ATMOS NPWT System and Dressing Setup

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ATMOS NPWT System and Dressing Setup

  1. 1. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />© 2009 ATMOS Inc. All Rights Reserved. S041.SG.V1.R0.080409.US<br />
  2. 2. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Setup Guide<br />Notice to Clinicians<br /> <br />The following content and procedural suggestions are intended for use with an ATMOS Negative Pressure Wound Therapy (NPWT) system. These guidelines are not intended as a guarantee certain clinical results, outcomes or system performance nor does ATMOS guarantee the efficacy of their NPWT systems. These guidelines are recommendations to help clinicians to integrate an ATMOS NPWT system into preexisting wound-treatment protocols.<br /> <br />Please consult with the patient’s attending physician for specific instructions concerning the patient’s individual wound treatment. Before using an ATMOS NPWT system please refer to the following documents:<br />Clinical Protocols Manual<br />Product Operating Instructions<br />Reference Guides<br /> <br />Please be aware of the following sections from the Product Operating Instructions before using the ATMOS S041 Wound NPWT system on a patient.<br />Indications<br />Contraindications<br />Warnings <br />Precautions<br /> <br />In event of a medical emergency, immediately dial 911 for emergency medical support. Additional product information can be obtained at www.atmos-npwt.com or by calling ATMOS at 1-866-862-8667. <br />Federal law restricts this device to sale or rental by or on the order of a physician.<br />
  3. 3. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Components<br /> Pump<br /> Vacuum Tube<br /> Hydrophobic Canister<br />2<br />1<br />1<br />2<br />3<br />3<br />
  4. 4. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Other Components<br /> Shoulder Strap<br /> Carrying Bag<br /> Universal Holder<br /><ul><li>For use with Beds, Wheel Chairs and IV Poles</li></ul> Power Supply and Power Cable<br />1<br />2<br />1<br />2<br />3<br />3<br />4<br />4<br />
  5. 5. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Place the Canister<br /> The patient port of the canister should be facing toward the patient.<br /> The canister should have a snug fit and will be completely level.<br /> The pour-spout should be closed.<br />3<br />Make sure you are using an 800cc Hydrophobic Canister!<br />1<br />1<br />2<br />2<br />3<br />
  6. 6. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Connect Vacuum Tube<br /> Connect the Vacuum Tube to the port on the pump.<br /> Connect the other end of the Vacuum Tube to the Vacuum Port on the top of the canister.<br />This tube does not require a filter. ATMOS uses canister which uses an integrated filter.<br />1<br />1<br />2<br />2<br />
  7. 7. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Connecting a Wound Drain<br /><ul><li>Remove cap from the patient port on the canister
  8. 8. Firmly place the connection tube on the patient port.</li></li></ul><li>ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Connecting Multiple Wound Drains<br />You may treat multiple wounds on a patient using the same NPWT system if the pressure setting prescribed is the same.<br /><ul><li>Remove cap from the patient port on the canister
  9. 9. Firmly place the silicone end of the Y-Connector on the patient port of the canister lid.
  10. 10. Firmly place multiple connection tubes on the white plastic end of the Y-Connector.
  11. 11. More wounds may be treated by using additional Y-Connectors</li></ul>Warning: Never treat more than one patient at a time with an NPWT system!<br />
  12. 12. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Control Panel Features<br /> Display Screen<br /> Increase/Decrease Buttons (Pressure Adjustment)<br /> On/Off Button<br /> LED Indicator Light<br /> Reset Button<br />1<br />1<br />2<br />3<br />4<br />4<br />2<br />5<br />3<br />5<br />
  13. 13. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Powering on the System<br /><ul><li>Press the On/Off Button
  14. 14. Product name and software version number will appear on the display screen.
  15. 15. The pump will immediately begin building a vacuum.
  16. 16. To stop building vacuum press the On/Off Button again.</li></li></ul><li>ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Adjusting the Pressure<br /><ul><li>Press the Increase or Decrease Buttons to adjust the pressure to the desired level.
  17. 17. Continuous NPWT in the range of 60 - 80 mmHg is recommended for most wounds. Always confirm the exact pressure settings with the attending physician.
  18. 18. Default pressure is set at 80 mmHg.</li></li></ul><li>ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Therapy Options<br />Continuous Therapy Mode<br /><ul><li>This mode maintains and holds constant sub-atmospheric pressure.</li></ul>Intermittent Therapy Mode<br /><ul><li>This therapy mode builds a sub-atmospheric pressure for a set period of time and then releases the pressure for another set period of time.
  19. 19. This therapy mode has be shown in studies to promote faster wound healing. </li></ul>“Pump” is displayed when continuous mode is activated.<br />“iPump” is displayed when intermittent mode is activated.<br />Be aware that use of this therapy mode may increase pain associated with the treatment.<br />
  20. 20. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Switching Therapy Modes<br /><ul><li>Press and hold the On/Off and Reset Buttons for 5 seconds. The screen will show a countdown until it enters into the Intermittent Menu Screen.</li></ul>The ATMOS S 041 is capable of constant and intermittent modes.<br />
  21. 21. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Intermittent Therapy Mode Options<br />Intermitting 0/1 (Off/On)<br /><ul><li>This option allows you to choose Continuous or Intermittent Mode.</li></ul>Pump Period<br /><ul><li>This option allows you to select how long the pump will generate a vacuum while in Intermittent Mode.</li></ul> Release Period<br /><ul><li>This option allows you to select how long the pump will release the vacuum while in Intermittent Mode.</li></ul>1<br />1<br />2<br />2<br />3<br />3<br />
  22. 22. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Customizing Intermittent Mode<br /><ul><li>Use the Increase/Decrease Buttons to move to the different options. Press the Enter Button to select that option. </li></ul>For Intermitting 0/1: Use the Increase/Decrease Buttons to toggle between Intermittent (1/1) and Constant Mode (0/1).<br />For Pump and Release Periods: Use the Increase/Decrease Buttons to adjust the timer. <br /><ul><li>Press the Reset Button to enter the selection.</li></ul>1<br />1<br />2<br />2<br />
  23. 23. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Locking Control Panel<br /><ul><li>Press both the Increase and Decrease Buttons at the same time to lock the control panel.
  24. 24. To unlock the control panel, press both buttons again.</li></ul>Please Note: It is important to lock the control panel after setting-up the pump to avoid accidental operations. <br />
  25. 25. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Powering Off the System<br /><ul><li>To Stop Vacuum: Press the On/Off Button quickly.
  26. 26. To Power Off the Pump: Press and hold the On/Off Button for several seconds. </li></ul>Please Note: While the unit is plugged-in or charging, the pump will remain on.<br />
  27. 27. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Recharging the System<br />Connect the Power Supply to the Power Cable.<br />Plug the Power Supply into the pump.<br />Connect the Power Cable to the wall outlet.<br />The pump’s Display Screen will confirm active charging with a charging symbol. <br />1<br />2<br />1<br />2<br />3<br />3<br />4<br />4<br />Please see the Operating Instructions for more information regarding charging and batteries.<br />
  28. 28. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Disconnecting a Wound Drain<br />You may need to cease NPWT temporarily for transportation or other therapies.<br /> Use a tubing clamp on the drain tube.<br /> Disconnect the drain tube from the connection tube.<br /> Drain all liquids from connection tube by raising it above the canister.<br /> Once all liquids are drained, disconnect the connection tube from the canister. <br /> Close the cap on the Patient Port and plug both ends of the connection tube with gauze and tape.<br />1<br />2<br />3<br />1<br />2<br />3<br />4<br />5<br />4<br />5<br />
  29. 29. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Setup Guide<br />Cleaning and Disinfecting<br />To minimize the risk of infection, always use personal protective equipment when cleaning and disinfecting ATMOS NPWT systems. Follow institutional or other written protocol for equipment cleaning and disinfecting, where applicable.<br /> <br />ATMOS S 041 Housing<br />The housing can be wiped with a damp cloth or with a mild surface disinfectant such as Viragard or other EPA approved medical surface disinfectants. Do not use solvents. Liquids must not enter the device.<br />If liquids have penetrated into the device, it must be inspected by an authorized service technician before being used again.<br /> <br />Suction Canisters & Tubing<br />For each new patient a new canister and tubing set is required. Canisters are single use only, and should be replaced weekly at a minimum. Disposal of used canisters and tubing should follow your institutional protocols and/or local medical waste management protocols.<br />
  30. 30. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />© 2009 ATMOS Inc. All Rights Reserved. S041.SG.V1.R0.080409.US<br />
  31. 31. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Dressing Change Guidelines<br /><ul><li>Dressings should be changed every 48 hours to 72 hours for optimal healing.
  32. 32. Most facilities employ a Monday, Wednesday, Friday dressing change schedule.
  33. 33. The single use only canister should be changed depending on the amount of drainage. The canister should be changed every week. Heavily draining wounds may require more frequent canister changes and should be monitored closely.</li></li></ul><li>ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Chariker-Jeter Dressing Kit<br />Components Include:<br /><ul><li>Transparent Dressing 8” x 10”
  34. 34. Transparent Dressing 1.75” x 2.75”
  35. 35. Antimicrobial Gauze 6” x 6.75”
  36. 36. Oil-Emulsion Dressing
  37. 37. Tape Strips
  38. 38. Ostomy Paste
  39. 39. Skin Sealant Wipe
  40. 40. Saline Solution 0.9%, 10ml
  41. 41. Silicone Drain with Connection Tube
  42. 42. Wound Ruler (18 cm)
  43. 43. Instruction for Use</li></li></ul><li>ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Dressing Kit Options<br />ATMOS has 4 types of dressing kits available.<br /><ul><li>Sterile and single use only.
  44. 44. These drains are 100% silicone.
  45. 45. For more information on the dressing kits please refer to the instructions included within the packaging.</li></ul>10mm Flat Drain Kit<br />10fr Round Drain Kit<br />15fr Channel Drain Kit<br />19fr Round Drain Kit<br />
  46. 46. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Selecting the Proper Dressing Kit<br /><ul><li>Please refer to the Drain Selection Guide for more detailed information.
  47. 47. To optimize healing, please use the best possible drain type.
  48. 48. Be aware of the indications and contraindications of each drain type.</li></ul>This document is available for download within this lesson and also on www.atmos-npwt.com.<br />
  49. 49. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Wound Drain Guide<br />
  50. 50. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Wound Drain Guide<br />
  51. 51. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Prior to Dressing the Wound<br />Ensure that patient (or the patient’s legal responsible party) understands the procedure and potential risks. Obtain informed consent before proceeding to next step.<br />Gather sterile supplies, inspect equipment and supply packages. Do not use equipment if visual inspection reveals concerns regarding safety. Do not use supplies if opened or damaged<br />Evaluate the patient for pain and medicate as ordered (allowing adequate time for medication to take effect) prior to dressing application or change if the patient communicates pain.<br />Maintain patient privacy. Wash hands, don gloves, and assemble supplies within reach.<br />Remove old dressing (if applicable), cleanse wound thoroughly, remove gloves, wash hands, and apply new set of gloves.<br />Inspect and measure the wound with appropriate measuring devices. Photograph wound (if required by facility protocol). <br />If debridement is necessary, refer to qualified clinician if needed, or perform debridement as warranted. <br />Cleanse wound post-debridement, ensuring that hemostasis has been achieved. Pat peri-wound skin to dry.<br />
  52. 52. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />1<br />Clean the wound bed according to your facility‘s protocol.<br />
  53. 53. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />2<br />Apply skin sealant to the area surrounding the wound bed. Optional: You may treat the edges of the wound with hydrocolloids for a better seal.<br />
  54. 54. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />3<br />Cut the non-adherent dressing to the size and shape of the wound. Lay the non-adherent dressing across the entire wound bed.<br />
  55. 55. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />4<br />1cm<br />Measure the base of the wound, subtracting approximately 1cm from the measurement.<br />
  56. 56. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />5<br />Cut the drain according to the adjusted measurement you have taken from the base of the wound.<br />
  57. 57. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />6<br />Open the antimicrobial gauze and saturate with the saline solution. <br />Remove excessive saline by sqeezing out the antimicrobial gauze. <br />
  58. 58. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />7<br />If using flat or round: Place a layer of saline moistened gauze onto the wound bed. Position the shortened drain on top of the first layer of gauze. <br />If using a channel drain: Wrap a portion of the saline moistened gauze around the shortened drain. Position the wrapped channel drain on top of the non-adherent dressing<br />Flat or Round Drains<br />Channel Drains<br />
  59. 59. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />8<br />Place a portion of the ostomy paste on the edge of the wound and the fixate drain.<br />Place the remaining saline saturated gauze over top of the drain to produce a full wound bed. Be careful not to over pack the wound bed. <br />
  60. 60. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />9<br />Place the transparent film dressing over the wound, leaving at least a 2-3 cm border to ensure a proper seal. <br />
  61. 61. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />10<br />Where the drain exits the the transparent film, squeeze the film under the drain to improve seal.<br />Apply two strips of waterproof tape in an X configuration to keep the film airtight.<br />
  62. 62. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />11<br />Connect the drain tubing to the “Christmas Tree” adapter on the connection tubing. <br />Remove cap from the patient port on the canister.<br />Firmly connect the other end of the connection tubing to the patient-port on the canister.<br />
  63. 63. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Application Procedure<br />12<br />Turn on the NPWT system. Select the proper therapy mode and pressure level. <br />Once the device is on, the dressing should contract noticeably. If it does not occur, check the dressing for a leak. <br />Document procedure in patient’s medical record.<br />
  64. 64. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Tips and Tricks for Optimal Dressing Efficacy<br /><ul><li>You may use ostomy paste around the edge of the wound and around the drain to improve the seal of the dressing.
  65. 65. Transparent dressing may be used on the peri-wound area to prevent skin maceration.
  66. 66. If you have trouble achieving a proper seal you may use “patch” pieces of transparent dressing and ostomy paste to minimize leaks.</li></li></ul><li>ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Reasons to Stop or Discontinue Therapy<br />Situations in which NPWT may be suspended or discontinued.<br /><ul><li> After wound is successfully healed.
  67. 67. If wound is dry or therapy is too painful.
  68. 68. If patient has different mobility needs.
  69. 69. Allergic reaction to dressing or drain.
  70. 70. Magnetic testing.
  71. 71. Dialysis (if dialysis unit is unable to accommodate NPWT equipment).
  72. 72. Patient is unable or unwilling to be compliant with plan of care.</li></li></ul><li>ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Dressing Removal Procedure<br />To safely remove for dressing changes and/or safely discontinue NPWT upon orders of prescribing clinician.<br />Explain procedure to patient.<br />Provide for privacy, evaluate for need for pain medication (as per orders), and medicate as needed, allowing time for medication to take effect.<br />Gather supplies, wash hands, and don clean gloves.<br />Safely position patient for the procedure.<br />Close clamp (if using) and turn off pump.<br />Disconnect canister tubing from wound drain tubing.<br />Gently remove waterproof tape and transparent dressing, beginning at the drain exit site.<br />Cleanse wound. Remove gloves, wash hands, and don new clean gloves. If continuing on NPWT, obtain new dressing kit and proceed as outlined in “Wound Dressing Application”. If discontinuing NPWT, place treatment as ordered by prescribing clinician.<br />Document procedure in patient’s medical record.<br />
  73. 73. ATMOS S 041 Wound<br />Negative Pressure Wound Therapy (NPWT) System<br />Dressing Application Guide<br />Reference<br />Chariker ME, Jeter KF, Tintle TE, Bottsford JE. “Effective management of incisional and cutaneous fistulae with closed suction wound drainage.” Contemp Surg. 1989; 34:59.<br />

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