Fabius

Training
 Delivery Unit – Intern gas flow diagram ......... 12
Contents O2 -
Flush (Bypass) ....................................................... 13

Flowmeter ...................................................................... 14

Vapor .............................................................................. 15
Circle
System ............................................................... 16
6. Gas flow diagram: How does it work?..............................
17
IPPV
Inspiration (Ppeak ó Pmax)................................ 18
IPPV
Inspiration (Ppeak ò Pmax)................................ 19
IPPV
Expiration ............................................................ 20
MAN.
Inspiration........................................................... 22
MAN.
Expiration............................................................ 23

SPONT. Inspiration .................................................... 24

SPONT. Expiration ...................................................... 25

Circle
system without fresh gas decoupling ......... 26
Circle
system with fresh gas decoupling ............... 27
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 Contents
Standard setting of pressure limit values for

disconnection and stenosis alarm ........................... 32

Screen ........................................................................... 33
User
concept................................................................. 38
8.
Ventilator ................................................................................
39

Position Standby .......................................................... 40

Position MAN./SPONT. ............................................. 41

Working position ......................................................... 42

Valves .............................................................................43

Changing the membrane ........................................... 44

9.
Preparation ............................................................................
45
10. Switch
on ............................................................................... 46
11. Putting Fabius into Operation ...........................................
47
12. Cleaning and Disinfection...................................................
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48 3
 Training Manual for
Practical Training on Fabius

The information given herein is only a guide to the person

providing practical training on the Fabius. It cannot be
used to replace the proper instruction by a trained
personnel using the »Instructions for Use« manual in the
correct operation of the machine.

The current edition of the Fabius's »Instructions for Use«

manual is the binding document for the operation of the
machine.

Drägerwerk AG

09/97, Training, Produkt Marketing 4

 Intended Use of the Fabius

A compact inhalation anaesthesia machine for

anaesthesia in a semi-closed system (rebreathing system)

For low flow anaesthesia using reduced fresh gas flow

For ventilation of adults and children during anaesthesia

Manual ventilation

Automatic ventilation

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Spontaneous breathing 5
 Sales Arguments for Fabius

Aligned to environment and working

Increased working space in an operation
Its features are your advantages
theatre

Compact and integrated design Clear, safe and easily under-stood even in
stressful situation

Easy to handle, manoeuvre and transport

Alarm and signals displayed in different
languages Safety feature in case of power failure

Light weight Easy to assemble, handle and clean

Mis-connection is eliminated and the
near-zero leakage optimises the use of
Uninterruptable Power Supply Low-flow anaesthesia
(Battery Backup)
Precise and reliable ventilation for both
Breathing system (circle system) adults and children without having to
change the bellow

Money saving feature

Electronically controlled, electrically driven Safer for patient, simpler for use
ventilator
Simple operation and clear visual
No driving gas overview enable quick and correct use
of the machine everytime
Fresh gas decoupled; Vt doesn’t depend
upon the fresh gas flow Easy to learn and operate: only one user
philosophy
One single user interface for monitor and
ventilator Safe operation on Low-flows

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Simple rotary knob
 What’s what
Front view

Ventilator

Circle system Control box

Gas
delivery
unit

Vapor

D N
N
N
Fa b iu s

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 What’s what
Rear view (2-Gas version)

Main switch

P
N
N
ON 1 AT 1 AT
I

P aw V-S en sor

m
2 4V-A ccu M o tor C o n tro l 2- S en sor
O

Connection for
O2 central gas supply

Connection for N2O

central gas supply

O2 outlet for
suction unit

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 What’s what
Rear view (2-Gas version with gas cylinder)

Main switch

P
N
N
ON 1 AT 1 AT
I

P aw V-S en s or

m
2 4V-A c c u Mo tor Co n t ro l 2-S en sor
O

Connection for
O2 central gas supply
N2O central gas supply
O2 Gas cylinder
N2O Gas cylinder

O2 outlet for
suction unit

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 What’s what
Rear view (3-Gas version with gas cylinder)

Main swicht

P
N
N
ON 1 AT 1 AT
I

P aw V-S en s or

m
2 4V-A c cu M o tor Co n tro l 2-S en s or
O

Connection for
O2 central gas supply
Air central gas supply
N2O central gas supply
O2 Gas cylinder
N2O Gas cylinder
O2 outlet for
suction unit

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 Components

Description of:

Gas delivery unit

Gas delivery unit

- Intern gas flow diagram

O2-Flush (Bypass)

Flowmeter

Vapor

Circle system

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 Gas delivery unit

Fresh gas outlet O2-Flush

Flow meter
unit

Vaporiser

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 Gas delivery unit
Intern gas flow diagram (2-Gas version)

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 Gas delivery unit
Intern gas flow diagram (3-Gas version)

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 O2-Flush (Bypass)

Caution:
Monitor pressure within the
breathing system.
During controlled ventilation,
it is possible that a high
Airway Pressure may occur
if the O 2 -Flush is switched on
without the pressure limitation
function.

Push down lever for O2 -flush

When the lever is pushed down, approx. 55 L/min of O 2 will flow
09/97, Training, Produkt Marketing
into the circle system, by-passing flowmeter unit and vaporizer. 15
 Flowmeter Unit (2-Gas version)
(Gas Flow Control)

O2 Manometer N2O Manometer

S-O RC
O xyg e n -Ra tio -C o n tro lle r

N 10 0 ,5 0 10
0 ,5 0

0 ,4 5 0 ,4 5

0 .4 0 5 ,0 0 .4 0 5 ,0

4 ,0 4 ,0
0 ,3 5 0 ,3 5
O2 flowmeter N2O flowmeter
3 ,0 3 ,0
tube tube
0 .3 0 0 .3 0
0.02-0.50 L/min 0.02-0.50 L/min
0 ,2 5 2 ,0 0 ,2 5 2 ,0

0 ,2 0 1 ,5 0 ,2 0 1 ,5

O2 flowmeter 0 ,1 5
1 ,0
0 ,1 5 1 ,0 N2O flowmeter
tube tube
0 ,9 0
0.55-10.0 L/min 0 ,1 0 0 ,9 0 0 ,1 0
0.55-10.0 L/min
0 ,8 0 0 ,8 0
0 .0 5 0 ,7 0 0 .0 5 0 ,7 0
0 ,6 0 0 ,6 0
0 ,0 2 0 ,5 5 0 ,0 2 0 ,5 5

Float Set value O2 N2 O

is shown above
top edge of
float N2O flow controlvalve
09/97, Training, Produkt Marketing 16
O2 flow control valve
 Flowmeter Unit (3-Gas version)
(Gas Flow Control)

AIR Manometer N2O Manometer

L/m in
O2 Air N2 O
O2 Manometer
0 ,5 0 10 0 ,5 0 10
14

0 ,4 5 12 0 ,4 5

0 .4 0 5 ,0 9 0 .4 0 5 ,0

4 ,0 8 4 ,0
0 ,3 5 7 0 ,3 5
O2 flowmeter 3 ,0 3 ,0
N2O flowmeter
6
tube 0 .3 0 0 .3 0 tube
0.02-0.50 L/min
5
0.02-0.50 L/min
0 ,2 5 2 ,0 4 0 ,2 5 2 ,0

0 ,2 0 1 ,5 3 0 ,2 0 1 ,5

2
O2 flowmeter 0 ,1 5
1 ,0 1 ,8 0 ,1 5 1 ,0 N2O flowmeter
tube 1 ,6 tube
0 ,1 0 0 ,9 0 1 ,4 0 ,1 0 0 ,9 0
0.55-10.0 L/min 0.55-10.0 L/min
0 ,8 0 0 ,8 0
1 ,2
0 .0 5 0 ,7 0 0 .0 5 0 ,7 0
0 ,5 0 ,6 0
0 ,6 0
0 ,0 2 0 ,5 5 0 ,2 0 ,0 2 0 ,5 5
AIR flowmeter
tube
0.2-14.0 L/min
O2 O2 Air N2 O N2 O

Float Set value

S-O RC
is shown above
top edge of
float
O2 flow control
09/97, Training, Produkt Marketing 17
valve N
Air
2Oflow
flowcontrol
controlvalve
valve
 Vapor 19.3
(with filling spout)

Anaesthetic Vaporizer for

Halothane, Enflurane, Isoflurane, Servoflurane

Locking disc
for Interlock
system II

Handwheel
Scale in percent
to indicate
volume concentr. Zero-point interlock
has to be pressed in
before the handwheel
Halothane can be turned.
0.2 - 0.4 Vol.% Handwheel

Enflurane
0.2 - 5.0 Vol.% Colour-coding of
anaesthetic agent
Isoflurane
0.2 - 5.0 Vol.%

No setting below
0.2 % volume
concentration
Sight glass to
indicate filling level
Overfill safety
mechanism prevents
overfilling of the
09/97,Vapor
Training, Produkt Marketing 18
 Circle system Fabius

O2 -Sensor Insp.
valve

To the patient Pressure

mesure-
ment
FGE valve
Ventilator
Freshgas
inlet
CO2-Absorber

Exp. valve
servo controlled for
Pmax and PEEP
From the patient

APL valve

Fresh gas
To breathing connection
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Scavenging bag (not in use) 19
 Gas flow diagram: How does it work?

IPPV

- inspiration
- expiration

MAN.

- inspiration
- expiration

SPONT.

- inspiration
- expiration

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 Gas flow diagram
IPPV Inspiration

Normal working condition (Ppeak ó Pmax)

Ve n tila to r
se ttin g
Pm a x

FG E

Fre sh g a s

Ab so rb e r

APL-
Va lve
IPPV/ man
sp o n t

Sc a ve n g in g
09/97, Training, Produkt Marketing 2
 Gas flow diagram
IPPV Inspiration

If Ppeak ò Pmax Pressure Limitation

Ve ntila to r
se ttin g
Pm a x

FG E

Fre sh g a s

Ab so rb e r

APL-
Va lve
IPPV man
sp o nt

Sc a ve ng in g
09/97, Training, Produkt Marketing 3
 Gas flow diagram
IPPV Expiration 1

Ve n tila to r
se tting
PEEP

FG E

Fre sh g a s

Ab so rb e r

APL-
Va lve
IPPV man
sp o n t

Sc a ve n g in g
09/97, Training, Produkt Marketing 4
 Gas flow diagram
IPPV Expiration 2

Ve n tila to r
se tting
PEEP

FG E

Fre sh g a s

Ab so rb e r

APL-
Va lve
IPPV man
sp o n t

Sc a ve n g in g
09/97, Training, Produkt Marketing 5
 Gas flow diagram
MAN. Inspiration

Ve n tila to r

FG E

Fre sh g a s

Ab so rb e r

APL-
Va lve
IPPV man
sp o nt

09/97, Training, Produkt Marketing 6

 Gas flow diagram
MAN. Expiration

Ve n tila to r

FG E

Fre sh g a s

Ab so rb e r

APL-
Va lve
IPPV
man
sp o n t

Sc a ve n g ing
09/97, Training, Produkt Marketing 7
 Gas flow diagram
SPONT. Inspiration

Ve n tila to r

FG E

Fre sh g a s

Ab so rb e r

APL-
Va lve
IPPV man
sp o n t

09/97, Training, Produkt Marketing 8

 Gas flow diagram
SPONT. Expiration

Ve ntila to r

FG E

Fre sh g a s

Ab so rb e r

APL-
Va lve
IPPV man
sp o n t

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Sc a ve n g in g 9
 Circle system
without fresh gas decoupling

Circle system without fresh gas decoupling

no buffer volume

fresh gas is flowing continuously into the circle system

09/97, Training, Produkt Marketing 10

 Circle system
with fresh gas decoupling

Circle system with fresh gas decoupling

switching valve controlled by the ventilator (closed during inspiration)

buffer volume (reservoir) fills with fresh gas during inspiration
the set tidal volume of ventilator = the applied tidal volume

09/97, Training, Produkt Marketing 11

 What’s what
Control box - Front view

Caution LED (yellow)

Screen selection Warning LED (red)

Ventilation mode Default screen
Configuration

Ventilation parameter Sensor Rotary Stand-by

calibration knob
Alarm silence
Alarm limits (2 minutes)

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 What’s what
Control box - Rear view

2 3
1

1 Main switch
2 Pressure measuring
line
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FlowMarketing
sensor 13
 Control box (1)
Measured Parameter

inspiratory oxygen concentration FiO 2

ventilation pressure
(Pmax, Peak, PEEP, Paw)

minute volume MV, tidal volume VT

respiratory frequency fIPPV

09/97, Training, Produkt Marketing 14

 Control box (2)
Setting Parameter

Paw : 10 … 70 hPa
VT : 0.05 … 1.4 L
fIPPV : 6 … 60 1/min
TI :TE : 1:3 … 2:1
TIP : TE [%] : 5% … 50%
PEEP : 0.2 … 15 hPa

Ventilation parameter

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 Standard Setting of Pressure Limit Values
for Disconnection and Stenosis Alarm

Patient connected

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 Control box
Screen

Screen 1:

Default screen

Screen 2:

Paw curve 1-2--

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 Control box
Screen

Screen 3:
1-2--
Ventilator settings

Screen 4:

Failure and Alarm Display:

shows alarms and their priorities 1-2--

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 Control box
Screen

Screen 5:
Menu
Configuration menu

1. Key code .......................................... for

DrägerService

2. Display timeout [s] ...........................

returns to standard screen

3. Chinese text .....................................

Warning/Caution messages in Chinese

4. Power on setting ..............................

LAST USE:
starts with last settings used

STANDARD:
starts with standard settings

5. Curve IPPV ....................................... FREE RUNNING:

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Paw curve is displayed as it runs
 Control box
Screen

Screen 6:

Default screen with alarm limits

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 Control box
Screen

Screen 7:
0
Sensor calibration

Calibration of O2 sensor:

21 %: expose sensor to ambient air

100 %: flush sensor with O2

Calibration of flow sensor:

Fabius in Standby

No fresh gas

09/97,Calibration begins
Training, Produkt after pressing the rotary knob.
Marketing 5
 User concept

1. select a function/parameter with the appropriate button

m a n./ Vt
sp o n t. (m l)
600

IPPV
VT

2. set the required level for the parameter by moving

the cursor with the rotary knob

Vt
(m l)
6 00

3. confirm your selection by pressing the rotary knob

09/97, Training, Produkt Marketing 6

 Ventilator

connector for electrically controlled

patient hose piston-cylinder-unit

ventilation mode
– IPPV
– Manual ventilation
– Spontaneous
breathing

The movement of the

ventilator can be seen
09/97,through thisMarketing
Training, Produkt window. 7
 Ventilator (1)
Position Standby

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 Ventilator

connector for electrically controlled

patient hose piston-cylinder-unit

ventilation mode
– IPPV
– Manual ventilation
– Spontaneous
breathing

The movement of the

ventilator can be seen
09/97,through thisMarketing
Training, Produkt window. 1
 Ventilator (1)
Position Standby

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 Ventilator (2)
Position MAN./SPONT.

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 Ventilator (3)
Working Position

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 Ventilator (4)
Valves

valve for additional air

(in case of
fresh gas flow deficit)

safty valve
75 hPa

2 0 0 h Pa

p um p

09/97, Training, Produkt Marketing 5

 Ventilator (5)
Fabius in Standby (not MAN/SPONT!)
Changing the Membrane

1. Open the door for ventilator

2. Turn two screws off and

take the lid off.

3. Remove the membrane.

Do not touch inside of the sterilized

membrane
when you put it back in the ventilator!
09/97, Training, Produkt Marketing 6
 Preparation

Actions to be taken before the machine is switched on:

Ensure that personnel involved are instructed according

to the prevailing national laws.

Ensure that the Fabius is completely assembled (please

refer to the Instructions for Use for more details).

Connect gas supply.

Connect gas scavenger.

Connect power.

09/97, Training, Produkt Marketing 7

 Switch on

Verify the Fabius according to the Check-list.

Press main switch on the rear of the control box.

After completion of the self test (approx. 30 sec.),

the control box switches into »Standby«.

Fabius is ready for use.

09/97, Training, Produkt Marketing 8
 Putting Fabius into Operation

Control box is in Standby

Set APL valve

for spontaneous breathing and
automatic ventilation (IPPV)
for manual ventilation
in AUTO/SPONT (set pressure limit required)

in MAN

Ventilation is activated by
pressing the function keys
on the control box

m a n./
sp o n t.

IPPV
Confirm by pressing the rotary
knob
09/97, Training, Produkt Marketing 9
 Cleaning and Disinfecting

Wipe off any obvious stains with

disposable cloth.

Moisten cloth with detergent or

disinfectant.

Disinfect the following with moist

heat:
patient hoses, rubber parts and
chromium-plated metal parts.

Sterilize at 134 °C

Sterilize all parts which come into

contact with breathing gas in hot
steam.

09/97, Training, Produkt Marketing

Please refer to the Instructions for Use for more details. 10