Puritan-Bennett 800 User and technical manual
Operator’s and
800
Series Ve nt i l at or S y s t e m
Technical Reference Manual
Part No. 4-070088-00
Rev. L
August 2010
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
Copyright Information
Copyright 2010 Nellcor Puritan Bennett LLC. All rights reserved. The Puritan
Bennett™ 840 Ventilator System is manufactured in accordance with Nellcor
Puritan Bennett LLC proprietary information, covered by one or more of the
following U.S. Patents and foreign equivalents: 5,271,389; 5,319,540; 5,339,807;
5,390,666; 5,771,884; 5,791,339; 5,813,399; 5,865,168; 5,881,723; 5,884,623;
5,915,379; 5,915,380; 6,024,089; 6,161,539; 6,220,245; 6,269,812; 6,305,373;
6,360,745; 6,369,838; 6,553,991; 6,668,824; 6,675,801; 7,036,504; 7,117,438; and
RE39225. 840, 800 Series, DualView, SandBox, SmartAlert, Flow-by, and PTS 2000 are
trademarks of Nellcor Puritan Bennett LLC.
The information contained in this manual is the sole property of
Nellcor Puritan Bennett LLC and may not be duplicated without permission. This
manual may be revised or replaced by Nellcor Puritan Bennett LLC at any time
and without notice.
You should ensure you have the most current applicable version of this
manual; if in doubt, contact Nellcor Puritan Bennett LLC or visit the Puritan
Bennett product manual web page at:
http://www.puritanbennett.com/serv/manuals.aspx
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.
Nellcor Puritan Bennett’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 Nellcor Puritan Bennett’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, Nellcor Puritan Bennett LLC has no obligation to
furnish any such revisions, changes, or modifications to the owner or user of the
equipment (including its software) described herein.
Applicability
Warning
Caution
The information in this manual applies to Puritan Bennett
840 ventilator versions manufactured or updated after August
2005. Some of this information may not apply to earlier versions.
Contact your Puritan Bennett representative if in doubt.
Definitions
This manual uses three special indicators to convey information
of a specific nature. They include:
Indicates a condition that can endanger the patient or the
ventilator operator.
Indicates a condition that can damage the equipment.
NOTE:
Indicates points of particular emphasis that make
operation of the ventilator more efficient or
convenient.
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
i
Warnings, cautions, and notes
Please take the time to familiarize yourself with the following
safety considerations, special handling requirements, and
regulations that govern the use of the Puritan Bennett 840
Ventilator System.
• 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 Puritan Bennett.
• 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.
• 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 Puritan Bennett 840 Ventilator System
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, facility power, and backup
power source.
• When handling any part of the Puritan Bennett 840 Ventilator
System, always follow your hospital infection control
guidelines for handling infectious material.
Puritan Bennett recognizes cleaning, sterilization, sanitation,
and disinfection practices vary widely among health care
institutions. It is not possible for Puritan Bennett to specify or
require specific practices that will meet all needs, or to be
responsible for the effectiveness of cleaning, sterilization, and
other practices carried out in the patient care setting. As a
manufacturer Puritan Bennett does not have any guidelines or
recommendations regarding specific pathogens as they relate
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
ii
to the usage of our products. In regards to transmission of any
specific pathogen, Puritan Bennett can offer the specifications
of our products as well as our recommendations for cleaning
and sterilization. Any further clarification regarding pathogens
as they relate to our products should be brought to the
attention of your lab Pathologist as well as your infection
control personnel and/or risk committee.
• Patients on life-support equipment should be appropriately
monitored by competent medical personnel and suitable
monitoring devices.
The Puritan Bennett 840 Ventilator System 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.
• For a thorough understanding of ventilator operations, be sure
to thoroughly read this manual before attempting to use the
system.
• Before activating any part of the ventilator, be sure to check
the equipment for proper operation and, if appropriate, run
SST as described in this manual.
• Do not use sharp objects to make selections on the graphic
user interface (GUI) display or keyboard.
• US federal law restricts this device to sale by or on the order of
a physician.
• Check the ventilator periodically as outlined in the Puritan
Bennett 800 Series Ventilator System Service Manual; do not use if
defective. Immediately replace parts that are broken, missing,
obviously worn, distorted, or contaminated.
• An alternative source of ventilation should always be available
when using the Puritan Bennett 840 Ventilator System.
• This ventilator offers a choice of breath delivery modes and
types. Throughout the patient’s treatment, the clinician
should carefully select the ventilation mode and/or breath
type to use for that patient. This selection should be based on
the clinician’s clinical judgment, considering the condition
and needs of the individual patient, as such condition and
needs change from time to time, and considering the benefits,
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
iii
limitations and operating characteristics of each mode and/or
breath type.
Warranty
The Puritan Bennett 840 Ventilator System is warranted against
defects in material and workmanship in accordance with the
Puritan Bennett Medical Equipment Warranty supplied with your
ventilator. Keep a maintenance record to ensure the validity of the
warranty.
Year of manufacture
The graphic user interface (GUI), breath delivery unit (BDU),
backup power source (BPS), and compressor contain a specific
year of manufacture applicable only for that assembly. The year of
manufacture is indicated by the fifth and sixth digits of the serial
number which is located at the back panel of the GUI, BDU, and
BPS, and the side panel of the compressor.
Manufacturer
Tyco Healthcare Group LP
Nellcor Puritan Bennett Division
4280 Hacienda Drive
Pleasanton, CA 94588-2719 USA
Authorized representative
Tyco Healthcare UK LTD
154 Fareham Road
Gosport PO13 0AS, U.K.
Electromagnetic susceptibility
The Puritan Bennett 840 Ventilator System complies with the
requirements of
IEC 60601-1-2:2004 (EMC Collateral Standard), including the Efield susceptibility requirements at a level of 10 volts per meter, at
frequencies from 80 MHz to 2.5 GHz, and the ESD requirements
of this standard.
However, even at this level of device immunity, certain
transmitting devices (cellular phones, walkie-talkies, cordless
phones, paging transmitters, etc.) emit radio frequencies that
could interrupt ventilator operation if operated in a range too
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
iv
close to the ventilator. It is difficult to determine when the field
Warning
strength of these devices becomes excessive.
Practitioners should be aware radio frequency emissions are
additive, and 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.
Accessory equipment connected to the power receptacle,
analog, and digital interfaces must be certified according
to IEC 60601-1. Furthermore, all configurations shall
comply with the system standard IEC 60601-1-1. Any
person who connects additional equipment to the power
receptacle, signal input part, or signal output part of the
Puritan Bennett 840 ventilator configures a medical
system, and is therefore responsible for ensuring the
system complies with the requirements of the system
standard IEC 60601-1-1. If in doubt, consult
Puritan Bennett Technical Services at 1.800.255.6774 or
your local representative.
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
For further assistance contact your local Puritan Bennett
representative.
For online technical support, visit the
SM
SolvIT
http://www.puritanbennett.com
The SolvIT Center provides answers to
frequently asked questions about the Puritan Bennett 840
Ventilator System and other Puritan Bennett products 24 hours a
day, 7 days a week.
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
Center Knowledge Base at
v
Preface
This manual is divided into two parts: the operator’s manual and
the technical reference. The operator’s manual describes how to
operate the Puritan Bennett 840 Ventilator System. It also
provides product specifications and accessory order numbers. The
technical reference includes background information about how
the ventilator functions, including details on its operating modes,
self-tests, and other features. In the table of contents and index,
the prefix OP- identifies page numbers in the operator’s manual,
and the prefix TR- identifies page numbers in the technical
reference.
®
Any references to the software options BiLevel
®
(VV+) which includes VC+ and VS breath types, NeoMode®,
Plus
Proportional Assist Ventilation
®
(PAV+), Tube Compensation (TC),
Respiratory Mechanics (RM) and Trending in this manual assume
that the option has been installed on the ventilator. If these
options aren’t installed, then references to their functions do not
apply.
While this manual covers the ventilator configurations currently
supported by Puritan Bennett, it may not be all-inclusive and may
not be applicable to your ventilator. Contact Puritan Bennett for
questions about the applicability of the information.
Some illustrations and images are shown with a ready-to-assemble
(RTA) cart, Puritan Bennett 800 Series Ventilator Compressor
Mount Cart, or a Puritan Bennett 800 Series Ventilator Pole Cart.
Please note that these images are for illustrative purposes only,
and regardless of which cart you have, the required information is
provided.
, Volume Ventilation
The term “RTA cart” refers to the ready-to-assemble cart and any
earlier cart versions.
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
vi
Contents
Operator’s Manual
1 Introduction OP 1-1
1.1 Technical description. . . . . . . . . . . . . . . . . . . . . . . . . .OP 1-3
1.1.1 General background . . . . . . . . . . . . . . . . . . . . . . OP 1-3
1.1.2 Pressure and flow triggering . . . . . . . . . . . . . . . .OP 1-5
1.1.3 Breathing gas mixture . . . . . . . . . . . . . . . . . . . . .OP 1-5
1.1.4 Inspiratory pneumatics . . . . . . . . . . . . . . . . . . . . OP 1-6
1.1.5 Patient circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 1-6
1.1.6 AC mains and backup power system . . . . . . . . . . OP 1-7
1.1.7 Ventilator emergency states. . . . . . . . . . . . . . . . .OP 1-8
1.2 Graphic user interface . . . . . . . . . . . . . . . . . . . . . . . . . OP 1-9
1.3 User interface controls and indicators . . . . . . . . . . . . .OP 1-11
1.3.1 Onscreen symbols and abbreviations . . . . . . . . . . OP 1-19
1.4 Ventilator system labeling symbols. . . . . . . . . . . . . . . . OP 1-25
2 How to set up the Puritan Bennett 840 ventilator OP 2-1
2.1 How to connect the electrical supply . . . . . . . . . . . . .OP 2-4
2.2 How to connect the air and oxygen supplies . . . . . . . .OP 2-10
2.3 How to connect the patient circuit components . . . . .OP 2-13
2.3.1 How to select and connect a patient circuit . . . . . OP 2-14
2.3.2 How to install the expiratory filter
and collector vial . . . . . . . . . . . . . . . . . . . . . . . . .OP 2-17
2.3.3 How to install the flex arm. . . . . . . . . . . . . . . . . .OP 2-21
2.3.4 How to install the humidifier . . . . . . . . . . . . . . . . OP 2-23
2.3.5 How to use the ventilator cart . . . . . . . . . . . . . . .OP 2-26
3 How to run Short Self Test (SST) OP 3-1
3.1 Introduction to SST . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 3-1
3.2 When to run SST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-2
3.3 SST components and requirements . . . . . . . . . . . . . . .OP 3-3
3.4 SST Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 3-4
3.5 SST Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-12
3.5.1 How to interpret individual SST test results . . . . . OP 3-14
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
vii
Contents
3.5.2 SST outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-15
4 How to use the Puritan Bennett 840 ventilator OP 4-1
4.1 Structure of user interface . . . . . . . . . . . . . . . . . . . . . . OP 4-2
4.2 Patient setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-3
4.2.1 How to ventilate with most recent
control parameters . . . . . . . . . . . . . . . . . . . . . . . OP 4-4
4.2.2 How to ventilate with new control parameters . . OP 4-4
4.2.3 Patient data and current settings. . . . . . . . . . . . . OP 4-8
4.2.4 Ideal Body Weight (IBW). . . . . . . . . . . . . . . . . . . OP 4-10
4.3 How to change the main ventilator control
parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-17
4.4 Ideal Body Weight (IBW), vent type, mode,
and other changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-17
4.5 How to select a constant timing variable during
respiratory rate changes . . . . . . . . . . . . . . . . . . . . . . . OP 4-19
4.6 How to change apnea ventilation settings. . . . . . . . . . OP 4-21
4.7 How to set alarms OP 4-22
4.8 How to change other settings . . . . . . . . . . . . . . . . . . . OP 4-24
4.9 Expiratory pause maneuvers . . . . . . . . . . . . . . . . . . . . OP 4-25
4.10 Inspiratory pause maneuvers. . . . . . . . . . . . . . . . . . . OP 4-26
4.11 How to interpret inspiratory pause maneuver
results for static compliance and resistance. . . . . . . . OP 4-28
4.12 How to use NIV. . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-29
4.12.1 NIV intended use . . . . . . . . . . . . . . . . . . . . . . . OP 4-29
4.12.2 NIV breathing interfaces . . . . . . . . . . . . . . . . . . OP 4-29
4.12.3 NIV setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-30
4.12.4 High spontaneous inspiratory time limit setting. OP 4-34
4.12.5 Apnea setup . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-34
4.12.6 Alarm setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-34
4.12.7 Changing patient from INVASIVE to
NIV Vent Type . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-36
4.12.8 Changing patient from NIV to
INVASIVE Vent Type . . . . . . . . . . . . . . . . . . . . . OP 4-37
4.12.9 NIV patient data . . . . . . . . . . . . . . . . . . . . . . . . OP 4-38
viii
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
Contents
5 How to handle alarms OP 5-1
5.1 Ventilator alarm classifications . . . . . . . . . . . . . . . . . . .OP 5-1
5.2 Alarm silence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-2
5.3 Alarm reset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-5
5.4 Alarm log. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 5-6
5.5 Alarm volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-7
5.6 Alarm messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 5-8
6 How to view graphics OP 6-1
6.1 Graphics display function. . . . . . . . . . . . . . . . . . . . . . .OP 6-1
6.2 How to set up a graphics display . . . . . . . . . . . . . . . . . OP 6-3
6.3 Graphics display details and calculations . . . . . . . . . . . OP 6-4
6.4 How to adjust displayed graphics. . . . . . . . . . . . . . . . .OP 6-5
6.5 The graphics display FREEZE function . . . . . . . . . . . . .OP 6-6
6.6 How to print patient data graphics . . . . . . . . . . . . . . . OP 6-7
6.7 Automatic display of graphics . . . . . . . . . . . . . . . . . . .OP 6-7
6.8 When graphics are not accessible . . . . . . . . . . . . . . . . OP 6-8
7 Preventive maintenance OP 7-1
7.1 How to dispose of used parts. . . . . . . . . . . . . . . . . . . . OP 7-1
7.2 How to clean, disinfect and sterilize parts . . . . . . . . . . .OP 7-2
7.2.1 How to clean components. . . . . . . . . . . . . . . . . .OP 7-6
7.3 Disinfection and sterilization . . . . . . . . . . . . . . . . . . . . OP 7-6
7.4 Preventive maintenance procedures for the operator . . OP 7-8
7.4.1 Total operational hours . . . . . . . . . . . . . . . . . . . . OP 7-9
7.4.2 Inspiratory and expiratory bacteria filters . . . . . . . OP 7-12
7.4.3 Daily or as required: collector vial and drain bag . OP 7-14
7.4.3.1 How to remove the collector vial . . . . . . . . .OP 7-14
7.4.3.2 How to remove the drain bag . . . . . . . . . . .OP 7-14
7.4.4 Daily or as required: in-line water traps . . . . . . . . OP 7-16
7.4.5 Every 250 hours: compressor inlet filter . . . . . . . .OP 7-16
7.4.6 Every year: ventilator inspection. . . . . . . . . . . . . . OP 7-17
7.4.7 Every year or as necessary: oxygen sensor . . . . . .OP 7-17
7.4.7.1 Oxygen sensor replacement procedure . . . . OP 7-18
7.5 Additional preventive maintenance procedures . . . . . . OP 7-24
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
ix
Contents
7.6 Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 7-26
7.7 Repacking and shipping . . . . . . . . . . . . . . . . . . . . . . . OP 7-26
A Specifications OP A-1
A.1 Physical characteristics . . . . . . . . . . . . . . . . . . . . . . . . OP A-2
A.2 Environmental requirements . . . . . . . . . . . . . . . . . . . . OP A-5
A.3 Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . OP A-6
A.4 Electrical specifications . . . . . . . . . . . . . . . . . . . . . . . . OP A-7
A.5 Compliance and approvals . . . . . . . . . . . . . . . . . . . . . OP A-11
A.5.1 Manufacturer’s Declaration . . . . . . . . . . . . . . . . . OP A-12
A.6 Technical specifications. . . . . . . . . . . . . . . . . . . . . . . . OP A-22
A.7 Ranges, resolutions, and accuracies. . . . . . . . . . . . . . . OP A-29
A.7.1 Recommended limits . . . . . . . . . . . . . . . . . . . . . OP A-29
A.7.2 Software options. . . . . . . . . . . . . . . . . . . . . . . . . OP A-30
B Part numbers OP B-1
C Pneumatic schematic OP C-1
D Alarm and oxygen sensor calibration testing OP D-1
D.1 Alarm test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP D-1
D.2 Oxygen sensor calibration test . . . . . . . . . . . . . . . . . . OP D-7
E Remote alarm and RS-232 ports OP E-1
E.1 Remote alarm port . . . . . . . . . . . . . . . . . . . . . . . . . . . OP E-2
E.2 RS-232 port. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP E-3
E.3 How to configure the RS-232 ports . . . . . . . . . . . . . . . OP E-4
E.4 Printers and cables . . . . . . . . . . . . . . . . . . . . . . . . . . . OP E-5
E.5 RS-232 port commands. . . . . . . . . . . . . . . . . . . . . . . . OP E-7
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
x
Contents
Technical Reference
1 Introduction to breath delivery TR 1-1
2 Detecting and initiating inspiration TR 2-1
2.1 Internally triggered inspiration. . . . . . . . . . . . . . . . . . .TR 2-2
2.1.1 Pressure sensitivity . . . . . . . . . . . . . . . . . . . . . . . TR 2-2
2.1.2 Flow sensitivity . . . . . . . . . . . . . . . . . . . . . . . . . . TR 2-4
2.1.3 Time-cycled inspiration . . . . . . . . . . . . . . . . . . . . TR 2-6
2.2 Operator-triggered inspiration . . . . . . . . . . . . . . . . . . . TR 2-6
3 Detecting and initiating exhalation TR 3-1
3.1 Internally initiated exhalation. . . . . . . . . . . . . . . . . . . . TR 3-1
3.1.1 Time-cycled exhalation . . . . . . . . . . . . . . . . . . . .TR 3-1
3.1.2 End-inspiratory flow method . . . . . . . . . . . . . . . .TR 3-2
3.1.3 Airway pressure method . . . . . . . . . . . . . . . . . . .TR 3-3
3.2 Backup limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 3-4
3.2.1 Time limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .TR 3-4
3.2.2 High circuit pressure limit . . . . . . . . . . . . . . . . . . TR 3-4
3.2.3 High ventilator pressure limit. . . . . . . . . . . . . . . . TR 3-4
4 Mandatory breath delivery TR 4-1
4.1 Comparison of pressure- and volume-based
mandatory breaths . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 4-1
4.2 Compliance compensation for volume-based
mandatory breaths . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 4-3
4.3 BTPS compensation for volume-based
mandatory breaths . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 4-5
4.4 Manual inspiration. . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 4-5
5 Spontaneous breath delivery TR 5-1
6 Assist/control (A/C) mode TR 6-1
6.1 Breath delivery in A/C . . . . . . . . . . . . . . . . . . . . . . . . .TR 6-1
6.2 Rate change during A/C . . . . . . . . . . . . . . . . . . . . . . .TR 6-3
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
xi
Contents
6.3 Changing to A/C mode. . . . . . . . . . . . . . . . . . . . . . . . TR 6-3
7 Synchronous intermittent mandatory ventilation
(SIMV) TR 7-1
7.1 Breath delivery in SIMV . . . . . . . . . . . . . . . . . . . . . . . . TR 7-3
7.2 Apnea ventilation in SIMV . . . . . . . . . . . . . . . . . . . . . . TR 7-4
7.3 Changing to SIMV mode. . . . . . . . . . . . . . . . . . . . . . . TR 7-5
7.4 Rate change during SIMV . . . . . . . . . . . . . . . . . . . . . . TR 7-7
8 Spontaneous (SPONT) mode TR 8-1
8.1 Breath delivery in SPONT . . . . . . . . . . . . . . . . . . . . . . TR 8-1
8.2 Changing to SPONT mode . . . . . . . . . . . . . . . . . . . . . TR 8-1
9 Apnea ventilation TR 9-1
9.1 Apnea detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 9-1
9.2 Transition to apnea ventilation . . . . . . . . . . . . . . . . . . TR 9-3
9.3 Key entries during apnea ventilation . . . . . . . . . . . . . . TR 9-3
9.4 Resetting apnea ventilation. . . . . . . . . . . . . . . . . . . . . TR 9-3
9.4.1 Resetting to A/C . . . . . . . . . . . . . . . . . . . . . . . . . TR 9-4
9.4.2 Resetting to SIMV . . . . . . . . . . . . . . . . . . . . . . . . TR 9-4
9.4.3 Resetting to SPONT . . . . . . . . . . . . . . . . . . . . . . TR 9-4
9.5 Phasing in new apnea intervals . . . . . . . . . . . . . . . . . . TR 9-5
10
Detecting occlusion and disconnect TR 10-1
10.1 Occlusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 10-1
10.2 Disconnect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 10-3
10.3 Occlusions and disconnect annunciation. . . . . . . . . . TR 10-5
11 Phasing in setting changes TR 11-1
12 Ventilator settings TR 12-1
12.1 Apnea ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-1
12.2 Circuit type and Ideal Body Weight (IBW) . . . . . . . . TR 12-2
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
xii
Contents
12.3 Disconnect sensitivity (D
12.4 Expiratory sensitivity (E
12.5 Expiratory time (T
) . . . . . . . . . . . . . . . . . . . . . . . . . .TR 12-4
E
) . . . . . . . . . . . . . . . . . . TR 12-3
SENS
). . . . . . . . . . . . . . . . . . . .TR 12-3
SENS
12.6 Flow pattern . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-4
12.7 Flow sensitivity (V
12.8 High spontaneous inspiratory time limit (2T
). . . . . . . . . . . . . . . . . . . . . . . .TR 12-5
SENS
). .TR 12-6
I SPONT
12.9 Humidification type . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-7
12.10 I:E ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-7
12.11 Ideal body weight (IBW) . . . . . . . . . . . . . . . . . . . . . TR 12-7
12.12 Inspiratory pressure (P
12.13 Inspiratory time (T
) . . . . . . . . . . . . . . . . . . . . . . TR 12-8
I
) . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-8
I
12.14 Mode and mandatory breath type. . . . . . . . . . . . . . TR 12-9
12.15 O
12.16 Peak inspiratory flow (V
% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .TR 12-12
2
) . . . . . . . . . . . . . . . . . .TR 12-13
MAX
12.17 PEEP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .TR 12-13
12.17.1 PEEP restoration. . . . . . . . . . . . . . . . . . . . . . . . TR 12-14
12.18 Plateau time (T
12.19 Pressure sensitivity (P
12.20 Pressure support (P
) . . . . . . . . . . . . . . . . . . . . . . . . . .TR 12-14
PL
) . . . . . . . . . . . . . . . . . . . . TR 12-15
SENS
) . . . . . . . . . . . . . . . . . . . . . TR 12-15
SUPP
12.21 Respiratory rate (f) . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-16
12.22 Rise time % . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-16
12.23 Safety ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-17
12.24 Spontaneous breath type. . . . . . . . . . . . . . . . . . . . . TR 12-18
12.25 Tidal volume (V
). . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-19
T
12.26 Vent type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-19
13 Alarms TR 13-1
13.1 Alarm handling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-1
13.1.1 Alarm messages. . . . . . . . . . . . . . . . . . . . . . . . .TR 13-3
13.1.2 Alarm summary . . . . . . . . . . . . . . . . . . . . . . . . .TR 13-5
13.2 AC POWER LOSS alarm . . . . . . . . . . . . . . . . . . . . . . . TR 13-22
13.3 APNEA alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .TR 13-22
13.4 CIRCUIT DISCONNECT alarm . . . . . . . . . . . . . . . . . . TR 13-23
13.5 DEVICE ALERT alarm . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-23
13.6 High circuit pressure (P
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
) alarm. . . . . . . . . . . . . . TR 13-24
PEAK
xiii
Contents
13.7 High delivered O2% (O2%) alarm . . . . . . . . . . . . . . TR 13-25
13.8 High exhaled minute volume (V
13.9 High exhaled tidal volume (V
TE
13.10 High inspired tidal volume alarm (V
V
TI SPONT
13.11 High respiratory rate (f
) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-26
) alarm . . . . . . . . . . . . . TR 13-27
TOT
13.12 INSPIRATION TOO LONG alarm . . . . . . . . . . . . . . . TR 13-27
13.13 Low circuit pressure alarm (P
13.14 Low delivered O
% (O2%) alarm . . . . . . . . . . . . . TR 13-28
2
PEAK
13.15 Low exhaled mandatory tidal volume
(V
TE MAND
) alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-29
13.16 Low exhaled spontaneous tidal volume
(V
TE SPONT
) alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-30
13.17 Low exhaled total minute volume (V
13.18 PROCEDURE ERROR alarm. . . . . . . . . . . . . . . . . . . . TR 13-31
14 Patient data TR 14-1
14.1 Delivered O2% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-1
14.2 End expiratory pressure (PEEP) . . . . . . . . . . . . . . . . . TR 14-2
14.3 End inspiratory pressure (P
14.4 Exhaled minute volume (V
14.5 Exhaled tidal volume (V
TE
14.6 I:E ratio (I:E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-4
14.7 Intrinsic (auto) PEEP (PEEP
(PEEP
14.8 Mean circuit pressure (P
14.9 Peak circuit pressure (P
14.10 Plateau pressure (P
) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-5
TOT
MEAN
PEAK
) . . . . . . . . . . . . . . . . . . . . . . . TR 14-6
PL
14.11 Spontaneous minute volume (V
14.12 Static compliance and resistance (C
14.13 Total respiratory rate (f
TOT
) . . . . . . . . . . . . . . . . TR 14-2
I END
) . . . . . . . . . . . . . . . . TR 14-3
E TOT
) . . . . . . . . . . . . . . . . . . . . TR 14-4
) and total PEEP
I
). . . . . . . . . . . . . . . . . . TR 14-5
) . . . . . . . . . . . . . . . . . . . TR 14-5
) . . . . . . . . . . . . . . . . . . . TR 14-13
) alarm. . . . . . TR 13-25
ETOT
) alarm . . . . . . . . . . TR 13-26
TI
, V
TI MAND
,
) . . . . . . . . . . . . . TR 13-28
) alarm . TR 13-30
E TOT
E SPONT
) . . . . . . . . . TR 14-6
STAT
and R
). TR 14-7
STAT
15 Safety net TR 15-1
15.1 Patient problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 15-1
15.2 System faults. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 15-2
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
xiv
Contents
15.3 Ongoing background checks. . . . . . . . . . . . . . . . . . . TR 15-3
15.4 Hardware monitoring circuitry. . . . . . . . . . . . . . . . . .TR 15-4
15.5 Power on self test (POST). . . . . . . . . . . . . . . . . . . . . .TR 15-5
15.6 Short self test (SST) . . . . . . . . . . . . . . . . . . . . . . . . . . TR 15-5
15.7 Extended self test (EST) . . . . . . . . . . . . . . . . . . . . . . . TR 15-5
15.8 Oxygen sensor calibration . . . . . . . . . . . . . . . . . . . . . TR 15-6
15.9 Exhalation valve calibration . . . . . . . . . . . . . . . . . . . . TR 15-6
15.10 Ventilator inoperative test . . . . . . . . . . . . . . . . . . . .TR 15-6
15.11 Flow sensor offset calibration . . . . . . . . . . . . . . . . . . TR 15-7
15.12 Atmospheric pressure transducer calibration . . . . . . TR 15-7
16 Power on self test (POST) TR 16-1
16.1 Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 16-1
16.2 POST characteristics. . . . . . . . . . . . . . . . . . . . . . . . . .TR 16-2
16.3 POST following power interruptions . . . . . . . . . . . . .TR 16-3
16.4 POST fault handling. . . . . . . . . . . . . . . . . . . . . . . . . . TR 16-4
16.5 POST system interface . . . . . . . . . . . . . . . . . . . . . . . .TR 16-4
16.6 POST user interface . . . . . . . . . . . . . . . . . . . . . . . . . .TR 16-5
17 Short self test (SST) TR 17-1
18 Extended self test (EST) TR 18-1
18.1 EST results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .TR 18-2
18.2 EST failure handling. . . . . . . . . . . . . . . . . . . . . . . . . .TR 18-3
18.3 EST safety considerations . . . . . . . . . . . . . . . . . . . . . . TR 18-3
19 RS-232 commands TR 19-1
19.1 RSET command . . . . . . . . . . . . . . . . . . . . . . . . . . . . .TR 19-1
19.2 SNDA command . . . . . . . . . . . . . . . . . . . . . . . . . . . .TR 19-1
19.3 SNDF command . . . . . . . . . . . . . . . . . . . . . . . . . . . .TR 19-8
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
xv
Contents
This page is intentionally blank.
xvi
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
Figures
Operator’s Manual
Figure 1-1. Puritan Bennett 840 Ventilator System block diagram . . OP 1-4
Figure 1-2. Puritan Bennett 840 Ventilator System
Graphic User Interface (GUI) . . . . . . . . . . . . . . . . . . . . . . OP 1-10
Figure 2-1. How to lift the ventilator components . . . . . . . . . . . . . . OP 2-2
Figure 2-2. How to connect the ventilator power cord . . . . . . . . . . . OP 2-6
Figure 2-3. Ventilator power switch, AC indicator, and AC panel . . . OP 2-7
Figure 2-4. Power cord storage on the RTA cart . . . . . . . . . . . . . . . . OP 2-8
Figure 2-5. Power cord storage on the newer Puritan Bennett
800 Series Ventilator Compressor Mount Cart and
Puritan Bennett 800 Series Ventilator Pole Cart (shown) . OP 2-9
Figure 2-6. How to connect the air and oxygen supplies . . . . . . . . . OP 2-12
Figure 2-7. How to connect the patient circuit . . . . . . . . . . . . . . . . . OP 2-16
Figure 2-8. How to install the expiratory filter and collector vial . . . . OP 2-18
Figure 2-9. How to use the collector vial with or without
the drain bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 2-19
Figure 2-10. How to install the flex arm on RTA cart . . . . . . . . . . . . . . OP 2-21
Figure 2-11. How to install the flex arm on the newer
Puritan Bennett 800 Series Ventilator Compressor
Mount Cart or Puritan Bennett 800 Series Ventilator
Pole Cart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 2-22
Figure 2-12. How to install the humidifier (Fisher & Paykel
version shown) for ventilators mounted on RTA carts . . . OP 2-25
Figure 2-13. Location of cart lot number label. . . . . . . . . . . . . . . . . . . OP 2-27
Figure 2-14. How to lock and unlock the RTA cart’s front wheels. . . . . OP 2-28
Figure 2-15. How to lock and unlock the Puritan Bennett 800 Series
Ventilator Compressor Mount Cart or Puritan Bennett
800 Series Ventilator Pole Cart front wheels. . . . . . . . . . . OP 2-28
Figure 3-1. Test button location . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-5
Figure 4-1. Touch screen user interface . . . . . . . . . . . . . . . . . . . . . . . OP 4-2
Figure 4-2. Ventilator Startup screen . . . . . . . . . . . . . . . . . . . . . . . . OP 4-3
Figure 4-3. Touch screen appearance during normal ventilation
(shown with alarm silence and
100% O
T
Figure 4-4.
Figure 4-5. Alarm setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-23
(or TH) selected as the constant during rate change. . . OP 4-20
I
/CAL in progress) . . . . . . . . . . . . . . . . . . . . . . . OP 4-9
2
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
Figures
xvii
Figures
Figure 4-6. New patient setup screen — NIV . . . . . . . . . . . . . . . . . . OP 4-31
Figure 4-7. NIV ventilator settings screen . . . . . . . . . . . . . . . . . . . . . OP 4-33
Figure 4-8. New patient default alarm settings . . . . . . . . . . . . . . . . . OP 4-35
Figure 4-9. More patient data screen — NIV. . . . . . . . . . . . . . . . . . . OP 4-38
Figure 5-1. Alarm indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-1
Figure 5-2. Alarm Silence in Progress indicator (lower screen). . . . . . OP 5-4
Figure 5-3. Alarm log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-6
Figure 5-4. Alarm message format . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-9
Figure 6-1. Pressure-volume loop . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 6-2
Figure 6-2. Flow-volume loop. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 6-3
Figure 7-1. How to empty the collector vial and seal the drain bag . OP 7-15
Figure 7-2. 806 compressor with inlet filter. . . . . . . . . . . . . . . . . . . . OP 7-17
Figure 7-3. Dislodge the O
Figure 7-4. Open O
Figure 7-5. Locate O
sensor access port . . . . . . . . . . . . . . . . . . . . . . OP 7-21
2
2
Figure A-1. Recommended patient circuit configurations . . . . . . . . . OP A-27
Figure B-1. Ventilator accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . OP B-2
Figure B-2. Ventilator accessories (Puritan Bennett 800 Series
Ventilator Compressor Mount Cart shown) . . . . . . . . . . OP B-11
Figure B-3. Puritan Bennett 840 Ventilator System shown
mounted on Puritan Bennet 800 Series Ventilator
Pole Cart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP B-19
Figure C-1. Pneumatic schematic . . . . . . . . . . . . . . . . . . . . . . . . . . . OP C-1
Figure E-1. Remote alarm and RS-232 ports . . . . . . . . . . . . . . . . . . . OP E-1
Figure E-2. Remote alarm port pinout (view from back of GUI). . . . . OP E-2
Figure E-3. RS-232 serial port pinout . . . . . . . . . . . . . . . . . . . . . . . . OP E-3
sensor access cover . . . . . . . . . . . . . . . . OP 7-20
2
sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 7-22
Technical Reference
Figure 2-1. Declaring inspiration using pressure sensitivity . . . . . . . . TR 2-3
Figure 2-2. Declaring inspiration using flow sensitivity . . . . . . . . . . . TR 2-4
Figure 2-3. Time-cycled inspiration . . . . . . . . . . . . . . . . . . . . . . . . . TR 2-6
Figure 3-1. Initiating exhalation using the end-inspiratory
flow method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 3-2
Figure 3-2. Initiating exhalation using the airway pressure method . TR 3-3
Figure 6-1. A/C mode, no patient effort detected . . . . . . . . . . . . . . TR 6-2
Figure 6-2. A/C mode, patient effort detected . . . . . . . . . . . . . . . . . TR 6-2
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
xviii
Figures
Figure 6-3. A/C mode, VIM and PIM breaths . . . . . . . . . . . . . . . . . . TR 6-2
Figure 7-1. SIMV breath cycle (mandatory and
spontaneous intervals) . . . . . . . . . . . . . . . . . . . . . . . . . . TR 7-1
Figure 7-2. SIMV breath cycle, PIM delivered within
mandatory interval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 7-2
Figure 7-3. SIMV breath cycle, PIM not delivered within
mandatory interval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 7-2
Figure 7-4. Apnea ventilation in SIMV . . . . . . . . . . . . . . . . . . . . . . . TR 7-5
Figure 9-1. Apnea interval equals breath period . . . . . . . . . . . . . . . . TR 9-2
Figure 9-2. Apnea interval greater than breath period . . . . . . . . . . . TR 9-2
Figure 9-3. Apnea interval less than breath period . . . . . . . . . . . . . . TR 9-2
Figure 12-1. Puritan Bennett 840 Ventilator System modes
and breath types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-11
Figure 13-1. Alarm message format (upper GUI screen) . . . . . . . . . . . TR 13-3
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
xix
Figures
This page is intentionally blank.
xx
Puritan Bennett 800 Series Ventilator System Operator’s and Technical Reference Manual
Tables
Operator’s Manual
Table 1-1. Controls and indicators . . . . . . . . . . . . . . . . . . . . . . . . . . OP 1-11
Table 1-2. BDU indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 1-18
Table 1-3. Symbols and abbreviations . . . . . . . . . . . . . . . . . . . . . . . OP 1-19
Table 2-1. Patient circuit and IBW values. . . . . . . . . . . . . . . . . . . . . . OP 2-15
Table 3-1. SST test sequence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-8
Table 3-2. Individual SST test results . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-14
Table 3-3. Overall SST outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-15
Table 4-1. Ideal Body Weight (IBW) based
on patient height (cm to kg) . . . . . . . . . . . . . . . . . . . . . . OP 4-10
Table 4-2. Determining IBW based
on patient height (ft., in. to lb.) . . . . . . . . . . . . . . . . . . . . OP 4-13
Table 4-3. Soft bound ranges for Ideal Body Weight and tube
Internal Diameter (ID) . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-15
Table 4-4. Patient circuit and IBW values. . . . . . . . . . . . . . . . . . . . . . OP 4-16
Table 4-5. Monitored ventilator control parameters . . . . . . . . . . . . . OP 4-17
Table 4-5. Automatic settings changes — INVASIVE to NIV
on same patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-36
Table 4-6. Automatic settings changes — NIV to INVASIVE
on same patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-37
Table 5-1. Alarm messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-10
Table 7-1. Procedures to clean, disinfect, and sterilize parts. . . . . . . . OP 7-3
Table 7-2. Disinfection and sterilization procedures. . . . . . . . . . . . . . OP 7-7
Table 7-3. Operator preventive maintenance procedures
and frequency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 7-10
Table 7-4. Service preventive maintenance procedures and intervals . OP 7-25
Table A-1. Physical characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-3
Table A-2. Environmental requirements . . . . . . . . . . . . . . . . . . . . . . . OP A-5
Table A-3. Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-6
Table A-4. Electrical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-7
Table A-5. Compliance and approvals . . . . . . . . . . . . . . . . . . . . . . . . OP A-11
Table A-6. Electromagnetic Emissions . . . . . . . . . . . . . . . . . . . . . . . . OP A-13
Table A-7. Electromagnetic Immunity . . . . . . . . . . . . . . . . . . . . . . . . OP A-15
Table A-8. Electromagnetic Immunity – conducted and radiated RF . OP A-17
Puritan Bennett 800 Series Operator’s and Technical Reference Manual
xxi
Tables
Table A-9. Recommended separation distances between
portable and mobile RF communications equipment
and the Puritan Bennett 840 Ventilator System . . . . . . . . OP A-19
Table A-10. Compliant cables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-20
Table A-11. Technical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-22
Table 1-12. Patient circuit configurations . . . . . . . . . . . . . . . . . . . . . . OP A-28
Table A-13. Ventilator settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-30
Table A-14. Alarm settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-48
Table A-15. Patient data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-54
Table A-16. Other Screens — displayed data. . . . . . . . . . . . . . . . . . . . OP A-60
Table B-1. Ventilator parts and accessories . . . . . . . . . . . . . . . . . . . . OP B-3
Table B-2. Ventilator parts and accessories . . . . . . . . . . . . . . . . . . . . OP B-12
Table B-3. Ventilator Pole Cart and accessories . . . . . . . . . . . . . . . . . OP B-20
Technical Reference
Table 4-1. Comparison of pressure- and volume-based
mandatory breaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 4-2
Table 4-2. Compliance volume factors . . . . . . . . . . . . . . . . . . . . . . . TR 4-5
Table 5-1. Spontaneous breath delivery characteristics . . . . . . . . . . TR 5-1
Table 12-1. Modes and breath types . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-9
Table 13-1. Alarm urgency levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-2
Table 13-2. Alarm summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-5
Table 13-3. Applicability of high inspired tidal volume alarm symbols. TR 13-26
Table 14-1. Inspiratory pause maneuver displays . . . . . . . . . . . . . . . . TR 14-9
Table 19-1. MISCA response. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 19-3
Table 19-2. MISCF response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 19-9
Puritan Bennett 800 Series Operator’s and Technical Reference Manual
xxii
CHAPTER
1 Introduction
The intended use of the Puritan Bennett™ 840 Ventilator System
is for acute and subacute care of infant, pediatric, and adult
patients. Software options, available from Puritan Bennett,
provide additional ventilation functions.
The Puritan Bennett 840 Ventilator System facilitates work of
breathing management, offers selectable modes of breath delivery,
and assists the practitioner in the selection of the most
appropriate ventilator control parameters for the patient. The user
interface is intuitive and easy to operate for those with prior
knowledge of ventilator operation.
The user interface includes DualView™ touch screens that display
monitored patient data for easy assessment of the patient’s
condition. The touch screens also display the current ventilator
control parameters.
The SandBox™ area on the touch screen allows the practitioner to
preview the selected ventilator control parameters prior to active
ventilation of the patient.
The SmartAlert™ system intercepts alarms, or events, provides
specific information about the cause, and prompts the user with
actions to resolve the reported condition(s).
1
The breath delivery unit (BDU) comprises the pneumatics and the
patient circuit.
The ventilator uses two independent Central Processing Units
(CPUs):
• Breath delivery unit (BDU) CPU
• Graphic user interface (GUI) CPU
The BDU CPU uses the ventilator control parameters, selected by
the practitioner, to deliver breaths to the patient. The BDU CPU
also runs continuous and extensive operational background
checks to ensure proper operation of the ventilator.
Puritan Bennett 800 Series Ventilator System Operator’s Manual
OP 1-1
OP 1 Introduction
The GUI CPU monitors the ventilator and the ventilator/patient
interaction. The GUI CPU also monitors the operation of the BDU
CPU and prevents simultaneous failure of control and monitor
functions when a single fault is reported.
The Puritan Bennett 840 Ventilator System supplies mandatory or
spontaneous breaths with a preset level of positive end expiratory
pressure (PEEP), trigger sensitivity, and oxygen concentration. A
mandatory breath can either be pressure- or volume-controlled,
but it is always pressure-controlled in the optional BiLevelmode. A
spontaneous breath allows patient inspiratory flows of up to
200 L/min, with or without pressure support.
The optional 806 Compressor unit provides compressed air to the
BDU, and can be used in place of wall or bottled air. The
compressor unit is powered through and communicates with the
BDU.
The 802 Backup Power Source (BPS) or 803 Extended Backup
Power Source provides DC power to the BDU and GUI in the
event AC power is lost. A new, fully charged BPS runs the
ventilator (without a compressor or a humidifier) for at least 60
minutes (30 minutes on ventilators built prior to July 2007),
which allows transport of the patient and the ventilator within
the healthcare facility. The 803 extended BPS (available after
October 2009) can power the ventilator for at least four hours
under the same conditions.The same conditions apply,
respectively, to the one-hour or four-hour BPS assembly in the
Puritan Bennett 800 Series Ventilator Compressor Mount Cart and
the one-hour or four-hour batteries in the Puritan Bennett 800
Series Ventilator Pole Cart.
This manual tells you how to operate and perform simple
maintenance for the Puritan Bennett 840 Ventilator System.
Become familiar with this manual and accompanying labels
before attempting to operate or maintain the ventilator.
To ensure optimum performance of the Puritan Bennett
840 Ventilator System, Puritan Bennett strongly recommends
certified biomedical engineering technicians, or other personnel
with equivalent experience and training in the service of this type
of equipment, perform periodic maintenance on the ventilator.
For more information, contact your representative.
Puritan Bennett 800 Series Ventilator System Operator’s Manual
OP 1-2
Introduction OP 1
1.1 Technical description
1.1.1 General background
The practitioner uses the GUI touch screens, the off-screen keys,
and GUI knob to select the ventilator control parameters and
input data (see Figure 1-1). The GUI CPU processes this
information and stores it in ventilator memory. The BDU CPU
uses this stored information to control and monitor the flow of
gas to and from the patient. The two CPUs communicate to
transfer and verify any new ventilator control parameters or alarm
limits. Each CPU then performs continuous background
verification of operational and data integrity.
Puritan Bennett 800 Series Ventilator System Operator’s Manual
OP 1-3
OP 1 Introduction
Active exhalation valve
Pressure transducer
Flow sensor
Exhalation
module:
Expiratory
filter
Collector
vial
(Expiratory
limb)
(Inspiratory
limb)
Patient
circuit
Humidification
device
Inspiratory
filter
Oxygen
supply
Air
supply
Air
regulator
Oxygen
regulator
PSOLs
Safety valve
Oxygen sensor
Pressure transducers
Flow sensors
Inspiratory
module:
interface (GUI)
Graphic user
Puritan Bennett 800 Series Ventilator System Operator’s Manual
Figure 1-1. Puritan Bennett 840 Ventilator System block diagram
OP 1-4
Introduction OP 1
1.1.2 Pressure and flow triggering
The ventilator uses flow or pressure triggering to recognize patient
effort. When pressure triggering is in effect, the ventilator monitors
pressure in the patient circuit. As the patient draws gas from the
circuit and airway pressure drops by at least the value selected for
pressure sensitivity, the ventilator delivers a breath.
When flow triggering (Flow-by
the difference between the inspiratory and expiratory flow sensor
measurements. As the patient inhales, the ventilator measures less
exhaled flow while the delivered flow remains constant. The
result is an increase in the difference between the inspiratory and
expiratory flows. When the difference is at least the operatorselected value for flow sensitivity, the ventilator delivers a breath.
If the patient is not inhaling, any difference between the delivered
and exhaled flow is due to sensor inaccuracy or leaks in the
patient system. To compensate for leaks in the patient system
which can cause autotriggering, the operator can increase the flow
sensitivity setting.
As a backup method of triggering inspiration, a pressure
sensitivity of 2 cmH
O is also in effect. This setting is the most
2
sensitive setting still large enough to avoid autotriggering, yet will
trigger with acceptable patient effort.
) is in effect, the ventilator monitors
1.1.3 Breathing gas mixture
Air and oxygen from cylinders, wall supplies, or compressor (air
only) enter the ventilator through hoses and fittings (the fittings
are available in several versions). Once inside the ventilator, air
and oxygen are regulated to pressures appropriate for the
ventilator, then mixed according to the selected O
The ventilator delivers the mixed air and oxygen through the
inspiratory module and out to the patient. The oxygen
concentration of the delivered gas is monitored here, using a
galvanic oxygen sensor. The galvanic sensor generates a voltage
proportional to the oxygen concentration. The ventilator reports
an alarm if the O
sensor is enabled and monitored oxygen
2
concentration is more than seven percent above or below the
O
% setting, or below 18% after the concentration stabilizes.
2
Puritan Bennett 800 Series Ventilator System Operator’s Manual
%.
2
OP 1-5
OP 1 Introduction
The inspiratory manifold also includes a safety valve to relieve
patient pressure if necessary (for example, if the patient circuit is
kinked or occluded). The inspiratory module also corrects for gas
temperature and humidity, based on the practitioner-set
humidification type.
1.1.4 Inspiratory pneumatics
Ventilator inspiratory pneumatics consist of two parallel circuits:
one for oxygen and one for air. The primary elements of the
inspiratory pneumatics are two proportional solenoid valves
(PSOLs), which control the flow of gas delivered to the patient. Air
and oxygen flow sensors, along with pressure signals from the
patient circuit, provide feedback that the BDU CPU uses to
control the PSOLs.
As a result, the ventilator supplies mixed breathing gas to the
patient, based on the practitioner-set ventilator control
parameters. The mixed air and oxygen passes through the patient
circuit external to the ventilator. The system delivers the
breathing gas mixture to the patient at the patient wye, located in
the external patient circuit.
1.1.5 Patient circuit
The patient circuit comprises the components external to the
ventilator that route gas between the ventilator and the patient.
These components include:
•an inspiratory filter that protects against contamination
between the patient and ventilator
• a humidification device (optional) in line with the patient
circuit
• the inspiratory and expiratory limbs of the patient circuit that
conduct the breathing gas to and from the patient
•a collector vial that protects the expiratory pneumatics from
bulk moisture in the exhaled gas
•an expiratory filter that limits the escape of microorganisms and
particulates in the patient’s exhaled gas into the room air or
inside the ventilator exhalation pneumatics
Puritan Bennett 800 Series Ventilator System Operator’s Manual
OP 1-6
Loading...