Becton Dickinson avea AVEA ventilator user guide critical care ventilation

AVEA® ventilator
user guide

Critical care ventilation

Table of contents

AVEA® front panel..........................................1

AVEA rear panel .............................................2

Circuit assembly .............................................3

Disposable filter and water trap insertion ....... 6

Patient circuit assembly .................................. 7

Attaching flow sensors ................................8-9

User verification test ....................................10

Performing an EST test ........................11-13

Setting the ventilation mode ........................ 14

Graphics ......................................................15

Loops ........................................................... 16

Configure Loops screen ...............................17

Freeze ..........................................................18

Saving loops ................................................19

Create reference loops .................................20

Rear panel connections ................................ 27

Ventilator operations ....................................28

The AVEA ventilator User Guide is not intended as a replacement for the operator’s manual. You must
become completely familiar with the AVEA ventilator operator’s manual before using the AVEA ventilator.

Connecting gas sources ............................... 37

Touch-Turn-Touch™/Touch-Turn-Accept™ .......38

New patient setup .......................................39

Setting the breath type and mode ................ 40

Infant mode select screen ............................41

Setting nCPAP/IMV ...................................... 42

Setting the breath type and mode ................ 44

Breath type and mode .................................45

Monitored parameters ................................. 46

The Monitor screen ......................................47

Graphics ......................................................48

Waveforms .................................................. 49

Events ..........................................................50

Trends ..........................................................51

Synchronized nebulizer ................................ 52

Alarms ......................................................... 53

Notes ......................................................55-57

i

AVEA ventilator front panel

C

E

A

D

A. Membrane buttons

B. Data dial

C. Screen indicators

D. Monitored parameters

E. Screen graphics

F. Primary controls

G. Message window

H. Patient type

F

B

H

G

1

AVEA ventilator rear panel

B

KC

A. AC power module

B. UIM connection

C. Analog input /output/ILV

D. Power on/off switch

A

E. Nurse’s call jack

J

F. Air/heliox smart connector

I

E

G. Oxygen sensor

D

H. Oxygen connection

I. External battery

H

connector

F

J. External battery fuse

K. Internal battery fuse

G

2

Circuit assembly

Assembling the exhalation filter and water trap

1.

2.

3

3. Align the locating ridge on the water
trap assembly with the slot in the
exhalation filter cartridge.

4. Slide the water trap/exhalation filter
assembly into the cartridge.

4

5. Open locking lever. 6. Insert exhalation filter.

5

Disposable filter and water trap insertion

AVEA ventilator di spos able
water tra p.

Inser t car tridge into filter cav ity.
Close lever whe n fully in ser ted.

6

Cart ridge f ully ins erted with
lever clo sed.

Patient circuit assembly

The passive humidification system should be placed in-line in the patient circuit per the
manufacturer’s instructions.

Patient circuit with active humidifier Patient circuit without active humidifier

Inspiratory limb
of patient circuit

7

Attaching flow sensors

The AVEA ventilator can accept either a hot wire or a variable orifice proximal flow sensor.
The monitored values displayed for volume and flow is proximal values when a proximal sensor
is in use. These are in addition to the instrument’s internal inspiratory flow sensor and heated
expiratory flow sensor.

Variable orifice flow sensor Hot wire flow sensor

Retractable
plastic collar

These are locking connectors. To attach, first pull back the plastic locking collar, then push
firmly onto the ventilator receptacle. Then push the locking collar forward to lock the flow
sensor in place.

To disconnect, first retract the plastic collar then firmly pull the connector away from the
ventilator. Do not pull up or down as this can damage the connector.

8

Attaching flow sensors (continued)

The standard hot wire flow sensor is suitable for neonatal and pediatric applications
where the peak inspiratory flow rate is less than 30 L /min. This flow sensor is not active in
adult applications.

NOTE: Hot wire flow sensors will not function with Heliox gas mixtures. During Heliox delivery,
a variable orifice flow sensor should be used for monitoring delivered volumes at the proximal
airway. Variable orifice flow sensors are also available on some AVEA ventilator models. The
neonatal VariFlex flow sensor is compatible in neonatal and pediatric applications where the
peak inspiratory flow rate is less than 30 L/min and is not active in adult applications. For
adult and large pediatric applications, a pediatric / adult VariFlex flow sensor is available for
use with patients whose flow requirements fall within the range of 1.2 to 180 L/min. Detailed
information on the specifications of each flow sensor can be found in Appendix E: Sensor
specifications and circuit resistance of the AVEA ventilator operator’s manual.

Hot wire flow sensor must be zeroed prior to use. Follow operator manual instructions.

9

User verification test

The User Verification Test consists of three separate elements:

1. Post Test: Automatic on power up. Normal ventilation begins after completion.

2. Extended System Test (EST)

• Patient circuit leak test

• Patient circuit compliance measurement

• Two-point calibration of O2 sensor

3. Manual Alarms Testing: Detailed instructions are found in Ch. 2 of the AVEA ventilator
operator’s manual.

10

User verification test (continued)

Performing an Extended Systems Test (EST):

The EST is accessed from the Setup screen. To open this screen, press the Setup button on the
lower left of the user interface. Select the appropriate Patient Size and proceed to second menu
of Setup screen.

Press the EST button to access the EST screen

11

Performing an Extended Systems Test (EST) (continued)

Remove the patie nt and bl ock
the patient wye, then p ress the
Continu e (Cont) but ton.

All tests are performed
simult aneou sly. The m aximu m
time for the EST is 9 0 seco nds.
To restar t the ES T at any tim e,
selec t the Cancel bu tton to
return to the Setup screen.

Press the Conti nue button to
return to the Setup screen.

When possible the EST should be performed with an oxygen supply connected. A two point
calibration of the oxygen sensor is performed during the EST.

NOTE: If you do not connect the ventilator to an oxygen supply, the O

sensor calibration

2

will immediately fail.

CAUTION: Although failure of any of the above tests will not prevent the ventilator
from functioning, it should be checked to make sure it is operating correctly before use
on a patient.

12

Performing an Extended Systems Test (EST) (continued)

When possible the EST should be performed with an oxygen supply connected. A two point
calibration of the oxygen sensor is performed during the EST.

NOTE: If you do not connect the ventilator to an oxygen supply, the O2 sensor calibration
will immediately fail.

CAUTION: Although failure of any of the above tests will not prevent the ventilator
from functioning, it should be checked to make sure it is operating correctly before use
on a patient.

13

Setting the ventilation breath type and mode

Advanced settings

You can further refine delivery of the breath by accessing the Advanced Settings. Not all
primary controls have advanced settings. Primary Controls that feature advanced settings
will display a yellow triangle to the right of the control name.

Accessing the advanced settings

Press the Adv Se ttings
membrane but ton.

Press the primary con trol to di splay th e advan ced
settings available fo r that pa rticular cont rol.

14

Graphics

Configure main screen graphics for scale and sweep speed

1. Touch the vertical or horizontal axis

to highlight.

2. Turn the data dial to adjust scale or

sweep speed. Touch the axis again
or press the Accept button to confirm
the changes.

15

Loops

Accessing the Loops screen

To access the Loops screen, press the screen
indicator or the Screens membrane button on
the left of the UIM. Select Loop.

SCREEN SELECT

MAIN MONITOR

LOOP

STANDBYMANEUVERTRENDS

UTILITY

Choice of loops

The ventilator displays two loops in real time, selected from the following. Touch the Loop
heading to open the scrollable menu. Press the Accept button or touch the Loop heading to
confirm the change.

• Vt - Flow Flow / Volume loop.

• PAW - Vt Airway Pressure / Volume loop.

• PINSP - Vt Inspiratory Pressure / Volume loop.

16

Configure Loops screen

Change vertical and horizontal scales with Touch-Turn-Touch or Touch-Turn-Accept techniques.

1. Touch the vertical or horizontal axis

to highlight.

250 500 750

2. Turn the data dial to adjust the scale.
Touch the axis again or press the Accept
button to confirm the change.

17

Freeze

The Freeze button freezes the current
screen and suspends real-time update
of data until pressed again. When a
screen is frozen you can use the data dial
to scroll through displayed waveforms,
loops or trends.

A Flow/ Volume loop in Freeze mode is
shown below. As the dotted line cursor
traces the Frozen loop, flags display the
values along the curve of the loop.

Flow/ Volum e
loop trac ing

18

270

0.0

250 500 750

Flags sho wing
X and Y value s
at variou s
points a long
the loop t racing

Cursor c urrentl y
overlays th e “X”
axis at zer o

Saving loops

1. Press the Freeze button to freeze the

graphics display.

2. Press Save Loop.

3. Saved loops will appear with a
time reference. A total of 4 loops
can be saved at any time. If a 5
loop is selected, the oldest saved
loop is removed.

th

19

Create reference loops

1. Press the Freeze button to freeze the
graphic display.

2. Touch the saved loop you want as a reference.

3. Press Ref Loop Off to toggle the Ref Loop On.

4. Press the Freeze button to return to live loops
display over the reference loop.

To remove the reference loop, press the Freeze

button. Then press the Ref Loop On button to
turn off the reference loop.

20

Message Alarm condition Range Priority

High PPEAK Peak inspiratory pressure is greater tha n the

High nCPAP
pressure

set high PP EAK. Inspiration is terminated and
the circuit p ressure is allowed to return to
baseline pressure + 5 ± 1.5 cmH
next bre ath is deli vered.

Pressure during nCPAP exceeds the high
airway pressure threshold for a perio d of
greater tha n 20 seconds.

Pressure during nCPAP falls below the low
airway pressure threshold for a perio d of
greater tha n 20 seconds.

O before the

2

Normal breath rang e:
10 to 105 cmH
Default 75 cmH
10 to 85 cmH
Default 50 cmH
(Inspirator y pressure +3 cmH
rate not zero )
Sigh Breath Range: 1.5

Thresho ld: Set CPAP +c cmH
±0.5 cmH

Thresho ld: Set CPAP level -2 cmH
CPAP ≥ 3 cmH
(if set CPAP le vel <3 cmH

O (adult /pediatric)

2

O

2

O (neonate)

2

O nCPAP/ IMV 2 to 45 cmH20

2

0

2

0) or set CPAP level -1 cmH20

2

0, nCPAP/ IMV

2

0 tolerance

2

0)

2

0 (if set

2

High

High

High

21

Message Alarm condition Range Priority

nCPAP Pressure
Limit

Low Ppeak Low P peak is displayed an d a high prio rity

High Ppeak,
SUST

Low PEEP Baseline pressure (Posi tive End E xpiratory

Activated when nCPAP pressure is greater
than airway pressure for 3 seco nds.
Deactivated wh en nCPAP pressure drops
below 4.5 cmH

tone sounds, whenever the pe ak inspiratory
pressure for a given bre ath is les s than the
preset threshold fo r Low Ppeak.

Activates whenever the High Ppeak alarm has
been ac tive for mo re than 5 seconds (i.e., if
the circuit p ressure fails to return to PEEP +
5 cmH
exhalation valves open and no breaths are
delivered. The Safety Valve O pen alar m acti ­vates. Bia s flow is suspended w hile this alarm
is active. PEEP may not b e maintained. This
alarm will remain active until t he condition
is resolv ed.

Pressure) is less than the set Low PEEP alarm
threshold for a period greater than 0.25 ±

0.05 seconds. This alarm is of f if set to zero.

0.

2

0 within 5 se conds) . The safety and

2

Pressure Limit: 11 cmH20 (nCPAP only, rate
set to off )
Set CPAP level + I nspirato ry pres sure + 3

0 (nCPAP/ IMV, rate not zero)

cmH

2

Range: 3 to 99 cmH
Defaults: 8 cmH

0 (neonate) for nCPAP / IMV: 1-40

5 cmH

2

0 (neonatal –nCPAP/ IMV )

cmH

2

Limitat ions: N ot acti ve for
spontan eous breaths

0

2

0 (adult /pediatric)

2

High

High

N/A High

0 to 60 cmH
Defaults:3 cmH

0 (neonate)

1 cmH

2

0

2

0 (adult /pediatric)

2

High

22

Message Alarm condition Range Priority

Low Ve Monitored exhaled minute volume (Ve) is less

High Ve Monitored exhaled minute volume (Ve) is

Flow Sens or
Error (ne onatal
volume
guarantee o nly)

Low expired
volume

than the set Low Ve alarm threshold.

greater tha n the set High Ve alarm threshold.

Occurs when 1) neonatal flow s ensor is in
use 2) volume guarante e is enabled and

3) monitored Vti drops below 20% of net
delivered volume. T he system will revert to
operator set inspiratoy pressure.

When volume guarantee is active and
monitore d expiratory tid al volume is less than
the set threshold of the volume t arget.

Off ( 0), 1 to 50 L (adult )
Off(0), 0.1 to 30 L (ped iatric)
Off ( 0), 0.01 to 5.00 L (neonate )
Default Off

0 to 75 L (adult)

0.0 to 30.0 L (pediatr ic)

0.00 to 5.0 0 L (neo nate)
Defaults: 30.0 L (adult /pediatric)

Neonat al mode w ith volum e guarantee
active, D elay is 3 breaths or 10 sec if greater,
or 30 sec if l ess

Neonat al mode w ith volum e guarantee
active, 3 0 sec or 10 breaths, whichever
is greater

High

High

Medium

Medium

23

Message Alarm condition Range Priority

High Vt The absolute m onitored exhaled tidal volume

Apnea Interval Active in A /C, SIMV, APRV / BiPhasic and CPAP/

High Rate The monitored total breath rate exceeds the set

I-Time Limit The inspiratory t ime for a brea th plus pause

Limit The I: E ratio for a mandatory breat h

Low FiO

2

High FiO

2

Circuit
Disconnect

is greater than the set High Vt alar m thresho ld.
(Inactive when using Volume Guarantee in
Neonat al mode )

PSV modes if the ve ntilator d oes not detect a
breath within the pre set Apnea time interval.

High Rate alarm threshold.

time exceeds 5.0 seconds for adult/ pediatric
patient s and 3.0 seconds for ne onatal patients.

exceeds 4 :1. The inspirato ry phas e of the
breath is terminated.

Delivered oxyge n percent age falls below the

minus 6% or 18% Fi O2, whichever

set FiO

2

is greater.

Delivered oxyge n percent age rise s above the

plus 6%.

set FiO

2

A high priority audible /visual alarm is a ctivated,
and Circuit Disconnec t displayed, when ever the
patient circuit becomes disconnec ted from the
ventilator or patient. (See o perator ’s manual for
nCPAP/ IMV di sconnect sensi tivit y)

0.10 to 3.00 L (adult)
25 to 1,000 mL ( pediat ric)

2.0 to 300.0 m L (neonate)
Defaults: 3.00 L ( adult)
1,000 mL ( pediatric)

300.0 mL (neonate)

6 to 60 seconds
Default 20 se conds

1 to 200 bpm
Default 20 0 bpm

High

High

Medium

N/A Medium

Not active in APRV/ BiPhasic mode.

N/A

N/A

N/A

24

Message Alarm condition Range Priority

Low Battery A high priority audible /visual alarm is a ctivated, and Low Batter y displayed,

Loss, AC Power A high priority audible /visual alarm is a ctivated and Los s, AC Power is

ILV Disconne ct A high priority audible /visual alarm is activated, and I LV Disconnect

Invalid Gas ID A medium priority audible /visual alarm shall be activated, and Invalid Ga s

Fan Failure A low prior ity audible /visual alarm is activated, and Fan Failure indicated,

Volume
Guarantee
Disabled

Volume
Guarantee is
only available
in Pressure and
TCPL

Set Vol Target
will increase
delivered press
and volume

wheneve r the internal battery has be en depleted to a level that provides a
minimum of t wo minutes of safe ope ration.

displayed, whenever the power switch is on and AC power has
been removed from th e ventilator (i.e., powe r cord disconnect or loss of
supply po wer)

displayed, whenever the master ventila tor becomes disco nnected from the
slave ventilator durin g ILV.

ID shall be indicate d, whenever a defec tive gas ID connector is ins talled
in the ventilator. When a defective Gas ID connector is detec ted, the ga s
correc tions default to air.

wheneve r the fan has stopped rotating.

Proximal flow sensor disconnected or damage d (neonatal mode only) . N /A Message

Selec tion of Volume Guarante e on the mode scree n is not Pres sure or TCPL
(neonatal mode only).

Volume Target set more than 20 % above current set ting (neonatal
mode only).

N/A High

N/A High

N/A High

N/A Medium

N/A Low

N/A Message

N/A Message

25

Message Alarm condition Range Priority

Set Vol Target
will decrease
delivered press
and volume

High Ppeak
<PEEP +7 cm H

Volume
Guarantee
pressure is
limited

Volume Target set more than 20 % below
current setting ( neonat al mode only).

When nCPAP / IMV mode is ac tive and breath

0

rate is not Of f, attempt to set High P peak

2

alarm limit or nCPAP such that High Ppe ak
alarm limit settin g is less than +2 cmH

The pressure required to deliver the desired
tidal volume is greate r than the Hi gh Ppeak
alarm limit of -3 cmH

0.

2

N/A Message

N/A Message

0.

2

N/A Message

26

Rear panel connections

Oxygen sensor

The oxygen sensor cell is located on the rear panel, between the two gas fittings. The oxygen
sensor cable emerges from the rear panel directly above the sensor. Carefully align and then
gently push the connector onto the oxygen sensor until it seats, then slide the cover down and
push over the sensor.

27

Ventilator operations

AVEA ventilator systems

The Membrane buttons are the UIM
controls that surround the Touch Screen.
Starting at the top right and moving
clockwise around the UIM they are:

A. Alarm Silence (LED)

Pressing this button will disable the audible
portion of an alarm for 2 minutes
(± 1 second) or until the Alarm Silence
button is pressed again. This button is not
functional for a Vent Inop alarm.

NOTE: Pressing the Alarm Silence
button will not prevent the audible
alarms sounding again later for
certain alarm conditions.

User interface module (English) showing
button labels

28

B. Alarm Reset

Cancels the visual indicator for alarms that are no longer active.

C. Alarm Limits

Opens the Alarm Limits screen for data entry or adjustment. Toggles the screen on and off.

NOTE: Pressing the Freeze button while the Alarm Limits window is open will automatically
close the window and freeze the graphics.

D. Manual Breath

Pressing this button during the expiration phase of a breath delivers a single mandatory breath
at current ventilator settings. No breath is delivered if the key is pressed during inspiration.

NOTE: The Manual Breath button is not active in APRV / BiPhasic.

E. Suction (LED)

Pressing this button initiates a Disconnect for Suction maneuver. The ventilator will:

• Enable an Increase % O

maneuver for 2 minutes (see Increase O2 below).

2

• While the Circuit Disconnect alarm is active, the ventilator will stop cycling and set a bias

flow. The ventilator will automatically detect the patient upon reconnection and resume
normal ventilation.

• Silences alarms for 120 seconds.

29

E. Suction (LED) (continued)

If the Suction key is pressed again during the 2 minutes that the disconnect for suction
maneuver is active, the maneuver will be cancelled.

F. Increase O

2

When this key is pressed, the ventilator increases the oxygen concentration delivered to the
patient for 2 minutes. If the ↑%O2 key is pressed again within this two-minute period, the
maneuver is cancelled and the ventilator will return to prior settings.

Defaults : +20% neonatal; 79% adult /pediatric

Adult/pediatric: 79% above the set % O

2

Neonate: 20% above the set % O2 or 100%, whichever is less

,

To configure the Increase FiO

Increase FiO

2

access the configuration tab on the Utilities screen:

2

Configures the step increase used during the increase oxygen maneuver. Sets the amount of
oxygen the ventilator will increase above the current set FiO2.

30

Example: If the Increase FiO

is set at 20%

2

AND

The set FiO

is 40%

2

WHEN

The increase FiO

maneuver is activated the FiO2 will increase to 60% for two

2

minutes after which it will return to 40%.

The default setting for infants is 20% and 79% for pediatric and adult applications.

NOTE: The settings will be reset to default values when New Patient is selected in the setup.

NOTE: To achieve 100% delivered FiO

during the Increase O2 maneuver set the Increase FiO2

2

setting to its maximum of 79% .

WARNING: Heliox delivery will be interrupted for the time that either the Suction or the
Increase O

buttons are pressed during administration of Heliox. Tidal volume may be affected

2

after the two-minute timeout period, or when the button is pressed, until the accumulator has
been purged.

31

G. Data dial

Changes the values for a selected field on the touch screen.

H. Accept

Accepts data entered into a field on the touch screen.

I. Cancel

Cancels data entered into a field on the touch screen. The ventilator will continue to ventilate at
current settings.

J. Expiratory Hold

When the Exp Hold button is pressed, at the start of the next breath interval, the ventilator will
not allow the patient to inspire or exhale for a maximum of 20 seconds (adult/pediatric) or 3
seconds (neonate). Expiratory Hold is NOT active in TCPL breaths.

K. Inspiratory Hold (Manual)

When the Insp Hold button is pressed, once the preset of a volume control or pressure control
breath has been delivered, the patient will not be allowed to exhale for a maximum of 3.0
seconds (± 0.1 second).

32

L. Nebulizer

The ventilator supplies blended gas to the nebulizer port at 10 ± 1.5 psig (0.7 bar) when an
in-line nebulizer is attached and the Nebulizer key is pressed, provided that the calculated
delivered flow is >15 L/min.

Delivery of the nebulized gas is synchronized with the inspiratory phase of a breath and lasts for
20 minutes. Press the Nebulizer key a second time to end the treatment prior to the end of the
20-minute period.

CAUTION: Use of an external flow source to power the nebulizer is not recommended.

WARNING: Using the nebulizer may impact delivered tidal volumes.

NOTE: Do not operate the nebulizer while using heliox

M. Patient Size

The Patient Size Indicators for adult, pediatric and neonate at the bottom
of the UIM show which patient size is currently selected. These LED
indicators have no associated membrane button on the UIM.

33

M. Patient Size (continued)

NOTE: The ventilator will not allow patient size changes when the active mode of ventilation is
not available in the new patient size selection. The ventilator will display a message instructing
you to first change the ventilation mode. For example, in neonatal ventilation with TCPL active,
you cannot change to a pediatric or adult patient size without first changing the mode to one
available for those patients.

The ventilator will also not allow size changes if Machine Volume is active. A message displays
indicating that Machine Volume must first be turned off before making a patient size change.

N. Panel Lock (LED)

The Lock key disables all front panel and screen controls except Manual Breath, Suction, ↑ %O
Alarm Reset, Alarm Silence and Lock.

O. Print

The Print key outputs the contents of the currently displayed screen to a suitably connected
parallel printer.

34

,

2

P. Set-up

Opens the ventilator Set up screen.

NOTE: Pressing the Set-Up button a second time before accepting Set-Up will close the
window and restore the previous settings. The Set-Up screen uses an on-screen accept button.
To change patient size without selecting a new patient requires that patient Set-Up be accepted
after selecting patient size.

Q. Advanced Settings (LED)

Opens the Advanced Settings screen for data entry or adjustment. Toggles the screen
on and off.

NOTE: Pressing the Freeze button while the Advanced Setting window is open will
automatically close the window and freeze the graphics.

R. Mode

Opens the Mode Select screen for data entry or adjustment toggles the screen on or off.
Pressing the Mode indicator at the top of the touch screen will also access the screen.

NOTE: Pressing the Mode button a second time before accepting the Mode will close the
window and restore the previous settings. The Mode screen uses an on screen accept button.

S. Event

Records an event for future reference. Some Events are recorded automatically others can
be logged manually to display in this screen. See Chapter 4, Monitors and Displays, for a
full list of Events.

35

T. Freeze

The Freeze key freezes the current screen and suspends real-time update of screen data until
pressed again. While the screen is frozen, a scrollable cursor appears. The data dial can be used
to scroll the cursor through data points on waveform, loop or trend screens. To restore the
screen to active, press the Freeze button a second time.

Figure 3.2 shows a flow/volume loop in freeze mode. The cursors trace the “frozen”
loop curve along an X-Y plot line. The values along the curve of the loop are displayed
as shown below.

Flags sho wing

270

Dashed c ursor li ne

0.0

X and Y value s
at variou s
points a long
the loop
tracing

250 500 750

Flow/ Volum e
loop trac ing

Cursor c urrentl y
overlays th e
“X” axi s at zero

36

Connecting gas sources

Gas fittings

To connect either the Air or Heliox (80/20) Smart
connector, align the connector, seat gently onto the
fitting and screw down the fitting until finger tight.

Each Smart connector is permanently tethered to the
rear of the ventilator.

WARNING: Connection of a gas supply at the Helium-Oxygen mixture inlet that does not
contain 20% oxygen can cause hypoxia or death.

Although an 80/20 mixture of Helium and Oxygen is marketed as medical grade gas, the
Helium/Oxygen gas mixture is not labeled for any specific medical use.

In order to prevent delivery of excess tidal volume, allow 90 seconds for the accumulator to
purge before initiating patient ventilation with Heliox gas.

37

Touch-Turn-Touch/Touch-Turn-Accept techniques

Changes to controls and displays are accomplished with a three-step technique.

1. Touch the control or

display to be changed.

15

BPM
Rate

500

ml

Volume

2. Turn the data dial to reach

15

the desired setting.

BPM
Rate

500

ml

Volume

3. Touch the control again or press Accept to confirm change.

Changes not accepted by either method within 15 seconds revert to previous settings. Press
Cancel prior to accepting proposed changes to return to previous settings.

38

New patient setup

1. Power on the ventilator and perform User Verification

Tests as described in chapter 2 of your operator’s manual.

2. After the power is turned on, a single audible tone may

be heard when the internal capacitor linked to the alarm
system reaches full charge.

3. Select New Patient. Select Resume Current or New

Patient. Touch Patient Accept. Selecting Resume Current
resumes ventilation and trending at previous settings.
Selecting New Patient clears all trends and saved loops,
and sets all controls to defaults. The Patient Size Select
screen appears as the first step of the new patient setup
sequence.

4. Using Touch-Turn-Touch or

Touch-Turn-Accept technique, set
controls found on the ventilation
Setup screen as desired.

5. Touch Setup Accept to accept

this screen.

39

Patient Select

RESUME
CURRENT

NEW

PATIENT

PATIENT
ACCEPT

Setting the ventilation breath type and mode

Adult/pediatric breath type and mode screen

40

Infant mode select screen

Apnea Backup ventilation choices appear when CPAP / PSV or APRV / BiPhasic modes
are selected. Apnea Backup is active in all Assist Control, SIMV, APRV / BiPhasic and
CPAP/PSV modes.

41

Setting nCPAP/IMV (neonatal mode only)

When mode is accepted, follow the on-screen instructions for flow characterization. See
Operator’s Manual for a list of approved nCPAP interfaces.

42

1. Once flow characterization is completed, the screen above is displayed.

bmp

2. Connect patient to ventilator, and set desired settings.

3. Alarm settings are only adjustable if rate is set other than Off. If nIMV is desired, then

set rate, inspiratory pressure and inspiratory time to desired settings.

4. Check disconnect sensitivity. See operator’s manual for detailed instructions.

Non-Invasive Support.

APNEA Backup Disabled.

Off 5 0.35 5 21

bmp

Rate

cmH20

Insp Pres

Non Alarm Limits in cCPAP when settings are disabled.

sec

Insp Time

cmH20

nCPAP

Fi02

43

%

Setting the ventilation breath type and mode

1. Touch the Mode indicator or the Mode membrane

button to open the mode window (see pg. 1).

2. Select the desired mode and set the primary controls.

Touch Mode Accept to accept the new mode and
control settings.

3. Advanced settings and alarm limits may also be

adjusted at this time.

44

Breath type and mode

Setting Volume Guarantee (neonatal mode only)

1. Select Volume Guarantee with pressure or TCPL breath

type ONLY! Assure proximal flow sensor is
zeroed and in place if needed.

2. Select desired settings. Volume will then

appear in place of inspiratory pressure. Set
desired expired volume.

3. Under volume advanced settings, delivered

starting pressure limit will appear. Set desired
starting inspiratory pressure.

4. Pressure will vary ± 3 cm maximum to achieved

set volume, but will give initial breath at set
inspiratory pressure.

NOTE:

• If flow sensor becomes disconnected or non-functional, breath type will divert to preset

inspiratory pressure. Inspiratory pressure will be limited to High Pressure Limit alarm -3 cm.

• In TCPL breath type, flow and /or inspiratory time may limit volume delivery. Expiratory

volume alarm will be activated if expiratory volume falls below alarm threshold.

• Flow cycling is functional only in TCPL breath type.

45

Monitored parameters

Main screen monitors

Five monitored parameters are
continuously displayed on the left
of the touch-screen display.

1. Touch the monitor you wish to set.

2. Scroll through the menu choices.

3. To accept your selection, press the

Accept button.

NOTE: The main screen monitored values may be different than the monitored values on the
Loops screen or Trends screen.

46

The Monitor screen

To open the Screen Select menu, press the
Screen indicator or the Screens membrane
button to the left of the touch screen.
Select Monitor.

The Monitor screen can be configured in the
same way as monitored parameters on the
main or loops screen displays. For a complete
list of monitored parameters, refer to chapter
4 of the AVEA ventilator operator’s manual.

47

SCREEN SELECT

MAIN MONITOR

LOOP

STANDBYMANEUVERTRENDS

UTILITY

Graphics

Graphic displays are color coded to provide the clinician with helpful information. They may
appear as red, blue, yellow, green or purple tracings.

• Red indicates the inspiratory portion of a mandatory breath

• Yellow indicates the inspiratory portion of an assisted or spontaneous breath (patient

assisted or spontaneous breaths are also denoted with a yellow demand indicator that
appears in the left hand corner of the mode indicator)

• Blue represents the expiratory phase of a mandatory, assisted or spontaneous breath

• Green during the expiratory phase of a single breath indicates that a purge of the expiratory

flow sensor, or wye flow sensor (if attached) has occurred

• Purple indicates safety state, which occurs when the safety valve is open

48

Waveforms

Three waveforms can be selected and simultaneously displayed on the main screen.

Scroll through the waveform choices. Make your selection, touch the heading again or press the
Accept button to confirm the change.

49

Events

Pressing the Event button opens a menu of selectable
events that will appear in the trend buffer along
with the monitored parameters. Scroll the menu and
highlight the desired event. Press the Accept button
adjacent to the data dial to place the event in the trend
buffer. Events appear on the trend screen spreadsheet
in green text. Certain events are automatically
recorded by the ventilator. All events are listed below.

Selectable event

• Change of a primary or
advanced control

• Powering the ventilator
off or on

• Entering and exiting standby

• Activation of the nebulizer

• Activation of the inspiratory
or expiratory hold

• A manual breath

• Activation of the suction
button

• Activation of the increase
O

button

2

• Selecting new patient

• Involuntary power loss
and recovery

50

Selectable event

• Arterial blood gas

• Chest X-ray

• Suction

• Intubation

• Feeding

• Diagnostic procedure

• Therapeutic procedure

Trends

1 2 3 4 5 6

1 2 3 4 5 6

120

P

peak

(cmH20

Press the Screens button or the Screen
indicator. Press Trends on the screen
select menu. Monitored parameters are
trended as one minute averages over a
24-hour period.

NOTE: If left open, the Trends screen
will refresh every 10 minutes.

09:29

09

09

09

09

90
60
30
0

120
90
60
30
0

T

i

me

:

30

:

31

:

32

:

33 57.157.1

)

1 2 3 4 5 6

mea

n

P

(cmH2O

)

1 2 3 4 5 6

V

te

V

e

PEEP

m

l

l

cm

H2O

0.8

53.6

56.7

52.4

57.0

6

0.9

6

0.9

6

1.0

6

1.1

6

Each histogram and column can be configured from the monitored parameters menu.
Touch the title bar of any histogram or the heading of any column. Select the parameter
to be displayed. Press the Accept button to accept the parameter.

Histograms can be scaled by touching either axis. Use the data dial to adjust the scale.
Touch the axis again or press the Accept button to accept the change.

To look at histogram or spreadsheet trends over time, press the Freeze button and use the
data dial to move the cursor through the timeline. The timeline is shown as yellow text on the
spreadsheet. Event markers appear in green text.

51

20

PEEP

(cmH20
15
10
5
0

200
150
100
50
0

A

i

r Inlet

V

de

l

P

sig

m

l

94.0

93.6

93.4

93.1

92.32222

peak

cm

H2O

22

22

22

p

0

0

0

0

0

)

R

ate

(

bpm

)

P

PI

EE

P

F

R

PEF

cm

H2O

6

6

6

6

6

R

min

min

m

I/

l/cm

I/

41

41

41

41

41

40

41

41

41

41

C

dyn

H2O

3

4

3

4

4

Synchronized nebulizer

An in-line nebulizer can be used with the
AVEA ventilator. Nebulization is synchronized
with inspiration, and will deliver gas at the set
FiO2/FiHe for 20 minutes. Attach the nebulizer
tubing to the fitting at the bottom of the
front panel.

NOTE: To use the internal nebulizer, the AVEA ventilator must be connected to a high pressure
Air or Heliox source. The nebulizer is not active while the AVEA ventilator is operating on its
internal compressor. The nebulizer requires an inspiratory flow rate of at least 15 liters per
minute to activate and is flow compensated to maintain set tidal volumes. The nebulizer is not
active in neonatal applications.

CAUTION: When the internal nebulizer is used, the ventilator decreases the flow rate by 6 L/
min to compensate for the nebulizer output. However, since flow from the internal nebulizer
can vary, using the internal nebulizer may impact the tidal volumes delivered to the patient.

52

Alarms

Setting an alarm limit

Press the red Limits membrane button.

Use Touch-Turn-Touch/Touch-Turn­Accept technique to make changes
to alarm controls.

NOTE: Red indicators appearing on the primary controls display the relative alarm settings of
any associated alarm.

53

Message Alarm condition Range Priority

Safety Valve
Open

Vent Inop Ventilator failure due to non-recoverable conditio n. The safety valv e opens,

Loss, Air

Loss, O

2

Loss, Heliox The alarm is trigge red if heli ox is being used and the heliox gas supply to

Loss, Gas Supply All sources of gas fail; wall air, internal compressor (if ins talled ) and

Safety valve is open. N/A High

indicate d by a Safet y Valve Ope n messa ge, and the patient is allowed to
breathe ro om air. PEEP is not maintaine d.

Wall air drops below 18.0 ps ig (1.2 bar) and no functional compre ssor
is installed, or the compressor output is insufficient to m eet inst rument
demand. Patient will continue to b e ventilated by O

Oxygen supply to the ventilator drops below 18.0 psig (1.2 bar) and

2

is set to > 21%. Pati ent will continue to be ventilated by the

the %O
air supply o nly.

the ventila tor drops b elow 18.0 psig (1.2 bar). The patient co ntinues to b e
ventilated by the oxygen suppl y only.

oxygen. The safety valve o pens, ind icated by a S afety Val ve Open message,
and the patient is allowed to breat he room air. PEEP is not maintained.

2

supply only.

N/A High

N/A High

N/A Medium

N/A Low

N/A Message

54

Notes

55

Notes

56

Notes

57

WARNING—U.S. Federal Law restricts this device to sale by or on the order of a physician.

CareFusion
22745 Savi Ranch Parkway
Yorba Linda, C A 92887

800.231.2466 toll-free

714.283. 2228 tel

714.283. 8493 fax

CareFusion Germany 234 GmbH
Leibnizstrasse 7
97204 Hoechberg
Germany

[phone] tel
[phone] fax

carefusion.com

© 2011 CareFusi on Corp oration o r one of it s subsi diarie s. AVEA , Touch­Turn-Acce pt and Touc h-Turn-Touch are t radema rks or re giste red trad emark s
of CareF usion Co rpora tion or on e of its su bsidia ries. A ll right s reser ved.
RC260 5 (0611/2 000 ) L2242 Rev. B