The document provides an overview and instructions for setting up and using the Puritan Bennett 980 ventilator. It discusses installing filters, a humidifier, breathing circuit and proximal flow sensor. It also covers powering on the device, performing a short self test, setting up a new patient, making settings changes, managing alarms and how the proximal flow sensor impacts monitoring.
Mechanical ventilation involves using a ventilator to mechanically move air into and out of the lungs to maintain proper oxygen and carbon dioxide levels. It has several purposes including improving gas exchange, relieving respiratory distress, and avoiding complications. There are various modes of ventilation including pressure control, volume control, and time-cycled modes. Parameters like tidal volume, respiratory rate, and PEEP must be set and monitored appropriately for different patients and conditions.
The document provides an overview and instructions for setting up and using the Puritan Bennett 980 ventilator. It discusses installing filters, a humidifier, breathing circuit and proximal flow sensor. It also covers powering on the device, performing a short self test, setting up a new patient or same patient, and making parameter changes. The document reviews how the proximal flow sensor impacts monitoring and describes managing and prioritizing alarms.
Definition of LVA Centerline analysis of RWMA on LV angio in 30º RAO shows hypocontractile segments moving more than 2 standard deviations out of normal range.
The document describes various surgical approaches for acquired mitral valve disease. It discusses considerations for mitral valve repair versus replacement and emphasizes the importance of surgeon experience for complex repairs. Standard median sternotomy is described as the most common approach, while minimally invasive approaches through smaller incisions are also discussed. Specific techniques for exposing the mitral valve through the right atrium, interatrial groove, or left atrial dome are outlined. Factors such as concomitant procedures, myocardial protection, and closure are addressed.
Lung transplantation involves removing one or both diseased lungs and replacing them with healthy donor lungs. It is used to treat end-stage lung diseases that are unresponsive to other therapies. The first successful lung transplant was performed in 1963, though early recipients only survived briefly. Advances since then have improved outcomes. Lung transplantation may involve single, double, or heart-lung transplants depending on the condition. Selection criteria evaluate patients' medical status and potential for rehabilitation. Careful donor screening and organ preservation are important for success. Post-operative care focuses on monitoring for complications like infection, acute rejection, and bronchiolitis obliterans syndrome.
This document discusses different ventilator waveforms and modes of ventilation. It describes basic modes like pressure and volume ventilation. It identifies different types of waveform abnormalities that can occur which indicate patient-ventilator desynchrony, such as auto-PEEP, trigger desynchrony, and cycle desynchrony. The document contains diagrams of normal and abnormal ventilator waveforms to help illustrate concepts like auto-PEEP and pressure ventilation flow patterns.
Pumps, oxygenators, and priming solutions are essential components of cardiopulmonary bypass. There are two main types of pumps - roller pumps and centrifugal pumps. Roller pumps work by rolling blood through tubing while centrifugal pumps use centrifugal force to move blood. Membrane oxygenators allow for gas exchange through a semi-permeable barrier, separating blood from gas, and eliminating the damage caused by bubble oxygenators. Proper selection of the components depends on factors such as flow needs, biocompatibility and minimizing trauma to blood during bypass.
This document discusses fetal circulation and how congenital heart defects impact circulation. It notes that fetal circulation differs significantly from neonatal/adult circulation in aspects like gas exchange, ventricular circuitry, dominant ventricle, and presence of anatomical shunts. Key features of normal fetal circulation like distribution of cardiac output and preferential streaming in vessels are described. The effects of various hemodynamic perturbations on fetal cardiac output are reviewed based on studies in fetal lambs. Specific congenital heart defects and their effects on fetal circulation are also summarized.
Mechanical ventilation involves using a ventilator to mechanically move air into and out of the lungs to maintain proper oxygen and carbon dioxide levels. It has several purposes including improving gas exchange, relieving respiratory distress, and avoiding complications. There are various modes of ventilation including pressure control, volume control, and time-cycled modes. Parameters like tidal volume, respiratory rate, and PEEP must be set and monitored appropriately for different patients and conditions.
The document provides an overview and instructions for setting up and using the Puritan Bennett 980 ventilator. It discusses installing filters, a humidifier, breathing circuit and proximal flow sensor. It also covers powering on the device, performing a short self test, setting up a new patient or same patient, and making parameter changes. The document reviews how the proximal flow sensor impacts monitoring and describes managing and prioritizing alarms.
Definition of LVA Centerline analysis of RWMA on LV angio in 30º RAO shows hypocontractile segments moving more than 2 standard deviations out of normal range.
The document describes various surgical approaches for acquired mitral valve disease. It discusses considerations for mitral valve repair versus replacement and emphasizes the importance of surgeon experience for complex repairs. Standard median sternotomy is described as the most common approach, while minimally invasive approaches through smaller incisions are also discussed. Specific techniques for exposing the mitral valve through the right atrium, interatrial groove, or left atrial dome are outlined. Factors such as concomitant procedures, myocardial protection, and closure are addressed.
Lung transplantation involves removing one or both diseased lungs and replacing them with healthy donor lungs. It is used to treat end-stage lung diseases that are unresponsive to other therapies. The first successful lung transplant was performed in 1963, though early recipients only survived briefly. Advances since then have improved outcomes. Lung transplantation may involve single, double, or heart-lung transplants depending on the condition. Selection criteria evaluate patients' medical status and potential for rehabilitation. Careful donor screening and organ preservation are important for success. Post-operative care focuses on monitoring for complications like infection, acute rejection, and bronchiolitis obliterans syndrome.
This document discusses different ventilator waveforms and modes of ventilation. It describes basic modes like pressure and volume ventilation. It identifies different types of waveform abnormalities that can occur which indicate patient-ventilator desynchrony, such as auto-PEEP, trigger desynchrony, and cycle desynchrony. The document contains diagrams of normal and abnormal ventilator waveforms to help illustrate concepts like auto-PEEP and pressure ventilation flow patterns.
Pumps, oxygenators, and priming solutions are essential components of cardiopulmonary bypass. There are two main types of pumps - roller pumps and centrifugal pumps. Roller pumps work by rolling blood through tubing while centrifugal pumps use centrifugal force to move blood. Membrane oxygenators allow for gas exchange through a semi-permeable barrier, separating blood from gas, and eliminating the damage caused by bubble oxygenators. Proper selection of the components depends on factors such as flow needs, biocompatibility and minimizing trauma to blood during bypass.
This document discusses fetal circulation and how congenital heart defects impact circulation. It notes that fetal circulation differs significantly from neonatal/adult circulation in aspects like gas exchange, ventricular circuitry, dominant ventricle, and presence of anatomical shunts. Key features of normal fetal circulation like distribution of cardiac output and preferential streaming in vessels are described. The effects of various hemodynamic perturbations on fetal cardiac output are reviewed based on studies in fetal lambs. Specific congenital heart defects and their effects on fetal circulation are also summarized.
1) An arterial line allows continuous monitoring of a patient's blood pressure by connecting an arterial catheter to a pressure transducer. The transducer converts pressure oscillations into an electrical waveform displayed on a monitor.
2) The arterial waveform provides information about cardiovascular physiology and hemodynamics. An accurate waveform depends on proper catheter placement, monitoring equipment setup, and avoiding issues like dampening or resonance.
3) Key portions of the arterial waveform include the anacrotic limb, representing ventricular ejection; the dicrotic notch, indicating aortic and pulmonary valve closure; and stroke volume variance seen with respiration. Proper waveform analysis guides fluid and pressor management.
Tetralogy of Fallot is a congenital heart defect characterized by four abnormalities: pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, and overriding of the aorta. It occurs in approximately 1 in 2,500 live births. Without treatment, it can cause cyanosis and heart failure in infants. The definitive treatment is open-heart surgery to repair the abnormalities. After successful surgery, patients typically enjoy an active life without symptoms.
ECMO is a form of extracorporeal life support that involves removing blood from the body, oxygenating it using an artificial lung, then returning it to circulate in the body. It can be used for both cardiac and respiratory support for neonates and involves different configurations depending on whether support is needed for the heart, lungs, or both. Indications for ECMO include meconium aspiration syndrome, congenital diaphragmatic hernia, respiratory distress syndrome, and persistent pulmonary hypertension among others. Outcomes have improved over time with advances in technology and experience with the procedure.
This randomized controlled trial compared the effects of 6% hydroxyethyl starch (HES) and saline for fluid resuscitation in over 7,000 critically ill patients. The primary outcome of 90-day mortality was similar between the HES and saline groups. However, the HES group had significantly higher rates of acute kidney injury, renal replacement therapy use, and pruritus. While HES achieved better intravascular volume expansion initially, it provided no clinical benefit and was associated with worse renal outcomes compared to saline for fluid resuscitation in critically ill patients.
Flotrac is a monitoring platform that displays both intermittent and continuous hemodynamic measurements related to the assessment of the essential components of oxygen delivery as well as the balance of oxygen delivery against consumption
The document discusses mitral valve replacement surgery. It defines mitral valve replacement as replacing a diseased mitral valve with a mechanical or tissue valve. Common causes of mitral valve disease include rheumatic fever, infections, and inherited conditions. The document outlines the types of artificial valves used, selection criteria for the procedure, and the roles and responsibilities of nurses in pre-operative, intra-operative, and post-operative care of patients undergoing mitral valve replacement surgery.
This document discusses hemodynamic monitoring, which involves measuring the pressure, flow, and oxygenation of blood within the cardiovascular system. It describes both noninvasive and invasive methods of hemodynamic monitoring. Noninvasive methods include measuring vital signs like blood pressure and heart rate, while invasive methods involve placing catheters in the central circulation to directly measure pressures. Specific invasive monitoring techniques covered are arterial line placement, central venous pressure monitoring via a central line, and pulmonary artery catheterization to measure pressures and determine cardiac output. Normal ranges for various hemodynamic parameters are also provided.
The document discusses mechanical ventilation and various ventilation modes. It describes how mechanical ventilators work using positive or negative pressure to maintain oxygen delivery. Some key ventilation modes discussed include CPAP which maintains continuous elevated airway pressure, PEEP which applies positive pressure at the end of expiration, and SIMV which provides mandatory breaths at set intervals allowing spontaneous breathing in between.
Intra Aortic Balloon Pump by Rubina Shehzadi RNRubina Shehzadi
An intra-aortic balloon pump (IABP) is a type of therapeutic device which helps heart to pump more blood. You may need it if your heart is unable to pump enough blood for your body. The IABP consists of a thin, flexible tube called a catheter. Attached to the tip of the catheter is a long balloon.
Ebstein's anomaly is a congenital heart defect where the tricuspid valve does not form properly, causing the leaflets to displace downward into the right ventricle. This leads to abnormalities in blood flow including back and forth flow between the right atrium and ventricle. Presentation varies from cyanosis and heart failure in infants to fatigue and arrhythmias in adults. Diagnosis involves echocardiogram demonstrating leaflet displacement and abnormalities in right heart structures and blood flow. Treatment depends on severity but may include surgery to repair or replace the tricuspid valve.
Pulmonary embolism is a potentially deadly condition caused by blood clots in the lungs. It is difficult to diagnose due to non-specific symptoms. Imaging tests like CT scans and ventilation-perfusion scans are used to identify clots in the lungs. Prompt diagnosis and treatment are important to reduce the high mortality rate associated with untreated pulmonary embolism.
This document provides information about a seminar on hemodynamic monitoring presented by UMAdevi.k. It discusses the purpose of hemodynamic monitoring in critically ill patients, which is to continuously assess the cardiovascular system and diagnose/manage complex medical conditions. Specific techniques covered include arterial blood pressure monitoring, central venous pressure monitoring, and pulmonary artery catheter pressure monitoring. Key aspects of each technique like indications, equipment, procedures, nursing responsibilities, and potential complications are defined. Normal hemodynamic values are also provided.
Volume control ventilation (ACV) is the most commonly used ventilation mode. It delivers a constant tidal volume with each breath, whether triggered by the ventilator or patient. ACV aims to unload respiratory muscles and improve gas exchange. While it ensures consistent ventilation, ACV also constrains the patient's breathing pattern. Settings like inspiratory flow must be optimized to balance respiratory muscle unloading and patient comfort. ACV is effective for acute respiratory failure but requires adjustments over time as patient needs and lung mechanics change. Future research is needed to better understand patient-ventilator interactions and respiratory muscle function during ACV.
This document discusses various modes of mechanical ventilation. It begins by describing the basic components and functions of a ventilator. The document then explains the key parameters that ventilators can control including tidal volume, frequency, pressure, and time settings. Several common ventilation modes are described including controlled mandatory ventilation (CMV), assist-control ventilation, intermittent mandatory ventilation (IMV), and synchronized intermittent mandatory ventilation (SIMV). Each mode is defined by how the ventilator delivers breaths in terms of being time-triggered or patient-triggered and how breaths are cycled. The advantages and disadvantages of different modes are also briefly discussed.
The key points of the document are:
1) The most important part of pre-use checks on an anesthesia workstation is verifying the presence of a self-inflating resuscitation bag in case of issues with ventilation or oxygenation.
2) An ideal vaporizer would maintain a constant output concentration regardless of changes in gas flow, temperature, pressure, or carrier gas composition, but real vaporizers are affected by these factors.
3) Modern vaporizers use various techniques like temperature compensation and automatic controls to minimize fluctuations in vapor concentration due to changes in ambient conditions.
Module 2.5 Invasive & Non-Invasive VentilationHannah Nelson
Invasive ventilation requires an artificial airway such as an endotracheal tube or tracheostomy tube connected to a mechanical ventilator. Non-invasive ventilation uses a nasal or face mask without an artificial airway. Both methods provide positive pressure to support breathing. Invasive ventilation is used when the airway needs protection or for severe respiratory failure, while non-invasive ventilation is preferred when possible due to lower risk of complications. Careful monitoring is needed for both methods and weaning should begin as soon as the patient can safely breathe independently.
This document discusses mechanical ventilation and its complications. It begins by defining mechanical ventilation as assisted or controlled ventilation using mechanical devices. It then describes invasive mechanical ventilation, which uses an endotracheal or tracheostomy tube, and non-invasive ventilation without an artificial airway. Common indications for mechanical ventilation are then listed. The main body discusses complications of long-term ventilation, including infections like pneumonia, pneumothorax, injuries to the face and airway, gastrointestinal effects, renal effects, disrupted sleep, decubitus ulcers, malnutrition, depression/anxiety, and delirium.
The document provides information on breathing systems used in anesthesia. It discusses the components and classifications of breathing systems. The key types discussed are the Mapleson systems (A, B, C, D, E), which are bidirectional flow systems classified by the placement of the reservoir bag. The Mapleson systems are analyzed in terms of their efficiency for spontaneous and controlled ventilation. The Bain modification of the Mapleson D system is also described.
Pyothorax, or empyema thoracis, is an accumulation of pus in the pleural cavity that is usually caused by bacterial pneumonia. It progresses through three stages - exudative, fibrinopurulent, and organizing. Symptoms include chest pain, cough, fever, and shortness of breath. Diagnosis involves chest x-ray, CT scan, and thoracentesis of pleural fluid. Treatment requires antibiotics, drainage of pus from the pleural space, and sometimes surgical procedures like VATS to debride the pleural space and allow for lung re-expansion. Complications can include bronchopleural fistula, spread of infection, and sepsis.
The Puritan Bennett 980 ICU ventilator system aims to help patients breathe more naturally through innovative breath delivery technology. It uses a simple, safe, and smart design along with advanced synchrony tools to adapt to patient needs and provide appropriate ventilation support. Compared to conventional ventilation, it is designed to improve patient comfort while reducing the need for sedation. Extensive research and testing went into its development to ensure it effectively compensates for leaks, measures respiratory mechanics, and continues functioning even if certain systems fail.
The document provides an overview of ventilator use, including basic equipment, terminology, settings, and procedures. It discusses checking ventilators, recommended initial settings for adult patients, different ventilation modes, transporting intubated patients, available resources, and types of ventilators. Safety procedures are emphasized, such as using standby mode before transferring patients or turning ventilators off and on.
1) An arterial line allows continuous monitoring of a patient's blood pressure by connecting an arterial catheter to a pressure transducer. The transducer converts pressure oscillations into an electrical waveform displayed on a monitor.
2) The arterial waveform provides information about cardiovascular physiology and hemodynamics. An accurate waveform depends on proper catheter placement, monitoring equipment setup, and avoiding issues like dampening or resonance.
3) Key portions of the arterial waveform include the anacrotic limb, representing ventricular ejection; the dicrotic notch, indicating aortic and pulmonary valve closure; and stroke volume variance seen with respiration. Proper waveform analysis guides fluid and pressor management.
Tetralogy of Fallot is a congenital heart defect characterized by four abnormalities: pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, and overriding of the aorta. It occurs in approximately 1 in 2,500 live births. Without treatment, it can cause cyanosis and heart failure in infants. The definitive treatment is open-heart surgery to repair the abnormalities. After successful surgery, patients typically enjoy an active life without symptoms.
ECMO is a form of extracorporeal life support that involves removing blood from the body, oxygenating it using an artificial lung, then returning it to circulate in the body. It can be used for both cardiac and respiratory support for neonates and involves different configurations depending on whether support is needed for the heart, lungs, or both. Indications for ECMO include meconium aspiration syndrome, congenital diaphragmatic hernia, respiratory distress syndrome, and persistent pulmonary hypertension among others. Outcomes have improved over time with advances in technology and experience with the procedure.
This randomized controlled trial compared the effects of 6% hydroxyethyl starch (HES) and saline for fluid resuscitation in over 7,000 critically ill patients. The primary outcome of 90-day mortality was similar between the HES and saline groups. However, the HES group had significantly higher rates of acute kidney injury, renal replacement therapy use, and pruritus. While HES achieved better intravascular volume expansion initially, it provided no clinical benefit and was associated with worse renal outcomes compared to saline for fluid resuscitation in critically ill patients.
Flotrac is a monitoring platform that displays both intermittent and continuous hemodynamic measurements related to the assessment of the essential components of oxygen delivery as well as the balance of oxygen delivery against consumption
The document discusses mitral valve replacement surgery. It defines mitral valve replacement as replacing a diseased mitral valve with a mechanical or tissue valve. Common causes of mitral valve disease include rheumatic fever, infections, and inherited conditions. The document outlines the types of artificial valves used, selection criteria for the procedure, and the roles and responsibilities of nurses in pre-operative, intra-operative, and post-operative care of patients undergoing mitral valve replacement surgery.
This document discusses hemodynamic monitoring, which involves measuring the pressure, flow, and oxygenation of blood within the cardiovascular system. It describes both noninvasive and invasive methods of hemodynamic monitoring. Noninvasive methods include measuring vital signs like blood pressure and heart rate, while invasive methods involve placing catheters in the central circulation to directly measure pressures. Specific invasive monitoring techniques covered are arterial line placement, central venous pressure monitoring via a central line, and pulmonary artery catheterization to measure pressures and determine cardiac output. Normal ranges for various hemodynamic parameters are also provided.
The document discusses mechanical ventilation and various ventilation modes. It describes how mechanical ventilators work using positive or negative pressure to maintain oxygen delivery. Some key ventilation modes discussed include CPAP which maintains continuous elevated airway pressure, PEEP which applies positive pressure at the end of expiration, and SIMV which provides mandatory breaths at set intervals allowing spontaneous breathing in between.
Intra Aortic Balloon Pump by Rubina Shehzadi RNRubina Shehzadi
An intra-aortic balloon pump (IABP) is a type of therapeutic device which helps heart to pump more blood. You may need it if your heart is unable to pump enough blood for your body. The IABP consists of a thin, flexible tube called a catheter. Attached to the tip of the catheter is a long balloon.
Ebstein's anomaly is a congenital heart defect where the tricuspid valve does not form properly, causing the leaflets to displace downward into the right ventricle. This leads to abnormalities in blood flow including back and forth flow between the right atrium and ventricle. Presentation varies from cyanosis and heart failure in infants to fatigue and arrhythmias in adults. Diagnosis involves echocardiogram demonstrating leaflet displacement and abnormalities in right heart structures and blood flow. Treatment depends on severity but may include surgery to repair or replace the tricuspid valve.
Pulmonary embolism is a potentially deadly condition caused by blood clots in the lungs. It is difficult to diagnose due to non-specific symptoms. Imaging tests like CT scans and ventilation-perfusion scans are used to identify clots in the lungs. Prompt diagnosis and treatment are important to reduce the high mortality rate associated with untreated pulmonary embolism.
This document provides information about a seminar on hemodynamic monitoring presented by UMAdevi.k. It discusses the purpose of hemodynamic monitoring in critically ill patients, which is to continuously assess the cardiovascular system and diagnose/manage complex medical conditions. Specific techniques covered include arterial blood pressure monitoring, central venous pressure monitoring, and pulmonary artery catheter pressure monitoring. Key aspects of each technique like indications, equipment, procedures, nursing responsibilities, and potential complications are defined. Normal hemodynamic values are also provided.
Volume control ventilation (ACV) is the most commonly used ventilation mode. It delivers a constant tidal volume with each breath, whether triggered by the ventilator or patient. ACV aims to unload respiratory muscles and improve gas exchange. While it ensures consistent ventilation, ACV also constrains the patient's breathing pattern. Settings like inspiratory flow must be optimized to balance respiratory muscle unloading and patient comfort. ACV is effective for acute respiratory failure but requires adjustments over time as patient needs and lung mechanics change. Future research is needed to better understand patient-ventilator interactions and respiratory muscle function during ACV.
This document discusses various modes of mechanical ventilation. It begins by describing the basic components and functions of a ventilator. The document then explains the key parameters that ventilators can control including tidal volume, frequency, pressure, and time settings. Several common ventilation modes are described including controlled mandatory ventilation (CMV), assist-control ventilation, intermittent mandatory ventilation (IMV), and synchronized intermittent mandatory ventilation (SIMV). Each mode is defined by how the ventilator delivers breaths in terms of being time-triggered or patient-triggered and how breaths are cycled. The advantages and disadvantages of different modes are also briefly discussed.
The key points of the document are:
1) The most important part of pre-use checks on an anesthesia workstation is verifying the presence of a self-inflating resuscitation bag in case of issues with ventilation or oxygenation.
2) An ideal vaporizer would maintain a constant output concentration regardless of changes in gas flow, temperature, pressure, or carrier gas composition, but real vaporizers are affected by these factors.
3) Modern vaporizers use various techniques like temperature compensation and automatic controls to minimize fluctuations in vapor concentration due to changes in ambient conditions.
Module 2.5 Invasive & Non-Invasive VentilationHannah Nelson
Invasive ventilation requires an artificial airway such as an endotracheal tube or tracheostomy tube connected to a mechanical ventilator. Non-invasive ventilation uses a nasal or face mask without an artificial airway. Both methods provide positive pressure to support breathing. Invasive ventilation is used when the airway needs protection or for severe respiratory failure, while non-invasive ventilation is preferred when possible due to lower risk of complications. Careful monitoring is needed for both methods and weaning should begin as soon as the patient can safely breathe independently.
This document discusses mechanical ventilation and its complications. It begins by defining mechanical ventilation as assisted or controlled ventilation using mechanical devices. It then describes invasive mechanical ventilation, which uses an endotracheal or tracheostomy tube, and non-invasive ventilation without an artificial airway. Common indications for mechanical ventilation are then listed. The main body discusses complications of long-term ventilation, including infections like pneumonia, pneumothorax, injuries to the face and airway, gastrointestinal effects, renal effects, disrupted sleep, decubitus ulcers, malnutrition, depression/anxiety, and delirium.
The document provides information on breathing systems used in anesthesia. It discusses the components and classifications of breathing systems. The key types discussed are the Mapleson systems (A, B, C, D, E), which are bidirectional flow systems classified by the placement of the reservoir bag. The Mapleson systems are analyzed in terms of their efficiency for spontaneous and controlled ventilation. The Bain modification of the Mapleson D system is also described.
Pyothorax, or empyema thoracis, is an accumulation of pus in the pleural cavity that is usually caused by bacterial pneumonia. It progresses through three stages - exudative, fibrinopurulent, and organizing. Symptoms include chest pain, cough, fever, and shortness of breath. Diagnosis involves chest x-ray, CT scan, and thoracentesis of pleural fluid. Treatment requires antibiotics, drainage of pus from the pleural space, and sometimes surgical procedures like VATS to debride the pleural space and allow for lung re-expansion. Complications can include bronchopleural fistula, spread of infection, and sepsis.
The Puritan Bennett 980 ICU ventilator system aims to help patients breathe more naturally through innovative breath delivery technology. It uses a simple, safe, and smart design along with advanced synchrony tools to adapt to patient needs and provide appropriate ventilation support. Compared to conventional ventilation, it is designed to improve patient comfort while reducing the need for sedation. Extensive research and testing went into its development to ensure it effectively compensates for leaks, measures respiratory mechanics, and continues functioning even if certain systems fail.
The document provides an overview of ventilator use, including basic equipment, terminology, settings, and procedures. It discusses checking ventilators, recommended initial settings for adult patients, different ventilation modes, transporting intubated patients, available resources, and types of ventilators. Safety procedures are emphasized, such as using standby mode before transferring patients or turning ventilators off and on.
nice Neotech Medical Systems Pvt. Ltd is an Indian company established in 1997 that produces medical devices for neonatal care. The presentation discusses their nice 5020 infant resuscitator, which provides controlled and precise ventilation for newborns in need of respiratory support. Key features of the resuscitator include adjustable peak inspiratory pressure, positive end expiratory pressure, and maximum pressure settings. Accessories like a humidifier and air/oxygen blender are also described. Maintenance procedures and product specifications are reviewed.
MECHANICAL VENTILATOR OD22BEE GROUP 7.pptxmendu7000
The document discusses equipment used in an intensive care unit, focusing on ventilators. It provides an introduction to ventilators, describes the basic components and parts of mechanical ventilators. It also covers the basic operating principles of ventilators, common ventilation modes, maintenance procedures and troubleshooting steps. Standard operating procedures for ventilating a patient are also outlined.
The document provides guidance on managing endotracheal tubes in the pediatric intensive care unit (PICU). It describes appropriate endotracheal tube sizes and intubation methods, maintaining a patent airway, assessing tube placement, identifying cuff pressures, and ventilating patients using tubes connected to a Servo-I ventilator with oxygen and nitric oxide. Diagrams show airway anatomy and endotracheal tube components. Guidelines address securing tubes, calculating suction catheter sizes, and performing nebulizer treatments continuously or intermittently.
The document outlines Maine's new airway management algorithm which was developed in response to quality assurance concerns. The algorithm provides a step-by-step process for evaluating and managing a patient's airway from basic to advanced life support. It also reviews various airway devices and procedures, outlines mandatory equipment requirements, and provides training objectives for providers.
This document describes a disposable ventilator called the Vortran Automatic Resuscitator (VAR). It summarizes the VAR's features such as being lightweight, easy to use, and compatible with MRI/CT. It can provide pressure cycled or pressure support ventilation. The VAR aims to address challenges with manual resuscitators like inconsistent ventilation. It is meant for short-term use during transport, procedures, or emergencies. The document outlines the VAR's applications in hospitals and disasters. It also discusses the VAR's safety features and quality standards.
Spirometry for Primary Care Physician OfficeRandy Clare
Step by step description of how to collect spirometry tests for Asthma and COPD. Quality control tips supported by literature with links to NIH, NIOSH and the Mayo Clinic. This is a presentation that I use to discuss hand held spirometry products from Carefusion. Micro Loop, Micro Lab, Micro 1 and Pulmolife
H sk circuit guard powerpoint presentationSteve Koontz
ARC Medical produces the circuitGuard system, a single-use filter that connects between the patient and anesthesia breathing circuit. It protects patients from potential contamination between uses of the circuit by filtering gases with >99.99% efficiency. Using circuitGuard allows facilities to reuse anesthesia circuits rather than discarding them after each patient, reducing waste and costs while maintaining patient safety as validated by independent testing showing the filter prevents cross-contamination.
This document summarizes recent developments in airway management. It discusses new techniques for preoperative airway assessment including nasopharyngoscopy and use of ultrasound. It also discusses newer airway devices like videolaryngoscopes and second-generation supraglottic airways. Issues around techniques like cricoid pressure and extubation of difficult airways are analyzed. The importance of human factors, simulation-based training and dissemination of difficult airway information is emphasized to improve patient safety.
The document provides an overview of mechanical ventilation using the Medumat Standard 2 ventilator. It discusses the ventilator's modes of ventilation including IPPV, CPAP, BiPAP, PCV, SIMV, and PRVC. It also covers initial setup based on patient height and weight, ventilator strategies, adjusting settings to optimize oxygenation and ventilation, ventilator curves and alarms, troubleshooting, and the use of non-invasive ventilation with CPAP and BiPAP modes. The primary mode discussed for most patients is IPPV, and adjustments to settings like respiratory rate and PEEP/FiO2 are recommended to maintain normocarbia and optimal oxygenation.
The document provides instructions for using the Exacta external drainage and monitoring system. It describes how to assemble the various components such as attaching the drainage system to an IV pole and patient line. Instructions are given for priming the system to remove air, leveling the drainage to the patient's head, setting the pressure threshold, zeroing the pressure transducer, and positioning the stopcock. Diagrams accompany the text to illustrate the assembly and setup of the Exacta system.
nice Neotech Medical Systems is an Indian company established in 1997 that produces medical devices including Bubble CPAP systems. Bubble CPAP provides non-invasive respiratory support for infants by maintaining positive airway pressure. The company's Bubble CPAP systems feature accurate pressure delivery, humidification, and an integrated gas blender. nice Neotech has grown to over 125 employees and 4000 satisfied customers while achieving certifications like CE and FDA approval.
This document provides information about using bi-level positive airway pressure (BIPAP) ventilation for pediatric patients. It describes what BIPAP is, why patients may need it, how BIPAP works, appropriate patient care and monitoring, potential complications, equipment cleaning, and case studies. Nurses, respiratory therapists, and physicians will work as a team to care for pediatric patients receiving BIPAP treatment according to the hospital's policies and procedures.
Mechanical ventilators- Applications and Usageshashi sinha
The Medical Ventilators are also known as Mechanical Ventilators, Artificial Ventilators etc. We will henceforth refer all these as Ventilators.
When a patient breathes on its own it is known as Spontaneous Breathing and when the patient is unable to breathe on its own we use a device called Ventilator which helps the patient breathe artificially. This is called Mechanical Ventilation and is a method to mechanically assist the patient to breathe and in extreme cases replace the entire breathing process. Spontaneous breathing is done by a process called Respiratory System.
Based on the information provided:
1. The appropriate ICD-10-PCS code for mechanical ventilation would be 5A1935Z Continuous mechanical ventilation for less than 24 hours.
2. An additional ICD-10-PCS code for the endotracheal intubation would be 0BH17EZ Insertion of endotracheal airway into trachea via natural or artificial opening.
3. The principal diagnosis would be J21.0 Acute bronchiolitis due to respiratory syncytial virus.
4. A secondary diagnosis for the ventricular septal defect would be Q21.0 Ventricular septal defect.
5. Other significant conditions treated such as the antibiotics
This document provides information on mechanical ventilation management. It discusses the goals of airway management and indications for mechanical ventilation. The roles of nurses include monitoring patients on ventilators and notifying respiratory therapists when issues arise. There are two main types of ventilators and settings must be individualized. Modes of ventilation are described along with weaning and extubation processes. Alarms are addressed and their common causes.
This document provides guidance on vacuum aspiration (VA) procedures for early pregnancy termination. It discusses the objectives of VA training and describes the parts and proper preparation of manual vacuum aspiration (MVA), foot pump suction evacuation (FSE), and electric vacuum aspiration (EVA) equipment. The steps of the VA procedure are outlined, including pre-procedure client care, the evacuation process, and post-procedure care and record keeping. Potential technical and procedural problems are reviewed with solutions.
HEPA filters are recommended for use with bag valve masks to filter expired air from patients with influenza or coronavirus. They fit between the BVM valve and mask or endotracheal tube. HEPA filters protect patients, equipment, and providers by filtering out bacteria, viruses, water droplets, and other particles from ambient air and patient exhalation. Precautions must be taken if filters become obstructed by secretions to avoid increased airway pressures and ventilation issues.
El documento proporciona información técnica sobre el oxicapnógrafo portátil Capnostream 35. El dispositivo monitorea continuamente los niveles de dióxido de carbono espirado, frecuencia respiratoria, saturación de oxígeno y pulso. Incluye especificaciones sobre las características del monitor, la pantalla, la capnografía, la pulsioximetría, las alarmas, y los requisitos de funcionamiento, almacenamiento y conformidad.
Este documento proporciona información técnica sobre un monitor para capnografía y oximetría de pulso. El monitor monitorea de forma continua valores como el dióxido de carbono al final de la respiración, la frecuencia respiratoria, la saturación de oxígeno y el ritmo cardiaco. Incluye especificaciones sobre sus características, pantalla, alarmas, batería, conexiones y clasificación.
Este documento proporciona información sobre un electrodo de retorno universal fabricado por Covidien/ValleyLab. Describe las características del electrodo, incluido su tamaño, área de conductividad efectiva, composición del gel adhesivo y características de seguridad. También especifica que el electrodo es libre de látex, PVC y DEHP, y debe almacenarse a temperatura ambiente en su empaque original sellado para evitar el exceso de calor.
SISTEMA DE DISECCIÓN ULTRASÓNICO SONICISION™IME COLOMBIA
El documento describe el sistema de disección ultrasónica inalámbrico SonicisionTM con mandíbula curva, incluyendo sus características, beneficios y mejoras tecnológicas en comparación con la generación anterior y otros sistemas competidores. Ofrece un acceso más preciso a los tejidos, mayor libertad de movimiento para el cirujano y una limpieza y esterilización optimizadas.
The Valleylab LS10 generator contains LigaSure vessel sealing technology. It is indicated for sealing vessels up to 7mm in diameter and tissue bundles during general surgery. LigaSure technology uses pressure and radiofrequency energy to fuse vessels and lymphatics without sutures or clips. Clinical studies show LigaSure reduces operative blood loss and complications, while also decreasing procedure time and length of hospital stay compared to mechanical ligation. The generator automatically controls energy delivery, with a double beep signaling when the seal is complete.
Este documento describe una unidad electroquirúrgica microprocesada portátil que ofrece calidad y rendimiento para procedimientos quirúrgicos básicos en entornos ambulatorios de manera asequible. La unidad incluye 11 modos monopolares y bipolares para un mayor control, características de seguridad como el monitoreo del electrodo de retorno para reducir quemaduras, y 4 modos de ECUT pulsada para la resección eficiente de tejidos. El dispositivo es compacto, portátil, de fácil uso y reduce los
La plataforma de energía Force Triad proporciona energía monopolar, bipolar y sellado de vasos en una sola unidad. Ofrece cinco modalidades de salida de energía, incluidos modos de corte, coagulación y bipolar, así como la tecnología Ligasure para sellado de vasos. El sistema monitorea la calidad del electrodo de retorno y detiene la energía si se compromete la posición del electrodo.
Este manual proporciona instrucciones sobre el uso y mantenimiento del videolaringoscopio McGRATH® MAC. Describe las características y especificaciones técnicas del dispositivo, incluida su batería y hojas desechables. También incluye procedimientos de limpieza, desinfección, almacenamiento y resolución de problemas, así como información sobre garantía y cumplimiento normativo.
Este generador de electrocirugía proporciona corte y coagulación monopolar y bipolar, monitorea la calidad del contacto del paciente, y tiene varios modos de salida y potencias. Pesa 8,1 kg y mide 11,1 x 35,6 x 43,9 cm. Requiere una alimentación de 85-132 VAC y 50-60 Hz, y se puede montar en un carro o base. Incluye características como tecnología de respuesta instantánea del tejido y coagulación simultánea.
El electrocardiógrafo BeneHeart R3 de Mindray ofrece un diagnóstico preciso de ECG en reposo mediante el algoritmo de Glasgow, el cual considera factores como la edad, el sexo, la raza, los medicamentos y la clase del paciente. Destaca diagnósticos críticos como infarto agudo de miocardio e isquemia aguda de miocardio. Cuenta con una pantalla a color de alta resolución, batería de larga duración, peso ligero y compatibilidad con diferentes formatos de papel para registro, lo que lo hace portá
Este documento describe una bomba de infusión de un canal con múltiples modos de infusión, pantalla táctil, batería recargable y protección contra flujo libre. La bomba ofrece seis modos de infusión y alarma si hay oclusión u otros errores. Es portátil, precisa y fácil de usar.
Este documento describe un carro hospitalario de plástico ecológico con 5 módulos con correderas de aluminio de diferentes tamaños, una chapa de seguridad para bloquear los módulos, una bandeja portamonitor o multiusos y una bandeja lateral extraíble. El carro también incluye una tabla CPR para reanimaciones, correas para sujetar una bala de oxígeno y un cable eléctrico, y un atril portasueros de 4 ganchos con altura ajustable. Tiene ruedas de plá
Este documento proporciona información técnica sobre un succionador quirúrgico, incluyendo su capacidad de 5,000 ml dividido en dos botellas de 2,500 ml cada una, un motor de pistón seco de 1/8 Hp, una presión negativa ajustable de 0-330 mm/Hg, control de llenado automático, panel de control de polietileno de alta densidad, y accesorios como botellas, tapas, mangueras y cable de corriente. El succionador está destinado a usos quirúrgicos, debe al
El documento presenta la ficha técnica del sistema de calentamiento por convección WarmTouch WT 6000. El sistema consiste en una unidad térmica que suministra aire caliente a través de una manta para evitar y tratar la hipotermia. La unidad ofrece varios ajustes de temperatura, filtro HEPA y protección contra temperaturas extremas. Se incluyen especificaciones técnicas, modo de funcionamiento, mantas disponibles y conformidad con normas.
Sistema De Gestión De Equipos EndoscopiaIME COLOMBIA
This document provides information about the NAVIGATOR Endoscopy Equipment Management System made by NUVO, including:
- Details on different models including reach, weight limits, and number of service heads
- Diagrams showing front, back, left and right views of the systems and cutout details
- A brief description of how the system can increase efficiency and number of procedures by centralizing endoscopy equipment off the floor within easy reach of medical staff.
This document outlines the specifications for several general purpose radiographic systems from EcoRay including the HF-525PLUS. It describes the key components of systems ranging from 400mA/125kVp to 800mA/150kVp including the x-ray tube, generator, output console, tube stand, controller, bucky table, and other optional upgrades. The document provides technical details on the components and capabilities of different output levels for radiographic imaging systems.
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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 |
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 |
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 |
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 |
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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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)
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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
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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
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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.
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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.
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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.
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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.
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66. Yellow Triangle - Unread items icon.
Pay Attention - Check or View the Tab Prompt
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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
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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.
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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.
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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.
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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.
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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
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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.