ATMOS C 31 Operating Instructions Index 34 Aug 2015

Contents

2

Page

Page

1.0 1.1 1.2 1.3 1.4

Introduction Notes on operating instructions ... 3 Intended use... 4 Function ... 4 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 3.7

Installation and starting-up Front view ... 7 Service compartment ... 8 Setting up proposal ... 9 Connection to electrical power line ... 10 Connection to water supply (optional) ... 10 Independent water supply ... 10 Water drain (optional)... 11 Starting-up the ATMOS® C 31 ... 11

6.4 6.5

4.0 Operation 4.1 ATMOS® C 31 - Basic unit... 13 4.2 Basic functions ... 13 4.2.1 Main switch... 13 4.2.2 Maximum loads ... 13 4.2.3 How to open the covering ... 13 4.2.4 Suction system ... 14 4.2.4.1 Emptying the secretion canister ... 15 4.2.4.2 Application with disposable secretion canister systems ... 15 4.2.5 Halogen cold-light system ... 16 4.2.6 Mirror quick heater ... 17 4.3 Options ... 18 4.3.1 Ear rinsing system ... 18 4.3.2 Mirror preheater ... 19 4.3.3 Secretion canister evacuation, fully-automatic .19 4.3.4 Quiver for cleaning and disinfecting solution ... 19 4.3.5 Hose rinsing system ... 20 4.3.6 Kidney-shaped rinsing basin ... 20 4.3.7 Compressed-air system ... 21 4.3.8 Connection for warm-light headlamp/ Nystagmus binoculars ... 22 4.3.9 Headlamp suspension ... 22 4.3.10 Counter-mirror lamp... 22 4.3.11 Endoscope heating ... 23 4.3.12 Tongue patches and swab dispenser ... 23 4.3.13 Waste bin... 23 4.3.14 Microscope ... 23 4.3.15 Video system ... 24 4.3.16 Tulip-shaped ear rinsing bowl... 24 4.3.17 Hygiene filter for the ear irrigation system ... 24 4.3.18 Holder for standard rail ... 24

5.0

Cleaning... 25

6.0 6.1 6.2 6.3

6.6

Maintenance and servicing... 30 Changing the bacterial filter ... 31 Changing the tube cassette of the tube pump ... 32 Changing the heating coil of the mirror quick heater ... 33 Changing halogen cold-light lamp... 34 Changing the halogen bulb of the counter-mirror lamp ... 35 Changing the rinsing container ... 35

7.0

Trouble-shooting ... 36

8.0

Consuming material, accessories, spare parts, options ... 41

9.0

Technical Specifications ... 45

10.0

Disposal ... 46

11.0

Hygiene Plan ... 47

12.0

Notes on EMC... 49

1.1

Notes on operating instructions

⚫ These operating instructions contain important notes on how to operate the ATMOS® 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-time. 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.

⚫

⚫

⚫

⚫

⚫ ⚫

ATMOS MedizinTechnik GmbH & Co. KG Kudwig-Kegel-Straße 16 79853 Lenzkirch Deutschland

⚫

⚫ ⚫

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 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 operation instructions apply for the following appliances: ATMOS® C 31 Set... Art. Nr. 506.7350.0 ATMOS® C 31 Function Column ... Art. Nr. 506.7510.0 Please note that these operating instructions apply for all ATMOS® 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 31 bears CE marking CE-0124 according to the EEC guideline of the council for medical products 93/42/EEC and meets the basic requirements of annex I of this guideline. The product ATMOS® 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 9001 and EN 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 written permission by ATMOS. Subject to alterations. Errors excepted.

Abbreviations / symbols in these operating instructions:

Telefon: + (49) 7653 689-0 Fax: + (49) 7653 689-190 + (49) 7653 689-493 (Service Center) e-mail: [email protected] Internet: http://www.atmosmed.de

⚫

Indicating a list • Subdivision of a list/activity.

The recommended sequence must be followed in each case! 👉 Indicating particularly important advice!



Describing the effect of an activity.

3

1.2

Intended use

1.3

Name: ATMOS® C 31

⚫ The ATMOS® C 31 is started by activating the main switch

Main functions: • Suction • Compressed air module 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 Med. 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 rinsing with 37 °C ± 1 °C, max. 500 ml/min • electric power supply for LED, 700 mA • Light source 15 V, 150 W • Light source 24 V, 150 W Application organ: mouth to pharynx, auditory canal to the ear drum and the nasal cavities Application time: ENT unit: Short term use on the patient (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:

X active

□ not active

Sterility: The ENT unit is no sterile product. Single use product / reprocessing: The device and part of the accessories are reusable, for information on reprocessing and disinfection please see the operating instructions.

4

Function

(, fig. 1, page 7).

⚫ The exact mode of function of the standard equipment and optional functions is described in detail in chapters 4.2 to 4.3.17.

1.4

I O

Explanation of symbols On / Off switch

Basin rinsing

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

Water temperature for ear rinsing too high

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

Correct water temperature for ear rinsing

Pay attention to operating instructions ! as to ISO /7000/0434 DIN 30600/1008 IEC 348

Water temperature for ear rinsing too low

Warm water system

Button for increasing lamp intensity

Suction system Button for decreasing lamp intensity Compressed-air system Dangerous voltage as to IEC 417/5036, DIN 30600/131 Cleaning in flow procedure (hose rinsing) Protective earth (ground) as to IEC 417/5019, DIN 30600/1545 Cold-light system Fuse as to IEC 417/5016, DIN 30600/0186 Microscope connection (cold light) Type B equipment Headlamp

Transfer of heat, in general; mirror heater

Short-time operation

Type BF equipment (only for cold light)

~

Alternating current

Do not lean against it!

Footswitch Danger of tilting for units with a microscope! Screw the unit into the ground or position it near a wall. 060.0628.0

5

⚫ The ATMOS® 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!

⚫ The control panel must be well visible to and in reach of the operator.

⚫ When a microscope is mounted: Screw the unit into the

⚫ Do not place used contaminated instruments on the ENT unit!

ground or position it near a wall. If the microscope is in an unfavourable position it could tilt the unit backwards.

⚫ The ambient conditions specified in section 9.0 "Technical specifications" must be strictly observed!

⚫ Attention! Mirror and endoscope heaters may generate

⚫ The suction system of the ATMOS® C 31 is only to be used for the suction of fluids in medical ranges. Never remove explosive, inflammable or corrosive gases or fluids.

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 resp. 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! Do 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. Harmful heat rays are eliminated by special built-in filters: but 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.

⚫ The ATMOS® C 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 specified on the type plate must correspond with the data of the power supply system.

⚫ 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: blue: black resp. brown:

protective conductor (PE) neutral conductor (N) phase (L)

⚫ Switch off main switch after finishing work in practice and close water supply, if present. ⚫ The ATMOS® 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 31 fully complies with the electromagnetic immunity requirements of standard IEC 601-1-2 / EN 60601-1-2 "Electromagnetic compatibility - Medical Electrical Equipment". ⚫ The ATMOS® 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)". ⚫ 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. ⚫ This operation manual corresponds with the construction of the unit and with the current status of safety-related standards at the time of printing. Proprietary rights are existing for all described circuits, processes, names, software programs and units. ⚫ 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 60601-1 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.

⚫ Units with water consuming systems may only be switched on when the water supply is guaranteed!

⚫ When connecting several devices on one grounding receptacle, the allowed strain and leakage current have to be observed!

⚫ This product is not re-sterilisable. Repeated reuse of components which are marked with a 2 is forbidden.

⚫ Never leave the patient unattended at the treatment unit.

In case of repeated reuse these components lose their function and there is a high infection risk.

6

⚫ The ENT unit 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 !

⚫ It is not allowed to use flammable substances with the device.

3.1

3

2

4

Front view

5

6

1

18 17

7

16

15

8

9

14

Fig. 1.

13

12

11

10

ATMOS® C 31 Front view 1 Main switch 2 Sprayer (optional) 3 Laryngoscope holder 4 Surface for medicament bottles etc. 5 Headlamp hook 6 Cover for upper instrument deposit 7 Instrument surface 8 Free surface 9 Drawer or deposit for used instruments (optional)

10 Drawer resp. waste pin (optional) 11 Connections for light guide cables 12 Vacuum control 13 Door for service compartment 14 Compressed-air control (optional) 15 Suction 16 Rinsing basin (optional) 17 Compressed-air handle (optional) 18 Rinsing container for hose rinsing (optional)

7

3.1.1

  

 







Fig. 2.

®

ATMOS C 31 Service compartment

 Connection nipple with hose to the vacuum pump (green coding)  Secretion canister  Hose rinsing container (optional)  Secretion hose (black coding)  Hose for automatic secretion canister evacuation (optional) (transparent coding)

 Connecting electrodes for automatic

secretion canister evacuation (optional)

 Attachment for secretion hose  Lid (version with bacterial filter plate)

8

Service compartment

3.2

Setting up proposal

By the 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"

9

3.3

Fig. 3.

 Socket outlets with earthing contact  Water drainage G3/4" external thread

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 31 is connected to an 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. 1). ⚫ The power consumption of the ATMOS® C 31 comes to 5 A max. ⚫ For the connection of further electrical devices, please allow for extra plugs. (Installation of an electrically operated patient chair).

(optional)

 Water supply with water tap G 3/4" external thread (optional)

3.4

G 3/4"

G 1/2"

≥ 350

Dimensions in mm

Fig. 4.

 Water drainage G 3/4" external thread

Connection to water supply (optional)

Water supply: ⚫ Requirements: • 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 when leaving the device 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 country-specific 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 . ⚫ A water connection with pipe ventilation is recommended! ⚫ 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.

(optional)

 Water supply G 1/2" internal thread (optional) (with water tap G 3/4" external thread)

10

3.5

Independent water supply

If the system is not connected to the water supply then we recommend you to fill the storage tank of the ear irrigation system with 2 litres of tap water or distilled water. For information on the maintenance and cleaning of the water supply, see chapter 5.2 in the operating instructions.

3.6

Waste water drain (optional)

⚫ Requirements: • Permanently installed connection fitting with G3/4" external thread.

👉 To adapt the ¾ 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 (, Fig. 5) and the G3/4" connection fitting (insert pertaining seals).

 Fig. 5.



 Connection for wase water hose  Inlet connector for non-heating apparatus 3.7





Join the inlet connector for non-heating apparatus(, fig.5) with the earth socket outlet using the mains cable supplied.

⚫ Waste water connection (with optional automatic secretion canister evacuation) • Connect the waste water connector (, fig.5) to the water drain (, fig. 5).

⚫ Connection of suction hose



•

Fig 6a. Lid for bacterial filter plate

Fig 6b. Lid for integrated bacterial filter

Secretion canister lid with hose coding  green: Filter – Pump  white: Lid– Hose pump (only with fully-automatic secretion canister evacuation)

 black: Secretion canister lid – Patient

Fig. 7.

⚫ Electrical connection •



Starting-up the ATMOS® C 31

Thread the suction hose through the hole on the side into the service compartment and push it straight onto the connector for the secretion hose (, fig. 6). 👉The transport locking screws on the unit's baseplate must be removed by skilling 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.

⚫ Connection of fibre-optic cable •

Plug the fibre-optic cables into the variable connections of the light source (Storz connector). 👉If you require several adapter sleeves (e.g. Olympus, Pentax, Wolf, etc.), they may be interchanged as necessary (see chapter 8.2.4). 👉So that the fibre-optic cables do not rest on the floor, they may be threaded through behind the handle support.

Connection of the light guide cables

11

3.0 Installation and starting-up 



Starting-up the ATMOS® C 31 (contin.)

3.6

⚫ Light package LED REF 506.7550.0 (Fig. 7a) •

 Switch LED I and LED II  Holder for ATMOS HL 21 LED headlight  Holder for ATMOS LS 21 LED light source  Connecting socket LED II  Connecting socket LED I



Fig. 7a. Connecting LED

Connecting for the ATMOS LS 21 LED light source and ATMOS HL 21 LED headlight.

 ⚫ Connection of the compressed-air hose (optional)



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 (, fig. 8) 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 pump if the handles are transposed!

Fig. 8.

 CPC-Coupling





⚫ Connecting the hose for ear rinsing (optional) The hose for the warm water system is screwed on the CPC coupling. 👉Different socket nipples; misplacing of the hoses is thus impossible !

⚫ Connecting the hose for ear rinsing (optional) Connect the aqua stop valve with the water tap (local connection). Open the water supply. When the main switch is set to ON and a water consuming device (basin rinsing or hose rinsing system) is used the water supply is opened by automatic opening of the magnetic valve in the aqua stop system.  Thus, there is no pressure inside the water supply hose if no water consuming device is activated.

Fig. 9.

12

Connecting the hose for ear rinsing  Connection for compressed-air hose  Connection for ear rinsing hose

4.0 Operation 4.1

ATMOS® C 31 - Basic unit

The ENT unit ATMOS® 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 (, fig. 1, page 7), so that the instrument deposit area can be used to its best advantage for instruments. There is also the facility for protective storage of less frequently used instruments and consumables in the drawers ( and , fig. 1). 👉Most of the unit's surfaces are coated with a special textured lacquer that fulfills 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 31 is switched ON and OFF by means of the main switch (, fig. 1, page 7).

4.2.2

Maximum loads

⚫ Persons must not support on the ATMOS® C 31 (danger of tilting).

⚫ Maximum load of the instrument surface: 15 kg.

 max. 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

⚫ Open the unit covering up to the stop. Fig. 10.

Maximum load

13

4.0 Operation 4.2.4

Suction system 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: •



  

Fig. 11. Suction system

 Suction attachment  Vacuum control  Vacuumgauge  ON/OFF switch

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 suction rate by means of rotary knob for vacuum control ( , fig. 11). ⚫ Indication of set vacuum at vacuumgauge (, fig. 11) (keep suction attachment closed by hand). ⚫ Secretion is collected in 1.25 l canister with mechanical overflow safety and water-repellent bacterial filter.  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 must be exchanged daily.

👉 The suction hose must never come into direct contact with the application site. Do 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.

14

4.0 Operation    

4.2.4.1 Emptying the secretion canister ⚫ 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. For systems with bacterial filter plates or integrated bacterial filter: Remove filter and dispose of it. ⚫ 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).

Fig. 12.  Bacterial filter plate

 Secretion hose  Green coding ring: pump connection  Black coding ring: suction hose connection

4.2.4.2 Application with disposable secretion canister systems (Fig 12b) Assembly of 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. The bag is a disposable system. The canister can be reprocessed, cleaned and disinfected. Fig. 12b Disposable secretion canister systems

! !

Please observe the valid hygiene and waste disposal measures. Only the recommended ATMOS disposable secretion canister with integrated filter may be used!

15

4.0 Operation 



4.2.5

Halogen cold-light system

👉 Attention with the cold-light source!

 Fig. 13. Cold-light system

 Switch for selecting the light exit  Intensity control  Holder for cold-light cable  Endoscope holder



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 resp. 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! Do 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 off the light when you do not require the light over a prolonged period of time.

⚫ The cold-light source used in the ATMOS® C 31 consists of four halogen low-voltage lamps with a colour temperature of 3300 K. The halogen lamps are only switched on if the respective light exit is activated.

⚫ The brightness is individually adjustable for each of the four light exits; a memory function realizes which optics are used and guarantees the availability of the previously set light performance with every use of the chosen instrument.

⚫ The light guide connectors are installed on the right side of the function column.

The respective connections are marked with the corresponding symbols:

Headlamp Microscope Light guide 1 Light guide 2

Starting the cold-light system ⚫ After having operated the main switch of the ATMOS® C 31

(, fig. 1, page 7) the cold-light source changes over to standby mode, i.e. none of the halogen lamps is switched on. • When removing a light guide resp. when swivelling down the microscope or removing the headlamp from its suspension the respective instrument is supplied with light. Manual selection of a light exit on the foil keyboard is, of course, possible at any time.

16





Priority circuit:

⚫ Activating the priority circuit: When switching on the ATMOS® C 31, keep pressing the +button ( , fig. 14). Deactivating the priority circuit: When switching on the ATMOS® C 31, keep pressing the –button ( , fig. 14).

Fig. 14. Front foil

 +Button for activating the priority switching  –Button for deactivating the priority switching

Highest priority is allocated to endoscope 1 and lowest priority to the headlamp. Thus, an instrument with high priority (e.g. endoscope 2) is supplied with light even if another instrument with low priority (e.g. headlamp) is already used. When the endoscope is put back the light supply changes automatically to the instrument with lowest priority. Without this priority circuit the light would expire and a manual switchover to headlamp would be necessary. 👉Due to their limited durability, the halogen bulbs of the cold-light system may fail at any time during use. In case of inadvertent switching over or switching off of the individual light exits, they may at any time again be manually switched on with the buttons on the operating panel. 👉The cold-light system is designed for continuous operation in stand-alone application. However, it is possible that the thermal cut-out will be triggered and the cold light will be switched off if it is operated contrary to defined use whilst the suction and compressed-air systems are operated conisly at over-voltage at the same time. The coldlight system will be operable again following a cooling period.

4.2.6

Mirror quick heater

⚫ Switch on the mirror quick-heater with key switch (, fig.15) The mirror quick heater heats up for 10 sec. and switches off automatically afterwards. ⚫ Supply voltage of the heating coils: 6 V/15 A. ⚫ Hold the mirror to be heated over the burning heating coil (, fig. 15) located beneath the round grid. 👉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 !

⚫ Changing the heating coil, see section 6.3.





Fig. 15. Mirorr quick heater

 Key  Heating coil

17

4.0 Operation 4.3

Options

4.3.1

Ear rinsing system (option)

⚫ The ear rinsing system is supplied with water by a heated

(37°C) 4.5 l storage container (, Fig. 17). This container can easily be filled, cleaned or disinfected. The pump turns on automatically only when pressure drops. Water pressure and flow quantity may be regulated with the release lever on the irrigation handle. With the switch , Fig 17 a, the ear irrigation system can be switched on and off. 👉Switch on the ENT unit only after water has been filled in the storage container of the ear rinsing sy stem.



⚫ Use e.g. the measuring cup (000.0583.0) to fill the storage Fig. 16.  Water temperature display



container with water of drinking quality (at least 2 l, max. 4.5 l) 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 water of drinking quality available, you may also fill in 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 might 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 is lit the water has reached the desired temperature.



⚫ Take the water handle out of its holder and spray off water

Fig. 17.  Storage container for ear rinsing 37°C

until all air bubbles are removed and the level of the pump noise gets lower (repeat this procedure every time the pump noise gets loud, e.g. after long periods during which it has not been used or after the water level has dropped below the suction limit).

 Connection for irrigation handle  Irrigation handle

⚫ Change the jet connection daily. Only use disinfected jet connections to avoid a spreading of germs. Use the hose tip to avoid damages to the tympanic membrane.

⚫ Cleaning: Empty the storage container and the hose system



every evening using the irrigation handle. The remaining fluid can, for example, be removed with the suction system. 👉To avoid a contamination of the storage container please use a disinfected suction attachment.

⚫ Disinfection: The storage container has to be disinfected

Fig17a.

once a week with a surface disinfectant (see list of recommended disinfectants in chapter 5.5).

⚫ The hose system of the ear rinsing equipment has also to



be effected disinfected once a week with a hose disinfectant.

⚫ A measuring of the total number of germs is to be effected in regular intervals. If there is a considerable increase in germs between storage container and irrigation handle a biofilm removing procedure and a special disinfection of the hose system have to be effected by an ATMOS service technician. 👉Before cleaning the storage container, switch off the unit as, otherwise, the canister might get too hot when no liquid is filled in.

Fig. 18. Mirror preheater

 Mirror rack

18

4.0 Operation   

  4.3.2

Mirror preheater (option)

⚫ The mirror preheater is switched on when the main switch

(, fig. 1, page 7) is activated.  The rack ( , fig. 18) containing the mirrors is heated up to about 40°C. 👉ENT unit should be switched on about 20 minutes before starting work, to ensure preheating in good time!

👉 Attention, high temperatures ! 👉Prior to use of the mirror, always check its temperature (with hand etc.) !

4.3.3

Secretion canister evacuation, fully-automatic (option)

⚫ Purpose: • • •





Fig. 19. Service compartment

 Connecting nipple  Secretion canister  Hose rinsing container (option)  Secretion hose  Hose for automatic secretion canister evacuation  Connecting electrodes for automatic secretion canister evacuation (optional)

 Connection for secretion hose

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 6.2) !

👉  Pay attention to cleaning described in chapter 5.0 !

4.3.4

Quiver for cleaning and disinfecting solution (option)

⚫ Cannulae and suction hose should be rinsed through each time after use to prevent sticking and clogging up. We therefore offer an optional quiver that may be attached to the handle support (see fig. 20). 👉After cleaning, cannulae may no longer be used in patients (exception: if the cleaning solution is changed after every patient).

⚫ Particularly suitable: ATMOS special cleanser (080.0005.0).

Fig. 20. Plastic quiver for cleaning and disinfecting solution (506.7015.0) 19

4.3.5

Hose rinsing system (option)

⚫ After use, the suction system has to be rinsed by means of the hose rinsing system. • Insert the suction attachment into the white rinsing attachment of the hose rinsing system. Press the rinsing insert in and rinse the hose for a few seconds.  This procedure will prevent the hoses and suction cannulae from clogging up.

 



⚫ The tank 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. 080.0005.0) to the rinsing liquid. The tank may, optionally, be automatically filled up with fresh water. Water supply is then controlled by a level switch. A safety switch in the tank holder next to the tank prevents the filling if the tank is missing. 👉The suction attachment of the hose rinsing system may be contaminated. Therefore, it must be cleaned and disinfected daily !

Fig. 21.  Float switch

 Hose rinsing container  Line to hose rinsing system

4.3.6

Kidney-shaped rinsing basin (option)

⚫ Purpose: •

The basin receives the water that returns from rinsing procedures of the ear and the maxillary sinus.

⚫ Remove the basin from its support and hold it under the ear to be rinsed.

⚫ After use, we recommend to activate the rinsing system. To do so, press the key on the unit; a time mechanism will then start the rinsing procedure (for abt. 10 sec.). 👉The rinsing basin is not suited to collect large water quantities, e. g. when evacuating a pail, as water might overrun the interior of the unit!

Fig. 22.

20

Kidney-shaped rinsing basin