GE Healthcare

Aisys CS2
Participant Guide

Spirometry

Ref.
Gas

Gas
Exhaust

Clinical Systems
Clinical and Educational Development
Aisys CS2
Participant Guide
Version A

Clinical Systems
Clinical and Educational Development

Customer Support Center: 800-345-2700

Notice
Configurations available for this product depend on local market and standards requirements.
Illustrations in this course may not represent all configurations of the product. This course
does not cover the operation of every accessory.
The materials contained in this document are intended for educational purposes only.
This document does not establish specifications, operating procedures or maintenance
methods for any of the products referenced. Always refer to the official written materials
(labeling) provided with the product for specifications, operating procedures and maintenance
requirements.
Proprietary Training Material Property of GE Healthcare. The materials contained in this
document are intended for educational purposes only. Use of these materials is limited to
agents and employees of GE Healthcare of other parties expressly licensed by GE. Unlicensed
use is strictly prohibited. These materials may include clinical concepts and definitions.
No diagnostic statements are inferred or included in these materials. All clinical diagnosis
should be made by a trained physician or clinician. All patient names or other protected health
information or data contained in any image within this material is fictitious. Any similarity to
actual persons is coincidental.

Note! This participant guide is not intended to replace the User’s Reference Manuals
that you received with the machine. Please refer to the disclaimer notice at the end of
this participant guide for more information.
This course is intended for Aisys CS2 software level 10.X. The material contained in this
course is intended for educational purposes only. Always refer to the official written
materials provided with the Aisys CS2 for specifications, operating procedures, and
maintenance requirements.
i
Contents
1 Welcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1 Navigating the Display . . . . . . . . . . . . . . . . . . . . . . . . . 3.8

Class Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1 Menu Components . . . . . . . . . . . . . . . . . . . . . . . . . 3.8

Class Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 Using Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.8

Using the ComWheel . . . . . . . . . . . . . . . . . . . . . . . 3.9

2 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 Using Quick Keys . . . . . . . . . . . . . . . . . . . . . . . . . . 3.9
Aisys CS2 Overview Objectives . . . . . . . . . . . . . . . . . 2.1
Front View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2
4 Vaporization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1
Rear View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4
Vaporization - Aladin2 Cassettes . . . . . . . . . . . . . . . 4.1
Advanced Breathing System
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1
(ABS) Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6
Aladin2 Features . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2
Breathing System Options . . . . . . . . . . . . . . . . . 2.8
Turning On and Adjusting Agent Level
Display Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.10
Using Quick Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.3
System Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.11
Filling the Aladin2 Cassette . . . . . . . . . . . . . . . . . . . . . 4.4
O2 Information Sources . . . . . . . . . . . . . . . . . . . . . . . . 2.12
Changing Aladin2 Cassettes . . . . . . . . . . . . . . . . . . . . 4.6
O2 Flush Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.14
Alternate O2 Control . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.15
5 Advanced Breathing System . . . . . . . . . . . . . . . . . . 5.1
Types of Scavenging Systems . . . . . . . . . . . . . . . . . . 2.16
Aisys CS2 Advanced Breathing
Active Adjustable Flow . . . . . . . . . . . . . . . . . . . . . 2.16 System Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1

Active AGSS with Flow Indicator . . . . . . . . . . . . 2.17 Bag/Vent Switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.3

Connecting Passive AGSS . . . . . . . . . . . . . . . . . . 2.18 APL Valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.3

Bag Support Arm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.4

3 Display Navigation . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 Absorber Canister . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.5

Aisys CS2 Display Navigation Objectives . . . . . . . . 3.1 Canister Access on a Standard Machine . . . . . . . . 5.6

Positioning the Display . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 Canister Access on a Machine with

the EZchange Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.7
System Display Overview . . . . . . . . . . . . . . . . . . . . . . 3.3
Condenser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.8
Digit Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4
Flow Sensors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.9
Waveform Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4
Preventing Moisture Buildup . . . . . . . . . . . . . . . . 5.10
Split Screen Field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5
Auxiliary Common Gas Outlet (ACGO) . . . . . . . . . . . 5.11
Display Touch Points . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6
Measured Value Touch Points . . . . . . . . . . . . . . 3.7
Active Alarm Touch Points . . . . . . . . . . . . . . . . . 3.7

ii
6 Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1 7 Ventilation Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1
Aisys CS2 Operation Objectives . . . . . . . . . . . . . . . . 6.1 Aisys CS2 Ventilation Modes Objectives . . . . . . 7.1
Starting a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2 About Ventilator Modes . . . . . . . . . . . . . . . . . . . . 7.2
Minimum Alveolar Concentration (MAC) . . . . . 6.3 Volume Control Mode (VCV) . . . . . . . . . . . . . . . . . 7.2
Starting a Case Using Default Settings . . . . . 6.3 Pressure Control Mode (PCV) . . . . . . . . . . . . . . . . 7.3
Starting a Case Using Custom Settings . . . . . 6.3 Pressure Control Ventilation with Volume
Guarantee Mode (PCV-VG) . . . . . . . . . . . . . . . . . . 7.4
Ending a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.4
Synchronized Intermittent Mandatory
Turning Off the System . . . . . . . . . . . . . . . . . . . . 6.4
Ventilation - Volume Control Ventilation
Ventilator Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.5 Mode (SIMV-VCV) . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5
Changing Ventilator Mode . . . . . . . . . . . . . . . . . 6.5 Synchronized Intermittent Mandatory
Ventilation – Pressure Control Ventilation
Changing Ventilator Settings . . . . . . . . . . . . . . . 6.5
Mode (SIMV-PCV) . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.6
Gas Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.6
Synchronized Intermittent Mandatory
Changing Gas Settings . . . . . . . . . . . . . . . . . . . . 6.6 Ventilation – Pressure Control Ventilation -
Volume Guaranteed Mode (SIMV PCV-VG) . . . 7.7
Changing Balance Gas . . . . . . . . . . . . . . . . . . . . 6.6
PSVPro Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.8
Changing Circuit Type . . . . . . . . . . . . . . . . . . . . . 6.6
CPAP + PSV Mode . . . . . . . . . . . . . . . . . . . . . . . . . . 7.9
System Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.7
Patient Demographics . . . . . . . . . . . . . . . . . . . . . 6.7
8 Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1
Screen Setup Menu . . . . . . . . . . . . . . . . . . . . . . . . 6.7
Aisys CS2 Spirometry Objectives . . . . . . . . . . . . . . . 8.1
ecoFLOW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.11
About the Spirometry Menu . . . . . . . . . . . . . . . . . . . 8.2
Using ecoFLOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.13
Spirometry Loops . . . . . . . . . . . . . . . . . . . . . . . . . 8.2
Alarm Management . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.14
Using the Spirometry Loop Split Screen . . . . . . . . 8.3
Alarm Priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.14
Setting the Loop Type . . . . . . . . . . . . . . . . . . . . . 8.3
Pausing Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.14
Saving, Viewing, and Deleting
Cancelling Audio Pause . . . . . . . . . . . . . . . . . . . . 6.14
Spirometry Loops . . . . . . . . . . . . . . . . . . . . . . . . . 8.3
De-escalating Alarms . . . . . . . . . . . . . . . . . . . . . 6.14
Spirometry Menu Setup . . . . . . . . . . . . . . . . . . . . . . . 8.4
Setting Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . 6.15
Setting Loop Graph Scaling . . . . . . . . . . . . . . . . 8.4
Setting Volume Apnea Alarm . . . . . . . . . . . . . . . 6.15
Setting Patient and Sensor Type . . . . . . . . . . . 8.5
Setting MV/TV Alarm . . . . . . . . . . . . . . . . . . . . . . 6.15
Setting the Data Source . . . . . . . . . . . . . . . . . . . 8.5
Viewing Alarm History . . . . . . . . . . . . . . . . . . . . . 6.16
Setting Spirometry Volume Type . . . . . . . . . . . 8.5
Alarm Setup Configure Tab . . . . . . . . . . . . . . . . . 6.16
Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.17

iii
9 Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1 Breathing Circuit Module . . . . . . . . . . . . . . . . . . . . . . 11.6

Aisys CS2 Procedures Objectives . . . . . . . . . . . . . . . .9.1 Remove the Breathing Circuit Module . . . . . . 11.6

The Procedure Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2 Replace the Breathing Circuit Module . . . . . . 11.7

Pause Gas Flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2 Bellows Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8

Cardiac bypass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.3 Disassemble the Bellows Assembly . . . . . . . . 11.8

Using Manual Ventilation Cardiac Bypass . . . 9.3 Assemble the Bellows Assembly . . . . . . . . . . . 11.9

Using VCV Cardiac Bypass . . . . . . . . . . . . . . . . . . 9.3 Exhalation Valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.10

Vital Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.4 Remove the Exhalation Valve Assembly . . . . 11.10

Using Vital Capacity . . . . . . . . . . . . . . . . . . . . . . . . 9.4 Replace the Exhalation Valve Assembly . . . . 11.10

Changing Vital Capacity Settings . . . . . . . . . . . .9.4

Cycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5 12 Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1

Using Cycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5 Aisys CS2 User Operational

Maintenance Schedule . . . . . . . . . . . . . . . . . . . . . . . . 12.1
Changing Cycling Settings . . . . . . . . . . . . . . . . . . 9.5
Aisys CS2 Anesthesia Supplies
and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.3
10 Checkout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.1
Aisys CS2 Quick Guide . . . . . . . . . . . . . . . . . . . . . . . . . 12.5
Aisys CS2 Checkout Objectives . . . . . . . . . . . . . . . . .10.1
Aisys CS2 Troubleshooting Guide . . . . . . . . . . . . . . 12.7
About the Checkout Menu . . . . . . . . . . . . . . . . . . . . . 10.2
Full Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10.2
13 Clinical Training Documents . . . . . . . . . . . . . . . . 13.1
Performing a Full Test . . . . . . . . . . . . . . . . . . . . . 10.2
Aisys CS2 Clinical Training Checklist . . . . . . . . . . . . 13.1
Tests Performed During a Full Test . . . . . . . . . 10.3
Aisys CS2 Clinical Skills Checklist . . . . . . . . . . . . . . . 13.3
Individual Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10.3
Aisys CS2 Clinical Training Quiz . . . . . . . . . . . . . . . . 13.5
Low P Leak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.3
Aisys CS2 Clinical Training Quiz Answers . . . . . . . 13.8

11 Assembly and Cleaning . . . . . . . . . . . . . . . . . . . . . 11.1

14 Non-clinical Training Documents . . . . . . . . . . . 14.1
Aisys CS2 Assembly and Cleaning Objectives . . 11.1
Aisys CS2 Non-Clinical Training Checklist . . . . . . . 14.1
Advanced Breathing System . . . . . . . . . . . . . . . . . . 11.2
Aisys CS2 Non-clinical Skills Checklist . . . . . . . . . . .14.3
Replace the Breathing System . . . . . . . . . . . . . 11.3
Aisys CS2 Non-clinical Training Quiz . . . . . . . . . . . . 14.5
Flow Sensor Module . . . . . . . . . . . . . . . . . . . . . . . . . . 11.4
Aisys CS2 Non-clinical Training Quiz Answers . . 14.8
Remove the Flow Sensor Module . . . . . . . . . . 11.4
Remove the Flow Sensors . . . . . . . . . . . . . . . . . 11.4
15 Course Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1
Replace the Flow sensors . . . . . . . . . . . . . . . . . 11.5
Replace the Flow Sensor Module . . . . . . . . . . 11.5

iv
 Aisys CS2 1 Welcome

1 Welcome

1 Welcome
We would like to take a moment to thank you for choosing GE Healthcare for your anesthesia
system needs. Our goal now is to provide you with the best training service available while
continuing to support you as you use our products in your workplace.

Class Description
This course is designed to give Participants the information and product knowledge needed to
proficiently operate the Aisys CS2 anesthesia system. This class will use discussion, scenarios
and return demonstrations.

Participant Learning Objectives

Specific learning objectives will be listed for each section at the beginning of the section.
Overall learning objectives include:
• Describe the main components of the system

• Power up and shut down the system

• Utilize the O2 flush and alternate O2 control

• Navigate the display

• Replace and fill an Aladin2 cassette

• Utilize the bag/vent switch and APL valve

• Replace the CO2 canister

• Zero the flow sensors

• Start and end a case

• Change ventilation mode and balance gas

• Utilize ecoFLOW

• Manage alarms

• View trends

• Describe the eight modes of ventilation available

• View, save and erase a spirometry loop

• Perform a Pause Gas Flow, Cardiac Bypass, Vital Capacity and

Cycling procedure

• Perform a full test from the checkout menu

1.1
 Aisys CS2 2 Overview

2 Overview
Aisys CS2 Overview Objectives
After completing this section, the participant will be able to:
• Describe the main components on the front of the system
• Describe the main components on the rear of the system

2 Overview
• Describe the main components of the Advanced Breathing System (ABS)
• Describe the optional breathing system options
• Describe the display controls
• Power up the system and recognize when AC power is connected
• Identify the three types of battery symbols
• Identify the components of the airway module and galvanic cell
• Utilize the O2 flush button
• Active alternate O2 control and adjust the flow.
• Describe the three types of scavenging systems available

Spirometry

Ref.
Gas

Gas
Exhaust

2.1
Aisys CS2 Participant Guide

Front View
1. Aladin2 Cassette Storage Bay: Storage bay for Aladin cassettes that are not in use.

2. Aladin2 Cassette and Active Bay: The Aladin2 cassette is an electronic vaporizer that
controls agent mixing and delivery.

3. Alternate O2 Control: The Alternate O2 control activates automatically in the case of

certain failures or errors and delivers O2 through an independent path to the vaporizers
and patient circuit. It can also be activated manually.

4. System Switch: Used to turn the system on and off. When the system is turned on, the
display will show the power-up screen and the system does a series of automated self-
tests.

5. Mains Indicator: The mains indicator is lit when AC power is connected.

6. O2 Flush Button: Push the O2 flush button to deliver a high flow of O2 to the breathing
system.

7. Brake: Push down the brake pedal to lock the system in place. Lift up on the brake pedal to
release the brake.

8. Integrated Suction: The optional integrated suction adjusts the vacuum used to suction
fluids from the patient during a case. The switch can be set to max for full vacuum, Off for
no vacuum, or On for adjustable vacuum.

9. Auxiliary O2 Control: The optional auxiliary O2 flowmeter is most often used to deliver
oxygen through a nasal cannula or mask.

10. Anesthesia Display: The anesthesia display is used throughout the anesthesia delivery
process and allows the clinician to interact with the system. The display also provides
real-time patient data.

2.2
 Aisys CS2 2 Overview

2 Overview
Anesthesia
Display 10

Spirometry

Ref.
Gas
1 Aladin2 cassette
storage bay
Gas
Exhaust

Auxiliary O2 Flow Control 9 2 Aladin2 cassette

and active bay
Integrated Suction 8 3 Alternate O2
Control

4 System Switch

Mains
5 Indicator

6 O2 Flush
Button

7 Brake

Figure 2.1 Aisys CS2 Front View

2.3
Aisys CS2 Participant Guide

Rear View
1. Collection Bottle: The collection bottle prevents fluids from entering the optional suction
regulator.

2. Vacuum Connection: Connect the vacuum connection to the source vacuum supply.

3. AGSS (Anesthesia Gas Scavenging System): The scavenging system is designed to safely
remove excess gas from the anesthesia machine.

4. Mains Inlet: AC power is connected to the system through the mains inlet.

5. System Circuit Breaker: This is the main circuit breaker. It should not be mistaken for an
on/off switch. Accidentally pressing this switch will cause the system to be powered by its
reserve battery instead of electricity from the wall outlet.

6. Isolated Electrical Outlet: A place to plug in low power accessories that are used in
conjunction with the anesthesia machine.

Note! The electrical outlets are for low power only! Do not use these outlets for
equipment such as blanket warmers and operating room beds.

7. Outlet Circuit Breaker: An automatically operated electrical switch designed to protect the
system from damage caused by overload. Unlike a fuse, which operates once and then
must be replaced, a circuit breaker can be reset to resume normal operation.

8. Cylinder Yokes: Gas cylinders are mounted on the cylinder yoke.

9. Pipeline Connections: Hoses are connected between the pipeline inlets and the gas
outlets in the hospital.

10. Cylinder Wrench: The cylinder wrench is used to open and close the gas cylinders.

2.4
 Aisys CS2 2 Overview

2 Overview
Cylinder wrench 10
1 Collection bottle

2 Vacuum connection

Pipeline connections 9

Cylinder yokes 8

Outlet circuit 7
breakers

Isolated electrical 6
outlet 3 AGSS
(Anesthesia Gas
Scavenging System)

System circuit breaker 5

Mains inlet 4

Figure 2.2 Aisys CS2 Rear View

2.5
Aisys CS2 Participant Guide

Advanced Breathing System (ABS) Components

1. Airway Module (optional): The airway module measures and monitors gases delivered to
the patient. Depending on the configuration, this component may include sensors for
measuring carbon dioxide, nitrous oxide, anesthetic agents and oxygen.

2. Adjustable Pressure Limiting (APL) Valve: During manual ventilation, the APL Valve allows
you to change the pressure limit from minimum to 70 cmH2O.

3. Bellows Assembly: During mechanical ventilation, the gases that are to be delivered to
the patient are contained within the bellows assembly.

4. Bag/Vent Switch: The Bag/Vent switch selects between manual ventilation (bag) and
mechanical ventilation (vent). When the switch is changed from bag to vent mode, the
ventilator is automatically switched on.

5. Expiratory Check Valve: The expiratory check valve opens during expiration and closes at
the start of inspiration.

6. Inspiratory Check Valve: The inspiratory check valve opens during inspiration and closes
at the start of expiration.

7. Inspiratory Flow Sensor: The inspiratory flow sensor determines the volume of gas
flowing to the patient.

8. Expiratory Flow Sensor: The expiratory flow sensor determines the volume of gas flowing
from the patient.

9. Absorber Canister: This component removes carbon dioxide from the patient’s exhaled
breath. These scrubbed gases can then be sent back to the patient.

10. Absorber Canister Release: Push the absorber canister release to remove the canister
from the holder.

11. Leak Test Plug: Occlude the breathing circuit using the leak test plug as part of the
preoperative tests.

12. Breathing System Release: Push the absorber canister release to remove the
breathing system.

13. Manual Bag Port: The bag hose and rebreathing bag attach to the manual bag port.

14. AGSS Indicator (only on some AGSS versions): With an active Anesthesia Gas Scavenging
System (AGSS) that includes a flow indicator, the ball on the indicator should rise to the
green zone.

2.6
 Aisys CS2 2 Overview

1 Airway Module

Spirometry

Ref.
Gas

Gas
Exhaust

2 Overview
2 Adjustable Pressure Limiting (APL) Valve)

Bellows Assembly Bag/Vent Switch

3 4
Expiratory Inspiratory
Check Valve Check Valve
5 6

AGSS Indicator 14

Manual Bag Port 13 7 Inspiratory

Flow Sensor

8 Expiratory
Flow Sensor
12 9 Absorber Canister
Breathing
Absorber Canister
System
Release
10 Release

11 Leak Test Plug

Figure 2.3 Advanced Breathing System

2.7
Aisys CS2 Participant Guide

Breathing System Options

1. Bag Support Arm: Use the optional bag support arm to hold the breathing circuit bag.

2. ACGO Port: Fresh gas flows through the ACGO port when the ACGO switch is set to
the ACGO position.

3. Auxiliary Common Gas Outlet (ACGO) Switch: Use the optional Auxiliary Common Gas
Outlet (ACGO) switch to direct the fresh gas flow through the ACGO port on the front of the
system to a manual breathing circuit.

4. EZchange Canister Mode (CO2 bypass): Use the optional EZchange canister mode
for continued ventilation of the patient while changing the absorber canister.

5. EZchange Canister Release: Push the EZchange canister release to unlock the
canister cradle.

6. Condenser: Use the optional condenser to remove water in the system that is produced
from the reaction of CO2 gas with the absorbent.

7. Condenser Drain Button: Place a container under the reservoir and push the drain button
to empty any water in the condenser.

2.8
 Aisys CS2 2 Overview

Spirometry

Ref.
Gas

Gas
Exhaust

2 Overview
1

2 3

4
5

6
7

Figure 2.4 Breathing System Options

2.9
Aisys CS2 Participant Guide

Display Controls
The touchscreen has numerous touch point areas that make accessing menus and settings
quick and easy. The buttons on the right side of the screen provide direct access to commonly
used functions. The ventilation quick keys enable setup of ventilation modes. The gas control
quick keys provide a method to set up the gas used for a case.
Touch only one touch point at a time to ensure the correct selection is made.
1. ComWheel: Selects a menu item or confirms a setting. Turn clockwise or counterclockwise
to scroll through menu items or change settings.

2. Home Key: Removes all menus from the screen.

3. Screen Lock/Unlock Key: Locks the touchscreen. Toggles between lock and unlock functions.

4. Start/End Case Key: Initiates Start or End Case function.

5. Touchscreen: Activates functions when touch areas on the screen are selected.

6. Audio Pause Key: Stops audio for 120 seconds for any active, eligible high and medium
priority alarms. Prevents audio (audio off) for 90 seconds when no medium or high priority
alarms are active. Allows the operator to acknowledge any non-active medium or high
priority latched alarms. Hold the key for 2 seconds to cancel the audio pause function.

6 5 4 3 2 1
Figure 2.5 Display Controls

2.10
 Aisys CS2 2 Overview

System Power
Turning On the System
1. Plug the power cord into an electrical outlet and make sure the system circuit breaker is
on. The mains indicator is lit when AC power is connected and the battery is charging (if it
is not already fully charged).

2. Check that the breathing system is properly connected.

3. Turn the System Switch to On. The display will show the power up screen and the system

2 Overview
does a series of automated self-tests.

4. Perform a Full Test before the first case of the day (this is covered in full detail later in
the course).

5. Perform a preoperative checkout before each case. See the Preoperative checkout
section of the user's manual for more information.

Figure 2.6 Mains Indicator and System Switch System Mains

Switch Indicator

Battery Information
If AC power is lost, the battery has the capacity to operate for 50 minutes under typical
operating conditions and 30 minutes under extreme conditions.
The color and fill amount of the battery in use symbol indicates the amount of battery
power remaining.

Note! Electrical outlets

Green indicates greater (if provided) will not
than 10 minutes. function while the system
is on battery power.

ellow indicates between

Y
10 and 5 minutes.

Red indicates less
than 5 minutes.

Figure 2.7 Battery in use symbol

2.11
Aisys CS2 Participant Guide

O2 Information Sources
Airway Modules
There are two sources of O2 information available on the system. The first source is the
optional compact airway module.
The compact airway modules measure and monitor gases delivered to the patient and
exhaled through the breathing circuit. The modules consist of:
• An infrared sensor for measuring CO2, N2O, and anesthetic agents.
• A paramagnetic O2 sensor.
• A gas sampling system with D-fend water separation system.

1
Spirometry

Ref.
Gas
2
Gas

3
Exhaust

4
5

Figure 2.8 Compact Airway Module

1. Connectors for patient spirometry only.

2. D-fend water trap with washable container.

3. Sampling line connector on the D-fend water trap.

4. Water trap latch.

5. Oxygen reference gas inlet.

6. Sample gas outlet.

7. Cooling fan with dust filter.

8. Sample gas return port.

2.12
 Aisys CS2 2 Overview

Galvanic Cell
The second O2 information source is an optional Galvanic Cell, or O2 Sensor, located within the
Advanced Breathing System (ABS). The Galvanic Cell measures the circuit O2. The O2 sensor is
calibrated daily during the system checkout, and can be expected to last approximately
eighteen months. It CANNOT be disinfected.

2 Overview
O2 Cell

Figure 2.9 O2 Sensor

Note! Systems with an airway gas module may not include the optional Galvanic
Cell. Systems with both an airway module and an O2 cell will display the patient
inspired O2 value obtained from the airway module.

2.13
Aisys CS2 Participant Guide

O2 Flush Button
The O2 Flush Button delivers a high flow of 100% O2 to the breathing system, bypassing
the vaporizers.

Spirometry

Ref.
Gas

Gas
Exhaust

Figure 2.10 O2 Flush Button

2.14
 Aisys CS2 2 Overview

Alternate O2 Control
When Alternate O2 control is enabled, flow from the electronic mixer is stopped. O2 is flowing
through the Alternate O2 control to the breathing system. To activate anesthetic agent flow
to the breathing system, set the agent to the desired concentration.
Use the Alternate O2 control to deliver O2 through an independent pneumatic path to the
vaporizer and patient circuit. Alternate O2 is connected to the system O2 supply. Alternate O2
control activates automatically in the case of certain failures or errors. It can also be
activated manually.

2 Overview
The Alternate O2 control is available approximately 20 seconds after the system is turned on.
The Alternate O2 flow is adjustable from approximately 0.5 l/min to 10 l/min as indicated on
the flow tube.

Figure 2.11 Alternate O2 Control

1. Alternate O2 ON/OFF button

2. Flow control

3. Flow tube

Using Alternate O2 control

1. Push the Alternate O2 ON/OFF button. The O2 flow is indicated on the flow tube.

2. Use the flow control to adjust the O2 flow.

3. Set the agent to the desired concentration.

4. To end Alternate O2 control, push the Alternate O2 ON/OFF button.

2.15
Aisys CS2 Participant Guide

Types of Scavenging Systems

Active Anesthesia Gas Scavenging Systems (AGSS)

There are several versions of the optional active Anesthesia Gas Scavenging System (AGSS)
available depending on the hospital’s type of waste gas disposal system. Each version has a
two-liter reservoir to capture peak exhaust flows that briefly exceed the extract flow.

Active Adjustable Flow

Provides the capability to adjust the flow with a needle valve and a visual indicator bag
which should be properly inflated. To ensure adequate scavenging, adjust the needle valve
so the visual indicator bag puffs out slightly with each breath. The bag should not be
completely collapsed (close the needle valve slightly) nor completely inflated (open the
needle valve slightly).
Problems with Active Adjustable Flow gas scavenging can cause a High Peep alarm. Make sure
the scavenge hose is connected to suction. Make sure that the needle valve is open enough
that the scavenger bag moves with inspiration and expiration.
You can connect the sample gas exhaust tube to the gas return port. Exhaust gas will be
directed to the scavenging system.

Rotating DISS Connector

Optional Gas Return Port

Scavenging Hose

Adjustable Needle Valve

Figure 2.12
Active Adjustable Flow Three-liter Bag

2.16
 Aisys CS2 2 Overview

Active AGSS with Flow Indicator

The active AGSS with flow indicator does not use a needle valve or a visual indicator bag.
A flow indicator will verify that there is a proper extraction flow rate.
With the AGSS operating, verify that the ball on the flow indicator rises to the green zone,
indicating adequate flow.
The ball in the upper red zone indicates excessively high extraction flow. The ball in the lower
red zone indicates extraction flow rate is too low or a blocked filter.

2 Overview
Scavenging
Hose Connector
Figure 2.13
Open Reservoir System

Scavenging Hose

Figure 2.14
Flow Indicator

2.17
Aisys CS2 Participant Guide

Passive AGSS (Anesthetic Gas Scavenging System)

The optional passive anesthesia gas scavenging system (AGSS) is for use in operating room
environments that do not have an active gas extraction system for waste gas disposal.
The passive AGSS contains both positive and negative pressure relief valves to protect the
breathing system and the patient.
Passive AGSS may be used with a non-recirculating ventilation system for waste gas disposal.
The tube connection from passive AGSS to the non-recirculating ventilation system should be
an open connection, essentially at atmospheric pressure. For example, to an exhaust grill.

Connecting Passive AGSS

1. Connect a large diameter tube to the 30-mm tapered connector on the bottom of the
AGSS receiver.

2. Route the large diameter tube from the passive AGSS to exterior of the building or to a
non-recirculating ventilation system. The tube should be as large in diameter and as
short as possible.

30 mm Passive
Scavenging Connector

Purple Adapter

19 mm Hose End

Passive Scavenging Hose

Figure 2.15 Passive Anesthetic Gas Scavenging System

2.18
 Aisys CS2 3 Display Navigation

3 Display Navigation
Aisys CS2 Display Navigation Objectives
After completing this section, the participant will be able to:
• Position the display
• Describe the various areas of the display, such as waveform fields, digit fields and
split screen.
• Navigate through a menu using the ComWheel
• Use a Quick Key to change a setting

3 Display Navigation
11:07 Audio Pause

40 Paw 40 Paw cmH2O 40

Ppeak Pmean Alarm Setup

25
20 60

Paw
20
VCV 7 System
0 cmH20
80 0 PEEP Setup

-20 100
2
Flow 60 Next Page
Flow l/min 2.0 10.0
I/min
MV

5.0
15
0 Trends
TVexp ml
10
-60 500 Spirometry
CO2 mmHg 20 60
5

35
Et
CO2 40 Procedures
1
Fi Stop
0 0 00:27:32
0.5
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0

10
O2 N2O Air RR /min Et Fi Sev Et Fi

Air 02 0 0 0
O2
42 47 1.4 2.6
1.6 0.95
Compl
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case

Fresh Gas: O2 + Air Ventilator On: Volume Control

O2 Total Flow Sev Mode TV RR I:E PEEP
More
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off Settings
% l/min % ml /min cmH2O

3.1
Aisys CS2 Participant Guide

Positioning the Display

The display can be moved for optimal viewing:

1. Unlock the display arm.

2. Raise or lower the display arm to adjust the height of the display.

3. Lock the display arm.

4. Rotate the display arm toward or away from the system to adjust the horizontal position of
the display.

5. Tilt the display up or down to adjust the vertical angle of the display.

6. Tilt the display left or right to adjust the horizontal angle of the display.

Spirometry

Ref.
Gas

Gas
Exhaust

Figure 3.1 Display • front view

3.2
 Aisys CS2 3 Display Navigation

System Display Overview

1 2 3 4 5
Unable to Please Do 11:07
12 Apnea > 120 s MVexp low
drive bellows Checkout Audio Pause

40 Paw 40 Paw cmH2O 40

Ppeak Pmean Alarm Setup

25
20 60

Paw
20
VCV 7 System
0 cmH20
80 0 PEEP Setup

-20 100
2
Flow 60 Next Page
Flow l/min 2.0 10.0
I/min
MV

5.0
15
0 Trends
TVexp ml

11 10
-60 500 Spirometry
6
CO2 mmHg 20 60
5

35
Et
CO2 40 Procedures
1
Fi Stop
0 0 00:27:32
0.5
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0

10

3 Display Navigation
O2 N2O Air RR /min Et Fi Sev Et Fi

Air 02 0 0 0
O2
42 47 1.4 2.6
1.6 0.95
Compl
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case

Fresh Gas: O2 + Air

O2 Total Flow Sev
Ventilator On: Volume Control
Mode TV RR I:E PEEP
7
More
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off Settings
% l/min % ml /min cmH2O

10 8
9 Figure 3.2 Display Components

1. Alarm Message Fields: Displays the active alarms.

2. Waveform Fields: Displays the waveforms of measured values. For example: Paw, Flow,
and CO2.

3. General Message Fields or Lock Touchscreen Indicator: Displays general messages and
the touchscreen lock indicator.

4. Clock: Displays the current time.

5. Measured Values Fields: Displays the measured values. For example: Paw, Flow, and CO2.

6. Function Keys: Functions available are Audio Pause, Alarm Setup, System Setup, Next
Page, Trends, Spirometry, Procedures, Timer, Start, and End Case.

7. Digit Fields: Contains information for Spirometry, Resp, Agent, and Gases.

8. Ventilator Quick Keys: Displays mode, associated ventilation parameters, and more
settings. For example: Mode, TV, RR, I:E, PEEP, and More Settings.

9. Ventilation Mode: Displays the selected ventilation mode. For example: Ventilator On, and
Volume Control.

10. Gas Quick Keys: Displays O2, Total Flow, and Gas Setup.

11. Split Screen Field: Contains airway pressure, gas flow values, compliance, trends, and
optional ecoFLOW information.

12. Audio Pause Symbol and Countdown Clock: Indicates when alarm audio is paused and
the countdown clock until audio is on.
3.3
 Flow 60 Flow l/min
Total Flow Agent
Aisys CS2 Participant Guide
MV

5.0
I/min
0
Digit Fields15 $ 12.10/h

9 The digit fields can be set to show specific information such as gas types, gas supply, flow,
-60
ml/h and spirometry
agent, respiration, loops. If the digit field is set to show agent and no airway
3 module is inserted, the area is blank. CO2 mmH
200

35
Et
Paw, O2, and either TVexp
CO2 40or CO2 must show on the display during a case. If any of these
2 parameters are not selected to show on the display, the right most digit field information is
replaced with the
20 missing parameter.
1 0
Fi25 11:07
Gas Supplies psi Resp Off Off Gases % 21 Off Agent %
Apnea > 120 s MVexp low Unable to Please Do
drive bellows Checkout Audio Pause

40 Paw 40 Paw cmH2O 40

10
Ppeak Pmean Alarm Setup

25
60

Et Fi
20

O2 N2O Air Sev

20
VCV 7 System

RR /min
Paw
80 0 Setup

47
0 cmH20 PEEP

O2 Total
2
Sev
O2
42 1
-20 100
Flow 60 Next Page
Flow l/min 2.0 10.0

37
I/min

1.3
MV

5.0 0 0 0
15
0 Trends
TVexp ml
10
-60 500 Spirometry

Compl
20
CO2 mmHg 20 60

Fi25 O2 Total MAC

5

35
0
Et
CO2 40 Procedures

57 54 89
1

0.79 ml/cmH2O
Fi Stop

40 y
0 0 00:27:32
0.5
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0

10
O2 N2O Air RR /min Et Fi Sev Et Fi

Air 02 0 0 0
O2
42 47 1.4 2.6
1.6 0.95
Fresh Gas: O20.7+ Air Ventilator On:Example
Volume of
Control
Compl
57 54 89 ml/cmH2O 20 MAC
40 y
End Case

Fresh Gas: O2 + Air

O2 Total Flow Sev
Ventilator On: Volume Control
Mode TV RR I:E PEEP
Figure 3.3 Digit Fields
O2 10 1:2 OffTotal Flow Mode TV RR I:E Tpause
More
50 2.60 2.6 Gas Setup
VCV 500 Settings
% l/min % ml /min cmH2O

50 2.60 Gas Setup

VCV 500 10 1:2 Off
Waveform Fields
% l/min ml /min %

Up to three waveforms can be shown on the normal screen view. Each waveform can be set to
show specific Paw, agent, flow, or CO2 data. The corresponding numeric information shows in
the measured values field to the right of the waveform. If the waveform is set to show the
agent and no airway module is inserted, that waveform and numeric area is blank.
When one waveform is turned off, that waveform and the corresponding numerics information
are removed from the normal screen view. The remaining waveforms and numerics increase
in size to fill the waveform area. When two waveforms are turned off, those waveforms and
the corresponding numerics information are removed from the normal screen view.
The remaining waveform is centered in the waveform area.
When in a case, touch the waveform field area to close the menu.
40 Paw 40 Paw cmH2O
Ppeak

25
20 60
11:07
20
Apnea > 120 s MVexp low Unable to Please Do
drive bellows Checkout Audio Pause

VCV
40 Paw 40 Paw cmH2O 40
Ppeak Pmean Alarm Setup

Paw
25
20 60
20
7
0
VCV System

80
Paw

0
0 cmH20
80 0 PEEP Setup

-20

I/min
100
Flow 60 cmH20 2
Flow l/min 2.0 10.0
Next Page

MV

5.0
15
0 Trends
TVexp ml

500
100
10

-20
-60 Spirometry
CO2 mmHg 20 60

Flow 60
5

35 Flow l/min
Et
CO2 40 Procedures
1

Total Flow Agent

Fi Stop
0 0 00:27:32
0.5
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0

MV

5.0
10I/min
O2 N2O Air RR /min Et Fi Sev Et Fi

Air 02 0 0 0 42 47 O2
1.4 2.6
1.6 0.95
Compl
57 54 89 ml/cmH2O 20 MAC
0.7
End Case

0
40 y

15500 $ 12.10/h
Fresh Gas: O2 + Air Ventilator On: Volume Control
O2 Total Flow Sev Mode TV RR I:E PEEP
More
50 2.60 2.6 Gas Setup
VCV 10 1:2 Off Settings
% l/min % ml /min cmH2O

9
ml/h -60
3 CO2 mmHg
200

35
Et
CO2 40
2

20
1 0
Fi25
Gas Supplies psi FigureResp Gases %
Off Off Fields
3.4 Example of Waveform 21 Off Agent %

10
O2 N2O Air Et Fi Sev Et
RR /min

47
O2 Total Sev
3.4
1.3 37 0 0 0
O2
42 1.4
 Aisys CS2 3 Display Navigation

Split Screen Field

The split screen field can be set to show gas delivery, trends, spirometry loops, Paw gauge,
airway compliance, and optional ecoFLOW information. If None is selected, the split screen
area will be blank.
Touch the spilt screen field to directly open the Screen Setup menu.

Apnea > 120 s MVexp low Unable to

drive bellows
Please Do
Checkout
11:07 Audio Pause
40
60
Paw 40 Paw cmH2O 40

20
40
Ppeak Pmean Alarm Setup

25
20 60

Paw
20
VCV 7 System
0 cmH20
80 0 PEEP Setup

-20 100
2
Flow 60 Next Page
Flow l/min 2.0 10.0
I/min
MV

5.0 Paw
15
0 Trends
TVexp ml

80
500
0
10
-60 Spirometry

cmH20
CO2 mmHg 20 60
5

35
Et
CO2 40 Procedures
1
Fi Stop
0 0 00:27:32
0.5
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0

10
O2 N2O Air Et Fi Sev Et Fi

100
RR /min

47 2.6
-20
Air 02 0 0 0
O2
42 1.4
1.6 0.95
Compl
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case

Fresh Gas: O2 + Air Ventilator On: Volume Control

O2 Total Flow Sev Mode TV RR I:E PEEP

I/min
More
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off Settings

3 Display Navigation
% l/min % ml /min cmH2O

15

10

0.5

Air 02

1.6 0.95
Figure 3.5 Example of Split Screen Field

3.5
Aisys CS2 Participant Guide

Display Touch Points

CAUTION! Do not apply excessive force to the touchscreen as damage may occur.

The blue outlined areas indicates the touch points of the display.

Apnea > 120 s MVex

V p low Unable to
drive bellows
Please Do
Checkout
11:07 Audio Pause

Paw 40 Paw
w cmH2O 40
1 2 3
40

60 20 60
20
Ppeak Pmean
7
4
Alarm Setup

Paw
VCV System
80 0 cmH20
80 0 PEEP Setup

-20 100
2
100
Flow 60 Next Page
Flow l/min 2.0 10.0
I/min
MV
15
0 Trends
TVe
V xp ml
10
-60 500 Spirometry
r
CO2 mmHg 20 60
5
Et
CO2 40 Procedures
1
Fi Stop
0 0 00:27:32
0.5
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0
O2 N2O Air RR /min Et Fi Sev Et Fi

02 Air 02 0 0 0 5 O2
42 47 1.4 2.6
1.6 0.95
Compl
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case

Fresh Gas: Ar
Ai Ventilator On V
V Volume
o Conntro
O Total Flow
T Mod TV

2.60 7 2.6 10 6 1:2

More
50 Gas Setup
VCV 500 Off
f Settings
% l/min % ml /mi cmH2O

Figure 3.6 Display Touch Points

1. Split screen values

2. Wave fields

3. Measured values

4. Function keys

5. Digit fields

6. Ventilator quick keys

7. Gas quick keys

3.6
 Aisys CS2 3 Display Navigation

Measured Value Touch Points

Touching measured values provides access to the Alarm Setup menu and alarm limits.

1. Touch the measured value to

access the Alarm Setup menu.
Apnea > 120 s MVex
V p low Unable to
drive bellows
Please Do
Checkout
11:07 Audio Pause

60 20
40
60
Paw 40

20
Paw
w cmH2O
Ppeak
40
Pmean
7
Alarm Setup
2. The Alarm Setup menu displays.
Paw
VCV System
80 0 cmH20
80 0 PEEP Setup
2
100 -20

I/min
100
Flow 60 Flow l/min 2.0 10.0
Next Page
3. Select the alarm limit and set it
MV
15
0
TVe
V xp ml
Trends
to the correct value. Touch the
10
500
5
-60
CO2 mmHg 20 60
Spirometry
r
value on the touchscreen or
Et
1 CO2 40
Fi
Procedures

Stop
push the ComWheel to confirm
0
0.5
0
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0
00:27:32
the desired setting.
O2 N2O Air RR /min Et Fi Sev Et Fi

02 Air 02 0 0 0
O2
42 47 1.4 2.6
1.6 0.95 4. Push the Home key, touch the
Compl
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case

Fresh Gas: Air

A Ventilator On V
V Volume
o Conntro
O Total Flow
T Mod TV
More
waveform area of the display, or
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off
f Settings
% l/min % ml /mi cmH2O
select Close to close

3 Display Navigation
the menu.

Figure 3.7 Measured Touch Points

4

Active Alarm Touch Points

When an alarm sounds the alarm message is displayed at the top of the screen and,
if applicable, the alarming numeric field and digit field flashes. The Alarm messages at the top
of the screen are message alerts only and not active touch points.

Alarm Setup 1. Touch the flashing numeric field to access the

Primary
More Limits
Alarm
Configure
Alarm Setup menu and alarm limits for the
Limits History
active alarm.
CO2 Alarms Vol Apnea Alarm MV/TV Alarm
2. The Alarm Setup menu displays with the
On On On
active alarm limit highlighted.
Low Limit High Limit
For example: If the Ppeak high alarm
Pmax
activates, the high alarm limit setting for
cmH2O 40 Ppeak displays with the highlight.

MV 2.0 10.0 3. Select the active alarm limit and change it to

l/min the desired setting.
EtCO2 50.0
10.0
mmHg

FiO2 Off
21
%

FiSev
Off 8.0
%

Close

Figure 3.8 Alarm Setup Menu

3.7
Aisys CS2 Participant Guide

Navigating the Display

Use the touchscreen and ComWheel to navigate the display.

5 11:07 Audio Pause

1 Vital Capacity Paw

w cmH2O
Ppeak
40
Pmean Alarm Setup

7
Start Vital
Capacity VCV System
PEEP Setup
2
Next Page
Flow l/min 2.0 10.0

2 Pressure Hold
cmH2O
35
MV
Trends
TVex
V p ml
Hold Time
s
15 500 Spirometry
CO2 mmHg 20 60
PEEP on Exit
4
cmH2O Et
Procedures

Fi Stop
0 00:27:32
Resp Off Off Gases % 21 Off Agent % Off 8.0

3 Turn on mechanical ventilation. Then

RR /min
10
Et Fi Sev Et Fi

42 47 2.6
select Start. O2
1.4
Close
6
Compl
ml/cmH2O 20 MAC
40 y 0.7
End Case

FreshGas:
Fresh Gas: O2
O2 ++Air
Air Ventilator On: Volume Control
Ventilator On: Volume Control
O2 Total Flow Sev Mode TV RR I:E PEEP

4 50 2.60 2.6 Gas Setup

VCV 500 10 1:2 Off
More
Settings
% l/min % ml /min cmH2O

6
Figure 3.5 Example split screen fields 5

Figure 3.9 Menu Overlaying - Normal View

Menu Components
1. Menu Heading: Displays the title of the open menu.

2. Menu Items: Contains the items to either adjust or select from a drop-down list.

3. Instructions or Help Information: This shows any additional instructions or help messages.

Using Menus
Use the function keys to access the corresponding menus. When a menu is selected, the menu
field overlays the normal view and the waveform fields start at the right edge of the menu.

4. Select a function or quick key to access the corresponding menu.

5. Select a menu item to choose the item, or turn the ComWheel left or right to highlight a
menu item and then push to confirm. If the menu item selected is an adjustment, turn the
ComWheel left or right to make the setting and then push to confirm. If the menu item has
a drop-down list, select the desired value from the list by touching the item.

6. Select Close, touch the waveform area, or push the Home key to exit the menu.

3.8
 Aisys CS2 3 Display Navigation

Using the ComWheel

Use the ComWheel to scroll through the quick key settings
and function keys, make selections, change settings, and
confirm settings.
1. Push the ComWheel to make a selection.

2. Turn the ComWheel to the right.

• For menu items, the highlight moves down.
• For quick keys, the highlight moves to the next
key on the right.
• For settings, the value changes to the next
available setting.
• For pull-down selections, the highlight moves to Figure 3.10
Press ComWheel
the next available selection.
3. Turn the ComWheel to the left.

3 Display Navigation
• For menu items, the highlight moves up.
• For quick keys, the highlight moves to the next
key on the left.
• For settings, the value changes to the previous
available setting.
• For pull-down selections, the highlight moves to
the previous available selection.
4. Push the ComWheel to confirm a setting.

Figure 3.11
Turn ComWheel

Using Quick Keys

The gas settings and the main ventilator settings for each ventilation mode can be changed
using the quick keys.

Fresh Gas: O2 + Air Ventilator On: Volume Control

O2 Total Flow Sev Mode TV RR I:E PEEP
More
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off Settings
% l/min % ml /min cmH2O

Figure 3.12 Quick Keys

1. Select a quick key to open the menu or select a parameter.

2. If Gas Setup, Mode, or More Settings is selected, a menu displays. Select the desired value
on the menu by touching the value. If any other quick key is selected, the value displays
with a highlight. Turn the ComWheel left or right to set the desired value.

3. Push the ComWheel or select the quick key to confirm the change.

Note! To cancel a quick key selection, push the Home key.

3.9
 4 Vaporization

4 Vaporization
Vaporization - Aladin2 Cassettes
Overview
The working principle behind the Aladin2 cassette is based on the free vaporizing of the liquid
agent inside the cassette. Agent concentration is adjusted by electronically controlling gas
flow through the cassette in order to achieve the set concentration. Output of agent
concentration remains constant with changes in fresh gas flow, and the vaporizer is not out of
commission if cassettes are tilted.
Aladin2 cassettes are agent specific and color coded. Each cassette is magnetically coded for
its specific agent allowing the unit to automatically identify the cassette being used.
Scheduled maintenance or calibration is not needed for Aladin2 cassettes, as they contain an
electronic self-diagnosis.

Inlet Valve Outlet Valve

4 Vaporization
Temperature
Note! Desflurane is Sensor
heated by the internal
electronics of the
system and is available
immediately without a
warm-up period.

Wicking Material

Identification Locking
Magnet Mechanism
Positions

Fill System

Liquid Level Indicator

Handle
Figure 4.1 Aladin2 Internal View

4.1
Aisys CS2 Participant Guide

Aladin2 Features
Below are the external features of the Aladin2 vaporizer.

Note! The Aladin2 is the newer version of the vaporizer cassette. Older units may have
the original Aladin cassette. The Aladin2 cassette has a handle lock, a larger liquid
level indicator and electronic agent level sensing.

Locking
Mechanism
Electronic Bus

Handle

Agent Filling Port

with Cap

Lock

Large Label
ISO
Liquid Level Indicator

Figure 4.2 Aladin2 Front View

Outlet Valve Inlet Valve

Temperature Sensor

Figure 4.3 Aladin2 Back View

4.2
 4 Vaporization

Turning On and Adjusting Agent Level Using Quick Keys

Before turning on the Aisys Carestation check to make sure the cassette is fully engaged.
After turning the system on, check that there is adequate O2 flow into the breathing system.
To turn on and adjust the agent:
1. Press the agent (third) Quick Key.
2. Adjust the level of agent using the ComWheel.
3. Confirm by pressing the ComWheel or the agent Quick Key again.

11:07 Audio Pause

40 Paw 40 Paw cmH2O 40

Ppeak Pmean Alarm Setup

25
20 60

Paw
20
VCV 7 System
0 cmH20
80 0 PEEP Setup

-20 100
2
Flow 60 Next Page
Flow l/min 2.0 10.0
I/min
MV

5.0
15
0 Trends
TVexp ml
10
-60 500 Spirometry
CO2 mmHg 20 60
5

35
Et
CO2 40 Procedures
1

1
Fi Stop
0 0 00:27:32
0.5
Gas Supplies psi Resp Agent % Off 8.0

Sev
Off Off Gases % 21 Off

10
O2 N2O Air RR /min Et Fi Sev Et Fi

Air 02 0 0 0
O2
42 47 1.4 2.6
1.6 0.95
Compl

2.6
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case

Fresh Gas: O2 + Air Ventilator On: Volume Control

O2 Total Flow Sev Mode TV RR I:E PEEP
More
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off Settings
% l/min % ml /min cmH2O

4 Vaporization
2 3

Figure 4.4 Turn on and adjust agent

4.3
Aisys CS2 Participant Guide

Filling the Aladin2 Cassette

1. Remove the cassette
from the cassette slot
by turning the lock on
the handle to the
vertical position and
then pulling on the
release lever. Place it on
a flat, horizontal surface.
Figure 4.5 Remove the Aladin2 Cassette

Note! Do not fill the cassette while it is fully or partially inserted in the cassette slot,
as you risk spilling or leaking agent into the Aisys.

2. Ensure that the pins at

the rear of the cassette
are free of any contact.

Pin

Figure 4.6 Check pins

3. Attach the EZ fill adapter

to the bottle of agent.

EZ fil Adapter

Agent Bottle
Forane ®
(Isoflurane,
Liquid for Inhalation

Figure 4.7 Attach adapter cap

Note! Desflurane cassettes use the traditional Saf-T-Fil adapters and should also be
completely removed before filling.

4.4
 4 Vaporization

4. Remove the filling port cap from

the cassette.

ISO

Figure 4.8 Remove Port Cap

5. Insert the attached EZ fill adapter

and bottle into the cassette and
push the bottle down to fill.

4 Vaporization
6. Watch the liquid level indicator Liquid level
and remove bottle when Indicator

cassette is full.
Figure 4.9 Insert bottle and fill cassette

7. Remove the EZ fill adapter from

the bottle and replace with the
original cap.

8. Replace cassette filling port cap.

Forane ®
(Isoflurane,
Liquid for Inhalation

Note! Agent flow is turned off when an agent cassette is removed. After filling and
re-engaging the cassette, remember to turn agent flow back on if you are filling it
during a case.
4.5
Aisys CS2 Participant Guide

Changing Aladin2 Cassettes

1. Push the Agent quick key and set

agent delivery to Off using the
ComWheel. 11:07 Audio Pause

40 Paw 40 Paw cmH2O 40

2. Turn the lock on the cassette Ppeak Pmean Alarm Setup

25
20 60

Paw
20
VCV 7 System
0 80 0 Setup
handle to the vertical position
cmH20 PEEP

-20 100
2
Flow 60 Next Page
Flow l/min 2.0 10.0

(unlocked) and remove cassette

I/min
MV

5.0
15
0 Trends
TVexp ml

from the active bay. 10

-60 500 Spirometry
CO2 mmHg 20 60
5

35
Et
3. Store the cassette in the 1 CO2 40
Fi
Procedures

Stop
0
cassette bay. 0.5
0
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0
00:27:32

10
O2 N2O Air RR /min Et Fi Sev Et Fi

4. Install a new cassette using the Air 02 0 0 0

O2
42 47 1.4 2.6
1.6 0.95
Compl
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case

following procedure: Fresh Gas: O2 + Air

O2 Total Flow Sev
Ventilator On: Volume Control
Mode TV RR I:E PEEP
More
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off Settings

• Ensure that the new cassette % l/min % ml /min cmH2O

is filled to the appropriate level

using the liquid level indicator
1 5
• Turn the lock on the cassette
to the vertical position
(unlocked)
• Insert the cassette into the
active bay until a click is heard
• Turn the lock on the cassette
to the horizontal position
(locked) ~

• A tone will sound and the

agent setting above the quick 3
key will flash.
5. To set the new agent concentration,
turn the ComWheel to the desired Spirometry

Ref.

setting and push the ComWheel

Gas

Gas
Exhaust
E-CAiOVX

to confirm. 2
Note! If a cassette of the
same type is removed
and installed during a case,
the last agent setting used is
displayed above the Agent
quick key. To confirm the
agent setting, push the
ComWheel, and then push
the Agent quick key.
If the setting is not
confirmed within sixty
seconds, the agent delivery
is set to Off.

Figure 4.10 Changing the Aladin2 Cassette

4.6
 Aisys CS2 5 Advanced Breathing System

5 Advanced Breathing System

Aisys CS2 Advanced Breathing System Objectives
After completing this section, the participant will be able to:

• Utilize the Bag/Vent switch

• Utilize the APL valve
• Describe the purpose of the Bag Support Arm
• Remove and replace the CO2 canister
• Drain the condenser, if applicable
• Zero the flow sensors
• Describe the various methods of preventing moisture buildup

5 Advanced Breathing
System

5.1
Aisys CS2 Participant Guide

Overview
The Aisys CS2 includes the Advanced Breathing System (ABS). The ABS is a small compact
system with a 2.7L circuit vent volume designed for low flow anesthesia. It also allows for rapid
control of fresh gas flows and concentrations. Changes to fresh gas concentration are applied
at the next breath, which allows for the quick administration and removal of agent from the
system.
Fresh gases are delivered just behind the inspiratory check valve and then immediately
delivered into the inspiratory limb of the breathing circuit. Any changes to fresh gas
concentration or flows are immediately delivered to the patient, which gives you rapid control
of fresh gas flows and concentrations at the point where it matters, the patient. In addition,
the ABS is autoclavable, allowing you to rapidly disassemble it, autoclave it, and reassemble
the breathing system because it does not retain heat. You can assemble it quickly and return it
to service -ready for the next case.
The ABS is not made with natural rubber latex. There are no cables and hoses, which
minimizes improper connections or disconnects, and can integrate either passive or active
scavenging systems.

30

300
600
900
1200
1500 ! AGSS

(mL)
! ~ VT

Figure 5.1 Removing the Breathing System

0
11
4-
00 %
-0
60
50 02
F
RE
34
15
15
P7
!
Figure 5.2 Advanced Breathing System
SN

5.2
 Aisys CS2 5 Advanced Breathing System

Bag/Vent Switch
The Bag/Vent Switch is a bi-stable mechanical switch that selects between manual ventilation
(bag) and mechanical ventilation (vent). When the switch is changed from bag to vent mode,
the ventilator is automatically switched on.
Be sure to check the ventilator parameters before changing from bag to vent mode.
Also keep in mind that the APL Valve is not in the circuit while the ventilator mode is active.

300
600
900
1200
1500
(mL)
~ VT

Figure 5.3 Bag/Vent Switch

APL Valve
The APL Valve allows you to change the settings from minimum to 70 cmH2O. When the APL is
between 30 and 70 cmH2O, you will notice that the valve becomes a tactile indicator, meaning
that the knob clicks at each additional cmH2O.

Note! The APL can go from 70 cmH2O to minimum with one turn.

5 Advanced Breathing
System
300
600
900
1200
30 1500
(mL)
~ VT

Figure 5.4 APL Valve

5.3
Aisys CS2 Participant Guide

Bag Support Arm

The ABS also provides for the use of a Bag Support Arm. This bag arm is different than
traditional anesthesia systems because it does not actually carry patient gas. Patient gas is
carried through the bag arm hose from the ABS out to the bag. The bag can be used while
attached to or detached from the bag support arm.

Optional Bag Arm Bag Hose

Rebreathing Bag

Figure 5.5 Bag Support Arm

5.4
 Aisys CS2 5 Advanced Breathing System

Absorber Canister
The canisters hold 950 ml and are available as disposable or reusable. The reusable canister
is autoclavable. The Advanced Breathing System also includes an EZChange mode for the
canister. The EZchange canister mode seals the breathing circuit when the canister holder is
down. While the absorber canister is out of the breathing circuit, the patient re-breaths
exhaled gases without any gas passing through the absorbent. When the canister holder is
down, the message CO2 Absorber Out of Circuit shows in the waveform area on the
anesthesia display. Systems with EZchange canister mode have a label on the canister
holder. Both disposable and reusable canisters can be used with the EZChange option.
These canisters can be exchanged simply by pushing on the teal-colored release latch and
disconnecting the canister, removing it for replacement.

Figure 5.6
Canister on Standard Machine

5 Advanced Breathing
System

EZChange
Sealing
Component

Figure 5.7
Canister on Machine with EZChange Mode

5.5
Aisys CS2 Participant Guide

Canister Access on a Standard Machine

To remove a canister on a standard system:
1. Hold the canister by the handle.
2. Push the Absorber Canister Release.
3. Push it down and away from the attachment point/support pins to remove the canister.

2 3

Figure 5.8 Removing the Canister

To replace a canister on a standard system:

1. Hold the canister by the handle.
2. Tilt the canister down and place the lip of the canister so that it catches at its attachment
point/support pins.
3. Push the other side of the canister up until you hear it snap into place.

Note! For standard systems (systems without the EZChange Mode), the breathing
system is open to air and you will have a leak when the canister is out of the cradle.

5.6
 Aisys CS2 5 Advanced Breathing System

Canister Access on a Machine with the EZchange Mode

To remove a canister on a system with the EZChange Mode:
1. Hold the canister by the handle.
2. Push the Absorber Canister Release to unlock the canister cradle.
3. Tilt the cradle down, and slide the canister up and out of the cradle.

2
3
1

5 Advanced Breathing
Figure 5.9
Removing Canister on Machine with EZChange Mode

System
To replace a canister on a system with the EZChange Mode:
1. Hold the canister by the handle.
2. Slide the canister into the cradle.
3. Tilt the cradle up to lock into place.

5.7
Aisys CS2 Participant Guide

Condenser
Use the optional condenser to remove water in the system that is produced from the reaction
of CO2 gas with the absorbent. The condenser is connected between the outlet of the
absorber canister and the inlet of the circuit module. Moisture in the gas is condensed into
water droplets, which run into the condenser’s reservoir. The condenser adds 715 ml of volume
to the breathing system.

Note! Visually check the condenser reservoir daily, and drain if needed.

Condenser

Figure 5.10
Optional Condenser

Drain Button

5.8
 Aisys CS2 5 Advanced Breathing System

Flow Sensors
Flow Sensors are differential pressure pneumotachs that measure inspiratory pressures and
both inspiratory and expiratory volumes.
The Flow Sensors are either plastic or metal. The plastic Flow Sensors may be sterilized using
only liquid or gas methods. The metal Flow Sensors may be sterilized using liquid, gas or
steam autoclave methods.

Expiratory Flow
Sensor Inspiratory Flow
Sensor

300
600
900
1200
1500
(mL)
! ~ VT

Flow Sensor Location

Flow Sensor Bracket RE

F 60
50
-0
00
4-

15
11

15
34
0

%
02

P7
! SN

Flow Sensor Cover

5 Advanced Breathing
Figure 5.11 Flow Sensors

System
The flow sensors should be calibrated daily by removing them from the system. On-screen
instructions are available through System Setup > Calibration > Flow and Pressure.
1. Set the Bag/Vent switch to Bag.
2. Remove the flow sensor module.
3. Wait for No insp flow sensor and No exp flow sensor alarms to occur.
4. Reinsert the flow sensor module. Make sure the flow sensors are securely latched when
they are reinserted. Wait for alarms to clear.
5. Start mechanical ventilation when ready.

Note! Room temperature fluctuations of more than 5°C may affect sensor
measurements. Recalibrate the flow sensors if the room temperature changes by
more than 5°C.

5.9
Aisys CS2 Participant Guide

Preventing Moisture Buildup

Pooled water in the flow sensors or water in the sensing lines may cause false alarms. Small
beads of water or a foggy appearance in the flow sensors is okay.
Water results from exhaled gas and the chemical reaction between CO2 and the absorbent
that takes place within the absorber canister.
At lower fresh gas flows more water builds up because less gas is scavenged and more CO2
stays in the absorber to react and produce water. Also, more moist and exhales gas stays in
the patient circuit and the absorber.
To help prevent moisture buildup:

• Equip systems with the optional condenser

• Empty the water reservoir in the canister when changing the absorbent
• Ensure that water condensing in the breathing circuit tubes is kept lower than the flow
sensors and is not allowed to drain back into the flow sensors
• Water condensation in the breathing circuit tubing might be lessened by using a Heat
and Moisture Exchange (HME) filter at the airway connection

Figure 5.12 Optional Condenser and Canister

5.10
 Aisys CS2 5 Advanced Breathing System

Auxiliary Common Gas Outlet (ACGO)

The optional Auxiliary Common Gas Outlet (ACGO) is not required for operation of the
Aisys CS2. A negative pressure leak test can be accomplished through the ACGO.
Set the switch to ACGO position to have fresh gas flow through the ACGO port. The ACGO may
be used to provide fresh gas to an auxiliary manual breathing circuit, such as a Mapleson or
Jackson-Reese circuit.

Note! Mechanical ventilation is not available when operating an auxiliary manual

breathing circuit with fresh gas from the ACGO. Volume and pressure monitoring
are also not available.

ACGO Selected

5 Advanced Breathing
System

Breathing System Selected

Figure 5.13 ACGO

5.11
 Aisys CS2 6 Operation

6 Operation
Aisys CS2 Operation Objectives
After completing this section, the participant will be able to:

• Start a case using the Start Case menu

• Enter a patient age and ideal weight
• End a case
• Turn off the system
• Change a ventilator mode
• Change a ventilator setting
• Change a gas setting
• Change the balance gas
• Change the circuit type
• Set a waveform field
• Set a digit field
• Set a split screen
• Set the time and date
• Set the data source
• Set the sweep speed
• Set the fresh gas controls
• View fresh gas usage
• Utilize ecoFLOW
• Describe the three alarm priorities
• Pause an alarm

6 Operation
• Set an alarm limit
• Set volume apnea and MV/TV alarms
• View alarm history
• Describe the settings on the Alarm Setup Configure Tab
• View trends

Apnea > 120 s MVexp low Unable to

drive bellows
Please Do
Checkout
11:07 Audio Pause

40 Paw 40 Paw cmH2O 40

Ppeak Pmean Alarm Setup

25
60 20 60

Paw
20
VCV 7 System
80 0 cmH20
80 0 PEEP Setup

-20 100
2
100
Flow 60 Next Page
Flow l/min 2.0 10.0
I/min
MV

5.0
15
0 Trends
TVexp ml
10
-60 500 Spirometry
CO2 mmHg 20 60
5

35
Et
CO2 40 Procedures
1
Fi Stop
0 0 00:27:32
0.5
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0

10
O2 N2O Air RR /min Et Fi Sev Et Fi

02 Air 02 0 0 0
O2
42 47 1.4 2.6
1.6 0.95
Compl
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case

Fresh Gas: O2 + Air Ventilator On: Volume Control

O2 Total Flow Sev Mode TV RR I:E PEEP
More
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off Settings
% l/min % ml /min cmH2O

6.1
Aisys CS2 Participant Guide

Starting a Case
Use the Start Case menu to set the case data and to start the gas flow.
A case can be started using default settings or using custom settings. The default settings are
configured by the Super User.

Note! A Super User is a person that has been given the authority to change default
settings using a special password.

Default Settings selection shows the first of five default case types when the Start Case menu
is accessed. Four of the default case types are configured by the Super User. The fifth default
case is Last Case.
The Ideal Weight, Age, and Volume Apnea Alarm values are set to the pre-selected settings
defined by the Super User corresponding to the case type.

Start Case
Case Defaults ADULT

Volume Apnea Alarm On

CO2 Alarms On

Age
40
y

Ideal Weight
150
lb

Select to start gas flow.

Start Case Now

Figure 6.1 Start Case Menu

6.2
 Aisys CS2 6 Operation

Minimum Alveolar Concentration (MAC)

The adjusted Minimum Alveolar Concentration (MAC) is calculated based on the patient age
entered in the Start Case menu or the Patient Demographics menu. The default patient age of
the selected case type is used if no patient age value is entered.
The MAC value is calculated from the exhaled gas concentration and the related affects based
on the age of the patient. Typically, younger patients have better liver function and can clear a
drug faster, resulting in a higher MAC value. When two agents are detected, the MAC values of
each agent are added together.
The adjusted MAC value shows on several areas of the screen including in the mini-trend,
agent waveform numeric information, agent digit field, and graphical trends page.

Starting a Case Using Default Settings

Start a case using the default settings by case type defined by the Super User.
Case Defaults contain five case type selections. Each case type has preset values for Ideal
Weight, Age, and Volume Apnea Alarm. The first four default case types are configured and
named by the Super User. The fifth default case is Last Case.
1. Set the Bag/Vent switch to Bag.
2. Select Start Case from the right side of the display. The Case Defaults selection shows the
first preset case type. Ideal Weight, Age, CO2 Alarms, and Volume Apnea Alarm show the
default settings that correspond to the case type shown.
3. Verify or change the Case Defaults selected.
4. Verify the settings are clinically appropriate.
Start Case Now
5. Select Start Case Now. Gas flow starts.

Starting a Case Using Custom Settings

Ideal Weight, Age, CO2 Alarms, and Volume Apnea Alarm can be custom set on the Start Case

6 Operation
menu before starting a case. Additional ventilator settings, ventilation mode, alarm settings,
and gas settings can be custom set through the Vent Mode menu and other ventilation quick
keys, Alarm Setup menu, Gas Setup menu.
1. Set the Bag/Vent switch to Bag.
2. Select Start Case. The Case Defaults selection shows the first preset case type.
Ideal Weight, Age, CO2 Alarms, and Volume Apnea Alarm show the default settings that
correspond to the case type shown.
3. Change Ideal Weight, Age, or Volume Apnea Alarm settings on the menu. The Case
Defaults changes from the case name to Preset. If the CO2 Alarms setting on the menu is
changed, the Case Defaults remains as previously selected.
4. To change ventilation mode, select Mode. Make the change. To change the ventilation
settings, select a ventilator quick key or More Settings. Make the change.
5. To change alarm settings, select Alarm Setup. Make the change.
6. To change the gas settings or the circuit type, select Gas Setup. Make the change.
7. From the Start Case menu, select Start Case Now. Gas flow starts.

6.3
Aisys CS2 Participant Guide

Ending a Case
Use the End Case menu to stop gas flow and end the patient alarms.
1. Set the Bag/Vent switch to Bag.
2. Select End Case from the right side of the display.
3. Select End Case Now on the menu to put the system in standby (stops the gas flow and
patient alarms). The End Case menu shows the gas and agent usage for the case.

End Case

End Case Now

Gas Used O2 57.761

Air 0.00 l
N2O 0.00 l

Agent Used Des 0 ml

Des 0 ml
Enf 0 ml
Hal 0 ml

Turn off mechanical ventilation or

cardiac bypass. Then select End Case
Now.

Close

Figure 6.2 End Case Menu

Turning Off the System

1. Select End Case Now to put the system in standby, if appropriate.
2. Turn the System switch to Standby.
3. Turn the suction switch (optional) to the off position.
4. Rotate the Auxiliary O2 knob fully clockwise to turn off the flow.
5. Disconnect or turn off any scavenging.

6.4
 Aisys CS2 6 Operation

Ventilator Setup
Use the Vent Mode menu to set the ventilation mode. Use ventilator quick keys and More
Settings to change ventilator settings.

Mode Vent Mode

VCV
VCV
Volume Control

PCV
Pressure Control

Vent Mode Quick Key Pressure Control + PCV-VG

Volume Guarantee

Synchronized Volume SIMV VCV

Control

Synchronized Pressure SIMV PCV

Control

Synchronized Pressure SIMV PCV-VG

Control + Volume Guarantee

PSVPro
PSVPro

Continous Positive CPAP + PSV

Airway Pressure + PSV

Close

Figure 6.3 Vent Mode Menu

Changing Ventilator Mode

1. Select the Mode quick key from the bottom of the display. The Vent Mode menu shows.
2. Select the desired ventilation mode.

6 Operation
3. Set and confirm the primary ventilation setting to activate the ventilation mode. Controls
that are frequently used in the ventilation mode can be adjusted with the ventilator quick
keys and the More Settings quick key.

Changing Ventilator Settings

Change the ventilator settings for the ventilation mode when a case is running.
1. Select the ventilation setting to be adjusted. Set the desired value.
2. Push the ComWheel to activate the change.

6.5
Aisys CS2 Participant Guide

Gas Setup
Use the Gas Setup menu to adjust the Agent, O2% and total flow, to change the balance gas,
and to change the circuit type.

Gas Setup

Circuit Circle Gas Setup Gas Setup Quick Key

Other Gas Air

O2 Changing Gas Settings

% 50
1. Select the Gas Setup quick key from the
Total Flow bottom of the display.
l/min 2.6
2. Select the setting to change from the Gas
AA Setup menu.
% Insert
3. Change the setting.
4. For Circuit, select the menu item and
change using the dropdown menu. Select
Confirm.
5. For Other Gas, select the menu item and
change using the dropdown menu.
6. For Agent, O2% and Total Flow, select the
Close setting and make the change using the
ComWheel and push to confirm the
Figure 6.4 Gas Setup Menu

setting.
Changing Balance Gas
1. Select the Gas Setup quick key.
2. Select the Other Gas menu item.
3. Select the balance gas to use with O2.

Changing Circuit Type

1. Select the Gas Setup quick key.
2. Select Circle or Non-Circle.
3. Select Confirm.
Note! Use the non-circle circuit mode to divert fresh gas around the inspiratory check
valve and out through the inspiratory port. This fresh gas source may be used with
circuits that do not have CO2 absorbent capability (for example, Mapleson variants).
Mechanical ventilation is not available when using the non-circle circuit. Tidal volume
monitoring is not available when using the non-circle circuit.

6.6
 Aisys CS2 6 Operation

System Setup
Use System Setup to access menus and settings for Patient Demographics, Screen Setup,
Fresh Gas Usage, System Status, Calibration, and Checkout. The System Setup key is located on
the right side of the display.

System Setup Patient Demographics

Patient Age
Demographics 40
y

Screen Setup Ideal Weight

150
lb

Fresh Gas TV for Ideal Body Weight

Usage 7.0
ml/kg

System Status TV 475 ml

Proposed Settings:
RR 10 /min

Calibration Set Vent by

Weight

Checkout
History

Super User Password Close

Close Close

Figure 6.5 System Setup Menu

Patient Demographics
Use the Patient Demographics menu to access menus and settings for Age, Ideal Weight, TV
for Ideal Body Weight, and Set Vent by Weight.

Screen Setup Menu

Screen Setup Use the Screen Setup menu to customize the screen

6 Operation
More
Layout Scales
Time and
Date Settings view. Areas of the screen can be customized to show
specific information.
Digit Fields
Waveform Fields
Note! There are also four configurable screen
Top Paw Left Resp views available that can be pre-programmed
by the Super User. Select Next Page on the
Middle Flow MIddle Left Flow
display to change to these configurable views.
Gas
Bottom CO2 Middle Right Supplies
The Screen Setup menu contains the Layout, Scales,
Right Gases Time and Date, and More Settings submenus.

Split Screen Paw

Close

Figure 6.6 Screen Setup Menu

6.7
Aisys CS2 Participant Guide

Screen Setup A. Setting Waveform Fields

1
Time and More The waveforms can be set to show
Scales agent, CO2, flow, Paw, or set to Off. If a
2 Layout Date Settings
waveform is set to the same value as
another waveform, the previously set
B waveform changes to off and is removed
A Waveform Fields Digit Fields
from the screen.
Top Paw Left Resp 1. Select System Setup > Screen Setup
from the right side of the display.
Middle Flow MIddle Left Flow 2. Select the Layout tab.
3. Select the desired waveform button
Gas
Bottom CO2 Middle Right Supplies and select the value from the drop-
down menu.
Right Gases 4. Select Close.

C Split Screen Paw B. Setting Digit Fields

The digit field can be set to show gas
supply, flow, spirometry loops, gases,
respiration, or agent. If the digit field is
set to show agent and no airway module
is inserted, the digit field will be blank.
1. Select System Setup > Screen Setup.
4 Close
2. Select the Layout tab.
3. Select the desired digit field button
Figure 6.7 Screen Setup Layout Tab and select the value from the drop-
down menu.
4. Select Close.

C. Setting the Split Screen

Use the Split Screen setting to show
metabolics, trends, spirometry loops,
Paw gauge, airway compliance, and
optional ecoFLOW information.
1. Select System Setup > Screen Setup.
2. Select the Layout tab.
3. Select Split Screen and select the
desired view from the dropdown
menu.
4. Select Close. 

6.8
 Aisys CS2 6 Operation

Screen Setup D. Setting Time and Date

More
Layout Scales 1. Select System Setup > Screen Setup.
D Time and
Date
Settings
2. Select the Time and Date tab.
Waveform Fields
W Digit Fields 3. Select the time or date item to change.
Hour 10

Left Resp
Make the change.
Top Paw
MInutes 46 4. Select Close.
Middle Flow MIddle Left Flow

Zero Seconds
Bottom CO2
Gas
Middle Right Supplies E. Setting the Data Source
Day 23
Use Data Source to specify the source of
Right Gases
spirometry data. Spirometry is discussed
in more detail in the Spirometry section.
Month Sep
Split Screen Paw
1. Select System Setup > Screen Setup >
More Settings or Spirometry > Setup
Year 2012
Loops.

Clock Format 24 h
2. Select Data Source.
3. Select Patient to have spirometry data
Close sourced from the airway module or
Close Vent to have spirometry data sourced
from the ventilator.
Figure 6.8 Screen Time and Date Tab 4. Select Back to view changes made and
access other functions of the
Screen Setup
p Spirometry menu.
Time and
Layout Scales Date More
Settings
F. Setting Sweep Speed
10
Hour Digit Fields
Waveform Fields
W
E Data Source Vent Use the Sweep Speed setting to set the
Top Paw Left Resp waveform draw rate to fast (6.25 mm/s) or
MInutes 46
slow (0.625 mm/s).
F

6 Operation
Sweep Speed Fast
Middle Flow MIddle Left Flow 1. Select System Setup > Screen Setup.
Zero Seconds
Display Brightness 4 Gas 2. Select More Settings.
Bottom CO2 Middle Right Supplies
Day 23 3. Select Sweep Speed and then select
Keypad Brightness 4
Right Gases Fast or Slow.
Month Sep 4. Select Close.
Fresh Gas Controls O2%
Split Screen Paw
Year 2012

Clock Format 24 h

Close
Close
Close

Figure 6.9 Screen More Settings Tab

6.9
Aisys CS2 Participant Guide

Screen Setup
p Setting Fresh Gas Controls
1
Time and Use the Fresh Gas Controls selection to
Layout Scales Date More 2 set the gas control style to O2% with
Settings
Total Flow or to individual gas flow.
10
Hour Digit Fields
Waveform Fields
W Selecting O2% shows O2% as the first
Data Source Vent
quick key and Total Flow l/min as the
Top Paw Left Resp second quick key. Selecting Flow shows
MInutes 46
Sweep Speed Fast balance gas l/min as one of the quick
Middle Flow MIddle Left Flow keys and O2 l/min as the other quick key.
Zero Seconds
Display Brightness 4 Gas Note! The Fresh Gas Control setting may
Bottom CO2 Middle Right Supplies not be available if the system is
Day 23
configured to disable this ability. The
Keypad Brightness 4
Right Gases Fresh Gas Controls cannot be accessed
Month Sep during a case.
3 Fresh Gas Controls
Split Screen Paw
O2% 4 1. Select System Setup > Screen Setup.
Year 2012
2. Select More Settings.
3. Select Fresh Gas Controls.
Clock Format 24 h
4. Select O2% or Flow from the drop-
down menu.
Close
Close • When set to O2%, balance gas
5 Close
adjusts automatically when either
the O2% or the Total Flow is
changed using the gas quick keys.
Figure 6.10 Screen More Settings Tab
• When set to Flow, balance gas and
the O2% are controlled individually
using the gas quick keys.
5. Select Close.

Viewing Fresh Gas Usage

Use Fresh Gas Usage to view the volume
of O2, Air, N2O, and agents used for the
three most recent cases.
1. Select System Setup > Fresh Gas
Usage.
2. Select Case Start Time to select the
patient case to view.
3. Select Close.

6.10
 Aisys CS2 6 Operation

ecoFLOW
The ecoFLOW option provides a split screen view that shows the approximate minimum O2
flow to maintain a preset FiO2 value. It also shows the approximate agent used per hour and
the cost.
The split screen shows the Paw gauge in the upper area and the ecoFLOW gauge in the lower
portion of the screen. The ecoFLOW gauge consists of a fresh gas flow tube, an agent flow
indicator, and related parameters.
The fresh gas flow tube is a stacked flow tube showing the total O2 flow on the bottom and the
remaining gas (N2 or N2O) on top. Below the fresh gas flow tube is the measured total O2 flow
to the patient and the calculated FiO2 flow value. The FiO2 flow value is based on the FiO2
setting specified in Super User mode. This is the minimum O2 flow needed to deliver a preset
inspired O2 concentration. The FiO2 flow value is specific to each patient and case. It is
calculated using the fresh gas settings, the patient O2 uptake, the dilution effect of agent being
delivered, and the effects of the circle breathing system.
The agent flow indicator shows the amount of liquid agent flow as related to the fresh gas
setting. The calculated cost of the agent shows above this indicator. This cost is based on
agent flow and the values entered in the Agent Costs menu set in Super User mode.

40
20 60

0 Paw
80
cmH20

-20 100

Total Flow Agent

I/min

15 $ 12.10/h

6 Operation
ml/h
3
200

20
1
Fi25

O2 Total Sev

1.3 37
Fi25 O2 Total

0.79
Figure 6.11 ecoFlow Display

6.11
Aisys CS2 Participant Guide

40 ecoFLOW Split Screen Components

1. Agent: Shows Agent cost and flow information.
20 60
2. Agent Cost: The cost of the current agent flow.
This value is determined by the agent flow
0 Paw
80 multiplied by the agent cost set in Super user
cmH20 mode.
3. Agent Flow: The measured value of the liquid
-20 100 agent flow from the vaporizer. The agent flow
may have a delayed response. For example:
10 Total Flow Agent 1
Sev.
I/min
4. FiO2 Flow Marker: The graphical
15 $ 12.10/h 2 representation on the flow tube of the FiO2
flow value. This marker can be removed by
disabling it in Super user mode.
9 5. FiO2 Flow: The minimum O2 flow needed to
ml/h maintain the set inspired O2 flow. This item can
3 be disabled in Super user mode. For example:
9 200 Fi25 O2 flow.
6. O2 Total (numeric): The numeric
2 representation of the total O2 flow. If N2O is the
8 balance gas, this equals the set O2 flow. If Air is
20 the balance gas, this is the set O2 flow plus
21% of the Air flow.
1
Fi25 7. O2 Total (graphical): The graphical
7 representation of the total O2 flow. If N2O is the
balance gas, this equals the set O2 flow. If Air is
6 O2 Total Sev the balance gas, this is the set O2 flow plus

1.3 37 3 21% of the Air flow.

8. Remaining Gas Flow: If N2O is the balance
5 Fi25 O2 Total
gas, this equals the set N2O flow. If Air is the
0.79 balance gas, this N2 is 79% of the Air flow.
9. Flow Bobbin: The height of this represents the
4 total fresh gas flow delivered to the patient.
10. Total Flow: Shows Total Flow information.
Figure 6.12 ecoFLOW Split Screen Components

6.12
 Aisys CS2 6 Operation

Using ecoFLOW:

1 Screen Setup
More
2 Layout Scales
Time and
Date Settings

Waveform Fields Digit Fields

Top Paw Left Resp

Middle Flow MIddle Left Flow

Gas
Bottom CO2 Middle Right Supplies

Right Gases

3 Split Screen ecoFLOW

Close 4

Figure 6.13 ecoFLOW Split Screen Selection

1. Select System Setup > Screen Setup from the right side of the display.
2. Select the Layout tab.
3. Select Split Screen and select ecoFLOW from the drop-down menu.
4. Select Close.

6 Operation

6.13
Aisys CS2 Participant Guide

Alarm Management
Alarm Priorities
Alarms may be high priority, medium priority, or low. Alarm priority is indicated by the color of
the alarm message and the audio sequence.

1 2 3

Apnea > 120 s MVexp low Unable to

drive bellows

Figure 6.14 Priority Alarm Examples

1. High-priority alarm messages appear in white text on a red background.

2. Medium-priority alarm messages appear in black text on a yellow background.
3. Low-priority alarms appear in black text on a blue background.

Pausing Alarms
Selecting Audio Pause for an active alarm stops the audible tone

11:07 Audio Pause

for 120 seconds. The alarm message shows in the alarm message
field. Selecting Audio Pause when no medium or high priority
alarms are active prevents the audible alarm tones (audio off) for
90 seconds.
Figure 6.15 Audio Pause Key

Cancelling Audio Pause

Selecting and holding Audio Pause for 2 seconds will cancel the audio pause function.

De-escalating Alarms
Some device related alarms, such as No insp flow sensor will de-escalate priority when the
alarm is acknowledged by selecting Audio Pause. The alarm message shows at the low-
priority alarm level until the alarm condition is resolved and the alarm is cleared. If that alarm
reoccurs after it has been resolved, the alarm occurs at its standard priority level.

6.14
 Aisys CS2 6 Operation

Alarm Setup A. Setting Alarm Limits

Primary Alarm
1. Select Alarm Setup from the right side of the display.
A Limits
More Limits
History Configure

CO2 Alarms Vol Apnea Alarm MV/TV Alarm

2. From the Primary Limits and More Limits tabs, select
the alarm limit and make the change.
On On On
3. Push the Home key, touch the waveform area of the
B Low Limit High Limit display, or select Close to close the menu.
C Pmax
cmH2O 40 B. Setting Volume Apnea Alarm
MV 2.0 10.0 Note! The Volume Apnea Alarm setting may not be
l/min available if the system has been configured to
EtCO2
10.0 50.0
disable this feature.
mmHg
Use the Vol Apnea Alarm setting to turn off the volume
FiO2 Off
%
21 apnea alarm during manual ventilation. The volume apnea
alarm remains off until the Bag/Vent switch is set to Vent or
FiSev
% Off 8.0 Vol Apnea Alarm is set to On.
1. Select Alarm Setup.
2. To turn the volume apnea alarms off, select Vol Apnea
Close Alarm to Off.
3. Volume Apnea Off shows in the general message field.
Figure 6.16 • If mechanical ventilation is started, the volume
Alarm Setup - Primary Limits Tab
apnea alarms are active
• If manual ventilation is restarted, a pop-up
confirmation window appears to resume the Off
Home Key setting
4. To turn the volume apnea alarms on, set Vol Apnea
Alarm to On.
5. Select Close.

6 Operation
C. Setting MV/TV Alarms
Use the MV/TV Alarms setting to turn off the MV and
TV alarms.
1. Select Alarm Setup.
2. To turn the volume alarms off, set MV/TV Alarms to Off.
• MV/TV Alarms Off appears in the general
message field
• The volume alarm limits waveform numerics shows
dashes during a case
3. To turn the volume alarms on, set MV/TV Alarms to On.
4. Select Close.
Note! Settings made during manual ventilation are
not retained when mechanical ventilation starts.
Settings made during mechanical ventilation are
retained when manual ventilation starts.
6.15
Aisys CS2 Participant Guide

Viewing Alarm History

Use the Alarm History tab to view the list of the 12 most recent high and medium priority
alarms that occurred since the start of the case. The alarm history clears at the start of a
new case.
1. Select Alarm Setup.
2. Select the Alarm History tab. The list of alarms shows in the window.
3. Select Close.

Alarm Setup Configure Tab

Alarm Setup
Primary More Limits Alarm Configure
Limits History

1 Alarm Volume 40

2 Apnea Delay
s
30

3 Leak Audio On

4 Auto MV LImits Off

5 Change to Default
Limits

Close

Figure 6.17 Alarm Setup Configure Tab

The following settings are available in the Alarm Setup Configure Tab:
1. Alarm Volume: Adjusts the alarm volume range from 1 to 5.
2. Apnea Delay: The apnea delay time is the amount of time that can pass without the
system detecting a measured breath before the apnea alarm occurs. The apnea time
delay range is 10 to 30 seconds in 1 second increments.
3. Leak Audio: Use the Leak Audio setting to silence audio alarms of small leaks. If the Low
MV alarm limits are off or MV/TV Alarms is set to Off, Leak Audio is automatically set to On
and cannot be changed.
4. Auto MV Limits: MV alarm limits can be calculated automatically for mechanical
ventilation when in VCV or PCV-VG modes and volume compensation is enabled. Use the
Auto MV Limits setting to turn on automatic calculations of the MV alarm limits.
5. Change to Default Limits: Sets the alarm limits to the values set by the Super User.

6.16
 Aisys CS2 6 Operation

Trends
Use the Trends menu to view patient trends and set the time scale. There are three views for
patient trends: measured (numerical), settings, and graphical. Trend information is saved every
15 seconds for the most recent 24 hours.

1 Trends
2 View Graphical

Page 1 Measured Data 15-Aug-2012

Measured
Time O2% CO2 AA% AA N2O%
Et/Fi mmHg Et/Fi ID Et/Fi
Settings 21/21
09.05 0/0 0.0/0.0 0/0

3 Scroll

4 Time Scale 1h

Page 1 of 4

5 Next Page 6 Close

Figure 6.18 Trends Menu

6 Operation
1. Select Trends from the right side of the display.
2. Select the desired view.
3. Select Scroll to move through the current trend view.
4. Select Time Scale to select the desired scale from the drop-down menu.
5. Select Next Page to view additional parameters.
6. Select Close.

6.17
 Aisys CS2 7 Ventilation

7 Ventilation
Aisys CS2 Ventilation Modes Objectives
After completing this section, the participant will be able to describe the following
modes of ventilation:

• Volume control ventilation (VCV)

• Pressure control ventilation (PCV)
• Pressure control ventilation - volume guaranteed (PCV-VG)
• Synchronized intermittent mandatory ventilation - volume control ventilation (SIMV VCV)
• Synchronized intermittent mandatory ventilation – pressure control ventilation (SIMV PCV)
• Synchronized intermittent mandatory ventilation – pressure control ventilation - volume
guaranteed (SIMV PCV-VG)
• Pressure support ventilation with apnea backup (PSVPro)
• Continuous positive airway pressure + pressure support ventilation (CPAP + PSV)

7 Ventilation

7.1
Aisys CS2 Participant Guide

About Ventilator Modes

The system has the Volume control ventilation (VCV) as the standard mode of mechanical
ventilation. The system offers the following optional modes of mechanical ventilation:

• Pressure control ventilation (PCV)

• Pressure control ventilation - volume guaranteed (PCV-VG)
• Synchronized intermittent mandatory ventilation - volume control ventilation (SIMV VCV)
• Synchronized intermittent mandatory ventilation – pressure control ventilation (SIMV PCV)
• Synchronized intermittent mandatory ventilation – pressure control ventilation - volume
guaranteed (SIMV PCV-VG)
• Pressure support ventilation with apnea backup (PSVPro)
• Continuous positive airway pressure + pressure support ventilation (CPAP + PSV)

Volume Control Mode (VCV)

Volume control ventilation supplies a set tidal volume. The ventilator calculates a flow based
on the set tidal volume and the length of the inspiratory time to deliver that tidal volume.
It then adjusts that output by measuring delivered volumes at the flow sensors. Since the
ventilator adjusts output, it can compensate for breathing system compliance, fresh gas flow,
and moderate breathing system leaks. A typical volume-control pressure waveform increases
throughout the entire inspiratory period, and rapidly decreases at the start of expiration.
An inspiratory pause is available to improve gas distribution.

VCV mode settings:

• TV Tinsp
• RR Texp
Insp
• I:E Pause

• Tpause
Pressure

• PEEP
• Pmax
Peep

Time

TV
Flow

Time

Figure 7.1 Example of Volume Control (VCV) Waveforms

7.2
 Aisys CS2 7 Ventilation

Pressure Control Mode (PCV)

(PCV) Pressure control ventilation supplies a constant set pressure during inspiration. The
ventilator calculates the inspiratory time from the frequency and I:E ratio settings. A high initial
flow pressurizes the circuit to the set inspiratory pressure. The flow then decreases to maintain
the set pressure (Pinsp). Pressure sensors in the ventilator measure patient airway pressure.
The ventilator automatically adjusts the flow to maintain the set inspiratory pressure.
PCV mode settings:
• Pinsp Tinsp Texp
• RR

Pressure
• I:E

Pinsp
• PEEP
• Pmax Peep

Time
• Rise Rate

Tinsp Texp
Flow

Time

Figure 7.2 Example of PCV Waveforms

7 Ventilation

7.3
Aisys CS2 Participant Guide

Pressure Control Ventilation with Volume Guarantee Mode (PCV-VG)

In PCV-VG, a tidal volume is set and the ventilator delivers that volume using a decelerating
flow and a constant pressure. The ventilator will adjust the inspiratory pressure needed to
deliver the set tidal volume breath-by-breath so that the lowest pressure is used. The pressure
range that the ventilator will use is between the PEEP + 2 cmH2O level on the low end and 5
cmH2O below Pmax on the high end. The inspiratory pressure change between breaths is a
maximum of +/- 3 cmH2O. If a high airway pressure alarm is active due to the current breath,
the next breath’s target will be 0.5 cmH2O less than the current breath’s pressure target.
This mode will deliver breaths with the efficiency of pressure controlled ventilation, yet still
compensate for changes in the patient’s lung characteristics. PCV-VG begins by first delivering
a volume breath at the set tidal volume. The patient’s compliance is determined from this
volume breath and the inspiratory pressure level is then established for the next PCV-VG
breath.
PCV-VG mode settings:
• TV Tinsp Texp
• RR Variable pressure to
Pressure

deliver desired TV
• I:E
• PEEP
• Pmax Peep

Time
• Rise Rate

Tinsp Texp
Flow

TV TV

Time

Figure 7.3 Example of PCV-VG Waveforms

7.4
 Aisys CS2 7 Ventilation

Synchronized Intermittent Mandatory Ventilation - Volume Control

Ventilation Mode (SIMV-VCV)
Synchronized intermittent mandatory ventilation with volume control is a mode in which
periodic volume breaths are delivered to the patient at preset intervals (time-triggered).
Between the machine delivered breaths, the patient can breathe spontaneously at the rate,
tidal volume, and timing that the patient desires.
At the specified time interval, the ventilator will not wait for the next inspiratory effort from the
patient. The sensitivity of this effort is adjusted using the flow trigger level. When the ventilator
senses the beginning of inspiration within the Trigger window it synchronously delivers a
volume breath using the set tidal volume, and the inspiratory time (Tinsp) that is set on the
ventilator. If the patient fails to make and inspiratory effort during the trigger window time
interval, the ventilator will deliver a machine breath to the patient. The ventilator will always
deliver the specific number of breaths per minute that the clinician has set.
In SIMV VCV, the spontaneous breaths can be pressure supported to assist the patient in
overcoming the resistance of the patient circuit and artificial airway. When the Psupport level
is set, the ventilator will deliver the pressure support level to the patient during inspiration.
PEEP can also be used in combination with this mode. Spontaneous breaths that occur during
this mode are indicated by a color change in the waveform.
SIMV-VCV mode settings:
• TV • Pmax
• RR • Trig Window
• Tinsp • Flow Trigger
• Tpause • End of Breath
• Psupport • Rise Rate
• PEEP

T1
Pressure

Spontaneous
Pressure Supported
Mandatory SIMV
breath
breath

Psupport

PEEP

Time

Figure 7.4 Example of SIMV-VCV Waveforms

7 Ventilation

7.5
Aisys CS2 Participant Guide

Synchronized Intermittent Mandatory Ventilation – Pressure Control

Ventilation Mode (SIMV-PCV)
Synchronized intermittent ventilation with pressure control ventilation (SIMV PCV) delivers a
relatively slow breathing rate with pressure controlled breathing. This mode combines
mandatory breaths with spontaneous breath support. If a trigger event occurs within the
synchronized window, a new pressure controlled breath is initiated. If a trigger event occurs
elsewhere during the expiratory phase, a support for a spontaneous breath is provided with
pressure support added as set by the clinician.
SIMV PCV mode settings:
• Pinsp • Trig Window
• RR • Flow Trigger
• Tinsp • End of Breath
• Psupport • Rise Rate
• PEEP • Exit Backup
• Pmax

Spontaneous Trigger
Tinsp
breathing period
window
Pressure

Pinsp
Pressure
supported
breath
Peep

Trigger
Spontaneous window
Tinsp
breathing period
Flow

Figure 7.5 Example of SIMV-PCV Waveforms

7.6
 Aisys CS2 7 Ventilation

Synchronized Intermittent Mandatory Ventilation – Pressure Control

Ventilation - Volume Guaranteed Mode (SIMV PCV-VG)
Synchronized intermittent mandatory ventilation with pressure control volume guaranteed
(SIMV PCV-VG) delivers a set rate of pressure controlled breaths with a guaranteed volume to
the patient. The patient can breathe spontaneously between mandatory breaths. Pressure
support can be used to support the spontaneous breaths.
The mandatory breaths will deliver the set tidal volume using a decelerating flow and a
constant pressure. The ventilator will adjust the inspiratory pressure needed to deliver the set
tidal volume breath-by-breath so that the lowest pressure is used. The pressure range that the
ventilator will use is between the PEEP + 2 cmH2O level on the low end and 5 cmH2O below
Pmax on the high end. The inspiratory pressure change between breaths is a maximum of +/-
3 cmH2O. If a high airway pressure alarm is active due to the current breath, the next breath’s
target will be 0.5 cmH2O less than the current breath’s pressure target.
SIMV PCV-VG begins by delivering a volume controlled breath. The patient’s compliance is
determined from the volume controlled ventilation breath and the inspiratory pressure level is
then established for the next PCV-VG breath. The remaining mandatory breaths will be
pressure controlled with a guaranteed volume at the inspiratory limb.
A portion of the exhalation phase is defined as the trigger window. If a spontaneous breath is
detected in this window, a new mandatory PCV-VG breath is initiated. If a spontaneous breath
is detected outside of this window, support for this breath is provided according to the set
pressure support. The remainder of the trigger window is added to the next non-triggering
phase.
The inspiratory phase of supported breaths will end if the set End of Breath is reached, if the
airway pressure exceeds (PEEP + Psupport + 3 cmH2O). Supportive breaths have a maximum
inspiratory time of 4 seconds.
SIMV PCV-VG mode settings:
• TV
Trigger Variable pressure to
• RR Tinsp Texp deliver desired TV
window
• Flow Trigger
Pressure

• Psupport
• PEEP
Peep

• Tinsp Time
• Pmax Trigger
Tinsp Texp
• Trig Window window
• End of Breath
• Rise Rate
TV TV
• PSV Rise Rate
Flow

Time
7 Ventilation

Figure 7.6 Example of SIMV-PCV-VG Waveforms

7.7
Aisys CS2 Participant Guide

PSVPro Mode
PSVPro is pressure supported ventilation with apnea backup. PSVPro is a spontaneous mode of
ventilation that provides a constant support pressure once the ventilator senses that the
patient has made an inspiratory effort. In this mode, the clinician sets the Pressure Support
(Psupport) and PEEP levels. The patient establishes the rate, inspiratory flow, and inspiratory
time. The tidal volume is determined by the pressure, lung characteristics, and patient effort.
PSVPro uses an inspiration termination level that establishes when the ventilator will stop the
pressure-supported breath and cycle to the expiratory phase. The inspiration termination level
is user adjustable from 5 to 75%. This parameter sets the percent of peak inspiratory flow that
the ventilator uses to end the inspiratory phase of the breath and to cycle into the expiratory
phase. If the inspiration termination is set to 30% then the ventilator will stop inspiration when
the flow decelerates to a level equal to 30% of the measured peak inspiratory flow. The lower
the setting, the shorter the inspiratory phase.
An apnea backup mode is provided if the patient stops breathing. When setting this mode the
clinician adjusts the inspiratory pressure (Pinsp), respiratory rate (RR), and the inspiratory time
(Tinsp). As long as the patient is triggering the ventilator and the apnea alarm does not
activate, the patient will get pressure-supported breaths and the ventilator will not deliver
machine breaths.
If the patient stops triggering the ventilator for the set apnea delay time, the apnea alarm will
activate and the ventilator will automatically switch to the backup mode that is SIMV PCV.
Once in this mode the ventilator will begin delivering machine pressure controlled breaths at
the inspiratory pressure level, inspiratory time, and rate that the user has set. If, during this
time, the patient takes spontaneous breaths in between the machine breaths, the patient will
receive pressure supported breaths.
PSVPro mode settings:
• Psupport • Backup Time
• PEEP • Pinsp
• Trig Window • RR
Pressure

• Flow Trigger • Tinsp T1

• End of Breath • Rise Rate

Peep
• Pmax • Exit Backup
Time
Figure 7.7 Example of PSVPro Waveforms

When the ventilator switches to the backup mode, the Backup Mode active alarm shows until
PSVPro is reinstated or until another ventilation mode is selected. PSVPro mode automatically
resumes when the ventilator registers the number of consecutive patient triggered breaths set
for the Exit Backup setting. The factory default setting for Exit Backup is 2. When Exit Backup is
set to Off, the user must reselect the PSVPro mode to reactivate PSVPro. Upon returning to
PSVPro the ventilator immediately begins providing pressure supported breaths to the patient
using the established settings. Spontaneous breaths that occur during this mode are indicated
by a color change in the waveform.

7.8
 Aisys CS2 7 Ventilation

CPAP + PSV Mode

Continuous positive airway pressure + pressure support ventilation mode is used on
spontaneously breathing patients. This mode of ventilation provides a constant support
pressure once the ventilator senses that the patient has made an inspiratory effort. In this
mode, the clinician sets the Pressure support (Psupport) and PEEP levels. The patient
establishes the rate, inspiratory flow, and inspiratory time. The tidal volume is determined by
the pressure, lung characteristics, and patient effort.
CPAP + PSV uses an inspiration termination level that establishes when the ventilator will stop
the pressure supported breath and cycle to the expiratory phase. The inspiration termination
level is user adjustable from 5 to 75%. This parameter sets the percent of the peak inspiratory
flow that the ventilator uses to end the inspiratory phase of the breath and to cycle into the
expiratory phase. If the inspiration termination is set to 30% then the ventilator will stop
inspiration when the flow decelerates to a level equal to 30% of the measured peak inspiratory
flow. The lower the setting the longer the inspiratory time and conversely, the higher the
setting the shorter the inspiratory phase.
If the spontaneous inspiratory effort does occur within the delay period, the ventilator delivers
pressure controlled breaths with the preset inspiratory pressure to bring the breath rate up to
the minimum rate. The delay period calculation is 60 s/minimum rate + ([60 s/ minimum rate]
- previous measured breath period).
The inspiratory support pressure and the inspiratory pressure settings are linked at the start of
each case. When the inspiratory support pressure setting is changed, the inspiratory pressure
setting is automatically adjusted to match the inspiratory pressure setting. The link can be
broken by changing the Pinsp setting through the Vent Mode menu during the case.
Spontaneous breaths that occur during this mode are indicated by a color change in the
waveform.
CPAP + PSV settings:
• Psupport
• PEEP
Pressure

• Flow Trigger
T1
• End of Breath
• Pmax Peep
• Pinsp Time
• Minimum RR Figure 7.8 Example of CPAP + PSV Waveforms
• Tinsp
• Rise Rate
7 Ventilation

7.9
 Aisys CS2 8 Spirometry

8 Spirometry

8 Spirometry
Aisys CS2 Spirometry Objectives
After completing this section, the participant will be able to:

• Set the spirometry loop type

• Set the loop graph scaling
• Set a patient type and sensor type
• Set the data source
• Set the spirometry volume type
• Save a spirometry loop
• View a spirometry loop
• Delete a spirometry loop

Apnea > 120 s MVex

V p low Unable to
drive bellows
Please Do
Checkout
11:07 Audio Pause

40 Paw 40 Paw
w cmH2O 40
Ppeak Pmean Alarm Setup
60 Spirometry
20 60

Paw
20
VCV 7 System
Spirometry Scaling Auto
80 Loop Type0 Paw-Vol
cmH20
80 0 PEEP Setup

-20 100
2
100
Flow 60
Volume 4000 Next Page
ml Flow l/min 2.0 10.0
I/min
Show Ref. None Paw
MV
15 140
Loop
0 cmH2O Trends
TVe
V xp ml

500
Delete Ref.
None 10 Flow
Loop 120
-60 l/min Spirometry
r
CO2 mmHg 20 60
5 Patient Sensor Adult Et
CO2 40 Procedures
1
Setup Loops
Data Source Vent Fi Stop
0 0 00:27:32
0.5
Gas Show
Supplies
MV or psi
TV TV Resp Off Off Gases % 21 Off Agent % Off 8.0
O2 N2O Air RR /min Et Fi Sev Et Fi

02 Air 02 0 0 0
O2
42 47 1.4 2.6
1.6 0.95
Compl

Save Loop
57 54 89 ml/cmH2O
Back
20 MAC
40 y 0.7
End Case

Fresh Gas: Air

A Ventilator On V
V Volume
o Conntro
O Total Flow
T Mod TV
More
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off
f Settings
% l/min % ml /mi cmH2O

8.1
Aisys CS2 Participant Guide

About the Spirometry Menu

Use the Spirometry menu to:

• Set the loop type

• Adjust the loop scaling
• Save a loop to memory
• Access the Setup Loops menu
• View a saved loop
• Delete a saved loop

Spirometry Loops
There are three types of spirometry loops: Pressure-Volume (Paw-Vol), Flow-Volume (Flow-Vol),
and Pressure-Flow (Paw-Flow).
The spirometry loops show in the spirometry window and can be set to show alongside the
waveforms as the split screen.
Spirometry

Loop Type Paw-Vol vol

900
ml
1
4
Show Ref.
Loop
None 3

Delete Ref.
None
Loop
0

2
Setup Loops

Figure 8.1 Example of Spirometry Window Loops on Split Screen

Save Loop Close

Spirometry loop components:
1. Volume axis
2. Pressure axis
3 Real-time loop
4. Reference loop (appears on display in gray)

8.2
 Aisys CS2 8 Spirometry

Using the Spirometry Loop Split Screen

8 Spirometry
Spirometry Spirometry 1

2 Loop Type Paw-Vol vol

900
Setting themlLoop Type
1. Select Spirometry from the right side of the display
2. Select Loop Type and select the
loop from the drop-down list.
A Show Ref. None 3. Select Close.
Loop

B Delete Ref.
None
Loop
Saving, Viewing, and Deleting
0
Spirometry Loops
Spirometry loops can be saved, viewed, and deleted
through the Spirometry menu.
1. Select Spirometry.
Setup Loops
A. To store a loop to memory, select Save Loop. Up
to six loops can be saved.
B. To delete a saved loop, set Delete Ref. Loop to
the time at which it was saved.
C. To view a saved loop, set Show Ref. Loop to the
time at which it was saved.
2. Select Close.

C Save Loop Close

Close

Figure 8.2 Spirometry Split Screen Menu

8.3
Aisys CS2 Participant Guide

Spirometry Menu Setup

Spirometry

Loop Type Paw-Vol Spirometry Scaling Auto A

Volume 4000
ml

Show Ref. None Paw

Loop cmH2O 140

Delete Ref.
None Flow
Loop 120
l/min

Patient Sensor Adult B

Spirometry 1 Setup Loops
Data Source Vent C

Show MV or TV TV D

Save Loop Back

Figure 8.3 Spirometry Setup Menu

3 4
Setting Loop Graph Scaling
Use the Scaling menu to set the scales of the spirometry loop graph. The available settings for
the volume, Paw, and flow graph axes are dependent on the set patient type of adult or
pediatric.

• Auto: Automatically adjusts the loop graph scaling based on the minimum and
maximum breath reading.
• Linked: When you change one of the scales, the remaining two scales automatically
change based on the one set scale.
• Indep: Allows the volume, Paw and flow axes of the loop graph to be changed separately.

A. To set the graph scaling:

1. Select Spirometry > Setup Loops.
2. Select Spirometry Scaling and set the scale type from the dropdown list.
3. Select Back to view changes made and access other functions of the Spirometry menu.

8.4
 Aisys CS2 8 Spirometry

Setting Patient and Sensor Type

Patient and sensor type refer to the style of airway adapter used with the airway module.

8 Spirometry
If spirometry data is obtained from the airway module, make sure that the sensor type
matches the type of airway adapter used. Adult or pediatric patient types are available.
Note! Make sure that the set sensor type corresponds to the type of airway
adapter in use. If the sensor type is not set correctly, the information displayed
may not be accurate.
B. To set the Patient and Sensor Type:
1. Select Spirometry > Setup Loops.
2. Select Patient Sensor and then select Adult or Pedi depending on the sensor used.
3. Select Back to view changes made and access other functions of the Spirometry menu.

Setting the Data Source

Use Data Source to specify the source of spirometry data.
C. To set the Data Source:
1. Select Spirometry > Setup Loops.
2. Select Data Source.
3. Select Patient to have spirometry data sourced from the airway module or Vent to have
spirometry data sourced from the ventilator.
4. Select Back to view changes made and access other functions of the Spirometry menu.

Setting Spirometry Volume Type

The volume shown on the spirometry split screen can be set to minute volume or tidal volume.
D. To set the Spirometry Volume Type:
1. Select Spirometry > Setup Loops.
2. Select Show MV or TV and select MV or TV from the drop-down list.
• Set to TV to show TVinsp and TVexp on the spirometry split screen.
• Set to MV to show MVexp and TVexp on the spirometry split screen.
3. Select Back to view changes made and access other functions of the Spirometry menu.

8.5
 Aisys CS2 9 Procedures

9 Procedures
Aisys CS2 Procedures Objectives
After completing this section, the participant will be able to:

• Perform a Pause Gas Flow procedure

9 Procedures
• Use manual and VCV cardiac bypass
• Perform a Vital Capacity procedure
• Change a Vital Capacity procedure setting
• Perform a Cycling procedure
• Change a Cycling procedure setting

11:07 Audio Pause

40 Paw 40 Paw
w cmH2O 40
Procedures Ppeak Pmean Alarm Setup
60 20 60

Paw
20
VCV 7 System
80 0 cmH20
80 0 PEEP Setup

-20 100
2
100
Flow 60 Next Page
Flow l/min 2.0 10.0
I/min Pause Gas Flow
MV
15
0 Trends
Start Cardiac TVe
V xp ml
Bypass
10
-60 500 Spirometry
r
CO2 mmHg 20 60
5
Et
CO2 40 Procedures
1 Vital Capacity
Fi Stop
Cycling 0 0 00:27:32
0.5
Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0
O2 N2O Air RR /min Et Fi Sev Et Fi

02 Air 02 0 0 0
O2
42 47 1.4 2.6
1.6 0.95
Compl
Stop gas flow for up to one minute.
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case
Close
Fresh Gas: Air
A Ventilator On
V
O2 Total Flow
T Mode RR Pmax

50 2.60 Gas Setup

VCV 10 1:2 Off
f Off
f 40
% l/min /min % cmH2O cmH2O

9.1
Aisys CS2 Participant Guide

The Procedure Menu

Procedures Use the Procedures menu to pause the gas flow,
start cardiac bypass, perform or change settings for
a vital capacity procedure, or perform or change the
settings for a cycling procedure. The procedures key
is located on the right side of the display.
2 Pause Gas Flow
The Vital Capacity and Cycling procedures may not
Start Cardiac be available if the system has been configured to
Bypass
disable these procedures. Vital Capacity and Cycling
are only selectable during mechanical ventilation.

Vital Capacity
Procedures 1
Cycling

Stop gas flow for up to one minute.

Close

Figure 9.1 Procedures Menu

Pause Gas Flow

Procedures Use Pause Gas Flow to temporarily suspend the flow
of gas during a case. Using Pause Gas Flow while the
3 breathing circuit is disconnected prevents the flow of
gas into the room. Pause Gas Flow is available
during both mechanical ventilation and manual
Flow Paused Restart Gas Flow
ventilation.
0:53 Start Cardiac 1. Select Procedures from the right side of the
Bypass
display.
2. Select Pause Gas Flow.
• The amount of time remaining in the gas flow
Vital Capacity pause shows in the window.
• Gas flow stops for 1 minute and automatically
Cycling resumes after 1 minute.
• If mechanical ventilation is on, mechanical
ventilation stops for 1 minute and then
automatically resumes after 1 minute.
3. Resume the flow of gas at any time during the
End pause. Restart gas flow and
mechanical ventilation.
Close pause by selecting Restart Gas Flow.

Figure 9.2 Pause Gas Flow Menu

9.2
 Aisys CS2 9 Procedures

Cardiac Bypass
There are two types of cardiac bypass. Manual ventilation cardiac bypass is standard.
VCV cardiac bypass is optional.
Manual ventilation cardiac bypass suspends alarms for patients on cardiac bypass when the
ventilator is not mechanically ventilating. The volume, apnea, low agent, CO2, and respiratory
rate alarms are suspended. The alarms are enabled when cardiac bypass is turned off or
mechanical ventilation is started.
Systems with the VCV cardiac bypass option enabled can mechanically ventilate while in VCV
mode. The VCV mode is the only ventilation mode available while using VCV cardiac bypass.

9 Procedures
The volume, apnea, low agent, CO2, low Paw, and respiratory rate alarms are suspended. The
alarms are enabled when VCV cardiac bypass is turned off or mechanical ventilation is
stopped.

Using Manual Ventilation Cardiac Bypass

Procedures 1. Set the Bag/Vent switch to Bag.
2. Select Procedures.
3. Select Start Cardiac Bypass. The Cardiac
Bypass message shows in the waveforms and
Pause Gas Flow in the general message field when manual
ventilation cardiac bypass is active.
Start Cardiac
3 Bypass
4. Select Close.

Using VCV Cardiac Bypass

Vital Capacity
1. Start mechanical ventilation in VCV mode.
Cycling
2. Select Procedures.
3. Select Start Cardiac Bypass.
• PEEP is set to 5 cmH2O
Stop gas flow for up to one minute.
Close
• TV settings of less than 170 ml prior to starting
cardiac bypass remain at the set TV
• TV settings of more than 170 ml prior to starting
Figure 9.3 Cardiac Bypass Button
cardiac bypass change to 170 ml
• The VCV Cardiac Bypass message shows in the
waveforms and in the general message field
when VCV cardiac bypass is active
4. Select Close.
Note! PEEP and TV settings can be changed
after entering cardiac bypass mode.

9.3
Aisys CS2 Participant Guide

Vital Capacity
Use the Vital Capacity procedure to deliver a pressure breath for a set time. The Vital Capacity
procedure provides a simple way to deliver one pressure breath during mechanical ventilation
without making multiple ventilator setting changes. The PEEP on Exit setting provides a way to
change the ventilation PEEP setting automatically at the end of the Vital Capacity procedure.
The Pressure Hold, Hold Time, and PEEP on Exit settings can be preset by the Super User. These
settings can be changed by the user before starting the procedure.
Note! PEEP on Exit shows if it has been enabled by the Super User.

Vital Capacity Using Vital Capacity

Start Vital 1. Select Procedures. Procedures
Capacity

2. Select Start Vital Capacity.

• One pressure breath is given at the set
pressure
Pressure Hold
cmH2O
35 • The pressure is held for the set time
• PEEP is set to the PEEP on Exit setting
Hold Time
15
s 3. Select Stop Vital Capacity at any time to stop
PEEP on Exit
the procedure.
4
cmH2O
4. Select Close.
Note! If the procedure is stopped before
completion, the PEEP on Exit setting is
not used.
Turn on mechanical ventilation. Then
select Start.

Close Changing Vital Capacity Settings

1. Select Procedures.
Figure 9.4 Vital Capacity Menu
2. Select the setting to change and make the
change.
• Set Pressure Hold to between 20 and
60 cmH2O.
• Set Hold Time to between 10 and 40 seconds.
• Set PEEP on Exit to Off or between 4 and 30
cmH2O.
3. Select Start Vital Capacity.
4. Select Close.

9.4
 Aisys CS2 9 Procedures

Cycling
Use the Cycling procedure to deliver pressure breaths through a series of ventilation steps.
The Cycling procedure provides a flexible way to deliver pressure breaths during ventilation
without making multiple ventilator setting changes. Up to seven preset steps with multiple
breaths are available.
Each procedure defaults steps and ventilation settings which can be preset by the Super User.
The ventilation settings of each step can be changed by the user before starting a procedure.

9 Procedures
Cycling Using Cycling
Start
Cycling
40 cmH20 1. Select Procedures. Procedures
2. Select Cycling.
3. Select a Procedure to perform.
4. Select Start Cycling.

0 138 s
• The procedure begins
• Procedure progress shows in the procedure
Step 1 2 3 4 5 6 7
Procedure 1 window
Pinsp 10 10 10 10 10 10 10
PEEP 2 4 6 8 6 4 2
5. Stop the procedure anytime by selecting Stop
Adjust
Settings
Breaths 3 3 3 5 3 3 3 Cycling.
I:E 1:2 1:2 1:2 1:1 1:2 1:2 1:2
6. Select Close.
RR 10 10 10 10 10 10 10

Turn on mechanical
ventilation. Then select Start.

Close
Changing Cycling Settings
1. Select Procedures.
Figure 9.5 Cycling Menu
2. Select Cycling.
3. Select a Procedure to perform.
4. Select Adjust Settings. The first setting of Step 1 in
the procedure window is selected.
5. Push the ComWheel to enter the adjustment
window.
6. Use the ComWheel to navigate the adjustment
window and change a value.
7. Select Start Cycling.
8. Select Close.

9.5
 Aisys CS2 10 Checkout

10 Checkout
Aisys CS2 Checkout Objectives
After completing this section, the participant will be able to:

• Access the Checkout menu

• Perform a Full Test
• Perform the Vent and Gas test
• Perform the Circuit Leak test
• Perform the Circuit O2 Cell test (if applicable)
• Perform the Low P Leak Test

10 Checkout
Apnea > 120 s MVex
V p low Unable to
drive bellows
Please Do
Checkout
11:07 Audio Pause

40 Paw 40 Paw
w cmH2O 40
Alarm Setup
60 Checkout 20 60 Ppeak Pmean

Paw
Instructions
20
VCV 7 System
Full Test
80 0 cmH20
80 0 PEEP Setup
In an Emergency, select Start Case.
Individual Tests
-20 100
2
100
1. ConnectFlow
Scavenging.
60 Next Page
Vent and
Flow l/min 2.0 10.0
I/min 2. Open and close the cylinders.
Gas
3. Connect a patient circuit.
MV
15
0 and the absorbent.
4. Check the absorber Trends
Circuit Leak TVe
V xp ml
5. Select a test from the menu.
10
Circuit O2
6. Complete the instructions and start the test.
-60 500 Spirometry
r
Cell 7. Automatic test beeps if action is required.
CO2 mmHg 20 60
5
Et
CO2 40 Procedures
1 Vent and Gas Pass 15-Sep-2013 15:47
Low P Leak Fi
Circuit Leak Pass 15-Sep-2013 15:41 Stop

Agent
Circuit O20Cell Done 23-Sep-2013 10:38 0 00:27:32
0.5 Low P Leak Pass 23-Sep-2013 10:38
Delivery Gas Supplies psi Resp Off Off Gases % 21 Off Agent % Off 8.0
O2 N2O Air RR /min Et Fi Sev Et Fi

02 Start Case
Air 02 0 0 0
O2
42 47 1.4 2.6
1.6 0.95
Compl
57 54 89 ml/cmH2O 20 MAC
40 y 0.7
End Case
Show Log
Fresh Gas: Air
A Ventilator On V
V Volume
o Conntro
O Total Flow
T Mod TV
More
50 2.60 2.6 Gas Setup
VCV 500 10 1:2 Off
f Settings
% l/min % ml /mi cmH2O

10.1
Aisys CS2 Participant Guide

About the Checkout Menu

The Checkout menu shows on the display after turning on the system. To access the Checkout
menu between cases, select Checkout from the right side of the display. Step-by-step
instructions show in the Checkout menu during the tests. Use the Checkout menu to:
• Perform a Full Test
• Perform any of the individual tests
• View the Test Log
• Start a case

Full Test
The Full Test or the individual tests must be performed at least once within every 24-hour
period. Perform the Full Test at the start of each day. The full test runs automatically and beeps
to indicate when it is finished or if interaction is required.
The Full Test does the following tests: Vent and Gas, Circuit Leak, and Circuit O2 Cell (if circuit O2
cell is present). When one of the tests is completed, the next test begins.

Performing a Full Test

1. From the Checkout menu, select Full Test and follow the instructions.
2. If a test fails, follow the instructions to perform a retest or accept the results.
3. When the Full Test is completed, select Start Case
Note! In case of a patient emergency, the Full Test may be bypassed by selecting
Start Case. The general message Please Do Checkout is displayed if a Full Test
or all of the individual tests are not completed with passing results within 24 hours.

Checkout
Instructions
1 Full Test
In an Emergency, select Start Case.
Individual Tests
1. Connect Scavenging.
Vent and
2. Open and close the cylinders.
Gas
3. Connect a patient circuit.
4. Check the absorber and the absorbent.
Circuit Leak
5. Select a test from the menu.
6. Complete the instructions and start the test.
Circuit O2
Individual Tests Cell 7. Automatic test beeps if action is required.

Vent and Gas Pass 15-Sep-2013 15:47

Low P Leak
Circuit Leak Pass 15-Sep-2013 15:41
Circuit O2 Cell Done 23-Sep-2013 10:38
Agent
Delivery Low P Leak Pass 23-Sep-2013 10:38

3 Start Case

Show Log

Figure 10.1 Checkout Menu

10.2
 Aisys CS2 10 Checkout

Tests Performed During a Full Test

• Vent and Gas: The Vent and Gas test checks the agent delivery, airway module, Bag/Vent
switch, proper gas supply pressures, ventilation operation and leak, battery and electrical
power, circuit compliance and flow control operation. This is a two-step test. To run this test,
follow the on-screen instructions. When the test passes, the next test starts.
• Circuit Leak: The Circuit Leak test checks the Bag/Vent switch, proper gas supply pressures,
airway pressure measurement transducer, APL valve, and manual circuit leak. To run this
test, follow the on-screen instructions. When the test passes, the next test starts.
• Circuit O2 Cell: If the circuit O2 cell is present, the Circuit O2 Cell test measures the O2
percent. To run this test, follow the on-screen instructions. Do not select Done when 21 is
first displayed. Allow the reading to stabilize, then select Done. Calibrate the O2 cell if
necessary.
• External Gas Monitor: When enabled by the Super User, the External Gas Monitor reminder
occurs. This is not a test. This is a reminder to connect a respiratory gas monitor.

10 Checkout
Individual Tests
Individual tests allow the user to perform any combination of single tests as opposed to
performing a Full Test. These tests are helpful if there is a specific problem/alarm and the user
wishes to test only that portion of the system. The Full Test or all of the individual tests must be
completed with passing results at least once within every 24-hour period.
The tests do not automatically move on to the next test. After completing a test, do another or
start a case. If a test fails, follow the instructions to perform a recheck or accept the results.

Low P Leak
The Low P Leak test is an individual test that is not performed as part of the Full Test. The
positive pressure Low P Leak test measures machine leaks before the breathing system,
between the common gas outlet and the high-pressure pneumatics and includes the gas mixer
and vaporizer. It measures low-pressure pneumatic leaks with a pass or fail limit of 50 ml.

10.3
 Aisys CS2 11 Assembly and Cleaning

11 Assembly and Cleaning

Aisys CS2 Assembly and Cleaning Objectives
After completing this section, the participant will be able to:

• Remove and replace the breathing system

• Remove and replace the flow sensor module
• Remove and replace the flow sensors
• Remove and replace the breathing circuit module
• Disassemble and assemble the bellows assembly
• Remove and replace the exhalation valve assembly

11 Assembly and
Cleaning
300
600
900
1200
1500
(mL)
! ~ VT

11.1
Aisys CS2 Participant Guide

Advanced Breathing System

Assemble and disassemble the breathing system including the flow sensor module, breathing
circuit module, bellows assembly, and exhalation valve assembly after removing the breathing
system using the steps bellow.
Remove the Breathing System (page 12 of the Advanced Breathing System Cleaning and
Sterilization User’s Reference Manual)
1. Disconnect the bag hose from the bag hose connector.
2. Hold the absorber canister by the handle and push on the release latch to unlock the
canister. Tilt the canister downward to remove it off of the two support pins. For EZchange
canisters, slide the canister up and out of the cradle.
3. Push the release button and gently pull the latch handle toward you to release the system.
4. Grasp the rear handle to support the breathing system. Slide the breathing system away
from the workstation by pulling it toward you using the latch handle.

20 70

1 !

30
30

! AGSS

3 4
Figure 11.1 Removing the Breathing System

11.2
 Aisys CS2 11 Assembly and Cleaning

Replace the Breathing System

1. Align the pin openings with the guide pins.
2. Hold the rear handle and the latch handle and slide the breathing system onto the
guide pins.
3. Use the grip under the latch handle to push the breathing system in fully until it
latches firmly.
4. Install the absorber canister and bag hose.
5. Complete a full machine check to ensure that the breathing system is properly assembled.
Note! Please refer to the Advanced Breathing System Cleaning and Sterilization
User’s Reference Manual for more information on cleaning and sterilization.
Any part labeled with 134 degree Celsius can be autoclaved.

Guide pins on the bulkhead wall insert into

300 the back of the breathing system
600
900
1200
1500
(mL)
! ~ VT

11 Assembly and
Cleaning
10
4-1
00 %
0-0 02
05
F6
RE
34
15
15

Figure 11.2 Replacing the Breathing System

P7
! SN

11.3
Aisys CS2 Participant Guide

Flow Sensor Module

Remove the Flow Sensor Module
1. Pull the latch to unlock the flow sensor module.
2. Pull the flow sensor module from the breathing system.

20 70

Flow Sensor Latch

Figure 11.3 Removing the Flow Sensor Module

Remove the Flow Sensors

1. Loosen the thumb screw.
2. Pull off the flow sensor cover from the flow sensor holder.
3. Remove the flow sensor connectors from the flow sensor holder.
4. Pull the flow sensors from the flow sensor holder.
5. Plastic flow sensors cannot be autoclaved and should last a minimum of three months.
Metal flow sensors can be autoclaved and should last a minimum of one year. Replace flow
sensors as necessary.

Flow Sensor Connector Pins

Flow Sensor Connector

Inspiratory and Expiratory Flow Sensors

Thumb Screw

Flow Sensor Holder

Flow Sensor Cover

Figure 11.4 Flow Sensor Components

11.4
 Aisys CS2 11 Assembly and Cleaning

Replace the Flow Sensors

1. Insert the flow sensors into the flow sensor holder with the black-lined tube facing toward
the flow sensor holder.
2. Attach the flow sensor connectors to the flow sensor holder.
3. Attach the cover to the flow sensor holder.
4. Tighten the thumbscrew to fasten the cover.

Replace the Flow Sensor Module

1. Attach the flow sensor module to the breathing system. Be sure to align the flow sensor
tubes with the grooves in the flow sensor holder.
2. Push the latch closed to lock the flow sensor module into place on the breathing system.

Connector pins in the back of the flow sensor

connector insert into the bulkhead wall

11 Assembly and
Cleaning
Breathing Circuit Module

Flow Sensor Module

Figure 11.5 Replacing the Flow Sensors

11.5
Aisys CS2 Participant Guide

Breathing Circuit Module

Remove the Breathing Circuit Module
1. If applicable - Remove the O2 cell cable from the cell. Unscrew the O2 cell counterclockwise
and remove it. Remove the O2 cell cable by pressing on the connector button while pulling
the connector out.
2. Rotate the breathing circuit module counterclockwise. After rotating, pull the breathing
circuit module apart from the bellows assembly by lifting up on the breathing circuit
module.
3. On the breathing circuit module, remove the check valve lens by squeezing the latches
together and pulling up on the lens. Lift out the check valve assemblies.

Expiratory Check Valve Lens Inspiratory

Check Valve Check Valve

Turn O2 Sensor
counterclockwise

Check Valve 0
Lens 4-11
-000
6050
REF
Release Latches
! R7
SN

Pins in bulkhead
wall insert through O2 Sensor Cable
these holes
Absorber Canister
Release Lever O2 Sensor Cable
Connector Button
Figure 11.6 Removing the Breathing Circuit Module

11.6
 Aisys CS2 11 Assembly and Cleaning

Replace the Breathing Circuit Module

1. On the breathing circuit module, replace the check valve assemblies. Push the check valve
circuit lens down onto the latches to lock the lens in place.

Check Valve Assembly

2. Insert the breathing circuit module into the bellows assembly aligned as shown.
3. Rotate the breathing circuit module clockwise at the point shown by the dotted line to
attach it to the bellows assembly.
4. If applicable – Replace the cell by screwing it in clockwise. Reconnect the O2 cell cable.

Pins in bulkhead wall insert through

breathing circuit module

11 Assembly and
Cleaning
Bellows Assembly Breathing Circuit Module

Figure 11.7 Replacing the Breathing Circuit

11.7
Aisys CS2 Participant Guide

Bellows Assembly
Disassemble the Bellows Assembly
1. Turn the bellows housing counterclockwise and lift.
2. Remove the bottom edge of the bellows and lift.
3. Push the two tabs toward the center and remove the rim.
4. Remove the pressure relief valve.
5. Push the latch toward the center and remove the locking tabs.
6. Remove the seal.

Bellows Housing

300
600
900
1200
1500
(mL)
! ~ VT

Bellows

Pressure Relief Valve

Locking Tabs
Seal

Rim

Figure 11.8 Bellows Assembly

11.8
 Aisys CS2 11 Assembly and Cleaning

Assemble the Bellows Assembly

1. Install the seal and verify the arrow and the groove on the seal point up.
2. Push the latch toward the center and attach the locking tabs.
3. Install the pressure relief valve.
4. Push the two tabs toward the center and install the rim. A click should be heard when the
rim is installed.
5. Attach the bottom edge of the bellows to the rim. Verify that the bottom ring of the bellows
is fitted over the rim.
6. Lower the bellows housing and turn it clockwise to lock. Verify housing is secure.

300
600
900
1200
1500
(mL)
! ~ VT

11 Assembly and
Cleaning
Figure 11.9 Bellows Assembly and Canister

Bellows assembly test (Verify the bellows is assembled correctly):

Your class instructor will demonstrate the proper method for testing the Bellows Assembly.
You may also refer to the Advanced Breathing System Cleaning and Sterilization User’s
Reference Manual, page 21.

11.9
Aisys CS2 Participant Guide

Exhalation Valve

Remove the Exhalation Valve Assembly

1. With the breathing system removed, the exhalation valve assembly can be removed.
2. Loosen the thumbscrews and lift the assembly off.

Replace the Exhalation Valve Assembly

1. Replace the exhalation valve assembly and tighten the thumbscrews.

Exhalation Valve Assembly

Relief
Valve
Thumb
Screws

Vented
Cover

Tube leading to
scavenging Diaphragm

Ventilator Housing

Figure 11.10 Exhalation Valve

11.10
 Aisys CS2 12 Resources

12 Resources
Aisys CS2 User Operational Maintenance Schedule

Activity Frequency User Manual

Page

Full Anesthesia Machine Daily 4-2

Checkout
Flow Sensor Calibration Daily 4-2

Flow Sensor Replacement PRN: Lasts a minimum of 3 months 9-4

Inspect and Clean Fan Filters PRN: Display and airway module 9-4

Suction Overflow Trap PRN 9-4

Empty Condenser Reservoir Daily 9-4

Change Absorbent Canister PRN: Immediately if color has changed 8-6, 9-4

GE / Datex-Ohmeda Gas Module

Gas Calibration Every six months or every two months 9-4

12 Resources
with heavy usage.

Black D-Fend Replace the D-Fend water trap at least 7-10

every two months or when a Sample line
blocked or Replace D-Fend alarm persists.

12.1
 Aisys CS2 12 Resources

Aisys CS2 Anesthesia Supplies and Accessories

Part Number Description

Flow Sensor Supplies
1503-3858-000 Flow sensor, disposable (plastic)
1503-3244-000 Flow sensor, autoclavable (metal)
1407-7001-000 Flow sensor module (does not include flow sensors)
Absorber Canister Supplies
1407-7004-000 Multi absorber, reusable (includes 40 pack of foam; does not
include absorbent)
1009-8240-000 Cover assembly, CO2 canister
1407-3201-000 Foam, CO2 canister (pack of 40)
1407-3204-000 O-ring
1407-3200-000 Canister, CO2 with handle
8003138 Multi absorber, disposable, white to violet (pack of 6)
Breathing System Supplies
8004515 Reusable, hytrel patient tubing 36” (for use on bag arm)
8004459 ABS Bag arm connector elbow (for use on bag arm)
8004454 Manual 3L vent bag arm hose and elbow, disposable (pack of 20)
1503-3857-000 O2 sensor plug
8004460 3L Scavenging Bag, Reusable
M1210946 Test plug (for low pressure leak test)

12 Resources
Vaporizer Supplies
1100-3025-000 Easy Fill Bottle Adapter, Isoflurane
1100-3026-000 Easy Fill Bottle Adapter, Halothane
1100-3027-000 Easy Fill Bottle Adapter, Enflurane
1100-3028-000 Easy Fill Bottle Adapter, Sevoflurane
Airway Module Supplies
876446 D-Fend Water Trap, black (pack of 10)
8004463 Gas Scavenger line-18cm with Colder fitting
73319 Sample lines (pack of 10)
755571 Calibration Gas (United States)
755583 Calibration Gas (Non-U.S.)
M1006864 Calibration Gas Regulator (United States)
755534 Calibration Gas Regulator (Non-U.S.)

Contact number for supplies issues, questions and orders will be supplied by the clinical
trainer in the area below:

12.3
 Aisys CS2 12 Resources

Aisys CS2 Quick Guide

To Start a Case: • Ensure that the Bag/Vent switch is set to Bag

• Select the Start Case function key on the right side of the display
• The Case Defaults selection shows the first preset case type
• Verify or change the Case Defaults selected
• Verify or change the Volume Apnea Alarm, CO2 Alarms, Age, and Ideal Weight set-
tings
• To change ventilation mode, select the Mode quick key at the bottom of the display.
Make the change. To change the ventilation settings, select a ventilator quick key or
More Settings. Make the change.
• To change alarm settings, select the Alarm Setup function key on the right side of the
display. Make the change.
• To change the gas settings or the circuit type, select the Gas Setup quick key at the
bottom of the display. Make the change.
• From the Start Case menu, select Start Case Now and gas flow will start.

To Change to • Select the Mode quick key at the bottom of the display
Vent Modes: • From the Vent Mode menu, select the desired ventilation mode
• To change the ventilation settings, select More Settings from the Vent Mode menu or
use the ventilator quick keys at the bottom of the display.
• Set and confirm the primary ventilation setting to activate the ventilation mode
To switch • Select the Gas Setup quick key at the bottom of the display
between N2O and • Select Other Gas
Air during a Case: • Select the balance gas to use with O2

12 Resources
To Turn CO2 • Select the Alarm Setup function key on the right side of the display
alarms off: • Set CO2 Alarms to Off
• CO2 Alarms Off appears in the general message field. The CO2 alarm limit waveform
numerics shows dashes during a case.
• The alarms remain disabled until the Bag/Vent switch is set to Vent, the case is ended,
or the CO2 Alarms is set to On.
• Select Close.
Note! The CO2 Alarms selection is also available from the Start Case menu when
starting a case.

To turn off the • Select the Alarm Setup function key on the right side of the display
Volume Apnea alarm • To turn the volume apnea alarms off, select Vol Apnea Alarm to Off.
during a MAC case: • Volume Apnea Off appears in the general message field.
• If mechanical ventilation is started, the volume apnea alarms are active.
• If manual ventilation is restarted, a pop-up confirmation window appears to resume
the Off setting.
Note! The ability to turn off the Volume Apnea alarm is only available if it has been
enabled for the facility by the Super User. The Vol Apnea selection is also available
from the Start Case menu when starting a case.

12.5
Aisys CS2 Participant Guide

Quick Guide Continued

To Turn the MV/TV • Select the Alarm Setup function key on the right side of the display
Alarms off: • Under the Primary Limits tab, set MV/TV Alarms to Off
• MV/TV Alarms Off appears in the general message field. The volume alarm limits
waveform numerics shows dashes during a case.
• Select Close

To switch • Select the Spirometry function key on the right side of the display
between Adult and • Select Setup Loops > Patient and Sensor and then select Adult or Pedi
Pedi sensor type • Select Back to view changes made and access other functions of the Spirometry menu.
when using the
spirometry
adapter:

To change the data • Select the Spirometry function key on the right side of the display
source when using • Select Data Source
the spirometry • Select Patient to have spirometry data sourced from the airway module or Vent to
adapter: have spirometry data sourced from the ventilator
• Select Back to view changes made and access other functions of the Spirometry menu

To switch • Select the System Setup function key on the right side of the display
between individual • Select Screen Setup > More Settings > Fresh Gas Controls
gas flow style and • When Flow is selected, balance gas and the O2% are controlled individually using the
O2% style: gas quick keys
• When O2% is selected, balance gas adjusts automatically when either the O2% or the
Total Flow is changed using the gas quick keys.
• Select Close
Note: The ability to switch between the two styles is only available if it has been
enabled for the facility by the Super User.

To turn off gas • Set the Bag/Vent switch to Bag

flows and silence • Select the End Case function key on the right side of the display
alarms at the end • Select End Case Now on the menu to put the system in standby. The End Case menu
of the case: shows the gas and agent usage for the case.

12.6
 Aisys CS2 12 Resources

Aisys CS2 Troubleshooting Guide Taken from: pages 7-4 through 7-11 of the User’s Reference Manual.

Message Cause Action/Concern

Apnea >120 s Apnea time exceeds 120 seconds. Check for leaks or blockages in the breathing
circuit. Ensure the Bag/Vent switch is in the
Vent position.
Check the patient.
Check D-Fend Water trap not attached. Check that the water trap is properly
attached to the airway module.
Check flow sensors System has detected an improper flow Ensure the flow sensors are connected
pattern in the breathing circuit. correctly.
Circuit leak Vent TVexp is less than half of vent Check for leaks in the patient circuit. Calibrate
TVinsp for at least 30 seconds. flow sensors. If problem persists, replace flow
sensors.
FiCO2 high. Absorbent High FiCO2 is greater than alarm limit. Check if absorbent needs to be changed.
OK?
No exp flow sensor Electrical signals show the flow sensor is Connect the flow sensor. Replace the flow
No insp flow sensor not connected. sensor if necessary.

No fresh gas flow! Possible patient detected while system is Disconnect the patient or start the case.
in checkout state.
PEEP high. Blockage? High Paw greater than or equal to Check for blockages in the patient circuit.
sustained limit for 15 seconds.
Plug in power cable. The mains supply is not connected or has Ventilate manually to save power. Make sure
On battery. failed and the system is using battery the power cable is plugged in and system
power. breaker is on.

12 Resources
Replace D-Fend Buildup in airway module sample line. Replace D-Fend.
Replace exp flow sensor EPROM calibration data read failure. Replace the expiratory or inspiratory flow
Replace insp flow sensor sensor.

Reverse exp flow. Flow toward the patient seen in the Calibrate the flow sensors.
Check valves OK? expiratory flow sensor during inspiration
for six breaths in a row.
Turn power Off and On System has been operating for longer Turn power off and back on between cases to
for self tests than 12 hours without a power-up self perform a self test.
test.
TV not achieved Measured tidal volume is less than set Check for leaks in the patient circuit.
tidal volume. Check for leaks in the breathing system.
Unable to drive bellows Bellows is collapsed. Check the drive gas. Increase fresh gas flow
(or push the O2 flush button) to fill the bellows.
Vol vent only. No PEEP Manifold pressure error. Pressure Control Use volume control ventilation mode. Shut
or PSV. unavailable. Medium priority alarm when down the system as soon as possible and
Bag/Vent switch is in Vent and running contact an authorized service representative
PCV, PSVPro, SIMV-PC, CPAP/PSV, or
PCV-VG mode.

12.7
 Aisys CS2 13 Clinical Training Documents

13 Clinical Training Documents

Aisys CS2 Clinical Training Checklist
The following topics will be presented.

The purpose of this document is to verify that the following items are covered during your
Aisys CS2 training. You should be prepared to operate the Aisys CS2 by the end of the training
time. If you still believe that you are not prepared, please talk to your trainer or your manager.
Please refer to the Aisys CS2 User’s Reference Manuals for complete instructions on the opera-
tion of the Aisys CS2.

Introduction to the Aisys CS2

Place a checkmark next to topics discussed.

 Overview
• System and display components
• System power and battery back-up power
• O2 information sources
• O2 flush
• Alternate O2 control
• Scavenging

 Screen Navigation
• Positioning the display
• Identifying display areas and touch points
• Using Menus, the ComWheel and Quick Keys

 Vaporization

13 Clinical Training
• Filling the Aladin2 cassettes

Documents
• Removing and replacing the Aladin2 cassettes

 Advanced Breathing System

• Bag/Vent switch
• APL valve
• Changing CO2 absorber canister
• Draining condenser
• Zeroing flow sensors and preventing moisture buildup

Continued
13.1
Aisys CS2 Participant Guide

Clinical Training Checklist Continued

 Operation
• Start and End Case procedures
• Minimum Alveolar Concentration
• Changing vent modes and settings
• System Setup
• Fresh Gas Controls
• ecoFLOW
• Alarm management
• Trends

 Ventilation Modes
• VCV
• PCV
• PCV-VG
• SIMV VCV
• SIMV PCV
• SIMV PCV-VG
• PSV Pro
• CPAP + PSV

 Spirometry
• Setting loop type and scaling
• Spirometry setup
• Storing and erasing loops

 Procedures
• Pause Gas Flow
• Cardiac Bypass
• Vital Capacity
• Cycling

 System Checkout
• Checkout menu
• Complete full test

 Maintenance and troubleshooting

 Hands-on exercises
 Clinical skills checklist - see attached
 Training quiz
 Evaluation
13.2
 Aisys CS2 13 Clinical Training Documents

Aisys CS2 Clinical Skills Checklist

To help ensure safe operation of the Aisys CS2, you must be able to perform the
following functions:

Place a checkmark next to topics completed.

 Calibrate (remove and replace) the flow sensor module.

 Remove and replace the CO2 absorber canister.
 Bypass the machine check out and start an emergency case.
 Perform a complete electronic machine check.
• Full test
• Circuit leak
• Low-pressure leak
 Start a case from the machine in Standby.
 Change gases between air and nitrous oxide.
 Fill and change a an Aladin2 cassette.
 Adjust agent concentration.
 Change ventilation modes.
 Change ventilation settings.
 Set and adjust alarm limits and alarm volume.
 End a case to stop gas flow and end the patient alarms.
 Remove and replace the D-fend and attached gas sample line.
 Manually activate the alternate O2 source and regulate O2 flow (the procedure used during
an emergency or failure).

13 Clinical Training
 Turn suction on to maximum, and then change to regulated suction and adjust suction

Documents
pressure.

 Utilize Pause Gas Flow, Cardiac Bypass, Vital Capacity and Cycling from the Procedures
menu.

 Save and view a loop from the Spirometry menu.

 I have been trained and am able to complete all of the above named skills.
Print Name: Date:

Signature:

13.3
 Aisys CS2 13 Clinical Training Documents

Aisys CS2 Clinical Training Quiz

After completion of the test, compare your answers to the answer key. Ask the instructor
to explain any answers you do not understand.
Circle the correct answer.
1. Which display component is used to select/change a menu item or to confirm a setting?
a. Home Key
b. ComWheel
c. Start/End Case Key
d. Audio Pause Key

2. Which feature of the system activates automatically in the case of certain failures or
errors and can also be activated manually?
a. Alternate O2 Control
b. O2 Flush
c. Galvanic Cell
d. ACGO

3. Which type of scavenge system uses a visual indicator bag?

a. Active AGSS with flow indicator
b. Passive AGSS
c. Active adjustable flow
d. ACGO

4. What is the maximum number of waveform fields that can be shown on the normal
screen view?
a. 1
b. 2
c. 3
d. 4

5. How many vaporizers can be turned on and operating at the same time?
a. 1
b. 2
c. 3

13 Clinical Training
d. 4

Documents
6. Which component of the system would you use to change from manual ventilation mode
to mechanical ventilation mode?
a. APL valve
b. ACGO switch
c. EZchange lever
d. Bag/Vent switch

7. Patient gas moves from the rebreathing bag to the breathing system through which com-
ponent?
a. Bag hose
b. Bag arm
c. AGSS
d. Bellows assembly

13.5
Aisys CS2 Participant Guide

Aisys CS2 Clinical Training Quiz Continued

8. What does the EZchange mode enable you to do?
a. Switch from VCV to PCV with one key press
b. Change from passive to active scavenging systems
c. Change power input from 120 volts to 220 volts
d. Seal the breathing system when changing absorber canisters

9. How often should the flow sensors be calibrated?

a. Every day
b. Every week
c. Every month
d. Every year

10. Which menu is used to set the case default, enter patient age and ideal weight and start
the gas flow?
a. Gas Setup
b. System Setup
c. Screen Setup
d. Start Case

11. Which quick key would you press to change from Volume Control Ventilation to Pressure
Control Ventilation?
a. Mode
b. System Setup
c. Start Case
d. Spirometry

12. Which quick key would you press to change from Air to N2O as a balance gas?
a. Mode
b. System Setup
c. Start Case
d. Gas Setup

13. Which menu would you use to change a waveform field from airway pressure to flow?
a. Start Case
b. Gas Setup
c. Screen Setup
d. Scales

14. Which option provides a split screen view that shows the approximate minimum O2 flow to
maintain a preset FiO2 value and also shows the approximate agent used per hour?
a. ecoFLOW
b. Alternate O2 Control
c. EZchange
d. Fresh Gas Controls

13.6
 Aisys CS2 13 Clinical Training Documents

15. To stop the audible tone of an active alarm for 120 seconds, you would press which
function key?
a. Alarm Setup
b. System Setup
c. Procedures
d. Audio Pause

16. Which function key would you press to turn off the MV/TV alarm?
a. Alarm Setup
b. System Setup
c. Procedures
d. Audio Pause

17. In this mode of ventilation, a tidal volume is set and the ventilator will adjust the inspiratory
pressure needed to deliver the set tidal volume breath-by-breath so that the lowest pres-
sure is used.
a. Pressure control
b. Synchronized intermittent mandatory ventilation with volume control
c. Synchronized intermittent mandatory ventilation with pressure control ventilation
d. Pressure control ventilation with volume guaranteed

18. With this procedure, a pressure breath is delivered for a set time, which provides a simple
way to deliver one pressure breathing during mechanical ventilation without making
multiple ventilator settings changes.
a. Pause Gas Flow
b. Cardiac Bypass
c. Vital Capacity
d. Cycling

19. How often should a full test checkout be performed?

a. At least once within every 24-hour period
b. Once a week
c. Once a month

13 Clinical Training
d. Every six months

Documents
20. If a condenser is in use, how often should it be drained?
a. Every six months
b. Once a month
c. Once a week
d. Daily

13.7
Aisys CS2 Participant Guide

Clinical Training Quiz Answer Sheet

1. Which display component is used to select/change a menu item or to confirm a setting?
b. ComWheel

2. Which feature of the system activates automatically in the case of certain failures or er-
rors and can also be activated manually?
a. Alternate O2 Control

3. Which type of scavenge system uses a visual indicator bag?

c. Active adjustable flow

4. What is the maximum number of waveform fields that can be shown on the normal
screen view?
c. 3

5. How many vaporizers can be turned on and operating at the same time?
a. 1

6. Which component of the system would you use to change from manual ventilation mode
to mechanical ventilation mode?
d. Bag/Vent switch

7. Patient gas moves from the rebreathing bag to the breathing system through which
component?
a. Bag hose

8. What does the EZchange mode enable you to do?

d. Seal the breathing system when changing absorber canisters

9. How often should the flow sensors be calibrated?

a. Every day

10. Which menu is used to set the case default, enter patient age and ideal weight and start
the gas flow?
d. Start Case

11. Which quick key would you press to change from Volume Control Ventilation to Pressure
Control Ventilation?
a. Mode

12. Which quick key would you press to change from Air to N2O as a balance gas?
d. Gas Setup

13. Which menu would you use to change a waveform field from airway pressure to flow?
c. Screen Setup

14. Which option provides a split screen view that shows the approximate minimum O2 flow to
maintain a preset FiO2 value and also shows the approximate agent used per hour?
a. ecoFLOW

13.8
 Aisys CS2 13 Clinical Training Documents

15. To stop the audible tone of an active alarm for 120 seconds, you would press which
function key?
d. Audio Pause

16. Which function key would you press to turn off the MV/TV alarm?
a. Alarm Setup

17. In this mode of ventilation, a tidal volume is set and the ventilator will adjust the inspiratory
pressure needed to deliver the set tidal volume breath-by-breath so that the lowest
pressure is used.
d. Pressure control ventilation with volume guaranteed

18. With this procedure, a pressure breath is delivered for a set time, which provides a simple
way to deliver one pressure breathing during mechanical ventilation without making
multiple ventilator settings changes.
c. Vital Capacity

19. How often should a full test checkout be performed?

a. At least once within every 24-hour period

20. If a condenser is in use, how often should it be drained?

d. Daily

13 Clinical Training
Documents

13.9
 Aisys CS2 14 Non-clinical Training Documents

14 Non-clinical Training Documents

Aisys CS2 Non-clinical Training Checklist
The following topics will be presented.

The purpose of this document is to verify that the following items are covered during your
Aisys CS2 training. You should be prepared to operate the Aisys CS2 by the end of the training
time. If you still believe that you are not prepared, please talk to your trainer or your manager.
Please refer to the Aisys CS2 User’s Reference Manuals for complete instructions on the opera-
tion of the Aisys CS2.

Introduction to the Aisys CS2

Place a check mark next to topics discussed.

 Overview
• System and display components
• System power and battery back-up power
• O2 information sources
• O2 flush
• Scavenging

 Screen Navigation
• Positioning the display
• Identifying display areas and touch points
• Using Menus, the ComWheel and Quick Keys

 Vaporization
• Filling the Aladin2 cassettes
• Removing and replacing the Aladin2 cassettes

 Advanced Breathing System

• Bag/Vent switch
• APL valve
Training Documents

• Changing CO2 absorber canister

14 Non-clinical

• Draining condenser
• Zeroing flow sensors and preventing moisture buildup

Continued
14.1
Aisys CS2 Participant Guide

Non-clinical Training Checklist Continued

 Operation
• Start and End Case procedures

 System Checkout
• Checkout menu
• Complete full test

 Maintenance and troubleshooting

 Hands-on exercises
 Clinical skills checklist - see attached
 Training quiz
 Evaluation

14.2
 Aisys CS2 14 Non-clinical Training Documents

Aisys CS2 Non-clinical Skills Checklist

To help ensure safe operation of the Aisys CS2, you must be able to perform the
following functions:

Place a checkmark next to topics completed.

 Calibrate (remove and replace) the flow sensor module.

 Remove and replace the CO2 absorber canister.
 Adjust the scavenging.
 Bypass the machine check out and start an emergency case.
 Perform a complete electronic machine check.
• Full test
• Circuit leak
• Low-pressure leak
 Start a case from the machine in Standby.
 Change gases between air and nitrous oxide.
 Fill and change a an Aladin2 cassette.
 End a case to stop gas flow and end the patient alarms.
 Remove and replace the D-fend and attached gas sample line.
 Manually activate the alternate O2 source and regulate O2 flow (the procedure used during
an emergency or failure).

 Turn suction on to maximum, and then change to regulated suction and adjust suction
pressure.

 I have been trained and am able to complete all of the above named skills.

Training Documents
14 Non-clinical

Print Name: Date:

Signature:

14.3
 Aisys CS2 14 Non-clinical Training Documents

Aisys CS2 Non-clinical Training Quiz

After completion of the test, compare your answers to the answer key. Ask the instructor
to explain any answers you do not understand.
Circle the correct answer.
1. Which display component is used to select/change a menu item or to confirm a setting?
a. Home Key
b. ComWheel
c. Start/End Case Key
d. Audio Pause Key

2. Which feature of the system activates automatically in the case of certain failures or
errors and can also be activated manually?
a. Alternate O2 Control
b. O2 Flush
c. Galvanic Cell
d. ACGO

3. Which type of scavenge system uses a visual indicator bag?

a. Active AGSS with flow indicator
b. Passive AGSS
c. Active adjustable flow
d. ACGO

4. How many vaporizers can be turned on and operating at the same time?
a. 1
b. 2
c. 3
d. 4

5. Which component of the system would you use to change from manual ventilation mode
to mechanical ventilation mode?
a. APL valve
b. ACGO switch
c. EZchange lever
d. Bag/Vent switch

6. Patient gas moves from the rebreathing bag to the breathing system through which com-
ponent?
a. Bag hose
b. Bag arm
c. AGSS
Training Documents
14 Non-clinical

d. Bellows assembly

7. What does the EZchange mode enable you to do?

a. Switch from VCV to PCV with one key press
b. Change from passive to active scavenging systems
c. Change power input from 120 volts to 220 volts
d. Seal the breathing system when changing absorber canisters

14.5
Aisys CS2 Participant Guide

Aisys CS2 Non-clinical Training Quiz Continued

8. How often should the flow sensors be calibrated?
a. Every day
b. Every week
c. Every month
d. Every year

9. Which menu is used to set the case default, enter patient age and ideal weight and start
the gas flow?
a. Gas Setup
b. System Setup
c. Screen Setup
d. Start Case

10. What color alarm is associated with a high priority alarm?

a. Yellow
b. Blue
c. Green
d. Red

11. To stop the audible tone of an active alarm for 120 seconds, you would press which
function key?
a. Alarm Setup
b. System Setup
c. Procedures
d. Audio Pause

12. How often should a full test checkout be performed?

a. At least once within every 24-hour period
b. Once a week
c. Once a month
d. Every six months

13. If a condenser is in use, how often should it be drained?

a. Every six months
b. Once a month
c. Once a week
d. Daily

14. Which menu would you use to stop gas flow and end the patient alarms?
a. End Case
b. System Setup
c. Procedures
d. Alarm Setup

15. At a minimum, how often should the D-Fend water trap be replaced?
a. Every two years
b. Every year
c. Every six months
d. Every two months
14.6
 Aisys CS2 14 Non-clinical Training Documents

Training Documents
14 Non-clinical

14.7
Aisys CS2 Participant Guide

Aisys CS2 Non-clinical Training Quiz Answers

1. Which display component is used to select/change a menu item or to confirm a setting?
b. ComWheel

2. Which feature of the system activates automatically in the case of certain failures or er-
rors and can also be activated manually?
a. Alternate O2 Control

3. Which type of scavenge system uses a visual indicator bag?

c. Active adjustable flow

4. How many vaporizers can be turned on and operating at the same time?
a. 1

5. Which component of the system would you use to change from manual ventilation mode
to mechanical ventilation mode?
d. Bag/Vent switch

6. Patient gas moves from the rebreathing bag to the breathing system through which
component?
a. Bag hose

7. What does the EZchange mode enable you to do?

d. Seal the breathing system when changing absorber canisters

8. How often should the flow sensors be calibrated?

a. Every day

9. Which menu is used to set the case default, enter patient age and ideal weight and start
the gas flow?
d. Start Case

10. What color alarm is associated with a high priority alarm?

d. Red

11. To stop the audible tone of an active alarm for 120 seconds, you would press which func-
tion key?
d. Audio Pause

12. How often should a full test checkout be performed?

a. At least once within every 24-hour period

13. If a condenser is in use, how often should it be drained?

d. Daily

14. Which menu would you use to stop gas flow and end the patient alarms?
a. End Case

15. At a minimum, how often should the D-Fend water trap be replaced?
d. Every two months
14.8
 Aisys CS2 15 Course Evaluation

Course Evaluation

15 Course Evaluation
10
Aisys CS2
Course Name: Date:
Location: Instructor:

Please complete the following survey. The information you provide will help us to improve the course for
future learners.
Rate the training by circling the appropriate number.

Instructor Delivery 10 = Strongly agree 1 = Strongly disagree NA = Not applicable

The instructor was knowledgeable about the course content. 10 9 8 7 6 5 4 3 2 1 NA
The instructor was able to transfer their knowledge to you. 10 9 8 7 6 5 4 3 2 1 NA
The instructor was prepared for the training session. 10 9 8 7 6 5 4 3 2 1 NA
The instructor was able to effectively present content and re-
10 9 8 7 6 5 4 3 2 1 NA
spond to questions.

Rate the overall effectiveness of the instructor. 10 9 8 7 6 5 4 3 2 1 NA

Comments about instructor delivery:

Course Content 10 = Strongly agree 1 = Strongly disagree NA = Not applicable

The relevance of the course content enables you to do your job. 10 9 8 7 6 5 4 3 2 1 NA
The content covered the topics adequately and clearly. 10 9 8 7 6 5 4 3 2 1 NA
The activities/exercises helped you to learn the content presented. 10 9 8 7 6 5 4 3 2 1 NA

The content was easy to follow. 10 9 8 7 6 5 4 3 2 1 NA

The knowledge checks and/or assessments in this course were ef-

fective in helping you to validate your existing or acquired knowl- 10 9 8 7 6 5 4 3 2 1 NA
edge.

Rate the overall effectiveness of the course content.

Comments about course content:

Course Experience 10 = Strongly agree 1 = Strongly disagree NA = Not applicable

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15.1
Aisys CS2 Participant Guide

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15.2
© 2014 General Electric Company – All rights reserved.
GE and GE Monogram are trademarks of General Electric Company.

General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the product
described at any time without notice or obligation.

Aisys CS2, Advanced Breathing System, ComWheel, D-fend, ecoFlow, EZchange, Disposable Multi Absorber, Reusable Multi Absorber,
PSVPro, and SmartVent are registered trademarks of Datex-Ohmeda, Inc. Other brand names or product names used in this participant
guide are trademarks or registered trademarks of their respective holders.

GE Medical Systems Information Technology, a General Electric company, doing business as GE Healthcare.

The materials contained in this document are intended for educational purposes only. This document does not establish specifications,
operating procedures or maintenance methods for any of the products referenced. Always refer to the official written materials (labeling)
provided with the product for specifications, operating procedures and maintenance requirements.

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other parties expressly licensed by GE Healthcare. Unlicensed use is strictly prohibited.

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by driving critical breakthroughs in biology and technology.
Our expertise in medical imaging and information technologies,
medical diagnostics, patient monitoring systems, drug discovery,
and biopharmaceutical manufacturing technologies is enabling
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to predict, diagnose and treat disease earlier. We call this model
of care “Early Health.” The goal: to help clinicians detect disease
earlier, access more information and intervene earlier with more
targeted treatments, so they can help their patients live their lives
to the fullest. Re-think, Re-discover, Re-invent, Re-imagine.

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www.gehealthcare.com

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