Operating Instructions

Anesthesia System
A N E S T H E S I A S YS T E M

A5_Ops Covers-046-001606-00_Eng.indd 1 3/3/11 12:27 PM

 Operating Instructions
™

Anesthesia System
A N E S T H E S I A S YS T E M

A5_Ops Covers-046-001613-00_Eng.indd 1 3/3/11 12:35 PM

A5™ is U.S. trademarks of Mindray DS USA, Inc.

SELECTATEC® is a registered trademark of Datex-Ohmeda, Inc.

Copyright © Shenzen Mindray Bio-Medical Electronics Co., Ltd, 2010 to 2018. All rights reserved. Contents of this
publication may not be reproduced in any form without permission of Shenzen Mindray Bio-Medical Electronics Co., Ltd.
 Table of Contents

Table of Contents
Table of Contents ................................................................................................................................................................................................................ i
Foreword .............................................................................................................................................................................................................................vii
Indications For Use ..........................................................................................................................................................................................................vii
Responsibilities of Operators .......................................................................................................................................................................................vii
Warnings, Cautions, and Notes ...................................................................................................................................................................................vii
Warnings............................................................................................................................................................................................................................ viii
Cautions...............................................................................................................................................................................................................................xii
Notes.....................................................................................................................................................................................................................................xv
Intellectual Property Statement............................................................................................................................................................................... xvii
Warranty Statements ................................................................................................................................................................................................... xvii
Disclaimers...................................................................................................................................................................................................................... xviii
Phone Numbers and How To Get Assistance..................................................................................................................................................... xviii
Manufacturer’s Responsibility ................................................................................................................................................................................. xviii
Manufacturer and Address ...................................................................................................................................................................................... xviii
Symbols............................................................................................................................................................................................................................ xviii
Product Description............................................................................................................................................1 - 1
General System Overview .........................................................................................................................................................................................1 - 2
General Description..........................................................................................................................................................................................1 - 2
Key Features ........................................................................................................................................................................................................1 - 3
Fresh Gas Dosing ...............................................................................................................................................................................................1 - 3
Flow Control ........................................................................................................................................................................................................1 - 4
Vaporizer Mounting..........................................................................................................................................................................................1 - 4
Anesthesia Ventilator.......................................................................................................................................................................................1 - 4
Breathing System ..............................................................................................................................................................................................1 - 4
Active Anesthetic Gas Scavenging System ..............................................................................................................................................1 - 5
Passive Anesthetic Gas Scavenging System ............................................................................................................................................1 - 5
Power Management / Battery Supply........................................................................................................................................................1 - 5
Workplace Ergonomics....................................................................................................................................................................................1 - 7
Hook .......................................................................................................................................................................................................................1 - 7
Physical Views................................................................................................................................................................................................................1 - 8
Main Unit (Front View).....................................................................................................................................................................................1 - 8
Main Unit (Rear View).................................................................................................................................................................................... 1 - 10
Main Unit (Left View)..................................................................................................................................................................................... 1 - 12
Main Unit (Right View).................................................................................................................................................................................. 1 - 13
Main Unit (Top View)..................................................................................................................................................................................... 1 - 14
Breathing System (Top View) ..................................................................................................................................................................... 1 - 15
Breathing System (Left View) ..................................................................................................................................................................... 1 - 16
Active Anesthetic Gas Scavenging System (AGSS) (Top, Right, and Rear Views).................................................................... 1 - 18
Passive Anesthetic Gas Scavenging System (AGSS) (Right View) ................................................................................................. 1 - 20
Installation ..........................................................................................................................................................2 - 1
Unpacking.......................................................................................................................................................................................................................2 - 3
Initial Setup.....................................................................................................................................................................................................................2 - 4
Install the Vaporizer.....................................................................................................................................................................................................2 - 5
Filling and Draining the Vaporizer ..............................................................................................................................................................2 - 7
System Interface .................................................................................................................................................3 - 1
Main Screen Components.........................................................................................................................................................................................3 - 2
System Information Header .....................................................................................................................................................................................3 - 5
Elapsed / Countdown Timer..........................................................................................................................................................................3 - 5
Patient Size ..........................................................................................................................................................................................................3 - 6
Alarm and Prompt Messages ........................................................................................................................................................................3 - 6

A5™ Operating Instructions 046-002773-00 i

Table of Contents

Alarm Silence Icon.............................................................................................................................................................................................3 - 7

Date and Time ....................................................................................................................................................................................................3 - 8
Battery Status......................................................................................................................................................................................................3 - 9
Fresh Gas Flow Display............................................................................................................................................................................................ 3 - 10
Waveforms Tab .......................................................................................................................................................................................................... 3 - 11
Waveforms Autoscaling ............................................................................................................................................................................... 3 - 11
Waveforms Manual Scaling ........................................................................................................................................................................ 3 - 12
Spirometry Tab........................................................................................................................................................................................................... 3 - 13
Loop Type.......................................................................................................................................................................................................... 3 - 15
Show Reference .............................................................................................................................................................................................. 3 - 16
Save Loop .......................................................................................................................................................................................................... 3 - 16
Review Loops Button .................................................................................................................................................................................... 3 - 16
Demographics Tab.................................................................................................................................................................................................... 3 - 19
Ventilation Mode Tabs............................................................................................................................................................................................. 3 - 21
Measured Values Area ............................................................................................................................................................................................. 3 - 23
System Softkeys ......................................................................................................................................................................................................... 3 - 24
Setup Softkey ................................................................................................................................................................................................... 3 - 24
Alarms Softkey................................................................................................................................................................................................. 3 - 24
Silence Softkey ................................................................................................................................................................................................ 3 - 24
Capture Event .................................................................................................................................................................................................. 3 - 24
History................................................................................................................................................................................................................. 3 - 24
Setup.............................................................................................................................................................................................................................. 3 - 32
General Tab ................................................................................................................................................................................................................. 3 - 32
Display Tab .................................................................................................................................................................................................................. 3 - 34
System Tab................................................................................................................................................................................................................... 3 - 38
Network Configuration................................................................................................................................................................................. 3 - 41
Service Tab................................................................................................................................................................................................................... 3 - 44
Preoperative Tests..............................................................................................................................................4 - 1
Preoperative Test Schedules ....................................................................................................................................................................................4 - 2
Test Intervals .......................................................................................................................................................................................................4 - 2
Inspect the System.......................................................................................................................................................................................................4 - 3
Pre-Operative Checkout List.....................................................................................................................................................................................4 - 4
Introduction.........................................................................................................................................................................................................4 - 4
Suggested Pre-Operative Checkout List ...................................................................................................................................................4 - 4
System Self-Test............................................................................................................................................................................................................4 - 6
Leak and Compliance Tests ......................................................................................................................................................................................4 - 9
Automatic Circuit Leak and Compliance Test .........................................................................................................................................4 - 9
Manual Circuit Leak Test .............................................................................................................................................................................. 4 - 14
Preoperative Check List (software bundle version 02.09.00 and later).................................................................................................. 4 - 17
Power Failure Alarm Test........................................................................................................................................................................................ 4 - 18
Pipeline Tests .............................................................................................................................................................................................................. 4 - 18
O2 Pipeline Test............................................................................................................................................................................................... 4 - 18
N2O Pipeline Test............................................................................................................................................................................................ 4 - 18
Air Pipeline Test............................................................................................................................................................................................... 4 - 19
Basic Ventilation Testing......................................................................................................................................................................................... 4 - 19
Cylinder Tests.............................................................................................................................................................................................................. 4 - 20
Check the Cylinder Pressure....................................................................................................................................................................... 4 - 20
O2 Cylinder High Pressure Leak Test ....................................................................................................................................................... 4 - 20
N2O Cylinder High Pressure Leak Test .................................................................................................................................................... 4 - 20
Air Cylinder High Pressure Leak Test....................................................................................................................................................... 4 - 20
Flow Control System Test....................................................................................................................................................................................... 4 - 21
Vaporizer Tests ........................................................................................................................................................................................................... 4 - 22

ii 046-002773-00 A5™ Operating Instructions

 Table of Contents

Vaporizer Back Pressure Test...................................................................................................................................................................... 4 - 22

Manual Leak Test ............................................................................................................................................................................................ 4 - 22
Vaporizer Leak Test........................................................................................................................................................................................ 4 - 22
Breathing System Tests ........................................................................................................................................................................................... 4 - 24
Bellows Test ...................................................................................................................................................................................................... 4 - 24
Breathing System Leak Test in Manual Ventilation Status .............................................................................................................. 4 - 24
APL Valve Test.................................................................................................................................................................................................. 4 - 25
Alarm Tests .................................................................................................................................................................................................................. 4 - 26
Prepare for Alarm Tests ................................................................................................................................................................................ 4 - 26
Test the O2 Concentration Monitoring and Alarms ........................................................................................................................... 4 - 26
Test the Low Minute Volume (MV) Alarm.............................................................................................................................................. 4 - 27
Test the Apnea Alarm.................................................................................................................................................................................... 4 - 27
Test the Continuous Airway Pressure Alarm ........................................................................................................................................ 4 - 27
Test the High Paw Alarm.............................................................................................................................................................................. 4 - 27
Test the Low Paw Alarm............................................................................................................................................................................... 4 - 28
Preoperative Preparations ..................................................................................................................................................................................... 4 - 28
Inspect the Active/Passive Anesthetic Gas Scavenging System .............................................................................................................. 4 - 29
Inspect the AGSS............................................................................................................................................................................................. 4 - 29
Inspect the Passive AGSS............................................................................................................................................................................. 4 - 29
Operations...........................................................................................................................................................5 - 1
Powering On the A5 Anesthesia System .............................................................................................................................................................5 - 2
Powering Off the A5 Anesthesia System .............................................................................................................................................................5 - 2
Patient Setup..................................................................................................................................................................................................................5 - 3
End Case / Standby Mode ..............................................................................................................................................................................5 - 3
Select the Patient Size (Adult, Pediatric, Infant) .....................................................................................................................................5 - 5
Oxygen Sensor Calibration .......................................................................................................................................................................................5 - 5
Input Fresh Gas .............................................................................................................................................................................................................5 - 6
Set N2O, Air, and O2 Inputs ............................................................................................................................................................................5 - 6
Set Anesthetic Agent .......................................................................................................................................................................................5 - 6
Ventilation Modes ........................................................................................................................................................................................................5 - 8
Monitored Parameters.....................................................................................................................................................................................5 - 8
Ventilation Modes .............................................................................................................................................................................................5 - 8
Change Ventilation Mode ..............................................................................................................................................................................5 - 8
Set Manual Ventilation Mode........................................................................................................................................................................5 - 9
Setting Monitor Mode (A5 with AG Module connected) ................................................................................................................. 5 - 11
Make Settings before Starting Mechanical Ventilation Mode ....................................................................................................... 5 - 14
Set Volume Control Ventilation (VCV)..................................................................................................................................................... 5 - 14
Set Pressure Control Ventilation (PCV) ................................................................................................................................................... 5 - 15
Synchronized Intermittent Mandatory Ventilation (SIMV).............................................................................................................. 5 - 16
Set Pressure Support Ventilation (PS) ..................................................................................................................................................... 5 - 18
Start Mechanical Ventilation ................................................................................................................................................................................. 5 - 19
Stop Mechanical Ventilation ................................................................................................................................................................................. 5 - 19
Relationships of Ventilation Parameters........................................................................................................................................................... 5 - 19
Parameter Monitoring (Numerics) ...................................................................................................................................................................... 5 - 20
Pressure.............................................................................................................................................................................................................. 5 - 20
Volume ............................................................................................................................................................................................................... 5 - 20
Gas (available with the AG module) ........................................................................................................................................................ 5 - 21
Inspired O2 (available without the AG module) .................................................................................................................................. 5 - 21
Parameter Monitoring (Waveforms)................................................................................................................................................................... 5 - 21
Pressure Waveform........................................................................................................................................................................................ 5 - 22
Flow Waveform ............................................................................................................................................................................................... 5 - 22
Volume Waveform ......................................................................................................................................................................................... 5 - 23

A5™ Operating Instructions 046-002773-00 iii

Table of Contents

Gas Waveform (available with the AG module) .................................................................................................................................. 5 - 23

Waveform Autoscaling ................................................................................................................................................................................. 5 - 24
Parameter Monitoring (Spirometry)................................................................................................................................................................... 5 - 25
Alarms and Messages .........................................................................................................................................6 - 1
Introduction ...................................................................................................................................................................................................................6 - 2
Alarm System Self-Test....................................................................................................................................................................................6 - 2
Types of Alarms and Messages.....................................................................................................................................................................6 - 3
Alarm Indicators.................................................................................................................................................................................................6 - 4
Displaying Alarms ........................................................................................................................................................................................................6 - 5
Displayed Order of Alarm Messages...........................................................................................................................................................6 - 6
Setting Alarm Volume ................................................................................................................................................................................................6 - 7
Silencing Alarms ...........................................................................................................................................................................................................6 - 8
Alarm Limits....................................................................................................................................................................................................................6 - 9
Setting Alarm Limits .........................................................................................................................................................................................6 - 9
Loading Alarm Defaults................................................................................................................................................................................ 6 - 12
Auto Alarm Limits........................................................................................................................................................................................... 6 - 14
Setting CO2 Apnea Delay Time (software bundle version 02.09.00 and later) ........................................................................ 6 - 14
Alarm and Prompt Messages ................................................................................................................................................................................ 6 - 15
Technical Alarm Messages .......................................................................................................................................................................... 6 - 18
Prompt Messages ........................................................................................................................................................................................... 6 - 26
Maintenance .......................................................................................................................................................7 - 1
Theory of Operation ....................................................................................................................................................................................................7 - 3
Block Diagram................................................................................................................................................................................................................7 - 3
Maintenance Schedule...............................................................................................................................................................................................7 - 4
Breathing System Maintenance ..............................................................................................................................................................................7 - 4
Flow Sensor Calibration .............................................................................................................................................................................................7 - 5
O2 Sensor Calibration..................................................................................................................................................................................................7 - 6
Calibrate the O2 Sensor...................................................................................................................................................................................7 - 7
Water Build-up in the Flow Sensor.........................................................................................................................................................................7 - 9
Prevent Water Build-up ...................................................................................................................................................................................7 - 9
Clear Water Build-up ........................................................................................................................................................................................7 - 9
AGSS Transfer Tube Maintenance..........................................................................................................................................................................7 - 9
Electrical Safety Inspection .......................................................................................................................................................................................7 - 9
Auxiliary Electrical Outlet Test ......................................................................................................................................................................7 - 9
Electrical Safety Inspection Test................................................................................................................................................................ 7 - 10
Cleaning and Disinfection...................................................................................................................................................................................... 7 - 11
General Guidelines......................................................................................................................................................................................... 7 - 11
Cleaning and Disinfecting Agents / Autoclaving................................................................................................................................ 7 - 11
External Surfaces............................................................................................................................................................................................. 7 - 12
Bellows Assembly........................................................................................................................................................................................... 7 - 12
Inspiration and Expiration Valves ............................................................................................................................................................. 7 - 15
Oxygen Sensor................................................................................................................................................................................................. 7 - 18
APL Valve ........................................................................................................................................................................................................... 7 - 19
PAW Gauge....................................................................................................................................................................................................... 7 - 20
Bag Arm.............................................................................................................................................................................................................. 7 - 21
Absorber Canister........................................................................................................................................................................................... 7 - 22
Breathing System Block................................................................................................................................................................................ 7 - 25
Active AGSS (Anesthetic Gas Scavenging System) and AGSS Transfer Hose ........................................................................... 7 - 27
Regular Maintenance............................................................................................................................................................................................... 7 - 29
AG and O2 Concentration Monitoring (Optional)............................................................................................8 - 1
Introduction ...................................................................................................................................................................................................................8 - 2
Understand MAC Values ............................................................................................................................................................................................8 - 3

iv 046-002773-00 A5™ Operating Instructions

 Table of Contents

Identify External AG Modules ..................................................................................................................................................................................8 - 4

Prepare to Measure AG ..............................................................................................................................................................................................8 - 5
Make AG Settings .........................................................................................................................................................................................................8 - 6
Set CO2 Unit ........................................................................................................................................................................................................8 - 6
Set CO2 Placement ...........................................................................................................................................................................................8 - 6
Set CO2 Scale ......................................................................................................................................................................................................8 - 6
Gas Bench Flow Rate ........................................................................................................................................................................................8 - 6
Set Alarm Limits .................................................................................................................................................................................................8 - 7
Measurement Limitations .........................................................................................................................................................................................8 - 8
Troubleshooting ...........................................................................................................................................................................................................8 - 8
Scavenge the Sample Gas .........................................................................................................................................................................................8 - 9
Calibrate the AG Module ........................................................................................................................................................................................ 8 - 10
Product Specifications........................................................................................................................................9 - 1
Standards Compliance ...............................................................................................................................................................................................9 - 2
Safety Designations.....................................................................................................................................................................................................9 - 4
Oxygen Enriched Environments ..................................................................................................................................................................9 - 4
Wiring and PC Board Materials .....................................................................................................................................................................9 - 4
Physical Specifications................................................................................................................................................................................................9 - 5
Stability Configurations and Conditions..............................................................................................................................................................9 - 5
Environmental Specifications ..................................................................................................................................................................................9 - 6
Electrical Specifications..............................................................................................................................................................................................9 - 7
Main Electrical Power Specifications ..........................................................................................................................................................9 - 7
Battery Power Specifications.........................................................................................................................................................................9 - 7
Auxiliary Electrical Outlets..............................................................................................................................................................................9 - 7
Communication Ports......................................................................................................................................................................................9 - 8
Pneumatic Specifications ..........................................................................................................................................................................................9 - 8
Pipeline Supply (N2O, Air, O2) .......................................................................................................................................................................9 - 8
Cylinder Supply (N2O, Air, O2).......................................................................................................................................................................9 - 8
Vaporizer Connections ....................................................................................................................................................................................9 - 9
Drive Gas...............................................................................................................................................................................................................9 - 9
N2O Automatic Cutoff......................................................................................................................................................................................9 - 9
O2 Controls ..........................................................................................................................................................................................................9 - 9
Oxygen Ratio Controller..................................................................................................................................................................................9 - 9
Breathing System Specifications ............................................................................................................................................................................9 - 9
Breathing System Volume..............................................................................................................................................................................9 - 9
CO2 Absorber Assembly..................................................................................................................................................................................9 - 9
Water Trap......................................................................................................................................................................................................... 9 - 10
Breathing System Connections ................................................................................................................................................................. 9 - 10
APL Valve ........................................................................................................................................................................................................... 9 - 10
Resistance.......................................................................................................................................................................................................... 9 - 12
Breathing System Temperature Controller........................................................................................................................................... 9 - 12
Breathing Circuit Parameters ..................................................................................................................................................................... 9 - 12
Materials ............................................................................................................................................................................................................ 9 - 13
Anesthetic Gas Scavenging System (AGSS)..................................................................................................................................................... 9 - 13
Monitor Module ......................................................................................................................................................................................................... 9 - 13
AG Module ........................................................................................................................................................................................................ 9 - 13
Alarms................................................................................................................................................................................................................. 9 - 16
Effect of Interfering Gas on AG Measured Value................................................................................................................................. 9 - 17
Ventilator Specifications ......................................................................................................................................................................................... 9 - 18
Displays and Controls Specifications ................................................................................................................................................................. 9 - 20
Electronic Controls......................................................................................................................................................................................... 9 - 20
Pneumatic Controls ....................................................................................................................................................................................... 9 - 21

A5™ Operating Instructions 046-002773-00 v

Table of Contents

Alarms............................................................................................................................................................................................................................ 9 - 21
Safety Specifications ................................................................................................................................................................................................ 9 - 22
ASTM F 1208 – 89 (2005) Disclosures................................................................................................................................................................. 9 - 23
Leakage of Breathing System..................................................................................................................................................................... 9 - 23
Resistance of Breathing Systems .............................................................................................................................................................. 9 - 23
CO2 Absorber Resistance............................................................................................................................................................................. 9 - 23
CO2 Absorber Capacity................................................................................................................................................................................. 9 - 23
Unidirectional Valve Opening Pressure.................................................................................................................................................. 9 - 24
Data Storage (Non-Volatile) and Recording .................................................................................................................................................... 9 - 24
Electromagnetic Compatibility ............................................................................................................................................................................ 9 - 24
Accessories ..........................................................................................................................................................A - 1
Accessory Kits ............................................................................................................................................................................................................... A - 2
AG Accessories ............................................................................................................................................................................................................. A - 2
CO2 Absorbent Canister............................................................................................................................................................................................ A - 2
Gas Cylinder Accessories .......................................................................................................................................................................................... A - 2
Gas Supply Hoses ........................................................................................................................................................................................................ A - 3
Manuals and Reference Cards ................................................................................................................................................................................ A - 3
Mounting Accessories ............................................................................................................................................................................................... A - 3
Networking and USB Storage ................................................................................................................................................................................. A - 4
Vaporizers....................................................................................................................................................................................................................... A - 4
Scavenging Accessories............................................................................................................................................................................................ A - 5
User Accessible Spare Parts ...............................................................................................................................B - 1
Active AGSS ................................................................................................................................................................................................................... B - 2
Breathing System ........................................................................................................................................................................................................ B - 2
CO2 Absorbent Canister............................................................................................................................................................................................ B - 2
Flow Sensor ................................................................................................................................................................................................................... B - 2
Gas Cylinder Accessories .......................................................................................................................................................................................... B - 3
O2 Sensor........................................................................................................................................................................................................................ B - 3
Battery ............................................................................................................................................................................................................................. B - 3
Parameters and Factory Defaults ......................................................................................................................C - 1
Waveform/Spirometry Tabs .................................................................................................................................................................................... C - 2
Alarm Limits................................................................................................................................................................................................................... C - 3
Setup Menu ................................................................................................................................................................................................................... C - 5
Alarm Volume and History....................................................................................................................................................................................... C - 8
Date and Time .............................................................................................................................................................................................................. C - 8
Demographics .............................................................................................................................................................................................................. C - 9
Ventilation Modes ....................................................................................................................................................................................................... C - 9
Linked Ventilation Parameter ...............................................................................................................................................................................C - 13
Ventilation Parameter Relationships..................................................................................................................................................................C - 15
Pneumatic Diagram ........................................................................................................................................... D - 1
Pneumatic Diagram of the A5 System.................................................................................................................................................................D - 2
Abbreviations, Symbols, and Units of Measure ............................................................................................... E - 1
Abbreviations ................................................................................................................................................................................................................E - 2
Symbols............................................................................................................................................................................................................................E - 4
Units of Measure...........................................................................................................................................................................................................E - 5
Attention Symbols .......................................................................................................................................................................................................E - 6
Preparation for Malignant Hyperthermia Susceptible Patients..................................................................... F - 1
Malignant Hyperthermia Causes, Effects and Treatment ..............................................................................................................................F - 2
Malignant Hyperthermia Washout ........................................................................................................................................................................F - 2
Washout Procedure for Malignant Hyperthermia Susceptible Patients with A5 Anesthesia Delivery Systems........................F - 2
References.......................................................................................................................................................................................................................F - 4

vi 046-002773-00 A5™ Operating Instructions

Foreword Introduction

Foreword
WARNING: Do not operate the A5 Anesthesia System before reading these
instructions.

The operating instructions for the A5 Anesthesia Delivery System (hereinafter referred to as A5
Anesthesia System, A5 System, A5, or individual A5 is intended to provide information for proper
installation, operation, and general maintenance of the A5 System to the user.

General knowledge and understanding of the features and functions of the A5 System are
prerequisites for its proper use.

For servicing information or assistance, please contact an authorized representative in your area.

Rx only: U.S. Federal Law restricts this device to sale by or on the order of a
physician or other practitioner licensed by state law to use or order the
use of this device.

NOTE: Figures in this manual are provided for reference purposes only.
Screens may differ based on the system configuration and selected
parameters.

Indications For Use

The A5 Anesthesia System is a device used to administer to a patient, continuously or intermittently, a
general inhalation anesthetic, and to maintain a patient's ventilation.

The A5 is intended for use by licensed clinicians, for patients requiring anesthesia within a health care
facility, and can be used for adult and pediatric populations.

WARNING: The A5 is intended to be operated only by licensed clinicians and

qualified anesthesia personnel who have received adequate training in
its use. Anyone unauthorized or untrained must not perform any
operation on the A5.

WARNING: The A5 is not suitable for use in an MRI environment.

Responsibilities of Operators
The proper function of the A5 System can only be guaranteed if it is operated and serviced in
accordance with the information provided in this manual and by an authorized Mindray service
representative. Non-compliance with this information voids all guarantee claims.

The A5 System must be operated by qualified and trained personnel only. All operators must fully
observe these operating instructions and relevant additional documentation. They must also comply
with the WARNINGS, CAUTIONS, and NOTES detailed in this manual.

Warnings, Cautions, and Notes

Please adhere to all warnings, cautions, and notes that are listed throughout this manual. They are
summarized here for your reference.

WARNING — Indicates a potential hazard or unsafe practice that, if not avoided, could result in death
or serious injury to the patient or user.

CAUTION — Indicates a potential hazard or unsafe practice that, if not avoided, could result in
product/property damage or minor personal injury to the patient or user.

NOTE — Provides application tips or other useful information.

A5™ Operating Instructions 046-002773-00 vii

Introduction Warnings

Warnings
WARNING: Do not operate the A5 Anesthesia System before reading these
instructions.

WARNING: All analog or digital products connected to this system must be

certified passing the specified IEC standards (such as IEC 60950 for data
processing equipment and IEC 60601-1 for medical electrical
equipment). All configurations shall comply with the valid version of
IEC 60601-1. The personnel who are responsible for connecting the
optional equipment to the I/O signal port shall be responsible for
medical system configuration and system compliance with IEC 60601-1.

WARNING: This machine must only be operated by trained, skilled medical staff.

WARNING: Before putting the system into operation, the operator must verify that
the equipment, connecting cables, and accessories are in correct
working order and operating condition.

WARNING: The equipment must be connected to a properly installed power outlet

with protective earth contacts only. If the installation does not provide
for a protective earth conductor, disconnect it from the power line or
operate from the equipment’s internal battery supply.

WARNING: Multiple AC power outlets are provided on the rear of the A5. These
outlets are intended to supply power to additional equipment that
form a part of the anesthesia system (i.e. vaporizers, gas analyzers,
etc.). Do not connect other equipment to these outlets, as patient
leakage current may be affected. Each outlet is rated 3 A; the total
current that may be drawn through all outlets is 10 A on the A5 System ;
do not attempt to exceed these load ratings. Do not connect additional
Multiple Portable Socket Outlets (i.e. Multiple outlet extension cords)
(MPSOs) or extension cords to these outlets.

WARNING: Do not put MPSOs on the floor.

WARNING: Connect the A5 Anesthesia System to an AC power source before the

internal battery power source is depleted.

WARNING: Do not open the equipment housings. All servicing and future
upgrades must be carried out only by trained and authorized Mindray
personnel.

WARNING: Do not rely exclusively on the audible alarm system for patient
monitoring.

WARNING: Adjustment of alarm volume to a low level may result in a hazard to the
patient.

WARNING: Alarm settings should be customized according to different patient

situations. Constantly keeping the patient under close surveillance is
the most reliable way for safe patient monitoring.

WARNING: The physiological parameters and alarm messages displayed on the

screen of the equipment are for the caregiver’s reference only and
cannot be directly used as the basis for clinical treatment.

WARNING: Dispose of the packaging material, observing the applicable waste

control regulations and keeping it out of children’s reach.

viii 046-002773-00 A5™ Operating Instructions

Warnings Introduction

WARNING: To avoid the possibility of explosion, do not use the equipment in the
presence of flammable anesthetic agents, vapors or liquids. Do not use
flammable anesthetic agents such as ether and cyclopropane for this
equipment. Use only non-flammable anesthetic agents that meet the
requirements specified in ISO 80601-2-13. The A5 Anesthesia System
can be used with halothane, enflurane, isoflurane, sevoflurane, and
desflurane. Only one anesthetic agent can be used at a time.

WARNING: Fresh gas flow must never be switched off before the vaporizer is
switched off. The vaporizer must never be left switched on without a
fresh-gas flow. Anesthetic agent vapor at a high concentration can get
into the machine lines and ambient air, causing harm to people and
materials.

WARNING: To avoid the risk of electric shock, this equipment must only be
connected to a supply mains with protective earth.

WARNING: The use of anti-static or electrically conductive breathing tubes, when

utilizing high frequency electric surgery equipment, may cause burns,
and is therefore not recommended in any application of this machine.

WARNING: Possible electric shock hazard. The machine may only be opened by
authorized service personnel.

WARNING: The patient should be visually monitored by qualified personnel. In

certain situations, life-threatening circumstances may occur that may
not necessarily trigger an alarm.

WARNING: Always set the alarm limits so that the alarm is triggered before a
hazardous situation occurs. Incorrectly set alarm limits may result in
operating personnel not being aware of drastic changes in the patient’s
condition.

WARNING: Connection of both medical and non-medical equipment to the

auxiliary mains socket outlet (s) may increase the leakage currents to
values exceeding the allowable limits.

WARNING: Electric shock and fire hazard: Do not clean the machine while it is
powered on and/or plugged into an outlet.

WARNING: Disconnect the power plug from the mains supply before removing the
rear panels or servicing the A5 unit.

WARNING: Malfunction of the central gas supply system may cause more than one
or even all devices connected to it to stop their operation
simultaneously.

WARNING: The anesthesia system will cease to deliver gas at pressures below the
minimum specified gas pipeline supply pressure.

WARNING: Use a cleaning and disinfection schedule that conforms to your

institution's disinfection and risk-management policies.

• Refer to the material safety data as applicable.

• Refer to the operation and maintenance manuals of all
disinfection equipment.
• Do not inhale fumes that may result from any disinfection process.

WARNING: Use extreme care while handling the absorbent as it is a caustic irritant.

A5™ Operating Instructions 046-002773-00 ix

Introduction Warnings

WARNING: Use care in lifting and manipulating vaporizers during the mounting
process as their weight may be greater than expected, based on their
size and shape.

WARNING: Do not use talc, zinc stearate, calcium carbonate, corn starch, or similar
material to prevent sticking of the bellows, as these materials may
enter the patient's lungs or airway, causing irritation or injury.

WARNING: All gas supplies should be of medical grade.

WARNING: Single use respiratory hoses, face masks, sensors, sodalime, water
traps, sampling lines, airway adapters, and other single use items may
be considered potential biologically hazardous items and should not
be reused. Dispose of these items in accordance with hospital policy
and local regulations for contaminated and biologically hazardous
items.

WARNING: To avoid endangering a patient, do not perform testing or maintenance

when the machine is in use.

WARNING: Review the performance specifications of the disposal system that the
transfer and receiving systems are intended to be used with, to ensure
compatibility.

WARNING: The A5 should not be used adjacent to or stacked with other

equipment. If adjacent or stacked use is necessary, the A5 should be
observed to verify normal operation in the configuration in which it will
be used.

WARNING: Ensure that the current alarm presets are appropriate before use on
each patient.

WARNING: A hazard can exist if different alarm presets are used for the same or
similar equipment in any single area.

WARNING: Due to the size and weight of the A5, it should only be moved by
qualified personnel.

WARNING: Overloading machine may cause tipping. Equipment attached to the

side of the machine should fall within the rated weights to prevent
tipping of the machine.

WARNING: Excess load may cause a tip hazard while moving the A5. Before
moving, remove all equipment from the top shelf and all monitoring
equipment mounted to the side of the A5. Use care when moving the
A5 up or down inclines, around corners, and across thresholds. Do not
attempt to roll the A5 over hoses, cords, or other obstacles.

WARNING: Leaks or internal venting of sampled gas may affect accuracy. Perform
the proper preoperative tests to ensure that the device is performing
properly. Leaky circuits can not be used.

WARNING: Connection of the A5 exhaust port to the hospital’s waste gas

scavenging system is strongly recommended to prevent exposure of
hospital personnel to the A5 exhaust gases.

WARNING: Operation of the A5 below the minimum flow values may cause
inaccurate results.

WARNING: Ensure that an independent means of ventilation (e.g. a self-inflating

manually powered resuscitator with mask) is available whenever the
A5 is in use.

x 046-002773-00 A5™ Operating Instructions

Warnings Introduction

WARNING: Usage of accessories with package damage may cause

biocontamination or failure. The operator should check accessory
packaging for storage integrity before use.

WARNING: Before using the A5 System (after cleaning or disinfecting), power up

the system and follow the on-screen prompts to perform the leak test
and the compliance test. See section 4.5 (page 4-9) "Leak and
Compliance Tests".

WARNING: Improperly cleaned materials may result in biocontamination. Use a

cleaning and disinfection schedule that conforms to your institution's
disinfection and risk-management policies.
• Refer to the material safety data as applicable.
• Refer to the operation and maintenance manuals of all disinfection
equipment.
The user should follow the recommended disinfection routine for this
machine and any reusable accessories.

WARNING: If the A5 is damaged in any way that compromises the safety of the
patient or user, discontinue use and attach a visible tag that marks the
A5 as unusable. Call Mindray Technical Support.

WARNING: Oxygen, when present in high concentrations, can significantly

increase the chance of fire or an explosion. Oil and grease may
spontaneously ignite and should not be used where oxygen
enrichment may occur.

WARNING: Use of lubricants not recommended by Mindray may increase the

danger of fire or explosion. Use lubricants approved by Mindray.

WARNING: Low-pressure regulators and flow-meters are susceptible to high

pressure, and may burst if improperly maintained or disassembled
while under pressure. Changing connectors or disassembling should be
performed only by qualified personnel.

WARNING: Do not disassemble the low-pressure regulator, flow-metering device,

or connector while under pressure. The release of sudden pressure may
cause injury.

WARNING: Review the specifications of the AGSS transfer and receiving systems
and the specifications of the A5 System to ensure compatibility and to
prevent a mismatched receiving system.

WARNING: Avoid connecting two or more hose assemblies in series as this may
cause a loss of pressure and flow.

WARNING: A hazard may exist due to the use of improper connectors. Ensure all
assemblies use the proper connectors.

WARNING: Avoid replacing a high-pressure flexible connection with one of lower

nominal inlet pressure.

WARNING: Reusing breathing circuits or reusable accessories that are not

disinfected may cause cross-contamination. Disinfect the breathing
circuits and reusable accessories before use.

WARNING: Inspect all breathing system components carefully before each use.
Ensure all components do not contain any obstructions or debris that
can cause a potential hazard to the patient.

WARNING: Use breathing circuits and manual bags in accordance with ASTM F1208
and compatible with standard 22mm male conical fittings per ASTM
specifications F 1054.

A5™ Operating Instructions 046-002773-00 xi

Introduction Cautions

WARNING: The mains plug is used to isolate the Anesthesia System circuits
electrically from the SUPPLY MAINS. Do not position the Anesthesia
System so that it is difficult to operate the plug.

WARNING: Do not touch the patient when connecting the peripheral equipment
via the I/O signal ports or replacing the oxygen cell to prevent patient
leakage current from exceeding the requirements specified by the
standard.

WARNING: If the Drive Gas Pressure Low alarm occurs when the gas supply
pressure is greater than 200 kPa, contact your service personnel or us.

WARNING: The anesthesia system shall not be serviced or maintained while being
connected on a patient.

WARNING: Additional MULTIPLE SOCKET- OUTLET or extension cord shall not be

connected to the ME SYSTEM.

Cautions
CAUTION: To ensure patient safety, use only parts and accessories specified in this
manual.

CAUTION: At the end of its service life, the equipment, as well as its accessories,
must be disposed of in compliance with the guidelines regulating the
disposal of such products, and in accordance with local regulations for
contaminated and biologically hazardous items.

CAUTION: Magnetic and electrical fields are capable of interfering with the proper
performance of the equipment. Ensure that all external devices
operating in the vicinity of the equipment comply with the relevant
EMC requirements. Mobile phones, x-ray equipment, and MRI devices
are possible sources of interference as they may emit higher levels of
electromagnetic radiation.

CAUTION: This system operates correctly at the electrical interference levels

identified in this manual. Higher levels can cause nuisance alarms that
may stop mechanical ventilation. Be aware of false alarms caused by
high-intensity electrical fields.

CAUTION: The A5 Anesthesia System may become unstable if the unit is tilted
beyond 10 degrees. Use extreme caution when moving or resting the
unit on surfaces exceeding a 10 degree slope. Do not hang articles on
the sides of the unit that would cause an excessive imbalance.

CAUTION: Perform the daily checks specified on the checklist. In case of a system
fault, do not operate the system until the fault has been corrected.

CAUTION: Before starting the machine, users must be familiar with the
information contained in these Operating Instructions and must have
been trained by an authorized representative.

CAUTION: If the machine does not function as described, it must be examined and
repaired as necessary by qualified service personnel before being
returned to use.

CAUTION: Handle the machine with care to prevent damage or functional faults.

CAUTION: Ensure that the gas supply of the machine always complies with the
technical specifications.

xii 046-002773-00 A5™ Operating Instructions

Cautions Introduction

CAUTION: Before clinical use, the machine must be correctly calibrated and/or the
respective tests must be performed, as described in these Operating
Instructions.

CAUTION: If system faults occur during the initial calibration or testing, the
machine should not be operated until those faults have been corrected
by a qualified service person.

CAUTION: After servicing, functional, sensor, and system tests must be performed
before clinical use.

CAUTION: Only vaporizers with Selectatec Interlock-Systems may be used with

the A5 unit.

CAUTION: After each exchange of a vaporizer, perform a fresh-gas system leak

test.

CAUTION: Use cleaning agent sparingly. Excess fluid could enter the machine,
causing damage.

CAUTION: Do not autoclave any parts of the A5 unless specifically identified as

autoclaveable in this manual. Clean the A5 only as specified in this
manual.

CAUTION: To prevent system damage:

• Refer to the literature supplied by the manufacturer of the

cleaning agent.
• Never use organic, halogenated or petroleum-based solvents,
anesthetics, glass cleaning agents, acetone or other irritant
agents.
• Never use abrasive agents (i.e. steel wool or silver polish) to clean
components.
• Keep all liquids away from electronic components.
• Prevent liquid from entering the equipment.
• All cleaning solutions used must have a pH between 7.0 and 10.5.

CAUTION: Never immerse the oxygen sensor or its connector in any type of liquid.

• Dispose of the oxygen sensor per the manufacturer’s

specification.

CAUTION: Do not use acetic hydroperoxide or formaldehyde steaming.

CAUTION: The valve disc in each of the inhalation and exhalation valve assemblies
on the breathing system is fragile and must be handled with care while
removing the valve cage from the valve assembly.

CAUTION: If moisture remains in the bellows after cleaning, the bellows surface
folds may become tacky and prevent the bellows from properly
expanding. Ensure all moisture is removed from the bellows after
cleaning.

CAUTION: Only connect Mindray approved equipment to the A5 communication

ports. Equipment connected to the A5 ethernet ports must comply with
IEC 60950.

CAUTION: Do not connect any non-isolated devices to the DB9/RS232C interface

of the A5.

A5™ Operating Instructions 046-002773-00 xiii

Introduction Cautions

CAUTION: Do not connect any devices to the SB ports other than Mindray
approved USB storage devices and a supported USB mouse (see
‘‘Networking and USB Storage’’ on page A-4).

CAUTION: Do not wash the inner surface of the oxygen sensor.

CAUTION: Do not autoclave the following components: Paw gauge, oxygen

sensor, flow sensor, and bellows. These components cannot withstand
immersion or the heat and pressure of autoclaving.

CAUTION: Users should monitor oxygen percentage (FiO2%) when using the
Auxiliary O2/Air Flow Meters. Unknown oxygen concentrations may be
delivered to the patient unless oxygen monitoring is used.

CAUTION: The A5 is NOT suitable for use in a magnetic resonance imaging (MRI)
environment.

CAUTION: To ensure measurement accuracy and to avoid possible damage to the

A5, use only Mindray-approved cables and accessories.

CAUTION: Use the power cord provided with the product. If a substitute is
necessary, use only hospital grade power cords.

CAUTION: Do not use a damaged or broken unit or accessory. Periodically check

all cables (e.g., AC line cord and patient connection cables) for damage
that may occur through normal use. Replace cables if damaged in any
way.

CAUTION: Use of other oxygen transducers may cause improper oximeter

performance.

CAUTION: Unintended movement may occur if the casters are not locked. The
operator should lock casters during use of the machine.

CAUTION: Unsecured devices may slide off the top shelf. Devices should be
securely attached to the top shelf.

CAUTION: The voltage on the auxiliary outlets is the same voltage as the outlet
into which the A5 machine is plugged. Ensure that devices plugged into
the auxiliary outlets are rated for the same supply voltage as the A5.

CAUTION: During the transport and storage of the vaporizer, block the gas inlet
and outlet of the vaporizer with plugs to prevent foreign substances
from entering the vaporizer.

CAUTION: Do not use any flow outlets as handles for moving the A5. The flow
outlets may become damaged. Use the metal side bars on the main
body when moving the A5.

CAUTION: Do not push down on the bag arm forcefully or hang heavy objects
onto it. Excessive weight may bend and damage the bag arm.

CAUTION: Use caution when disconnecting “quick connectors”, as the sudden

release of pressure may cause injury.

CAUTION: Avoid factors that can contribute to deterioration of the hose

assemblies. Factors include excessive bending, crushing, abrasion,
system pressures and temperatures that exceed hose ratings, and
improper installation.

CAUTION: Use care in lifting and manipulating the breathing system block during
removal from its mounting arm as handling may be awkward due to its
weight and shape.

xiv 046-002773-00 A5™ Operating Instructions

Notes Introduction

CAUTION: Turn the flow controls slowly. To avoid damaging the control valves, do
not turn further when the flowmeter reading is outside the range.
When turning a flow control knob clockwise to decrease flow, the
flowmeter should reach zero before the knob reaches its most
clockwise mechanical stop (Off) position. Do not turn any further when
the knob has reached the Off position.

Similarly, when turning a flow control knob counterclockwise to

increase flow from zero, the flowmeter reading should not indicate a
change from zero until the flow control knob is turned approximately
one (1) rotation counterclockwise from the Off position, and only if
permitted according to the gas ratio control system.

Notes
NOTE: Figures in this manual are provided for reference purposes only.
Screens may differ based on the system configuration and selected
parameters.

NOTE: Put the equipment in a location where you can easily see the screen and
access the operating controls.

NOTE: Keep this manual close to the equipment so that it can be obtained
conveniently when needed.

NOTE: The software was developed in compliance with IEC 60601-1. The
possibility of hazards arising from software errors is minimized.

NOTE: This manual describes all features and options. Your equipment may
not have all of them.

NOTE: The A5 is intended to be operated with its integral Breathing Pressure

monitoring in use.

NOTE: The A5 is intended to be operated with its integral Breathing Pressure

limitation devices in use.

NOTE: The A5 is intended to be operated with its integral Exhaled Volume

monitoring in use.

NOTE: The A5 is intended to be operated with its integral Breathing System

integrity Alarm System in use.

NOTE: The A5 is intended to be operated with its integral Continuing Pressure

Alarm in use.

NOTE: The A5 is intended to be operated with its integral O2 monitoring in

use.

NOTE: The A5 is intended to be operated with an external CO2 monitor

complying with ISO 80601-2-55. Connection to the CO2 monitor should
be via a sample line from the patient circuit.

NOTE: The Anesthesia Vapor Delivery Device is to be used with an Anesthetic

Agent Monitor complying withISO 80601-2-55. Connection to the
Agent monitor should be via a sample line from the Patient Circuit.

NOTE: Continuously monitor the anesthetic agent concentration when using

the Anesthesia System to ensure accurate output of the anesthetic
agent.

A5™ Operating Instructions 046-002773-00 xv

Introduction Notes

NOTE: Check the liquid level of the anesthetic agent before and during all
operations. When the liquid level is below the warning line, more
anesthetic agent needs to be added. Refer to the vaporizer Instructions
For Use for filling the vaporizer and other information.

NOTE: The A5 System is designed to be equipped with an anesthetic vapor

delivery device that complies with ISO 80601-2-13.

NOTE: The A5 battery supply is not a user serviceable component. Only an

authorized service representative can replace the battery supply. If the
system is not used for an extended period, contact a service
representative to have the battery supply disconnected. The batteries
may be subject to local regulations regarding disposal. At the end of
the battery life, dispose of the battery supply in accordance with local
regulations.

NOTE: Areas designated for the servicing of oxygen equipment shall be clean,
free of oil and grease, and not used for the repair of other equipment.

NOTE: Opening the cylinder valve quickly may cause unexpected pressure
differentials and create a potential for fire or explosion arising from
oxygen pressure shocks. Open and shut the cylinder valve slowly.

NOTE: Accuracy of the flowrate may be affected by varying inlet pressure,

varying outlet resistance, or varying ambient temperature.

NOTE: The power device, terminal units and pipeline system can be supplied
by one or several different manufacturers.

NOTE: Regional or national regulations that apply to manufacturers of

medical devices can exist.

NOTE: For the method of connecting A5 to external monitor or other devices,

please see Anesthesia Machine Bracket Installation Instructions.

NOTE: The A5 can be equipped with one scavenger system to provide the best
match with the hospital’s waste-gas disposal system. The scavenger
system shall comply with ISO 80601-2-13.

NOTE: The Anesthesia System is compatible with gases (O2, N2O, and Air) and
anaesthetic agents (Halothane, Enflurane, Isoflurane, Sevoflurane, and
Desflurane).

NOTE: The leakage of AGSS is measured by the method recommended in ISO

80601-2-13.

NOTE: The Anesthesia System is compatible with gases (O2, N2O, and Air) and
anaesthetic agents (Halothane, Enflurane, Isoflurane, Sevoflurane, and
Desflurane).

NOTE: The leakage of AGSS is measured by the method recommended in ISO

80601-2-13.

xvi 046-002773-00 A5™ Operating Instructions

Intellectual Property Statement Introduction

Intellectual Property Statement

SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. (hereinafter called Mindray) owns the
intellectual property rights to this Mindray product and this manual. This manual may refer to
information protected by copyright or patents and does not convey any license under the patent
rights or copyright of Mindray, or of others.

Mindray intends to maintain the contents of this manual as confidential information. Disclosure of
the information in this manual in any manner whatsoever without the written permission of Mindray
is strictly forbidden.

Release, amendment, reproduction, distribution, rental, adaptation, translation or any other derivative
work of this manual in any manner whatsoever without the written permission of Mindray is strictly
forbidden.

, and are the trademarks, registered or otherwise, of Mindray in

China and other countries. All other trademarks that appear in this manual are used only for
informational or editorial purposes. They are the property of their respective owners.

This posting serves as notice under 35 U.S.C.§287(a) for Mindray patents: http://
www.mindrayna.com/patents.

Warranty Statements
Shenzen Mindray Bio-Medical Electronics Co., Ltd. warrants that its products will be free from defects
in workmanship and materials for a period of three (3) years from the date of purchase except that
disposable or one-time use products are warranted to be free from defects in workmanship and
materials up to a date one year from the date of purchase or the date of first use, whichever is sooner.
This warranty does not cover consumable items such as, but not limited to, batteries, external cables,
O2 sensors, CO2 absorbents, breathing circuits, hoses, or mounts.

Calibration may be performed without the need to disassemble the instrument. It is the responsibility
of the purchaser to perform calibration as necessary, in accordance with the instructions provided in
this manual.

Recommended preventative maintenance, as prescribed in the Maintenance section of this manual,

is the responsibility of the user, and is not covered by this warranty.

Except as otherwise provided herein, the terms, conditions, and limitations of Shenzen Mindray Bio-
Medical Electronics Co., Ltd.’s standard warranty will remain in effect.

Shenzen Mindray Bio-Medical Electronics Co., Ltd. will not be liable for any incidental, special, or
consequential loss, damage, or expense directly or indirectly arising from the use of its products,
liability under this warranty and the buyer’s exclusive remedy under this warranty is limited to
servicing or replacing at Shenzen Mindray Bio-Medical Electronics Co., Ltd.’s option at the factory or at
an authorized distributor, any product which shall under normal use and service appear to the
Company to have been defective in material or workmanship.

No agent, employee, or representative of Shenzen Mindray Bio-Medical Electronics Co., Ltd. has any
authority to bind Shenzen Mindray Bio-Medical Electronics Co., Ltd. to any affirmation, representation,
or warranty concerning its products, and any affirmation, representation or warranty made by any
agent, employee, or representative shall not be enforceable by buyer.

This warranty is expressly in lieu of any other express or implied warranties, including any implied
warranty or merchantability or fitness, and of any other obligation on the part of the seller.

A5™ Operating Instructions 046-002773-00 xvii

Introduction Disclaimers

Disclaimers
Product Improvements — Shenzen Mindray Bio-Medical Electronics Co., Ltd. retains the right to
modify the machine and/or operating instructions without prior notification. These operating
instructions explain all features of the A5 System and are correct at time of manufacture. Instructions
and models produced at a later stage, may contain improvements or modifications that were not
included in previous models.

Phone Numbers and How To Get Assistance

A network of service representatives and factory-trained distributors is available. Prior to requesting
service, perform a complete operational check of the instrument to verify proper control settings. If
operational problems continue to exist, contact the Service Department at +86 755 26582479 /
26582888.

Please include the instrument model number, the serial number (located on the back of the A5), and
a description of the problem with all requests for service.

Warranty questions should be directed to a local representative. A list of offices, along with their
phone numbers, is provided at the end of this manual.

NOTE: Upon request, calibration instructions or other information will be

provided to assist the user’s appropriately qualified technical
personnel in repairing those parts of the A5 which are designated as
repairable.

Manufacturer’s Responsibility
The effects on safety, reliability, and performance of the equipment are the manufacturer’s
responsibility only if:

a. assembly operations, extensions, readjustments, modifications or repairs are carried out

by authorized personnel; and
b. the electrical installation of the relevant room complies with the appropriate
requirements; and
c. the equipment is used in accordance with the instructions for use

Manufacturer and Address

Manufacturer: Shenzhen Mindray Bio-Medical Electronics Co., Ltd.

Mindray Building, Keji 12th Road South, High-tech industrial park, Nanshan,
Address:
Shenzhen 518057, P.R. China

Symbols
The following table provides descriptions of symbols that are used on the device and/or within this
manual.

SYMBOL DESCRIPTION SYMBOL DESCRIPTION

Environment:
Caution
Temperature Range

Defibrillator proof Environment:

type BF equipment Humidity Range

xviii 046-002773-00 A5™ Operating Instructions

Symbols Introduction

Electrical:
Environment:
Alternating Current
Pressure Range
(AC)

Electrical:
Gas Cylinder
Equipotentiality

Electrical:
Gas Inlet
Fuse or circuit breaker

Electrical:
Gas Outlet
Input Output

Electrical: Gas Flow:

Internal Battery Flow Control

Electrical:
Gas Flow: Maximum
Light

Electrical:
Gas Flow: Minimum
Power On

Electrical:
Gas Flow Total
Power Standby

Electrical:
Gas:
Protective Earth
O2 Flush
(Ground)

Electrical:
WEEE (Waste of
E

Electrical and
Electronic
O2 Sensor Connector
Equipment) Marking.
Separate treatment
from general waste at
end of life.

Identifier:
Gas Pipeline Connection
Manufacturer

Identifier:
Manufacturer’s Material:
Reference/Catalog Polyphenyl-sulfone
Number
Identifier:
Material:
Serial Number
Polysulfone
Indicator

A5™ Operating Instructions 046-002773-00 xix

Introduction Symbols

Lock/Unlock:
Touchpad
Direction

Lock/Unlock:
Manual ventilation via Breathing Bag
Lock

Lock/Unlock:
Automatic Ventilation
Unlock

No Heavy Objects
Water Trap
Do Not Crush

134°C Autoclavable Do Not Oil

134°C Not Autoclavable Filter Access

Caution: Hot Direction of flow

Drawer weight limit

Water Drain

Conforms to AAMI Std. ES 60601-1,

IEC Std.60601- 1-8, ISO Std. 80601-2-
MR Unsafe - do not 13, ISO Std. 80601-2-55, IEC
subject to magnetic Std.60601-1-6.
resonance imaging Certified to CSA Std. C22.2 No. 60601-
(MRI) 1, CSA Std. C22.2 No.60601-1-8, ISO
Std. 80601-2-13, CSA Std. C22.2
No.80601-2-55, IEC Std.60601-1-6.

Canister opened Canister closed

Warning Refer to instruction manual/booklet

Protection against
IPX1 vertically falling water
drops

xx 046-002773-00 A5™ Operating Instructions

Symbols Introduction

Battery supply fully charged.

AC power connected and Alarm Icon
powering system.

Battery supply partially

charged. AC power connected,
Alarm Silence Icon
charging battery supply, and
power system.

Battery supply fully charged

and powering system. AC Low priority message
power not connected.

Battery supply partially

charged and powering system. Medium priority message
AC power not connected.

Battery supply low charged

and powering system.
High priority message
Recharging recommended. AC
power not connected.

Battery supply not installed. Breathing System Warmer Off

A5™ Operating Instructions 046-002773-00 xxi

Introduction Symbols

This page intentionally left blank.

xxii 046-002773-00 A5™ Operating Instructions

 1.0 Product Description

General System Overview ...................................................................................................................................................................1-2

Physical Views .............................................................................................................................................................................................1-8

A5™ Operating Instructions 046-002773-00 1-1

General System Overview Product Description

1.1 General System Overview

1.1.1 General Description
The A5 Anesthesia System is a device intended to administer, continuously or intermittently, a
general inhalation anesthetic to a patient, and to maintain a patient's ventilation. The A5 also
provides for ventilatory monitoring of the patient. The anesthesia system is intended to be used in
the patient environment.

The A5 Anesthesia System consists of a main unit (includes an anesthetic ventilator and flowmeter
monitor assembly) and a detachable breathing system. The applied part of the anesthesia system are
breathing tubes and masks. Connect the patient to the anesthesia system via breathing tubes and
masks.

The A5 Anesthesia System provides the following ventilation modes:

• Volume Control Ventilation (VCV), which includes the Pressure Limit Ventilation (PLV) function
• Pressure Control Ventilation (PCV) with/without Volume Guarantee (VG) ventilation mode
• Synchronized Intermittent Mandatory Ventilation (SIMV) with VC mode
(with/without PS option)
• Synchronized Intermittent Mandatory Ventilation (SIMV) with PC mode
(with/without PS option)
• Pressure Support (PS) ventilation mode
• Spontaneous ventilation in Manual mode with APL fully open
• Manual Ventilation through the use of a breathing bag
• Cardiac Bypass mode

•
Electronic PEEP is available in all automatic ventilation modes. User control over inspiratory flow
(Tslope) is possible in PCV, SIMV, and PS modes. Automatic fresh gas compensation limits the effect
on the patient ventilation from changes in fresh gas flow rate by the operator. The traditional bellows
system is driven by oxygen and makes patient disconnections clearly visible.

The A5 Anesthesia System provides the following common functions:

• Automatic leak detection

• Circuit gas leakage compensation and automatic compliance compensation
• Cylinder and central pipeline gas supply connections available for gas input
• Electronically displayed flowmeter and electronically adjustable PEEP
• Electronic timer to display the duration between the start and end of an operation
• Work table light
• Mounting rails to connect an external patient monitor
• Network-ready
• Flow trigger mode available for PS and SIMV
• Auxiliary O2 and air supply
• Active AGSS or optional Passive scavenging
• N2O cutoff
• Cardiac Bypass alarm mode.
• DEMO
• Vaporizer
• Total flow rotameter
• AG module
• Monitor mode
• APL Valve with quick release

1-2 046-002773-00 A5™ Operating Instructions

Product Description General System Overview

1.1.2 Key Features

FEATURE DESCRIPTION
Display 15 inch color LCD with touchscreen
Navigation Graphical user interface for easy navigation
Ventilation Manual and automatic ventilation modes and monitoring: VCV, SIMV-VC,
PCV, SIMV-PC , PS, and Manual
Fresh Gas Delivery Continuous and intermittent anesthesia flow, total flow rotameter,
virtual dual flow tubes, electronically displayed on screen for ease of use
3 cylinder mount locations on rear
Breathing System Heated, adjustable swivel, side hose ports, single turn APL valve
Ergonomics Large stainless steel work surface
Adjustable breathing system block via swivel up to 50 degrees
Electronic PEEP Positive End Expiratory Pressure (PEEP) is set and controlled electronically.
Clear Data Display Two large waveforms for pressure and flow or
Spirometry Loops
USB Mouse Support The A5 system supports a wired USB mouse, which can be plugged into one
of the two SB ports at the rear of the unit. A cursor appears when the mouse
is plugged. The cursor disappears if the user touches the screen or after 15
seconds of mouse inactivity.

The USB mouse can serve as a backup to both the touchscreen and
touchpad.

1.1.3 Fresh Gas Dosing

The A5 fresh gas dosing subsystem offers the following features:

• Virtual On-Screen dual flow tube and numerical readouts to display the O2, N2O, and Air flows
• A knob guard to prevent inadvertent movement of the flow control knobs
• Gas supply gauges to indicate the gas pipeline supply pressures and gas cylinder pressures
• Mechanical total flowmeter to display the combined flow of O2, Air, and N2O
• An O2 flush button
• A single combined output of auxiliary O2 and Air with flowmeters
Safety systems within the A5 work to prevent hypoxic mixtures from being delivered to the patient.
Nitrous oxide will not be delivered unless oxygen flow is present. A pneumatic safety system assures
that at least 21% O2 is present when setting mixtures of O2 and N2O. Additionally, if the A5 is placed
in the standby mode, O2 fresh gas flow is not available.

WARNING: Ensure that both O2 and N2O flow controllers are turned OFF fully at the
start and at the end of each case.

All A5 units are designed to maintain a safe O2:N2O ratio by allowing nitrous oxide to be set to a flow
rate that is proportional to a previously adjusted flow of oxygen. The N2O flow is limited by the flow
of O2 so that a safe ratio of no less than 21% oxygen can be maintained. The A5 is designed to
maintain oxygen flow at its previously set level when N2O is decreased.

When adjusting N2O and O2 flow rates, always adjust the oxygen flow first to enable the nitrous oxide
flow. To add N2O to the fresh gas flow, open the N2O flowmeter valve, but only after opening the O2
flowmeter valve.

A5™ Operating Instructions 046-002773-00 1-3

General System Overview Product Description

1.1.4 Flow Control

Flow Control needle Valve and Knob:
Three independent flow control knobs allow setting the input flow rates of N2O, Air, and O2 into the
fresh gas flow.

N2O Automatic Cutoff:

An N2O automatic cutoff valve stops the flow of N2O if O2 flow is less than 200 mL/min.

O2 Pressure Loss Alarm:

An O2 pressure loss alarm annunciates when oxygen pressure is less than 220 kPa (32 psi).

Oxygen Ratio Controller:

An O2 ratio controller ensures that there is always at least 21% oxygen concentration in the fresh flow
when N2O is fully open.

1.1.4.1 Flow/Pressure Sensing

The breathing system block contains patient flow and pressure sensors to measure inspiratory flow,
expiratory flow, and inspiratory pressure. These sensors enable spirometry as well as standard
pressure and flow monitoring.

1.1.5 Vaporizer Mounting

The A5 contains a 2-position Selectatec-type vaporizer mounting system to enable anesthetic agents
to be introduced into the fresh gas flow. The mounting system adapts vaporizers with interlock,
which permits only one agent at a time to be administered. Lighting above the vaporizers enables
them to be seen in a darkened environment. A maximum of three vaporizers can be attached for use
at any one time. The A5 comes standard with a two vaporizer mount. A three vaporizer mount is
optional. Halothane, Enflurane, Isoflurane, Desflurane, and Sevoflurane vaporizers can be used.

For the A5 model, a third, non-functional vaporizer parking spot on the side of the unit is provided as
part of the standard configuration.

1.1.6 Anesthesia Ventilator

The A5 ventilator offers multiple ventilation modes: Volume Control Ventilation (VCV), Synchronized
Intermittent Mandatory Ventilation-Volume Control (SIMV-VC), Pressure Control Ventilation (PCV),
Pressure Support (PS) ventilation, and Manual ventilation.

The A5 offers additional ventilation modes, which include Pressure Control Ventilation (PCV) with and
without Volume Guarantee (VG), and Synchronized Intermittent Mandatory Ventilation-Pressure
Control (SIMV-PC).

1.1.7 Breathing System

A portion of the patient circuit is integrated into an assembly block called the breathing system. The
system contains a temperature controller, which warms the block to a temperature of 35ºC typical at
20ºC ambient temperature to limit the formation of water condensate. The breathing system can be
swiveled horizontally up to 50 degrees for user convenience.

The breathing system provides access to the APL valve and breathing bag along with a view of the
airway pressure gauge. The APL valve has a single turn knob that provides a clear view of the manual
breathing pressure setting. The absorber assembly incorporates a cam-lock device that opens and
closes to provide access to the absorber canister. Either a CO2 absorbent Pre-Pak or loose fill can be
used. Two water traps that can be drained are located on the CO2 absorber assembly and on the
breathing system block.

NOTE: Operating the A5 with a full water trap in the breathing system block
does not allow the water to condense appropriately. The trap should be
removed and emptied when filled with water.

1-4 046-002773-00 A5™ Operating Instructions

Product Description General System Overview

Two (2) flow sensors in the breathing system measure inspired and expired gases for control and
monitoring. Inspired oxygen concentration is monitored via a fuel-cell type sensor. Breathing
pressure is monitored with both a PAW gauge (mechanical) and electronic gauge. The breathing
system can be swiveled for ease of positioning. A leak test port is provided to allow for leak testing
during startup.

The main pneumatic components of the breathing system are as follows:

• Inspiratory Valve (passive)

• Expiratory Valve (passive)
• Airway Pressure Limiting Valve (APL)
• Connection for O2 Sensor
• CO2 Absorber Assembly
• Bellows Assembly
• Auto/Manual bag switch
• Bag arm
• PAW Gauge

The breathing system connects to the A5 main unit through the following ports:

• Drive gas port, designed for use with oxygen as the drive gas
• Fresh gas port
• Exhaust gas port
• Flow sensor pressure transmission pipeline port

The breathing system contains the following ports for end-user connections:

• Inspiratory port for Inspiratory hose of patient breathing circuit

• Expiratory port for Expiratory hose of patient breathing circuit
• Manual Breathing Bag Arm
• Connection for the O2 cell
• Water trap
• Leak test port for sealing the breathing circuit during leak testing

1.1.8 Active Anesthetic Gas Scavenging System

The A5 includes a waste gas scavenger that attaches to the side rail mount on the system. The A5
provides a port for the connection of the waste line from an anesthetic gas monitor.

1.1.9 Passive Anesthetic Gas Scavenging System

The A5 includes a passive waste gas scavenger. The inlet port of the scavenger connects with the
AGSS port and the exhaust port connects with the hospital's waste gas scavenging system.

1.1.10 Power Management / Battery Supply

The advanced power management system of the A5 provides AC power for main system functions
while charging the system’s internal battery supply. During AC power failure, the A5 will operate on
battery power for a minimum of 150 minutes with two (2) new batteries installed. See ‘‘Battery Power
Specifications’’ on page 9-7.

A5™ Operating Instructions 046-002773-00 1-5

General System Overview Product Description

A recessed main switch is provided to power the system ON and to put the system on power standby
where the battery supply continues to charge as necessary when the A5 is plugged into an external
power source. The main switch also stops the O2 fresh gas supply when the A5 is placed in Power
Standby mode.

Auxiliary AC outlets on the rear of the machine operate independently of the main switch position.
The A5 provides four (4) auxiliary AC outlets. The auxiliary AC outlets are not powered when
operating the A5 on the internal battery supply.

NOTE: Use the battery supply in the A5 at least once every month to extend
battery life. Charge the battery supply before its power capacity is
depleted.

NOTE: Inspect and replace the battery supply at regular service intervals.
Long-term battery life depends on how frequent and how long the
battery supply is used. For a properly maintained and stored lithium-
ion battery, its long-term life expectancy is approximately three (3)
years. In more aggressive usage, life expectancy can be shortened.
Replacing lithium-ion batteries every three (3) years is recommended.

NOTE: The operating time of a battery depends on equipment configuration

and operation.

NOTE: In case of battery failure, contact Mindray service personnel for battery
supply replacement.

NOTE: When a battery has been stored for a long time, or the battery is
depleted, recharge the battery at once. Otherwise, the low battery may
not be sufficient to power the A5 if the AC power is unavailable.

CAUTION: Please replace your battery when it reaches the end of its service life.
Failure to replace the battery may cause serious damage to your device
from battery overheating.

The A5 Anesthesia System is designed to operate on battery power whenever AC power is

interrupted. When the A5 is connected to an AC power source, the battery supply is charged whether
or not the A5 is turned on. In case of power failure, the A5 will automatically switch to run from the
internal battery supply. When AC power source is restored within the specified time, the battery
supply begins recharging, and power is switched from battery to AC automatically to ensure
continuous system use.

When power is lost for less than or equal to 60 s, the alarm settings prior to the power loss shall be
restored automatically.

The on-screen battery symbol indicates the battery status (see FIGURE 1-1).

PART(S) DESCRIPTION
Battery supply is fully charged.
AC power is connected.
The A5 is being powered by AC power. The solid portion
represents the current charge level of the batteries in proportion
to its maximum charge level.
Battery supply is partially charged.
AC power is connected and charging battery supply.
The A5 is being powered by AC power.

1-6 046-002773-00 A5™ Operating Instructions

Product Description General System Overview

PART(S) DESCRIPTION
Battery supply is fully charged.
AC power is not connected.
The A5 is being powered by internal battery supply.

Battery supply is partially charged.

AC power is not connected.
The A5 is being powered by internal battery supply.

Battery supply is low charged. Batteries need to be charged

immediately to operate as a safe power backup.
AC power is not connected.
The A5 is being powered by internal battery supply.

Battery supply is not installed.

FIGURE 1-1 Battery Status

If the battery capacity is too low, power supply failure will result. A high-level alarm will be triggered
and the message Low Battery Voltage! will be displayed in the technical alarm area. In this case,
apply AC power to the A5 Anesthesia System to resume operation and charge the battery supply.

1.1.11 Workplace Ergonomics

The A5 is a full-featured anesthesia delivery work station. The raised perimeter of its stainless steel
work surface retains items that might otherwise roll or slide off its edge. The work surface light has
high and low brightness settings. The wrap-around handle enables fine positioning of the machine.
Three (3) large drawers are available for storage. All drawers can be locked with a key. Rail mounts on
both sides of the machine enable mounting of patient monitors and most standard attachment arms
for other devices. For the A5, a non-slip footrest and central brake are provided. The top shelf can be
used to mount additional equipment.

The operator of the A5 should be positioned in front of the monitor at a comfortable distance to view
all displayed waveforms, text, and controls.

1.1.12 Hook
There is a hook located on the front of the breathing system that can be used to hang the tubes of
the breathing circuit.

A5™ Operating Instructions 046-002773-00 1-7

Physical Views Product Description

1.2 Physical Views

1.2.1 Main Unit (Front View)

A1 A18

A19
A2
A20

A3 A21

A22
A4
A23
A5 A24
A6
A25
A7
A26
A8

A9 A27

A10
A28
A11

A12

A29
A13

A14

A15

A16

A17

FIGURE 1-2 Main Unit (Front View)

PART(S) DESCRIPTION
A1 Alarm Light Illuminates red, yellow, or cyan during an alarm condition
to indicate the alarm priority. Red = high priority,
Yellow = medium priority, cyan = low priority,
off = no alarm condition.
A2 LCD Touchscreen Display / See section ‘‘System Interface’’ on page 3-1
System Interface
A3 Auxiliary O2/Air Flowmeters Auxiliary O2/Air Flowmeters for auxiliary O2/Air output

1-8 046-002773-00 A5™ Operating Instructions

Product Description Physical Views

PART(S) DESCRIPTION
A4 Auxiliary O2/Air Gas Outlet Nozzle (barbed connector) for auxiliary O2/Air output.
Combines the auxiliary O2/Air flowmeters into a single
output of O2 only, Air only, or O2/Air blend, depending
upon the O2 and Air flow adjustments.
A5 Auxiliary O2 Gas Power Outlet High pressure O2 outlet (DISS connector) for connecting
external devices such as a jet ventilator.
A6 Flow Control Knobs N2O, Air, and O2 gas dosing. Turn each knob
counterclockwise to increase flow.
A7 Pressure Gauges (pipeline) Indicate the pressure at pipeline inlets for O2, Air, and N2O.
A8 Pressure Gauges (cylinder) Indicate the pressure at cylinder inlets for O2, Air, and N2O.
A9 Total Flow Meter Displays the combined flow rate of O2, Air, and N2O.
A10 O2 Sensor Electrical Port Connects the O2 sensor cable on the breathing system to
the main A5 unit.
A11 O2 Flush Button Provides high flow O2 to the inspiratory limb of the
breathing system.
A12 Vacuum suction fixing clip Holds the tubes of the negative pressure suction device.
A13 Touchpad Allows alternate control of the touch screen. Pull out to use.

A14 AGSS Anesthetic Gas Scavenging System

A15 Wheel Lock Locks or releases the brakes for all wheels when depressed.
A wheel lock indicator displays red to indicate that the
wheels are locked. Green indicates unlocked.
A16 Wheel Lock Indicator Displays a lock symbol in red background to indicate the
wheels are locked, or an unlock symbol in green
background to indicate the wheels are unlocked.
A17 Wheels Casters to enable the A5 System to be moved. Casters on
the A5 lock via a central brake.

A18 Work Light Located under the top shelf to illuminate the work level
shelf and allow the user to read the vaporizer dial setting in
a darkened room.
A19 Work Light Switch Turns on/off the work light. Three settings: Off, Low, and
High. The user can turn on the work light only when the
main power switch is turned on.
A20 Vaporizer Mounting Manifold / An interface for two/three Selectatec-type vaporizers to
Mounting Bar mount in this location. Bar holds two/three (optional)
vaporizers. An interlock within the vaporizers provides for
use of one vaporizer to deliver one agent at a time.
A21 Vaporizer Mount Valve Vaporizer index and outlet ports.
Cartridge
A22 Vaporizer Parking Spot Holds a non-functional vaporizer for user convenience.

A23 Vaporizer Locking Device Vaporizer locking mechanism to secure against accidental
disconnection
A24 AC Status LED Illuminated when the system is connected to an AC power
source.
A25 Battery Charging LED Illuminated when the battery supply is charging.
A26 Main Power Switch Switch to turn the system on or off.
A27 Handle Metal bar used to assist moving the A5

A5™ Operating Instructions 046-002773-00 1-9

Physical Views Product Description

PART(S) DESCRIPTION
A28 Key lock Key and lock for securing the drawers
A29 Storage Drawers Drawers (3) for storage (lockable)

1.2.2 Main Unit (Rear View)

B1 B2 B3

B4

B5

B6 B7

B9
B8

B10

B11

B13
B12

B14

FIGURE 1-3 Main Unit (Rear View)

PART(S) DESCRIPTION
B1 Circuit Breakers Breakers for each auxiliary outlet
3 A each (quantity 4), 10 A total (quantity 1)

B2 Mains Inlet Connects the mains power cord

1 - 10 046-002773-00 A5™ Operating Instructions

Product Description Physical Views

PART(S) DESCRIPTION
B3 Exhaust Fan Forces air to cool electronics and prevent buildup of O2
concentration. Do not block.
B4 Communication Ports SP1, DP1, CS1, SB1, SB2 (see section 9.6.4 (page 9-8)
"Communication Ports").

CAUTION: Do not connect any

devices to the SB ports
other than Mindray
approved USB storage
devices and a supported
USB mouse (see
‘‘Networking and USB
Storage’’ on page A-4).
B5 Auxiliary AC Outlets Additional devices up ‘to a total maximum power of 10
amps can be connected to four (4) outlets.

The A5 outlets are covered with two (2) metal plates, and
require a tool to access. Only authorized personnel can
access these outlets.
B6 Equipotential stud / lug Provides a ground point. Eliminates the ground potential
difference between different devices to ensure safety.
B7 Hooks Allows user to hang or wrap cords
B8 Cylinder Supply Connections Interface connectors to high pressure supply tanks (O2, Air,
and N2O)
B9 Gas Pipeline Supply Connections for O2, Air, and N2O from a pipeline gas supply
Connections
B10 Sample Line Exhaust Gas Inlet Inlet for exhaust gas from gas module. Merges with the
AGSS connector that connects to the AGSS.
B11 AGSS Connector Connects the AGSS or waste gas disposal system
B12 AGSS Anesthetic Gas Scavenging System
B13 Cylinders Supply tanks (E-size) containing high pressure O2, Air, and
N2O to act as backup supply if the pipeline pressure is
removed. Note: Tanks not supplied by Mindray.
B14 AGSS Transfer Hose Routes exhaust gases from main unit to scavenger.

A5™ Operating Instructions 046-002773-00 1 - 11

Physical Views Product Description

1.2.3 Main Unit (Left View)

C4 C1

C2

C3
C5

FIGURE 1-4 Main Unit (Left View)

PART(S) DESCRIPTION
C1 Auxiliary O2/Air Auxiliary O2/Air Flowmeters for auxiliary O2/Air output
Flowmeters
C2 Auxiliary O2/Air Gas Nozzle (barbed connector) for auxiliary O2/Air output. Combines the
Outlet auxiliary O2/Air flowmeters into a single output.
C3 Auxiliary O2 Gas High pressure O2 outlet (DISS connector) for connecting external
Power Outlet devices such as a jet ventilator.

C4 Rail Mount Enables mounting of patient monitors and most standard attachment
arms for other devices. Rail mounts are on both left and right sides of
the A5.
C5 Module slot AG module can be inserted into the slot and identified.

1 - 12 046-002773-00 A5™ Operating Instructions

Product Description Physical Views

1.2.4 Main Unit (Right View)

D1

D2

D3

D4

FIGURE 1-5 Main Unit (Right View)

PART(S) DESCRIPTION
D1 Vaporizer Mounting An interface for two/three Selectatec-type vaporizers to
Manifold / Mounting Bar mount in this location. Bar holds two/three (optional)
vaporizers. An interlock within the vaporizers provides for use
of one vaporizer to deliver one agent at a time.
D2 Key Lock Key and lock for securing the drawers
D3 Storage Drawers Drawers (3) for storage (lockable)
D4 Rail Mount Enables mounting of patient monitors and most standard
attachment arms for other devices. Rail mounts are on both
left and right sides of the A5.

A5™ Operating Instructions 046-002773-00 1 - 13

Physical Views Product Description

1.2.5 Main Unit (Top View)

E1
Rear

E4

E3

E2

Front

FIGURE 1-6 Main Unit (Top View)

PART(S) DESCRIPTION
E1 Top Shelf Top level surface
E2 Work Level Shelf Work Level surface (stainless steel)
E3 Handle Wrap-around metal bar used to assist moving the A5 device
E4 Mounting Holes Allows mounting of optional equipment to the top shelf
(i.e., DPM6 and DPM7 mounting plates and kits. See
section A.7 (page A-3) "Mounting Accessories")

1 - 14 046-002773-00 A5™ Operating Instructions

Product Description Physical Views

1.2.6 Breathing System (Top View)

F1

F9
F2

F3

F4 F8

F5

F6

F7

FIGURE 1-7 Breathing System (Top View)

PART(S) DESCRIPTION
F1 Bellows (including bellows Bellows that separates the breathing system gases from the
dome)1 oxygen drive gas
F2 PAW Gauge2 Indicates the patient airway pressure
F3 Expiratory Limb Exhaled breathing circuit connection
F4 Inspiratory Limb Inhaled breathing circuit connection
F5 Expiration Valve Allows flow of expiratory gas from the patient to the re-
breathing system, and prevents reverse flow.
F6 Inspiration Valve Allows flow of inspiratory gas to the patient, and prevents
reverse flow.
F7 O2 Sensor Cable Assembly An electro-galvanic fuel cell device to measure the
concentration of O2. The assembly is composed of the O2
cable, O2 cell cover, and O2 sensor.
1
The bellows dome is a transparent cover with graduation marks from 300 to 1500 mL. These marks are for
reference only. Tidal volume (Vt) should be read exclusively from the display of the user interface. Delivered Vt
is a combination of bellows displacement and fresh gas flow.
2
The APL valve and Paw gauge numerics are for reference only. Calibrated patient airway pressure is displayed
on the user interface.

A5™ Operating Instructions 046-002773-00 1 - 15

Physical Views Product Description

PART(S) DESCRIPTION
F8 APL (Airway Pressure Rotary regulator for setting the breathing system pressure
Limiting) Valve2 limit during manual ventilation. Its scale shows approximate
pressure. Set to SP during Spontaneous breathing.
or

Quick Release APL Valve2 Rotary regulator for setting the breathing system pressure
limit during manual ventilation. Its scale shows approximate
pressure. Set to SP during Spontaneous breathing. When
necessary, lift the APL valve upward to release pressure
quickly.
F19 Auto/Manual Bag Switch Enables switching between Automatic and Manual
ventilation modes
1 The bellows dome is a transparent cover with graduation marks from 300 to 1500 mL. These marks are for
reference only. Tidal volume (Vt) should be read exclusively from the display of the user interface. Delivered Vt
is a combination of bellows displacement and fresh gas flow.
2 The APL valve and Paw gauge numerics are for reference only. Calibrated patient airway pressure is displayed
on the user interface.

1.2.7 Breathing System (Left View)

G7

G6

G5
G4

G1

G3

G2

FIGURE 1-8 Breathing System (Left View, the Flexible Bag Arm (optional))

1 - 16 046-002773-00 A5™ Operating Instructions

Product Description Physical Views

G8

G6

G5

G4

G1

G3
G2

FIGURE 1-9 Breathing System (Left View, the Fixed Height Bag Arm (standard))

PART(S) DESCRIPTION
G1 CO2 Absorber Canister Container for CO2 absorbent material loose fill or Pre-Paks)
G2 Condensate Drain Valve Turn counter-clockwise (looking from bottom) to drain water
collected in the absorber canister.
G3 Absorber Canister Lock Lever-type locking mechanism to lock (horizontal position) or
unlock (vertical position) the absorber canister from the
canister assembly.
G4 Water Trap Accumulates condensate from the breathing system. Must be
removed and emptied periodically. To remove, turn clockwise
(looking from top).
G5 Absorber Bypass Assembly Maintains pressure in the breathing circuit when changing
the sodalime contents in the CO2 absorber canister.
G6 Hook Hang the tubes of the breathing system.

A5™ Operating Instructions 046-002773-00 1 - 17

Physical Views Product Description

PART(S) DESCRIPTION
G7 Flexible Bag Arm Provides the interface for the manual ventilation bag. The
flexible bag arm can be adjusted to desired height and the
bag port can be rotated 360°.
G8 Fixed Height Bag Arm Provides the interface for the manual ventilation bag The
height of fixed bag arm cannot be adjusted and the bag port
is in a fixed direction.

1.2.8 Active Anesthetic Gas Scavenging System (AGSS) (Top, Right,

and Rear Views)

Top View

H1

H2
Right View Rear View

H3

Max Max
H5

Min Min

H4

FIGURE 1-10 Active AGSS (Top, Right, and Rear Views)

1 - 18 046-002773-00 A5™ Operating Instructions

Product Description Physical Views

PART(S) DESCRIPTION
H1 Mounting Rail Attachment Allows the AGSS to be mounted on the side rail. Contains a
thumbscrew that must be tightened against the mounting
rail.
H2 Flow Adjust Knob Turn clockwise or counter-clockwise to adjust the flow in the
AGSS until the float is between Min and Max marks.
H3 Exhaust Port Exhaust port to the hospital’s waste gas scavenging system.
H4 Inlet Port Intake for exhaust gases from the breathing system. An AGSS
transfer hose connects the Inlet and AGSS ports (see
FIGURE 1-3) to transfer the exhaust gases.
H5 Float Indicates exhaust flow. Adjusted by turning the Flow Adjust
Knob (H2) until the float is between the Min and Max marks.

A5™ Operating Instructions 046-002773-00 1 - 19

Physical Views Product Description

1.2.9 Passive Anesthetic Gas Scavenging System (AGSS) (Right

View)

I1 I2

I3

Rear View

FIGURE 1-11 Passive AGSS (Right View)

PART(S) DESCRIPTION
I1 Inlet Port Intake for exhaust gases from the breathing system
connecting with the AGSS ports.
I2 Exhaust Port Exhaust port to the hospital’s waste gas scavenging system.
I3 Manual Bag When the manual bag is inflated, it indicates that the passive
AGSS is blocked.

1 - 20 046-002773-00 A5™ Operating Instructions

 2.0 Installation

Unpacking.....................................................................................................................................................................................................2-3

Initial Setup...................................................................................................................................................................................................2-4

Install the Vaporizer .................................................................................................................................................................................2-5

A5™ Operating Instructions 046-002773-00 2-1

 Installation

WARNING: This equipment must be installed by a factory authorized

representative.

WARNING: Continuous use of desiccated sodalime may endanger patient safety.

Adequate precautions should be taken to ensure that the sodalime in
the CO2 absorbent canister does not become desiccated. Turn off all
gases when finished using the system.

WARNING: When electrosurgical equipment is used, keep the electrosurgical leads

away from the breathing system, the O2 sensor, and other parts of the
A5 Anesthesia System. Keep available backup manual ventilation and a
respirator with mask in case the electrosurgical equipment prevents
safe use of the ventilator. Ensure the correct operations of all life
support and monitoring equipment.

WARNING: Do not use masks or breathing tubes that are antistatic or conductive.
They can cause burns if they are used near high frequency
electrosurgical equipment.

WARNING: This A5 Anesthesia System has waste gas exhaust ports. The operator of
the machine should pay attention to the disposal of the residual
breathing gas scavenged.

CAUTION: The operational environment and the power source of the equipment
must comply with the requirements as specified in the A5 ‘‘Product
Specifications’’ on page 9-1.

2-2 046-002773-00 A5™ Operating Instructions

Installation Unpacking

2.1 Unpacking
When the A5 Anesthesia System is delivered, IMMEDIATELY inspect the box for any damage.

a. If there is NO damage and ALL tip indicators on the box exterior are intact, then sign and
date the bill of lading or airway bill to indicate safe receipt of the A5.
b. If there is DAMAGE or ANY of the tip indicators on the box exterior have been activated,
then conditionally accept the delivery and clearly describe the damages on the bill of
lading or airway bill. BOTH the carrier and recipient must sign and date the bill of lading
or airway bill. Save all damaged factory packaging until further instructed by Mindray.
The receiver should immediately contact Mindray Customer Service at +86 755
26582479 / 26582888.

A5™ Operating Instructions 046-002773-00 2-3

Initial Setup Installation

2.2 Initial Setup

The initial setup of the A5 Anesthesia System must be performed by an authorized Mindray
service representative. Please contact Mindray Technical Support for any additional assistance.

NOTE: The A5 is intended to be operated with an external CO2 monitor

complying with ISO 80601-2-55. Connection to the CO2 monitor should
be via a sample line from the patient circuit.

2-4 046-002773-00 A5™ Operating Instructions

Installation Install the Vaporizer

2.3 Install the Vaporizer

CAUTION: Only vaporizers with Selectatec Interlock Systems may be used with the
A5 unit.

WARNING: Use vaporizers compliant to ISO 80601-2-13. See section A.9 (page A-4)
"Vaporizers". Refer to the vaporizer manufacturer’s Instructions For Use
for mounting, filling, or draining the vaporizer and other information.

WARNING: Use care in lifting and manipulating vaporizers during the mounting
process as their weight may be greater than expected, based on their
size and shape.

NOTE: The barometric pressure may differ from the calibration pressure of the
anesthetic vaporizer. This may cause an inaccurate output of the
anesthetic agent. The operator should continuously monitor the
concentration of anesthetic agent during system use to determine if
the outputted concentration is accurate.

Vaporizer mounts for two/three

(optional) inline vaporizers

Additional vaporizer mount for one

inactive vaporizer

FIGURE 2-1 Location of Vaporizer Mounting System

1. If replacing and removing the vaporizer, lift each vaporizer straight up off the manifold. Do
not pull the vaporizer forward. Do not rotate the vaporizer on the manifold.
2. Align the new vaporizer over the valve cartridges of the mounting bar, slightly tilting back
the vaporizer. Hang the vaporizer on the mounting bar as shown in FIGURE 2-2. Ensure that
the locking mechanism handle is in the unlocked position. Ensure that the dial is in the “0”
(Transport) position or equivalent, depending upon the vaporizer manufacturer’s
Instructions For Use.

A5™ Operating Instructions 046-002773-00 2-5

Install the Vaporizer Installation

Locking Mechanism
Handle in the
Unlocked Position

Vaporizer dial in the

“0” position

FIGURE 2-2 Vaporizer, Unlocked

3. Rotate the locking mechanism handle clockwise into the locked position as shown in
FIGURE 2-3.

NOTE: If installing a Desflurane vaporizer, refer to the manufacturer’s

Instructions For Use on installation and use of the vaporizer.

Locking Mechanism
Handle in the Locked

FIGURE 2-3 Vaporizer, Locked

4. Final check:
1. Ensure that the top of the vaporizer is horizontal. If not, remove and reinstall the vaporizer.
2. If a vaporizer lifts off the manifold, repeat steps 1 through 3 to reinstall the vaporizer. If the
vaporizer lifts off a second time, do not use the system.

WARNING: For the A5 Anesthesia System, using or turning on more than one
vaporizer simultaneously is prohibited and prevented by a mechanical
interlock. Do not attempt to override this safety mechanism.

2-6 046-002773-00 A5™ Operating Instructions

Installation Install the Vaporizer

2.3.1 Filling and Draining the Vaporizer

Install the vaporizers with a Selectatec interlock system that are compliant to ISO 80601-2-13 on
the A5 unit. See section A.9 (page A-4) "Vaporizers". Refer to the manufacturer’s vaporizer
Instructions For Use for filling or draining the vaporizer and other information.

WARNING: Ensure that the correct anesthetic agent is used. The vaporizer is
designed with the specific anesthetic agent named on it and further
indicated by color coded labeling. The concentration of the anesthetic
agent actually output will vary if the vaporizer is filled with the wrong
agent.

WARNING: Do not reuse the agent drained from the vaporizer. Treat as a hazardous
chemical and follow local regulations for proper disposal.

A5™ Operating Instructions 046-002773-00 2-7

Install the Vaporizer Installation

This page intentionally left blank.

2-8 046-002773-00 A5™ Operating Instructions

 3.0 System Interface

Main Screen Components ..................................................................................................................................................................3-2

System Information Header ...............................................................................................................................................................3-5

Fresh Gas Flow Display ....................................................................................................................................................................... 3-10

Waveforms Tab ........................................................................................................................................................................................ 3-11

Spirometry Tab ........................................................................................................................................................................................ 3-13

Demographics Tab................................................................................................................................................................................ 3-19

Ventilation Mode Tabs ........................................................................................................................................................................ 3-21

Measured Values Area......................................................................................................................................................................... 3-23

System Softkeys...................................................................................................................................................................................... 3-24

Setup ............................................................................................................................................................................................................. 3-32

General Tab................................................................................................................................................................................................ 3-32

Display Tab ................................................................................................................................................................................................. 3-34

System Tab................................................................................................................................................................................................. 3-38

Service Tab................................................................................................................................................................................................. 3-44

A5™ Operating Instructions 046-002773-00 3-1

Main Screen Components System Interface

3.1 Main Screen Components

1 2 3 4 5 17 6 7 8 9 10 11 12

15 16 13 14

FIGURE 3-1 A5 Main Screen Components

MAIN SCREEN
NUMBER COMPONENT DESCRIPTION
1 Elapsed / Countdown Timer Displays elapsed time or countdown time. Select to start,
stop, or reset the timer.
2 Fresh Gas Flow Area Displays real-time flowmeter levels for N2O, Air, and O2.
3 Patient Size Displays the currently selected patient size (Adult,
Pediatric, or Infant). Select to change the patient size when
the A5 is in Standby mode, Manual mode or Monitorl*
mode
4 Current Ventilation Mode Displays the current ventilation mode (VCV, SIMV-VC, PCV,
SIMV-PC*, PS, Manual, Bypass**,Monitor or Standby.)
5 Waveforms Tab See “Waveforms Tab” on page 3-11.
6 Spirometry Tab See “Spirometry Tab” on page 3-13.
7 Demographics Tab See “Demographics Tab” on page 3-19.
* Monitor mode is only available with the AG module.
**SIMV-PC and Bypass are only available on A5.

3-2 046-002773-00 A5™ Operating Instructions

System Interface Main Screen Components

MAIN SCREEN
NUMBER COMPONENT DESCRIPTION
8 Alarm / Prompt Message Displays physiological alarms, technical alarms, and
Area prompt messages. The most recent highest priority alarm is
displayed at the top.

The remaining alarms are displayed in the lower area and

grouped by priority. The most recent of these alarms is
displayed first. Select this area to display a list of all active
alarms.

See ‘‘Alarms and Messages’’ on page 6-1 for tables that list
the individual messages and their associated priority levels.
High priority messages are red. Medium priority messages
are yellow. Low priority messages are cyan. Prompt
messages are black text on white background.
9 Alarm Silence Icon Displays the alarm silence icon and Alarm Silence
countdown timer for 120 seconds when the Silence softkey
is selected.
10 Breathing System Warmer Icon Indicates the warmer is not active.
11 System Date and Time Displays the current system date and time. Select to adjust
the date and time. See ‘‘Date and Time’’ on page 3-8.
12 Main Power Supply and Displays the main power supply and battery state. See
Battery Status Icon “Power Management / Battery Supply” on page 1-5.
13 Ventilations Mode and Displays tabs for all ventilation modes (VCV, SIMV-VC, PCV,
Setting Parameters Area SIMV-PC*, PS, Manual/Bypass*or Monitor). Each tab
displays the ventilation mode and its parameters. Select a
tab and the “Set Mode” softkey to change the ventilation
mode. Select a parameter button to change the parameter
setting. See ‘‘Ventilation Modes’’ on page 5-8.
* Monitor mode is only available with the AG module.
**SIMV-PC and Bypass are only available on A5.

A5™ Operating Instructions 046-002773-00 3-3

Main Screen Components System Interface

MAIN SCREEN
NUMBER COMPONENT DESCRIPTION
14 System Softkeys Setup – Select to open the Setup menu. The Setup menu
contains the General tab, Display tab, System tab, and
Service tab.
Alarms – Select to open the Alarms menu to set alarm
limits, set alarm volume, and view all active alarms.
Silence – Select Silence softkey to silence all currently
sounding alarm tones. The alarm will sound if a new alarm
occurs.
If the silenced alarms contain middle or high level alarms,
the alarm audio will be paused for 120 seconds.The alarm
silence icon and 120 second countdown time appear at the
top of the screen. Select again to resume the alarm audio.
Note, however, the alarm will sound if that a new alarm
occurs while the system is in an audio-paused state. If this
occurs, you can select the Silence softkey again to silence
the new alarm and reset the silence countdown timer to
120 seconds.

If the silenced alarms are only low level alarms, the alarm
audio will be turned off till there is a new alarm occurs.
Note, however, the alarm will sound if that a new alarm
occurs while the system is in an audio-off state. If the new
alarm is low level alarm, you can select the Silence softkey
again to turn off the new alarm audio. If the new alarm is
medium or high level alarm, you can select the Silence
softkey again to silence the new alarm for 120 seconds.

History - Select to open the History menu. The History

menu contains the List Trends and Event log.
Capture Event - Select to capture an event and log it in the
event log.
15 Gas Area Displayed when AG module is connected. Displays real-
time inspiratory and expiratory levels of gas.
16 Waveforms/Spirometry Area Displays waveforms or spirometry.
17 Monitored Parameter Area Displays monitored parameters.
* Monitor mode is only available with the AG module.
**SIMV-PC and Bypass are only available on A5.

3-4 046-002773-00 A5™ Operating Instructions

System Interface System Information Header

3.2 System Information Header

3.2.1 Elapsed / Countdown Timer
Displays the elapsed time, countdown time, or both. Located at the top left of the main screen. Select
to start, stop, or reset the timer. Select the timer icon to open the timer menu (see FIGURE 3-2).

Elapsed / Countdown Timer

FIGURE 3-2 Elapsed / Countdown Timer

Elapsed Timer

Select the Start button to turn on the elapsed timer (see FIGURE 3-3). Select the Stop button to
pause the elapsed timer and the timer will flash. Select the Reset button to turn off the elapsed timer.

FIGURE 3-3 Only Elapsed Timer Screen

Countdown Timer (software bundle version 02.06.00 and later)

Input the time with the keypad and select the Start button to turn on the countdown timer (see
FIGURE 3-4). Select the Stop button to pause the countdown timer and the timer will flash. Select the
Reset button to turn off the countdown timer.

FIGURE 3-4 Only Countdown Timer Screen

When the countdown timer is expired, the system will pop-up a warning dialog (see FIGURE 3-5) and
provide a notification sound at the same time, The sound will repeat until the Done button is
pressed.

A5™ Operating Instructions 046-002773-00 3-5

System Information Header System Interface

FIGURE 3-5 Countdown Timer Expired

Elapsed and Countdown Timer (software bundle version 02.06.00 and later)

Turn on both the elapsed and countdown timer, the figure below displays on the screen (see
FIGURE 3-6).

Elapsed Timer

Countdown Timer

FIGURE 3-6 Elapsed and Countdown Timer Screen

3.2.2 Patient Size

Displays the currently selected patient size (Adult, Pediatric, or Infant). Select to change the patient
size when the A5 is in Standby mode, Manual mode or Monitor mode (available with the AG
module). (FIGURE 3-7)

Patient Size

FIGURE 3-7 Patient Size Menu (with AG module connected)

3.2.3 Alarm and Prompt Messages

Displays physiological alarms, technical alarms, and prompt messages. The most recent highest
priority alarm is displayed at the top.

The remaining alarms are displayed in the lower area and grouped by priority. The most recent of
these alarms are displayed first.

Select this area to display a list of all active alarms. See ‘‘Alarms and Messages’’ on page 6-1 for tables
that list the individual messages and their associated priority levels. High priority messages are red.
Medium priority messages are yellow. Low priority messages are cyan. Prompt messages are black
text on white background (see FIGURE 3-8).

3-6 046-002773-00 A5™ Operating Instructions

System Interface System Information Header

FIGURE 3-8 Alarm and Prompt Messages

3.2.4 Alarm Silence Icon

The Alarm Silence icon and Alarm Silence countdown timer are displayed after selecting the Silence
softkey is selected, which indicates that all currently sounding alarms are silenced for 120 seconds
(see FIGURE 3-9).

Alarm Silence Icon

FIGURE 3-9 Alarm Silence Icon (with AG module connected)

A5™ Operating Instructions 046-002773-00 3-7

System Information Header System Interface

3.2.5 Date and Time

Displays the current system date and time (see FIGURE 3-10).

Date and Time

FIGURE 3-10 Date and Time Icon (with AG module connected)

To adjust the date and time:

1. Select the Date and Time icon. The Date/Time dialog is displayed (see FIGURE 3-11).
2. Use the dialog keypad and softkeys to adjust the date, time, 12/24 hour format, date format,
and daylight savings time.

NOTE: If applicable, select Daylight Savings Time first before all other
settings.

NOTE: If the Daylight Savings Time On/Off button in the Date/Time

dialog (see FIGURE 3-11) is disabled and cannot be selected, it
is because the Daylight Savings setting has been set to Auto in
the System settings (see TABLE 3-10, “System Tab Settings,” on
page 39).

3. Select the “Accept” to finalize your changes.

FIGURE 3-11 Date and Time Menu

3-8 046-002773-00 A5™ Operating Instructions

System Interface System Information Header

3.2.6 Battery Status

Displays the main power supply and battery state (see FIGURE 3-13). For more information on the
advanced A5 power management system, see “Power Management / Battery Supply” on page 1-5.

Battery Status Icon

FIGURE 3-12 Battery Status Icon (with AG module connected)

PART(S) DESCRIPTION
Battery supply is fully charged.
AC power is connected.
The A5 is being powered by AC power. The solid portion
represents the current charge level of the batteries in proportion
to its maximum charge level.
Battery supply is partially charged.
AC power is connected and charging batteries.
The A5 is being powered by AC power.

Battery supply is fully charged.

AC power is not connected.
The A5 is being powered by internal batteries.

Battery supply is partially charged.

AC power is not connected.
The A5 is being powered by internal batteries.

Battery supply is low charged. Batteries need to be charged

immediately to operate as a safe power backup.
AC power is not connected.
The A5 is being powered by internal batteries.

Battery supply is not installed.

FIGURE 3-13 Battery Status

A5™ Operating Instructions 046-002773-00 3-9

Fresh Gas Flow Display System Interface

3.3 Fresh Gas Flow Display

Displays real-time flowmeter levels for N2O, Air, and O2 (see FIGURE 3-14).

The flowmeter numerics display a precision to two decimal digits for flows < 1 L/min and one
decimal digit for flows ≥ 1 L/min.

For the A5, the size (height) of the fresh gas flow tubes changes depending on whether the AG
module is connected as shown in FIGURE 3-14.

Fresh Gas Flow Display

FIGURE 3-14 Fresh Gas Flow Display

3 - 10 046-002773-00 A5™ Operating Instructions

System Interface Waveforms Tab

3.4 Waveforms Tab

Displays PAW , Flow, Volume, CO2, O2, N2O and AA (AA stands for anesthetic agent) waveforms (see
FIGURE 3-15).

NOTE: O2, N2O and AA waveforms are available in software bundle

version 02.06.00 and later.

Waveforms Tab

FIGURE 3-15 Main Screen Waveforms Tab (with AG module connected)

3.4.1 Waveforms Autoscaling

If the measured value of Paw or Flow is larger than the boundary at the end of breath cycle, the
system will auto scale the Paw or Flow at the beginning of the next breath cycle.

If the measured value of Paw or Flow is less than the boundary minus a margin at the end of two
continuous breath cycles, the A5 System will auto scale the Paw or Flow at the beginning of next
breath cycle.

Paw scale:
The margin will be 10 cmH2O if pressure ≥ 30 cmH2O.

The margin will be 3 cmH2O if pressure <30 cmH2O.

Flow scale:

A5™ Operating Instructions 046-002773-00 3 - 11

Waveforms Tab System Interface

• The margin will be 10 L/min if Flow ≤ 30 L/min

• The margin will be 15 L/min if Flow > 30 L/min
Volume scale:

• The margin will be 25mL if volume ≤ 100 mL

• The margin will be 100 mL if volume > 100 mL

3.4.2 Waveforms Manual Scaling

The scale of CO2, O2, N2O, and AA (AA stands for anesthetic agent) waveforms can be set manually
through the menu:

1. Select Setup softkey > Display tab.

2. Select the Gas Scales button.

GAS SCALES UNIT OF MEASURE SCALE

mmHg 0-40 0-60 0-80
CO2 Scale kpa 0.0-5.0 0.0-8.0 0.0-10.0
% 0.0-5.0 0.0-8.0 0.0-10.0
O2 Scale % 0-35 0-50 0-100
N2O Scale % 0-35 0-50 0-100
Des Scale % 0.0-6.0 0.0-9.0 0.0-18.0
Sev Scale % 0.0-2.0 0.0-4.0 0.0-8.0
Iso Scale % 0.0-1.2 0.0-2.5 0.0-5.0
Hal Scale % 0.0-1.2 0.0-2.5 %
Enf Scale % 0.0-1.2 0.0-2.5 0.0-5.0
TABLE 3-1 Gas Scales

3 - 12 046-002773-00 A5™ Operating Instructions

System Interface Spirometry Tab

3.5 Spirometry Tab

Displays separate looped graphsand waveforms (see FIGURE 3-16).

NOTE: Displaying spirometry and waveforms simultaneously is

available for software bundle version 02.06.00 and later.

You can press the button (see FIGURE 3-16) to only view the spirometry loop (see FIGURE 3-17).

Spirometry Tab

FIGURE 3-16 Spirometry and Waveforms

A5™ Operating Instructions 046-002773-00 3 - 13

Spirometry Tab System Interface

You can press the button (see FIGURE 3-17) to see the spirometry loop and waveforms (see
FIGURE 3-16).

FIGURE 3-17 Spirometry: Pressure-Volume Loop

FIGURE 3-18 Spirometry: Flow-Volume Loop

3 - 14 046-002773-00 A5™ Operating Instructions

System Interface Spirometry Tab

FIGURE 3-19 Spirometry: Pressure-Flow Loop (only for software bundle version 02.06.00 and
later)

Spirometry loops reflect patient lung function and ventilation. They also indicate other related
parameters such as compliance, over-inflation, breathing system leak, and airway blockage.

The system provides three spirometry loops: pressure - volume loop (see FIGURE 3-17), flow - volume
loop (see FIGURE 3-18) and pressure - flow loop (see FIGURE 3-19). Loops data comes from pressure
and flow data. Only one loop is displayed at a time.

The Spirometry tab displays four softkeys: Loop Type, Show Reference, Save Loop, and Review
Loops.

3.5.1 Loop Type

The Loop Type selection is used to select pressure - volume loop, flow - volume loop or pressure-
flow loop to display on the Spirometry screen. Default loop type is pressure - volume loop.

Show Reference Review Loops

Loop Type Save Loop

FIGURE 3-20 Spirometry Softkeys: Loop Type, Show Reference, Save Loop, and Review Loops

A5™ Operating Instructions 046-002773-00 3 - 15

Spirometry Tab System Interface

3.5.2 Show Reference

The Show Reference softkey can be selected only after a baseline has been saved via the Save Loop
softkey.

The Show Reference softkey (see FIGURE 3-20) is used to select and display a saved baseline loop,
reference loop, or no loop (Off ) in the spirometry loop window, overlapped with the currently
plotting loop. Only the four most recently saved reference loops are listed chronologically.

When a reference loop or baseline loop is selected to display in the spirometry loop window, the time
stamp will also be displayed.

3.5.3 Save Loop

Select the Save Loop softkey (see FIGURE 3-20) to save the currently plotting loop (including its
numeric data) as either a baseline loop or reference loop. Only one baseline loop and up to four
reference loops can be saved. Additional plotting loops can be saved to replace the baseline loop or
reference loops. Only the four most recent reference loops are saved.

The saved baseline or reference loop can be reviewed with its numeric data (via Review Loops
softkey) or displayed with the currently plotting loop on the same graph for comparison (via Show
Reference softkey).

NOTE: A reference loop cannot be saved without first saving a

baseline loop. The A5 System will always make the first saved
loop as the baseline loop if no previous loops have been saved.
Afterward, additional loops can be saved either as a baseline
replacement or as a new reference loop.

To save a baseline loop:

1. From the main screen, select Spirometry tab > Save Loop softkey.
If there is no baseline loop saved in memory, the currently plotting loop will be saved
automatically as the baseline loop.
2. If a baseline loop is already saved in memory, a dialog box will appear with the choices of
“Baseline“ and ”Reference“. Select ”Baseline”. A confirmation dialog will be displayed with
the text “Selecting Yes will replace the currently saved Baseline loop. Do you want to
proceed?” If “Yes” is selected, the currently saved baseline loop will be replaced. If “No” is
chosen, the save will be aborted.
To save a reference loop:

1. From the main screen, select Spirometry tab > Save Loop softkey. If a baseline loop is
already saved in memory, a dialog box will appear with the choices of "Baseline" and
"Reference". Select "Reference".
A maximum of four (4) sets of reference loops plus one (1) Baseline loop and corresponding numeric
data can be saved.

When the maximum of four (4) loops is reached, and the user attempts another save, a confirmation
dialog will be displayed with the following text, “Selecting Yes will replace the oldest reference
loop. Do you want to proceed?” If “Yes” is chosen, the oldest data will be removed as the new data
is added. If "No" is chosen, the save will be aborted.

3.5.4 Review Loops Button

Selecting the Review Loops softkey (see FIGURE 3-20) displays the Review Loops screen (see
FIGURE 3-21). The following areas and selections are displayed:

3 - 16 046-002773-00 A5™ Operating Instructions

System Interface Spirometry Tab

Small Loop Window: These small graphic windows show the baseline and reference loops. The
baseline loop (only one) is always located on the left and has a white border around its graph. The
reference loops (up to four) are located to the right of the baseline loop. The reference loops are
displayed from oldest (left) to newest (right).

The baseline loop information is displayed below the small baseline loop window. The reference loop
information is displayed in cyan highlight for the reference loop that is selected.

Large Loop Window: This graphic window shows an enlarged view of the selected reference loop
overlapped with the baseline loop.

Loop Type: The Loop Type softkey is used to choose the type of loop to review. The choices are:
Pressure - Volume, Flow - Volume and Pressure - Flow. Default loop type is Pressure - Volume
loop.

Delete Loop: The Delete Loop softkey is used to delete a selected Reference loop. When a reference
loop is deleted, the newer reference loops will shift to the left. The Delete Loop softkey will be
disabled (grayed out) if no reference loops have been saved. The baseline loop cannot be deleted. It
can only be replaced by another baseline loop.

Non-selected Non-selected Selected Reference Non-selected Reference

Baseline Loop Reference Loop Loop (small) Loop

Numeric Data Selected

Area Reference
Loop (large)

FIGURE 3-21 Review Loops window

Numeric Data Area: Displays the numerical data associated with a saved Baseline loop and saved
Reference loops. The parameters listed in column form include:

A5™ Operating Instructions 046-002773-00 3 - 17

Spirometry Tab System Interface

• Time
• Expiratory Minute Volume (Mv Exp)
• Inspiratory Minute Volume (Mv Insp)
• Expiratory Tidal Volume (Vt Exp)
• Inspiratory Tidal Volume (Vt Insp)
• Ratio of Inspiratory time to Expiratory time (I:E)
• Positive End Expiratory Pressure (PEEP)
• Rate
• Peak Inspiratory Pressure (PEAK)
• Plateau Pressure (PLAT)
• Mean Pressure (MEAN)
• Dynamic Airway Compliance (Compl)
• Airway Resistance (Raw)

3 - 18 046-002773-00 A5™ Operating Instructions

System Interface Demographics Tab

3.6 Demographics Tab

The Demographics tab is located on the main screen next to the Spirometry tab on the A5 system
(see FIGURE 3-22). The Demographics tab contains editable fields to enter patient and hospital data
(see TABLE 3-2).

NOTE: Facility data should be entered when first setting up the

machine. After entering facility data, the user should go to the
System tab>Manage Defaults>Save as O.R. Defaults so that the
data is not erased in case of power cycle or end of case.

EDITABLE FIELD COMMENT

Patient ID Enter up to 30 characters per field. These fields are cleared when the case has
First Name ended or if the A5 is power cycled.

Last Name
DOB (Date Of Birth) Enter the information from the virtual keypad. If the input is outside the
Age accepted range, a prompt message is displayed. If the age of the patient is less
than 1, the Age will display < 1. These fields are cleared when the case has
Weight (lbs/kg) ended or if the A5 is power cycled.
Bed Enter up to 20 characters per field. When the Restore default settings checkbox
is selected, these fields are NOT cleared when the cas has ended.
Room
Point of Care
Facility
TABLE 3-2 Demographic Tab Fields for Patient and Hospital Data

A5™ Operating Instructions 046-002773-00 3 - 19

Demographics Tab System Interface

Demographics Tab

FIGURE 3-22 Demographics Tab

3 - 20 046-002773-00 A5™ Operating Instructions

System Interface Ventilation Mode Tabs

3.7 Ventilation Mode Tabs

Displays tabs for all ventilation modes. Each tab displays the ventilation mode and its parameters (see
FIGURE 3-23 to FIGURE 3-29).

A5 ventilation modes:
• Volume Control Ventilation (VCV)
• Synchronized Intermittent Mandatory Ventilation with VC mode (SIMV-VC)
• Pressure Control Ventilation (PCV)
• Synchronized Intermittent Mandatory Ventilation with PC mode (SIMV-PC)
• Pressure Support ventilation (PS)
• Manual,
• Bypass
• Monitor (with AG module)

Ventilation Mode Tabs

FIGURE 3-23 Ventilation Mode Tabs (with AG module installed)

To change the ventilation mode:

1. Select a desired ventilation mode tab. The Set Mode softkey begins to blink green.
2. Optionally, select one or more parameter buttons to change the parameter settings of the
desired ventilation mode. Select the “Accept” button to save each parameter change.
3. Select the “Set Mode” softkey to finalize and change the ventilation mode.

NOTE: If the Set Mode softkey is not selected after several seconds, an
audible reminder is sounded, and then the desired ventilation
mode is cancelled.

FIGURE 3-24 Ventilation Mode: VCV

A5™ Operating Instructions 046-002773-00 3 - 21

Ventilation Mode Tabs System Interface

FIGURE 3-25 Ventilation Mode: SIMV-VC

FIGURE 3-26 Ventilation Mode: PCV

FIGURE 3-27 Ventilation Mode: SIMV-PC

FIGURE 3-28 Ventilation Mode: PS

FIGURE 3-29 Ventilation Mode: Manual

FIGURE 3-30 Ventilation Mode: Manual (with AG module installed)

NOTE: Monitor mode available when external AG module connected.

3 - 22 046-002773-00 A5™ Operating Instructions

System Interface Measured Values Area

3.8 Measured Values Area

The Measured Values area is used to display the numerical data. The parameters include: End tidal
CO2 (with AG module connected), Fractional CO2 (with AG module connected), Peak Inspiratory
Pressure (PEAK), Plateau Pressure (PLAT) (user can configure this to display Mean Pressure (MEAN) or
PLAT (see “Pressure Display” on page 3-35)), Positive End Expiratory Pressure (PEEP), I:E Ratio,
Expiratory Tidal Volume (Vt), Expiratory Minute Volume (MV),and Breath Rate (Rate), and Inspiratory
O2% (FiO2).

Measured Values Area

FIGURE 3-31 Measured Values Area (with AG module connected)

FIGURE 3-32 Measured Values Area (no AG module connected)

A5™ Operating Instructions 046-002773-00 3 - 23

System Softkeys System Interface

3.9 System Softkeys

The A5 System provides system softkeys at the bottom right of the main screen for direct access to
the history menu, system setup, and alarms menu, and for capturing events and silencing alarms (see
FIGURE 3-33).

FIGURE 3-33 System Softkeys

3.9.1 Setup Softkey

Select the Setup softkey on the main screen to display the Setup menu. See FIGURE 3-33, “System
Softkeys,” on page 24.

The Setup menu contains the General tab, Display tab, System tab, and Service tab. See
section 3.12 (page 3-34) "Display Tab".

3.9.2 Alarms Softkey

Select the Alarms softkey on the main screen to open the Alarms menu to set alarm limits, set alarm
volume, and view all active alarms. See “Alarms and Messages” on page 6-1.

3.9.3 Silence Softkey

Select Silence softkey to silence all currently sounding alarm tones. The alarm will sound if a new
alarm occurs.

If the silenced alarms contain middle or high level alarms, the alarm audio will be paused for 120
seconds.The alarm silence icon and 120 second countdown time appear at the top of the screen.
Select again to resume the alarm audio. Note, however, the alarm will sound if that a new alarm
occurs while the system is in an audio-paused state. If this occurs, you can select the Silence softkey
again to silence the new alarm and reset the silence countdown timer to 120 seconds.

If the silenced alarms are only low level alarms, the alarm audio will be turned off till there is a new
alarm occurs. Note, however, the alarm will sound if that a new alarm occurs while the system is in an
audio-off state. If the new alarm is low level alarm, you can select the Silence softkey again to turn off
the new alarm audio. If the new alarm is medium or high level alarm, you can select the Silence
softkey again to silence the new alarm for 120 seconds.

3.9.4 Capture Event

Select the Capture Event softkey on the main screen to capture parameters and log it in the Event
Log(see FIGURE 3-36). The Capture Event softkey is disabled when the machine is in Standby.

3.9.5 History
Select the History button on the main screen to access a patient’s historical physiological
parameters. The History dialog contains List Trends, Graphic Trends and an Event Log tab.

Found in software bundle version 02.06.00 and later:

There is an interactive link among the three history tabs. When switching between tabs, the cursor
will automatically position itself on the corresponding record that was selected in the previous tab.

3.9.5.1 List Trends

Select the History button on the main screen to access the List Trends. The History dialog displays
(see FIGURE 3-34) with the List Trends tab selected.

3 - 24 046-002773-00 A5™ Operating Instructions

System Interface System Softkeys

The List Trends displays a tabular list of the physiological parameters. Trend data automatically
displays in one minute intervals unless an alternate interval is selected.

FIGURE 3-34 List Trends

3.9.5.1.1 About List Trends

• List Trends displays the time and date on the horizontal axis and it is always visible.
• List Trends displays the parameter data on the vertical axis and it is always visible.
• List Trends displays the trend records in descending order beginning with the most recent on the
right side of the grid.
• ListTrends are not stored when the machine is in standby.
• The display period of data is a rolling 48 hours of continuous data.
• List Trends highlights the parameter data in the corresponding alarm color if an alarm condition
existed for the parameter at the time of trend record storage.

3.9.5.1.2 Navigating in List Trends

The dialog navigation buttons are described in TABLE 3-3.

NOTE: When a navigation button becomes disabled, this indicates that

there is no more data available or the end of the data range was
reached.

BUTTON FUNCTION
Moves the cursor to the oldest record from its current position.

Moves the cursor one page back from its current position.

A5™ Operating Instructions 046-002773-00 3 - 25

System Softkeys System Interface

BUTTON FUNCTION
Moves the cursor one record back from its current position.

Moves the cursor one record forward from its current position.

Moves the cursor one page forward from its current position.

Moves the cursor to the newest record from its current position.

Previous Event Moves the cursor to the previous event from its current position.
Next Event Moves the cursor to the next event from its current position.
Moves the cursor up one parameter from its current position.

Moves the cursor down one parameter from its current position.

TABLE 3-3

3.9.5.1.3 Display Interval

Display Interval allows for the trends to be displayed in a specified time interval between two
neighboring columns.

Set Display Interval to 1Min, 5Min, 10Min, 15Min, 30Min, 1Hour, or 2Hour.

3.9.5.1.4 Display Groups

Display Group allows for the trends to be displayed in a specified parameter group.

Set Display Group to Gas, Fresh Gas, Ventilation, or All.

3.9.5.1.5 List Trend Export (software bundle version 02.06.00 and later)
The Export button on the List Trend tab will allow the contents of the history to be exported to a
USB mass storage device. The format of the data exported is a .html file which can be opened using
Internet Explorer version 6.0, 7.0 and 8.0. The Export button on the List Trend tab is only available
when the system is in Standby mode.

NOTE: If Internet Explorer greater than version 8.0 is used to view the
exported file, set it to compatibility mode.

3.9.5.2 Graphic Trends

Select the History button on the main screen and then select the Graphic Trends tab to access the
Graphic Trends. The History dialog displays (see FIGURE 3-35) with the Graphic Trends tab selected.

Graphic trends display allows the user to observe the trend of the physiological parameters. The
trend is reflected through a curve. Every point on the curve corresponds to the parameter value at a
specific time point. Graphic Trends tab displays end case event, captured event and parameter alarm
event. Graphic trend data automatically displays in one minute intervals unless the zoom is selected.

3 - 26 046-002773-00 A5™ Operating Instructions

System Interface System Softkeys

FIGURE 3-35 Graphic Trends

NUMBER DESCRIPTION
1 Event marker. The Dotted,colored line indicate an event occurred at that time.
Events could be the followings: end case, capture an event or a physiological
alarm occurs. When end case or capture an event , the dotted line is white. When
a physiological alarm occurs, the dotted line is in the same color with alarm. If
multiple events occured, dotted line is in same color with the event of the highest
alarm level. The event level can be specified as:high alarm level event>medium
alarm level event>low alarm level event>capture event>end case event.An end
case event occured during this period.
2 Current cursor. The corresponding time displays above the cursor. If alarms or
events occured at that time, the corresponding alarm information will also display
above the cursor (hereinafter referred to as event bubble).
Found in software bundle version 02.06.00 and later:
Clicking on the event bubble will cause the event log tab (see FIGURE 3-36) to
open on that specific event.
3 An end case event occured during this period.
4 The parameter data of the time indicated by cursor.
TABLE 3-4

NOTE: The Graphic Trends will be cleared after the anesthesia machine
undergoes power failure or is turned off.

A5™ Operating Instructions 046-002773-00 3 - 27

System Softkeys System Interface

3.9.5.2.1 About Graphic Trends

• Graphic Trends store the data with the interval in 1 minute.
• Graphic Trends displays the trend records in descending order beginning with the most recent
on the right side of the grid.
• Graphic Trends are not stored when the machine is in standby.
• The display period of data is a rolling 48 hours of continuous data.
• Graphic Trends highlights the parameter data in the corresponding alarm color if an alarm
condition existed for the parameter at the time of trend record storage.

3.9.5.2.2 Navigating in Graphic Trends

The dialog navigation buttons are described in TABLE 3-5.

NOTE: When a navigation button becomes disabled, this indicates that

there is no more data available or the end of the data range was
reached.

BUTTON FUNCTION
Moves the cursor to the oldest record from its current position.

Moves the cursor one page back from its current position.

Moves the cursor one record back from its current position.

Moves the cursor one record forward from its current position.

Moves the cursor one page forward from its current position.

Moves the cursor to the newest record from its current position.

Previous Event Moves the cursor to the previous event from its current position.
Next Event Moves the cursor to the next event from its current position.
Moves the cursor up one parameter from its current position.

Moves the cursor down one parameter from its current position.

TABLE 3-5

3 - 28 046-002773-00 A5™ Operating Instructions

System Interface System Softkeys

3.9.5.2.3 Zoom
Zoom allows for the trends to be displayed in a specified time interval between two neighboring
columns.

Set Zoom to 5Min, 10Min, 15Min, 30Min, 1Hour, or 2Hour.

3.9.5.2.4 Display Groups

Display Group allows for the trends to be displayed in a specified parameter group.

Set Display Group to Gas, Fresh Gas, Ventilation, or All.

3.9.5.2.5 Graphic Trends Export (software bundle version 02.06.00 and later)
The Export button on the Graphic Trends tab will allow the contents of the history to be exported
to a USB mass storage device. The format of the data exported is a .html file which can be opened
using Internet Explorer version 6.0, 7.0 and 8.0. The Export button on the Graphic Trends tab is only
available when the system is in Standby mode.

NOTE: If Internet Explorer greater than version 8.0 is used to view the
exported file, set it to compatibility mode.

3.9.5.3 Event Log

Select the History button on the main screen and then select the Event Log tab to access the Event
Log. The History dialog displays (see FIGURE 3-36) with the Event Log tab selected.

FIGURE 3-36 Event Log

A5™ Operating Instructions 046-002773-00 3 - 29

System Softkeys System Interface

The Event Log tab logs such events as technical alarms, physiological alarms, capture events, delay
power off, end case, delay power off canceled and system time change. Events can be physiological
indicating that a patients physiological alarm thresholds have been violated or technical indicating
that a specific technical issue has occurred.

An alarm entry and captured events in the Event Log displays the time, date, event, priority and
additional information which includes the Ventilation Mode, Patient Size, and Monitored Parameters.

NOTE: The Event log will not be cleared after the anesthesia machine
undergoes power failure or is turned off.

NOTE: The system can store up to 500 records of Event Logbook. When
a new event occurs after 500 events are already stored, the new
event overwrites the earliest one.

3.9.5.3.1 Navigating in the Event Log

The dialog navigation buttons are described in TABLE 3-8.

NOTE: When a navigation button becomes disabled, this indicates that

there is no more data available or the end of the data range was
reached.

BUTTON FUNCTION
Moves the scroll up one record.

Moves the scroll up one page.

Moves the scroll to the top most parameter.

Moves the scroll down one record.

Moves the scroll down one page.

Moves the scroll to the bottom most parameter.

TABLE 3-6

3.9.5.3.2 Event Log Filter

The Filter button allows for the Event Log Entries trends to be displayed in a similar Event type.

Set Filter to High, Medium, Low, Informational or All. The A5 will display the corresponding event
based on your setting.

3 - 30 046-002773-00 A5™ Operating Instructions

System Interface System Softkeys

3.9.5.3.3 Event Log Export

The Export button on the Event Log tab will allow the contents of the history to be exported to a
USB mass storage device. The format of the data exported is a .html file which can be opened using
Internet Explorer version 6.0, 7.0 and 8.0. The Export button on the Event Log tab is only available
when the system is in Standby mode.

NOTE: If Internet Explorer greater than version 8.0 is used to view the
exported file, set it to compatibility mode.

A5™ Operating Instructions 046-002773-00 3 - 31

Setup System Interface

3.10 Setup
Select the Setup softkey (see FIGURE 3-33) to open the Setup menu (see FIGURE 3-37).

The Setup menu contains the General tab, Display tab, System tab, and Service tab. See
section 3.12 (page 3-34) "Display Tab".

NOTE: The System tab is only available in Standby mode.

NOTE: The Service tab is for use only by Mindray Technical Service.
Please contact Mindray Technical Support for details.

Many of these functions are only available if the A5 is in Standby mode.

3.11 General Tab

The General tab provides access to calibrate the O2 sensor and flow sensor, perform system leak and
compliance tests, activate the breathing system warmer, and zero flow meters. The General tab also
displays information for the most recent calibrations and leak test results, whether they were passed,
failed, or skipped (see FIGURE 3-37).

FIGURE 3-37 General Tab (with AG module connected)

Calibrate O2 Sensor (without AG module connected)

To calibrate the O2 sensor, select the Calibrate O2 Sensor button. Follow the on-screen directions
and prompts. See ‘‘O2 Sensor Calibration’’ on page 7-6 for more information. Note that information for
the last O2 sensor calibration is displayed next to the button.

Calibrate Flow Sensor

To calibrate the flow sensor, select the Calibrate Flow Sensor button. Follow the on-screen
directions and prompts. See ‘‘Flow Sensor Calibration’’ on page 7-5 for more information. Note that
information for the last flow sensor calibration is displayed next to the button.

3 - 32 046-002773-00 A5™ Operating Instructions

System Interface General Tab

Leak Test / Compliance

The Test Leak / Compliance button enables the A5 system to perform a manual leak test and
automatic leak test, and calculates the compliance for the A5.

To perform a leak test, select the Test Leak/Compliance button. Follow the on-screen directions and
prompts. See ‘‘Leak and Compliance Tests’’ on page 4-9 for more information. Note that information
for the last Leak Test / Compliance is displayed next to the button.

Breathing System Warmer

To set the breathing system warmer, select Warmer On (default) or Warmer Off. If the warmer is off
or if AC power is not connected, the system displays an icon to indicate that the warmer is not active
(see FIGURE 3-38).

FIGURE 3-38 Warmer Inactive Icon

After cycling power, the breathing system warmer will return to the default state.

NOTE: The breathing system warmer is inactive when the A5 is

powered by the battery supply.

Zero Flow Meters

To zero the flow meters, select the Zero Flow Meters button. Follow the on-screen directions and
prompts. Note that information for the last zeroing of the flow meters is displayed next to the button.

NOTE: Before zeroing the flow meters, make sure to disconnect the
gas supply (N2O, Air, O2).

Gas Bench Flow Rate

To set the gas bench flow rate, select the Gas Bench Flow Rate button. The flow rate can be set to
High, Medium, or Low (default).

A5™ Operating Instructions 046-002773-00 3 - 33

Display Tab System Interface

3.12 Display Tab

The Display tab provides access to screen cleaning, screen calibration, pressure parameter display,
CO2 waveform placement, gas scales, waveform display, screen brightness and key click volume (see
FIGURE 3-39).

Screen Brightness
To adjust the screen brightness:

1. Select Setup softkey > Display tab (see FIGURE 3-39).

2. In the Screen Brightness area, select the +/- buttons to adjust the screen brightness.
3. Select the Accept button to confirm the change, or select Cancel button to disregard the
change.

Select the +/- buttons to

adjust screen brightness.

FIGURE 3-39 A5 Display Tab> Screen Brightness Area

3 - 34 046-002773-00 A5™ Operating Instructions

System Interface Display Tab

Key Click Volume

To adjust the key click volume:

1. Select Setup softkey > Display tab.

2. In the Key Click Volume area, select the +/- buttons to adjust the key click volume.
3. Select the Accept button to confirm the change, or select Cancel button to disregard the
change.

Select the +/- buttons to

adjust the key click volume.

FIGURE 3-40 A5 Display Tab > Key Click Volume Area

Clean Screen
To clean the LCD touch screen:

1. Select Setup softkey > Display tab.

2. Select the Clean Screen button.
The screen will lock for 10 seconds for cleaning.

Calibrate Touch
To calibrate the LCD touch screen:

1. Select Setup softkey > Display tab.

2. Select the Calibrate Touch button.
3. Follow the on-screen directions.

Pressure Display
To change the pressure display:

1. Select Setup softkey > Display tab.

2. Select the Pressure Display button.
3. Choose between MEAN and PLAT.

A5™ Operating Instructions 046-002773-00 3 - 35

Display Tab System Interface

4. Select the Accept button to confirm the change, or select Cancel button to disregard the
change.

Plimit Line
The Plimit line function displays a dashed line in the Pressure waveform area to indicate the Plimit
position. The Plimit line can be displayed in VCV, SIMV-VC, and PCV with VG on mode. The Plimit line
function can be switched On or Off by the user. The default value for Plimit Line is On.

Plimit Line

FIGURE 3-41 Plimit Line

NOTE: The Plimit line does not affect the auto-scaling algorithm. If the
Plimit line is turned on but not visible, it may be because the
line is positioned off the waveform scale.

To set the Plimit Line to ON or OFF:

1. Select Setup softkey > Display tab.

2. Select the Plimit Line button to ON or OFF.
3. Select the Accept button to confirm the change, or select Cancel button to disregard the
change.

CO2 Placement (with an AG module connected)

The CO2 waveform/data can be positioned at the top or bottom of the Waveform area.

To set the CO2 placement:

1. Select Setup softkey > Display tab.

2. Select the CO2 Placement button.
3. Select Top or Bottom.
4. Select the Accept button to confirm the change, or select Cancel button to disregard the
change.

CO2 Scale (with an AG module connected)

The CO2 scale of the CO2 waveform can be adjusted to one of three settings. The table below shows
the CO2 scale options.
To set the CO2 scale:

1. Select Setup softkey > Display tab.

2. Select the CO2 Scale button.

3 - 36 046-002773-00 A5™ Operating Instructions

System Interface Display Tab

3. Select the desired scale setting according to the table below:

CO2 UNIT OF MEASURE SCALE

mmHg 0-40 0-60 0-80
kpa 0.0-5.0 0.0-8.0 0.0-10.0
% 0.0-5.0 0.0-8.0 0.0-10.0
TABLE 3-7 CO2 Scale

4. Select the Accept button to confirm the change, or select Cancel button to disregard the
change.

Gas Scales(software bundle version 02.06.00 and later, with an

AG module connected)
To set the Gas scales:

1. Select Setup softkey > Display tab.

2. Select the Gas Scales button.
3. Select the CO2 Scale, AA Scale, O2 Scale or N2O Scale button. If an aesthetic agent, such as
sevoflurane, is detected , the system displays Sev Scale instead of AA Scale.
4. Select the desired scale setting according to the table below:

GAS SCALES UNIT OF MEASURE SCALE

mmHg 0-40 0-60 0-80
CO2 Scale kpa 0.0-5.0 0.0-8.0 0.0-10.0
% 0.0-5.0 0.0-8.0 0.0-10.0
O2 Scale % 0-35 0-50 0-100
N2O Scale % 0-35 0-50 0-100
Des Scale % 0.0-6.0 0.0-9.0 0.0-18.0
Sev Scale % 0.0-2.0 0.0-4.0 0.0-8.0
Iso Scale % 0.0-1.2 0.0-2.5 0.0-5.0
Hal Scale % 0.0-1.2 0.0-2.5 %
Enf Scale % 0.0-1.2 0.0-2.5 0.0-5.0
TABLE 3-8 Gas Scales

5. If needed, select the Load Scales Defaults button and then select the Yes button to restore
the factory default configurations. Select the Accept button to confirm the change, or select
the Cancel button to disregard the change.

GAS SCALE FACTORY DEFAULT SCALE

CO2 Scale 0-60 mmHg 0.0-8.0 kpa 0.0-8.0 %
O2 Scale 0-100 %
N2O Scale 0-100 %
Des Scale 0-9.0 %
Sev Scale 0-4.0 %
Iso Scale 0-2.5 %
TABLE 3-9 Factory default scale

A5™ Operating Instructions 046-002773-00 3 - 37

System Tab System Interface

GAS SCALE FACTORY DEFAULT SCALE

Hal Scale 0-2.5 %
Enf Scale 0-2.5 %
TABLE 3-9 Factory default scale

Waveform Display
1. Select Setup softkey > Display tab.
2. Select the Waveform Display button.
3. Select the desired waveform.
4. Select the Accept button to confirm the change, or select Cancel button to disregard the
change.

3.13 System Tab

The System tab is accessible only by authorized administrative service personnel with password
access. The system tab can only be accessed in Standby mode.

NOTE: The authorized administrator should change the default

password immediately after the system is installed to prevent
unauthorized access to the System tab. The password can be
maximum of 6 digits in length containing numerals 0 to 9.

FIGURE 3-42 A5 Setup Menu > System Tab

3 - 38 046-002773-00 A5™ Operating Instructions

System Interface System Tab

SYSTEM TAB
BUTTON CHOICES DESCRIPTION
Calibration External AG Module Select to calibrate the External AG
O2 Sensor Module or O2 sensor. Follow the
screen directions. The date and time
of the last calibration is displayed
next to the O2 Sensor or External
AG Module button.

NOTE: The AG module information

appears only when an AG module is
connected to the A5 system.
Language ENGLISH(default) Select to set the user interface text
CHINESE language.
FRENCH
SPANISH

Default Settings Default Patient Size Select to set the default patient size.
(default=Infant, Adult, Pediatric

Default Vent Mode (default=VCV, Select to set the default mechanical

SIMV-VC, PCV, SIMV-PC, PS) ventilation mode.
For default changes to take effect:
NOTE: Default changes take 1. Press Accept.
effect after next case 2. Start next case.
or when O.R. defaults 3. End case.
are loaded.
Manage Defaults Save Defaults Select “Save Defaults” or “Save as O.R.
Save as O.R. Defaults Defaults” to save the current
configuration as the user default
configuration.

Load User Defaults Select “Load User Defaults” or “Load

Load O.R. Defaults O.R. Defaults” to load the user default
configuration.

Restore Partial Defaults Select “Restore Partial Defaults” to

overwrite the user defaults and
system settings with the factory
default settings. Note that network
settings will not be restored.

Import Defaults Select “Import Defaults” to import a

copy of the defaults from the USB
mass storage device if one has been
inserted into an SB port at the rear of
the A5 unit.

Export Defaults Select “Export Defaults” to export a

copy of the defaults to the USB mass
storage device if one has been
inserted into an SB port at the rear of
the A5 unit.
TABLE 3-10 System Tab Settings

A5™ Operating Instructions 046-002773-00 3 - 39

System Tab System Interface

SYSTEM TAB
BUTTON CHOICES DESCRIPTION
Time Settings Time Zone (Default = UTC-05:00) Select to set the UTC time zone offset.

Daylight Savings (Default =Manual, Select to set the Daylight Savings

Auto) Time (DST) to be adjusted
automatically by the A5 system, or
manually by the authorized
administrator. If the region or country
of installation does not observe DST,
change this setting to Manual.
If Daylight Savings is set to Auto, the
Daylight
Savings Time On/Off button in the
Date/Menu dialog becomes inactive
and cannot be selected (see
FIGURE 3-11).

DST Start (Default =First Sunday in Select to set the START of Daylight
April at 2:00 AM) Savings Time. This setting is not
available if DST is set to Manual.

DST End (Default =Last Sunday in Select to set the END of Daylight
October at 3:00 AM) Savings Time. This setting is not
available if DST is set to Manual.
Network See section 3.13.1 (page 3-41) "Network Configuration".
Set HL7 Most Recent (Default) Select the compatible HL7 version
Compatibility 02.00.00 according to the HL7 version of
01.05.02 clinical information system. If clinical
01.00.00 to 01.05.01 information system is not connected,
None keep the setting as default.
Change Password — Select to change the System tab
password. The authorized
administrator should change the
default password immediately after
the system is installed to prevent
unauthorized access to the System
tab. The password can be up to 6
digits in length containing numerals 0
to 9.
Units Pressure (default=cmH2O, hPa, Select to set the Pressure Unit of
mbar) measure.

CO2 (default=mmHg, kPa, %) Select to set the CO2 unit.

NOTE: Set CO2 Unit button

only displays if an
external AG module is
connected to the A5.
TABLE 3-10 System Tab Settings

3 - 40 046-002773-00 A5™ Operating Instructions

System Interface System Tab

SYSTEM TAB
BUTTON CHOICES DESCRIPTION
Configuration — Select to display the machine ID and
Information the status of system functions.

Export Data — Select to export patient data via mass

storage device.
Clear History On(default) Configures the Clear History setting
Off at the end of the case.
When turned on, event logs and all
trends will be deleted at the start of
the case.
When turned off, event logs and all
trends will not be deleted at the start
of the case.
TABLE 3-10 System Tab Settings

3.13.1 Network Configuration

Network configuration settings can be set via the Network button (see FIGURE 3-43).
Select main screen > Setup button > System tab > Network button.

FIGURE 3-43 Network Configuration Screen

A5™ Operating Instructions 046-002773-00 3 - 41

System Tab System Interface

NOTE: Set HL7 Compatibility displayed on Network Configuration

Screen is available in software bundle version 02.06.00 and
later.

TABLE 3-11 lists the network settings and parameters.

SETTINGS PARAMETERS
This Machine
Configure Ethernet Enter:
• IP Address (default = 192.168.23.250)
• Subnet (default = 255.255.255.0)
• Default Gateway (default = [blank])

TABLE 3-11 Network Configuration Settings and Parameters

3 - 42 046-002773-00 A5™ Operating Instructions

System Interface System Tab

SETTINGS PARAMETERS
Configure Serial Select:
• Protocol (None (default), MR-Link/HL7, MR-WATO,
Philips (software bundle version 02.09.00 and later))
• Baud Rate (57600, 11520 (default))
• Data Bits (8 (default), 7, 6, 5)
• Stop Bits (1(default), 2)
• Parity (Odd, Even, None (default))
• Interval:
Enabled when Protocol=None: Off (default);
Enabled when Protocol=HL7:10 Sec, 30 Sec, 1
Min (default), 5 Min, 30 Min, 1 Hour, 2 Hour, 6
Hour, 12 Hour, 24 Hour.

NOTE: When Protocol is set to MR-WATO,

the A5 can communicate with the
patient monitor of Mindray
through Benelink module of
Mindray.

NOTE: When Protocol is set to Philips, the

A5 can communicate with the
patient monitor of Philips through
IntelliBridge or VueLink module of
Philips.

Network Protocol
TABLE 3-11 Network Configuration Settings and Parameters

A5™ Operating Instructions 046-002773-00 3 - 43

Service Tab System Interface

SETTINGS PARAMETERS
Configure HL7 Interval(10 sec, 30 sec, 1 min (default), 5 min, 30 min,1
hour, 2 hour, 6 hour, 12 hour, 24 hour)
Destination IP (default = 192.168.23.200)
Port (default = 1550)
Set HL7 Compatibility(Most Recent (Default), 02.02.01
to 02.10.00, 02.00.00, 01.05.02, 01.00.00 to 01.05.01,
None)
Send Waveforms(Off(Default), On)
Send Alarms(Off(Default), On)
Send Alarm Ack.(Off(Default), On)

MD2 (software bundle version 02.09.00 and Select:

later) On, Off (default)

NOTE: MD2 is a communication protocol.

The A5 can connect to the
eGateway through MD2, and
communicates with the devices
connected to the eGateway.
Configure MD2 (enabled when MD2 = On) Destination IP (default = 192.168.23.99)
Port (default = 6678)
SNTP Protocol
Interval Select:
Off (default), 10 sec, 30 sec, 1 min, 5 min, 30 min,
1 hour, 2 hour, 6 hour, 12 hour, 24 hour
Primary Server IP Enter:
Primary Server IP (default = 132.163.4.103)
Secondary Server IP Enter:
Secondary Server IP (default = 210.72.145.44)
TABLE 3-11 Network Configuration Settings and Parameters

3.14 Service Tab

Accessible only by Mindray-authorized service personnel. Please contact Mindray Technical Support
for assistance.

3 - 44 046-002773-00 A5™ Operating Instructions

 4.0 Preoperative Tests

Preoperative Test Schedules ..............................................................................................................................................................4-2

Inspect the System ..................................................................................................................................................................................4-3

Pre-Operative Checkout List..............................................................................................................................................................4-4

System Self-Test .........................................................................................................................................................................................4-6

Leak and Compliance Tests ................................................................................................................................................................4-9

Preoperative Check List (software bundle version 02.09.00 and later)................................................................. 4-17

Pipeline Tests............................................................................................................................................................................................. 4-18

Basic Ventilation Testing .................................................................................................................................................................... 4-19

Cylinder Tests............................................................................................................................................................................................ 4-20

Flow Control System Test.................................................................................................................................................................. 4-21

Vaporizer Tests ......................................................................................................................................................................................... 4-22

Breathing System Tests....................................................................................................................................................................... 4-24

Alarm Tests ................................................................................................................................................................................................. 4-26

Preoperative Preparations ................................................................................................................................................................ 4-28

Inspect the Active/Passive Anesthetic Gas Scavenging System .............................................................................. 4-29

A5™ Operating Instructions 046-002773-00 4-1

Preoperative Test Schedules Preoperative Tests

4.1 Preoperative Test Schedules

Preoperative tests on the A5 follow the ASA guidelines and should be performed according to the
test intervals listed below. Refer to special procedures or precautions in this manual.

NOTE: This is a guideline which can be modified to accommodate variations in

local clinical practice. Such local modifications should have appropriate
peer review.

NOTE: It is recommended that the user check that N2O cutoff and O2/N2O ratio
are normal before use. Use an O2 concentration tester to monitor the O2
concentration in the gas output.

4.1.1 Test Intervals

Perform the preoperative tests listed below at these events:

• When required after a maintenance or service procedure

• Every day before the first patient:
• System Self-Test (Section 4.4)
• Leak and Compliance Tests (Section 4.5)
• Pipeline Tests (Section 4.8)
• Basic Ventilation Testing (Section 4.9)
• Cylinder Tests (Section 4.10)
• Flow Control System Test (Section 4.11)
• Vaporizer Tests (Section 4.12)
• Before each patient:
• Inspect the System (Section 4.2)
• Pre-Operative Checkout List (Section 4.3)
• Perform the Leak/Compliance Test (Section 4.5)
• Preoperative Check List (software bundle version 02.09.00 and later) (Section 4.6)
• Breathing System Tests (Section 4.13)
• Alarm Tests (Section 4.14)
• Preoperative Preparations (Section 4.15)
• Inspect the Active/Passive Anesthetic Gas Scavenging System (Section 4.16)

NOTE: Read and understand the operation and maintenance of each

component before using the A5 anesthesia machine.

NOTE: Do not use the A5 anesthesia machine if a test failure occurs. Contact
Mindray Technical Support for assistance.

NOTE: A checklist of the anesthetic system should be provided, including

anesthetic gas delivery system, monitoring device, alarm system, and
protective device, which are intended to be used for the anesthetic
system, whether they are used alone or assembled together.

4-2 046-002773-00 A5™ Operating Instructions

Preoperative Tests Inspect the System

4.2 Inspect the System

NOTE: Ensure that the breathing system is correctly connected and not
damaged.

Perform the following inspection checklist before operating the A5 unit:

1. The A5 anesthesia machine is correctly connected and undamaged.

2. Inspect the system for:
a. Damage to flowmeters, vaporizers, gauges, supply hoses
b. Complete breathing system with adequate CO2 absorbent Pre-Pak or loose fill
c. Correct mounting of cylinders in yokes
d. Presence of cylinder wrench
e. Auxiliary O2 supply, available and functioning
3. Check that:
a. Gas cylinders are turned off until needed to prevent the unintended use of gases
b. Flow-control valves are off
c. Vaporizers are off
d. Vaporizers are filled (not overfilled)
e. Filler caps are sealed tightly
f. Only one vaporizer can be turned on at the same time
4. All components are correctly attached.
5. The breathing system is correctly connected, the breathing tubes are undamaged, and the
self-inflating manual ventilation device is available and functioning.
6. The gas supplies are connected and the pressures are correct.
7. Cylinder valves are closed on models with cylinder supplies (Verify that the cylinder wrench
is attached.).
8. The necessary emergency equipment is available and in good condition.
9. Equipment for airway maintenance and tracheal intubation is available and in good
condition.
10. Inspect the color of the sodalime in the canister. Replace the sodalime immediately if
obvious color change is detected. The sodalime is white when new. If it is purple, it must be
changed.

WARNING: Check if the gasket is properly installed in place while installing the
absorber canister. If the gasket is not properly installed (for example,
gasket is not evenly seated and centered) it may cause breathing
system leakage.

11. Applicable anesthetic and emergency drugs are available.

12. The casters are not damaged or loose, and the brake (s) is set and prevents movement.
13. Ensure the breathing system is in proper position.
14. The AC mains indicator and the battery indicator are displayed when the power cord is
connected to the AC power source. If the indicators are not displayed, the system does not
have electrical power.
15. The A5 anesthesia machine is switched on or off normally.

A5™ Operating Instructions 046-002773-00 4-3

Pre-Operative Checkout List Preoperative Tests

4.3 Pre-Operative Checkout List

4.3.1 Introduction
The purpose of the pre-operative checkout is to detect potential system problems before use.

An effective method for detecting pneumatic circuit occlusions, leaks, and other system problems
can be found in the A5 pre-operative checkout procedures. In addition, it is recommended that the
breathing circuit be tested for the ability to effectively deliver positive pressure ventilation before
beginning each case. Testing the ability to properly ventilate a test lung can quickly identify an
occluded circuit limb and other breathing circuit problems.

Before starting each case, test the machine’s ability to ventilate the patient by removing the
breathing bag from the bag arm and connecting it to the patient connection (elbow or Y-piece on
the disposable circuit). Set the ventilator to deliver a specific tidal volume to the test lung and verify
the exhaled tidal volume monitor. Observe that the test lung (breathing bag) inflates as the bellows
descends, and that the test lung deflates during the exhalation phase. Observe that the measured
exhaled volume matches the tidal volume set on the ventilator. With the ventilator running, lower the
fresh gas flow to zero and observe if the bellows rapidly falls with each exhalation. If this occurs, then
a leak should be suspected, identified, and repaired.

This test should be performed before starting each case. By verifying that a test lung (breathing bag)
can be manually and mechanically ventilated, this indicates that the A5 is capable of ventilating a
patient with the attached breathing circuit.

4.3.2 Suggested Pre-Operative Checkout List

Below is a suggested checkout list that should be conducted before administering anesthesia. This is
a guideline which users are encouraged to modify according to their local clinical practice. Such local
modifications should have appropriate peer review. Users should refer to the A5 Operating
Instructions for special procedures, precautions, and step-by-step instructions.

WARNING: To ensure proper machine operation, user safety, and patient safety,
follow all checkout procedures established by the facility before
administering anesthesia to the patient.

Each day before administering anesthesia, the following should be done:

1. With the anesthesia machine connected to AC Power, turn the Mains switch to ON and verify
that the unit is operating on AC. Follow the on-screen prompts to perform and complete the
automatic machine start-up tests.
2. a. Check the O2 Supply fail-safe message and alarm.
(See “O2 Pipeline Test” on page 4-18.)
b. Test low O2 concentration alarm.
(See “Test the O2 Concentration Monitoring and Alarms” on page 4-26.
c. Test high and low airway pressure alarms.
(See “Test the High Paw Alarm” on page 4-27.)
(See “Test the Low Paw Alarm” on page 4-28.)
d. Test low minute volume and apnea alarms.
(See “Test the Low Minute Volume (MV) Alarm” on page 4-27.)
(See “Test the Apnea Alarm” on page 4-27.)
3. Verify that the O2 sensor displays approximately 21% in room air and above 94% after
exposure to 100% O2 (see“Test the O2 Concentration Monitoring and Alarms” on page 4-26).
4. Check that the vaporizers are properly installed and sufficiently filled and that filler ports are
tightly closed. Verify that only one vaporizer turns ON at a time (see “Install the Vaporizer” on
page 2-5).

4-4 046-002773-00 A5™ Operating Instructions

Preoperative Tests Pre-Operative Checkout List

5. Perform a 40 cmH2O manual leak test. If present, set the left vaporizer to ON and perform a
40 cmH2O manual leak test. Set the vaporizer to OFF. Repeat for the right vaporizer if
installed (see “Manual Leak Test” on page 4-22).
6. Perform a vaporizer leak test for each vaporizer installed on the A5 system (see “Manual Leak
Test” on page 4-22).
7. Check that the function of Anesthetic Gas Scavenging System is normal (see “Inspect the
Active/Passive Anesthetic Gas Scavenging System” on page 4-29).
8. Drain any moisture from the breathing system water trap.
9. Drain and wipe with a soft cloth out any moisture from the condensation drain valve at the
bottom of the absorber canister assembly.
Prior to each patient, before administering anesthesia, the following should be done:

1. Inspect the A5 for damage or hazardous conditions; ensure all necessary equipment and
supplies are present, e.g., drugs, CO2 absorbent (not exhausted), breathing circuits and tank
wrench.
2. Check that central supply O2, N2O and Air pressures are each within the pipeline input range
specifications (i.e., 40 to 87 psi).
3. Check that O2, N2O and Air flowmeters operate properly: Check that all flow levels on the
monitor screen are at zero flow with flow-control valves closed. Adjust flow of all gases
through their full ranges and check for erratic movements of the gas levels.
4. Check that a hypoxic mixture of less than 21% O2 may not be administered: Attempt to
create an hypoxic O2/ N2O mixture by slowly opening the N2O flow control valve fully with
the O2 flow valve fully closed (no N2O gas should be flowing). Then, slowly open the O2 flow
valve and observe O2 and N2O rise in proportion to maintain a minimum concentration of
21% O2 in fresh gas.
5. Perform a vaporizer leak test for each vaporizer installed on the A5 system (see “Manual Leak
Test” on page 4-22).
6. Verify that Auxiliary O2 and Air are available and functioning.
7. Verify that a Self-inflating Manual Ventilation device is available and functioning.
8. Check that the O2, N2O, and Air cylinders (if present) are mounted on the A5, have adequate
pressure, and no high pressure leaks are present (see “Cylinder Tests” on page 4-20).
9. Check that valves on the O2, N2O, and Air cylinders (if present) are closed until needed to
prevent unintentional use of gas.
10. With a breathing circuit and reservoir bag attached, check that the unidirectional valves
operate by visual inspection.
11. Check ventilation capability in Standby, Manual, VCV and PCV ventilator modes.
12. Check that patient suction is adequate to clear the airway.
13. Verify ability of required monitors and check alarms.
The following step is recommended to be performed when prompted by the machine:

• Complete the 21% O2 Calibration (see “O2 Sensor Calibration” on page 7-6).

A5™ Operating Instructions 046-002773-00 4-5

System Self-Test Preoperative Tests

The following step is recommended when replacing an O2 sensor:

• Complete the 21% and 100% O2 Calibration (see “O2 Sensor Calibration” on page 7-6).

The following step is recommended to be performed weekly, whenever a new vaporizer is

installed or when CO2 absorbent is replaced:

• Perform a vaporizer leak test (see “Manual Leak Test” on page 4-22).

4.4 System Self-Test

When the A5 is powered on, it performs a self-test to ensure its alarm system (alarm LED, speaker, and
buzzer) and hardware (flowmeter board, ventilator board, assistant ventilator board, power board,
and CPU board) are properly functioning.

To perform a system self-test:

1. Turn the power switch on the front panel to the ON position. The A5 powers up and begins
its system self-test. See TABLE 4-1 for the system self-test sequence.

After the system self-test is completed, the test results are displayed on the screen. Startup
alarm messages also may be displayed.

See TABLE 4-2 for a list of possible test result conditions.

See section 6.6.1.1 for a list of Startup Alarm Messages.
2. Proceed to operate or troubleshoot the A5 based on the self-test results.

SYSTEM SELF-TEST SEQUENCE COMMENTS

1. A high-pitched beep is sounded. Alarm self-test
2. The A5 startup screen is displayed.
3. The LED above the touchscreen illuminates in sequence: Alarm self-test
red, yellow, and blue.
4. A test low priority alarm is sounded. Alarm self-test
5. The System Self-Test progress bar is displayed.
6. The System Self-Test is automatically started. Hardware self-test
7. The results of the System Self-Test are displayed.
TABLE 4-1 A5 System Self-Test Sequence

4-6 046-002773-00 A5™ Operating Instructions

Preoperative Tests System Self-Test

RESULT COMMENTS/OPTIONS
Pass condition The Pass condition indicates that the A5 has passed the
Example: System Self-Test. No errors have been detected. Alarms
and hardware are functioning properly.

Select Continue to enter the Automatic Circuit Leak and

Compliance Test screen.
or
Select Skip to enter the Standby with automatic
ventilation enabled.

All-Functional error condition The All-Functional error condition indicates that errors
Example: have been detected. However, all automatic ventilation,
manual, and bypass modes are still enabled.

Select Accept to enter the Automatic Circuit Leak and

Compliance Test screen.
or
Select Skip to enter the main screen with automatic
ventilation enabled,

Manual Only error condition The Manual Only error condition indicates that the A5 can
Example: be used in manual mode only.

Select Retry to repeat the System Self-Test.

or
Select Manual Only to place the device in manual
ventilation mode only. The following low priority alarm
will be displayed on the main screen: Automatic
Ventilation Disabled.

WARNING: Selecting the “Manual

Only” button will
disable automatic
ventilation.

TABLE 4-2 Types of System Self-Test Results

A5™ Operating Instructions 046-002773-00 4-7

System Self-Test Preoperative Tests

RESULT COMMENTS/OPTIONS
Machine Non-Functional error condition The Machine Non-Functional error condition indicates
Example: that the A5 cannot be used.

Select Retry to repeat the System Self-Test.

or
Contact service if this error condition persists.

NOTE: “Service Access”

button: The Service
Access button is only
available to Mindray-
authorized service
personnel and requires
a service password.

TABLE 4-2 Types of System Self-Test Results

Bundle Version – The Bundle Version is displayed in all System Self-Test results. The Bundle Version is
the version number of the package of software that is installed in the A5. If the Bundle Version
displays a fail status, contact Mindray Technical Support.

4-8 046-002773-00 A5™ Operating Instructions

Preoperative Tests Leak and Compliance Tests

4.5 Leak and Compliance Tests

4.5.1 Automatic Circuit Leak and Compliance Test
The Automatic Circuit Leak Test screen is displayed in FIGURE 4-1.

FIGURE 4-1 Automatic Circuit Leak Test (software bundle version 03.13.00 and later)

To Perform an Automatic Circuit Leak Test:

NOTE: The A5 system records the result of the last Automatic Circuit Leak Test
in the General tab, including if the test had passed, failed, or was
skipped. To access this information, from the main screen, select the
Setup softkey > General tab.

NOTE: If fresh gas is detected by the system before proceeding with the
Automatic Circuit Leak & Compliance Test, a message is displayed on
the screen to adjust all flowmeters to zero.

1. From power up:

If the A5 System is being powered on, the system automatically initiates a self-test and
enters the Preoperative Check List screen. Select Continue to enter the Automatic Circuit
Leak Test screen, followed by the Manual Circuit Leak Test screen. If the Skip button is
selected, the system bypasses the Automatic Circuit Leak Test and the Manual Circuit
Leak Test and enters the Standby screen.

or

From the main screen:

Select the Setup softkey > General tab > Test Leak/Compliance button.

A5™ Operating Instructions 046-002773-00 4-9

Leak and Compliance Tests Preoperative Tests

2. Follow the directions on the screen:

1. Seal the Y-piece:

2. Ensure that the sample line port of the breathing circuit is occluded.
3. Install the manual bag.
4. Adjust all flowmeters to zero.
5. Set the Auto/Manual switch to the Auto position:

6. Ensure the CO2 Absorber Canister is closed and locked (software bundle version 03.13.00
and later).

7. Press the O2 flush button to completely fill the bellows.

8. Select Continue to proceed with the Automatic Circuit Leak Test.

NOTE: The “Continue” button can be selected only when the Auto/Manual
switch is set to the Auto position and when no fresh gas is detected.

3. Compare the test results with the information in TABLE 4-3, “Automatic Circuit Leak and
Compliance Test Results,” on page 4-11, and proceed accordingly.

4 - 10 046-002773-00 A5™ Operating Instructions

Preoperative Tests Leak and Compliance Tests

RESULTS COMMENTS/OPTIONS
Automatic Circuit Leakage: Pass Leak rate ≤200 mL/min
Compliance Test: XX.X mL/cmH2O Compliance test results are displayed in green.
Example:
Select Continue to proceed to the Manual Circuit Leak
Test screen.

Automatic Circuit Leakage: Pass Leak rate ≤200 mL/min

Compliance Test: Fail Compliance test failed.
Example:
The results screen displays the compliance values and
time of the last compliance test that passed. If the
compliance test has never been performed successfully,
the compliance values and test time are displayed as ---.

Select Accept to proceed to the Manual Circuit Leak Test

screen and use the previous compliance values.
or
Select Retry to repeat the Automatic Circuit Leak Test &
Compliance Test.

Automatic Circuit Leakage: XXX mL/min Leak rate >200 mL/min and ≤1000 mL/min
Compliance Test: Fail
Example: The results screen displays the compliance values and
time of the last compliance test that passed. If the
compliance test has never been performed successfully,
the compliance values and test time are displayed as ---.

Select Accept to proceed to the Manual Circuit Leak Test

screen and use the previous compliance values.
or
Select Retry to repeat the Automatic Circuit Leak Test &
Compliance Test.

TABLE 4-3 Automatic Circuit Leak and Compliance Test Results

A5™ Operating Instructions 046-002773-00 4 - 11

Leak and Compliance Tests Preoperative Tests

RESULTS COMMENTS/OPTIONS
Automatic Circuit Leakage: Fail: Fresh gas Fresh gas is detected. Approximate threshold for fresh gas
flow detected detection is 0.15 L/min of gas flow.
Compliance Test: Fail
Example: Adjust all flowmeters to zero.
Select Retry to repeat the test.

Automatic Circuit Leakage: Fail Leak rate >1000 mL/min.

Compliance Test: Fail Fresh gas is not detected.
Example:
Follow on-screen directions to troubleshoot the problem.
or
Select Manual Only to place the device in manual
ventilation mode only. The following low priority alarm
will be displayed on the main screen: Auto Ventilation
Disabled – Leak Test Failed:

WARNING: Selecting the “Manual

Only” button will
disable automatic
ventilation.

TABLE 4-3 Automatic Circuit Leak and Compliance Test Results

4 - 12 046-002773-00 A5™ Operating Instructions

Preoperative Tests Leak and Compliance Tests

RESULTS COMMENTS/OPTIONS
MACHINE NON-FUNCTIONAL Safety valve control test or pressure verification test failed.

Automatic Circuit Leakage: Pass Select Retry to repeat the Automatic Circuit Leak Test &
Compliance Test: XX.X mL/cmH2O Compliance Test.
Safety Valve Control: Fail or
Example: Contact service if this error condition persists.

NOTE: The Service Access

button is only available
to Mindray-authorized
service personnel and
requires a service
password.

Time out Test result cannot be shown due to an internal

Example: communication error.

Select Retry to repeat the Automatic Circuit Leak Test &

Compliance Test.
or
Select Override to skip the test.

TABLE 4-3 Automatic Circuit Leak and Compliance Test Results

A5™ Operating Instructions 046-002773-00 4 - 13

Leak and Compliance Tests Preoperative Tests

4.5.2 Manual Circuit Leak Test

The Manual Circuit Leak Test screen is displayed in FIGURE 4-2:

FIGURE 4-2 Manual Circuit Leak Test screen

To Perform a Manual Circuit Leak Test:

NOTE: If fresh gas is detected by the system before proceeding with the
Manual Circuit Leak Test, a message is displayed on the screen to adjust
all flowmeters to zero.

1. From power up:

If the A5 System is being powered on, the system automatically initiates a self-test and
enters the Preoperative Check List screen. Select Continue to enter the Automatic Circuit
Leak and Compliance Test and the Manual Circuit Leak Test. If the Skip button is
selected, the system bypasses these tests and enters the Standby screen.

or

From the main screen:

Select the Setup softkey > General tab > Test Leak/Compliance button.
2. Follow the directions on the screen:
1. Adjust the APL to the 50 cmH2O position.
2. Adjust all flowmeters to zero.
3. Set the Auto/Manual switch to Manual.
4. Press the O2 flush button until the PAW gauge value is between 25 and 35 cmH2O.
5. Select “Continue” to proceed with the Manual Circuit Leak Test.

or

Select “Skip” to go directly to operational mode.

NOTE: The “Continue” button can be selected only when the Auto/Manual
switch is set to the Manual position and when no fresh gas is detected.

4 - 14 046-002773-00 A5™ Operating Instructions

Preoperative Tests Leak and Compliance Tests

3. Compare the test results with the information in TABLE 4-4, “Manual Circuit Leak Test
Results,” on page 4-15, and proceed accordingly.

RESULTS COMMENTS/OPTIONS
Pass Manual Circuit Leak Test passed.
Example:
Adjust the APL valve to SP position.
Select Continue to proceed to the main screen.

Fail: Fresh gas flow detected Manual Circuit Leak Test failed.
Example: Fresh gas is detected.

Adjust all flowmeters to zero.

Select Retry to repeat the test.

TABLE 4-4 Manual Circuit Leak Test Results

A5™ Operating Instructions 046-002773-00 4 - 15

Leak and Compliance Tests Preoperative Tests

RESULTS COMMENTS/OPTIONS
Fail Manual Circuit Leak Test failed.
Example: Fresh gas is not detected.

Follow on-screen directions to troubleshoot the problem.

or
Adjust APL valve to SP position and select Accept to
proceed to the main screen.

Time out Test result cannot be shown due to an internal

Example: communication error.

Select Retry to repeat the Automatic Circuit Leak Test &

Compliance Test.
or
Select Accept to proceed.

TABLE 4-4 Manual Circuit Leak Test Results

4 - 16 046-002773-00 A5™ Operating Instructions

Preoperative Tests Preoperative Check List (software bundle version 02.09.00 and later)

4.6 Preoperative Check List (software bundle

version 02.09.00 and later)
While powering on the A5, the system automatically initiates a self-test and enters the
Preoperative Check List screen. Select Continue to proceed to Standby mode. The
Preoperative Check List screen is displayed in FIGURE 4-3 .

FIGURE 4-3 Preoperative Check List

A5™ Operating Instructions 046-002773-00 4 - 17

Power Failure Alarm Test Preoperative Tests

4.7 Power Failure Alarm Test

1. Set the system switch to the On position.
2. Disconnect the AC mains.
3. Ensure that the AC mains indicator and battery charge indicator are extinguished. An
audible alarm should sound and the prompt message "Battery in Use" should be displayed
on the main screen.
4. Reconnect the AC mains.
5. Ensure that the AC mains indicator and battery charge indicator are illuminated. The prompt
message "Battery in Use" should not be displayed on the main screen.
6. Set the system switch to the Off position.

4.8 Pipeline Tests

NOTE: If the pipeline suply is unavailable,please use the cylinder.

4.8.1 O2 Pipeline Test

1. Connect the O2 pipeline supply.
2. Close all cylinder valves if the A5 anesthesia machine is equipped with cylinders.
3. Set the system switch to the On position.
4. Set the flow controls approximately to mid-range (approximately 6 L/min).
5. Ensure that the O2 pipeline pressure gauges show 280 to 600 kPa (40 to 87 psi).
6. Disconnect the O2 pipeline supply.
7. As O2 pressure decreases, alarms for “O2 Supply Failure” and “Drive Gas Pressure Low”
should occur.
8. Ensure that the O2 gauge decreases to zero.

4.8.2 N2O Pipeline Test

NOTE: When doing the N2O pipeline test, connect the O2 supply first to enable
N2O flow control.

NOTE: Different from O2 pipeline supply, when N2O supply is disconnected, no

alarms related to N2O pressure occur as N2O pressure decreases.

1. Connect the O2 and N2O pipeline supplies.

2. Close all cylinder valves if the A5 anesthesia machine is equipped with cylinders.
3. Set the system switch to the On position.
4. Set the flow controls approximately to mid-range (approximately 6 L/min).
5. Check that the N2O pipeline pressure gauges show 280 to 600 kPa (40 to 87 psi).
6. Disconnect the N2O pipeline supply.Ensure that the N2O gauge decreases to zero.

4 - 18 046-002773-00 A5™ Operating Instructions

Preoperative Tests Basic Ventilation Testing

4.8.3 Air Pipeline Test

NOTE: Different from the O2 pipeline supply, when the air pipeline supply is
disconnected, no alarms related to Air pressure occur as Air pressure
decreases.

1. Connect the Air pipeline supply.

2. Close all cylinder valves if the A5 anesthesia machine is equipped with cylinders.
3. Set the system switch to the On position.
4. Set the flow controls approximately to mid-range (approximately 6 L/min).
5. Check that the Air pipeline pressure gauges show 280 to 600 kPa (40 to 87 psi).
6. Disconnect the Air pipeline supply.
7. Ensure that the Air gauge decreases to zero.

4.9 Basic Ventilation Testing

1. Attach a breathing circuit and breathing bag.
2. Attach an adult test lung or breathing bag to the patient end of the Y-fitting of the breathing
circuit.
3. Set the O2 flow to 3 L/min and set the N2O and AIR flow rates to zero flow.
4. Set the ventilator controls to:

VENTILATOR CONTROLS VENTILATOR SETTINGS

Patient Type Adult
Ventilation Mode PCV
Tidal Volume Guarantee - VtG Off
Target Pressure - Pinsp 20
Breath Rate - Rate 8
I:E Ratio - I:E 1:2
PEEP - PEEP Off
Inspiratory Slope - Tslope 0.5

5. Select PCV and begin ventilation.

6. Verify that the breathing bag at the patient end of the Y-fitting of the breathing circuit
inflates and deflates and that the PLAT on the display and the PAW gauge are consistent with
the Ptarget setting.

A5™ Operating Instructions 046-002773-00 4 - 19

Cylinder Tests Preoperative Tests

4.10 Cylinder Tests

NOTE: You do not need to perform cylinder tests if the A5 anesthesia machine
is not equipped with cylinders.

4.10.1 Check the Cylinder Pressure

1. Set the system switch to the Off position and connect the cylinders to be checked.
2. Open each cylinder valve using the supplied wrench.
3. Ensure that each cylinder has sufficient pressure. If not, close the applicable cylinder valve
and install a full cylinder.
O2 cylinder input range: 6.9 to15.5 MPa (1000 - 2250 psi)
N2O cylinder input range: 4.2 to 6 MPa (600 - 870 psi)
Air cylinder input range: 6.9 to15.5 MPa (1000 - 2250 psi)
4. Close all cylinder valves.

4.10.2 O2 Cylinder High Pressure Leak Test

1. Set the system switch to the Off position and disconnect the O2 pipeline supply.
2. Turn off the O2 flowmeter.
3. Open the O2 cylinder valve.
4. Record the current cylinder pressure.
5. Close the O2 cylinder valve.
6. Record the cylinder pressure after one minute.
If the cylinder pressure decreases more than1.25 MPa (181 psi), install a new cylinder gasket.
Repeat steps 1 through 6. If the leak continues, do not use the cylinder supply system.

4.10.3 N2O Cylinder High Pressure Leak Test

1. Set the system switch to the Off position and disconnect the N2O pipeline supply.
2. Turn off the N2O flowmeter.
3. Open the N2O cylinder valve.
4. Record the current cylinder pressure.
5. Close the N2O cylinder valve.
6. Record the cylinder pressure after one minute.
If the cylinder pressure decreases more than 0.5 MPa (73 psi), install a new cylinder gasket.
Repeat steps 1 through 6. If the leak continues, do not use the cylinder supply system.

4.10.4 Air Cylinder High Pressure Leak Test

1. Set the system switch to the Off position and disconnect the Air pipeline supply.
2. Turn off the Air flowmeter.
3. Open the Air cylinder valve.
4. Record the current cylinder pressure.
5. Close the Air cylinder valve.
6. Record the cylinder pressure after one minute.
If the cylinder pressure decreases more than 1.25 MPa (181 psi), install a new cylinder gasket.
Repeat steps 1 through 6. If the leak continues, do not use the cylinder supply system.

4 - 20 046-002773-00 A5™ Operating Instructions

Preoperative Tests Flow Control System Test

4.11 Flow Control System Test

WARNING: If N2O is available and flows through the system during this test, use a
safe and approved procedure to collect and remove N2O gas.

WARNING: Incorrect gas mixtures can cause patient injury. If the O2:N2O ratio
system does not supply O2 and N2O in the correct proportions, do not
use the system.

CAUTION: Slowly open the cylinder valves to avoid damage. Do not use excessive
force on the flow controls. After performing the cylinder tests, close all
cylinder valves if cylinder supplies are not used.

CAUTION: Turn the flow controls slowly. To avoid damaging the control valves, do
not turn further when the flowmeter reading is outside the range.
When turning a flow control knob clockwise to decrease flow, the
flowmeter should reach zero before the knob reaches its most
clockwise mechanical stop (Off) position. Do not turn any further when
the knob has reached the Off position.

Similarly, when turning a flow control knob counterclockwise to

increase flow from zero, the flowmeter reading should not indicate a
change from zero until the flow control knob is turned approximately
one (1) rotation counterclockwise from the Off position, and only if
permitted according to the gas ratio control system.

To perform the flow control system tests:

1. Connect the pipeline supplies or slowly open the cylinder valves.

2. Turn all flow controls fully clockwise (flow OFF).
3. Set the system switch to the On position.
4. Do not use the system if the low battery alarm or other ventilator failure alarms occur.
5. Test the O2:N2O ratio system with change of O2 flow:
Turn the O2 and N2O flow controls fully clockwise (flow OFF). Then, turn the N2O flow control
fully counterclockwise (open position). There should be no N2O flow since there is no O2
flow yet. Turn the O2 control to the values shown in the table below. The N2O value should
meet the criteria shown in the table.

STEP O2 FLOW SETTING (L/MIN) N2O FLOW (L/MIN)

1 0 0
2 0.3 ≤ 1.0
3 0.8 ≥ 2.0 and ≤ 2.5
4 1.0 ≥ 2.5 and ≤ 3.2
5 2.0 ≥ 4.90 and ≤ 6.3
6 3.0 ≥ 7.4 and ≤ 9.5
7 4.0 > 10.0 and ≤ 12.7
8 5.0 > 10.0 and ≤ 15.8
9 6.0 > 10.0 and ≤ 19.0
10 0 0

A5™ Operating Instructions 046-002773-00 4 - 21

Vaporizer Tests Preoperative Tests

4.12 Vaporizer Tests

WARNING: During the vaporizer tests, the anesthetic agent exits from the fresh gas
outlet. Use a safe and approved procedure to remove and collect the
agent.

WARNING: To prevent damage, turn the flow controls fully clockwise (flow OFF)
before using the system.

Before the test, ensure that the vaporizers are correctly installed. For details about vaporizer
installation, see ‘‘Install the Vaporizer’’ on page 2-5.

4.12.1 Vaporizer Back Pressure Test

1. Connect the O2 pipeline supply or open the O2 cylinder valve.
2. Set the O2 flow to 6 L/min.
3. Ensure that the O2 flow stays constant.
4. Adjust the vaporizer concentration from 0 to 1%. Ensure that the O2 flow must not decrease
more than 1 L/min through the full range. Otherwise, install a different vaporizer and repeat
this step. If the problem persists, the malfunction is in the anesthesia system. Do not use this
system.
5. Test each vaporizer as per the steps above.

NOTE: Do not perform this test on the vaporizer when the concentration
control is between “OFF” and the first graduation above “0” (zero) as
the amount of anesthetic drug outputted is very small within this
range.

4.12.2 Manual Leak Test

1. Set the Auto/Manual ventilation switch to Manual.
2. Connect a breathing circuit to the inspiratory and expiratory ports. Connect a ventilation
bag to the bag arm.
3. Set APL Valve to 75 cmH2O.
4. Close the breathing system at the patient connection by connecting the Y-piece on the
breathing circuit to the leak test port.
5. Inflate the ventilation bag with O2 flush to 40 cmH2O.
6. Verify that circuit holds pressure for greater than 10 seconds.
7. Set the APL valve to SP.

4.12.3 Vaporizer Leak Test

1. Set the Auto/Manual ventilation switch to Manual.
2. Set the APL valve to the SP position.

4 - 22 046-002773-00 A5™ Operating Instructions

Preoperative Tests Vaporizer Tests

3. Connect one end of the breathing circuit to the bag arm, one end to the inspiratory port and
the Y-piece to the test port:

4. Mount and lock the vaporizer onto the vaporizer mount. (Certain vaporizers need to be set
to at least 1% for correct testing. See the vaporizer manufacturer’s manual for details.)
5. Set the fresh gas flow to 200 mL/min.
6. Set the APL valve to 75 and verify that the pressure on the airway pressure gauge increases
above 30 cmH2O within 2 minutes.
7. Turn off the vaporizer.
8. Repeat Steps 4, 5, 6, and 7 for the other vaporizer.

A5™ Operating Instructions 046-002773-00 4 - 23

Breathing System Tests Preoperative Tests

4.13 Breathing System Tests

WARNING: Objects in the breathing system can stop gas flow to the patient. This
can cause injury or death. Ensure that there are no test plugs or other
objects in the breathing system.

WARNING: Do not use a test plug that is small enough to fall into the breathing
system.

1. Ensure that the breathing system is correctly connected and not damaged.
2. Ensure that the check valves in the breathing system work correctly:
1. The inspiratory check valve opens during inspiration and closes at the start of expiration.
2. The expiratory check valve opens during expiration and closes at the start of inspiration.

4.13.1 Bellows Test

1. Select the End Case button in the Manual tab.
2. Follow the screen prompts to end the case and enter Standby mode.
3. Set the Auto/Manual ventilation switch to Auto.
4. Set all flow controls to Off.
5. Close the breathing system at the patient connection by connecting the Y-piece on the
breathing circuit to the leak test port.
6. Push the O2 flush button to expand the bellows to the top of the bellows enclosure.
7. Ensure that the pressure does not increase to more than 15 cmH2O on the airway pressure
gauge.
8. The bellows should not fall faster than a rate of approximately 300 mL/min. If the leak rate is
greater, troubleshoot the source of the leak. If the source of the leak is the bellows, then the
bellows must be replaced.

4.13.2 Breathing System Leak Test in Manual Ventilation Status

1. Set the Auto/Manual ventilation switch to Manual.
2. Adjust all flowmeters to zero.
3. Select the End Case button in the Manual tab.
4. Follow the screen prompts to end the case and enter Standby mode.
5. Connect the manual bag to the manual bag port.
6. Turn the APL valve control to fully close the APL valve (75 cmH2O).
7. Turn the O2 flow control to set the O2 flow to 0.15 L/min.
8. Connect the Y-piece on the breathing circuit to the leak test port.
9. Push the O2 flush button to let the pressure increase to approximately 30 cmH2O on the
airway pressure gauge.
10. Release the flush button. A pressure decrease on the airway pressure gauge indicates a leak.
Contact your service personnel.

4 - 24 046-002773-00 A5™ Operating Instructions

Preoperative Tests Breathing System Tests

4.13.3 APL Valve Test

1. Select the End Case button in the Manual tab.
2. Follow the screen prompts to end the case and enter Standby mode.
3. Set the Auto/Manual switch to Manual.
4. Connect the manual bag to the manual bag port.
5. Connect the Y-piece on the breathing circuit to the leak test port.
6. Turn the APL valve control to 30 cmH2O.
7. Set the O2 flow to 10 L/min. Turn any other gases off.
8. Press the flush button until the manual bag is inflated and then release the button. Ensure
that the reading on the airway pressure gauge is with the range of 25 cmH2O to 40 cmH2O
after it is steady.
9. Turn the APL valve control to the fully open position.
10. Set the O2 flow to 3 L/min. Turn any other gases off.
11. Ensure that the reading on the airway pressure gauge is less than 5 cmH2O.
12. Push the O2 flush button continuously. Ensure that the reading on the airway pressure
gauge does not exceed 10 cmH2O.
13. Turn the O2 flow control to Off. Ensure that the reading on the airway pressure gauge does
not decrease below 0 cmH2O.

A5™ Operating Instructions 046-002773-00 4 - 25

Alarm Tests Preoperative Tests

4.14 Alarm Tests

Alarms also can be verified by creating an alarm condition on the A5 and verifying the corresponding
alarm indicators are present on the monitor.

4.14.1 Prepare for Alarm Tests

1. Connect a test lung or manual bag to the Y-piece of the breathing circuit.
2. Set the Auto/Manual switch to Auto.
3. Set the system switch to the On position.
4. Set the system to Standby mode.
5. Set the Patient Size to Adult.
6. Set the ventilator controls as follows:
• Ventilation mode: select VCV
• Vt: 500 mL
• Rate: 12 bpm
• I:E: 1:2
• Tpause: 10%
• PEEP: OFF
• Plimit: 30 cmH2O
7. Turn the O2 flow control to set the O2 flow to 0.5 to 1 L/min.
8. Push the O2 flush button to expand the bellows to the top of the bellow enclosure.
9. Touch the screen to exit Standby mode and begin ventilation.
10. Ensure that:
• The main screen displays the correctly set data. The measured values should be within the
tolerances specified in the specifications (see TABLE 9-28, “Control and Monitoring
Accuracy,” on page 9-19).
• The bellows inflates and deflates normally during mechanical ventilation.

4.14.2 Test the O2 Concentration Monitoring and Alarms

NOTE: For A5s with an installed gas module, disconnect the sample tube from
the Y-piece and breathe into it until you see a CO2 reading on the
screen. Then reconnect the sample tube to the Y-piece. This will activate
the gas module alarms.

1. Set the Auto/Manual switch to Manual.

2. Remove the O2 sensor. After three minutes, ensure that the sensor measures approximately
21% O2 in room air by verifying the FiO2 value on the main screen.
3. Select the Alarms softkey and then the Limits tab. Set the FiO2 low alarm limit to 50%.
4. Ensure that a low O2 alarm (“FiO2 Too Low”) occurs.
5. Set the FiO2 low alarm limit back to a value less than the measured O2 value and ensure that
the alarm cancels.
6. Put the O2 sensor back in the breathing system.
7. Select the Alarms softkey and then the Limits tab. Set the FiO2 high alarm limit to 50%.

4 - 26 046-002773-00 A5™ Operating Instructions

Preoperative Tests Alarm Tests

8. Connect the manual bag to the manual bag port. Push the O2 flush button to fill the manual
bag. Ensure that the sensor measures at least 90% O2.
9. Ensure that a high O2 alarm (“FiO2 Too High”) occurs.
10. Set the FiO2 high alarm limit to 100% and ensure that the alarm cancels.

4.14.3 Test the Low Minute Volume (MV) Alarm

1. Set the Auto/Manual ventilation switch to Auto.
2. Set the ventilator controls as follows:
• Ventilation mode: select VCV
• Vt: 500 mL
• Rate: 12 bpm
• I:E: 1:2
• Tpause: 10%
• PEEP: OFF
• Plimit: 30 cmH2O
3. Select the Alarms softkey and then the Limits tab. Set the MV low alarm limit to 8.0 L/min.
4. Ensure that a low MV alarm occurs after approximately 60 seconds.
5. Select the Alarms softkey and then the Limits tab. Set the MV low alarm limit back to a
value less than the measured MV value and ensure that the alarm cancels.

4.14.4 Test the Apnea Alarm

1. Connect the manual bag to the manual bag port
2. Set the Auto/Manual ventilation switch to Manual.
3. Turn the APL valve control to set the APL valve to 10 cmH2O.
4. Inflate using the O2 pushbutton and squeeze the manual bag to ensure that a complete
breathing cycle occurs on screen.
5. Stop inflating the manual bag and wait for more than 30 seconds to ensure that the apnea
alarm occurs.
6. Inflate and squeeze the manual bag to ensure that the apnea alarm cancels.

4.14.5 Test the Continuous Airway Pressure Alarm

1. Connect the manual bag to the manual bag port.
2. Turn the O2 flow control clockwise to set the O2 flow to Off.
3. Turn the APL valve control to set the APL valve to 30 cmH2O position.
4. Set the Auto/Manual ventilation switch to Manual.
5. Push the O2 flush button for approximately 15 seconds. Ensure that the Continuous Airway
Pressure alarm occurs.
6. Disconnect the breathing circuit and ensure that the alarm cancels.
7. Reconnect the breathing circuit.

4.14.6 Test the High Paw Alarm

1. Set the Auto/Manual ventilation switch to Auto.

A5™ Operating Instructions 046-002773-00 4 - 27

Preoperative Preparations Preoperative Tests

2. Select the Alarms softkey and then the Limits tab.

3. Set the PEAK low alarm limit to 0 cmH2O and PEAK high alarm limit to 10 cmH2O.
4. Ensure that a high Paw alarm (“Paw Too High”) occurs.
5. Set the PEAK high alarm limit to 40 cmH2O.
6. Ensure the high Paw alarm cancels.

4.14.7 Test the Low Paw Alarm

1. Set the Auto/Manual ventilation switch to Auto.
2. Select the Alarms softkey and then Limits tab.
3. Set the Peak low alarm limit to 2 cmH2O.
4. Disconnect the test lung or manual bag from the Y-piece of the breathing circuit.
5. Wait for 20 seconds. View the alarm area and ensure that a low Paw alarm occurs.
6. Connect the test lung or manual bag to the Y-piece of the breathing circuit. If using a
manual bag, squeeze the bag to cancel the alarm.
7. Ensure the low Paw alarm cancels.

4.15 Preoperative Preparations

1. Ensure that the ventilator parameters and alarm limits are set to applicable clinical levels.
2. Ensure that the system is in Standby.
3. Ensure that the equipment for airway maintenance, manual ventilation and tracheal
intubation, and applicable anesthetic and emergency drugs are available.
4. Set the Auto/Manual ventilation switch to Manual.
5. Connect the manual bag to the manual bag port.
6. Turn off all vaporizers.
7. Turn the APL valve control to the SP position to fully open the APL valve.
8. Turn all flow controls to set all gas flows to Off.
9. Ensure that the breathing system is correctly connected and not damaged.

WARNING: Before connecting a patient, flush the A5 anesthesia machine with 8 L/

min of O2 for at least two minutes. This removes unwanted mixtures
and by-products from the system.

4 - 28 046-002773-00 A5™ Operating Instructions

Preoperative Tests Inspect the Active/Passive Anesthetic Gas Scavenging System

4.16 Inspect the Active/Passive Anesthetic Gas

Scavenging System
4.16.1 Inspect the AGSS
1. Connect the vacuum hose to the EVAC port or vacuum port of the healthcare facility and
turn on the waste gas disposal system. Adjust the position of the float to be between the
MIN and MAX lines by turning its flow adjustment knob (counterclockwise increases flow,
clockwise decreases flow).
2. Check if the float can rise and exceed the “MIN” mark. If any blockage, tackiness, or damage
occurs to the float, disassemble, clean the filter, and assemble the float again or replace the
float.
3. Drain any moisture from the waste gas hose. Reconnect the waste gas hose to the active
AGSS waste gas port.

NOTE: Do not block the active AGSS pressure compensation openings during
the inspection. If the float cannot rise, the possible reasons are:
1. The float surface is tacky. Turn over the active AGSS and check if the
float moves up and down freely.
2. The float is rising slowly. The filter may be blocked. Check if the filter
is blocked.
3. The waste gas disposal system is not working or the pump rate is less
than 50 L/min at which the active AGSS works normally. Check the
waste gas disposal system.

NOTE: The knob on the top of the scavenger is meant to adjust the flow from
the EVAC. When the knob is fully closed it does not need to completely
shut off flow.

4.16.2 Inspect the Passive AGSS

1. Set the Auto/Manual ventilation switch to Auto.
2. Close the breathing system at the patient connection by connecting the Y-piece on the
breathing circuit to the leak test port.
3. Connect the passive AGSS assembly.
4. Set the O2 flow to 10 L/min.
5. Push the O2 flush button to expand the bellows to the top of the bellow enclosure.
6. Block up the exhaust port of the passive AGSS assembly. Ensure that the manual bag
expands slowly and reaches the inflated status after approximately 15 seconds.

A5™ Operating Instructions 046-002773-00 4 - 29

Inspect the Active/Passive Anesthetic Gas Scavenging System Preoperative Tests

This page intentionally left blank.

4 - 30 046-002773-00 A5™ Operating Instructions

 5.0 Operations

Powering On the A5 Anesthesia System....................................................................................................................................5-2

Powering Off the A5 Anesthesia System ...................................................................................................................................5-2

Patient Setup ...............................................................................................................................................................................................5-3

Oxygen Sensor Calibration .................................................................................................................................................................5-5

Input Fresh Gas ..........................................................................................................................................................................................5-6

Ventilation Modes ....................................................................................................................................................................................5-8

Start Mechanical Ventilation ........................................................................................................................................................... 5-19

Stop Mechanical Ventilation ........................................................................................................................................................... 5-19

Relationships of Ventilation Parameters .................................................................................................................................. 5-19

Parameter Monitoring (Numerics) .............................................................................................................................................. 5-20

A5™ Operating Instructions 046-002773-00 5-1

Powering On the A5 Anesthesia System Operations

WARNING: Before using the A5 Anesthesia System on the patient, ensure that the
system is correctly assembled and in good condition, and that all the
tests described in the Preoperative Test are already completed. In case
of test failure, do not use the system. Have a qualified Mindray service
representative repair the system.

5.1 Powering On the A5 Anesthesia System

1. Connect the gas supplies and gas cylinders to the A5.
2. Connect the power cord to the AC power source. Ensure that the AC power LED is
illuminated.
3. Set the system switch to ON. Ensure that both the operating state LED and battery LED are
illuminated (the battery is being charged or fully charged).
4. The display shows the start-up screen.
5. The alarm LED flashes red, yellow, and cyan once in turn and then a beep is given. This
verifies that audible and visual alarms are operational.
6. After several seconds, the system self-test screen is displayed and the A5 runs its system self-
test.

5.2 Powering Off the A5 Anesthesia System

The A5 system provides a powering off function with the following features:

• A prompt sound is given when user turns off the A5. If the power switch is turned off in
Standby mode, the A5 will immediately power off.
• If the power switch is turned off in Manual mode or in any of the Automatic ventilation
modes, the A5 will wait 12 seconds to power off completely. In the 12-second power off
delay period, the screen will display a 10 second countdown timer. If the A5 is performing
Automatic ventilation, the ventilator will continue ventilating the patient in the current
ventilation mode.
• A beep is sounded for each second of the countdown from 10 to 1 second, after which a
two-second shutdown sound is given when the timer reaches zero.
• The volume of power off delay sound can be adjusted in the System Alerts setting in the
Alarm Volume menu.
• When the user turns on the machine during the power off delay period, the countdown
timer will disappear, and the ventilator will resume its previous state.

NOTE: The powering off function is not implemented during Standby, only
when actively ventilating.

FIGURE 5-1 Countdown timer screen

5-2 046-002773-00 A5™ Operating Instructions

Operations Patient Setup

5.3 Patient Setup

NOTE: Discharge button was renamed End Case in software bundle version
02.06.00 and later.

5.3.1 End Case / Standby Mode

The End Case button is located in the Manual tab (see FIGURE 5-2). The End Case button can be
selected only when the Auto/Manual ventilation switch is set to Manual, and when all gas flows
are turned off.

FIGURE 5-2 End Case Button

Ending the case changes the current patient size to the default patient size and loads the user
defaults for the system; clears the patient demographics; clears the User Alarm Log and
Spirometry Loops (including the currently plotting loop, reference loop, and baseline loop); and
places the system into Standby mode (see FIGURE 5-4).

After the End Case button is selected, a warning box with a Restore default settings checkbox
will be displayed. Selecting the Restore default settings checkbox reloads the user defaults, clears
patient demographics, clears the history, clears the spirometry reference loops, and places the
system into Standby mode (see FIGURE 5-4).

If the Restore Default settings checkbox is not selected, all the settings are retained.

FIGURE 5-3 End Case Checkbox

In Standby, all system functions are idle. It is the default system startup mode and is used after
ending the case.

A5™ Operating Instructions 046-002773-00 5-3

Patient Setup Operations

FIGURE 5-4 Standby Mode

To end the case and enter Standby:

1. Set the Auto/Manual ventilation switch to Manual.

2. Turn off all fresh gas flows by turning their knobs clockwise. Wait until all fresh gas flow
levels are effectively at 0.0 L/min (i.e., flow < 0.05 L/min).

NOTE: The A5 system will not allow the End Case button to be selected until
the Auto/Manual ventilation switch is set to Manual, and system
detects the individual fresh gas flows are effectively turned off (i.e.,
flow < 0.05 L/min).

3. Select the End Case button in the Manual tab (see FIGURE 5-2).
4. Follow the screen prompts to end the case and enter Standby mode.
5. To exit Standby, set the Auto/Manual ventilation switch to Manual, then touch the screen
or turn on the fresh gas flow to more than 0.2 L/min of individual gas.

NOTE: To exit Standby by turning on the fresh gas flow, the flow must be
increased to more than 0.2 L/min.

NOTE: The End Case button can be selected only when the system is not in
Standby, all fresh gas flows are off, and the Auto/Manual switch is in the
Manual position.

NOTE: When the system is in Standby mode, the Bypass,Monitor and End Case
buttons in the Manual tab are disabled. However, the Alarms button
remains enabled and can be toggled to On or Off.

WARNING: Selecting End Case to enter Standby mode will stop ventilation and
parameter monitoring. Do not select Standby mode if the patient
requires continuous ventilation.

5-4 046-002773-00 A5™ Operating Instructions

Operations Oxygen Sensor Calibration

5.3.2 Select the Patient Size (Adult, Pediatric, Infant)

Patient size can only be changed when the current ventilation mode is Manual mode, Standby
mode or Monitor mode (available with AG module).

1. Select Manual mode or select the End Case button (in the Manual tab) to enter Standby
mode.
2. Select the Patient Size softkey at the top left of the main screen. The softkey displays
“Adult”, “Pediatric”, or “Infant”.
3. Select the Patient Size: Adult, Pediatric, or Infant.
4. Select the Accept softkey to finalize your selection.

NOTE: The A5 saves the latest patient parameter settings (VCV, PCV, PCV-VG ,
PS, SIMV-VC, SIMV-PC , and Alarms) for each patient type: Adult,
Pediatric, and Infant. Changing to another patient type does not erase
the parameter settings from the previous patient type. For example,
changing from Adult to Pediatric and back to Adult will result in the
Adult patient parameter settings still saved.

FIGURE 5-5 Patient Size Setup Menu

5.4 Oxygen Sensor Calibration

If oxygen sensor calibration is needed, please see ‘‘O2 Sensor Calibration’’ on page 7-6.

A5™ Operating Instructions 046-002773-00 5-5

Input Fresh Gas Operations

5.5 Input Fresh Gas

5.5.1 Set N2O, Air, and O2 Inputs
1. You can control the N2O, Air, and O2 flows in the fresh gas through the N2O, Air, and O2 flow
controls. Readings of the gas flow can be seen on the respective electronic flowmeter on the
screen. Below the electronic flowmeters and between the pressure gauges is the total
flowmeter showing the total flow of the mixed gas.
• Safety systems within the A5 work to prevent hypoxic mixtures from being delivered to
the patient. Nitrous oxide will not be delivered unless oxygen flow is present. A
mechanical safety system assures that at least 21% O2 is present when setting mixtures
of O2 and N2O.
• Ensure that both O2 and N2O flow controllers are turned OFF fully (clockwise) at the start
and at the end of each case.
• All A5 units are designed to maintain a safe O2:N2O ratio by allowing nitrous oxide to be
set to a flow rate that is proportional to a previously adjusted flow of oxygen. The N2O
flow is limited by the flow of O2 so that a safe ratio of no less than 21% oxygen can be
maintained.
• When adjusting N2O and O2 flow rates, always adjust the oxygen flow first to enable the
nitrous oxide flow. To add N2O to the fresh gas flow, the user must open the N2O
flowmeter valve, but only after opening the O2 flowmeter valve.

NOTE: You can adjust O2 concentration in the breathing system through the
O2 flow control.

NOTE: The total flowmeter is calibrated based on 100% O2. The accuracy of the
flowmeter may degrade with other gas or mixed gas.

NOTE: When viewing the readings on the total flowmeter, keep your visual
angle at the same level of the float. The reading of the scale may vary
when viewed at a different angle.

NOTE: If the readings shown on the electronic flowmeters differ from that on
the total flowmeter, the electronic flowmeter will prevail and the total
flowmeter is an approximate value.

NOTE: When the AC power supply is not connected and batteries are depleted,
the flow and the composition of the fresh gas are not affected. When
the individual N2O or Air supply fails, the corresponding fresh gas
cannot be achieved. When O2 supply fails, both O2 and N2O fresh gas
cannot be achieved.

5.5.2 Set Anesthetic Agent

NOTE: You do not need to perform this operation if inspiratory anesthetic
agent is not used.

NOTE: The A5 anesthesia system can be mounted with vaporizers

corresponding with halothane, enflurane, isoflurane, sevoflurane and
desflurane. Only one vaporizer can be opened at a time because of the
interlock system.

5-6 046-002773-00 A5™ Operating Instructions

Operations Input Fresh Gas

5.5.2.1 Select the Desired Anesthetic Agent

1. Determine the anesthetic agent to be used and then fill the vaporizer.

NOTE: Install the vaporizers with a Selectatec interlock system that are
compliant to ISO 80601-2-13 on the A5 unit. Refer to the manufacturer’s
vaporizer Instructions For Use for filling or draining the vaporizer and
other information.

WARNING: Ensure that the correct anesthetic agent is used. The vaporizer is
designed with the specific anesthetic agent named on it and further
indicated by color coded labeling. The concentration of the anesthetic
agent actually output will vary if the vaporizer is filled with the wrong
agent.

2. Mount the vaporizer filled with anesthetic agent onto the A5 Anesthesia System. See “Install
the Vaporizer” on page 2-5.

5.5.2.2 Adjust the Concentration of Anesthetic Agent

Push and turn the concentration control on the vaporizer to set the appropriate concentration of
anesthetic agent. For details about how to use the anesthetic agent, refer to the Vaporizer
Instructions for Use.

A5™ Operating Instructions 046-002773-00 5-7

Ventilation Modes Operations

5.6 Ventilation Modes

NOTE: In all ventilation modes, when inspiration pressure reaches the high
alarm limit of Paw, the system switches to expiration immediately and
airway pressure is released.

NOTE: When the drive gas supply fails, mechanical ventilation cannot work
normally.

5.6.1 Monitored Parameters

NOTE: The monitored parameters are measured in the condition of ATPS
(ambient temperature and pressure saturated).

The A5 monitors the following ventilation parameters:

PARAMETER RANGE* COMMENTS

PEAK -20 –120 cmH2O
MEAN -20 – 120 cmH2O
Vt 0 – 3000 mL
MV 0 – 100 L
PLAT -20 – 120 cmH2O
Rate 0 – 120 bpm
PEEP 0 – 70 cmH2O
FiO2 18 – 100%**
I:E — Displayed only in SIMV-VC, SIMV-PC, and PS modes
* If the monitored parameter is out of range, it will be displayed as “- - -”.
**FiO2 measurements between 100% and 110% inclusive will be displayed as 100%. Above this range, the system
will display “- - -”.

5.6.2 Ventilation Modes

The A5 provides the following ventilation modes:

VENTILATION MODE PARAMETERS

VCV Vt, Rate, I:E, Tpause, PEEP, Plimit
SIMV-VC Vt, Rate, Tinsp, Tpause, PEEP, Plimit, PS (On/Off), ΔP, Trigger, Tslope,
PCV VtG, PlimVG, Pinsp, Rate, I:E, PEEP, Tslope
SIMV-PC Pinsp, Rate, Tinsp, PS (On/Off ), ΔP, Trigger, PEEP, Tslope
PS Min Rate, ΔP, Trigger, PEEP, Tslope, Apnea Ti
Manual Bypass , Alarms, Monitor (available with AG module)

5.6.3 Change Ventilation Mode

To change ventilation mode to Manual
Use the Auto/Manual Bag switch on the breathing system block to enter and exit Manual
ventilation mode.

5-8 046-002773-00 A5™ Operating Instructions

Operations Ventilation Modes

To change ventilation mode to VCV, SIMV-VC, PCV, SIMV-PC , or PS:

1. Select the tab of the desired ventilation mode. The “Set Mode” button (or “Preset Mode”
button in manual) will flash (see FIGURE 5-6).
2. Select the “Set Mode” button (or “Preset Mode” button in manual) to confirm.
If the “Set Mode” button is not selected after several seconds, an audio reminder will sound
for several seconds and then the system will return to the previous ventilation mode.
3. Optionally, select each available ventilation parameter to edit the parameter setting.
4. Move the Auto/Manual Bag switch to the Auto position.

NOTE: When the Auto/Manual switch is in Auto position, all the buttons in
Manual tab (Alarms, Bypass, Monitor and End Case) are disabled;
Alarms are set to On; and Bypass is set to Off.

FIGURE 5-6 Ventilation Mode Tabs

5.6.4 Set Manual Ventilation Mode

Manual ventilation mode is used for manually ventilating a patient or to let a patient breathe
spontaneously. To use the manual mode, the user must first set the APL valve to the desired
pressure value and then use the Auto/Manual switch on the breathing module to enter and exit
Manual mode. Push the O2 flush button to inflate the bag if necessary.

When the Auto/Manual switch is set to Manual, and the Alarms button in the Manual mode
tab is set to Off, the alarm limit indicators on the main screen to the right of the measured values
related to Pressure and Volume (such as PEAK and MV) will change to Off (see FIGURE 5-7).

The Alarms button setting (On/Off) in the Manual mode tab is saved and restored when
toggling from Manual to Auto and back to Manual mode. For example, if the Alarms button is
set to Off, this setting will be saved and restored to Off after switching to Auto and back to
Manual mode.

FIGURE 5-7 Alarm Limit Indicators

A5™ Operating Instructions 046-002773-00 5-9

Ventilation Modes Operations

Setting the APL Valve for Manual Ventilation

Rotate the APL valve adjustment knob to the desired pressure. The number on the rotating
portion that lines up with the index mark on the bottom section of the valve indicates the
approximate pressure setting.

NOTE: Clockwise rotation increases the pressure, and counterclockwise

rotation decreases the pressure.

The patient can be ventilated by hand using the breathing bag. The pressure will be limited to
the value set on the APL valve.

Setting the APL Valve for Spontaneous Breathing

Rotate the APL valve adjustment knob fully counterclockwise until the SP marking on the knob
lines up with the index mark on the bottom section of the valve. The valve will then be open for
spontaneous patient breathing.

NOTE: In the manual ventilation mode, you can use the APL valve to adjust the
breathing system pressure limit and gas volume in the manual bag.
When the pressure in the breathing system reaches the pressure limit
set for the APL valve, the valve opens to release excess gas.

NOTE: The APL valve adjusts the breathing system pressure limit during
manual ventilation. Its scale shows approximate pressure.

Cardiac Bypass Mode

Cardiac Bypass mode is only available in Manual ventilation mode. This mode turns off pressure
volume and apnea alarms when they are not appropriate (e.g., during heart/lung bypass).

NOTE: When Bypass mode is On, the Alarms button is disabled and set to Off.

A confirmation dialogue appears when turning Bypass mode On or Off.

Enter Cardiac Bypass mode by setting the Bypass softkey in Manual mode to On. When the
Bypass softkey is set to On, the Alarm softkey is disabled and set to Off automatically. When
Bypass is set to Off, the Alarm button returns to its setting before entering Bypass. When
exiting Manual mode or discharging a patient, Bypass will be set to Off.

FIGURE 5-8 Bypass Mode Softkey

5 - 10 046-002773-00 A5™ Operating Instructions

Operations Ventilation Modes

5.6.5 Setting Monitor Mode (A5 with AG Module connected)

Monitor mode is only available in the Manual ventilation mode when there is an AG module
connected to the A5. This mode turns off all ventilation related alarms.

NOTE: When Monitor mode is On, the Alarms button is disabled and set to Off.

A confirmation dialog displays when turning Monitor mode On or Off.

Enter the Monitor mode by setting the Monitor softkey in Manual mode to On. When the
Monitor softeky is set to On, the Alarm softkey is disabled and set to Off automatically. When
Monitor is set to Off, the Alarm button restores to its settings before entering the Monitor mode.
When exiting Manual mode or discharging a patient, Monitor will be set to Off.

When the system is working in Monitor mode, the flow, volume and pressure waveforms and
measured values are removed from the Waveforms tab. Only the CO2 waveform and the CO2
parameters will remain on the Waveforms tab. The Rate as determined by the AG module is
displayed in the measured values area.

FIGURE 5-9 Monitor Mode

A5™ Operating Instructions 046-002773-00 5 - 11

Ventilation Modes Operations

Setting Alarms
In Manual ventilation mode, when Bypass and Monitor are set to Off, the pressure, volume and
apnea alarms can be turned off by setting the Alarms softkey to Off. The related alarm limits are
then displayed as Off.

Pressure, volume and apnea alarms can be turned on by setting the Alarms softkey to On, which
returns the related alarm limits to their original settings.

FIGURE 5-10 Set Alarms to Off

5 - 12 046-002773-00 A5™ Operating Instructions

Operations Ventilation Modes

Setting CO2 Alarms

In manual ventilation mode, the CO2 and the CO2 apnea alarms can be turned off by setting the
CO2 Alarms softkey to Off. The related alarm limits are then displayed as Off and the CO2 and
the CO2 Apnea Alarms are Off prompt will be displayed in the alarm area.

The CO2 and the CO2 apnea alarms can be turned on by setting the CO2 Alarms softkey to On or
by switching to mechanical ventilation mode which returns the related alarm limits to their
original settings.

NOTE: In mechanical ventilation mode, the CO2 alarms are turned on

and cannot be turned off.

When the system exits standby mode and the CO2 Alarms softkey is On, the system will not
activate the CO2 and the CO2 apnea alarms until three continuous CO2 waves are monitored.

The CO2 and the CO2 apnea alarms are disabled for 30 seconds when the ventilation mode is
switched from Manual to Auto or when the CO2 Alarms softkey is set from Off to On. After 30
seconds, the CO2 and the CO2 apnea alarms would be enabled even if CO2 has not been
detected.

FIGURE 5-11 Set CO2 Alarms to Off

WARNING: Risk of inadequate monitoring.National standards require a minimum

monitoring with some alarm functions. These standards may not be
met if the alarm function of the CO2 monitoring parameter is disabled.
Only disable this monitoring parameter after consulting national
standards.

A5™ Operating Instructions 046-002773-00 5 - 13

Ventilation Modes Operations

5.6.6 Make Settings before Starting Mechanical Ventilation Mode

1. Set the Auto/Manual ventilation switch to Manual. If discharging a patient, select the End
Case button in the Manual tab to enter Standby mode.
2. Select the desired ventilation mode tab.
3. Set the desired ventilation parameters.
4. Select the Preset button (flashing green) on the right of the ventilation tabs to confirm the
ventilation mode.
5. If necessary, push the O2 flush button to inflate the bellows.
6. If in Standby, exit Standby by touching the main screen or by turning on the fresh gas flow
to more than 0.2 L/min.
7. To begin mechanical ventilation, set the Auto/Manual ventilation switch to Auto.

5.6.7 Set Volume Control Ventilation (VCV)

Volume Control Ventilation (VCV) mode is a fully-mechanical ventilation mode. In the VCV mode,
each time mechanical ventilation starts, gas is delivered to the patient at a constant flow, which
reaches the preset Vt within the gas delivery time. To ensure a certain amount of Vt, the resulted
airway pressure (Paw) changes based on patient pulmonary compliance and airway resistance.

In VCV mode, you need to set Plimit to prevent high airway pressure from injuring the patient. In
this mode, you can select to set Tpause to improve patient pulmonary gas distribution and PEEP
to improve expiration of end-tidal carbon dioxide and to increase oxygenation of breathing
process.

To ensure the set tidal volume gas delivery, the ventilator adjusts gas flow based on the
measured inspiratory volume, dynamically compensates for the loss of tidal volume arising from
breathing system compliance and system leakage and eliminates the effect of fresh gas as well.
This is called tidal volume compensation.

In the VCV mode, if tidal volume compensation has failed, the A5 Anesthesia System can
continue delivering gas stably but cannot compensate for the effects of fresh gas flow and
breathing system compliance losses.

In VCV and SIMV-VC modes, when inspiration pressure reaches Plimit, respectively, the
inspiration pressure is held.

FIGURE 5-12 Volume Control Ventilation (VCV) Tab

5 - 14 046-002773-00 A5™ Operating Instructions

Operations Ventilation Modes

5.6.7.1 To Set VCV Mode

1. Select the VCV tab on the Main Screen.
2. Check that all VCV parameters are set appropriately.
If necessary, select the parameter softkey to edit the parameters settings (see FIGURE 5-12).
You can use the digital keyboard on the screen to enter the desired value, or continuously

press the or buttons to rapidly increase or decrease the parameter values.

3. Select the Set Mode softkey to confirm.
VCV parameters:
• Vt: Tidal volume (mL)
• Rate: Breath rate (bpm)
• I:E: Ratio of inspiratory time to expiratory time

NOTE: The screen displays the calculated Tinsp when adjusting the I:E ratio
(software bundle version 02.06.00 and later).

• Tpause: Percentage of inspiratory plateau time in inspiratory time (%)

• PEEP: Positive end-expiratory pressure (cmH2O)
• Plimit: Pressure limit level (cmH2O)

NOTE: Before activating a new mechanical ventilation mode, ensure that all
related parameters are set appropriately.

5.6.8 Set Pressure Control Ventilation (PCV)

Pressure control ventilation (PCV) mode is a basic fully-mechanical ventilation mode. In the PCV
mode, each time mechanical ventilation starts, PAW rises rapidly to the preset Pinsp. Then gas
flow slows down through the feedback system to keep PAW constant until expiration starts at the
end of inspiration. The tidal volume delivered in the PCV mode changes based on patient
pulmonary compliance and airway resistance.

In the PCV mode, you can set PEEP to improve expiration of end-tidal carbon dioxide and to
increase oxygenation of breathing process.

For the A5, in PCV mode, Tidal Volume Guarantee (VtG) can be enabled with the VtG setting.
When VtG is a value, then Pinsp is disabled. The ventilator attempts to deliver the set VtG while
maintaining the PAW at or below PlimVG. When VtG is Off, PlimVG is disabled and Pinsp is
enabled. Changing the value of Pinsp will automatically set PlimVG to the same value, but PlimVG
can be adjusted without affecting the value of Pinsp.

NOTE: In PCV mode, even when the PlimVG or Pinsp parameters are inactive,
they are restricted to the parameter relationship equations
PlimVG≥PEEP+5 and Pinsp≥PEEP+5. See section C.9 (pg. C-15)
"Ventilation Parameter Relationships".

FIGURE 5-13 Pressure Control Ventilation Tab

A5™ Operating Instructions 046-002773-00 5 - 15

Ventilation Modes Operations

5.6.8.1 To Set PCV Mode

1. Select the PCV tab on the Main Screen.
2. Check that all PCV parameters are set appropriately.
If necessary, select the parameter softkey to edit the parameters settings (see FIGURE 5-13).
You can use the digital keyboard on the screen to enter the desired value, or continuously

press the or buttons to rapidly increase or decrease the parameter values.

3. Select the Set Mode softkey to confirm.
PCV parameters:

• VtG : Tidal volume guarantee (mL)

• PlimVG : pressure limit level of volume guarantee (cmH2O)
• Pinsp: Peak inspiratory airway pressure (cmH2O)
• Rate: Breath rate (bpm)
• I:E: Ratio of inspiratory time to expiratory time

NOTE: The screen displays the calculated Tinsp when adjusting the I:E ratio
(software bundle version 02.06.00 and later).

• PEEP: Positive end-expiratory pressure (cmH2O)

• Tslope: Rise time (sec)

NOTE: Before activating a new mechanical ventilation mode, ensure that all
related parameters are set appropriately.

5.6.9 Synchronized Intermittent Mandatory Ventilation (SIMV)

The A5 supports two modes of SIMV: SIMV-volume control (SIMV-VC) and SIMV–pressure control
(SIMV-PC).

5.6.9.1 Pressure Support in Synchronized Intermittent Mandatory

Ventilation (SIMV)
In SIMV-VC and SIMV-PC Ventilation modes, PS Ventilation can be turned on and off by changing
the PS setting to On and Off, respectively. When PS Ventilation is Off, the ΔP and Tslope settings
are disabled in SIMV-VC mode, and the ΔP setting is disabled in SIMV-PC mode.

5.6.9.2 Synchronized Intermittent Mandatory Ventilation–Volume

Control (SIMV-VC)

FIGURE 5-14 Synchronized Intermittent Mandatory Ventilation–Volume Control (SIMV-VC)

Tab

5 - 16 046-002773-00 A5™ Operating Instructions

Operations Ventilation Modes

SIMV-VC means to deliver synchronized intermittent mandatory volume controlled ventilation to

the patient. In the SIMV-VC mode, the ventilator waits for patient’s next inspiration based on the
specified time interval. The sensitivity depends on Trigger. If Trigger is reached within the trigger
waiting time (called synchronous trigger window), the ventilator delivers volume controlled
ventilation synchronously with the preset tidal volume and inspiratory time. If the patient does
not inspire within the trigger window, the ventilator delivers volume controlled ventilation to the
patient at the end of trigger window. Spontaneous breathing outside trigger window can acquire
pressure support.

In VCV and SIMV-VC modes, when inspiration pressure reaches Plimit, the inspiration pressure is
held.

5.6.9.3 Synchronized Intermittent Mandatory Ventilation–Pressure

Control (SIMV-PC)

FIGURE 5-15 Synchronized Intermittent Mandatory Ventilation–Pressure Control (SIMV-PC)

Tab

SIMV-PC means to deliver synchronized intermittent mandatory pressure controlled ventilation

to the patient. In the SIMV-PC mode, the ventilator waits for patient’s next inspiration based on
the specified time interval. The sensitivity depends on Trigger. If Trigger is reached within the
trigger waiting time (called synchronous trigger window), the ventilator delivers pressure
controlled ventilation synchronously with the preset tidal volume and inspiratory time. If the
patient does not inspire within the trigger window, the ventilator delivers pressure controlled
ventilation to the patient at the end of trigger window.Spontaneous breathing outside trigger
window can acquire pressure support.

5.6.9.4 To Set SIMV-VC or SIMV-PC Mode

1. Select the SIMV-VC tab or SIMV-PC tab on the Main Screen.
2. Check that all SIMV-VC or SIMV-PC parameters are set appropriately.
If necessary, select the parameter softkey to edit the parameters settings (see FIGURE 5-15).
You can use the digital keyboard on the screen to enter the desired value, or continuously

press the or buttons to rapidly increase or decrease the parameter values.

3. Select the Set Mode softkey to confirm.
SIMV-VC parameters:
• Vt: Tidal volume (mL)
• Rate: Breath rate (bpm)
• Tinsp: Time of inspiration (sec)

NOTE: The screen displays the calculated I:E ratio based on Rate and Tinsp
when adjusting the Tinsp (software bundle version 02.06.00 and later).

A5™ Operating Instructions 046-002773-00 5 - 17

Ventilation Modes Operations

• Tpause: Inspiratory pause (%)

• PEEP: Positive end-expiratory pressure (cmH2O)
• Plimit: Pressure limit level
• Trigger: Flow trigger level (L/min)
• PS: Pressure support (On/Off )
• ΔP: Change in pressure (cmH2O)
• Tslope: Rise time (sec)

SIMV-PC parameters:

• Pinsp: Peak inspiratory airway pressure (cmH2O)

• Rate: Breath rate (bpm)
• Tinsp: Time of inspiration (sec)

NOTE: The screen displays the calculated I:E ratio based on Rate and Tinsp
when adjusting the Tinsp (software bundle version 02.06.00 and later).

• Trigger: Flow trigger level (L/min)

• PEEP: Positive end-expiratory pressure (cmH2O)
• Tslope: Rise time (sec)
• PS: Pressure support (On/Off )
• ΔP: Change in pressure (cmH2O)

NOTE: Before activating a new mechanical ventilation mode, ensure that all
related parameters are set appropriately.

5.6.10 Set Pressure Support Ventilation (PS)

In Pressure Support (PS) mode, the patient’s effort is supported by the A5 at a preset level of
inspiratory pressure. Inspiration is triggered and cycled by patient effort.

The user can set the Trigger flow, ΔP, PEEP, minimum allowed breathing frequency, and Slope
Time. If the Min Rate (bpm) is violated, the A5 will give an Apnea Ventilation breath to assure
ventilation is occurring.

5.6.10.1 To Set PS Mode

FIGURE 5-16 Pressure Support Tab

1. Select the PS tab on the Main Screen.

2. Check that all PS parameters are set appropriately.
If necessary, select the parameter softkey to edit the parameters settings (see FIGURE 5-16).
You can use the digital keyboard on the screen to enter the desired value, or continuously

press the or buttons to rapidly increase or decrease the parameter values.

5 - 18 046-002773-00 A5™ Operating Instructions

Operations Start Mechanical Ventilation

3. Select the Set Mode softkey to confirm.

PS parameters:
• Min Rate: Minimum rate (bpm), applies to apnea backup breaths only
• ΔP: Change in pressure (cmH2O)
• Trigger: Flow trigger level (L/min)
• PEEP: Positive end-expiratory pressure (cmH2O)
• Tslope: Rise time (sec)
• Apnea Ti: Apnea Inspiratory Time

NOTE: Apnea Ti permits the user to vary the inspiratory time of the apnea
backup breaths. Apnea backup breaths are only triggered when the
patient does not achieve the Min Rate that is set by the user. If the
patient’s spontaneous breaths meet or exceed the Min Rate, the apnea
backup is not used.

NOTE: Before activating a new mechanical ventilation mode, ensure that all
related parameters are set appropriately.

5.7 Start Mechanical Ventilation

NOTE: Before starting a new mechanical ventilation mode, ensure that all
related ventilation parameters are set appropriately.

To start mechanical ventilation from Standby mode:

1. Set the Auto/Manual ventilation switch to Manual.

2. Exit Standby by touching the main screen or by turning on the fresh gas flow to more than
0.2 L/min.
3. Set the Auto/Manual ventilation switch to Auto. The A5 system will begin mechanical
ventilation.

5.8 Stop Mechanical Ventilation

To stop mechanical ventilation:

1. Ensure that the breathing system is set up and the APL valve is set properly before stopping
mechanical ventilation.
2. Set the Auto/Manual Bag switch to the Manual Bag position. This selects manual
ventilation and stops mechanical ventilation.

5.9 Relationships of Ventilation Parameters

Ventilation modes may share the same ventilation parameters and values. For example, SIMV-VC
and VCV both include Vt, Plimit, Rate, Tpause, and PEEP. Therefore, these parameter values that
are linked may be passed from the previous ventilation mode to the current mode. Section C.8
‘‘Linked Ventilation Parameter’’ on page C-13 includes a table that lists how the linked parameter
values are set when changing ventilation modes.

Ventilation parameter values that are non-linked are set according to relationship equations.
Section C.9 ‘‘Ventilation Parameter Relationships’’ on page C-15 includes a table of equations to
show how non-linked parameter values are set when changing ventilation modes.

A5™ Operating Instructions 046-002773-00 5 - 19

Parameter Monitoring (Numerics) Operations

5.10 Parameter Monitoring (Numerics)

The system displays parameter monitored values in the monitored parameter area. The monitored
parameters are separated into three groups: pressure, volume and gas (available with the AG module)
or FiO2 (available without the AG module).

5.10.1 Pressure
The Pressure parameter group consists of 3 parameters (see FIGURE 5-17):

• Airway Peak Pressure (PEAK)

• Plateau Pressure (PLAT) or Mean Pressure (MEAN)
• Positive End Expiratory Pressure (PEEP)
If the parameter data is out of range, it is displayed as “– – –”.

NOTE: The high alarm limit for Airway Peak Pressure (PEAK) is displayed to the
top right of the reading. The low alarm limit for Airway Peak Pressure
(PEAK) is displayed to the bottom right of the reading.

NOTE: The display of either Plateau Pressure (PLAT) or Mean Pressure (MEAN)
is configured from the System menu tab.

FIGURE 5-17 Pressure Parameter Group

5.10.2 Volume
The Volume parameter group consists of 3 parameters (see FIGURE 5-18):

• Tidal Volume (VT)

• Minute Volume (MV)
• Respiratory Rate (Rate)
If the parameter data is out of range, it is displayed as “– – –”.

NOTE: The high alarm limit for Minute Volume (MV) is displayed to the top
right of the reading. The low alarm limit for Minute Volume (MV) is
displayed to the bottom right of the reading.

FIGURE 5-18 Volume Parameter Group

5 - 20 046-002773-00 A5™ Operating Instructions

Operations Parameter Monitoring (Waveforms)

5.10.3 Gas (available with the AG module)

The gas monitored parameter group consists of the following parameters:

• Fraction of inspired carbon dioxide and End-tidal carbon dioxide(FiCO2 and EtCO2)
• Fraction of inspired oxygen and End-tidal oxygen(FiO2 and EtO2)
• Fraction of inspired nitrous oxide and End-tidal nitrous oxide(FiN2O and EtN2O)
• Fraction of inspired anesthetic agent and End-tidal anesthetic agent(FiAA and EtAA, AA
stands for anesthetic agent)
• Minimum alveolar concentration(MAC)
• Age
If the parameter data is out of range, it is displayed as “– – –”.

NOTE: The high alarm limit is displayed to the top right of the reading. The low
alarm limit is displayed to the bottom right of the reading.

FIGURE 5-19 Gas Parameter Group

5.10.4 Inspired O2 (available without the AG module)

The unit of measure is % (volume %). If the parameter data is out of range, it is displayed
as “– – –”. FiO2 measurements between 100% and 110% inclusive will be displayed as 100%.
Above this range, the system will display “- - -”.

FiO2 values above 100%, although not realistic, are possible due to errors in calibration.

NOTE: The high alarm limit is displayed to the top right of the reading. The low
alarm limit is displayed to the bottom right of the reading.

FIGURE 5-20 FiO2 Parameter

5.11 Parameter Monitoring (Waveforms)

The system displays waveforms in the waveforms / spirometry area. The waveforms are separated
into four groups: pressure waveform, flow waveform, volume waveform and gas waveform (available
with the AG module).

A5™ Operating Instructions 046-002773-00 5 - 21

Parameter Monitoring (Waveforms) Operations

5.11.1 Pressure Waveform

The Pressure vs. Time waveform is displayed in the Waveform Area.

FIGURE 5-21 Example Simulated Pressure vs. Time Waveform

Pressure vs. Time

The Y-axis of the Pressure vs. Time waveform is labeled Paw (which represents Airway Pressure).
The unit of measure is cmH2O, hPa, or mbar. The Y-axis can automatically adjust the
scalesThough the X-axis is not labeled, it represents a time scale of 0 to 15 seconds.

NOTE: The purple in the waveform means it is a triggered breath.

5.11.1.1 Auto-zeroing the Pressure Sensors

The A5 auto-zeros the pressure sensors at regular intervals to compensate for changes in
temperature and/or barometric pressure that could affect both pressure and flow measurements.
This may affect the waveforms on the screen, but does not affect the volume/pressure delivered
to the patient.

The auto-zeroing intervals are: startup, 5 mins, 15 mins, 30 mins, 60 mins, and every 120 mins
thereafter.

NOTE: The A5 will display the message “Auto-zeroing in process” during the
auto-zeroing intervals.

5.11.2 Flow Waveform

The Flow vs. Time waveform is displayed in the Waveform Area.

FIGURE 5-22 Example Simulated Flow vs. Time Waveform

Flow vs. Time

The Y-axis of the Flow vs. Time waveform represents Flow. The unit of measure is L/min. The Y-
axis can automatically adjust the scales. Though the X-axis is not labeled, it represents a time
scale of 0 to 15 seconds.

5 - 22 046-002773-00 A5™ Operating Instructions

Operations Parameter Monitoring (Waveforms)

NOTE: The purple in the waveform means it is a triggered breath.

5.11.3 Volume Waveform

The Volume vs. Time waveform can be displayed in the waveform area. The default waveform
displayed on the waveform ares is Flow vs. Time waveform. Select Setup softkey > Display tab >
Waveform Display button and select Volume to set the waveform display.

FIGURE 5-23 Example Simulated Volume vs. Time Waveform

Volume vs. Time

The Y-axis of the Volume vs. Time waveform is labeled Volume . The unit of measure is ml. The Y-
axis can automatically adjust the scales. Though the X-axis is not labeled, it represents a time
scale of 0 to 15 seconds.

5.11.4 Gas Waveform (available with the AG module)

The CO2 vs. Time waveform can be displayed in the waveform area.

FIGURE 5-24 Example Simulated CO2 vs. Time Waveform

CO2 vs. Time

The Y-axis of the CO2 vs. Time waveform is labeled CO2 . The unit of measure is mmHg, kPa, or %.
The Y-axis can automatically adjust the scales. Though the X-axis is not labeled, it represents a
time scale of 0 to 15 seconds.

NOTE: N2O, O2, and AA waveforms are available for software bundle version
02.06.00 and later.

The N2O vs. Time waveform can be displayed in the waveform area.

FIGURE 5-25 Example Simulated N2O vs. Time Waveform (available with the AG module)

A5™ Operating Instructions 046-002773-00 5 - 23

Parameter Monitoring (Waveforms) Operations

N2O vs. Time

The Y-axis of the N2O vs. Time waveform is labeled N2O . The unit of measure is %. You can adjust
the scales of the Y-axis (See “Gas Scales (software bundle version 02.06.00 and later, with an AG
module connected)” on page 3-37.). Though the X-axis is not labeled, it represents a time scale of
0 to 15 seconds.

O2 vs. Time waveform can be displayed in the waveform area.

FIGURE 5-26 Example Simulated O2 vs. Time Waveform (available with the AG module)

O2 vs. Time

The Y-axis of the O2 vs. Time waveform is labeled O2 . The unit of measure is %. You can adjust the
scales of the Y-axis (See “Gas Scales (software bundle version 02.06.00 and later, with an AG
module connected)” on page 3-37.). Though the X-axis is not labeled, it represents a time scale of
0 to 15 seconds.

AA vs. Time waveform can be displayed in the waveform area.

FIGURE 5-27 Example Simulated AA vs. Time Waveform (available with the AG module)

AA vs. Time

The Y-axis of the AA vs. Time waveform is labeled AA . The unit of measure is %. You can adjust
the scales of the Y-axis (See “Gas Scales (software bundle version 02.06.00 and later, with an AG
module connected)” on page 3-37.). Though the X-axis is not labeled, it represents a time scale of
0 to 15 seconds. If no agent is detected, the system displays AA vs. Time waveform (see FIGURE 5-
27). If an anesthetic agent such as sevoflurane is detected, the system displays Sev vs. Time
waveform (see FIGURE 5-28)..

FIGURE 5-28 Example Simulated Sev vs. Time Waveform (available with the AG module)

5.11.5 Waveform Autoscaling

If the measured values of Paw, Flow, or Volume are larger than the boundary at the end of the
breath cycle, the system will autoscale the Paw, Flow, or Volume at the beginning of next breath
cycle.

5 - 24 046-002773-00 A5™ Operating Instructions

Operations Parameter Monitoring (Spirometry)

If the measured values of Paw, Flow, or Volume are less than the boundary minus a margin (see
TABLE 5-1) at the end of two continuous breath cycles, the system will autoscale the Paw, Flow, or
Volume at the beginning of the next breath cycle.

SCALE MARGIN
Paw 10 cmH2O if PAW ≥ 30 cmH2O
3 cmH2O if PAW < 30 cmH2O
Flow 10 L/min if Flow ≤ 30 L/min
15 L/min if Flow > 30 L/min
Volume 25 mL if volume ≤ 100 mL
100 mL if volume > 100 mL
TABLE 5-1 Autoscaling Margins of Paw, Flow, and Volume

5.12 Parameter Monitoring (Spirometry)

Spirometry is a respiratory monitoring technology that provides continuous (breath-by-breath)
measurement of patient lung mechanics. The resultant pressure, volume, flow, compliance, and
resistance data enables quick assessment of the patient’s pulmonary status.

Open the Spirometry Loop Window by selecting the SPIROMETRY tab.

NOTE: Thespirometry and waveforms can be displayed on the same screen in

software bundle version 02.06.00 and later (see section 3.5 (page 3-14)
"Spirometry Tab (A5 Only)").

Currently plotting loop, reference loop, and baseline loop can be displayed in manual and
mechanical ventilation modes.

End the case will clear spirometry loops (baseline and reference loops).

NOTE: This will not occur when the Restore default settings box is unselected .

Restart the machine will clear spirometry loops (baseline and reference loops).

Spirometry is disabled in Bypass mode. If Bypass mode is entered when the Spirometry tab is
open, then the system will switch to the Waveforms tab.

A5™ Operating Instructions 046-002773-00 5 - 25

Parameter Monitoring (Spirometry) Operations

Pressure - Volume Spirometry Loop

FIGURE 5-29 is an example of the Pressure-Volume loop.

FIGURE 5-29 Pressure-Volume Loop

The Y-axis of the Pressure-Volume Spirometry loop represents Volume. The X-axis is labeled Paw
(which represents Airway Pressure).

Flow-Volume Spirometry Loop

FIGURE 5-30 is an example of the Flow-Volume loop.

FIGURE 5-30 Flow-Volume Loop

The Y-axis of the Flow-Volume Spirometry loop represents Flow. The X-axis represents Volume.

5 - 26 046-002773-00 A5™ Operating Instructions

Operations Parameter Monitoring (Spirometry)

Pressure - Flow Spirometry Loop

FIGURE 5-31 is an example of the Pressure - Flow loop.

FIGURE 5-31 Pressure - Flow Loop

The Y-axis of the Pressure - Flow Spirometry loop labeled PAW represents airway pressure. The X-
axis represents Flow.

A5™ Operating Instructions 046-002773-00 5 - 27

Parameter Monitoring (Spirometry) Operations

This page intentionally left blank.

5 - 28 046-002773-00 A5™ Operating Instructions

 6.0 Alarms and Messages

Introduction .................................................................................................................................................................................................6-2

Displaying Alarms.....................................................................................................................................................................................6-5

Setting Alarm Volume............................................................................................................................................................................6-7

Silencing Alarms........................................................................................................................................................................................6-8

Alarm Limits .................................................................................................................................................................................................6-9

Alarm and Prompt Messages ......................................................................................................................................................... 6-15

A5™ Operating Instructions 046-002773-00 6-1

Introduction Alarms and Messages

6.1 Introduction
The A5 System provides alarms and messages that are indicated to the user by visual and audible
alerts. Alarms and messages appear at the top of the Main Screen and in the Alarms window (see
FIGURE 6-1). Users can adjust alarm properties, which include setting alarm limits to trigger alarm
conditions, adjusting alarm volume, and silencing alarms.

Alarm Messages Area

Alarms Window

Alarms Window Softkey

Silence Alarms Softkey

FIGURE 6-1 Alarms and Messages On The Main Screen and In The Alarms Window

6.1.1 Alarm System Self-Test

The A5 System performs a self-test of its alarm system when powered on. The self-test includes the
alarm LED and speaker as follows:

6-2 046-002773-00 A5™ Operating Instructions

Alarms and Messages Introduction

• During the self-test, the alarm LED will illuminate in sequence with the colors red, yellow, and
cyan for approximately 1 second each color.
• The system speaker will produce one tone after the alarm light is in self-test.

6.1.2 Types of Alarms and Messages

The A5 provides the following types of alarms and messages below. See section 6.6 (page 6-15)
"Alarm and Prompt Messages" for the list of alarms and messages:

• Physiological Alarm:
This is an alarm caused by a patient-related variable. It requires a response from the user. It can
have the following priority: high, medium, or low.
• Technical Alarm:
This is an alarm caused by a machine-related variable. It requires a response from the user. It can
have the following priority: high, medium, or low.
• Prompt Message:
This is a message to the user. It does not require a response from the user. It always has the lowest
priority, below Physiological and Technical alarms. It is displayed in black text on white
background.

A5™ Operating Instructions 046-002773-00 6-3

Introduction Alarms and Messages

6.1.3 Alarm Indicators

The A5 provides the following alarm indicators:

• An alarm LED located on top of the LCD monitor. The LED can illuminate red, yellow, cyan, or
OFF depending on the alarm condition.

TABLE 6-1 describes the alarm behavior of different alarm types and different alarm priority labels.
If multiple alarms occur simultaneously, the audio and LED behavior will follow the highest
priority active alarm.
• Colored alarm messages displayed on the Main Screen. High priority messages are red.
Medium priority messages are yellow. Low priority messages are cyan. Prompt messages are
black text, white background. Messages are displayed according to priority and time. (See
‘‘Displayed Order of Alarm Messages’’ on page 6-6.)
• Alarm audio through the system alarm speaker. TABLE 6-1 lists the audio behavior for each
type of alarm.

ALARM
ALARM LED
ALARM TYPE PRIORITY AUDIO BEHAVIOR MESSAGE BEHAVIOR COLOR
Physiological High Play high priority alarm white text red Red
Alarm sound, the interval between background, high
each play is 5 ± 1 sec. priority icon.

Medium Play medium priority alarm black text yellow Yellow

sound, the interval between background, medium
each play is 5 ± 1 sec. priority icon.

Low Play low priority alarm sound, white text cyan Cyan
the interval between each background, low
play is 17 ± 1 sec. priority icon.

Technical High Play high priority alarm white text red Red
Alarm sound, the interval between background, high
each play is 5 ± 1 sec. priority icon.

Medium Play medium priority alarm black text yellow Yellow

sound, the interval between background, medium
each play is 5 ± 1 sec. priority icon.

Low Play low priority alarm sound, white text cyan Cyan
the interval between each background, low
play is 17 ± 1 sec. priority icon.

Prompt None None black text with white Off

Message background

TABLE 6-1 Alarm Indicators (Audio and On-screen Messages)

6-4 046-002773-00 A5™ Operating Instructions

Alarms and Messages Displaying Alarms

6.2 Displaying Alarms

On the LCD monitor screen, alarm messages are automatically displayed at the top area of the Main
Screen when alarm conditions occur (see FIGURE 6-3). Additionally, a list of all active alarms and an
alarm log can be found in the Alarms window (see FIGURE 6-2).

Each message is displayed with an associated priority symbol as follows:

• High priority

• Medium priority

• Low priority

To display a list of all active alarms:

1. On the Main Screen, select the Alarms softkey or touch the Alarm Message area at the top
of the screen.
The Alarms windows is displayed.
2. Select the Active tab.
A list of all active alarm messages is displayed (see FIGURE 6-2). Up to 15 current alarms can
be displayed on screen, after which a scroll bar is used to display the remaining alarms.

Alarms are displayed in order of priority and time. See section 6.2.1 (page 6-6) "Displayed
Order of Alarm Messages" for more information.

FIGURE 6-2 Active Alarms list in the Alarms window

A5™ Operating Instructions 046-002773-00 6-5

Displaying Alarms Alarms and Messages

6.2.1 Displayed Order of Alarm Messages

Alarm messages are displayed in order of priority and time of occurrence. FIGURE 6-3 shows the
alarm messages list divided into two areas (Area A and Area B).

Area A (Highest priority AND most recent alarm)

Area B (Less priority or less recent alarms)

FIGURE 6-3 Displayed order of alarm messages

Alarm messages are displayed in Area A and Area B according to the following rules:

• To be in Area A, an alarm must be both the highest priority AND the most recent (Area A does not
cycle). The remaining active alarms and prompt messages cycle in Area B.
• New Alarms with less priority than alarms in Area A are displayed immediately in Area B, and the
cycle proceeds from that position in the list.
• Alarms cycling in Area B are grouped and displayed in the following order: highest priority,
medium priority, low priority, and prompt messages. In each group, the most recent alarm is
displayed first.
• If the alarm in Area A is removed, then the most recent and highest priority alarm from Area B is
moved to Area A.

6-6 046-002773-00 A5™ Operating Instructions

Alarms and Messages Setting Alarm Volume

6.3 Setting Alarm Volume

Users can set the audio level of alarms and system alerts by selecting the Alarms softkey on the Main
Screen to display the Alarms window (see FIGURE 6-4).

The Alarms volume settings adjust the audio level of all High, Medium, and Low Priority sounding
alarms. The System Alerts volume settings adjust the audio level of all sounding pop-up prompts
and non-confirmed ventilation mode alerts.

To set the Alarm Volume:

1. On the main screen, select the Alarms softkey.

The Alarms window is displayed.
2. Select the Audio tab.
Volume controls for Alarms and System Alerts are displayed.
3. Adjust the volume by selecting the + (increase) or – (decrease) buttons.
The Alarms volume has 10 levels of adjustment. Default level is 3.
The System Alerts volume has 10 levels of adjustment. Default level is 3.
4. Select Accept to activate your changes and exit the Alarms window. (Selecting Cancel will
discard your changes and exit the Alarms window.)

FIGURE 6-4 Audio Tab

WARNING: Do not rely exclusively on the audible alarm system when using the A5
Anesthesia System. Adjustment of alarm volume to a low level may
result in a hazard to the patient. Always keep the patient under close
surveillance.

NOTE: The auditory alarm signal A-weighted sound pressure level is within 45
to 85 dB.

A5™ Operating Instructions 046-002773-00 6-7

Silencing Alarms Alarms and Messages

6.4 Silencing Alarms

When an alarm condition occurs and the alarm audio is sounded, the user can select the Silence
softkey at the bottom of screen to silence the alarm audio. In silenced status, all the alarm indicators
work normally except audible alarm tones.

Select Silence softkey to silence all currently sounding alarm tones. The alarm will sound if a new
alarm occurs.

If the silenced alarms contain middle or high level alarms, the alarm audio will be paused for 120
seconds.The alarm silence icon and 120 second countdown time appear at the top of the screen.
Select again to resume the alarm audio.

NOTE: The alarm will sound if that a new alarm occurs while the system is in an
audio-paused state. If this occurs, you can select the Silence softkey
again to silence the new alarm and reset the silence countdown timer to
120 seconds.

Alarm audio-paused Icon 120 second countdown time icon

FIGURE 6-5 Alarm Audio-paused

If the silenced alarms are only low level alarms, the alarm audio will be turned off till there is a new
alarm occurs.

NOTE: The alarm will sound if that a new alarm occurs while the system is in an
audio-off state. If the new alarm is low level alarm, you can select the
Silence softkey again to turn off the new alarm audio. If the new alarm
is medium or high level alarm, you can select the Silence softkey again
to silence the new alarm for 120 seconds.

Alarm audio-off icon

FIGURE 6-6 Alarm Audio-off

6-8 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm Limits

6.5 Alarm Limits

6.5.1 Setting Alarm Limits
Users can set the high and low alarm limits of Paw, MV, and FiO2 to create alarm conditions consistent
with patient needs. The alarm is then triggered when the parameter value is greater than the High
Limit or lesser than the Low Limit.

NOTE: When using the A5 Anesthesia System, ensure that the alarm limits of
each parameter are set to the appropriate values for the patient.

There are two ways to set alarm limits:

1. On the main screen, select the Alarms softkey. The Alarms windows is displayed.

Alarm Softkey

or

When the monitoring value on the main screen is flashing , select the flashing area to open
the Alarms window with the currently alarming parameter selected.

Flashing monitoring value

2. Select the Limits tab or Agents tab. (see FIGURE 6-7, FIGURE 6-8 and FIGURE 6-9.)
3. Select a parameter softkey.
The softkey is highlighted when selected.
4. Use the on-screen keypad to enter the desired parameter value, or continuously press

the or buttons to rapidly increase or decrease the parameter value.

For each parameter, the range of values is displayed above the keypad. The section ‘‘Alarm
Limits’’ on page C-3 also lists the range of values for the parameters.
5. Optionally, to restore the default values, select the Load Alarm Defaults button. This
restores the high and low values for the parameters to the user default values.
6. Repeat Steps 3 to 4 for each parameter value.
Select Accept to save the change (or select Cancel to not save).

A5™ Operating Instructions 046-002773-00 6-9

Alarm Limits Alarms and Messages

FIGURE 6-7 Limits tab in the Alarms Window (without AG module connected)

FIGURE 6-8 Limits tab in the Alarms Window (with AG module connected)

6 - 10 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm Limits

FIGURE 6-9 Agents tab in the Alarms Window (with AG module connected)

A5™ Operating Instructions 046-002773-00 6 - 11

Alarm Limits Alarms and Messages

6.5.2 Loading Alarm Defaults

Users can load the user alarm limit defaults of all modules from the Alarms window.

To load alarm limit defaults:

1. On the Main Screen, select the Alarms softkey.

The Alarms windows is displayed.
2. Select the Load Alarm Defaults button at the bottom of the Alarms window.
This restores the high and low values for the parameters to the user default values.
3. Select the Accept button to save these settings and close the Alarms window.

Load Alarm Defaults button

FIGURE 6-10 Load Alarm Defaults button in the Alarms window (without AG module
connected)

Load Alarm Defaults button

FIGURE 6-11 Load Alarm Defaults button in the Alarms window (with AG module
connected)

6 - 12 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm Limits

Load Alarm Defaults button

FIGURE 6-12 Load Alarm Defaults button in the Agents window (with AG module
connected)

A5™ Operating Instructions 046-002773-00 6 - 13

Alarm Limits Alarms and Messages

6.5.3 Auto Alarm Limits

The Auto Alarm Limits function uses an algorithm based on measured values. The relationship is
shown in the TABLE 6-2.

The Auto Alarm Limits button is disabled when the A5 is in Standby mode, Manual mode or Monitor
mode (with AG module). The Auto Alarm Limits button is also disabled when the current mode is PS,
SIMV-VC, or SIMV-PC.

ALARM LIMIT ADJUST FORMULA

Paw High PEAK+5 or PLAT+10, whichever is greater
minimum 35 cmH2O
Paw Low (PLAT-PEEP) x 0.6 + PEEP - 1
minimum 3 cmH2O
maximum Paw High - 1
MV High MV x 1.4
minimum 2.0 L/min
MV Low MV x 0.6
minimum 0.3 L/min
maximum MV High - 0.1
TABLE 6-2 Auto Alarm Limits
The parameters in the formula are all measured parameters. The new alarm limits for Paw are
calculated on the basis of average values for PEAK, PLAT, and PEEP. The value used for average uses
the value of the last four ventilation cycles or the value in one minute, whichever is smaller.
Spontaneous breaths by the patient are not taken into account.

If there is not a valid measured minute volume (MV), the corresponding MV alarm limits will not be
adjusted.

If the average value for PEAK, PLAT, and PEEP cannot be calculated, the corresponding alarm limits
will not be adjusted.

If the calculated alarm limit is more than the high threshold of setting range or less than the low
threshold, the corresponding threshold is used as the auto alarm limit.

6.5.4 Setting CO2 Apnea Delay Time (software bundle version

02.09.00 and later)
The Apnea CO2 alarm is triggered when no breath is detected within a specified time.

To set the CO2 Apnea Delay Time:

1. On the main screen, select the Alarms softkey.

The Alarms window displays.
2. Select the Limits tab. (see FIGURE 6-7 and FIGURE 6-8)
3. Select the CO2 Apnea Delay Time button and set it to 10 sec, 15 sec, 20 sec, 25 sec, 30 sec,
35 sec, or 40 sec.

6 - 14 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm and Prompt Messages

6.6 Alarm and Prompt Messages

This section lists the following alarms and messages:

• Physiological Alarm Messages

• Technical Alarm Messages
• Prompt Messages

For each alarm message, corresponding actions are given instructing you to troubleshoot problems.
If the problem persists, contact your service personnel.

NOTE: The Disable in Manual and Cardiac Bypass mode column indicates how
this alarm is controlled by the alarm on/off button and the cardiac
bypass mode button in manual mode.

NOTE: The Disabled in Standby mode column indicates which physiological

alarms will be disabled automatically in Standby mode.

NOTE: The Disabled in Monitor mode column indicates which physiological

alarms will be disabled automatically in Monitor mode.

Physiological Alarm Messages

DISABL
DISABLED DISABLED ED IN
WHEN IN MONIT
ALARM ALARM IS STANDBY OR
MESSAGE CAUSE PRIORITY OFF MODE MODE
Apnea Two triggering conditions Medium Yes N/A * Yes
occur simultaneously:
1. Paw < (PEEP+3) cmH2O for
more than 30 seconds
2. Vt < 10 mL for more than
30 seconds
Apnea >2 min No breath has been detected High Yes N/A * Yes
within the last 120 seconds.
Paw Too High Ppeak ≥ Paw high alarm limit High Yes N/A * Yes
setting
Paw Too Low Ppeak ≤ Paw low alarm limit High Yes N/A * Yes
setting for 20 seconds
Pressure Paw ≥ Plimit Low N/A * N/A * N/A
Limiting
FiO2 Too High FiO2 > high alarm limit Medium No N/A * No
setting
FiO2 Too Low FiO2< low alarm limit setting High No N/A * No
MV Too High MV > high alarm limit setting Medium Yes N/A * Yes
MV Too Low MV < low alarm limit setting Medium Yes N/A * Yes
Continuous Paw in the breathing circuit > High No N/A * Yes
Airway sustained airway pressure
Pressure alarm limit for 15 seconds
Negative Paw < -10 cmH2O for 1 High No N/A * Yes
Pressure second.
* N/A - Not Applicable. This alarm message does not exist within this mode and therefore cannot be disabled
or enabled.
TABLE 6-3 Physiological Alarm Messages

A5™ Operating Instructions 046-002773-00 6 - 15

Alarm and Prompt Messages Alarms and Messages

DISABL
DISABLED DISABLED ED IN
WHEN IN MONIT
ALARM ALARM IS STANDBY OR
MESSAGE CAUSE PRIORITY OFF MODE MODE
EtCO2 Too EtCO2 > high alarm limit Medium No Yes No
High setting
EtCO2 Too Low EtCO2 < low alarm limit Medium No Yes No
setting
FiCO2 Too High FiCO2 > high alarm limit Medium No Yes No
setting
EtN2O Too EtN2O > high alarm limit Medium No Yes No
High setting
EtN2O Too Low EtN2O < low alarm limit Medium No Yes No
setting
FiN2O Too FiN2O > high alarm limit Medium No Yes No
High setting
FiN2O Too Low FiN2O < low alarm limit Medium No Yes No
setting
EtHAL Too EtHAL > high alarm limit Medium No Yes No
High setting
EtHAL Too Low EtHAL < low alarm limit Medium No Yes No
setting
FiHAL Too High FiHAL > high alarm limit Medium No Yes No
setting
FiHAL Too Low FiHAL < low alarm limit Medium No Yes No
setting
EtENF Too High EtENF > high alarm limit Medium No Yes No
setting
EtENF Too Low EtENF < low alarm limit Medium No Yes No
setting
FiENF Too High FiENF > high alarm limit Medium No Yes No
setting
FiENF Too Low FiENF < low alarm limit Medium No Yes No
setting
EtISO Too High EtISO > high alarm limit Medium No Yes No
setting
EtISO Too Low EtISO < low alarm limit Medium No Yes No
setting
FiISO Too High FiISO > high alarm limit Medium No Yes No
setting
FiISO Too Low FiISO < low alarm limit Medium No Yes No
setting
EtSEV Too High EtSEV > high alarm limit Medium No Yes No
setting
EtSEV Too Low EtSEV < low alarm limit Medium No Yes No
setting
FiSEV Too High FiSEV > high alarm limit Medium No Yes No
setting
* N/A - Not Applicable. This alarm message does not exist within this mode and therefore cannot be disabled
or enabled.
TABLE 6-3 Physiological Alarm Messages

6 - 16 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm and Prompt Messages

DISABL
DISABLED DISABLED ED IN
WHEN IN MONIT
ALARM ALARM IS STANDBY OR
MESSAGE CAUSE PRIORITY OFF MODE MODE
FiSEV Too Low FiSEV < low alarm limit Medium No Yes No
setting
EtDES Too High EtDES > high alarm limit Medium No Yes No
setting
EtDES Too Low EtDES < low alarm limit Medium No Yes No
setting
FiDES Too High FiDES > high alarm limit Medium No Yes No
setting
FiDES Too Low FiDES < low alarm limit Medium No Yes No
setting
EtO2 Too High EtO2 > high alarm limit Medium No Yes No
setting
EtO2 Too Low EtO2< low alarm limit setting Medium No Yes No
Apnea CO2 No breath is detected and High Yes Yes No
Apnea time ≥ Apnea alarm
time.
* N/A - Not Applicable. This alarm message does not exist within this mode and therefore cannot be disabled
or enabled.
TABLE 6-3 Physiological Alarm Messages

NOTE: If an Apnea CO2 alarm occurs, the CO2 apnea elapse timer will display
on the CO2 waveform screen. The time displayed is the time since the
last breath and the time will reset once the CO2 Apnea alarm has
cleared (software bundle version 02.06.00 and later).

A5™ Operating Instructions 046-002773-00 6 - 17

Alarm and Prompt Messages Alarms and Messages

6.6.1 Technical Alarm Messages

6.6.1.1 Startup Alarm Messages
NOTE: Startup alarms will not trigger the alarm sound and alarm light.

NOTE: Startup alarms priority is only used to display in the Service menu
alarm logbook.

NOTE: Startup Result if Fail column indicates the result when this startup
phase alarm is triggered, which may be ALL, only manual, and Non-
Functional.

NOTE: “All” indicates that all Automatic Ventilation, Manual Ventilation, and
Cardiac Bypass modes are enabled.

“Only Manual” indicates that only Manual Ventilation and Cardiac

Bypass modes are enabled.

“Non-Functional” indicates that the A5 Anesthesia System cannot be

used.

MACHINE
MODE STARTUP
ALARM WHEN RESULT IF
MESSAGE CAUSE PRIORITY CHECKED FAIL REMARK
Bundle Version Incompatible firmware High Startup Non- CPU Board
Error / version is installed. Functional
Incompatible
version found
Bundle Version: Self-test result cannot High Startup Non- CPU Board
Time out be obtained due to an Functional
internal communication
error.
Flowmeter DVCC, AVDD or VC High Startup Only Electronic
Voltage Error / voltage error Manual Flowmeter
Flowmeter Board
Voltage: Fail
Flowmeter Self CPU, Flash or WTD error High Startup Non- Electronic
Test Error / Functional Flowmeter
Flowmeter Self Board
Test Fail
Flowmeter Self Self-test result cannot High Startup Non- Electronic
Test: Time out be obtained due to an Functional Flowmeter
internal communication Board
error.
Aux Control 1. CPU, Flash or WTD High Startup Non- Aux Vent
Module Self Test error Functional Control
Error / Aux 2. After power on, CPU Board
Control Module board can't
Self Test: Fail communicate with the
Aux Control board.
Aux Control Self-test result cannot High Startup Non- Aux Vent
Module Self be obtained due to an Functional Control
Test: Time out internal communication Board
error.
TABLE 6-4 Startup Alarm Messages

6 - 18 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm and Prompt Messages

MACHINE
MODE STARTUP
ALARM WHEN RESULT IF
MESSAGE CAUSE PRIORITY CHECKED FAIL REMARK
Ventilator Self 1. CPU, TIMER, RAM, High Startup Non- Ventilator
Test Error / WTD, EEPROM or AD Functional Control
Ventilator Self error Board
Test: Fail 2. After power on, CPU
board cannot
communicate with the
ventilator board.
Ventilator Self Self-test result cannot High Startup Non- Ventilator
Test: Time out be obtained due to an Functional Control
internal communication Board
error.
Ventilator 5V or 12V voltage error High Startup Only Ventilator
Voltage Error / Manual Control
Ventilator Board
Voltage: Fail
PEEP Valve 1. PEEP valve voltage Medium Startup Only Ventilator
Failure / PEEP error. Manual Control
Valve: Fail 2. PEEP valve pressure Board
error.
Insp Valve 1. Inspiratory valve Medium Startup Only Ventilator
Failure / Insp voltage error. Manual Control
Valve: Fail 2. Inspiratory valve flow Board
error.
Safety Valve PEEP safety valve Medium Startup Only Ventilator
Failure / Safety voltage error. Manual Control
Valve: Fail Board
Flow Sensor Ventilator flow is out of Low Startup Only Ventilator
Failure / Flow range. Manual Control
Sensor: Fail Board
Calibrate Flow 1. Calibration table isn't Low Startup Only Ventilator
Sensor and Insp found in EEPROM. Manual Control
Valve 2. Checksum of Board
Calibration table does
not match.
Calibrate 1. Calibration table isn't Low Startup Only Ventilator
Pressure Sensor found in EEPROM. Manual Control
and PEEP Valve 2. Checksum of Board
Calibration table does
not match.
Perform 100% 1. Calibration table isn't Low Startup All Ventilator
O2 Sensor found in EEPROM. Control
Calibration 2. Checksum of Board
Calibration table does
not match.
Ventilator After powering on, CPU High Startup Non- CPU Board
Initialization board cannot send the Functional
Error / parameter settings to
Ventilator the ventilator board.
Initialization:
Fail
TABLE 6-4 Startup Alarm Messages

A5™ Operating Instructions 046-002773-00 6 - 19

Alarm and Prompt Messages Alarms and Messages

MACHINE
MODE STARTUP
ALARM WHEN RESULT IF
MESSAGE CAUSE PRIORITY CHECKED FAIL REMARK
Ventilator Self-test result cannot High Startup Non- CPU Board
Initialization: be obtained due to an Functional
Time out internal communication
error.
Drive Gas Drive Gas Pressure is High Startup All Ventilator
Pressure Low low. Control
Board
O2 Supply O2 Supply Failure. High Startup All Ventilator
Failure / O2 Control
Supply: Fail Board
Power Supply 3.3V, 5V, 12V voltage High Startup Only Power
Voltage Error / error. Manual Board
Power Supply
Voltage: Fail
RT Clock Needs There is no button High Startup only All CPU Board
Battery battery cell available in
the system, or the
button battery cell
power is depleted.
RT Clock Failure RT chip malfunction. High Startup only All CPU Board
/ RT Clock: Fail
External AG Self If the module sends the Low Startup only All AG
Test Error ErrorMsg, except for Module
data limit error and
unspecified accuracy,
"External AG Self Test
Error" will be triggered.
External AG: External AG selftest Low Startup only All AG
Time out result can not be Module
obtained due to
communication error.
TABLE 6-4 Startup Alarm Messages

6.6.1.2 CPU Board Runtime Alarm

MACHINE DISABLE IN
ALARM MODE WHEN STANDBY
MESSAGE CAUSE PRIORITY CHECKED MODE
IP Address Conflict The IP address of the Medium Runtime No
machine is the same as
the IP address of another
device in the local
network.
Fan Failure Speed of the fan ≤ 20% of Medium Runtime No
normal speed
Fan Failure O2 Speed of Module Rack Medium Runtime No
fan < 3640
TABLE 6-5 CPU Board Runtime Alarm Messages

6 - 20 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm and Prompt Messages

6.6.1.3 Power Board Runtime Alarm

MACHINE DISABLE IN
ALARM MODE WHEN STANDBY
MESSAGE CAUSE PRIORITY CHECKED MODE
Power System Lost communication with High Runtime No
Comm Stop CPU board for 10
seconds.
Power Supply 3.3V, 5V, 12V voltage error High Runtime No
Voltage Error
Low Battery Battery voltage is less High Runtime No
Voltage! than 10.6V for 5 seconds.
System going Battery voltage is less High Runtime No
DOWN, Battery than 10.2V.
depleted!
Battery Battery undetected Medium Runtime No
Undetected
Battery in Use AC power fail Low Runtime No
Power Board High Power board temperature High Runtime No
Temp is greater than 95° C
Heating Module 1. Both resistance Low Runtime No
Failure temperatures are greater
than 105° C or less than 0°
C for 20 seconds.
2. One of the resistance
temperatures is greater
than 110° C for 15
seconds.
Breathing Circuit Breathing Circuit is not High Runtime No
Not Mounted mounted.
TABLE 6-6 Power Board Runtime Alarm Messages

NOTE: If the power board loses communication with the CPU board for 10
seconds, the alarm buzzer will be turned on.

NOTE: If the system restarts accidentally, the alarm buzzer will sound for 10
seconds to show notification.

6.6.1.4 Electronic Flowmeter Board Runtime Alarm

MACHINE DISABLE IN
ALARM MODE WHEN STANDBY
MESSAGE CAUSE PRIORITY CHECKED MODE
Flowmeter DVCC, AVDD, or VC voltage High Runtime No
Voltage Error error
N2O Flow Too High N2O flow is greater than 15 Low Runtime No
L/min for 1 second.
O2 Flow Too High O2 flow is greater than 25 L/ Low Runtime No
min for 1 second.
Air Flow Too High Air flow is greater than 20 L/ Low Runtime No
min for 1 second.
TABLE 6-7 Electronic Flowmeter Board Runtime Alarm Messages

A5™ Operating Instructions 046-002773-00 6 - 21

Alarm and Prompt Messages Alarms and Messages

MACHINE DISABLE IN
ALARM MODE WHEN STANDBY
MESSAGE CAUSE PRIORITY CHECKED MODE
O2-N2O Ratio Error N2O flow is greater than 0.5 L/ High Runtime No
min and greater than 4 times
O2 flow for 1.6 seconds.
Flowmeter Comm Lost communication with High Runtime No
Stop CPU board for 10 seconds.
When this alarm is triggered,
the fresh gas flow value will
be displayed as '---'.
NO Fresh Gas Fresh gas flow is less than 50 Medium Runtime Yes
mL/min for 5 seconds when
the machine is not in
Standby mode or Monitor
mode..
Internal N2O Flow The I2C communication Low Runtime No
Failure between the CPU and N2O
flow sensor has failed.
Internal O2 Flow The I2C communication Low Runtime No
Failure between the CPU and O2 flow
sensor has failed.
Internal Air Flow The I2C communication Low Runtime No
Failure between the CPU and Air
flow sensor has failed.
TABLE 6-7 Electronic Flowmeter Board Runtime Alarm Messages

6.6.1.5 Ventilator Control Board Runtime Alarm

MACHINE DISABLE IN
ALARM MODE WHEN STANDBY
MESSAGE CAUSE PRIORITY CHECKED MODE
Aux Control Lost communication with High Runtime No
Module Comm CPU board for 10 seconds.
Stop
Ventilator Voltage 5V or 12V voltage error High Runtime No
Error
PEEP Valve Failure 1. PEEP valve voltage error Medium Runtime No
2. PEEP valve pressure
error
Insp Valve Failure 1. Inspiratory valve voltage Medium Runtime No
error
2. Inspiratory valve flow
error
Safety Valve PEEP safety valve voltage Medium Runtime No
Failure error
Flow Sensor 1. Inspiratory flow is out of Low Runtime No
Failure range.
2. Expiratory flow is out of
range.
* N/A - Not Applicable. This alarm message does not exist within this mode and therefore cannot be
disabled or enabled.
TABLE 6-8 Ventilator Control Board Runtime Alarm Messages

6 - 22 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm and Prompt Messages

MACHINE DISABLE IN
ALARM MODE WHEN STANDBY
MESSAGE CAUSE PRIORITY CHECKED MODE
Check Flow 1. Inspiratory reverse flow High Runtime N/A *
Sensors 2. Expiratory reverse flow
Pinsp Not Pinsp does not reach the Low Runtime N/A *
Achieved Pinsp setting in pressure
mode.
Vt Not Achieved Vt does not reach the Vt Low Runtime N/A *
setting in volume mode.
Auto Ventilation When system is in the Auto High Runtime N/A*
Disabled Ventilation, Non functional
state
Automatic The machine is in the Low Runtime No
Ventilation automatic ventilation
Disabled disabled state.
Auto Ventilation Automatic Circuit Leak Low Runtime No
Disabled-Leak Test Test failed, and the result is
Failed "Manual Only".
Patient Circuit 1. Ppeak is less than Medium Runtime N/A
Leak 2cmH2O for continuously
30s during mechanical
ventilation.
2. Patient is not connected.
CO2 Absorber CO2 Canister is not High Runtime No
Canister Not mounted.
Locked
O2 Sensor O2 Sensor is not Low Runtime No
Disconnected connected.
Replace O2 sensor The O2 value is less than Medium Runtime No
5%.
Perform 100% O2 O2 value is greater than Low Runtime No
Sensor Calibration 110% or between 5% and
15% for 3 seconds.
Ventilator Comm Lost communication with High Runtime No
Stop the CPU board for 10
seconds.
Drive Gas Pressure Drive Gas Pressure is low. High Runtime No
Low
O2 Supply Failure O2 Supply Failure High Runtime No
Fresh Gas Flow In VCV and SIMV-VC Low Runtime N/A
Too High modes, the fresh gas flow
is greater than or equal to
the desired flow.
* N/A - Not Applicable. This alarm message does not exist within this mode and therefore cannot be
disabled or enabled.
TABLE 6-8 Ventilator Control Board Runtime Alarm Messages

A5™ Operating Instructions 046-002773-00 6 - 23

Alarm and Prompt Messages Alarms and Messages

6.6.1.6 Anesthetic Gas (AG) Module Alarm Messages

DISABLE
WHEN
EXTERNAL AG
MACHINE IS IN
ALARM MODE WHEN STANDBY
MESSAGE CAUSE PRIORITY CHECKED MODE
AG Hardware Error AG module Hardware Medium Runtime Yes
Error.
O2 Sensor Error Paramagnetic O2 sensor Medium Runtime Yes
error.
External AG Self Module fault or Low Runtime Yes
Test Error communication failure
between the module and
anesthesia system.
AG Hardware AG module hardware High Runtime Yes
Malfunction malfunction. The AG
module enters Standby
and measurement stops.
AG Init Error The AG module was High Runtime Yes
installed improperly or
malfunctioned.
AG No Watertrap The AG module Low Runtime Yes
watertrap was installed
improperly or not
installed.
AG Watertrap Type When the patient type is Low Runtime Yes
Wrong infant, but the watertrap
type is adult/pediatric,
this alarm will be
triggered.
AG Change When the actual flow is Medium Runtime Yes
Watertrap less than 75% of the set
flow, the alarm indicates
that the watertrap is
gradually occluded and it
is necessary to replace
the water trap.
AG Comm Stop AG module malfunction High Runtime No
or communication
failure.
AG Airway Pump rate is lower than High Runtime Yes
Occluded 20ml/min for 1 second.
AG Zero Failed Gas measurements may Low Runtime Yes
have bad accuracy
during zeroing.
Mixed Agent and More than one Low Runtime Yes
MAC < 3 anesthetic gas and MAC
<3
Mixed anesthetic More than one Medium Runtime Yes
gas and MAC >= 3 anesthetic gas and MAC
>= 3

TABLE 6-9 AG Module Alarm Messages

6 - 24 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm and Prompt Messages

DISABLE
WHEN
EXTERNAL AG
MACHINE IS IN
ALARM MODE WHEN STANDBY
MESSAGE CAUSE PRIORITY CHECKED MODE
External AG When external AG High Runtime No
Module module is removed, this
Disconnected alarm will be triggered.
Incompatible AG The AG Version Limit is High Runtime No
Software Version On, and the AG module is
loaded while the AG
software version is lower
than 1.7.3.0.
CO2 Over Range The monitoring value Low Runtime Yes
N2O Over Range exceeds the measurable
range.
HAL Over Range
ENF Over Range
ISO Over Range
SEV Over Range
DES Over Range
O2 Over Range
Rate Over Range The monitoring value of Low Runtime Yes
Rate exceeds the
measurable range when
this type of alarm is
triggered, “--” will be
displayed.

TABLE 6-9 AG Module Alarm Messages

A5™ Operating Instructions 046-002773-00 6 - 25

Alarm and Prompt Messages Alarms and Messages

6.6.2 Prompt Messages

6.6.2.1 Prompt Messages Displayed in Alarm Area

MESSAGE TIMEOUT REMARK

Pressure, Volume and Correspond status This Alarms Off icon and message appear on a
Apnea Alarms are OFF does not exist. white background when the Alarms button in
the Manual mode tab is set to Off.
CO2 and CO2 Apnea Alarms Correspond status This message appears when the CO2 Alarms
are OFF does not exist. button in the Manual mode tab is set to OFF.
Load Configuration Failure 10 sec This message appears when the download or
latest configuration update failed.
DEMO Mode - Not for Never This message appears when the system is set to
Clinical Use demo mode from the Service tab.
Service Mode - Not for Never This message appears when the machine is
Clinical Use worked in Service mode.
Apnea Ventilation Correspond status This message appears when the Min Rate
does not exist. triggers a breath in PS ventilation mode.
Calibrate O2 sensor for 21% • When the machine is powered on, if more than 72 hours have elapsed
since the last successful calibration, the prompt message "Calibrate O2
sensor for 21%" is displayed. The message disappears after successful
calibration.
• If the machine is kept powered on, the prompt message “Calibrate O2
sensor for 21%” is displayed at the next Standby mode after 5am after
72 hours have elapsed since the last successful calibration.
• If the alarm message "RT Clock Needs Battery" or "RT Clock Failure"
is displayed, the prompt message "Calibrate O2 sensor for 21%" is
disabled.
• If the calibrate time is empty, the prompt message "Calibrate O2
sensor for 21%" is displayed.
Auto-zero in process Correspond status This message appears when auto-zeroing of the
does not exist. pressure sensors is in process.
Fresh Gas Is On Correspond status This message is displayed if the fresh gas flow
does not exist. value is flashing in Standby mode.
New functions activated, After the machine This message appears when activation
please restart! restart successfully completed.
Calibrate )2 sensor for It will not disappear This message displays when the 100%
100% until 02 sensor calibration data could not be revised correctly
calibration after 21% O2 sensor calibrate successfully.
successfully
performed
Could not locate time server It will not disappear This message displays when the Interval SNTP
until the Interval of Protocol is not Off and the time server is
SNTP Protocol is set unavailable for five (5) intervals.
to Off or the time
server is available
again.
External AG Loaded 5s “External AG Loaded Successfully.” and “External
Successfully AG Unloaded.” will not display at the same time.
Only the latest one will be shown when both of
External AG Unloaded 5s
them exist.
Successfully
External AG Startup / External AG module is starting up. This prompt
message is triggered by External AG.
TABLE 6-10 Prompt Messages Displayed in Alarm Area

6 - 26 046-002773-00 A5™ Operating Instructions

Alarms and Messages Alarm and Prompt Messages

MESSAGE TIMEOUT REMARK

External AG Warmup / External AG module is warming up. This prompt
message is triggered by External AG.
External AG Zeroing / Gas concentrations cannot be measured during
zero, instead the last measured concentrations
are reported to the application.
Leak Test Not Performed Only appears in This message displays when either the
standby mode. It automatic leak test or manual leak test was
will disappear skipped from startup, or when the last time that
when both the the leak test was performed was more than 24
automatic and hours ago (software bundle version 02.06.00
manual leak test and later).
has been
performed.
TABLE 6-10 Prompt Messages Displayed in Alarm Area

6.6.2.2 Prompt Messages Displayed in Pop-up Area

MESSAGE TIMEOUT REMARK

Can only End Case i in 5 sec This message appears if the End Case
Manual Mode! button is selected when the Manual
switch is set to Auto and the machine is in
non-standby.
Invalid Age! Please check 5 sec This message appears after entering the
DOB or current system patient’s date of birth if the calculated age
time. of the patient is outside the accepted
range (0-150).
Patient Size can only be 5 sec This message appears when the Patient
changed in Manual Mode Size selection is pressed while the system
or in Standby is in Automatic Ventilation mode.
Vent modes can only be 5 sec This message appears when the Current
changed using "Set Mode" Mode area is pressed.
button below
Out of Range 5 sec This message appears when the entered
value is outside the allowable range.
Invalid Password 5 sec This message appears when the entered
password is wrong.
Saving User Configuration 5 sec This message appears when the Saving
has failed. User Configuration process has failed.
New password input is 5 sec This message appears when the new
inconsistent. password and the confirmed new
password do not match.
Automatic ventilation 15 sec This message appears when exiting
disabled. Check lever on Standby mode while the Auto/Manual
breathing system. switch is in Auto position and system is in
the Automatic Ventilation disabled state.
Fresh gas flow detected! After fresh gas flow is This message appears in the first "Manual
Adjust all flowmeters to turned off or after exiting Circuit Leak Test" or "Automatic Circuit
zero "Manual Circuit Leak Leak Test & Compliance Test" screen when
Test" or "Automatic fresh gas flow is detected.
Circuit Leak Test &
Compliance Test" screen.
TABLE 6-11 Prompt Messages Displayed in Pop-up Area

A5™ Operating Instructions 046-002773-00 6 - 27

Alarm and Prompt Messages Alarms and Messages

MESSAGE TIMEOUT REMARK

Access to System settings 5 sec This message appears when the current
only available in Standby mode is in non-standby and the user tries
to enter the Setup > System menu.
Can not end case while 5 sec This message appears when user tries to
fresh gas flow is detected! end the case by pressing the disabled End
Case button while fresh gas is on, Auto/
Manual switch is set to Manual, and the
system is in non-standby.
Set Auto/Manual switch to 1. When triggered by When Auto/Manual switch is in Auto
Manual position before turning on fresh gas, it position and system is in Standby mode,
starting case will disappear after fresh this message will appear in the following
gas flow is turned off or cases:
Auto/Manual switch is 1. Turning on fresh gas
set to Manual; 2. Touching the Waveforms/Spirometry
2. When triggered by screen
touching the Waveforms/
Spirometry screen, it will
disappear after 5 seconds
or Auto/Manual switch
is set Manual.
Set Auto/Manual switch to 5 sec This message appears in the first
Manual position and adjust "Automatic Circuit Leak Test & Compliance
all flowmeters to zero. Test" screen when pressing the disabled
Continue button.
Set Auto/Manual switch to 5 sec This message appears in the first "Manual
Auto position and adjust Circuit Leak Test" screen when pressing the
all flowmeters to zero. disabled Continue button.
Can only End Case in 5s This message displays when the Auto/
Manual Mode! Manual switch is in Auto position and the
system is in non-Standby, then if the user
presses the disabled End Case button.
TABLE 6-11 Prompt Messages Displayed in Pop-up Area

6 - 28 046-002773-00 A5™ Operating Instructions

 7.0 Maintenance

Theory of Operation................................................................................................................................................................................7-3

Block Diagram.............................................................................................................................................................................................7-3

Maintenance Schedule .........................................................................................................................................................................7-4

Breathing System Maintenance.......................................................................................................................................................7-4

Flow Sensor Calibration ........................................................................................................................................................................7-5

O2 Sensor Calibration.............................................................................................................................................................................7-6

Water Build-up in the Flow Sensor ................................................................................................................................................7-9

AGSS Transfer Tube Maintenance...................................................................................................................................................7-9

Electrical Safety Inspection.................................................................................................................................................................7-9

Cleaning and Disinfection................................................................................................................................................................ 7-11

Regular Maintenance .......................................................................................................................................................................... 7-29

A5™ Operating Instructions 046-002773-00 7-1

 Maintenance

WARNING: Do not use a malfunctioning A5 Anesthesia System. Have all repairs and
service done by an authorized service representative.

WARNING: Use a cleaning and disinfection schedule that conforms to your

institution's disinfection and risk-management policies.

• Refer to the material safety data as applicable.

• Refer to the operation and maintenance manuals of all
disinfection equipment.
• Do not inhale fumes that may result from any disinfection process.

WARNING: Do not use talc, zinc stearate, calcium carbonate, corn starch, or similar
material to prevent sticking of the bellows, as these materials may
enter the patient's lungs or airway, causing irritation or injury.

WARNING: Only use lubricants approved for anesthesia or O2 equipment.

WARNING: Do not use lubricants that contain oil or grease. They can burn or
explode in the presence of high O2 concentrations.

WARNING: Obey infection control and safety procedures. Used equipment may
contain blood and body fluids.

WARNING: Movable parts and removable components may present a pinch or a

crush hazard. Use care when moving or replacing system parts and
components.

WARNING: Before using the A5 System (after cleaning or disinfecting), power up

the system and follow the on-screen prompts to perform the leak test
and the compliance test. See section 4.5 (page 4-9) "Leak and
Compliance Tests".

CAUTION: To prevent system damage:

• Refer to the literature supplied by the manufacturer of the

cleaning agent.
• Never use organic, halogenated or petroleum-based solvents,
anesthetics, glass cleaning agents, acetone or other irritant
agents.
• Never use abrasive agents (i.e. steel wool or silver polish) to clean
components.
• Keep all liquids away from electronic components.
• Prevent liquid from entering the equipment.
• All cleaning solutions used must have a pH between 7.0 and 10.5.

CAUTION: Never immerse the oxygen sensor or its connector in any type of liquid.
Dispose of the oxygen sensor per the manufacturer’s specification.

CAUTION: Do not wash the inner surface of the oxygen sensor.

CAUTION: Do not autoclave the following components: Paw gauge, oxygen

sensor, flow sensor, and bellows. These components cannot withstand
immersion or the heat and pressure of autoclaving.

NOTE: No repair should ever be attempted by anyone not having experience

in the repair of devices of this nature. Replace damaged parts with
components manufactured or sold by Mindray. Then test the unit to
ensure that it complies with the manufacturer’s published
specifications.

7-2 046-002773-00 A5™ Operating Instructions

Maintenance Theory of Operation

7.1 Theory of Operation

The A5 System is a pneumatically-driven and electronically-controlled anesthesia machine. Three
types of supply gases are available: N2O, O2, and Air. The user adjusts supply gas flows through the
flowmeters. The mixed gas outputted from the flowmeters is further mixed with the anesthetic agent
inside the anesthetic vaporizer to form fresh gas.

During the inspiratory phase, the microprocessor-controlled inspiratory valve produces the preset
drive gas inspiratory flow and the expiratory valve closes. The drive gas enters the bellows dome in
the patient circuit and depresses the bellows inside the dome to move downward. This forces the gas
inside the bellows to enter the patient's lungs until the end of the inspiratory phase.

During the expiratory phase, the inspiratory valve closes and the expiratory valve opens. The patient
can expire freely. The patient's expired gas, mixed with the fresh gas, enters and lifts the bellows
inside the dome. The drive gas outside the bellows is scavenged to the Anesthetic Gas Scavenging
System (AGSS) until the end of the expiratory phase.

During ventilation, the ventilator performs real-time monitoring over airway pressure and flow. If the
airway pressure or minute volume is outside the user-preset alarm limits, an audible and visible alarm
occurs. When the airway pressure is higher than the limit value determined by the PEAK high alarm
limit, the ventilator enters the expiratory phase automatically to avoid causing injury to the patient.
Additionally, the ventilator has a built-in pressure safety valve that opens at an approximate pressure
of 110 cmH2O (11kPa).

7.2 Block Diagram

Anesthetic Ventilator Anesthetic Gas

Scavenging System
(AGSS)

Anesthetic Gas Hospital’s

Delivery Device Disposal System
(Vaporizer)

Breathing Patient
Anesthetic Gas Delivery System
System

FIGURE 7-1 Block Diagram of A5 System

A5™ Operating Instructions 046-002773-00 7-3

Maintenance Schedule Maintenance

7.3 Maintenance Schedule

The schedules listed in TABLE 7-1 are the minimum frequency based on 2000 hours of usage per year.
The equipment should be serviced more frequently if used more than this yearly usage. Maintenance
should be performed by a trained technician.

NOTE: During cleaning and setup, inspect the parts and seals for damage.
Replace or repair as necessary.

MINIMUM
FREQUENCY MAINTENANCE
Daily Clean the external surfaces.
Every 72 hours Perform 21% O2 calibration (O2 sensor in breathing system).
The A5 will prompt the user for 21% O2 calibration (only for units with an galvanic
O2 cell).
Monthly Water trap on AG module.
Annually Periodic maintenance due, to be performed by a trained technician.
Gas Bench calibration.
Contact Mindray Technical Support for details.
Every three years Periodic maintenance due, to be performed by a trained technician.
Contact Mindray Technical Support for details.
As necessary • Perform 100% O2 calibration after replacing the O2 sensor.
• Replace the O2 sensor if it cannot be calibrated.
• Before installing the cylinder, use a new cylinder gasket on the cylinder yoke.
• Empty the water trap if there is water buildup.
• Replace the sodalime in the canister if sodalime color change is detected. Follow
the manufacturer’s instructions.
• Replace the flow sensor if the seal for the flow sensor is damaged, the membrane
inside the flow sensor is cracked or distorted, or the flow sensor is cracked or
distorted.
• Calibrate the flow sensor after re-installing the cleaned or disinfected flow sensor,
replacing with a new flow sensor, or when tidal volume measurement is inaccurate.
• Replace the transfer tube if it is damaged.
• Inspect the O2 flush button for normal movement. If not ,refer to the service
manual for the disassembling and cleaning.

TABLE 7-1 Maintenance Schedule

7.4 Breathing System Maintenance

When cleaning the breathing system, replace any parts that are visibly cracked, chipped, distorted or
worn. For details, refer to ‘‘Inspect the System’’ on page 4-3 and ‘‘Cleaning and Disinfection’’ on page
7-11.

7-4 046-002773-00 A5™ Operating Instructions

Maintenance Flow Sensor Calibration

7.5 Flow Sensor Calibration

WARNING: Do not perform calibration while the unit is connected to a patient.

NOTE: During calibration, do not operate the pneumatic parts. Do not move or
press the breathing tubes.

NOTE: Calibrate the flow sensor after re-installing the cleaned or disinfected
flow sensor, replacing with a new flow sensor, or when tidal volume
measurement is inaccurate.

The flow sensor must be calibrated whenever the flow volume is out of specification or after
changing the flow sensor.

To calibrate the flow sensor:

1. Ensure that the supply gas pressure is normal.

2. Turn off all fresh gas inputs.
3. Set the ventilation switch to the automatic ventilation position.
4. Remove the bellows and reinstall the bellows housing.
5. Plug the Y-piece of the breathing circuit into the leak test port to close the breathing system.
6. Remove the water trap.
7. Ensure that the system is in Standby mode. If not, select the End Case button in the Manual
tab and follow the screen prompts to end the case and enter Standby mode.
8. Select the Setup softkey, then the Calibrate Flow Sensor button.
9. Follow the on-screen prompts and select the Begin button to start to calibrate the flow
sensor (see FIGURE 7-2). The calibration process takes several minutes. The system will
display the results of the calibration status when the process is completed.
10. Reinstall the bellows and water trap.
11. Select Done to close the Calibration window (see FIGURE 7-3).
12. Select the Accept or Cancel softkey to close the Setup window.

NOTE: In case of repeated calibration failure, contact Mindray Technical

Support.

FIGURE 7-2 Flow Sensor Calibration FIGURE 7-3 Flow Sensor Calibration
Begin Successful

A5™ Operating Instructions 046-002773-00 7-5

O2 Sensor Calibration Maintenance

7.6 O2 Sensor Calibration

Perform O2 calibration when the measured value of O2 concentration has a large deviation from
other reference sources or when the O2 sensor is replaced. If the O2 sensor is replaced, 100% O2
sensor calibration is required.

For continued O2 sensor accuracy, the A5 checks for 21% O2 calibration approximately every 72
hours. The A5 prompts the user for 21% O2 calibration as follows:

• When the machine is powered on, if more than 72 hours have elapsed since the last
successful calibration, the prompt message "Calibrate O2 sensor for 21%" is displayed. The
message disappears after successful calibration.
• If the machine is kept powered on, the prompt message “Calibrate O2 sensor for 21%” is
displayed at the next Standby mode after 5am after 72 hours have elapsed since the last
successful calibration.

NOTE: If the alarm message "RT Clock Needs Battery" or "RT Clock Failure" is
displayed, the prompt message "Calibrate O2 sensor for 21%” is
disabled.

The O2 sensor must be removed from the breathing system before calibrating it at 21%. The O2
sensor can be reinstalled after verifying that there is no water build-up in the O2 sensor and its
installation part.

7-6 046-002773-00 A5™ Operating Instructions

Maintenance O2 Sensor Calibration

7.6.1 Calibrate the O2 Sensor

21% O2 sensor calibration can be performed in all ventilation modes when calibrating from the
Setup > General tab. When calibrating from the Setup > System tab, the A5 must be placed in
Standby mode and a system password is required. See ‘‘System Tab’’ on page 3-38 for password
information.

NOTE: The breathing system automatically seals off the O2 sensor port when
the O2 sensor is removed.

1. Set the A5 to Standby mode:

a. Set the Auto/Manual ventilation switch to Manual.
b. Turn off all fresh gas flows by turning their knobs clockwise. Wait until all fresh gas flow
levels are effectively at 0.0 L/min (i.e., flow < 0.05 L/min).
c. Select the End Case button in the Manual tab.

NOTE: The A5 system will not allow the End Case button to be selected until
the Auto/Manual ventilation switch is set to Manual, and system
detects the individual fresh gas flows are effectively turned off (i.e.,
flow < 0.05 L/min).

d. Follow the screen prompts to end the case and enter Standby mode.
2. Select Setup > General > Calibrate O2 Sensor.
Only 21% O2 sensor calibration is available in the General tab,

or

Select Setup > System (system password needed) > Calibration > O2 Sensor.
Both 21% and 100% O2 sensor calibrations are available in the System tab.
The 21% button is highlighted by default.

NOTE: In the System tab, 21% oxygen sensor calibration must be completed
before performing 100% calibration. The 100% button is disabled if a
21% oxygen sensor calibration has not been successfully completed
within 72 hours.

3. Remove the O2 sensor from the O2 sensor port on the breathing system.
Allow three (3) minutes for the sensor to acclimate to the environment.
4. Carefully follow the on-screen prompts to prepare for calibration.
5. Select the Begin button to start 21% O2 sensor calibration. The system will indicate the
calibration status when the process is completed.
6. When 21% O2 sensor calibration is successfully completed, reinstall the O2sensor into the O2
sensor port on the breathing system. If an error code in red (e.g., 00 00 00 10) is displayed,
see TABLE 7-2, “O2 Sensor Calibration Error Codes,” on page 7-8 for troubleshooting
information.
7. If you are in the Setup > General, select Done when 21% O2 sensor calibration is
completed. Skip the remaining steps below.

or

If you are in the Setup > System and wish to skip 100% O2 sensor calibration, select Done to
close the calibration window. Skip the remaining steps below.
8. Select the 100% button to perform 100% O2 sensor calibration.
9. Carefully follow the on-screen prompts to prepare for calibration.

A5™ Operating Instructions 046-002773-00 7-7

O2 Sensor Calibration Maintenance

10. Select the Begin button to start 100% O2 sensor calibration. The system will indicate the
calibration status when the process is completed. If an error code in red (e.g., 00 00 00 10) is
displayed, see TABLE 7-2, “O2 Sensor Calibration Error Codes,” on page 7-8 for
troubleshooting information.
11. After calibration, select Done to close the calibration window.

NOTE: In case of repeated calibration failures, replace the O2 sensor and

repeat the calibration. If calibration still fails, contact Mindray Technical
Support.

ERROR CODE DESCRIPTION RECOMMENDED ACTION

00 00 00 01 O2 sensor calibration is . Perform O2 sensor calibration again.
canceled.

00 00 00 02 O2 supply pressure is low. . Check that the O2 sensor is connected to the cable
During 100% calibration correctly.
process, O2 supply pressure . Check the O2 supply pressure.
was not sufficient. . Check that the O2 sensor output voltage in the
calibration menu is steady.
. Replace the O2 sensor.
00 00 00 04 O2 sensor is disconnected. . Check that the O2 sensor is connected to the cable
Sampled data is greater correctly.
than 2900 (AD value). . Check that the O2 sensor output voltage in the
calibration menu is steady.
. Replace the O2 sensor.
00 00 00 08 21% calibration value is . Check that the O2 sensor is connected to the cable
outside of the expected correctly.
range (150~500) . Check that the O2 sensor is in 21% O2.
(AD value). . Check that the O2 sensor output voltage in the
calibration menu is steady.
. Replace the O2 sensor.
00 00 00 10 100% calibration value is . Check that the O2 sensor is connected to the cable
outside of the expected correctly.
range (800~2028) (AD . Check that the O2 sensor is in 100% O2.
value). . Check that the O2 sensor output voltage in the
calibration menu is steady.
. Replace the O2 sensor.
00 00 00 20 Error writing to EEPROM. . Repeat the calibration.
. Replace the O2 sensor.
. Replace the CPU board.
TABLE 7-2 O2 Sensor Calibration Error Codes

NOTE: The error code can be a combination of 2 codes e.g. 00 00 00 18 is 00 00

00 10 and 00 00 00 08.

7-8 046-002773-00 A5™ Operating Instructions

Maintenance Water Build-up in the Flow Sensor

7.7 Water Build-up in the Flow Sensor

7.7.1 Prevent Water Build-up
Water comes from the condensation of exhaled gas and a chemical reaction between CO2 and the
sodalime in the CO2 absorbent canister. At lower fresh gas flows more water builds up because of the
following:

• More CO2 stays in the CO2 absorbent canister to react and produce water.
• More moist, exhaled gas stays in the breathing system and CO2 absorbent canister to
produce condensed water.

Check the inspiratory and expiratory flow sensors when abnormal flow waveform or unstable tidal
volume fluctuation is detected. Check the sensor for water. If there is water build-up, clear it
immediately before use.

To prevent water build-up:

• Use a filter between the flow sensor and the patient to limit water condensation in the flow
sensor.
• Check the water trap for water before using the A5 Anesthesia System. If there is water build-
up, clear it immediately.

7.7.2 Clear Water Build-up

The water build-up inside the flow sensor will result in inaccurate measured value of tidal volume. If
there is water built up inside the flow sensor, remove the sensor and clear the water. Then reinstall the
sensor for use.

WARNING: Check water build-up inside the flow sensor before every system use.
Pooled water in the flow sensor causes erroneous readings.

WARNING: Ensure that all breathing system parts are completely dried after the
breathing system is cleaned and disinfected.

7.8 AGSS Transfer Tube Maintenance

Check the tube of the AGSS transfer system.Replace it if it is damaged.

7.9 Electrical Safety Inspection

NOTE: Perform electrical safety inspection after servicing or routine
maintenance. Before the electrical safety inspection, make sure all the
covers, panels, and screws are correctly installed.

NOTE: The electrical safety inspection should be performed once a year.

7.9.1 Auxiliary Electrical Outlet Test

Verify the mains voltage is present at each auxiliary outlet when the A5 is connected with power.

A5™ Operating Instructions 046-002773-00 7-9

Electrical Safety Inspection Maintenance

7.9.2 Electrical Safety Inspection Test

1. Perform protective earth resistance test:
a. Plug the probes of the analyzer into the protective earth terminal and equipotential
terminal of the AC power cord.
b. Test the earth resistance with a current of 25 A.
c. Verify the resistance is less than 0.1ohms (100 mohms).
d. Plug the probes of the analyzer into the protective earth terminal of the AC power cord
and the protective earth terminal of any auxiliary outlet. Repeat steps b and c.
e. If the resistance is larger than 0.1ohms (100 mohms) but less than 0.2ohms (200
mohms), disconnect the AC power cord and plug the probe that is previously plugged in
the protective earth terminal of the AC power cord into the protective earth contact of
the power outlet. Repeat steps a to d.
2. Perform the following earth leakage current tests:
• normal polarity;
• reverse polarity;
• normal polarity with open neutral; and
• reverse polarity with open neutral.
3. Verify the maximum leakage current does not exceed 300 μA (0.3 mA) in the first two tests.
While for the last two tests, verify that the maximum leakage current does not exceed 1000
μA (1 mA).

NOTE: Make sure the safety analyzer is authorized by certificate organizations

(UL, CSA, or AAMI etc.). Follow the instructions of the analyzer
manufacturer.

7 - 10 046-002773-00 A5™ Operating Instructions

Maintenance Cleaning and Disinfection

7.10 Cleaning and Disinfection

CAUTION: Before using the A5 System (after cleaning or disinfecting), power up
the system and follow the on-screen prompts to perform the leak test
and the compliance test. See section 4.5 (page 4-9) "Leak and
Compliance Tests".

CAUTION: To prevent system damage:

• Refer to the literature supplied by the manufacturer of the

cleaning agent.
• Never use organic, halogenated or petroleum-based solvents,
anesthetics, glass cleaning agents, acetone or other irritant
agents.
• Never use abrasive agents (i.e. steel wool or silver polish) to clean
components.
• Keep all liquids away from electronic components.
• Prevent liquid from entering the equipment.
• All cleaning solutions used must have a pH between 7.0 and 10.5.
• Do not use Cavacide: Cavacide is known to cause degradation of
plastic polymers.
• Do not use Oxicide: May cause discoloration of device hardware.

7.10.1 General Guidelines

Follow all WARNINGS and CAUTIONS listed at the beginning of this chapter. Prior to use, refer to the
facility’s infection control policy to determine the frequency and level at which cleaning and
disinfection should be performed. If disinfection is required, all components must first be cleaned
and dried as described in the following sub-sections. For additional information about infection
control practices, refer to the APIC Guidelines for Selection and Use of Disinfectants, published in the
American Journal of Infection Control, Vol. 24, No. 4, August 1996.

For additional information about infection control, refer to the ASA’s Recommendations for Infection
Control for the Practice of Anesthesiology, second edition. For additional information on reprocessing
medical devices, refer to AAMI TIR 30:2003, A compendium of process, materials, test methods, and
acceptance criteria for cleaning reusable medical devices.

7.10.2 Cleaning and Disinfecting Agents / Autoclaving

The A5 should be cleaned and disinfected before its first use, then daily and as often as needed. (see
TABLE 7-1, “Maintenance Schedule,” on page 7-4.)

TABLE 7-3 lists the cleaning and disinfecting agents and autoclaving process that may be used on the
A5 Anesthesia System.

AGENT CLASSIFICATION
Water Cleaning agent
Green soap tincture Cleaning agent
Sodium hypochlorite solution, 10% available chlorine Disinfecting agent
Isopropyl alcohol (70%) Disinfecting agent
* All breathing system components are autoclavable except the Paw gauge, flow sensor, O2 sensor, and
bellows. The components can be autoclaved up to a maximum temperature of 134 ºC (273 ºF).

TABLE 7-3 Cleaning and Disinfecting Agents

A5™ Operating Instructions 046-002773-00 7 - 11

Cleaning and Disinfection Maintenance

AGENT CLASSIFICATION
Super Sani-Cloth (0.5% Quaternary ammonium chloride Disinfecting agent
and 55% Isopropyl alcohol)
Cidex (Only for bellows, Inspiratory Pressure Gauge and Ins/ Exp Disinfecting agent
Flow sensors)
ALPET D2 Surface sanitizer wipes Disinfecting agent
Viraguard surface disinfectant towelette Disinfecting agent
Autoclaving process * Autoclaving
* All breathing system components are autoclavable except the Paw gauge, flow sensor, O2 sensor, and
bellows. The components can be autoclaved up to a maximum temperature of 134 ºC (273 ºF).

TABLE 7-3 Cleaning and Disinfecting Agents

7.10.3 External Surfaces

Use a soft cloth with an approved cleaning agent (see section 7.10.2 (page 7-11) "Cleaning and
Disinfecting Agents / Autoclaving") to clean all outer surfaces, hoses, and cables.

7.10.4 Bellows Assembly

FIGURE 7-4 Bellows Assembly

Read all content in this section before disassembling, cleaning, disinfecting, and re-assembling the
bellows to avoid equipment malfunction and patient injury.

1. The bellows dome is a transparent cover with graduation marks from 300 to 1500 mL.
Remove the bellows dome by turning it counterclockwise and lifting it away from the
breathing system (see FIGURE 7-5).

7 - 12 046-002773-00 A5™ Operating Instructions

Maintenance Cleaning and Disinfection

FIGURE 7-5 Removing the Bellows Dome

2. Detach the bellows from the base plate (see FIGURE 7-6).

FIGURE 7-6 Detaching the Bellows

3. Detach the top plate from the bellows (see FIGURE 7-7).

FIGURE 7-7 Detaching the Bellows Top Plate

A5™ Operating Instructions 046-002773-00 7 - 13

Cleaning and Disinfection Maintenance

4. Remove the bellows adapter ring from inside the bellows (see FIGURE 7-8). Note the
orientation of the bellows adapter ring as it is being removed to ensure that it is properly
inserted during reassembly. (If the ring contains grooves, the ring should be oriented so that
the grooves are facing downward in the final reassembly.)

Grooves on adapter ring face

downward.

FIGURE 7-8 Removing the Bellows Adapter Ring

5. Remove the bellows dome O-ring (see FIGURE 7-9).

FIGURE 7-9 Removing the Bellows Dome O-ring

6. Cleaning
a. To prevent damage, wash each component gently using a recommended cleaning
agent (see section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving").
Ensure that all bellows surfaces are cleaned. Do not autoclave the bellows.
b. Rinse with clean, hot water, and allow to dry.

NOTE: Dry the bellows by allowing it to hang so that it is fully expanded. This
will facilitate thorough drying and prevent it from sticking to itself.

CAUTION: Do not autoclave the following components: Paw gauge, oxygen

sensor, flow sensor, and bellows. These components cannot withstand
immersion or the heat and pressure of autoclaving.

7 - 14 046-002773-00 A5™ Operating Instructions

Maintenance Cleaning and Disinfection

CAUTION: If moisture remains in the bellows after cleaning, the bellows surface
folds may become tacky and prevent the bellows from properly
expanding. Ensure all moisture is removed from the bellows after
cleaning.

c. After all bellows components are completely dry, inspect them for damage before
disinfection or re-assembly and functional testing.
d. If disinfecting the bellows components, continue with step 7, otherwise skip to step 8.
7. Disinfection

NOTE: Ensure that all bellows components have been cleaned as described in
step 6 before disinfecting.

See section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving" and use an
approved disinfecting agent for all bellows components while adhering to facility policies and
procedures.

8. Connect the bellows to the breathing system by reassembling all components in the reverse
order. Prior to use after cleaning or disinfecting, power up the system and follow the on-
screen prompts to perform the leak test and the compliance test (see section 4.5 (page 4-9)
"Leak and Compliance Tests").

7.10.5 Inspiration and Expiration Valves

The following procedure is written generically for a single, unspecified valve. It should be performed
on both the inspiration and expiration valves.

Expiration
Valve

Inspiration
Valve

FIGURE 7-10 Location of Expiration and Inspiration Valves

1. Remove the valve dome (see FIGURE 7-11), turning it counterclockwise.

A5™ Operating Instructions 046-002773-00 7 - 15

Cleaning and Disinfection Maintenance

FIGURE 7-11 Valve Dome Removal

CAUTION: The valve disc in each of the inhalation and exhalation valve assemblies
on the breathing system is fragile and must be handled with care while
removing the valve cage from the valve assembly.

2. The valve cage will be removed in this step (see FIGURE 7-12). The six prongs of the valve
cage have tabs that secure it in the valve assembly. While noting the previous CAUTION, use
two hands to remove the valve cage by gently manipulating the prongs to release the tabs.
As the valve cage is lifted away from the assembly, ensure that the valve disc does not fall
out.
3. Remove the valve disc from the valve cage (see FIGURE 7-12).
4. Remove the O-ring from the bottom of the valve assembly (see FIGURE 7-12.

Valve Cage

Valve Disc

O-ring

FIGURE 7-12 Valve Cage Removal

CAUTION: The valve disc in each of the inhalation and exhalation valve assemblies
on the breathing system is fragile and must be handled with care while
removing the valve cage from the valve assembly.

7 - 16 046-002773-00 A5™ Operating Instructions

Maintenance Cleaning and Disinfection

5. Cleaning
a. Wash each component using a recommended cleaning agent (see section 7.10.2 (page
7-11) "Cleaning and Disinfecting Agents / Autoclaving").
b. Rinse with clean, hot water, and allow to dry.
c. After all components are completely dry, verify that the valve disc and the prongs of the
valve cage are undamaged before disinfection or re-assembly and functional testing.
d. If disinfecting the valve components, continue with step 6, otherwise skip to step 7.
6. Disinfection

NOTE: Ensure that all valve components have been cleaned as described in
step 5 before disinfecting.

See section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving" and use an
approved disinfecting agent for all valve components while adhering to facility policies and
procedures.
7. Reassembly

Reassemble the valve components in the reverse order, noting any previously stated CAU-
TION. Prior to use after cleaning or disinfecting, power up the system and follow the on-
screen prompts to perform the leak test and the compliance test (see section 4.5 (page 4-9)
"Leak and Compliance Tests").

A5™ Operating Instructions 046-002773-00 7 - 17

Cleaning and Disinfection Maintenance

7.10.6 Oxygen Sensor

1. The oxygen sensor is a component that is pressed into position for use. It is not necessary to
remove this component to clean it. However, if removal is desired, first disconnect the
oxygen sensor cable from the main unit (see FIGURE 7-13). Then hold the oxygen sensor and
pull straight out firmly from the breathing system block

Oxygen Sensor Cable

Connection to Main Unit

Oxygen Sensor

FIGURE 7-13 Oxygen Sensor and Cable

CAUTION: Never immerse the oxygen sensor or its connector in any type of liquid.

• Dispose of the oxygen sensor per the manufacturer’s

specification.

CAUTION: Do not wash the inner surface of the oxygen sensor.

CAUTION: Do not autoclave the following components: Paw gauge, oxygen

sensor, flow sensor, and bellows. These components cannot withstand
immersion or the heat and pressure of autoclaving.

2. Clean the oxygen sensor exterior with a soft, lint-free cloth, and a recommended cleaning
agent (see section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving").
Allow to dry thoroughly.
3. Inspect the oxygen sensor for damage and replace as necessary.
4. Re-insert the oxygen sensor if it had been removed.

7 - 18 046-002773-00 A5™ Operating Instructions

Maintenance Cleaning and Disinfection

7.10.7 APL Valve

1. The APL valve is a component that is plugged into position and secured by a threaded base
collar. Loosen the base collar of the APL valve by turning the collar (not the valve knob)
counterclockwise until it is no longer threaded (see FIGURE 7-14). Then, firmly pull the APL
valve upward to remove.

APL Valve Knob

APL Valve Base Collar

(threaded)

FIGURE 7-14 APL Valve Removal

2. Cleaning
a. Clean the APL valve with a soft, lint-free cloth and a recommended cleaning agent (see
section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving"). Allow it to
dry thoroughly.
b. If disinfecting the APL valve, continue with step 3, otherwise skip to step 4.
3. Disinfection

NOTE: Ensure that the APL valve has been cleaned as described in step 2
before disinfecting.

See section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving" and use an
approved disinfecting agent for the APL valve while adhering to facility policies and procedures.

4. Reassemble the APL valve by turning its base collar clockwise until it is securely tightened.
Prior to use after cleaning or disinfecting, power up the system and follow the on-screen
prompts to perform the leak test and the compliance test (see section 4.5 (page 4-9) "Leak
and Compliance Tests").

A5™ Operating Instructions 046-002773-00 7 - 19

Cleaning and Disinfection Maintenance

7.10.8 PAW Gauge

1. The PAW gauge is a component that is pressed into position for use. It is not necessary to
remove this component to clean it. However, if removal is desired, simply hold it and lift it
straight up from the absorber block (see FIGURE 7-15).

FIGURE 7-15 PAW Gauge Removal

CAUTION: Do not autoclave the following components: Paw gauge, oxygen

sensor, flow sensor, and bellows. These components cannot withstand
immersion or the heat and pressure of autoclaving.

2. Clean the PAW gauge with a soft, lint-free cloth and a recommended cleaning agent (see
section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving"). Allow it to dry
thoroughly.
3. Re-insert the PAW gauge if it was removed. Prior to use after cleaning or disinfecting, power
up the system and follow the on-screen prompts to perform the leak test and the
compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests").

7 - 20 046-002773-00 A5™ Operating Instructions

Maintenance Cleaning and Disinfection

7.10.9 Bag Arm

1. At the base of the bag arm, locate the retaining ring. Turn the ring counterclockwise until it
is no longer threaded. Lift the bag arm from the breathing system block (see FIGURE 7-16).

Bag Arm

Retaining
Ring

FIGURE 7-16 Bag Arm Removal

2. Cleaning
a. Clean the bag arm with a soft, lint-free cloth and a recommended cleaning agent (see
section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving"). Allow it to
dry thoroughly.
b. If disinfecting the bag arm, continue with step 3, otherwise skip to step 4.
3. Disinfection

NOTE: Ensure that the bag arm has been cleaned as described in step 2 before
disinfecting.

See section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving" and use an
approved disinfecting agent for the bag arm while adhering to facility policies and procedures.

4. Reassemble the bag arm to the breathing system. Prior to use after cleaning or disinfecting,
power up the system and follow the on-screen prompts to perform the leak test and the
compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests").

A5™ Operating Instructions 046-002773-00 7 - 21

Cleaning and Disinfection Maintenance

7.10.10 Absorber Canister

1. Locate the condensate drain valve at the bottom of the absorber canister assembly.

Absorber Canister

Condensate Drain

FIGURE 7-17 Condensate Drain Valve Location

Turn the condensate

drain valve to open
and close

FIGURE 7-18 Condensate Drain Valve (Close Up View)

2. While holding a small cup below the drain, turn the condensate drain valve clockwise to
open the drain and collect any water that may have gathered. Turn the drain valve counter-
clockwise to close the drain. After draining out moisture wipe out excess moisture with a
soft cloth. Discard any water collected.

WARNING: Use extreme care while handling the absorbent as it is a caustic irritant.

3. Rotate the locking mechanism handle clockwise into the unlocked position (see FIGURE 7-
19). This separates the absorber canister from the top of the assembly. While noting the
previous WARNING, remove the absorber canister. Then remove the Pre-Pak or loose fill
absorbent from the canisters. Dispose of the absorbent per the manufacturer’s specification.

7 - 22 046-002773-00 A5™ Operating Instructions

Maintenance Cleaning and Disinfection

Unlocked Position Gasket Gasket Locked Position

FIGURE 7-19 Absorber Canister, Unlocked FIGURE 7-20 Absorber Canister, Locked

4. Cleaning
a. Clean the absorber canister with a soft, lint-free cloth and a recommended cleaning
agent (see section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving").
Allow them to dry thoroughly.
b. If disinfecting the absorber canister,, continue with step 5, otherwise skip to step 7.
5. Disinfection

NOTE: Ensure that the absorber canister has been cleaned as described in step
4 before disinfecting.

6. See section 7.10.2 (page 7-11) "Cleaning and Disinfecting Agents / Autoclaving" and use an
approved disinfecting agent for the absorber canister, while adhering to facility policies and
procedures.Make sure that the gasket is correctly installed. The comparison between correct
installation and incorrect installation is shown below.

A5™ Operating Instructions 046-002773-00 7 - 23

Cleaning and Disinfection Maintenance

Correct installation Incorrect installation

Correct
installation

Incorrect
installation

FIGURE 7-21 Gasket installation

WARNING: Use extreme care while handling the absorbent as it is a caustic irritant.

WARNING: Check if the gasket is properly installed in place while installing the
absorber canister. If the gasket is not properly installed (for example,
gasket is not evenly seated and centered) it may cause breathing
system leakage.

NOTE: Ensure that the absorber canister is completely dry before adding
absorbent.

WARNING: The gasket on the absorber canister should be cleaned before adding
new absorbent.

7. While noting the previous WARNING, add new Pre-Pak or loose fill absorbent to the
absorber canister. Re-install the absorber canister into the assembly. Rotate the locking
mechanism handle clockwise into the locked position (see FIGURE 7-20). Prior to use after
cleaning or disinfecting, power up the system and follow the on-screen prompts to perform
the leak test and the compliance test (see section 4.5 (page 4-9) "Leak and Compliance
Tests").

7 - 24 046-002773-00 A5™ Operating Instructions

Maintenance Cleaning and Disinfection

7.10.11 Breathing System Block

1. Remove all of the following components from the breathing system block:
• Bellows Assembly
• Oxygen Sensor
• Inspiratory and Expiratory Valves (all components)
• APL Valve
• PAW Gauge
• Bag Arm
• Absorber Canister
• Inspiratory and Expiratory Flow Sensors
2. Remove the absorber canister (see section 7.10.10 (page 7-22) "Absorber Canister").
3. Press and hold the buckle on the bypass assembly to take out the bypass assembly
downward.

Buckle

Bypass Assembly

FIGURE 7-22 Remove Bypass Assembly

4. Pull out the canister bottom plate upward.

Canister Bottom Plate

FIGURE 7-23 Remove Canister Bottom Plate

A5™ Operating Instructions 046-002773-00 7 - 25

Cleaning and Disinfection Maintenance

CAUTION: Use care in lifting and manipulating the breathing system block during
removal from its mounting arm as handling may be awkward due to its
weight and shape.

CAUTION: The breathing system block is calibrated and matched with the
anesthesia machine at the factory. A label in the back of the machine
indicates the serial number of the matching breathing system block.
When reassembling, ensure that the breathing system block and
anesthesia machine are properly matched. Otherwise, the breathing
system must be recalibrated.

5. While holding the sides of the breathing system block, firmly separate and slide it away from
its mounting arm.

FIGURE 7-24 Breathing System Block Removal, Top View

FIGURE 7-25 Breathing System Block Removal, Bottom View

7 - 26 046-002773-00 A5™ Operating Instructions

Maintenance Cleaning and Disinfection

6. Cleaning
a. Clean the breathing system block exterior with a soft, lint-free cloth and a
recommended cleaning agent (see section 7.10.2 (page 7-11) "Cleaning and Disinfecting
Agents / Autoclaving"). Allow to dry thoroughly.
b. If disinfecting the breathing system block, continue with step 7, otherwise skip to step 8.
7. Disinfection

NOTE: Ensure that the breathing system block has been cleaned as described
in step 6 before disinfecting. High level disinfection of the breathing
system block can be performed through steam autoclaving up to a
maximum temperature of 134 ºC (273 ºF).

Using an autoclave, follow the manufacturer’s instructions for high level disinfection of the breathing
system block while adhering to facility policies and procedures.

8. Reassemble the breathing system components in reverse order. Prior to use after cleaning or
disinfecting, power up the system and follow the on-screen prompts to perform the leak test
and the compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests").

CAUTION: To ensure patient safety, use only parts and accessories specified in this
manual.

CAUTION: To ensure measurement accuracy and to avoid possible damage to the

A5, use only Mindray-approved cables and accessories.

CAUTION: Inspiratory and expiratory flow sensors are flow-direction-sensitive.

7.10.12 Active AGSS (Anesthetic Gas Scavenging System) and AGSS

Transfer Hose
1. Disconnect the EVAC hose from the AGSS (see FIGURE 7-26).
2. Remove the AGSS and Transfer Hose from the A5.

A5™ Operating Instructions 046-002773-00 7 - 27

Cleaning and Disinfection Maintenance

Transfer Hose

EVAC Hose Port

FIGURE 7-26 AGSS and Transfer Hose Removal

3. Clean the outer surface of the AGSS and Transfer Hose with a soft, lint-free cloth and a
recommended cleaning agent (see section 7.10.2 (page 7-11) "Cleaning and Disinfecting
Agents / Autoclaving"). Allow to dry thoroughly.
4. Remove the top of the AGSS. Inspect the AGSS filter and shake it over a waste container to
clean it as necessary (see FIGURE 7-27). If the filter must be replaced, dispose of the old filter
per local disposal regulations.

AGSS Filter

FIGURE 7-27 Removal of AGSS Top / AGSS Filter Inspection

5. Reassemble the AGSS and Transfer Hose and reconnect them to the A5 in the reverse order.

7 - 28 046-002773-00 A5™ Operating Instructions

Maintenance Regular Maintenance

7.11 Regular Maintenance

WARNING: To avoid endangering a patient, do not perform testing or maintenance
when the machine is in use.

Visual inspection should be performed every 30 days to ensure timely replacement of worn or
damaged parts.

1. Power off the system.

2. Perform an overall visual inspection of the system.
3. Power up the system and follow the on-screen prompts to perform the leak test and the
compliance test (see section 4.5 (page 4-9) "Leak and Compliance Tests").

A5™ Operating Instructions 046-002773-00 7 - 29

Regular Maintenance Maintenance

This page intentionally left blank.

7 - 30 046-002773-00 A5™ Operating Instructions

 8.0 AG and O2 Concentration Monitoring
(Optional)

Introduction .................................................................................................................................................................................................8-2

Understand MAC Values.......................................................................................................................................................................8-3

Identify External AG Modules............................................................................................................................................................8-4

Prepare to Measure AG .........................................................................................................................................................................8-6

Make AG Settings......................................................................................................................................................................................8-6

Measurement Limitations ...................................................................................................................................................................8-8

Troubleshooting........................................................................................................................................................................................8-8

Scavenge the Sample Gas...................................................................................................................................................................8-9

Calibrate the AG Module .................................................................................................................................................................. 8-10

A5™ Operating Instructions 046-002773-00 8-1

Introduction AG and O2 Concentration Monitoring (Optional)

8.1 Introduction
The Anaesthetic Gas (AG) module measures the patient's anesthetic and respiratory gases, and
incorporates the features of the O2 module as well.

The AG (anesthesia gas) module determines the concentrations of certain gases using the infrared
(IR) light absorption measurement. The gases that can be measured by the AG module absorb IR
light. Each gas has its own absorption characteristic. The gas is transported into a sample cell, and an
optical IR filter selects a specific band of IR light to pass through the gas. For multiple gas
measurement, there are multiple IR filters. This means that higher concentration of IR absorbing gas
causes a lower transmission of IR light. The amount of IR light transmitted after it has been passed
though an IR absorbing gas is measured. From the amount of IR light measured, the concentration of
gas present can be calculated.

Oxygen does not absorb IR light as other breathing gases and is therefore measured relying on its
paramagnetic properties. Inside the O2 sensor are two nitrogen-filled glass spheres mounted on a
strong rare metal taut-band suspension. This assembly is suspended in a symmetrical non-uniform
magnetic field. In the presence of paramagnetic oxygen, the glass spheres are pushed further away
from the strongest part of the magnetic field. The strength of the torque acting on the suspension is
proportional to the oxygen concentration. From the strength of the torque, the concentration of
oxygen is calculated.

The measurement provides:

1. An EtCO2 waveform;
2. Measured parameters: O2, EtCO2, FiCO2, EtN2O, FiN2O, EtAA, FiAA and MAC,
where, AA stands for any of the five anesthetic agents: Des (desflurane), Iso (isoflurane), Enf
(enflurane), Sev (sevoflurane), or Hal (halothane),

8-2 046-002773-00 A5™ Operating Instructions

AG and O2 Concentration Monitoring (Optional) Understand MAC Values

8.2 Understand MAC Values

Minimum alveolar concentration (hereinafter referred to as MAC) can be displayed on the screen
when the anesthesia system is configured with an external AG module.

MAC is a basic index indicating the depth of inhaled anesthesia. The ISO 80601-2-55 defines MAC as
follows: alveolar concentration of an inhaled anesthetic agent that, in the absence of other anesthetic
agents and at equilibrium, prevents 50% of subjects from moving in response to a standard surgical
stimulus.

The following table lists 1 MAC of various inhaled anesthetic agents.

Anesthetic
Des Iso Enf Sev Hal N 2O
agent
1 MAC 6.0% 1.15% 1.7% 2.1% 0.77% 105%*
* 1 MAC nitrous oxide can only be reached in a hyperbaric chamber.
TABLE 8-1 1 MAC of various inhaled anesthetic agents

NOTE: The data shown in this table is from ISO 80601-2-55, which are
published by the U.S. Food and Drug Administration for a
healthy 40-year-old male patient.

NOTE: In actual applications, although the A5 accounts for patient age, the
effects of weight and other factors on the inhaled anesthetic agent
should be considered.

When one or more than one anesthetic agents are used, the formula for calculating MAC is:
N −1
EtAgenti
MAC = 
i =0 AgentVolagei

Where, N stands for the number of all anesthetic agents (including N2O) which the AG module can
measure, EtAgenti for the concentration of end-tidal anesthetic agent and AgentVolagei for the 1MAC
value corresponding to the anesthetic agent after age correction.

The formula for calculating age correction of 1MAC is:

MAC age = MAC 40 × 10 ( −0.00269×( age − 40))

NOTE: The formula above is only suitable for patients who are older than one
year old. If the patient is less than one year old, the system will use one
year to do age correction.

For example, for a 60-year-old patient, if the AG module detects 0.9% Iso and 50% N2O in the patient
end-tidal mixed gas, the 1MAC of Iso is 1.01% and 1MAC of N2O is 92.7% of the 60-year-old patient
based on the above age correction formula. The MAC value is calculated as follows:

0 .9 % 50%
MAC = + = 1 .4
1.01% 92.7%

A5™ Operating Instructions 046-002773-00 8-3

Identify External AG Modules AG and O2 Concentration Monitoring (Optional)

8.3 Identify External AG Modules

Indicator

Gas outlet Watertrap

FIGURE 8-1External AG Module

NOTE: The AG module (see FIGURE 8-3) is configured with the function of
compensating barometric pressure automatically.

NOTE: The hardkey on the AG module has been disabled.

8-4 046-002773-00 A5™ Operating Instructions

AG and O2 Concentration Monitoring (Optional) Prepare to Measure AG

8.4 Prepare to Measure AG

1. Select the appropriate watertrap according to patient type and attach it to the watertrap
fixer.
2. Connect one end of the gas sampling tube to the watertrap.
3. Connect the other end of the gas sampling tube to the patient via the airway adapter.
4. Connect the exhaust tube to the gas outlet on the module to scavenge the sample gas to
the waste gas disposal system.

Airway adapter External AG module Exhaust tube

Connect to the patient Gas sampling tube

FIGURE 8-2Prepare to Measure AG

CAUTION: Position the airway adapter properly so that the part connecting to the
gas sampling tube is pointing upwards. This prevents condensed water
from entering the gas sampling tube and causing an occlusion as a
result.

CAUTION: The watertrap collects water drops condensed in the sampling tube and
therefore prevents them from entering the module. If the collected
water reaches a certain amount, you should drain it to avoid airway
blockage.

CAUTION: The watertrap has a filter preventing bacterium, vapor and patient
secretions from entering the module. After long-term use, dust or other
substances may compromise the performance of the filter or even
block the airway. In this case, replace the watertrap. Replacing the
watertrap once a month is recommended.

WARNING: Do not apply high volume watertraps to Infant patients. Otherwise, patient injury
could result.

WARNING: Make sure that all connections are reliable. Any leak in the system can result in
erroneous readings due to patient breathing gas mixed with ambient air.

A5™ Operating Instructions 046-002773-00 8-5

Make AG Settings AG and O2 Concentration Monitoring (Optional)

8.5 Make AG Settings

Perform the settings below when the anesthesia system is configured with an external AG
module.

8.5.1 Set CO2 Unit

To change the CO2 Unit:

1. Select Setup softkey > System tab.

2. Select the CO2 Unit button.
3. Choose between mmHg, kPa and %.
4. Select the Accept button to confirm the change.

8.5.2 Set CO2 Placement

To change the CO2 Placement:

1. Select Setup softkey > Display tab.

2. Select the CO2 Placement button.
3. Choose between TOP and Bottom.
4. Select the Accept button to confirm the change.

8.5.3 Set CO2 Scale

To change the CO2 Scale:

1. Select Setup softkey > Display tab.

2. Select the CO2 Scale button.
3. Choose between 0-40, 0-60 and 0-80.
4. Select the Accept button to confirm the change.

8.5.4 Gas Bench Flow Rate

To change the Gas Bench Flow Rate:

1. Select Setup softkey > General tab.

2. Select the Gas Bench Flow Rate button.
3. Choose between High (recommended), Med and Low, as follows:
High: 200 mL/min for high volume watertrap; 120 mL/min for low volume watertrap
Med: 150 mL/min for high volume watertrap; 90 mL/min for low volume watertrap
Low: 120 mL/min for high volume watertrap; 70 mL/min for low volume watertrap
4. Select the Accept button to confirm the change.

8-6 046-002773-00 A5™ Operating Instructions

AG and O2 Concentration Monitoring (Optional) Make AG Settings

8.5.5 Set Alarm Limits

Users can set the high and low alarm limits of N2O, CO2, and Agents to create alarm conditions
consistent with patient needs. The alarm is then triggered when the parameter value is greater than
the High Limit or lesser than the Low Limit.

NOTE: When using the A5 Anesthesia System, ensure that the alarm limits of
each parameter are set to the appropriate values for the patient.

To set the Alarm Limits:

1. On the main screen, select the Alarms softkey.

The Alarms window is displayed.
2. Select the Limits tab (see FIGURE 6-8) or Agents tab (see FIGURE 8-3).
3. Select a parameter softkey.
The softkey is highlighted when selected.
4. Use the on-screen keypad to enter the desired parameter value.
For each parameter, the range of values is displayed above the keypad.
5. Optionally, to restore the default values, select the “Load Alarm Defaults” button. This
restores the high and low values for the parameters to the user default values.
6. Select the Accept to save the change (or select Cancel to not save).
7. Repeat Steps 3 to 6 for each parameter value.

FIGURE 8-3Agents Tab

A5™ Operating Instructions 046-002773-00 8-7

Measurement Limitations AG and O2 Concentration Monitoring (Optional)

8.6 Measurement Limitations

Measurement accuracy may degrade due to:

• Leakage or internal leakage of the sample gas

• Mechanical shock
• Humidity or condensate
• Cyclic pressure which is greater than 10 kPa (100 cmH2O)
• Other interference source (if available)

NOTE: Gas data is reported as zero if the measured concentration is below the
defined threshold level during more than 3 s: CO2 - 0.1/0.3%; N2O - 3/
3%; O2 - 0/0%, Agents - 0.15/0.3% (Full/ISO accuracy).

NOTE: Inaccuracy is specified at 10-55 °C operating temperature and default

compensated for an H2O partial pressure of 11 mBar (i e 22 °C @40% RH
ambient conditions) and using a DRYLINETM sampling system. Any
other ambient H2O partial pressure will dilute the gas sample to a
different extent, causing a measurement error. Under typical operating
conditions this effect is negligible. An increase of the ambient H2O
partial pressure to 30 mBar (i e 28 °C @80% RH or 33 °C @60% RH) will
cause a general error for all measured gases of -2%REL. For automatic
compensation of the ambient humidity effect on the gas sample
composition, the actual ambient H2O partial pressure can be input to
AIONTM from the host via the communication interface.

8.7 Troubleshooting
If the gas inlet (including watertrap, sampling tube and airway adapter) is occluded by condensed
water, airway occlusion will be prompted on the screen.

To remove the occlusion:

• Check the airway adapter for occlusion and replace if necessary.

• Check the sampling tube for occlusion or kinking and replace if necessary.
• Check the watertrap for water build-up. Empty the watertrap. If necessary, replace the watertrap.
If that does not resolve it, internal occlusions may exist. Contact your service personnel.

If the expired O2 concentration is higher than the inspired O2 concentration, it is possible that the
pump rate is too low. Setting Gas Bench Flow Rate to High is recommended.

8-8 046-002773-00 A5™ Operating Instructions

AG and O2 Concentration Monitoring (Optional) Scavenge the Sample Gas

8.8 Scavenge the Sample Gas

Metal lever

Exhaust tube

To scavenge the sample gas to the waste gas disposal system, depress the metal lever and then plug
the exhaust tube to the sample gas return port marked as shown in the above picture.

WARNING: When using the AG module to perform AG measurements on the patients who are
receiving or have recently received anesthetic agents, connect the outlet to the sample
gas return port to prevent the medical staff from breathing in the anesthetic agents.

A5™ Operating Instructions 046-002773-00 8-9

Calibrate the AG Module AG and O2 Concentration Monitoring (Optional)

8.9 Calibrate the AG Module

Prepare the following before doing the calibration:

• Gas cylinder, with a certain standard gas or mixture gas. Gas concentration should meet the
following requirements: AA≥1.5%, CO2≥1.5%, N2O≥40%, O2≥40%, of which AA represents an
anesthetic agent. a/c≤0.01 (a is the gas absolute concentration accuracy; c is the gas
concentration).
• T-shape connector
• Tubing
Follow this procedure to perform a calibration:

1. Connect the test system as follows.

Open to the air

Tubing

Relief valve

AG module
Gas cylinder

2. Ensure that the system is in Standby mode. If not, select the End Case button in the Manual
tab and follow the on-screen prompts to end the case and enter Standby mode.
3. Select the Setup softkey> System tab (system password needed).
4. Select the Calibration button.
5. Select the External AG Module button.
6. Wait for the AG module to be completely warmed up
7. Enter the actual concentration of the calibration gas.
8. Turn on the calibration gas canister. The system displays the real-time concentration of
calibration gas.
9. Select the Calibrate button to start to calibrate the AG Module. The system will display the
results of the calibration status when the process is completed.
10. After calibration, select Done to close the Calibration window.
11. Select Accept to close the Setup window.

8 - 10 046-002773-00 A5™ Operating Instructions

 9.0 Product Specifications

Standards Compliance ..........................................................................................................................................................................9-2

Safety Designations.................................................................................................................................................................................9-4

Physical Specifications...........................................................................................................................................................................9-5

Stability Configurations and Conditions ....................................................................................................................................9-5

Environmental Specifications............................................................................................................................................................9-6

Electrical Specifications.........................................................................................................................................................................9-7

Pneumatic Specifications.....................................................................................................................................................................9-8

Breathing System Specifications .....................................................................................................................................................9-9

Anesthetic Gas Scavenging System (AGSS) .......................................................................................................................... 9-13

Monitor Module...................................................................................................................................................................................... 9-13

Ventilator Specifications .................................................................................................................................................................... 9-18

Displays and Controls Specifications......................................................................................................................................... 9-20

Alarms ........................................................................................................................................................................................................... 9-21

Safety Specifications ............................................................................................................................................................................ 9-22

ASTM F 1208 – 89 (2005) Disclosures........................................................................................................................................ 9-23

Data Storage (Non-Volatile) and Recording.......................................................................................................................... 9-24

Electromagnetic Compatibility ..................................................................................................................................................... 9-24

A5™ Operating Instructions 046-002773-00 9-1

Standards Compliance Product Specifications

9.1 Standards Compliance

The A5 Anesthesia System is in compliance with the following industry standards.

ISO 14971: 2007 Medical devices -- Application of risk management

to medical devices
IEC 62304: 2006 Medical device software - Software life cycle
processes
CAN/CSA-C22.2 NO. 60601-1:2014 Medical electrical equipment – Part 1: General
requirements for basic safety and essential
performance
IEC 60601-1-2: 2014-Ed.3.0 Medical electrical equipment - Part 1-2: General
requirements for basic safety and essential
performance - Collateral standard: Electromagnetic
compatibility - Requirements and tests
IEC 60601-1-6: 2006-Ed.2.0 Medical electrical equipment - Part 1-6: General
requirements for safety - Collateral standard:
Usability
IEC 60601-1-8: 2006-Ed.2.0 Medical electrical equipment - Part 1-8: General
requirements for safety - Collateral standard:
General requirements, tests and guidance for alarm
systems in medical electrical equipment and
medical electrical systems
ISO 80601-2-13: 2011 Medical electrical equipment Part 2-13: Particular
requirements for basic safety and essential
performance of an anaesthetic workstation
ISO 10993-1: 2003 Biological evaluation of medical devices - Part 1:
Evaluation and testing
ISO 10993-5: 1999 Biological evaluation of medical devices - Part 5:
Tests for in vitro cytotoxicity
ISO 10993-10: 2002 Biological evaluation of medical devices - Part 10:
Tests for irritation and delayed-type hypersensitivity
ISO 80601-2-55:2011 Medical electrical equipment - Part 2-55: Particular
requirements for the basic safety and essential
performance of respiratory gas monitors
IEC 60529:2001-Ed.2.1/Cor.3:2009 Degrees of protection provided by enclosures(IP
Code)

TABLE 9-1 Standards Compliance

9-2 046-002773-00 A5™ Operating Instructions

Product Specifications Standards Compliance

The anesthesia workstation shall be used together with the monitoring devices, alarm system and
protective devices below:

• The pressure measurement device in compliance with ISO 80601-2-13;

• The pressure restriction device in compliance with ISO 80601-2-13;
• The expiratory volume monitor in compliance with ISO 80601-2-13;
• The breathing system with alarm system in compliance with ISO 80601-2-13;
• The anaesthetic vapour delivery system in compliance with ISO 80601-2-13;
• The anaesthetic gas scavenging system in compliance with ISO 80601-2-13;
• The anesthetic gas delivery device in compliance with ISO 80601-2-13;
• The anesthetic ventilator in compliance with ISO 80601-2-13;
• The O2 monitor in compliance with ISO 80601-2-55;
• The CO2 monitor in compliance with ISO 80601-2-55;
• The AG monitor in compliance with ISO 80601-2-55.
The anesthesia workstation is integrated with the pressure measurement device, pressure restriction
device, expiratory volume monitor, anaesthetic breathing system with alarm system, anaesthetic gas
delivery system, anaesthetic vapour delivery system, anaesthetic ventilator, optional anesthetic gas
(AG) monitor and O2 monitor in compliance with the afore mentioned standards, where:

• The pressure restriction device, expiratory volume monitor and breathing system with alarm
system also comply with ISO 80601-2-13.
• AG monitor in compliance with ISO 80601-2-55.
• O2 monitor in compliance with ISO 80601-2-55.

A5™ Operating Instructions 046-002773-00 9-3

Safety Designations Product Specifications

9.2 Safety Designations

Type of Protection against Class I equipment with internal electric power supply.
Electric Shock: Where the integrity of the external protective earth
(ground) in the installation or its conductors is in doubt, the
equipment shall be operated from its internal electric power
supply (i.e., battery supply).
Degree of Protection against BF, defibrillation-proof
Electric Shock:
Power Supply Connection: External electric power supply:
100 to 120 VAC, 60 Hz, 12 A

Internal battery supply:

Lithium-ion, 11.1V, 4.5 Ah (1 or 2 batteries installed)
Mode of Operation: Continuous
Degree of Protection against Ordinary equipment, without protection against explosion;
Hazards of Explosion: not for use with flammable anesthetics.
Degree of Protection against Protection against vertically falling water drops - IPX1 (IEC
Harmful Ingress of Water: 60529)
Electrical Connection between Equipment designed for non-electrical connection to the
Equipment and Patient: patient
Degree of Mobility: Mobile: including the base and casters of the anesthesia
system
Disinfection: Steam autoclavable or disinfectable

TABLE 9-2 Safety Designations

9.2.1 Oxygen Enriched Environments

The A5 complies with the standards for oxygen-enriched environments by staying below the
required power threshold or by providing forced ventilation and ventilation failure monitoring and
alarm.

9.2.2 Wiring and PC Board Materials

The A5 complies with NRTL standards for wiring and PC board materials. Primary wiring is double
insulated (jacketed). All wires are UL recognized.

9-4 046-002773-00 A5™ Operating Instructions

Product Specifications Physical Specifications

9.3 Physical Specifications

Dimensions: Height: 1400 mm ± 25 mm
Width: 1050 mm ± 25 mm
(including breathing system)
Depth: 805 mm ± 25 mm
Weight 160 kg (353 lbs) ± 5 kg
(no vaporizers or gas cylinders):
Work Surface Width: 616 mm (24.3 in) ± 25 mm
(stainless steel): Depth: 380 mm (15.0 in) ± 25 mm
Height: 850 mm (33.5 in) ± 25 mm
Top Shelf: Weight Capacity: 40 kg (88.2 lbs)
Width: 616 mm (24.3 in) ± 25 mm
Depth: 362 mm (14.3 in) ± 25 mm

Dimensions of the mounting holes:

Length: 258 mm ± 0.3 mm
Width: 150 mm ± 0.3 mm
Depth of the mounting hole: 11.5 mm
The screw type: M4
Side Mounting Rails: Supporting weight: 25 kg at a maximum distance of 0.41 m
Bag Arm: Fixed Height Bag Arm:
Length: 312 mm ± 10 mm
Height: 1150 mm ± 10 mm
Swiveling angle: 150 ± 10 degrees
Flexible Bag Arm:
Length: 550mm ± 10mm
The height and angle of the flexible bag arm can be adjusted freely.
Drawers Drawers are of equal size:
(internal dimensions): • Height: 135 mm ± 10 mm
• Width: 440 mm ± 10 mm
• Depth: 385 mm ± 10 mm
Casters: Diameter: 15 cm (6 in)
Brake:
• central brake with lock/unlock indicator
Cable pusher: cable pusher with each caster
Handle Length: 650mm± 25 mm

TABLE 9-3 Physical Specifications

9.4 Stability Configurations and Conditions

Maintains stability when tilted 10 degrees, as required by IEC60601-1, clause 9.4.

WARNING: Due to the size and weight of the A5, it should only be moved by
qualified personnel.

WARNING: To avoid tip hazards, use care when moving the A5 up or down inclines,
around corners and across thresholds. Remove all equipment from the
top shelf and mounted to the side of the A5 before moving. Do not
attempt to roll the A5 over hoses, cords or other obstacles.

A5™ Operating Instructions 046-002773-00 9-5

Environmental Specifications Product Specifications

9.5 Environmental Specifications

Operating Temperature: +10 to +40°C
+50 to 104°F
Storage Temperature: -20 to +60°C
-4 to 140°F
oxygen sensor: -20 to +50°C
Humidity (Operating and Storage): 15 to 90% RH, non-condensing
Atmospheric Pressure (Operating): 70 kPa to 106.7 kPa
Atmospheric Pressure (Storage): 50 kPa to 106.7 kPa
Resistance to Ingress of Water: Complies with the requirements of clause 11.6.3 in IEC
60601-1 and also the requirements in IEC 60529 for
protection against vertically falling water drops (IPX1)

TABLE 9-4 Environmental Specifications

9-6 046-002773-00 A5™ Operating Instructions

Product Specifications Electrical Specifications

9.6 Electrical Specifications

9.6.1 Main Electrical Power Specifications
The A5 complies with IEC 60601-1 for its main power supply.

Power Supply Input Voltage: 100 to 120 VAC @ 60 Hz

Power Supply Input Current: 12 A maximum (2A maximum for A5 unit. 10 A maximum for
A5 auxiliary outlets)
Power Cord: 5 ±0.05 m (length), hospital grade

TABLE 9-5 Main Electrical Power Specifications

9.6.2 Battery Power Specifications

Battery Type: Sealed Lithium-ion, 11.1 V, 4.5 Ah
Two (2) batteries
Battery Run-time: One (1) new battery installed: >75 minutes
Two (2) new batteries installed: >150 minutes
Run-time criteria: VCV mode (Tv = 500 mL, Rate = 10 bpm,
I:E = 1:2, Plimit = 30 cmH2O, PEEP = OFF)
Time to Shutdown from >5 minutes (new fully-charged battery supply)
Lower Battery Alarm:
Battery Charge Time: New Battery: <8 hours from an initial charge of 10%
Charging occurs whenever AC is applied to the A5 System.

TABLE 9-6 Battery Power Specifications

9.6.3 Auxiliary Electrical Outlets

Number of Outlets: 4
Output Voltage: 100 to 120 VAC @ 60 Hz (corresponds to power supply input
voltage)
Output Current of Each Auxiliary Outlet: 3A
Output Current Total: 10 A
Breaker Rating per Auxiliary Outlet: 3A
Breaker Rating Total: 10 A

TABLE 9-7 Auxiliary Electrical Outlets

A5™ Operating Instructions 046-002773-00 9-7

Pneumatic Specifications Product Specifications

9.6.4 Communication Ports

Communication Port (SP1): One DB9 male connector on the rear of the A5. Provides a
non-isolated output serial RS232C interface.

CAUTION: Do not connect any non-

isolated devices to the
DB9/RS232C interface of
the A5.
Network Port (CS1): One RJ-45 network port
SB Ports (SB1, SB2): Two SB ports

CAUTION: Do not connect any

devices to the SB ports
other than Mindray
approved USB storage
devices and a supported
USB mouse (see
‘‘Networking and USB
Storage’’ on page A-4).
Data Port (DP1): One test port for connection of calibration equipment by a
Mindray-authorized service representative

TABLE 9-8 Communication Ports

9.7 Pneumatic Specifications

9.7.1 Pipeline Supply (N2O, Air, O2)

Pipeline Input Pressure Range: N2O: 280 to 600 kPa (40 to 87 psi)
Air: 280 to 600 kPa (40 to 87 psi)
O2: 280 to 600 kPa (40 to 87 psi)
Pipeline Input Flow Rate Range: O2: Max. 190 L/min (Including maximum drive gas flow rate,
maximum flow rate to seal PEEP valve, maximum O2 Flow
meter and maximum O2 flush)
Air: Max. 20 L/min
N2O: Max. 20 L/min
Pipeline Connections: DISS threaded body as per CGA V-5
Gas Configuration: N2O, Air, O2

TABLE 9-9 Pipeline Supply

9.7.2 Cylinder Supply (N2O, Air, O2)

Cylinder Supply: E-cylinder (American style) and pin indexed
per CGA V-1
O2 Cylinder Input Pressure Range: 6.9 to 15.5 MPa (1000 to 2250 psi)
N2O Cylinder Input Pressure Range: 4.2 to 6 MPa (600 to 870 psi)
Air Cylinder Input Pressure Range: 6.9 to 15.5 MP (1000 to 2250 psi)

TABLE 9-10 Cylinder Supply

9-8 046-002773-00 A5™ Operating Instructions

Product Specifications Breathing System Specifications

Cylinder Input Flow Rate Range: O2: Max. 190 L/min (Including maximum drive gas flow rate,
maximum flow rate to seal PEEP valve, maximum O2 Flow
meter and maximum O2 flush)
Air: Max. 20 L/min
N2O: Max. 20 L/min
Cylinder Connections: Pin-Index Safety System (PISS)
Yoke Configuration: N2O, Air, O2

TABLE 9-10 Cylinder Supply

9.7.3 Vaporizer Connections

Vaporizer Positions: Two vaporizer mount or three vaporizer mount.
Vaporizer Parking Mount: Inactive, for storage only (A5 only)
Mounting Mode: SELECTATEC®, with interlocking function (SELECTATEC® is
registered trademark of Datex-Ohmeda Inc.)

TABLE 9-11 Vaporizer Connections

9.7.4 Drive Gas

O2

9.7.5 N2O Automatic Cutoff

An N2O automatic cutoff stops the flow of N2O when O2 flow is less than 200 mL/min.

9.7.6 O2 Controls
O2 supply failure alarm: 185.5 to 254.5 kPa (27 to 36 psi)

9.7.7 Oxygen Ratio Controller

Provides 25% ± 4% O2 when N2O valve is fully open and O2 flow range is 0.8L/min to 3L/min

9.8 Breathing System Specifications

9.8.1 Breathing System Volume
Automatic Ventilation: Total volume: 4350 mL +/-100 mL (including bellows)
Bellows: 1500 mL +/-100 mL
Manual Ventilation: 3300 mL +/-100 mL (not including breathing bag)

TABLE 9-12 Breathing System Volume

9.8.2 CO2 Absorber Assembly

Absorber Capacity: 1 Pre-Pak (1500 ±100 mL)
Absorber Canister Contents: 1 Pre-Pak canister or Loose Fill absorbent

TABLE 9-13 CO2 Absorber Assembly

A5™ Operating Instructions 046-002773-00 9-9

Breathing System Specifications Product Specifications

9.8.3 Water Trap

Mode: detachable separately
Capacity: 6 ±1 mL

TABLE 9-14 Water Trap

9.8.4 Breathing System Connections

Exhalation Connection: 22 mm OD ISO 15 mm ID ISO Taper
Inhalation Connection: 22 mm OD ISO 15 mm ID ISO Taper
Connections from Breathing System to 30 mm OD ISO
a Gas Scavenger:

TABLE 9-15 Breathing System Connections

9.8.5 APL Valve

Range: SP, Approximately 0 to 75 cmH2O
Adjustable Range of Motion: 330 ±10 degrees
Tactile Knob Indication: 30 cmH2O and above
Minimum pressure to open the APL Dry: 0.15 kPa
valve: Wet: 0.15 kPa
Resistance of APL valve in dry gas:
Pressure drop (kPa)

Flow (L/min)

TABLE 9-16 APL Valve

9 - 10 046-002773-00 A5™ Operating Instructions

Product Specifications Breathing System Specifications

Resistance of APL valve in wet gas:

Pressure drop(kPa)

Flow(L/min)

Resistance of APL valve in dry gas (Lift the APL Valve):

Pressure drop (kPa)

Flow (L/min)

Resistance of APL valve in wet gas (Lift the APL Valve):

Pressure drop (kPa)

Flow(L/min)

TABLE 9-16 APL Valve

A5™ Operating Instructions 046-002773-00 9 - 11

Breathing System Specifications Product Specifications

9.8.6 Resistance
Expiratory resistance:

Pressure drop(kPa)

Flow(L/min)

Inspiratory resistance:
Pressure drop(kPa)

Flow(L/min)

TABLE 9-17 Resistance

9.8.7 Breathing System Temperature Controller

Breathing System Temperature 35ºC typical at 20ºC ambient temperature
Maintained to:

Note: The block heater does not operate while the system is being powered by the internal battery supply.
TABLE 9-18 Breathing System Temperature Controller

9.8.8 Breathing Circuit Parameters

System Compliance: Volume of gas lost due to internal compliance (manual
ventilation mode only):
≤ 2mL/cm H2O
Internal Compliance: ≤ 4mL/cm H2O
Impedance in Manual Mode: ≤ 6 cmH2O (the gas under test is a bi-directional sine wave
at a frequency of 20 with tidal volume of 1 L)
Impedance in Automatic ≤ 6 cmH2O (the gas under test is a semi-sine wave at a
Ventilation Mode: frequency of 20 with tidal volume of 1 L)

TABLE 9-19 Breathing Circuit Parameters

9 - 12 046-002773-00 A5™ Operating Instructions

Product Specifications Anesthetic Gas Scavenging System (AGSS)

Leakage: ≤ 150 mL @ 3kPa

System Safety Pressure on 110 ±10 cmH2O @ 10-110 L/min
Patient Circuit:

TABLE 9-19 Breathing Circuit Parameters

9.8.9 Materials
All materials in contact with the patient’s exhaled gas are autoclavable, except the flow sensors,
pressure gauge, bellows, and O2 cell. All materials in contact with the patient's gas comply with
ISO 10993-1, ISO 10993-5, ISO 10993-10.

9.9 Anesthetic Gas Scavenging System (AGSS)

Type of the Applicable Low flow
Disposable System:
Size: 430mm x 132mm x 114mm
Tolerance: +/- 5mm
Weight 2.15 kg +/- 0.05 kg
Extract Flow: 25 to 50 L/min
Resistance: ≤ 0.35 kPa @ 75 L/min

TABLE 9-20 Anesthetic Gas Scavenging System (AGSS)

9.10 Monitor Module

9.10.1 AG Module
Measurement mode: Sidestream
Warm-up time: ISO accuracy mode: <45 s
Full accuracy mode: <10 min
Sampling rate: Sampling rate:
120/150/200 ml/min: High Volume AG Watertrap
70/90/120 ml/min: Low Volume AG Watertrap
Accuracy: ±10 ml/min or ±10%, whichever is greater
Emptying interval (half full, worst case): High volume AG watertrap: 17h @ 200 mL/min,
37°C, 100% RH
Low volume AG watertrap: 20h @ 120 mL/min,
37°C, 100% RH
Gas: CO2, O2 (Paramagnetic O2 module), N2O, and any of the five
anesthetic agents: DES, ISO, ENF, SEV and HAL.

1): 10% to 90%. Sample gas flow: 200 ml/min. DRYLINETM watertrap. Adult DRYLINETM sampling line (2.5 m).
2): 10% to 90%. Sample gas flow: 120 ml/min. DRYLINETM watertrap. Pediatric DRYLINETM sampling line (2.5 m).
TABLE 9-21 AG Module

A5™ Operating Instructions 046-002773-00 9 - 13

Monitor Module Product Specifications

Range: CO2 : 0 to 30 %
O2 : 0 to 100 %
N2O : 0 to 100 %
DES : 0 to 30 %
SEV : 0 to 30 %
ENF : 0 to 30 %
ISO : 0 to 30 %
HAL : 0 to 30 %
ISO accuracy mode As Full accuracy specifications, but derated as follows:
Add ±0.3%ABS to accuracy for CO2;
Add ±8%REL to accuracy for all agents;
N2O accuracy is ± (8%REL+2%ABS).
Full accuracy mode Gas Range (%REL) Accuracy (%ABS)
CO2 0 to 1 ±0.1
1 to 5 ±0.2
5 to 7 ±0.3
7 to 10 ±0.5
>10 Unspecified
N2O 0 to 20 ±2
20 to 100 ±3
O2 0 to 25 ±1
25 to 80 ±2
80 to 100 ±3
DES 0 to 1 ±0.15
1 to 5 ±0.2
5 to 10 ±0.4
10 to 15 ±0.6
15 to 18 ±1
>18 Unspecified
SEV 0 to 1 ±0.15
1 to 5 ±0.2
5 to 8 ±0.4
>8 Unspecified
ENF, ISO, HAL 0 to 1 ±0.15
1 to 5 ±0.2
>5 Unspecified
1)
Rise time@200ml/min CO2 : ≤250 ms
O2 :≤500 ms
N2O : ≤250 ms
ENF : ≤350 ms
DES, SEV, ISO, HAL: ≤300 ms

1): 10% to 90%. Sample gas flow: 200 ml/min. DRYLINETM watertrap. Adult DRYLINETM sampling line (2.5 m).
2): 10% to 90%. Sample gas flow: 120 ml/min. DRYLINETM watertrap. Pediatric DRYLINETM sampling line (2.5 m).
TABLE 9-21 AG Module

9 - 14 046-002773-00 A5™ Operating Instructions

Product Specifications Monitor Module

Rise time@120ml/min 2) CO2 : ≤250 ms

O2 : ≤500 ms
N2O : ≤250 ms
ENF : ≤350 ms
DES, SEV, ISO, HAL: ≤300 ms
Delay time <4 s
Update time Once per second
Calibration Once per year
Primary agent ID threshold 0.15% (0.4% during ISO accuracy mode)
Secondary agent ID threshold 0.3% (0.5% during ISO accuracy mode) or 5%REL (10% REL for
Isoflurane) of primary agent if primary agent >10%
Agent ID time Less than 3 breaths, typically 12 seconds
Measurement accuracy drift Meets accuracy requirements within 6 hours
Rate measurement Measurement range: 2 rpm to 100 rpm
Resolution: 1 rpm
Measurement accuracy:
2 rpm to 60 rpm: ± 1 rpm
60 rpm to 100 rpm: ± 2 rpm
1): 10% to 90%. Sample gas flow: 200 ml/min. DRYLINETM watertrap. Adult DRYLINETM sampling line (2.5 m).
2): 10% to 90%. Sample gas flow: 120 ml/min. DRYLINETM watertrap. Pediatric DRYLINETM sampling line (2.5 m).
TABLE 9-21 AG Module

NOTE: Inaccuracy specifications are affected by the breath rate and I:E change.
The end-tidal gas reading is within specification for breath rate below
15BPM and I:E ratio smaller than 1:1 relative to the gas readings
without breath; Add ±6%REL to inaccuracy for HAL and O2 for breath
rate larger than 15 BPM; Add ±6%REL to inaccuracy for all gases for
breath rate larger than 30 BPM (inaccuracy for HAL and O2 are
unspecified in this case); inaccuracy is unspecified for breath rate larger
than 60 BPM.

NOTE: The ability to properly resolve end-tidal values can be measured by

using the set-up described in ISO 80601-2-55:2011 figure 201.101. In
short, the method consists of sampling gas from two different sources
connected to an electrically controlled pneumatic valve to permit rapid
switching between the two sources. During the test, the valve is set to
switch gas source at a number of frequencies (simulating the range of
specified breath rates) and for each frequency the end-tidal value
presented by the gas analyzer is noted. From a diagram of end-tidal
value over frequency, the frequency at which the gas analyzer is no
longer able to resolve end-tidal values according to specification is
identified. This ability to properly resolve end-tidal values is listed in
the corresponding AIONTM Multigas Analyzer technical specification.

NOTE: Data sample rate 25 Hz. Data presentation is 50 Hz, every second data
point is interpolated.

NOTE: Inspiratory and end tidal CO2 concentration readings are identified by
AIONTM Platinum Multigas Analyzers using the lowest and highest
values respectively of the temporal CO2-curve. Corresponding
readings of N2O and anesthetic agents are taken at the same point in
time. Inspiratory and end-tidal O2 concentration readings are
identified by the O2 mean value during the respiratory phase as
identified by the temporal CO2 curve. Once correctly identified, the
highest and lowest O2 concentration readings during each part of the
phase will be presented as inspiratory and end-tidal O2 respectively.

A5™ Operating Instructions 046-002773-00 9 - 15

Monitor Module Product Specifications

NOTE: The rated respiration rate measurement range for AG module is 2 to

100 bpm. The data sample rate is 25 Hz. The EtCO2 concentration
reading uses the highest value of the CO2 waveform within the
breathing cycle. The EtN2O and EtAA concentration readings use the
value measured at the moment when the EtCO2 concentration is
recorded. The FiO2 concentration reading uses the highest value of the
O2 waveform within the breathing cycle.

NOTE: The rated respiration rate measurement range for AG module is

calculated based on the CO2 waveform. The test method used to
determine the rated respiration rate range: Utilize the valves to switch
the two sampling gases at different frequencies (simulating specified
breath rates). Record the EtCO2 value at each frequency. By drawing the
coordinate diagram which indicates the corresponding relationship
between end-tidal value and breathing frequency, the range of
breathing frequency can be obtained.

9.10.2 Alarms
AG Alarm Limits Range Default Step Unit
EtCO2 High Limit Off, 2 to 99 Adult/Ped: 50 mmHg 1 mmHg, %, kPa
Infant: 45 mmHg
EtCO2 Low Limit Off, 0 to 97 Adult/Ped: 25 mmHg
Infant: 30 mmHg
FiCO2 High Limit Off, 1 to 99 4 mmHg
EtO2 High Limit Off, low+2 to 100 88%
EtO2 Low Limit Off, 18 to high-2 18%
EtN2O High Limit Off, 2 to 100 55% 1 %
EtN2O Low Limit Off, 0 to 98 0%
FiN2O High Limit Off, 2 to 100 53%
FiN2O Low Limit Off, 0 to 98 0%
EtHal High Limit Off, 0.2 to 5.0 3% 0.1 %
EtHal Low Limit Off, 0.0 to 4.8 0%
FiHal High Limit Off, 0.2 to 5.0 2%
FiHal Low Limit Off, 0.0 to 4.8 0%
EtEnf High Limit Off, 0.2 to 5.0 3% 0.1 %
EtEnf Low Limit Off, 0.0 to 4.8 0%
FiEnf High Limit Off, 0.2 to 5.0 2%
FiEnf Low Limit Off, 0.0 to 4.8 0%
EtIso High Limit Off, 0.2 to 5.0 3% 0.1 %
EtIso Low Limit Off, 0.0 to 4.8 0%
FiIso High Limit Off, 0.2 to 5.0 2%
FiIso Low Limit Off, 0.0 to 4.8 0%
EtSev High Limit Off, 0.2 to 8.0 6% 0.1 %
EtSev Low Limit Off, 0.0 to 7.8 0%
FiSevHigh Limit Off, 0.2 to 8.0 5%
FiSev Low Limit Off, 0.0 to 7.8 0%

TABLE 9-22 Alarms

9 - 16 046-002773-00 A5™ Operating Instructions

Product Specifications Monitor Module

EtDes High Limit Off, 0.2 to 18.0 8% 0.1 %

EtDes Low Limit Off, 0.0 to 17.8 0%
FiDes High Limit Off, 0.2 to 18.0 6%
FiDes Low Limit Off, 0.0 to 17.8 0%
Mixed Agent Low priority
Multiple halogenated Anesthesia agents value > 3 MAC Medium priority

TABLE 9-22 Alarms

9.10.3 Effect of Interfering Gas on AG Measured Value

Gas Contaminants Quantitive effect(%ABS)3)
CO2 N 2O Agents 1) O2

CO2 0 0.1 0.1 0.2

N 2O 0.1 0 0.1 0.2
Agents 1) 2) 0 0.1 0.14) 1.0

<100% Xenon 0.1 0 0 0.5

<50% Helium 0.1 0 0 0.5
<0.1% Ethanol 0 0 0 0.5
<1% Acetone 0.1 0.1 0 0.5
<1% Methane 0.1 0.1 0 0.5
Saturated Isopropanol vapour 0.1 0 0 0.5
Metered dose inhaler propellants Unspecified Unspecified Unspecified 0.5

1) Agents represents one of DES, ISO, ENF, SEV, and HAL.

2) Multiple agent interference on CO2, N2O and O2 is typically the same as single agent interference.
3) For CO2, N2O and Agents, maximum interference from each gas at concentrations within specified accuracy
ranges for each gas. The total interference of all gases is never larger than 5%REL.
4) Interference for one of the five agents with secondary agent.
TABLE 9-23 Effect of Interfering Gas on AG Measured Value

A5™ Operating Instructions 046-002773-00 9 - 17

Ventilator Specifications Product Specifications

9.11 Ventilator Specifications

General Ventilator Specifications
Ventilation Modes: • Manual ventilation mode with breathing bag
• Spontaneous ventilation in manual mode with APL fully
open
• Volume Control Ventilation (VCV) mode with PLV function
• Pressure Control Ventilation (PCV) mode
with/without VG ventilation mode
• Pressure Support (PS) ventilation mode
• Synchronous Intermittent Mandatory Ventilation (SIMV)
mode with VCV ventilation mode
• Synchronous Intermittent Mandatory Ventilation (SIMV)
mode with PCV ventilation mode
Patient Size: Adult, Pediatric, Infant
Fresh Gas Flow Compensation: Volume-compensated ventilation
Inspiratory Flow (Min/Max): The A5 does not allow combinations of ventilation
parameters (e.g., I: E, Vt and Freq.) to be set if the resultant
inspiratory flow is greater than 110 L/m maximum or less
than 2.4 L/min minimum.
Inspiratory Flow Range: 2.4 to 110 L/min
Low Flow Anesthesia: Tidal volume delivery at 1 L/min total fresh gas flow.
Trigger Window: PS and SIMV are adjustable flow triggers.
Inspiratory Trigger Level: 1 to 15 L/min
Plateau (End Insp.): Plateau pressure in VCV and SIMV-VC mode. Adjustable
from Off, 5 to 60% of inspiratory period.

TABLE 9-24 General Ventilator Specifications

Ventilator Parameter Settings Range

Apnea Ti: 0.2 to 5.0 sec (PS), Step: 0.1 sec
Tidal Volume: 20 to 1500 mL (VCV, SIMV-VC, PCV), Step: 1 mL
Respiration Rate: 4 to 100 bpm (VCV, SIMV-VC, PCV, SIMV-PC),
Step: 1 bpm
Minimum Rate: 2 to 60 bpm (PS), Step: 1 bpm
I:E 4:1 to 1:8 (VCV, PCV), Step: 0.5
Tinsp: 0.2 to 5 sec (SIMV-PC, SIMV-VC), Step: 0.1 sec
Pinsp: 5 to 70 cmH2O (PCV, SIMV-PC), Step: 1 cmH2O
5 to 1500 mL volume delivery
Tpause: OFF, 5 to 60% (VCV, SIMV-VC), Step: 1%
Plimit: 10 to 100 cmH2O (VCV, SIMV-VC), Step: 1 cmH2O
PEEP: OFF, 3 to 30 cmH2O (VCV, SIMV-VC, PCV, SIMV-PC, PS), Step:
1 cmH2O
ΔP: 3 to 50 cmH2O (SIMV-VC, SIMV-PC, PS), Step: 1 cmH2O
Trigger: 1 to 15 L/min (SIMV-VC, SIMV-PC, PS), Step: 1 L/min
Tslope: 0.0 to 2.0 sec (SIMV-VC, SIMV-PC*, PCV, PS), Step: 0.1 sec
NOTE: The Tslope setting is an approximation. The exact
waveform shape may not be realized under certain clinical
scenarios.

TABLE 9-25 Ventilator Parameter Settings Range

9 - 18 046-002773-00 A5™ Operating Instructions

Product Specifications Ventilator Specifications

VtG* Off, 20 to 1500 mL (PCV), Step: 1

PlimVG* 5 to 100 cmH2O (PCV), Step: 1 cmH2O

TABLE 9-25 Ventilator Parameter Settings Range

Ventilator Performance
Drive Pressure: 280 to 600 kPa
Inspiratory flow range: 2.4 to 110 L/min
Flow Valve Range: 1 to 110 L/min

TABLE 9-26 Ventilator Performance

Ventilator Monitored Parameters

Oxygen Monitor: Type: Galvanic fuel cell
FiO2 displayed: 18 to 100 vol% O2
Accuracy of measurements: ± (volume fraction of
2.5%+2.5% gas level)
Response Time of O2 Sensor: ≤ 20 seconds
Measurement accuracy drift: Meets accuracy requirements
within 6 hours
Pressure Monitor: PEEP range: 0 to 70 cmH2O
Pmean range: -20 to 120 cmH2O
Ppeak range: -20 to 120 cmH2O
Pplateau range: -20 to 120 cmH2O
Ventilator Monitor: Tidal Volume Range: 0 to 3000 mL
Minute Volume Range: 0 to 100 L/min
Respiration Monitor: Rate range: 0 to 120 bpm

TABLE 9-27 Ventilator Monitored Parameters

Control and Monitoring Accuracy *

Volume Control (O2 driving): <60 mL ±10 mL
≥60 mL and ≤210 mL ±15 mL
>210 mL ±7% of the set value
Pressure Control: Pinsp: ±2.5 cmH2O or ±7% of the set value, whichever is
greater
Plimit: ±10% of the set value
PEEP Control: 3 to 30 cmH2O: ± 2.0 cmH2O, or ±10% of the displayed
value, whichever is greater
OFF: not defined
Volume Monitoring (O2 driving): <60 mL ±10 mL
≥60 mL and ≤210 mL ±18 mL
>210 mL ±9% of the set value
Airway Pressure Monitoring: ±2.0cmH2O or ±5% of the set value, whichever is greater
PEEP Monitoring Accuracy 0 to 30 cmH2O: ±2.0 cmH2O, or ±10% of the displayed value,
whichever is greater
> 30 cmH2O: not defined
Respiration Monitoring Accuracy: ±1 bpm or ±10% of the set value, whichever is smaller

TABLE 9-28 Control and Monitoring Accuracy

A5™ Operating Instructions 046-002773-00 9 - 19

Displays and Controls Specifications Product Specifications

Minute Volume Monitoring Accuracy: 0 to 30 L/min ±15% of the displayed value, repeatable to
±5% over a 1-hour period
* Specifications are applicable after warm-up time of the Breathing System (Section 9.8.6).

TABLE 9-28 Control and Monitoring Accuracy

9.12 Displays and Controls Specifications

9.12.1 Electronic Controls
Display Size: Color LCD, 15 inch diagonal, 4:3 ratio, 1024 X 768 resolution
TFT technology with touch screen
Graphic Waveforms: Airway Pressure and Flow
Graphic Virtual Flow Meters: Displayed range (N2O, Air, O2): 0 to 15 L/min
Control range (Air, O2): 0 to 15 L/min
Control range (N2O): 0 to 10 L/min
Accuracy: ±10% or 0.12 L/min, whichever is greater
Resolution:
50 mL/min @ 0 to 1 L/min
100 mL/min @ 1 to 15 L/min
Numeric Data: Tidal Volume, Minute Volume, Peak airway pressure, PEEP,
Mean or Plateau pressure, Breath Rate, FiO2
AC Power Indicator LED: Green illuminated = plugged active AC power line
Not illuminated = unplugged or inactive AC power line
Battery State Indicator LED: Solid green illuminated = battery supply is charging or fully
charged
Not illuminated = battery supply is discharging or not
charging
Work Light: Settings: Off, Low, High
Main Power Switch: ON position = power applied to unit, O2 fresh gas flow
available
Power Standby position = power applied only to charge
battery supply, O2 fresh gas flow not available

Note: Flow of Air is independent of the main power switch

position and is regulated by the flow control knobs.
Touchpad : Allows alternate control of the touch screen
Mouse: SB port on rear of A5 allows connection of a mouse for
alternate control of the touch screen.

TABLE 9-29 Electronic Controls

9 - 20 046-002773-00 A5™ Operating Instructions

Product Specifications Alarms

9.12.2 Pneumatic Controls

Line Pressure Gauges: Gauges: N2O, Air, O2
Range: 0 to 145 psi (0 to 1000 kPa)
Accuracy: ± (4% of full scale reading + 8% of actual reading)
Units of measure: kPa, psi
Cylinder Pressure Gauges: Gauges: N2O, Air, O2
N2O: 0 to 1400 psi (0 to 10 MPa)
Air: 0 to 3500 psi (0 to 25 MPa)
O2: 0 to 3500 psi (0 to 25 MPa)
Accuracy: ± (4% of full scale reading + 8% of actual reading)
Units of measure: kPa, psi
Individual Flow Meter, Control Needle Configuration: N2O, Air, O2
Valve and Knob: Displayed Range: N2O, Air, O2: 0 to 15 L/min
Control Range (N2O): 0 to 10 L/min
Control Range (Air): 0 to 15 L/min
Control Range (O2): 0 to 15 L/min
Accuracy: ±10% or 0.12 L/min, whichever is greater
Resolution: 50 mL/min @ 0 to 1 L/min
100 mL/min @ 1 to 15 L/min
Rotations: 5 (from 0 flow to maximum flow)
Total Flow Meter Range: 0 to 10 L/min ±10% of the indicated value for flows
(between 10% and 100% of full scale with oxygen)
Auxiliary O2 and Air Flow Meter: Flow range for each meter: 0 to 15 L/min
Auxiliary O2 Gas Power Outlet: Pressure range: 280 to 600 kPa
Maximum flow: ≥90 L/min
O2 Flush Pushbutton (green): Flow rate: 35 to 50 L/min
Inspiratory Airway Pressure Gauge: Range: -20 to 100 cmH2O
Accuracy: ± (2% of full scale reading + 4% of actual reading)

TABLE 9-30 Pneumatic Controls

9.13 Alarms
Self-test: Self-testing of alarm system functions (alarm light, speaker,
and buzzer) is performed when A5 System is powered on.
Alarm Indicators: Audible: speaker / buzzer
Visual: alarm light and on-screen alarm messages
(Audible and visual alarms comply with the requirements of
IEC 60601-1-8.)
Alarm Categories: Physiological alarms: three levels (high, medium, low)
Technical alarms: three levels (high, medium, low)
Sound Levels: 10 alarm sound levels, adjustable (levels 1 to 10)
Alarm Status: Normal Status: all alarms are functioning properly
Silence Status: silenced alarms do not produce alarm audio;
only new alarms produce alarm audio
Sound Pressure levels (normal ≤ 60 dBA
operation without alarm): Measured from the patient's head location at 1 meter
height, 1 meter from the front of the unit, and 1 meter to the
left of the unit.

TABLE 9-31 Alarms

A5™ Operating Instructions 046-002773-00 9 - 21

Safety Specifications Product Specifications

9.14 Safety Specifications

Vibration Test: Frequency range: 10 to 2000 Hz

ASD10 to 100Hz: 1.0 (m/s2)2/Hz
ASD 100 to 200Hz: -3 dB/Octave
ASD200 to 2000Hz: 0.5 (m/s2)2/Hz
Duration: 10 min per perpendicular axis (3 total)
Shock Test: Peak acceleration: 150 m/s2 (15 g)
Duration: 11 ms
Pulse shape: half-sine
Number of shocks: 3 shocks per direction per axis (18 total)
Drop: Complies with the requirements of clause 15.3.5 in IEC 60601-1.
Spillage and Harmful Complies with the requirements of clause 11.6.3 in IEC 60601-1 and also the
Ingress of Water: requirements in IEC 60529 for protection against vertically falling water drops
equipment (IPX1).
Surface Temperature: Complies with the requirements of clauses 11.1 in IEC 60601-1.
Mechanical Stability: Complies with the requirements of clause 9.4 in IEC 60601-1.
Incompatibility with Complies with the requirements of clause 15.4 in IEC 60601-1.
External Connectors:
Enclosure Rigidity and Complies with the requirements of clauses 15.3.2, 15.3.3, 15.3.6, and 15.3.7 in
Strength: IEC 60601-1.
Impairment of Complies with the requirements of clause 13.2.7 in IEC 60601-1.
Cooling:
Leakage Current: Complies with the requirements of clause 8.7 in IEC 60601-1.
Earth leakage current:
• Normal condition ≤ 500 uA
• Single fault condition ≤ 1000 uA
Enclosure leakage current:
• Normal condition ≤ 100 uA
• Single fault condition ≤ 300 uA
Patient leakage current:
• Normal condition ≤ 100 uA
• Single fault condition ≤ 500 uA
Patient auxiliary current d.c.:
• Normal condition ≤ 10 uA
• Single fault condition ≤ 50 uA
Patient auxiliary current a.c.:
• Normal condition ≤ 100 uA
• Single fault condition ≤ 500 uA
Patient leakage current (applied part plus mains voltage):
• Single fault condition ≤ 5000 uA
Dielectric Strength: Complies with the requirements of clause 8.8.3 in IEC 60601-1.
Mains supply to earth (A-a1): 1500 VRMS, 1 min
Mains supply to applied part (B-a): 4000 VRMS, 1 min
Applied part to earth (B-d): 1500 VRMS, 1 min
Isolation at network port: 1500 VRMS, 1 min

TABLE 9-32 Safety Specifications

9 - 22 046-002773-00 A5™ Operating Instructions

Product Specifications ASTM F 1208 – 89 (2005) Disclosures

Grounding Complies with the requirements of clause 8.6 in IEC 60601-1.

Impedance: The impedance between the protective earth terminal and any accessible
metal part (e.g., screw and equipotential stud) that is protectively earthed
does not exceed 0.1 ohm.
Protective Grounding: Complies with the requirements of clause 8.6 in IEC 60601-1.
The protective earth terminal is not used for the mechanical connection
between different parts of the equipment or the fixing of any component not
related to protective earthing or functional earthing.

TABLE 9-32 Safety Specifications

9.15 ASTM F 1208 – 89 (2005) Disclosures

Based on the following disclosures, the A5 meets ASTM Standard Specification F1208 for Anesthesia
Breathing Systems.

9.15.1 Leakage of Breathing System

Mode Resistance Pressure
Leakage 10.19 mL/min @3kPa
(Manual mode, Bypass Off )
Leakage 15.10 mL/min @3kPa
(Manual mode, Bypass On)
Leakage 8.15 mL/min @3kPa
(Mechanical Ventilation mode,
Bypass Off )
Leakage 14.77 mL/min @3kPa
(Mechanical Ventilation mode,
Bypass On)

TABLE 9-33 Leakage of Breathing System

9.15.2 Resistance of Breathing Systems

The typical pressure drops due to inspiratory and expiratory gas flow in the breathing system at
reference flows of 0.5 and 1.0 L/sec are:

• Manual, Inspiratory flow: flow rate = 0.5 L/s @ 0.59 kPa resistance
• Manual, Inspiratory flow: flow rate = 1.0 L/s @ 0.24 kPa resistance
• Manual, Expiratory flow: flow rate = 0.5 L/s @ 0.21 kPa resistance
• Manual, Expiratory flow: flow rate = 1.0 L/s @ 0.43 kPa resistance
• Auto, Inspiratory flow: flow rate = 0.5 L/s @ 0.23 kPa resistance
• Auto, Inspiratory flow: flow rate = 1.0 L/s @ 0.58 kPa resistance
• Auto, Expiratory flow: flow rate = 0.5 L/s @ 0.44 kPa resistance
• Auto, Expiratory flow: flow rate = 1.0 L/s @ 0.20 kPa resistance

9.15.3 CO2 Absorber Resistance

For a filled CO2 absorber, resistance at 1 L/sec flow = 0.14 kPa

9.15.4 CO2 Absorber Capacity

CO2 absorber capacity is 1 Pre-Pak or 1500 mL.

A5™ Operating Instructions 046-002773-00 9 - 23

Data Storage (Non-Volatile) and Recording Product Specifications

9.15.5 Unidirectional Valve Opening Pressure

Dry: 0.03 kPa opening pressure
Wet: 0.05 kPa opening pressure.

9.16 Data Storage (Non-Volatile) and Recording

Configuration Storage: A5 anesthesia system supports one factory configuration group
and one user configuration group. Each configuration has three
patient size types: Adult, Pediatric, and Infant.
Log Storage: 500 entries of event log
500 entries of activity log
500 entries of error log
500 entries of service log

TABLE 9-34 Data Storage (Non-Volatile) and Recording

9.17 Electromagnetic Compatibility

The A5 meets the requirements of IEC 60601-1-2: 2014.

NOTE: Using accessories, sensors and cables other than those specified may
result in increased electromagnetic emission or decreased
electromagnetic immunity of the equipment.

NOTE: The anesthesia machine or its components should not be used adjacent
to or stacked with other equipment. If adjacent or stacked use is
necessary, the anesthesia machine or its components should be
observed to verify normal operation in the configuration in which it will
be used.

NOTE: The anesthesia machine needs special precautions regarding EMC and
needs to be installed and put into service according to the EMC
information provided below.

NOTE: Other devices may interfere with this equipment even though they
meet the requirements of CISPR.

NOTE: When the input signal is below the minimum amplitude provided in
technical specifications, erroneous measurements could result.

NOTE: Use of portable or mobile communications devices can degrade the

performance of the equipment.

NOTE: The A5 is intended for use in professional healthcare facility

environment, If it is used in special environment, such as magnetic
resonance imaging environment, the equipment may be disrupted by
the operation of nearby equipment.

WARNING: Use of accessories, transducers and cables other than those specified or
provided by the manufacturer of this device could result in increased
electromagnetic emissions or decreased electromagnetic immunity of
this device and result in improper operation.

WARNING: Use of this device adjacent to or stacked with other device should be
avoided because it could result in improper operation. If such use is
necessary, this device and the other device should be observed to
verify that they are operating normally

9 - 24 046-002773-00 A5™ Operating Instructions

Product Specifications Electromagnetic Compatibility

WARNING: Portable RF communications equipment (including peripherals such as

antenna cables and external antennas) should be used no closer than
30 cm (12 inches) to any part of the this device, including cables
specified by the manufacturer. Otherwise, degradation of the
performance of this device could result.

GUIDANCE AND DECLARATION - ELECTROMAGNETIC EMISSION

The A5 is intended for use in the specified electromagnetic environment. The customer or the user of the
A5 should assure that it is used in such an environment as described below.

EMISSIONS TEST COMPLIANCE ELECTROMAGNETIC ENVIRONMENT - GUIDANCE

RF emissions CISPR 11 Group 1 The A5 uses RF energy only for its internal function.
Therefore, its RF emissions are very low and are not likely to
cause any interference in nearby electronic equipment.
RF emissions CISPR 11 Class B The A5 is suitable for use in all establishments, including
Harmonic emissions Not applicable domestic establishments and those directly connected to
the public low-voltage power supply network that supplies
IEC 60601-1-2
buildings used for domestic purposes.
EN 61000-3-2
Voltage fluctuations/ Not applicable
flicker emissions
IEC 60601-1-2
EN 61000-3-3
TABLE 9-35 Guidance and Declaration - Electromagnetic Emission

GUIDANCE AND DECLARATION - ELECTROMAGNETIC IMMUNITY

The A5 is intended for use in the specified electromagnetic environment. The customer or the user of the
A5 should assure that it is used in such an environment as described below.

IEC 60601 TEST COMPLIANCE ELECTROMAGNETIC

IMMUNITY TEST LEVEL LEVEL ENVIRONMENT - GUIDANCE
Electrostatic ±8 kV contact ±8 kV contact Floors should be wood, concrete or
discharge (ESD) ±15kV air ±15kV air ceramic tile. If floors are covered
IEC 61000-4-2 with synthetic material, the relative
humidity should be at least 30%.
Electrical fast ±2 kV for power ±2 kV for power Mains power quality should be that
transient/burst supply lines supply lines of a typical commercial or hospital
IEC 61000-4-4 ±1 kV for input/ ±1 kV for input/ environment.
output lines output lines
(length greater than (length greater than
3 m) 3 m)
Surge ±1 kV line(s) to ±1 kV line(s) to
IEC 61000-4-5 line(s) line(s)
±2 kV line(s) to ±2 kV line(s) to
earth earth
Voltage dips and 0 % UT for 0,5 cycle 0 % UT for 0,5 cycle Mains power quality should be that
Voltage of a typical commercial or hospital
interruptions 0 % UT for 1 cycle 0 % UT for 1 cycle environment. If the user of our
IEC 61000-4-11 and 70 % UT for 25/ and 70 % UT for 25/ product requires continued
30 cycles 30 cycles operation during power mains
interruptions, it is recommended
0 % UT for 250/300 0 % UT for 250/300 that our product be powered from
cycle cycle an uninterruptible power supply or
a battery.
TABLE 9-36 Guidance and Declaration - Electromagnetic Immunity

A5™ Operating Instructions 046-002773-00 9 - 25

Electromagnetic Compatibility Product Specifications

GUIDANCE AND DECLARATION - ELECTROMAGNETIC IMMUNITY

The A5 is intended for use in the specified electromagnetic environment. The customer or the user of the
A5 should assure that it is used in such an environment as described below.

IEC 60601 TEST COMPLIANCE ELECTROMAGNETIC

IMMUNITY TEST LEVEL LEVEL ENVIRONMENT - GUIDANCE
RATED power 30 A/m 30 A/m Power frequency magnetic fields
frequency should be at levels characteristic of
magnetic fields a typical location in a typical
IEC 61000-4-8 commercial or hospital
environment.
UT is the A.C. mains voltage prior to application of the test level.
TABLE 9-36 (Continued) Guidance and Declaration - Electromagnetic Immunity

GUIDANCE AND DECLARATION - ELECTROMAGNETIC IMMUNITY

The A5 is intended for use in the specified electromagnetic environment. The customer or the user of the
A5 should assure that it is used in such an environment as described below.

IMMUNITY IEC 60601 TEST COMPLIANCE ELECTROMAGNETIC ENVIRONMENT -

TEST LEVEL LEVEL GUIDANCE
Conduced RF 3 Vrms 3 Vrms (V1) Portable and mobile RF communications
IEC 61000-4-6 150k to 80 MHz equipment should be used no closer to
6 Vrms 6 Vrms (V2) any part of the device, including cables,
than the recommended separation
in ISM bands and
distance calculated from the equation
amateur radio
applicable to the frequency of the
bandsa between transmitter. Recommended separation
0,15 MHz and 80 distance:
MHz
 3 .5 
Radiated RF EM 10V/m 10 V/m(E1) d =  P
fields 80 MHz to 2.7 GHz  V 1  150k to 80 MHz
IEC 61000-4-3
 3 .5 
Proximity fields 27 V/m 27 V/m d =   P
from RF 380 MHz to 390 MHz  E1  80 MHz to 800 MHz
wireless 28 V/m 28 V/m  7 
communicatio d =  P
 E 1 
430 MHz to 470 MHz,
ns equipment 800 MHz to 2.7 GHz
800 MHz to 960 MHz,
IEC61000-4-3 1700 MHz to 1990 where P is the maximum output power
MHz, 2400 MHz to rating of the transmitter in watts (W)
2570 MHz according to the transmitter
manufacturer and d is the
9 V/m 9 V/m recommended separation distance in
704 MHz to 787 MHz,
meters (m)b.
5100 MHz to 5800
Field strengths from fixed RF
MHz
transmitters, as determined by an
electromagnetic site surveyc, should be
less than the compliance level in each
frequency ranged
Interference may occur in the
vicinity of equipment marked
with the following symbol:

9 - 26 046-002773-00 A5™ Operating Instructions

Product Specifications Electromagnetic Compatibility

GUIDANCE AND DECLARATION - ELECTROMAGNETIC IMMUNITY

The A5 is intended for use in the specified electromagnetic environment. The customer or the user of the
A5 should assure that it is used in such an environment as described below.

IMMUNITY IEC 60601 TEST COMPLIANCE ELECTROMAGNETIC ENVIRONMENT -

TEST LEVEL LEVEL GUIDANCE
NOTE: At 80 MHz and 800 MHz, the higher frequency range applies.

NOTE: These guidelines may not apply in all situations. Electromagnetic

propagation is affected by absorption and reflection from
structures, objects and people.
a. The ISM (industrial, scientific, and medical) bands between 150 kHz and 80 MHz are 6.765 MHz
to 6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70
MHz. The amateur radio bands between 0,15 MHz and 80 MHz are 1,8 MHz to 2,0 MHz, 3,5 MHz
to 4,0 MHz, 5,3 MHz to 5,4 MHz, 7 MHz to 7,3 MHz, 10,1 MHz to 10,15 MHz, 14 MHz to 14,2 MHz,
18,07 MHz to 18,17 MHz, 21,0 MHz to 21,4 MHz, 24,89 MHz to 24,99 MHz, 28,0 MHz to 29,7 MHz
and 50,0 MHz to 54,0 MHz.
b. Compliance level in the ISM frequency bands between 150 kHz to 80 MHz and in the frequency
range 80 MHz to 2.7 GHz are intended to decrease the likelihood that portable/ mobile
communication equipment could cause interference if it is inadvertently brought into patient
areas. For this reason, an additional factor of 10/3 is used in calculating the recommended
separation distance for transmitters in these frequency ranges.
c. Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV
broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic
environment due to fixed RF transmitters, an electromagnetic site survey should be considered.
If the measured field strength in the location in which the device is used exceeds the applicable
RF compliance level above, the device should be observed to verify normal operation. If
abnormal performance is observed, additional measures may be necessary, such as reorienting
or relocating the device.
d. Over the frequency ranges 150 kHz to 80 MHz, field strengths should be less than 3V/m.

A5™ Operating Instructions 046-002773-00 9 - 27

Electromagnetic Compatibility Product Specifications

RECOMMENDED SEPARATION DISTANCES BETWEEN PORTABLE AND MOBILE RF

COMMUNICATIONS EQUIPMENT AND THIS EQUIPMENT
The A5 is intended for use in an electromagnetic environment in which radiated RF disturbance are
controlled. The customer or the user of the equipment can help prevent electromagnetic interference by
maintaining a minimum distance between portable and mobile RF communications equipment
(transmitters) and the equipment as recommended below, according to the maximum output power of
the communication equipment.
SEPARATION DISTANCE ACCORDING TO FREQUENCY OF TRANSMITTER
RATED MAXIMUM
OUTPUT POWER m
OF TRANSMITTER
WATTS (W)
150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.7 GHz

 3 .5   3 .5   7 
d = P d = P d =  P
 V 1   E 1   E1 
0.01 0.12 0.12 0.23
0.1 0.38 0.38 0.73
1 1.20 1.20 2.30
10 3.80 3.80 7.30
100 12.00 12.00 23.00
For transmitters at a maximum output power not listed above, the recommended separation distanced in
meters (m) can be determined using the equation applicable to the frequency of the transmitter, where P
is the maximum output power rating of the transmitter in watts (W) according to the transmitter
manufacturer.
NOTE: At 80 MHz and 800 MHz, the higher frequency range applies.

NOTE: These guidelines may not apply in all situations. Electromagnetic

propagation is affected by absorption and reflection from
structures, objects and people.

NOTE: At 80 MHz and 800 MHz, the separation distance for the higher
frequency range applies.

NOTE: An additional factor of 10/3 is used in calculating the recommended

separation distance for transmitters in the ISM frequency bands
between 150 kHz and 80 MHz and in the frequency range 80 MHz to
2,7 GHz to decrease the likelihood that mobile/portable
communications equipment could cause interference if it is
inadvertently brought into patient areas.

NOTE: These guidelines may not apply in all situations. Electromagnetic

propagation is affected by absorption and reflection from
structures, objects and people.

9 - 28 046-002773-00 A5™ Operating Instructions

Product Specifications Electromagnetic Compatibility

ESSENTIAL
PERFORMANCE
ANESTHESIA SYSTEM'S ESSENTIAL
PERFORMANCE TESTED DURING
EMC IMMUNITY CRITERIA DURING EMC
TESTS IMMUNITY
1. Oxygen flow under 1.1 Oxygen 1.1.1 Oxygen supply No false O2 supply failure
all conditions except supply failure failure protection alarm shall be activated and
the failure of the protection device device the fresh gas flow shall be
oxygen supply maintained when the O2
(pipeline or cylinder) supply pressure is within the
to the anaesthetic rated input pressure range.
workstation or the
generation of a 1.2 Interruption 1.2.1 Power The anesthesia system can run
technical alarm of the electrical management on AC power supply and
condition power supply battery supply, and
1. Battery in Use alarm of low
priority shall be indicated only
in case of AC power supply
failure.
2. The ventilation shall be
maintained, and the control
and monitoring accuracy shall
meet the requirements of the
specification.
3. The fresh gas flow shall be
maintained, and the accuracy
shall meet the requirements of
the specification.
1.3 Oxygen flush / /

A5™ Operating Instructions 046-002773-00 9 - 29

Electromagnetic Compatibility Product Specifications

ESSENTIAL
ANESTHESIA SYSTEM'S ESSENTIAL PERFORMANCE
TESTED DURING
PERFORMANCE EMC IMMUNITY CRITERIA DURING EMC
TESTS IMMUNITY
2. Delivery of a non- 2.1 Alarm / /
hypoxic gas mixture to condition for
the patient or power supply
generation of a failure
technical alarm 2.2 Internal 2.2.1 Battery power The residual capacity of
condition
electrical power supply battery power can be
source indicated normally when
battery power works.
2.3 Protection 2.3.1 Control and Control accuracy:
against monitoring accuracy Tidal volume: 30±10 ml
hazardous Breath rate: 30± 1 bpm or ± 10
output % of the set value, whichever is
greater

Monitoring accuracy:
Tidal volume: 30±10 ml
Breath rate: 30± 1 bpm or ± 10
% of the set value, whichever is
greater

Airway pressure: ±2.0 cmH2O

or ±5% of the measured value,
whichever is greater
2.4 Reverse flow / /
and cross-flow
protection device
2.5 Gas mixers 2.5.1 Gas mixers Accuracy:
0.2±0.1 L/min
2.6 Oxygen flush / /
3. Non-delivery of 3.1 Delivered / /
excessive vapour
concentrations of a concentration
volatile anaesthetic 3.2 Anaesthetic 3.2.1 Anaesthetic Accuracy (%):
agent or generation of
agent monitoring agent monitoring CO2: 0±0.43%
a technical alarm
equipment equipment N2O: 0±2%
condition
O2: 21± (2.5%+2.5% gas level)
DES: 2± (0.2%+15% gas level) (
only applicable for equipping
with Desflurane electrical
vaporizer )
4. Airway pressure 4.1 Airway / /
monitoring and pressure
associated alarm monitoring
equipment
5. Measurement 5.1 Measurement / /
accuracy and gas accuracy
reading alarm
5.2 Alarm / /
condition or
condition priority
generation of a
technical alarm 5.3 Supply failure / /
condition (AG module) technical alarm
condition

9 - 30 046-002773-00 A5™ Operating Instructions

 A.0 Accessories

Accessory Kits............................................................................................................................................................................................. A-2

AG Accessories .......................................................................................................................................................................................... A-2

CO2 Absorbent Canister ...................................................................................................................................................................... A-2

Gas Cylinder Accessories..................................................................................................................................................................... A-2

Gas Supply Hoses .................................................................................................................................................................................... A-3

Manuals and Reference Cards.......................................................................................................................................................... A-3

Mounting Accessories .......................................................................................................................................................................... A-3

Networking and USB Storage .......................................................................................................................................................... A-4

Vaporizers ..................................................................................................................................................................................................... A-4

A5™ Operating Instructions 046-002773-00 A-1

Accessory Kits Accessories

WARNING: Use only accessories specified in this chapter. Using other accessories
may cause incorrect measured values or equipment damage.

WARNING: Disposable accessories cannot be reused. Reuse may degrade

performance or cause cross-contamination.

WARNING: Check the accessories and their packages for damage. Do not use them
if any sign of damage is detected.

WARNING: At the end of its service life, the equipment, as well as its accessories,
must be disposed of in compliance with the guidelines regulating the
disposal of such products, and in accordance with local regulations for
contaminated and biologically hazardous items.

The following accessories are designed for the A5 Anesthesia System. The use of other accessories is
not recommended. To place an order for these or other accessories, contact Customer Service at +86
755 26582479 / 26582888 or order accessories online at www.mindray.com.

A.1 Accessory Kits

PART NUMBER DESCRIPTION
121-000994-00 A5 Kit, User Resource Kit

A.2 AG Accessories
PART NUMBER DESCRIPTION
125-000005-00 DRYLINE I, Watertrap (adult/pediatric, reusable, 3-slot)
125-000006-00 DRYLINE I, Watertrap (neonate, reusable, 3-slot)
115-043017-00 Sampling line (adult/pediatric, disposable)
115-043018-00 Sampling line (neonate, disposable)
115-043020-00 Airway adapter (straight, disposable)
115-043021-00 Airway adapter (elbow, disposable)
6800-30-50842 Multi-gas module with accessory kit (3-slot)
115-016612-00 O2 Port Cover Kit

A.3 CO2 Absorbent Canister

PART NUMBER DESCRIPTION
0683-00-0326-12 CO2 Absorbent, Pre-Pak (12)

A.4 Gas Cylinder Accessories

PART NUMBER DESCRIPTION
0348-00-0185 Washer, Seal for Cylinder

A-2 046-002773-00 A5™ Operating Instructions

Accessories Gas Supply Hoses

A.5 Gas Supply Hoses

PART NUMBER DESCRIPTION (15 FOOT LENGTH)
082-001825-00 O2 Gas Supply Hose, 15 ft, Ohmeda
082-001826-00 N2O Gas Supply Hose, 15 ft, Ohmeda
082-001827-00 Air Gas Supply Hose, 15 ft, Ohmeda
082-001828-00 VAC Gas Supply Hose, 15 ft, Ohmeda
082-001829-00 EVAC Gas Supply Hose, 15 ft, Ohmeda
082-001830-00 O2 Gas Supply Hose, 15 ft, Chemetron
082-001831-00 N2O Gas Supply Hose, 15 ft, Chemetron
082-001832-00 Air Gas Supply Hose, 15 ft, Chemetron
082-001833-00 VAC Gas Supply Hose, 15 ft, Chemetron
082-001834-00 EVAC Gas Supply Hose, 15 ft, Chemetron
082-001835-00 O2 Gas Supply Hose, 15 ft, Puritan Bennett
082-001836-00 N2O Gas Supply Hose, 15 ft, Puritan Bennett
082-001837-00 Air Gas Supply Hose, 15 ft, Puritan Bennett
082-001838-00 VAC Gas Supply Hose, 15 ft, Puritan Bennett
082-001839-00 EVAC Gas Supply Hose, 15 ft, Puritan Bennett
082-001840-00 O2 Gas Supply Hose, 15 ft, DISS Female
082-001841-00 N2O Gas Supply Hose, 15 ft, DISS Female
082-001842-00 Air Gas Supply Hose, 15 ft, DISS Female
082-001843-00 VAC Gas Supply Hose, 15 ft, DISS Female
082-001844-00 EVAC Gas Supply Hose, 15 ft, DISS Female

A.6 Manuals and Reference Cards

PART NUMBER DESCRIPTION
046-002773-01 A5 Operations Manual (Hardcopy, English)
115-040734-00 Disinfection / Cleaning Card
801-0631-00081-00 A5 Pre-Operation Checklist (English)
801-0631-00082-00 A5 Auxiliary O2/Air Reference Card

A.7 Mounting Accessories

PART NUMBER DESCRIPTION
0436-00-0169 Monitor Mounting Arm, Pivot, 12"
0386-00-0344 Mounting Kit, GM3 to GCX mount adapter plate
0040-00-0452 Mounting Kit, Passport 12M / 17M, DPM6/7, T5 & T8 to GCX Mount
Adapter Plate
115-009637-00 Kit for SMR to A5 without Hooks
0436-00-0198 Monitor Mounting Arm, Pivot, 16"
0436-00-0258 Utility Tray, Two Pivot, 24"

A5™ Operating Instructions 046-002773-00 A-3

Networking and USB Storage Accessories

PART NUMBER DESCRIPTION

045-000250-00 Writing Surface Insert (for Utility Tray)
0436-00-0259 Mount, Suction Canister
0992-00-0256 Regulator, Patient Suction
0436-00-0207 Mounting Arm, Suction Regulator
050-000702-00 Mounting Adapter Plate with Cable Hooks
115-011304-00 Cable Management Kit
115-004003-00 Mounting Kit for Passport 17M / DPM7 Monitor (top mounting)
115-004004-00 Mounting Kit for Passport 12M / DPM6 Monitor (top mounting)
008-000468-00 CPU Mount 3-4.5”/7.6-11.4 cm wide
008-000468-01 CPU Mount 1.5-3”/3.8-7.6 cm wide
008-000468-02 CPU Mount 4.5-7”/11.4-17.8 cm wide
008-000468-03 CPU Mount 7-9.5”/17.8-24.1 cm wide
115-021015-00 Spring hook material package
034-000288-00 AIMS Mounting Arm
121-001106-00 V21 w/2 modules to A Series mounting kit (kit contents listed below)
121-001111-00 A Series AIMS Mounting Ergotron kit (kit contents listed below)
045-000794-00 Ergotron AIMS Adjustable Mounting Bracket
045-000795-00 Ergotron AIMS Mounting Arm
115-017467-00 Ergotron Mounting System

A.8 Networking and USB Storage

PART NUMBER DESCRIPTION
0012-00-1274-01 CAT 5 Ethernet Cable, Patch, STP, 6' (1.83m)
0012-00-1274-02 CAT 5 Ethernet Cable, Patch, STP, 25' (7.62m)
0012-00-1392-06 CAT 5 Ethernet Cable, Crossover, STP, 6’ (1.83 m)
0012-00-1392-07 CAT 5 Ethernet Cable, Crossover, STP, 10’ (3.05 m)
0992-00-0297-01 USB Storage Device, 2GB
023-000361-00 USB Wired Mouse
0992-00-0297-04 USB Storage Device, 16GB
023-000218-00 USB Storage Device, 4GB

A.9 Vaporizers
PART NUMBER DESCRIPTION
0992-00-0148 Sevoflurane Vaporizer with Quick Fill Adapter
0004-00-0100 Sevoflurane Quick Fill Bottle Adapter
0992-00-0149 Isoflurane Vaporizer with Fill Adapter
0004-00-0101 Isoflurane Fill Bottle Adapter
115-020218-00 Three vaporizer mount
040-001997-00 Desflurane Vaporizer

A-4 046-002773-00 A5™ Operating Instructions

Accessories Scavenging Accessories

PART NUMBER DESCRIPTION

115-025532-00 Mindray Sevoflurane Quik Filler Vaporizer
040-000067-00 Mindray Quik-Fil Drain Funnel Adaptor
115-026747-00 Mindray Quik-Fil filling adapter for sevoflurane
115-025535-00 Mindray Isoflurane Key Filler Vaporizer
040-002707-00 Mindray Key Filler Adaptor for Isoflurane
801-0631-00076-00 Storage Mount for Vaporizer

A.10 Scavenging Accessories

PART NUMBER DESCRIPTION
115-037548-00 Passive scavenging kit

NOTE: The Active AGSS comes standard with the A5 system.

A5™ Operating Instructions 046-002773-00 A-5

Scavenging Accessories Accessories

This page intentionally left blank.

A-6 046-002773-00 A5™ Operating Instructions

 B.0 User Accessible Spare Parts

Active AGSS ..................................................................................................................................................................................................B-2

Breathing System......................................................................................................................................................................................B-2

CO2 Absorbent Canister .......................................................................................................................................................................B-2

Flow Sensor ..................................................................................................................................................................................................B-2

Gas Cylinder Accessories......................................................................................................................................................................B-3

O2 Sensor .......................................................................................................................................................................................................B-3

Battery..............................................................................................................................................................................................................B-3

A5™ Operating Instructions 046-002773-00 B-1

Active AGSS User Accessible Spare Parts

The following spare parts are designed for the A5 Anesthesia System. The use of other spare parts is
not recommended. To place an order for these or other spare parts, contact Customer Service at +86
755 26582479 / 26582888 or order spare parts online at www.mindray.com.

B.1 Active AGSS

PART NUMBER DESCRIPTION
115-023175-00 Waste Gas Scavenger Assembly
801-0631-00074-00 AGSS Transfer Tube
115-052160-00 Waste Gas Hose for Gas module to Quick Release Fitting

B.2 Breathing System

PART NUMBER DESCRIPTION
801-0631-00054-00 Bellows Dome, A Series
0601-30-78968 Bellows Assembly, A Series
801-0631-00057-00 Insp/Exp Connector, A Series
801-0631-00059-00 Insp/Exp Connector Rotary Cap, A Series
801-0631-00058-00 Water Trap, A Series
801-0631-00061-00 Check valve dome, A Series
801-0631-00104-00 Check valve, A Series
115-048600-00 Bag Arm - Fixed Height, A Series
115-048035-00 Flexible Bag Arm, A Series
115-051819-00 Airway pressure gauge, A Series
801-0631-00062-00 APL valve, A Series
115-046756-00 Quick release APL valve
115-025569-00 Breathing system, A5

B.3 CO2 Absorbent Canister

PART NUMBER DESCRIPTION
801-0631-00066-00 CO2 Absorbent Canister, A Series
801-0631-00099-00 CO2 Bypass Assembly, A Series
801-0631-00092-00 CO2 Absorber Hose, A Series
801-0631-00100-00 CO2 Absorber Base with Drain Valve, A Series

B.4 Flow Sensor

PART NUMBER DESCRIPTION
801-0631-00056-00 Expiratory Flow Sensor Assembly, A Series
801-0631-00060-00 Inspiratory Flow Sensor Assembly, A Series
115-008264-00 Flow sensor kit

B-2 046-002773-00 A5™ Operating Instructions

User Accessible Spare Parts Gas Cylinder Accessories

B.5 Gas Cylinder Accessories

PART NUMBER DESCRIPTION
115-033063-00 Gas Cylinder Wrench

B.6 O2 Sensor
PART NUMBER DESCRIPTION
040-001270-00 O2 Sensor, A Series
801-0631-00102-00 O2 Sensor Cable and Housing, A Series
801-0631-00091-00 O2 Sensor Cable, A Series

B.7 Battery
PART NUMBER DESCRIPTION
115-018012-00 Lithium-ion Battery

A5™ Operating Instructions 046-002773-00 B-3

Battery User Accessible Spare Parts

This page intentionally left blank.

B-4 046-002773-00 A5™ Operating Instructions

 C.0 Parameters and Factory Defaults

Waveform/Spirometry Tabs................................................................................................................................................................C-2

Alarm Limits .................................................................................................................................................................................................C-3

Setup Menu..................................................................................................................................................................................................C-5

Alarm Volume and History..................................................................................................................................................................C-8

Date and Time.............................................................................................................................................................................................C-8

Demographics ............................................................................................................................................................................................C-9

Ventilation Modes ....................................................................................................................................................................................C-9

Linked Ventilation Parameter .........................................................................................................................................................C-13

Ventilation Parameter Relationships ..........................................................................................................................................C-15

A5™ Operating Instructions 046-002773-00 C-1

Waveform/Spirometry Tabs Parameters and Factory Defaults

C.1 Waveform/Spirometry Tabs

Current selection
saved when
OBJECT RANGE DEFAULT powered off
Waveform/Spirometry Waveform tab, Spirometry Waveform tab No
Tab tab
Spirometry Tab: Loop Pressure - Volume, Flow - Pressure - Volume No
Type Volume, Pressure- Flow
Spirometry Tab: Save Reference, Baseline Reference No
Loop
Spirometry Tab: Show Off, Baseline, [time] Off No
Reference
Spirometry Tab: Pressure - Volume, Flow - Pressure - Volume No
Review Loops: Loop Volume, Pressure- Flow
Type

C-2 046-002773-00 A5™ Operating Instructions

Parameters and Factory Defaults Alarm Limits

C.2 Alarm Limits

Current selection
saved when
PARAMETER RANGE DEFAULT UNIT powered off
Peak High The greater of 10 and Adult: 50 cmH2O Yes
(Paw Low+1) to 100 Pediatric: 40
Step: 1 Infant: 40
Peak Low 0 to the lesser of 70 and Adult: 10 cmH2O Yes
(Paw High–1) Pediatric: 8
Step: 1 Infant: 8
MV High The greater of 0.2 and Adult: 12 L/min Yes
(MV Low+0.1) to 25 Pediatric: 6
Step: 0.1 Infant: 6
MV Low 0 to the lesser of 20 and Adult: 1 L/min Yes
(MV High–1) Pediatric: 1
Step: 0.1 Infant: 0.2
FiO2 High The greater of 21 and Off % Yes
(FiO2 Low+1) to 100,
Off
Step: 1
FiO2 Low 18 to the lesser of 98 18 % Yes
and (FiO2 High–1)
Step: 1
EtCO2 High Off, 2 to 99 Adult: 50 mmHg mmHg, % Yes
Step: 1 Pediatric: 50 kPa
mmHg
Infant: 45mmHg
EtCO2 Low Off, 0 to 97 Adult: 25 mmHg mmHg, % Yes
Step: 1 Pediatric: 25 kPa
mmHg
Infant: 30
FiCO2 High Off, 1 to 99 4 % Yes
Step: 1
EtN2O High Off, (Low+2) to 100 55 % Yes
Step: 1
EtN2O Low Off, 0 to (High-2) 0 % Yes
Step: 1

FiN20 High Off, (Low+2) to 100 53 % Yes

Step: 1
FiN2O Low Off, 0 to (High-2) 0 % Yes
Step: 1
EtHal High Off, (Low+0.2) to 5.0 3 % Yes
Step: 0.1
EtHal Low Off, 0.0 to (High-0.2) 0 % Yes
Step: 0.1
FiHal High Off, (Low+0.2) to 5.0 2 % Yes
Step: 0.1
FiHal Low Off, 0.0 to (High-0.2) 0 % Yes
Step: 0.1
EtEnf High Off, (Low+0.2) to 5.0 3 % Yes
Step: 0.1

A5™ Operating Instructions 046-002773-00 C-3

Alarm Limits Parameters and Factory Defaults

Current selection
saved when
PARAMETER RANGE DEFAULT UNIT powered off
EtEnf Low Off, 0.0 to (High-0.2) 0 % Yes
Step: 0.1
FiEnf High Off, (Low+0.2) to 5.0 2 % Yes
Step: 0.1
FiEnf Low Off, 0.0 to (High-0.2) 0 % Yes
Step: 0.1
Etlso High Off, (Low+0.2) to 5.0 3 % Yes
Step: 0.1
Etlso Low Off, 0.0 to (High-0.2) 0 Yes
Step: 0.1
Filso High Off, (Low+0.2) to 5.0 2 % Yes
Step: 0.1
Filso Low Off, 0.0 to (High-0.2) 0 % Yes
Step: 0.1
EtSev High Off, (Low+0.2) to 8.0 6 % Yes
Step: 0.1
EtSev Low Off, 0.0 to (High-0.2) 0 Yes
Step: 0.1
FiSev High Off, (Low+0.2) to 8.0 5 % Yes
Step: 0
FiSev Low Off, 0.0 to (High-0.2) 0 % Yes
Step: 0.1
EtDes High Off, (Low+0.2) to 18.0 8 % Yes
Step: 0.1
EtDes Low Off, 0.0 to (High-0.2) 0 % Yes
Step: 0.1
FiDes High Off, (Low+0.2) to 18.0 6 % Yes
Step: 0.1
FiDes Low Off, 0.0 to (High-0.2) 0 % Yes
Step: 0
EtO2 High Off, (Low+0.2) to 100 88 % Yes
Step: 1
EtO2 Low Off, 10 to (High-2) Off % Yes
Step: 1
CO2 Apnea 10 sec, 15 sec, 20 sec, 30 sec, Yes
Delay Time 25 sec, 30 sec, 35 sec,
40 sec

C-4 046-002773-00 A5™ Operating Instructions

Parameters and Factory Defaults Setup Menu

C.3 Setup Menu

Current selection
saved when powered
PARAMETER RANGE DEFAULT off
General Tab: Breathing Warmer On, Warmer Warmer On No
System Off
General Tab: Gas Bench Adult watertrap: Low (120 ml/min), Yes
Flow Rate Low(120 ml/min),
Med(150ml/min),
High(200 ml/min)

Infant watertrap:
Low(70 ml/min),
Med(90 ml/min),
High(120 ml/min)

Display Tab: Pressure Mean, PLAT PLAT Yes

Display
Display Tab: Plimit Line On/Off On Yes
Display Tab: Screen level 1-10 5 Yes
Brightness
Display Tab: Key Click level 1-10 3 Yes
Volume
Display Tab: CO2 Top, Bottom Top Yes
Placement
Display Tab: Gas 0-40 mmHg, 0-60 mmHg Yes
Scales:CO2 Scale 0-60 mmHg,
0-80 mmHg
Display Tab: Gas 0-6.0%, 0-9.0% Yes
Scales:Des Scale 0-9.0%,
0-18.0%
Display Tab: Gas 0-2.0%, 0-4.0% Yes
Scales:Sev Scale 0-4.0%,
0-8.0%
Display Tab: Gas 0-1.2%, 0-2.5% Yes
Scales:Iso Scale 0-2.5%,
0-5.0%
Display Tab: Gas 0-1.2%, 0-2.5% Yes
Scales:Hal Scale 0-2.5%,
0-5.0%
Display Tab: Gas 0-1.2%, 0-2.5% Yes
Scales:Enf Scale 0-2.5%,
0-5.0%
Display Tab: Gas 0-35%, 0-100% Yes
Scales:O2 Scale 0-50%,
0-100%
Display Tab: Gas 0-35%, 0-100% Yes
Scales:N2O Scale 0-50%,
0-100%

A5™ Operating Instructions 046-002773-00 C-5

Setup Menu Parameters and Factory Defaults

Current selection
saved when powered
PARAMETER RANGE DEFAULT off
Display Tab: Waveform No module: Flow Yes
Display Volume, Flow
AG module:
Volume, Flow, AA, O2,
N2O

System Tab: Language CHINESE,ENGLISH, ENGLISH Yes

FRENCH, SPANISH,
PORTUGUESE,
RUSSIAN, TURKISH,
DUTCH
System Tab: Default Adult, Pediatric, Infant Infant Yes
Settings: Default Patient
Size
System Tab: Default VCV, SIMV-VC, PCV, VCV Yes
Settings: Default Vent SIMV-PC, PS
Mode
System Tab: Manage Save as O.R. Defaults, Save as O.R. No
Defaults Load O.R. Defaults, Defaults
Restore Partial Defaults,
Import Defaults,
Export Defaults
System Tab: Change — — Yes
Password
System Tab: Units: cmH2O, hPa, mbar cmH2O Yes
Pressure
System Tab: Units: CO2 mmHg, kPa, % mmHg Yes
System Tab: Clear On, Off Off Yes
Historys
System Tab: Time Manual, Auto Manual Yes
Settings: Daylight
Savings

System Tab: Network: 0 - 255 192.168.23.250 Yes

This Machine: Configure
Ethernet: IP Address
System Tab: Network: 0 - 255 255.255.255.0 Yes
This Machine: Configure
Ethernet: Subnet
System Tab: Network: 0 - 255 — Yes
This Machine: Configure
Ethernet: Default
Gateway
System Tab: Network: 4800, 9600, 57600, 9600 Yes
This Machine: Configure 115200
Serial: Baud Rate
System Tab: Network: Odd, Even, None None Yes
This Machine: Configure
Serial: Parity
System Tab: Network: 8, 7, 6, 5 8 Yes
This Machine: Configure
Serial: Data Bits

C-6 046-002773-00 A5™ Operating Instructions

Parameters and Factory Defaults Setup Menu

Current selection
saved when powered
PARAMETER RANGE DEFAULT off
System Tab: Network: None, HL7, MR-WATO, None Yes
This Machine: Configure Philips
Serial: Protocol
System Tab: Network: 10 sec, 30 sec, 1 min, 5 1 min Yes
This Machine: Configure min, 30 min, 1 hour, 2
Serial: Interval hour , 6 hour, 12 hour,
24 hour
System Tab: Network: 2, 1. 1 Yes
This Machine: Configure
Serial: Stop Bits
System Tab: Network: 10 sec, 30 sec, 1 min, 5 1 min Yes
Network Protocol: min, 30 min, 1 hr, 2 hr, 6
Configure HL7: Interval hr, 12 hr, 24 hr
System Tab: Network: — 192.168.23.200 Yes
Network Protocol:
Configure HL7:
Destination IP
System Tab: Network: 0 - 65535 1550 Yes
Network Protocol:
Configure HL7: Port
System Tab: Network: Most Recent, 02.02.01 Most Recent Yes
Network Protocol: to 02.10.00, 02.00.00,
Configure HL7: Set HL7 01.05.02, 01.00.00 to
Compatibility 01.05.01, None
System Tab: Network: On, Off Off Yes
Network Protocol:
Configure HL7: Send
Waveforms
System Tab: Network: On, Off Off Yes
Network Protocol:
Configure HL7: Send
Alarms
System Tab: Network: On, Off Off Yes
Network Protocol:
Configure HL7: Send
Alarms Ack.
System Tab: Network: On, Off Off Yes
Network Protocol: MD2
System Tab: Network: — 192.168.23.99 Yes
Network Protocol:
Configure MD2:
Destination IP
System Tab: Network: — 6678 Yes
Network Protocol:
Configure MD2: Port
System Tab: Network: 10 sec, 30 sec, 1 min, 5 Off Yes
SNTP Protocol: Interval min, 30 min, 1 hr, 2 hr, 6
hr, 12 hr, 24 hr

A5™ Operating Instructions 046-002773-00 C-7

Alarm Volume and History Parameters and Factory Defaults

Current selection
saved when powered
PARAMETER RANGE DEFAULT off
System Tab: Network: 0 - 255 132.163.4.103 Yes
SNTP Protocol: Primary
Server IP
System Tab: Network: 0 - 255 210.72.145.44 Yes
SNTP Protocol:
Secondary Server IP

C.4 Alarm Volume and History

Current selection
saved when powered
PARAMETER RANGE DEFAULT off
Alarm Volume level 1-10 3 Yes
System Alerts level 1-10 3 Yes
Volume
Event Log: Filter High, Medium, Low, All, All Yes
Informational
Display Interval 1 min, 5 min, 10 min, 1 min, 30 1 min Yes
min, 1 hr, 2 hrs
Display Group Fresh Gas, Gas, Ventilation, All All Yes

C.5 Date and Time

Current selection
saved when powered
PARAMETER RANGE DEFAULT off
Day 1-31 1 Yes
Month 1-12 1 Yes
Year 1900-2099 2009 Yes
Hour — 00 (24 hr) Yes
12 am (12 hr)
Minute 00-60 00 Yes
AM/PM AM/PM AM Yes
12/24 hour 12, 24 12 Yes
Date format YYYY/MM/DD, MM/DD/YYYY, YYYY/MM/DD Yes
DD/MM/YYYY
Daylight Savings On, Off Off Yes
Time

C-8 046-002773-00 A5™ Operating Instructions

Parameters and Factory Defaults Demographics

C.6 Demographics
PARAMETER RANGE DEFAULT
Patient ID — —
Bed — —
First Name — —
Room — —
Last Name — —
Point of Care — —
DOB — —
Age — —
Weight(Lbs.) — —
Facility — —

C.7 Ventilation Modes

Current selection saved
OBJECT RANGE DEFAULT when powered off
Ventilation VCV, SIMV-VC, PCV, VCV Yes
Mode Tab SIMV-PC*, PS

* SIMV-PC available only on A5.

VENTILATION MODE PARAMETERS

Manual Bypass**, Alarms
VCV Vt, Rate, I:E, Tpause, PEEP, Plimit
SIMV-VC Vt, Rate, Tinsp, Tpause, PEEP, Plimit, PS (On/Off), ΔP, Trigger, Tslope,
PCV VtG**, PlimVG**, Pinsp, Rate, I:E, PEEP, Tslope
SIMV-PC** Pinsp, Rate, Tinsp, PS (On/Off ), ΔP, Trigger, PEEP, Tslope
PS Min Rate, ΔP, Trigger, PEEP, Tslope, Apnea Ti
** SIMV-PC, VtG, PlimVG, and Bypass are available only on A5.

A5™ Operating Instructions 046-002773-00 C-9

C - 10

Ventilation Modes
PARAMETER VCV SIMV-VC PCV SIMV-PC PS MANUAL
Vt Range: Range: — — — —
20 to 1500 mL 20 to 1500 mL
Step: 1 Step: 1

Defaults: Defaults:
Adult: 600 mL Adult: 600 mL
Pediatric: 120 mL Pediatric: 120 mL
Infant: 20 mL Infant: 20 mL
VtG — — Range: — — —
20 to 1500 mL
Step: 1

Default:
Off

VG — — Default: — — —
046-002773-00

Off
Rate Range: 4 to 100 bpm Range: 4 to 100 bpm Range: 4 to 100 bpm Range: 4 to 100 bpm — —
Step: 1 bpm Step: 1 bpm Step: 1 bpm Step: 1 bpm

Defaults: Defaults: Defaults: Defaults:

Adult: 8 bpm Adult: 8 bpm Adult: 8 bpm Adult: 8 bpm
Pediatric: 15 bpm Pediatric: 15 bpm Pediatric: 15 bpm Pediatric: 15 bpm
Infant: 20 bpm Infant 20 bpm Infant: 20 bpm Infant: 20 bpm
Min. Rate — — — — Range: 2 to 60 bpm —
Step: 1 bpm

Defaults:
Adult: 4 bpm
Pediatric: 6 bpm

Parameters and Factory Defaults

Infant: 12 bpm
I:E Range: 1:8 to 4:1 — Range: 1:8 to 4:1 — — —
A5™ Operating Instructions

Step: 0.5 Step: 0.5

Default: 1:2 Default: 1:2

A5™ Operating Instructions

Parameters and Factory Defaults

PARAMETER VCV SIMV-VC PCV SIMV-PC PS MANUAL
Tinsp — Range: 0.2 to 5 sec — Range: 0.2 to 5 sec — —
Step: 0.1 sec Step: 0.1 sec

Defaults: Defaults:
Adult: 2.0 sec Adult: 2.0 sec
Pediatric: 1.0 sec Pediatric: 1.0 sec
Infant: 1.0 sec Infant: 1.0 sec
Pinsp — — Range: Range: — —
PEEP+5 to 70 cmH2O PEEP+5 to 70 cmH2O
Step: 1 cmH2O Step: 1 cmH2O

Defaults: Defaults:
Adult: 15 cmH2O Adult: 15 cmH2O
Pediatric: 10 cmH2O Pediatric: 10 cmH2O
Infant: 10 cmH2O Infant: 10 cmH2O
Tpause Range: Range: — — — —
Off, 5% to 60% Off, 5% to 60%
Step: 1% Step: 1%
046-002773-00

Default: 10% Default: 10%

Plimit Range: Range: — — — —
10 to 100 cmH2O 10 to 100 cmH2O
Step: 1 cmH2O Step: 1 cmH2O

Defaults: Defaults:
Adult: 50 cmH2O Adult: 50 cmH2O
Pediatric: 40 cmH2O Pediatric: 40 cmH2O
Infant: 20 cmH2O Infant: 20 cmH2O
PlimVG — — Range: 5 - 100 — — —
cmH2O
Step: 1 cmH2O

Default:
Pinsp
PEEP Range: Range: Range: Range: Range: —
Off, 3 to 30 cmH2O Off, 3 to 30 cmH2O Off, 3 to 30 cmH2O Off, 3 to 30 cmH2O Off, 3 to 30 cmH2O
Step: 1 cmH2O Step: 1 cmH2O Step: 1 cmH2O Step: 1 cmH2O Step: 1 cmH2O

Ventilation Modes
Default: Off Default: Off Default: Off Default: Off Default: Off
C - 11
C - 12

Ventilation Modes
PARAMETER VCV SIMV-VC PCV SIMV-PC PS MANUAL
ΔP — Range: — Range: Range: —
3 to 50 cmH2O 3 to 50 cmH2O 3 to 50 cmH2O
Step: 1 Step: 1 Step: 1

Defaults: Defaults: Defaults:

Adult: 8 cmH2O Adult: 8 cmH2O Adult: 8 cmH2O
Pediatric: 5 cmH2O Pediatric: 5 cmH2O Pediatric: 5 cmH2O
Infant: 5 cmH2O Infant: 5 cmH2O Infant: 5 cmH2O
Trigger — Range: — Range: Range: —
1 to 15 L/min 1 to 15 L/min 1 to 15 L/min
Step: 1 Step: 1 Step: 1

Defaults: Defaults: Defaults:

Adult: 3 L/min Adult: 3 L/min Adult: 3 L/min
Pediatric: 2 L/min Pediatric: 2 L/min Pediatric: 2 L/min
Infant: 2 L/min Infant: 2 L/min Infant: 2 L/min
Tslope * — Range: 0.0 to 2.0 sec Range: 0.0 to 2.0 sec Range: 0.0 to 2.0 sec Range: 0.0 to 2.0 sec —
Step: 0.1 sec Step: 0.1 sec Step: 0.1 sec Step: 0.1 sec
046-002773-00

Default: 0.2 sec Default: 0.2 sec Default: 0.2 sec Default: 0.2 sec
PS — Range: On, Off — Range: On, Off — —
Step: — Step: —

Default: Off Default: Off

Bypass — — — — — Range: On, Off
Step: —

Default: Off
Alarm — — — — — Range: On, Off
Step: —

Default: On

Parameters and Factory Defaults

Apnea Ti — — — — Range: 0.2 to 5.0 sec —
A5™ Operating Instructions

Step: 0.1 sec

Default:
5.0 sec (adult)
3.0 sec (Pediatric)
2.0 sec (Infant)
* The Tslope setting is an approximation. The exact waveform shape may not be realized under certain clinical scenarios.
Parameters and Factory Defaults Linked Ventilation Parameter

C.8 Linked Ventilation Parameter

The table below lists how parameter values are affected when changing ventilation modes. For
example, ventilation modes that share the same parameters may also share the same parameter
values when changing from one ventilation mode to the other. Other parameters may have their
values set differently when changing ventilation modes.

CURRENT PREVIOUS VENTILATION MODE

VENTILATION MODE &
PARAMETERS
AFFECTED VCV SIMV-VC PCV SIMV-PC PS
VCV Vt — * Measured Vt * *
or last value
Rate — * * * *
I:E — * * * *
Tpause — * * * *
PEEP — * * * *
Plimit — * * * *
SIMV-VC Vt * — Measured Vt * *
or last value
Rate * — * * *
Tinsp * — * * *
Tpause * — * * *
PEEP * — * * *
Plimit * — * * *
PS * — * * PS = On
ΔP * — * * *
Trigger * — * * *
Tslope * — * * *
PCV VtG * * — * *
Pinsp PLAT * — * *
or 80% PEAK
or last value
Rate * * — * *
I:E * * — * *
PEEP * * — * *
PlimVG If VtG=OFF, If VtG=OFF, — If VtG=OFF, If VtG=OFF,
then Pinsp. then Pinsp. then Pinsp. then Pinsp.
If VtG is a If VtG is a If VtG is a If VtG is a
value, then value, then value, then value, then
last value of last value of last value last value of
PlimVG. PlimVG. of PlimVG. PlimVG.
Tslope * * — * *
* The parameter value is shared between the previous and current ventilation modes.

A5™ Operating Instructions 046-002773-00 C - 13

Linked Ventilation Parameter Parameters and Factory Defaults

CURRENT PREVIOUS VENTILATION MODE

VENTILATION MODE &
PARAMETERS
AFFECTED VCV SIMV-VC PCV SIMV-PC PS
SIMV- Pinsp PLAT * * — *
PC*** or 80% PEAK
or last value
Rate * * * — *
Tinsp * * * — *
PS * * * — PS = On
ΔP * * * — *
Trigger * * * — *
PEEP * * * — *
Tslope * * * — *
PS Min Rate * * * * —
ΔP * * * * —
Trigger * * * * —
Peep * * * * —
Tslope * * * * —
Apnea Ti * * * * —
* The parameter value is shared between the previous and current ventilation modes.

C - 14 046-002773-00 A5™ Operating Instructions

Parameters and Factory Defaults Ventilation Parameter Relationships

C.9 Ventilation Parameter Relationships

VENTILATION Parameter
MODE Parameter Relationship Equation (s)
VCV Rate

4 ≤ Rate ≤ 100
Vt

20 ≤ Vt ≤ 1500
Plimit Plimit ≥ PEEP+5
10 ≤ Plimit ≤ 100
SIMV-VC Rate

4 ≤ Rate≤ 100
Vt

20 ≤ Vt ≤1500
ΔP ΔP ≤ Plimit-PEEP
3 ≤ ΔP ≤ 50
Plimit Plimit ≥ PEEP+5
Plimit ≥ ΔP+PEEP
10 ≤ Plimit ≤ 100

A5™ Operating Instructions 046-002773-00 C - 15

Ventilation Parameter Relationships Parameters and Factory Defaults

VENTILATION Parameter
MODE Parameter Relationship Equation (s)
PCV Rate

4 ≤ Rate ≤ 100
VtG If VtG is not Off.

20 ≤ Vt ≤ 1500
Pinsp Pinsp ≥ PEEP+5
5 ≤ Pinsp ≤ 70
PlimVG PlimVG ≥ PEEP+5
5 ≤ PlimVG≤ 100
SIMV-PC Rate

4 ≤ Rate ≤ 100
Pinsp Pinsp ≥ PEEP+5
5 ≤ Pinsp ≤ 70

NOTE: Even when the PlimVG, Pinsp, or ΔP parameters are inactive, they are
restricted to the parameter relationship equations.

C - 16 046-002773-00 A5™ Operating Instructions

 D.0 Pneumatic Diagram

Pneumatic Diagram of the A5 System........................................................................................................................................D-2

A5™ Operating Instructions 046-002773-00 D-1

Pneumatic Diagram of the A5 System Pneumatic Diagram

D.1 Pneumatic Diagram of the A5 System


$*66




)ORZ


)ORZ







3




2










12
1&






 














3

)ORZ



)ORZ




)ORZ










)ORZ





12
1&



 



























FIGURE D-1 Pneumatic Diagram of the A5 System

D-2 046-002773-00 A5™ Operating Instructions

Pneumatic Diagram Pneumatic Diagram of the A5 System

NO. DESCRIPTION NO. DESCRIPTION

1. O2 Gas Pipeline Connection 33. Bypass Valve
2. O2 Gas Cylinder Connection 34. O2 Sensor
3. N2O Gas Pipeline Connection 35. Airway Pressure Gauge
4. N2O Gas Cylinder Connection 36. Inspiratory Flow Sensor
5. Air Gas Pipeline Connection 37. Patient Connector
6. Air Gas Cylinder Connection 38. Expiratory Flow Sensor
7. Gas Cylinder Pressure Regulator 39. Watertrap
(360kPa)
8. Pressure Relief Valve (758kPa) 40. Expiratory Check Valve
9. Drive Gas Inlet Filter 41. Auto/Manual Bag Switch
10. Pressure Regulator (200kPa) 42. Breathing Bag
11. Inspiratory Flow Control Valve 43. APL Valve
12. Inspiratory Flow Sensor 44. Auxiliary O2 Gas Power Outlet
13. Safety Valve (110 cmH2O) 45. Bellows
14. Pop-off Valve 46. Pressure Relief Valve (1kPa, 10 cmH2O)
15. PEEP Safety Valve 47. Negative Pressure Check Valve (1 cmH2O)
16. Drive Gas Pressure Switch (140kPa) 48. Gas Container
17. PEEP Proportional Valve 49. Pressure Sensor
18. Exhaust Valve 50. Total Flowmeter
19. Flow Restrictor 51. Auxiliary Oxygen Flowmeter
20. O2 Flush Valve 52. Negative Pressure Check Valve
21. Flow Restrictor 53. Pressure Sensor
22. O2 Pressure Switch (220kPa) 54. AGSS
23. Pressure Regulating Valve (200kPa) 55. Check Valve
24. System Switch 56. Back Pressure Valve
25. Oxygen Ratio Controller (ORC) 57. Flow Compensation Valve
26. Flow Control and Electronic Display 58. Venturi Generator
Module
27. Dual Vaporizer Block 59. Muffler
28. Check Valve 60. Negative Pressure Regulator
29. Pressure Relief Valve (37.9kPa) 61. Negative Pressure Gauge
30. Auxiliary Air Flowmeter 62. Floating Overfill Protection Valve
31. Inspiratory Check Valve 63. Filter
32. Sodalime Absorber Canister 64. AG Watertrap

A5™ Operating Instructions 046-002773-00 D-3

Pneumatic Diagram of the A5 System Pneumatic Diagram

This page intentionally left blank.

D-4 046-002773-00 A5™ Operating Instructions

 E.0 Abbreviations, Symbols, and Units of
Measure

Abbreviations, Symbols, and Units of Measure...................................................................................................................... E-2

Symbols .......................................................................................................................................................................................................... E-4

Units of Measure ....................................................................................................................................................................................... E-5

Attention Symbols ................................................................................................................................................................................... E-6

A5™ Operating Instructions 046-002773-00 E-1

Abbreviations Abbreviations, Symbols, and Units of Measure

E.1 Abbreviations
ABBREVIATION DESCRIPTION
AA anesthetic agent
AG anesthetic gas
AGSS anesthetic gas scavenging system
APL airway pressure limit
Apnea Ti inspiratory time for apnea backup breaths
BTPS body temperature and pressure, saturated
C compliance (Cdyn)
CO2 carbon dioxide
Des desflurane
ENF enflurane
Et end-tidal
EtAA end-tidal anesthetic agent
EtCO2 end-tidal carbon dioxide concentration at expiration
EtDES end-tidal desflurane concentration at expiration
EtENF end-tidal enflurane concentration at expiration
EtHAL end-tidal halothane concentration at expiration
EtISO end-tidal isoflurane concentration at expiration
EtN2O end-tidal nitrous oxide concentration at expiration
EtO2 end-tidal oxygen concentration at expiration
EtSEV end-tidal sevoflurane concentration at expiration
EUI extended unique identifier
Fi fractional concentration
FiAA fractional concentration of anesthetic agent in inspired gas
FiCO2 fractional concentration of carbon dioxide in inspired gas
FiDES fractional concentration of desflurane in inspired gas
FiENF fractional concentration of enflurane in inspired gas
FiHAL fractional concentration of halothane in inspired gas
FiISO fractional concentration of isoflurane in inspired gas
FiN2O fractional concentration of nitrous oxide in inspired gas
FiO2 fractional concentration of oxygen in inspired gas
FiSEV fractional concentration of sevoflurane in inspired gas
Flow flow
HAL halothane
I:E ratio of inspiration time to expiration time
ISO isoflurane
MAC mean aveolar concentration
MEAN mean pressure
Min Rate minimum breath rate
MV minute volume
N2O nitrous oxide
O2 oxygen

E-2 046-002773-00 A5™ Operating Instructions

Abbreviations, Symbols, and Units of Measure Abbreviations

ABBREVIATION DESCRIPTION
Pinsp pressure control level of inspiration
Plimit pressure limit level
PlimVG pressure limit level of volume guarantee
PAW airway pressure
PCV pressure control ventilation
PEAK peak pressure
PEEP positive end-expiratory pressure
PLAT plateau pressure
PS pressure support
ΔP pressure support level added to PEEP
R resistance
Rate breath rate
SEV sevoflurane
SIMV-PC synchronized intermittent mandatory ventilation - pressure control
SIMV-VC synchronized intermittent mandatory ventilation - volume control
SP Spontaneous breathing
Tinsp time of inspiration
Tpause percentage of inspiratory plateau time in inspiratory time
Tslope time for the pressure to rise to target pressure
Trigger trigger sensitivity
Vt tidal volume
VtG tidal volume guarantee
VCV volume control ventilation
VG volume guarantee control

A5™ Operating Instructions 046-002773-00 E-3

Symbols Abbreviations, Symbols, and Units of Measure

E.2 Symbols
SYMBOL DESCRIPTION SYMBOL DESCRIPTION
- minus > greater than
% percent ≤ less than or equal to
/ per, divide, or ≥ greater than or equal to
≈ approximately ± plus or minus
^ power × multiply
+ plus © copyright
= equal to ™ trademark
< less than ® registered trademark

E-4 046-002773-00 A5™ Operating Instructions

Abbreviations, Symbols, and Units of Measure Units of Measure

E.3 Units of Measure

UNIT OF UNIT OF
MEASURE DESCRIPTION MEASURE DESCRIPTION
A Ampere, Amp m meter
Ah Amp hour mAh microAmp hour
bpm breath per minute mbar mbar
°C degree Celsius mg milligram
cc cubic centimeter min minute
cm centimeter ml, mL milliliter
cmH2O centimeter of water mm millimeter
dB decibel mmHg millimeter of mercury
°F Fahrenheit ms millisecond
g gram mV milliVolt
hr hour mW milliWatt
Hz Hertz ppm part per million
hPa hectoPascal s, sec second
inch inch V Volt
k kilo VA Volt Amp
kg kilogram VAC Volts alternating current
kPa kiloPascal Ω Ohm
psi pound-force per square inch μA microAmp
L, l liter μV microVolt
lb pound W Watt
nm nanometer

A5™ Operating Instructions 046-002773-00 E-5

Attention Symbols Abbreviations, Symbols, and Units of Measure

E.4 Attention Symbols

The following figures provide descriptions of symbols of Attention that are used on the device and/or
within this manual.

02

01

FIGURE E-1 Main Unit (Front View)

E-6 046-002773-00 A5™ Operating Instructions

Abbreviations, Symbols, and Units of Measure Attention Symbols

ATTENTION!
NUMBER DESCRIPTION
01 Total Flowmeter: The total flowmeter is calibrated based on 100% O2. The accuracy of
the flowmeter may degrade with other gas or mixed gas.

When viewing the readings on the total flowmeter, keep your visual angle at the same
level of the float. The reading of the scale may vary when viewed at a different angle.

If the readings shown on the electronic flowmeters differ from that on the total
flowmeter, the electronic flowmeter will prevail and the total flowmeter is an
approximate value.
02 Only vaporizers with Selectatec Interlock-Systems may be used with the A5 unit.

Use vaporizers compliant to ISO 80601-2-13. See section A.9 (page A-4) "Vaporizers".
Refer to the manufacturer’s vaporizer Instructions For Use for filling or draining the
vaporizer and other information.

Use care in lifting and manipulating vaporizers during the mounting process as their
weight may be greater than expected, based on their size and shape.

A5™ Operating Instructions 046-002773-00 E-7

Attention Symbols Abbreviations, Symbols, and Units of Measure

03 04

05

FIGURE E-2 Main Unit (Rear View)

ATTENTION!
NUMBER DESCRIPTION
03 Each auxiliary outlet is rated at 100 to 120 VAC @ 60 Hz.
04 Individual outlet current is limited to 3 A. Total mains output current is limited to 10 A.
05 Sample Line Exhaust Gas Inlet: Inlet for waste gas from an optionally attached gas
module. Merges with the AGSS connector that connects to the AGSS.

E-8 046-002773-00 A5™ Operating Instructions

Abbreviations, Symbols, and Units of Measure Attention Symbols

06

08

07

FIGURE E-3 Main Unit (Left View)

ATTENTION!
NUMBER DESCRIPTION
06 Auxiliary O2/Air Gas Outlet: Nozzle (barbed connector) for auxiliary O2/Air output.
Combines the auxiliary O2/Air flowmeters into a single output.
07 Maximum supporting weight: 25 kg at a maximum distance of 0.31 m
08 Warning: Hot

A5™ Operating Instructions 046-002773-00 E-9

Attention Symbols Abbreviations, Symbols, and Units of Measure

09

11
10

FIGURE E-4 Main Unit (Right View)

ATTENTION!
NUMBER DESCRIPTION
09 Maximum supporting weight: 25 kg at a maximum distance of 0.31 m
10 Maximum supporting weight: 25 kg at a maximum distance of 0.31 m
11 Maximum supporting weight: 25 kg at a maximum distance of 0.31 m

E - 10 046-002773-00 A5™ Operating Instructions

Abbreviations, Symbols, and Units of Measure Attention Symbols

Rear

12

Front

FIGURE E-5 Main Unit (Top View)

ATTENTION!
NUMBER DESCRIPTION
12 Top Shelf: 40 kg MAX. 88 lbs MAX.

A5™ Operating Instructions 046-002773-00 E - 11

Attention Symbols Abbreviations, Symbols, and Units of Measure

14

15

13

FIGURE E-6 Breathing System (Top View)

ATTENTION!
NUMBER DESCRIPTION
13 Do not push down on the bag arm forcefully or hang heavy objects onto it. Excessive
weight may bend and damage the bag arm.
14 Autoclavable up to 134°C. Polyphenylsulfone (PPSU).
15 APL Valve: The APL valve and PAW gauge numerics are for reference only. Calibrated
patient airway pressure is displayed on the user interface.

E - 12 046-002773-00 A5™ Operating Instructions

Abbreviations, Symbols, and Units of Measure Attention Symbols

17

16

FIGURE E-7 Breathing System (Left View)

ATTENTION!
NUMBER DESCRIPTION
16 134°C >PPSU<. Autoclavable up to 134°C.

Operating the A5 with a full water trap in the breathing system block does not allow
the water to condense appropriately. The trap should be removed and emptied when
filled with water.

Operating without a water trap will cause the Leak Test to fail.
17 Bellows Dome: The bellows dome is a transparent cover with graduation marks from
300 to 1500. These marks are for qualitative purposes only. Tidal volume (VT) should
be read exclusively from the display of the user interface. Delivered tidal volume (VT)
is a combination of bellows displacement and fresh gas flow.

A5™ Operating Instructions 046-002773-00 E - 13

Attention Symbols Abbreviations, Symbols, and Units of Measure

This page intentionally left blank.

E - 14 046-002773-00 A5™ Operating Instructions

 F.0 Preparation for Malignant
Hyperthermia Susceptible Patients

Malignant Hyperthermia Causes, Effects and Treatment ................................................................................................F-2

Malignant Hyperthermia Washout ................................................................................................................................................ F-2

Washout Procedure for Malignant Hyperthermia Susceptible Patients with A5 Anesthesia Delivery
Systems ........................................................................................................................................................................................................... F-2

References..................................................................................................................................................................................................... F-4

A5™ Operating Instructions 046-002773-00 F-1

Malignant Hyperthermia Causes, Effects and Treatment Preparation for Malignant Hyperthermia Susceptible Patients

F.1 Malignant Hyperthermia Causes, Effects and

Treatment
Malignant Hyperthermia (MH) is an uncommon inherited, life-threatening pharmacokinetic skeletal
muscle disorder involving the dysregulated myoplasmic Ca2+, hypercontracture, and
hypermetabolism. Triggering factors include exposure to potent volatile anesthetic gases and
depolarizing muscle relaxants.1-4

The disorder is characterized by skeletal muscle hypermetabolism, which is related to an

uncontrolled release of calcium from skeletal muscle sarcoplasmic reticulum. These results in
increased carbon dioxide production, increased core temperature, and generalized muscle rigidity
with resultant rhabdomyolysis, acidosis, and hyperkalemia. If untreated, MH may lead to cardiac
arrhythmia, multiorgan system failure, and death.2,3

MH has had a reported mortality rate decrease from 70%-80% to less than 5% if preventive measures
and effective management are adopted.2 The early therapy requires immediate discontinuation of all
the triggering agents, adequate oxygenation and ventilation, institution of aggressive cooling
measures, administration of dantrolene sodium, and appropriate treatment for hyperkalemia.
Ultimately, the only effective treatment for an MH crisis is the intravenous administration of
dantrolene sodium and supportive therapy to combat the symptoms.1,2

F.2 Malignant Hyperthermia Washout

To prevent MH in susceptible patients or to treat MH occurring during inhalational anesthesia, all
inhalational anesthetics should be removed from the anesthesia machine. Avoidance of potent vapor
anesthetics, such as Sevoflurane, Isoflurane or Desflurane,4 in patient cases is more challenging,
based on the complex newer generation anesthesia machines and breathing circuits which retain
anesthetic vapors long after discontinuation. The ultimate goal is to eliminate the residual anesthetic
vapor concentration within the breathing system. The recommended instructions for clearing
residual anesthetic gases include removal or disabling of vaporizers, flushing the machine using the
ventilator with a fresh gas flow rate more than 10 L/min, replacement of the carbon dioxide
absorbent and anesthesia circuit.1,3

F.3 Washout Procedure for Malignant

Hyperthermia Susceptible Patients with A5
Anesthesia Delivery Systems
The minimum inhaled concentration for triggering an episode of MH is unknown. Studies assumed a
trace concentration of inhalational anesthetics below 5 ppm to be safe.5-8 the following steps are
recommended to prepare a A5 anesthesia system for an MH-susceptible patient.

1. Turn off and remove all the vaporizers from the anesthesia system to prevent their
inadvertent use.
2. Remove the carbon dioxide absorbent, breathing bag and the entire patient breathing
circuit, filters, sampling line, water trap, and airway adapter and replace with new circuit and
parts, connect a new breathing bag or test lung to the patient Y-piece.
3. Ventilate for a minimum of 40 minutes using mechanical ventilation with the following
settings, 700 ml tidal volume, I:E ratio of 1:2, 12 breaths/minute, PEEP Off, and oxygen fresh
gas flow rate of 15 L/min.
4. Upon completion of the 40 minute flush, remove the patient breathing circuit. Allow the
bellows to deflate completely. Replace with a new patient breathing circuit, including bag
and new carbon dioxide absorbent. Perform the pre-operative checkout.

F-2 046-002773-00 A5™ Operating Instructions

Preparation for Malignant Hyperthermia Susceptible Patients Washout Procedure for Malignant Hyperthermia Susceptible Patients with

5. Maintain the oxygen fresh gas flow rate of 15 L/min throughout the case to functionally
create a non-rebreathing system and minimize rebound of volatile concentration at low
fresh gas flow rates.

Agent washout time with

A5 Anesthesia Systems
(Data on file)

FIGURE F-1 Washout Procedure for Malignant Hyperthermia Susceptible Patients

A5™ Operating Instructions 046-002773-00 F-3

References Preparation for Malignant Hyperthermia Susceptible Patients

The following guidelines are recommended by the Malignant Hyperthermia Association of

the United States (MHAUS)*

Preparation of Anesthesia Workstations to Anesthetize MH Susceptible Patients

Recommendations (4 alternatives):

1. Flush and prepare workstation according to manufacturer's recommendations or published

studies; this may take 10 to >90 minutes. Most studies also physically disconnect vaporizers
from the workstation; use a new, disposable breathing circuit; and replace the carbon
dioxide absorbent. During the case, fresh gas flow should be kept at 10 liters per minute to
avoid "rebound phenomenon" (increased release of residual volatile anesthetic agent when
fresh gas flow is reduced after a set period of flushing). or
2. Use commercially available charcoal filters that have been shown to remove trace levels of
volatile anesthetic agents within 10 minutes of application, without additional preparation.
These filters may have to be regularly replaced during the anesthetic.++ or
3. If available, use a dedicated "vapor free" machine for MH-susceptible patients. The machine
must be regularly maintained and safety-checked. or
4. If appropriate to the institution, use an ICU ventilator that has never been exposed to
volatile anesthetic agents.
For further information contact the Malignant Hyperthermia Association of the United States at http:/
/www.mhaus.org/
*: Guidelines are excerpted from the MHAUS website and do not replace the indicated instructions for

preparation of the A5.

++: This method has not been tested with A5.

F.4 References
1. Hopkins PM. Malignant hyperthermia: pharmacology of triggering. Br J Anaesth. 2011 Jul;
107 (1): 48-56.
2. Kim DC. Malignant hyperthermia. Korean J Anesthesiol. 2012 Nov; 63 (5): 391-401.
3. Kim TW, Nemergut ME. Preparation of modern anesthesia workstations for malignant
hyperthermia-susceptible patients: a review of past and present practice. Anesthesiology.
2011 Jan;114 (1):205-212.
4. Schuster F, Johannsen S, Schneiderbanger D, Roewer N. Evaluation of suspected malignant
hyperthermia events during anesthesia. BMC Anesthesiology 2013, 13: 24.
5. Gunter JB, Ball S, Tan-Win S. Preparation of the Drager Fabjus anesthesia machine for the
malignant -hyperthermia susceptible patient. Anesth Analg 2008; 107: 1936-45.
6. Reber A, Schumacher P, Urwyler A. Effects of three different types of management on the
elimination kinetics of volatile anaesthetics. Implications for malignant hyperthermia
treatment. Anaesthesia 1993; 48: 862-5.
7. Crawford MW, Prinzhausen H, Petroz GC. Accelerating the washout of inhalational
anesthetics from the Drager Primus anesthetic workstation. Anesthesiology 2007; 106:289-
94.
8. Prinzhausen H, Crawford MW, O'Rourke J, Petroz GC. Preparation of the Drager Primus
anesthetic machine for malignant hyperthermia-susceptible patients. Can J Anesth 2006; 53:
885-90.

F-4 046-002773-00 A5™ Operating Instructions

046-002773-00(13.0) December 26, 2018