthesia machine be used during the
Inspiratory phase of the breathing cycle.
There is the extreme danger of rupturing a lung. The flush button introduces 50 - 100 lpm,
perhaps more, of oxygen flow into the breathing system. During inspiration the discharge valve in the
control unit is closed so that flush flow is added to the inspiratory flow
generated by the ventilator and has no where else to go except to the patient's
lungs. It is recommended that the flush feature on the anesthesia machine NEVER
be used with patient connected. The
oxygen flow valve can be opened further than normal providing a more controllable
high flow of oxygen.
CLEANING & STERILIZATION
A majority of the Hallowell
EMC Model 2000 and Model 2002TM components do
not come in contact with the breathing gas; consequently, they require cleaning with
only a damp cloth. This includes the
entire control unit as well as certain bellows assembly components. Only the bellows base interior and the inside
of the bellows come in contact with the breathing system gases.
CAUTION:
NEVER
use an abrasive cleaner to clean any part of the ventilator. Abrasives will scratch the transparent acrylic
bellow housing and other surfaces of the ventilator. Also, DO NOT allow water from an overly-damp
cloth to collect on or penetrate into the ventilator.
Cleaning
the Ventilator Surfaces: The outer surface
of the ventilator may be cleaned simply by using a clean, soft, slightly damp
cloth. A mild detergent solution may be
used to remove persistent surface dirt or grime. Be sure to use only a mild detergent, if
necessary, and use care to ensure that the cloth is only slightly damp.
WARNING:
Clean bellows and bellows housing
only with water and a mild detergent.
Use a soft cloth. Avoid abrasives
and aromatic spirits. (USE NO ALCOHOL.)
Cleaning
the Bellows Housing: Remove the bellows
housing for cleaning and for access to the bellows and pop-off valve. Twist the housing counterclockwise until the
tabs at the base of the housing clear the bayonet locks. (This may require some degree of force
because of a tight o-ring fit.) Tilt the
top of the bellows housing toward you and lift it off. DO NOT attempt to steam-sterilize the bellows
housing. Since it does not come in
contact with the breathing gas, it needs only occasional cleaning with a clean,
soft slightly damp cloth, or by immersion in a mild detergent bath, followed by
rinsing. Moreover, steam sterilization
may warp or deform the housing rendering it useless. USE NO ALCOHOL.
Cleaning
the pop-off valve: With the bellows
housing removed, it is necessary to also remove the bellows to gain access to
the pop-off valve. This is easily accomplished
by gently pulling the bellows to the side until it detaches from the base.
Removing the bellows exposes the pop-off
valve and the three small red thumbscrews which attach it to bellows base. Loosen the three screws and remove the
valve. The black, ULTEMā pop-off valve
seat will now be exposed. This valve
seat has a precision machined and lapped surface, which is relatively
delicate: USE CONSIDERABLE CARE while cleaning the seat with a clean, soft,
damp-cloth. Clean P.O.V. disk with
cotton swab and alcohol.
CAUTION:
NEVER use an abrasive cleaner or
hard object to clean the valve seat.
Abrasives or hard objects will scratch or damage the seat, causing the
pop-off valve to leak, which will result in a serious malfunction of the ventilator.
NOTE THAT EVEN A PIECE OF LINT ON THE
SEAT COULD CAUSE A LEAK.
After cleaning the pop-off valve seat,
replace the valve taking care to ensure that the small orange o-ring (PN
180A1429) under the pop-off valve is securely in place. If this orange o-ring is dislodged or
missing, the ventilator will not be able to function properly.
Sterilizing the bellows base from the
controller and bellows interior surface:
The bellows and its interior surface do come in contact with the
breathing gas, and require periodic sterilization. Sterilization is accomplished with the
bellows housing and bellows removed, as described above. The pop-off valve, and the 300 ml bellows
adapter, if used may remain on the base during sterilization.
To remove the bellows base from the
controller for sterilization, disconnect the hoses from the base and loosen the
four black thumbscrews, located at the corners.
First, clean the base using a clean, soft, slightly dampened cloth. Then wrap the whole base and steam sterilize
it using the same standard hospital techniques as used for any surgical
apparatus.
Finally, clean and sterilize the bellows
using an appropriate hospital technique for delicate latex supplies. DO NOT steam sterilize the bellows.
After completing the above sterilization
procedures, complete the reassembly of the unit by first reattaching the
bellows base to the ventilator control unit, reconnect the hoses, and slip the
first convolution of the bellow over the bellows mounting ring. Then and finally, reattach the bellows housing
to the base. This completes the cleaning
and sterilization procedures.
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TROUBLESHOOTING
Leaks in the circle (breathing) system
are very common. Particularly, the reuse
of "single use" circle systems frequently results in leaks. This reuse practice is not recommended. Circle system leaks are not as apparent when
bagging a patient or when using an older style ventilator with a
falling-during-exhalation bellows system.
The Hallowell EMC Model
2000 and Model 2002TM Ventilator with it's state-of-the-art
standing (ascending)-during-exhalation bellows system will, more readily reveal
system leaks.
The determination as to whether a leak
is in the circle system and/or anesthesia machine or in the ventilator is
easily accomplished. The following
procedure should be conducted:
1. Close the anesthesia machine's pop-off valve.
2. Turn off the flow of fresh gas.
3. Disconnect the 22 mm tube from the bellows
base assemblies' BREATHING SYSTEM port and connect it to the patient wye piece
to produce a closed loop.
4. While observing the breathing system
pressure, slowly increase the fresh gas flow to the system until the pressure
builds to about 50 cm H2O.
5. Turn the flow off.
6. The pressure should hold steady without
falling appreciably.
If the system passes this test, refer to
the following table to locate the problem with the ventilator.
A Note On Fuse Replacement
Units with SN 2757 and higher have a dual fused Power Inlet Module. The fuse compartment is accessed by removing the power cord and sliding the fuse drawer open. Replace fuses ONLY with fuses of the same size and rating as listed on the rear panel below the Power Inlet.
The voltage selector switch with the screwdriver slot IS NOT the fuse holder
Units prior to SN 2757 are shipped with a Power Inlet Module with one spare fuse. The fuse compartment is accessed by removing the power cord from the controller and, using a small screwdriver, pry out the rectangular fuse carrier. Once the fuse carrier is removed, you can see the fuse. The spare fuse is located inside the rectangular part of the carrier. Slide the drawer out from one end to gain access to the spare fuse
Note that the voltage
selector switch with the screwdriver slot
IS NOT the fuse holder.
|
Symptom Symptom
|
Potential Causes
|
Possible Remedies
|
|
Ventilator sounds as though it is cycling. I can hear the valves clicking but nothing happens. Ventilator hums with each inspiration.
|
- No supply gas pressure.
- VOLUME control is set at it's minimum.
- Supply gas pressure at the ventilator inlet is dropping to around 25 - 30 psi with O2 flow.
- Pipeline or tank pressure is low.
|
- Unkink the supply gas hose.
- Replace empty tank.
- Increase the VOLUME setting.
- Unkink supply gas hose.
- Anesthesia machine power outlet is incapable of supplying the required flow. Bypass it. Switch to new supply gas source.
|
|
Nothing happens when the ventilator is turned on. No valves are clicking, green LED not lit.
|
|
- Plug ventilator into the proper power source.
- Check voltage setting.
- Check the outlet.
- Check the fuse
|
|
Pop-off valve in the Bellows Base chatters and the bellows shakes after it reaches the top during exhalation.
|
- Pressure within the bellows housing is exceeding 70 cm H2O.
- Working pressure limit is shutting off the switch Inspiratory flow.
|
- Inflate collapsed bellows.
- Unkink the drive gas tube.
- Unkink breathing system hose.
|
|
The ventilator operation sounds normal but the TV delivered is incorrect and or inconsistent.
|
- Missing or damaged pop-off valve o-ring.
|
|
|
Irregular cycling when using cautery or other electro-surgical device.
|
- Excessive generation of EMI and/or RFI.
|
- Locate and repair source of disturbance.
|
|
Bellows dislodges from mounting ring.
|
- Partially detached or improperly mounted bellows.
- Either pressure or vacuum is occurring at the Bellows Base EXHAUST port.
|
- Reattach or replace the bellows.
- Repair defective or poorly regulated scavenger system.
|
| Bellows is bulging. |
- P.O.V. is stuck closed. (To determine if this is the problem, temporarily disconnect scavenger to isolate problem.)
|
|
| Everything seems normal, but the bellows progressively becomes less full. |
- Breathing system gas is leaking from the system. (SEE THE FIRST PARAGRAPH OF THIS SECTION )
- Inadequate fresh gas supply from anesthesia machine.
- Missing or damaged pop-off valve o-ring
- Hole in Bellows
- Partially detached or improperly
- installed bellows.
- Damaged pop-off valve or valve seat.
- Anesthesia machines pop-off valve is not completely closed.
|
- Remove obstruction.
- Increase flow.
- Replace o-ring
- Replace Bellows
- Reattach Bellows to the mounting ring.
- Replace damaged part.
- Check all tubes and tubing connections for leaks.
- Clean P.O.V. and seat.*
- Close, repair or replace valve.
|
*See "Cleaning the P.O.V." page 15.
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RETURNING FOR SERVICE
No Hallowell EMC products or accessories can be accepted for
repair or return without a Return Authorization from Hallowell.
To obtain a Return Authorization number call 413-445-4263, fax to 413-496-9254, or
email your request to info@hallowell.com.
Please have the following information ready and available:
1.
The serial number of the item to be returned, if
applicable.
2.
The nature of the problem, reason for return and action
requested.
3.
The name, phone number and extension of the party to
contact should we have future questions.
4.
The billing name, address, phone number and PO number of the responsible party.
5.
If the item is to be returned, such as with a repair,
the name of the party to whom we should ship the item, the shipping address and
receiver's PO number if needed for acceptance.
6.
AND a fax
number or email address to which we can send a "Return Goods Instructions
Sheet." This sheet will have the RA # at
the top. Clearly mark the RA # on the
outside of the box that you will be returning to Hallowell EMC.
Please follow the procedures faxed to you carefully. It is based on our experience of how best to
get your items back to us without damage and delay.
Deliveries will not be accepted for packages that are not
expected, i.e. that do not have a valid (on file) authorization number clearly
marked on them along with a complete return address.
We thank you for your understanding and cooperation.
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HALLOWELL EMC MODEL 2000 AND MODEL 2002TM SPECIFICATIONS