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Dräger Fabius Series

Dräger Fabius Series
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Drägerwerk AG & Co. KGaA, 23542 Lübeck
Drägerwerk AG & Co. KGaA
Moislinger Allee 53-55
23558 Lübeck, Germany
Postal address:
23542 Lübeck, Germany
Tel +49 451 882-0
Fax +49 451 882-2080
info@draeger.com
www.draeger.com
VAT no. DE135082211
Bank details:
Commerzbank AG, Lübeck
IBAN: DE95 2304 0022 0014 6795 00
Swift-Code: COBA DE FF 230
Sparkasse zu Lübeck
IBAN: DE15 2305 0101 0001 0711 17
Swift-Code: NOLADE21SPL
Registered office: Lübeck
Commercial register:
Local court Lübeck HRB 7903 HL
General partner: Drägerwerk Verwaltungs AG
Registered office: Lübeck
Commercial register:
Local court Lübeck HRB 7395 HL
Chairman of the Supervisory Board
for Drägerwerk AG & Co. KGaA and
Drägerwerk Verwaltungs AG:
Stefan Lauer
Executive Board:
Stefan Dräger (chairman)
Rainer Klug
Gert-Hartwig Lescow
Dr. Reiner Piske
Anton Schrofner
To Dräger Customers and
Health Care Professionals
in the United States of America
April 24
th
2020
COVID-19: Usage of Dräger anesthesia devices for long-term ventilation Rev. 5
Dear Customers and Health Care Professionals,
The World Health Organization (WHO) declared COVID-19 a pandemic on March 11
th
, 2020 with currently
over 2,600,000 confirmed cases of the coronavirus illness reported in over 180 countries worldwide. The
pandemic has created a high demand for mechanical ventilation that may exceed the number of available ICU
ventilators in hospitals treating patients with the disease. In the last few days, many customers and health care
professionals have approached us to obtain information about possibly using Dräger anesthesia devices for
long-term ventilation as an alternative ventilator for ICU patients when existing devices are fully utilized and
there is no other ventilator option.
Our reference
COVID-19 Draeger, Inc
Phone
1-800-4-DRAGER
E-mail
remosaus @draeger.com
Please visit the Dräger COVID-19 website
https://www.draeger.com/en-
us_us/Home/novel-coronavirus-outbreak
for updates and other useful information

Table of Contents

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Dräger Fabius Series Specifications

General IconGeneral
TypeAnesthesia Workstation
ManufacturerDräger
Ventilation ModesSIMV
Flow ControlElectronic
Tidal Volume Range20 to 1400 mL (model dependent)
Respiratory Rate4 to 60 breaths/min
PEEP0-20 cmH2O
Gas SupplyO2, Air, N2O
Vaporizer Mounts2
MonitoringO2, CO2, N2O
DimensionsVaries by model
WeightVaries by model
ModelFabius Series
CategoryAnesthesia

Summary

General instructions

Prerequisites & preparation

Training of medical personnel

Ensure medical personnel are well-trained and familiar with anesthesia device characteristics.

Location requirements

Anesthesia devices should be used in rooms with adequate ventilation and protected from unauthorized users.

Manual resuscitator

A manual resuscitator must always be available for backup ventilation in case of device malfunctions.

Oxygen backup cylinder

An O2 backup cylinder is required to ensure desired FiO2 levels in case of central gas supply shortages.

Evacuation of gases (Scavenging)

Proper scavenging is recommended to avoid oxygen accumulation in the device environment.

Disconnection of vaporizers & N2 O

Disconnect all vaporizers and prevent N2O use to avoid anesthetic agent risks like malignant hyperthermia.

Infection prevention

Follow hospital guidelines for infection prevention, including device reprocessing and bacteria filters.

Filters & humidification

Use only mechanical filters; active humidification requires specific circuit configurations and monitoring.

Regular checks

System Test

Devices must be tested every 24 hours to ensure readiness for operation; perform a complete test for new patients.

System restart & refreshing internal memory

Restart devices periodically to prepare software for long-term use.

Check for overall status and accessories

Regularly check the overall status of the device and accessories, preventing issues like exhausted CO2 absorbers.

Therapy

Fresh gas flow

Maintain a high fresh gas flow (at least 150% of minute volume) to avoid rebreathing and humidity issues.

Handling leakages

Leakages are not compensated; pressure control mode offers advantages, and appropriate alarms should be monitored.

Modes of operation

Understand specific modes like Man/Spon and be aware that not all ICU ventilator modes are available.

Alarm volume 100%

Set alarm volume to maximum (100%) to ensure timely recognition of alarms.

Patient-specific limits for all alarms

Set patient-specific alarm limits for parameters like minute volume and CO2 to generate necessary alarms.

Alarm notifications

Alarm notifications are removed when the situation is no longer valid; check the alarm history periodically.

Gas measurement

Gas measurement modules must be connected; values have a delay, and FiO2 requires attention due to rebreathing.

Endotracheal suctioning in a closed system

Reduce suction power and consider disconnecting the manual breathing bag to prevent negative pressures.

Nebulization of drugs and aerosol therapy

Nebulization is not approved; use mechanical filters or disconnect the sampling gas line.

In case of failure

If a main component fails, immediately switch to an alternative means of ventilation.

Consumption of fresh gas and soda lime

Oxygen concentrator O2 93

Direct injection of volatile agents at Y-piece (not recommended)

Ventilating multiple patients with one device (not recommended)

Attachments

Attachment 1: Comments on particular modes of operation

Discusses differences in modes like Volume Control, Pressure Support, and NIV compared to ICU ventilators.

Attachment 2: Overview of Ventilation Modes

Provides a comparison of ventilation modes across Fabius, Apollo, and Perseus families.

Attachment 3: Drger Fabius Family with Installed Fresh Gas Outlet (FGO)

Details the correct setup and variants of the Fresh Gas Outlet (FGO) on Fabius devices.

Attachment 4 - Active Gas Scavenging (AGS) alternatives

Explains recommendations for proper scavenging to avoid oxygen accumulation.

Attachment 5: Increasing fresh gas flow by opening the emergency O2 flow control

Describes how to increase fresh gas flow using the emergency O2 flow control on Perseus devices.

Attachment 6: Fresh gas settings

Provides tables and examples for setting fresh gas flow and O2 concentration.

Attachment 7: Decision support in case of supply shortages

Offers guidance and decision trees for managing supply shortages of components like soda lime and filters.

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