Concentration Test Report for Anaesthetic Vaporizer

according EN ISO 21647:2004

Location:

Equipment:

Serial Number:

Testing procedure:

– flush sensor and hose with O2 or air for 1 minute with 4 l of flow
– set measurement equipment to zero
– connect measurement equipment with Vaporizer
– set flow to 4 l of air or O2

Test results with AIR:

Vaporizer setting Target range Test result Passed

0 Vol. % 0 Vol. %
1 Vol. % 0.7 – 1.3 Vol. %
2 Vol. % 1.6 – 2.4 Vol. %
3 Vol. % 2.3 – 3.7 Vol. %
4 Vol. % 3.0 – 5.0 Vol. %

or

Test results with O2:

Vaporizer setting Target range Test result Passed

0 Vol. % 0 Vol. %
1 Vol. % 0.8 – 1.4 Vol. %
2 Vol. % 1.8 – 2.6 Vol. %
3 Vol. % 2.5 – 4.0 Vol. %
4 Vol. % 3.2 – 5.3 Vol. %

Remarks:

Date: Technician: Signature: