SECTION 6

e360 OVP TEST RECORD SHEET

Hospital or Organization ______________________________________________________________

e360 Serial Number ___________________ Hour Meter ________ Software Rev. __________

Service Technician ________________________________________

Date __________________
Released by ____________________________________________

Test Equipment: ID No. Electrical Safety Tol. Value

Test
Calibration Analyzer Ground resistance <0.1?
Oxygen Analyzer Max leakage current <100 µA
Electrical Safety Analyzer
FIO2
Test Pass Set Displayed Measured Tol. Range
FI02 FI02

Front Panel Visual LED Check 21 + 3 Variance

Pneumatic Leak Test 40 + 3 Variance
Loss of Gas Alarms (Air/O2 ) 60 + 3 Variance
FIO2 80 + 3 Variance
Main Flow 100 + 3 Variance
Bias Flow Main Flow (L/min) FIO2 = 21%
Set V? peak I Measured Tol. Range
Flow/89%
Inspiratory time

Respiratory Rate 5 + 1 Variance

Pressure Control 10 + 1 Variance
Pressure Support 50 + 4 Variance
Ptrig sensitivity 80 + 5 Variance
Main Flow (L/min) FIO2 = 100%
V? peak I
PEEP/CAP
Set Measured Tol. Range
Flow/89%
Manual Inflation
Insp. Tidal Volume
Exp. Tidal volume (VTE) 5 + 1 Variance
Alarm Silence 10 + 1 Variance
Loss of power/battery operation 50 + 4 Variance
80 + 5 Variance
Bias Flow (L/min)
Set Bias Flow Tol. Range
3 2.5 - 3.5

SER360 A1106 6-13

OPERATIONAL VERIFICATION PROCEDURE

5e360 OVP TEST RECORD SHEET (CONTINUED)

Inspiratory Time (sec) Ptrig Sensitivity (cmH2O)
Set tI Measured Tol. Set Actual Tol. Range
Insp. Time Range
0.25 0.2 - 0.3 1 +0-2
0.5 0.4 - 0.6 3 +2-4
Respiratory Rate (b/min) PEEP/CPAP (cmH2O)
Set ƒtot Measured Tol. Set PEEP Measured Tol. Range
Resp. Rate Range Pressure
5 +1 3 + 1 Variance
Variance 10 + 1 Variance
20 +1 20 + 1 Variance
Variance
Pressure Control (cmH2O)
Set Ppeak Measured Tol. Inspiratory Tidal Volume (mL)
Range
+ 10% Set VTI Measured Tol. Range
Volume
10
Variance
+ 10% 200 + 10%
20
Variance Variance
+ 10% 500 + 10%
50
Variance Variance
Pressure Support (cmH2O) Expiratory Tidal Volume (mL)
Set Ppeak Measured Tol. Set VTE Tol. Measured Tol.
Pressure Range Range Volume Range
+ 10% 250 212-259 + 10%
10
Variance Variance

20 + 10% 500 423-517 + 10%

Variance Variance
1000 880-1030 + 10%
Variance

6-14 SER360 A1106