Mindray A5 Service Manual

Selectatec® is a registered trademark of Ohmeda. Copyright © Mindray DS USA, Inc., 2010. All rights reserved. Contents of this publication may not be reproduced in any form without permission of Mindray DS USA, Inc.

Warnings, Cautions and Notes...............................................................................................1-1 Warnings................................................................................................................................1-1 Cautions.................................................................................................................................1-2 Notes......................................................................................................................................1-3 1 Theory of Operation .........................................................................................................1-4 1.1 Introduction......................................................................................................................1-4 1.2 Electrical and Pneumatic Connections.............................................................................1-6 1.2.1 Electrical Connections (A3)................................................................................1-6 1.2.2 Electrical Connections (A5)................................................................................1-8 1.2.3 Pneumatic Connection (A3)..............................................................................1-10 1.2.4 Pneumatic Connection (A5)..............................................................................1-13 1.2.5 Connections Between Pneumatic Circuit, Breathing System and Ventilator Control Board ...................................................................................................................................1-16 1.3 Gas Flow........................................................................................................................1-18 1.3.1 Pneumatic Circuit Diagram...............................................................................1-18 1.3.2 Parts List ...........................................................................................................1-18 1.3.3 Key to Symbols.................................................................................................1-20 1.3.4 Description........................................................................................................1-20 1.4 Anesthesia System Components ....................................................................................1-34 1.4.1 Auxiliary Outlets...............................................................................................1-34 1.4.2 Work Light Board .............................................................................................1-34 1.5 The Breathing System....................................................................................................1-35 1.5.1 Brief Introduction .............................................................................................1-35 1.5.2 Automatic Mode, Inspiration ............................................................................1-36 1.5.3 Automatic Mode, Expiration.............................................................................1-37 1.5.4 Manual Mode, Inspiration.................................................................................1-38 1.5.5 Manual Mode, Expiration.................................................................................1-39 1.5.6 Pneumatic PEEP ...............................................................................................1-39 1.5.7 Ventilator in Standby.........................................................................................1-39 1.5.8 Breathing System Components.........................................................................1-40 1.6 Ventilator UI ..................................................................................................................1-41 1.6.1 Display..............................................................................................................1-41 1.6.2 CPU Board........................................................................................................1-46 1.7 Ventilator Control and Drive..........................................................................................1-48 1.7.1 Mother Board....................................................................................................1-48 1.7.2 Ventilator Control and Drive Board..................................................................1-57 1.7.3 Battery...............................................................................................................1-64 1.7.4 Breathing System Heater ..................................................................................1-65 1.8 Ventilator Pneumatic- O2 Drive Gas .............................................................................1-65 1.8.1 Ventilator Pneumatic Drive...............................................................................1-65 1.8.2 Drive Pressure-High Pressure Regulator (200 kPa, 29 psi) ..............................1-65 1.8.3 Drive Gas Assembly .........................................................................................1-65 1.8.4 Tube Color Coding............................................................................................1-65 2 Installation Guide .............................................................................................................2-1 2.1 Preparation – Additional Material Required....................................................................2-1 2.2 Assembly..........................................................................................................................2-1 2.2.1 Unpacking and Setup..........................................................................................2-1 2.2.2 Breathing System and Breathing System Accessories and Checkout Procedures2-13 2.2.3 AGSS Connections ...........................................................................................2-13 2.2.4 Vaporizers .........................................................................................................2-14

2.2.6 Breathing Circuit, CO2 Absorbent and Liquid Vaporizer Agent.......................2-16 2.2.7 Monitoring Products Mounting and Electrical Connection (if available).........2-16 2.2.8 Agent Monitor Waste Gas Scavenging..............................................................2-16 2.3 Functional Tests .............................................................................................................2-17 2.3.1 Gas Delivery System Tests ...............................................................................2-17 2.3.2 Breathing System Leak Test .............................................................................2-17 2.3.3 O2 Sensor Calibration.......................................................................................2-23 2.4 Pneumatic Leak Tests.....................................................................................................2-39 2.4.1 N2O Cylinder Leak Test ...................................................................................2-39 2.4.2 O2 Cylinder Leak Test......................................................................................2-39 2.4.3 AIR Cylinder Leak Test ....................................................................................2-39 2.4.4 N2O Line Pressure Leak Test ...........................................................................2-40 2.4.5 O2 Line Pressure Leak Test ..............................................................................2-40 2.4.6 AIR Line Pressure Leak Test.............................................................................2-40 2.5 Breathing System Checks ..............................................................................................2-41 2.5.1 Waste Gas Scavenger Test (if available)...........................................................2-41 2.5.2 Internal Gas Connections Test ..........................................................................2-41 2.5.3 Drive Gas Pressure Loss Alarm, N2O Cutoff Test............................................2-41 2.6 Performance Verification ...............................................................................................2-41 2.6.1 Standby Mode Ventilation Test .........................................................................2-41 2.6.2 Manual Mode Ventilation Test..........................................................................2-42 2.6.3 APNEA Alarm Test...........................................................................................2-42 2.6.4 Alarm Silence Test ............................................................................................2-42 2.6.5 VCV Adult Ventilation Mode Test....................................................................2-43 2.6.6 VCV Child Ventilation Mode Test....................................................................2-44 2.6.7 Airway Disconnect Alarm Test .........................................................................2-44 2.6.8 PCV Adult Ventilation Mode Test.....................................................................2-44 2.6.9 Pressure Support (PS) Ventilation Mode Test...................................................2-45 2.7 Alarms and Fail safe Functions......................................................................................2-46 2.7.1 Set Up ...............................................................................................................2-46 2.7.2 Low FiO2 Alarm Test .......................................................................................2-46 2.7.3 High FiO2 Alarm Test.......................................................................................2-46 2.7.4 Peak Pressure Alarms Test ................................................................................2-47 2.7.5 Minute Volume Alarm Test ...............................................................................2-47 2.8 Miscellaneous Tests .......................................................................................................2-48 2.8.1 Test the Line Voltage Alarm..............................................................................2-48 2.8.2 Top Light and Auxiliary Light Test...................................................................2-48 2.8.3 Anesthesia System Installation Checklist .........................................................2-48 2.9 Vaporizer Interlock Test.................................................................................................2-48 2.10 Vaporizer Accuracy Test ..............................................................................................2-49 2.11 Electrical Tests .............................................................................................................2-50 2.11.1 Auxiliary AC Outlets Test ...............................................................................2-50 2.11.2 Electrical Safety Inspection Test.....................................................................2-50 3 Periodic Maintenance.......................................................................................................3-1 3.1 Maintenance Schedule .....................................................................................................3-1 3.2 Periodical Maintenance Consumable Parts Kits ..............................................................3-1 3.3 Periodical Maintenance Schedule....................................................................................3-1 3.4 Visual Inspection Checklist..............................................................................................3-1 3.5 List of Parts inside the Periodical Maintenance Consumable Parts Kits .........................3-1 3.6 Battery Maintenance and Replacement............................................................................3-7 3.7 Functional Tests ...............................................................................................................3-8 3.7.1 Gas Delivery System Tests .................................................................................3-8 3.7.2 Breathing System Leak Test ...............................................................................3-9 3.7.3 Check the Sensor Zero Point.............................................................................3-16 3.7.4 Check the Flow Sensor Accuracy .....................................................................3-19

3.8 Pneumatic Leak Tests.....................................................................................................3-26 3.8.1 N2O Cylinder Leak Test ...................................................................................3-26 3.8.2 O2 Cylinder Leak Test......................................................................................3-26 3.8.3 AIR Cylinder Leak Test ....................................................................................3-26 3.8.4 N2O Line Pressure Leak Test ...........................................................................3-26 3.8.5 O2 Line Pressure Leak Test ..............................................................................3-26 3.8.6 AIR Line Pressure Leak Test.............................................................................3-27 3.9 Breathing System Checks ..............................................................................................3-27 3.9.1 Waste Gas Scavenger Test (if available)...........................................................3-27 3.9.2 Internal Gas Connections Test ..........................................................................3-27 3.9.3 Drive Gas Pressure Loss Alarm, N2O Cutoff Test............................................3-28 3.10 Performance Verification .............................................................................................3-28 3.10.1 Standby Mode Ventilation Test .......................................................................3-28 3.10.2 Manual Mode Ventilation Test........................................................................3-28 3.10.3 APNEA Alarm Test.........................................................................................3-28 3.10.4 Alarm Silence Test ..........................................................................................3-29 3.10.5 VCV Adult Ventilation Mode Test..................................................................3-29 3.10.6 VCV Child Ventilation Mode Test..................................................................3-30 3.10.7 Airway Disconnect Alarm Test .......................................................................3-30 3.10.8 PCV Adult Ventilation Mode Test...................................................................3-31 3.10.9 Pressure Support (PS) Ventilation Mode Test.................................................3-31 3.11 Alarms and Fail safe Functions....................................................................................3-32 3.11.1 Set Up..............................................................................................................3-32 3.11.2 Low FiO2 Alarm Test......................................................................................3-32 3.11.3 High FiO2 Alarm Test.....................................................................................3-32 3.11.4 Peak Pressure Alarms Test ..............................................................................3-33 3.11.5 Minute Volume Alarm Test .............................................................................3-33 3.12 Miscellaneous Tests .....................................................................................................3-33 3.12.1 Test the Line Voltage Alarm............................................................................3-33 3.12.2 Top Light and Auxiliary Light Test.................................................................3-33 3.12.3 Auxiliary AC Outlets Test...............................................................................3-34 3.12.4 Anesthesia System Installation Checklist .......................................................3-34 3.13 Vaporizer Interlock Test...............................................................................................3-34 3.14 Vaporizer Accuracy Test ..............................................................................................3-34 3.15 Electrical Tests.............................................................................................................3-35 3.15.1 Convenience AC Outlets Test .........................................................................3-35 3.15.2 Electrical Safety Inspection Test.....................................................................3-35 4 Calibration.......................................................................................................................4-37 4.1 Introduction....................................................................................................................4-37 4.2 Calibration Warnings, Precautions, and Notes...............................................................4-37 4.3 System Calibration.........................................................................................................4-38 4.3.1 Flow Calibration (user).....................................................................................4-39 4.3.2 Flow Calibration (Service)................................................................................4-44 4.3.3 Pressure Calibration (Service) ..........................................................................4-62 4.3.4 Pressure and Flow Zeroing (Service)................................................................4-75 4.3.5 Electronic Flowmeter Zeroing (user)................................................................4-77 4.3.6 O2 Sensor Calibration.......................................................................................4-80 4.3.7 ORC Calibration ...............................................................................................4-89 4.3.8 Cylinder Yoke Regulator Calibration................................................................4-96 5 Repair and Troubleshooting.............................................................................................5-1 5.1 Troubleshooting Guidelines.............................................................................................5-1 5.1.1 Identify the problem............................................................................................5-1 5.1.2 Avoid shorting component leads together...........................................................5-1 5.1.3 Use the proper equipment ...................................................................................5-1

5.2 Technical Alarms Check ..................................................................................................5-1 5.2.1 Startup Alarm Messages......................................................................................5-2 5.2.2 CPU Board Runtime Alarm ................................................................................5-6 5.2.3 Power Board Runtime Alarm..............................................................................5-6 5.2.4 Fresh Flow Sensor Board Alarm.........................................................................5-8 5.2.5 Ventilator Control Board Runtime Alarm .........................................................5-10 5.3 Pneumatic Circuit System Problems..............................................................................5-13 5.3.1 Tools for on-site Maintenance...........................................................................5-13 5.3.2 Gas Supplies and Drive Gas .............................................................................5-27 5.3.3 Anesthetic Gas Delivery System.......................................................................5-37 5.3.4 Breathing System..............................................................................................5-51 5.3.5 Tidal Volume.....................................................................................................5-66 5.4 Sensors and Valves Problems.........................................................................................5-68 5.4.1 Correspondence with Pneumatic Circuit Components .....................................5-68 5.4.2 Correspondence with Hardware Components...................................................5-69 5.4.3 Preparations before Using Diagnostic Tests......................................................5-69 5.4.4 Zero Points of Flow & Pressure Sensors Problems ..........................................5-69 5.4.5 Connections and Measurement of the Flow Sensors Problems ........................5-70 5.4.6 Connections and Measurement of the Pressure Sensors Problems...................5-70 5.4.7 Opening State of the Inspiratory Valve Problems .............................................5-72 5.4.8 Opening States of the PEEP Safety Valve Problems.........................................5-72 5.4.9 Opening State of the PEEP Valve Problems .....................................................5-73 5.5 Hardware and Electrical Problems.................................................................................5-73 5.6 Software Update and Software Configuration Activation .............................................5-76 6 Repair and Disassembly ...................................................................................................6-1 6.1 Prepare for Disassembly ..................................................................................................6-1 6.1.1 Tools....................................................................................................................6-1 6.1.2 Preparations ........................................................................................................6-1 6.1.3 Bleed Gas Pressure .............................................................................................6-2 6.2 Disassemble the Assemblies ............................................................................................6-2 6.2.1 Disassemble the Internal Assemblies of the Machine Upper Half......................6-2 6.2.2 Disassemble Hardware Box................................................................................6-8 6.2.3 Disassemble the Work Surface..........................................................................6-15 6.2.4 Disassemble the Display...................................................................................6-22 6.2.5 Remove the Panel of Pressure Gauges..............................................................6-28 6.2.6 Remove the Auxiliary Gas Outlet Assembly ....................................................6-31 6.2.7 Remove the Rotating Block of Breathing Circle ..............................................6-31 6.2.8 Remove the AGSS Assembly............................................................................6-32 6.2.9 Disassemble the Base Assembly.......................................................................6-32 6.3 Disassemble the Breathing System................................................................................6-34 6.3.1 Remove the O2 Sensor and Cable.....................................................................6-34 6.3.2 Remove the Breathing Tubes............................................................................6-35 6.3.3 Remove the Flow Sensor ..................................................................................6-36 6.3.4 Remove the Manual Bag...................................................................................6-37 6.3.5 Remove the Absorbent Canister........................................................................6-37 6.3.6 Remove the CO2 Bypass Assembly..................................................................6-38 6.3.7 Remove the drain valve ....................................................................................6-38 6.3.8 Remove the Bypass Valve And the Trigger Board............................................6-39 6.3.9 Remove the Patient Circle Assembly................................................................6-41 6.3.10 Remove the Bellows Assembly ......................................................................6-41 6.3.11 Remove the Pop-off Valve Assembly..............................................................6-42 6.3.12 Disassemble the Expiratory/Inspiratory Check Valve Assemblies..................6-43 6.3.13 Remove the Water Collection Cup..................................................................6-43 6.3.14 Remove the Airway Pressure Gauge...............................................................6-44 6.3.15 Remove the Bag Arm......................................................................................6-44

6.3.17 Remove the Front Upper Cover, Median Plate and Front Lower Cover Assemblies 6-46 6.3.18 Disassemble the Automatic/Manual Ventilation Switch Assembly ................6-48 6.3.19 Remove the APL Valve Assembly ..................................................................6-50 7 Replacement Parts............................................................................................................7-1 7.1 Introduction......................................................................................................................7-1 7.2 Ordering Replaceable Parts..............................................................................................7-1 7.3 Diagrams and Tables........................................................................................................7-2 7.3.1 A5/A3 Structure ..................................................................................................7-2 7.3.2 A5/A3 Upper Half...............................................................................................7-4 7.3.3 A5/A3 Hardware Box ........................................................................................7-5 7.3.4 A5/A3 Work Surface...........................................................................................7-6 7.3.5 A5/A3 Patient Circuit Main Body.......................................................................7-7 7.3.6 A5/A3 Pre-pak Absorber Canister Assembly......................................................7-8 7.3.7 A5/A3 Valve assembly........................................................................................7-9 7.3.8 A5/A3 O2 Cable Assembly...............................................................................7-10 7.3.9 A5/A3 Display Assembly..................................................................................7-11 7.3.10 A5/A3 Display Assembly Main Body.............................................................7-12 7.3.11 A5/A3 Vaporizer Mounting Minifold..............................................................7-13 7.3.12 A5/A3 Auxiliary Gas Outlet Assembly...........................................................7-14 7.3.13 Base Assembly (A5) .......................................................................................7-15 7.3.14 Other ...............................................................................................................7-16 7.3.15 Tubes (A5/A3) ................................................................................................7-17 7.3.16 O-rings (A5/A3)..............................................................................................7-18 7.3.17 Yellow Number Rings (A5/A3) ......................................................................7-19 8 Warranty............................................................................................................................8-1 8.1 Warranty Statements ........................................................................................................8-1 8.2 Disclaimers ......................................................................................................................8-2 8.3 Manufacturer’s Responsibility.........................................................................................8-2 8.4 Phone Numbers and How to Get Assistance....................................................................8-2

repair and calibration procedures. Warnings, Cautions, and Notes Warnings, Cautions and Notes Please read and adhere to all warnings, cautions, and notes listed here and in the appropriate areas throughout this manual. A WARNING is provided to alert the user to potential serious outcomes (death, injury, or serious adverse events) to the patient or the user. A CAUTION is provided to alert the user to use special care necessary for the safe and effective use of the device. They may include actions to be taken to avoid effects on patients or users that may not be potentially life threatening or result in serious injury, but about which the user should be aware. Cautions are also provided to alert the user to adverse effects on this device of use or misuse and the care necessary to avoid such effects. A NOTE is provided when additional general information is applicable. Warnings WARNING: Whenever using anesthetic gases, nitrous oxide, oxygen, or any hospital gas, always follow the appropriate agent evacuation/collection procedures. Use the hospital gas evacuation system. WARNING: Use only an approved lubricant on any O-ring in contact with oxygen. Krytox® is the recommended oxygen service lubricant. WARNING: For continued protection against fire hazard, replace all fuses with the specified type and rating. WARNING: In order to prevent an electric shock, the machine (protection class I) may only be connected to a correctly grounded mains connection (socket outlet with grounding contact). WARNING: Remove all accessory equipment from the shelf before moving the anesthesia machine over bumps or on any inclined surface. Heavy top loading can cause the machine to tip over causing injury. WARNING: Possible explosion hazard. Do not operate machine near flammable anesthetic agents or other flammable substances. Do not use flammable anesthetic agents (e.g., ether or cyclopropane.) WARNING: The use of anti-static or electrically conductive respiration tubes, when utilizing high frequency electric surgery equipment, may cause burns and is therefore not recommended in any application of this machine. WARNING: Possible electric shock hazard. The machine may only be opened by authorized service personnel. WARNING: Compressed gasses are considered Dangerous Goods/Hazardous Materials per I.A.T.A (International Air Transport Association). and D.O.T. (Department Of Transport) regulations. It is a violation of federal and international law to transport dangerous goods

documented according to D.O.T. and I.A.T.A. regulations. Please refer to the applicable I.A.T.A. Dangerous Goods Regulations and /or the Code of Federal Regulations 49 (Transportation, Parts 171-180) for further information. WARNING: Avoid exposure to respiratory gases by always directing the fresh gas flow from the fresh gas outlet to the waste gas scavenger. Cautions CAUTION: This device uses high pressure compressed gas. When attaching or disconnecting backup gas cylinders, always turn the cylinder valves slowly. Use the A5/A3 flow meters to bleed down the pressure, watching the cylinder gauge indicate the depleting cylinder pressure, before disconnecting the cylinder from the yoke. Always open and close cylinder valves fully. CAUTION: This device operates using compressed gas at high pressures from the hospital central supply. When connecting gas supply lines attach the hose connection to the machine before connecting the quick disconnect fitting to the hospital source. Disconnect the supply hose from the hospital source connection prior to disconnecting it from the A5/A3 gas connection fittings. CAUTION: Refer to Section 3.3 Periodical Maintenance Schedule for assistance when performing scheduled periodic maintenance. CAUTION: Do not leave gas cylinder valves open if the pipeline supply is in use and the system master switch is turned to 'ON'. If used simultaneously, cylinder supplies could be depleted, leaving an insufficient reserve supply in the event of pipeline failure. CAUTION: Use cleaning agent sparingly. Excess fluid could enter the machine, causing damage. CAUTION: This machine must only be operated by trained, skilled medical staff. CAUTION: Perform the electrical safety inspection as the last step after completing a repair or after routine maintenance. Perform this inspection with all covers, panels, and screws installed. CAUTION: After changing the CO2 absorbent, carry out a system leak test. CAUTION: Only Selectatec™ compatible vaporizers with Interlock-System may be used with the A5/A3 unit. CAUTION: After each exchange of a vaporizer, carry out a system Leak test. CAUTION: Do not clean the machine while it is on and/or plugged in. CAUTION: Pressing “cancel” at any time during the procedure will cancel the session's settings and reload the previously-stored calibration coefficients. CAUTION: Depleted sodalime changes color. Replace the sodalime if approximately 2/3 of the absorber content is discolored. CO2 absorbent can be safely changed without stopping mechanical ventilation. CAUTION: This equipment contains parts sensitive to damage by electrostatic discharge (ESD). Use ESD precautionary procedures when touching, removing, or inserting parts or assemblies.

factory or with a local authorized distributor to determine the warranty status of a particular instrument.

1.1 Introduction The A5/A3 Anesthesia System is a continuous flow inhalation gas anesthesia system that delivers anesthetic vapor, and provides for automatic and manual modes of ventilation. It is equipped with a monitoring system for ventilation, inspired, and expired gas. The A5/A3 is intended for use in operating rooms. It will be used with O2, N2O, and AIR supplied by a medical gas pipeline system or by externally mounted gas cylinders. Anesthetic agents can be delivered via vaporizers mounted on the machine. The A5 ventilator provides the following ventilation modes:  Volume Control Ventilation (VCV), which includes the Pressure Limit Ventilation (PLV) function  Pressure Control Ventilation (PCV) with/without Volume Guarantee (VG) ventilation mode  Synchronized Intermittent Mandatory Ventilation (SIMV) with VC mode  Synchronized Intermittent Mandatory Ventilation (SIMV) with PC mode  Pressure Support (PS) ventilation mode  Spontaneous ventilation in Manual mode with APL fully open  Manual ventilation through the use of a breathing bag The A3 ventilator provides the following ventilation modes:  Volume Control Ventilation (VCV), which includes the Pressure Limit Ventilation (PLV) function  Pressure Control Ventilation (PCV)  Synchronized Intermittent Mandatory Ventilation (SIMV) with VC mode  Pressure Support (PS) ventilation mode  Spontaneous ventilation in Manual mode with APL fully open  Manual ventilation through the use of a breathing bag Electronic PEEP is available in all ventilation modes. User control over inspiratory flow (Tslope) is possible in PCV, SIMV, and PS modes. Automatic fresh gas compensation limits the effect on the patient ventilation from changes in fresh gas flow rate by the operator. The traditional bellows system is driven by oxygen and makes patient disconnections clearly visible. The A5/A3 fresh gas dosing subsystem offers the ease of use and features of a traditional anesthesia system. The dual-flow tubes electronic flowmeter, which includes redundant numerical readouts, displays the O2, N2O, and Air flows at all times. A knob guard prevents inadvertent movement of the flow control knobs. Gas supply gauges and auxiliary O2/Air flowmeters with blended output indicate the gas pipeline supply pressures and gas cylinder pressures. An auxiliary O2 flowmeter is placed at a convenient location for the operator. The O2 flush button is in the traditional location near the front left corner of the table top. Safety systems within the A5/A3 work to prevent hypoxic mixtures from being delivered to the patient. Nitrous oxide will not be delivered unless oxygen pressure is present. A pneumatic safety system assures that at least 21% O2 is present when setting mixtures of O2 and N2O. The A5/A3 breathing system is heated to minimize condensation inside the breathing system block and to return humid gas to the patient. The breathing system provides easy access to the Airway Pressure Limiting (APL) valve and breathing bag, and easy viewing of the Airway Pressure gauge (PAW). The APL valve has a comfortable, single turn knob that provides a

cam lock device that is convenient to open and close. CO2 absorbent Pre-paks or loose fill can be used. A water trap that can be drained is also provided on the absorber assembly. Two flow sensors in the breathing system measure inspired and expired gases for control and monitoring. Spirometry is standard on the A5. Inspired oxygen is monitored via a fuel-cell type sensor. Breathing pressure is also monitored. The breathing system can swivel into position. A test plug, next to the two main hose connections, allows automated leak testing during startup. The Anesthesia Gas Scavenging System (AGSS) connections are at the rear of A5/A3. The A5/A3 is powered by an AC power source. In turn, the A5/A3 power management system provides DC power for its main system functions while charging its internal battery supply. In case of AC power failure, the A5/A3 operates on battery power for a minimum of 75 minutes with one (1) new battery installed (A3) or 150 minutes with two (2) new batteries installed (A5). A recessed main switch is provided to power the system ON and OFF. Four (4) auxiliary AC outlets on the A5 and three (3) auxiliary AC outlets on the A3 at the rear of the machine operate independently of the main switch position. NOTE: The breathing system heater does not operate when the A5/A3 is on battery power. NOTE: If the main switch is set to OFF, the O2 fresh gas flow will not flow.

801-0631-00109-00 B3 Mother Board 801-0631-00108-00 B4 Warning Light Board 801-0631-00019-00 B5 Indicator Light Board 801-0631-00004-00 B6 Touch Screen Control Board 801-0631-00018-00 B7 Display Interface Board 801-0631-00017-00 B8 CPU Board PCBA (A5) 801-0631-00026-00 B9-11 Ventilator Control Board 801-0631-00027-00 B12 Sensor Interface board 801-0631-00089-00 B13 Top Lighting Board 801-0631-00039-00 B14 Fresh Flow Sensor Board 801-0631-00040-00 B15 Flow Meter Lighting Board 801-0631-00002-00 P1 Filter Power 250VAC 15A Panel Mount 801-0631-00029-00 P2-4 Auxiliary Output Socket 801-0631-00032-00 P5-7 Breaker (3.0A) 801-0631-00031-00 P8 Lithium-ion Battery 022-000008-00 P9 Speaker and Connecting Cable 801-0631-00038-00 P10 Fan 801-0631-00028-00 P11 Main Body of Drive Gas Assembly 801-0631-00088-00 P12 Display Exchange Package 801-0631-00075-00 P13 Circuit Heater 801-0631-00069-00 P14 Solenoid valve assembly 801-0631-00046-00 P15 A5 Calibration set FRU 801-0631-00121-00 P16 Touch Screen 801-0631-00014-00

B3 B1 P11 B8 J9:Ethernet P1 P12 B2 P13 J8:USB P14 B9/B10/B11 J1(Mon Brd) J8（Valve Brd） J2（Valve Brd） J12(Mon Brd) (Mon Brd)J6 J7(Mon Brd) J3(Mon Brd) J2 System Switch P15 J4 J1 B14 J3 J7 J8 J9 J10 J11 P17 TFT 15" LCD B7 Inverter B4 P19 Pressure Switch1 Manual/Auto Switch Oxygen sensor CO2 Switch Circuit Switch P16 Cable to cable connection P18 P7 P3 Lin Nin Lout Nout P8 P4 Lin Nin Lout Nout P9 P5 Lin Nin Lout Nout P10 P6 Lin Nin Lout Nout J1 J3 J1 J2 J3 J1 J1 J2 J4 J5 B5 J1 #11 #11 #11 #11 #11 #11 #12 #12 #12 #13 #14 #15 #16 #23 #24 #25 B6 J4:RS-232 B12 J2 J13 P2 Lout Nout Lin Nin B13 J2 Top lighting Switch J1 J3 B15 J4（Valve Brd） #11 #11 J5(Mon Brd) J5 P20 VT PLUS PF-300 Board to board Connection Board to board Connection P21 J1 J2 Cable to cable connection Cable to cable connection Cable to cable connection Cable to cable connection Cable to cable connection Cable to cable connection Cable to cable connection Cable to cable connection Cable to cable connection Cable to cable connection #12 #12 #12 #12 #12 #12 #12 #12 #20 #20 #18 #17 #16 #16 #16 #15 #19 #22 #26 #21 #8 #8 #8 #9 #10 #26 #1 #2 #3 #4 #5 #6 B8： USB Interface J8 #7 #27 #28 #29 #30 #31 #25 #25 #25 Board to board Connection Board to board Connection Cable to cable connection O2 Source Switch

801-0631-00109-00 B3 Mother Board 801-0631-00108-00 B4 Warning Light Board 801-0631-00019-00 B5 Indicator Light Board 801-0631-00004-00 B6 Touch Screen Control Board 801-0631-00018-00 B7 Display Interface Board 801-0631-00017-00 B8 CPU Board PCBA 801-0631-00026-00 B9-11 Ventilator Control Board 801-0631-00027-00 B12 Sensor Interface board 801-0631-00089-00 B13 Top Lighting Board 801-0631-00039-00 B14 Fresh Flow Sensor Board 801-0631-00040-00 B15 Flow Meter Lighting Board 801-0631-00002-00 P1 Filter Power 250VAC 15A Panel Mount 801-0631-00029-00 P2 Breaker (10.0A) 801-0631-00030-00 P3-6 Auxiliary Output Socket 801-0631-00032-00 P7-10 Breaker (3.0A) 801-0631-00031-00 P11-12 Lithium-ion Battery 022-000008-00 P13 Speaker and Connecting Cable 801-0631-00038-00 P14 Fan 801-0631-00028-00 P15 Touchpad 801-0631-00052-00 P16 Main Body of Drive Gas Assembly 801-0631-00088-00 P17 Display Exchange Package 801-0631-00075-00 P18 Circuit Heater 801-0631-00069-00 P19 Solenoid valve assembly 801-0631-00046-00 P20 A5 calibration set FRU 801-0631-00121-00 P21 Touch Screen 801-0631-00014-00

Vaporizer Manifold M6G-020014--- 26 Back Pressure Regulator Total Flow Meter M6G-020014--- 27 N2O Flow Sensor Gas Mixer 082-000524-00 28 Air Flow Sensor Gas Mixer 082-000520-00 29 O2 Flow Sensor Gas Mixer 082-000522-00 30 Restrictor Assembly ORC Assembly 082-000524-00 31 Restrictor Assembly Air Flow Sensor 082-000520-00 32 ORC Assembly N2O Flow Sensor 082-000524-00 33 ORC Assembly Y2 082-000522-00 34 N2O Cylinder Yoke Y1 082-000662-00 35 Y1 N2O Regulator 082-000662-00 36 Air Cylinder Yoke Y1 082-000517-00 37 Y1 Air Regulator 082-000517-00 38 Y1 Y1 082-000521-00 39 O2 Pipeline Pressure Gauge O2 Pipeline Assembly 082-000523-00 40 N2O Pipeline Pressure Gauge N2O Pipeline Assembly 082-000516-00 41 Air Pipeline Pressure Gauge AIR Pipeline Assembly 082-000518-00 42 O2 Regulator Y2 082-000522-00 43 Y2 System Switch 082-000522-00 44 Y2 O2 Flush Button 082-000522-00 45 System Switch O2 Needle Valve 082-000522-00 46 Y2 ORC Assembly 082-000522-00 47 Y1 O2 Regulator 082-000521-00 48 N2O Regulator ORC Assembly 082-000524-00 49 ORC Assembly N2O Needle Valve 082-000524-00 50 Air Regulator Y2 082-000520-00 51 Y2 Air Needle Valve 082-000520-00 52 O2 Flush Button Common Gas Outlet 082-000522-00 53 Vaporizer Manifold Common Gas Outlet M6G-020014--- 54 Y1 Air Pipeline Assembly 082-000517-00 55 Exhalation Valve Assembly Gas Reservoir 082-000522-00 56 Y2 Y2 082-000522-00 57 Y2 Auxiliary O2 Assembly 082-000522-00 58 Gas Mixer Back Pressure Regulator M6G-020014--- 59 Y1 O2 Pipeline Assembly 082-000521-00 60 O2 Cylinder Yoke Y1 082-000521-00 62 Y1 N2O Pipeline Assembly 082-000662-00 63 Y1 Exhalation Valve Assembly 082-000521-00 64 Auxiliary Air Assembly Y2 082-000520-00 65 Auxiliary O2 Assembly Y2 082-000522-00 66 Y2 Auxiliary Gas Outlet M6G-020026---

082-000520-00 73 O2 Needle Valve Y2 082-000522-00 74 Y2 Y2 082-000522-00 75 O2 Poppet Valve Y2 082-000522-00 76 O2 Poppet Valve Y2 082-000522-00 77 Y2 O2 Poppet Valve 082-000522-00 78 Y2 O2 Flow Sensor 082-000522-00 79 Y1 O2 Pipeline Assembly 082-000521-00 81 Y1 Y1 082-000521-00 90 Air Needle Valve Restrictor Assembly 082-000520-00 91 N2O Needle Valve Restrictor Assembly 082-000524-00 Y1 Three-way Connector 082-000583-00 Y2 Three-way Connector 082-000582-00

O2 N2O AIR O2 N2O AIR N2O pipeline assembly O2 N2O AIR O2 N2O AIR 39 40 41 48 49 32 33 31 91 27 28 29 26 25 53 52 44 43 45 56 42 57 59 60 61 69 63 55 50 51 67 65 64 66 54 Pipeline pressure gauges Cylinder pressure gauges N2O cylinder yoke Air cylinder yoke O2 cylinder yoke AIR pipeline assembly O2 pipeline assembly ORC assembly Flow sensor Gas mixer Total flowmeter Vaporizer manifold Needle valve Common gas outlet Exhalation valve assembly Gas reservoir Auxiliary air assembly Auxiliary O2 assembly Auxiliary gas outlet Main pneumatic system tube connection diagram Back pressure regulator 58 O2 flush button System switch 36 37 38 47 Regulator assembly O2 poppet valve 46 73 74 75 76 77 78 79 81 90 30 Restrictor assembly

Vaporizer Manifold M6G-020014--- 26 Back Pressure Regulator Total Flow Meter M6G-020014--- 27 N2O Flow Sensor Gas Mixer 082-000524-00 28 Air Flow Sensor Gas Mixer 082-000520-00 29 O2 Flow Sensor Gas Mixer 082-000522-00 30 Restrictor Assembly ORC Assembly 082-000524-00 31 Restrictor Assembly Air Flow Sensor 082-000520-00 32 ORC Assembly N2O Flow Sensor 082-000524-00 33 ORC Assembly Y2 082-000522-00 34 N2O Cylinder Yoke Y1 082-000662-00 35 Y1 N2O Regulator 082-000662-00 36 Air Cylinder Yoke Y1 082-000517-00 37 Y1 Air Regulator 082-000517-00 38 Y1 Y1 082-000521-00 39 O2 Pipeline Pressure Gauge O2 Pipeline Assembly 082-000523-00 40 N2O Pipeline Pressure Gauge N2O Pipeline Assembly 082-000516-00 41 Air Pipeline Pressure Gauge AIR Pipeline Assembly 082-000518-00 42 O2 Regulator Y2 082-000522-00 43 Y2 System Switch 082-000522-00 44 Y2 O2 Flush Button 082-000522-00 45 System Switch O2 Needle Valve 082-000522-00 46 Y2 ORC Assembly 082-000522-00 47 Y1 O2 Regulator 082-000521-00 48 N2O Regulator ORC Assembly 082-000524-00 49 ORC Assembly N2O Needle Valve 082-000524-00 50 Air Regulator Y2 082-000520-00 51 Y2 Air Needle Valve 082-000520-00 52 O2 Flush Button Common Gas Outlet 082-000522-00 53 Vaporizer Manifold Common Gas Outlet M6G-020014--- 54 Y1 Air Pipeline Assembly 082-000517-00 55 Exhalation Valve Assembly Gas Reservoir 082-000522-00 56 Y2 Y2 082-000522-00 57 Y2 Auxiliary O2 Assembly 082-000522-00 58 Gas Mixer Back Pressure Regulator M6G-020014--- 59 Y1 O2 Pipeline Assembly 082-000521-00 60 O2 Cylinder Yoke Y1 082-000521-00 61 Y1 Y1 082-000521-00 62 Y1 N2O Pipeline Assembly 082-000662-00 63 Y1 Exhalation Valve Assembly 082-000521-00 64 Auxiliary Air Assembly Y2 082-000520-00 65 Auxiliary O2 Assembly Y2 082-000522-00

M6G-020026--- 67 Y2 Auxiliary Air Assembly 082-000520-00 69 Y1 Auxiliary Gas Outlet 082-000521-00 73 O2 Needle Valve Y2 082-000522-00 74 Y2 Y2 082-000522-00 75 O2 Poppet Valve Y2 082-000522-00 76 O2 Poppet Valve Y2 082-000522-00 77 Y2 O2 Poppet Valve 082-000522-00 78 Y2 O2 Flow Sensor 082-000522-00 79 Y1 O2 Pipeline Assembly 082-000521-00 81 Y1 Y1 082-000521-00 90 Air Needle Valve Restrictor Assembly 082-000520-00 91 N2O Needle Valve Restrictor Assembly 082-000524-00 Y1 Three-way Connector 082-000583-00 Y2 Three-way Connector 082-000582-00

System and Ventilator Control Board 4 80 86 84 82 5 6 7 88 9 8 11 17 15 13 10 16 14 12 22 23 24 18 2 Gas reservoir Exhalation valve assembly Common gas outlet Breathing system connector Hardware box connector Three way valve Monitor board 1 3 Y1 Y2 Y2 72

Flow Sensor connector A21-000007--- 2 Exhalation Gas Assembly Hardware Box Connector A21-000007--- 3 Exhalation Gas Assembly Flow sensor connector A21-000007--- 4 Three-way Valve Ventilator Control Board A21-000007--- 5 Three-way Valve Y2 A21-000007--- 6 Three-way Valve Ventilator Control Board A21-000007--- 7 Three-way Valve Y2 A21-000007--- 8 Y2 Ventilator Control Board A21-000007--- 9 Y2 Ventilator Control Board A21-000007--- 10 Hardware Box Connector Y1 A21-000007--- 11 Y1 Breathing System Connector M6G-020046--- 12 Hardware Box Connector Y1 A21-000007--- 13 Y1 Breathing System Connector M6G-020046--- 14 Hardware Box Connector Y1 A21-000007--- 15 Y1 Breathing System Connector M6G-020046--- 16 Hardware Box Connector Y1 A21-000007--- 17 Y1 Breathing System Connector M6G-020046--- 18 Exhalation Gas Assembly Gas Reservoir M6G-020018--- 22 Gas-out Connector of CGO Connector Fresh Gas 082-000519-00 23 Breathing System Connector Exhalation Gas Assembly M6G-020039--- 24 Breathing System Connector Gas Reservoir M6G-020042--- 72 Hardware Box Connector Ventilator Control Board A21-000007--- 80 Hardware Box Connector Ventilator Control Board A21-000007--- 82 Hardware Box Connector Ventilator Control Board A21-000007--- 84 Hardware Box Connector Ventilator Control Board A21-000007--- 86 Hardware Box Connector Y2 A21-000007--- 88 Y2 Three-way Valve A21-000007--- Y1 Two-way Connector M02A-10-25945 Y2 Three-way Connector M90-100030---

1.3.1 Pneumatic Circuit Diagram Vapori zor Flow 9 10 11 13 12 17 18 20 19 24 22 23 25 21 29 28 23 23 41 42 45 26 27 16 15 3 4 8 5 1 8 2 14 Flow O2 32 34 38 35 37 33 33 47 48 31 40 Flow 39 36 46 P 49 51 P 53 52 AGSS 54 Flow Flow Flow 6 7 7 7 43 50 8 30 44 55 57 58 56 58 58 NO NC NO NC 59 59 1.3.2 Parts List 1 O2 Pipeline 30 Auxiliary Air Supply 2 O2 Cylinder 31 Inspiratory Valve 3 N2O Pipeline 32 CO2 Absorber Canister

7 Regulator (0.4 MPa) 36 Inspiratory Flow Sensor 8 Pressure Relief Valve 37 Patient 9 Filter 38 Expiratory Flow Sensor 10 Regulator (0.2 MPa) 39 Water Collection Cup 11 Inpiratory Flow Valve 40 Expiratory Valve 12 Flow Sensor 41 Auto/Manual Ventilation Switch 13 Mechanical Overpressure Valve (110 cmH2O) 42 Manual Bag 14 Pop-Off Valve 43 APL Valve 15 PEEP Safety Valve 44 High Pressure O2 Output 16 Pressure Switch (140 kPa) 45 Bellows Assembly 17 Proportional PEEP Valve 46 Pressure Relief Valve (10 cmH2O) 18 Expiratory Valve 47 Negative Pressure Valve (1 cmH2O 19 Pneumatic Resistor 48 Scavenging Reservoir and Noise Eliminator 20 O2 Flush Valve 49 Pressure Sensor 21 Flow Restrictor 50 Total Flow Meter 22 Pressure Switch 51 Auxiliary O2 Supply 23 Regulator (0.2 MPa) 52 Negative Pressure Valve 24 System Switch 53 Pressure Sensor 25 Oxygen Ratio Controller (ORC) 54 AGSS (AGSS Transfer and Receiving System) 26 Electronic Flowmeter Sensor 55 Check Valve 27 Double-vaporizer Manifold 56 Back Pressure Valve 28 Check Valve 57 Poppet Valve 29 Pressure Relief Valve 58 Needle Valve 59 Adjustable Restrictor

Filter Regulator Pressure Gauge Check Valve Gas Supply Connector Pressure Relief Valve Flowmeter Flow Control Valve Pressure Switch Flow Restrictor 1.3.4 Description 1.3.4.1 Anesthetic Gas Delivery System The Anesthetic Gas Delivery System is connected to the anesthetic agent delivery device (vaporizer), breathing system, and anesthetic ventilator; and outputs fresh gas. The following figure shows the pneumatic circuit of the Anesthetic Gas Delivery System.

pathways – system switch (24), O2 flush valve (20), auxiliary O2 supply (51), and high pressure O2 output (44), respectively. Air enters two pathways – one pathway to the needle valve (58) and the other to the auxiliary Air supply (3). N2O goes to the ORC (25). When the system switch (24) is turned on, O2 enters the needle valve (58). When O2 flow is greater than 300ml, N2O can enter the needle valve (58) through ORC 25. After passing through the needle valve (58), the pre-set pneumatic resistance (59) controls the O2 and N2O proportions and ensures the minimum O2 concentration. After passing through the pneumatic resistance (59), O2 and N2O enter the electronic flow N2O tube O2 tube Air tube 24.System switch 20. O2 flush valve To auxiliary Air supply To auxiliary O2 supply To high pressure O2 output 25. ORC Needle valve Adjust pneumatic resistance 29. CGO From anesthetic agent delivery device to CGO From O2 flush to CGO

(58) and the electronic flow meter monitors, and displays the gas flow. The converged gas goes from the total flow meter (50) to the anesthetic agent delivery device (vaporizer), forming fresh gas after mixed with the anesthetic agent. The fresh gas then goes from the check valve (28) through the CGO (29) assembly to the breathing system. The flushing O2 also enters the breathing system through the CGO (29) assembly. 26. Flow sensor 56. Back pressure valve 50. Total flow meter Inlet of anesthetic agent delivery device Outlet of anesthetic agent delivery device Built-in 28. check valve

pneumatic circuit starts from the gas supplies, which function to introduce the external pipeline or cylinder gases into the machine. Since the pressure of external gas is very high and the external gas contains foreign substances, the pressure reducing valves, filters, and pressure relief valves are available in the supply gas circuit. Also, the check valves are equipped in the supply gas circuit to prevent gas from flowing back into the pipeline or cylinder. The anesthesia machine has pipeline and cylinder gas supplies available. Pipeline gas supplies go into the pipeline gas supply inlet assemblies through pipeline connectors 1, 3, and 5, respectively. The pipeline pressure ranges between 280 and 600 kPa. Cylinder gas supplies go into the system through cylinder connectors 2, 4, and 6, respectively. The O2 and Air cylinder pressures are 6.9 to 15 MPa, and the N2O cylinder pressure is 4.2 to 6 MPa, both of which are decreased to 400 kPa through three regulators (7). Each connector is clearly marked and designed to prevent misconnection. All connectors have filters and check valves. Color coded gauges show the pipeline and cylinder pressures. The Pressure Relief Valve (8) functions to prevent the supply gas pressure from being too high. It releases excess gas when the gas pressure exceeds 758 kPa. Each supply gas is outputted after gas pressure is decreased below 200 kPa through the regulator (23). The Pressure Switch (22) monitors the O2 supply pressure. When the O2 supply pressure is less than approximately 220 kPa, the ventilator gives an alarm indicating O2 supply failure. O2 pipeline supply inlet 22. Pressure switch 8. Pressure Relief Valve Pressure sampling tube for O2 supply gas pressure gauge

O2 goes into the system switch (24); and flows into the needle valve. The system switch has an electrical outlet that controls the power-on status of the system. When the system switch is turned on, O2 enters the needle valve and the system is powered on simultaneously. The anesthetic ventilator starts to monitor the status of the system. When the system switch is turned off, O2 cannot enter the needle valve and the system is powered off. Flow Adjust and Control Assembly The Needle Valve (58) controls the gas flows. The ORC (25) controls the proportion between O2 and N2O, and ensures that the O2 concentration is not less than 21%. Turning the needle valve knob counterclockwise increases the flow; turning it clockwise decreases the flow. O2 chamber N2O chamber 58. Flow adjustment needle valve 59. Adjust pneumatic resistance 59. Adjust pneumatic resistance

The electronic flowmeter (26) and total flow meter (50) constitute the flow display assembly. Gases from the flow adjust and control assembly and mixed gas going through the anesthetic agent delivery device (vaporizer) are outputted. The electronic flowmeter (26) measures and displays the flow of each gas. The total flow meter (50) displays the total gas flow. O2 Flush Button Assembly The above picture shows the O2 flush button assembly. When the O2 flush valve (20) is depressed, O2 rushes into the pneumatic circuit, which is cut off when this valve is released. The O2 supply gas at 0.2 MPa, after being regulated, goes through the O2 flush valve, the CGO assembly, and into the breathing system. The O2 flush button assembly is not affected by the system switch. Flushing O2 can be performed as long as O2 supply is normal. The O2 flush valve has a slide valve structure inside that ensures automatic reset each time the valve is depressed and released via the spring. 26. Flow sensor 50. Total flow rotameter

device (vaporizer) is connected to the anesthetic gas delivery system. The mixed gas of N2O, O2, and Air go into the device; the fresh gas containing these three gases and anesthetic agent is finally outputted to the CGO assembly. Either vaporizer manifold (27) is integrated with a check valve (28) that prevents flushed O2 and fresh gas from flowing back to the vaporizer. The Selectatec mounting with interlocking function prevents the user from turning on two vaporizers simultaneously. CGO Assembly The above picture shows the CGO assembly. The CGO assembly includes a flow restrictor (21) and a pressure relief valve (29). Flushed O2 and fresh gas that are mixed enter the CGO. The pressure relief valve (29) at the front restricts the pressure of flushed O2, and also restricts the fresh gas from exceeding 37.9 kPa. Auxiliary O2 and Air Supply Assembly The Auxiliary O2 Supply Assembly (51) and Auxiliary Air Supply Assembly (30) control flow by two needle valves. The individual flows are displayed by glass tube flowmeters. The blended gas is output through a single barbed fitting to the patient. The flow range adjusted is from 0 to 15 L/min. Turning the flow control counterclockwise increases the flow; turning it clockwise decreases the flow.

The high pressure O2 output (available on the A5 only) comes from the gas source directly and provides high pressure O2 for the external ventilation device (jet ventilation devices) without passing through the pressure regulator. When no external device is connected, the high pressure O2 output is closed. The maximum flow is greater than 90L/min. Outputs high pressure O2 (A5 only) Outputs auxiliary gas supply

The anesthetic ventilator provides drive gas for the patient to breathe. O2 from the gas supply inlet assembly enters the anesthetic ventilator and is outputted in three pathways: drive gas entering the breathing system, drive gas discharged through the AGSS outlet, and drive gas discharged through the PEEP outlet. The ventilator controls drive gas flow to prevent excessively high pressure inside the pneumatic circuit from injuring the patient. The following picture shows the gas flow direction and the components of the anesthetic ventilator. The following is the pneumatic circuit diagram of the anesthetic ventilator. Flow 9 10 11 13 12 17 18 19 45 16 15 14 46 P 49 52 Drive Gas Breathing System AGSS The proportional electromagnetic valve (11) controls inlet gas flow. The filter (9) filters drive gas again. The regulator (10) regulates pressure inside the pneumatic circuit. Component 12 is a flow sensor of differential pressure type that monitors gas flow in the drive gas circuit. Pneumatically-controll ed module Input tube of the pneumatically-con trolled module Gas exhaust tube Outputs gas discharged through PEEP outlet Outputs drive gas

not exceed safe pressure. It releases excess gas when gas pressure exceeds 11 kPa.. Component 18 is the expiratory valve. During expiration, gas inside the bellows is discharged from this valve. The PEEP function is performed through the expiratory valve. Component 15 is a low-flow proportional electromagnetic valve. When it opens, gas is bled from the pneumatic resistor (19), forming relatively stable pressure in the PEEP branch. Such pressure is exerted on the membrane of the expiratory valve (18) to form PEEP. To prevent excessively high pressure inside the pneumatic circuit from injuring the patient and damaging the equipment, the pressure relief valve (15), which is an electromagnetic on-off valve, is placed before the gas pathway of the expiratory valve. The “16” component is a pressure switch. When the drive gas pressure is less than 140 kPa, an alarm is triggered. Component 49 is a pressure sensor that monitors the pressure at which the expiratory valve is closed. The Pressure relief valve (46) ensures the tube pressure after the expiratory valve is less than 10 cmH2O. 1.3.4.3 Breathing System The breathing system provides a closed loop for the anesthetic gas. The expired gas from the patient can be inspired in the inspiration phase to maintain the temperature and humidity conditions of the patient’s expired gas. During inspiration, the drive gas depresses the bag inside the bellows to force the inside gas to enter the patient’s lung. During expiration, the patient’s expired gas goes into the bag inside the bellows. The CO2 Absorber Canister (32) absorbs CO2 that the patient expires. The following figure shows the pneumatic circuit of the breathing system. 41 42 45 14 Flow O2 32 34 38 35 37 33 33 31 40 Flow 39 36 P 53 43 NO NC Drive Gas AGSS Mechanical and manual ventilation modes are selected through the Auto/Manual ventilation switch (41). When the Auto/Manual switch is placed in the Manual position, the operator squeezes the manual bag (42) to supply gas for the breathing system. The APL valve (43) is used to adjust the pressure inside the pneumatic circuit in case of manual ventilation. When the Auto/Manual switch is placed in the Auto position, the A5/A3 starts its ventilator to

controls the drive gas to depress the folding bag inside bellows (45) and supply gas for the breathing system according to the selected ventilation mode. The breathing system is connected to the anesthesia machine main unit through the circuit adapter. The breathing system is highly integrated, as its tubes are all internal except the tube connected to the patient and the O2 cell cable, as shown below. 43.APL valve 41.Auto/Manual ventilation switch 45.Bellows assembly Bag arm 35.Airway pressure gauge 40.Expiratory valve 31. Inspiratory valve Patient end (built-in inspiratory and expiratory flow sensors)

ventilation switch (41), BYPASS valve (33) or CO2 absorber canister (32), inspiratory valve (31), O2 sensor (34), airway pressure gauge (35), and inspiratory flow sensor (36) to the patient. During expiration, gas flows through the expiratory flow sensor (38), expiratory valve (40), and Auto/Manual ventilation switch (41) to the folding bag. Airway pressure is monitored by the pressure sensor (53). Excess water condensation from the exhaled gas is collected in the water collection cup, located on the bottom side of the breathing system. The breathing system is easily disassembled and is autoclavable at 134℃. 1.3.4.4 Anesthetic Gas Scavenging System The Anesthetic Gas Scavenging System (AGSS) is composed of the AGSS transfer system, the AGSS receiving system, and the AGSS disposal system. Waste gas goes from the exhaust port of the anesthesia machine through the AGSS transfer system and the AGSS receiving system to the hospital’s waste gas disposal system (AGSS disposal system), as shown below. 32. CO2 Absorber Canister 33. Built-in BYPASS valve Operating handle

the effect of negative pressure at the AGSS outlet onto the flow at the entrance. The float helps the user determine if the disposal system meets the requirement for the minimum pump rate. The filter provides for filtering of foreign substances to prevent the disposal system from being occluded. The gas reservoir is connected to the air through pressure compensation openings. When positive or negative pressure occurs inside the gas reservoir, gas is inputted or outputted to ensure pressure balance inside the system. The AGSS transfer system is a clear tube with 30 mm purple conical connectors at both ends. The inlet of the transfer system is a female 30 mm conical connector and the outlet a male 30 mm conical connector. The transfer system is connected to the receiving system through the male 30 mm conical connector. The receiving system is connected to the receiving hose through the 30 mm connector. The following picture shows the AGSS structure and the connections between the AGSS transfer system, receiving system, and disposal system.

1.4.1 Auxiliary Outlets The A3 anesthesia system has three 125V 15A Hospital Grade auxiliary outlets. Each outlet has one 250V 3A breaker. The A5 anesthesia system has four 125V 15A Hospital Grade auxiliary outlets. Each outlet has one 250V 3A breaker. Additionally, a main breaker limits the combined current of the four outlets to 10A. Breaker 4 Breaker 3 Breaker 2 Breaker 1 Auxiliary Outlet 1 Auxiliary Outlet 2 Auxiliary Outlet 3 Auxiliary Outlet 4 1.4.2 Work Light Board 1.4.2.1 Top lighting board Top Lighting Board, Top View Top Lighting Board, Bottom View The Flow Meter Lighting Board Interface，J1 PIN NAME FUNCTION 1 12V The 12V Power Supply of the Flow Meter Lighting Board 2 GND Ground 3 GND Ground 4 LIGHT_OUT Flow Meter Lighting Control Lighting Grade Option Switch Interface，J2 PIN NAME FUNCTION

2 HIGH_BRIGHTNESS High Brightness Grade 3 OFF Close Light Grade 4 OFF Close Light Grade 5 LOW_BRIGHTNESS Low Brightness Grade 6 LOW_BRIGHTNESS Low Brightness Grade Power Supply Interface，J3 PIN NAME FUNCTION 1 12V 12V Power Supply of the Top Lighting Board 2 GND Ground 3 12V_AUX The 12V Power Supply of the Flow Meter Lighting Board 1.4.2.2 Flow Meter Lighting board Flow Meter Lighting Board, Top View Flow Meter Lighting Board, Bottom View Flow Meter Lighting Board Interface，J1 PIN NAME FUNCTION 1 12V 12V Power Supply of the Flow Meter Lighting board 2 GND Ground 3 GND Ground 4 LIGHT_IN Flow Meter Lighting Control Signal 1.5 The Breathing System 1.5.1 Brief Introduction The A5/A3 Breathing System supports three types of operational modes: mechanical ventilation, manual ventilation, and standby. These modes allow the operator to apply proper ventilation strategy based on the patient’s needs. The types of flow paths through the breathing system vary with the operating mode or status.

When the Auto/Manual switch is positioned at Auto, the system closes the manual ventilation path. Drive gas pushes down on the bellows. Gas flows from the bellows, through the CO2 absorber canister, and through the inspiratory check valve to the patient. During inspiration, fresh gas flows into the inspiratory limb, upstream of the inspiratory check valve. In volume mode, tidal volume is compensated for variations in fresh gas flow to ensure that the volume delivered to the patient meets the set value. In pressure mode, the inspiratory pressure is regulated both in gas flow and airway pressure to ensure the airway pressure is held at the set inspiratory pressure during the patient inspirationn. Bellows Breathing Bag Exhaust valve Auto/Manu Switch Drive Gas Pop-Off valve Exp. Flow Sensor O2 Cell Exp. Valve NO NC AGSS APL Valve Insp. Flow Sensor Insp. Valve Absorber Canister Water trap cup Fresh Gas

When the Auto/Manual switch is set to Auto, the system closes the manual ventilation path. Drive-gas flow stops and the exhaust valve opens. Exhaled gas flows from the patient, through the expiratory check valve, and into the bellows. Residual drive gas flows out of the bellows dome through the exhaust valve to the scavenging system (AGSS). If PEEP is selected, static pressure on the pilot port of the exhaust valve sets the PEEP level. During exhalation, fresh gas flows backwards through the CO2 absorber into the expiratory limb, downstream of the expiratory check valve. Bellows Breathing Bag Exhaust valve Auto/Manu Switch Drive Gas Pop-Off valve Exp. Flow Sensor O2 Cell Exp. Valve NO NC AGSS APL Valve Insp. Flow Sensor Insp. Valve Absorber Canister Water trap cup Fresh Gas

When the Auto/Manual switch is set to Manual, the system closes the Auto ventilation path. Gas flows from the breathing bag when compressed, through the CO2 absorber canister, into the breathing circuit, and through the inspiratory check valve to the patient. During inspiration, fresh gas flows from the machine into the inspiratory limb, upstream of the inspiratory check valve. If airway pressure exceeds the set value of the APL Valve, the residual gas will pass through the APL Valve to the scavenging system (AGSS). Bellows Breathing Bag Exhaust valve Auto/Manu Switch Pop-Off valve Exp. Flow Sensor O2 Cell Exp. Valve NO NC AGSS APL Valve Insp. Flow Sensor Insp. Valve Absorber Canister Water trap cup Fresh Gas

When the Auto/Manual switch is set to Manual, the system closes the Auto ventilation path. Gas flows from the patient, through the expiratory check valve, and into the breathing bag. During exhalation, fresh gas enters the Breathing System. Residual fresh gas passes through the APL valve to the AGSS. Bellows Exhaust valve Auto/Manu Switch Pop-Off valve Exp. Flow Sensor O2 Cell Exp. Valve NO NC AGSS APL Valve Insp. Flow Sensor Insp. Valve Absorber Canister Water trap cup Fresh Gas Breathing Bag 1.5.6 Pneumatic PEEP The PEEP valve regulates the pressure at which the exhaust valve opens. Therefore, if PEEP is selected, static pressure on the pilot port of the exhalation valve sets the PEEP level during the automatic ventilation. 1.5.7 Ventilator in Standby When the anesthesia system is in standby mode, monitoring will be inactive, and automatic ventilation will be unavailable. The patient should not be ventilated when the system is in standby mode.

1.5.8.1 Ventilation Bellows System The ventilator's driving system is a flow generator. Driving gas fills the bellows dome to compress the bellows. The breathing gas is pressed out of the bellows into the patient breathing circuit. The bellows is refilled with fresh gas and the expired gas from the patient. 1.5.8.2 Manual Breathing Bag In manual mode, this device acts as a normal breathing bag, enabling the user to ventilate the patient manually. 1.5.8.3 CO2 Absorber Canister The sodalime inside the CO2 absorber canister absorbs the carbon dioxide from the exhaled gas. The CO2 absorber canister accommodates standard sized Pre-paks or loose-fill CO2 absorbent. 1.5.8.4 Inspiratory and Expiratory Valves To ensure correct gas flow direction to and from the patient, check-valves are integrated in the inspiratory and expiratory limb of the Breathing System. 1.5.8.5 APL (Airway Pressure Limiting) Valve In manual mode, the APL Valve acts as a normal spring-loaded pressure relief valve, limiting the maximum pressure in the Breathing System.

1.6.1 Display 1.6.1.1 Display Interface Board Display Interface Board, Top View Display Interface Board, Bottom View Inverter interface，J1 PIN NAME FUNCTION 1 12V Inverter 12V Power Supply 2 12V Inverter 12V Power Supply 3 GND Ground 4 GND Ground 5 LCD_EN LCD Backlight Enable 6 LCD_BR LCD Backlight Brightness Control

PIN NAME FUNCTION 1 12V Warning Light Board 12V Power Supply 2 GND Ground 3 SDA_CPU CPU Board I2C Data Signal 4 SCL_CPU CPU Board I2C Clock Signal 5 3_3V 3.3V Power Supply 6 GND Ground Touch Screen Control Board interface，J4 PIN NAME Function 1 5V 5V Power Supply 2 RXD_TOUCH_PANEL Touch Screen Control Board Serial Port Receive Signal 3 TXD_TOUCH_PANEL Touch Screen Control Board Serial Port Transmit Signal 4 GND Ground Display Control Signal Interface，J5 PIN Name Function 1 LCD_EN LCD Backlight Enable 2 LCD_BR LCD Backlight Brightness Control 3 RXD_TOUCH_PANEL Touch Screen Control Board Serial Port Receive Signal 4 TXD_TOUCH_PANEL Touch Screen Control Board Serial Port Transmit Signal 5 GND Ground 6 LED_AC AC Indicator Light Drive Signal 7 LED_BAT Battery Indicator Light Drive Signal 8 SDA_CPU CPU Board I2C Signal 9 SCL_CPU CPU Board I2C Signal 10 RSVD Reserved 11 RSVD Reserved 12 RSVD Reserved 13 RSVD Reserved 14 RSVD Reserved 15 RSVD Reserved 16 12V 12V Power Supply 17 12V 12V Power Supply 18 GND Ground 19 GND Ground 20 GND Ground

Warning Light Board，Top View Warning Light Board，Bottom View Warning Light Board interface，J1 PIN NAME FUNCTION 1 12V 12V Power Supply 2 GND Ground 3 MAIN_BRD_SDA CPU Board I2C Data Signal 4 MAIN_BRD_SCL CPU Board I2C Clock Signal 5 3_3V 3.3V Power Supply 1.6.1.3 Display The anesthesia system display is a 15-inch, 24-bit, 1024x768 LVDS touch screen. Its LCD backlight brightness can be adjusted by the inverter.

Fresh Flow Sensor Board，Top View Fresh Flow Sensor Board，Bottom View Fresh Flow Sensor Board Interface，J1 PIN NAME FUNCTION 1 TXD_FLOW_BRD Fresh Flow Sensor Board Serial Port Transmit Signal 2 RXD_FLOW_BRD Fresh Flow Sensor Board Serial Port Receive Signal 3 GND Ground 4 12V Fresh Flow Sensor Board 12V Power Ssupply

Indicator Light Board, Top View Indicator Light Board, Bottom View Indicator Light Board interface，J1 PIN NAME FUNCTION 1 LED_AC AC Indicator Light Drive Signal 2 LED_BAT Battery Indicator Light Drive Signal 3 GND Ground

PIN NAME FUNCTION 1 TX+ Positive End of Transmit Signal 2 TX- Negative End of Transmit Signal 3 RX+ Positive End of Receive Signal 4 CT1 No Definition 5 CT1 No Definition 6 RX- Negative End of Receive Signal 7 CT2 No Definition 8 CT2 No Definition USB Interface, J8 PIN NAME FUNCTION 1 VCC USB Power Supply 2 DM0 USB Data Signal – (Negative) 3 DP0 USB Data Signal + (Positive) 4 GND Ground 5 VCC USB Power Supply 6 DM1 USB Data Signal – (Negative) 7 DP1 USB Data Signal + (Positive) 8 GND Ground RS-232 Interface, J4 PIN NAME FUNCTION 1 NC No Connection 2 RXD RS-232 Receive Signal 3 TXD RS-232 Transmit Signal 4 NC No Connection 5 GND Ground 6 NC No Connection 7 NC No Connection 8 NC No Connection 9 NC No Connection

1.7.1 Mother Board Mother Board, Top View Mother Board , Bottom View

2 7VIN Inspiration Valve Drive Signal 3 INSP_VALVE Inspiration Valve Drive Signal 4 7VIN PEEP Valve Drive Signal 5 PEEP_VALVE PEEP Valve Drive Signal 6 SOLENOID_VALVE1 Three-way Valve 1 7 SOLENOID_VALVE2 Three-way Valve 2 8 SOLENOID_VALVE3 Three-way Valve 3 9 SOLENOID_VALVE4 Three-way Valve 4 10 PNEUM_PRES_SW Pneumatic Block Pressure Switch Signal 11 NC No Connection 12 NC No Connection 13 O2_PRE_SW O2 Pressure Switch Signal at Gas Supply Inlet 14 MANU_AUTO_SW Auto/Manual Switch Signal 15 GND Ground 16 CO2_BYPASS_SW Circuit CO2 Absorber Canister Signal 17 O2+ O2 Concentration Signal 18 O2- O2 Concentration Signal 19 TXD_AUX_BRD VPM Serial Port Transmit Signal 20 RXD_AUX_BRD VPM Serial Port Receive Signal 21 GND Ground 22 RSVD Reserved 23 RSVD Reserved 24 RSVD Reserved 25 VF Differential Pressure Sensor Flow Signal 26 GND Ground 27 TXD_MON_BRD VCM Serial Port Transmit Signal 28 RXD_MON_BRD VCM Serial Port Receive Signal 29 12V 12V Power Supply 30 GND Ground 31 5V VCM Close Pressure Relief Valve Signal 32 5V 5V Power Supply 33 TXD_CALIBRATE Calibration Serial Port Transmit Signal 34 RXD_CALIBRATE Calibration Serial Port Receive Signal 35 GND Ground 36 12V 12V Power Supply

PIN NAME FUNCTION 1 7Vout Pressure Relief Valve Power Supply 2 SAFE_VALVE Pressure Relief Valve Drive Signal 3 7Vout Inspiration Valve Power Supply 4 INSP_VALVE Inspiration Valve Drive Signal 5 7Vout PEEP Valve Power Supply 6 PEEP_VALVE PEEP Valve Drive Signal 7 12V Three-way Valve Power Supply 8 SOLENOID_VALVE1 Three-way Valve Drive Signal 1 9 12V Three-way Valve Power Supply 10 SOLENOID_VALVE2 Three-way Valve Drive Signal 2 11 12V Three-way Valve Power Supply 12 SOLENOID_VALVE3 Three-way Valve Drive Signal 3 13 12V Three-way Valve Power Supply 14 SOLENOID_VALVE4 Three-way Valve Drive Signal 4 15 RSVD Reserved 16 RSVD Reserved 17 RSVD Reserved 18 VF Thermal Mass Sensor Flow Sensor 19 12V Sensor Board 12V pPower Supply 20 GND Ground 21 NC No Connection 22 NC No Connection 23 NC No Connection 24 GND Ground 25 O2_PRE_SW O2 Pressure Switch Signal at Gas Supply Inlet 26 GND Ground 27 PNEUM_PRES_SW Pneumatic Block Pressure Switch Signal 28 GND Ground 29 MANU_AUTO_SW Auto/Manual Switch Signal 30 GND Ground 31 CO2_BYPASS_SW Circuit CO2 Absorber Canister Signal 32 GND Ground 33 NC No Connection 34 GND Ground 35 O2+ O2 Concentration Signal 36 O2- Ground 37 LOOP_SW Circuit Switch 38 GND Ground 39 NTC_R11 Signal of Thermistor 1 40 NTC_R12 Signal of Thermistor 2 41 NTC_R21 Signal of Thermistor 1 42 NTC_R22 Signal of Thermistor 2 43 HEA_PWR_15V Heater Drive Voltage Signal 44 HEA_PWR_15V Heater Drive Voltage Signal 45 GND Ground 46 GND Ground 47 12V Electronic Flowmeter Power Supply 48 GND Ground 49 RXD_FLOW_BRD Electronic Flowmeter Serial Port Receive Signal 50 TXD_FLOW_BRD Electronic Flowmeter Serial Port Transmit Signal

2 LCD_BR Inverter Brightness Adjustment Signal 3 RXD_TOUCH_PANEL Touch Screen Control Board Serial Port Receive Signal 4 TXD_TOUCH_PANEL Touch Screen Control Board Serial Port Transmit Signal 5 NC No Connection 6 LED_AC AC Indicator Light Drive Signal 7 LED_BAT Battery Indicator Light Drive Signal 8 MAIN_BRD_SDA CPU Board I2C Signal 9 MAIN_BRD_SCL CPU Board I2C Signal 10 NC No Connection 11 NC No Connection 12 NC No Connection 13 NC No Connection 14 NC No Connection 15 NC No Connection 16 12V 12V Power Supply 17 GND Ground 18 GND Ground 19 VCC_LCD Optional Backplane Power Supply or CPU Board Power Supply for Display 20 VCC_LCD Optional Backplane Power Supply or CPU Board Power Supply for Display 21 GND Ground 22 GND Ground 23 LVDS_DATA0+ LVDS Data Difference to Positive Signal 0 24 LVDS_DATA0- LVDS Data Difference to Negative Signal 0 25 GND Ground 26 LVDS_DATA1+ LVDS Data Difference to Positive Signal 1 27 LVDS_DATA1- LVDS Data Difference to Negative Signal 1 28 GND Ground 29 LVDS_DATA2+ LVDS Data Difference to Positive Signal 2 30 LVDS_DATA2- LVDS Data Difference to Negative Signal 2 31 GND Ground 32 LVDS_DATA3+ LVDS Data Difference to Positive Signal 3 33 LVDS_DATA3- LVDS Data Difference to Negative Signal 3 34 GND Ground 35 LVDS_CLK+ LVDS Clock Difference to Positive Signal 36 LVDS_CLK- LVDS Clock Difference to Negative Signal 37 GND Ground Infrared Module Rack Interface for Patient Monitor，J4 PIN NAME FUNCTION 1 LED_AC AC Indicator Light Drive Signal 2 3V3 3.3V Power Supply 3 12V 12V Power Supply 4 12V 12V Power Supply 5 GND Ground 6 GND Ground 7 NC No Connection 8 NC No Connection 9 12V 12V Power Supply

14 PCON-_NON Power ON/OFF Inverse Phase Signal 15 GND Ground 16 PCON+ Power ON/OFF Circuit 3.3V 17 PCON- Power ON/OFF Signal 18 TOUCHPAD_5V 5V Power Supply 19 TOUCHPAD_GND Ground 20 TOUCHPAD_USB+ TOUCHPAD_USB Difference to Positive Signal 21 TOUCHPAD_USB- TOUCHPAD_USB Difference to Negative Signal 22 12V 12V Power Supply 23 GND Ground 24 NC No Connection 25 NC No Connection Calibration Interface，J5 PIN NAME FUNCTION 1 NC No Connection 2 NC No Connection 3 NC No Connection 4 NC No Connection 5 NC No Connection 6 12V 12V Power Supply 7 RXD_CALIBRATE Calibration Serial Port Receive Signal 8 TXD_CALIBRATE Calibration Serial port Transmit Signal 9 GND Ground Anesthetic Ventilator Cooling Fan Interface，J7 PIN NAME FUNCTION 1 12V3 12V Power Supply 2 RSVD Reserved 3 FAN1_STATE Fan Status Signal 4 GND Ground Speaker Interface，J8 PIN NAME FUNCTION 1 Speak+ Speaker Positive End 2 Speak- Speaker Negative End Battery Adaptation Board Interface，J9 PIN NAME FUNCTION 1 BAT1+ Battery Voltage 2 NTC1 Battery Internal Thermistor 3 BC1 Battery In-position Signal 4 GND Ground 5 BAT2+ Battery Voltage 6 NTC2 Battery Internal thermistor 7 BC2 Battery In-position Signal 8 GND Ground

PIN NAME FUNCTION 1 PLAM Buzzer Drive Signal (drives the buzzer directly) 2 RXD_PWR_BRD Power Board Serial Port (receives signal) 3 LOOP_SW Circuit Switch (reflects if the circuit is in position) 4 TXD_PWR_BRD Power Board Serial Port (transmits signal) 5 NC Power Board Cooling Fan Drive 6 GND Ground 7 LED-BAT Battery Status Indicator Light Drive Output 8 LCD_EN Backlight Enable Signal 9 LED-AC AC Status Indicator Light Drive Output 10 LCD_BR Backlight Brightness Control Voltage 11 PCON- Power ON/OFF Signal, LVTTL Pulse Signal. If this signal is high level, the system is turned on; if this signal is low level, the system is turned off. 12 3.3VBF 3.3V only used for power ON/OFF the machine 13 BAT2+ 2＃ Battery Input, connect to battery positive end 14 GND Ground 15 BC2F 2＃ Battery Availability Signal. Low level indicates battery available; high level indicates battery unavailable 16 NTC2 2＃ Lithium-ion Battery Internal Thermistor Signal 17 BAT1+ 1＃ Battery Input, connect to battery positive end 18 GND Ground 19 BC1F 1＃ Battery Availability Signal. Low level indicates battery available; high level indicates battery unavailable 20 NTC1 1＃ Lithium-ion Battery Internal Thermistor Signal 21 GND Ground 22 GND Ground 23 HEA_PWR_15V Heat Wire Drive Voltage Output 24 HEA_PWR_15V Heat Wire Drive Voltage Output 25 NTC_R12 Thermistor (for controlling heat wire) Pin 1 26 NTC_R22 Thermistor (for controlling heat wire) Pin 2 27 NTC_R11 Thermistor (for controlling heat wire) Pin 1 28 NTC_R21 Thermistor (for controlling heat wire) Pin 2 29 GND Ground 30 GND Ground 31 3V3 3.3V Supply Voltage Output 32 3V3 3.3V Supply Voltage Output 33 5V 5V Supply Voltage Output 34 GND Ground 35 GND Ground 36 GND Ground 37 NC No Connection 38 GND Ground 39 NC No Connection 40 NC No Connection 41 GND Ground 42 GND Ground 43 12V 12V Power Supply Output 44 GND Ground 45 12V 12V Power Supply Output 46 12V 12V Power Supply Output 47 NC No Connection

49 NC No Connection 50 15V2 15.2V Supply Voltage Output CPU Board Interface，J11 PIN NAME FUNCTION A1 LCD_VDD LCD Power Supply A2 GND LCD Ground A3 NC No Connection A4 NC No Connection A5 RSVD Serial Port Transmit Signal A6 RSVD Serial Port Receive Signal A7 GND Ground A8 RSVD Serial Port Transmit Signal A9 RSVD Serial Port Receive Signal A10 GND Ground A11 UIVCC_USB USB Power Supply A12 TOUCHPAD_USB+ TOUCHPAD_USB Data Signal + A13 TOUCHPAD_USB- TOUCHPAD_USB Data Signal - A14 GND Ground A15 SCL CPU Board I2C Clock A16 SDA CPU Board I2C Data A17 GND Ground A18 NC No Connection A19 NC No Connection A20 NC No Connection A21 NC No Connection A22 FAN1_STATE Fan Status Detected Signal A23 NC No Connection A24 GND Ground A25 3V3 CPU Board Main Power Supply A26 3V3 CPU Board main Power Supply A27 GND Ground A28 GND Ground A29 5V CPU Board Interface Chip Power Supply A30 5V CPU Board Interface Chip Power Supply A31 GND Ground A32 GND Ground B1 NC Not Connected B2 NC Not Connected B3 NC Not Connected B4 SPK_OUT+ Speaker Drive Signal +

B6 GND Ground B7 NC No Connection B8 NC No Connection B9 NC No Connection B10 NC No Connection B11 NC No Connection B12 GND Ground B13 TXD_PWR_BRD Power Board Serial Port Transmit Signal B14 RXD_PWR_BRD Power Board Serial Port Receive Signal B15 GND Ground B16 TXD_FLOW_BRD Fresh Flow Sensor Board Serial Port Transmit Signal B17 RXD_FLOW_BRD Fresh Flow Sensor Board Serial Port Receive Signal B18 GND Ground B19 TXD_TOUCH_PANEL Touch Screen Controller Serial Port Transmit Signal B20 RXD_TOUCH_PANEL Touch Screen Controller Serial Port Receive Signal B21 RSVD Reserved B22 RSVD Reserved B23 GND Ground B24 NC No Connection B25 NC No Connection B26 NC No Connection B27 GND Ground B28 NC No Connection B29 NC No Connection B30 NC No Connection B31 NC No Connection B32 NC No Connection C1 GND Ground C2 LVDS-TO0+ LVDS Data Signal C3 LVDS-TO0- LVDS Data Signal C4 GND Ground C5 LVDS-TO1+ LVDS Data Signal C6 LVDS-TO1- LVDS Data Signal C7 GND Ground C8 LVDS-TO2+ LVDS Data Signal C9 LVDS-TO2- LVDS Data Signal C10 GND Ground C11 LVDS-TO3+ LVDS Data Signal C12 LVDS-TO3- LVDS Data Signal C13 GND Ground

C15 LVDS-TOC- LVDS Clock Signal C16 GND Ground C17 TXD_MON_BRD Ventilator Control Board Serial Port Transmit Signal C18 RXD_MON_BRD Ventilator Control Board Serial Port Receive Signal C19 GND Ground C20 TXD_AUX_BRD Auxiliary Ventilator Control Board Serial Port Transmit Signal C21 RXD_AUX_BRD Auxiliary Ventilator Control Board Serial Port Receive Signal C22 GND Ground C23 NC No Connection C24 NC No Connection C25 GND Ground C26 TP_PWR_CTRL Touch Pad Power Supply Control Signal C27 RSVD Reserved C28 RSVD Reserved C29 RSVD Reserved C30 RSVD Reserved C31 NC No Connection C32 NC No Connection Debugging Power ON/OFF Interface，J12 PIN NAME FUNCTION 1 PCON+ Power ON/OFF Signal 2 PCON- Power ON/OFF Signal Test Point Definition DESIGNATOR NAME FUNCTION RANGE (Unit: V) T1 BAT1 Lithium-ion Battery Voltage 1 Fully charged 12.6±5% T2 BAT2 Lithium-ion Battery Voltage 2 Fully charged 12.6±5% T3 LED_BAT Battery Indicator Light Drive Signal With battery: 2.5~3.5; Without battery: 0~0.4 T4 TXD_7024 Auxiliary Ventilator Control Board Serial Port Transmit Signal High level 2.4~5; Low level 0~0.4 T5 TXD_TOUCH Touch Screen Controller Serial Port Transmit Signal High level 2.4~5; Low level 0~0.4 T6 RXD_7024 Auxiliary Ventilator Control Board Serial Port Receive Signal High level 2.4~5; Low level 0~0.4 T7 RXD_TOUCH Touch Screen Controller Serial Port Receive Signal High level 2.4~5; Low level 0~0.4 T8 TXD_33209 VPM Serial Port Transmit Signal High level 2.4~5; Low level 0~0.4 T9 TXD_FLOW Fresh Flow Sensor Board Serial Port Transmit Signal High level 2.4~5; Low level 0~0.4

T10 RXD_33209 VPM Serial Port Receive Signal High level 2.4~5; Low level 0~0.4 T11 RXD_FLOW Fresh Flow Sensor Board Serial Port Receive Signal High level 2.4~5; Low level 0~0.4 T12 TXD_POWER Power Board Serial Port Transmit Signal High level 2.4~5; Low level 0~0.4 T13 RXD_POWER Power Board Serial Port Receive Signal High level 2.4~5; Low level 0~0.4 T14 5V 5V Power Supply 4.75~5.25 T15 3.3V 3.3V Power Supply 3.135~3.465 T16 15V2 15.2V Power Supply 14.44~15.96 T17 12V 12V Power Supply 11.4~12.6 T18 P15V Heater Power Supply 0~15 T19 LED_AC AC Indicator Light Drive Signal With AC: 5~3.5; Without AC: 0~0.4 T20 12V1 12V Power Supply 11.4~12.6 T21 12V2 12V Power Supply 11.4~12.6 T22 12V3 12V Power Supply 11.4~12.6 T23 7V 7V Power Supply 6.65~7.35 T24 LCD_EN LCD Backlight Enable Signal High level 3.145~3.465; Low level 0~0.3 T25 LCD_BR LCD Backlight Brightness Adjustment Signal Brightest 0~1.5; least bright 4.75~5.25 1.7.2 Ventilator Control and Drive Board The monitor subsystem performs pressure and flow detection of the anesthetic ventilator and anesthetic breathing system, valve control, status monitoring collection, O2 concentration reading, accuracy monitoring of pressure and flow inside the circuit, and accuracy control of tidal volume. The monitor subsystem is composed of four boards: monitor signal detection board, valve drive board, ventilator sensor interface board, and VPM (auxiliary ventilator control board).

Monitor Signal Detection Board, Top View Monitor Signal Detection Board, Bottom View

PIN NAME FUNCTION 1 TXD Serial Port Transmit 2 RXD Serial Port Receive 3 12V 12V Power Supply 4 GND Ground 5 GND Ground 6 12V 12V Power Supply 7 PRST Pressure Relief Valve Control Signal 8 5V 5V Power Supply Ventilator Sensor Interface, J3 PIN NAME FUNCTION 1 SDA I2C Data Signal 2 SCL I2C Clock Signal 3 VT Thermal Mass Flow Sensor Temperature Signal 4 VF Thermal Mass Flow Sensor Flow Signal 5 12V Sensor Power Supply 6 GND Ground VT Calibration Communication Interface, J7 PIN NAME FUNCTION 1 TXD_CALIBRATE Calibration Serial Port Transmit Signal 2 RXD_CALIBRATE Calibration Serial Port Receive Signal 3 GND Ground 4 12V 12V Power Supply Three-way Valve Control Interface, J6 PIN NAME FUNCTION 1 12V Three-way Valve Power Supply 2 SOLENOID_VALVE1 Three-way Valve Control 1 3 12V Three-way Valve Power Supply 4 SOLENOID_VALVE2 Three-way Valve Control 2 5 12V Three-way Valve Power Supply 6 SOLENOID_VALVE3 Three-way Valve Control 3 7 12V Three-way Valve Power Supply 8 SOLENOID_VALVE4 Three-way Valve Control 4

PIN NAME FUNCTION 1 TXD_AUX_BRD VPM Serial Port Transmit Signal 2 RXD_AUX_BRD VPM Serial Port Receive Signal 3 GND Ground 4 12V 12V Power Supply O2 Cell Detection Interface, J12 PIN NAME FUNCTION 1 O2+ O2 Cell + 2 O2- O2 Cell - 3 GND Ground Test Point Definition DESIGNATOR NAME FUNCTION RANGE (unit: V) T1 O2 O2 Concentration Voltage 0~3.5 T2 PP PEEP Pressure 0.2~4.5 T3 PW Airway Pressure 0.2~4.5 T6 FM Ventilator Flow Detection 0.21~5.25 T8 FE Expiratory Flow Value 0.2~5.5 T9 VAJF3 Offset Voltage 0.602~0.622 T10 10V5 10.5V 10.25~10.75 T11 REF_4V 4.096V Baseline Power Supply 3.096~4.196 T12 1V2 1.2V Baseline Power Supply 1.1~1.3 T13 VADJ_P Offset Voltage 0.602~0.622 T14 FI Inspiratory Flow Value 0.2~5.5 T15 VADJ_FI Offset Voltage 0.602~0.622 T16 TXD1 Serial Port Transmit Signal (to CPU Board) 0~3.3 T17 RXD1 Serial Port Receive Signal (from CPU board) 0~5 T18 TXD2 Serial Port Transmit Signal (for calibration) 0~3.3 T19 RXD2 Serial Port Receive Signal (for calibration) 0~5 T20 VD 7V 6.8~7.6 T21 DVDD 3.3V Digital Voltage 3.15~3.45 T22 AVCC 5V Analog Voltage 4.75~5.25 T23 WDI Watchdog Signal 0~3.3 T24 RST Reset Signal 0~3.3 T25 CLK Clock Signal 0~3.3 T26 SAN1 Signal of Three-way Valve 1 0~12 T27 SAN2 Signal of Three-way Valve 2 0~12 T28 SAN3 Signal of Three-way Valve 3 0~12 T29 SAN4 Signal of Three-way Valve 4 0~12

PIN NAME FUNCTION 1 7V Pressure Relief Valve Power Supply 2 SAFE_VALVE Pressure Relief Valve Control Signal 3 7V Inspiration Valve Power Supply 4 INSP_VALVE Inspiration Valve Control Signal 5 7V PEEP Valve Power Supply 6 PEEP_VALVE PEEP Valve Control Signal Power Supply Interface, J2 PIN NAME FUNCTION 1 GND Ground 2 GND Ground 3 12V 12V Power Supply Status Monitor Detection Interface, J8 PIN NAME FUNCTION 1 GND Ground 2 PNEUM_PRE_SW Circuit block pressure Switch Signal 3 GND Ground 4 NC / 5 GND Ground 6 QUICK_O2_SW O2 Flushing Pressure Switch Signal 7 GND Ground 8 CGO_PRE_SW CGO Switch Signal 9 GND Ground 10 O2_PRE_SW O2 Pressure Switch Signal at Gas Supply Inlet 11 GND Ground 12 MANU_AUTO_SW Auto/Manual Switch Signal Test Point Definition DESIGNATOR NAME FUNCTION RANGE(unit: V) T1 K_OUT1 Status Monitor Signal 0~3.45 T2 K_OUT2 Status Monitor Signal 0~3.45 T3 SAFE Pressure Relief Valve Signal 0~7 T4 VOC Reserved DA Output Signal 0~1.2 T5 AD2 Analog Channel Output Signal 0~5 T6 FLOW Inspiration Valve Control Signal 0~7 T7 PEEP PEEP Valve Control Signal 0~7 T8 10V 12V Input Signal 10~14 T9 7V Valve Power Supply 6.65~7.35 T10 SGND Ground 0

Sensor Interface Board, Top View Sensor Interface Board, Bottom View Sensor Interface Board Interface, J2 PIN NAME FUNCTION 1 MON_BRD_SDA VCM I2C Data Signal 2 MON_BRD_SCL VCM I2C Clock Signal 3 VT Thermal Mass Flow Sensor Temperature Signal 4 VF Thermal Mass Flow Sensor Flow Signal 5 12V 12V Power Supply 6 GND Ground

PIN NAME FUNCTION TP1 3V3 Test 3.3V Power Supply TP2 5V Test 5V Power Supply TP3 5VA Test Analog 5V Power Supply 1.7.3 Battery 1.7.3.1 Battery Power For A3 anesthesia system: Battery: 11.1V, 4.5Ah×1V Lithium-ion battery (sealed) Battery running time: 75 minutes (new battery) Battery charge time: 8 hours max from an initial charge of 10% For A5 anesthesia system: Battery: 11.1V, 4.5Ah×2V Lithium-ion Battery (sealed) Battery Run Time: 150 minutes (new battery) Battery Charge Time: 8 hours max from an initial charge of 10% 1.7.3.2 Battery Adaptation Board Battery Adaptation Board, Top View Battery Adaptation Board, Bottom View Battery Interface, J1 and J2 PIN NAME FUNCTION 1 BAT+ Battery+ 2 BAT+ Battery+ 3 BC Battery In-position Signal 4 BAT- Battery- 5 NTC Temperature Signal 6 BAT- Battery- 7 BAT- Battery-

PIN NAME FUNCTION 1 VBAT1 Battery Voltage 2 NTC1 Battery Internal Thermistor 3 BC1 Battery In-position Signal 4 GND Ground 5 VBAT2 Battery Voltage 6 NTC2 Battery Internal Thermistor 7 BC2 Battery In-position Signal 8 GND Ground 1.7.4 Breathing System Heater The anesthesia system heater provides software and hardware dual-protection from overheating. The heater can switch over its operating mode automatically according to the change in ambient temperature. 1.8 Ventilator Pneumatic- O2 Drive Gas 1.8.1 Ventilator Pneumatic Drive Oxygen is the driving gas for the ventilator. In addition to the flow meter block, a high pressure regulator reduces the supply pressure to 200 kPa (29 psi). This pressure represents the drive gas for the ventilator. The drive pressure regulator is placed ahead of the proportional valve that generates the driving gas flow during the inspiratory phase. This flow fills the bellows dome that surrounds the bellows. 1.8.2 Drive Pressure-High Pressure Regulator (200 kPa, 29 psi) The drive pressure regulator stabilizes the supply pressure provided to the proportional valve. The flow generated by the proportional valve is therefore independent of pressure variations at the supply. Setting the drive pressure regulator at 200 kPa (29 psi) allows for a maximum inspiratory flow of 110 L/min at the ventilator. 1.8.3 Drive Gas Assembly The manifold assembly module mainly consists of the inspiratory circuit and PEEP circuit. The inspiratory circuit goes through the normally closed proportional solenoid valve, which generates a gas flow of 0 to 110 L/min by the valve drive board. The gas flow of the PEEP circuit goes through the normally closed proportional solenoid valve, which also generates a gas pressure of 3 to 30 cmH2O by the valve drive board. 1.8.4 Tube Color Coding All the pneumatic tubes used in the anesthesia system are color coded for use in the United States only. GAS US STANDARD O2 GREEN N2O BLUE AIR ORANGE

2.1 Preparation – Additional Material Required The following additional material are required before installation. The customer is responsible for supplying this material. Missing items may result in delays, incomplete installations, and/or additional service visits.  Compatible emergency O2, N2O, and AIR cylinders  Agent vaporizers and key fillers (if not purchased with the anesthesia system)  Liquid agent medication  CO2 absorbent Pre-Paks or loose fill  Active O2, N2O, and AIR lines (280 to 600 kPa (40 to 87 psi))  Dropdown hoses for ceiling-mounted medical gas utilities that are compatible with quick-disconnect hoses (if not purchased with the anesthesia system) 2.2 Assembly NOTE: The Anesthesia Machine is matched with its Breathing System Block via calibration of its Flow Sensors. If the Breathing System Block is removed, ensure that it is reinstalled on its matching Anesthesia Machine. If a different Breathing System Block is reinstalled, then the Flow Sensors must be recalibrated. (Refer to Section 4.3.2 Flow Sensor Calibration.) 2.2.1 Unpacking and Setup 1. When the A5/A3 is delivered, IMMEDIATELY inspect the box for any damage. a. If there is NO damage and ALL tip indicators on the box exterior are intact, then sign and date the bill of lading or airway bill to indicate safe receipt of the anesthesia system. b. If there is DAMAGE or ANY of the tip indicators on the box exterior have activated, then conditionally accept the delivery and clearly describe the damages on the bill of lading or airway bill. BOTH the carrier and recipient must sign and date the bill of lading or airway bill. Save all damaged factory packaging until further instructed by Mindray. The receiver should immediately contact Mindray Customer Service at (800) 288-2121 or (201) 995-8000. NOTE: When unpacking the unit, keep as much of the plastic covering on the unit as possible. When all parts are unpacked, return the packing material to its original box. Place the smaller box inside the larger box.

3. Pull the box top straight up off the box and place on the floor near the unit. The box top will be used later as a ramp when rolling down the A5/A3 onto the floor. 4. Pull the box straight up and over the unit.

6. Cut the plastic tie wrap as shown below. Roll down the plastic bag from the unit. 7. Using a pair of scissors, cut the plastic wrap from the A5/A3 near the back of the unit, using care to not scratch or otherwise damage the unit. Remove and discard the plastic wrap. Remove the empty box on the tray from the unit.

9. After removing the plastic wrap and foam, check that there is a box on the side of the unit, as shown below. 10. At the base of the box platform, remove both sets of orange straps. Save the straps in case the A5/A3 needs to be repacked.

material from around the front of the unit. 12. Remove the foam packing material from around the back of the unit. 13. Create a ramp for the unit by placing the top of the container next to the base of the container as shown. The flat side of the wood should be facing up. The other side of the wood has support to hold up the ramp. Secure the ramp to the container using the hook- and-loop straps. 14. Rotate the casters 90° and carefully roll the A5/A3 unit down the ramp. Remove the bag from the unit. Save the bag in case repacking is needed.

the Bag Arm Assembly (P/N: 115-006543-00). 16. Install the Breathing Assembly on the side of the A5/A3. Align the Assembly carefully, and then push it firmly towards the A5/A3 until the Assembly clicks into place. 17. Carefully open the small box that contains the Folding Bag Assembly (Bellows) (P/N: 0601-30-78968) and Bellows Dome (P/N: 043-001134-00). Remove the plastic bags from the Assembly. Place the foam pieces and plastic bags in the box.

completely around the lip on the breathing system when installed. 19. Install the bellows dome by placing it down on the breathing system and turning it clockwise to lock it in place (the gradation markings on the bellows dome should face front and be visible to the operator).

21. Then, push the Bag Arm Assembly into the Breathing System and tighten the knurled collar as shown below.

Assembly (P/N: 115-007453-00), Waste Gas Scavenger Hose (P/N: 115-006557-00) and the Waste Gas Scavenger Assembly (P/N: 115-006556-00). 23. Install the white Absorber hose on the Absorber Assembly. Then, install the Absorber Assembly without the canister in place. Install the lower part first, line up the pins with the holes, and then align the top part. Push the top part in (upward) until both the front and back latches click into place.

Absorber Assembly. Turn the locking lever 90° counter-clockwise to lock the canister in place. 25. Slide the Scavenger Assembly in the track on the lower left side (i.e., same side as the Breathing Assembly) of the A5/A3 and tighten the thumbscrew on the Scavenger Assembly to lock it in place. Install one side of the Scavenger Hose to the Scavenger Assembly and the other side of the Hose to the A5/A3 as shown below.

• Auxiliary O2/Air Reference Card (PN: 047-004342-00) • Preoperative Checkout List (PN: 047-004343-00) • Exhaust Emission Pipe (PN: 115-008426-00) • Inspiratory Flow Sensor & Expiratory Flow Sensor (PN: 115-008264-00) • O2 Cable Assembly (PN: 115-006551-00) • Gas Cylinder Wrench (PN: 041-004480-00) • Wired USB Mouse (PN: 0000-10-10751) (A3 only) 27. Open the rear panel and unscrew the thumbscrews to open the battery compartment. Install one or two batteries with the proper polarity. Close the compartment and tighten the thumbscrews. 28. Before installing the gas cylinders at the rear of the A5/A3, verify that the tank washers are installed. Remove the tape holding washers in place. Then, install the gas cylinders. Ensure that the cylinders are secured to their matching cylinder supply connections, which are labeled “O2”, “Air”, and “N2O”. 29. Connect each gas supply by connecting the hose connectors to the gas supply sockets (DISS type). Turn the connectors clockwise to fasten them securely to the sockets. Verify that the pressure of the gas supply is within the specifications of the machine. 30. Connect a manual ventilation bag (supplied by the user) to the bag arm on the breathing system. 31. Connect a patient breathing circuit (supplied by the user) to the inspiratory and expiratory connections. WARNING: Use breathing circuits and manual bags in accordance with ASTM F1208 and compatible with standard 22mm male conical fittings per ASTM specifications F 1054. 32. At the AGSS tank, turn the knob on top of the scavenger until the float is between the Min and Max markings. Connect the hose from the gas scavenger to the operating room’s EVAC connector.

should be tightened only enough to compress the o-ring about a 1/4 turn. 34. Screw the O2 Cable housing onto the stainless steel housing until it is snug. Do not overtighten. 35. Connect the oxygen sensor external cable between the oxygen sensor and the side of the A5/A3, aligning the yellow marks on the cable and connector. 36. Plug the mains cable into a grounded socket. Power up the A5/A3 by turning the main power switch (located on the front of the A5/A3) to the ON position. Wait until the LCD display provides information about the leak test. Observe that the start-up self-test is successful. Do not connect, disconnect or move the breathing circuits or breathing bags while the self-test is in process. 37. Mount the monitors and arms per instructions in the monitoring kit. WARNING: Use only Mindray-approved monitors and arms with the A5/A3. 38. Connect Hose (P/N: 801-0631-00078-00 or P/N: 115-008426-00) to the outlet of the gas module and to the Colder fitting at the back of the A5/A3. Place the unused hose in the bottom drawer. 39. Place the following parts into the bottom drawer: • A5/A3 Operating Instructions (P/N: 046-001586-00) • A5/A3 Anomalies List (P/N: 046-001764-00) • Washer, Seal (P/N: 0348-00-0185) 40. Hang the Pre-operative Checkout List (P/N: 047-004343-00) and the Auxiliary O2/AIR Reference Card (P/N: 047-004342-00) to the handle of the A5/A3 unit.

and Checkout Procedures 1.Breathing System 2.AGSS Transfer Hose 3.AGSS 4.CO2 Absorbent 5.O2 sensor cable with sensor 2.2.3 AGSS Connections 1. Remove the Anesthetic Gas Scavenging System (AGSS) from the foam and bag. 2. Mount the AGSS to the A5/A3 via the GCX compatible rail system. 3. Attach the AGSS Transfer Hose between the inlet port of the AGSS and the exhaust port of the A5/A3. 2.2.3.1 Tank Wrench and Pre-operation Checklist 1. Mount the tank wrench on the rear of the A5/A3 so that it can be used to open or close each cylinder without disconnecting it from the machine. 2. Attach the pre-operation checklist to a location on the A5/A3 where the operator can access it.

will not work at all. Use vaporizers with Selectatec mounting system that are compliant to ISO 8835-4. Refer to the vaporizer manufacturer’s Instructions For Use for filling or draining the vaporizer and other information. WARNING: For the A5/A3 Anesthesia System, using or turning on more than one vaporizer simultaneously is mechanically prevented by the Selectatec mount system. Do not attempt to override this safety feature. WARNING: Use care in lifting and manipulating vaporizers during the mounting process as their weight may be greater than expected, based on their size and shape. NOTE: The barometric pressure may differ from the calibration pressure of the anesthetic vaporizer. This may cause an inaccurate output of the anesthetic agent. The operator should continuously monitor the concentration of anesthetic agent during system use. 1. Align the vaporizer over the valve cartridges of the mounting bar. Hang the vaporizer on the mounting bar as shown below. Note that the locking mechanism handle is in the unlocked position. 2. Rotate the locking mechanism handle clockwise into the locked position as shown below. Locking Mechanism Handle in the Unloc - ked Position

1. Mount the vaporizer onto the manifold. 2. Push and turn the locking lever clockwise to lock the vaporizer in position. 3. Ensure that the top of the vaporizer is horizontal. If not, remove the vaporizer and reinstall it. 4. When reinstalling the vaporizer, lift each vaporizer straight up off the manifold rather than pulling forward. Do not rotate the vaporizer on the manifold. 5. If a vaporizer unintentionally lifts off the manifold, install it again and complete steps 1 through 3. If the vaporizer lifts off a second time, do not use the system. NOTE: A Desflurane vaporizer may be mounted similarly as other vaporizers, but may require a power cord. For more detailed instructions on installation and proper use, refer to the specific manufacturer’s Instructions for Use of the Desflurane vaporizer. 2.2.4.2 Fill the Vaporizer NOTE: The A5/A3 should use vaporizers with Selectatec mounting system that are compliant to ISO 8835-4. Refer to the vaporizer manufacturer’s Instructions For Use for filling or draining the vaporizer and other information. WARNING: Ensure that the correct anesthetic agent is used. The vaporizer is designed with the specific anesthetic agent named on it and further indicated by color coded label. The concentration of the anesthetic agent actually output will vary if the vaporizer is filled with the wrong agent. 2.2.4.3 Drain the Vaporizer WARNING: Do not reuse the agent drained from the vaporizer. Treat as a hazardous chemical and follow local regulations for proper disposal. NOTE: The A5/A3 should use vaporizers with Selectatec mounting system that are compliant to ISO 8835-4. Refer to the vaporizer manufacturer’s Instructions For Use for filling or draining the vaporizer. Locking Mechanism Handle in the locked Position

1. Remove the cover from a new O2, N2O, and AIR cylinder. 2. Mount one cylinder at a time onto the rear of the anesthesia machine. 3. Discard the cylinder's tank washer. Always use the approved tank washer provided with the A5/A3. 4. Open the bail of each yoke and mount the cylinder over the tank washer. 5. Ensure the O2 cylinder mates to the O2 Pin Index Safety System (PISS) connection on the O2 yoke. Close the yoke bail and use the hand-screw to tighten the cylinder to the yoke port. 6. Ensure that the N2O cylinder mates to the N2O PISS connection on the N2O yoke. 7. Close the yoke bail and use the hand-screw to tighten the cylinder to the yoke port. 8. Ensure that the AIR cylinder mates to the AIR PISS connection on the AIR yoke. Close the yoke bail and use the hand-screw to tighten the cylinder to the yoke port. 2.2.6 Breathing Circuit, CO2 Absorbent and Liquid Vaporizer Agent 1. Attach a breathing circuit to the inspiratory and expiratory ports as detailed in the directions for use. Attach the breathing bag and any other respiratory accessories as described. 2. Insert the Pre-Pak into the absorber canister. 3. Install the absorber canister with a quarter turn of the lever at the bottom the absorber assembly, ensuring tight seal. 2.2.7 Monitoring Products Mounting and Electrical Connection (if available) 1. Mount the monitor (if available) according to the manufacturer’s monitor assembly instructions. NOTE: Use of other monitors and mounting hardware is the responsibility of the installer. 2. After mounting a monitor to the A5/A3, connect it to one of the AC outlets located on the rear of the A5/A3. 3. Turn on each monitor one at a time. Verify that the circuit breaker holds without tripping. 4. Dress each line cord neatly along the side of the anesthesia machine or tucked inside the monitor arm. An optional cable routing kit is available. The cable routing kit contains three (3) clips, screws, and two (2) ethernet cables. The clips attach to three (3) sets of holes on the rear door of the A5/A3. Ethernet and power cables can be routed through the clips. 2.2.8 Agent Monitor Waste Gas Scavenging 1. Respiratory gas monitoring products have an exhaust port from which waste gas expels. The exhaust port on the gas monitor must be connected to the open Colder fitting on the rear side of the A5/A3. 2. Ensure that a tight connecting fitting is attached to the exhaust port of the gas monitor. Ensure that the other end of the same tube has a tight fitting connection attached on the rear side of the A5/A3. 3. Dress the exhaust tubing neatly along the side of the anesthesia machine or tucked inside the monitor arm so that it can not be easily pulled and it does not extend far from the main chassis.

Refer to 4 Calibration if any values are out of specification. NOTE: The A5/A3 system must be powered on (AC power, not battery) and the Breathing System Warmer set to ON (version 2.01.00 and higher) at least an hour before performing the Ventilation Tests starting in Section 2.6.5. 2.3.1 Gas Delivery System Tests 2.3.1.1 O2 Flush Verification 1. Using a breathing hose, connect the bag arm to the expiratory port. 2. Put the Manual/Auto lever to the manual position. 3. Set the APL Valve to 75. 4. Connect a flow meter to the inspiratory port. 5. Verify that the O2 flush flow is between 35 to 50 L/min when pressing the O2 flush valve. 2.3.1.2 O2:N2O Ratio System 1. Set the O2 and N2O Flow Control Valves to minimum. 2. Rotate the O2 Flow Control Valve until the flow meter displays 1L/min. 3. Turn on the N2O flow control and adjust N2O flow to maximum. 4. Verify that the N2O flow is between 2.5 L/min and 3.7 L/min. 5. Lower the N2O flow to minimum. 6. Lower the O2 flow to minimum. 2.3.2 Breathing System Leak Test NOTE: Always perform a leak test after servicing the anesthesia machine, replacing the components, or reconnecting the tubes. 2.3.2.1 Breathing System Leak Test in Manual Ventilation Mode This test checks the pneumatic circuit for leaks in manual ventilation mode. Test items include the APL valve, check valve, CO2 absorber canister, patient tubes, flow sensors, and flow sensor connectors. To perform the breathing system leak test in manual ventilation mode: 1. You can access the manual circuit leak test screen after the Power-On Self Test has passed. You can also open the Setup in Standby and select Test Leak/Compliance on the Calibrate/General menu to access the manual circuit leak test screen. The manual circuit leak test screen is shown below.

manual circuit leak test. 3. The ongoing manual circuit leak test is as shown below. You can select Cancel to cancel the ongoing leak test. The following screen is displayed if the manual circuit leak test is failed. If so, you must perform the test again. The following screen is displayed if the manual circuit leak test is completed. Select Continue to enter automatic circuit leak test.

problems as described in 5.3 Pneumatic Circuit System Problems. Repeat the leak test after the source of the failure has been resolved.

This test checks the pneumatic circuit for leaks in mechanical ventilation mode. Test items include the bellows, drive gas circuit, CO2 absorber canister, patient tubes, flow sensors, and flow sensor connectors. To perform the breathing system leak test in mechanical ventilation mode: 1. You can access the automatic circuit leak test screen after the manual circuit leak test has passed. The automatic circuit leak test screen is shown below. Set up the machine as per the instructions on the screen. Then, select Continue to execute automatic circuit leak test. You can select Skip to access the Standby screen directly. The ongoing automatic circuit leak test is as shown below. You can select Cancel to cancel the ongoing leak test.

The automatic circuit leak test results are listed in the following table. Test results System Limitation Safety valve control failed The machine cannot be used. Automatic circuit leak test failed Only manual ventilation can be applied. Compliance test failed Both automatic ventilation and manual ventilation can still be applied applied using the previous compliance value in the A5/A3 system memory, but may not meet the accuracy of the delivered volume. The following screen is displayed if the safety valve control test is failed. You can select Service Access and enter the required service password to access service mode. You can select Retry to perform automatic circuit leak test again. The following screen is displayed if the automatic circuit leak test is failed. You can select Override to enter Standby mode. But mechanical ventilation is disabled. You can select Retry to perform automatic circuit leak test again.

enter Standby mode.You can select Retry to perform automatic circuit leak test again. The following screen is displayed if the automatic circuit leak test is completed. Select Continue to enter Standby mode. NOTE: If the leak test fails, check all of the possible leak sources, including the bellows, breathing system tubes, and CO2 absorber canister. Check that they are correctly connected and their connectors are not damaged. NOTE: If there is a leak, check the pneumatic circuit system for leakage and troubleshoot the problems as described in 5.3.4 Breathing System. After the leak has been resolved, repeat the leak test.

The following table lists the commonly-encountered problems and recommends actions for 2.3.2.2Breathing System Leak Test in Mechanical Ventilation Mode. Failure description Possible cause Recommended action The Auto/Manual ventilation switch is set to the bag position and the message [Manual Vent.] is prompted. Set the Auto/Manual ventilation switch to the mechanical ventilation position. Leak test failure is prompted immediately after [Start] is selected (typically, the leak test requires at least 3 minutes). The reading on the drive gas (O2) pressure gauge indicates drive gas pressure low (lower than 200 kPa) and the alarm of [Drive Gas Pressure Low] is produced. Replace or connect gas supplies and make sure that the drive gas pressure is at 350 to 450 kPa. During leak test, the pressure indicated by the airway pressure gauge fails to reach 30 cmH2O. 1. Before the leak test, the bellows is not fully inflated. 2. The Y piece on the breathing tube is not connected to the test plug. 3. The bellows housing is not properly installed. Check the connections of the pneumatic circuit and re- install the pneumatic circuit. 2.3.3 O2 Sensor Calibration NOTE: Both a 21% and 100% O2 calibration MUST BE performed before first use of the A5/A3. The O2 sensor is not calibrated with the machine at the factory. NOTE: Calibrate the O2 sensor when a great deviation of O2 concentration monitored value occurs or when the O2 sensor or ventilator control board is replaced or when prompted by the anesthesia system. NOTE: Before calibration, observe if the O2 sensor displays numerics on the measure screen. If not, check the O2 sensor connection line, or replace the O2 sensor until measure numerics are displayed.

NOTE: In version 01.03.02 and earlier, 21% O2 sensor calibration can be performed from the Setup > Calibrate menu and Setup > Service menu. Follow these steps to calibrate the O2 sensor at 21% O2. 1. Select Setup > Calibrate > Calibrate O2 Sensor or Setup > Service > Calibration > O2 Sensor to access the screen as shown below. Set up the machine as per the instructions on the screen. Select Begin to start calibration. 2. The calibration screen as shown below is displayed when Begin is selected. During the calibration, you can select Cancel to cancel the calibration.

Again to repeat the calibration. Select Done to exit the calibration screen. 4. The screen shown below is displayed if the calibration has failed. Select Try Again to repeat the calibration. Select Done to exit the calibration screen.