USER INTERFACE WORKSHOP PRESENTED BY LEE FAH HOONG PRINCIPAL - - PowerPoint PPT Presentation

PRESENTED BY LEE FAH HOONG PRINCIPAL TECHNICAL SUPPORT ENGINEER, SEA

840 USER INTERFACE WORKSHOP

WORKSHOP REQUIREMENTS

PB840 Vent AC BPS Inspiratory and Expiratory Filters Wall Air and Wall Oxygen sources & hoses

• Grasp the Oxygen Hose firmly and push the Quick

Connect fitting into the Oxygen Outlet:

CONNECTING THE GAS SOURCES:

CONNECT THE PATIENT CIRCUIT, FILTERS & LUNG

NOTE: to eliminate leaks, make sure that the barbs of the patient circuit wye fit snuggly in the patient circuit tubing grooves.

THE RIGHT WAY TO POWER UP THE 840:

• The 840 should always be powered on with an open circuit.

By leaving the Expiratory Bacteria Filter Latch open, you’ve created an open circuit condition. You can also leave the test lung disconnected.

NORMAL OPERATION STARTUP SCREENS

• On power up the ventilator runs POST.
• Default startup screen is displayed there

are no failure conditions

• Note what is displayed on the upper

screen:

• Vent Startup in progress
• Circuit type?
• Humidification type?
• Time and date?
• SST & EST overall test result?

“NORMAL OPERATION”

LOWER SCREEN DISPLAY AT START-UP

• NOTE: Running EST

wipes out the SAME PATIENT settings from the previous setup. In that case, you may

• nly see NEW PATIENT

& SST buttons available in normal operation.

IMPROPER 840 START-UP:

• For safety, the ventilator issues a Procedure Error

Alarm and initiates Safety Ventilation Mode if a patient (or closed circuit condition) is detected before all of the ventilator settings have been entered and confirmed (accepted).

• Safety ventilation is an emergency mode of

ventilation per the displayed settings.

SAFETY VENTILATION

After POST: 840 generates 10 LPM Flow to check for patient connection.

If the measurement circuitry detects the 10 LPM flow, Procedure Error is initiated.

GUI STATUS INDICATOR PANEL

GUI KEYBOARD

• Rotary Encoder Knob
• ACCEPT key
• CLEAR key
• MANUAL INSP key
• 100% O2 / CAL 2 min key
• RESET key
• 2 min key
• VOL key
• SCREEN LOCK key

GUI SCREEN SECTIONS

Patient Data Alarm and Status Miscellaneous Data SandBox Primary Settings Symbols Definitions Prompt Area

LOWER STARTUP SCREEN

• Press the “Same Patient”

button

LOWER STARTUP SCREEN

• A button is

activated when it turns orange.

• Press ACCEPT.

UPPER GUI SCREEN

• Now lower the

blue expiratory bacteria filter latch

THE NEXT SCREEN DEFAULTS TO THE APNEA SETUP SCREEN AFTER SELECTING SAME PATIENT OR COMPLETING A NEW PATIENT SETUP

ALWAYS PRESS THE ALARM SETUP BUTTON TO ADJUST THE ALARM SETTINGS OR TO TURN THEM OFF IF YOU ARE EVALUATING (ASSESSING) THE VENT OR RUNNING PVT. HOWEVER, FOR NOW, DO NOT ADJUST THEM.

PATIENT DATA – WHAT DOES IT MEAN?

CIRCUIT & HUMIDIFICATION TYPE AND TIME & DATE

THE MORE INFORMATION SCREEN IF LEAK COMPENSATION IS ENABLED

O2 Sensor Reading – if the reading is

• ut, can calibrate, disable or replace

ALARM LOG ICON

SAMPLE MORE ALARMS SCREEN

ALARMING DOGGIES

PRESS THE OTHER SCREENS BUTTON & TO VIEW THE OTHER

• SCREENS. AFTER SELECTING A SCREEN TO VIEW, YOU MUST

PRESS THE OTHER SCREENS BUTTON AGAIN TO BRING BACK THE SCREEN SELECT MENU BELOW:

PRESS TEST SUMMARY

Next, press the Other Screens button to bring back the screen select menu.

PRESS VENTILATOR CONFIGURATION

• Ventilator S/W
• POST S/W
• GUI & Ventilator

serial numbers (S/N)

• Compressor S/N
• SAAS S/W
• Options

Next, press the Other Screens button to bring back the screen select menu.

SAAS = Safety Audible Alarm System

PRESS DIAGNOSTIC CODE LOG

Next, press the Other Screens button to bring back the screen select menu.

PRESS OPERATIONAL TIME LOG

Next, press the Other Screens button to bring back the screen select menu.

PRESS SST RESULTS LOG

Next, press the Other Screens button to bring back the screen select menu.

PRIMARY SETTINGS AREA: CONTAINS VENTILATOR SETTINGS DEFINING HOW A BREATH IS DELIVERED TO THE PATIENT.

10

A/C VC V-TRIG 50

365 44 21

RAMP

• 1. Which button represents how often the vent will deliver a

controlled breath? 2. Which button represents how much oxygen is delivered? 3. Which button represents how much volume is delivered? 4. Which button represents how much positive pressure is maintained during exhalation? 5. Which button represents the rate of volume delivery?

SYMBOLS DEFINITIONS AREA – PRESS THE PEAK FLOW BUTTON TO VIEW ITS NAME:

When a button is pressed, you know it is activated because it changes to an

• range color.

10 44 21

AC

RAMP

CHANGING THE IBW FROM VENT SETUP TOUCH THE IBW BUTTON:

50

110

50

110

CURRENT

SETUP Current Vent Settings

Sandbox

CHANGING THE IBW FROM VENT SETUP: TURN THE KNOB TO LOWER THE IBW BELOW RECOMMENDED S/W LIMITS:

12

A/C VC V-TRIG 50

400 50 21

RAMP

25

55

Press OK & continue to turn the knob.

TOUCH CONTINUE & PRESS THE ACCEPT KEY

12

A/C VC V-TRIG 50

400 50 21

RAMP

9

20

UPDATED IBW SETTING

12

A/C VC V-TRIG 50

400 50 21

RAMP

9

20

9

Now change the IBW Back to 50 kg!

Peak Pressure = PEEP + Pi

20

Now change the PC breath type back to VC and PEEP from 10 to 3cmH2O.

Pressure Control Ventilation

ALARM SETUP ICON

Ppeak (High circuit pressure limit) – sets the maximum circuit pressure allowed during inspiration

ALARM SETUP ICON

fTot (Breath rate) – sets the maximum breath rate limit (may be an indicator of breath stacking, autocycling or patient distress) VeTot (Minute Volume) – sets the min & max exhaled minute volume for mandatory & spontaneous breath types

ALARM SETUP ICON

Vte mand (Mandatory exhaled tidal volume limit) – sets the min and max mandatory exhaled tidal volume limit

ALARM SETUP SCREEN

Medium urgency alarm High urgency alarm

LAST 200 BREATHS TO HELP CLINICIANS SET APPROPRIATE ALARM LIMITS

TURNING OFF THE 840 ALARMS

• Touch the alarm setup icon in the lower screen to

activate that screen if it is not already selected.

• Turn off all alarms by pressing the gray alarm

buttons and turning the knob to raise the upper limit alarms until they read OFF or 100 cmH2O for Ppeak (it’s max setting).

• Turn off all the lower limit alarms until they read OFF
• r 0.050 ml for Vetot (it’s min setting).

OTHER SCREENS ICON

Click on each of the buttons to view the associated screen

WORK?

• Performed during normal operation when

ventilating – should be performed DAILY when in use

• When the 100% O2 Cal 2 MIN key is pressed, vent

performs a single-point oxygen sensor calibration during the 100% suctioning procedure

• Allows you to calibrate the sensor without having

to disconnect the patient

Oxygen Sensor Calibration

CALIBRATE THE OXYGEN SENSOR

Press the 100% O2/CAL 2min key on the keyboard to calibrate the Oxygen sensor. Press the More Information icon in the Upper Screen to view the O2 Sensor reading:

UNDERSTANDING THE VT VS VTE RELATIONSHIP

• Locate Vt in lower screen and compare to Vte in

upper screen Vte Must be +/-10mls +/- 10% of set VtVte = Spirometry = Patient’s Exhaled Tidal Volume

• Set Tidal Volume (Vt) 365 mls

+ 10 mls 375 mls + 36.5 mls (+ 10%) High Limit 411.5 mls

• Set Tidal Volume (Vt) 365 mls
• 10 mls

355 mls

• 36.5 mls (- 10%)

Low Limit 318.5 mls

5 CONDITIONS THAT MAY CAUSE THE SPIROMETRY READING TO BE INACCURATE.

• 1. A leak
• 2. An obstruction
• 3. Wrong humidifier type
• 4. Wrong circuit type
• 5. A bad Q3 exhalation flow

sensor.

Time & Date Stamps Scroll Bar

Alarm Log

 Can store up to 80 of the most recent events  Tracks PATIENT RELATED ALARMS, Device Alerts, and

System Faults such as Low/Loss AC, Low/Loss of O2 and/or Air, Circuit Disconnects, and Occlusions

 Completing a new patient setup clears log memory

ALARM LOG

• The Alarm Log shows

alarm events in order

• f occurrence, with

the most recent event at the top of the list:

• Time stamped alarms
• Alarm silences
• Alarm resets

The question mark in a triangle appears if the log contains an event that has/had not been viewed yet.

ALARMS

High-urgency alarm indicator Medium-urgency alarm indicator Low-urgency alarm indicator

Alarms on the 840 Ventilator System are classified as High, Medium, or Low urgency ! ! !

High Priority Alarm: 5 tones

SMART ALARMS

• High urgency- requires immediate attention.
• Red high urgency !!! indicator flashes rapidly
• High urgency audible alarm sounds (5 tones repeated

twice)

• Upper screen flashes alarm message

ALARMS

CIRCUIT DISCONNECT ALARM

• Press the Alarm Log icon in the upper GUI screen

and the Alarm setup icon in the lower GUI screen.

• Create a tubing disconnect by removing the test

lung from the patient wye.

• What urgency alarm is generated?
• What is displayed in the upper GUI screen?
• Does pressing the Alarm Silence button silence the alarm?
• What new entry is in the Alarm Log?
• Reconnect the test lung. What happened? Does

the Alarm Log reflect the series of events?

Medium Priority Alarm: 3 tones

SMART ALARMS

Alarms

 Medium urgency requires prompt attention

 Yellow medium urgency !! indicator flashes

slowly

 Medium urgency audible alarm (a repeating 3

tone sound) is enunciated

 The upper screen flashes an alarm message

Low Priority Alarm: 2 tones

Smart Alarms

• Low urgency alarms tell you there has been a

change in patient-ventilator system

• Yellow low urgency !! indicator lights
• Low urgency audible alarm (two tone non-repeating sound) is enunciated
• Upper screen displays an alarm message

ALARMS

• Alarm handling:
• Medium urgency alarms may escalate to high or de-escalate to low urgency
• Low urgency alarms may escalate to medium or high urgency
• All patient alarms will auto-reset if the criteria is reached

ALARMS

2 of last 4 mand breaths < set limit. Check for leaks, changes in patient’s R & C.

V TE MAND

Base Message: Analysis: Remedy:

ALARMS

GOLDEN RULE #1

If possible, always review and, if applicable, make note of the Alarm Log,

Ventilator Settings, Alarm Settings, and Apnea Settings, before

doing anything to the ventilator:

Turn to the Sample Alarm Log

• n pages 4 & 5 of the Reference

Manual Addendum

End!

QUESTIONS? Q&A