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The Puritan Bennett™ 980 Ventilator
Education Presentation
COVIDIEN, COVIDIEN with logo, Covidien logo and positive results for life are U.S. and internationally registered
trademarks of Covidien AG. Other brands are trademarks of a Covidien company. ©2013 Covidien. 13-VE-0043
Covidien Respiratory & Monitoring Solutions | April 14, 20142 |
Overview
This presentation is provided as a convenience companion document to the
Operator’s Manual. It is not intended to replace the Operator’s Manual, which should
always be available while using the ventilator. It is important to familiarize yourself
with all information in the Operator’s Manual relevant to your institution’s use of the
ventilator, including on-screen helps, instructions, warnings and cautions.
Breathe More Naturally
Simple
Safe
Smart
The new Puritan Bennett™ 980
ventilator helps enable patients to
breathe more naturally* through
some of the most innovative
breath delivery technology
available. Our simple, safe and
smart design provides more
natural ventilation that may help
clinicians improve patient comfort.1
* Compared to conventional mechanical ventilation (VC,VC+,PC,PS)
1. Grasso S, Puntillo F, Mascia L, et al. Compensation for increase in respiratory
workload during mechanical ventilation. Pressure-support versus proportional-assist
ventilation. Am J Respir Crit Care Med. 2000;161(3 Pt 1):819-26.
Covidien Respiratory & Monitoring Solutions | April 14, 20143 |
Overview
The Puritan Bennett™ 980 ventilator is designed for:
• Neonatal through adult populations
• In-room use and intra-hospital transport
• Invasive (via endotracheal tube) and noninvasive (via mask or nasal prongs)
applications
The ventilator is available in three models:
Pediatric – Adult
Ventilator
Ventilates pediatric or adult patients with predicted body weights
from 3.5 kg to 150 kg, and with tidal volumes from 25 mL to
2500 mL.
Neonatal
Ventilator
Ventilates neonatal patients with predicted body weights from
0.3 kg to 7.0 kg, and with tidal volumes for mandatory volume-
controlled breaths from 2 mL to 320 mL.
Universal
Ventilator
Ventilates neonatal, pediatric and adult patients with predicted
body weights from 0.3 kg to 150 kg, and with tidal volumes for
mandatory volume-controlled breaths from 2 mL to 2500 mL.
Covidien Respiratory & Monitoring Solutions | April 14, 20144 |
Finding Your Way Around
Covidien Respiratory & Monitoring Solutions | April 14, 20145 |
Finding Your Way Around
On/Off switch
User interface
Breath delivery
unit
Expiratory
filter
Inspiratory filter
Fan
Hot swappable
batteries
Communication ports
Covidien Respiratory & Monitoring Solutions | April 14, 20146 |
Finding Your Way Around
the User Interface
Touch screen
Patient data banner on top
•  Additional patient data display tab
•  Large font data display tab
Left menu tab
Graphics in middle
Ventilator setup button lower left
Constant access icons
Bezel control keys
Adjustment knob
	
  
	
  
	
  
Covidien Respiratory & Monitoring Solutions | April 14, 20147 |
Positioning the User Interface
for Ease of Viewing
The user interface
can be repositioned
for easier viewing.
8 |
Touch Screen Navigation
• Swipe
• Double-tap
• Drag
• Touch and hold
• Drag and drop
• “Touch, turn, accept”
9 |
Setting Up the Puritan Bennett™
980 Ventilator Prior to Use
Covidien Respiratory & Monitoring Solutions | April 14, 201410 |
Setting Up Prior to Patient Use
Setting up for patient use will include installing:
•  Filters
•  Humidifier
•  Breathing circuit
•  EVQ*
•  Air and oxygen hoses
•  Puritan Bennett™ Proximal Flow Sensor (if applicable)
Powering on and performing a short self test (SST).
Covidien Respiratory & Monitoring Solutions | April 14, 201411 |
*U.S. only
Installing the Filters
Three filters help reduce the spread
of pathogens.
Expiratory filter is heated to keep the gas
that flows through it from cooling to the dew
point and creating condensate in the filter.
Reusable and disposable filter options are
available.* An optional drain bag is available
for managing condensate.
Pediatric-adult and neonatal applications
use different expiratory filter configurations.
Covidien Respiratory & Monitoring Solutions | April 14, 201412 |
*only disposable inspiratory and expiratory filters may be used in the U.S.
Expiratory
filter assembly
Inspiratory filters
(internal and
external)
Installing the Inspiratory Filter on the
‘To Patient’ Port
•  Install the inspiratory filter on the
“To Patient” port by pushing it directly
onto the port.
•  Ensure the direction of the flow arrow
is pointing outward, toward the patient
circuit’s inspiratory limb.
Covidien Respiratory & Monitoring Solutions | April 14, 201413 |
*only disposable inspiratory and expiratory filters may be
used in the U.S.
Installing the Expiratory Filter Assembly:
Pediatric-Adult Application
1)  Assemble the
condensate vial
and reusable
expiratory filter.
2) Raise the expiratory
filter latch to unlock
the expiratory filter
door.
3) Insert the new
filter* assembly.
4) Lower the
expiratory filter
latch.
Covidien Respiratory & Monitoring Solutions | April 14, 201414 |
*only disposable inspiratory and expiratory filters may be used in
the U.S.
Installing the Expiratory Filter Assembly:
Neonatal Application
1)  Raise the latch, (remove
adult door if applicable),
install the neonatal filter
door if applicable
2) Raise the expiratory
filter latch to unlock
the expiratory filter
door.
3) Insert the new
filter assembly.
4) Lower the
expiratory filter
latch.
Covidien Respiratory & Monitoring Solutions | April 14, 201415 |
Installing the Humidifier
•  The ventilator accommodates Teleflex
(Hudson RCI) and Fisher & Paykel humidifiers.
•  To install, slide the rear of the humidifier into
the corresponding slot on the humidifier
bracket, until it is fully seated.
•  During SST, enter the humidifier volume
setting when you enter the breathing circuit
type.
•  The humidifier volume setting entered during
SST should always be equal to the chamber’s
empty compressible volume.
•  The operator’s manual contains a chart with
the Fisher & Paykel and Teleflex Hudson RCI chamber
volumes listed.
Covidien Respiratory & Monitoring Solutions | April 14, 201416 |
Installing the Breathing Circuit
The breathing circuit type should be selected based on the patient’s
predicted body weight (PBW).
If changing a breathing circuit type, run an SST.
•  The circuit type and PBW entered during the SST will determine the new
patient ventilation and alarm settings and also the range limits.
	
  
Covidien Respiratory & Monitoring Solutions | April 14, 201417 |
Circuit type PBW
Neonatal 0.3 kg to 7 kg
Pediatric 7 kg to 24 kg
Adult >24 kg
Puritan Bennett™ Proximal Flow Sensor
(Neonatal Application Only)
Measures flow, volume and pressure at the patient wye;
does not control flow volume or pressure
Intended for neonatal invasive ventilation
To install the sensor:
•  Install during SST (according to prompts).
•  Install the sensor end at the patient circuit wye.
•  Attach the other end to the keyed pneumatic connector
on the ventilator’s front panel behind a clear door.
About the Exhalation Valve Flow Sensor
Assembly (EVQ)
•  Contains the expiratory port,
expiratory flow sensor,
exhalation valve diaphragm,
expiratory filter seal and
pressure sensor filter
•  Can be cleaned and disinfected
if a high-risk communicable
contamination occurs*
•  Disinfection is not required on
a routine basis
Covidien Respiratory & Monitoring Solutions | April 14, 201419 |
*in the U.S. the EVQ has to be cleaned and disinfected in between patients
Powering On
Power on
using the
ON/OFF
switch
Covidien Respiratory & Monitoring Solutions | April 14, 201420 |
Why Perform the Short Self Test (SST)?
•  Impacts accuracy of breath delivery and spirometry
•  The SST is a way of calibrating the ventilator
to the circuit and humidifier you are using.
It impacts both breath delivery and spirometry.
•  The power-on self test (POST) does basic testing of
the system. The SST expands that testing.
It is the best way to prepare the ventilator for
patient use.
•  Run SST following a circuit change, change in circuit
configuration (including circuit type, additions and removal of
water traps and accessories, humidifiers, proximal flow
sensor) and/or every 15 days.
•  In the event that the patient is connected without ventilation
parameters being specified, the ventilator enters Safety
PCV, a safe mode of ventilation. Complete the parameter
selection to exit Safety PCV.
Covidien Respiratory & Monitoring Solutions | April 14, 201421 |
Performing a Short Self Test (SST)
•  Select the patient circuit type and humidification,
and then follow the amber-colored prompts.
•  As a general rule, keep doing what you are
prompted to do until you are told to do something
else. For instance, if you are prompted to
occlude the patient wye, keep occluding it until
you are told not to.
•  You are given the option to repeat a test if
there is a failure. When necessary, you may
also continue in the presence of an alert.
•  The SST status screen will display the test in
progress and the results of completed tests.
•  After completing the SST you will proceed with
the patient setup process.
	
  
	
  
Covidien Respiratory & Monitoring Solutions | April 14, 201422 |
Patient Setup
Covidien Respiratory & Monitoring Solutions | April 14, 201423 |
Patient Setup
New patient Manual setup Quick start
1.  Select PBW or Gender and Height
2.  Select ventilation type—Invasive or
Noninvasive (NIV)
3.  Select a Mode
4.  Select Mandatory, Spontaneous and
Trigger types
5.  Set the Primary settings
6.  Touch Accept or Accept ALL to confirm
the change(s)
1.  Touch New
Patient.
2.  Enter PBW or
gender and
height.
3.  Touch Quick
Start.
4.  Connect the
circuit wye
adapter to the
patient’s airway
or interface
connection.
Same patient The ventilator will be ready to start ventilating at the settings in
place at power down.
•  You can choose to
set up a new patient
or the same patient.
•  In New Patient setup,
you can choose a full
manual setup or the
Quick Start feature.
Covidien Respiratory & Monitoring Solutions | April 14, 201424 |
How to Enable and Disable the Puritan
Bennett™ Proximal Flow Sensor
•  To enable/disable the
Proximal Flow Option
–  Touch the Configure/Wrench icon
–  Touch the Options tab
–  Touch the Prox tab
–  Touch the Enabled or Disabled
button.
•  To complete a Manual Purge,
push the Start button
When the Proximal Flow Sensor is enabled, new and replacement data
values appear, representing data measured with the Proximal Flow Sensor.
The monitored volume labels have a Y added to indicate that the
measurement comes from the Proximal Flow Sensor.
How the Puritan Bennett™ Proximal Flow
Sensor Impacts Monitoring
VTI Y
Inspired tidal volume (mandatory or spontaneous)
at patient circuit wye
VTE Y
Exhaled spontaneous/mandatory tidal volume at patient
circuit wye
VTE SPONT Y
Exhaled spontaneous tidal volume at patient circuit wye
VTE MAND Y
Exhaled mandatory tidal volume at patient circuit wye
VE TOT Y
Exhaled total minute volume at patient circuit wye
Covidien Respiratory & Monitoring Solutions | April 14, 201426 |
How Puritan Bennett™ Proximal Flow Sensor
and Puritan Bennett™ Leak Sync Software
Affect Monitoring
VTLY
Inspired tidal volume (mandatory or spontaneous)
at patient circuit wye (Leak Sync enabled and leak
adjusted)
VTL
Inspired tidal volume (mandatory or spontaneous)
(Leak Sync enabled and leak adjusted) as measured
by the ventilator’s internal sensors
Covidien Respiratory & Monitoring Solutions | April 14, 201427 |
Making Settings Changes
After Initial Setup
Covidien Respiratory & Monitoring Solutions | April 14, 201428 |
Making Settings Changes After Initial Setup
Touch the Vent Setup
button in the bottom-
left corner of the touch
screen display.
There are several ways
to make a settings
change after initial setup:
Swipe the Menu tab
on the left margin of
the touch screen and
touch the Setup button.
Touch a parameter in
the lower margin of the
touch screen.
Covidien Respiratory & Monitoring Solutions | April 14, 201429 |
Managing Alarms
Covidien Respiratory & Monitoring Solutions | April 14, 201430 |
Touch the hotlink from an
alarm violation message.
Swipe the Menu tab to
open the Settings menu,
then touch the Alarms
settings tab.
Touch the alarm icon
(constant access icon).
Managing Alarms
There are three ways to
access the Alarms screen:
Covidien Respiratory & Monitoring Solutions | April 14, 201431 |
Apnea Alarm
Not on the Alarm Screen
•  Touch the Vent Setup button to access the Apnea settings tab.
•  Apnea alarm triggers apnea backup:
•  Current apnea ventilation settings are displayed.
•  Non-apnea ventilation settings may be changed during apnea backup.
•  Apnea timer resets with every breath.
•  Autoreset of apnea backup occurs when the patient triggers two consecutive
inspirations and the exhaled volume is equal to or greater than 50% of the
delivered volume. To manually reset it, touch the Alarm Reset key.
•  Apnea ventilation setting for inspiratory pressure or tidal volume is also used for
manual inflations; it is displayed in the Vent Setup button.
Covidien Respiratory & Monitoring Solutions | April 14, 201432 |
Alarm Conditions
•  Alarm violations are visually indicated in three places:
•  The omnidirectional lamp on top of the touch screen
•  On the alarm banners
•  On the alarm settings screen
•  Low-, medium- and high-priority alarms—unique sounds
•  Alarm loudness escalates if a high-priority alarm is not acknowledged
within 30 seconds, and then again at 60 seconds
•  Alarm banners indicate which alarm has been violated and provide
a base message. Touching the individual alarm banner causes
an expanded explanation to appear, containing analysis and remedy
messages, and may contain a link to the alarm log or the alarms
settings screen.
Covidien Respiratory & Monitoring Solutions | April 14, 201433 |
Omni-directional LED
Normal
mode
• Steadily lit green
Alarm
condition
• LED flashes—color
corresponds to alarm
priority
Concurrent
alarms
• LED displays
highest-priority color
Alarm
de-escalates
• Latched (sides)
display highest
priority
• Center displays
current alarm priority
Covidien Respiratory & Monitoring Solutions | April 14, 201434 |
Alarm Priorities
Alarm priority Visual indicator Audible indicator/Reset criteria
Low
A change in the
patient-ventilator
system has occurred.
•  Yellow LED
•  Yellow alarm banner on screen
•  Yellow bar next to alarm setting icon
on Alarms screen
•  Low-priority audible alarm (two tone,
non-repeating)
•  LED indicator turns off and autoreset
is entered into the alarm log.
Medium
Prompt attention
necessary.
•  Flashing yellow LED
•  Yellow alarm banner on screen
•  Yellow bar next to alarm setting icon
on Alarms screen
•  Medium-priority audible alarm
(a repeating sequence of three tones)
•  LED indicator turns off and autoreset
is entered into the alarm log.
High
Attention required to
ensure patient safety.
•  Flashing red LED
•  Red alarm banner on screen
•  Red bar next to alarm setting icon
on Alarms screen.
•  High-priority audible alarm (a
sequence of five tones that repeats
twice, pauses, then repeats again)
•  Visual alarm indicators remain steadily
illuminated following an autoreset.
•  The alarm reset key must be pressed
to extinguish visual indicator.
Immediate
Attend to immediately.
•  Specific to alarm condition or
component failure.
•  Continuous tone alarm sounding for at
least 120 seconds in the case of Vent Inop
or complete loss of power
Covidien Respiratory & Monitoring Solutions | April 14, 201435 |
Alarm Silence
•  Mutes the audible alarm for 2 minutes.
•  Alarm silence key LED illuminates.
•  Countdown timer appears.
•  Press Alarm Reset to cancel alarm silence.
•  Press again to restart silence period.
Covidien Respiratory & Monitoring Solutions | April 14, 201436 |
Alarm Reset
•  Use for any non-technical alarm.
•  Resets the color of the dome light.
•  Reinitializes the algorithm the ventilator
used to detect the alarm (except for
A/C POWER LOSS, LOW BATTERY,
NO AIR SUPPLY, NO O2 SUPPLY,
PROCEDURE ERROR alarms and
active battery alarms).
•  Captured in the log if there is an active
alarm.
Covidien Respiratory & Monitoring Solutions | April 14, 201437 |
Alarm Log – Up to 1000 Events
The Alarm Log contains the last 1000 alarms that have occurred,
whether they have been reset or autoreset, the priority level, and
their analysis messages.
•  Accessible during Normal and
Service states
•  Records:
•  Date/time-stamped entry when
an alarm is detected, escalated,
reset or autoreset
•  Date/time-stamped entry if the
ventilator enters backup ventilation
•  Priority level
•  Analysis message
•  Alarm silence interval begins,
ends or is cancelled
•  If one or more alarms have
occurred since the last time
the alarm log was viewed,
a yellow triangle appears on
the touch screen indicating
there are unread items.
•  Alarm log is cleared when
New Patient is selected during
the ventilator startup process.
Covidien Respiratory & Monitoring Solutions | April 14, 201438 |
Patient Data and Data Monitoring
Covidien Respiratory & Monitoring Solutions | April 14, 201439 |
Locating Commonly Used
Patient Data Values
• Patient data banner
• Graphics
• Additional patient
data screen
• Large-font patient
data screen
Status display
Covidien Respiratory & Monitoring Solutions | April 14, 201440 |
Patient Data Banner
• Eight patient data measurements
are displayed across the top of
the touch screen.
• Four on the right can be swiped
to the left or right in order to
display additional data.
• Double-tap a cell to show
the data available for viewing
and select the one to be
displayed.
• A “blank cell” feature is available
to reduce the number of patient
data measurements showing in
the top banner.
Covidien Respiratory & Monitoring Solutions | April 14, 201441 |
Graphics
• The Puritan Bennett™ 980 ventilator displays
color-coded waveforms for flow, pressure and
volume versus time.
• It also displays color-coded loops for volume
versus pressure and flow versus volume.
• The inspiratory portion of a mandatory breath
is green, the inspiratory portion of a
spontaneous breath is orange and exhalation
is always yellow.
Covidien Respiratory & Monitoring Solutions | April 14, 201442 |
Graphics: Changing the Scale
and Maximizing/Minimizing
Two ways to change the scale of a graphic:
•  Touch and drag the scale.
•  Touch to select the scale and then use the
adjustment knob to change the scale.
Graphics can also be enlarged to full screen
by double-tapping the graph, swiping
upward, or tapping the arrow in the upper-
right corner.
To return to the previous size, tap the arrow
in the upper-right corner of the graph again,
swipe downward, or double tap the graph.
Covidien Respiratory & Monitoring Solutions | April 14, 201443 |
Graphics: Pause and Review
•  Graphics can be paused and historical data
(up to 60 seconds) can be reviewed.
•  Touch the Pause icon in the lower-right
corner.
•  Drag or use the adjustment knob to move the
cursor and identify measurements along the
waveform(s) or loop.
•  Numerical data continues to update while
waveform/loop plotting is paused.
•  Touch the Pause icon again to unpause the
graphics.
Covidien Respiratory & Monitoring Solutions | April 14, 201444 |
Graphics: Storing a Screen Image
•  Touch the camera icon to store an image
of the screen.
•  May be used with or without Pause.
•  Data continues to update during the pause
—graph and numerical data on a stored
image will not likely be aligned.
•  Open the Menu tab (left margin of screen)
and touch Screen Capture to access
stored screen images and download
through the USB port.
Covidien Respiratory & Monitoring Solutions | April 14, 201445 |
Screen Layout for Graphics
•  Use the waveform layout icon to access
alternate screen configurations.
•  You can choose to display up to three
waveforms and two loops simultaneously
in the waveform area.
Covidien Respiratory & Monitoring Solutions | April 14, 201446 |
Additional Patient Data
FPO	
  
•  Tap or swipe down the tab in the center of
the lower margin of the patient data banner
to display additional patient data.
•  View page 1 or tap page 2 to view another
set of additional patient data.
•  Additional patient data values have fixed
positions.
Covidien Respiratory & Monitoring Solutions | April 14, 201447 |
Patient Data Large Font Screen
•  Tap the tab in the center of the lower
margin of the additional patient data
screen to view the large-font patient data
screen
•  Double-tap a cell to show the data and
waveforms/loops available for viewing
and select the one to be displayed.
Covidien Respiratory & Monitoring Solutions | April 14, 201448 |
Status Display (on Breath Delivery Unit)
Visible whenever power is on – not interactive
During ventilation, the status display shows gas
sources, power source, battery status, alarm
volume setting, ventilation hours, and circuit
pressure graph: pressure units, ↑PPEAK alarm
setting and PPEAK / PEEP values.
Before starting ventilation, the status display
shows the EST, SST and POST results, including
the patient circuit size and type cleared by SST.
This screen also displays valuable device
messages, such as stand-by state, low or empty
battery alarms, ventilation assurance (BUV) state
or safe state/safety valve open.
Covidien Respiratory & Monitoring Solutions | April 14, 201449 |
Patient Data Log:
Historical Record of Patient Data
•  The patient data log records data every
minute for a total of up to 4320 patient data
entries.
•  3 tabs are contained in the patient data log:
vital patient data, additional patient data-1,
additional patient data-2.
•  During ventilator operation, the log records:
•  Date and time of entry
•  Data label—which measurement
it is recording
•  Patient data value
•  Access via the clipboard icon.
•  The log is cleared when the ventilator is
set up for a new patient.
Covidien Respiratory & Monitoring Solutions | April 14, 201450 |
Menu Tab
Covidien Respiratory & Monitoring Solutions | April 14, 201451 |
Menu Tab
•  Swipe to the right to access Setup,
Respiratory Mechanics, Stand-by and Screen
Capture menus.
•  Touch the Setup button to view the Vent,
Apnea, Alarms and More Settings tabs.
This is another way to access mode and
breath type changes.
Covidien Respiratory & Monitoring Solutions | April 14, 201452 |
More Settings
•  More settings:
– Leak Sync: Enabled/
Disabled
– O2 sensor: Enabled/
Disabled/Calibrate
– Humidification type: Heated
Exp Tube/Non-heated Exp
Tube/HME (impacts
expiratory spirometry)
More Settings
More vent settings
DSENS
•  DSENS determines the amount of lost volume
(inspiration versus exhalation) that is used to
determine that the breathing circuit is
disconnected.
•  A low setting (minimum 20%) is the most
sensitive and a high setting (maximum 95%) is
least sensitive to a leak or disconnect.
•  During NIV, the DSENS value is automatically
set to Off.
•  With the Puritan Bennett™ Leak Sync feature
enabled, DSENS is expressed in L/min instead
of percent. In this case the leak compensation
flow between breaths is used to determine that
the breathing circuit is disconnected.
Covidien Respiratory & Monitoring Solutions | April 14, 201454 |
Stand-by
Stand-by state can be used to pause
ventilation during a planned disconnect of the
breathing circuit.
•  Stop spray from circuit during disconnect.
•  Ventilation resumes automatically when the
circuit is reconnected to the patient.
Setup:
1. Touch the Menu tab on the left side of the touch screen.
2. Touch the Stand-by button. A stand-by state pending dialog appears instructing
the clinician to disconnect the patient circuit. An on-screen timer allows 30 seconds
for disconnect.
3. After you disconnect, you must reconfirm your intent by touching the Confirm
button within 30 seconds.
4. Flow sensors are monitored to detect patient reconnection.
5. To exit stand-by—reconnect the patient to the ventilator.
Covidien Respiratory & Monitoring Solutions | April 14, 201455 |
During Stand-by
•  Patient-related alarms are temporarily suppressed.
•  The ventilator displays an indicator that it is in stand-by state and a timer
indicating the elapsed time the ventilator has been in stand-by state.
•  The exhalation valve is open.
•  Base flow is set to 10 L/min.
•  100% O2 is delivered for pediatric or adult application.
•  40% O2 is delivered for neonatal application.
•  Entry into and exit from stand-by state is recorded in the general event
log.
Covidien Respiratory & Monitoring Solutions | April 14, 201456 |
Respiratory Mechanics
Covidien Respiratory & Monitoring Solutions | April 14, 201457 |
Respiratory Mechanics
Respiratory Mechanics Maneuvers are used to make certain
patient data measurements and calculations, for example:
•  Plateau Pressure (PPL)
•  Static Compliance (CSTAT)
•  Static Resistance (RSTAT)
•  Intrinsic PEEP (PEEPI)
•  Negative Inspiratory Force (NIF)
•  Occlusion Pressure (P0.1)
•  Vital Capacity (VC)
Covidien Respiratory & Monitoring Solutions | April 14, 201458 |
Respiratory Mechanics – Inspiratory Pause
•  The Inspiratory Pause
maneuver is used to
determine plateau
pressure, static compliance
and static resistance.
•  It takes place at the end of
the inspiratory phase of a
breath.
•  Breathing efforts could
skew the measurement so
it is important to ensure
that the patient is not
actively breathing when
you perform the maneuver.
There are two ways to access this function, which
can be done in two ways, automatically or manually:
1.  Access via Menu tab:
a) Automaticà touch RM key à touch
Inspiratory Pause à touch Start à touch
Accept or Reject
b) Manual à touch RM key à touch Inspiratory
Pause à touch and hold Start for up to 7
seconds à touch Accept or Reject
2.  Access via bezel key:
a) Automatic à touch and release Inspiratory
Pause bezel key à touch Start à touch
Accept or Reject
b) Manual à touch and hold Inspiratory Pause
bezel key for up to 7 seconds à touch Start
à touch Accept or Reject
Covidien Respiratory & Monitoring Solutions | April 14, 201459 |
Respiratory Mechanics – Expiratory Pause
•  The Expiratory Pause
maneuver is used to
determine Total PEEP
(PEEPTOT) and intrinsic
PEEP (PEEPI).
•  It takes place at the end
of the expiratory phase of
a breath.
•  Breathing efforts could
skew the measurement so
it is important to ensure
that the patient is not
actively breathing when
you perform the maneuver.
There are two ways to access this function, which
can be done in two ways, automatically or manually:
1.  Access via Menu tab:
a) Automaticà touch RM key à touch
Expiratory Pause à touch Start à touch
Accept or Reject
b) Manual à touch RM key à touch Expiratory
Pause à touch and hold Start for up to 15
seconds à touch Accept or Reject
2.  Access via bezel key:
a) Automatic à touch and release Expiratory
Pause bezel key à touch Start à touch
Accept or Reject
b) Manual à touch and hold Expiratory Pause
bezel key for up to 15 seconds à touch Start
à touch Accept or Reject
Covidien Respiratory & Monitoring Solutions | April 14, 201460 |
Respiratory Mechanics – Vital Capacity
•  This maneuver is done to determine
the maximum amount of air that a
patient can exhale after inhaling all
the way.
•  The Vital Capacity (VC) maneuver
is a coached maneuver.
1.  Touch or swipe the Menu tab on the
left side
of the screen.
2.  Touch the RM key.
3.  Touch the Vital Capacity tab.
4.  Prepare the patient.
5.  Touch and release the Start key.
6.  Coach the patient to inhale all the
way and then slowly and fully
exhale.
7.  Keep coaching until the exhalation
is complete.
8.  Touch the Accept or Reject key to
save or dismiss results.
Covidien Respiratory & Monitoring Solutions | April 14, 201461 |
Respiratory Mechanics –
Occlusion Pressure (P0.1)
•  The Occlusion Pressure (P0.1)
maneuver is used to determine the
patient’s neuromuscular drive to
breathe.
•  Like the NIF maneuver, it is done by
having the patient pull against an
occluded airway with the ventilator’s
inspiratory and exhalation valves
closed.
•  There are two differences between
the P0.1 and NIF maneuvers:
1) This P0.1 maneuver measures the
negative airway pressure generated
during the first 100 ms of the patient’s
effort.
2) No coaching of any kind is involved.
1.  Touch or swipe the Menu tab
on the left side of the screen.
2.  Touch the RM key.
3.  Touch the P0.1 tab.
4.  Touch and release the Start
key.
5.  Touch the Accept or Reject
key to save or dismiss results.
Covidien Respiratory & Monitoring Solutions | April 14, 201462 |
Respiratory Mechanics –
Negative Inspiratory Force (NIF)
•  The Negative Inspiratory Force
(NIF) maneuver is used to
determine the patient’s ability to
pull a negative inspiratory
pressure against an occluded
airway.
•  You can perform the maneuver
for up to 30 seconds.
•  During the entire time you are
touching the Start key, the
ventilator’s inspiratory and
exhalation valves are held
closed.
•  When working with a cooperative
patient, the patient is coached to
draw a maximum inspiration.
1.  Touch or swipe the Menu tab on the
left side of the screen.
2.  Touch the RM key.
3.  Touch the NIF tab.
4.  Touch and release the
Start key.
5.  Touch the Accept or Reject key to
save or dismiss results.
•  The ventilator does not deliver
any breaths in response to
patient effort until the maneuver
is completed.
•  After the maneuver is completed,
a PEEP restoration breath is
delivered then normal breath
delivery resumes.
Covidien Respiratory & Monitoring Solutions | April 14, 201463 |
Additional Icons, Keys, Buttons
Covidien Respiratory & Monitoring Solutions | April 14, 201464 |
User Interface
Constant access icons Function
Home icon (house) Dismisses all open dialogs on the touch screen.
Resumes showing ventilator waveforms screen.
Configure (wrench icon) Opens the configure display to access SST.
(history), Options, Comm Setup, and Date/Time
change tabs.
Logs (clipboard icon) Opens the log screen containing tabs for alarms,
settings, patient data, diagnostics, EST/ SST
status, general event and service logs.
Elevate O2 (O2 icon) Increases oxygen concentration to the
institutional default O2 configuration, if
institutional default has been configured, for 2
minutes, or allows the operator to determine the
additional percentage of oxygen to increase.
Terminate prior to completion of the 2-minute
interval by touching Stop.
Screen capture (camera
icon)
Captures the image displayed on the touch
screen.
Help icon (question
mark)
Drag the help (question mark) icon to the item
in question and release. A tooltip will appear
describing the item’s function.
Covidien Respiratory & Monitoring Solutions | April 14, 201465 |
Yellow Triangle - Unread items icon.
Pay Attention - Check or View the Tab Prompt
Covidien Respiratory & Monitoring Solutions | April 14, 201466 |
Breath Phase Indicator
Breath Phase Indicator
A	
   Assisted mandatory breath	
  
C	
   Controlled mandatory breath	
  
S	
   Spontaneous breath	
  
A, C, or S glows in reverse video during inspiratory phase
A, C, or S appears solid during expiratory phase
Covidien Respiratory & Monitoring Solutions | April 14, 201467 |
Indicators
Patient Circuit Indicator (Adult, Pediatric or Neonatal)
•  This indicator appears right above
the Vent Setup button.
•  It indicates the size of the patient circuit
cleared during the SST.
Covidien Respiratory & Monitoring Solutions | April 14, 201468 |
Indicators
Screen Opacity Icon
•  Appears on the vent setup screen
and on all of the respiratory mechanics
maneuvers screens.
•  Select and then use the adjustment knob
to adjust the opacity of the displayed
information between 50% and 100%.
•  The lower the percentage, the more the
waveform display will be visible through
the other screen information.
Covidien Respiratory & Monitoring Solutions | April 14, 201469 |
Indicators
Pushpin Icon
•  Appears in the corner of the
settings screen.
•  Touch the Pushpin Icon to keep
a settings window open.
•  To the reverse the action,
unpin or touch the home icon.
Covidien Respiratory & Monitoring Solutions | April 14, 201470 |
User Interface
Bezel Control Keys (Off Screen)
1. Display Brightness
2. Display Lock
3. Alarm Volume
4. Manual Inspiration
5. Adjustment Knob
6. Inspiratory Pause
7. Expiratory Pause
8. Alarm Reset
9. Alarm Silence
	
  
	
  
	
  
	
  
	
  
	
  Covidien Respiratory & Monitoring Solutions | April 14, 201471 |
Easy to Access
Additional Safety Features
Covidien Respiratory & Monitoring Solutions | April 14, 201472 |
Ventilation Assurance Feature
•  Provides continued ventilation if the background diagnostics detect
a problem with certain components in the gas mix, inspiratory or
expiratory subsystems.
•  If the gas mix system has a problem, either 100% oxygen or room
air gas will be delivered.
•  If the inspiratory or expiratory systems have a problem, the Puritan
Bennett™ 980 ventilator delivers pressure control ventilation with
an inspiratory pressure of 15 and a PEEP of 3.
Covidien Respiratory & Monitoring Solutions | April 14, 201473 |
Other Safety Assurance Systems
Status display shows:
•  Power source—plug symbol
versus battery symbol
•  Presence of batteries and their
charging status
•  Relative available battery
charge level
•  Alarms related to power source
•  Patient circuit size and type
•  Circuit pressure graph
displaying pressure units, PPEAK
alarm setting, and current PPEAK
and PEEP values
•  Presence of oxygen and air
source
•  Presence of compressor
•  Ventilator operational hours
•  Alarm loudness
•  EST, SST and POST results
•  Safety Valve Open/Vent Inop
state
Covidien Respiratory & Monitoring Solutions | April 14, 201474 |
Breath Delivery Unit
Hot Swappable Batteries
•  Two battery slots
•  Primary hot swappable LiOn battery
must be installed to pass POST
•  Primary hot swappable LiOn battery
on right side should not be removed
during normal operation
•  Extended hot swappable LiOn battery
is optional
•  Up to one hour of power at standard
temperatures and settings/battery
•  Six-hour recharge time/battery
•  Charge level shown on status display
and with green LEDs on battery
Covidien Respiratory & Monitoring Solutions | April 14, 201475 |
Additional Assistance
Covidien Respiratory & Monitoring Solutions | April 14, 201476 |
Covidien Representative
Contact your Covidien representative
[Name, phone email]
Covidien Respiratory & Monitoring Solutions | April 14, 201477 |
Help Via www.covidien.com/solvit-center
The SolvIT Center provides answers
to frequently asked questions about the
ventilator system and other Puritan Bennett™
products 24 hours a day, 7 days a week.

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Ventilador puritan bennette 980

  • 1. The Puritan Bennett™ 980 Ventilator Education Presentation COVIDIEN, COVIDIEN with logo, Covidien logo and positive results for life are U.S. and internationally registered trademarks of Covidien AG. Other brands are trademarks of a Covidien company. ©2013 Covidien. 13-VE-0043
  • 2. Covidien Respiratory & Monitoring Solutions | April 14, 20142 | Overview This presentation is provided as a convenience companion document to the Operator’s Manual. It is not intended to replace the Operator’s Manual, which should always be available while using the ventilator. It is important to familiarize yourself with all information in the Operator’s Manual relevant to your institution’s use of the ventilator, including on-screen helps, instructions, warnings and cautions.
  • 3. Breathe More Naturally Simple Safe Smart The new Puritan Bennett™ 980 ventilator helps enable patients to breathe more naturally* through some of the most innovative breath delivery technology available. Our simple, safe and smart design provides more natural ventilation that may help clinicians improve patient comfort.1 * Compared to conventional mechanical ventilation (VC,VC+,PC,PS) 1. Grasso S, Puntillo F, Mascia L, et al. Compensation for increase in respiratory workload during mechanical ventilation. Pressure-support versus proportional-assist ventilation. Am J Respir Crit Care Med. 2000;161(3 Pt 1):819-26. Covidien Respiratory & Monitoring Solutions | April 14, 20143 |
  • 4. Overview The Puritan Bennett™ 980 ventilator is designed for: • Neonatal through adult populations • In-room use and intra-hospital transport • Invasive (via endotracheal tube) and noninvasive (via mask or nasal prongs) applications The ventilator is available in three models: Pediatric – Adult Ventilator Ventilates pediatric or adult patients with predicted body weights from 3.5 kg to 150 kg, and with tidal volumes from 25 mL to 2500 mL. Neonatal Ventilator Ventilates neonatal patients with predicted body weights from 0.3 kg to 7.0 kg, and with tidal volumes for mandatory volume- controlled breaths from 2 mL to 320 mL. Universal Ventilator Ventilates neonatal, pediatric and adult patients with predicted body weights from 0.3 kg to 150 kg, and with tidal volumes for mandatory volume-controlled breaths from 2 mL to 2500 mL. Covidien Respiratory & Monitoring Solutions | April 14, 20144 |
  • 5. Finding Your Way Around Covidien Respiratory & Monitoring Solutions | April 14, 20145 |
  • 6. Finding Your Way Around On/Off switch User interface Breath delivery unit Expiratory filter Inspiratory filter Fan Hot swappable batteries Communication ports Covidien Respiratory & Monitoring Solutions | April 14, 20146 |
  • 7. Finding Your Way Around the User Interface Touch screen Patient data banner on top •  Additional patient data display tab •  Large font data display tab Left menu tab Graphics in middle Ventilator setup button lower left Constant access icons Bezel control keys Adjustment knob       Covidien Respiratory & Monitoring Solutions | April 14, 20147 |
  • 8. Positioning the User Interface for Ease of Viewing The user interface can be repositioned for easier viewing. 8 |
  • 9. Touch Screen Navigation • Swipe • Double-tap • Drag • Touch and hold • Drag and drop • “Touch, turn, accept” 9 |
  • 10. Setting Up the Puritan Bennett™ 980 Ventilator Prior to Use Covidien Respiratory & Monitoring Solutions | April 14, 201410 |
  • 11. Setting Up Prior to Patient Use Setting up for patient use will include installing: •  Filters •  Humidifier •  Breathing circuit •  EVQ* •  Air and oxygen hoses •  Puritan Bennett™ Proximal Flow Sensor (if applicable) Powering on and performing a short self test (SST). Covidien Respiratory & Monitoring Solutions | April 14, 201411 | *U.S. only
  • 12. Installing the Filters Three filters help reduce the spread of pathogens. Expiratory filter is heated to keep the gas that flows through it from cooling to the dew point and creating condensate in the filter. Reusable and disposable filter options are available.* An optional drain bag is available for managing condensate. Pediatric-adult and neonatal applications use different expiratory filter configurations. Covidien Respiratory & Monitoring Solutions | April 14, 201412 | *only disposable inspiratory and expiratory filters may be used in the U.S. Expiratory filter assembly Inspiratory filters (internal and external)
  • 13. Installing the Inspiratory Filter on the ‘To Patient’ Port •  Install the inspiratory filter on the “To Patient” port by pushing it directly onto the port. •  Ensure the direction of the flow arrow is pointing outward, toward the patient circuit’s inspiratory limb. Covidien Respiratory & Monitoring Solutions | April 14, 201413 | *only disposable inspiratory and expiratory filters may be used in the U.S.
  • 14. Installing the Expiratory Filter Assembly: Pediatric-Adult Application 1)  Assemble the condensate vial and reusable expiratory filter. 2) Raise the expiratory filter latch to unlock the expiratory filter door. 3) Insert the new filter* assembly. 4) Lower the expiratory filter latch. Covidien Respiratory & Monitoring Solutions | April 14, 201414 | *only disposable inspiratory and expiratory filters may be used in the U.S.
  • 15. Installing the Expiratory Filter Assembly: Neonatal Application 1)  Raise the latch, (remove adult door if applicable), install the neonatal filter door if applicable 2) Raise the expiratory filter latch to unlock the expiratory filter door. 3) Insert the new filter assembly. 4) Lower the expiratory filter latch. Covidien Respiratory & Monitoring Solutions | April 14, 201415 |
  • 16. Installing the Humidifier •  The ventilator accommodates Teleflex (Hudson RCI) and Fisher & Paykel humidifiers. •  To install, slide the rear of the humidifier into the corresponding slot on the humidifier bracket, until it is fully seated. •  During SST, enter the humidifier volume setting when you enter the breathing circuit type. •  The humidifier volume setting entered during SST should always be equal to the chamber’s empty compressible volume. •  The operator’s manual contains a chart with the Fisher & Paykel and Teleflex Hudson RCI chamber volumes listed. Covidien Respiratory & Monitoring Solutions | April 14, 201416 |
  • 17. Installing the Breathing Circuit The breathing circuit type should be selected based on the patient’s predicted body weight (PBW). If changing a breathing circuit type, run an SST. •  The circuit type and PBW entered during the SST will determine the new patient ventilation and alarm settings and also the range limits.   Covidien Respiratory & Monitoring Solutions | April 14, 201417 | Circuit type PBW Neonatal 0.3 kg to 7 kg Pediatric 7 kg to 24 kg Adult >24 kg
  • 18. Puritan Bennett™ Proximal Flow Sensor (Neonatal Application Only) Measures flow, volume and pressure at the patient wye; does not control flow volume or pressure Intended for neonatal invasive ventilation To install the sensor: •  Install during SST (according to prompts). •  Install the sensor end at the patient circuit wye. •  Attach the other end to the keyed pneumatic connector on the ventilator’s front panel behind a clear door.
  • 19. About the Exhalation Valve Flow Sensor Assembly (EVQ) •  Contains the expiratory port, expiratory flow sensor, exhalation valve diaphragm, expiratory filter seal and pressure sensor filter •  Can be cleaned and disinfected if a high-risk communicable contamination occurs* •  Disinfection is not required on a routine basis Covidien Respiratory & Monitoring Solutions | April 14, 201419 | *in the U.S. the EVQ has to be cleaned and disinfected in between patients
  • 20. Powering On Power on using the ON/OFF switch Covidien Respiratory & Monitoring Solutions | April 14, 201420 |
  • 21. Why Perform the Short Self Test (SST)? •  Impacts accuracy of breath delivery and spirometry •  The SST is a way of calibrating the ventilator to the circuit and humidifier you are using. It impacts both breath delivery and spirometry. •  The power-on self test (POST) does basic testing of the system. The SST expands that testing. It is the best way to prepare the ventilator for patient use. •  Run SST following a circuit change, change in circuit configuration (including circuit type, additions and removal of water traps and accessories, humidifiers, proximal flow sensor) and/or every 15 days. •  In the event that the patient is connected without ventilation parameters being specified, the ventilator enters Safety PCV, a safe mode of ventilation. Complete the parameter selection to exit Safety PCV. Covidien Respiratory & Monitoring Solutions | April 14, 201421 |
  • 22. Performing a Short Self Test (SST) •  Select the patient circuit type and humidification, and then follow the amber-colored prompts. •  As a general rule, keep doing what you are prompted to do until you are told to do something else. For instance, if you are prompted to occlude the patient wye, keep occluding it until you are told not to. •  You are given the option to repeat a test if there is a failure. When necessary, you may also continue in the presence of an alert. •  The SST status screen will display the test in progress and the results of completed tests. •  After completing the SST you will proceed with the patient setup process.     Covidien Respiratory & Monitoring Solutions | April 14, 201422 |
  • 23. Patient Setup Covidien Respiratory & Monitoring Solutions | April 14, 201423 |
  • 24. Patient Setup New patient Manual setup Quick start 1.  Select PBW or Gender and Height 2.  Select ventilation type—Invasive or Noninvasive (NIV) 3.  Select a Mode 4.  Select Mandatory, Spontaneous and Trigger types 5.  Set the Primary settings 6.  Touch Accept or Accept ALL to confirm the change(s) 1.  Touch New Patient. 2.  Enter PBW or gender and height. 3.  Touch Quick Start. 4.  Connect the circuit wye adapter to the patient’s airway or interface connection. Same patient The ventilator will be ready to start ventilating at the settings in place at power down. •  You can choose to set up a new patient or the same patient. •  In New Patient setup, you can choose a full manual setup or the Quick Start feature. Covidien Respiratory & Monitoring Solutions | April 14, 201424 |
  • 25. How to Enable and Disable the Puritan Bennett™ Proximal Flow Sensor •  To enable/disable the Proximal Flow Option –  Touch the Configure/Wrench icon –  Touch the Options tab –  Touch the Prox tab –  Touch the Enabled or Disabled button. •  To complete a Manual Purge, push the Start button
  • 26. When the Proximal Flow Sensor is enabled, new and replacement data values appear, representing data measured with the Proximal Flow Sensor. The monitored volume labels have a Y added to indicate that the measurement comes from the Proximal Flow Sensor. How the Puritan Bennett™ Proximal Flow Sensor Impacts Monitoring VTI Y Inspired tidal volume (mandatory or spontaneous) at patient circuit wye VTE Y Exhaled spontaneous/mandatory tidal volume at patient circuit wye VTE SPONT Y Exhaled spontaneous tidal volume at patient circuit wye VTE MAND Y Exhaled mandatory tidal volume at patient circuit wye VE TOT Y Exhaled total minute volume at patient circuit wye Covidien Respiratory & Monitoring Solutions | April 14, 201426 |
  • 27. How Puritan Bennett™ Proximal Flow Sensor and Puritan Bennett™ Leak Sync Software Affect Monitoring VTLY Inspired tidal volume (mandatory or spontaneous) at patient circuit wye (Leak Sync enabled and leak adjusted) VTL Inspired tidal volume (mandatory or spontaneous) (Leak Sync enabled and leak adjusted) as measured by the ventilator’s internal sensors Covidien Respiratory & Monitoring Solutions | April 14, 201427 |
  • 28. Making Settings Changes After Initial Setup Covidien Respiratory & Monitoring Solutions | April 14, 201428 |
  • 29. Making Settings Changes After Initial Setup Touch the Vent Setup button in the bottom- left corner of the touch screen display. There are several ways to make a settings change after initial setup: Swipe the Menu tab on the left margin of the touch screen and touch the Setup button. Touch a parameter in the lower margin of the touch screen. Covidien Respiratory & Monitoring Solutions | April 14, 201429 |
  • 30. Managing Alarms Covidien Respiratory & Monitoring Solutions | April 14, 201430 |
  • 31. Touch the hotlink from an alarm violation message. Swipe the Menu tab to open the Settings menu, then touch the Alarms settings tab. Touch the alarm icon (constant access icon). Managing Alarms There are three ways to access the Alarms screen: Covidien Respiratory & Monitoring Solutions | April 14, 201431 |
  • 32. Apnea Alarm Not on the Alarm Screen •  Touch the Vent Setup button to access the Apnea settings tab. •  Apnea alarm triggers apnea backup: •  Current apnea ventilation settings are displayed. •  Non-apnea ventilation settings may be changed during apnea backup. •  Apnea timer resets with every breath. •  Autoreset of apnea backup occurs when the patient triggers two consecutive inspirations and the exhaled volume is equal to or greater than 50% of the delivered volume. To manually reset it, touch the Alarm Reset key. •  Apnea ventilation setting for inspiratory pressure or tidal volume is also used for manual inflations; it is displayed in the Vent Setup button. Covidien Respiratory & Monitoring Solutions | April 14, 201432 |
  • 33. Alarm Conditions •  Alarm violations are visually indicated in three places: •  The omnidirectional lamp on top of the touch screen •  On the alarm banners •  On the alarm settings screen •  Low-, medium- and high-priority alarms—unique sounds •  Alarm loudness escalates if a high-priority alarm is not acknowledged within 30 seconds, and then again at 60 seconds •  Alarm banners indicate which alarm has been violated and provide a base message. Touching the individual alarm banner causes an expanded explanation to appear, containing analysis and remedy messages, and may contain a link to the alarm log or the alarms settings screen. Covidien Respiratory & Monitoring Solutions | April 14, 201433 |
  • 34. Omni-directional LED Normal mode • Steadily lit green Alarm condition • LED flashes—color corresponds to alarm priority Concurrent alarms • LED displays highest-priority color Alarm de-escalates • Latched (sides) display highest priority • Center displays current alarm priority Covidien Respiratory & Monitoring Solutions | April 14, 201434 |
  • 35. Alarm Priorities Alarm priority Visual indicator Audible indicator/Reset criteria Low A change in the patient-ventilator system has occurred. •  Yellow LED •  Yellow alarm banner on screen •  Yellow bar next to alarm setting icon on Alarms screen •  Low-priority audible alarm (two tone, non-repeating) •  LED indicator turns off and autoreset is entered into the alarm log. Medium Prompt attention necessary. •  Flashing yellow LED •  Yellow alarm banner on screen •  Yellow bar next to alarm setting icon on Alarms screen •  Medium-priority audible alarm (a repeating sequence of three tones) •  LED indicator turns off and autoreset is entered into the alarm log. High Attention required to ensure patient safety. •  Flashing red LED •  Red alarm banner on screen •  Red bar next to alarm setting icon on Alarms screen. •  High-priority audible alarm (a sequence of five tones that repeats twice, pauses, then repeats again) •  Visual alarm indicators remain steadily illuminated following an autoreset. •  The alarm reset key must be pressed to extinguish visual indicator. Immediate Attend to immediately. •  Specific to alarm condition or component failure. •  Continuous tone alarm sounding for at least 120 seconds in the case of Vent Inop or complete loss of power Covidien Respiratory & Monitoring Solutions | April 14, 201435 |
  • 36. Alarm Silence •  Mutes the audible alarm for 2 minutes. •  Alarm silence key LED illuminates. •  Countdown timer appears. •  Press Alarm Reset to cancel alarm silence. •  Press again to restart silence period. Covidien Respiratory & Monitoring Solutions | April 14, 201436 |
  • 37. Alarm Reset •  Use for any non-technical alarm. •  Resets the color of the dome light. •  Reinitializes the algorithm the ventilator used to detect the alarm (except for A/C POWER LOSS, LOW BATTERY, NO AIR SUPPLY, NO O2 SUPPLY, PROCEDURE ERROR alarms and active battery alarms). •  Captured in the log if there is an active alarm. Covidien Respiratory & Monitoring Solutions | April 14, 201437 |
  • 38. Alarm Log – Up to 1000 Events The Alarm Log contains the last 1000 alarms that have occurred, whether they have been reset or autoreset, the priority level, and their analysis messages. •  Accessible during Normal and Service states •  Records: •  Date/time-stamped entry when an alarm is detected, escalated, reset or autoreset •  Date/time-stamped entry if the ventilator enters backup ventilation •  Priority level •  Analysis message •  Alarm silence interval begins, ends or is cancelled •  If one or more alarms have occurred since the last time the alarm log was viewed, a yellow triangle appears on the touch screen indicating there are unread items. •  Alarm log is cleared when New Patient is selected during the ventilator startup process. Covidien Respiratory & Monitoring Solutions | April 14, 201438 |
  • 39. Patient Data and Data Monitoring Covidien Respiratory & Monitoring Solutions | April 14, 201439 |
  • 40. Locating Commonly Used Patient Data Values • Patient data banner • Graphics • Additional patient data screen • Large-font patient data screen Status display Covidien Respiratory & Monitoring Solutions | April 14, 201440 |
  • 41. Patient Data Banner • Eight patient data measurements are displayed across the top of the touch screen. • Four on the right can be swiped to the left or right in order to display additional data. • Double-tap a cell to show the data available for viewing and select the one to be displayed. • A “blank cell” feature is available to reduce the number of patient data measurements showing in the top banner. Covidien Respiratory & Monitoring Solutions | April 14, 201441 |
  • 42. Graphics • The Puritan Bennett™ 980 ventilator displays color-coded waveforms for flow, pressure and volume versus time. • It also displays color-coded loops for volume versus pressure and flow versus volume. • The inspiratory portion of a mandatory breath is green, the inspiratory portion of a spontaneous breath is orange and exhalation is always yellow. Covidien Respiratory & Monitoring Solutions | April 14, 201442 |
  • 43. Graphics: Changing the Scale and Maximizing/Minimizing Two ways to change the scale of a graphic: •  Touch and drag the scale. •  Touch to select the scale and then use the adjustment knob to change the scale. Graphics can also be enlarged to full screen by double-tapping the graph, swiping upward, or tapping the arrow in the upper- right corner. To return to the previous size, tap the arrow in the upper-right corner of the graph again, swipe downward, or double tap the graph. Covidien Respiratory & Monitoring Solutions | April 14, 201443 |
  • 44. Graphics: Pause and Review •  Graphics can be paused and historical data (up to 60 seconds) can be reviewed. •  Touch the Pause icon in the lower-right corner. •  Drag or use the adjustment knob to move the cursor and identify measurements along the waveform(s) or loop. •  Numerical data continues to update while waveform/loop plotting is paused. •  Touch the Pause icon again to unpause the graphics. Covidien Respiratory & Monitoring Solutions | April 14, 201444 |
  • 45. Graphics: Storing a Screen Image •  Touch the camera icon to store an image of the screen. •  May be used with or without Pause. •  Data continues to update during the pause —graph and numerical data on a stored image will not likely be aligned. •  Open the Menu tab (left margin of screen) and touch Screen Capture to access stored screen images and download through the USB port. Covidien Respiratory & Monitoring Solutions | April 14, 201445 |
  • 46. Screen Layout for Graphics •  Use the waveform layout icon to access alternate screen configurations. •  You can choose to display up to three waveforms and two loops simultaneously in the waveform area. Covidien Respiratory & Monitoring Solutions | April 14, 201446 |
  • 47. Additional Patient Data FPO   •  Tap or swipe down the tab in the center of the lower margin of the patient data banner to display additional patient data. •  View page 1 or tap page 2 to view another set of additional patient data. •  Additional patient data values have fixed positions. Covidien Respiratory & Monitoring Solutions | April 14, 201447 |
  • 48. Patient Data Large Font Screen •  Tap the tab in the center of the lower margin of the additional patient data screen to view the large-font patient data screen •  Double-tap a cell to show the data and waveforms/loops available for viewing and select the one to be displayed. Covidien Respiratory & Monitoring Solutions | April 14, 201448 |
  • 49. Status Display (on Breath Delivery Unit) Visible whenever power is on – not interactive During ventilation, the status display shows gas sources, power source, battery status, alarm volume setting, ventilation hours, and circuit pressure graph: pressure units, ↑PPEAK alarm setting and PPEAK / PEEP values. Before starting ventilation, the status display shows the EST, SST and POST results, including the patient circuit size and type cleared by SST. This screen also displays valuable device messages, such as stand-by state, low or empty battery alarms, ventilation assurance (BUV) state or safe state/safety valve open. Covidien Respiratory & Monitoring Solutions | April 14, 201449 |
  • 50. Patient Data Log: Historical Record of Patient Data •  The patient data log records data every minute for a total of up to 4320 patient data entries. •  3 tabs are contained in the patient data log: vital patient data, additional patient data-1, additional patient data-2. •  During ventilator operation, the log records: •  Date and time of entry •  Data label—which measurement it is recording •  Patient data value •  Access via the clipboard icon. •  The log is cleared when the ventilator is set up for a new patient. Covidien Respiratory & Monitoring Solutions | April 14, 201450 |
  • 51. Menu Tab Covidien Respiratory & Monitoring Solutions | April 14, 201451 |
  • 52. Menu Tab •  Swipe to the right to access Setup, Respiratory Mechanics, Stand-by and Screen Capture menus. •  Touch the Setup button to view the Vent, Apnea, Alarms and More Settings tabs. This is another way to access mode and breath type changes. Covidien Respiratory & Monitoring Solutions | April 14, 201452 |
  • 53. More Settings •  More settings: – Leak Sync: Enabled/ Disabled – O2 sensor: Enabled/ Disabled/Calibrate – Humidification type: Heated Exp Tube/Non-heated Exp Tube/HME (impacts expiratory spirometry)
  • 54. More Settings More vent settings DSENS •  DSENS determines the amount of lost volume (inspiration versus exhalation) that is used to determine that the breathing circuit is disconnected. •  A low setting (minimum 20%) is the most sensitive and a high setting (maximum 95%) is least sensitive to a leak or disconnect. •  During NIV, the DSENS value is automatically set to Off. •  With the Puritan Bennett™ Leak Sync feature enabled, DSENS is expressed in L/min instead of percent. In this case the leak compensation flow between breaths is used to determine that the breathing circuit is disconnected. Covidien Respiratory & Monitoring Solutions | April 14, 201454 |
  • 55. Stand-by Stand-by state can be used to pause ventilation during a planned disconnect of the breathing circuit. •  Stop spray from circuit during disconnect. •  Ventilation resumes automatically when the circuit is reconnected to the patient. Setup: 1. Touch the Menu tab on the left side of the touch screen. 2. Touch the Stand-by button. A stand-by state pending dialog appears instructing the clinician to disconnect the patient circuit. An on-screen timer allows 30 seconds for disconnect. 3. After you disconnect, you must reconfirm your intent by touching the Confirm button within 30 seconds. 4. Flow sensors are monitored to detect patient reconnection. 5. To exit stand-by—reconnect the patient to the ventilator. Covidien Respiratory & Monitoring Solutions | April 14, 201455 |
  • 56. During Stand-by •  Patient-related alarms are temporarily suppressed. •  The ventilator displays an indicator that it is in stand-by state and a timer indicating the elapsed time the ventilator has been in stand-by state. •  The exhalation valve is open. •  Base flow is set to 10 L/min. •  100% O2 is delivered for pediatric or adult application. •  40% O2 is delivered for neonatal application. •  Entry into and exit from stand-by state is recorded in the general event log. Covidien Respiratory & Monitoring Solutions | April 14, 201456 |
  • 57. Respiratory Mechanics Covidien Respiratory & Monitoring Solutions | April 14, 201457 |
  • 58. Respiratory Mechanics Respiratory Mechanics Maneuvers are used to make certain patient data measurements and calculations, for example: •  Plateau Pressure (PPL) •  Static Compliance (CSTAT) •  Static Resistance (RSTAT) •  Intrinsic PEEP (PEEPI) •  Negative Inspiratory Force (NIF) •  Occlusion Pressure (P0.1) •  Vital Capacity (VC) Covidien Respiratory & Monitoring Solutions | April 14, 201458 |
  • 59. Respiratory Mechanics – Inspiratory Pause •  The Inspiratory Pause maneuver is used to determine plateau pressure, static compliance and static resistance. •  It takes place at the end of the inspiratory phase of a breath. •  Breathing efforts could skew the measurement so it is important to ensure that the patient is not actively breathing when you perform the maneuver. There are two ways to access this function, which can be done in two ways, automatically or manually: 1.  Access via Menu tab: a) Automaticà touch RM key à touch Inspiratory Pause à touch Start à touch Accept or Reject b) Manual à touch RM key à touch Inspiratory Pause à touch and hold Start for up to 7 seconds à touch Accept or Reject 2.  Access via bezel key: a) Automatic à touch and release Inspiratory Pause bezel key à touch Start à touch Accept or Reject b) Manual à touch and hold Inspiratory Pause bezel key for up to 7 seconds à touch Start à touch Accept or Reject Covidien Respiratory & Monitoring Solutions | April 14, 201459 |
  • 60. Respiratory Mechanics – Expiratory Pause •  The Expiratory Pause maneuver is used to determine Total PEEP (PEEPTOT) and intrinsic PEEP (PEEPI). •  It takes place at the end of the expiratory phase of a breath. •  Breathing efforts could skew the measurement so it is important to ensure that the patient is not actively breathing when you perform the maneuver. There are two ways to access this function, which can be done in two ways, automatically or manually: 1.  Access via Menu tab: a) Automaticà touch RM key à touch Expiratory Pause à touch Start à touch Accept or Reject b) Manual à touch RM key à touch Expiratory Pause à touch and hold Start for up to 15 seconds à touch Accept or Reject 2.  Access via bezel key: a) Automatic à touch and release Expiratory Pause bezel key à touch Start à touch Accept or Reject b) Manual à touch and hold Expiratory Pause bezel key for up to 15 seconds à touch Start à touch Accept or Reject Covidien Respiratory & Monitoring Solutions | April 14, 201460 |
  • 61. Respiratory Mechanics – Vital Capacity •  This maneuver is done to determine the maximum amount of air that a patient can exhale after inhaling all the way. •  The Vital Capacity (VC) maneuver is a coached maneuver. 1.  Touch or swipe the Menu tab on the left side of the screen. 2.  Touch the RM key. 3.  Touch the Vital Capacity tab. 4.  Prepare the patient. 5.  Touch and release the Start key. 6.  Coach the patient to inhale all the way and then slowly and fully exhale. 7.  Keep coaching until the exhalation is complete. 8.  Touch the Accept or Reject key to save or dismiss results. Covidien Respiratory & Monitoring Solutions | April 14, 201461 |
  • 62. Respiratory Mechanics – Occlusion Pressure (P0.1) •  The Occlusion Pressure (P0.1) maneuver is used to determine the patient’s neuromuscular drive to breathe. •  Like the NIF maneuver, it is done by having the patient pull against an occluded airway with the ventilator’s inspiratory and exhalation valves closed. •  There are two differences between the P0.1 and NIF maneuvers: 1) This P0.1 maneuver measures the negative airway pressure generated during the first 100 ms of the patient’s effort. 2) No coaching of any kind is involved. 1.  Touch or swipe the Menu tab on the left side of the screen. 2.  Touch the RM key. 3.  Touch the P0.1 tab. 4.  Touch and release the Start key. 5.  Touch the Accept or Reject key to save or dismiss results. Covidien Respiratory & Monitoring Solutions | April 14, 201462 |
  • 63. Respiratory Mechanics – Negative Inspiratory Force (NIF) •  The Negative Inspiratory Force (NIF) maneuver is used to determine the patient’s ability to pull a negative inspiratory pressure against an occluded airway. •  You can perform the maneuver for up to 30 seconds. •  During the entire time you are touching the Start key, the ventilator’s inspiratory and exhalation valves are held closed. •  When working with a cooperative patient, the patient is coached to draw a maximum inspiration. 1.  Touch or swipe the Menu tab on the left side of the screen. 2.  Touch the RM key. 3.  Touch the NIF tab. 4.  Touch and release the Start key. 5.  Touch the Accept or Reject key to save or dismiss results. •  The ventilator does not deliver any breaths in response to patient effort until the maneuver is completed. •  After the maneuver is completed, a PEEP restoration breath is delivered then normal breath delivery resumes. Covidien Respiratory & Monitoring Solutions | April 14, 201463 |
  • 64. Additional Icons, Keys, Buttons Covidien Respiratory & Monitoring Solutions | April 14, 201464 |
  • 65. User Interface Constant access icons Function Home icon (house) Dismisses all open dialogs on the touch screen. Resumes showing ventilator waveforms screen. Configure (wrench icon) Opens the configure display to access SST. (history), Options, Comm Setup, and Date/Time change tabs. Logs (clipboard icon) Opens the log screen containing tabs for alarms, settings, patient data, diagnostics, EST/ SST status, general event and service logs. Elevate O2 (O2 icon) Increases oxygen concentration to the institutional default O2 configuration, if institutional default has been configured, for 2 minutes, or allows the operator to determine the additional percentage of oxygen to increase. Terminate prior to completion of the 2-minute interval by touching Stop. Screen capture (camera icon) Captures the image displayed on the touch screen. Help icon (question mark) Drag the help (question mark) icon to the item in question and release. A tooltip will appear describing the item’s function. Covidien Respiratory & Monitoring Solutions | April 14, 201465 |
  • 66. Yellow Triangle - Unread items icon. Pay Attention - Check or View the Tab Prompt Covidien Respiratory & Monitoring Solutions | April 14, 201466 |
  • 67. Breath Phase Indicator Breath Phase Indicator A   Assisted mandatory breath   C   Controlled mandatory breath   S   Spontaneous breath   A, C, or S glows in reverse video during inspiratory phase A, C, or S appears solid during expiratory phase Covidien Respiratory & Monitoring Solutions | April 14, 201467 |
  • 68. Indicators Patient Circuit Indicator (Adult, Pediatric or Neonatal) •  This indicator appears right above the Vent Setup button. •  It indicates the size of the patient circuit cleared during the SST. Covidien Respiratory & Monitoring Solutions | April 14, 201468 |
  • 69. Indicators Screen Opacity Icon •  Appears on the vent setup screen and on all of the respiratory mechanics maneuvers screens. •  Select and then use the adjustment knob to adjust the opacity of the displayed information between 50% and 100%. •  The lower the percentage, the more the waveform display will be visible through the other screen information. Covidien Respiratory & Monitoring Solutions | April 14, 201469 |
  • 70. Indicators Pushpin Icon •  Appears in the corner of the settings screen. •  Touch the Pushpin Icon to keep a settings window open. •  To the reverse the action, unpin or touch the home icon. Covidien Respiratory & Monitoring Solutions | April 14, 201470 |
  • 71. User Interface Bezel Control Keys (Off Screen) 1. Display Brightness 2. Display Lock 3. Alarm Volume 4. Manual Inspiration 5. Adjustment Knob 6. Inspiratory Pause 7. Expiratory Pause 8. Alarm Reset 9. Alarm Silence            Covidien Respiratory & Monitoring Solutions | April 14, 201471 | Easy to Access
  • 72. Additional Safety Features Covidien Respiratory & Monitoring Solutions | April 14, 201472 |
  • 73. Ventilation Assurance Feature •  Provides continued ventilation if the background diagnostics detect a problem with certain components in the gas mix, inspiratory or expiratory subsystems. •  If the gas mix system has a problem, either 100% oxygen or room air gas will be delivered. •  If the inspiratory or expiratory systems have a problem, the Puritan Bennett™ 980 ventilator delivers pressure control ventilation with an inspiratory pressure of 15 and a PEEP of 3. Covidien Respiratory & Monitoring Solutions | April 14, 201473 |
  • 74. Other Safety Assurance Systems Status display shows: •  Power source—plug symbol versus battery symbol •  Presence of batteries and their charging status •  Relative available battery charge level •  Alarms related to power source •  Patient circuit size and type •  Circuit pressure graph displaying pressure units, PPEAK alarm setting, and current PPEAK and PEEP values •  Presence of oxygen and air source •  Presence of compressor •  Ventilator operational hours •  Alarm loudness •  EST, SST and POST results •  Safety Valve Open/Vent Inop state Covidien Respiratory & Monitoring Solutions | April 14, 201474 |
  • 75. Breath Delivery Unit Hot Swappable Batteries •  Two battery slots •  Primary hot swappable LiOn battery must be installed to pass POST •  Primary hot swappable LiOn battery on right side should not be removed during normal operation •  Extended hot swappable LiOn battery is optional •  Up to one hour of power at standard temperatures and settings/battery •  Six-hour recharge time/battery •  Charge level shown on status display and with green LEDs on battery Covidien Respiratory & Monitoring Solutions | April 14, 201475 |
  • 76. Additional Assistance Covidien Respiratory & Monitoring Solutions | April 14, 201476 |
  • 77. Covidien Representative Contact your Covidien representative [Name, phone email] Covidien Respiratory & Monitoring Solutions | April 14, 201477 |
  • 78. Help Via www.covidien.com/solvit-center The SolvIT Center provides answers to frequently asked questions about the ventilator system and other Puritan Bennett™ products 24 hours a day, 7 days a week.