SedanaMedical AnaConDa Mode D'emploi page 5

EN Instructions for Use
When a main stream gas monitor is used:
- Remove the red cap on the AnaConDa
- Connect the required airway adapter between the AnaConDa and the patient. Remove the
flag from the monitor port and close the monitor port with the closure
• Connect the AnaConDa between the endotracheal tube and the Y-piece of the ventilator
breathing circuits
• Position the AnaConDa as indicated in fig 1 with the gas monitor sampling port directed
towards the patient
• Position the AnaConDa patient side connector lower than the machine side (as per angle in
fig 1) to avoid accumulation of condensate and with black face uppermost
• Set the gas monitor for the anaesthetic agent used
• Wait for the calibration of the gas monitor to be performed
• Set appropriate alarm limits on the gas monitor
• Connect the agent supply line of the AnaConDa to the syringe and ensure it is secure
6. OPERATING
6.1 Priming the agent line
• Administer a bolus of 1,5 ml (1,5 ml when initially connecting AnaConDa, 1,2 ml when
changing / replacing already connected AnaConDa)
• Stop the syringe pump and wait until the gas monitor displays a CO
• Set the clinical dosage
• Start the syringe pump (check point 6.2 below)
Alternative method:
• If the bolus function on the syringe pump has been programmed to give 0,3 – 0,5 ml then
press the bolus knob the number of times required to give 1,5 ml (1,5 ml when initially
connecting AnaConDa or 1,2 ml when replacing an already connected AnaConDa)
• Stop the syringe pump and wait until the gas monitor displays a CO
• Set the clinical dosage
• Start the syringe pump (check 6.2 below)
6.2 Dosing the Anaesthetic agent
All dosing is individual and guided by experienced clinical evaluation and reading of the
Fet value on the gas monitor. There is a higher patient uptake of the volatile during the first
10-30 minutes (Induction Phase) of administration and therefore corrections of the pump rate
need to be made according to the measured end tidal concentration (Fet) and the clinical needs
of the patient. Isoflurane is approximately twice as potent as sevoflurane.
The following rates are typical for the initial syringe pump rate of Isoflurane and Sevoflurane
- Isoflurane: 3 ml/h - Sevoflurane: 5 ml/h
The syringe pump rate necessary to reach a certain patient concentration depends on the
minute volume and the targeted patent concentration.
Volatile Agent Expected Pump Rates
Isoflurane 2 – 7 ml/hr
Sevoflurane 4 – 10 ml/hr
If a rapid increase of the concentration is deemed necessary, a bolus of 0.3 ml liquid agent may
be given.
At higher Fet values and/or high tidal volumes and / or high respiratory rates, the AnaConDa is
less efficient. Therefore relatively more anaesthetic, and thus a higher pump rate is needed to
keep the concentration stable.
6.3 Changing concentration
Any change in concentration must be titrated to the desired Fet value by changing the pump
rate and closely monitoring the Fet value on the gas monitor. The Fet value should be verified
following any change to the ventilator parameters.
If there is a clinical need for decreasing the Fet concentration quickly then remove the
AnaConDa from the patient. Always verify any new concentration on the gas monitor.
6.4 Ending the Therapy
Immediate Cessation
1. Stop the syringe pump. The concentration will decrease rapidly
2. Disconnect the agent supply line from the AnaConDa Syringe
3. Seal the syringe with the syringe closure
4. Disconnect the gas monitor from the AnaConDa. Close the gas monitor port with the gas
sampling port closure
5. Remove the AnaConDa from the patient. Disconnect from the Y-piece first
6. Consider replacing the AnaConDa with a Bacterial-/Viral filter with heat and moisture
exchanger
7. Close the AnaConDa (Ventilator side) connector with the red sealing cap and dispose of it
according to hospital protocol
Short Weaning Process
1. Stop the syringe pump and leave the AnaConDa in place
2. The concentration will gradually decrease
3. As the Fet value approaches 0% follow the above steps (1-7) under 'Immediate Cessation'
Prolonged Weaning
1. In the case of prolonged weaning reduce the pump rate in steps over several hours
2. The concentration will decrease
3. When it has reached a concentration level of almost 0% Fet value, follow the above steps (1-7)
under 'Immediate Cessation'
6.5 Changing the AnaConDa
• Prepare a new AnaConDa, and a new filled syringe if needed (as per 5.1)
• Stop the syringe pump.
• Disconnect the agent supply line from the AnaConDa syringe and close the syringe with the
syringe closure cap.
• Disconnect the gas monitor line from the AnaConDa, and close the gas sampling port with the
gas sampling port closure.
• Take out the used AnaConDa. Disconnect from the Y-piece first
• Connect the gas sampling line
• Insert the new AnaConDa by connecting to the ET-tube first and then the Y-piece
• Connect the agent line to the syringe in the syringe pump
• Prime the agent line as in 6.1 with 1,2 ml
• Start the syringe pump with the same rate as before
• Check the Fet value
6.6 Changing the AnaConDa Syringe
• Stop the syringe pump
• Disconnect the agent supply line from the syringe and close the syringe with the syringe
closure cap
• Remove the empty syringe from the syringe pump
• Place the new AnaConDa Syringe in the syringe pump. For filling see 4.1.
• Connect the agent supply line to the syringe
• Start the syringe pump with the same rate as before
• Do not prime the agent line unless the AnaConDa has been replaced by a new one also
• Check the Fet value
For further instructions, practice videos and much more, please visit www.sedanamedical.com
AnaConDa (Anaesthetic Conserving Device) –
Administration system for anaesthetic agents
7. CONNECTING A NEBULISER TO THE ANACONDA SYSTEM
It is possible to use a jet nebuliser or ultrasonic nebuliser with the AnaConDa system. The
nebuliser should be connected between the patient intubation tube and the AnaConDa.
Ultrasonic nebulisers are preferable as they do not add extra airflow. If a jet nebuliser is
connected it may be necessary to increase the syringe pump rate, to compensate for the extra
flow from the nebuliser. When connecting a nebulizer set the ventilator on stand-by or hold an
expiratory pause on the ventilator.
WARNING! Repeated nebulisations may increase the flow resistance of the AnaConDa.
Pay attention to signs of occlusions.
NOTE! Always consider the increased dead space when connecting extra items.
8. SUCTIONING
• Using a closed suction system or using a swivel connector with suction port is preferable
• Hold pause on the ventilator if disconnecting AnaConDa from the ET-tube during the
procedure. When disconnecting, remove the AnaConDa from the Y-piece first and when
attaching, attach the AnaConDa to the ET-tube first
CAUTION! It is important to be aware that Polycarbonate based components if used in
the patient breathing circuit may become degraded or undergo stress cracking in the
value
2
presence of the anaesthetic gasses Isoflurane or Sevoflurane.
9. DISPOSAL
Dispose of the AnaConDa and the sealed syringe according to hospital protocols.
10. TECHNICAL INFORMATION
value
2
TECHNICAL SPECIFICATION
Anaesthetic Agents
Syringe
Stability of filled syringes
Tidal volume working range
Dead space
Resistance to gas flow at 60 l/min
Moisture loss
Resulting Fet Values
0,2 – 0,7% Filter capacity:
0,5 – 1,4%
Weight
Agent Line Length
Connectors (According to ISO 5356)
Gas Sampling Port
For further information regarding policies or procedures relating to the AnaConDa the user
should refer to Technical Handbook or contact Sedana Medical AB.
Sedana Medical Ltd., Unit 2A The Village Centre,
Two Mile House, Naas, Co. Kildare, W91 PWH5, Ireland
100 ML
Only use room temperature isoflurane or
sevoflurane (Room Temp 18°-25° Celsius)
Only use the AnaConDa syringe REF 26022
5 days
350 ml - 1200 ml
Approx. 100 ml
2.5 cm H O (250 pa)
2
5 mg/l (@ 0.75L x
12 bpm)
7 mg/l (@ 1.0L x
10 bpm)
Bacterial filtration 99.999%
Viral Filtration 99.98%
50 g
2.2 m
15F/22M-15M
Female Luer Lock
3 000 020-0609/EN/ Rev.
EN
50 ML
200 ml - 800 ml
Approx. 50 ml
3.0 cm H O (300 pa)
2
5 mg/l (@ 0.5L x
15 bpm)
6 mg/l (@ 0.75L x
15 bpm)
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