Puritan Bennett 840 User Manual

840

Ventilator System

Part No. 4-070088-00 Rev. F October 2006

Technical Reference Manual

Operator’s and

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s & Technical Reference Manual

Copyright 1997, 1998, 2003, 2005, 2006 Puritan-Bennett Corporation. All rights reserved. The 840 Puritan Bennett proprietary information, covered by one or more of the following U.S. Patents and foreign equivalents: 4,954,799; 5,161,525; 5,271,389; 5,301,921; 5,319,540; 5,339,807; 5,368,019; and 5,390,666. 840, 800 Series, DualView, SandBox, SmartAlert, Flow-by, and PTS 2000 are trademarks of Puritan-Bennett Corporation.

The information contained in this manual is the sole property of Puritan-Bennett Corporation and may not be duplicated without permission. This manual may be revised or replaced by Puritan-Bennett Corporation at any time and without notice. You should ensure that you have the most current applicable version of this manual; if in doubt, contact Puritan-Bennett Corporation or visit the Puritan Bennett product manual web page at:

http://www.mallinckrodt.com/respiratory/resp/Serv_Supp/

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. 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 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, Puritan Bennett has no obligation to furnish any such revisions, changes, or modifications to the owner or user of the equipment (including its software) described herein.

Ventilator System is manufactured in accordance with

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s & Technical Reference Manual

Applicability

The information in this manual applies to

ventilator versions

840

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:

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.

840 Ventilator System Operator’s & Technical Reference Manual 4-070088-00 Rev. F (10/06)

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

• 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

Ventilator System and oxygen

840

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.

Ventilator System.

840

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

Ventilator System, always

840

follow your hospital infection control guidelines for handling infectious material.

Puritan Bennett recognizes that 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.

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s & Technical Reference Manual

iii

• Patients on life-support equipment should be appropriately monitored by competent medical personnel and suitable monitoring devices.

The

Ventilator System is not intended to be a

840

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

840 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

Ventilator System.

840

Warranty

The 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.

Ventilator System is warranted against defects in material

840

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.

840 Ventilator System Operator’s & Technical Reference Manual 4-070088-00 Rev. F (10/06)

Manufacturer

Puritan-Bennett Corporation 4280 Hacienda Drive Pleasanton, CA 94588 USA

Authorized representative Tyco Healthcare UK LTD 154 Fareham Road Gosport PO13 0AS, U.K.

Electromagnetic susceptibility

The 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 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.

Ventilator System complies with the requirements of

840

Warning

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 840 ventilator configures a medical system, and is therefore responsible for ensuring that 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.

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s & Technical Reference Manual

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.

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 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

Plus

(VV+)

which includes VC+ and VS breath types

Proportional Assist Ventilation

that are made 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.

Ventilator System. It also

840

, Volume Ventilation

Tube Compensation (TC)

(PAV+),

BiLevel

and

, NeoMode®,

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.

840 Ventilator System Operator’s & Technical Reference Manual 4-070088-00 Rev. F (10/06)

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 1-18

1.4 Ventilator system labeling symbols. . . . . . . . . . . . . . . . . . . . . . . . . OP 1-24

2 How to set up the 840 ventilator OP 2-1

2.1 How to connect the electrical supply . . . . . . . . . . . . . . . . . . . . . . OP 2-3

2.2 How to connect the air and oxygen supplies . . . . . . . . . . . . . . . . . OP 2-8

2.3 How to connect the patient circuit components . . . . . . . . . . . . . . OP 2-11

2.3.1 How to select and connect a patient circuit . . . . . . . . . . . . . . OP 2-12

2.3.2 How to install the expiratory filter and collector vial. . . . . . . . OP 2-15

2.3.3 How to install the flex arm. . . . . . . . . . . . . . . . . . . . . . . . . . . OP 2-18

2.3.4 How to install the humidifier . . . . . . . . . . . . . . . . . . . . . . . . . OP 2-19

2.3.5 How to use the ventilator cart . . . . . . . . . . . . . . . . . . . . . . . . OP 2-22

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

3.5.2 SST outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-15

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s and Technical Reference Manual

vii

Contents

4 How to use the 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 4-7

4.2.4 Ideal Body Weight (IBW). . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-10

4.3 How to change the main ventilator control parameters. . . . . . . . . OP 4-15

4.4 Mode, breath type, and other changes . . . . . . . . . . . . . . . . . . . . . OP 4-16

4.5 How to select a constant timing variable during

respiratory rate changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-17

4.6 How to change apnea ventilation settings. . . . . . . . . . . . . . . . . . . OP 4-19

4.7 How to set alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-20

4.8 How to change other settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-22

4.9 Expiratory pause maneuvers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-23

4.10 Inspiratory pause maneuvers. . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-24

4.11 How to interpret inspiratory pause maneuver results

for static compliance and resistance . . . . . . . . . . . . . . . . . . . . . . OP 4-26

4.12 How to use NIV. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-27

4.12.1 NIV intended use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-27

4.12.2 NIV breathing interfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-27

4.12.3 NIV setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-28

4.12.4 High spontaneous inspiratory time limit setting. . . . . . . . . . OP 4-32

4.12.5 Apnea setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-32

4.12.6 Alarm setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-32

4.12.7 Changing patient from INVASIVE to NIV Vent Type. . . . . . . OP 4-34

4.12.8 Changing patient from NIV to INVASIVE Vent Type. . . . . . . OP 4-35

4.12.9 NIV patient data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-35

840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev. F (10/06)

viii

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 5-4

5.4 Alarm log. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-5

5.5 Alarm volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-6

5.6 Alarm messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-7

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 6-2

6.3 Graphics display details and calculations . . . . . . . . . . . . . . . . . . . . OP 6-3

6.4 How to adjust displayed graphics. . . . . . . . . . . . . . . . . . . . . . . . . . OP 6-4

6.5 The graphics display FREEZE function . . . . . . . . . . . . . . . . . . . . . . OP 6-5

6.6 How to print patient data graphics . . . . . . . . . . . . . . . . . . . . . . . . OP 6-6

6.7 Automatic display of graphics . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 6-6

6.8 When graphics are not accessible . . . . . . . . . . . . . . . . . . . . . . . . . OP 6-7

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 7-15

7.4.5 Every 250 hours: compressor inlet filter . . . . . . . . . . . . . . . . . OP 7-15

7.4.6 Every year: ventilator inspection. . . . . . . . . . . . . . . . . . . . . . . OP 7-16

7.4.7 Every 2 years or as necessary: oxygen sensor . . . . . . . . . . . . . OP 7-17

7.4.7.1 Oxygen sensor replacement procedure . . . . . . . . . . . . . OP 7-17

7.5 Additional preventive maintenance procedures . . . . . . . . . . . . . . . OP 7-23

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s and Technical Reference Manual

Contents

7.6 Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 7-25

7.7 Repacking and shipping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 7-25

A Specifications OP A-1

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

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

A.3 Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-4

A.4 Electrical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-5

A.5 Compliance and approvals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-7

A.5.1 Manufacturer’s Declaration . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-9

A.6 Technical specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-18

A.7 Ranges, resolutions, and accuracies . . . . . . . . . . . . . . . . . . . . . . . . OP A-23

A.7.1 Recommended limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-23

A.7.2 Software options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-24

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-6

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-6

840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev. F (10/06)

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

6.3 Changing to A/C mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 6-3

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s and Technical Reference Manual

Contents

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

12.3 Disconnect sensitivity (D

12.4 Expiratory sensitivity (E

12.5 Expiratory time (T

840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev. F (10/06)

xii

). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-4

) . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-3

SENS

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-4

SENS

Contents

12.6 Flow pattern . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-4

12.7 Flow sensitivity (V

12.8 High spontaneous inspiratory time limit (2T

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

12.14 Mode and mandatory breath type. . . . . . . . . . . . . . . . . . . . . . . TR 12-9

12.15 O

% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-12

12.16 Peak inspiratory flow (V

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

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

12.26 Vent type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-19

). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-5

SENS

I SPONT

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-8

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-8

) . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-13

MAX

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-14

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-15

SENS

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-15

SUPP

). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-19

). . . . . . . . . . . TR 12-6

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 (

13.7 High delivered O

13.8 High exhaled minute volume (

13.9 High exhaled tidal volume (

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s and Technical Reference Manual

↑P

) alarm. . . . . . . . . . . . . . . . . . . . . . . TR 13-24

PEAK

% (↑O2%) alarm . . . . . . . . . . . . . . . . . . . . . . . TR 13-25

↑V

↑

) alarm . . . . . . . . . . . . . . . TR 13-25

ETOT

) alarm. . . . . . . . . . . . . . . . . . . . TR 13-26

xiii

Contents

13.10 High inspired tidal volume alarm (↑VTI, ↑V

↑V

TI SPONT

13.11 High respiratory rate (

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-26

↑f

) alarm . . . . . . . . . . . . . . . . . . . . . . TR 13-27

TOT

TI MAND

13.12 INSPIRATION TOO LONG alarm . . . . . . . . . . . . . . . . . . . . . . . . TR 13-27

13.13 Low circuit pressure alarm (

13.14 Low delivered O

% (↓O2%) alarm . . . . . . . . . . . . . . . . . . . . . . TR 13-28

↓P

) . . . . . . . . . . . . . . . . . . . . . . TR 13-28

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

13.17 Low exhaled total minute volume (

) alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-30

↓

) alarm . . . . . . . . . . TR 13-30

E TOT

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

14.6 I:E ratio (I:E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-4

14.7 Intrinsic (auto) PEEP (PEEP

14.8 Mean circuit pressure (P

14.9 Peak circuit pressure (P

14.10 Plateau pressure (P

MEAN

PEAK

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-6

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 (PEEP

) . . . . . . . . . TR 14-5

TOT

). . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-5

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-5

E SPONT

) . . . . . . . . . . . . . . . . . . TR 14-6

STAT

and R

) . . . . . . . . . . TR 14-7

STAT

) . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-13

15 Safety net TR 15-1

15.1 Patient problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 15-1

15.2 System faults. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 15-2

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

840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev. F (10/06)

xiv

Contents

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 15-6

15.12 Atmospheric pressure transducer calibration . . . . . . . . . . . . . . . TR 15-6

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

Glossary

Index

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s and Technical Reference Manual

Contents

This page is intentionally blank.

840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev. F (10/06)

xvi

Figures

Operator’s manual

Figure 1-1. 840 Ventilator System block diagram . . . . . . . . . . . . . . . OP 1-4

Figure 1-2. 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 2-5

Figure 2-3. Ventilator power switch, AC indicator, and AC panel. . . . OP 2-6

Figure 2-4. Power cord storage on the cart . . . . . . . . . . . . . . . . . . . . OP 2-7

Figure 2-5. How to connect the air and oxygen supplies. . . . . . . . . . OP 2-10

Figure 2-6. How to connect the patient circuit . . . . . . . . . . . . . . . . . OP 2-14

Figure 2-7. How to install the expiratory filter and collector vial . . . . OP 2-16

Figure 2-8. How to use the collector vial with or

without the drain bag . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 2-17

Figure 2-9. How to install the flex arm. . . . . . . . . . . . . . . . . . . . . . . . OP 2-18

Figure 2-10. How to install the humidifier

(Fisher & Paykel version shown) . . . . . . . . . . . . . . . . . . . OP 2-21

Figure 2-11. How to lock and unlock the cart’s front wheels . . . . . . . . OP 2-22

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 Figure 4-4.

(or TH) selected as the constant during rate change. . . OP 4-18

Figure 4-5. Alarm setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-21

Figure 4-6. New patient setup screen — NIV. . . . . . . . . . . . . . . . . . . OP 4-29

Figure 4-7. NIV ventilator settings screen . . . . . . . . . . . . . . . . . . . . . OP 4-31

Figure 4-8. New patient default alarm settings . . . . . . . . . . . . . . . . . OP 4-33

Figure 4-9. More patient data screen — NIV . . . . . . . . . . . . . . . . . . . OP 4-36

Figure 5-1. Alarm indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-2

Figure 5-2. Alarm Silence in Progress indicator (lower screen) . . . . . . OP 5-3

Figure 5-3. Alarm log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-5

Figure 5-4. Alarm message format. . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-8

Figure 6-1. Pressure-volume loop . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 6-2

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 7-16

/CAL in progress) . . . . . . . . . . . . . . . . . . . . . . . OP 4-9

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s and Technical Reference Manual

xvii

Figures

Figure 7-3. Dislodge the O2 sensor access cover . . . . . . . . . . . . . . . . OP 7-19

Figure 7-4. Open O Figure 7-5. Locate O

Figure A-1. Recommended patient circuit configurations . . . . . . . . . OP A-22

Figure B-1. Ventilator accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . OP B-2

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

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

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. 840 ventilator modes and breath types. . . . . . . . . . . . . . TR 12-11

Figure 13-1. Alarm message format (upper GUI screen) . . . . . . . . . . . TR 13-3

sensor access port . . . . . . . . . . . . . . . . . . . . . . OP 7-20

sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 7-21

840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev. F (10/06)

xviii

Tables

Operator’s manual

Table 1-1. 840 Ventilator System controls and indicators . . . . . . . . . OP 1-11

Table 1-2. BDU indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 1-17

Table 1-3. 840 Ventilator System symbols and abbreviations . . . . . . OP 1-18

Table 2-1. Patient circuit and IBW values . . . . . . . . . . . . . . . . . . . . . OP 2-13

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. Determining 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. Patient circuit and IBW values . . . . . . . . . . . . . . . . . . . . . OP 4-15

Table 4-4. Monitored ventilator control parameters . . . . . . . . . . . . . OP 4-16

Table 4-5. Automatic settings changes—INVASIVE to NIV . . . . . . . . OP 4-34

Table 4-6. Automatic settings changes—NIV to INVASIVE . . . . . . . . OP 4-35

Table 5-1. Alarm messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-9

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 7-24

Table A-1. Physical characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-2

Table A-2. Environmental requirements . . . . . . . . . . . . . . . . . . . . . . OP A-3

Table A-3. Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . . . OP A-4

Table A-4. Electrical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-5

Table A-5. Compliance and approvals . . . . . . . . . . . . . . . . . . . . . . . OP A-8

Table A-6. Electromagnetic Emissions. . . . . . . . . . . . . . . . . . . . . . . . OP A-10

Table A-7. Electromagnetic Immunity . . . . . . . . . . . . . . . . . . . . . . . OP A-11

Table A-8. Electromagnetic Immunity – conducted and radiated RF . OP A-13 Table A-9. Recommended separation distances between portable

and mobile RF communications equipment

and the 840 Ventilator System . . . . . . . . . . . . . . . . . . . . OP A-15

Table A-10. Compliant cables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-16

Table A-11. Technical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-18

4-070088-00 Rev F (10/06) 840 Ventilator System Operator’s and Technical Reference Manual

xix

Tables

Table A-12. Ventilator settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-24

Table A-13. Alarm settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-40

Table A-14. Patient data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-45

Table A-15. Other Screens — displayed data . . . . . . . . . . . . . . . . . . . OP A-52

Table B-1. Ventilator parts and accessories. . . . . . . . . . . . . . . . . . . . OP B-3

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. 840 ventilator 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

840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev F (10/06)

HAPTER

Introduction

The intended use of the Puritan Bennett for acute and subacute care of infant, pediatric, and adult patients. Software options, available from Puritan Bennett, provide additional ventilation functions.

The 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 monitored patient data, for easy assessment of the patient’s condition. The touch screens also display the current ventilator control parameters.

The preview the selected ventilator control parameters prior to active ventilation of the patient.

The specific information about the cause, and prompts the user with actions to resolve the reported condition(s).

Ventilator System facilitates work of breathing

840

SandBox

SmartAlert

Ventilator System is

840

DualView

™ area on the touch screen allows the practitioner to

™ system intercepts alarms, or events, provides

™ touch screens that display

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.

4-070088-00 Rev. F (10/06) 840 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 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 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) provides DC power to the BDU and GUI in the event that AC power is lost. A new, fully charged BPS runs the ventilator (without a compressor or a humidifier) for at least 30 minutes, which allows transport of the patient and the ventilator within the healthcare facility.

This manual tells you how to operate and perform simple maintenance for the this manual and accompanying labels before attempting to operate or maintain the ventilator.

To ensure optimum performance of the Puritan Bennett strongly recommends that 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 Puritan Bennett representative.

Ventilator System supplies mandatory or spontaneous

840

BiLevel

Ventilator System. Become familiar with

840

Ventilator System,

840

mode. A

840 Ventilator System Operator’s Manual 4-070088-00 Rev. F (10/06)

OP 1-2

Introduction

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.

OP 1

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s Manual

OP 1-3

OP 1

Exhalation module:

Active exhalation valve Pressure transducer Flow sensor

Introduction

Graphic user

interface (GUI)

Inspiratory module:

PSOLs Safety valve Oxygen sensor Pressure transducers Flow sensors

Collector

vial

supply

Oxygen

Expiratory filter

(Expiratory

limb)

(Inspiratory limb)

Patient

circuit

supply

Figure 1-1. 840 Ventilator System block diagram

Air

regulator

Air

Humidification device

Oxygen regulator

Inspiratory

filter

8-00001

840 Ventilator System Operator’s Manual 4-070088-00 Rev. F (10/06)

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

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

monitors 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 operator-selected 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

sensitive setting that is still large enough to avoid autotriggering, yet will trigger with acceptable patient effort.

is in effect, the ventilator monitors



) is in effect, the ventilator

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

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s Manual

sensor is enabled and monitored oxygen

OP 1-5

OP 1

Introduction

concentration is more than seven percent above or below the O

% setting, or below 18% after the concentration stabilizes.

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

ventilator that route gas between the ventilator and the patient. These components include:

•an

• a humidification device (optional) in line with the patient

• the inspiratory and expiratory limbs of the patient circuit that

•a

840 Ventilator System Operator’s Manual 4-070088-00 Rev. F (10/06)

OP 1-6

inspiratory filter

between the patient and ventilator

circuit

conduct the breathing gas to and from the patient

collector vial

bulk moisture in the exhaled gas

comprises the components external to the

that protects against contamination

that protects the expiratory pneumatics from

Introduction

OP 1

•an

expiratory filter

particulates in the patient’s exhaled gas into the room air or inside the ventilator exhalation pneumatics

The ventilator actively controls the exhalation valve that the software accurately positions throughout the patient’s inspiration and exhalation. The exhalation valve allows the ventilator to deliver aggressive breaths while pressure overshoots are minimized, PEEP is controlled, and excess patient pressures are relieved. The exhalation system monitors the exhaled gas leaving the patient circuit for spirometry.

Throughout the respiratory cycle, pressure transducers monitor inspiratory, expiratory, and atmospheric pressures. The temperature of the exhaled gas is heated to a temperature above its dew point to prevent condensation in the exhalation compartment. Refer to Appendix C for a detailed diagram of the ventilator’s pneumatic system and patient circuit.

that limits the escape of microorganisms and

1.1.6 AC mains and backup power system

The ventilator derives its power to operate from the AC mains (wall) power or the backup power system (BPS). The design of the BDU integral power supply protects against excessive voltages, temperatures, or current draws. A power cord retainer prevents accidental disconnection of the BDU from the AC mains. A power switch cover on the front face of the BDU protects against spills and accidental AC power-off.

The ventilator connects to the 802 BPS, which supplies DC power to the ventilator if AC power is lost. A fully charged BPS operating under nominal ambient conditions, can power the ventilator for at least 30 minutes (the BPS does not power the compressor unit or the humidifier, if present). The GUI indicates when the ventilator is operating on the BPS, rather than AC mains.

When AC power is connected, it recharges the BPS. The BPS continues to recharge from the AC power during normal ventilator operation.

4-070088-00 Rev. F (10/06) 840 Ventilator System Operator’s Manual

OP 1-7

OP 1

Introduction

1.1.7 Ventilator emergency states

Emergency states include

. When a

(SVO)

includes the SVO state. A SVO state can also occur independent of a

ventilator inoperative

The following describe the two ventilator emergency states:

•

Safety valve open (SVO)

enters a oxygen supplies are lost, or an occlusion is detected, or the ventilator enters the condition.

The safety valve open the patient to breathe room air unassisted by the ventilator. The ventilator remains in the caused the emergency state is corrected.

When the ventilator enters the on the front face of the BDU illuminates, and a high-urgency alarm sounds.

In case of a malfunction that prevents software from opening the safety valve, there is also an analog circuit that opens the safety valve if system pressure exceeds 100 to 120 cmH

•

Ventilator inoperative

declares a ventilator inoperative condition if a hardware failure or critical software error occurs that could compromise safe ventilation of the patient.

When a ventilator inoperative condition occurs, the ventilator inoperative indicator on the front face of the BDU illuminates and the ventilator enters the which in turns sounds a high-urgency alarm.

ventilator inoperative

state if both air and

SVO

Ventilator Inoperative

ventilator inoperative

condition occurs, it always

condition.

: The ventilator

state allows

(SVO)

state until the condition that

SVO

: The ventilator

and

state, the

safety valve open

indicator

SVO

state,

SVO

If a ventilator inoperative condition occurs, immediately remove the ventilator from use until qualified service personnel evaluate and correct the

840 Ventilator System Operator’s Manual 4-070088-00 Rev. F (10/06)

OP 1-8

Vent Ino p

condition.

+ 398 hidden pages

Puritan Bennett 840 User Manual

Specifications and Main Features

Frequently Asked Questions

User Manual

Introduction

1.1 Technical description

1.1.1 General background

1.1.2 Pressure and flow triggering

1.1.3 Breathing gas mixture

1.1.4 Inspiratory pneumatics

1.1.5 Patient circuit

1.1.6 AC mains and backup power system

1.1.7 Ventilator emergency states