Respironics V200 Ventilator Operator’s Manual 1057983 50
For Technical Support and Customer Service, contact: USA and Canada: 1-800-345-6443 or 724-387-4000 Respironics Europe, Africa, Middle East: +33-1-47-52-30-00 Respironics Asia Pacific: +852-3194-2280 Facsimile: 724-387-5012 USA Respironics California, Inc. 2271 Cosmos Court Carlsbad, CA 92011 Email and web addresses service@philips.com clinical@philips.com www.philips.
Table of Contents REF 1057983 A 1. Introduction and Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1 2. Warnings, Cautions, and Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1 Summary of Warnings, Cautions, and Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1 3. Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1 4. Getting Started . . . . . . . . . . . . . .
Contents 8. Operating Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Front Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ventilator Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Settings Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Selecting a New Ventilation Breath Type (VCV, PCV, or NPPV) .
Contents Patient Data Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5 Front Panel Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-6 Level Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7 Calculated Values from Expiratory Hold Maneuver. . . . . . . . . . . . . . . . . . . . . . 12-7 Interface Ports . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents Graphics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Starting Graphics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Using Graphics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Replotting and Scrolling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rescaling the Display. . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents Flow-Trak® Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-83 On the Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-84 Breath Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-85 Inspiratory Hold. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-85 Respiratory Mechanics . . . . . . . . . . . . . . . .
Contents A. RS-232 Communications Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RS-232 Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Commands Transmitted to the Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transmission of Data from the Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ventilator Report Command and Response (VRPT) . . . . . . . . . . . . . . . . . . . . . .
Chapter 1. Introduction and Intended Use The Respironics V200 Ventilator is a microprocessor-controlled, electrically powered mechanical ventilator. It is intended for use by qualified medical personnel to provide continuous or intermittent ventilatory support for adult, pediatric, and neonatal patients as prescribed by a physician. The ventilator is intended for use in either invasive or non-invasive applications in institutional environments.
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Chapter 2. Warnings, Cautions, and Notes Throughout this manual the following definitions apply: WARNING: A condition that could cause injury to a patient or operator if the operating instructions in this manual are not followed correctly. CAUTION: A condition that could cause damage to, or shorten the service life of, the Respironics V200 Ventilator. NOTE: Important information concerning the construction or operation of the Respironics V200 Ventilator.
Chapter 2 Warnings, Cautions, and Notes ventilator power before removing the heated expiratory bacteria filter. Exercise caution when handling the filter housing. 2-2 • All oxygen connections should be carefully inspected to ensure that leaks are not present. Excessive leaks can result in higher than normal ambient oxygen concentrations and create a potentially hazardous oxygen-enriched environment.
Chapter 2 Warnings, Cautions, and Notes REF 1057983 A • When using the Remote Alarm Port be sure to fully test the Remote Alarm Port and cable by: • Verifying that annunciated alarms on the ventilator are also annunciated on the remote alarm. • Verifying that disconnecting the cable from the Remote. Alarm port results in an alarm notification at the Remote Alarm. • Verifying that disconnecting the cable from the remote alarm results in an alarm notification at the Remote Alarm.
Chapter 2 Warnings, Cautions, and Notes 2-4 • Disposable or single-patient filters must be discarded between patients. Do not chemically disinfect or expose single patient use bacteria filters to ETO gas. • The patient must be disconnected from the ventilator before entering the Diagnostic Mode since normal ventilation is suspended. • Do not use a ventilator that has failed SST without verifying operational readiness by other means. Doing so may place a patient at risk.
Chapter 2 Warnings, Cautions, and Notes • Backup battery operating life may be affected by battery age and the number of times it has been discharged and recharged. Over time the battery will degenerate and will not provide the same amount of operating time per charge that is available from a fully charged new battery. Use only the Respironics backup battery P/ N 1059956. • Titrate the EPAP level such that the masks air entrainment valve (if present) remains closed to room air.
Chapter 2 Warnings, Cautions, and Notes ventilator to lose power. For further information, consult a service technician or a trained biomedical technician. 2-6 • The ventilator is shipped with a power cord that complies with electrical safety standards. Do not use substitute power cords unless specifically instructed to do so by an authorized distributor or qualified personnel. Do not modify the power cord or connect it with electrical extension cords or outlet adapters.
Chapter 2 Warnings, Cautions, and Notes REF 1057983 A • Follow the detergent manufacturer’s instructions. Exposure to detergent solution stronger than necessary can shorten the useful life of the product. Rinse parts thoroughly to remove all detergent residues. Wipe parts dry. Detergent residue can cause blemishes or fine cracks, especially on parts exposed to elevated temperatures during sterilization.
Chapter 2 Warnings, Cautions, and Notes Notes 2-8 • Follow the setup instructions in this manual before placing the Respironics V200 Ventilator into service. If you have questions, contact Respironics Customer Service at 1-800-345-644 • Save the shipping container in case the backup battery has to be returned to Respironics.
Chapter 2 Warnings, Cautions, and Notes REF 1057983 A • To disconnect the ventilator from MAINS power, remove the AC plug from the wall power receptacle. The MAIN switch/circuit breaker is covered to prevent unintentional ventilator turn off. • If the operator sets the %O2 setting to 100%, the 100% O2 indicator does not light. The 100% O2 indicator only lights when the 100% O2 front panel key has been pressed.
Chapter 2 Warnings, Cautions, and Notes 2-10 • If the EXP HOLD key is held continuously, and the expiratory hold maneuver exceeds 5 seconds, the ventilator automatically terminates the expiratory hold maneuver and begins a new inspiratory period. • If Auto PEEP as calculated in Equation 1: Auto-PEEP = Expiratory Pause Pressure – End Expiratory Pressure, is negative, Auto-PEEP will be displayed as “—.” • All components of the patient circuit must not have leaks in order to pass SST.
Chapter 2 Warnings, Cautions, and Notes REF 1057983 A • Medical electrical equipment needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in Chapter 12, “Technical Specifications”. • Speaking Mode is available ONLY in invasive ventilation mode.
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Chapter 3. Symbols The following symbols appear on the Respironics V200 Ventilator, accessories, documentation, and packaging. Additional symbols pertaining to options and accessories are included in the documentation for each option or accessory. Refer to Chapter 13, “Options and Accessories”. Symbols Symbol Description READ THE USER MANUAL OR ACCOMPANYING DOCUMENTS ATTENTION ON condition for part of the equipment.
Chapter 3 Symbols Symbols (Continued) Symbol Description DC BATTERY CONNECTION HOT SURFACE warning EUROPEAN CONFORMITY REMOTE ALARM connection RS-232 serial output PARALLEL PORT printer connection ALARM SILENCE (Silences alarm for two minutes) BRIGHTNESS ADJUST AUDIO ALARM VOLUME CONTROL ACCEPT ALARM RESET 100% OXYGEN Located between the ALARM RESET and 100% O2 buttons, this symbol indicates that the two keys (ALARM RESET AND 100% O2) must be pressed simultaneously for approximately five secon
Chapter 3 Symbols Symbols (Continued) Symbol Description MANUAL BREATH EXPIRATORY HOLD SCREEN LOCK (Symbol version of the front panel only) Illuminates yellow to indicate backup battery IN USE (backup) (Symbol version of the front panel only) llluminates yellow to indicate backup battery CHARGING (Symbol version of the front panel only) Flashes red to indicate that the backup battery is LOW (Symbol version of the front panel only) MAINS battery indicator (Symbol version of the front panel only) EXTERN
Chapter 3 Symbols Symbols (Continued) Symbol Description The product must be disposed of in accordance with the WEEE directive. SEALED, NON-SPILLABLE LEAD ACID BATTERY. MUST BE RECYCLED Pb SEALED, NON-SPILLABLE LEAD-ACID BATTERY. MUST BE RECYCLED Pb RECYCLE THIS SIDE UP AT LEAST TWO PEOPLE ARE REQUIRED TO LIFT THE VENTILATOR TO AVOID POSSIBLE PERSONAL INJURY OR DAMAGE TO THE EQUIPMENT.
Chapter 3 Symbols Symbols (Continued) Symbol Description STORE AT 10%-95% RELATIVE HUMIDITY % 10-95 Do not stack > 2 high 2 Table 3-1: Symbols (Sheet 5 of 5) REF 1057983 A Respironics V200 Ventilator Operator’s Manual 3-5
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Chapter 4. Getting Started Unpacking The Respironics V200 Ventilator has been carefully packaged to assure safe shipping. In addition, the packing container has been designed for easy unpacking. Do not discard packing materials. Before unpacking the ventilator, examine the shipping carton(s) for visible damage. If the shipping carton(s) arrives damaged or if you suspect the contents are damaged, contact the carrier for an inspection report.
Chapter 4 Getting Started NOTE: Medical electrical equipment needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in Chapter 12, “Technical Specifications”. Unpacking Instructions Refer to Figure 4-1. • Tools Required: Box knife 1. Using a box knife, cut a slit in packaging tape on top of shipping carton. 2. Remove accessories box and optional flex arm box (not shown). 3. Remove top foam insert from inside carton. 4.
Chapter 4 Getting Started NOTE: Repacking We recommend that before using the ventilator for the first time, wipe the exterior clean and disinfect or sterilize its components according to the instructions in Chapter 10, “Care and Maintenance” or the component manufacturer’s instructions. Should the ventilator need to be returned to Respironics for servicing, or shipped elsewhere for any reason, instructions for repacking are listed below.
Chapter 4 Getting Started Ventilator Positioning For information about mounting the ventilator on a table top, see the Esprit Operator’s Manual (580-1000-01). If the ventilator is on a cart, lock the cart wheels as needed as shown in Figure 4-2. Figure 4-2: Locking Ventilator Wheel Backup Battery 4-4 The ventilator will automatically switch to operating on backup battery power when the AC power fails or the system is disconnected from AC mains power.
Chapter 4 Getting Started Backup Battery Removal and Installation Required Tool: Philips screwdriver Remove the backup battery from the internal packaging material and shipping bag. Do not discard packing materials until the backup battery has been installed on the ventilator and its operation has been confirmed. NOTE: Save the shipping container in case the backup battery has to be returned to Respironics. Figure 4-3 illustrates the backup battery assembly. Figure 4-3: Backup Battery 1.
Chapter 4 Getting Started Figure 4-4: Disconnecting the Battery Cable 2. Remove the rear cable channel cover from the cart by gently prying it back from the top of the center column, freeing it from the column.
Chapter 4 Getting Started 3. Loosen the ventilator mounting screws (4) from the underside of the cart, and remove the ventilator from the cart. WARNING: One person alone should not attempt to lift the ventilator or remove it from the shipping carton or the cart. At least two people are required to avoid possible personal injury or damage to the equipment.
Chapter 4 Getting Started 4. Remove the screws (4) holding the battery tray to the cart. Battery tray mounting screws Figure 4-7: Removing the Battery Tray 5. Gently pull up the battery tray and remove it from the cart.
Chapter 4 Getting Started 6. If a battery is present in the battery tray, disconnect the old battery from the battery tray’s cable. Figure 4-9: Disconnecting the Old Battery from the Battery Tray’s Cable 7. Undo the straps, remove the old battery if present, and place the new battery in the battery tray.
Chapter 4 Getting Started 8. Position the D ring on the straps as shown below. NOTE: If the D rings are not positioned properly, the excess strap will interfere with the tray’s channel guide. Figure 4-11: Positioning the D Rings on the Battery Straps 9. Connect the battery to the battery tray’s cable. Figure 4-12: Connecting the Battery to the Battery Tray’s Cable 10.
Chapter 4 Getting Started Figure 4-13: Installing the Battery Tray 11. Slide the battery halfway down the center column, and insert the circular right angle battery connector into the cutout. Pull the cable downward as the tray is fully inserted into the cart's center column.
Chapter 4 Getting Started 12. Fasten the battery tray to the cart using the 4 screws used when the tray was removed. Battery tray mounting screws Figure 4-15: Battery Tray Mounting Screws 13. Set the ventilator back on the cart, ensuring that the four ventilator feet meet the four circular recesses on the top of the cart. Tighten the four mounting screws that were loosened in step 3.
Chapter 4 Getting Started 14. Routing the backup battery cable from the tray between the rear of the ventilator and the rear handle of the cart, connect the cable to the circular battery connector on the back of the ventilator. Snap the rear channel cover back into place. Battery backup connector Figure 4-16: Backup Battery Connector 15. Plug the ventilator into an AC outlet. 16. Allow the backup battery to charge as required (see “Battery Charging” on page 4-15). 17.
Chapter 4 Getting Started Backup Battery Operation When the backup battery is attached and the Respironics V200 Ventilator is operating in normal ventilation mode anytime there is a loss of AC power, the ventilator will automatically switch to battery power and continue ventilation without interruption. Whenever the ventilator is powered by the backup battery, it will generate a non-silenceable, non-resettable alarm that creates an alarm sound every 60 seconds.
Chapter 4 Getting Started Battery Charging When the ventilator is plugged into a viable AC supply, it will charge the backup battery if the Mains Circuit Breaker is on and the machine is operating as a ventilator, or in diagnostic mode or the Power ON/OFF switch is OFF ( ). Charging time will depend on the amount of charge the batteries require. A fully discharged backup battery will be fully recharged within 10 hours.
Chapter 4 Getting Started Inspiratory Bacteria Filter Installation The inspiratory bacteria filter (4) in Figure 4-19, mounts on the gas outlet port (1) located in the lower right corner on the front of the ventilator. If the optional O2 sensor (2) will be used, it will be connected to the gas outlet port (1) before the inspiratory bacteria filter is connected. For more information regarding the optional O2 sensor, refer to Chapter 13, “Options and Accessories”.
Chapter 4 Getting Started WARNING: To reduce the chance of contamination or infection, always use an inspiratory and expiratory filter when the ventilator is in operation. Refer to manufacturer’s instructions and follow institutional infection control guidelines when replacing the inspiratory and expiratory filter. WARNING: Do not use anti-static or conductive hoses or conductive patient tubing.
Chapter 4 Getting Started Heated Expiratory Bacteria Filter Installation Figure 4-20: Installing Expiratory Bacteria Filter WARNING: The expiratory filter housing may be hot if removed from the ventilator immediately after use. Wait 15 minutes after turning off ventilator power before removing the heated expiratory bacteria filter. Exercise caution when handling the filter housing. CAUTION: Do not operate the ventilator without a properly functioning expiratory filter and heater.
Chapter 4 Getting Started 1. Locate the heated expiratory bacteria filter (1) and receiving compartment (6) in the lower center of front panel. 2. Turn knob (2) counterclockwise to unlatch retaining bracket (3). 3. Open retaining bracket (3) by pulling it out and away from the ventilator. 4. Use tabs (4) to gently pull the heater housing (5) away from the ventilator. 5. Ensure that ventilator has been turned off for 15 minutes. If not, allow the heater housing (5) to cool before touching it with fingers.
Chapter 4 Getting Started Oxygen Source Connection Figure 4-21: O2 Gas Connections and Filter 4-20 WARNING: All oxygen connections should be carefully inspected to ensure that leaks are not present. Excessive leaks can result in higher than normal ambient oxygen concentrations and create a potentially hazardous oxygen-enriched environment.
Chapter 4 Getting Started Oxygen Source Connection Instructions Refer to Figure 4-21. 1. Locate the O2 filter with water trap (1) located in the lower left corner of the rear panel. 2. Ensure that the O2 filter and water trap (1) are properly attached to the ventilator. Inspect the bowl (1) for cracks or potential leaks. Ensure all connections are tight. 3. Inspect the O2 hose (2), hose connector (3) and the hose connector mate (4). 4. Check the oxygen gas supply.
Chapter 4 Getting Started Patient Circuit Flex Arm Installation A patient circuit flex arm is provided for use on the ventilator. The patient circuit flex arm may be installed on either the left or right side rail on the cart. 3 1 5 2 4 Figure 4-22: Patient Circuit Flex Arm Installation Patient Circuit Flex Arm Installation Instructions Refer to Figure 4-22. 1. Slide flex arm bracket (1) on to the side rail of the cart (one per side). 2. Tighten black screw knob (2) on flex arm bracket. 3.
Chapter 5. Setup Back Panel Connections and Controls 1.RS-232 Serial Port 2. Remote Alarm Nurse Call 3. Parallel Printer Port 4. PCMCIA Card Slot 5. Analog Port 6. DC Battery Connector 7. AC Inlet 17. Cooling Fan Inlet 8 Humidifier AC Circuit Breaker 9. Circuit Breaker Cover (not shown) 16. Potential Equalization Connection 10. Mains Circuit Breaker 15. O2 Inlet Filter and Water Trap 11. Humidifier AC Outlet 14. O2 Inlet Connector 12. Air Inlet Duct and Filter 13.
Chapter 5 Setup WARNING: The cover plate for the PCMCIA slot at the back of the ventilator must be replaced after the adapter and card are installed. This is to protect the ventilator. CAUTION: The PCMCIA card should only be removed by trained service personnel once power to the ventilator is off. 5. Analog Port: Pin 12 signals an unsilenced high or medium urgency alarm. Other pins are used by the Communications Option. Refer to Chapter 13, “Options and Accessories”. 6.
Chapter 5 Setup NOTE: All volumes entered into the ventilator are assumed to be BTPS (Body Temperature atmospheric Pressure Saturated (with H2O)) volumes unless otherwise noted. All volumes reported by the ventilator are reported as BTPS volumes. All pressures are assumed to be relative to atmospheric pressure unless otherwise noted. NOTE: The Air Inlet Filter houses a reusable foam filter that should be periodically cleaned.
Chapter 5 Setup Connecting AC Power Cord Instructions Refer to Figure 5-2. • Tools Required: Small Phillips screwdriver 1. Ensure that the ventilator is properly positioned on a secure table top, wall mount, or pedestal. 2. Connect the AC Power Cord (1) to the AC inlet (3) located on the rear panel. (Refer to Figure 5-1.) 3. After cord is fully inserted, tighten the retaining bracket screw (2) so that the power cord cannot be inadvertently disconnected from the ventilator.
Chapter 5 Setup Turning the Ventilator On 1. Ensure that the Mains Circuit Breaker (refer to Figure 5-1), located on the ventilator back panel, is in the ON ( ) position. 2. For 120V applications, if a humidifier is attached to the ventilator, ensure that the Humidifier AC Circuit Breaker (refer to Figure 5-1), located on the ventilator back panel, is in the ON ( ) position. A humidifier connection is only available on 100-120VAC ventilators. 3.
Chapter 5 Setup Entering Diagnostic Mode 1. To access the Diagnostic Mode, simultaneously press the ALARM RESET and 100% O2 keys on the front panel for approximately five seconds while turning the ventilator power on. The following message will appear on the screen: Figure 5-4: Warning in Diagnostic Mode 2. Press the OK button to enter the Diagnostic Mode.
Chapter 5 Setup User Configuration Screen The buttons across the top and bottom bars are used to select the Diagnostic Mode functions. To set up the machine for the first time for operation as a ventilator, USER CONFIG should be selected. When this button is pressed, the following screen appears.
Chapter 5 Setup 3. Press the ACCEPT button to confirm the change and return to the User Config screen. Press the CANCEL button to leave the value unchanged. Window insert to change the value of Month Figure 5-7: Setting the Date Window insert to change the value of Hour Figure 5-8: Setting the Time 4. After the date and time values have been set, the changes will be shown on the screen. 5. Press the APPLY DATE and APPLY TIME buttons to activate the change.
Chapter 5 Setup Apply Date button Apply Time button Figure 5-9: User Configuration Screen After Date and Time are Set 6. The 24 HR CLOCK button allows the operator or technician to set the displayed time in an AM/PM (e.g., 1:15 PM) or 24 Hr. (e.g., 13:15) format. When the 24 HR CLOCK button has a white background, time is displayed in the 24 Hr. format; when it has a gray background, time is displayed in the AM/PM format. 7. Press the 24 HR CLOCK button to toggle between AM/PM and 24 Hr. formats.
Chapter 5 Setup 4. Press ACCEPT to accept the changed value. Press the CANCEL button to leave the value unchanged. Window insert to change the value of Altitude Figure 5-10: Setting Altitude Enabling/Disabling Tubing Compliance The operator can activate or deactivate “tubing compliance compensation” in the User Configuration screen. To enter Diagnostic Mode, follow the instructions for “Entering Diagnostic Mode” on page 5-6. At Figure 5-5, select USER CONFIG and the screen in Figure 5-11 appears.
Chapter 5 Setup You can have the ventilator compensate the volumes delivered in volume controlled, mandatory breaths with the tubing compliance volume by activating the COMPLIANCE button (Figure 5-11). Circuit compliance is activated when this button has a white background. When the function is activated the exhaled volumes reported by the ventilator will also be tubing compliance compensated.
Chapter 5 Setup Press the OK button to clear the message from the screen. You may continue to use the ventilator without the backup battery or power off the ventilator and reconnect the backup battery. WARNING: Always turn the ventilator power OFF before connecting additional equipment. To turn this feature off, enter Diagnostic Mode and deactivate the messaging feature by pressing the BKUP BATTERY button. 1. Power off the ventilator. 2.
Chapter 6. Connecting Additional Equipment Communication Interface WARNING: Always turn the ventilator power OFF before connecting additional equipment. CAUTION: To prevent the risk of excessive leakage due to external equipment being connected to the ventilator via the communication ports, a means for external separation of the conductive earth paths must be provided.
Chapter 6 Connecting Additional Equipment Connecting Serial Communications Devices The serial port is designed to transmit data on a one device to one device serial communications channel. In the connection between the two devices, the ventilator assumes the “slave” role and responds to commands transmitted to it via the serial port by the external “master.” The serial communications port uses a standard RS-232, null modem, pin configuration.
Chapter 6 Connecting Additional Equipment Remote Alarm Cable Kits System Part Number Remote Alarm Cable Kit (Normally Open Protocol) 1003741 Remote Alarm Cable Kit (Normally Closed Protocol) 1003742 Remote Alarm Cable Kit — Respironics (LifeCare) 1003743 Table 6-1: Remote Alarm Cable Kits Connecting Humidifier WARNING: Use only Respironics approved cables when connecting to the remote alarm port. Be sure to fully insert the cable into the remote alarm port and into the remote alarm.
Chapter 6 Connecting Additional Equipment WARNING: Vent Inop is a serious condition, which is indicated by both visual and audible alarms. If the ventilator is attached to a patient when Vent Inop occurs, the patient must be supported with another means of life support ventilation. When connecting a humidifier to the patient circuit, follow the setup procedure supplied by the humidifier manufacturer.
Chapter 6 Connecting Additional Equipment 3. Run any test procedures recommended by the humidifier manufacturer before the ventilator and humidifier are used on a patient. WARNING: Connecting the Patient Circuit AC power is applied to the humidifier from the ventilator humidifier outlet (only available on 100-120 VAC ventilators). Under no circumstances does the Respironics V200 Ventilator provide control for the humidifier.
Chapter 6 Connecting Additional Equipment Figure 6-6: Humidifier Outlet to Patient Wye Connection Figure 6-7: Expiratory Limb of Patient Circuit to Water Trap Connection (Shows Down Tube between Ventilator and Water Trap) 6-6 Respironics V200 Ventilator Operator’s Manual REF 1057983 A
Chapter 6 Connecting Additional Equipment When connecting a patient circuit without a humidifier (for example, when using a heat and moisture exchanger), refer to Figure 6-8. Figure 6-8: Patient Circuit Connections Without Humidifier Connecting the Analog Port REF 1057983 A The analog output port adds a second remote alarm output. Pin 12 (fourth pin from the top left is pin 12) signals an unsilenced high or medium urgency alarm: • 0 VDC = active alarm • 1.
Chapter 6 Connecting Additional Equipment The Communications option provides additional signals on this port. Refer to Chapter 13, “Options and Accessories”.
Chapter 7. Operating Theory Introduction This chapter describes the ventilator’s breath delivery capabilities. It includes a system overview and descriptions of the ventilation modes and available breath types. For descriptions of button settings and general operating instructions, refer to Chapter 8, “Operating Instructions”.
Chapter 7 Operating Theory Figure 7-1: Volume Control Ventilation (VCV) Waveform Pressure Control Ventilation (PCV) In Pressure Control Ventilation, breaths may be controlled by the ventilator (mandatory) or by the patient (spontaneous). When controlled by the ventilator, breaths are pressure limited and time cycled, resulting in an operator set (PRESSURE) pressure being delivered for an operator set (I-TIME) period of time. Refer to Figure 7-2.
Chapter 7 Operating Theory Ventilation Modes Common to VCV and PCV In Volume Control Ventilation and Pressure Control Ventilation, the operator can select between ventilation modes of Assist/Control, SIMV, and CPAP. Assist Control Ventilation (A/C) With the Assist/Control mode (refer to Figure 7-1 or Figure 7-2), a minimal rate and tidal volume (or inspiratory pressure) are set by the operator.
Chapter 7 Operating Theory Continuous Positive Airway Pressure (CPAP) CPAP is a spontaneous mode of ventilation. No mandatory breaths are delivered. Throughout the breath cycle, an operator set pressure is provided. The level of pressure delivered during CPAP is the baseline pressure, or PEEP (Positive end Expiratory Pressure). Refer to Figure 7-3.
Chapter 7 Operating Theory Positive End Expiratory Pressure (PEEP) The PEEP pressure is the operator set baseline pressure maintained during exhalation. All breaths are referenced to this baseline pressure and the resulting pressure is in addition to the baseline pressure. Refer to Figure 7-5. Figure 7-5: Positive End Expiratory Pressure (PEEP) Rise Time Setting Rise Time applies to all pressure targeted breaths — PSV, PCV, and IPAP in NPPV.
Chapter 7 Operating Theory Patient Leak Display Estimated patient leak (Pt Leak) is displayed in LPM and updated at each breath. Pt Leak is the average leak rate during a breath (delivered volume minus exhaled volume divided by the breath time). Pt Leak is estimated breath by breath. If the physical characteristics of the leak change, there will be a corresponding change in the actual leak flow, which will be detected and leak estimation will be updated in subsequent breaths.
Chapter 7 Operating Theory Figure 7-7: Spont/T Mode Emergency Modes of Ventilation The ventilator has the following two emergency modes of ventilation that are entered in response to certain alarm conditions: • Apnea Ventilation • Safety Valve Open Apnea Ventilation Apnea ventilation provides an emergency mode of ventilation if the ventilator does not deliver a breath for an operator set interval of time. The apnea time can be set between 10 and 60 seconds.
Chapter 7 Operating Theory Parameters Used in Apnea Ventilation, Settings, and Alarm Limits VCV Settings Tidal Volume Peak Flow PEEP I-Trigger (pressure/flow) Flow pattern O2 % Insp Hold Apnea Rate Alarm Limits High Pressure Low Insp Pressure Low PEEP Low Mandatory Tidal Volume High Rate High Exhaled Minute Volume Low Exhaled Minute Volume PCV NPPV Inhalation Pressure Inhalation Time PEEP I-Trigger (pressure/flow) Rise Time O2 % Apnea Rate IPAP EPAP Inhalation Time Rise Time I-Trigger (flow) E-Cycle
Chapter 8. Operating Instructions Overview WARNING: Ensure that an alternative means of ventilation (that is, a resuscitator or similar device) is available while the ventilator is in use on a patient. WARNING: The ventilator complies with the requirements of IEC 601-1-2 (EMC collateral standard), including the E-field susceptibility requirements at a level of 10 volts per meter. However, even at this level of immunity, certain transmitting devices (cellular phones, walkie-talkies, etc.
Chapter 8 Operating Instructions Increase bar, the farther from the middle the bar is pushed the faster the value changes. Similarly for the decrease bar. Digital value of setting to be changed Figure 8-1: Entering Settings and Alarm Parameters 2. Press the INCREASE bar or DECREASE bar until the desired value appears in the digital window, or use the front panel control knob to increase or decrease the displayed value. 3.
Chapter 8 Operating Instructions The Front Panel Alarm Status Indicators The text version of the ventilator’s front panel includes the indicators and controls shown in Figure 8-2. The symbol version of the front panel is shown in Figure 8-3.
Chapter 8 Operating Instructions Alarm Status Indicators Vent Inop Safety Valve Touch Display Power Status Indicators Front Panel Keys Level Controls Power On/Off Switch Figure 8-3: Front Panel — Symbol Version 8-4 Respironics V200 Ventilator Operator’s Manual REF 1057983 A
Chapter 8 Operating Instructions Alarm Status Indicators The alarm status indicators located at the top of the ventilator alert you to the ventilator’s alarm conditions. (Refer to Chapter 9, “Alarms” for more detailed descriptions.) Normal Alarm High Alarm Med/Low VENT INOP SAFETY VALVE Figure 8-4: Alarm Status Indicators Alarm Status Indicators Alarm Indicator Status Description Normal Green No active or auto reset alarm condition exists.
Chapter 8 Operating Instructions Power Status Indicators Power status indicators alert you to the status of the backup battery. The text version of the power status indicators is shown in Figure 8-5. The symbol version of the power status indicators is shown in Figure 8-6. NOTE: The ventilator selects its power source based on the following prioritization: AC power (if present), external battery, then backup battery.
Chapter 8 Operating Instructions Power Status Indicators (Continued) Battery Indicator Status Description Mains Green The ventilator is connected to an AC power source and the rear panel Mains circuit breaker is on ( I ). Ext. Battery Yellow Continuously illuminated when the external battery is in use. NOTE: The external battery is an optional accessory. See “Options and Accessories” on page 13-1 for more information.
Chapter 8 Operating Instructions Front Panel Keys The front panel keys enable you to initiate ventilator functions. The keys that include an indicator ( ) also provide operational status of the function that it performs. The text version of the front panel keys is shown in Figure 8-7. The symbol version of the front panel keys is shown in Figure 8-8. (Refer to Chapter 9, “Alarms” for more detailed information on the alarm keys and buttons).
Chapter 8 Operating Instructions Front Panel Keys (Continued) Key Symbol Definition Description Alarm Silence Function: Disables the audio alarm for two minutes. When Alarm Silence is pressed before the end of a two-minute period, the two-minute timer is reset. Alarms that cannot be silenced are listed in Table 9-1: “Alarm Alert Messages” on page 9-5. Indicator: Illuminated yellow when the audible alarm has been disabled; is active and stays on for two minutes when the ALARM SILENCE button is pressed.
Chapter 8 Operating Instructions Front Panel Keys (Continued) Key Symbol Definition Description Manual Breath Function: Delivers an operator-initiated, mandatory (OIM) breath. Delivery of the breath is based on the current ventilation breath type settings. NOTE: Manual breaths are not permitted during the inspiratory phase of a breath (whether manual or spontaneous). Pressing the MANUAL BREATH key during these times will not result in the delivery of a manual breath.
Chapter 8 Operating Instructions Ventilator Screens Front Panel Touch Display The front panel display allows you to select ventilation modes, breath types, settings, alarms, and access patient data. The front panel display is a touch screen that lets you select settings and data so you can monitor the status of the patient, ventilator, and control ventilator operation.
Chapter 8 Operating Instructions Figure 8-10 shows the top bar and describes its buttons. Active Mode: push to display the settings for the active ventilation mode and breath type. Active Alarms: push to show current alarm settings for the active ventilation mode and breath type. Patient Data: push to show the Patient Data screen. Monitor: push to display the monitor screen (ventilator settings and patient data).
Chapter 8 Operating Instructions Figure 8-12 shows the real time manometer displays. Waveform: airway pressure versus time Indicator Upper limit of real time display determined by High Pressure alarm setting High pressure alarm setting press this button to modify HIP. Zero pressure line Breath Indicator Manometer with Waveform Manometer only (for mode setting screens) Figure 8-12: Manometer (common to operational screens) Table 8-5: “Breath Indicator” describes the breath indicator.
Chapter 8 Operating Instructions Pressing the HIP indicator on the screen (Figure 8-12) will immediately allow the operator to modify the high pressure limit for VCV or PCV. In NPPV, the high pressure limit is automatically set to 10 cmH2O (hPa) above IPAP. The HIP indicator does not appear near the manometer in NPPV. HIP Settings Screens The buttons in the middle of the settings and alarm limit screens all have two states: active and inactive.
Chapter 8 Operating Instructions Ventilation mode: A/C, SIMV, or CPAP. Spont or Spont/T are available during NPPV Ventilation control settings: VCV, PCV, or NPPV Figure 8-13: VCV Settings Screen (VCV active) Selecting Settings Follow these steps to adjust ventilator control settings: 1. Push VCV SETTINGS, PCV SETTINGS, or NPPV SETTINGS. 2. Push the button for the control settings you want to select.
Chapter 8 Operating Instructions Push this bar to increase the value Current or new value displayed digitally and graphically Push this bar to decrease the value Press ACCEPT to activate the new setting Press CANCEL to leave the setting unchanged Figure 8-14: Changing a Setting When a value is entered, as shown in Figure 8-14, the ventilator checks to assure that the value has been accepted by the operator, is within limits, and will not cause other settings to be out of limits.
Chapter 8 Operating Instructions Active ventilation mode and breath type button displayed Indicates this screen is for VCV alarms Push button of alarm you want to adjust Figure 8-15: Setting Alarm Limits That Are Currently Active The High Pressure Alarm Setting may be accessed through the Alarms Settings Screen or through the HIP Indicator adjacent to the manometer in the PCV and VCV Settings, Alarm Settings, Patient Data, and Monitor Screens.
Chapter 8 Operating Instructions ACTIVATE button Figure 8-16: PCV Setting while NPPV is the active breath type 2. From the control settings screen, push the ACTIVATE button. Refer to Figure 8-16. The ventilator displays a prompt insert (Figure 8-17). Figure 8-17: Change Breath Type Insert Window for PCV 3. Select the REVIEW ALARMS button to display the alarm settings for PCV (Figure 8-18). 4.
Chapter 8 Operating Instructions Grayed out buttons indicate that the alarm limits are not active Push button of alarm setting to adjust Press this ACTIVATE button to switch to the ventilation breath type indicated.
Chapter 8 Operating Instructions Descending ramp and square wave act as mutually exclusive select/non-select buttons. Push this button to select descending ramp waveform Push this button to select square waveform Figure 8-19: Selecting Waveforms (descending ramp selected) Selecting Adult/Pediatric Buttons You can configure ventilation for adult or pediatric patients (Figure 8-20) from the active ventilation type screen.
Chapter 8 Operating Instructions Selecting the Inspiratory Trigger (I-Trigger) The I-Trigger setting determines how inspiratory effort is detected (by measuring a drop in airway pressure or an increase in patient inspiratory flow) and when inspiration begins. • In VCV and PCV, you can select a pressure or flow I-Trigger. • In NPPV, the I-Trigger is always Flow. Follow these steps to set the I-Trigger: 1. Push the VCV SETTINGS, PCV SETTINGS, or NPPV SETTINGS button. 2. Push the I-TRIGGER button.
Chapter 8 Operating Instructions displayed, the calculated value for the I:E ratio that will result from the PCV rate value is also displayed. When the setting window insert for VCV Apnea Rate is displayed, the calculated minute ventilation that will exist if the ventilator goes into Apnea Ventilation in VCV is shown. When the setting window insert for PCV Apnea Rate is displayed, the I:E Ratio shown is the I:E Ratio that will exist if the ventilator goes into Apnea Ventilation in PCV.
Chapter 8 Operating Instructions Changing IPAP or EPAP in NPPV When changing the IPAP or EPAP settings in NPPV, the difference between IPAP and EPAP is displayed in the window insert as PSV. Figure 8-23: Changing IPAP or EPAP in NPPV Selecting a New Ventilation Breath Type (VCV, PCV, or NPPV) Follow these steps to select the ventilation breath type: 1. Press the button for the new breath type you want to select from the bottom bar (Figure 8-24) [PCV in this example].
Chapter 8 Operating Instructions ACTIVATE button Figure 8-25: Settings Screen (PCV settings, PCV not currently active) 3. Press the ACTIVATE button. The prompt in Figure 8-26 is displayed on the screen. Figure 8-26: Prompt when Activate is pressed and PCV settings selected 4. At • • • this prompt the operator can: Move directly into PCV by pressing the OK button, or Review the PCV alarm settings, or Change nothing and return to the PCV settings screen by pressing the CANCEL button.
Chapter 8 Operating Instructions (b) Press the Review Alarms button to go to this screen. (c) Press the Cancel button and return to this screen. Figure 8-27: Destination Screens after Activate Prompt If the REVIEW ALARMS button is pressed the ventilator immediately displays the screen shown in Figure 8-27(b) appears. If the CANCEL button is pressed, the ventilator returns to the settings screen for the selected breath type as shown in Figure 8-27(c). 5.
Chapter 8 Operating Instructions 6. If the operator reviews alarm settings and then activates the new breath type, the ventilator uses the new breath type and displays the alarm settings of the new breath type (Figure 8-29).
Chapter 8 Operating Instructions The ventilation mode buttons are the selected/not-selected type. Follow these steps to select the mode: 1. Press the button for the mode you want to select (the active mode is highlighted) from the top bar: • • If VCV or PCV breath types are active, you can select A/C, SIMV, or CPAP mode (Figure 8-30). If NPPV is active, you can select Spont/T or Spont. Figure 8-30: Ventilation Mode buttons (A/C and Spont/T active as shown) 2.
Chapter 8 Operating Instructions Patient Data Screen You can view the patient data screen (Figure 8-33) by pressing the PATIENT DATA button in the top bar. The format of this screen is the same in VCV, PCV, and NPPV. Table 8-7: “Patient Data Definitions: Range, Units & Resolution” summarizes the definitions, display ranges, and resolution for patient data parameters.
Chapter 8 Operating Instructions Patient Data Definitions: Range, Units & Resolution (Continued) Parameter Description Display Range Resolution Spont VE Spontaneous Minute Volume The spontaneous ventilation normalized to one minute. Compliance compensated (if enabled). 0.00 to 99.9 L (BTPS) 0.01 for 0.00 to 9.99 0.1 for 10.0 to 99.9 Total VE Exhaled Minute Volume The total volume exhaled by the patient in one minute. Compliance compensated (if enabled.) 0.00 to 99.9 L (BTPS) 0.01 for 0.00 to 9.
Chapter 8 Operating Instructions This screen is displayed in VCV. This screen is displayed in PCV. This screen is displayed in NPPV.
Chapter 8 Operating Instructions Special Procedures Auto-PEEP Calculation The ventilator allows the operator to calculate Auto-PEEP from an expiratory hold procedure. This function is active only at the end of a mandatory breath and is not available in the emergency ventilation mode. Expiratory hold is initiated by pressing the EXP HOLD key on the front panel.
Chapter 8 Operating Instructions Preoperational Procedure The preoperational procedure verifies that the ventilator is ready for use on a patient. WARNING: Ensure that an alternative means of ventilation (that is, a resuscitator or similar device) is available while the ventilator is in use on a patient. WARNING: DO NOT perform the preoperational procedure when the ventilator is on a patient. Follow these steps: 1. Follow the setup procedures in Chapter 5, “Setup”, to prepare the ventilator for use.
Chapter 8 Operating Instructions 7. Push USER CONFIG to check time, time format, date and altitude and set compliance compensation as required (Figure 8-37). NOTE: If time is found to be incorrect more than once in the preoperational procedure, an internal battery may have to be replaced. Contact qualified service personnel or call Respironics Customer Service at 1-800-345-6443. 8. Press START SST to begin Short Self Test, and follow the screen prompts.
Chapter 8 Operating Instructions Altitude set Date set Compliance compensation enable/disable Time format (12 or 24_hour) set Time set Backup Battery (confirm at startup) enable/disable Figure 8-38: User Config Screen 10. Once you have reviewed all the parameters on the User Config screen, the ventilator is ready for patient use. Turn the ventilator off, then on, without holding down any front panel keys. 11. Ventilator settings from the previous use are in effect at power up.
Chapter 9. Alarms Introduction The Respironics V200 Ventilator provides an easy-to-use hierarchical alarm system that includes both visual and audible alarms. When the ventilator detects an operating condition that requires attention, it generates an alarm. The alarm system communicates three levels of urgency and priority: • High Urgency: Alerts the operator that immediate response is required. (red flashing indicator) • Medium Urgency: Alerts the operator that prompt response is required.
Chapter 9 Alarms Alarm Insert Figure 9-2: Alarm Alerts Audible Alarms When an alarm condition exists, the ventilator will generate a sequence of audible tones to alert the operator. The sequence varies according to the urgency and priority level of the alarm: • High Urgency: The ventilator emits a repeating sequence of five tones. • Medium Urgency: The ventilator emits a repeating sequence of three tones. • Low Urgency: No audible tone emitted.
Chapter 9 Alarms message is higher priority than one of the currently displayed messages. The highest three priority messages will be displayed. ALARM SILENCE is immediately terminated if ALARM RESET is pressed. Any medium or high priority alarm that is active will immediately begin audible annunciation. CAUTION: Alarm Reset The ventilator alarm indicators and the Alerts insert should be monitored closely during the Alarm Silence period to ensure that unexpected alarms are noticed.
Chapter 9 Alarms Alarm Volume Control Under the left hand bottom edge of the front panel is a partially exposed round control that enables you to control the volume of audible alarms (Figure 9-3). Alarm Volume Control Knob Figure 9-3: Alarm Volume Control The volume control can be adjusted between a minimum and maximum setting to suit the particular clinical situation.
Chapter 9 Alarms Alarm Alert Messages Alert Message Description Air Source Fault A high urgency alarm indicates the internal air source is not functioning properly, patient ventilation continues using the 100% O2 gas source if available. Call for service. Cannot be silenced or manually reset. Apnea The ventilator triggers a medium urgency alarm condition and enters Apnea Ventilation mode if no inspiration is started within the operator set apnea interval while in a nonemergency breathing mode.
Chapter 9 Alarms Alarm Alert Messages (Continued) Alert Message Description High Minute Volume Indicates total minute ventilation (VE) measured in exhalation is higher than the set limit. This alarm is available in Volume Control and Pressure Control modes. It is elevated to high urgency after one minute. High O2 A high urgency alarm indicates that the monitored O2 concentration is at least 6% above the set value (%O2) for 30 seconds. Verify operation of the O2 sensor. Alarm cannot be manually reset.
Chapter 9 Alarms Alarm Alert Messages (Continued) Alert Message Description Low Insp Pressure If the peak airway pressure during any mandatory inhalation is less than the Low Insp Pressure limit, the ventilator will immediately signal a high priority alarm. Note: If an inspiration is triggered immediately after the mandatory minimum exhalation time of 200 msec, this alarm will not be activated unless this condition occurs for three consecutive breaths.
Chapter 9 Alarms Alarm Alert Messages (Continued) Alert Message Description Low Vt Mandatory The ventilator triggers a medium urgency alarm to indicate that the VCV or PCV mandatory tidal volume is less than the set limit. It is elevated to high urgency after one minute. Note: A Low Vt setting of zero (0) will disable this alarm.
Chapter 9 Alarms Alarm Indicators Normal Alarm High Alarm Med/Low Vent Inop Safety Valve Figure 9-4: Alarm and Status Indicators Normal The Normal indicator remains lit with a steady green light as long as there are no active or auto reset alarm conditions present. Alarm High The Alarm High indicator visually indicates a high priority alarm. When a high priority alarm condition exists, this indicator flashes red and an audible five tone sequence sounds until the condition is corrected or reset.
Chapter 9 Alarms When a ventilator inoperative condition is detected, the Vent Inop indicator will display a steady red light, and the ventilator will sound a five-tone audible alarm sequence. The Vent Inop alarm cannot be reset by an operator. It cannot be auto-reset or silenced. The ventilator must be serviced by a qualified service representative, in order for the Vent Inop audible and visual alarms to be cleared.
Chapter 10. Care and Maintenance General Information Procedures for ventilator cleaning, sterilizing, and periodic maintenance must be performed to ensure consistent ventilator operation. Institutional policies may also provide guidelines, procedures, and schedules for cleaning and sterilizing equipment before, during and after patient use. In addition, recommended methods and time frames for performing all necessary care and maintenance procedures for the ventilator are presented in this section.
Chapter 10 Care and Maintenance Sterilization WARNING: Do not expose expiratory and inspiratory bacteria filters or reusable patient tubing to ETO gas. NOTE: Because conditions and practices in health care institutions vary, this manual can only describe general guidelines. It is the user’s responsibility to ensure the validity and effectiveness of the methods used. Do not clean, disinfect, sterilize or reuse disposable products.
Chapter 10 Care and Maintenance CAUTION: Formaldehyde, phenol-based, and quaternary ammonium compound (QUATS) disinfectants are not recommended because these agents can cause cracking and crazing of plastic parts. Exposure of components to disinfectant concentrations stronger than required or for excessive time may shorten product life. Parts should be thoroughly rinsed and dried to prevent spotting and blemishes when exposed to elevated temperatures. 1.
Chapter 10 Care and Maintenance Reusable Patient Circuit Tubing, Couplings, and Connectors Disassemble and clean manually followed by steam-autoclave. Follow all institutional guidelines for autoclaving. Visually inspect tubing for nicks, cuts and holes prior to use with the ventilator. Reusable In-line Water Traps Disassemble and clean water traps as per the manufacturers instructions. Inspect for cracks or leaks prior to use with the ventilator. Replace if cracked or leaking.
Chapter 10 Care and Maintenance Removing and Replacing Inspiratory Bacteria Filter Follow the steps outlined below to remove and replace the inspiratory bacteria filter. Figure 10-2: Removing and Replacing Inspiratory Bacteria Filter 1. Disconnect circuit tubing (1) from inspiratory bacteria filter outlet (2). 2. Disconnect filter (3) from the gas outlet (4). If optional O2 sensor is installed, ensure it is not dislodged. When used, O2 sensor is located between gas outlet (4) and filter (3). 3.
Chapter 10 Care and Maintenance Figure 10-3: Removing and Replacing Expiratory Bacteria Filter 1. Disconnect circuit tubing from filter inlet (not shown). 2. Unscrew knob (1) to unlatch retaining bracket (2). 3. Open retaining bracket (2). 4. Use tabs (3) to gently remove heater housing (5) and filter (4) from the ventilator. 5. Do not touch heater housing. If ventilator has not been turned off and heater housing has not been allowed to cool, it may be hot to the touch. 6.
Chapter 10 Care and Maintenance Periodic Maintenance This section includes detailed operator maintenance. Schedule for Periodic Maintenance Frequency During ventilator setup Component • Inspiratory bacteria filter • Ventilator and patient circuit components • Inspiratory and expiratory filters At least daily, and as recommended by filter manufacturers • Inspiratory and expiratory filters Maintenance • Check filter for occlusions, cracks and tears.
Chapter 10 Care and Maintenance 12,500 hours • 12,500 hour preventive maintenance kit (P/N 1001733). Kit contents are subject to change. • Install 12,500 hour preventive maintenance kit • Clean ventilator interior and exterior • Complete performance verification procedure CAUTION: The 12,500 hour preventive maintenance procedure is to be performed only by a qualified service technician.
Chapter 10 Care and Maintenance Removing and Replacing O2 Input Filter Element 1 5 4 3 2 Figure 10-5: Removing and Replacing O2 Input Filter Element Refer to Figure 10-5. 1. Disconnect O2 Hose (1). 2. Unscrew filter housing (3). 3. Unscrew filter element retaining screw (4). 4. Remove and replace filter element (5). 5. Reconnect filter element retaining screw (4). 6. Reinstall filter housing (3). 7. Reconnect O2 hose (1). 8. Check system for leaks prior to patient use.
Chapter 10 Care and Maintenance Removing and Replacing Internal Air Source Inlet Filter 1 2 Pull filter out from underside of duct. Figure 10-6: Removing and Replacing Internal Air Source Inlet Filter Refer to Figure 10-6. Figure 10-6 shows exploded view of the duct (2) and filter (1), but it does not have to be disassembled. 1. Move the ventilator so that there is easy access to the underside of the internal air source duct (2). 2. The internal air source filter (1) can be removed manually.
Chapter 11. Diagnostics The Diagnostic Mode allows you to: REF 1057983 A • Run short self test (SST) • Run extended self test (EST) • Run hardware diagnostics to help you troubleshoot SST or EST failures • Check the software revision of the ventilator • Set • • • • • Check diagnostic codes.
Chapter 11 Diagnostics Entering Diagnostic Mode To enter Diagnostic Mode, hold down the ALARM RESET and 100% O2 keys for approximately 5 seconds while you turn on the ventilator. A message appears on the ventilator prompting you to confirm that the patient is disconnected before entering Diagnostic Mode (Figure 11-1). Press OK to enter Diagnostic Mode. Figure 11-1: Entering Diagnostic Mode Once you’ve entered Diagnostic Mode, you can select any of diagnostic functions by pressing its button.
Chapter 11 Diagnostics Diagnostic Functions Short Self Test (SST) SST verifies the integrity of the patient circuit tubing by measuring its leak rate and compliance. SST also tests critical hardware components, including the safety valve, flow sensors, and autozero solenoids. Perform SST before every patient circuit change. If SST passes, the ventilator and all attached components are ready for use.
Chapter 11 Diagnostics Extended Self Test (EST) EST verifies the overall functional integrity of the ventilator by testing all critical hardware subsystems and components. Perform EST between patients as part of preventive maintenance, a performance verification, or if the operational integrity of the ventilator is in question. EST is typically run by qualified trained personnel. WARNING: Never initiate EST while the patient is connected to the ventilator.
Chapter 11 Diagnostics User Config The User Config function allows you to: • Set the date and time when first setting up the ventilator. • Set the altitude for the location of the ventilator. This setting allows for more accurate tidal volume delivery. • Enable or disable the automatic patient circuit compliance compensation feature. Compliance compensation corrects the delivered volumes of VCV mandatory breaths for patient circuit compliance.
Chapter 11 Diagnostics Diagnostic codes associated with EST and SST are only recorded the first time the failure is encountered. The log holds the last 20 diagnostic codes. The screen can only display 10 codes at a time. Press NEXT PAGE button to see the next group of codes or PREV PAGE to view the previous group. The CLEAR CODES button allows a qualified service technician to delete codes from the log.
Chapter 11 Diagnostics Diagnostic Codes and Descriptions (Continued) Code Description 2134 Cannot Calibrate Air Flow Sensor 2135 Cannot Calibrate O2 Flow Sensor 2136 Cannot Calibrate Exh Flow Sensor 2137 Verify Failure—Air Flow Sensor Cal 2138 Verify Failure—O2 Flow Sensor Cal 2139 Verify Failure—Exh Flow Sensor Cal 2140 Cannot Erase Flow Sensor Tables 2141 Cannot Open Inh Autozero Solenoid 2142 Cannot Open Exh Autozero Solenoid 2152 Patient Wye Not Unblocked 3XXX Extended Self Test
Chapter 11 Diagnostics Diagnostic Codes and Descriptions (Continued) Code Description 3123 O2 Valve Cracking Flow Outside Range 3124 O2 Valve Full Flow Outside Range 3125 Air Flow Sensor/Exh Flow Sensor Disagreement or Inhalation Pressure/Exhalation Pressure Disagreement 3126 O2 Flow Sensor/Exh Flow Sensor Disagreement 3127 Heated Filter Backpressure Out of Range 3128 Circuit Compliance Out of Range 3129 Pressure Leak Out of Range 3130 Safety Valve Cannot Open 3131 Patient Wye Not Block
Chapter 11 Diagnostics Diagnostic Codes and Descriptions (Continued) Code Description 3158 Exhalation Valve initial pressure —Outside Range 3159 Exhalation Valve final pressure —Outside Range 3160 Exhalation Valve flow —Outside Range 5XXX Safety Valve Open or Backup Battery Not connected 5000 Occlusion - Safety Valve Open Alarm 5001 Gas Supplies Lost - Safety Valve Open Alarm 5002 Backup Battery Not Connected 8XXX Software Diagnostic information 8003 Software Option Button Failure 8004
Chapter 11 Diagnostics Self Test Introduction The Respironics V200 ventilator has an extensive system of checks designed into the system to ensure that it operates safely and detects fault conditions that can compromise the performance of the system as a ventilator. These checks include hardware that checks the integrity of the software and software that checks the hardware to ensure that it is operating within normal ranges. These checks are described below.
Chapter 11 Diagnostics Built-In Test When the Respironics V200 ventilator is operating as a ventilator, it is constantly making reasonableness checks on the operation of the hardware to ensure that failures have not occurred and that the hardware appears to be operating normally. Also, while the microprocessor is operating, there is execution time available that is not required for ventilator operation.
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Chapter 12. Technical Specifications Breath Types Breath Types Volume Controlled Ventilation VCV Pressure Controlled Ventilation PCV Non-Invasive Positive Pressure Ventilation NPPV Apnea Ventilation Table 12-1: Breath Types Modes Modes Assist/Control (A/C) VCV, PCV SIMV VCV,PCV CPAP VCV, PCV Spont/T NPPV Spont NPPV Table 12-2: Modes Volume Ventilation Settings, Ranges and Resolution Resolution is one unit unless otherwise noted (cmH2O is considered numerically equivalent to hPa).
Chapter 12 Technical Specifications Volume Ventilation Settings, Ranges & Resolution (Continued) Setting Range Inspiratory Trigger (I-trigger) Pressure Sensitivity -20 to -0.1 cmH2O (hPa) (Resolution is 0.1 cmH2O (hPa)) Flow Sensitivity 0.5 to 20 LPM (Resolution is 0.1 LPM) Expiratory Trigger (E-Cycle) % Peak Flow 10 to 80% of inspiratory peak flow Rise Time 0.1 to 0.9 seconds (Resolution is 0.1 second) %O2 21% to 100% Insp. Hold 0 to 2.0 seconds (Resolution is 0.
Chapter 12 Technical Specifications Pressure Control Ventilation Settings, Ranges & Resolution (Continued) Setting Range Rise Time 0.1 to 0.9 seconds %O2 21% to 100% Patient Type Adult/Pediatric Table 12-4: Pressure Control Ventilation Settings, Ranges & Resolution (Sheet 2 of 2) Non-Invasive Positive Pressure Ventilation Settings, Ranges and Resolution Resolution is one unit unless otherwise noted (cmH2O is considered numerically equivalent to hPa).
Chapter 12 Technical Specifications Value Entry Message If you enter a value that is outside the operational limits of the ventilator, you will be shown a message window on the screen. Once you acknowledge the message, the ventilator returns to the value modification display without changing the value. Assist/Control Ventilation Value Entry Reasonability Checks Item Limit Exceeded Message Apnea Rate I:E Ratio>3:1 I:E Ratio must be less than or equal to 3:1. Check Vt, Peak Flow, or Insp.
Chapter 12 Technical Specifications Non-Invasive Ventilation Value Entry Reasonability Checks Item Limit Exceeded Message Changed Apnea Rate I:E Ratio>4:1 I:E Ratio must be less than or equal to 4:1. Check ITime. Readjust the Apnea Rate or adjust I-Time or Rate. I-Time I:E Ratio>4:1 I:E Ratio must be less than or equal to 4:1. Check Apnea Rate. Readjust the I-Time or adjust Apnea Rate or Rate. IPAP IPAP
Chapter 12 Technical Specifications Patient Data Range, Resolution, Units & Accuracy (Continued) Patient Data Display Range Units Resolution Accuracy I:E 9.9:1 to 1:99 none 0.1 for 9.9:1-1:9.9; 1 for 1:10-1:99 ±10% Peak Inspiration Pressure -20.0 to 130 cmH2O (hPa) 1 for 100-130; 0.1 for -20.0 to 99.9 ±10% End Inspiration Pressure (Pi End) -20.0 to 130 cmH2O (hPa) 1 for 100-130; 0.1 for -20.0 to 99.9 ±10% Mean Airway Pressure -20.0 to 120 cmH2O (hPa) 1 for 100-120; 0.1 for -20.
Chapter 12 Technical Specifications Level Controls Level Controls Control Adjustment Display Brightness (underneath front panel keys) Continuous (min to max) Alarm Volume (underneath front panel key Continuous (54 to 77 db) Adjust Control Continuous—to change values on screen Table 12-12: Level Controls Calculated Values from Expiratory Hold Maneuver Calculated Values from Expiratory Hold Maneuver Value Range End Expiratory Pressure -20 to 120 cmH2O (hPa) Expiratory Pause Pressure -20 to 120
Chapter 12 Technical Specifications Environmental Specifications Environmental Specifications Temperature/Humidity Operating 10º to 40ºC (50º to 104ºF) 10 to 95% R.H. (non-condensing) Storage -20º to 60ºC (-4º to 140ºF) 10 to 100% R.H. (non-condensing) Operating 700 to 1060 cmH2O (hPa) Storage 500 to 1060 cmH2O (hPa) Altitude Operating 0 to 3280m (0 to 10,000 ft.) Storage up to 6560m (20,000 ft.) Oxygen Inlet Supply Pressure 276 to 620 kPa (40-90 psig) Flow 200 L/min.
Chapter 12 Technical Specifications Alarms (Continued) Alarm Settings Alarm Status Indicators High Inspiratory Pressure 10 to 105 cmH2O (hPa) Low Inspiratory Pressure 3 to 105 cmH2O (hPa) Low PEEP Pressure 0 to 35 cmH2O (hPa) High Respiratory Rate 0 to 150 Bpm Low Exhaled Mandatory Tidal Volume 0 mL to 2500 mL Low Exhaled Spontaneous Tidal Volume 0 mL to 2500 mL Low Exhaled Minute Volume 0 to 60 Lpm High Exhaled Minute Volume 0 to 60 Lpm High Leak (NPPV mode only) 0 to 60 Lpm Normal In
Chapter 12 Technical Specifications Filters Filters Inspiratory See filter instruction sheets for complete specification. Bacterial Filter Efficiency: 99.999+% Viral Filtration Efficiency: 99.99+% Expiratory See filter instruction sheets for complete specification. Typical efficiency: 99.97% for nominal particle size of 0.3 micro meter (micron) at 100L/min flow.
Chapter 12 Technical Specifications Leakage Current Leakage Current Ventilator Earth Leakage Current 100 to 240VAC; 300µA maximum Enclosure/Patient Leakage Current 100 to 240VAC; 100µA maximum Table 12-22: Leakage Current WARNING: When connecting a humidifier to the humidifier outlet (available only on 100-120 VAC ventilators) allowable leakage current values may be exceeded.
Chapter 12 Technical Specifications NOTE: The humidifier power connection is available only on 100-120VAC ventilators. Dimensions and Weights Dimensions and Weights Height Ventilator Cart 17inches (42 cm) 42 inches (107 cm) Width 15 inches (38 cm) 23 inches (58 cm) Depth 25 inches (65 cm) 37 inches (95 cm) 29 inches with water trap filter (74 cm) Weight 66 pounds (30 kg) 80 pounds (36.
Chapter 12 Technical Specifications Guidance and Manufacturer's Declaration - Electromagnetic Immunity The ventilator is intended for use in the electromagnetic environment specified below. The user of the ventilator should assure that it is used in such an environment. Immunity Test IEC 60601 Test Level Compliance Level Electrostatic Discharge (ESD) ±6kV contact ±6kV contact IEC 61000-4-2 ±8kV air t±8kV air Electrical Fast Transient/burst ±2kV for power supply lines.
Chapter 12 Technical Specifications Guidance and Manufacturer's Declaration - Electromagnetic Immunity The ventilator is intended for use in the electromagnetic environment specified below. The user of the ventilator should assure that it is used in such an electromagnetic environment.
Chapter 12 Technical Specifications Guidance and Manufacturer's Declaration - Electromagnetic Immunity NOTE 1 At 80 MHz and 800 MHz, the higher frequency range applies. NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people. a The ISM (industrial, scientific and medical) bands between 150 kHz and 80 MHz are 6.765 MHz to 6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.
Chapter 12 Technical Specifications Recommended Separation Distances Between Portable and Mobile RF Communications Equipment and the Respironics V200 Ventilator The ventilator is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled.
Chapter 12 Technical Specifications Pneumatic System Internal Blower Inspiratory Module w/SV and PRV O2 Inlet To Patient Oxygen Assembly Expiratory Gas to Atmosphere Exhalation Valve Assembly Heated Exhalation Filter Assy From Patient System Electromechanical Controls User Interface Figure 12-1: Pneumatic System REF 1057983 A Respironics V200 Ventilator Operator’s Manual 12-17
Chapter 12 Technical Specifications Labels Ventilator Labels Label Description On/Off Switch Label Heated Expiratory Filter Label Gas Return Label Gas Outlet Label Serial Port, Remote Alarm Nurse Call, parallel printer port Label Keep Covered Label Analog port Potential Equalization Connector DC Battery Connection Label AC Power Label Humidifier Outlet Label Power Switch on Front Label Circuit Breakers Label 12-18 Respironics V200 Ventilator Operator’s Manual REF 1057983 A
Chapter 12 Technical Specifications Ventilator Labels (Continued) Oxygen Inlet Label Emergency Air Intake Label Cooling Inlet Label Date of Manufacture/Manufacturer Label 1059179 REV A Manufacturer Label Respironics California, Inc. Authorized Representative: 2271 Cosmos Court Respironics Deutschland GmbH Carlsbad, CA 92011 Gewerbestrasse 17 D-82211 Herrsching Germany MADE IN THE U.S.A. Covered by one or more of the following patents: 6,543,449. Other patents pending.
Chapter 12 Technical Specifications Ventilator Labels (Continued) Air Intake Label WARNING: Air Intake - Do Not Obstruct! Protective Earth (Ground) Label 12-20 Respironics V200 Ventilator Operator’s Manual REF 1057983 A
Chapter 13. Options and Accessories Introduction This chapter lists and describes the Respironics V200 ventilator options and accessories.
Chapter 13 Options and Accessories Options and Accessories (Continued) Remote Alarm Cable Kit (Normally Open Protocol) 1003741 Remote Alarm Cable Kit (Normally Closed Protocol) 1003742 Remote Alarm Cable Kit — Respironics (LifeCare) 1003743 Test Lung 1001737 Reusable Items Reusable Exhalation Bacteria Filter Omni (Single) 1002970 Reusable Inspiratory Bacteria Filter (Single) 1003847 Reusable Patient Circuit Kit, Adult Kit includes: 1 - Reusable Inspiratory Bacteria Filter 1 - Reusable Exhalati
Chapter 13 Options and Accessories Oxygen Sensor Option The optional Oxygen sensor (O2 sensor) may be installed to allow monitoring of delivered O2 to the inspiratory limb of the patient circuit. The ventilator will accept the MSA MiniOX® O2 and Analytical Industries Inc. sensors, P/N 1001454. Figure 13-1: O2 Sensor exploded view Assemble O2 Sensor Refer to Figure 13-1 for the following instructions. MSA MiniOX O2 1. Remove the O2 sensor (a) from the package.
Chapter 13 Options and Accessories Attaching the Sensor to the Ventilator The O2 sensor attaches to the gas outlet port located below the front panel on the ventilator’s lower right corner. Figure 13-2: O2 Sensor Orientation 1. Rotate the sensor assembly so that the sensor is pointing up. 5 4 3 5 4 3 2 2 1 1 Flow Figure 13-3: Connecting O2 Sensor and Patient Circuit 2. Connect the T-fitting (2) to the gas outlet port (1). 3.
Chapter 13 Options and Accessories 4. Connect inspiratory limb of patient circuit (5) to bacteria filter (4). 5. Ensure that all connections are tight. Warranty NOTE: Record O2 sensor manufacturing or warranty numbers and installation date for future reference. NOTE: To ensure accurate O2 monitoring, check O2 sensors periodically and replace as per manufacturer specification.
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External Battery Option The V200 External Battery is designed for use with a Respironics V200 Ventilator equipped with a backup battery.
Chapter 13 Options and Accessories Installation Contact Respironics Customer Service at 1-800-345-6443 to arrange installation or refer to the installation section of the Ventilator External Battery Service Instructions (1013569). WARNING: Power Consumption Sequence Do not lift the external battery. If the battery needs to be removed from the cart, contact Respironics Customer Service at 1-800-345-6443.
Chapter 13 Options and Accessories On/Off switch Figure 13-6: External Battery On/Off Switch WARNING: The external battery ON/OFF switch must be in the ON (I) position to ensure operation during a power failure. When this switch is in the OFF (O) position, the external battery is disabled. Switch off ONLY when connecting or disconnecting cables or when the ventilator or external battery is in storage for more than 2 weeks and is not connected to AC power.
Chapter 13 Options and Accessories Battery Capacity The external battery is used with the backup battery. Under optimal running conditions, both batteries together can operate the ventilator for up to four hours. However, ventilator power consumption varies according to environmental conditions and ventilator settings. Battery capacity varies with the age and charge level of the battery. The external battery should be kept fully charged to ensure maximum capacity when needed.
Chapter 13 Options and Accessories Testing Battery Specifications CAUTION: The External Battery is designed to recharge only as described here. Do not use any other method to recharge the External Battery. CAUTION: If the ventilator is expected to be stored for more than 2 weeks, the external battery ON/OFF switch should be set to the OFF (O) position to avoid discharging the external battery.
Chapter 13 Options and Accessories Warranty Respironics warrants the Respironics V200 external battery to be free from defects in material and workmanship for a period of twelve months from the date of installation, provided that the unit is operated under conditions of normal use as described in this operator’s manual. At its discretion, Respironics will make replacements, repairs, or issue credits for equipment or parts that are found to be defective.
Oxygen Manifold Option The oxygen manifold allows two O2 cylinders and one wall oxygen supply line to be used as inputs to the ventilator. Each of the three inlets has a checkvalve that prevents pressure loss when disconnecting from the wall or cylinders. This allows quick, easy transfer between oxygen supplies without interruption of flow. Easy transfer of oxygen supply facilitates patient transport within the facility and allows replacement of one cylinder while operating from the other.
Chapter 13 Options and Accessories Assembly Instructions WARNING: The Oxygen Manifold is for oxygen use only. WARNING: Maximum inlet pressure: 90 PSIG Minimum inlet pressure: 50 PSIG at 200 SLPM WARNING: Keep all hoses within the limits of the ventilator footprint to prevent a tripping or snag hazard. CAUTION: Use this kit with the Respironics V200 Ventilator only. CAUTION: Do not use the oxygen manifold or oxygen hoses to move the ventilator. 1. Lock the front wheels of the ventilator.
Chapter 13 Options and Accessories 2. Attach the oxygen manifold assembly to the ventilator by threading the adapter fitting onto the oxygen inlet elbow fitting. Using the manifold for leverage, rotate the oxygen inlet elbow fitting until the manifold assembly is vertical, as shown in Figure 13-10.
Chapter 13 Options and Accessories 3. Position the manifold support bracket so that the Wall O2 connection of the manifold fits snugly into the manifold support bracket grommet. Using the Allen wrench, attach the bracket to the cart using the two M6 x 10mm screws.
Chapter 13 Options and Accessories 5. When using oxygen from a wall supply, attach a wall oxygen hose (not included) to the center inlet of the oxygen manifold assembly. Replacement Parts: Using the Manifold The following replacement parts can be ordered from Respironics: • Check Valve Assembly (PN 1007190) • 24-inch Medical Hose Assemblies - Oxygen (PN 1006655) • Bracket and Hardware Kit (PN 1062294) To Use Wall Supply Oxygen Connect the wall oxygen supply to the manifold.
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Chapter 13 Options and Accessories Graphics The Graphics software enhances the display screens with graphical data of the patient’s flow, pressure, and volume. The Graphics software offers a choice of screens: • The Waveform screen displays two windows displaying pressure, flow, or volume within a specified time scale. • The Loops screen displays three windows: a waveform window (pressure, flow, or volume), a flow/volume loop window, and a pressure/volume loop window.
Chapter 13 Options and Accessories Figure 13-14: Waveform Screens Replotting and Scrolling Rescaling the Display You can select one of two plotting methods for waveforms: • Replotting selects a waveform that is drawn from left to right, then clears and restarts from the left edge (similar to an oscilloscope). • Scrolling selects a waveform that is drawn from left to right, then continuously shifts to the left to display the most recent data at the right edge of the screen (similar to a stripchart).
Chapter 13 Options and Accessories Figure 13-16 shows waveforms before and after rescaling. (a) BEFORE Rescale (b) AFTER Rescale Figure 13-16: Waveforms Screen (a) Before and (b) After Rescale Follow these steps to change scales manually: 1. Touch the upper or lower portion of the scale you want to change. 2. Press the INCREASE or DECREASE bar or turn the knob to adjust the scale range. 3. Press ACCEPT (onscreen button or offscreen key).
Chapter 13 Options and Accessories Press the INCREASE or DECREASE bar or turn knob to adjust scale range Upper portion of Scale Lower portion of Scale Figure 13-17: Manually Adjusting a Scale Freeze Feature The FREEZE button (Figure 13-18) pauses the Waveforms or Loops windows for extended viewing when the waveform window is full. Freeze button Figure 13-18: Freeze Button Once the Freeze feature is in effect, each graphics window shows numeric data for the cursor position on the waveform display.
Chapter 13 Options and Accessories Cursor position selects waveform and position (and corresponding points on loops) Use arrow buttons or knob to set cursor position. Continue button unfreeze graphics Figure 13-19: Frozen Loops Display with Numeric Data Windows Save and Overlay Features Follow these steps to save a frozen loop for later reference against future data (for example, before and after bronchodilator therapy): 1. Press the FREEZE button to save the Loops screen. 2.
Chapter 13 Options and Accessories SAVE button OVERLAY icon button SINGLE VIEW icon button Figure 13-20: Loops Display with Overlay Feature Active Inspiratory Area The Loops screen includes a window for the inspiratory area (Figure 13-21F). This window displays a numeric value that represents the ventilator imposed work of breathing, and is only calculated and displayed for a frozen loop. If the ventilator is supporting the entire breath, the Insp Area window displays “0.000”.
Chapter 13 Options and Accessories Alarms During Graphics If an alarm occurs during Graphics, an Alerts window (Figure 13-22) lists the active alarms.
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Chapter 13 Options and Accessories Communications Option (Com1) The Communications option allows the Respironics V200 Ventilator to: • Print out the ventilator's screen contents. • Communicate with a Philips/Agilent/HP VueLink module. • Connect another device, such as a chart recorder, via the analog output port. Using the Communications option does not affect ventilation or monitoring.
Chapter 13 Options and Accessories Parallel Printer Port Ventilator (Back Panel) Parallel Printer Cable Figure 13-24: Connecting the Ventilator to a Printer Printing a Screen To print a screen, touch the printer icon in the lower right corner of the screen. While the ventilator processes the print screen request, the screen freezes (typical freeze time of 30-60 seconds, depending on ventilator settings) and the printer icon turns gray.
Chapter 13 Options and Accessories Message Corrective action Print aborted: Printer paper empty Load paper and retry print screen. Print aborted: Printer offline Check printer, cycle power to printer, retry print screen. Print aborted: Printer error Check printer, retry print screen if printer is busy, cycle power to printer. Print canceled: Touching the screen while a print is in progress will cancel the Print.
Chapter 13 Options and Accessories RS-232 Serial Port Analog Port CMS Ventilator (Back Panel) VueLink cable VueLink module Figure 13-25: Connecting a Ventilator to a VueLink Module Configuring the VueLink Module A VueLink Ventilator Module M1032A #A02, is required for communication with the ventilator. The VueLink Module can communicate to three different protocols for external devices: VueLink Interface, Analog Interface, or VueLink Open Interface. The ventilator uses the VueLink Open Interface.
Chapter 13 Options and Accessories 2. Press "Monitor Setup" on a Standard Control Panel, or "Instrument Config." on a Classic Control Panel of the Component Monitoring System (CMS). 3. Highlight "Operating Modes" on the displayed window and press "Confirm". The current operating mode will appear in the task window (for example, "Operating Mode - Monitoring") along with a prompt for the password. 4. Enter the password, 1245. If the password is entered correctly, the "Change OpMode" key will be highlighted.
Chapter 13 Options and Accessories NOTE: If "On/Off Preselect" is pressed a second time, the preselection is switched off. NOTE: If there are already three devices preselected, one of the preselected devices must be turned "off" before adding a new one. 7. Press "Store Preselect", then "Confirm". 8. Attach the adhesive label containing "Open Device" to the VueLink module. The adhesive labels MUST be placed on the module in the same order as they appear in the Preselection Task Window. 9.
Chapter 13 Options and Accessories Available CMS on message CareNet X X V200 equivalent Comments FIO_2 %O2 Measured oxygen percentage (fractional inspired oxygen). sPkFl set Peak Flow Set peak flow. RiseTi Rise Time Set rise time. sAWRR set Rate Set (airway) respiratory rate. SpAWRR Spont Rate Measured spontaneous respiratory rate. AWRR Rate Measured (airway) respiratory rate. F/TV F/Vt Ratio of frequency to tidal volume (rapid shallow breathing index).
Chapter 13 Options and Accessories Available CMS on message CareNet V200 equivalent Comments X AWF Flow Delivered flow. X AWP Pressure Delivered pressure. AWV Volume Delivered volume. sIPAP set IPAP Set inspiratory positive airway pressure. sEPAP set EPAP Set expiratory positive airway pressure. PIP PIP Measured peak inspiratory pressure. MnAwP MAP Measured mean airway pressure. Pplat Pi End Measured end inspiratory (plateau) pressure.
Chapter 13 Options and Accessories Available CMS on message CareNet V200 equivalent Comments X HIGH LEAK RATE High Leak Rate High leak alarm limit violation. Yellow Alarm. X LOW EXH MAND TV Low Vt Mandatory Low mandatory tidal volume limit violation. Yellow Alarm. X HIGH EXH MV High Minute Volume High exhaled minute volume limit violation. Yellow Alarm. X LOW EXH TV Low Tidal Volume Low exhaled tidal volume limit violation. Yellow Alarm.
Chapter 13 Options and Accessories Available CMS on message CareNet V200 equivalent Comments X HIGH INT TEMP High Temperature Temperature within ventilator enclosure exceeds maximum limit. X HIGH INT O2% High Internal O2 Oxygen concentration within ventilator enclosure exceeds maximum limit.
Chapter 13 Options and Accessories Respironics V200 Ventilator Analog Output Port Pinout 13 Nebulizer (0 V = exhalation phase, 5 V = inhalation or plateau phase) 14 No data 15 No data NOTE: All analog outputs = 0 V at power up. Voltages have a linear relationship to the corresponding values. For example, 2.5 V on pin 9 = 0 LPM, 2.5 V on pin 11 = 70 cmH2O. NOTE: The resolution of the analog output is 0 to 5 V in 256 increments.
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Chapter 13 Options and Accessories RS-232 Communications Option 2 (Com2) The Respironics V200 Ventilator allows the transmission of data from the ventilator to the RS-232 communications interface. The Com2 option allows the ventilator to communicate with data systems The ventilator has two communications options, Com1 and Com2, which work exclusively of one another.
Chapter 13 Options and Accessories Commands Transmitted to the Ventilator Commands are transmitted as a series of four ASCII characters followed by a carriage return. Valid commands will be stored and response transmissions will be sent in the order the corresponding commands were received. Transmission of Data from the Ventilator Unless stated otherwise, all fields will be left justified and six (6) characters in length. A comma will separate each field, except for the field following the start code.
Chapter 13 Options and Accessories Ventilation Report Description Example Not used Resolution Range Units Comments N/A N/A N/A Outputs example value. Date FEB 23 1997 N/A N/A N/A 12 character field, MMM DD YYYY Mode setting CMV N/A CMV SIMV CPAP N/A Assist/Control = CMV, Spont/Timed = SIMV, Spont = CPAP Active Respiratory Rate setting 12.0 0.1 or 1 1.0 – 9.0 10 – 80 BPM Outputs when mode is CPAP or Spont. VCV Tidal Volume setting 0.50 0.01 0.05 – 2.
Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units VCV Apnea Respiratory Rate setting 12.0 0.1 or 1 1.0 – 9.
Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments Measured peak inhalation pressure 0.0 0.1 or 1 0.0 – 99.9 100 – 130 cm H2O Outputs when ventilation mode is CPAP or Spont and No Apnea alarm is present. Measured mean airway pressure 0.9 0.1 or 1 0.0 – 99.9 100 - 130 cm H2O Measured end inhalation pressure 7.7 0.1 or 1 0.0 – 99.
Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments Low Exhaled Mandatory Tidal Volume Alarm setting 0.00 0.01 0.00 – 2.50 L For VCV and PCV types of ventilation, set to Low Exhaled Mandatory Tidal Volume alarm limit (for A/C and Apnea) and Low Exhaled Spontaneous Tidal Volume Alarm limit (for SIMV and CPAP). When active type of ventilation is NPPV uses Low Exhaled Tidal Volume alarm limit. Low Exhaled Minute Volume Alarm setting 0.0 0.
Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments Low Exhaled Mandatory/ Spontaneous Tidal Volume Alarm status NORMAL N/A NORMAL, RESET ALARM N/A Outputs ALARM when any of the following alarms are active: Low Mandatory Tidal Volume Alarm, or Low Spontaneous Tidal Volume Alarm, or Low Tidal Volume Alarm Outputs RESET when any of the above alarms are reset and none are active. Outputs NORMAL when none of the above alarms are reset or active.
Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments Date FEB 23 1997 N/A N/A N/A 12 character field, MMM DD YYYY Static Compliance 0 1 0 - 350 ml/ cm H2O Outputs when Mechanics option is not installed or no maneuver was performed. Static Resistance 0.0 0.1 or 1 0.1 – 99.9 100 – 400 cm H2O/ L/s Outputs when Mechanics option is not installed or no maneuver was performed.
Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments Flow trigger setting 2 1 1 – 20 LPM Outputs Flow trigger setting of active ventilation type. Not used N/A N/A N/A Outputs example value. Not used N/A N/A N/A Outputs example value. Not used N/A N/A N/A Outputs example value. Not used N/A N/A N/A Outputs example value. Not used N/A N/A N/A Outputs example value. Not used N/A N/A N/A Outputs example value.
Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments PCV Inhalation Time Setting 0.10 0.01 0.10 – 9.
Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Occlusion Alarm Status or SM Occlusion Alarm Status or I-Time Too Long Alarm Status NORMAL N/A NORMAL, RESET ALARM N/A Comments Not used N/A N/A Outputs example value. Not used N/A N/A Outputs example value. Not used N/A N/A Outputs example value. Not used N/A N/A Outputs example value. N/A Outputs example value. Not used I-TIME N/A I-TIME I:E Ratio 1:99 N/A 9.
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Chapter 13 Options and Accessories Respiratory Mechanics Option The Respiratory Mechanics option allows the Respironics V200 Ventilator to perform respiratory mechanics maneuvers, including: Accessing Respiratory Mechanics Data • Vital Capacity (VC): The VC maneuver measures the patient’s lung capacity. It is available only in Volume Control Ventilation (VCV) and Pressure Control ventilation (PCV).
Chapter 13 Options and Accessories When you touch the Mechanics icon button, the Patient Status screen appears, see Figure 13-28. This screen displays patient data and includes derived lung mechanics results, weaning parameters, ventilator settings, maneuver date and time stamps, and other patient data. It also provides access to the respiratory mechanics maneuvers via the maneuver buttons on the bottom of the screen.
Chapter 13 Options and Accessories 3. At the end of a successful maneuver, a pop-up screen displays the result of the maneuver and asks you to accept or reject the results by touching the Accept or Reject button. 4. At the end of the maneuver (whether successful or cancelled), the Stop button changes to Continue. While the Continue button is displayed, the graph is frozen and can be rescaled. Touch Continue or exit the screen to unfreeze the display. 5.
Chapter 13 Options and Accessories Information type Description Flow-Volume or VolumeTime button Flow-Volume: Displays a real-time flow-volume loop. Volume-Time: Displays a real-time volume-time waveform. Start button Starts the maneuver. Changes to Stop when the maneuver is started. Changes to Continue when the maneuver is complete or when the Stop button is touched. Changes to Start when Continue is touched. Vital Capacity window Displays the most recently accepted VC maneuver results.
Chapter 13 Options and Accessories 5. At the end of the maneuver (whether successful or cancelled), the Stop button changes to Continue. While the Continue button is displayed, the graph is frozen and can be rescaled. Touch Continue or exit the screen to unfreeze the display. 6. Touch Continue: the button changes to Start and you can repeat the maneuver. WARNING: Perform the MIP maneuver according to instructions.
Chapter 13 Options and Accessories Information type Description Start MIP Press & Hold button Starts the MIP maneuver. Changes to Continue when the maneuver is complete or when finger is lifted from the button. Changes to Start when Continue is touched. Start P0.1 button Starts the P0.1 maneuver. Changes to Stop when the maneuver is started. Changes to Continue when the maneuver is complete or when the Stop button is touched. Changes to Start when Continue is touched.
Chapter 13 Options and Accessories 3. At the end of a successful maneuver, a pop-up screen displays the result of the maneuver and asks you to accept or reject the results by touching the Accept or Reject button. 4. At the end of the maneuver (whether successful or cancelled), the Stop button changes to Continue. While the Continue button is displayed, the graph is frozen and can be rescaled. Touch Continue or exit the screen to unfreeze the display. 5.
Chapter 13 Options and Accessories Information type Description Pplat window Displays the most recently accepted maneuver results. The date and time of the maneuver appear below each window. Scale (button at left of graphic display) Allows you to adjust graphic scales manually. The default scales for the Static C & R screen are 0 cmH2O to the High Pressure limit for pressure, 0 to Vt + 100 mL for volume. Default scales are in effect every time you enter the Static C and R screen.
Chapter 13 Options and Accessories Maneuver Error Messages Temporarily Disabled Alarms VC Measurement out of range Measured volume exceeds 9999 mL. •Low Exhaled Minute Volume Vital Capacity unavailable due to alarm condition Alarm condition exists when maneuver requested. Maneuver cancelled Operator presses Stop button.
Chapter 13 Options and Accessories Maneuver Error Messages Temporarily Disabled Alarms P0.1 Measurement out of range Measured pressures exceed –100 to +200 cmH2O. None: all alarms are active during the P0.1 maneuver. P0.1 unavailable due to alarm condition Alarm condition exists when maneuver requested. Maneuver cancelled Operator presses Stop button and no P0.1 maneuver breaths performed. Maneuver cancelled by alarm condition Alarm condition occurs after maneuver begins.
Chapter 13 Options and Accessories Maneuver Error Messages Temporarily Disabled Alarms Static C and R Measurement out of range. Check tubing system for leaks Static compliance exceeds 0 to 350 mL/ cmH2O or static resistance exceeds 0 to 400 cmH2O/L/s: None: all alarms are active during the Static C and R maneuver. Static C & R unavailable due to alarm condition Alarm condition exists when maneuver requested. Static C & R only available in VCV Ventilator not in VCV mode.
Chapter 13 Options and Accessories Parameter Vital Capacity (VC) maneuver Description Procedure: The clinician instructs the patient to inhale to maximum capacity at the next inspiration, then exhale completely, followed by a normal inspiration. The maneuver automatically ends at the next inspiration (following the maneuver breath) or if 20 seconds elapse without another inspiration. Available in VCV and PCV. Not available in NPPV.
Chapter 13 Options and Accessories Parameter Occlusion pressure at 100 ms (P0.1) maneuver Description Procedure: No instructions to the patient are required. Available in VCV and PCV. Not available in NPPV. During the maneuver: Settings do not change during the P0.1 maneuver. The ventilator briefly occludes the patient circuit and measures occlusion pressure in the first 100 ms of four preselected patient initiated breaths. If you press Stop during a P0.
Chapter 13 Options and Accessories Parameter Static compliance and resistance (static C and R) maneuver Description Procedure: Patient participation is not required, and patient interference can affect the accuracy of the maneuver. If the patient initiates a breath when a maneuver breath is scheduled, the ventilator does not perform the maneuver. Available in VCV only. Not available in PCV and NPPV. During the maneuver: The ventilator delivers a square waveform, regardless of the current setting.
Chapter 13 Options and Accessories Parameter Description Peak lung flow (Peak L-Flow) The maximum measured inspiratory flow at the patient wye. Available in VCV and PCV. Peak L-Flow is displayed in LPM. An estimation of the compliance and resistance of the patient’s lungs, using the Least Square Estimation algorithm on the equation of motion (P = R • Q + V /C, where Q = lung flow and V = lung volume), performed during each machine or operator initiated inspiration.
Chapter 13 Options and Accessories Dynamic Resistance Dynamic resistance is calculated using this equation.
Chapter 13 Options and Accessories CL = The value of the combined compliance of the lungs and chest wall RL = The value of the combined resistance elements between the patient wye and the alveoli of the lungs V = Lung volume Peplat = End of plateau pressure Vplat = Lung volume added during the plateau phase QLend = Patient flow at the end of the delivery phase (beginning of plateau phase) REF 1057983 A P0 = Pressure at the start of inspiration Pei = Pressure at the end of inspiration Respiro
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Chapter 13 Options and Accessories Trending Option The Trending option allows the ventilator to store and display ventilator information for intervals from 2 to 72 hours. Trended data includes: • Patient data. • Ventilator settings. • Lung mechanics data (most of the data in this category is available only if the Respiratory Mechanics option is installed).
Chapter 13 Options and Accessories Patient Data button Graphics button Figure 13-32: VCV Settings Screen In the Patient Data screen (Figure 13-33) or Graphics screen (not shown), touch the Trending button to display the Trending screen (Figure 13-34).
Chapter 13 Options and Accessories The Trending screen (Figure 13-34) displays three trending waveforms as well as a summary of ventilator settings and patient data. You can change the waveforms and time scale at any time.
Chapter 13 Options and Accessories Time scale button Displays the time scale menu to select from 2 to 72 hours. The button shows the currently selected time scale. View 1 and View 2 buttons Displays either of two user-defined views. Each view consists of three trending waveforms and a time scale. The button shows the active view. Clear button Clears all stored trended data.
Chapter 13 Options and Accessories • The Pt Data category includes measured and calculated patient data parameters. • The Settings category includes ventilator settings. • The Mech category includes lung mechanics data (most of the Mech parameters are available only if the Respiratory Mechanics option is installed). • The NICO category includes data collected from the Respiratory Profile Monitor.
Chapter 13 Options and Accessories Using the Manual Rescale Function The Manual rescale buttons (Figure 13-36) allow you to adjust the vertical scale for most waveforms. Press the top half of the scale to change the upper limit, and the bottom half of the scale to change the lower limit. A pop-up window allows you to adjust the scale. Press the Cancel button to exit the popup window without making changes, or press Accept to select the new value and exit the pop-up window.
Chapter 13 Options and Accessories Cursor Data display window Cursor arrow buttons Begin Trending Time Cursor Time End Trending Time Figure 13-37: Changing Cursor Position on the Trending Screen Selecting the Time Scale The selected time scale (Figure 13-38) applies to all three waveforms on the Trending screen. To choose a different scale, press the Time scale button: a Time Scale pop-up window allows you to select another scale.
Chapter 13 Options and Accessories Grayed-out button indicates that the time scale is not available Figure 13-38: Selecting the Time Scale for the Trending Screen Using the +2 Hrs/-2 Hrs buttons Using the Zoom Function The +2 Hrs and –2 Hrs buttons shift all three waveforms forward or backward by two hours without changing the time scale. If you press and hold the buttons, the time scale shifts every ½ second. If less than 2 hours of data exist, the waveform shifts by the amount of available data.
Chapter 13 Options and Accessories Using the View 1/ View 2 buttons The View 1 and View 2 buttons make it possible for the user to store three trending waveforms and a time scale and recall them with a press of a button. A highlighted View button indicates that a preselected view is being displayed. If neither button is highlighted, the view (waveform(s) and/ or time scale) has been changed from the preselected view.
Chapter 13 Options and Accessories Trending Not Available WARNING: The cover plate for the PCMCIA slot at the back of the ventilator must be replaced after the adaptor and card are installed. This is to protect the ventilator. CAUTION: The PCMCIA card should only be removed by trained service personnel once power to the ventilator is off. This Trending Not Available message indicates a problem with Trending option data storage.
Chapter 13 Options and Accessories Trended data The Trending option simultaneously trends 32 parameters from four categories: patient data, settings, lung mechanics (Mech) and (NICO). Parameters that are not currently displayed are stored in memory for viewing.
Chapter 13 Options and Accessories Trended data: Alarm Pt Data (continued) (alarm occurrence) %O2 (percentage of oxygen delivered) F / Vt (rapid shallow breathing index) Ti/Ttot (the ratio of inspiratory time to total respiratory cycle time for spontaneous breaths) Peak L-Flow (peak flow of gas during the inspiratory phase) % Pt Trigger (percentage of patient triggered breaths) Pt Leak (patient leak) Trended data: Settings Set Tidal Vol (set tidal volume, only available in VCV mode) Set Pressure (set pre
Chapter 13 Options and Accessories Trended data: Mech Static C (static compliance maneuver, only available if Mechanics option is installed) Static R (static resistance maneuver, only available if Mechanics option is installed) VC (vital capacity maneuver, only available if Mechanics option is installed) MIP (maximum inspiratory pressure maneuver, only available if Mechanics option is installed) P0.1 (P0.
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Chapter 13 Options and Accessories Flow-Trak® Option Flow-Trak provides additional flow to Volume Control Ventilation (VCV) breaths. It allows the patient to draw additional flow or volume as desired. Ventilators with Flow-Trak installed are identified by the option label as seen in Figure 13-39. Figure 13-39: Flow-Trak option label Once the Flow-Trak option has been loaded on the ventilator it is active. Follow these steps to turn Flow-Trak Off and On: 1.
Chapter 13 Options and Accessories NOTE: If the Ftrak On button is grayed out in the settings window (Figure 13-41) then the Flow-Trak Option has not been installed. Contact Respironics Customer Service Within the U.S.A. 1-800-345-6443 Outside the U.S.A.
Chapter 13 Options and Accessories Breath Delivery The Flow-Trak option allows the ventilator to give additional flow to patients who are not receiving the flows or volumes they desire by monitoring the pressure during a mandatory or assist breath. If the patient draws more flow or volume than what has been set, the inhalation pressure drops and Flow-Trak is initiated. The target pressure during Flow-Trak is 2 cmH2O above PEEP.
Chapter 13 Options and Accessories Respiratory Mechanics Maneuvers with Flow-Trak Maneuver Affect of Flow-Trak Static C & R The maneuver is cancelled if the patient initiates a Flow-Trak breath. A message appears when the maneuver is cancelled due to the change in breath type. Dynamic C & R Dynamic C & R are not calculated for Flow-Trak breaths. Ti/Ttot Ti/Ttot is not calculated for Flow-Trak breaths. Peak Lung Flow Peak Lung Flow is calculated for Flow-Trak breaths.
Chapter 13 Options and Accessories Respiratory Profile Monitor Interface (NICOEsprit) Option The respiratory profile monitor interface (NICO-Esprit) software allows the ventilator and the respiratory profile monitor to exchange information via a bidirectional RS-232 serial link. Through this link, the ventilator supplies the monitor with breath type and FIO2 information and in turn, the monitor provides the ventilator with data for trending parameters related to measuring CO2 elimination (VCO2).
Chapter 13 Options and Accessories Communications When the respiratory profile monitor interface (NICO-Esprit) option is installed, the RS-232 communications port is configured for all communications functions in the following manner: Ventilator RS-232 Communications Port Settings Specification Setting Baud Rate 19200 Data Bits 8 Parity None Stop Bits 1 Table 13-17: Ventilator RS-232 Communications Port Settings NOTE: Hardware Setup The respiratory profile monitor interface (NICO-Esprit) opti
Chapter 13 Options and Accessories WARNING: Always turn the ventilator power OFF before connecting additional equipment. 2. Attach one end of the RS-232 serial communications cable to the RS232 port 1 or 2 on the back of the respiratory profile monitor. See Figure 13-44. 3. Attach the other end of the RS-232 serial communications cable to the serial communications port on the back of the ventilator. See Figure 13-44. Figure 13-44: RS-232 Communication Ports for the Monitor and the Ventilator 4.
Chapter 13 Options and Accessories • Connect the sensors to the monitor, ventilator circuit, and patient according to the Respiratory Monitoring section of the user’s manual for your Respironics respiratory profile monitor. 7. Select the NICO-Esprit interface on the respiratory profile monitor. • Press the MENU key to activate the SELECT A SCREEN menu. Figure 13-45: Select A Screen Menu screen • Turn the knob to highlight SETUP and then press the knob. The SETUP screen appears.
Chapter 13 Options and Accessories • Turn the knob to highlight EXIT and then press the knob. Turn the knob to highlight EXIT again and then press the knob.The monitor returns to the SETUP screen. The ventilator and the respiratory profile monitor will begin communication within 60 seconds. RS-232 Communications The bidirectional communication between the respiratory profile monitor and ventilator is initiated by the monitor.
Chapter 13 Options and Accessories Information Transferred from the Ventilator to the Respiratory Profile Monitor The ventilator provides the respiratory profile monitor with the following information. Information Transferred from the Ventilator to the Respiratory Profile Monitor Data Description Breath Type Mandatory, Assisted, Spontaneous, or Supported FIO2 The percentage of oxygen in the gas delivered to the patient.
Chapter 13 Options and Accessories Patient Data button Figure 13-48: VCV Settings Screen 2. Touch the Trending button to display the Trending screen (Figure 1333). Trending button Figure 13-49: Patient Data Screen The Trending screen (Figure 13-34) displays three trending waveforms as well as a summary of ventilator settings and patient data. You can change the waveforms and time scale at any time.
Chapter 13 Options and Accessories Parameter select button Manual rescale button Begin trending time Cursor time and date End trending time View 1, View 2 buttons Figure 13-50: Trending Screen The parameter select button above each waveform shows the name of the currently displayed parameter. To choose a different parameter for display, press the button above the waveform. The Trended Data pop-up window appears showing the available data choices. 3.
Chapter 13 Options and Accessories Figure 13-51: Trended Data screen NOTE: REF 1057983 A For more information regarding the Trending Data screen or using the Trending Option, refer to “Trending Option” on page 13-69.
Chapter 13 Options and Accessories Troubleshooting Troubleshooting NICO button does not appear on the Trended Data screen NICO button on the Trended Data screen is grayed out Ventilator is not capturing data sent from the respiratory profile monitor Probable Cause: The ventilator may not have respiratory profile monitor interface software. What to Do: Contact Respironics Technical Service: 1-800-345-6443.
Chapter 13 Options and Accessories Neonatal Option The Neonatal option allows the Respironics V200 Ventilator to ventilate intubated neonatal patients with an ideal body weight range of 0.5 - 6.5 kg (1.10 - 14.33 lb.) and an endotracheal tube I.D. range from 2.5 - 4.0 mm. The option provides pressure control in A/C, SIMV, and Apnea ventilation and also provides pressure support in SIMV and CPAP. The Neonatal Option is not available in VCV or NPPV modes.
Chapter 13 Options and Accessories Changing Patient Types The Neonatal option is available once the software option is installed. The current patient is identified by the icon found on any active ventilation type screen. In Figure 13-53 the neonatal patient type has been selected, which is identified by the neonatal patient type icon.
Chapter 13 Options and Accessories Heated Filter Test The heated filter test in EST for adult and pediatric patient types automatically tests for pressure drop of the exhalation filter. This portion of EST is not possible with neonatal circuits. We recommend running this test according to the filter manufacturers recommendations. The following steps can be run in diagnostics mode: 1. Power off the ventilator. 2.
Chapter 13 Options and Accessories Initial Neonatal Settings When the ventilator is first powered on and the neonatal patient type is selected, the initial startup settings found in Table 13-21: are applied. Each subsequent startup will display the settings from the last use of the ventilator of that patient type with the exception of O2. The last O2 setting used on the ventilator will remain regardless of patient type.
Chapter 13 Options and Accessories Percent Leak NOTE: Patient data ranges and accuracies can be found in Chapter 12, “Technical Specifications” with the exception of the Exhaled Tidal Volume. The accuracy for exhaled Tidal Volume is ±(4ml ±10%) NOTE: Neither Respiratory Mechanics nor Expiratory Hold are active when the neonatal patient type is selected. Flow trigger is the only trigger type available. All other features apply.
Chapter 13 Options and Accessories Patient Leak Values Patient Leak values (as seen in the Patient Data window, Figure 13-56) between 0 and 1 LPM are rounded values. Refer to Chapter 7, “Operating Theory”, for more information about Patient Leak Display.
Chapter 13 Options and Accessories Speaking Mode Option The Speaking Mode software option for the Respironics V200 Ventilator allows tracheostomized adult and pediatric patients who meet certain criteria to vocalize without the need of a speaking valve. The Speaking Mode software, when activated, closes the ventilator’s exhalation valve, keeping it closed during the expiratory phase.
Chapter 13 Options and Accessories • Do not use with neonatal tracheostomy tubes. • Do not use on neonates. • Do not inflate the tracheostomy tube cuff until Speaking Mode has been turned off. • Do not use on patients who are dependent on PEEP therapy. • Do not use with HME filters. • Discontinue using Speaking Mode promptly and institute appropriate ventilation if the patient experiences difficulty or their status deteriorates from baseline parameters.
Chapter 13 Options and Accessories Tracheostomized patient ventilated in (PSV, PCV, VCV, SIMV, CPAP) mode Patient assessment Procedure halted FAIL PASS Baseline clinical parameters Observe patient settings Monitor with pulse oximeter Instruct patient Suction oral airway and tracheostomy tube Position patient Deflate cuff Activate Speaking Mode on the ventilator Confirm airway patency FAIL PASS Encourage speech PASS Monitor patient FAIL Discontinue Speaking Mode Inflate cuff Check ventilator
Chapter 13 Options and Accessories Settings Speaking Mode Ventilator Settings Available in Modes Pressure Control Ventilation (AC, SIMV, and CPAP) Volume Control Ventilation (AC, SIMV, and CPAP) Pressure Support Ventilation (SIMV and CPAP) Apnea Ventilation Starting Speaking Mode Patient Type: Adults & Pediatrics PEEP Automatically reset to zero and low PEEP alarm is reset to zero Trigger-type Automatically will switch from flow triggering, if previously selected, to a pressure triggering of 1 cm
Chapter 13 Options and Accessories 2. Press Continue to continue or Cancel to exit Speaking Mode. Figure 13-60: Turn Speaking Mode On? First Message Box The second message box then appears with the same command, Turn Speaking Mode On?, reminding the user to: Please be sure there is NO Speaking Valve installed and the tracheostomy cuff is deflated. 3. Press Accept to continue or Cancel to exit Speaking Mode.
Chapter 13 Options and Accessories Speaking Mode is ON when the Active Mode button in the upper left-hand corner of the screen is orange and the Speaking Mode button at the bottom of the screen has a white background. Active Mode button is orange Speaking Mode button Figure 13-62: How the Ventilator Screen Appears When Speaking Mode Is ON 4. We recommend reviewing alarm and ventilator settings at this time. Continue to monitor patient's respiratory effort and clinical status.
Chapter 13 Options and Accessories Alarms While in Speaking Mode, the ventilator switches all volumetric alarms from exhaled to delivered alarms. This means that all alarms that were triggered based on exhaled volumes will now be based on delivered volumes. These alarms include: • Low Exhaled Minute Volume • High Exhaled Minute Volume • Low Exhaled Mandatory Tidal Volume • Low Exhaled Spontaneous Tidal Volume Disabled Alarms The Low PEEP alarm is disabled while in Speaking Mode.
Chapter 13 Options and Accessories Mode-Specific Alarms Disconnect Alarm If the tracheostomy tube becomes disconnected from the patient circuit, a high urgency Disconnect Alarm will sound. When the disconnect alarm is active, the ventilator continues ventilation. If the tracheostomy tube becomes re-connected, the alarm auto-resets. Airway Occlusion Alarm If the area surrounding the tracheostomy tube becomes obstructed during ventilation in Speaking Mode (e.g.
Chapter 13 Options and Accessories Displayed Data While in Speaking Mode, the ventilator switches all volumetric readings from exhaled to delivered readings. This means that all data displayed based on exhaled volumes will now be based on delivered volumes. Some data is not available in Speaking Mode, including data on Patient Leak (circled below in Figure 9).
Chapter 13 Options and Accessories Data not available in Speaking Mode Figure 13-66: Active Mode: Patient Data Screen Trended Data NOTE: NICO data is not available when the Speaking Mode is active NOTE: The time spent in Speaking Mode can be recorded as trended data. This requires the Trending Option be loaded and active on the ventilator. To access the Trending screen: 1. Press the Patient Data button at the top of the settings screen (see Figure 13-66). 2.
Chapter 13 Options and Accessories 1. Press the Settings button. 2. Press the Speaking Mode button to show trended data options available in Speaking Mode (Figure 13-68).
Chapter 13 Options and Accessories The trended data will appear as blocks of time shown as either ON or OFF. Speaking Mode trended data Figure 13-68: Speaking Mode Trended Data Screen For more information regarding Trending, see the Trending Option instructions or contact Respironics. Inc.
Chapter 13 Options and Accessories Discontinue Speaking Mode Removing a patient from Speaking Mode is very similar to starting a patient on Speaking Mode. 1. Press the Speaking Mode button. 2. The message box appears, Turn Speaking Mode Off?, reminding the user to: Please be sure to inflate tracheostomy cuff AFTER switching SM OFF, Patent Data values and alarms will be based on exhaled volumes. WARNING: • Do not inflate the tracheostomy tube cuff until Speaking Mode has been turned off.
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Chapter 13 Options and Accessories Auto-Trak Sensitivity™ Introduction Auto-Trak Sensitivity is a feature designed to enhance patient comfort and ventilation effectiveness and reduce patient work of breathing. Auto-Trak automatically triggers and cycles breathing without the need for useradjustment of I-Trigger (sensitivity) and E-Trigger (cycling) thresholds.
Chapter 13 Options and Accessories How to Select AutoTrak 1. Touch either the I-Trigger or E-Trigger button in the Settings screen (Figure 13-70). Figure 13-70: Settings Screen 2. When the I-Trigger or E-Trigger window appears, touch the Auto button (Figure 13-71 and Figure 13-72).
Chapter 13 Options and Accessories Figure 13-72: Sample Expiratory Trigger Window with Auto-Trak Option Available. The Pressure or Flow values that previously appeared in the I-Trigger and E-Trigger windows are removed (Figure 13-73 and Figure 13-74).
Chapter 13 Options and Accessories Figure 13-74: Sample Expiratory Trigger Window with Auto-Trak Option Selected 3. Touch the Accept button. The ventilator does not begin using AutoTrak until you touch the Accept button. The Settings screen now displays Auto as the I-Trigger and E- Trigger settings (Figure 13-75).
Chapter 13 Options and Accessories Turning Auto-Trak Off 1. Touch either the I-Trigger or E-Trigger button in the Settings screen (Figure 13-70). The I- Trigger or E-Trigger window will appear as shown in Figure 13-73 or Figure 13-74. 2. Change the I-Trigger setting to Pressure or Flow, or change the ETrigger setting to %Peak Flow. (When you change the I-Trigger setting to Pressure or Flow, the E- Trigger reverts to the most recently selected %Peak Flow value.
Chapter 13 Options and Accessories • For adult patients: Bias flow = Pt Leak + 5 LPM. • For pediatric patients: Bias flow= Pt Leak + 3 LPM. Patient flow is estimated as the delivered flow (Bias flow during exhalation) minus the estimated Leak Flow, minus the measured expiratory flow (flow through the exhalation valve): • Patient flow = Delivered flow - Leak flow measured expiratory flow The estimated Leak Flow value in the above equation differs from the Patient Leak value defined earlier.
Appendix A. RS-232 Communications Protocol The ventilator will allow for the transmission of data from the ventilator via the RS-232 communications interface. The ventilator receives commands from the remote device and responds with fixed format records.
Appendix A RS-232 Communications Protocol Ventilation Report Description Example Resolution Range Units Comments Command Name VRPT N/A N/A N/A Number of characters between the start and stop codes 990 N/A N/A N/A 3 character field Number of fields between the start and stop codes 134 N/A N/A N/A 3 character field Start Code 0x02 N/A N/A N/A ASCII Start Transmission Character (STX) Time of request 13:45◆ N/A N/A N/A 24 hour clock, hh:mm◆ Date FEB◆23◆1997◆ N/A N/A N/A 1
Appendix A RS-232 Communications Protocol Ventilation Report (Continued) Description Example Resolution Range Units VCV E-Cycle Type %Flow◆ N/A %FLOW◆ AUTO◆◆ N/A VCV %Flow Expiratory Cycle Setting 25◆◆◆◆ 1 10 - 80 % VCV Rise Time 0.1◆◆◆ 0.1 0.1 - 0.9 Sec VCV Oxygen Concentration Setting 21◆◆◆◆ 1 21 - 100 % VCV Plateau Setting 0.0◆◆◆ 0.1 0.0 - 2.
Appendix A RS-232 Communications Protocol Ventilation Report (Continued) Description Example Resolution Range Units PCV Inspiratory Time Setting 1.00◆◆ 0.01 0.1 - 9.9 sec PCV PEEP Setting 0◆◆◆◆◆ 1 0 - 35 cmH2O (hPa) PCV Pressure Support Setting 0◆◆◆◆◆ 1 0 - 100 cmH2O (hPa) PCV I-Trigger Type PRESS◆ N/A PRESS◆ FLOW◆◆ AUTO◆◆ N/A PCV Pressure I-Trigger Setting 2.0◆◆◆ 0.1 0.1 - 20.0 cmH2O (hPa) PCV Flow I-Trigger Setting 3.0◆◆◆ 0.1 0.3 - 20.
Appendix A RS-232 Communications Protocol Ventilation Report (Continued) Description Example Resolution Range Units PCV Low Minute Volume Alarm Limit Setting 1.00◆◆ 0.01 for 0.00 to 9.99 0.1 for 10.0 to 60.0 0.00 - 60.0 L PCV High Minute Volume Alarm Limit Setting 60.0◆◆ 0.01 for 0.00 to 9.99 0.1 for 10.0 to 60.0 0.00 - 60.
Appendix A RS-232 Communications Protocol Ventilation Report (Continued) Description Example Resolution Range Units Comments NPPV High Respiratory Rate Alarm Limit Setting 150◆◆◆ 1 0 - 150 NPPV Low Minute Volume Alarm Limit Setting 1.00◆◆ 0.01 for 0.00 to 9.99 0.1 for 10.0 to 60.0 0.00 - 60.0 L NPPV Apnea Interval Alarm Limit Setting 20◆◆◆◆ 1 10 - 60 sec NPPV High Leak Alarm Limit Setting 60◆◆◆◆ 1 10 - 60 sec Measured Peak Inspiratory Pressure 24.1◆◆ 0.1 for -20.0 to 99.
Appendix A RS-232 Communications Protocol Ventilation Report (Continued) Description Example Resolution Range Units Comments Measured I:E Ratio 1:4.1◆ 0.1 for 9.9:1 to 1:9.9 1 for 1:10 to 1:99 4.1:1-1:99 N/A The I:E Ratio display from the Patient Data screen. Measured Patient Leak 0.0◆◆◆ 0.1 for 0.0 to 99.9 1 for 100 to 140 0.0 - 140 LPM The Pt Leak display. Measured Percent of Breaths Triggered by the Patient (NPPV Spont/T mode only; otherwise ◆◆◆◆◆◆) 56.2 0.1 for 0.0 to 99.
Appendix A RS-232 Communications Protocol Ventilation Report (Continued) Description Example Resolution Range Units Comments Vital Capacity Time of Last Maneuver 11-1401◆◆13:11 1 minute 01-01-70 0:00 to 01-19-38 3:14 N/A Time of Last Maneuver display from the Vital Capacity Screen.15 character field, 24 hour clock: MMDD-YYuuHH:MM MIP -54.1◆ 0.1 for -99.9 to 99.9 1 for -100 and 100 to 200 -100 - 200 cmH20 MIP display from MIP/P0.
Appendix A RS-232 Communications Protocol Ventilation Report (Continued) Description Example Resolution Range Units Comments AutoPeep 1.2◆◆ 0.1 for -9.9 to 9.
Appendix A RS-232 Communications Protocol Ventilation Report (Continued) Description Example Resolution Range Units Comments Exhalation Valve Stuck Open Alarm Status NORMAL N/A NORMAL ALARM◆ RESET◆ N/A Low O2 Supply Alarm Status NORMAL N/A NORMAL ALARM◆ RESET◆ N/A Low supply pressure Low O2 Alarm Status NORMAL N/A NORMAL ALARM◆ RESET◆ N/A Low O2 concentration Low Minute Volume Alarm Status NORMAL N/A NORMAL ALARM◆ RESET◆ N/A Low Mandatory Tidal Volume Alarm Status NORMAL N/A
Appendix A RS-232 Communications Protocol Ventilation Report (Continued) Description Example Resolution Range Units Low EPAP Alarm Status NORMAL N/A NORMAL ALARM◆ RESET◆ N/A High Leak Alarm Status NORMAL N/A NORMAL ALARM◆ RESET◆ N/A 100% O2 Function Status OFF◆◆◆ N/A ON◆◆◆◆ OFF◆◆◆ N/A Status of the 100% O2 LED on the front panel Alarm Silence Status OFF◆◆◆ N/A ON◆◆◆◆ OFF◆◆◆ N/A Status of the Alarm Silence LED on the front panel Screen Lock Status OFF◆◆◆ N/A ON◆◆◆◆ OFF◆◆◆ N/A
Appendix A RS-232 Communications Protocol fields between the start and stop codes. The fourth field is the start code, 0x02. The last field in the string is the stop code, 0x03.
Appendix A RS-232 Communications Protocol Volume Control Ventilation Settings Report (Continued) Description Example Resolution Range Units VCV Flow I-Trigger Setting 3.0◆◆◆ 0.1 0.5 - 20.0 LPM VCV E-Cycle Type %Flow◆ N/A %FLOW◆ AUTO◆◆ N/A VCV %Flow Expiratory Cycle Setting 25◆◆◆◆ 1 10 - 80 % VCV Rise Time 0.1◆◆◆ 0.1 0.1 - 0.9 Sec VCV Oxygen 21◆◆◆◆ Concentration Setting 1 21 - 100 % VCV Plateau Setting 0.0◆◆◆ 0.1 0.0 - 2.
Appendix A RS-232 Communications Protocol Pressure Control Ventilation Settings Report (PCVS) When the ventilator receives PCVS followed by a carriage return, it will respond by transmitting the information shown in Table A-3: “Pressure Control Ventilation Settings Report”. The ventilator responds to the PCVS command by returning a string with a variable length. Fields 2 through 4 define the length of the message. The last character transmitted is a stop code indicating the end of the message.
Appendix A RS-232 Communications Protocol Pressure Control Ventilation Settings Report (Continued) Description Example Resolution Range Units PCV I-Trigger Type PRESS◆ N/A PRESS◆ FLOW◆◆ AUTO◆◆ N/A PCV Pressure I-Trigger Setting 2.0◆◆◆ 0.1 0.1 - 20.0 cmH2O (hPa) PCV Flow I-Trigger Setting 3.0◆◆◆ 0.1 0.3 - 20.0 LPM PCV E-Cycle Type %FLOW◆ N/A %FLOW◆ AUTO◆◆ N/A PCV %Flow Expiratory Cycle Setting 25◆◆◆◆ 1 10 - 80 % PCV Rise Time 0.1◆◆◆ 0.1 0.1 - 0.
Appendix A RS-232 Communications Protocol Pressure Control Ventilation Settings Report (Continued) Description Example Resolution Range Units PCV High Minute Volume Alarm Limit Setting 60.0◆◆ 0.01 for 0.00 to 9.99 0.1 for 10.0 to 60.0 0.00 - 60.
Appendix A RS-232 Communications Protocol Non-Invasive Positive Pressure Ventilation Settings Report (Continued) Description Example Resolution Range Units NPPV Mode Setting SPONT/T N/A SPONT/T SPONT◆◆ NPPV Patient Type ADULT◆ N/A ADULT◆ PED◆◆◆ NEO◆◆◆ NPPV Respiratory Rate Setting 12◆◆◆◆ 1 1 - 80 BPM NPPV EPAP Setting 5◆◆◆◆◆ 1 2 - 25 cmH2O (hPa) NPPV IPAP Setting 5◆◆◆◆◆ 1 2 - 35 cmH2O (hPa) NPPV Inspiratory Time Setting 1.0◆◆◆ 0.1 0.1 - 9.9 sec NPPV Rise Time 0.1◆◆◆ 0.
Appendix A RS-232 Communications Protocol Non-Invasive Positive Pressure Ventilation Settings Report (Continued) Description Example Resolution Range Units NPPV High Leak Alarm Limit 60◆◆◆◆ 1 1 - 60 LPM Stop Code 0x03 N/A N/A N/A Comments ASCII End Transmission Character (ETX) Table A-4: Non-Invasive Positive Pressure Ventilation Settings Report (Sheet 3 of 3) Patient Data Report (PTDT) When the ventilator receives PTDT followed by a carriage return, it will respond by transmitting the i
Appendix A RS-232 Communications Protocol Patient Data Report (Continued) Description Example Resolution Range Units Comments Measured End Expiratory Pressure Data 2.0◆◆◆ 0.1 -20.0-99.9 cmH2O The End Exp. value (hPa) from the Patient Data screen. Measured End 24.0◆◆ Inhalation Pressure 0.1 for -20.0 to 99.9 -20.0 - 130 cmH2O The Plateau value (hPa) from the Patient 1 for 100 to 130 Data screen. Measured Tidal Volume 468◆◆◆ 1 0 - 2500 Measured Spontaneous Minute Volume 0.00◆◆ 0.01 for 0.
Appendix A RS-232 Communications Protocol Patient Data Report (Continued) Description Example Resolution Range Units Comments Dynamic Resistance 5.43◆◆ 0.01 for 0.00 to 9.990.1 for 10.0 to 99.91 for 100 to 400 0.00 - 400 cmH2 0/L/ Sec The Dynamic Resistance display from the Mechanics Patient Status Screen Dynamic Compliance 19.2◆◆ 0.01 for 0.00 to 9.990.1 for 10.0 to 99.91 for 100 to 350 0.
Appendix A RS-232 Communications Protocol Patient Data Report (Continued) Description Example Resolution Range Units Comments Static Compliance 19.2◆◆ 0.01 for 0.00 to 9.990.1 for 10.0 to 99.91 for 100 to 350 0.00 - 350 mL/ cmH2 O Static Compliance display from the Static C & R Screen Static C & R Time of Last Maneuver 11-14-01◆◆13:11 1 minute 01-01-70 0:00 to 01-19-38 3:14 N/A Static C & R Time of Last Maneuver display from Static C & R Screen.
Appendix A RS-232 Communications Protocol Alarm Status Report Description Example Range Comments Command Name ALRM N/A Number of characters between the start and stop codes 202 N/A 3 character field Number of fields between the start and stop codes 28 N/A 2 character field Start Code 0x02 N/A ASCII Start Transmission Character (STX) Time of request 13:45◆ N/A 24 hour clock, hh:mm◆ Date FEB◆23◆1997◆ N/A 12 character field, MMM◆DD◆YYYY◆ Occlusion Alarm Status or SM Occlusion Statu
Appendix A RS-232 Communications Protocol Alarm Status Report (Continued) Description Example Range Comments Exhalation Valve Stuck Open Alarm Status NORMAL NORMAL ALARM◆ RESET◆ Low O2 Supply Alarm Status NORMAL NORMAL ALARM◆ RESET◆ Low supply pressure Low O2 Alarm Status NORMAL NORMAL ALARM◆ RESET◆ Low O2 concentration Low Minute Volume Alarm Status NORMAL NORMAL ALARM◆ RESET◆ Low Mandatory Tidal Volume Alarm Status NORMAL NORMAL ALARM◆ RESET◆ High Minute Volume Alarm Status NORMAL
Appendix A RS-232 Communications Protocol Alarm Status Report (Continued) Description Example Range Low EPAP Alarm Status NORMAL NORMAL ALARM◆ RESET◆ High Leak Alarm Status NORMAL NORMAL ALARM◆ RESET◆ Stop Code 0x03 N/A Comments ASCII End Transmission Character (ETX) Table A-6: Alarm Status Report (Sheet 3 of 3) Unrecognized Commands If an unrecognized command is received, the ventilator will respond by transmitting the information shown in Table A-7: “Unrecognized Commands”.
Appendix B. Customer Service & Warranty Customer Service For further information or assistance in operating the Respironics V200, contact Respironics Customer Service: Within the United States: 800-345-6443 Outside the United States: 724-387-4000 Fax: 724-387-5012 email: service@respironics.
Appendix B Customer Service & Warranty Options and Accessories Appendix B-2 Warranties are available for various options and accessories. See the specific option or accessory in Chapter 13 for complete warranty information.
Appendix C. Alarm Testing Procedure The following procedure is available if the operator wants to test the operation of the following alarms. We recommend following “Preoperational Procedure” on page 8-32 before performing the Alarm Testing procedure. It is assumed that the preoperational procedure has been run before the Alarm Testing Procedure is followed. Setup 1. Connect O2 supply to the Respironics V200 Ventilator. 2. Connect optional O2 sensor. 3. Run EST. 4. Attach the test lung to the patient wye.
Appendix C Alarm Testing Procedure High Inspiratory Pressure Alarm Test 1. During inhalation squeeze the test lung for at least two breaths until the High Pressure alarm sounds. 2. Wait for one normal breath, the alarm auto resets. 3. RESET the alarm. Low Volume Alarm Test 1. Set the Low Vt Mand alarm limit to 500 ml. 2. Wait for one breath and alarm should sound. 3. Set the Low Vt Mand to 0 ml. 4. Wait for one breath and RESET the alarm. Low O2 Alarm Test (If optional O2 sensor is installed.) 1.
Appendix C Alarm Testing Procedure 4. Alarm should reset. (If the backup battery is attached, the ventilator should return to AC power. If no battery is attached, the ventilator will resume operating.) Apnea Alarm Test 1. Set the rate to 1 breath per minute. 2. Wait for 20 seconds. 3. The Respironics V200 should begin ventilating at a rate of 20 BPM while activating the Apnea alarm. 4. Reset the rate to 10 BPM. 5. RESET the alarm. 6. The Respironics V200 should begin ventilating normally.
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Glossary Abbreviations 24 Hrs used to describe format for time-of-day when AM or PM does not appear AC alternating current (power) A/C assist/control ventilation AM/PM used to describe format for time-of-day when AM or PM occurs ASCII commonly accepted 8-bit binary code for characters Assist assist/control ventilation ATPS ambient temperature, ambient pressure, saturated (with water vapor) Auto-PEEP end-expiratory alveolar pressure above set PEEP level Aux auxiliary BTPS Body temperature (98°F, ambient pres
Glossary f respiratory frequency FIO2 fractional inspired oxygen FRC functional residual capacity f/VT rate versus tidal volume ratio; rapid shallow breathing index HIP high inspiratory pressure HME heat and moisture exchanger hPa unit of pressure measurement hecto Pascals I:E ratio inspiration:exhalation ratio ICU intensive care unit ISO International Standards Organization IMV intermittent mandatory ventilation Inop inoperational IPAP inspiratory positive airway pressure I-Time inspiratory time L Liter MA
Glossary PEEP positive end-expiratory pressure Pi End airway pressure at the end of inhalation PIP peak inspiratory pressure Plateau inspiratory plateau pressure, pressure at end exhalation and no flow from or out of the ventilator Pplat end-inspiratory plateau pressure psi pounds per square inch; Unit of pressure measurement psig pounds per square inch gauge (above atmospheric pressure) PSV pressure-support ventilation SIMV synchronous intermittent mandatory ventilation Spont Rate spontaneous respiratory r
Glossary Definitions Airway Pressure the pressure in the patient circuit, measured at the distal end of the exhalation filter. Baseline as in baseline pressure. The pressure at end exhalation. Baud serial transmission speed usually bits/second. Bias flow a continuous flow of gas used during expiratory phase when flow triggering is active. Bit binary digit. Compliance a measure of stiffness for containers that hold gas (i.e. lungs, patient tubing).
Glossary Inspiratory pause inspiratory pause is a brief pause (0.1 to 2 seconds) at endinspiration during which pressure is held constant and flow is zero. The purpose of the pause is to improve gas distribution throughout the lungs. Same as Plateau pressure. Intermittent Mandatory Ventilation (IMV) a mode of ventilatory support that allows spontaneous breathing in between mandatory breaths from the ventilator.
Glossary Pressure Sensitivity a measure of the amount of negative pressure that must be generated by a patient to trigger a mechanical ventilator into the inspiratory phase; alternatively, the mechanism used to set or control this level. Pressure Trigger initiation of inspiration when the patients inspiratory effort exceeds the sensitivity threshold. PVC O2 Sensor Tee An external oxygen sensor adapter made of polyvinyl chloride (PVC).
Glossary Trigger normally a patient effort to begin inhalation. Volume space occupied by matter measured in milliliters or liters. Window either a period of time or a portion of a screen depending on the context.
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Index Symbols 100% O2 Key, 8-9 A A/C, Assist Control, 7-3 AC Inlet, 5-2 ACCEPT key, 5-8, 8-2 Accept Key, 8-8 Accessories, 4-2, 13-1 Adjust Control Knob, 8-11, 12-7 Adult Disposable Patient Circuit, 13-2 Patient Circuit Kit, 13-2 Adult/Pediatric Keys, 8-20 Air Inlet Filter, 5-1 Air Source Fault Alarm, 9-5 Airway Pressure, 7-4 Alarm Reset Key, 8-9 Alarm Silence, 12-9 Alarm Silence Key, 8-9 Alarm Status Indicators, 8-5 Alarms, 9-1 Audible, 9-2 Auto-Reset of, 9-3 Descriptions, 9-5, 9-8 High Urgency, 9-1, 9-2
Index Compliance, G-1, G-4 Circuit, 5-5, 11-5 Compensation, 8-33, 11-1 Tubing, 5-10 Compliance and Approvals, 12-11 Continuous Positive Airway Pressure, CPAP, 7-4 F 7-4 D Date of Manufacture, 3-3 Date Setting, 5-7 Delivered O2, %O2, 8-29 Diagnostic Codes, 11-5 Descriptions, 11-6, 11-8 Mode, 5-5, 11-2 Diagnostics, 11-1 Display Front Touch Panel, 8-11 Patient Leak, 7-6 F/Vt, 8-29 Filters Removal/Installation Bacteria, 10-4 Cooling, 10-8 Heated Bacteria, 4-18 Inspiratory Bacteria, 4-16 Internal Air Source
Index I N I:E Ratio, 8-29 Inspiratory Bacteria Filter, 4-17, 13-2, Installation, 4-16 Removing and Replacing, 10-5 Inspiratory Trigger (I-Trigger), 8-21 IPAP, 7-6, 8-23, 12-3 I-TIME, 7-2 I-Time Too Long Alarm, 9-6 Non-Invasive Positive Pressure Ventilation (NPPV), 7-6 Non-Invasive Ventilation, 7-1, 7-6, 8-1 Normal Indicator, 8-5, 12-9 Notes, 2-8 NPPV, 7-6, 8-23 L Labels, 12-18 Lock Screen, 8-8 Low Backup Battery Alarm, 9-6 Low EPAP Alarm, 9-6 Low Insp Pressure Alarm, 9-7 Low Minute Volume Alarm, 9-7 Lo
Index Respiratory Mechanics, 13-1 RS-232 Communications 2, 13-1 Trending, 13-1 Output Analog label, 3-1 Analog port, 6-7 Field, A-1 Port, 6-1 Serial label, 3-2 Oxygen Source Connection, 4-21 Oxygen Sensor, 13-3 P Panel, Back Connections and Controls, 5-1 Panel, Front Dispay, 8-11 Patient Initiated Breath Triggering, 7-5 Patient Leak Display, 7-6 Pediatric Patient Circuit Kit, 13-2 Positive End Expiratory Pressure (PEEP), 7-5 POST, 11-10 Power Cord, 5-3 Power On Self Test (POST), 11-10 Power Status Indicat
