Medical devices -ventilation

1. INTESIVE CARE
UNIT EQUIPMENTS
OD22 BEE GROUP ASSIGNMENT
GROUP 07

2. GROUP MEMBERS
• MKOGA JEROME SALEHE 220323466233
• MFINANGA SAMSON YESSAYA 220323491397
• KIMAZI HENERIKO SAKANI 2103211219043
• MBELWA RAMADHANI MGAZA 220323324893
• MULAMULA JACKSON RUTAKUBISIBWA 220323411031
• MAKAMLA HAFSWA ABAS 220323481836

3. VENTILATOR
• Introduction
• Basic ventilation modes
• Operating principles
• Safety inspection procedures

4. INTRODUCTION
• VENTILATOR is the machine that provide mechanical ventilation by
moving breathe air in to and out of the lungs to deliver breaths to patient
who is physically unable to breath .
• There are different types of ventilator including , face mask ventilator,
mechanical ventilator, manual resuscitator bags ventilator ,Tracheostomy
ventilators .

5. MECHENICAL
VENTILATOR
• This is the medical machine that provides
mechanical ventilation by moving breathe
air in to and out of the lungs to deliver
breaths to patient who is unable to breath.
• In medical field is mainly found in intensive
care unit and also can be found in theatre
room.
• Mechanical ventilator in medical field are
used by healthcare professionals to control
the breathing process of a patient .

6. PARTS OF MECHANICAL VENTILATOR
They are categorized in two :
• Machine circuits
 Electronic circuits include control an display
 Pneumatic circuits(Air control devices) include Flow sensor(monitor expired air ),Oxygen sensor (control and maintain oxygen content in the air that is breathed in by
patient .
 Storage cabinet includes medicine mask , conjugated tubing ,refilling bags and forceps.
• Patient Circuts
 Mask
 Humidifier
 Suction catheter
 Nebulizer and inhaler
 Connecting tubes
 Filters

7. CONT..
 Breathing tube support arm; this is a medical device for supporting and anchoring a patient’s breathing tube.
 Inspiratory port with filter; this is special for protecting the equipment from the rare event of contamination with exhaled air and also protecting the patient in case
he/she breathes a room air through the safety valve that some ventilators open in case of sudden failure.
 Active humidifier; this is the medical device for increase the heat and water vapor content of inspired gas.
 Inspiratory line with water trap; this is the medical device used to collect condensation in the circuit to prevent it from damaging the ventilator of flowing back to the
patient during inhalation.
 Flexible connector; this is special for providing piping systems with the flexible needed to absorb noise and vibration , compensate for thermal growth, or permit
motion of the other piping elements.
 Expiratory line with water trap; this is the medical device used to collect condensation in the circuit to prevent it from damaging the ventilator or flowing back to the
patient during exhalation.
 Inspiratory port; this is the medical device which is incorporated within the circuit or in the mask in order to allow gas wash out during exhalation.
 Proximal flow pressure sensor; this is the special sensor which measures the breathing flow rate and the volume of breathing gas in an endotracheal tube (ET) inserted
into mouth of the patient into their airway.
 Nebulizer; this is a small medical machine special for turning liquid medicine into mist.

8. BASIC COMPONENTS OF VENTILATOR
Therefore the main components of the ventilator are;
• Power source
• Controls
• Monitors
• Safety features

9. BASIC VENTILATION MODES
• There are two main ventilation modes which can be used to practice
ventilation action which are Invasive mode and Non invasive mode. All the
modes are suitable for children and adults.
• Invasive ventilation mode has to do with the insertion of medical devices or
tubes internal to the patient while
• Non invasive mode the ventilation is done when the medical devices are
external to the patient. Note Nebulizer use is not available in non invasive
(NIV) modes.

10. Key words :Abbreviations
• Assist mode means each breath is initiated by the patient.
• Control mode means each breath is initiated by the machine.
• Assist –control mode means dynamic hybrids of the two above are possible.
• VCV means Volume controlled ventilation.
• PCV means Pressure controlled ventilation.
• SIMV means Sychronius Intermittent Mandatory Ventilation
• .PSV means Pressure support ventilation.
• CPAP means Continuos Positive Airway Pressure.
• PRVC means Pressure –regulated volume controlled.

11. Invasive ventilation mode
This includes
 Assist /Control ventilation (A/C) modes.
These modes allow mandatory ventilation and include VCV,PCV and PRVC.
 Synchronius Intermittent Mandatory Ventilation (SIMV) modes.
These modes allow both mandatory ventilation including (VCV,PCV and PRVC) and spontaneous ventilation (including
spontaneous ventilation and pressure support ventilation (PSV) ).
 Spontaneous ventilation /Continuos positive Airway Pressure ventilation (SPONT/CPAP) mode.
This mode only allows spontaneous ventilation.
 Bi Level ventilation (BIVENT ) mode.
This mode allows both mandatory ventilation (Switching between high level CPAP and low level CPAP) and spontaneous
ventilation.

12. Non invasive ventilation modes
• This includes;
 Non invasive /Continuos mode of operation Positive Airway Pressure(NIV/CPAP) mode or CPAP mode in NIV.
In this mode the spontaneous mode of operation and no ventilator controlled breaths are provided.Throughout the ventilation cycle ,an operator
set pressure(CPAP)may be provided. In NIV/CPAP,the ventilator controls the Airway pressure as the pre set PEEP value.
 Non invasive –T mode or A/C (PCV) mode in NIV.
In NIV-T mode ,breaths shall be controlled by the ventilator (mandatory ) or shall be triggered by the patient (Spontaneous) or shall be triggered
by the operator.In which when controlled by the ventilator ,breaths shall be pressure limited and time cycled ,resulting in an operator set
pressure(Pinsp) being delivered for an operator set period (Tinsp).Extra breaths shall be possible if the patient overcomes the pre set trigger level
or if the operator selects a manual ventilation .Patient triggered breaths shall be flow triggered.
 Non invasive –S/T mode or SPONT mode in NIV.
In this mode the spontaneous mode of operation and no ventilator controlled breaths are provided. Throughout the ventilation cycle ,spontaneous
may be also be assisted by the ventilator at an operator set of inspiratory pressure (pressure support). If the trigger time of the patient exceeds the
setting value of the apnea time ,the mode will enter into back up ventilation .

13. OPERATING PRINCIPLES
The mechanical ventilator operates under the mechanical ventilation principles which includes:
 Ventilation
The process of moving air in and out of the lungs during a breathing cycle.
 Oxygenation
The process of absorbing oxygen into the bloodstream.
 Lung compliance
The measurement of the ability of the lungs to expand and contact.
 Airway resistance
The measurement of impedance to the movement of air through the respiratory tract during inspiration and expiration.
 Dead space ventilation
This is the volume of ventilated air that does not participate in gas exchange.
 Respiratory failure
This occur when the lungs are unable to adequately oxygenate the blood or remove carbon dioxide from the body.

14. CONT…
 The ventilator uses pressure to blow air into the lungs, this pressure is known as positive pressure .A patient
usually exhales the air on their own, but sometimes the ventilator does it for the patient.
 The amount of oxygen the patient receives can be controlled through a monitor connected to the ventilator
.if the patients condition is particulary fragile ,the monitor will be set up to send an alarm to the car giver
indicating an increase in air pressure .
 The machine works by bringing to the lungs and taking carbon dioxide out of the lungs.This allows the
patient who has trouble in breathing to receive proper amount of oxygen .It also helps the body of the
patient to heal, since it eliminates the extra energy of labored breathing .
 A ventilator blows air into the air ways through breathing tube .One end of the tube is inserted into the
patient windpipe and the other end is attach to the ventilator .The breathes tube serves as an airway by
letting oxygen from the ventilator flows into the lungs .Depending on the condition of the patient ,they may
be able to use a respirstory mask instead of the breathing tube.

15. Block diagram of mechanical diagram

16. MAINTANANCE OF MECHANICAL
VENTILATOR
o Check the electrical system connections and mechanical connections including tubes regularly before and
after the use of the machine.
o Examine the battery life ; normally we need to change the ventilator batteries once a year but it is important
to periodically check the ventilators battery life especially to the machine that experience a high number of
patients.
o Change or clean the filters; the filters protect the patient from inhaling unsafe particles and protect the
ventilator from malfunction. For safety ensure the filters are well clean regularly if necessary change them for
proper functions.
o Clean external and internal parts of the machine by using proper solution
o Keep the machine in a safe place if not in use

17. TROUBLESHOOTING
Problem Causes Remedy
The machine doesn’t turn on No power supply
Battery low
Turn on the power source
Change the batteries
Fan blocked alarm Cooling fan failure Remove any obstruction, repair
or change the fan
Carbon dioxide Adapter failure
alarm
Detected by Carbon dioxide
sensor.
Reconnect the adapter if
necessary replace it.
Internal Battery Calibration
required alarm
AC power failure Calibrate the internal battery then
restart the ventilator.

18. STANDARD OPERATING PROCEDURES
FOR VENTILATOR
Starting up
o Connect the ventilator to AC power supply.
Switching On
o Switch on the ventilator by actuate the power switch of a ventilator ON/OFF.
Technical test
o Including voltage test, data test ,communication test, AD and DA converter test and valve control test where the ventilator is not operational during this period .
Pre-use test
o Including Gas supply test, leak test ,Flow sensor test ,Pressure sensor test and safety valve test where in this period the ventilator does not support patient ventilation
since the inspiratory valve is closed and expiratory valve is opened.
Equipment use to the patient
o Specify pressure limits
o Select maximum pressure according to the user adults or children
o Place well a sterile mask and air tubes from a ventilator to a patient.

19. RECOMMENDATIONS
The machine is more complicated to use there for to reduce inefficiency of the
machine
• It should be operated only by well trained person.
• When used the biomedical engineer or technician should be near for any
corrective maintenance.