840 USER INTERFACE WORKSHOP - Mr Bagaimana · Alarms on the 840 Ventilator System are classified as...
Transcript of 840 USER INTERFACE WORKSHOP - Mr Bagaimana · Alarms on the 840 Ventilator System are classified as...
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PRESENTED BY LEE FAH HOONG PRINCIPAL TECHNICAL SUPPORT ENGINEER, SEA
840 USER INTERFACE WORKSHOP
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WORKSHOP REQUIREMENTS
PB840 Vent
AC
BPS
Inspiratory and Expiratory Filters
Wall Air and Wall Oxygen sources & hoses
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Grasp the Oxygen Hose firmly and push the Quick Connect fitting into the Oxygen Outlet:
CONNECTING THE GAS SOURCES:
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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.
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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.
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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?
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“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
only see NEW PATIENT
& SST buttons available
in normal operation.
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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.
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SAFETY VENTILATION
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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.
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GUI STATUS INDICATOR PANEL
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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
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GUI SCREEN SECTIONS Patient Data
Alarm and Status
Miscellaneous Data
SandBox
Primary Settings
Symbols Definitions
Prompt Area
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LOWER STARTUP SCREEN
• Press the “Same Patient”
button
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LOWER STARTUP SCREEN
• A button is activated when it turns orange.
• Press ACCEPT.
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UPPER GUI SCREEN
• Now lower the blue expiratory bacteria filter latch
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THE NEXT SCREEN DEFAULTS TO THE APNEA SETUP SCREEN AFTER
SELECTING SAME PATIENT OR COMPLETING A NEW PATIENT SETUP
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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.
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PATIENT DATA – WHAT DOES IT MEAN?
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CIRCUIT & HUMIDIFICATION TYPE AND TIME & DATE
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THE MORE INFORMATION SCREEN IF LEAK COMPENSATION IS ENABLED
O2 Sensor Reading – if the reading is out, can calibrate, disable or replace
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ALARM LOG ICON
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SAMPLE MORE ALARMS SCREEN
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ALARMING DOGGIES
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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:
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PRESS TEST SUMMARY
Next, press the Other Screens button to bring back the screen select menu.
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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
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PRESS DIAGNOSTIC CODE LOG
Next, press the Other Screens button to bring back the screen select menu.
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PRESS OPERATIONAL TIME LOG
Next, press the Other Screens button to bring back the screen select menu.
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PRESS SST RESULTS LOG
Next, press the Other Screens button to
bring back the screen select menu.
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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?
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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
orange color.
10 44 21
AC
RAMP
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CHANGING THE IBW FROM VENT SETUP TOUCH THE IBW BUTTON:
50 110 50
110
CURRENT
SETUP
Current Vent Settings
Sandbox
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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 0
25 55 Press OK
& continue to
turn the knob.
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TOUCH CONTINUE & PRESS THE ACCEPT KEY
12
A/C VC V-TRIG 50
400 50 21
RAMP 0
9 20
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UPDATED IBW SETTING
12
A/C VC V-TRIG 50
400 50 21
RAMP 0
9 20
9
Now change the IBW
Back to 50 kg!
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Peak Pressure = PEEP + Pi
20
Now change the PC breath type back to VC and PEEP
from 10 to 3cmH2O.
Pressure Control Ventilation
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ALARM SETUP ICON
Ppeak (High circuit pressure limit) – sets the maximum circuit pressure allowed during inspiration
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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
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ALARM SETUP ICON
Vte mand (Mandatory exhaled tidal volume limit) – sets the min and max mandatory exhaled tidal volume limit
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ALARM SETUP SCREEN
Medium urgency alarm High urgency alarm
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LAST 200 BREATHS TO HELP CLINICIANS SET APPROPRIATE ALARM LIMITS
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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 or 0.050 ml for Vetot (it’s min setting).
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OTHER SCREENS ICON
Click on each of
the buttons
to view the
associated
screen
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WORK?
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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
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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:
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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
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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.
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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
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ALARM LOG The Alarm Log shows
alarm events in order of 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.
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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
! !
!
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High Priority Alarm: 5 tones
SMART ALARMS
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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
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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?
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Medium Priority Alarm: 3 tones
SMART ALARMS
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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
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Low Priority Alarm: 2 tones
Smart Alarms
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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
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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
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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
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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 on pages 4 & 5 of the Reference Manual Addendum
End!
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QUESTIONS? Q&A