Draeger Fabius GS Pre-Use Check

Remember to enter Machine #

Fabius GS front view

Fabius GS pre-use checkout procedure Fabius GS pre-use checkout procedure This checkout, or a reasonable equivalent should be conducted before administration of anesthesia. These recommendations are only valid for the Draeger Fabius GS anesthesia system that includes an inspired oxygen monitor, respiratory volume monitor (spirometer) and breathing system pressure monitor with high and low pressure alarms. Users should refer to the operator's manual for additional information.

Fabius GS pre-use checkout procedure Electrical power 1. Verify the machine is powered on and functional a. Conduct the system test (left hand softkey in standby) Emergency Ventilation Equipment 2. Verify Backup Ventilation Equipment is Available & Functioning High Pressure System 3. Confirm oxygen cylinder supply pressure a. Open 0 2 cylinder and verify at least half full (about 1000psi) b. Close cylinder 4. Confirm Central Pipeline Supply pressures a. Check that hoses are connected and pipeline gauges read about 50psi

Fabius GS pre-use checkout procedure Low Pressure Systems 5. Check Initial Status of Low Pressure System a. Close flow control valves and turn vaporizers off b. Check fill level and tighten vaporizer filler caps 6. Test Fresh gas flow controls a. Adjust flow of all gases through their full range, checking for smooth operation of needles valves and displays b. Attempt to create a hypoxic 0 2 /N 2 0 mixture and verify correct behavior of the Oxygen Ratio Controller

Fabius GS pre-use checkout procedure Scavenging System 7. Adjust and Check Scavenging System a. Ensure proper connection between the scavenging system and the breathing system b. Adjust waste gas vacuum (open reservoir system) Breathing System 8. Calibrate expiratory flow sensor (2 nd softkey from left in standby) 9. Calibrate 0 2 Monitor (3 rd softkey from left in standby) a. Ensure monitor reads 21% in room air b. Verify low Fi0 2 alarm is enabled and functioning c. Reinstall sensor in circuit and flush breathing system with oxygen d. Verify that monitor now reads greater than 90%

Fabius GS pre-use checkout procedure 10. Check Initial Status of Breathing System a. Connect breathing circuit b. Verify that C0 2 absorbent is adequate c. Disconnect gas analyzer sample line and seal port 11. Perform Leak Check of the Breathing System (4 th softkey from left in standby) Ventilation Systems 12. Test Automatic Ventilation System and Unidirectional Valves a. Place a second breathing bag on Y-piece b. Set appropriate ventilator parameters for next patient c. Switch to automatic ventilation (Volume or Pressure Control) mode d. Flush system with oxygen e. Set 0 2 flow to minimum, other gas flows to zero f. Verify correct function of the ventilator (manual bag should not collapse) g. Check for proper action of unidirectional valves

Fabius GS pre-use checkout procedure 13. Test Manual Ventilation System a. Switch ventilator to Man / Spont. mode b. Ventilate manually and assure inflation and deflation of artificial lungs and appropriate feel of system resistance and compliance c. Remove second breathing bag from Y-piece.

Fabius GS pre-use checkout procedure Monitors 14. Check, Calibrate and/or Set Alarm Limits of all Monitors a. Capnograph, Pulse Oximeter b. Airway Pressure Monitor with high and low alarms Final Position 15. Check Final Status of Machine a. Vaporizers off b. APL valve open c. Ventilator in Standby or Man/Spont. d. All fresh gas flow controls to zero e. Patient suction level adequate f. Breathing system ready to use

Stand-by, ready for test

Run System Test

Calibrate Flow Sensor

FGF=0, open exp port to air

Piston will draw known volume flow sensor will measure it

Press to start test

Calibrate Flow Sensor

Calibrate O2 sensor

Remove Sensor, plug hole

Major leak if forgotten

Replace Oxygen Sensor

Leak & Compliance Test

Piston moves to get ready

FGF=0, fill bag, piston tests all

FGF = 0

Don t leave gas sampler on

Remove or seal gas sample line

Place Y on circuit plug

Set APL 40 70 cmh2o

Flush to pressurize circuit

Circuit Pressure 40 70 cmh2o

Tests in progress

Compliance Test first

Piston moves volume, Pressure is measured

Reservoir bag is not tested nut is in the circuit

Leak and compliance are tabulated

Press left button Man Vent

Fabius screen in use

Reservoir bag is not tested yet

Use Test Bag as patient

Ventilate Test Bag both Bag mode and Vent mode

Thank you If you have questions, please write to me jphilip@partners.org