Atrium OASIS - Dry Suction Water Seal Chest Drain

Atrium OASIS

Dry Suction Water Seal Chest Drain

• Set up

Step 1. Fill water seal to 2 cm line

Add 45 ml of sterile water or sterile saline via the blue

suction port located on top of the drain. For models

available with sterile fluid, twist top off bottle and insert

tip into suction port. Squeeze contents into water seal

until fluid reaches 2 cm fill line.

Step 2. Connect chest drain to patient(A)

Connect chest drain to patient prior to initiating suction.

Step 3. Connect chest drain to suction

Attach suction line to the blue suction port on top of

chest drain.

Step 4. Turn suction source on

Increase suction source vacuum to –80 mmHg or

higher. Suction regulator is preset to –20 cmH

Adjust as required.

Have a question or need help in a hurry?

Call Maquet toll free at 1-800-528-7486.

What to check during system operation

• Verifying suction operation via the suction

monitor bellows

The bellows located in the

suction monitor window will

expand only when suction

is operating. The bellows

will not expand when

suction is not operating

or is disconnected. The s

mark allows quick and easy

confirmation of vacuum

operation over a wide

range of continuously

adjustable suction control

settings.

•Increase vacuum source when bellows is not

expanded to smark

If the bellows is observed to be expanded, but less

than the smark, the vacuum source pressure must be

increased to –80 mmHg or higher.

• Changing suction pressures

Changing suction pressure

is accomplished by adju-

sting the rotary dry suction

control dial located on the

side of the drain. Dial down

to lower the suction pres-

sure and dial up to increase

the suction pressure.

NOTE: When changing suction pressure from a higher

to lower level, use of the manual high negativity vent

after regulator adjustment will reduce excess vacuum

pressure down to the lower prescribed level.

•Verifying water seal operation

The water seal must be filled and maintained at the

2 cm level to ensure proper operation and should be

checked regularly when used for extended periods. As

required, additional water may be added by a 20 gauge

or smaller needle and syringe via the grommet located

on the back. Fill to the 2 cm line.

•Placement of unit

Always place chest drain below the patient’s chest in an

upright position. To avoid accidental knock-over, open

the floor stand for secure placement on floor or hang the

system bedside with the hangers provided.

•Recording drainage volume

The collection chamber incorporates a writing surface

with easy-to-read fluid level graduations. Please refer

to individual product inserts for specific model gradu-

ations.

•Observing water seal for

patient air leaks

The chest drain offers air leak

detection with rapid air leak

assessment and enhanced

visibility due to the tinted

water. When air bubbles are

observed going from right to left in the air leak monitor,

this will confirm a patient air leak.

Continuous bubbling in the bottom of the water seal

air leak monitor will confirm a persistent air leak.

Intermittent bubbling in the air leak monitor with float

ball oscillation will confirm the presence of an intermit-

tent air leak.

No bubbling with minimal float ball oscillation at bot-

tom of the water seal will indicate no air leak is present.

• Observing graduated water seal column for

changes in patient pressure

Patient pressure can be

determined by observing the level

of the blue water and small float

ball in the graduated water seal

column. With suction operating,

patient pressure will equal the

suction control setting plus the

graduated water seal column level.

For gravity drainage (no suction) patient pressure will

equal the graduated water seal column level only.

•Graduated air leak monitor

For those models with a graduated air leak monitor,

air leak bubbling can range from 1 (low) to 5 (high). Air

bubbles create an easy to follow air leak pattern for

monitoring patient air leak trends.

•High negativity float valve

The high negativity float valve,

with its controlled release action,

enables the thoracic patient to

draw as much intra thoracic pres-

sure as is required during each

respiratory cycle. During prolon-

ged episodes of extreme negative

pressure, a controlled release

system will automatically relieve excess vacuum to the

lower, prescribed pressure level.

•Manual high negativity vent

To lower the height of the water seal column or to

lower patient pressure when connected to suction,

depress the manual

vent located on top of

the drain until the float

valve releases and the

water column returns to

the desired level. Do not

use manual vent to lower water seal column when

suction is not operating or when the patient is on

gravity drainage.

•Positive pressure protection

The positive pressure

release valve, located on top

of drain, opens to release

accu mulated positive

pressure. Do not obstruct

the positive pressure

release valve.

Bellows must be expanded to s

mark or beyond for a –20 cmH

or higher regulator setting.

Do not use when suction is not operating.

A Dry Suction Regulator

B Water Seal Chamber

C Air Leak Monitor

D Collection Chamber

E Suction Monitor Bellows

F Easy-to-Grip Handle

G Positive Pressure Release Valve

H Suction Port

I Manual High Negativity Vent

J Multi-position Hangers

K In-line Connector

L Needleless Access Port

M Patient Pressure Float Ball

N Swing Out Floor Stand

O Patient Tube Clamp

P Patient Connector

Troubleshooting

•Sampling patient drainage

Sampling of patient drainage must be in accordance

with approved hospital infection control standards.

Selected models include a needleless Luer port on the

patient tube connector for sampling patient drainage.

Alcohol swab the Luer port prior to syringe attach-

ment (no needle). Fluid samples can also be taken

directly from the patient tube by forming a temporary

dependent loop and inserting a 19 gauge needle at an

oblique angle. Alcohol swab the patient tube prior to

inserting syringe at a shallow angle. Do not puncture

patient tube with an 18 gauge or larger needle.

•System disconnection

For models equipped with an in-line connector, close

the patient tube clamp prior to disconnecting the

chest drain patient tube from patient. Clamp off all

indwelling thoracic catheters prior to disconnecting

chest drain from patient.

•System disposal

Disposal of chest drain and its contents should be in

accordance with all applicable regulations.

Have a question or need help in a hurry?

Call Maquet toll free at 1-800-528-7486.

M Atrium Ocean Chest Drain is manufactured by Atrium Medical Corporation, 5 Wentworth Drive, Hudson NH 03051 603-880-1433. • Protected by the following international and U.S. patent(s): http://patents.maquet.com. • Y CAUTION: Federal (US) law restricts

this device to sale by or on the order of a physician. • Maquet is a Trademark and/or Registered Trademark of Maquet GMBH, its subsidiaries, and/or afﬁliates in the United States and/or other countries. • Maquet is registered in U.S. Patent and Trademark Ofﬁce.

• Ocean and Atrium are Trademarks and/or Registered Trademarks of Atrium Medical Corp., its subsidiaries, and/or afﬁliates in the United States and/or other countries. • Ocean and Atrium are registered in U.S. Patent and Trademark Ofﬁce. All other company or

product names are the trademarks or registered trademarks of their respective holders. • Copyright 2015 Atrium Medical Corp. or its afﬁliates. • All rights not expressly granted are reserved. • 03/15 • Part No. 010394 Rev AA Letter. Refer to Instructions for Use for

current indications, warnings, contraindications, and precautions.

What to check during system operation

How do I determine patient pressure with a dry suc-

tion chest drain?

Whether using a traditional wet or dry suction operating

system, one cannot overemphasize the importance

of the graduated water seal column when it comes to

diagnosing the patient’s condition or monitoring normal

system operation. Patient pressure can be determined

by observing the level of the blue water and small float

ball in the graduated water seal column. With suction

operating and the bellows expanded across the suction

monitor window, patient pressure will equal the suction

control setting (read directly from the regulator dial) plus

the graduated water seal column level. For example,

when the suction monitor bellows is expanded to the

s mark or beyond to confirm a –20 cmH

O suction

setting, and the graduated water seal column reads

–15 cmH

O, patient pressure is –35 cmH

O (–20 cmH

+ –15 cmH

O = –35 cmH

O). For gravity drainage (no

suction) patient pressure will equal the graduated water

seal column only.

What should I do when the suction monitor bellows

is not expanded to the s mark when the regulator is

set at -20 cmH

O or higher?

The position of the bellows across the suction monitor

window will alert the operator that the suction source

has fallen below the minimum operating range for the

prescribed suction control setting. Simply increase the

vacuum source to –80 mmHg or higher. The suction

monitor bellows must expand to the smark or beyond

for –20 cmH

O or higher suction regulator setting.

What should I do when the bellows does not fully

expand to the smark after I increase the suction

source vacuum?

Dry suction chest drains require higher levels of vacuum

pressure and air flow from the suction source to operate

properly at each suction control setting as compared

to traditional water controlled operating systems. The

suction source should provide a minimum vacuum

pressure of –80 mmHg at 20 liters of air flow per minute

for chest drain operating efficiency at a suction control

setting of –20 cmH

O. The suction source should be

greater than –80 mmHg when multiple chest drains are

connected to a single suction source. If the bellows

does not fully expand to the smark, it may simply

be that the suction source is not functioning to its full

potential to provide the minimum vacuum pressure or

air flow required to “drive” the suction control regulator.

Additionally, conditions may exist that can reduce, or

“restrict” air flow from the suction source. A restrictive

clamp, connector, or kink in the suction line tubing can

potentially “starve” the chest drain of air flow. A leak in a

connection or wall canister, along with extensive lengths

of suction tubing can also reduce air flow to the unit.

To troubleshoot this situation, first check to be sure

that all connections are air-tight. Inspect the suction

tubing and connections for possible cracks, leaks,

kinks, or occlusion. You may need to simply bypass a

“leaky” wall canister. Try connecting the chest drain to

a different suction source or wall regulator. When mul-

tiple chest drains are “Y” connected to a single suction

source, if possible, reconnect the drains to separate

suction sources. Finally, replace the chest drain if you

suspect the unit is cracked or damaged.

Does the bellows need to expand beyond the s

mark for a –10 cmH

O regulator setting?

No. For a regulator setting less than –20 cmH

O suction

(–10 cmH

O), any observed bellows expansion across

the monitor window will confirm suction operation. The

bellows need not be expanded to the smark for suc-

tion pressures less than –20 cmH

O, just visibly expan-

ded to confirm suction operation.

How do I confirm my patient has an air leak when:

• There is no bubbling in the water seal?

If there are no air bubbles observed going from right to

left in the air leak monitor, there is no patient air leak.

In order to confirm that your patient’s chest catheter

is patent, temporarily turn suction off and check for

oscillation of the patient pressure float ball in the water

seal column coinciding with patient respiration.

•Bubbling is present in the water seal?

Whenever constant or intermittent bubbling is present

in the water seal air leak monitor, this will confirm an

air leak is present. Oscillation of the patient pressure

float ball at the bottom of the water seal without

bubbling will indicate no apparent air leak. Bubbling

from right to left must be present to confirm an air

leak. To determine the source of the air leak (patient or

catheter connection), momentarily clamp the patient

tube close to the chest drain and observe the water

seal. If bubbling stops, the air leak may be from the

catheter connections or the patient’s chest. Check

the cathe ter connectors and patient dressing for a

partially withdrawn catheter. If bubbling continues after

temporarily clamping the patient tube, this will indicate a

system air leak requiring system replacement.

What does it mean when the small float ball is

located at the bottom of the water seal column?

If the small float ball is located and oscillating at the

bottom of the water seal column with no bubbling,

there is no apparent patient air leak. However, the water

seal should be carefully monitored for the presence of

an occasional or intermittent air leak.

Is it normal for the patient pressure float ball to

fluctuate up and down (tidal) near the bottom of the

water seal column?

Yes. Once your

patient’s air leak is

resolved, you will

generally observe

moderate tidaling

in the water seal

column. Increases in

intrathoracic pressure

will cause the water

level to rise (the ball

rises) during patient

inspiration and will lower or decrease (the ball drops)

during expiration. This diagnostic tool will help to

confirm patency of your patient’s catheter(s).What

happens when the water rises to the top of the

water seal float valve?

The water seal column is a diagnostic manometer for

monitoring your patient’s intrathoracic pressure. When

intrathoracic pressures increase, causing the water

to rise to the top of the water seal float valve, the ball

floats up and “seats” up against a valve seat. This

valve seat has been engineered to allow a specific

amount of water to pass through it during a defined

amount of time. When vacuum pressures greater

than –20 cmH

O on gravity or –40 cmH

O on suction

occur for an extended period of time, water will pass

through the valve seat and float valve to allow the

water seal to release automatically. The benefit of the

controlled release design is that during normal or deep

inspiration, the float valve will float up and down with

each respiratory cycle, not allowing the water seal to

release. This enables thoracic patients to draw as much

intrathoracic pressure as they may require during each

respiratory cycle.

How do I lower the water seal column?

Changes in your patient’s intrathoracic pressure will

be reflected by the height of the water in the water seal

column. These changes are usually due to mechanical

means such as milking or stripping patient drainage

tubes, or simply by deep inspiration by your patient after

all air leaks have subsided. If desired, the height of the

water column and patient pressure can be reduced by

temporarily depressing the filtered manual vent located on

top of the drain, until the float valve releases and the water

column lowers to the desired level. Do not lower water

seal column when suction is not operating, or when

patient is on gravity drainage.

If the chest drainage system has been knocked

over, can I use it and what should I do?

After a chest drainage system has been knocked over,

set it upright and immediately check the fluid level of the

water seal for proper volume. The drain provides a con-

venient diaphragm for access by a 20 gauge or smaller

needle and syringe to adjust the water level in the water

seal chamber, if required. Alcohol swab the needle access

area and aspirate any overfill that may have occurred.

If the water seal has an inadequate fluid level, simply

replace the lost volume. If a significant amount of

blood has entered the water seal, it may be advisable

to change the system for a new one.

Not enough vacu um for

-20 cmH

O or higher suction

control setting.

Normal suction operation for

- 20 cmH

O or higher.

Increase suction source

to -80 mmHg or higher.

Maquet Medical Systems USA | 45 Barbour Pond Drive, Wayne, NJ 07470 | www.maquetusa.com MCV00033028 REVA