Dräger Evita 4 Instructions For Use Manual

Evita 4

Intensive Care Ventilator

Instructions for Use

D

MEDICAL

Software 4.n

1-159-99

Working with these Instructions for Use

Working with these Instructions for Use

Header line – the title...
of the main chapter

The title of the specific sub-section is printed underneath
the main header – to help you find your way quickly from
subject to subject.

Page body...
the Instructions for Use

in combined text/illustrations. The information is
expressed in the form of practical actions, giving the user
direct hands-on experience in learning how to use the
machine.

Left-hand column – the text...

provides explanations and instructs the user step-by-step
in the practical use of the product, with short, clear
instructions in easy-to-follow sequence.
Bullet points indicate separate actions. Where several
actions are described, numbers are used both to refer to
the relevant details in the illustrations and to specify the
sequence of actions.

Operation
Calibrating

Calibrating the CO2 sensor

The CO2 sensor must be calibrated:
– if the check values are not met on checking

calibration with filter or calibration gas.

– as part of the half-yearly inspection of Evita 4.

● Switch on Evita 4. Wait about for 3 minutes for

the machine to complete its warm-up phase.

● Press the »Calibration« key.

Display (example):

● Touch »CO2« screen key.

Display (example):

● Carry out CO2 zero calibration, page 74.

After the CO2 zero calibration:
Touch the »Cal.« screen key.

Right-hand column – the illustrations...

provide the visual reference for the text and make it easier
to locate the various parts of the equipment. Elements
mentioned in the text are highlighted. Unnecessary details
are avoided.
Screen displays prompt the user to proceed and confirm
correct actions.

● Connect the calibration gas supply.

Use the cuvette from the calibration set!

1 Connect the calibration gas cylinder and the

cuvette of the calibration set to the hose.

2 Remove the CO2 sensor from its park bracket

and fit it to the cuvette of the calibration set.

● Read the CO2, O2 and N2O concentrations

(vol.%) of the calibration gas from the test
cylinder.

2

1

3

2

What's new in Evita 4 software 4.n*

What's new in Evita 4 software 4.n

Specification of the humidifier used

– »Active humidifier«

or
– »HME/Filter« (artificial nose)
– for more accurate measurement of the volume

parameters

Apnoea ventilation On/Off

– can be selected as starting configuration

Extended range of settings for the alarm time
TApnoea >>

– from 5 to 60 seconds

Frequency can be reduced to 0

– for BIPAP and SIMV, for weaning without transitions

Ventilation mode BIPAPAssist

– for pressure-controlled assisted ventilation

>>

(formerly 15 to 60 seconds)

Additional weaning parameters

available as software version 4.n plus upgrade
in addition to the parameter occlusion pressure P 0.1
Evita 4.4n also determines the parameters
– RSB Rapid Shallow Breathing index
and
– NIF Negative Inspiratory Force index

External flow source
available as software version 4.n plus upgrade
– The amount of external flow is calculated by Evita 4.4n

(e.g. for additional tracheal gas insufflation) and
adjusts the volume monitoring tolerances in order to
avoid inadvertent alarms

Extended use of loop presentations

available as software version 4.n plus upgrade
– Loops can be zoomed and frozen
– Loops can be displayed permanently in the upper part

of the screen

Patient mode »prev. patient« can be selected

– to adopt the settings, including alarms, which were

effective before switching off the equipment

Leakage compensation On/Off

– for activation and deactivation of the automatic

leakage compensation function

Extended logbook entries

– Evita 4.4n identifies alarms which are active but not

displayed with an asterisk

Monitoring of tube blockages

– New alarm message »Tube blocked !!!«

Evita Remote (Remote Pad)
optionally available
– Remote control pad for parallel remote operation of

function keys on Evita 4

NIV

optionally available
– Application mode to support non-invasive ventilation

therapies

Nurse call

optionally available
– Connection for transmitting alarm signals to a central

hospital alarm station

* See pages 187 and 188 for new features in software

versions 2.n and 3.n

3

4

Contents

Contents

For Your Safety and that of Your Patients ..............................................11

Intended Medical Application.................................................................. 13

Operating Concept...................................................................................15

Structure of the Control Unit................................................................... 16

On-Screen Controls................................................................................. 17

Screen Keys for Function Selection

without Confirmation..................................................................................18

Screen keys for Function Selection,

Adjustment and Confirmation.....................................................................18

On-Screen Parameter Setting Knobs.........................................................20

Screen Pages...........................................................................................21

Standard page...........................................................................................22

»Adjustment« Screen Page........................................................................ 22

»Alarm Limits« Screen Page...................................................................... 24

»Measured values« Screen Page............................................................... 25

»Measurement Manoeuvre« Screen Page.................................................. 26

»Calibration« Screen Page.........................................................................26

»Configuration« Screen Page.....................................................................27

Positioning the Control Unit.....................................................................27

Ergonomic Positioning...............................................................................27

Preparation...............................................................................................29

Attaching components.............................................................................30

Fitting expiration valve................................................................................30

Fitting flow sensor..................................................................................... 30

Fitting O2 sensor capsule.......................................................................... 31

Note on Use of Heat and Moisture Exchanger (HME)............................. 31

Ventilation Adults and Children............................................................... 32

Connecting Aquapor humidifier..................................................................32

Connecting ventilation hoses..................................................................... 32

Fitting temperature sensor.........................................................................33

Fitting CO2 cuvette and CO2 sensor......................................................... 34

Ventilating Infants.................................................................................... 34

Fitting bacterial filter.................................................................................. 34

Fitting humidifier and ventilation hose.........................................................35

5

Contents

Contents

If using bacterial filters............................................................................ 35

Supply and Connections..........................................................................36

Electrical power supply..............................................................................36

Note on use of a socket strip for ancillary equipment..................................36

Temporary interruption of power supply..................................................... 36

Gas supply................................................................................................37

Evita Remote (optional).............................................................................38

Connection................................................................................................38

Note automatic self-test............................................................................. 39

Nurse call (optional)..................................................................................40

Technical Data...........................................................................................40

Before Using for the First Time............................................................... 41

Selecting the language of the display texts.................................................41

Device Check...........................................................................................42

Before use on patient................................................................................ 42

Performing device check........................................................................... 43

Checking the hose system for leaks...........................................................46

Positioning the control unit......................................................................47

To position the control unit on the wall rail..................................................47

To position the control unit on the device................................................... 47

Operation................................................................................................. 49

Starting up............................................................................................... 50

Switching on............................................................................................. 50

Patient mode............................................................................................50

Selecting the patient mode........................................................................ 51

Entering the ideal body weight...................................................................51

Select the previous settings.......................................................................51

Starting ventilation..................................................................................... 52

Setting Ventilation Modes........................................................................53

IPPV..........................................................................................................53

SIMV, SIMV/ASB......................................................................................57

BIPAP, BIPAP/ASB.................................................................................. 60

BIPAPAssist................................................................................................62

CPAP, CPAP/ASB....................................................................................63

MMV, MMV/ASB...................................................................................... 65

APRV........................................................................................................ 67

Independent Lung Ventilation ILV............................................................69

Preparation................................................................................................69

Setting the master and slave device...........................................................71

6

Contents

Contents

Apnoea ventilation................................................................................... 76

Setting Alarm Limits.................................................................................77

In the Event of an Alarm.......................................................................... 78

Cancel alarm tone..................................................................................... 79

Information J............................................................................................ 79

Displaying Curves and Measured Values................................................ 80

Displaying measured values.......................................................................81

Trends.......................................................................................................82

Loops........................................................................................................83

Reference curve displays...........................................................................83

Single stroke displays................................................................................83

Zoom loops (optional)................................................................................83

Display loops in the upper graphic area..................................................... 84

Logbook....................................................................................................85

Screen freeze............................................................................................86

Special Functions.....................................................................................87

Manual inspiration......................................................................................87

Exspiration Hold........................................................................................ 87

Medicament nebulisation........................................................................... 88

Oxygen enrichment for bronchial suction................................................... 91

Special measurement procedure: intrinsic PEEP........................................93

Special measurement procedure: occlusion pressure P 0.1....................... 94

Shut-down.................................................................................................95

Selecting Standby Mode..........................................................................96

Quitting Standby Mode..............................................................................96

Calibration................................................................................................97

Calibrating O2 sensor................................................................................97

Calibrating flow sensor..............................................................................98

External flow source.................................................................................. 99

Checking/calibrating CO2 sensor............................................................100

CO2 zero checking................................................................................. 100

Testing CO2 calibration with test filter..................................................... 102

Testing CO2 calibration with test gas...................................................... 103

Calibrating CO2 sensor...........................................................................105

Resetting CO2 calibration........................................................................106

Configuration......................................................................................... 107

Sound.....................................................................................................108

Adjusting the volume of the alarm tone.....................................................108

7

Contents

Contents

Screen....................................................................................................109

Selecting displayed measured values.......................................................109

Selecting displayed curves...................................................................... 111

Selecting displayed trends.......................................................................112

Ventilation.............................................................................................. 113

Selecting ventilation modes..................................................................... 113

Selecting Pmax pressure limit..................................................................115

Selecting AutoFlow as start-up ventilation mode....................................116

Apnoea ventilation On/Off....................................................................... 117

Selecting patient mode............................................................................118

Start-up values for ventilation parameters and alarm limits........................119

Setting start-up values for ventilation parameters »VT, f«...........................119

Setting start-up values for ventilation parameters »Pressure, O2, I:E«....... 121

Leakage compensation On/Off................................................................122

Setting start-up values for alarm limits......................................................123

System Defaults.....................................................................................124

Setting external interface......................................................................... 124

Setting time and date.............................................................................. 125

Setting language and units...................................................................... 125

Service diagnosis....................................................................................126

Troubleshooting.....................................................................................127

Preparing............................................................................................... 135

Dismantling............................................................................................136

CO2 sensor (optional)............................................................................. 136

Temperature sensor................................................................................ 136

Medicament nebuliser............................................................................. 137

Ventilation hoses..................................................................................... 137

Flow sensor............................................................................................ 137

Expiration valve........................................................................................138

Humidifier................................................................................................138

Disinfecting/Cleaning............................................................................ 139

Assembling............................................................................................ 142

Fitting expiration valve............................................................................. 142

Before Reusing on Patient.....................................................................143

Maintenance Intervals ...........................................................................143

Clean or replace cooling air filter............................................................. 144

Disposing of batteries and O2 sensors.................................................... 144

Removing/fitting ambient air filter.............................................................144

Correct disposal of apparatus................................................................. 145

8

Contents

Contents

What's what........................................................................................... 147

Control unit............................................................................................. 148

Front connections................................................................................... 149

Back panel..............................................................................................150

Technical Data....................................................................................... 151

Environmental conditions.........................................................................152

Settings.................................................................................................. 152

Performance data....................................................................................153

Measured value displays..........................................................................153

Monitoring...............................................................................................155

Operating data........................................................................................ 156

Machine outputs......................................................................................157

Electromagnetic compatibility (EMC)....................................................... 158

Classification...........................................................................................158

UMDNS-Code........................................................................................ 158

Materials used.........................................................................................158

Description.............................................................................................159

Ventilation Modes.................................................................................. 160

Volume-controlled ventilation with PLV and AutoFlow............................ 160

Classic volume constant mandatory ventilation stroke.............................. 160

Manual pressure limiting with Pmax ........................................................ 160

AutoFlow.............................................................................................. 161

Start-up procedure with AutoFlow.........................................................162

Sigh........................................................................................................ 163

SIMV.......................................................................................................164

ASB........................................................................................................165

BIPAP.....................................................................................................166

BIPAPAssist............................................................................................. 167

APRV......................................................................................................168

MMV.......................................................................................................168

Flow measurement..................................................................................170

Compensation of the effect of hose system compliance...........................170

Conversion according to ambient conditions............................................170

Automatic leakage compensation.............................................................172

Weaning parameters............................................................................... 174

Occlusion pressure P 0.1........................................................................174

Rapid Shallow Breathing RSB.................................................................175

Negative Inspiratory Force NIF................................................................ 175

Intrinsic PEEP......................................................................................... 176

Insp. O2 concentration during medicament nebulisation...........................177

9

Contents

Contents

Abbreviations......................................................................................... 178

Symbols................................................................................................. 181

Bibliography...........................................................................................182

Parts List................................................................................................ 183

Order List............................................................................................... 185

What was new in Evita 4 software 2.n................................................... 187

What was new in Evita 4 software 3.n................................................... 188

Index...................................................................................................... 189

10

For Your Safety and that of Your
Patients

For Your Safety and that of Your Patients

Strictly follow the Instructions for Use

Any use of the apparatus requires full understanding and
strict observation of these instructions. The apparatus is
only to be used for purposes specified here.

Maintenance

The apparatus must be inspected and serviced regularly
by trained service personnel at six monthly intervals
(and a record kept).
Repair and general overhaul of the apparatus may only be
carried out by trained service personnel.
We recommend that a service contract be obtained with
DrägerService and that all repairs also be carried out by
them. Only authentic Dräger spare parts may be used for
maintenance.
Observe chapter "Maintenance Intervals".

Accessories

Do not use accessory parts other than those in the order
list.

Liability for proper function or damage

The liability for the proper function of the apparatus is
irrevocably transferred to the owner or operator to the
extent that the apparatus is serviced or repaired by
personnel not employed or authorized by DrägerService
or if the apparatus is used in a manner not conforming to
its intended use.

Dräger cannot be held responsible for damage caused
by non-compliance with the recommendations given
above. The warranty and liability provisions of the terms
of sale and delivery of Dräger are likewise not modified
by the recommendations given above.

Dräger Medical AG & Co. KGaA

Not for use in areas of explosion hazard

This apparatus is neither approved nor certified for use in
areas where combustible or explosive gas mixtures are
likely to occur.

Safe connection with other electrical equipment

Electrical connections to equipment which is not listed in
these Instructions for Use should only be made following
consultations with the respective manufacturers or an
expert.

11

For Your Safety and that of Your Patients
Safe use of the equipment

Safe use of the equipment

This equipment must only be used under the
supervision of qualified medical staff, so that help is
available immediately if any faults or malfunctions
occur.

This equipment must not be used with flammable
gases or anaesthetic agents. Danger of fire!

Do not use mobile telephones within 10 metres of
ventilators!

Mobile telephones may impair the functioning of
electromedical equipment and endanger the patient1).

Appropriate ventilation monitoring
The built-in monitoring facilities of Evita 4 ensure

appropriate monitoring of ventilation therapy and there­fore detect any undesirable changes in the following
ventilation parameters:

– Airway pressure, Paw
– Expiratory minute volume, MV
– Inspiratory O2 concentration, FiO2
– Inspiratory breathing gas temperature, T
– Expiratory CO2 concentration, etCO2 (optional)
– Inspiratory breathing volume, VTI
– Apnoea time
– Tachypnoea monitoring

Back-up ventilation with an independent manual
ventilation device

If a fault is detected in Evita 4 so that its life-support
functions are no longer assured, ventilation using an
independent ventilation device must be started without
delay – if necessary with PEEP and/or increased
inspiratory O2 concentration (e.g. with the Dräger
Resutator 2000).

Changes in these parameters may be caused by:
– Acute changes in the patient's condition

– Incorrect settings and faulty handling
– Equipment malfunctions
– Failure of power and gas supplies

If a fault occurs in this equipment, separate measuring
instruments should be used.

1) Dräger medical equipment meets the requirements for immunity to
interference in accordance with the specific product standards and
EN 60601-1-2 (IEC 601-1-2). Depending on the type of mobile
telephone used and on the application situation, however, field
strengths exceeding the values specified in the applicable standards
may develop in the immediate vicinity of the mobile telephone and
therefore lead to faults and malfunctions.

12

Intended Medical Application

Contents

Intended Medical Application

Contents

Intended Medical Application.................................................................. 14

13

Intended Medical Application

Intended Medical Application

Long-term ventilator for intensive care.
For adults, children and neonates.
For premature babies with the "NeoFlow" option.

With the following ventilation modes:
IPPV Intermittent Positive Pressure Ventilation,

controlled and assisted constant-volume ventilation.
With the options:
– CPPV (Continuous Positive Pressure Ventilation)
– PLV (Pressure Limited Ventilation)
– AutoFlow



for automatic regulation of inspiration flow

– IRV (Inversed Ratio Ventilation)
SIMV Synchronized Intermittent Mandatory Ventilation,

procedure for weaning patients off the ventilator after
they have started spontaneous breathing.
With the options:
– PLV (Pressure Limited Ventilation)
– AutoFlow



for automatic regulation of inspiration flow.

MMV Mandatory Minute Volume Ventilation,
spontaneous breathing with automatic adjustment of
mandatory ventilation to the patient's minute volume
requirement.
With the options:
– PLV (Pressure Limited Ventilation)
– AutoFlow

for automatic regulation of inspiration flow.

BIPAPAssist (Biphasic Positive Airway Pressure Assisted)
Pressure-controlled assisted ventilation

APRV Airway Pressure Release Ventilation,
Spontaneous breathing on two pressure levels with long
time ranges – independently adjustable.

Special modes:

Apnoea Ventilation

For switching over automatically to
volume-controlled mandatory ventilation, if breathing
stops.
If apnoea occurs, Evita 4 emits an alarm after the preset
alarm period (TApnoea > ) and starts volume-controlled
ventilation.

ILV Independent Lung Ventilation,
Separate, differentiated, synchronised ventilation with
two Evita units, one for each lung.

Diagnostics:
Intrinsic PEEP-measurement

for determining intrinsic PEEP and measuring trapped
volume.

Occlusion pressure measurement

for evaluating breathing drive during spontaneous
breathing.

SB Spontaneous Breathing,
Spontaneous breathing at ambient pressure.

CPAP Continuous Positive Airway Pressure,
Spontaneous breathing with positive airway pressure.

ASB Assisted Spontaneous Breathing,
pressure-assisted spontaneous breathing.

BIPAP* Biphasic Positive Airway Pressure,
Pressure-controlled ventilation combined with free
spontaneous breathing during the complete breathing
cycle, and adjustable pressure increase to CPAP level.

–––––––––––

* Registered trade mark

With monitoring for:

airway pressure, Paw
expiratory minute volume, MV
inspiratory O2 concentration, FiO2
inspiratory breathing gas temperature, T
expiratory CO2 concentration, etCO2
inspiratory breathing volume, VTI
apnoea time
tachypnoea monitoring to detect rapid, shallow
spontaneous breathing

Automatic gas switch-over.
In the event of a gas failure, the change-over to another
gas is automatic.

14

Operating Concept

Contents

Operating Concept

Contents

Structure of the Control Unit.................................................................. 16

On-Screen Controls................................................................................ 17

Screen Keys for Function Selection

without Confirmation................................................................................ 18

Screen keys for Function Selection,

Adjustment and Confirmation....................................................................18

On-Screen Parameter Setting Knobs........................................................20

Screen Pages..........................................................................................21

Standard page......................................................................................... 22

»Adjustment« Screen Page....................................................................... 22

»Alarm Limits« Screen Page..................................................................... 24

»Measured values« Screen Page.............................................................. 25

»Measurement Manoeuvre« Screen Page................................................. 26

»Calibration« Screen Page........................................................................26

»Configuration« Screen Page....................................................................27

Positioning the Control Unit....................................................................27

Ergonomic Positioning..............................................................................27

15

Operating Concept
Structure of the Control Unit

Structure of the Control Unit

The main components of the control unit are the screen,
a set of fixed function keys and the central rotary dial-
knob.

The function keys are used to call up the screen pages
appropriate to the application.

In addition to curves, measured values and status
displays, the screen contains, in a separate field, touch­sensitive keys and touch-sensitive rotary knobs for
parameter setting.

The touch-sensitive screen keys and the screen knobs
are used in a similar way to ordinary keys and knobs:

D Evita 4

Touching with the fingertip is equivalent to pressing a key
or taking hold of a knob.

The display always contains only the screen keys and
screen knobs required for function selection and/or
adjustment.

Settings and confirmations are made by turning and
pressing the central, rotary knob.

The keys for routine functions are placed to the right and
left on the outside of the front panel.

Frequently used function keys are placed on the right,
e.g.

the key »? « for selecting the standard page

or the »Alarm Reset« key for resetting or confirming
messages.

Less frequently used function keys are placed on the left­hand side of the front panel,
e.g.
the key » « for switching the medicament nebuliser
on/off,
or the »O2 suction« key for bronchial suctioning.

D Evita 4

16

The power switch
for switching the device on/off.

The power switch is located on the back panel and has a
pivoting cover to protect against being inadvertently
switched off.

Operating Concept

Structure of the Control Unit

On-Screen Controls

On-Screen Controls

The lower half of the screen contains touch-sensitive
coloured screen keys and screen knobs.

Touching these controls with the fingertip is equivalent to
pressing key or taking hold of a knob.

The colour displays the status of the "control" and
"LEDs":

green = usable
white = not usable
yellow = adjust/confirm
black = effective function/display

IPPV

60

40

20

0

-10

O2 [%]

A

Assist

[mbar]

P

aw

0 2 4 6 8 t [s]

21

.500

VT

60

Flow

m

1.7

Tinsp

21

f

5

PEEP

FiO2 21

P

33 >

peak

P

27

plat

MV 5.3 _

Basic
settings

Extra
settings

IPPV

BIPAP

SIMV

ASB

1
2
3

50

7.0

4.0

17

Operating Concept
On-Screen Controls

Screen Keys for Selecting Functions without
Confirmation

e.g. for paging through the system on-screen

for changing the menu
for switching over displays

example:

● Press the »Table« key = select display.

The key goes black to show that the function is active.

IPPV

60

40

20

0

-10

20

10

0

11:03 12:03

A

Assist

[mbar]

P

aw

0246

MV

11:06 total 1.5

spon 0.0

m

40

20

0

11:03 12:03

Table Table

8 t [s]

f

11:06 total 1.5

spon 0.0

FiO2 21

P

33 >

peak

P

27

plat

MV 5.3 _

Zoom in

Zoom out

Table

Trends

Loops

Logbook

1
2

3

50

7.0

4.0

Screen Keys for Function Selection,
Adjustment and Confirmation

Display (example):

IPPV

60

40

20

0

-10

MV 5.3 L/min

f

spn

V

Ti

P

aw

A

P

[mbar]

aw

0 2 4 6 8 t [s]

0.0 bpm

.497 L

33 L/min

m

7.0

4.0

_

_

_

_

30

780

50

T

Apnoea

etCO

s

– – mmHg

2

FiO2 21

P

33 >

peak

P

27

plat

MV 5.3 _

15

_

100

_

0

Monitoring

Logbook

Limits

1
2
3

50

7.0

4.0

18

1 Touch the relevant screen key for the alarm limits,

e.g.:

MV 2.3 L/min

9.3

3.1

The colour changes from green to yellow = setting
function is set.

Operating Concept

On-Screen Controls

1

MV 2.3 L/min

2 Turn the rotary knob = adjust the alarm limit.

The value is displayed in the screen key.

3 Press the rotary knob = the colour changes from

yellow to green, and the set alarm limit is confirmed
and effective.

To cancel the setting:

● Touch the screen key again

or

● touch another screen key.

2

3

19

Operating Concept
On-Screen Controls

Screen Knobs for Setting Parameters

Display (example):

e.g. »PEEP« screen knob.
1 Touch the »PEEP« screen knob:

It changes colour from green to yellow =
setting function selected.

2 Turn rotary knob = Adjust setting. The value is

displayed in the knob.

3 Press rotary knob = Confirm. The knob changes

colour from yellow to green, and the setting is
validated and takes effect.

IPPV

60

40

20

0

-10

O2 [%]

A

Assist

[mbar]

P

aw

0 2 4 6 8 t [s]

21

.500

VT

60

Flow

m

1.7

Tinsp

21

f

5

PEEP

1

PEEP

2

FiO2 21

P

33 >

peak

P

27

plat

MV 5.3 _

Basic
settings

Extra
settings

5

PEEP [mbar]

10

1

2
3

IPPV

BIPAP

SIMV

ASB

50

7.0

4.0

While pressure values, such as Pmax, are being set, they
are displayed in the Paw (t) curve as a dashed black line.

To cancel the setting:

● Press the screen knob again

or

● press another screen knob.

PEEP [mbar]

3

20

Screen Pages

Operating Concept

Screen Pages

All the screen pages have the same structure, i.e. their
contents are always arranged in the same positions on
the screen:

Messages indicating ventilation modes and alarms,
displays of measured values and curves, and help
functions, always appear in the same position on the
screen:

➀ The active ventilation mode/patient mode is

displayed on the left-hand side of the top line.
The ventilation mode is indicated by its abbreviation,
e.g. BIPAP.

The patient mode is indicated by a symbol:
A m for adults
P m for paediatric

In the case of spontaneous breathing activity by the
patient, a lung symbol ⁄ is briefly displayed as
indicator.

➁ Curves are displayed in the upper left-hand quarter of

the screen.

➂ The lower half of the screen shows curves and

measured values or screen keys and screen knobs –
depending which screen page is selected.

Current ventilation mode/patient mode Alarms

➀

Curves Measured

➁

Curves or screen knobs Measured

➂

Help functions

➅

➃

values

values or
screen keys

➄

➃ Alarms are displayed on the right of the top line.
➄ Measured values are displayed in the upper right-

hand quarter of the screen.

➅ Help functions appear in the bottom line of the

screen. On the right, Evita 4 provides setting
instructions. On the left, Evita 4 provides information
on the current status – this information can be
accessed by pressing key » «

The solid function keys to the right of the screen are used
to select the screen pages for the following specific
application situations:

– Settings
– Alarm limits
– Measured values
– Special measurement procedures

– Calibration
– Configuration

D Evita 4

21

Operating Concept
Screen Pages

Screen page

For displaying the ventilation status

● Press »? « key.

Display (example):

The standard page shows the ventilation situation at a
glance – reduced to the most important measurement
parameters and curves.

Four measured values are shown on the right, and two
curves on the left.

Other measured values and curves can be selected in
the standard page and all subsequent screen pages.

To select other measured value combinations:

1

● Touch screen key » « repeatedly.

2
3

To select other curves:

● Touch key » «, and touch the screen key

corresponding to the desired curve.

»Settings« screen

For displaying the setting parameters.
The bottom right-hand side of the screen contains the

screen keys for selecting the ventilation modes.
The screen key displayed in black (IPPV in the example)

represents the currently activated ventilation mode.
The bottom left-hand side of the screen contains the on-

screen rotary control knobs.
The values of the setting parameters are displayed in the

screen knobs relevant to the ventilation mode.
The user-definable start-up settings are marked by an

arrow (j) on the scales of the screen knobs. See
"Configuration" on page 107 onwards.

012 37 207 01337 207

Changing the settings of an active ventilation mode

● Touch the appropriate screen knob, which will change

colour from green to yellow = setting function
enabled.

● Turn the rotary knob on the control unit = adjustment

of the value of setting in the screen knob.

● Press the rotary knob: the screen knob changes

colour from green to yellow = the setting is confirmed
(validated) and active.

22

Selecting another ventilation mode and setting its
parameters

● Touch the appropriate screen key, e.g. »BIPAP«. The

key changes colour from green to yellow, and the
parameter setting page for BIPAP is displayed.

To set the parameters for BIPAP:

● Touch the screen knob, which changes colour from

green to yellow = adjustment function selected.

● Turn rotary knob = adjust value displayed in screen

knob.

Operating Concept

Screen Pages

● Press rotary knob: the screen knob changes colour

from yellow to green = setting validated and effective.

If the indicator "LED" next to a screen knob is illuminated
white, the knob setting will only be effective after the new
ventilation mode has been switched on (example: »PASB«
knob).

If the indicator "LED" is illuminated yellow, the relevant
knob setting is already active in the existing ventilation
mode (example: »O2« knob).

The start-up values effective on switching on the
ventilator are marked on the relevant knob-scale with an
arrow (j).
Example: PASB = 0 mbar

● Press the rotary knob: the screen key changes colour

from yellow to black = the ventilation mode is active.

For detailed instructions on setting the ventilation modes,
please refer to page 49.

Cancel selection/setting

014 37 207

PEEP +

10

PASB

● Press the screen key or screen knob again.

or

● Press another screen key or another screen knob.

To quit a screen page:

1 Press »? « key = return to standard page

or
2 press any of the function keys next to the screen on

the right.

D Evita 4

2

1

23

Operating Concept
Screen Pages

»Alarm limits« Screen Page

This page is used for:
Displaying the measured values and the corresponding

alarm limits.
Setting the alarm limits.
Setting the monitoring function.
Displaying the logbook.
The alarm limits are grouped together in a field and

combined with a curve and four measured values.

Limits, monitoring and logbook are selected by the
screen keys on the right of the screen.
The currently activated screen key is highlighted in black.

017 37 207

Displaying/Setting Alarm Limits

● Touch the »Limits« screen key. The screen key will

change to black.
The monitored measured values will be displayed,
together with their alarm limits:

Example:

MV 5.4 L/min

5.5

7.5

Left-hand screen key = lower alarm limit.
Right hand screen key = upper alarm limit.

Set the alarm limit:

● Touch the relevant screen key.

The key changes colour to yellow = adjustable.

● Turn the rotary knob = adjust value displayed in the

key.

● Press the dial-knob. The screen key changes colour

to green = setting confirmed.
The alarm limit is now effective.

For detailed operating instructions, please refer to
page 77.

24

»Measured values« Screen Page

This page is used to display:
– the measured values in table format
– the trend curve
– loops
– logbook.

Tables, trend, loop and logbook are selected by the right­hand block of screen keys.

Example table of measured values »Table 1«

For detailed operating instructions, please refer to
page 81.

Operating Concept

Screen Pages

018 37 207019 37 207

Display Logbook

● Touch the »Logbook« screen key.

● Turn the dial-knob = select alarm events.

For detailed operating instructions, please refer to
page 85.

25

Operating Concept
Screen Pages

»Special Procedures« Screen Page

This page is used to display and perform the following
special measuring procedures:

– Intrinsic PEEP
and
– Occlusion pressure P 0.1

The desired special procedure is selected by the
appropriate screen key on the right. The result of the last
special procedure is displayed.

Example: Intrinsic PEEP:

To start the special procedure:

● Touch the »Start« screen key.

For detailed operating instructions, please refer to
page 93 and 94.

»Calibration« Screen Page

This page is used for calibrating
– the O2 sensor
– the Flow sensor
– the CO2 sensor

● Select the desired sensor with the »O2«, »Flow« or

»CO2« screen keys.
Calibration starts as soon as the relevant key is
pressed.

020 37 207021 37 207

Evita 4 provides the necessary calibration instructions in
the Help Function line at the bottom of the screen.

For detailed operating instructions, please refer to
page 97 et seq..

26

»Configuration« Screen Page

For selecting/adjusting the following functions:

Sound

Setting the volume of the alarm tone.

Screen

Selecting the displayed measured values.
Selecting the displayed curves.
Selecting the displayed trends.

Ventilation

Selecting ventilation modes.
Selecting the patient mode.
Selecting the initial setting.

System Defaults

Setting the external interface.
Setting the time and date.
Selecting the language and measurement units.
Selecting service diagnosis.

Operating Concept

Screen Pages

Control Unit Location

022 37 207

For detailed operating instructions, see page 107.

Control Unit Location

To adapt to the situation of the ventilation location, the
control unit can be placed

either directly on the device
or
separately, on a wall rail.

For detailed instructions on placing, see page 47.

Ergonomic Positioning

To ensure best viewing, free of reflections.

D Evita 4

1 Hold down the blue segments on the right and left

and

2 at the same time, tilt the control unit to the desired

position.

1

2

1

2

27

28

Preparation

Contents

Preparation

Contents

Attaching components............................................................................30

Fitting expiration valve...............................................................................30

Fitting flow sensor.................................................................................... 30

Fitting O2 sensor capsule.........................................................................31

Note on Use of Heat and Moisture Exchanger (HME)............................31

Ventilation Adults and Children.............................................................. 32

Connecting Aquapor humidifier................................................................ 32

Connecting ventilation hoses.................................................................... 32

Fitting temperature sensor........................................................................33

Fitting CO2 cuvette and CO2 sensor........................................................34

Ventilating Infants................................................................................... 34

Fitting bacterial filter................................................................................. 34

Fitting humidifier and ventilation hose........................................................35

If using bacterial filters........................................................................... 35

Supply and Connections.........................................................................36

Electrical power supply.............................................................................36

Note on use of a socket strip for ancillary equipment.................................36

Temporary interruption of power supply....................................................36

Gas supply...............................................................................................37

Evita Remote (optional)........................................................................... 38

Connection.............................................................................................. 38

Note automatic self-test............................................................................ 39

Nurse call (optional).................................................................................40

Technical Data......................................................................................... 40

Before Using for the First Time.............................................................. 41

Selecting the language of the display texts................................................41

Device Check..........................................................................................42

Before use on patient............................................................................... 42

Performing device check.......................................................................... 43

Checking the hose system for leaks..........................................................46

Positioning the control unit.....................................................................47

To position the control unit on the wall rail.................................................47

To position the control unit on the device.................................................. 47

29

Preparation
Attaching components

The following instructions include:
– Equipment assembly.
– Electrical and gas connections.
– Setting the language for the display texts.
– Automatic device check with sensor calibration.

Attaching components

● Always use properly prepared parts, see Preparing,

page 135.

Fitting the expiration valve

● Tilt the control unit upwards.

● Push the expiration valve as far as it will go into the

mounting. Check that it is properly engaged by gently
pulling the port.

Fitting the flow sensor

1 Push socket to left as far as it will go.

1

2 Fit flow sensor – with the probe facing towards the

ventilator – into the mounting and push it into the
socket as far as it will go.

Then:

3 Push flow sensor to the right as far as it will go into

the rubber lip of the expiration valve.

30

3

2