Page 2
User responsibility This product will perform in conformity with the description thereof contained in this User’s Reference Manual and accompanying labels and/or inserts, when assembled, operated, maintained, and repaired in accordance with the instruction provided. This product must be checked periodically. A defective product should not be used.
MR unsafe. This system is not suitable for use in a magnetic resonance imaging (MRI) environment. Indications for use The Carestation 620/650/650c anesthesia systems are intended to provide general inhalation anesthesia and ventilatory support to a wide range of patients (neonate, pediatric, and adult). The anesthesia systems are suitable for use in a patient environment, such as hospitals, surgical centers, or clinics.
1 Introduction Residual risks The anesthesia machines include a mechanical ventilator. All mechanical ventilators are associated with potential complications such as ventilator induced lung injury, hypoxia and hypercarbia. Anesthesia delivery which exceeds or falls short of settings could cause patient harm like awareness or excessive hemodynamic changes.
Page 16
™ Carestation 620/650/650c (A1) The User’s Reference manual is intended to provide training on the operation of the system. Operate the system from the front with a clear view of the display. It must be operated according to the instructions in this User’s Reference manual. Make sure that all user documents are obtained from the manufacturer.
1 Introduction Figure 1-1 • Front view Serial numbers Products have unit serial numbers with coded logic which indicates a product group code, the year of manufacture, the week of manufacture, a sequential unit number for identification, manufacture location, and product type. 2076152-001...
620/650/650c (A1) XXX YY FW 0000 S M The XXX represents product codes: SM6 = Carestation 620, SM7 = Carestation 650, and SM8 = Carestation 650c. The YY represents a number indicating the year the product was manufactured: 10 = 2010, 11 = 2011, and so on.
Page 19
1 Introduction Hardware feature Carestation 620 A1 Carestation 650 A1 Carestation 650c A1 Top shelf color White Black Black Integrated monitoring Carestation 620 A1 Carestation 650 A1 Carestation 650c A1 Integrated Airway module slot Optional Optional Optional O2 cell, breathing system...
Page 20
™ Carestation 620/650/650c (A1) Pneumatic Options Carestation 620 A1 Carestation 650 A1 Carestation 650c A1 Pipeline inlets 2 or 3 (2nd O2 optional) 2 or 3 (2nd O2 optional) 2 or 3 (2nd O2 optional) User guidance lighting Included Included...
1 Introduction Symbols used in the manual or on the equipment Symbols replace words on the equipment, on the display, or in product manuals. Warnings and Cautions tell you about dangerous conditions that can occur if you do not follow all instructions in this manual. Warnings tell about a condition that can cause injury to the operator or the patient.
Page 22
™ Carestation 620/650/650c (A1) Caution Refer to instruction manual or booklet (blue background) Operating instructions General warning (yellow background) Electrical input/output Sample gas inlet to scavenging Pneumatic inlet Pneumatic outlet Equipotential Lamp, lighting, illumination Control with variable function Fuse Suction bottle outlet Off (for a part of the machine) Bag position/manual ventilation Mechanical ventilation...
Page 23
1 Introduction Indicates that the waste of electrical GOST R Russian certification and electronic equipment must not be disposed as unsorted municipal waste and must be collected separately. Please contact an authorized representative of the manufacturer for information concerning the decommissioning of equipment.
™ Carestation 620/650/650c (A1) Ukraine national conformity Unique device identifier Eurasian conformity Need tools and refer to installation instruction. Harmful China RoHS symbol Electrical test certification Medical device Symbols used on the user interface Lock Lock/unlock button Indicates the touchscreen is locked. Button label to lock or unlock the touchscreen.
1 Introduction Typeface conventions used Soft keys and menu items are written in bold italic typeface; for example, System Setup. Messages that are displayed on the screen are enclosed in single quotes; for example, ‘Check sample gas out’. When referring to different sections and other documents, the names are written in italic typeface and enclosed in double quotes;...
™ Carestation 620/650/650c (A1) Abbreviations Abbreviation Definition Anesthetic agent ACGO Auxiliary common gas outlet AGSS Anesthesia gas scavenging system Adjustable pressure-limiting Apnea ATPD Ambient temperature and pressure, dry humidity conditions Aux Gas Auxiliary Gas Aux O2+Air Auxiliary O2+Air BTPS Body temperature, ambient pressure, saturated humidity conditions Compact breathing system Carbon monoxide...
1 Introduction System information System classification This system is classified as follows: • Class I Equipment. • Type B Equipment. • Type BF Equipment (airway modules). • Ordinary Equipment • Not for use with flammable anesthetics. • Continuous operation. Device standards IEC 60601-1:2005 Devices used with this anesthesia system shall comply with the following standards where applicable: •...
™ Carestation 620/650/650c (A1) Integral system components This anesthesia system contains the following integral components, monitoring devices, alarm systems, and protection devices that comply with European, international, and national standards: • Breathing system pressure-measuring device. • Airway pressure-limitation device. • Exhaled-volume monitor.
1 Introduction System safety Preparing for use WARNING Read each component’s User’s Reference manual and understand the following before using this system: • All system connections. • All warnings and cautions. • How to use each system component. • How to test each system component. •...
™ Carestation 620/650/650c (A1) • Risk of fire. Limit the use of supplemental oxygen concentrations to less than 30 percent when using a heat source or device that may lead to combustion. Consult facility risk management procedures to minimize the risk of fire if an oxygen concentration of more than 30 percent is required for any reason.
1 Introduction • The anesthesia system or other equipment does not block the wall mains outlet. • If an optional suction regulator is present, ensure there is adequate suction. Electrical safety Any non-medical equipment used with the system must be supplied by a power source using a separating transformer.
Page 34
™ Carestation 620/650/650c (A1) • Use of portable phones or other radio frequency (RF) emitting equipment (that exceed electromagnetic interference levels specified in IEC 60601-1-2) near the system may cause unexpected or adverse operation. Monitor operation when RF emitters are in the vicinity. •...
™ Carestation 620/650/650c (A1) System overview Digital fresh gas display Bag hose connection Fresh gas control knob O2 flush Total fresh gas flow meter Breathing system door Vaporizer Leak test plug Suction regulator and control Bag/Vent switch On/Standby switch Adjustable pressure-limiting (APL) valve Flip-up shelf Bellows assembly Drawer lock...
Page 37
2 System controls and menus Display arm Equipotential stud Cable hook Mains inlet Third cylinder mount Mains power fuses (inside) Cylinder guard Right dovetail Caster guard Pipeline connections Electrical outlets Side rail Outlet circuit breakers Top shelf monitor mount Figure 2-2 • Rear view (Left) 2076152-001...
Page 38
™ Carestation 620/650/650c (A1) Bag support arm Left dovetail Breathing system guard Anesthesia Gas Scavenging System (AGSS) port Inspiratory port Sample gas return port Expiratory port Airway module Absorber canister Suction trap Absorber canister lifter handle Suction fitting Figure 2-3 • Rear view (Right) 2076152-001...
Page 39
2 System controls and menus Casters Pendant mount interface Figure 2-4 • Front and rear view of pendant system Wall-mounting rack Wall-mounting interface Figure 2-5 • Front and rear view of wall mount system Note See "Feature overview" for more information on product specific offerings.
™ Carestation 620/650/650c (A1) Using the brake The system has two brake options that hold the system in place. • The system has an option of one central brake with two brakes on the rear casters. • The system has an option of brakes on the four casters. WARNING Do not use the brake while moving the anesthesia system.
2 System controls and menus Figure 2-8 • Brake on four casters Using flow controls The flow controls regulate the amount of gas flow to the breathing circuit. The System switch must be On for the gas to flow. Turn the knob counterclockwise to increase gas flow. Turn the knob clockwise to decrease gas flow.
™ Carestation 620/650/650c (A1) Positioning the display The display can be moved for optimal viewing with two display arm options. • The display can be positioned closer to or further from the system, with only one pivot point and no tilt available. •...
Page 43
2 System controls and menus Holder Clip Bag arm base Figure 2-9 • Bag hose holder Open cover of the holder at the end of the bag arm and insert the hose into the holder. Close the cover of the holder. Push the hose into the clip on the bag arm.
™ Carestation 620/650/650c (A1) Bag hose port Bag hose connection Figure 2-10 • Bag hose connection Using the bag support arm Use the optional bag support arm to hold the breathing circuit bag. The bag support arm can be moved up or down and left or right. 2-10 2076152-001...
2 System controls and menus Vaporizer controls Refer to the vaporizer User’s Reference manual for more detailed information on the vaporizer. Lock lever Concentration control and release Audio pause touch key Figure 2-11 • Vaporizer controls 2-11 2076152-001...
™ Carestation 620/650/650c (A1) Display controls The system uses touchscreen technology, hard keys, and a ComWheel to access system functions, menus, and settings. The touchscreen has numerous touch point areas that make accessing menus and settings quick and easy. The buttons on the right side of the screen provide direct access to commonly used functions.
2 System controls and menus Audio Pause key Stops audio for 120 seconds for any active, eligible high and medium priority alarms. Prevents audio (audio off) for 90 seconds when no medium or high priority alarms are active. Allows the operator to acknowledge any non-active medium or high priority latched alarms.
™ Carestation 620/650/650c (A1) Touch the measured value to access the Alarm Setup menu. The Alarm Setup menu displays. Select the alarm limit and set it to the correct value. Touch the value on the touchscreen or push the ComWheel to confirm the desired setting.
2 System controls and menus Anesthesia system display 03:18 Audio Pause 1:52 Paw cmH2O Alarm Setup Auto Limits System 10.0 Flow Flow l/min Setup Next Page Trends CO2 % Spirometry Procedures Agent % 1200 Resp Gases % Start 00:00:00 0.0 0.0 End Case Ventilator Off: Volume Control Total Flow...
™ Carestation 620/650/650c (A1) 10. Ventilator quick keys Displays Mode, associated ventilation parameters, and More Settings. For example: Mode, TV, RR, I:E, Tpause PEEP, and Pmax. 11. Total Flow Contains information for Total Flow and FGO2 %. 12. Split screen Contains airway pressure, gas flow values, compliance, trends, spirometry and optional ecoFLOW information.
2 System controls and menus Split screen field The split screen field can be set to show gas trends, spirometry loops, Paw gauge, airway compliance, and optional ecoFLOW information. If None is selected, the waveforms expand to fill the split screen area.
™ Carestation 620/650/650c (A1) ACGO display P-ACGO P-ACGO cmH2O P-ACGO ACGO in use: Ventilator Off Total Flow Turn off ACGO to use circle circuit. 1.3 2.4 0.9 PEEP [ VCV ] [ 500 ] [ 12 ] [ Off ] FGO2 % Split screen Shows P-ACGO, gas flow values, compliance, trends and optional ecoFLOW...
Page 53
2 System controls and menus Note View and change ventilator parameters when in ACGO mode. When the ACGO switch is set to ventilation mode, the system starts mechanical ventilation using the parameters set in ACGO mode. Note When the ACGO is used with an open patient circuit, the only ™...
™ Carestation 620/650/650c (A1) Aux O2+Air display Total Flow FGO2 % 1. Auxiliary Gas status Shows that the Aux O2+Air switch is set to Aux O2+Air position. 2. Status field Shows Aux O2+Air status and alarm or status messages. For example: Aux Gas in use: Ventilator Off.
2 System controls and menus Display navigation Use the touchscreen and ComWheel to navigate the display. Menu Displays the title of the open menu. For example: Start Case. Instructions or help information This shows any additional instructions or help messages. Menu items Shows Case Defaults, Volume Apnea Alarm, CO2 Alarms, Age, Ideal Weight, and Start Case Now.
™ Carestation 620/650/650c (A1) Select a menu item to choose the item, or turn the ComWheel left or right to highlight a menu item and then push to confirm. If the menu item selected is an adjustment, turn the ComWheel left or right to make the setting and then push to confirm.
Page 57
2 System controls and menus Push the ComWheel or select the quick key to confirm the change. 2-23 2076152-001...
™ Carestation 620/650/650c (A1) System operation safety WARNING Do not use antistatic or electrically-conductive breathing tubes or masks. They can cause burns if used near high- frequency surgical equipment • The manufacturer recommends the use of filter(s) that protect both the inspiratory and expiratory ports to reduce the risk of cross-contamination.
Page 61
3 Operation • Unplug the system power cord to run the system on the battery power if the integrity of the protective earth conductor is in doubt. • The top shelf weight limit is 25 kg (55 lb). • Do not subject the system to excessive shock and vibration.
™ Carestation 620/650/650c (A1) Turning on the system Plug the power cord into an electrical outlet. Make sure the mains indicator light is on. • The mains indicator is lit when AC power is connected. • Battery is charging if it is not already fully charged. Mains indicator On/Standby switch Figure 3-1 •...
Page 63
3 Operation Note Wait a minimum of 5 seconds after the display keypad lighting turns off before restarting the system. 2076152-001...
™ Carestation 620/650/650c (A1) Starting manual ventilation Connect a manual breathing circuit. Make sure the APL valve is set to a clinically appropriate value. Set the Bag/Vent switch to Bag. 2076152-001...
3 Operation Starting mechanical ventilation WARNING Make sure that the patient breathing circuit is correctly assembled and that the ventilator settings are clinically appropriate before starting ventilation. Incorrect breathing circuit assembly and incorrect ventilator settings can injure the patient. • Make sure that the preset alarm limits are appropriate for the patient before starting ventilation.
™ Carestation 620/650/650c (A1) Start a case Use the Start Case menu to set the case data and start the case. A case can be started using default settings or using custom settings. The default settings are configured by the Super User. See the "Super user mode"...
3 Operation ™ The MAC age value is shown when using a CARESCAPE airway module. The MAC age value is calculated from the exhaled gas concentration and the related affects based on the age of the patient. The MAC age calculation used is based on the Eger formula. When two agents are detected, the MAC values of each agent are added together.
Page 68
™ Carestation 620/650/650c (A1) Select Start Case. The Case Defaults selection shows the first preset case type. Ideal Weight, Age, CO2 Alarms, and Volume Apnea Alarm show the default settings that correspond to the case type shown. Change Ideal Weight, Age, or Volume Apnea Alarm settings on the menu.
3 Operation End a case Use the End Case menu to end the patient alarms. Set the Bag/Vent switch to Bag. Turn off the gas flows. Select End Case. Select End Case Now on the menu to put the system in Standby (stops patient alarms).
™ Carestation 620/650/650c (A1) Standby When in Standby, most of the alarms are disabled. The Standby screen shows after End Case is selected. If the fresh gas flow is more than 300 ml/min, a medium priority alarm ‘Turn off gas flow’ occurs reminding the user to turn off the fresh gas flow.
3 Operation Turning off the system Perform the "End a case" procedure, if appropriate. Push and hold the On/Standby switch for 1 second. Select Confirm or push the ComWheel within 10 seconds to turn off the system. If no action is performed within 10 seconds, the screen automatically returns to the previous display.
™ Carestation 620/650/650c (A1) Ventilator setup Use the Vent Mode menu to set the ventilation mode. Use ventilator quick keys and More Settings to change ventilator settings. WARNING Most anesthetic agents will cause patients to have reduced ventilatory responses to carbon dioxide and to hypoxemia.
3 Operation Auto limits Use the Auto Limits menu to quickly set alarm ranges for ‘MV’, ‘TV’, and ‘EtCO2’ during mechanical ventilation. Setting auto limits Select Auto Limits. The menu shows the current measured values and the proposed low and high alarm limits. Check the proposed parameters.
™ Carestation 620/650/650c (A1) System setup Use System Setup to access menus and settings for Patient Demographics, Screen Setup, Fresh Gas Usage, System Status, Calibration, and Checkout. Note System Status shows the status of gas supplies, electrical supplies, and the software version. See the "User maintenance"...
Page 75
3 Operation Select System Setup - Screen Setup. Select the Layout tab. Select the desired digit field button and select the value from the drop-down menu. Select Close. Setting the split screen Use the Split Screen setting to show trends, spirometry loops, Paw gauge, airway compliance, and optional ecoFLOW information.
Page 76
™ Carestation 620/650/650c (A1) Select Patient to have spirometry data sourced from the airway module or Vent to have spirometry data sourced from the ventilator. Note When using the Airway Gas Option, only Vent is available for the Data Source. Note If no airway module is installed, all settings will default back to Vent.
3 Operation Fresh gas usage Use Fresh Gas Usage to view the volume of O2, Air, N2O, and agents used for the three most recent cases. • Data only shows for gases available on the system. • Agent data shows the three most recently used agents. Select System Setup - Fresh Gas Usage.
™ Carestation 620/650/650c (A1) Alarm setup Use the Alarm Setup menu to set and adjust alarm limits, alarm volume, and other alarm settings and to view alarm history. The Alarm Setup menu contains the Primary Limits, More Limits, Alarm History, and Configure submenus. Setting Leak Audio to Off silences audio alarms for small leaks.
3 Operation Setting CO2 alarms Use the CO2 Alarms setting to turn off the CO2 ‘Apnea’ alarm, ‘EtCO2 low’, ‘EtCO2 high’, and ‘FiCO2 high. Absorbent OK?’ alarms during manual ventilation. CO2 information is obtained from the airway module installed in the anesthesia system module bay.
™ Carestation 620/650/650c (A1) Setting MV/TV alarms Use the MV/TV Alarms setting to turn off the MV and TV alarms. Settings made during manual ventilation are not retained when mechanical ventilation starts. Settings made during mechanical ventilation are retained when manual ventilation starts. For example, if MV/TV Alarms is set to Off during manual ventilation, the alarms remain off until the Bag/Vent switch is set to Vent or the MV/TV Alarms is set to On.
3 Operation Select Close. Setting alarm volume WARNING Set alarm volume loud enough to be heard over surrounding noise. If the volume is not loud enough, the user may not hear the alarm. Select Alarm Setup. Select the Configure tab. Set Alarm Volume to the desired value.
™ Carestation 620/650/650c (A1) Note If the Low MV alarm limits are off or MV/TV Alarms is set to Off, Leak Audio is automatically set to On and cannot be changed. Setting auto MV limits MV alarm limits can be calculated automatically for mechanical ventilation when in VCV or PCV-VG modes and volume compensation is enabled.
3 Operation Next page Select Next Page to change the screen view. A default view and four configurable screen views are available. A general message displays identifying the page number of the screen view. See the "Super user mode" section for information on setting the preset screen views.
™ Carestation 620/650/650c (A1) Trends Use the Trends menu to view patient trends and set the time scale. There are three views for patient trends: measured (numerical), settings, and graphical. Trend information is saved every 15 seconds for the most recent 24 hours. Setting trends Select Trends.
3 Operation Spirometry Use the Spirometry menu to: • Set the loop type. • Adjust the loop scaling. • Save a loop to memory. • Access the Setup Loops menu. • View a saved loop. • Delete a saved loop. There are three types of spirometry loops: Pressure-Volume (Paw- Vol), Flow-Volume (Flow-Vol), and Pressure-Flow (Paw-Flow).
™ Carestation 620/650/650c (A1) Setting loop graph scaling Use Spirometry Scaling to set the scales of the spirometry loop graph. The available settings for the volume, Paw, and flow graph axis are dependent on the set patient type of adult or pediatric. •...
3 Operation Select System Setup - Screen Setup - More Settings or Spirometry - Setup Loops. Select Data Source. Select Patient to have spirometry data sourced from the airway module or Vent to have spirometry data sourced from the ventilator. Note When using the Airway Gas Option, only Vent is available for the Data Source.
™ Carestation 620/650/650c (A1) Procedures Use the Procedures menu to pause the gas flow, start cardiac bypass, perform or change settings for a vital capacity procedure, or perform or change the settings for a cycling procedure. Note Vital Capacity shows in the menu if it is set to Yes by the Super User.
3 Operation alarms are suspended. The alarms are enabled when VCV cardiac bypass is turned off or mechanical ventilation is stopped. WARNING Manual ventilation cardiac bypass and VCV cardiac bypass modes should only be used when the patient is receiving extra-corporeal oxygenation by means of a heart-lung machine.
™ Carestation 620/650/650c (A1) The Pressure Hold, Hold Time, and PEEP on Exit settings can be preset by the Super User. These settings can be changed by the user before starting the procedure. Note PEEP on Exit shows if it is set to Yes by the Super User. Using vital capacity Select Procedures.
Page 91
3 Operation Select Cycling. Select a Procedure to perform. Select Start Cycling. The procedure begins. Procedure progress shows in the procedure window. Stop the procedure anytime by selecting Stop Cycling. Select Close. Changing cycling settings Select Procedures. Select Cycling. Select a Procedure to perform. Select Adjust Settings.
™ Carestation 620/650/650c (A1) Timer function Use Start as a timer function. When selected a clock will display counting up from zero. Using the timer Select Start to start the clock. Select Stop to pause or stop the clock. If Start is selected, the clock will resume operation. If Start is selected and held for longer than 1 second, the clock will reset to zero.
3 Operation ecoFLOW This feature provides a split screen view that shows the approximate minimum O2 flow to maintain a preset inspired O2 concentration. Also shown is the approximate agent used per hour and the cost. The ecoFLOW functionality is only available when an airway module is installed and the system is delivering mechanical ventilation.
™ Carestation 620/650/650c (A1) Using ecoFLOW Select System Setup - Screen Setup. Select the Layout tab. Select Split Screen and select ecoFLOW from the drop-down menu. Select Close. 3-36 2076152-001...
3 Operation Auxiliary Common Gas Outlet Use the optional Auxiliary Common Gas Outlet (ACGO) switch to direct the fresh gas flow through the ACGO port on the front of the system. The ACGO may be used to provide fresh gas to an auxiliary manual breathing circuit.
Page 96
™ Carestation 620/650/650c (A1) Set the ACGO switch to the ACGO position. Fresh gas flows through the ACGO port. Fresh gas oxygen concentration is displayed on the screen if the system has the airway module option. Set the alarm limits to clinically appropriate settings. To stop fresh gas flow through the ACGO port, set the ACGO switch to the circle circuit position.
3 Operation Auxiliary O2+Air Use the optional Auxiliary O2+Air (Aux O2+Air) switch to deliver O2 and Air through the Aux O2+Air outlet on the front of the system. No anesthetic agent is delivered through the Aux O2+Air outlet. When the switch is set to the Aux O2+Air position during a case, the outlet indicator is lit and N2O flow is automatically shut off.
4 Preoperative checkout Preoperative checkout In this section Every day before your first patient....4-2 Before every patient....... 4-3 2076152-001...
™ Carestation 620/650/650c (A1) Every day before your first patient □ Check that necessary emergency equipment is available and in good condition. □ Check that the equipment is not damaged and that components are correctly attached. □ Check that the pipeline gas supplies are connected. If equipped with cylinders, check that there is sufficient reserve capacity and that the cylinder valve is closed.
4 Preoperative checkout Before every patient Note This check does not need to be done before the first case of the day if the "Every day before your first patient" checklist was done. □ Check that the necessary emergency equipment is available and in good condition.
™ Carestation 620/650/650c (A1) Vaporizer installation ™ ™ WARNING Use only Selectatec series vaporizers Tec 6 Plus or greater. • Do not use a vaporizer that lifts off of the manifold when the lock lever is in the locked position. •...
Page 105
5 Preoperative tests • Test each possible combination. • If more than one vaporizer turns on at the same time, remove the vaporizers, install them again, and repeat the test. 2076152-001...
™ Carestation 620/650/650c (A1) Flow and pressure calibration Calibrate the flow sensors by opening the breathing circuit. On- screen instructions are available through the Checkout menu or System Setup - Calibration - Flow and Pressure. Pull down the canister lifter handle and remove the absorber canister.
5 Preoperative tests Circuit compliance compensation The ventilator adjusts gas delivery and monitoring to compensate for the compliance of the patient circuit if: • The Circuit Compliance is set to On from Super User - System Config. - Ventilator Settings. •...
™ Carestation 620/650/650c (A1) Checkout menu The Checkout menu shows on the display after turning on the system. To access the Checkout menu between cases, select Checkout. Step-by-step instructions show in the Checkout menu during the tests. Use the Checkout menu to: •...
5 Preoperative tests Full test The Full Test or the individual tests must be performed at least once within every 24-hour period. Perform the Full Test at the start of each day. The full test runs automatically and the color of the test indicator changes when the test is finished or if user action is required.
™ Carestation 620/650/650c (A1) Note The airway module sampling flow is paused during the checkout when an airway module is installed within the system. If an airway module is installed on an external monitor outside of the system, disconnect the gas sampling line from the patient circuit and close the sample port before performing the checkout.
Page 111
5 Preoperative tests To run this test, follow the on-screen instructions. When the test passes, the next test starts. 2076152-001...
™ Carestation 620/650/650c (A1) Individual tests The Full Test or all of the individual tests must be completed with passing results at least once within every 24-hour period. Individual tests allow the user to perform any combination of single tests. These tests are helpful if there is a specific problem/alarm and the user wishes to test only that portion of the system.
Page 113
5 Preoperative tests Note Make sure the bag is connected to the bag hose connection. To run this test, follow the on-screen instructions. 5-11 2076152-001...
™ Carestation 620/650/650c (A1) Vaporizer back pressure test WARNING Anesthetic agent comes out of the circuit during this test. Use a safe, approved procedure to collect and remove the agent. • Agent mixtures from the vaporizer back pressure test stay in the system. Always flush the system with O2 after the vaporizer back pressure test (1 l/min for at least one minute).
5 Preoperative tests Low pressure leak test (with ACGO) This is an alternate manual test for low pressure leaks on systems with an ACGO. WARNING Do not use a system with a low-pressure leak. If there is a low-pressure leak anesthetic gas will go into the atmosphere instead of the breathing system.
Page 116
™ Carestation 620/650/650c (A1) • Set the System switch to On. • Set the O2 flow to 1 l/min. • Continue the O2 flow for one minute. • Turn the O2 flow control fully clockwise (closed). Set the ACGO switch to the breathing circle position. 5-14 2076152-001...
Page 117
6 Airway modules Airway modules In this section Airway modules........6-2 Connecting the airway module.
™ Carestation 620/650/650c (A1) Airway modules The optional airway modules measure and monitor gases delivered to the patient and exhaled through the breathing circuit. The modules consist of: • An infrared sensor for measuring CO2, N2O, and anesthetic agents. • A paramagnetic O2 sensor.
Excessive air or gas pressure may destroy sensitive airway modules. WARNING EtCO2 values displayed on the screen may differ from blood gas readings. CAUTION Use only cables and accessories approved by GE Healthcare Finland Oy. Other cables and accessories 2076152-001...
™ Carestation 620/650/650c (A1) may damage the system or interfere with measurement. Single-use accessories are not designed to be reused. WARNING Strong scavenging suction on the monitor exhaust port may change the operation pressure of the monitor and cause inaccurate readings or internal damage. WARNING Do not connect the gas sampling line to the patient spirometry connectors as this may damage the...
6 Airway modules CARESCAPE airway modules Water trap latch Gas sample connector D-fend Pro water trap Connectors for patient spirometry Sample gas outlet Figure 6-2 • CARESCAPE airway module (figure may not represent all models) 2076152-001...
™ Carestation 620/650/650c (A1) Connecting the airway module Check that the airway module is installed. Check that the airway adapter connections are tight and that the adapter is correctly installed. Check that the water trap container is empty and properly attached.
6 Airway modules Connecting the Pedi-lite and D-lite sensors WARNING Use the Pedi-lite sensor for patients with tidal volumes up to, and including 200 ml. ™ • Use the D-lite sensor for patients with tidal volumes greater than 200 ml. •...
™ Carestation 620/650/650c (A1) Parameters setup Use the Spirometry menu to change the monitoring settings of the data source, CO2, O2, agent, and spirometry. To access the Spirometry menu, push the Spirometry button and then select Setup Loops. Data source Several monitoring parameters can be obtained from the ventilator or the airway module.
6 Airway modules Automatic agent identification Airway modules with agent identification automatically identify Halothane, Enflurane, Isoflurane, Sevoflurane, and Desflurane. The inspiratory and expiratory concentrations of the agent appear in the digit field or the agent waveform field if selected. CARESCAPE modules identify two agents simultaneously and display them as primary and secondary agents.
™ Carestation 620/650/650c (A1) Calibrating the airway module Calibrate airway modules once every six months or whenever there are indications of errors in the gas readings. Use a manufacturer approved calibration gas and regulator to calibrate the modules. See the "Parts" section for the stock numbers of the calibration gas and regulator.
Page 127
6 Airway modules • Do not close the regulator until all the adjustments have been made. 10. Close the regulator. 11. Compare the measured values shown on the screen, by gas, against the calibration gas cylinder value. If a gas needs adjustment, select the gas to be adjusted.
™ Carestation 620/650/650c (A1) Alarms Alarms may be high priority, medium priority, or low priority. When an alarm occurs during a case, an alarm tone sounds and the alarm message is displayed in the alarm message field. The system checks for alarm conditions at 1 second intervals. The alarm tone is from 43 to 78 db(A) depending on the alarm volume setting.
7 Alarms and troubleshooting Cancelling audio pause Selecting and holding Audio Pause for 2 seconds will cancel the audio pause function. Display changes during alarms Messages may appear in the waveform field during some alarms. If more than one alarm has a message, the message for the highest priority alarm is displayed.
™ Carestation 620/650/650c (A1) • Red indicates less than 5 minutes. Internal failure ‘Internal problem prevents normal operation.’ shows on the display during a software or hardware failure that requires service. If this message occurs, contact an authorized service representative. Informational tones The system provides informational tones that are 43 to 78 dB(A) depending on the alarm volume setting.
7 Alarms and troubleshooting List of alarms If corrective action does not resolve the alarm message, contact an authorized service representative. Circuit pressures and volumetric flows are measured by the ventilator and airway gas module. If the Data Source is set to Patient the displayed waveforms and numeric information are measured by the airway gas module.
Page 134
™ Carestation 620/650/650c (A1) Message Priority Cause Action Backup Mode No spontaneous breaths in set period Select a new ventilation mode. The active of time (Backup Time) since starting number of consecutive patient triggered ™ PSVPro mode. breaths reaches the Exit Backup setting.
Page 135
7 Alarms and troubleshooting Message Priority Cause Action Cooling fans Medium Fan reporting error. May also be Shut down system as soon as possible. failed. May caused by a display unit or CPU Then, check cooling fans and filters. overheat. temperature sensor reporting error.
Page 136
™ Carestation 620/650/650c (A1) Message Priority Cause Action FiDes low FiDes is less than alarm limit. Check the fill level of the vaporizers. Set alarm limit appropriately. Check agent setting. FiEnf high Medium FiEnf is greater than alarm limit. The Set the alarm limits appropriately.
Page 137
7 Alarms and troubleshooting Message Priority Cause Action Low gas sample Sample flow is less than 80% of Check for blockage in the airway flow nominal flow for 20 seconds. module sample gas line. Memory Software error. Contact an authorized service (EEPROM) representative.
Page 138
™ Carestation 620/650/650c (A1) Message Priority Cause Action Plug in power The mains supply is not connected or Ventilate manually to save power. Make cable. On battery. has failed and the system is using sure the power cable is plugged in and battery power.
Page 139
7 Alarms and troubleshooting Message Priority Cause Action Service Calibration data is corrupt. Contact an authorized service calibration representative. advised System leak? Leak detected between ventilator and Check for leaks in the breathing system. patient circuit. System shutdown High Remaining battery power is between Plug in the power cable.
™ Carestation 620/650/650c (A1) Sustained pressure threshold The sustained pressure threshold is calculated from the maximum pressure (Pmax) setting. The sustained limit is calculated as follows: Mechanical Ventilation with For Pmax less than 30 cmH2O, the sustained pressure limit is 6 cmH2O. PEEP Off: For Pmax between 30 and 60 cmH2O, the sustained pressure limit is 20% of Pmax.
7 Alarms and troubleshooting Alarm ranges The alarm names are listed in the Primary Limits and More Limits tabs on the Alarm Setup menu. See the "Super user mode" section for more information on the alarm default settings. Alarm Range Increment Pmax (only high) 12-100 cmH2O...
Page 142
™ Carestation 620/650/650c (A1) Alarm Range Increment EtIso Low Off, 0.1 - 6.9% 0.1% EtSev High 0.1 - 10.0%, Off 0.1% EtSev Low Off, 0.1 - 9.9% 0.1% EtDes High 0.1 - 20%, Off 0.1% EtDes Low Off, 0.1 - 19.9% 0.1% EtEnf High 0.1 - 7.0%, Off...
7 Alarms and troubleshooting Alarm tests Test the system to verify that alarms are functioning. Note If an airway module is installed, the FiO2 readings are taken from the module instead of from the O2 cell. A sample line must be connected from the airway module to the breathing circuit to test the O2 alarms.
Page 144
™ Carestation 620/650/650c (A1) Test the Ppeak low. Leak? alarm: • Unblock the patient connection. • Set the Bag/Vent switch to Vent. • Set the tidal volume and total flow to minimum. • Other alarms such as MVexp low can occur. •...
7 Alarms and troubleshooting Breathing system problems Symptom Problem Solution Gas scavenging flow is too low Scavenging extract flow problem. Use a different scavenging extraction or too high. system. Verify flow is within specification. Pressure sensor problem. Contact an authorized service representative to repair the pressure sensor on anesthesia control board.
™ Carestation 620/650/650c (A1) Electrical problems WARNING If a circuit breaker opens frequently, do not use the system. Contact an authorized service representative to repair the system. Symptom Problem Solution Mains indicator is not on. The electrical power cable is not Connect the power cable.
Page 147
7 Alarms and troubleshooting Symptom Problem Solution Indication lights are not on The gas port is not active. The LED or Contact and authorized service power management board has failed. representative to repair the system. 7-19 2076152-001...
™ Carestation 620/650/650c (A1) Pneumatic problems Symptom Problem Solution High-pressure leak test Controls are not set correctly. Make sure no gas is flowing, turn off the fails. auxiliary flow meter, and repeat the test. Incorrect cylinder connection. Make sure that there is only one cylinder gasket, the gasket is in good condition, and the connection is tight.
To report to the manufacturer: • Either contact your local service representative. • Or report to: in-box.complaints@ge.com. Please provide the following information: • The catalogue number or the model designation of the device as stated on its identification plate affixed on the device •...
™ Carestation 620/650/650c (A1) Setup safety WARNING The system should always be used with an oxygen monitor, a CO2 monitor, an anesthetic agent monitor, and an exhaled volume monitor. Refer to local standards for mandatory monitoring requirements. • Always make sure the pipeline supply hoses and the breathing circuit components are not toxic and will not: •...
Page 153
8 Setup and connections • Use only breathing tubes that comply with EN12342 or ISO 5367 on this system. • A malfunction of the medical gas central supply system may cause all connected devices to stop. • All gases supplied to the system must be medical grade. Use of non-medical grade gases could result in equipment damage.
™ Carestation 620/650/650c (A1) Moving and transporting the system WARNING The system may overbalance or tip if tilted more than 10 degrees. • Do not exceed specified load ratings when mounting equipment on the top of the machine or on any of the side rails.
8 Setup and connections Connecting the breathing system Attach the patient circuit to the inspiratory and expiratory ports on the system. Perform the individual "Ventilator leak" test to set proper circuit compliance. Expiratory port Inspiratory port Figure 8-1 • Breathing system connection 2076152-001...
™ Carestation 620/650/650c (A1) Setting up the absorber canister The absorber canister is available in two versions: disposable absorber and reusable absorber. Both are removed and installed on the breathing system the same way. Both absorber versions should only be used with mixtures of air, oxygen, nitrous oxide, halothane, enflurane, isoflurane, desflurane and sevoflurane.
8 Setup and connections • The disposable absorber is a sealed unit which should not be opened or refilled. • Avoid skin or eye contact with the contents of the absorber. In the event of skin or eye contact, immediately rinse the affected area with water and seek medical assistance.
™ Carestation 620/650/650c (A1) Lift the canister and remove it from the canister lifter base. Filling the reusable absorber canister To open the canister cover, lift the latch handle up. 2076152-001...
Page 159
8 Setup and connections Push the latch handle down to release the cover. Pull the latch hook away from the canister and lift the cover off the canister. Remove and properly discard the absorbent and any water in the canister body. WARNING Be careful when emptying the absorber canister.
Page 160
™ Carestation 620/650/650c (A1) Insert the cover into the groove on the canister handle so that the arrows get covered by the black zone. 10. Attach the cover latch hook to the canister body. Push the latch handle down until it is flush with the canister cover. WARNING Failure to properly lock the canister cover could cause canister malfunction and breathing circuit leaks.
8 Setup and connections Circuit O2 cell installation Use the following instructions to add an O2 cell to the system. Note If an O2 cell is already in the system and needs replacement, see the "Circuit O2 cell replacement" section. Install the O-ring onto the adapter and screw the adapter onto the O2 cell.
Page 162
™ Carestation 620/650/650c (A1) Remove the O2 cell plug from the patient port assembly (if present). Pull the cable out of the O2 cell bracket. Plug the cable connector into the O2 cell. 8-12 2076152-001...
Page 163
8 Setup and connections Note Make sure the O2 cell plug is removed before reattaching the breathing system. Lift and reattach the breathing system base. A click sound will be heard when attached properly. 10. Close the breathing system door. 11.
™ Carestation 620/650/650c (A1) Electrical connections Mains inlet The arrow shows the mains power inlet and cord. Equipotential stud The equipotential stud is used to connect the anesthesia machine to an equipotential grounding system by attaching a potential equalization conductor. Equipotential grounding is used in some hospitals to enhance electrical safety in critical care areas by attempting to keep the conductive surfaces of all equipment in the patient care area at the same ground potential, thereby minimizing...
8 Setup and connections Circuit breaker Outlet socket Serial port The system has a Universal Serial Bus (USB) port on the back of the display unit. This port is for use by super user or authorized service personnel to access log files, and for authorized service personnel to load software.
™ Carestation 620/650/650c (A1) Pneumatic connections CAUTION Use only medical grade gas supplies. Other types of gas supplies may contain water, oil, or other contaminants which could affect the operation of the pneumatic system. The gas supplies provide gas to these devices through internal connections: •...
8 Setup and connections Figure 8-3 • AGSS connection Scavenging a gas monitor sample flow Sample gas from a gas monitor can be scavenged by connecting the exhaust from the monitor to the sample gas return port on the left side of the machine.
™ Carestation 620/650/650c (A1) Suction control panel Suction switch variable control position Suction switch Off position Suction switch maximum position Suction mode selection switch Suction variable pressure control knob Figure 8-4 • Suction control panel Vacuum suction regulator (optional) The vacuum suction regulator uses an external vacuum supply. Connect the vacuum connection to the source vacuum supply.
8 Setup and connections External vacuum connection Overflow safety trap Splash guard Collection bottle connection Figure 8-5 • External vacuum suction Venturi suction regulator (optional) The venturi suction regulator uses the system air supply source. Connect the collection bottle connection on the overflow safety trap to the collection bottle.
™ Carestation 620/650/650c (A1) Auxiliary O2 flowmeter (optional) The auxiliary O2 port is available to provide supplemental oxygen to patients undergoing surgical procedures. Auxiliary O2 outlet Auxiliary O2 flow control Figure 8-7 • Auxiliary O2 flowmeter Auxiliary O2+Air (optional) The optional auxiliary O2+Air port provides supplemental O2 or a mixture of O2 and Air to patients undergoing surgical procedures.
8 Setup and connections Third cylinder supply (optional) The third cylinder supply option is used to connect a third high pressure cylinder. See "Installing cylinders with pin indexed yokes" in the "Installing gas cylinders" section for installation instructions. High pressure hose Pin index cylinder interface Third cylinder mount kit Figure 8-9 •...
™ Carestation 620/650/650c (A1) Installing gas cylinders CAUTION Do not leave gas cylinder valves open if the pipeline supply is in use. Cylinder supplies could be depleted, leaving an insufficient reserve supply in case of pipeline failure. Cylinder cover Some systems have an optional cylinder cover. The cover needs to be opened before installing or removing cylinders.
8 Setup and connections 10. Make sure there is a cylinder plug and gasket in any empty cylinder yokes. 11. Complete "Performing a high-pressure leak test". Installing cylinders with DIN connections Close the cylinder valve on the cylinder to be replaced. Loosen the adapter and remove the cylinder.
™ Carestation 620/650/650c (A1) Passive AGSS WARNING To avoid possible exposure to anesthetic agent, always verify the proper operation of any gas scavenging system. Make sure the scavenging system is not occluded. The optional passive anesthesia gas scavenging system (AGSS) is for use in operating room environments that do not have an active gas extraction system for waste gas disposal.
8 Setup and connections Active AGSS WARNING To avoid possible exposure to anesthetic agent, always verify the proper operation of any gas scavenging system. Make sure the scavenging system is not occluded. There are several versions of the optional active Anesthesia Gas Scavenging System (AGSS) available depending on the hospital’s type of waste gas disposal system.
Page 176
™ Carestation 620/650/650c (A1) the hospital extract system is able to meet the AGSS flow needs. • The active low flow system with 30 mm ISO taper, or 12.7 mm hose barb connector, is for use with low vacuum disposal systems.
8 Setup and connections Attaching equipment to the top of the machine WARNING The top of the machine has a weight limit of 25kg (55 lb). • Check the stability of the system in its final configuration. Make sure the weight is evenly distributed throughout the system.
Page 178
™ Carestation 620/650/650c (A1) Tighten all thumb screws on the rear of the mounting plate. 8-28 2076152-001...
8 Setup and connections Cable management arm (optional) If necessary, the cable management arm can be removed when moving the anesthesia system through narrow openings. Remove any monitoring cables from the cable management arm. Lift up on the cable management arm by grasping near the mounting post.
™ Carestation 620/650/650c (A1) Cable routing groove Use the cable routing groove to organize cables attached to the patient monitoring display. Route the cable through the hole on the display arm. Push the cable into the groove under the display arm. Place the cable in the cable routing groove.
8 Setup and connections Cable cover Lift up the cable cover at the rear of the machine. Connect the gas pipelines to the pipeline inlets. Use straps to bundle the pipelines and electrical cable. Insert the hook on the cover into the grooves, and push down the cover to lock it.
™ Carestation 620/650/650c (A1) Maintenance safety WARNING To help prevent fires: • Do not use lubricants that contain oil or grease. They may burn or explode in high O2 concentrations. • All covers used on the system must be made from antistatic (conductive) materials.
9 User maintenance Repair policy Do not use malfunctioning equipment. Make all necessary repairs or have the equipment serviced by an authorized service representative. After repair, test the equipment to ensure that it is functioning properly, in accordance with the manufacturer’s published specifications.
™ Carestation 620/650/650c (A1) Maintenance summary and schedule These schedules indicate the minimum frequency of maintenance based on typical usage of 2000 hours per year. Service the equipment more frequently if it is used more than the typical yearly usage. Please contact an authorized representative of the manufacturer for information concerning the decommissioning of equipment.
9 User maintenance Minimum Frequency Maintenance As necessary • Install new cylinder gaskets on cylinder yokes. • Replace the absorbent in the canister. • Empty and clean the overflow trap on the optional suction regulator. • Replace the circuit O2 cell. (Under typical use the cell meets specifications for 2 years.
™ Carestation 620/650/650c (A1) Circuit O2 cell replacement WARNING Handle and dispose of O2 cells according to site biohazard policies. Do not incinerate. Note It may take a new O2 cell 90 minutes to stabilize. If the O2 cell calibration fails after a new O2 cell is installed, wait 90 minutes and repeat the calibration.
Page 189
9 User maintenance Replace the O2 cell. Install the O-ring onto the adapter and screw the adapter onto the new O2 cell. O2 cell Adapter O-ring Reconnect the cable connector to the O2 cell and reinstall into holder. Rotate up and push the breathing system base to lock it into place.
Page 190
™ Carestation 620/650/650c (A1) 12. Calibrate the new O2 cell according to the "Circuit O2 cell" procedure. 2076152-001...
9 User maintenance Flow control test Note The Link-25 system is tested during the "Gas controls" part of the checkout procedure. This procedure is an alternate manual test for significant malfunction of the Link-25 system. WARNING This procedure tests for significant malfunction of the Link-25 system.
Page 192
™ Carestation 620/650/650c (A1) • Set the O2 flow to 3 l/min. • Slowly turn the O2 flow control clockwise, until the N2O flow is decreased to the rates shown in the following table and make sure the O2 flow is as specified. N2O flow l/min O2 flow greater than l/min Adjust the flow of all gases through the full range and make sure...
9 User maintenance Calibration menu Access the Calibration menu from the Checkout menu or by selecting the System Setup button. Follow the instructions on the screen. Note The Calibration menu is not available during a case. See "Calibrating the airway module" in the "Airway modules" section for information on calibrating the airway modules.
™ Carestation 620/650/650c (A1) Airway gas calibration The airway gas selection is only available on the Calibration menu when the system detects an airway module and the module has completed the warm up phase. See the "Airway modules" section for calibration instructions.
9 User maintenance Water buildup Water results from exhaled gas and the chemical reaction between CO2 and the absorbent that takes place within the absorber canister. At lower fresh gas flows more water builds up because less gas is scavenged and: •...
™ Carestation 620/650/650c (A1) Absorber canister Item Description Stock number Absorber canister assembly, reusable (does not 2071165-001-S include absorbent) Cover assembly, with wiper seal 2078337-001-S Wiper seal 2071173-001-S Canister body, CO2 with handle 2071166-001-S Absorber canister, disposable, white to violet, 2079796-001 Medisorb (pack of six) Absorber canister, disposable, white to violet,...
10 Parts Test tools and system parts Description Stock number Airway module calibration gas 755583-HEL Airway module calibration gas (U.S. variant only) 755571-HEL Airway module exhaust line, long 8004462 Airway module exhaust line, short 8004463 Calibration gas regulator 755534-HEL Calibration gas regulator (U.S. variant only) M1006864 D-fend Pro, dark steel blue M1182629...
™ Carestation 620/650/650c (A1) Anesthesia system accessories ISO 80601-2-13:2011 requires the manufacturer test the system using accessories that may impact essential performance and basic safety. This list of accessories demonstrates compliance to the standard. Some items may not be available in every country. Some items may have country specific variants.
Page 203
11 Specifications and theory of operation Specifications and theory of operation In this section System pneumatic circuits......11-2 Pneumatic specifications.
™ Carestation 620/650/650c (A1) To help prevent problems with the gas supplies: • Install yoke plugs on all empty cylinder connections. • When a pipeline supply is connected, keep the cylinder valve closed. • Disconnect the pipeline supplies when the system is not in use. WARNING Do not leave gas cylinder valves open if the pipeline supply is in use.
11 Specifications and theory of operation Mixed gas The mixed gas goes from the flowmeter outlet through the vaporizer that is on, to the fresh gas outlet, and into the breathing system. 11-5 2076152-001...
™ Carestation 620/650/650c (A1) Pneumatic specifications CAUTION All gases supplied to the system must be medical grade. Gas supplies Pipeline gases O2, Air, N2O Cylinder gases O2, Air, N2O (3 cylinder maximum) Cylinder connections Pin indexed Nut and gland DIN-477 Large cylinder kit available for O2 and N2O Primary regulator output Pin indexed: The primary regulator is set to...
11 Specifications and theory of operation Electrical block diagram Inlet/Fuses/Filter Auxiliary/ACGO light and switch, optional Transient suppression board Bottom task light board AC outlets, optional Air control valve Isolation transformer, optional N2O control valve AC/DC O2 bypass valve Power management board O2 latching valve O2 control flow sensor Battery...
11 Specifications and theory of operation Electrical power Supply voltage 100-120, 220-240, or 120/220-240 Vac +/- 10% at 50 or 60 Hz Average power Less than 55 VA consumption Note: Measured through the power cord when operated at the ventilation setting VCV, TV = 500 ml/min, RR = 12/min, I:E = 1:2 with nothing plugged into auxiliary outlets and an airway module inserted.
™ Carestation 620/650/650c (A1) Battery information The system is not a portable unit. A sealed lead acid battery supplies backup power in the event of a power failure. • Capacity to support full system functionality and ventilation for 90 minutes when fully charged. •...
11 Specifications and theory of operation Flow specifications O2 Flush Flush flow 25 to 75 l/min Fresh gas 0, 0.1 to 15.0 l/min 0, 0.1 to 15.0 l/min 0, 0.1 to 10.0 l/min Total flow tube 1 to 10 l/min O2, Air, and N2O 0.1 l/min resolution...
™ Carestation 620/650/650c (A1) Breathing system specifications Compressible volume Ventilator side 2006 ml Bag side 500 ml Reusable canister 1000 ml Disposable canister 1000 ml Absorbent Reusable canister 1370 ml Disposable canister 1400 ml Connections Auxiliary Common Gas Outlet: ISO 5356 type connector on the front of the system (standard 22 mm OD or 15 mm ID conical friction fit connectors).
11 Specifications and theory of operation Expiratory breathing resistance in bag mode* l/min cmH2O Absorber canister installed 0.057 0.57 0.247 2.47 0.560 5.60 Absorber canister removed 0.057 0.57 0.247 2.47 0.560 5.60 *Values include patient circuit tubing and Y-piece 0.065 kPa (0.65 cmH2O) at 60 l/min.
Page 216
™ Carestation 620/650/650c (A1) Active scavenging Disposal system Outlet Flow range Disposal type connector* connection Low flow, low 25 mm hose barb 25 to 50 l/min ISO 1 L vacuum Low flow, low 12.7 mm hose 25 to 50 l/min ISO 1 L vacuum barb...
WARNING Maintain system balance. When using rails or dovetails, distribute equipment on each side of the system. Uneven system balance could cause the system to tip. Carestation 620 Carestation 650 A1 Carestation 650c A1 Carestation 650c A1 Pendant Wall Mount...
™ Carestation 620/650/650c (A1) Note Maximum configured mass includes nominal configuration, external cylinders and maximum loads on all mounting and storage locations. System loading Left dovetail loading The dovetail on the left side of the machine is separated into upper and lower load ratings.
Page 219
11 Specifications and theory of operation Right dovetail loading The dovetail on the right side of the machine is separated into upper and lower load ratings. Maximum allowable upper dovetail loading is 12.1 kg and 54 Nm. Maximum allowable lower dovetail loading is 22.7 kg and 16.2 Nm.
Page 220
™ Carestation 620/650/650c (A1) Figure 11-6 • Top shelf rail load in kg (vertical) versus load distance from the top shelf rail in cm (horizontal). 11-18 2076152-001...
11 Specifications and theory of operation Environmental requirements Operation Storage and Transport Temperature 10 to 40°C -25 to 60°C Oxygen cell 10 to 40°C Oxygen cell storage is -15 to 50°C, 10 to 95% RH LCD display storage is -20 to 60°C Humidity 15 to 95% RH, non-condensing 15 to 95% RH, non-condensing...
™ Carestation 620/650/650c (A1) Airway module specifications Use only airway modules that have anesthetic agent monitoring and O2 monitoring on this system. The following modules can be used on this system: • Airway Gas Option: N-CAiO ™ • CARESCAPE series: E-sCAiO and E-sCAiOV Gas specifications for airway modules Airway humidity (patient 10% RH to 100% RH...
Page 223
11 Specifications and theory of operation Accuracy during stable conditions Hal, Enf, Iso, Sev, Des +/- (0.15 vol% + 5% of reading) Typical performance Measurement range 0 to 15 vol% (0 to 15 kPa, 0 to 113 mmHg). Measurement rise time less than 260 ms typical. Accuracy +/- (0.2 vol% + 2% of reading).
™ Carestation 620/650/650c (A1) Suction regulators (optional) Venturi Suction Regulator Performance Category Pharyngeal Suction Supply Air from system gas supply Drive Gas Consumption* 28 l/min with pipeline drive gas at 280 kPa 52 l/min with pipeline drive gas at 600 kPa Maximum Vacuum* 600 mmHg with pipeline drive gas at 280 kPa 550 mmHg with pipeline drive gas at 600 kPa...
11 Specifications and theory of operation Ventilator theory The ventilator engine is located in the middle pan of the system, under the user work surface. A precision flow servo system controls gas flow to the patient. During inspiration, this gas flow closes the exhalation valve and pushes the bellows down.
™ Carestation 620/650/650c (A1) electrode. This oxidation produces an electrical current proportional to the partial pressure of the oxygen at the electrodes sensing surface. The base metal electrode gradually wears out from the oxidation process. The voltage from the cell cartridge is affected by the temperature of the monitored gas mixture.
Page 227
11 Specifications and theory of operation • Volume control ventilation (VCV) The system offers the following optional modes of mechanical ventilation: • Pressure control ventilation (PCV) • Pressure control ventilation - volume guaranteed (PCV-VG) • Synchronized intermittent mandatory ventilation - volume control ventilation (SIMV VCV) •...
Page 228
™ Carestation 620/650/650c (A1) Paw waveform Tinsp Insp Pause Texp PEEP Flow waveform Figure 11-7 • Volume control waveform Pressure control mode (PCV) Pressure control ventilation supplies a constant set pressure during inspiration. The ventilator calculates the inspiratory time from the frequency and I:E ratio settings.
Page 229
11 Specifications and theory of operation Paw waveform Tinsp Texp Pinsp PEEP Flow waveform Figure 11-8 • Pressure control waveform PCV-VG mode In PCV-VG, a tidal volume is set and the ventilator delivers that volume using a decelerating flow and a constant pressure. The ventilator will adjust the inspiratory pressure needed to deliver the set tidal volume breath-by-breath so that the lowest pressure is used.
Page 230
™ Carestation 620/650/650c (A1) • Rise Rate Paw waveform Tinsp Texp Variable pressure to deliver desired TV PEEP Flow waveform Figure 11-9 • PCV-VG waveforms SIMV VCV mode Synchronized intermittent mandatory ventilation with volume control is a mode in which periodic volume breaths are delivered to the patient at preset intervals (time-triggered).
Page 231
11 Specifications and theory of operation Spontaneous breaths that occur during this mode are indicated by a color change in the waveform. SIMV VCV mode settings: • • • Tinsp • Tpause • Psupport • PEEP • Pmax • Trig Window •...
Page 233
11 Specifications and theory of operation level on the low end and 5 cmH2O below Pmax on the high end. The inspiratory pressure change between breaths is a maximum of +/- 3 cmH2O. If a high airway pressure alarm is active due to the current breath, the next breath’s target will be 0.5 cmH2O less than the current breath’s pressure target.
Page 234
™ Carestation 620/650/650c (A1) Paw waveform Tinsp Spontaneous breathing period Trig Window Variable pressure to deliver desired TV PEEP Flow waveform Figure 11-12 • SIMV PCV-VG waveforms PSVPro mode PSVPro is pressure supported ventilation with apnea backup. PSVPro is a spontaneous mode of ventilation that provides a constant support pressure once the ventilator senses that the patient has made an inspiratory effort.
Page 235
11 Specifications and theory of operation An apnea backup mode is provided if the patient stops breathing. When setting this mode the clinician adjusts the inspiratory pressure (Pinsp), respiratory rate (RR), and the inspiratory time (Tinsp). As long as the patient is triggering the ventilator and the apnea alarm does not activate, the patient will get pressure-supported breaths and the ventilator will not deliver machine breaths.
Page 236
™ Carestation 620/650/650c (A1) setting for Exit Backup is 2. When Exit Backup is set to Off, the user must reselect the PSVPro mode to reactivate PSVPro. Upon returning to PSVPro the ventilator immediately begins providing pressure supported breaths to the patient using the established settings.
11 Specifications and theory of operation • Tinsp • Rise Rate PEEP Time Figure 11-14 • CPAP + PSV waveform Ventilation modes factory default settings The ventilation mode factory default settings for the ADULT case default show in the following table. An * indicates the setting is not used for the ventilation mode.
11 Specifications and theory of operation Ventilator operating specifications Based on the ventilator settings in use, the setting ranges may be constrained so that the specifications stated are met. Pneumatics Gas source Anesthesia system Gas composition Medical Air or O2 Peak gas flow 120 l/min at 240 kPa (35 psi), 0.75 seconds Flow valve range...
11 Specifications and theory of operation Ventilator accuracy data The following accuracy data is based on patient conditions and settings described in ISO 80601-2-13. For the following to be true, the ventilator is operating with 100 percent oxygen in the breathing system and is connected to an integrated airway module.
™ Carestation 620/650/650c (A1) Electromagnetic compatibility (EMC) WARNING Changes or modification to this equipment not expressly approved by the manufacturer could cause EMC issues with this or other equipment. Contact the manufacturer for assistance. This device is designed and tested to comply with applicable regulations regarding EMC as follows.
11 Specifications and theory of operation Display optional output Cables used for EMC testing ports Ethernet Standard 8-pin RJ45 connector with unshielded Ethernet cable - 7.6 m maximum length. Ethernet Standard 8-pin RJ45 connector with unshielded Ethernet cable - 7.6 m maximum length. Universal Serial Bus Standard Type A connector USB cable with foil (USB)
Page 244
™ Carestation 620/650/650c (A1) Guidance and manufacturer's declaration - electromagnetic immunity The system is suitable for use in the specified electromagnetic environment. The customer and/or user of the system should assure that it is used in an electromagnetic environment as described below. Phenomenon Basic EMC Professional healthcare facility environment...
Page 245
11 Specifications and theory of operation Phenomenon Basic EMC Professional healthcare facility environment standard or test method Note: UT is the AC mains voltage prior to application of the test level Recommended separation distances The system is intended for use in the electromagnetic environment in which radiated RF disturbances are controlled.
™ Carestation 620/650/650c (A1) Super user mode WARNING Do not enter Super User mode when a patient is connected to the system. Gas flow will cease, and the system must be powered down in order to restart gas flow. • Changes made in Super User mode affect the system configuration.
12 Super user mode Gas usage Use the Gas Usage menu to view the total fresh gas usage since the last reset, to reset the gas usage to zero, and view optional ecoFLOW and agent cost information. Resetting cumulative gas usage From Super User mode, select Gas Usage and then Cumulative Gas Usage.
Page 250
™ Carestation 620/650/650c (A1) Set the cost for each agent. Select Back to return to the Gas Usage menu. 12-4 2076152-001...
12 Super user mode System configuration Use the System Config. menu to set default information for the system. Use the System Config. menu to access menus and settings for Colors, Units, Ventilator Settings, Alarm Settings, Parameter Settings, Trends Setup, and Pages Setup. Display settings Use the Colors menu to set the default colors for waveforms, digit fields, and trends.
™ Carestation 620/650/650c (A1) Select the item to change. Set VCV Cardiac Bypass to Yes to enable alveolar support during cardiac bypass. This menu item is only available on systems with the VCV Cardiac Bypass option installed. Set Circuit Compliance to On to allow tidal volume compensation for circuit compliance.
12 Super user mode Setting principal setting defaults From Super User mode, select System Config. and then Parameter Settings. Select the item to change. For Principal Volume, select MV or TV from the drop-down list. For Principal O2, select Et or Fi from the drop-down list. For Principal Agent, select Et or Fi from the drop-down list.
™ Carestation 620/650/650c (A1) Setting the default trend type From Super User mode, select System Config. and then Trends Setup. Select Default Trend and then select the trend type from the drop-down list. Graphical shows the graphical trends. Measured shows the numeric trends. Settings shows the trends for the settings.
Page 255
12 Super user mode Setting page views The table shows the factory default settings for each page view. Default settings for Page view setup Page 1 Page 2 Page 3 Page 4 Middle Flow Flow Flow Bottom Left Loops/Off Loops/Off Middle Left Resp Resp...
™ Carestation 620/650/650c (A1) Case defaults Use the Case Defaults menu to set the default case types that show on the Start Case menu and access the Volume Apnea Setup menu. Configuring case defaults Set the case defaults for the case types that are selectable from the Start Case menu.
12 Super user mode Select Volume Apnea Setup. Set Volume Apnea Selection to Enable or Disable. Set to Enable to allow the user to turn the volume apnea alarm on or off from the Start Case menu. Set to Disable to set the volume apnea alarms as always on during manual ventilation.
Page 258
™ Carestation 620/650/650c (A1) Page 2 Default settings for default case types Settings ADULT PEDIATRIC LOCAL CUSTOM 1 Tpause PEEP Page 3 Default settings for default case types Settings ADULT PEDIATRIC LOCAL CUSTOM 1 Pmax Pinsp Tinsp Trig Window Flow Trigger Psupport End of Breath Page 4 Default settings for default case types...
Page 259
12 Super user mode Page 5 Default settings for default case types Settings ADULT PEDIATRIC LOCAL CUSTOM 1 Right Digit Field Gases Gases Gases Gases Page 6 Default settings for default case types Settings ADULT PEDIATRIC LOCAL CUSTOM 1 MV Low MV High 10.0 10.0...
Page 260
™ Carestation 620/650/650c (A1) Page 7 Default settings for default case types Settings ADULT PEDIATRIC LOCAL CUSTOM 1 FiEnf High Page 8 Default settings for default case types Settings ADULT PEDIATRIC LOCAL CUSTOM 1 EtHal Low EtHal High FiHal Low FiHal High 12-14 2076152-001...
12 Super user mode Copy logs Use the Copy Logs menu to save logs to a USB memory device. The system can copy error logs, event logs, alarm logs, and key press logs. Using copy logs From Super User mode, select Copy Logs. Follow the instructions on the screen.
™ Carestation 620/650/650c (A1) Procedures setup Use the Procedures menu to set the procedures available to the user. From this menu select the default settings for Vital Capacity and Cycling procedures. Setting vital capacity defaults From Super User mode, select Procedures. Select Vital Capacity.
Index viewing alarm history 3-22 Anesthesia system display 2-15 Abbreviations 1-14 Apnea delay 3-23 Absorbent color change 8-7 Auto MV Limit 3-24 Absorber canister Automatic agent identification 6-9 reusable 8-8 Auxiliary O2 flowmeter 8-20 when to change the absorbent 8-7 Auxiliary O2+Air 3-39 ACGO 3-37 ActiveAGSS 8-25...
Page 264
™ Carestation 620/650/650c (A1) Cycling changing settings 3-33 Hard keys 3-18 Cylinder back cover 8-22 High-pressure leak test 8-23 Data source 3-17, 3-28, 7-5 Indications for use 1-2 Digit field setup 3-16 Digit fields 2-16 Display Keypad brightness 3-18 controls 2-12 Display brightness 3-18 Display navigation 2-21 Leak audio alarms 3-23...
Page 265
Index flow sensors 10-3 menu functions 3-27 O2 cell 10-2 setting loop type 3-27 patient port assembly 10-3 Spirometry setup tools and system parts 10-5 loopgraph scaling 3-28 Passive AGSS 8-24, 8-24 setting patient and sensor type 3-28 Patient demographics 3-16 volume type 3-29 Pause gas flow 3-30 Split screen field 2-17...
Page 267
Warranty This Product is sold by the manufacturer under the warranties set forth in the following paragraphs. Such warranties are extended only with respect to the purchase of this Product directly from the manufacturer or the manufacturer’s Authorized Dealers as new merchandise and are extended to the Buyer thereof, other than for the purpose of resale.