Copyright 2000 Mallinckrodt Inc. EasyCart, EasyNeb, 740, 760, and 700 Series are
trademarks of Mallinckrodt Inc. All rights reserved. The 700 Series
(including the 740
proprietary information, covered by one or more of the following U.S. Patents and foreign
equivalents: 5,524,615; 5,540,222; 5,596,984; 5,632,270; 5,664,560; and 5,673,689.
The information contained in this manual is the sole property of Mallinckrodt Inc. and may not
be duplicated without permission. This manual may be revised or replaced by Mallinckrodt
Inc. at any time and without notice. You should ensure that you have the most current
applicable version of this manual; if in doubt, contact the Technical Publications Department
of Mallinckrodt Inc. 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. Mallinckrodt’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 Mallinckrodt’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, Mallinckrodt Inc. has
no obligation to furnish any such revisions, changes, or modifications to the owner or user of
the equipment (including its software) described herein.
Ô
and 760Ôventilators) are manufactured in accordance with Mallinckrodt
Ô
Ventilator System
Definitions
This manual uses these special indicators to convey information of a specific
nature:
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.
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700 Series Ventilator Operator’s ManualG-061874-00 Rev. D (09/00)
Please take the time to familiarize yourself with the following safety
considerations, special handling requirements, and regulations that govern the use
of the 700 Series Ventilator System.
Warning
To avoid an electrical shock hazard while servicing the ventilator, be
sure to remove all power to the ventilator by disconnecting the power
source and turning off all ventilator power switches.
Warning
To avoid a fire hazard, keep matches, lighted cigarettes, and all other
sources of ignition (e.g., flammable anesthetics and/or heaters) away
from the ventilator and oxygen hoses.
Do not use oxygen hoses that are worn, frayed, or contaminated by
combustible materials such as grease or oils. (Textiles, oils, and other
combustibles are easily ignited and burn with great intensity in air
enriched with oxygen.)
In case of fire or a burning smell, immediately disconnect the ventilator
from the oxygen supply and electrical power source.
Warning
Patients on life-support equipment should be appropriately monitored
by competent medical personnel and suitable monitoring devices.
The 700 Series Ventilator is not intended to be a comprehensive
monitoring device and does not activate alarms for all types of
dangerous conditions for patients on life-support equipment.
Warning
Check the ventilator periodically as outlined in the service manual; do
not use if defective. Immediately replace parts that are broken,
missing, obviously worn, distorted, or contaminated.
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iii
Warning
An alternative source of ventilation should always be available when
using the 700 Series Ventilator System.
Warning
To ensure proper servicing and avoid the possibility of physical injury,
only qualified personnel should attempt to service or make authorized
modifications to the ventilator.
The user of this product shall have sole responsibility for any ventilator
malfunction due to operation or maintenance performed by anyone not
trained by Mallinckrodt staff.
Warning
For a thorough understanding of ventilator operations, be sure to read
the 700 Series Ventilator System Operator's Manual in its entirety
before attempting to use the system.
Warning
Before activating any part of the ventilator, be sure to check the
equipment for proper operation and, if appropriate, run the selfdiagnostic short self test (SST) program described in this manual.
Caution
U.S. Federal law restricts this device to sale by or on the order of a
physician.
Warranty
The 700 Series Ventilator System is warranted against defects in material and
workmanship in accordance with Mallinckrodt Medical Equipment Warranty for
a period of one year from the time of sale. To ensure the validity of the warranty,
be sure to keep a maintenance record.
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The 700 Series Ventilator System’s year of manufacture is indicated by the fifth
and sixth digits of the serial number which is located at the lower edge of the
ventilator front panel.
Manufacturer
anufactured by
Nellcor Puritan Bennett Ireland
A subsidiary of Mallinckrodt Inc.
Mervue, Galway, Ireland
Phone: +353.91.753.771
Fax: +353.91.753.922
European Headquarters
Mallinckrodt Europe BV
Hambakenwetering 1
5231 DD ’s-Hertogenbosch
The Netherlands
Phone: +31.73.6485200
Fax: +31.73.6410915
Electromagnetic susceptibility
The 700 Series Ventilator System complies with the requirements of IEC 606011-2 (EMC Collateral Standard), which includes E-field susceptibility and ESD
requirements. However, even though the device is compliant at the levels of
immunity specified in the standard, certain transmitting devices (cellular phones,
walkie-talkies, cordless phones, paging transmitters, etc.) emit radio frequencies
that could interrupt ventilator operation if located in a range too close to the
ventilator. It is difficult to determine when the field strength of these devices
becomes excessive. Practitioners should be aware that radio frequency emissions
are additive, and that the ventilator must be located a sufficient distance from
transmitting devices to avoid interruption. Do not operate the ventilator in a
magnetic resonance imaging (MRI) environment. The Alarm handling section of
this manual describes possible ventilator alarms and what to do if they occur.
Consult with your institution’s biomedical engineering department in case of
interrupted ventilator operation, and before relocating any life support equipment.
Customer assistance
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For further assistance contact your local Mallinckrodt representative.
v
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700 Series Ventilator Operator’s ManualG-061874-00 Rev. D (09/00)
The 700 Series Ventilator System (including the 740 and 760 Ventilators)
provides respiratory support for a wide range of pediatric to adult patients for a
wide variety of clinical conditions. The ventilator’s mixing technique allows it to
ventilate critically ill patients at adjustable oxygen concentrations without the
need for a blender, compressor, or hospital-grade wall air.
The 700 Series Ventilator System can be mains- or battery-powered. Each
ventilator includes two microcontrollers: one for breath delivery (which controls
ventilation), and one for the user interface (which monitors ventilator and patient
data). Each microcontroller verifies that the other is functioning properly. Using
two independent microcontrollers in this fashion prevents a single fault from
causing a simultaneous failure of controlling and monitoring functions.
The 700 Series Ventilator System supplies mandatory or spontaneous breaths
with a piston-based pneumatic system. Table 1-1 summarizes the modes and
breath types offered by the 740 and 760 Ventilators. Mandatory breaths can be
volume control ventilation (VCV, available on 740 and 760 Ventilators) or
pressure control ventilation (PCV, available on the 760 Ventilator only). VCV
delivers breaths to the patient at a preset tidal volume, peak flow, waveform, and
oxygen concentration at a minimum respiratory rate. PCV delivers breaths to the
patient at a preset inspiratory pressure, I:E ratio or inspiratory time, rise time
factor (how quickly inspiratory pressure rises to achieve the set inspiratory
pressure), and oxygen concentration at a minimum respiratory rate. A
spontaneous breath allows the patient inspiratory flows of up to 300 L/min, with
or without pressure support ventilation (PSV). On the 760 Ventilator, you can set
the rise time factor and exhalation flow sensitivity (that is, the point at which the
ventilator cycles from inspiration to exhalation) in PSV.
The ventilator begins apnea ventilation if no breath (patient- , ventilator-, or
operator-initiated) is delivered within the selected apnea interval. Apnea
ventilation is active during all modes. On the 740 Ventilator, only VCV breaths
are available in apnea ventilation. On the 760 Ventilator, VCV or PCV breaths are
available in apnea ventilation.
The 760 Ventilator also offers the ability to perform respiratory mechanics
calculations and maneuvers as a standard feature using the EXP PAUSE (to
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1-1
1Introduction
calculate auto-PEEP) and INSP PAUSE (to calculate patient resistance and
compliance) keys.
Table 1-1: Mode/breath type availability on 740/760 Ventilators
Mode/breath type740 Ventilator760 Ventilator
VCV breath type••
PCV breath type•
PSV breath type (support pressure
setting)
PSV (rise time factor and exhalation
sensitivity settings)
SIMV mode••
Apnea ventilation (VCV breath type)••
Apnea ventilation (choice of VCV or
PCV breath type)
Respiratory mechanics (EXP PAUSE
and INSP PAUSE)
••
•
•
•
This manual tells you how to operate and perform simple maintenance for the 700
Series Ventilator. Mallinckrodt recommends that you become familiar with this
manual and accompanying labels before attempting to operate or maintain the
ventilator. If you need additional copies of this manual, contact your Mallinckrodt
representative.
To ensure optimum performance of the 700 Series Ventilator System,
Mallinckrodt recommends that a qualified service technician perform periodic
maintenance on the ventilator. For more information, contact your Mallinckrodt
representative.
1.1 Functional description
By pressing keys and turning the knob on the ventilator keyboard, the operator
gives initial instructions and data to the ventilator
(Figure 1-1). The user interface microcontroller processes this information and
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stores it in the ventilator’s memory. The breath delivery microcontroller uses this
stored information to control and monitor the flow of gas to and from the patient.
The 700 Series Ventilator uses a flow trigger to recognize patient effort. The
trigger monitors flow from the piston during exhalation. When the patient
inhales, patient circuit pressure drops very slightly below end-expiratory
pressure. At the same time, the piston moves forward to deliver flow to the
ventilator breathing circuit and maintain the preset PEEP/CPAP level. The level
of flow depends on the patient’s effort. If this flow exceeds the user-set level, the
ventilator triggers. By design, the ventilator attempts to maintain PEEP in the
presence of a circuit leak. Since a leak drives the piston to deliver flow to make
up for pressure losses, a circuit leak can require an increase in the flow trigger
level to avoid autocycling.
During exhalation, the ventilator’s piston retracts and draws air and oxygen into
the cylinder. The ventilator uses room air, which means the ventilator can operate
without a compressor or wall air source. Room air enters the ventilator through a
protected user-replaceable air intake filter just inside the ventilator cabinet. This
filter captures airborne particles.
Oxygen from a cylinder or wall supply enters the ventilator through a hose and
oxygen fitting (the fitting is available in several versions). Once inside the
ventilator, the oxygen is regulated to a pressure the ventilator can use, then mixed
with air, according to the selected % O
The flow-triggered piston/cylinder system and motor controller circuit control the
flow of gas to the patient. On the 760 Ventilator in PCV or PSV, the rate of flow
is also determined by the preset rise time factor. This system is designed with a
minute gap (about the size of a thin sheet of paper) between the piston and the
cylinder wall. This design eliminates the friction between the piston and cylinder,
allowing it to respond more rapidly than a “sealed” system.
.
2
A small amount of gas leaks through the gap between the piston and cylinder.
Ventilator software and a continuous forward motion of the piston compensate for
this leak.
The piston delivers the mixed air and oxygen through the inspiratory manifold system, and out to the patient. The oxygen concentration and temperature of the
delivered gas are monitored here, using a galvanic oxygen sensor and a
thermistor. The galvanic sensor generates a voltage proportional to the partial
pressure of oxygen, from which the oxygen concentration is calculated. The
ventilator alarms if the monitored oxygen concentration is more than ten
percentage points above or below the % O
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setting. The inspiratory manifold
2
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1Introduction
system also includes a safety valve to relieve patient pressure if necessary (for
example, if the ventilator breathing circuit is kinked or occluded).
The patient system includes the components external to the ventilator that route
gas between the ventilator and the patient. These components include the
inspiratory filter (which protects against contamination between the ventilator
and patient), a humidification device, ventilator breathing circuit (the tubing
through which the gas travels), collector vial (which protects the exhalation
system from moisture in the exhaled gas, and can be emptied without losing
circuit PEEP), and an expiratory filter (which limits the bacteria in the patient’s
exhaled gas from escaping to room air or contaminating the ventilator).
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Figure 1-1. Block diagram: 700 Series Ventilator function
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1-5
1Introduction
The heated exhalation system monitors the flow of the patient’s exhaled gas using
a differential pressure transducer. The patient exhales through the exhalation valve. During exhalation, the PEEP/CPAP system maintains user-selected
pressure in the ventilator breathing circuit.
Throughout the respiratory cycle, pressure transducers monitor inspiratory,
expiratory, and atmospheric pressures. The temperatures of the pneumatic
compartment and inspiratory gas are also monitored. Information from these
transducers is continuously used to update the calculations that control
ventilation. (Appendix F provides a diagram of the ventilator’s pneumatic system
and ventilator breathing circuit.)
Power to operate the ventilator comes from ac mains (wall) or battery power. The
power supply is designed to protect against excessive voltages, temperatures, or
current draws. A power cord retainer prevents the cord from accidental
disconnection.
The ventilator includes an internal battery, and accommodates an optional
external battery. Depending on the ventilator settings, battery backup power can
be supplied for up to 2 ½
the external battery. Both batteries are recharged during operation from ac power.
If both are installed, the external battery is used first when ac power is not
present. If the external battery is depleted or not installed, the internal battery
supplies power to the ventilator when ac power is not available. The keyboard
indicates the source of power and battery charge level of the internal battery at all
times.
hours using the internal battery, and up to 7 hours using
1-6
Emergency modes: The ventilator declares a ventilator inoperative (VENT INOP)
condition if a hardware failure or critical software error that could compromise
safe ventilation occurs. In case of a ventilator inoperative condition, the VENT
INOP indicator lights and the ventilator enters the safety valve open (SVO) state.
To correct a ventilator inoperative condition, the ventilator must be turned off,
then powered on again; at power-on, the operator must run extended self-test
(EST). The ventilator must pass EST before normal ventilation can resume.
The safety valve allows the patient to breathe room air unassisted when the
ventilator is in the SVO state. The ventilator remains in the SVO state until
power-on self-test (POST) verifies that power levels to the ventilator are
acceptable and that the motor controller and microcontrollers are functioning
correctly, and until the user has confirmed ventilator settings.
If the ventilator enters the SVO state and POST is not running, the SAFETY
VALVE OPEN indicator lights and a high-priority alarm sounds. The ventilator
enters the SVO state if it detects a hardware or software failure that could
700 Series Ventilator Operator’s ManualG-061874-00 Rev. D (09/00)
compromise safe ventilation. In case of a malfunction that prevents software from
opening the safety valve, there is also an analog circuit that opens the safety valve
when system pressure exceeds 115 cmH
If the ventilator detects an occlusion or a continuous high inspiratory pressure
condition, it opens the safety and exhalation valves to vent excess pressure, then
shuts them and begins occlusion cycling mode. In occlusion cycling mode the
ventilator uses current settings except for those summarized in Table 1-2. If the
ventilator again detects an occlusion or continuous high pressure condition, it
again opens the safety and exhalation valves then resumes occlusion cycling
mode. If the operator presses the alarm reset key or the ventilator does not detect
an occlusion or continuous high pressure condition, it reverts to normal
ventilation using the most recently accepted settings.
Table 1-2: Changes to current settings in occlusion cycling mode
SettingChange to setting
O (113 hPa).
2
HIGH PRESSURE
alarm (VCV breath
type)
PEEP (all modes)Set to 0 cmH2O
(all modes)Set to 100%
%O
2
SPONT mode (PSV
breath type)
SUPPORT
PRESSURE (PSV
breath type)
SUPPORT
PRESSURE (PCV
breath type)
RISE TIME FACTOR
(PCV breath type)
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Setto30cmH
Breaths are delivered at a rate of 12/min with an inspiratory time
of 2 seconds.
If less than 15 cmH
If 15 cmH
If less than 15 cmH
If 15 cmH2O or above: the current setting is used (no change).
Set to 70%
O
2
O:setto15cmH2O.
2
O or above: the current setting is used (no change).
2
O:setto15cmH2O.
2
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1Introduction
1.2 Symbols and labels
These symbols and labels appear on the 700 Series Ventilator System:
Power switch positions per IEC 601-1.”I” represents ON position; “O”
represents OFF position.
7-00421
Refer to manual per IEC 601-1. When this symbol appears on
product, it means “Refer to documentation for information.”
7-00418
Potential equalization point, per IEC 601-1
7-00416
External battery connection
7-00426
Circuit breaker
1-8
7-00414
Serial number
SN
ac current
7-00427
Type B equipment, per IEC 601-1
7-00415
Indicates the degree of protection provided by enclosure (drip-proof).
IPX1
7-00403
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To avoid damaging the keyboard, do not press on it with sharp objects.
The keyboard (Figure 1-2 shows the 740 keyboard and Figure 1-3 shows the 760
keyboard) is grouped into three sections:
•VENTILATOR SETTINGS: Where you set breath delivery variables.
•PATIENT DATA: Where you set alarm limits and view the monitored
pressures, breath timing, and volumes.
•VENTILATOR STATUS: Where you see the alarm status and operating
condition of the ventilator.
Patient dataVentilator status
Ventilator settings
Figure 1-2. 740 Ventilator System keyboard
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7-00048
1-13
1Introduction
Patient dataVentilator status
1-14
Ventilator settings
7-00123
Figure 1-3. 760 Ventilator System keyboard
1.3.1 VENTILATOR SETTINGS
The VENTILATOR SETTINGS section of the keyboard allows you to select the
ventilation mode, breath type, and settings. For more detail on ventilation modes
and breath delivery, see Appendix D.
To change the mode and settings, select the mode, then the breath type, and then
the ventilator settings. The keys flash during setup and mode changes to ensure
that you review all pertinent settings. The keyboard is designed to minimize
accidental or unintentional changes.
Table 1-3 summarizes the functions of the keys, knob, and indicators in the
VENTILATOR SETTINGS section of the keyboard. Ventilator settings are also
limited by these breath delivery boundaries:
•I:E ratio £ 4:1 for PCV (760 Ventilator only), £ 3:1 for all other breath types
•Inspiratory time = 0.2 to 8 seconds (excluding plateau)
•Expiratory time ³ 0.2 seconds
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