COVIDIEN, COVIDIEN with logo, and the Covidien logo and Positive Results for Life are U.S. and internationally registered trademarks of Covidien AG. ™* brands are trademarks of their respective owners.
All other brands are trademarks of a Covidien company.
The information contained in this manual is the sole property of Covidien and may not be duplicated
without permission. This manual may be revised or replaced by Covidien at any time and without
notice. You should ensure that you have the most current applicable version of this manual; if in
doubt, contact Covidien's Technical Support department or visit the product manuals web page at:
While the information set forth herein is believed to be accurate, it is not a substitute for the exercise
of professional judgment.
The ventilator should be operated and serviced only by trained professionals. Covidien’s sole responsibility with respect to the ventilator, and its use, is as stated in the limited warranty provided.
Nothing in this manual shall limit or restrict in any way Covidien’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, Covidien has no obligation to furnish any such revisions, changes, or modifications to the owner or user of the equipment (including its software)
described herein.
To obtain information about a warranty, if any, contact Covidien Technical Services at 1 800 635 5267
or your local representative.
Purchase of this instrument confers no express or implied license under any Covidien patent to use
the instrument with any ventilator that is not manufactured or licensed by Covidien.
This manual contains important information regarding the safe operation of your Puritan Bennett™
560 ventilator. Your ventilator is an electrical device that can provide years of useful service with the
proper care, as described in this manual.
Ensure that you read and understand the instructions contained in this manual before operating the
ventilator.
< WARNING:
Before operating the ventilator, read, understand, and strictly follow the information contained in
Chapter 1, Safety Information.
Qualification of Personnel
Installation and maintenance of the device must be made by authorized and trained personnel. In
particular, training for the handling of products sensitive to electrostatic discharges must include the
use of electrostatic discharge (ESD) protection devices and knowledge of the meaning of the symbol
at left, as well as using original spare parts and respecting quality assurance and traceability rules
approved by Covidien.
Warranty
Information regarding your product warranty is available from your sales representative or Covidien.
Extended Service
The Puritan Bennett™ 560 ventilator offers extended service contracts/warranties for purchase when
the ventilator is purchased. Please contact your local Covidien sales or service representative for additional information.
xi
Preface
For online technical support, visit the SolvITSM Center Knowledge Base
by clicking the link at www.medtronic.com/covidien/support/solvitcenter-knowledge-base/. Here, you will find answers to frequently
asked questions about the product and other Covidien products 24
hours a day, 7 days a week. If you require further assistance, contact
your local Covidien representative.
Service Centers
Covidien Argentina
Pacheco Trade Center
Marcos Sastre 1990, El Talar,
Buenos Aires, Argentina,
B1610CRH
[T] +54 01157898107
[F] +54 114863 4142
Covidien Belgium BVBA/SPRL
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] 0220 08260
[F] 0270 06690
[E]techservices.csBelgium@medtronic.com
Covidien China
2F, Tyco Plaza
99 Tian Zhou Rd
Shang Hai 200233
P.R. China
[T] +86 4008 1886 86
[F] +86 2154 4511 18
Covidien Asia
Singapore Regional Service
Centre
15 Pioneer Hub, #06-04
Singapore 627753
[T] +65 6578 5288
[F] +65 6515 5260
Covidien Brazil
Av. Das Nações Undias 12995
Andar 23 - Brooklin
São Paulo, SP
Brasil 04578-000
[T] +5511 2187 6200
[F] +5511 2187 6380
Covidien Colombia
Avenida Calle 116 # 7-15 /
Oficina 1101
Torre Cusezar, Bogotá, Colombia
[T] +57 1 7427300
[F] +571 619 5425
Covidien Australia
52A Huntingwood Drive
Huntingwood, NSW 2148
Australia
[T] +61 1800 350702
[F] +61 2967 18118
Covidien Canada
19600 Clark Graham
Baie d'Urfe, QC, H9X 3R8
Canada
[T] 514 695 1220 (ext 4004)
[F] 514 695 4965
Covidien Costa Rica
Global Park, Parkway 50
La Aurora de Heredia
Costa Rica
[T] +506 2239 5386
[F] +506 2239 5319
Covidien Austria GmbH
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] 01 20609 1143
[F] 01 20609 2457
[E] techservices.csAustria@
medtronic.com
Covidien Chile
Camino lo Boza (Ex 8395) Pudehuel
Santiago
Chile
[T] +562 739 3000
[F] +562 783 3149
Covidien ECE
Organizačni Složka
Prosecká 852/66
190 00 Praha 9
Czech Republic
[T] +420 241 095 735
[F] +420 239 016 856
Covidien Danmark A/S
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +45 43 68 21 71
[F] +45 43 31 48 99
[E]techservices.csDenmark@
medtronic.com
xii User Manual
Covidien Deutschland GmbH
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +49 6951709670
[F] +49 69299571608
[E] techservices.csGermany@
medtronic.com
Covidien ECE
Galvahiho 7 / A
832104 Bratislava
Slovakia
[T] +421 2 4821 4573
[F] +421 2 4821 4501
Covidien Finland OY
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +358 972519288
[F] +358 972522072
[E] techservices.csFinland@
medtronic.com
Service Centers
Covidien France SAS
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +33 151 323 510
[F] +33 157 327 010
[E] techservices.csFrance@
medtronic.com
Covidien Ireland
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +353 0 1 4073173
[F] +353 0 1 9075668
[E] techservices.csIreland@
medtronic.com
Covidien Korea
5F, Hibrand Living Gwan, #215,
Yangjae-Dong, Seocho-Gu
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +39 02 91 483320
[F] +39 02 91 294863
[E} techservices.csItaly@
medtronic.com
Covidien Nederland BV
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +31 202061470
[F] +31 707709229
[E] techservices.csItaly@
medtronic.com
Covidien India
10th Floor Building No 9B
DLF Cyber City Phase III Gurgaon
Haryana - 122002
India
[T] +91 1 244 709800
[F] +91 1 244 206850
Covidien Japan Inc.
Technical Support Center
83-1, Takashimadaira 1-Chome
Itabashi-ku, Tokyo
175-0082 Japan
[T] +81 0 3 6859 0120
[F] +81 0 3 6859 0142
Covidien New Zealand
Cnr Manu Tapu Dr & Joseph
Hammond Pl.
Auckland Airport
New Zealand
[T] +64 508 489 264
Covidien Norge AS
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +47 24159887
[F] +47 23024955
[E] techservices.csNorway@
medtronic.com
Covidien Puerto Rico
Palmas Industrial Park
Road 869 Km 2.0 Bdlg. #1
Cataño, PR 00962
[T] 787 993 7250 (ext. 7221/22)
[F] 787 993 7234
Covidien Panama
Parque Industrial Costa del Esta
Calle Primera, Edificio # 109
Panama City, Panama
[T] +507 264 7337
[F] +507 236 7408
Covidien Russia
Tupikovy proezd, Building 1,
Marushinsky, Krekshino village
Moscow, Russia
[T] +7 495 995 1898
[F] +7 495 933 6468
[E] service.repair.russia@
medtronic.com
Covidien Polska
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +48 223060034
[F] +48 223060853
[E] techservices.csPoland@
medtronic.com
Covidien Saglik A.S.
LTD.ŞTI
Akçaburgaz Mah. 1567 Sok. No. 2
DHL Depolama Tesisleri
Esenyurt Istanbul, Turkey
[T] +90 212 6223 500
[F] +90 212 6720 722
[E] service.repair.turkey@
medtronic.com
Covidien Portugal Lda.
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +351 21 761 62 44
[F] +351 800 781385
[E] techservices.csPortugal@
medtronic.com
Covidien South Africa
Waterfall Distribution Campus
Cnr Bridal Veil Road & K101 Pretoria Main Road
Midrand
South Africa 1685
[T] +27 11 542 9584
[F] +27 86 604 8360
[E]service.repair.southafrica@medtronic.com
User Manual xiii
Preface
Covidien Spain S.L.
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +34 91 275 48 54
[F] +34 91 276 89 33
[E] techservices.csSpain@
medtronic.com
Covidien UK
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +44 0 2030271757
[F] +44 0 2036848869
[E] techservices.csUK@medtronic.com
Covidien Sverige AB
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +46 8517 61573
[F] +46 8502 52110
[E] techservices.csSweden@
medtronic.com
Covidien Switzerland
C-Mill Gebouw K
Jan Campertstraat 21-A
6416 SG Heerlen, Netherlands
[T] +41 44 511 82 71
[F] +41 44 511 16 34
[E] techservices.csSwitzerland@medtronic.com
Covidien Thailand
99 Soi Rubia
Sukhumvit 42 Road
13-14 Fl., Berli Jucker Building
Prakanong, Klongtoey
Bangkok 10110, Thailand
[T] +66 2 207 3100
[F] +66 2 657 6325
xiv User Manual
1Safety Information
1.1 Definitions
This manual uses three indicators to highlight critical information: warning, caution, and note.
They are defined as follows:
WARNING
Indicates a condition that can endanger the patient or the ventilator operator.
Caution
Indicates a condition that can damage the equipment.
Note
Indicates points of particular emphasis, that make operation of the ventilator more efficient or convenient.
It is essential to read, understand and follow these instructions before using the Puritan Bennett™
560 ventilator.
In order to use the ventilator correctly and efficiently and to help prevent incidents, please pay
particular attention to section 1.2, Warnings, as well as all warnings and cautions contained
throughout this manual.
: Note:
Many ventilator functions are not accessible when the Locking key is enabled.
For additional assistance contact your clinician or equipment representative.
1.2 Warnings
1.2.1 General Warnings Regarding Use of Equipment
< WARNING:
The ventilator must be used only under the responsibility and on the prescription of a doctor.
1-1
Safety Information
< WARNING:
The ventilator must be used according to its intended use. Refer to section 2.1, Indications for Use.
< WARNING:
Be aware this manual describes how to respond to the ventilator, but does not tell you how to respond
to the patient.
< WARNING:
While the ventilator is in use, an alternative means of ventilation should always be available in the event
of a ventilator problem. This is particularly true for ventilator-dependent patients. Supplementary
observation, appropriate for the patient’s condition, is also recommended.
< WARNING:
To ensure that ventilation continues uninterrupted, ensure alternative power sources are available (AC
power source, extra batteries, or an auxiliary DC car adapter). Be prepared for the possibility of power
failure by having an alternative means of ventilation ready for use—particularly for ventilatordependent patients.
< WARNING:
Do not allow a patient to remain connected to the ventilator when ventilation is stopped, because a
substantial quantity of exhalation gas, primarily carbon dioxide, may be inhaled by the patient. In some
circumstances, inhaling carbon dioxide may lead to under-ventilation, suffocation, and serious injury or
death.
< WARNING:
Always have immediate access to an alternative means of ventilation, which is ready for use, to avoid
patient death or serious injury.
< WARNING:
The ventilator must not be used with flammable anesthetic substances.
< WARNING:
Do not start ventilation until you ensure that the device is suitably assembled, that the air inlet filter is
properly installed and is not obstructed, and that there is proper clearance all around the unit. Also
ensure that the patient circuit is suitably connected to both the ventilator and the patient and that the
patient circuit, including all hoses, is not damaged or obstructed.
< WARNING:
A ventilator-dependent patient should always be monitored by trained and competent medical
personnel. Ensure that the patient’s caregiver is able and prepared to take suitable action in the event
the ventilator identifies an alarmed condition or experiences a problem.
< WARNING:
Do not use a patient circuit with a leak accessory for ventilator-dependent patients.
1-2 User Manual
< WARNING:
Refer to this manual for equipment compatible with this ventilator. It may be unsafe to interconnect this
equipment with other equipment not described in this manual.
< WARNING:
Before dispensing the ventilator to caregivers or the patient for home use, ensure the Locking Key is
activated so that critical ventilator settings are not modified.
< WARNING:
Do not perform ventilator alarm tests while the patient is connected to the ventilator. Provide the
patient with an alternate means of ventilation before conducting these tests.
< WARNING:
Verify the functionality of the alarms before connecting the patient to the ventilator. Refer to Appendix
E, Alarms Tests.
Warnings
< WARNING:
If the ventilator fails the alarm tests or if you cannot complete the tests, refer to Chapter 3, Alarms and
Troubleshooting or call your equipment supplier or Covidien.
< WARNING:
When an alarm condition is triggered, or there is evidence of a patient-ventilator fault or problem,
examine the patient first before examining the ventilator.
< WARNING:
A continuous alarm condition will be activated if the ventilator power switch is turned off while
ventilation is in progress. When the power switch is turned back on again, ventilation will resume
without having to press the VENTILATION ON/OFF button.
< WARNING:
To reduce the risk of infection, wash your hands thoroughly before and after handling the ventilator or
its accessories.
< WARNING:
A patient treated by mechanical ventilation is highly vulnerable to the risks of infection. Dirty or
contaminated equipment is a potential source of infection. Clean the ventilator and its accessories
regularly and systematically before and after each use and following any maintenance procedure to
reduce the risks of infection. The use of a bacterial filter at the ventilator’s outlet (TO PATIENT) port—or
both ports if a double-limb circuit is used—is recommended. Refer to Chapter 7, Cleaning.
< WARNING:
Handle the ventilator with care during and after use, particularly when ambient temperatures are high.
Some ventilator surfaces may become hot, even if safety specifications are not exceeded.
User Manual 1-3
Safety Information
< WARNING:
Do not connect the ventilator to any device other than a PC with a dedicated compatible Puritan
Bennett™ software package.
< WARNING:
The ventilator system is not intended to be a comprehensive monitoring device and does not activate
alarms for all types of conditions. For a detailed understanding of ventilator operations, be sure to
thoroughly read this manual before attempting to use the ventilator system.
1.2.2 Warnings Regarding Installation and Environment of Use
< WARNING:
Even though the Puritan Bennett™ 560 ventilator meets current safety standards, the internal Lithiumion battery of the device exceeds the 100Wh threshold and is therefore considered to be Dangerous
Goods (DG) Class 9 – Miscellaneous, when transported in commerce. As such, the Puritan Bennett™ 560
ventilator and/or the associated Lithium-ion battery are subject to strict transport conditions under the
Dangerous Goods Regulation for air transport (IATA: International Air Transport Association),
International Maritime Dangerous Goods code for sea and the European Agreement concerning the
International Carriage of Dangerous Goods by Road (ADR) for Europe. Private individuals who transport
the device are excluded from these regulations although for air transport some requirements apply. For
air transport; the Puritan Bennett™ 560 ventilator is permitted as checked-in or carry-on baggage. Two
spare batteries per person may be taken on board as carry-on luggage only, with the prior approval of
the airline. This classification and regulatory requirements may vary depending upon the country and
mode of transport. Therefore it is recommended that users verify with the carrier / airline as to which
measures to take before the voyage.
< WARNING:
To minimize the risk of damage, you must use the ventilator’s dual bag to transport the ventilator.
Ventilator accessories are listed in TableF-1.
< WARNING:
When using the ventilator in a carrying case, only use a carrying case that is listed in the instructions for
use to prevent adverse ventilator performance, which can consequently result in patient death.
< WARNING:
Regularly clean the ventilator’s dual bag according to manufacturer’s recommendations.
< WARNING:
The ventilator should never be immersed in any liquid, and any liquid on the surface of the device
should be wiped away immediately.
1-4 User Manual
< WARNING:
To avoid damage to the ventilator, in particular the batteries or electrical components, fluids must not
be allowed to enter the device, particularly through the air inlet filter or the cooling apertures located
in the side, rear, and bottom panels of the ventilator.
< WARNING:
To ensure correct and lasting operation of the device, ensure that the ventilator is installed and
operated in the environmental conditions recommended in Appendix A, Specifications.
< WARNING:
Do not leave power cables lying on the ground where they may pose a hazard.
< WARNING:
Do not operate the ventilator in a magnetic resonance imaging (MRI) environment. Doing so could
cause a ventilator malfunction.
Warnings
< WARNING:
Do not operate the ventilator in the presence of active high frequency (HF) surgical equipment. Doing
so could cause a ventilator malfunction.
< WARNING:
Do not operate the ventilator in direct sunlight, near heat sources, outdoors, or near installations where
liquid may pose a risk without first providing adequate protection for the device.
< WARNING:
Avoid using the ventilator, if possible, in dusty environments. Dusty environments may require more
vigilant monitoring, cleaning, and/or replacement of air intake and other filters.
< WARNING:
Ensure that the ventilator’s immediate surroundings allow for the proper operational connection of the
device without folding, pinching, or damaging any of the required cables or tubes, and that the
connection of the patient circuit to the patient provides for a secure, comfortable fit.
< WARNING:
Ensure that the ventilator is not positioned or located such that the AC and DC connections at the back
of the ventilator are difficult to access.
< WARNING:
Do not cover the ventilator or place in a position that affects proper operation, e.g., blocking a front or
lateral opening.
User Manual 1-5
Safety Information
< WARNING:
Place the ventilator in a safe place when ventilating and according to the recommendations in this
manual.
< WARNING:
Do not place the ventilator in a position where a child, pet or pest can reach it, or in any position that
might cause it to fall on the patient or someone else.
< WARNING:
To ensure correct and lasting operation of the ventilator, ensure that its air circulation holes (main inlet
or cooling) are never obstructed. Place the device in an area where air can freely circulate around the
ventilator and avoid installing it near floating fabrics, such as curtains.
< WARNING:
If the ventilator has been transported or stored at a temperature that differs more than ±20°C (±36°F)
from the temperature in which it will be operating, the ventilator should be allowed to stabilize in its
operating environment for at least 2 hours prior to use. When the ambient temperature is 20°C, 2 hours
are required to warm the ventilator from the minimum storage temperature or to cool the ventilator
from the maximum storage temperature prior to use.
< WARNING:
If the ambient temperature where the device is operated is greater than 35°C (95°F), the temperature of
the patient circuit or the flow supplied at the device outlet may exceed 41°C (106°F), and the patient
circuit may reach up to 60°C (140°F). This may lead to undesirable side effects for the patient. To avoid
injury to the patient move the patient and the ventilator to a cooler location. For more information,
contact Covidien.
< WARNING:
The default setting for altitude compensation is YES. Altitude compensation should always be set to YES
for accurate volume delivery calculations at all elevations.
< WARNING:
To reduce the risk of a fire hazard, keep matches, lighted cigarettes, and all other sources of ignition
(such as flammable anesthetics and/or heaters) away from the ventilator and oxygen hoses.
< WARNING:
Regularly check the cleanliness of the air inlet filter located on the rear of the ventilator. If necessary,
replace the filter before the recommended replacement period is over (see Chapter 8, Routine
Maintenance). This is particularly important when the ventilator is installed on a wheelchair, because
environmental conditions may cause the filter to become dirty more rapidly.
< WARNING:
Handle the ventilator with care during and after use, particularly when ambient temperatures are high.
Some ventilator surfaces may become hot, even if safety specifications are not exceeded.
1-6 User Manual
< WARNING:
Exercise care to avoid any potential significant risks of reciprocal interference posed by the ventilator
and accessories during specific investigations or treatments.
1.2.3 Warnings Regarding Electrical Power Supplies
< WARNING:
The operator should connect the ventilator to an AC power source whenever available, for safer
operation.
< WARNING:
The maximum recommended shelf life of the internal battery is 2 years. Do not use a battery that has
been stored for 2 years prior to its first use.
< WARNING:
Periodic recharging is important to help maximize useful life of the battery. Do not store the internal
battery for extended periods, without recharging, as this may reduce the maximum life.
Warnings
< WARNING:
For the AC (“mains”) power cable to be properly secured, the attachment located on the power cable
must be fitted into the power cable holder incorporated in the battery access cover and located under
the AC (mains) power socket. Refer to section 4.2, Connecting to External AC Power.
< WARNING:
The power supply to which the ventilator is connected (both AC and DC) must comply with all
applicable standards and provide electrical power corresponding to the voltage characteristics
inscribed on the rear of the ventilator to ensure correct operation. Refer also to the electrical
specifications found in Appendix A, Specifications.
< WARNING:
Ensure that the ventilator’s internal battery is fully charged before connecting the ventilator to an
external DC power source. Powering the ventilator using an external 12–30 VDC power source (via the
DC power cable) does not enable its internal battery to recharge.
< WARNING:
Due to the internal battery’s limited reserve capacity, the ventilator should only be operated on the
internal battery when no other power source is available. Ensure that the internal battery never
becomes fully discharged.
< WARNING:
When using a car auxiliary adapter (cigarette lighter) ensure the car has been started prior to plugging
in the ventilator’s DC adapter. Refer to section 4.3, Connecting to an External DC Power Source.
User Manual 1-7
Safety Information
< WARNING:
Even if the internal battery charging indicator is off, charging of the battery may sometimes be
incomplete if the ambient temperature is above 40°C (104°F) because of the battery’s internal heat
safety device.
< WARNING:
When the Low Battery alarm is triggered, immediately connect the ventilator to an AC power supply to
maintain ventilation and recharge the internal battery.
< WARNING:
Batteries should be disposed of according to environmental legislation in your country and locality.
< WARNING:
Never expose any batteries to direct flame.
< WARNING:
Ensure that the AC power cable is in perfect condition and not compressed. The device should not be
turned on if the AC power cable is damaged.
1.2.4 Warnings Regarding Hoses and Accessories
< WARNING:
The ventilator must not use, nor be connected to, any anti-static or electrically conductive hoses,
tubing, or conduits.
< WARNING:
Minimum and maximum VTE alarm parameters must be properly set to warn in the event of patient
disconnection.
< WARNING:
Before opening the packaging for the patient circuit, ensure that no damage is evident to the packaging
or its contents. Do not use if evidence of damage exists.
< WARNING:
The patient circuit should not be changed during ventilation.
< WARNING:
On a DAILY basis, inspect the patient circuit to ensure that it shows no signs of damage, is properly
connected, and is operating correctly without leakage.
< WARNING:
Single use accessories should not be reused.
1-8 User Manual
< WARNING:
The exhalation block is intended for single use by a single patient. It may periodically be cleaned, but
it cannot be disinfected or sterilized. To maintain good measurement quality when used continuously,
clean the exhalation block periodically (refer to section 7.3, Cleaning the Exhalation Block). The
exhalation block should be changed every 4 months and cannot be reused with any other patient.
< WARNING:
During invasive ventilation (when an artificial airway bypasses the patient’s upper respiratory system),
the patient’s upper respiratory system cannot humidify the incoming gas. For this reason, a humidifier,
to minimize drying of the patient’s airway and subsequent irritation and discomfort, must be used.
< WARNING:
If exhaled tidal volume measurements are required to ensure correct patient ventilation a double-limb
patient circuit configuration must be used in order to detect leaks. In this case, both the minimum and
maximum VTE alarm parameters must be properly set to warn in the event of patient disconnection.
< WARNING:
Failing to replace a dirty air inlet filter or operating the ventilator without a filter may cause serious
damage to the ventilator.
Warnings
< WARNING:
Before cleaning the ventilator, first disconnect the ventilator and the patient circuit.
< WARNING:
If the ventilator is used indoors, the condition of the air inlet filter should be checked monthly. If the
ventilator is used outdoors or in a dusty environment, the filter should be checked weekly and replaced
as necessary.
< WARNING:
The air inlet filter is not reusable; do not attempt to wash, clean, or reuse it.
< WARNING:
The patient circuit should always be positioned to avoid hindering the patient's movements, to prevent
accidental disconnection or leakage, and to minimize the risk of patient strangulation.
< WARNING:
For pediatric use, ensure that the patient circuit type fits, and, in all respects, is suitable for use with a
child. Use a pediatric circuit for patients that weigh under 53 lb. (23 kg). To ensure proper performance
of the ventilator, use a recommended patient circuit; see TableF-2.
< WARNING:
Resistance of the exhalation valve and accessories (water traps, filters, HMEs, etc.) must be as low as
possible.
User Manual 1-9
Safety Information
< WARNING:
Adding attachments to the ventilator breathing system can cause the pressure during exhalation at the
patient connection port to increase.
< WARNING:
The exhalation valve must allow rapid discharge of the circuit pressure. Ensure that the exhalation valve
is always clean and its evacuation aperture (exhaust port) is never obstructed.
< WARNING:
Users must always possess an additional breathing circuit and exhalation valve while using the Puritan
Bennett™ 560 ventilator.
< WARNING:
Always ensure that the humidification device is positioned lower than both the ventilator and the
patient. Use water traps, if necessary, to limit water in the patient circuit and periodically empty these
water traps. Take precautions when discarding the fluid in the water trap. Discard per local ordinance
for proper disposal.
< WARNING:
Use of a nebulizer or humidifier can lead to an increase in the resistance of inspiratory and exhalation
filters. Monitor the filters frequently for increased resistance or blockage.
< WARNING:
If a heated humidifier is used, you should always monitor the temperature of the gas delivered to the
patient. Gas delivered from the ventilator that becomes too hot may burn the patient's airway.
< WARNING:
Adding accessories to the ventilator breathing circuit, such as a humidifier and water trap(s), may result
in a decrease in tidal volume delivered to the patient due to the added compressible volume of the
accessory. Always assure that the patient is receiving the appropriate inspired volume when altering
the breathing circuit configuration.
< WARNING:
The level of inspiratory resistance of the circuit and accessories (bacteria filter, humidifier, HMEs, etc.)
must be as low as possible. Settings—particularly the Patient Disconnection alarm, maximum inspired
volume (Max VTI), and minimum inspired volume (Min VTI) settings—must be periodically adjusted
according to changes in the patient circuit resistance—especially when filters are replaced.
< WARNING:
To ensure proper performance of the ventilator, use a patient circuit recommended by Covidien in this
manual; refer to Chapter 4, Installation and Assembly and Appendix F, Parts and Accessories. The total
specified length of the patient circuit tubing as measured from the ventilator outlet to the ventilator
inlet is 1.1 meters (3.6 feet) to 2.0 meters (6.6 feet). The tubing must conform to all applicable standards
and must be fitted with Ø 22 mm terminals that also conform to all applicable standards. Ensure that
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both the length and the internal volume of the patient circuit are appropriate for the tidal volume: a
corrugated tube of Ø 22 mm for adult patients, and a corrugated tube of Ø 15 mm for pediatric patients
with a tidal volume lower than 200 ml.
< WARNING:
To ensure proper performance of the ventilator, use only accessories (including oxygen accessories)
approved and recommended by Covidien. See Appendix F, Parts and Accessories or contact your
customer services.
< WARNING:
To reduce the likelihood of disconnection and to prevent adverse ventilator performance, use only
accessories compatible with the ventilator. Compatibility is determined by reviewing the instructions
for use of either the ventilator or the accessories.
< WARNING:
When using non-invasive ventilation (NIV) without an exhalation valve, use a vented nose or face mask
or a non vented combined with a leak accessory. When using non-invasive ventilation (NIV) with an
exhalation valve, use a non-vented mask.
Warnings
1.2.5 Warnings Regarding Settings
< WARNING:
Before starting ventilation, always verify that all settings are properly set in accordance with the
required prescription.
< WARNING:
Before starting ventilation, ensure that the device is properly assembled and that the air inlet, cooling
vents, and alarm sound diffusion holes are not obstructed. Ensure also that the patient circuit is of the
proper configuration (double or single limb), properly connected to the ventilator, and that the circuit
hoses are neither damaged nor compressed and contain no obstructions or foreign bodies.
< WARNING:
The CPAP mode does not provide a set respiratory rate. Do not use this mode for ventilator-dependent
patients.
< WARNING:
Do not allow a patient to remain connected to the ventilator when ventilation is stopped, because a
substantial quantity of exhalation gas, primarily carbon dioxide, may be inhaled by the patient.
< WARNING:
Alarm volume should be adjusted with respect to the ventilator’s operating environment and so that
the patient's caretakers can hear the alarms. The audible alarm vents located at the front of the device
should never be obstructed. The alarm can be paused with the Alarm Pause function by pressing the
ALARM CONTROL key twice once the alarm has been declared.
User Manual 1-11
Safety Information
< WARNING:
Ensure that the I Sens setting is not set to OFF when ventilating patients capable of triggering
spontaneous breaths.
< WARNING:
The ventilator offers a variety of breath delivery options. Throughout the patient’s treatment, the
clinician should carefully select the ventilation mode and settings to use for that patient, based on
clinical judgment, the condition and needs of the patient, and the benefits, limitations, and
characteristics of the breath delivery options. As the patient’s condition changes over time, periodically
assess the chosen modes and settings to determine whether those are best for the patient’s current
needs.
< WARNING:
In adult or pediatric use ensure that the adjusted tidal volume is compatible with the needs of the
patient.
< WARNING:
When changing the mode during ventilation, significant transitions of pressure, flow or cycling rate
might occur, depending on the difference between the modes. Before setting the new mode, first
ensure that the settings between the different modes are compatible. This reduces the risk of
discomfort and harm to the patient.
< WARNING:
Do not conduct the ventilator alarm test while the patient is connected to the ventilator. Switch the
patient to an alternate means of ventilation before testing.
< WARNING:
The Min PIP alarm setting must be adjusted for the patient, but must also be set high enough to allow
the Patient Disconnection alarm to trigger properly. Perform the low pressure test to ensure the alarm
is properly set.
< WARNING:
The Max Leak alarm setting must be adjusted for the patient, but must also be set low enough to allow
the High Leakage alarm to trigger properly. Perform the max leak test to ensure the alarm is functioning
properly. This alarm only applies to leak configuration (NIV).
< WARNING:
If Apnea Time is set to a value higher than 60/Control R then the Apnea alarm will not activate.
< WARNING:
If an Apnea alarm is required, set the Apnea setting to YES in the Preferences Menu.
1-12 User Manual
< WARNING:
The Apnea alarm should be set to YES for ventilator dependent patients.
< WARNING:
Setting any alarm limits to OFF or extreme high or low values can cause the associated alarm not to
activate during ventilation, which reduces its efficacy for monitoring the patient and alerting the
clinician to situations that may require intervention.
< WARNING:
Ensure the Insp Time setting is compatible with the physiological requirements of the patient.
< WARNING:
Adjustable alarms should not be systematically canceled; instead, they should be adjusted according to
the needs and condition of the patient.
< WARNING:
Do not pause, disable, or decrease the volume of the ventilator’s audible alarm if patient safety could
be compromised.
Warnings
< WARNING:
A continuous alarm condition will be activated if the ventilator power switch is turned off while
ventilation is in progress. When the power switch is turned back on again, the ventilation will resume
without having to press the VENTILATION ON/OFF button.
< WARNING:
In the SIMV mode the use of a double-limb circuit is recommended. The Min VTE setting should remain
active in the event that pressure losses are present on the patient circuit downstream from the proximal
pressure link. In such cases the Patient Disconnection alarm would not be systematically activated in
case of a disconnection of the circuit.
< WARNING:
The inspiration trigger threshold should be carefully modified in order to avoid the risk of false
triggering or “autotriggering” of the ventilator. For example, Level 0P, the most sensitive mode, is
recommended for pediatric use. However, for an adult, this setting may result in autotriggering.
< WARNING:
The sound level of the alarms should be adjusted according to the installation environment and the size
of the area monitored by the patient’s caregiver. Ensure that the alarm sound apertures at the front of
the device are never obstructed.
User Manual 1-13
Safety Information
1.2.6 Warnings Regarding PC Connection and USB Memory Devices
< WARNING:
Do not connect the ventilator to any device other than a PC with a dedicated compatible Puritan
Bennett™ software package.
< WARNING:
Always verify the file ID before using a USB memory device to transfer data between the ventilator and
a PC.
< WARNING:
USB connections are not intended for connection to any devices other than the specified USB flash
storage (see section 5.2.1, USB Memory Device Specifications).
1.2.7 Warnings Regarding Maintenance
< WARNING:
Never use a ventilator or any components or accessories that appear to be damaged. If any signs of
damage are evident, contact your equipment supplier or Covidien.
< WARNING:
To ensure proper servicing and avoid the possibility of physical injury to personnel or damage to the
ventilator, only personnel authorized and qualified by Covidien should attempt to service or make
authorized modifications to the Puritan Bennett™ 560 ventilator.
< WARNING:
If you cannot determine the cause of a problem with your ventilator, contact your equipment supplier.
Do not use the ventilator until the problem has been corrected.
< WARNING:
To ensure proper performance of the ventilator, the preventative maintenance schedule should be
followed. For further information contact Covidien.
< WARNING:
On a daily basis, ensure the proper connection and operation of the patient circuit.
< WARNING:
If a problem with the ventilator is suspected, FIRST CHECK THAT THE PATIENT IS NOT IN DANGER. If
necessary, remove the patient from the ventilator and provide an alternative means of ventilation.
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< WARNING:
After assembling, cleaning, or reassembling the patient circuit, and on a daily basis, inspect the hoses
and other components to ensure that there are no cracks or leaks and that all connections are secure.
< WARNING:
Use all cleaning solutions and products with caution. Read and follow the instructions associated with
the cleaning solutions you use to clean your ventilator. Use only those solutions listed in Table7-1.
< WARNING:
Never use a liquid cleaner inside the patient circuit, or on any component of a gas pathway. Clean the
patient circuit only as specified by the manufacturer's instructions.
< WARNING:
Do not attempt to open, repair or otherwise service the ventilator yourself. Doing so might endanger
the patient, damage the ventilator, or void your warranty. Only personnel authorized and qualified by
Covidien should repair, open or service the ventilator.
Warnings
< WARNING:
If the ventilator is damaged, or its external housing is not correctly closed, or it behaves in a way that is
not described in this manual (excessive noise, heat emission, unusual odor, alarms not triggered during
the start-up procedure), the oxygen and power supplies should be disconnected and use of the device
stopped immediately.
< WARNING:
The exhalation block is intended for single use by a single patient. It may periodically be cleaned, but
it cannot be disinfected or sterilized. To maintain good measurement quality when used continuously,
clean the exhalation block periodically (refer to section 7.3, Cleaning the Exhalation Block). The
exhalation block should be changed every 4 months and cannot be reused with any other patient.
< WARNING:
Ensure that the exhalation block is completely dried after cleaning and prior to use.
< WARNING:
When an exhalation block is set up, each time it is removed, or after installing a new exhalation block on
the machine, it is essential that the exhalation flow sensor be recalibrated before the exhalation block
is used. Refer to section 8.3, Calibrating the Exhalation Flow Sensor.
< WARNING:
The patient circuit is intended for single use by a single patient and should be changed according to
the manufacturer’s recommendations and according to the patient circuit lifetime. Refer to the
instructions for use supplied by the manufacturer of the patient circuit (included with the ventilator)
and Chapter 4, Installation and Assembly.
User Manual 1-15
Safety Information
< WARNING:
A patient treated by mechanical ventilation is highly vulnerable to the risks of infection. Dirty or
contaminated equipment is a potential source of infection. Clean the ventilator and its accessories
regularly and systematically before and after each use and following any maintenance procedure to
reduce the risks of infection. The use of a bacterial filter at the ventilator’s outlet (TO PATIENT) port—or
both ports if a double-limb circuit is used—is recommended. Refer to Chapter 7, Cleaning.
< WARNING:
Regularly check the cleanliness of the air inlet filter located on the rear of the ventilator. If necessary,
replace the filter before the recommended replacement period is over (see Chapter 8, Routine
Maintenance). This is particularly important when the ventilator is installed on a wheelchair, because
environmental conditions may cause the filter to become dirty more rapidly.
< WARNING:
For environmental protection, the ventilator and its components, whatever their respective conditions
of operation, cannot be disposed of with household waste and must be submitted for suitable selective
collection and possible recycling. Observe all applicable regulations when disposing of the ventilator
and any of its components.
< WARNING:
Before using the ventilator’s internal battery, ensure that the battery is fully charged and that the
charge holds. Back up ventilators or those in storage should be connected to an AC power source to
protect the integrity of the battery.
< WARNING:
The maximum recommended shelf life of the internal battery is 2 years. Do not use a battery that has
been stored for 2 years prior to its first use. Periodic recharging is important to help maximize useful life
of the battery. Do not store the internal battery for extended periods, without recharging, as this may
reduce the maximum life.
< WARNING:
To connect the ventilator to an external power source, first ensure the ventilator’s I/O (power) switch is
off (O). Then, connect the desired power cable to the ventilator. Finally, connect the power cable to the
external power source.
< WARNING:
To disconnect the ventilator from an external power source, first power down the ventilator. Then,
disconnect the power cable from the external power source and, finally, the ventilator.
< WARNING:
Connect the external DC power source by first connecting the power cable to the ventilator and then to
the external DC source. Follow the reverse procedure to disconnect the device from the external DC
power source.
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