Hamilton G5 Operator's Manual

Operator‘s manual

624074/07

Software version 2.2X

624074/07

© 2012 HAMILTON MEDICAL AG. All rights reserved. Printed in
Switzerland. No part of this publication may be reproduced or
stored in a database or retrieval system, nor transmitted, in any
form or by any means, electronic, mechanical, by photocopy­ing, recording, or otherwise, without the prior written permis­sion of HAMILTON MEDICAL.

This manual may be revised or replaced by HAMILTON
MEDICAL at any time and without notice. Ensure that you have
the most current applicable version of this manual; if in doubt,
contact HAMILTON MEDICAL AG Marketing Department.
While the information set forth is believed to be accurate, it is
not a substitute for the exercise of professional judgment.

Nothing in this manual shall limit or restrict in any way
HAMILTON MEDICAL’s right to revise or otherwise change or
modify the equipment (including its software) described herein,
without notice. In the absence of an express, written agree­ment to the contrary, HAMILTON MEDICAL has no obligation
to furnish any such revisions, changes, or modifications to the
owner or user of the equipment (including software) described
herein.

The equipment must be operated and serviced by trained pro­fessionals only. HAMILTON MEDICAL’s sole responsibility with
respect to the equipment and its use is as stated in the Limited
Warranty provided in this manual.

Product and company names mentioned herein may be the
trademarks of their respective owners.

HAMILTON MEDICAL will make available on request circuit dia­grams, component parts lists, descriptions, calibration instruc­tions, or other information that will assist the user’s authorized
trained personnel to repair those parts of the equipment
deemed by HAMILTON MEDICAL to be repairable.

624074/07 iii

Manufacturer Distributor in USA

HAMILTON MEDICAL AG
Via Crusch 8
CH-7402 Bonaduz
Switzerland
Phone: [phone]
Fax: [phone]
[e-mail]
www.hamilton-medical.com

HAMILTON MEDICAL, Inc.
4990 Energy Way
P.O. Box 30008
Reno, NV 89520, USA
Phone: [phone]
Toll-free: [phone]
Fax: [phone]
[e-mail]

iv 624074/07

Safety warnings, cautions, notes

The software version for the HAMILTON-G5 is visible in the

System -> Info window

(ventilator unit processor) (that is, the digit to the left of the
decimal point for VUP) should match the version on the title
page of this manual. See section 4.3.1 for details.

WARNING

A WARNING alerts the user to the possibility of

injury, death, or other serious adverse reactions
associated with the use or misuse of the device. It

also describes potential serious adverse reactions
and safety hazards.

CAUTION

A CAUTION alerts the user to the possibility of a
problem with the device associated with its use of
misuse, such as device malfunction, device failure,
damage to the device, or damage to other prop­erty. It also alerts against unsafe practices. This

includes the special care necessary for the safe and
effective use of the device.

. The software version for the VUP

NOTE:

A NOTE emphasizes information of particular impor­tance.

624074/07 v

Displayed only when the P/V Tool maneuver
option is installed

Displayed only when the adaptive support venti­lation (ASV) option is installed.

Displayed when the heliox option is installed

Displayed only when the CO

sensor option is

2

installed

Displayed only when the SpO2 sensor option is
installed

Displayed only when neonatal option is installed

vi 624074/07

Displayed when the INTELLiVENT-ASV option is
installed

Displayed when the intelliCuff option is installed

This manual shows screenshots and hardware with several
options installed.

General warnings, cautions, and notes

Intended use

CAUTION

Federal (USA) law restricts this device to sale by or
on the order of a physician.

NOTE:

• Not all options are available in all markets.

•ASV

®

and INTELLiVENT®-ASV for adult and pediatric

use only.

The HAMILTON-G5 ventilator is designed for intensive care
ventilation of adult and pediatric patients, and optionally infant
and neonatal patients. The device is intended for use in the
hospital and institutional environment where health care pro­fessionals provide patient care. The HAMILTON-G5 ventilator is
intended for use by properly trained personnel under the direct
supervision of a licensed physician. The HAMILTON-G5 ventila­tor may be used for transport within a hospital or hospital type

624074/07 vii

facility provided compressed gas is supplied. The device is not
to be used in the presence of flammable anesthetic agents or
other ignition sources. The ventilator is not to be used in an
environment with magnetic resonance imaging (MRI) equip­ment. The device is not intended for transportation outside the
hospital or for use in the home environment.

General notes for operators

• Operators must familiarize themselves with this manual
before using the ventilator on a patient. For training options
of the HAMILTON-G5, please contact the HAMILTON
MEDICAL representatives.

• The displays shown in this manual may not exactly match
what you see on your own ventilator. Your ventilator may
not include all the modes and features described in this
manual.

Monitoring and alarms

• The HAMILTON-G5 is not intended to be a comprehensive
vital sign monitor for patients on life-support equipment.
Patients on life-support equipment must be appropriately
monitored by qualified medical personnel and suitable
monitoring devices. The use of an alarm monitoring system
does not give absolute assurance of warning for every form
of malfunction that may occur with the ventilator. Alarm
messages may not exactly pinpoint a problem; the exercise
of clinical judgment is necessary.

• An alternative means of ventilation shall be available when­ever the ventilator is in use. If a fault is detected in the ven­tilator or its life-support functions are in doubt, disconnect
the HAMILTON-G5 from the patient and immediately start
ventilation with such a device (for example, a resuscitation
bag), using PEEP and/or increased oxygen concentration
when appropriate. The ventilator must be removed from
clinical use and serviced by HAMILTON MEDICAL authorized
service personnel.

• It is recommended that additional independent monitoring
devices be used during mechanical ventilation. The opera-

viii 624074/07

tor of the ventilator must still maintain full responsibility for
proper ventilation and patient safety in all situations.

• Do not silence the audible alarm when leaving the patient

unattended.

• Do not use the exhaust port of the expiratory valve for

spirometry. Due to the HAMILTON-G5’s base flow, the
exhaust gas output is larger than the patient’s actual
exhaled volume.

• Heliox gas is not compatible with INTELLiVENT

• The Masimo Rainbow SpHb sensor is valid for a total of 66

hours of operation. Once this time expires, you must
connect a new SpHb sensor. For details, see Appendix F,
Pulse oximetry.

Fire and other hazards

• To reduce the risk of fire or explosion, do not place the

HAMILTON-G5 in a combustible or explosive environment
(for example, around flammable anesthetics or other
ignition sources). Do not use it with any equipment
contaminated with oil or grease.

• To minimize the risk of fire, do not use high-pressure gas

hoses that are worn or contaminated with combustible
materials like grease or oil.

• To reduce the risk of fire, use only breathing circuits

intended for use in oxygen-enriched environments. Do not
use antistatic or electrically conductive tubing.

• In case of fire, immediately secure the patient’s ventilatory

needs, switch off the HAMILTON-G5, and disconnect it
from its gas and electrical sources.

• Do not put a vessel filled with a liquid on the ventilator.

If a liquid enters the product, a fire and/or electric shock
may occur.

®

-ASV use.

624074/07 ix

Service and testing

• To ensure proper servicing and to prevent possible physical
injury, only qualified personnel should attempt to service
the ventilator.

• To reduce the risk of electrical shock, do not remove the
ventilator housing. Refer the ventilator for servicing by qual­ified personnel.

• To reduce the risk of electrical shock, disconnect electrical
power from the ventilator before servicing. Be aware that

battery power remains even after the mains is discon­nected. Be aware that if the power switch is off, some parts
still carry high voltage.

• Do not attempt service procedures other than those speci­fied in the service manual.

• Use replacement parts supplied by HAMILTON MEDICAL
only.

• Any attempt to modify the ventilator hardware or software
without the express written approval of HAMILTON
MEDICAL automatically voids all warranties and liabilities.

• The preventive maintenance program requires a general
service every 5000 hours or yearly, whichever comes first.

• To ensure the ventilator’s safe operation, always run the
tests and calibrations prescribed in Chapter 4, Tests, calibra­tions, and utilities, before using the ventilator on a patient.
If the ventilator fails any tests, remove it from clinical use
immediately. Do not use the ventilator until necessary
repairs are completed and all tests have passed.

Electromagnetic susceptibility

For further information see Appendix A.

Electromagnetic emissions

For further information see Appendix A.

x 624074/07

Units of measure

Air and oxygen pressures are indicated on the HAMILTON-G5
in cmH2O or mbar. Hectopascals (hPa) are used by some insti­tutions instead. Since 1 mbar equals 1 hPa, which equals

1.016 cmH2O, the units may be used interchangeably.

measurements are indicated in mmHg, Torr, and kPa.

CO

2

These units are user configurable.

SpO

measurements are indicated in %.

2

Disposal

Dispose of all parts removed from the device according to your
institution’s protocol. Follow all local, state, and federal regula­tions with respect to environmental protection, especially when
disposing an electronic device or parts of it (for example,
oxygen cell, batteries).

Year of manufacture

The year of manufacture is shown on the serial number label
on the HAMILTON-G5 ventilation unit.

624074/07 xi

xii 624074/07

Table of Contents

Safety warnings, cautions, notes . . . . . . . . . . . . . . .v

General warnings, cautions, and notes . . . . . . . . . . . . . . . vii

Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

General notes for operators . . . . . . . . . . . . . . . . . . . . . . . viii

Monitoring and alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . viii

Fire and other hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix

Service and testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x

Electromagnetic susceptibility . . . . . . . . . . . . . . . . . . . . . . . x

Electromagnetic emissions . . . . . . . . . . . . . . . . . . . . . . . . . . x

Units of measure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi

Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi

Year of manufacture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi

List of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxvii

List of Tables. . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxxv

1 General information. . . . . . . . . . . . . . . . . . . . . . . . 1-1

1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2

1.2 Functional description . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-9

1.2.1 System overview . . . . . . . . . . . . . . . . . . . . . . . . . 1-9

1.2.2 Gas supply and delivery . . . . . . . . . . . . . . . . . . . 1-10

1.2.3 Gas monitoring with the flow sensor . . . . . . . . . 1-12

1.3 Physical description . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-13

1.3.1 Breathing circuits and accessories . . . . . . . . . . . 1-13

1.3.2 Ventilation cockpit . . . . . . . . . . . . . . . . . . . . . . . 1-17

1.3.3 Ventilation unit . . . . . . . . . . . . . . . . . . . . . . . . . 1-23

1.4 Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-26

2 Preparing for ventilation . . . . . . . . . . . . . . . . . . . . 2-1

2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

2.2 Installing and positioning the Ventilation Cockpit. . . . . . . 2-4

2.2.1 Mounting the Ventilation Cockpit . . . . . . . . . . . . 2-4

2.2.2 Adjusting the Ventilation Cockpit (tilt and swivel) 2-6

2.3 Installing the patient tubing support arm . . . . . . . . . . . . . 2-7

624074/07 xiii

Table of Contents

2.4 Installing the humidifier. . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8

2.4.1 Connecting and attaching the humidifier . . . . . . .2-9

2.5 Installing the modules (CO

, SpO2, Aeroneb,

2

HAMILTON-H900 humidifier) . . . . . . . . . . . . . . . . . . . . .2-12

2.6 Verifying the oxygen cell installation . . . . . . . . . . . . . . . . 2-13

2.7 Installing the patient breathing circuit . . . . . . . . . . . . . . . 2-14

2.8 Using the auxiliary pressure (Paux) measurement. . . . . . . 2-22

2.9 Using an expiratory filter . . . . . . . . . . . . . . . . . . . . . . . . . 2-23

2.10 Connecting to AC power . . . . . . . . . . . . . . . . . . . . . . . . 2-24

2.11 Using the optional power strip . . . . . . . . . . . . . . . . . . . . 2-25

2.12 Using the backup batteries . . . . . . . . . . . . . . . . . . . . . . . 2-25

2.12.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-26

2.12.2 Replacing the optional extended battery pack. . .2-28

2.13 Connecting gas supplies . . . . . . . . . . . . . . . . . . . . . . . . .2-29

2.14 Connecting to an external patient monitor or other

device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-32

2.15 Starting up the ventilator . . . . . . . . . . . . . . . . . . . . . . . . 2-33

2.16 Shutting down the ventilator. . . . . . . . . . . . . . . . . . . . . .2-34

2.17 Ventilation cockpit navigation guidelines . . . . . . . . . . . . . 2-35

3 Hardware options. . . . . . . . . . . . . . . . . . . . . . . . . . 3-1

3.1 Set up CO2 sensor monitoring. . . . . . . . . . . . . . . . . . . . . . 3-3

3.1.1 Enabling CO

3.1.2 CO

mainstream measurement . . . . . . . . . . . . . . .3-5

2

3.1.2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . 3-5

3.1.2.2 Connecting the CO

3.1.3 CO

sidestream measurement. . . . . . . . . . . . . . . . 3-9

2

3.1.3.1 Using the LoFlo™ CO

3.1.3.2 Module mounting . . . . . . . . . . . . . . . . . 3-9

3.1.3.3 Module exhaust . . . . . . . . . . . . . . . . . .3-10

3.1.3.4 Connecting the CO

3.1.3.5 Sidestream sample kit . . . . . . . . . . . . . . 3-13

3.2 SpO

monitoring options . . . . . . . . . . . . . . . . . . . . . . . . 3-14

2

3.3 Installing the pneumatic nebulizer . . . . . . . . . . . . . . . . . .3-15

xiv 624074/07

. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5

2

mainstream sensor .3-6

2

Module . . . . . . . . 3-9

2

sidestream sensor . 3-10

2

3.4 Integrated Aeroneb® system . . . . . . . . . . . . . . . . . . . . . 3-17

3.4.1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17

3.4.2 Indications for use . . . . . . . . . . . . . . . . . . . . . . . 3-18

3.4.3 System description . . . . . . . . . . . . . . . . . . . . . . . 3-18

3.4.4 Enabling the Aeroneb option . . . . . . . . . . . . . . . 3-20

3.4.5 Connecting the nebulizer. . . . . . . . . . . . . . . . . . 3-20

3.4.6 Continuous nebulization . . . . . . . . . . . . . . . . . . 3-22

3.4.6.1 Setting the flow-rate for continuous

nebulization . . . . . . . . . . . . . . . . . . . . 3-23

3.4.7 Installation in breathing circuit . . . . . . . . . . . . . . 3-24

3.4.8 Adding medication . . . . . . . . . . . . . . . . . . . . . . 3-26

3.4.9 Configuring nebulization . . . . . . . . . . . . . . . . . . 3-27

3.4.9.1 Configuring nebulization for
intermittent doses less than or equal

to 6 ml . . . . . . . . . . . . . . . . . . . . . . . . 3-27

3.4.9.2 Configuring nebulization for

continuous doses . . . . . . . . . . . . . . . . . 3-28

3.4.10 Functional test . . . . . . . . . . . . . . . . . . . . . . . . . . 3-29

3.4.11 Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-30

®

3.5 IntelliCuff

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-30

3.5.1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-30

3.5.2 Indications for use . . . . . . . . . . . . . . . . . . . . . . . 3-30

3.5.3 System description . . . . . . . . . . . . . . . . . . . . . . . 3-30

3.5.4 Enabling the integrated cuff pressure controller

option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-33

3.5.5 Operation of the automatic cuff pressure

controller. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-34

3.5.6 Operating modes . . . . . . . . . . . . . . . . . . . . . . . . 3-35

3.5.6.1 Cuff pressure control OFF . . . . . . . . . . 3-35

3.5.6.2 Setting constant cuff pressure

(MANUAL) . . . . . . . . . . . . . . . . . . . . . . 3-36

3.5.6.3 Setting cuff pressure relative to

airway pressure (AUTO) . . . . . . . . . . . . 3-37

3.5.6.4 Full deflation of the cuff . . . . . . . . . . . 3-38

3.5.7 Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-39

624074/07 xv

Table of Contents

3.6 Working with the integrated HAMILTON-H900

humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-39

3.6.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-40

3.6.2 Humidifier overview . . . . . . . . . . . . . . . . . . . . . .3-40

3.6.3 Setting up the humidifier . . . . . . . . . . . . . . . . . . 3-42

3.6.4 Humidifier display on the ventilator. . . . . . . . . . . 3-42

3.6.5 Controlling humidifier options . . . . . . . . . . . . . .3-44

3.6.6 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-45

4 Tests, calibrations and utilities . . . . . . . . . . . . . . . 4-1

4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2

4.2 Pre-operational checks . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

4.2.1 Pre-operational check with heliox . . . . . . . . . . . . . 4-6

4.3 System functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8

4.3.1 Info: Viewing ventilator operating hours,

options, and versions . . . . . . . . . . . . . . . . . . . . . . 4-8

4.3.2 Tests & calib: Running sensor calibrations and the

tightness test . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10

4.3.2.1 Flow sensor calibration . . . . . . . . . . . . . 4-10

4.3.2.2 Tightness test . . . . . . . . . . . . . . . . . . . . 4-13

4.3.2.3 Oxygen cell calibration . . . . . . . . . . . . . 4-14

4.3.2.4 CO

4.3.2.5 SpO

4.3.3 Sensors on/off: Enabling/disabling SpO

and CO

4.3.3.1 Gas source: Assigning air or heliox . . . . 4-18

4.3.4 Setting day and night . . . . . . . . . . . . . . . . . . . . . 4-19

4.3.5 Setting date and time . . . . . . . . . . . . . . . . . . . . .4-20

4.4 Alarm tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-20

4.4.1 High pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-21

4.4.2 Low minute volume . . . . . . . . . . . . . . . . . . . . . . 4-21

4.4.3 Oxygen supply failed and low oxygen alarms . . . 4-21

4.4.4 Disconnection . . . . . . . . . . . . . . . . . . . . . . . . . . .4-22

4.4.5 Loss of mains power . . . . . . . . . . . . . . . . . . . . . . 4-22

4.4.6 Exhalation obstructed . . . . . . . . . . . . . . . . . . . . .4-22

4.4.7 Apnea. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-22

sensor/adapter zero calibration . . .4-15

2

sensor/adapter test . . . . . . . . . . .4-16

2

, O2,

monitoring . . . . . . . . . . . . . . . . . . . . . .4-17

2

2

xvi 624074/07

5 Ventilator settings . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2

5.2 Setting up the patient . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3

5.3 Patient window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5

5.3.1 Patient window: Changing patient gender

and height. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5

5.3.2 Patient window: Ventilation timer . . . . . . . . . . . . 5-6

5.4 Modes window: Setting the ventilation mode . . . . . . . . . 5-7

5.5 Controls window: Settings including apnea backup

ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-10

5.5.1 Adjusting and confirming control settings

without mode change . . . . . . . . . . . . . . . . . . . . 5-10

5.5.2 Adjusting and confirming control settings

after mode change . . . . . . . . . . . . . . . . . . . . . . 5-12

5.5.3 About apnea backup ventilation . . . . . . . . . . . . 5-14

5.6 Additions window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-15

5.6.1 Sigh: Enabling/disabling the sigh function . . . . . 5-16

5.6.2 TRC: Setting tube resistance compensation . . . . 5-17

5.6.3 Table of control settings, additions, and ranges . 5-19

5.7 Alarms window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-27

5.7.1 Limits: Setting alarm limits . . . . . . . . . . . . . . . . . 5-28

5.7.2 Loudness: Adjusting alarm loudness. . . . . . . . . . 5-30

5.7.3 Buffer: Viewing active alarms . . . . . . . . . . . . . . . 5-31

5.7.4 Table of alarm limit settings and ranges . . . . . . . 5-31

6 Neonatal ventilation . . . . . . . . . . . . . . . . . . . . . . . 6-1

6.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2

6.2 Breathing circuit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3

6.3 Flow sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3

6.4 Test and calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-4

6.5 Ventilation modes and mode additions . . . . . . . . . . . . . . 6-4

6.6 Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5

6.6.1 Ti max . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5

6.6.2 Flowtrigger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5

6.6.3 P-ramp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-6

6.7 Others . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-6

624074/07 xvii

Table of Contents

7 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

7.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2

7.2 Monitoring window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4

7.2.1 Monitored parameter windows and sensor

data window: Viewing numeric patient data . . . . . 7-4

7.2.2 Paw/Paux: Assigning Paw or Paux as pressure

input for numeric patient data . . . . . . . . . . . . . . . 7-5

7.3 Graphics window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7

7.3.1 Graphics window: Set up for the ventilation

cockpit (layout and setting trend timing). . . . . . . .7-7

7.3.2 Setting up individual panels . . . . . . . . . . . . . . . . .7-8

7.3.3 About graphic types . . . . . . . . . . . . . . . . . . . . . . . 7-9

7.3.3.1 Waveforms . . . . . . . . . . . . . . . . . . . . . . 7-10

7.3.4 Loops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10

7.3.4.1 Trends . . . . . . . . . . . . . . . . . . . . . . . . . 7-12

7.3.4.2 Dynamic lung . . . . . . . . . . . . . . . . . . . . 7-13

7.3.4.3 Vent status . . . . . . . . . . . . . . . . . . . . . . 7-13

7.3.4.4 INTELLiVENT

7.3.4.5 ASV graphics window . . . . . . . . . . . . . .7-14

7.3.4.6 ASV data window . . . . . . . . . . . . . . . . .7-14

7.3.5 Freeze and cursor measurement . . . . . . . . . . . . . 7-14

7.4 Tools window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-15

7.4.1 Hold: Performing inspiratory/expiratory hold

maneuvers . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-15

7.4.2 Performing a static P/V maneuver . . . . . . . . . . . . 7-18

7.5 Monitored parameters . . . . . . . . . . . . . . . . . . . . . . . . . . 7-18

®

-specific intelligent panels 7-13

8 Intelligent panels . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1

8.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

8.2 Dynamic lung panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

8.2.1 Tidal volume (Vt). . . . . . . . . . . . . . . . . . . . . . . . . . 8-3

8.2.2 Compliance (Cstat) . . . . . . . . . . . . . . . . . . . . . . . .8-3

8.2.3 Patient triggering: Muscle . . . . . . . . . . . . . . . . . . . 8-4

8.2.4 Resistance: Bronchial tree . . . . . . . . . . . . . . . . . . . 8-4

8.2.5 Heart circulation . . . . . . . . . . . . . . . . . . . . . . . . . .8-5

xviii 624074/07

8.3 Heart-Lung Interaction . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-6

8.3.1 Graphic Display . . . . . . . . . . . . . . . . . . . . . . . . . . 8-6

8.4 Vent status. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-7

8.5 ASV monitored data window . . . . . . . . . . . . . . . . . . . . . . 8-9

8.6 ASV target graphics window . . . . . . . . . . . . . . . . . . . . . 8-10

8.7 INTELLiVENT®-specific intelligent panels . . . . . . . . . . . . 8-10

8.8 Quick Wean-specific intelligent panels . . . . . . . . . . . . . . 8-10

9 P/V tool maneuver option . . . . . . . . . . . . . . . . . . . 9-1

9.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

9.1.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

9.1.2 Required conditions for use . . . . . . . . . . . . . . . . . 9-3

9.1.3 Indication for use . . . . . . . . . . . . . . . . . . . . . . . . 9-3

9.1.4 Contraindications for use . . . . . . . . . . . . . . . . . . . 9-4

9.1.5 How the P/V Tool works . . . . . . . . . . . . . . . . . . . 9-4

9.2 Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-5

9.2.1 Performing the maneuver . . . . . . . . . . . . . . . . . . 9-6

9.2.2 Using the cursor feature to graphically analyze

the plot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-12

9.2.3 Analyzing the curve . . . . . . . . . . . . . . . . . . . . . . 9-14

9.2.4 Selecting plot type . . . . . . . . . . . . . . . . . . . . . . . 9-17

9.2.5 Using the Reference feature to review stored

curves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-18

9.2.6 Flow sensor and breathing circuit check. . . . . . . 9-19

9.2.7 P/V Tool against P/V Tool Pro . . . . . . . . . . . . . . . 9-23

9.3 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-23

10 Responding to alarms . . . . . . . . . . . . . . . . . . . . . 10-1

10.1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

10.2 How to respond to an alarm . . . . . . . . . . . . . . . . . . . . . 10-5

10.3 Active alarm buffer . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-6

10.4 Event logs: Reviewing events . . . . . . . . . . . . . . . . . . . . . 10-7

10.5 Alarm troubleshooting table. . . . . . . . . . . . . . . . . . . . . . 10-8

624074/07 xix

Table of Contents

11 Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1

11.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2

11.2 Cleaning, disinfection, and sterilization . . . . . . . . . . . . . .11-2

11.2.1 General guidelines for cleaning . . . . . . . . . . . . . 11-10

11.2.2 General guidelines for chemical disinfection . . .11-10

11.2.3 General guidelines for autoclave sterilization. . .11-11

11.3 Preventive maintenance . . . . . . . . . . . . . . . . . . . . . . . .11-11

11.3.1 Cleaning or replacing the fan filter . . . . . . . . . . 11-14

11.3.2 Removing a gas supply filter housing . . . . . . . . 11-14

11.3.3 Replacing the oxygen cell . . . . . . . . . . . . . . . . .11-14

11.4 Calibration of the extended battery . . . . . . . . . . . . . . . . 11-15

11.5 Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-15

11.6 Repacking and shipping . . . . . . . . . . . . . . . . . . . . . . . . 11-15

12 Special functions. . . . . . . . . . . . . . . . . . . . . . . . . . 12-1

12.1 Standby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-2

12.2 O

12.3 Suctioning tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-5

12.4 Manual breath . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-6

12.5 Pneumatic and Aeroneb

12.6 Print screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7

12.7 Screen Lock/Unlock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-8

enrichment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4

2

®

nebulizer. . . . . . . . . . . . . . . . .12-6

A Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-1

A.1 Physical characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . A-2

A.2 Environmental requirements . . . . . . . . . . . . . . . . . . . . . . A-3

A.3 Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . . . A-3

A.4 Electrical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . A-4

A.5 Control settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-6

A.6 Monitored parameters . . . . . . . . . . . . . . . . . . . . . . . . . A-20

A.7 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-26

A.8 Configuration specifications . . . . . . . . . . . . . . . . . . . . . A-33

A.9 Breathing circuit specifications . . . . . . . . . . . . . . . . . . . A-37

A.10 Other technical data . . . . . . . . . . . . . . . . . . . . . . . . . . . A-38

A.11 Standards and approvals . . . . . . . . . . . . . . . . . . . . . . . . A-41

xx 624074/07

A.12 EMC declarations (IEC 60601-1-2) . . . . . . . . . . . . . . . . . A-42

A.13 Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-47

A.14 Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-48

B Modes of ventilation . . . . . . . . . . . . . . . . . . . . . . . B-1

B.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-2

B.2 Mandatory modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-5

B.2.1 Synchronised controlled mandatory ventilation

((S)CMV) mode . . . . . . . . . . . . . . . . . . . . . . . . . . B-5

B.2.2 Pressure-controlled CMV (P-CMV) mode . . . . . . . B-6

B.3 SIMV (synchronized intermittent mandatory ventilation)

modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-7

B.3.1 SIMV mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-8

B.3.2 P-SIMV mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . B-9

B.4 Pressure support mode (SPONT) . . . . . . . . . . . . . . . . . . . B-10

B.5 Advanced ventilation modes . . . . . . . . . . . . . . . . . . . . . B-11

B.5.1 Adaptive pressure ventilation (APV) . . . . . . . . . . B-11

B.5.1.1 Advantages . . . . . . . . . . . . . . . . . . . . . B-13

B.5.1.2 Principles of operation . . . . . . . . . . . . . B-14

B.5.2 Adaptive support ventilation (ASV). . . . . . . . . . . B-15

B.5.3 DuoPAP (Duo positive airway pressure) and

APRV (Airway pressure release ventilation) . . . . . B-15

B.5.3.1 Introduction . . . . . . . . . . . . . . . . . . . . B-15

B.5.3.2 Differences between DuoPAP and APRV B-18
B.5.3.3 The many faces of DuoPAP and APRV . B-18
B.5.3.4 Pressure support in DuoPAP/APRV

breaths . . . . . . . . . . . . . . . . . . . . . . . . B-19

B.5.3.5 Synchronization . . . . . . . . . . . . . . . . . . B-20

B.5.3.6 References . . . . . . . . . . . . . . . . . . . . . . B-21

B.5.4 Noninvasive ventilation (NIV and NIV-ST) . . . . . . B-21

B.5.5 nCPAP-PS mode . . . . . . . . . . . . . . . . . . . . . . . . B-23

B.5.5.1 Introduction . . . . . . . . . . . . . . . . . . . . B-23

B.5.5.2 Controls of nCPAP-PS . . . . . . . . . . . . . B-24

B.6 Leak compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-25

624074/07 xxi

Table of Contents

CASV® (Adaptive Support Ventilation). . . . . . . . . . C-1

C.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-2

C.2 ASV use in clinical practice . . . . . . . . . . . . . . . . . . . . . . . C-3

C.3 Detailed functional description of ASV . . . . . . . . . . . . . C-15

C.3.1 Normal minute ventilation. . . . . . . . . . . . . . . . . C-15

C.3.2 Targeted minute ventilation . . . . . . . . . . . . . . . C-15

C.3.3 Lung-protective rules strategy . . . . . . . . . . . . . C-17

C.3.4 Optimal breath pattern . . . . . . . . . . . . . . . . . . . C-20

C.3.4.1 Initial breaths: How ASV starts . . . . . . C-21

C.3.4.2 Approaching the target . . . . . . . . . . . C-22

C.3.5 Dynamic adjustment of lung protection . . . . . . C-24

C.3.6 Dynamic adjustment of optimal breath pattern . C-25

C.4 Minimum work of breathing (Otis’ equation). . . . . . . . . C-26

C.5 ASV technical data . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-28

C.6 ASV Start up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-31

C.7 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-32

D NIV (Noninvasive ventilation) . . . . . . . . . . . . . . . .D-1

D.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-2

D.2 Benefits of noninvasive ventilation, . . . . . . . . . . . . . . . . . D-3

D.3 Required conditions for use . . . . . . . . . . . . . . . . . . . . . . . D-4

D.4 Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-5

D.5 Potential adverse reactions . . . . . . . . . . . . . . . . . . . . . . . D-5

D.6 Selecting a patient interface . . . . . . . . . . . . . . . . . . . . . . D-5

D.7 Control settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-7

D.8 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-8

D.9 Monitored parameters . . . . . . . . . . . . . . . . . . . . . . . . . . D-8

D.10 Additional notes about using noninvasive ventilation. . . . D-9

D.11 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-11

ECO2 sensor option: Volumetric Capnography . . . E-1

E.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-2

E.2 CO
E.3 End-tidal CO

E.4 Airway dead space (VDaw) . . . . . . . . . . . . . . . . . . . . . . . . E-5

E.5 Alveolar minute ventilation (V’alv) . . . . . . . . . . . . . . . . . . . E-6

xxii 624074/07

elimination (V’CO2) . . . . . . . . . . . . . . . . . . . . . . . . . . E-3

2

(PetCO2 and FetCO2) . . . . . . . . . . . . . . . . . E-5

2

E.6 Capnogram shape (slope of the alveolar plateau,

slopeCO

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-7

2

E.7 Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-9

E.8 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-10

F Pulse oximetry . . . . . . . . . . . . . . . . . . . . . . . . . . . . F-1

F.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F-3

F.2 SpO2 monitoring options . . . . . . . . . . . . . . . . . . . . . . . . F-13

F.2.1 About Masimo SET and Masimo Rainbow SET . F-14

F.2.1.1 Masimo SpHb sensor modes of

operation . . . . . . . . . . . . . . . . . . . . . . F-15

F.2.2 About Nihon-Kohden . . . . . . . . . . . . . . . . . . . . F-17

F.3 Monitored parameters and settings . . . . . . . . . . . . . . . . F-17

F.3.1 About the Masimo SpO

measurements F-19

F.4 SpO

pulse oximeter data display . . . . . . . . . . . . . . . . . . F-19

2

F.4.1 SpO

parameters in the Monitoring window . . . F-20

2

F.4.2 Quality index indicators . . . . . . . . . . . . . . . . . . . F-21

F.5 Working in SpHb Spot Check mode . . . . . . . . . . . . . . . . F-23

F.5.1 Performing an SpHb spot check . . . . . . . . . . . . . F-25

F.6 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F-26

F.6.1 Masimo SpO
F.6.2 SpO

Alarm Limits window . . . . . . . . . . . . . . . . F-27

2

alarm delay . . . . . . . . . . . . . . . . . F-26

2

F.6.3 Table of pulse oximeter-related alarm settings . . F-27

F.7 Masimo information codes and troubleshooting. . . . . . . F-29

F.7.1 About the pulse oximeter information codes . . . F-30

F.8 Configuring the oximeters . . . . . . . . . . . . . . . . . . . . . . . F-32

F.8.1 Configuring the Masimo options . . . . . . . . . . . . F-32

F.8.1.1 Configuring Masimo data acquisition

options . . . . . . . . . . . . . . . . . . . . . . . . F-33

F.8.1.2 Table of Masimo data acquisition

settings . . . . . . . . . . . . . . . . . . . . . . . . F-34

F.8.1.3 Enabling and configuring monitoring

settings . . . . . . . . . . . . . . . . . . . . . . . . F-35

F.8.1.4 Table of Masimo monitoring options . . F-36
F.8.1.5 Enabling and configuring Masimo

alarms . . . . . . . . . . . . . . . . . . . . . . . . . F-37

Raw parameter

2

624074/07 xxiii

Table of Contents

F.8.2 Configuring the Nihon-Kohden options . . . . . . . F-38

F.9 Connecting the equipment . . . . . . . . . . . . . . . . . . . . . . . F-38

F.9.1 Connecting the Masimo oximeter . . . . . . . . . . . . F-39

F.9.1.1 Attaching the adapter to a rail . . . . . . . F-40

F.9.1.2 Attaching the adapter cable . . . . . . . . . F-42

F.9.1.3 Attaching the patient cable to the

adapter . . . . . . . . . . . . . . . . . . . . F-43

SpO

2

F.9.1.4 Attaching the sensor to the patient

cable . . . . . . . . . . . . . . . . . . . . . . . . . . F-43

F.9.2 Connecting the Nihon-Kohden oximeter . . . . . . . F-44

F.9.3 Confirming measurements . . . . . . . . . . . . . . . . . F-45

F.9.4 Disconnecting the SpO

F.10 Troubleshooting Masimo issues . . . . . . . . . . . . . . . . . . . . F-45

F.11 Masimo specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . F-49

F.12 Basics of pulse oximetry . . . . . . . . . . . . . . . . . . . . . . . . . F-54

F.13 SpO

F.14 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F-57

/FiO2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F-56

2

sensor . . . . . . . . . . . . . . F-45

2

G Pneumatic diagram. . . . . . . . . . . . . . . . . . . . . . . . .G-1

H Parts and accessories . . . . . . . . . . . . . . . . . . . . . . .H-1

I Communication interface. . . . . . . . . . . . . . . . . . . . I-1

I.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-2

I.2 RS-232 interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-3

I.3 Patient monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-4

I.4 PDMS or other computer system . . . . . . . . . . . . . . . . . . . . I-7

I.5 Inspiratory:Expiratory (I:E) timing outlet . . . . . . . . . . . . . . . I-8

I.6 Remote alarm outlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-9

I.7 Connector pin assignments . . . . . . . . . . . . . . . . . . . . . . . I-10

J Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-1

J.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-2

J.2 Begin configuration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-2

J.3 Language: Choosing the default language . . . . . . . . . . . . J-3

J.4 Customize: Choosing the ventilation philosophy and

alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-4

xxiv 624074/07

J.4.1 Breath timing philosophies (adult patients). . . . . . .J-5

J.5 Quick Wean: Choosing the default weaning activity

criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J-7

J.6 MMP selection: Choosing the default main monitoring

parameter display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J-10

J.7 Vent Status: Configuring the Vent Status intelligent

panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .J-11

J.8 Options: Activating software and hardware options . . . . .J-13

J.9 Interface: Configuring the I:E timing outlet. . . . . . . . . . . . J-14

J.10 Nebulizer: Configuring the nebulizer type . . . . . . . . . . . .J-15

J.11 SpO

: Configuring pulse oximeter settings . . . . . . . . . . . .J-16

2

J.12 Defaults: configuring default settings . . . . . . . . . . . . . . . .J-18

Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . Glossary-1

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Index-1

624074/07 xxv

Table of Contents

xxvi 624074/07

List of Figures

1-1 Closed-loop ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3

1-2 Controller conceptual design . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4

1-3 HAMILTON-G5 system overview . . . . . . . . . . . . . . . . . . . . . . . . 1-9

1-4 Gas delivery in the device . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11

1-5 Flow sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-13

1-6 Ventilator with accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-14

1-7 Ventilation Cockpit front view . . . . . . . . . . . . . . . . . . . . . . . . 1-17

1-8 Ventilation Cockpit rear view . . . . . . . . . . . . . . . . . . . . . . . . . 1-19

1-9 Default screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-21

1-10 Front of ventilation unit (patient breathing circuit

connections). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-23

1-11 Rear of ventilation unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-25

2-1 Ventilation Cockpit mounting positions . . . . . . . . . . . . . . . . . . 2-5

2-2 Disconnecting the Ventilation Cockpit . . . . . . . . . . . . . . . . . . . 2-5

2-3 Mounting the Ventilation Cockpit . . . . . . . . . . . . . . . . . . . . . . . 2-6

2-4 Tilting the Ventilation Cockpit. . . . . . . . . . . . . . . . . . . . . . . . . . 2-6

2-5 Swiveling the Ventilation Cockpit . . . . . . . . . . . . . . . . . . . . . . . 2-7

2-6 Installing the patient tubing support arm . . . . . . . . . . . . . . . . . 2-8

2-7 Back of humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10

2-8 Power, communication connections (bottom) . . . . . . . . . . . . . 2-11

2-9 HAMILTON-900 communications cable connected to RS-232

port on ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12

2-10 CO

2-11 Check for the oxygen cell . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-14

2-12 Patient breathing circuit for use with heater wire

2-13 Patient breathing circuit for use with heater wire (neonatal) . . 2-18

2-14 Patient breathing circuit for use with HME . . . . . . . . . . . . . . . 2-19

2-15 Installing the expiratory valve membrane . . . . . . . . . . . . . . . . 2-20

2-16 Installing the expiratory valve cover. . . . . . . . . . . . . . . . . . . . . 2-21

2-17 Installing the flow sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-22

2-18 Electrical power symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-27

2-19 To open the front cover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-28

2-20 To remove the extended battery pack . . . . . . . . . . . . . . . . . . . 2-29

2-21 HAMILTON-G5 inlet fittings . . . . . . . . . . . . . . . . . . . . . . . . . . 2-32

, SpO2, Aeroneb modules. . . . . . . . . . . . . . . . . . . . . . . . . 2-13

2

(pediatric/adult) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-17

624074/07 xxvii

List of Figures

2-22 Power switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-34

3-1 Selecting CO
3-2 Connecting the CO
3-3 Attaching the CO
3-4 Connecting the CO

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5

2

sensor cable . . . . . . . . . . . . . . . . . . . . . . . 3-6

2

sensor to the airway adapter . . . . . . . . . . . . 3-7

2

sensor/airway adapter to the patient

2

circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8

3-5 Mounting bracket . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9

3-6 Connecting the CO

sensor cable . . . . . . . . . . . . . . . . . . . . . . 3-11

2

3-7 Inserting the sample cell into the receptacle. . . . . . . . . . . . . . . 3-11

3-8 Attaching the CO

sensor to the airway adapter . . . . . . . . . . . 3-12

2

3-9 Installing a pneumatic nebulizer. . . . . . . . . . . . . . . . . . . . . . . . 3-16

3-10 System components. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-19

3-11 Selecting Aeroneb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-20

3-12 Connecting nebulizer to T-adapter. . . . . . . . . . . . . . . . . . . . . . 3-21

3-13 Connecting HAMILTON-G5 Aeroneb module. . . . . . . . . . . . . . 3-21

3-14 Aeroneb solo nebulizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-23

3-15 Nebulizer for adult breathing circuit. . . . . . . . . . . . . . . . . . . . . 3-24

3-16 Nebulizer for pediatric breathing circuit . . . . . . . . . . . . . . . . . . 3-24

3-17 Nebulizer for neonatal breathing circuit . . . . . . . . . . . . . . . . . . 3-25

3-18 Add medication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-27

3-19 Intermittent nebulization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-28

3-20 Continuous nebulization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-28

3-21 Connecting cuff tubing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-32

3-22 Cuff tubing connected to cuff inflating tube . . . . . . . . . . . . . . 3-32

3-23 Selecting the cuff pressure controller . . . . . . . . . . . . . . . . . . . . 3-34

3-24 User Interface for automatic cuff pressure control (manual

or no automatic adjustment activated) . . . . . . . . . . . . . . . . . . 3-35

3-25 User Interface for cuff controller, showing cuff pressure

kept constant at manually set level. . . . . . . . . . . . . . . . . . . . . . 3-36

3-26 User Interface for cuff controller, cuff pressure automatically

adapted to actual airway pressure . . . . . . . . . . . . . . . . . . . . . . 3-37

3-27 Concept of automatically set Pcuff based on patient’s

airway pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-38

3-28 User Interface for cuff controller, showing full deflation of

cuff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-39

3-29 HAMILTON-900 humidifier, front view . . . . . . . . . . . . . . . . . . . 3-41

3-30 Humidifier window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-43

4-1 Info window, screen 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8

xxviii 624074/07

4-2 Info window, screen 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-9

4-3 Tests & calib window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10

4-4 CO

sensor/adapter calibration setup . . . . . . . . . . . . . . . . . . . 4-16

2

4-5 Sensors on/off window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-18

4-6 Gas Source window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-19

4-7 Day/Night window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-20

5-1 Patient setup window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4

5-2 Patient window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5

5-3 Modes window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

5-4 Controls window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-11

5-5 Controls window after mode change . . . . . . . . . . . . . . . . . . . 5-13

5-6 INTELLiVENT®-ASV mode window . . . . . . . . . . . . . . . . . . . . . 5-13

5-7 Sigh window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-16

5-8 TRC window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-18

5-9 Ptrach and Paw waveforms (with TRC active) . . . . . . . . . . . . . 5-19

5-10 Alarm Limits 1 window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-29

5-11 Alarm Limits 2 window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-30

5-12 Alarm Loudness window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-31

7-1 Basic display with monitoring windows . . . . . . . . . . . . . . . . . . . 7-3

7-2 Monitored parameter window 1 . . . . . . . . . . . . . . . . . . . . . . . . 7-4

7-3 Monitored window 2, with sensor data . . . . . . . . . . . . . . . . . . 7-5

7-4 Paw/Paux window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6

7-5 Graphics window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7

7-6 Panel setup window (waveform window shown) . . . . . . . . . . . 7-9

7-7 Pressure waveform display . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10

7-8 Dynamic pressure/volume loop display . . . . . . . . . . . . . . . . . . 7-11

7-9 Trend display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-13

7-10 Freeze and cursor function . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-15

7-11 Hold window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-16

8-1 Dynamic Heart/Lung panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

8-2 Compliance shown by the dynamic lung. . . . . . . . . . . . . . . . . . 8-3

8-3 Patient triggering shown by the dynamic lung muscle. . . . . . . . 8-4

8-4 Rinsp shown by the bronchial tree of the dynamic lung . . . . . . 8-4

8-5 Heart circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-5

8-6 Dynamic Heart-Lung Interaction panel . . . . . . . . . . . . . . . . . . . 8-6

8-7 Vent status panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-8

9-1 How the P/V Tool works . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-5

624074/07 xxix

List of Figures

9-2 P/V Tool information window . . . . . . . . . . . . . . . . . . . . . . . . . . 9-7

9-3 P/V Tool window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-8

9-4 P/V Tool Pro window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-10

9-5 Using the cursor function in the P/V Tool window: Creating

the linear compliance curve . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-13

9-6 Using the cursor function in the P/V Tool Pro window:

Creating the linear compliance curve . . . . . . . . . . . . . . . . . . . . 9-14

9-7 Interpreting the P/V curve . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-15

9-8 P/V Tool plot window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-17

9-9 Paw/Flow plot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-18

9-10 Demonstration lung assembly . . . . . . . . . . . . . . . . . . . . . . . . . 9-19

9-11 Checking for a gas leak between the Flow Sensor and

the demonstration lung . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-22

9-12 Checking flow sensor performance . . . . . . . . . . . . . . . . . . . . . 9-22

10-1 Visual alarm indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4

10-2 Active alarm buffer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-7

10-3 Events window (all events shown) . . . . . . . . . . . . . . . . . . . . . . 10-8

12-1 Special function keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-3

12-2 Activate standby window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-3

12-3 Standby activated window . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4

A-1 HAMILTON-G5 dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-2

B-1 (S)CMV control window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-6

B-2 P-CMV control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-7

B-3 Breath delivery in SIMV modes . . . . . . . . . . . . . . . . . . . . . . . . . . B-8

B-4 SIMV control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-9

B-5 PSIMV+ control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-10

B-6 SPONT control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-11

B-7 APVcmv control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-12

B-8 APVsimv control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-13

B-9 DuoPAP control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-16

B-10 APRV control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-17

B-11 DuoPAP pressure curve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-18

B-12 APRV pressure curve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-18

B-13 Pressure support in DuoPAP/APRV . . . . . . . . . . . . . . . . . . . . . . B-20

B-14 NIV control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-22

B-15 NIV-ST control window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-22

B-16 Breath timing in nCPAP-PS. . . . . . . . . . . . . . . . . . . . . . . . . . . . B-23

B-17 nCPAP-PS basic controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-24

xxx 624074/07