ATMOS C 21 and C 31 Operating Instructions Index 03 Sug 2019

Content 1.0 1.1 1.2 1.2.1 1.2.2 1.3 1.4

Introduction...3 Notes on operating instructions...3 Intended use...4 ATMOS C 21...4 ATMOS C 31...4 Function...5 Explanation of symbols...5

2.0

For your safety...6

3.0 3.1 3.1.1 3.2 3.3 3.4 3.5 3.6 3.6.1 3.6.2

Setting up and starting up...8 Front view...8 Service compartment...9 Setting up proposal...10 Connection to electrical power line...11 Water supply / Water drainage (option)...11 Independent water supply (only ATMOS C 31)... 11 Starting up...12 Electrical connection...12 Waste water connection (with optional automatic secretion canister evacuation)...12 Connection of suction hose...12 Connection of the light guide and light source...12 Connection of the compressed air hose (option).13 Connection of the hose for ear irrigation (option, only ATMOS C 31)...13 Connection of the water system (option, only ATMOS C 31)...13

3.6.3 3.6.4 3.6.5 3.6.6 3.6.7 4.0 4.1 4.2 4.2.1 4.2.2 4.2.3 4.2.4 4.2.4.1 4.2.4.2

Operation...14 ATMOS C 21 / C 31 - Basic unit...14 Basic functions...14 Main switch...14 Maximum loads...14 How to open the covering...14 Suction system...14 Emptying the secretion canister...15 Application with disposable secretion canister systems...15 4.2.5 Light sources...16 4.2.6 Mirror quick-heater...16 4.3 Options...17 4.3.1 Secretion canister evacuation, fully-automatic (option)...17 4.3.2 Hose rinsing system (option)...17 4.3.3 Compressed-air system (option)...18 4.3.4 Connection of the ear irrigation system (option, only ATMOS C 31)...20 4.3.5 Tulip-shaped ear irrigation bowl...20 4.3.6 Mirror preheater (option)...21 4.3.7 Headlamp suspension (option)...21 4.3.8 Endoscope heating (option)...21 4.3.9 Tongue patches and swab dispenser (option)...21 4.3.10 Waste bin (option)...21 4.3.11 Holder for standard rail...21

2

5.0 5.1

Cleaning and care...22 General information on cleaning and disinfection...22 5.1.1 Cleaning the unit surface...22 5.1.2 Cleaning "application parts"...22 5.1.3 Secretion canister (without autom. secretion canister evacuation), bacterial filter and suction hose...22 5.1.4 Secretion canister and electrodes (automatic evacuation of secretion canister)...22 5.1.5 Storage canister for ear irrigation system (option, only ATMOS C 31)...22 5.1.6 Medicament sprayers...23 5.1.7 Instrument trays...23 5.1.8 Irrigation bottles and accessories...23 5.1.9 Endoscope quivers...23 5.1.10 Ear irrigation bowl...23 5.2 Recommended instrument disinfectants...24 5.3 Recommended surface disinfectants...25 5.4 Recommended endoscope disinfectants...26 6.0 6.1 6.2 6.3 6.4

Maintenance and Service...26 Changing the bacterial filter...27 Changing the rinsing container...27 Changing the hose box of the hose pump...28 Changing the heating coil of the mirror quick-heater...29

7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9

Troubleshooting...30 Electrical protection...30 Power supply...30 Mirror heating...30 Suction system...31 Light sources...31 Compressed-air system...32 Automatic secretion canister evacuation...32 Endoscope support...32 Automatic hose rinsing...32

8.0 8.1 8.2

Consumables, Accessories, Spare Parts...33 Consumables...33 Accessories and spare parts...33

9.0

Technical data...36

10.0

Disposal...38

11.0

Hygienic plan...39

12.0

Notes on EMC...41

1.0 1.1

Introduction Notes on operating instructions

These operating instructions contain important notes on how to operate the ATMOS C 21 / C 31 safely, correctly and effectively. Therefore, they are intended not only for new operating personnel to be instructed in its use, but also for use as a reference manual. They help to avoid risks, and also to reduce repair costs and down-times. Furthermore, reliability and service-life of the equipment will be increased. For these reasons these operating instructions must always be kept available near the appliance. Prior to first use please peruse the chapter 2.0 “For your safety”, in order to be prepared for any possible dangerous situations. The basic principles are: Judicious and careful work provides best protection against accidents! Operational safety and readiness for use depend not only on your capabilities, but also on care and maintenance given to the ATMOS C 21 / C 31. For this reason regular cleaning and service work are a must. Major maintenance and repair work may be carried out only by expert personnel authorised by ATMOS. In case of repairs you should insist that original spare parts only are used. You will then have the warranty that operational safety, readiness for work and the value of your appliance will be preserved. These operating instructions are valid for the following devices: ATMOS C 21 Economy Function Column REF 506.7500.0 ATMOS C 31 Economy Function Column REF 506.7510.0

• Please note that these operation instructions apply for all ATMOS C 21 / C 31 models and subsequently feature all options and applications. Therefore, it is possible that this document may contain descriptions not relevant for your specific appliance type. • The product ATMOS C 21 / C 31 bears CE marking CE 0124 according to the EC Directive of the council for medical products 93/42/EEC and meets the basic requirements of Appendix I of the directive. • The product ATMOS C 21 / C 31 complies with all applicable requirements of the directive 2011/65/EC restricting the use of certain hazardous substances in electrical and electronic equipment (“RoHS”). • The declaration of conformity and our general standard terms and conditions can be obtained on our website at www.atmosmed.com. • The quality management system applied at ATMOS has been certified according to international standards EN ISO 13485. • ATMOS will supply a service manual containing detailed circuit descriptions and schematics as well as information on adjustment and servicing to service organizations authorized by ATMOS. • Reprints - also in extracts - only with permission in written form by ATMOS. Short cuts / symbols contained in this operating instructions • Indicating a list -- Subdivision of a list/activity The recommended sequence must be followed in each case! )) Indicating particularly important advice! ªª Describing the effect of an activity.

ATMOS MedizinTechnik GmbH & Co. KG Ludwig-Kegel-Str. 16 79853 Lenzkirch Germany

Phone: + (49) 7653 689-0 Fax: + 49 7653 689-190 + 49 7653 689-493 (Service Centre) E-mail: [email protected] Internet: www.atmosmed.de

3

1.0 1.2

Introduction Intended use

1.2.1 ATMOS C 21 Name: ATMOS C 21 Main functions: • Suction • Compressed air system for medication spraying and the Politzer manoeuvre • Ear irrigation • Electric power supply for LED light handles and LED headlight • Light sources • Storage and heating of endoscopes • Mirror quick heater • Instrument deposit and heating Medical indications / application: Standard ENT examination and/or therapy Specification of the main function: • Suction at 40 l/min / -76 kPa • Alternatively suction at 55 l/min / -98 kPa • Compressed air for medication spraying, max. 2 bar • Compressed air for the Politzer manoeuvre, regulated • Ear irrigation with 37 °C ± 1 °C, max. 500 ml/min • Electric power supply for LED, 700 mA • Light source LED for light guide Application organ: Mouth to pharynx, auditory canal to the ear drum and the nasal cavities Application time: • ENT unit: Short term use (up to 30 days) • Suction / Compressed air / ear rinsing / light source: Temporary application on the patient (less than 60 minutes) Application site: Application sites are clinics and practices for ENT doctors and phoniatrists. The examination and/or therapy with the ENT unit may only be executed by medically trained persons. Contraindications: May not be used for irrigation of the paranasal sinuses. The ear irrigation should not be applied to an infected auditory canal or a perforated eardrum. The product is: active Sterility: The ENT unit is no sterile product. Single-use product / reprocessing: The ENT unit is intended for multiple use. The device and parts of the accessories are reusable. For information on reprocessing, cleaning and disinfection, please see the operating instructions.

4

1.2.2 ATMOS C 31 Name: ATMOS C 31 Main functions: • Suction • Compressed air system for medication spraying and the Politzer manoeuvre • Ear irrigation • Electric power supply for LED light handles and LED headlight • Light sources • Storage and heating of endoscopes • Mirror quick heater • Instrument deposit and heating Medical indications / application: Standard ENT examination and/or therapy Specification of the main function: • Suction at 40 l/min / -76 kPa • Alternatively suction at 55 l/min / -98 kPa • Compressed air for medication spraying, max. 2 bar • Compressed air for the Politzer manoeuvre, regulated • Ear irrigation with 37 °C ± 1 °C, max. 500 ml/min • Electric power supply for LED, 700 mA • Light source LED for light guide Application organ: Mouth to pharynx, auditory canal to the ear drum and the nasal cavities Application time: • ENT unit: Short term use (up to 30 days) • Suction / Compressed air / ear rinsing / light source: Temporary application on the patient (less than 60 minutes) Application site: Application sites are clinics and practices for ENT doctors and phoniatrists. The examination and/or therapy with the ENT unit may only be executed by medically trained persons. Contraindications: May not be used for irrigation of the paranasal sinuses. The ear irrigation should not be applied to an infected auditory canal or a perforated eardrum. The product is: active Sterility: The ENT unit is no sterile product. Single-use product / reprocessing: The ENT unit is intended for multiple use. The device and parts of the accessories are reusable. For information on reprocessing, cleaning and disinfection, please see the operating instructions.

2.0 1.3

Introduction Function

• The ATMOS C 21 / C 31 is operated by activating the main switch ( 1 , fig. 1, page 8). • The exact mode of function of the standard equipment and optional functions is described in detail in chapters 4.2 and 4.3.

1.4

Explanation of symbols

ATMOS C 21 / C 31

I

O

On / Off switch

Type B equipment as to IEC 417/5333

ON (power) as to IEC 417/5007 and DIN 30600/16

Type BF equipment as to IEC 417/5333

OFF(power) as to IEC 417/5007 and DIN 30600/16 Follow operating instructions (blue)

~

Alternating current Do not lean against it!

Warm water system Suction system Compressed-air system Cleaning with the flow method (hose rinsing)

060.0628.0

Danger of tilting for units with a microscope! Screw the unit into the ground or position it near a wall.

Only ATMOS C 31

Light guide connection

Water temperature for ear irrigation is too high

No function

Correct water temperature for ear irrigation

Transfer of heat, in general; mirror heater

Water temperature for ear irrigation is too low

Short-time operation Foot switch Dangerous voltage as to IEC 417/5036, DIN 30600/131 Protective earth (ground) as to IEC 417/5019, DIN 30600/1545 Fuse as to IEC 417/5016, DIN 30600/0186

5

2.0

For your safety

• The ATMOS C 21 / C 31 is produced according to IEC 601 / EN 60601 and listed in the following classes: -- VDE Class of protection 1 -- Class IIa (EEC 93/42). • The unit may be connected only to a socket outlet with earthing contact installed according to the rules of the trade. • The unit should not be positioned directly next to a wall, because of the ventilation openings on the rear side! • When a microscope is mounted: Screw the unit into the ground or position it near a wall. If the microscope is in an unfavourable position it could tilt the unit backwards. • The ATMOS C 31 requires clean water (drinking-water quality) for the operation. In case the clean water cannot be provided by the water supply, a pre-filter has to be installed. The relevant country specific regulations for the installation have to be considered. • Caution! Mirror and endoscope heaters may generate temperatures above 40° C! • Attention with the cold-light source! Because of the high energy of the light there is a large amount of heat emission at the point of the optical system. Avoid too small a distance between the tissue and the field of light emission of the light guide respective of the endoscope, as this may cause coagulation of the patient's tissue. When using the endoscope avoid the direct contact between area of light emission and the tissue. Attention, Fire Hazard! Never place the area of light emission from the light guide or from the endoscope onto heat-absorbing surfaces (dark pieces of cloth, etc.), because this will cause unacceptable high heating or even ignition of the material. Switch the light off when you do not require the light over a prolonged period of time. • Care is to be paid in respect to light sources when working with endoscopes. The intensity of the light is very high. Do not look directly into the light outlets! In case of possible light failure remove the endoscope from the working area. • Always make sure that you do not blind patients with the light source! Watch out that patients do not look directly into the light source! Never look directly into the light source! > Damage to the eyes due to the strong glare. • Exclusively connect ATMOS HL 21 LED and ATMOS LS 21 LED to the connections for ATMOS HL 21 LED and ATMOS LS 21 LED. Unsuitable application parts may result in an electric shock or damage. Cardiac arrhythmia and even death are possible.

6

• The ATMOS C 21 / 31 may be used in supervised operation by qualified personnel only which has been authorised by ATMOS and which has been trained for operating the appliance (IEC 601-1/EN 60601-1). • The mains voltage indicated on the type plate must correspond to the values of the supply network. • Make sure prior to every application of the equipment that it is technically safe and in proper condition. Damaged leads and hoses must be replaced immediately! • Display instruments and valves must be checked for correct function in regular intervals! • Inspection of compressed air and vacuum display by service technician every 2 years! • Correct configuration in assembly of country-specific connections: -- green/yellow: protective conductor (PE) -- blue: neutral conductor (N) -- black or brown: phase (L) • This product is not re-sterilizable. Repeated reuse of components which are marked with a 2 is forbidden. In case of repeated reuse these components lose their function and there is a high infection risk. • The control panel must be well visible to and in reach of the operator. • Do not place used contaminated instruments on the ENT unit! • The ambient conditions specified in the "Technical data" (chapter 9.0) must be strictly observed! • The suction system of the ATMOS C 21 / C 31 is only to be used for the suction of fluids in the medical field. Never remove explosive, inflammable or corrosive gases or fluids. • Switch off main switch after finishing work in practice and close water supply, if present. • The ATMOS C 21 / C 31 may be operated only in rooms used for medical purposes, but not in areas subject to explosion hazards and in oxygen rich environments. • The ATMOS C 21 / C 31 fully complies with the electromagnetic immunity requirements of standard IEC 601-1-2 / EN 60601-1-2 "Electromagnetic compatibility Medical Electrical Equipment".

2.0

For your safety

• The ATMOS C 21 / C 31 may not be operated with units not complying with the requirements of standard EN 60601-1 "Medical Electrical Equipment" and EN 606011-2 "Electromagnetic compatibility (Medical Electrical Equipment)". • The warranty will be rendered invalid in case of damages caused due to the utilization of accessories or consumables which are not approved by ATMOS for use with this unit. • ATMOS is not liable for personal injury and damage to property if -- no original ATMOS parts are being used, -- the advice for use in these operating instructions is not being observed, -- assembly, new settings, alterations, extensions and repairs have been carried out by personnel not authorised by ATMOS. • Please pay also attention to the safety information in following chapters. • Please note: A medical insulating transformer with earth leakage monitor or any similar safety system acc. to EN 60 601-1 is required, if several devices are connected over one common power supply. The transformer must correspond to the power consumption of all the devices to be connected. • When connecting several devices on one grounding receptacle, the allowed strain and leakage current have to be observed! • Never leave the patient unattended at the treatment unit. • It is not allowed to use flammable substances with the device.

7

3.0 3.1

Setting up and starting up Front view

1

2

3

4

5

6

7

19

18 17 8 16

9

10

15

14

13

Fig. 1. ATMOS C 21 / C 31 Front view 1 Main switch 2 Sprayer (option) 3 Laryngoscope holder 4 Surface for medicament bottles etc. 5 Ear irrigation (option, only ATMOS ® C 21) 6 Headlamp suspension 7 Cover for upper instrument deposit 8 Instrument surface 9 Free surface

8

12

11

Drawer resp. deposit for used instruments (optional) Drawer resp. waste bin (option) 12 Connections for light guide 13 Vacuum control 14 Door for service compartment 15 Compressed-air control (option) 16 Suction 17 Compressed-air handle (option) 18 Handle ear irrigation (option, only ATMOS C 31) 19 Irrigation canister for hose rinsing (option) 10 11

3.0

Setting up and starting up

3.1.1 Service compartment

1

2

3

4

5

7

6

Fig. 2. ATMOS C 21 / C 31 Service compartment 1 Hose for automatic secretion canister evacuation (optional) 2 Connecting nipple with hose to the vacuum pump 3 Secretion hose 4 Connecting electrodes for automatic secretion canister evacuation (optional) 5 Attachment for secretion hose 6 Secretion canister 7 Lid (variant with bacterial filter plate)

9

3.0 3.2

Setting up and starting up Setting up proposal

At option 2 - where the instrument deposit is slidable (backwards) - an extra 250 mm distance to the wall is required. 560 mm + 250 mm = 810 mm 22.5" + 9.84" = 31.84"

10

3.0

Setting up and starting up 3.4

Fig. 3. 1 Socket outlets with earthing contact 2 Water drainage G3/4" external thread (optional) 3 Water supply with water tap G 3/4" external thread (optional)

Water supply / Water drainage (option)

Water supply: Prerequisites: • There must be existing water pipes with a G 1/2" (internal thread). For connecting a corresponding water or ball valve with a G 3/8" hose connection. • This (water tap) ball valve must be installed in such a way that it can be turned off without any problem. • The water which is provided by the household connection must at least meet the WHO guidelines or the countryspecific guidelines for drinking water. • Rinse water supply line in order to remove any contamination from the system. • When clean water is available, connect delivery hose to water tap mentioned above. • Required pressure in domestic water system: > 2 bar, but < 5 bar. • There are country-specific regulations for the installation to be considered when the unit is connected to the public water supply. • There is no special calcification safety device integrated in the water system. Such a system is to be connected when the respective drinking water is of hardness grade 3 (14 - 21°d resp. 2.5 - 3.8 mol/m³ = hard water) but especially with hardness grade 4 (from 21°d resp. from 3.8 mol/m³ = very hard water). You may receive information on the hardness grade of your water from the water supply office. Water drainage (option): Prerequisites: • Permanently installed connection fitting with G3/4" external thread.

1

2

Fig. 4. 1 Inlet connector for non-heating apparatus 2 Connection for waste water hose

3.3

Connection to electrical power line

• According to the directions of VDE 0107 and VDE 0100, medically used rooms have to be equipped with a leakage current protective circuit (FI protective circuit) with a nominal leakage current of < 0.03 A. Installation must correspond with VDE 0107. • The ATMOS C 21 / C 31 is connected to a earthing contact socket which is to be mounted near the unit (max. 3 m, preferably on the left side, next to the function column) (see fig. 3). • The current consumption of the ATMOS C 21 / C 31 is maximum 5 A . • For the connection of further electrical devices, please allow for extra plugs (installation of an electrically operated patient chair).

• To adapt the 3/4” draining hose to standard HT 40 a connection adapter 510.2130.0 can be ordered (510.2129.0 for HT 50). • Connect waste water hose with unit ( 2 , fig. 4) and the G3/4" connection fitting (insert pertaining seals!). An anti-syphon trap is not required!

3.5

Independent water supply (only ATMOS C 31)

If the system is not connected to a water supply, we recommend you to fill the storage canister for the ear irrigation system with 2.0 litres of tap water or hygienically safe drinking water. For information on the maintenance and cleaning of the water supply, see chapter 5.1.5 in the operating instructions.

11

3.0

Setting up and starting up 3.6

Starting up

3.6.1 Connection to electrical power line • Join the inlet connector for non-heating apparatus ( 1 , fig. 4) with the earth socket outlet using the power cable supplied.

3.6.2 Waste water connection (with optional automatic secretion canister evacuation) • Connect the waste water connector ( 2 , fig. 4) to the water drain ( 2 , fig. 3).

3.6.3 Connection of suction hose • Thread the suction hose through the hole on the side into the service compartment and insert it onto the secretion hose connector ( 5 , fig. 2). )) The transport locking screws on the unit's baseplate must be removed by skilled staff prior to starting up! To do this, the rear panel must be opened and the two front screws must be unscrewed. The pump unit is removed from the rear locking device by pulling it forwards.

3.6.4 Connection of the light guide and light source The unit has different connections depending on the configuration: Light package LED economy: • 2 connections for ATMOS HL 21 LED and ATMOS LS 21 LED

1

Fig. 5.

12

2

3

4

Connections light package 2-channels version 1

1, 2

Connections for light guide

3, 4

Connections for ATMOS HL 21 LED and ATMOS LS 21 LED

!

Light package 2-channel with 2 or 4 channels: Version 1 (fig. 5): • 2 connections for light guide • 2 connections for ATMOS HL 21 LED and ATMOS LS 21 LED Version 2: • 2 or 4 connections for light guide Version 3: • 2 or 4 connections for ATMOS HL 21 LED and ATMOS LS 21 LED Exclusively connect ATMOS HL 21 LED and ATMOS LS 21 LED to the connections for ATMOS HL 21 LED and ATMOS LS 21 LED. Unsuitable application parts may result in an electric shock or damage. Cardiac arrhythmia and even death are possible. • Connect the light guide or light source. )) If you require several adapter sleeves (e.g. Olympus, Pentax, Wolf, etc.), they may be interchanged as necessary (see chapter 8.2). )) So that the fibre-optic cables do not rest on the floor, they may be threaded through behind the handle support.

3.0

Setting up and starting up 3.6.5 Connection of the compressed air hose (option) Connection of the function hose for compressed air at the side of the column. • Compressed-air hose is connected by means of plug connections; make sure that the plug attachment is engaged. The hose is disconnected by pressing the release slide ( 1 , fig. 6) at the plug connector and by pulling out the plug attachment. )) Push the handles into the handle support as indicated by the symbols. The photoelectric barriers will operate the wrong units if the handles are transposed!

Fig. 6. 1 CPC coupling

1

1

2

3.6.6 Connection of the hose for ear irrigation (option, only ATMOS C 31) The hose for the warm water system is screwed on the CPC coupling. )) Different socket nipples; swapping of the hoses is not possible!

Fig. 7. Connecting the hose for ear irrigation 1 Connection for the ear irrigation hose 2 Connection for the compressed-air hose

3.6.7 Connection of the water system (option, only ATMOS C 31) Connect the aqua stop valve to the water tap (house connection). Open the water tap. If the main switch is activated and a water consuming device (basin rinsing or hose rinsing system) is used, the water supply is opened by an automatic opening of the magnetic valve in the aqua stop system. ªª Thus, there is no pressure inside the water supply hose if no water consuming device is activated.

13

4.0

Operation 4.1

ATMOS C 21 / C 31 - Basic unit

The ENT unit ATMOS C 21 / C 31 offers optimum instrument handling whilst at the same time providing an optimum arrangement of all functions that an ENT specialist requires for his daily work in the practice. The instrument deposit area: At the top of the functional column there is an area designed to take medicine bottles ( 4 , Fig. 1, page 8), hence the instrument deposit area is also very suitable instruments. There is also the facility for protective storage of less frequently used instruments and consumables in the drawers ( 10 and 11 , fig. 1). )) Most of the unit's surfaces are coated with a special textured lacquer that fulfils the requirements for workplace hygiene. However, as the lacquer is not resistant to all medicines and disinfectants it is imperative to wipe up splashes immediately.

4.2

Basic functions

4.2.1 Main switch • The ATMOS C 21 / C 31 is switched ON and OFF by means of the main switch ( 1 , fig. 1, page 8).



max. 15 kg

4.2.2 Maximum loads • Persons must not lean on the ATMOS C 21 / C 31 (danger of tilting). • Maximum load of the instrument surface: 15 kg. • Maximum load of the writing and working surface: 10 kg. • Maximum load of the second deposit surface (optional): 7.5 kg.

4.2.3 How to open the covering Fig. 8.

• Open the unit covering up to the stop.

Maximum load

4.2.4 Suction system !

14

The hose attachment must be exchanged after each patient. )) Prior to each application, proper function of the display instruments and control valves must be checked! • Purpose of the suction system: -- Suction of fluids and secretions; collecting the secretion in the secretion canister. • Automatic activation of the suction mode by taking out the suction attachment. • Control of the suction performance via the rotary knob for vacuum control ( 2 , fig. 9).

4.0

Operation

1

Fig. 9.

2

3

• Indication of set vacuum at vacuum gauge ( 3 , fig. 9) (keep suction attachment closed by hand). • Secretion is collected in 1.25 l canister with mechanical overflow safety and water-repellent bacterial filter. ªª Prevents ingress of secretion into the pump. )) Secretion canister to be emptied when half full at the latest, see chapter 4.2.4.1! )) The suction system may be operated only with inserted bacterial filter. In case the filter is blocked it has to be exchanged (see chapter 6.1) ! For hygienic reasons, the bacterial filter should be exchanged daily. )) The suction hose must never come into direct contact with the application site. Always use a suction catheter, suction tip, or medical suction set! )) Change the suction catheter after every patient and clean the suction hose, e.g. with the aid of the optional hose rinsing system (aspirate rinsing fluid or disinfectant solution)! • All commercially available models of suction cannulae (Adson, Walter, Frazier, Fergusson, Plester, Yankauer, Torrington) may be attached to the silicone attachment.

4

Suction

1

Suction attachment

2

ON switch

4.2.4.1 Emptying the secretion canister

3

Vacuum gauge

4

Vacuum control

• Detach all hose connections carefully on the lid system and take secretion canister out carefully to prevent spills and contamination of the area. Dispose of secretions properly. • Grip lid system firmly, open lid of filter housing by turning in anti-clockwise direction. With bacterial filter plate or integrated bacterial filter: Remove filter and dispose it of. • Rinse all parts thoroughly under running water. A detergent or cleaning agent may also be used if required. • After cleaning a new filter must be inserted (with bacterial filter plate: smooth side down). See chapter 6.1. See also suction accessories (chapter 8.2).

1

2

4.2.4.2 Application with disposable secretion canister systems Fig. 10. 1 2

Secretion hose Bacterial filter plate

Assemble the disposable canister system: Insert the disposable bag into the canister. Seal properly on all sides. Check again for tightness, otherwise there will be no build up of vacuum. Connect the vacuum hose. )) Please observe the operating instructions of the disposable secretion canister system. )) Please observe the valid hygiene and waste disposal measures. )) Only the recommended ATMOS disposable secretion canisters with integrated filter may be used!

Fig. 11 Disposable secretion canister systems

15

4.0

Operation 4.2.5 Light sources

1

)) Do not look directly into the light outlets. )) Because of the high energy of the light there is a large amount of heat emission at the point of the optical system. )) Switch the light off when you do not require the light over a prolonged period of time. Light package LED economy: • Select the light source with the switch 1 (fig. 12).

Fig. 12. Light package LED economy: 1 Switch for selecting the light source 1

2

3

Light package 2-channel with 2 or 4 channels: Switch on • Remove the light guide from the holder ( 4 , fig 13) or the headlight from the headlamp suspension ( 3 , fig 13). )) You can manually switch on the light source with the buttons 1 to 4 ( 5 , fig. 13) . Intensity control • Switch on the light source. • Press the button 1 (fig.13), to reduce the brightness or press 2 , to increase the brightness. )) When the device is switched off the last adjustment will be kept.

5

4

Fig. 13. Light package 2-channel with 2 or 4 channels: 1 Reduce brightness 2 Increase brightness 3 Headlamp suspension 4 Holder for the light guide 5 Selection of the light channel

4.2.6 Mirror quick-heater • Switch on the mirror quick-heater with key switch ( 2 , fig. 14). The mirror quick-heater heats up for 10 seconds and then switches off automatically. • Supply voltage of the heating coils: 6 V / 15 A. • Hold the mirror to be heated over the burning heating coil ( 1 , fig. 14) located beneath the safety cover. )) Prior to use of the mirror, always check its temperature (with hand etc.)! )) Automatic switching to avoid overheating! )) Safety cover, sleeve and heating element might be very hot. Do not touch directly after heating-up (hot)! • Changing the heating coil, see chapter 6.4.

1

Fig. 14. Mirror quick heater 1 Heating coil 2 Push-button

16

2

4.0

Operation 1

2

3

4

5

4.3

Options

4.3.1 Secretion canister evacuation, fullyautomatic (option) • Purpose: -- Prevents interruption of work in practice. -- Secretion is not held in canister over a longer period of time. -- Prevents contact of staff with secretion. • Activated automatically when: -- Reaching the upper filling limit (electrodes). -- Returning suction attachment to holder. )) The tube cassette of the tube pump is a wear part and must be replaced at regular intervals (see chapter 6.3)! )) Pay attention to cleaning described in chapter 5.0!

6

Fig. 15. Service compartment 1

Hose for automatic secretion canister evacuation (optional)

2

Connecting nipple with hose to the vacuum pump

3

Secretion hose

4 5

Connecting electrodes for automatic secretion canister evacuation (optional) Attachment for secretion hose

6

Secretion canister

4.3.2 Hose rinsing system (option)

1

2

3

Fig. 16. 1 Float switch 2 Pipe for the hose rinsing system 3 Hose rinsing canister

After use, the suction system must be rinsed by means of the hose rinsing system. • Insert the silicone suction attachment onto the white attachment of the hose rinsing (front of the unit) and clean the hose system by rinsing the hose for a few seconds. ªª This procedure will prevent the hoses and suction cannula from clogging up. The canister for the rinsing fluid of the hose rinsing is located in the service compartment at the front of the unit. For optimum cleaning, add the ATMOS special cleanser (Art. No. 080.0006.0) to the rinsing liquid. Optionally the canister can be automatically filled up with fresh water. Water supply is then controlled by a level switch. A safety switch beside the canister in the canister support prevents overflowing, in case the canister overflows or is not available. )) The suction attachment of the hose rinsing system may be contaminated. Therefore, it must be cleaned and disinfected daily!

17

4.0

Operation 4.3.3 Compressed-air system (option) )) Prior to each application, proper function of the display instruments and control valves must be checked!

1

5

4

3

2

Fig. 17. Compressed-air system

18

1

Sprayer suspension

2

Compressed-air display

3

Compressed-air control

4

Support for automatic photoelectric barrier control

5

Compressed-air handle

Purpose of compressed-air system: a) Medicaments can be applied to the nasopharynx: • The pump for the compressed-air system switches on after the compressed-air handle has been removed from its holder. • Handle is mounted on a sprayer. The top of the compressed-air handle locks in place in the ring of the sprayer bottle. • Available sprayers: -- with straight spraying tube for normal liquid medicaments -- with twin tube and adjustable angular jet for oily medicaments. )) If a sprayer is used with medication the instructions of the medication manufacturers have to be observed. )) Do not use the sprayer for the storage of medication! )) Caution to be paid to avoid injury when introducing sprayer jet! Please note, in case the ventilation opening is blocked or the sprayer head is immersed in fluids (e.g. blood, secretion, etc.) a negative pressure could occur and the fluid could flow back into the bottle. In this case the medicine sprayer, sprayer head, flexible nozzle as well as the hose piece for the medicine sprayer must be reprocessed as described in chapter 5.0 cleaning. • Pull the release lever. ªª The medicament sprayer is supplied with air and the medicament in the sprayer bottle is atomized. • The amount of compressed air is adjusted with the control knob ( 3 , fig 17) in conjunction with the compressed air gauge ( 2 , fig 17). • After use, the medicament sprayer is again inserted in its holder, the bar is pressed, the handle is removed from the sprayer and again inserted in its support. ªª Compressed-air system is again switched off. )) For hygienic reasons, the spraying tubes are to be exchanged following each application or with each patient.

4.0

Operation

1

2

3

Fig. 18. Compressed-air handle with Politzer adapter 1 Politzer olive 2 Adapter for Politzer olive 3 Compressed-air handle

!

Fig. 19. Removal of the irrigation bottle

1 2

3

Fig. 20. Compressed-air handle 1 Release button 2 Air valve 3 Adjusting lever

b) Politzer manoeuvres with Politzer olives or Eustachian catheter can be carried out. • The pump for the compressed-air system switches on after the compressed-air handle has been removed from its holder. • The adapter ( 2 , fig. 18) supplied for this purpose is locked into the compressed-air handle. • Politzer olive ( 1 , fig. 18) is inserted in the adapter. )) The pressure for the insufflation of the Eustachian tube can be controlled by means of the manometer and the compressed-air regulator. Select an insufflation pressure adapted to the condition of the tympanic membrane. If the tympanic membranes are already pre-damaged even low pressure values might lead to injuries ! Maximum pressure must not exceed 0.2 bar! • Activating, adjusting and regulating the compressed air and switching off the compressed-air system as described above. • Scope of delivery: -- Compressed-air system with pump, regulating valve, manometer, handle and handle holder with photoelectric barrier control; -- 3 medicament sprayers (2 single tube, 1 twin tube sprayers for viscous medicaments); -- Politzer adapter; -- Politzer olive (for children); -- Politzer olive (universal size). • Accessories, see chapter 8.2. c) For ear irrigation Prior to each ear irrigation perform a visual check to see if the patient's eardrum is perforated. Do not irrigate the ear if it is perforated or inflamed! Otherwise the inflammation can spread. Preparation • Fill both irrigation bottles with microbiologically safe drinking water. Ideally the drinking water is at room temperature. • Position the reprocessed irrigation lid with irrigation hose. • Attach the splash protection and hose tip. • Place both irrigation bottles in the heated quiver for warming. Irrigate ear • Attach the compressed air handle to an irrigation bottle. • Remove the compressed air handle with the irrigation bottle from the heated quiver. • Check the water temperature with the back of your hand. Cold water causes dizziness for patients. • Position the ear irrigation nozzle. • Close the air valve with your thumb. • Press the release lever to irrigate the ear. Conclude • Release the lever. • Remove your thumb from the air valve. • Place the irrigation bottle in the heated quiver. • Press the release button and remove the compressed air handle from the irrigation bottle. • Hang the compressed air handle in the holder.

19

4.0

Operation 4.3.4 Ear irrigation system (option, only ATMOS C 31)

Schutzvermerk (Copyright notice) DIN ISO16016

1

2

3

4

1

37°C

Grundfarbe: RAL 9002 Grauweiß

Fig. 21. 1 Water temperature display

Präge-, Tastenflächen, Symbole: RAL 7043 Verkehrsgrau B

Datum

Tasten und Fläche geprägt, Tasten Ø13 mm

Erstellt 03.11.16

Name O.Eirich

Bearb.

Logo und Symbol Ø9 mm „Anleitung beachten“: RAL 5005 Signalblau Transparent Ø3,0 und Ø4,5 mm, und 7,0x25,0 mm

A3

Alle Maße in mm/ all dimensions in mm Allgemeintoleranzen/ Generaltolerances DIN ISO 2768 - mK

Abgesetzte Fläche: RAL 7042 Verkehrsgrau A

Gepr.

Zust.

(index)

Änderung (revision)

Datum (date)

Name (name)

MedizinTechnik

ATMOS Medizin Technik GmbH & Co.KG Ludwig - Kegel - Str. 16 79853 Lenzkirch / Germany Tel: +497653689-0 Fax: +497653689-190 [email protected] www.atmosmed.de

Maßstab (scale) 1:1

Frontfolie ATMOS C 31 Bedienteil LED 4 Zeichnungs / Artikel-Nr. (part no.)

060.0700.0

Ers.f.:

Ers.d.:

4 1

3

2

Fig. 22. 1 Irrigation handle 2 Connection for irrigation handle 3 Storage canister for ear irrigation 37°C 4 Irrigation hose

1

Konstr. Nr. 060.0411.0

Benennung (description)

Blatt (sheet)1

Bl.1/1

• The ear irrigation system is supplied with water from a heated storage canister (37°C) 4.5 l ( 3 , fig. 22). This canister can easily be filled, cleaned or disinfected. The pump only switches on automatically when required. Water pressure and flow quantity may be regulated with the release lever on the irrigation handle. With the switch 1 , fig 23, the ear irrigation system can be switched on and off. )) Do not switch on the ENT unit until water has been filled in the storage canister of the ear irrigation system. • Fill the storage canister,e.g. using a measuring cup (000.0583.0), with microbiologically safe drinking water (min. 2 l, max. 4,5 l, drinking water quality) and close the lid. )) The water must not be contaminated and its temperature must not exceed 37°C as it cannot be cooled down. If there is no drinking water available, you may also fill the storage canister with an isotonic saline solution. Alternatively, you may achieve drinking water quality by filtering or boiling the water resp. by adding disinfectants. )) This system may not be used if the auditory canal is injured as there could be a risk of infection if the irrigation liquid is contaminated. • The temperature display indicates the water temperature. It takes approx. 15 min. until 2 litres of cold tap water are heated up to 37°C. Observe the temperature display and check water temperature prior to every application. As soon as the middle lamp illuminates the water has reached the desired temperature. • Take the water handle from the support and spray off the water until it is free of air bubbles and the level of the pump noise becomes less (repeat this procedure every time the pump noise gets louder, e.g. after long periods during which it has not been used or after the water level has dropped below the suction limit). • Change the jet connection daily. Only use disinfected jet connections, in order to prevent spreading germs. Use the hose tip, REF 502.0844.0, to avoid damages to the eardrum. Exchange the hose tip after every patient.

Fig. 23.

4.3.5 Tulip-shaped ear rinsing bowl • Purpose: To collect the water during ear irrigation. • The tulip-shaped bowl is attached to the suction attachment of the suction system. • We provide a special support for the ear irrigation bowl., as an accessory.

Fig. 24. Ear irrigation bowl

20