Medical electrical equipment - Part 2-90: Particular requirements for basic safety and essential performance of respiratory high-flow therapy equipment (ISO 80601-2-90:2021)

EN-ISO 80601-2-90 applies to the basic safety and essential performance of respiratory high-flow therapy equipment, as defined in 201.3.220, hereafter also referred to as ME equipment or ME system, in combination with its accessories: - intended for use with patients who can breathe spontaneously; and - intended for patients who would benefit from improved alveolar gas exchange; and who would benefit from receiving high-flow humidified respiratory gases, which can include a patient whose upper airway is bypassed. Respiratory high-flow therapy equipment can be intended for use in the home healthcare environment or intended for use in professional healthcare facilities.

Medizinische elektrische Geräte - Teil 2-90: Besondere Festlegungen für die Sicherheit und die wesentlichen Leistungsmerkmale von Geräten für die Beatmungstherapie mit hohem Durchfluss (ISO 80601-2-90:2021)

Dieses Dokument gilt für die Basissicherheit und die wesentlichen Leistungsmerkmale von Atemtherapiegeräten mit hohem Durchfluss, wie in 201.3.220 definiert, im Folgenden auch als ME Geräte oder ME Systeme bezeichnet, in Kombination mit ihrem Zubehör:
- die für die Verwendung bei Patienten, die spontan atmen können bestimmt sind; und
- die für Patienten bestimmt sind, die von einem verbesserten alveolären Gasaustausch profitieren würden; und die davon profitieren würden, befeuchtete Atemgase mit hohem Durchfluss zu erhalten, was einen Patienten, dessen obere Atemwege umgangen werden, beinhalten kann.
BEISPIEL 1 Patienten mit Typ 1-Atmungsinsuffizienz, die eine Verminderung der Oxygenierung arteriellen Bluts aufweisen.
BEISPIEL 2 Patienten, die von einer verminderten Atemarbeit profitieren würden, wie sie bei Typ 2-Atmungsinsuffizienz mit hohem arteriellem Kohlendioxid erforderlich ist.
BEISPIEL 3 Patienten, die eine Anfeuchtung zur Verbesserung der mukoziliären Reinigung benötigen.
Atemtherapiegeräte mit hohem Durchfluss können für die medizinische Versorgung in häuslicher Umgebung oder in professionellen Gesundheitseinrichtungen vorgesehen sein.
ANMERKUNG 1 Bei der medizinischen Versorgung in häuslicher Umgebung ist das Versorgungsnetz oft nicht zuverlässig.
Atemtherapiegeräte mit hohem Durchfluss können sein:
- voll integrierte ME Geräte; oder
- eine Kombination aus separaten Elementen, die ein ME System bilden.
Diese Norm gilt auch für andere Typen von Atemgeräten, wenn diese Geräte eine Betriebsart für Atemtherapie mit hohem Durchfluss aufweisen.
ANMERKUNG 2 Diese Norm und ISO 80601 2 12[14] gelten für ein Intensivpflege-Beatmungsgerät mit einer Betriebsart für Therapie mit hohem Durchfluss.
Atemtherapiegeräte mit hohem Durchfluss können betriebsfähig bei Bewegung sein.
Dieses Dokument gilt auch für Zubehör, das durch den Hersteller für den Anschluss an Atemtherapiegeräte mit hohem Durchfluss vorgesehen ist, sofern die Merkmale dieses Zubehörs die Basissicherheit oder die wesentlichen Leistungsmerkmale der Atemtherapiegeräte mit hohem Durchfluss beeinflussen können.
BEISPIEL 4 Atemsets, Verbindungsstücke, Anfeuchter, Atemsystemfilter, externe elektrische Spannungsquelle, verteiltes Alarmsystem, Nasenbrille mit hohem Durchfluss, Trachealtubus, Tracheotomietubus, Gesichts-Maske und supra-laryngealer Luftweg.
Wenn ein Abschnitt oder Unterabschnitt speziell nur auf ME Geräte oder ME Systeme angewendet werden soll, wird dies aus der Überschrift und dem Inhalt des jeweiligen Abschnitts oder Unterabschnitts deutlich. Ist dies nicht der Fall, gilt der Abschnitt oder Unterabschnitt, je nach Zutreffen, für das ME Gerät und das ME System.
Gefährdungen, die der vorgesehenen physiologischen Funktion der in den Anwendungsbereich dieses Dokuments fallenden ME Geräte oder ME Systeme inhärent sind, werden nicht durch die spezifischen Anforderungen in diesem Dokument abgedeckt, ausgenommen in der Allgemeinen Norm, 7.2.13 und 8.4.1.
ANMERKUNG 3 Zusätzliche Informationen sind in der Allgemeinen Norm, 4.2, zu finden.
[...]

Appareils électromédicaux - Partie 2-90: Exigences particulières pour la sécurité de base et les performances essentielles des équipements de thérapie respiratoire à haut débit (ISO 80601-2-90:2021)

Medicinska električna oprema - 2-90. del: Posebne zahteve za osnovno varnost in bistvene lastnosti opreme za respiratorno terapijo z velikim pretokom (ISO 80601-2-90:2021)

General Information

Status
Published
Public Enquiry End Date
14-Dec-2020
Publication Date
08-Nov-2021
Technical Committee
Current Stage
6060 - National Implementation/Publication (Adopted Project)
Start Date
13-Oct-2021
Due Date
18-Dec-2021
Completion Date
09-Nov-2021

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SLOVENSKI STANDARD
SIST EN ISO 80601-2-90:2021
01-december-2021
Medicinska električna oprema - 2-90. del: Posebne zahteve za osnovno varnost in

bistvene lastnosti opreme za respiratorno terapijo z velikim pretokom (ISO 80601-2

-90:2021)

Medical electrical equipment - Part 2-90: Particular requirements for basic safety and

essential performance of respiratory high-flow therapy equipment (ISO 80601-2-90:2021)

Medizinische elektrische Geräte - Teil 2-90: Besondere Festlegungen für die Sicherheit

und die wesentlichen Leistungsmerkmale von Geräten für die Beatmungstherapie mit
hohem Durchfluss (ISO 80601-2-90:2021)

Appareils électromédicaux - Partie 2-90: Exigences particulières pour la sécurité de base

et les performances essentielles des équipements de thérapie respiratoire à haut débit

(ISO 80601-2-90:2021)
Ta slovenski standard je istoveten z: EN ISO 80601-2-90:2021
ICS:
11.040.10 Anestezijska, respiratorna in Anaesthetic, respiratory and
reanimacijska oprema reanimation equipment
SIST EN ISO 80601-2-90:2021 en,fr,de

2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

---------------------- Page: 1 ----------------------
SIST EN ISO 80601-2-90:2021
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SIST EN ISO 80601-2-90:2021
EN ISO 80601-2-90
EUROPEAN STANDARD
NORME EUROPÉENNE
October 2021
EUROPÄISCHE NORM
ICS 11.040.10
English Version
Medical electrical equipment - Part 2-90: Particular
requirements for basic safety and essential performance of
respiratory high-flow therapy equipment (ISO 80601-2-
90:2021)

Appareils électromédicaux - Partie 2-90: Exigences Medizinische elektrische Geräte - Teil 2-90: Besondere

particulières pour la sécurité de base et les Festlegungen für die Sicherheit und die wesentlichen

performances essentielles des équipements de Leistungsmerkmale von Geräten für die

thérapie respiratoire à haut débit (ISO 80601-2- Beatmungstherapie mit hohem Durchfluss (ISO 80601-

90:2021) 2-90:2021)
This European Standard was approved by CEN on 26 July 2021.

CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this

European Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references

concerning such national standards may be obtained on application to the CEN-CENELEC Management Centre or to any CEN

member.

This European Standard exists in three official versions (English, French, German). A version in any other language made by

translation under the responsibility of a CEN member into its own language and notified to the CEN-CENELEC Management

Centre has the same status as the official versions.

CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia,

Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway,

Poland, Portugal, Republic of North Macedonia, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and

United Kingdom.
EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION
EUROPÄISCHES KOMITEE FÜR NORMUNG
CEN-CENELEC Management Centre: Rue de la Science 23, B-1040 Brussels

© 2021 CEN All rights of exploitation in any form and by any means reserved Ref. No. EN ISO 80601-2-90:2021 E

worldwide for CEN national Members.
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SIST EN ISO 80601-2-90:2021
EN ISO 80601-2-90:2021 (E)
Contents Page

European foreword ....................................................................................................................................................... 3

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SIST EN ISO 80601-2-90:2021
EN ISO 80601-2-90:2021 (E)
European foreword

This document (EN ISO 80601-2-90:2021) has been prepared by Technical Committee ISO/TC 121

"Anaesthetic and respiratory equipment" in collaboration with Technical Committee CEN/TC 215

“Respiratory and anaesthetic equipment” the secretariat of which is held by BSI.

This European Standard shall be given the status of a national standard, either by publication of an

identical text or by endorsement, at the latest by April 2022, and conflicting national standards shall be

withdrawn at the latest by April 2022.

Attention is drawn to the possibility that some of the elements of this document may be the subject of

patent rights. CEN shall not be held responsible for identifying any or all such patent rights.

This document has been prepared under a Standardization Request given to CEN by the European

Commission and the European Free Trade Association.

Any feedback and questions on this document should be directed to the users’ national standards

body/national committee. A complete listing of these bodies can be found on the CEN website.

According to the CEN-CENELEC Internal Regulations, the national standards organizations of the

following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria,

Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland,

Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Republic of

North Macedonia, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and the

United Kingdom.
Endorsement notice

The text of ISO 80601-2-90:2021 has been approved by CEN as EN ISO 80601-2-90:2021 without any

modification.
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SIST EN ISO 80601-2-90:2021
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SIST EN ISO 80601-2-90:2021
INTERNATIONAL ISO
STANDARD 80601-2-90
First edition
2021-08
Medical electrical equipment —
Part 2-90:
Particular requirements for basic
safety and essential performance
of respiratory high-flow therapy
equipment
Appareils électromédicaux —
Partie 2-90: Exigences particulières pour la sécurité de base et les
performances essentielles des équipements de thérapie respiratoire à
haut débit
Reference number
ISO 80601-2-90:2021(E)
ISO 2021
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SIST EN ISO 80601-2-90:2021
ISO 80601-2-90:2021(E)
COPYRIGHT PROTECTED DOCUMENT
© ISO 2021

All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may

be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting

on the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address

below or ISO’s member body in the country of the requester.
ISO copyright office
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
Phone: +41 22 749 01 11
Email: copyright@iso.org
Website: www.iso.org
Published in Switzerland
ii © ISO 2021 – All rights reserved
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SIST EN ISO 80601-2-90:2021
ISO 80601-2-90:2021(E)
Contents

Foreword ......................................................................................................................................................................... v

Introduction ................................................................................................................................................................... vi

201. 1 Scope, object and related standards ......................................................................................................... 1

201. 2 Normative references .................................................................................................................................... 4

201. 3 Terms and definitions .................................................................................................................................... 5

201. 4 General requirements ................................................................................................................................. 10

201. 5 General requirements for testing of ME equipment ......................................................................... 12

201. 6 Classification of ME equipment and ME systems ................................................................................ 13

201. 7 ME equipment identification, marking and documents .................................................................. 13

201. 8 Protection against electrical hazards from ME equipment ............................................................ 20

201. 9 Protection against mechanical hazards of ME equipment and ME systems .............................. 20

201. 10 Protection against unwanted and excessive radiation hazards .......................................... 21

201. 11 Protection against excessive temperatures and other hazards .......................................... 22

201. 12 Accuracy of controls and instruments and protection against hazardous outputs ..... 26

201. 13 Hazardous situations and fault conditions for ME equipment .............................................. 33

201. 14 Programmable electrical medical systems (PEMS) ................................................................... 34

201. 15 Construction of ME equipment ......................................................................................................... 34

201. 16 ME systems .............................................................................................................................................. 35

201. 17 Electromagnetic compatibility of ME equipment and ME systems ...................................... 36

201.101 Gas connections .................................................................................................................................... 36

201.102 Requirements for the breathing system and accessories ....................................................... 39

201.103 * Indication of duration of operation ............................................................................................ 40

201.104 Functional connection ......................................................................................................................... 41

201.105 Power supply cords ............................................................................................................................... 41

201.106 Respiratory high-flow therapy equipment security .................................................................. 42

202 Electromagnetic disturbances — Requirements and tests ........................................................... 42

206 Usability ........................................................................................................................................................... 43

208 General requirements, tests and guidance for alarm systems in medical electrical

equipment and medical electrical systems ......................................................................................... 44

211 Requirements for medical electrical equipment and medical electrical systems used

in the home healthcare environment .................................................................................................... 46

Annex C (informative) Guide to marking and labelling requirements for ME equipment and

ME systems ....................................................................................................................................................... 48

Annex D (informative) Symbols on marking .................................................................................................... 54

Annex AA (informative) Particular guidance and rationale ...................................................................... 55

AA.1 General guidance .......................................................................................................................................... 55

iii
© ISO 2021 – All rights reserved
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SIST EN ISO 80601-2-90:2021
ISO 80601-2-90:2021(E)

AA.2 Rationale for particular clauses and subclauses .............................................................................. 55

Annex BB (informative) Data interface requirements ................................................................................ 69

BB.1 Background and purpose .......................................................................................................................... 69

BB.2 Data definition............................................................................................................................................... 70

Annex CC (informative) Reference to the IMDRF essential principles and labelling guidances.... 73

Annex DD (informative) Reference to the essential principles ................................................................. 76

Annex EE (informative) Reference to the general safety and performance requirements ............ 79

Annex FF (informative) Terminology — Alphabetized index of defined terms ................................. 82

© ISO 2021 – All rights reserved
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SIST EN ISO 80601-2-90:2021
ISO 80601-2-90:2021(E)
Foreword

ISO (the International Organization for Standardization) and IEC (the International Electrotechnical

Commission) form the specialized system for worldwide standardization. National bodies that are

members of ISO or IEC participate in the development of International Standards through technical

committees established by the respective organization to deal with particular fields of technical activity.

ISO and IEC technical committees collaborate in fields of mutual interest. Other international

organizations, governmental and non-governmental, in liaison with ISO and IEC, also take part in the

work.

The procedures used to develop this document and those intended for its further maintenance are

described in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the

different types of document should be noted. This document was drafted in accordance with the editorial

rules of the ISO/IEC Directives, Part 2 (see www.iso.org/directives or
www.iec.ch/members_experts/refdocs).

Attention is drawn to the possibility that some of the elements of this document may be the subject of

patent rights. ISO and IEC shall not be held responsible for identifying any or all such patent rights. Details

of any patent rights identified during the development of the document will be in the Introduction and/or

on the ISO list of patent declarations received (see www.iso.org/patents) or the IEC list of patent

declarations received (see patents.iec.ch).

Any trade name used in this document is information given for the convenience of users and does not

constitute an endorsement.

For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and

expressions related to conformity assessment, as well as information about ISO's adherence to the World

Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT),

see www.iso.org/iso/foreword.html. In the IEC, see www.iec.ch/understanding-standards.

This document was prepared by Technical Committee ISO/TC 121, Anaesthetic and respiratory

equipment, Subcommittee SC 3, Lung ventilators and related equipment, and Technical Committee

IEC/TC 62, Electrical equipment in medical practice, Subcommittee SC D, Electromedical equipment, in

collaboration with the European Committee for Standardization (CEN) Technical Committee CEN/TC

215, Respiratory and anaesthetic equipment, in accordance with the Agreement on technical cooperation

between ISO and CEN (Vienna Agreement).

A list of all parts in the ISO 80601 series and the IEC 80601 series can be found on the ISO and IEC

websites.

Any feedback or questions on this document should be directed to the user’s national standards body. A

complete listing of these bodies can be found at www.iso.org/members.html and www.iec.ch/national-

committees.
© ISO 2021 – All rights reserved
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SIST EN ISO 80601-2-90:2021
ISO 80601-2-90:2021(E)
Introduction

Respiratory high-flow therapy equipment has been used successfully for years with neonatal patients. In

recent years there is more information about treating adults with respiratory high-flow therapy

equipment when it is used as an intermediate therapy to improve oxygenation in adult critical care

patients, respiratory care units and for palliative care. High-flow therapy equipment is also used in the

treatment of chronic respiratory disease to reduce exacerbation, improve physiological outcomes and

[30][43][44][47] 1

quality of life . The use of respiratory high-flow therapy equipment continues to increase as it

is easily set up and is well tolerated by patients.

Since the outbreak of COVID-19 in January of 2020, its spread has been rapid and fierce. In hospitals

across the world, all kinds of respiratory high-flow therapy equipment have been widely used. In general,

there is a trend to use more non-invasive respiratory therapy. More and more new manufacturers of

respiratory high-flow therapy equipment have rapidly emerged. Neither international nor national

standards are available for respiratory high-flow therapy equipment. With the spread of the epidemic

globally, the demand for this document is clear and very urgent.

The first respiratory high-flow therapy equipment was constructed by the connection of a humidifier,

air/oxygen mixer/blender, flowmeter, breathing tube and cannula. Based on the improvement in

technical integration in recent years, there are several technical routes for respiratory high-flow therapy

equipment on the market. Respiratory high-flow therapy equipment is not fully covered by the existing

standards for humidifiers, gas mixers for medical use, flowmeters or ventilators.

This document addresses the basic safety and essential performance requirements of respiratory high-

flow therapy equipment, including risks related to oxygen (e.g., fires, incorrect oxygen concentration,

incorrect flow delivery, etc.).

Specifically, the following risks and related requirements were considered in the development of this

document.

— Contaminated air entering the gas intake port of the respiratory high-flow therapy equipment.

— Instability of gas supply from a high-pressure inlet.

— Insufficient pressure from a high-pressure inlet, and subsequent effects on oxygen delivered to the

patient.

— Insufficient oxygen being delivered to the patient, and related alarm condition.

— Usability by operators wearing personal protective equipment (such as gloves and blurred visors),

when setting up equipment, or viewing or changing settings.

— Instability of output delivered to patients, necessitating frequent operator adjustment.

— Processing of equipment, including the surface of the enclosure and internal gas pathways,

particularly after use on infectious patients.
— Infectious exhaled gas.
— Overheating of respiratory high-flow therapy equipment.
In this document, the following print types are used:
— requirements and definitions: roman type;

— test specifications and terms defined in Clause 3 of the general standard, in this document or as noted:

italic type;
Numbers in square brackets refer to the Bibliography.
© ISO 2021 – All rights reserved
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SIST EN ISO 80601-2-90:2021
ISO 80601-2-90:2021(E)

— informative material appearing outside of tables, such as notes, examples and references: in smaller type.

Normative text of tables is also in a smaller type.
In referring to the structure of this document, the term:

— “clause” means one of the five numbered divisions within the table of contents, inclusive of all

subdivisions (e.g. Clause 201 includes subclauses 201.7, 201.8, etc.);

— “subclause” means a numbered subdivision of a clause (e.g. 201.7, 201.8 and 201.9 are all subclauses

of Clause 201).

References to clauses within this document are preceded by the term “Clause” followed by the clause

number. References to subclauses within this particular document are by number only.

In this document, the conjunctive “or” is used as an “inclusive or” so a statement is true if any combination

of the conditions is true.
For the purposes of this document, the auxiliary verb:

— “shall” means that conformance with a requirement or a test is mandatory for conformance with this

document;

— “should” means that conformance with a requirement or a test is recommended but is not mandatory

for conformance with this document;

— “may” is used to describe permission (e.g. a permissible way to achieve conformance with a

requirement or test);
— "can" is used to describe a possibility or capability;
— "must" is used express an external constraint.

An asterisk (*) as the first character of a title or at the beginning of a paragraph or table title indicates

that there is guidance or rationale related to that item in Annex AA.
vii
© ISO 2021 – All rights reserved
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SIST EN ISO 80601-2-90:2021
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SIST EN ISO 80601-2-90:2021
INTERNATIONAL STANDARD ISO 80601-2-90:2021(E)
Medical electrical equipment —
Part 2-90:
Particular requirements for basic safety and essential
performance of respiratory high-flow therapy equipment
201.1 Scope, object and related standards
Clause 1 of IEC 60601-1:2005+AMD1:2012+AMD2:2020 applies, except as follows:
NOTE The general standard is IEC 60601-1:2005+AMD1:2012+AMD2:2020.
201.1.1 * Scope
Replacement:

This document applies to the basic safety and essential performance of respiratory high-flow therapy

equipment, as defined in 201.3.220, hereafter also referred to as ME equipment or ME system, in

combination with its accessories:
— intended for use with patients who can breathe spontaneously; and

— intended for patients who would benefit from improved alveolar gas exchange; and who would

benefit from receiving high-flow humidified respiratory gases, which can include a patient whose

upper airway is bypassed.

EXAMPLE 1 Patients with Type 1 Respiratory Failure who exhibit a reduction in arterial blood oxygenation.

EXAMPLE 2 Patients who would benefit from reduced work of breathing, as needed in Type 2 Respiratory

Failure, where arterial carbon dioxide is high.
EXAMPLE 3 Patients requiring humidification to improve mucociliary clearance.

Respiratory high-flow therapy equipment can be intended for use in the home healthcare environment or

intended for use in professional healthcare facilities.

NOTE 1 In the home healthcare environment, the supply mains is often not reliable.

Respiratory high-flow therapy equipment can be:
— fully integrated ME equipment; or
— a combination of separate items forming a ME system.

This standard also applies to other types of respiratory equipment when that equipment includes a

respiratory high-flow therapy mode.
[14]

NOTE 2 This standard and ISO 80601-2-12 are applicable to a critical care ventilator with a high-flow therapy

mode.
Respiratory high-flow therapy equipment can be transit-operable.
© ISO 2021 – All rights reserved
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SIST EN ISO 80601-2-90:2021
ISO 80601-2-90:2021(E)

This document is also applicable to those accessories intended by their manufacturer to be connected to

the respiratory high-flow therapy equipment, where the characteristics of those accessories can affect the

basic safety or essential performance of the respiratory high-flow therapy equipment.

EXAMPLE 4 Breathing sets, connectors, humidifier, breathing system filter, external electrical power source,

distributed alarm system, high-flow nasal cannula, tracheal tube, tracheostomy tube, face mask and supra-laryngeal

airway.

If a clause or subclause is specifically intended to be applicable to ME equipment only, or to ME systems

only, the title and content of that clause or subclause will say so. If that is not the case, the clause or

subclause applies both to ME equipment and to ME systems, as relevant.

Hazards inherent in the intended physiological function of ME equipment or ME systems within the scope

of this document are not covered by specific requirements in this document except in the general

standard, 7.2.13 and 8.4.1.
NOTE 3 Additional information can be found in the general standard, 4.2.
This document does not specify the requirements for:

— ventilators or accessories for ventilator-dependent patients intended for critical care applications,

[14]
which are given in ISO 80601-2-12 ;

— ventilators or accessories intended for anaesthetic applications, which are given in

[15]
ISO 80601-2-13 ;

— ventilators or accessories intended for the emergency medical services environment, which are given

[20]
in ISO 80601-2-84 ;

— ventilators or accessories intended for ventilator-dependent patients in the home healthcare

[17]
environment, which are given in ISO 80601-2-72 ;

— ventilatory support equipment or accessories intended for patients with ventilatory impairment,

[18]
which are given in ISO 80601-2-79 ;

— ventilatory support equipment or accessories intended for patients with ventilatory insufficiency,

[19]
which are given in ISO 80601-2-80 ;
[16]
— sleep apnoea therapy ME equipment, which are given in ISO 80601-2-70 ;
— continuous positive airway pressure (CPAP) ME equipment;
[31] [21]
— high-frequency jet ventilators (HFJVs) , which are given in ISO 80601-2-87 ;
[9]
— gas mixers for medical use, which are given in ISO 11195 ;
[11]
— flowmeters, which are given in ISO 15002
[21]

— high-frequency oscillatory ventilators (HFOVs), which are given in ISO 80601-2-87 ; and

— cuirass or “iron-lung” ventilation equipment.

This document is a particular standard in the IEC 60601 series, the IEC 80601 series and the ISO 80601

series.
201.1.2 Object
Replacement:

The object of this document is to establish particular basic safety and essential performance requirements

for respiratory high-flow therapy equipment, as defined in 201.3.220, and its accessories.

© ISO 2021 – All rights reserved
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SIST EN ISO 80601-2-90:2021
ISO 80601-2-90:2021(E)

NOTE 1 Accessories are included because the combination of the respiratory high-flow therapy equipment and the

accessories needs to be adequately safe. Accessories can have a significant impact on the basic safety or essential

performance of the respiratory high-flow therapy equipment.

NOTE 2 This document has been prepared to address the relevant International Medical Device Regulators Forum

(IMDRF) essential principles and labelling guidances as indicated in Annex CC.

NOTE 3 This document has been prepared to address the relevant essential principles of safety and performance of

ISO 16142-1:2016 as indicated in Annex DD.

NOTE 4 This document has been prepared to address the relevant general safety and performance requirements of

[26]
European regulation (EU) 2017/745 as indicated in Annex EE.
201.1.3 Collateral standards
Amendment (add after existing text):

This document refers to those applicable collateral standards that are listed in Clause 2 of the general

standard and Clause 201.2 of this document.
IEC 60601-1-2:2014+AMD1:2020+AMD2:2020, IEC 60601-1-6:2010+AMD1:2013+AMD2:2020,

IEC 60601-1-8:2006+AMD1:2012+AMD2:2020 and IEC 60601-1-11:2015+AMD1:2020 apply as

[22]

modified in Clauses 202, 206, 208 and 211 respectively. IEC 60601-1-3 does not apply. All other

published collateral standards in the IEC 60601-1 series apply as published.
201.1.4 Particular standards
Replacement:

In the IEC 60601 series, particular standards define basic safety and essential performance requirements,

and may modify, replace or delete requirements contained in the general standard, including the

collateral standards as appropriate for the particular ME equipment under consideration.

A requirement of a particular standard takes priority over the general standard.

For brevity, IEC 60601-1:2005+AMD1:2012+AMD2:2020 is referred to in this particular document as the

general standard. Collateral standards are referred to by their document number.

The numbering of clauses and subclauses of this document corresponds to that of the general standard

with the prefix “201” (e.g. 201.1 in this document addresses the content of Clause 1 of the general

standard) or applicable collateral standard with the prefix “2xx”, where xx is the final digits of the

collateral standard document number (e.g. 202.4 in this document addresses the content of Clause 4 of

the IEC 60601-1-2 collateral standard, 211.10 in this document addresses the content of Clause 10 of the

IEC 60601-1-11 collateral standard, etc.). The changes to the text of the general standard are specified by

the use of the following words:

"Replacement" means that the clause or subclause of the general standard or applicable collateral

standard is replaced completely by the text of this document.

"Addition" means that the text of this document is additional to the requirements of the general standard

or applicable collateral standard.

"Amendment" means that the clause or subclause of the general standard or applicable collateral

standard is amended as indicated by the text of this document.

Subclauses, figures or tables that are additional to those of the general standard are num

...

SLOVENSKI STANDARD
oSIST prEN ISO 80601-2-90:2020
01-december-2020
Medicinska električna oprema - 2-90. del: Posebne zahteve za osnovno varnost in
bistvene lastnosti opreme za respiratorno terapijo z velikim pretokom (ISO/DIS
80601-2-90:2020)

Medical electrical equipment - Part 2-90: Particular requirements for basic safety and

essential performance of ventilatory high-flow therapy equipment (ISO/DIS 80601-2-

90:2020)

Medizinische elektrische Geräte - Teil 2-90: Besondere Festlegungen für die Sicherheit

und die wesentlichen Leistungsmerkmale von Geräten für die Beatmungstherapie mit
hohem Durchfluss (ISO/DIS 80601-2-90:2020)

Appareils électromédicaux - Partie 2-90: Exigences particulières pour la sécurité de base

et les performances essentielles des équipements de thérapie respiratoire à haut débit

(ISO/DIS 80601-2-90:2020)
Ta slovenski standard je istoveten z: prEN ISO 80601-2-90
ICS:
11.040.10 Anestezijska, respiratorna in Anaesthetic, respiratory and
reanimacijska oprema reanimation equipment
oSIST prEN ISO 80601-2-90:2020 en,fr,de

2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

---------------------- Page: 1 ----------------------
oSIST prEN ISO 80601-2-90:2020
---------------------- Page: 2 ----------------------
oSIST prEN ISO 80601-2-90:2020
DRAFT INTERNATIONAL STANDARD
ISO/DIS 80601-2-90
ISO/TC 121/SC 3 Secretariat: ANSI
Voting begins on: Voting terminates on:
2020-10-07 2020-12-30
Medical electrical equipment —
Part 2-90:
Particular requirements for basic safety and essential
performance of ventilatory high-flow therapy equipment
ICS: 11.040.10
THIS DOCUMENT IS A DRAFT CIRCULATED
This document is circulated as received from the committee secretariat.
FOR COMMENT AND APPROVAL. IT IS
THEREFORE SUBJECT TO CHANGE AND MAY
NOT BE REFERRED TO AS AN INTERNATIONAL
STANDARD UNTIL PUBLISHED AS SUCH.
IN ADDITION TO THEIR EVALUATION AS
ISO/CEN PARALLEL PROCESSING
BEING ACCEPTABLE FOR INDUSTRIAL,
TECHNOLOGICAL, COMMERCIAL AND
USER PURPOSES, DRAFT INTERNATIONAL
STANDARDS MAY ON OCCASION HAVE TO
BE CONSIDERED IN THE LIGHT OF THEIR
POTENTIAL TO BECOME STANDARDS TO
WHICH REFERENCE MAY BE MADE IN
Reference number
NATIONAL REGULATIONS.
ISO/DIS 80601-2-90:2020(E)
RECIPIENTS OF THIS DRAFT ARE INVITED
TO SUBMIT, WITH THEIR COMMENTS,
NOTIFICATION OF ANY RELEVANT PATENT
RIGHTS OF WHICH THEY ARE AWARE AND TO
PROVIDE SUPPORTING DOCUMENTATION. ISO 2020
---------------------- Page: 3 ----------------------
oSIST prEN ISO 80601-2-90:2020
ISO 80601-2-90:2020(E)
ISO/DIS 80601-2-90:2020(E)
1 Contents

2 Contents ........................................................................................................................................................................... iii

3 Introduction ................................................................................................................................................................... vi

4 201.1 Scope, object and related standards ........................................................................................................ 1

5 201.2 Normative references .................................................................................................................................... 3

6 201.3 Terms and definitions ................................................................................................................................... 5

7 201.4 General requirements ................................................................................................................................... 9

8 201.5 General requirements for testing of ME equipment ......................................................................... 11

9 201.6 Classification of ME equipment and ME systems ................................................................................. 11

10 201.7 ME equipment identification, marking and documents................................................................... 11

11 201.8 Protection against electrical hazards from ME equipment ............................................................ 18

12 201.9 Protection against mechanical hazards of ME equipment and ME systems .............................. 18

13 201.10 Protection against unwanted and excessive radiation hazards .................................................. 20

14 201.11 Protection against excessive temperatures and other hazards ................................................... 20

15 201.12 Accuracy of controls and instruments and protection against hazardous outputs .............. 23

16 201.13 Hazardous situations and fault conditions for ME equipment ...................................................... 30

17 201.14 Programmable electrical medical systems (PEMS) ............................................................................ 31

18 201.15 Construction of ME equipment ................................................................................................................. 31

19 201.16 ME systems ....................................................................................................................................................... 32

20 201.17 Electromagnetic compatibility of ME equipment and ME systems ............................................... 32

21 201.101 Gas connections ..................................................................................................................................... 33

22 201.102 Requirements for the breathing system and accessories ....................................................... 35

23 201.103 * Indication of duration of operation ............................................................................................ 36

24 201.104 Functional connection .......................................................................................................................... 37

25 201.105 Power supply cords ............................................................................................................................... 37

26 201.106 Respiratory high-flow therapy equipment security .................................................................. 37

27 202 Electromagnetic disturbances — Requirements and tests ............................................................ 38

28 206 Usability ........................................................................................................................................................... 38

29 208 General requirements, tests and guidance for alarm systems in medical electrical

30 equipment and medical electrical systems ......................................................................................... 40

31 211 Requirements for medical electrical equipment and medical electrical systems

32 used in the home healthcare environment ......................................................................................... 42

33 Annex C (informative) Guide to marking and labelling requirements for ME equipment and

COPYRIGHT PROTECTED DOCUMENT

34 ME systems ....................................................................................................................................................... 43

© ISO 2020

35 Annex D (informative) Symbols on marking .................................................................................................... 49

All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may

be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting

36 Annex AA (informative) Particular guidance and rationale ....................................................................... 50

on the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address

below or ISO’s member body in the country of the requester. 37 Annex BB (informative) Data interface requirements ................................................................................. 63

ISO copyright office
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
© ISO 2020 – All rights reserved iii
Phone: +41 22 749 01 11
Fax: +41 22 749 09 47
Email: copyright@iso.org
Website: www.iso.org
Published in Switzerland
ii © ISO 2020 – All rights reserved
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oSIST prEN ISO 80601-2-90:2020
ISO 80601-2-90:2020(E)
1 Contents

2 Contents ........................................................................................................................................................................... iii

3 Introduction ................................................................................................................................................................... vi

4 201.1 Scope, object and related standards ........................................................................................................ 1

5 201.2 Normative references .................................................................................................................................... 3

6 201.3 Terms and definitions ................................................................................................................................... 5

7 201.4 General requirements ................................................................................................................................... 9

8 201.5 General requirements for testing of ME equipment ......................................................................... 11

9 201.6 Classification of ME equipment and ME systems ................................................................................. 11

10 201.7 ME equipment identification, marking and documents................................................................... 11

11 201.8 Protection against electrical hazards from ME equipment ............................................................ 18

12 201.9 Protection against mechanical hazards of ME equipment and ME systems .............................. 18

13 201.10 Protection against unwanted and excessive radiation hazards .................................................. 20

14 201.11 Protection against excessive temperatures and other hazards ................................................... 20

15 201.12 Accuracy of controls and instruments and protection against hazardous outputs .............. 23

16 201.13 Hazardous situations and fault conditions for ME equipment ...................................................... 30

17 201.14 Programmable electrical medical systems (PEMS) ............................................................................ 31

18 201.15 Construction of ME equipment ................................................................................................................. 31

19 201.16 ME systems ....................................................................................................................................................... 32

20 201.17 Electromagnetic compatibility of ME equipment and ME systems ............................................... 32

21 201.101 Gas connections ..................................................................................................................................... 33

22 201.102 Requirements for the breathing system and accessories ....................................................... 35

23 201.103 * Indication of duration of operation ............................................................................................ 36

24 201.104 Functional connection .......................................................................................................................... 37

25 201.105 Power supply cords ............................................................................................................................... 37

26 201.106 Respiratory high-flow therapy equipment security .................................................................. 37

27 202 Electromagnetic disturbances — Requirements and tests ............................................................ 38

28 206 Usability ........................................................................................................................................................... 38

29 208 General requirements, tests and guidance for alarm systems in medical electrical

30 equipment and medical electrical systems ......................................................................................... 40

31 211 Requirements for medical electrical equipment and medical electrical systems

32 used in the home healthcare environment ......................................................................................... 42

33 Annex C (informative) Guide to marking and labelling requirements for ME equipment and

34 ME systems ....................................................................................................................................................... 43

35 Annex D (informative) Symbols on marking .................................................................................................... 49

36 Annex AA (informative) Particular guidance and rationale ....................................................................... 50

37 Annex BB (informative) Data interface requirements ................................................................................. 63

© ISO 2020 – All rights reserved iii
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oSIST prEN ISO 80601-2-90:2020
ISO 80601-2-90:2020(E)

38 Annex CC (informative) Reference to the IMDRF essential principles and labelling guidances .... 67

39 Annex DD (informative) Reference to the essential principles .................................................................. 70

40 Annex EE (informative) Reference to the general safety and performance requirements............. 73

41 Annex FF (informative) Terminology — Alphabetized index of defined terms .................................. 76

43 Tables

44 Table 201.101 — Distributed essential performance requirements ......................................................... 9

45 Table 201.102 — Examples of permissible combinations of temperature and

46 relative humidity .......................................................................................................................................... 20

47 Table 201.103 — STPD and BTPS conversion factor for altitude .............................................................. 25

48 Table 201.104 — Test conditions for oxygen concentration tests ............................................................ 27

49 Table 201.C.101 — Marking on the outside of respiratory high-flow therapy equipment,

50 its parts or accessories ............................................................................................................................... 43

51 Table 201.C.102 — Accompanying documents, general ............................................................................... 43

52 Table 201.C.103 — Instructions for use .............................................................................................................. 44

53 Table 201.C.104 — Technical description ......................................................................................................... 48

54 Table 201.D.2.101 — Additional symbols on marking .................................................................................. 49

55 Table BB.101 — Parameters and units of measurement .............................................................................. 64

56 Table BB.102 — Equipment Identification ........................................................................................................ 64

57 Table BB.103 — Usage monitoring ....................................................................................................................... 65

58 Table BB.104 — Equipment settings .................................................................................................................... 65

59 Table BB.105 — Therapy monitoring .................................................................................................................. 65

60 Table BB.106 — Respiratory high-flow therapy equipment alarm limits.............................................. 66

61 Table BB.107 — Event information ...................................................................................................................... 66

62 Table BB.108 — Service monitoring .................................................................................................................... 66

63 Table CC.1 — Correspondence between this document and the essential principles ....................... 67

64 Table CC.2 — Correspondence between this document and the labelling principles ........................ 69

65 Table DD.1 — Correspondence between this document and the essential principles ...................... 70

66 Table EE.1 — Correspondence between this document and the general safety and

67 performance requirements ....................................................................................................................... 73

iv © ISO 2020 – All rights reserved
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oSIST prEN ISO 80601-2-90:2020
ISO 80601-2-90:2020(E)
70 Foreword

71 ISO (the International Organization for Standardization) is a worldwide federation of national standards bodies

72 (ISO member bodies). The work of preparing International Standards is normally carried out through ISO

73 technical committees. Each member body interested in a subject for which a technical committee has been

74 established has the right to be represented on that committee. International organizations, governmental and

75 non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely with the International

76 Electrotechnical Commission (IEC) on all matters of electrotechnical standardization.

77 The procedures used to develop this document and those intended for its further maintenance are described in

78 the ISO/IEC Directives, Part 1. In particular the different approval criteria needed for the different types of ISO

79 documents should be noted. This document was drafted in accordance with the editorial rules of the

80 ISO/IEC Directives, Part 2 (see www.iso.org/directives).

81 Attention is drawn to the possibility that some of the elements of this document may be the subject of patent

82 rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of any patent rights

83 identified during the development of the document will be in the Introduction and/or on the ISO list of patent

84 declarations received (see www.iso.org/patents).

85 Any trade name used in this document is information given for the convenience of users and does not constitute

86 an endorsement.

87 For an explanation on the voluntary nature of standards, the meaning of ISO specific terms and expressions

88 related to conformity assessment, as well as information about ISO's adherence to the World Trade

89 Organization (WTO) principles in the Technical Barriers to Trade (TBT) see the following URL:

90 www.iso.org/iso/foreword.html.

91 This document was prepared by Technical Committee ISO/TC 121, Anaesthetic and respiratory equipment,

92 Subcommittee SC 3, Lung ventilators and related equipment, and Technical Committee IEC/TC 62, Electrical

93 equipment in medical practice, Subcommittee SC D, Electrical equipment. The draft was circulated for voting to

94 the national bodies of both ISO and IEC.
95 This is the first edition of ISO 80601-2-90.
© ISO 2020 – All rights reserved v
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oSIST prEN ISO 80601-2-90:2020
ISO 80601-2-90:2020(E)
97 Introduction

98 Respiratory high-flow therapy equipment has been used successfully for years with neonatal patients. In recent

99 years there is more information about treating adults with respiratory high-flow therapy equipment when it is

100 used as an intermediate therapy to improve oxygenation in adult critical care patients, respiratory care units

101 and for palliative care. The use of respiratory high-flow therapy equipment continues to increase as it is easily

102 set up and is well tolerated by patients.

103 Since the outbreak of COVID-19 in China in January of 2020, its spread has been rapid and fierce. In hospitals

104 across the world, all kinds of respiratory high-flow therapy equipment have been widely used. More and more

105 new manufacturers of respiratory high-flow therapy equipment have rapidly emerged. Neither international nor

106 national standards are available for respiratory high-flow therapy equipment. With the spread of the epidemic

107 globally, the demand for this document is clear and very urgent.

108 The first respiratory high-flow therapy equipment was constructed by the connection of a humidifier, air/oxygen

109 mixer/blender, breathing tube and cannula. Based on the improvement in technical integration in recent years,

110 there are several technical routes for respiratory high-flow therapy equipment on the market. Respiratory high-

111 flow therapy equipment is not fully covered by the existing standards for humidifiers, gas mixers for medical use

112 or ventilators.

113 This document addresses the basic safety and essential performance requirements of respiratory high-flow

114 therapy equipment, including risks related to oxygen (e.g., fires, incorrect oxygen concentration, incorrect flow

115 delivery, etc.).

116 Specifically, the following risks and related requirements were considered in the development of this document.

117 — The air entering the gas intake port by the respiratory high-flow therapy equipment might be contaminated.

118 What measures are needed to avoid or reduce the contamination of the gas pathways.

119 — The input oxygen source pressure might be unstable.

120 — When the pressure of the oxygen source is insufficient, is there an additional gas source, such as adding an

121 additional oxygen input to maintain the delivered oxygen concentration?

122 — When the oxygen concentration of the respiratory high-flow therapy equipment does not reach the set value,

123 does the respiratory high-flow therapy equipment need to generate an alarm condition?

124 — Is the respiratory high-flow therapy equipment easy to install and adjust by operators wearing multiple

125 layers of protective clothing and gloves?

126 — Are the markings and displays of the respiratory high-flow therapy equipment clear enough for operators

127 whose vision is blurred due to aerosol on their goggles?

128 — To reduce unnecessary risk of infection and reduce the burden on the operators, respiratory high-flow

129 therapy equipment needs to remain stable, reducing the need for frequent operator adjustment.

130 — For the respiratory high-flow therapy equipment used in an infected area, after one patient's use, before the

131 next patient's use or before the respiratory high-flow therapy equipment is transferred to a non-infected

132 area, the respiratory high-flow therapy equipment needs cleaning and disinfection, including the surface of

133 the enclosure and the internal gas pathways.
134 — The risk of infectious exhaled gas.

135 This publication has been drafted in accordance with the ISO/IEC Directives, Part 2.

136 In this document, the following print types are used:
137 — requirements and definitions: roman type;
138 — test specifications: italic type;

139 — informative material appearing outside of tables, such as notes, examples and references: in smaller type. Normative

140 text of tables is also in a smaller type.
vi © ISO 2020 – All rights reserved
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oSIST prEN ISO 80601-2-90:2020
ISO 80601-2-90:2020(E)

141 — terms defined in Clause 3 of the general standard , in this document or as noted: small capitals.

142 In referring to the structure of this document, the term

143 — “clause” means one of the five numbered divisions within the table of contents, inclusive of all subdivisions

144 (e.g. Clause 201 includes subclauses 201.7, 201.8, etc.);

145 — “subclause” means a numbered subdivision of a clause (e.g. 201.7, 201.8 and 201.9 are all subclauses of

146 Clause 201).

147 References to clauses within this document are preceded by the term “Clause” followed by the clause number.

148 References to subclauses within this particular document are by number only.

149 In this document, the conjunctive “or” is used as an “inclusive or” so a statement is true if any combination of

150 the conditions is true.

151 The verbal forms used in this document conform to usage described in ISO/IEC Directives, Part 2. For the

152 purposes of this document, the auxiliary verb:

153 — “shall” means that conformance with a requirement or a test is mandatory for conformance with this

154 document;

155 — “should” means that conformance with a requirement or a test is recommended but is not mandatory for

156 conformance with this document;

157 — “may” is used to describe permission (e.g. a permissible way to achieve conformance with a requirement or

158 test);
159 — "can" is used to describe a possibility or capability;
160 — "must" is used express an external constraint.

161 An asterisk (*) as the first character of a title or at the beginning of a paragraph or table title indicates that there

162 is guidance or rationale related to that item in Annex AA.

163 The ISO and IEC 80601 family of documents are also parts of the IEC 60601 family of documents.

The general standard is IEC 60601-1:2005+AMD1:2012+AMD2:2020, Medical electrical equipment — Part 1: General

requirements for basic safety and essential performance.
© ISO 2020 – All rights reserved vii
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oSIST prEN ISO 80601-2-90:2020
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oSIST prEN ISO 80601-2-90:2020
Draft International Standard ISO 80601-2-90:2020(E)
164 Medical electrical equipment
165 Part 2-90:
166 Particular requirements for basic safety and essential
167 performance of respiratory high-flow therapy equipment
168 201.1 Scope, object and related standards
169 IEC 60601-1:2005+AMD1:2012+AMD2:2020, Clause 1, applies, except as follows:
170 201.1.1 * Scope
171 Replacement:

172 This document applies to the basic safety and essential performance of respiratory high-flow therapy equipment,

173 as defined in 201.3.219, hereafter also referred to as ME equipment, in combination with its accessories:

174 — intended for use with patients who can breathe spontaneously; and

175 — intended for patients who would benefit from improved alveolar gas exchange; and who would benefit from

176 receiving high-flow humidified respiratory gases, including a patient whose upper airway is bypassed.

177 EXAMPLE 1 Patients with Type 1 Respiratory Failure who exhibit a reduction in arterial blood oxygenation or

178 patients who would benefit from reduced work of breathing, as needed in Type 2 Respiratory Failure, where arterial

179 carbon dioxide is high.

180 Respiratory high-flow therapy equipment can be intended for use in the home healthcare environment or

181 intended for use in professional healthcare facilities.

182 NOTE 1 In the home healthcare environment, the supply mains is often not reliable.

183 Respiratory high-flow therapy equipment can be transit-operable.

184 This document is also applicable to those accessories intended by their manufacturer to be connected to the

185 respiratory high-flow therapy equipment, where the characteristics of those accessories can affect the basic safety

186 or essential performance of the respiratory high-flow therapy equipment.

187 EXAMPLE 2 Breathing sets, connectors, water traps, expiratory valve, humidifier, breathing system filter, external

188 electrical power source, distributed alarm system.

189 If a clause or subclause is specifically intended to be applicable to ME equipment only, or to ME systems only,

190 the title and content of that clause or subclause will say so. If that is not the case, the clause or subclause applies

191 both to ME equipment and to ME systems, as relevant.

192 Hazards inherent in the intended physiological function of ME equipment or ME systems within the scope of this

193 document are not covered by specific requirements in this document except in IEC 60601-1:2005+AMD1:2012,

194 7.2.13 and 8.4.1.

195 NOTE 2 Additional information can be found in IEC 60601-1:2005+AMD1:2012, 4.2.

196 This document does not specify the requirements for:

197 — ventilators or accessories for ventilator-dependent patients intended for critical care applications, which are

[15]
198 given in ISO 80601-2-12 ;
© ISO 2020 – All rights reserved 1
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oSIST prEN ISO 80601-2-90:2020
ISO 80601-2-90:2020(E)
[16]

199 — ventilators or accessories intended for anaesthetic applications, which are given in ISO 80601-2-13 ;

200 — ventilators or accessories intended for the emergency medical services environment, which are given in

[21]2
201 ISO 80601-2-84 ;

202 — ventilators or accessories intended for ventilator-dependent patients in the home healthcare environment,

[18]
203 which are given in ISO 80601-2-72 ;

204 — ventilatory support equipment or accessories intended for patients with ventilatory impairment, which are

[19]
205 giv
...

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