GE Healthcare Avance

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Manual Reference

Avance Anesthesia Machine Technical Reference Manual, 1009-0357-000, Revision ZAB, October 2024; Planned Maintenance Checklist 1009-0357-000-PMC, Revision C.

Manufacturer Recommendation / AEM Status

GE Healthcare provides a sequential planned-maintenance procedure for the Avance. The manufacturer-listed planned-maintenance interval is every 12 months, except for components with separately listed replacement intervals.

The procedure is intended for trained personnel and must not be performed while the anesthesia machine is connected to or supporting a patient. Unless a procedure specifies otherwise, flow and pressure test instruments should have an accuracy of ±2.5% of reading or better.

Manufacturer-Listed Replacement Intervals

Every 12 Months

Replace applicable ACGO covers using kit stock number 2084453-001.
Replace vaporizer-port O-rings using kit stock number 1102-3016-000.

Every 24 Months

In addition to the applicable 12-month items:

Replace free-breathing flapper valve, stock number 0211-1454-100.
Replace free-breathing-valve O-ring, stock number 1503-3208-000.

Every 36 Months

In addition to the applicable 12- and 24-month items:

Replace both system batteries as a pair using battery-pair stock number 4873474-S.
The system uses sealed lead-acid, 12 V batteries.

Every 48 Months

In addition to the applicable 24-month items:

Replace the Display Unit battery, stock number 1009-5800-000.

The fan filter behind the display and the filter above the AC power inlet are inspected and replaced as necessary rather than at a fixed interval.

Post-Repair Electrical Safety

Perform the electrical safety tests every time a machine cover is removed. Following repair, replace damaged parts with GE Healthcare-manufactured or supplied components and verify that the machine complies with the manufacturer’s published specifications.

AEM Status

If the facility changes the manufacturer-listed interval or maintenance activities, document the change under the facility’s approved alternative equipment maintenance program, risk assessment, maintenance history, and applicable regulatory requirements.

What This PM Procedure Covers

Manufacturer-listed interval-based parts replacement.
External, frame, hose, cable, caster, and brake inspection.
Startup annunciator verification.
Pipeline, cylinder, and O2 supply-failure testing.
AGSS inspection and relief testing.
Advanced Breathing System inspection.
Ventilator diagnostic and relief-system tests.
Gas mixer and oxygen-flow verification.
Vaporizer manifold back-pressure and interlock testing.
O2 flush-flow testing.
System checkout and alarm verification.
AC power-failure and battery-capacity testing.
Electrical safety testing.
Final return-to-service configuration.

Required Tools and Equipment

Use current calibrated equipment appropriate for the installed configuration.

Avance Planned Maintenance Checklist, 1009-0357-000-PMC.
Calibrated anesthesia-machine analyzer.
Calibrated pressure-measurement device.
Calibrated flow-measurement device.
Test lung.
Breathing circuit.
Low-pressure leak-test device or manufacturer-specified leak-test setup.
Oxygen analyzer where independent O2 measurement is required.
Electrical safety analyzer.
Grounding clip assembly.
Appropriate pipeline gas supplies.
Full reserve O2 cylinder.
Cylinder wrench and approved cylinder gaskets.
Vacuum source and test gauge for integrated suction, if equipped.
Manufacturer-specified service application and interface equipment where diagnostic menus or logs are required.
Replacement parts due at the machine’s current age or maintenance interval.

Unless otherwise specified, flow and pressure test devices should have an accuracy of ±2.5% of reading or better.

Step-by-Step PM Procedure

1. Remove the Machine From Clinical Use

Confirm that the machine is not connected to a patient. Follow facility infection-control procedures and remove or identify contaminated disposable components before service.

Record the equipment ID, serial number, software version, installed options, and current hour or service-log information when available. Review prior corrective-maintenance history and unresolved service-log entries.

Expected outcome: The machine is safely available for maintenance and its configuration is documented.

2. Replace Interval-Based Parts

Perform scheduled parts replacement before testing, calibration, or checkout.

At 12 months, replace applicable ACGO covers using kit 2084453-001.
At 12 months, replace vaporizer-port O-rings using kit 1102-3016-000.
At 24 months, replace free-breathing flapper valve 0211-1454-100.
At 24 months, replace free-breathing-valve O-ring 1503-3208-000.
At 36 months, replace both system batteries as a pair using 4873474-S.
At 48 months, replace the Display Unit battery using 1009-5800-000.

Expected outcome: All manufacturer-listed components due at the current interval have been replaced and documented.

3. Inspect the Frame and External Components

Inspect the display housing and mount, cabinet, tabletop, drawers, shelves, rails, arms, fasteners, attachment points, labels, power cord, electrical cables, pipeline hoses, fittings, tubing, rubber components, cylinder yokes, restraints, vaporizers, vaporizer mounting system, brakes, and casters.

Inspect the fan filter behind the display and the filter above the AC power inlet. Replace either filter as necessary.

Verify that caster mounting marks remain aligned. Where marks are absent, verify that the caster nut is flush with the base casting, confirm that the caster cannot be loosened by hand, and apply an alignment mark according to the manual. Do not lubricate the casters.

Expected outcome: No loose, damaged, deteriorated, unreadable, or insecure components are present. The casters roll correctly and the brake prevents movement.

4. Verify Startup Annunciators

Turn the system on and verify:

An audible beep occurs immediately after the system switch is turned on.
A second beep occurs several seconds into startup.
A third and fourth beep occur from the Display Unit before startup completes.

Observe startup for hardware, software, battery, gas-delivery, ventilator, or monitor faults.

Expected outcome: All four startup annunciator tones are heard and no unresolved startup fault remains.

5. Inspect Service Logs and Diagnostic Records

Open the service-log and diagnostic menus. Review active and stored entries, investigate recurring or unresolved entries, and document corrective action for significant faults.

Run the manufacturer-listed Flow and Pressure diagnostic test. Run the Circuit O2 Cell 21% and 100% tests where applicable.

Expected outcome: Flow and Pressure displays Pass. Circuit O2 Cell 21% and Circuit O2 Cell 100% display Pass where applicable. Appropriate action has been taken on significant service-log entries.

Do not clear meaningful service information merely to obtain a clean log.

6. Test Pipeline and Cylinder Supplies

Pipeline Cross-Connection Test

Display the Gas Supply window. Disconnect pipeline supplies and close all cylinder valves. Verify that all pressure readings return to zero.

Connect each pipeline gas one at a time and confirm that only the corresponding gas-pressure indication increases.

Expected outcome: Each pipeline connection produces the correct gas indication with no evidence of crossed gas supplies.

Cylinder-Pressure Test

Disconnect pipeline supplies. Open each cylinder individually, verify the corresponding cylinder-pressure indication, and confirm adequate cylinder pressure.

Expected outcome: Each cylinder is correctly identified and its pressure is displayed.

High-Pressure Cylinder Leak Test

For each cylinder, turn auxiliary O2 flow fully off and turn off venturi-derived suction if equipped. Open the cylinder, record the pressure, close the cylinder, and record the pressure after one minute.

Pass criterion: Pressure decrease is no greater than 690 kPa or 100 psig in one minute for each gas cylinder.

If the test fails, install a new approved cylinder gasket and repeat the test. Close cylinder valves when pipeline gas is in use.

7. Test the O2 Supply Alarm and Gas-Failure Response

Start a simulated case. Establish O2, air, and N2O supplies as equipped. Set O2 to 25%, select N2O as the balance gas or air on machines without N2O, and set total flow to 3 L/min.

Interrupt the O2 supply and verify:

The O2 supply pressure low alarm occurs.
O2 flow stops.
N2O flow stops, if equipped.
Air continues or the system provides the appropriate air-selection prompt.

Reconnect O2 after the test.

Expected outcome: The alarm and gas-delivery response occur as described.

8. Inspect and Test the AGSS

Perform the procedure appropriate for the installed passive, adjustable-active, or active AGSS configuration.

Remove and inspect the scavenging reservoir and receiver. Drain accumulated water. Inspect hoses, ports, reservoir bag, receiver, relief valves, retainers, and fittings. Confirm that unused evacuation ports are capped.

Clean contaminated components according to manufacturer instructions. Replace worn, missing, distorted, damaged, or sticking parts. Verify that relief-valve disks move freely and that scavenging is connected and adjusted correctly.

Perform the manufacturer’s scavenger positive-relief functional check.

Pass criterion: Pressure rise is not more than 10 cmH2O.

Expected outcome: The scavenging assembly is mechanically intact, unobstructed, correctly connected, and passes the positive-relief check.

9. Inspect the Advanced Breathing System

Inspect:

Inspiratory and expiratory flow sensors.
Flow-sensor module.
Breathing-circuit module.
O2 sensor and connector.
Inspiratory and expiratory check valves.
Absorber canister and locking mechanism.
Canister-release mechanism.
Bellows and bellows housing.
Bellows-base latch.
APL valve and bag port.
Negative-pressure relief valve.
Bag/Vent switch.
Exhalation valve.
EZchange canister system, if equipped.
Condenser and drain, if equipped.
Seals, O-rings, tubes, and mating surfaces.

Look for contamination, water, cracks, deformation, sticking valves, missing seals, incorrect assembly, or loose components.

Bellows Drop Test

Test the bellows in the upright and inverted configurations as directed by the manual.

Pass criterion: The bellows do not fall within one minute in either tested position.

Expected outcome: The breathing system is clean, correctly assembled, mechanically secure, and leak tight.

10. Inspect the Free-Breathing Valve

Inspect the free-breathing valve and its seating surfaces. At the 24-month interval, confirm replacement of flapper valve 0211-1454-100 and O-ring 1503-3208-000.

Verify unrestricted movement and correct reassembly.

Expected outcome: The valve moves freely, seals correctly, and all interval-based parts are current.

11. Perform Ventilator Tests

Use the service diagnostic procedures and exact configurations listed in the technical reference manual.

Complete:

Flow and pressure diagnostic test.
MOPV pressure-relief test.
Pressure-limit-circuit test.
Inspiratory-flow and airway-pressure verification.
Gas-inlet-valve feedback verification.
Ventilator leak and functional checks.
Ventilation with a breathing circuit and test lung.

Manufacturer-listed outcomes include:

Flow and Pressure test displays Pass.
The MOPV relief weight operates and the expected relief or purring sound occurs.
Over Pressure Circuit briefly reads High and then returns to OK.
Gas Inlet Valve Feedback reads Closed.

Expected outcome: The ventilator completes all diagnostic and functional tests without an unresolved fault.

12. Perform Machine and Gas Mixer Testing

Perform the manufacturer’s machine-testing sequence, including:

Gas-mixer diagnostics.
Mixer outlet check-valve leak test.
Mixer flow verification.
Gas selection and total-flow verification.
O2 concentration verification.
Low-flow verification.
Response to gas-supply changes.

Use the service menu and calibrated analyzer as directed by the manual. Do not substitute adjustment ranges for operating pass/fail tolerances.

Expected outcome: Mixer tests pass and measured flow and oxygen concentration remain within the manufacturer’s stated test limits.

13. Test Optional O2 Flowmeters and Suction

Alternate O2 Flowmeter

Where equipped, verify smooth control operation and verify flow indication and measured output using the manual’s test points.

Auxiliary O2 Flowmeter

Where equipped, verify that the control operates smoothly and shuts flow off. Measure output at the manufacturer-specified settings.

Integrated Suction Regulator

Where equipped, inspect tubing, collection-bottle connections, regulator, and venturi assembly. Verify suction regulation and maximum suction using the manufacturer’s procedure.

Expected outcome: Each installed option operates smoothly and passes its applicable flow, pressure, leak, and shutoff checks.

14. Test Vaporizer Back Pressure and Interlock

Inspect vaporizer mounting ports, seals, locking levers, and O-rings. Confirm that the vaporizers are correctly seated and locked.

Confirm that each vaporizer can be turned on individually and that the interlock prevents simultaneous activation of more than one vaporizer.

Perform the vaporizer back-pressure test using the manufacturer’s test setup and check each manifold position.

Expected outcome: Vaporizers mount securely, the interlock functions correctly, and back pressure remains within the manufacturer’s specification.

15. Test O2 Flush Flow

Using an appropriate calibrated flow-measurement setup, activate the O2 flush control. Verify that flow is delivered only while the control is pressed and that the control releases and shuts correctly. Record the measured flow.

Expected outcome: O2 flush flow meets the manufacturer’s specified range and the valve does not stick or leak.

16. Calibrate the Airway Module, if Applicable

Inspect the sampling line, water trap, sample inlet, exhaust connection, and sample-gas return. Replace contaminated or damaged external sampling components as needed.

Perform the manufacturer-directed room-air and reference-gas calibration applicable to the installed module. Verify O2, CO2, N2O, and anesthetic-agent readings as equipped.

Expected outcome: Calibration completes without error and gas readings meet the module’s stated verification criteria.

17. Perform System Checkout

Run the complete Avance system checkout, including:

Machine Check – System.
Machine Check – Circuit.
Circuit O2 check.
Monitor check where applicable.
Low-pressure leak test.
Ventilator-circuit testing.
Bag-circuit testing.

Document displayed leak results and any failed checkout stage.

Manufacturer-listed leak criterion: The checkout procedure includes a leak less than 250 mL criterion.

Expected outcome: All applicable system-checkout stages pass with no unresolved leak, sensor, gas, ventilator, or monitor failure.

18. Perform Alarm Tests

Verify applicable audible and visual alarms, including:

High airway pressure.
Low airway pressure.
Apnea.
Low minute volume.
Low tidal volume.
O2 concentration alarms.
Gas-supply alarms.
Power-failure and battery-operation alarms.
Ventilator and system-malfunction alarms.

Confirm that alarm messages display, audible tones are present, alarm silence operates correctly, alarm limits can be set and restored, and alarms clear when the test condition is corrected.

Expected outcome: Every tested alarm activates, annunciates, and clears correctly.

19. Perform AC Power-Failure Test

Operate the system from AC power and begin ventilation with a breathing circuit and test lung. Interrupt mains input using the system breaker or the manual’s specified procedure.

Verify that the machine transitions to battery operation and that the appropriate AC-power-loss message and audible alarm occur. Restore AC power and confirm charging resumes.

Expected outcome: Ventilation, display, alarms, and gas delivery continue during transition to battery power.

20. Perform Battery-Capacity Test When Applicable

The battery-capacity procedure is intended to demonstrate that the system can operate for at least 45 minutes under the specified test load.

Before testing, verify that the batteries are fully charged and that diagnostic status indicates Float Charge.

Test Configuration

Start a simulated case.
Connect a breathing circuit and test lung.
Mode: VCV.
Tidal volume: 400 mL.
Rate: 12 breaths/min.
I:E ratio: 1:2.
PEEP: Off.
Task lights: Maximum brightness.
Gas module: Installed, if available.
Bag/Vent switch: Vent.

Turn off the mains system breaker and allow the system to operate on battery.

Pass criterion: The system remains operational after 45 minutes, or the recorded Last Full Discharge time is greater than 45 minutes.

Fail criterion: Last Full Discharge time is less than 45 minutes. Replace both system batteries.

After testing, restore mains power and allow the batteries to recharge fully. Charging can take up to eight hours. Capacity testing is not required immediately after battery installation during PM.

21. Complete Final Machine Checks

Disconnect all test devices. Reconnect pipeline hoses, monitors, and accessories. Verify the light bar or gooseneck light if equipped.

Confirm:

The APL valve is fully open at its minimum setting.
Panels and tray tops are installed.
Pipeline hoses are connected correctly.
Cylinder valves are closed and cylinder-supply readings are zero.
The system is connected to an appropriate AC power source.
Vaporizers are locked and set to OFF.
The breathing system is fully assembled.
Scavenging is connected and adjusted.
Batteries are charging.
No tools, plugs, test adapters, or temporary tubing remain attached.

Apply the facility PM label and document any controls or calibration adjustments.

Expected outcome: The machine is correctly assembled, passes checkout, and is configured for safe clinical setup.

Electrical Safety Testing

The manufacturer directs electrical safety testing during planned maintenance and whenever a machine cover has been removed.

Preparation

Place the system switch in Standby.
Disconnect pipeline hoses from medical-gas outlets.
Disconnect electrical monitors and accessories.
Connect the Avance to the electrical safety analyzer.
Connect the analyzer to an AC wall outlet.
Verify normal line polarity.
Connect the analyzer grounding clip.

Ground Resistance

Measure between the protective-ground pin of the power-cord plug and a pipeline inlet.

Ground resistance measured in ohms, expected ≤ 0.20 Ω per the manufacturer:

Result =

Pass / Fail =

Chassis Leakage Current

Use an approved electrical safety test device.

Manufacturer limits:

100/120 Vac system: less than 300 µA.
220/240 Vac system: less than 500 µA.

Touch/chassis leakage measured in microamps:

Input voltage tested =

Facility limit used =