Puritan-Bennett 840 Technical Reference manual

840

Ventilator System

Part No. 4-075609-00
Rev. G
October 2006

Technical Reference Manual

Operator’s and

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s and Technical Reference Manual

Copyright Information

Copyright 2003, 2005, 2006 Puritan-Bennett Corporation. All rights reserved. The

TM

840

Ventilator System is manufactured in accordance with 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.

Rx ONLY

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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 and Technical Reference Manual 4-075609-00 Rev. G (10/06)

ii

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.

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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 Puritan Bennett Medical
Equipment Warranty for 2 years from the time of sale. Keep a
maintenance record to ensure the validity of the warranty.

840 Ventilator System Operator’s and Technical Reference Manual 4-075609-00 Rev. G (10/06)

iv

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.

Manufacturer

Puritan-Bennett Corporation
4280 Hacienda Drive
Pleasanton, CA
USA

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.

Ventilator System complies with the requirements of

840

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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.

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.

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 call Puritan Bennett Technical Services at

1.800.255.6774 or contact your local Puritan Bennett

representative.

840 Ventilator System Operator’s and Technical Reference Manual 4-075609-00 Rev. G (10/06)

vi

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.

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. Within the USA, contact
Puritan Bennett at 1.800.255.6774 for questions about the
applicability of the information.

Ventilator System. It also

840

®

, Volume Ven t ilation

Tube Compensation (TC)

®

(PAV+),

BiLevel

and

, NeoMode®,

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This page is intentionally blank.

840 Ventilator System Operator’s and Technical Reference Manual 4-075609-00 Rev. G (10/06)

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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 1-10

1.3.1 Onscreen symbols and abbreviations . . . . . . . . . OP 1-15

1.4 Ventilator system labeling symbols . . . . . . . . . . . . . . . OP 1-22

2 How to set up the 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 2-8

2.3 How to connect the patient circuit components . . . . . OP 2-10

2.3.1 How to select and connect a patient circuit . . . . OP 2-11

2.3.2 How to install the expiratory filter and

collector vial . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 2-14

2.3.3 How to install the flex arm . . . . . . . . . . . . . . . . . OP 2-17

2.3.4 How to install the humidifier. . . . . . . . . . . . . . . . OP 2-18

2.3.5 How to use the ventilator cart . . . . . . . . . . . . . . OP 2-20

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 3-4

3.4 SST Procedure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-5

3.5 SST Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-14

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Contents

3.5.1 How to interpret individual SST test results. . . . . .OP 3-15

3.5.2 SST outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 3-16

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 4-13

4.4 Mode, breath type, and other changes . . . . . . . . . . . .OP 4-14

4.5 How to select a constant timing variable during

respiratory rate changes . . . . . . . . . . . . . . . . . . . . . . . .OP 4-15

4.6 How to change apnea ventilation settings . . . . . . . . . .OP 4-17

4.7 How to set alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 4-18

4.8 How to change other settings . . . . . . . . . . . . . . . . . . .OP 4-19

4.9 Expiratory pause maneuvers. . . . . . . . . . . . . . . . . . . . .OP 4-21

4.10 Inspiratory pause maneuvers . . . . . . . . . . . . . . . . . . .OP 4-22

4.11 How to interpret inspiratory pause maneuver results

for static compliance and resistance. . . . . . . . . . . . . .OP 4-24

4.12 How to use NIV . . . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 4-25

4.12.1 NIV intended use . . . . . . . . . . . . . . . . . . . . . . . .OP 4-25

4.12.2 NIV breathing interfaces. . . . . . . . . . . . . . . . . . .OP 4-25

4.12.3 NIV setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 4-26

4.12.4 High spontaneous inspiratory time limit setting .OP 4-30

4.12.5 Apnea setup. . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 4-30

4.12.6 Alarm setup . . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 4-31

4.12.7 Changing patient from INVASIVE to NIV

Vent Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 4-33

4.12.8 Changing patient from NIV to INVASIVE

Vent Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . .OP 4-34

4.12.9 NIV patient data. . . . . . . . . . . . . . . . . . . . . . . . .OP 4-34

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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 7-15

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

7.4.7.1 Oxygen sensor replacement procedure. . . . OP 7-18

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Contents

7.5 Additional preventive maintenance procedures . . . . . .OP 7-24

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-4

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

A.4 Electrical specifications. . . . . . . . . . . . . . . . . . . . . . . . .OP A-6

A.5 Compliance and approvals. . . . . . . . . . . . . . . . . . . . . .OP A-9

A.5.1 Manufacturer’s Declaration . . . . . . . . . . . . . . . . .OP A-10

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

A.7 Ranges, resolutions, and accuracies . . . . . . . . . . . . . . .OP A-24

A.7.1 Recommended limits . . . . . . . . . . . . . . . . . . . . . .OP A-24

A.7.2 Software options . . . . . . . . . . . . . . . . . . . . . . . . .OP A-25

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-6

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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 2-3

2.1.3 Time-cycled inspiration. . . . . . . . . . . . . . . . . . . . TR 2-5

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 3-2

3.2 Backup limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 3-3

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

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Contents

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

7 Synchronous intermittent mandatory

ventilation (SIMV) TR 7-1

7.1 Breath delivery in SIMV . . . . . . . . . . . . . . . . . . . . . . . .TR 7-2

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

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Contents

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

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

E

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

12.7 Flow sensitivity (V

SENS

12.8 High spontaneous inspiratory time limit (2T

12.9 Humidification type . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-6

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

12.14 Mode and mandatory breath type . . . . . . . . . . . . . TR 12-8

12.15 O

%. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-11

2

12.16 Peak inspiratory flow (V

12.17 PEEP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-12

12.17.1 PEEP restoration . . . . . . . . . . . . . . . . . . . . . . . TR 12-13

12.18 Plateau time (T

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

PL

12.19 Pressure sensitivity (P

12.20 Pressure support (P

SUPP

12.21 Respiratory rate (f) . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-15

12.22 Rise time %. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-15

12.23 Safety ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-16

12.24 Spontaneous breath type . . . . . . . . . . . . . . . . . . . . TR 12-17

12.25 Tidal volume (V

) . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-18

T

12.26 Vent type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-18

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

SENS

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

SENS

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

) . TR 12-6

I SPONT

) . . . . . . . . . . . . . . . . . . . . . TR 12-7

I

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

MAX

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

SENS

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

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Contents

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 13-23

13.3 APNEA alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .TR 13-23

13.4 CIRCUIT DISCONNECT alarm. . . . . . . . . . . . . . . . . . .TR 13-24

13.5 DEVICE ALERT alarm. . . . . . . . . . . . . . . . . . . . . . . . . .TR 13-24

13.6 High circuit pressure (

13.7 High delivered O

13.8 High exhaled minute volume (

13.9 High exhaled tidal volume (

13.10 High inspired tidal volume alarm (

↑V

TI SPONT

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

13.11 High respiratory rate (

13.12 INSPIRATION TOO LONG alarm . . . . . . . . . . . . . . .TR 13-28

13.13 Low circuit pressure alarm (

13.14 Low delivered O

13.15 Low exhaled mandatory tidal volume
(

↓V

TE MAND

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

13.16 Low exhaled spontaneous tidal volume
(

↓

V

TE SPONT

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

13.17 Low exhaled total minute volume (

13.18 PROCEDURE ERROR alarm . . . . . . . . . . . . . . . . . . . .TR 13-31

↑

P

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

PEAK

% (↑O2%) alarm . . . . . . . . . . . . . .TR 13-26

2

↑

V

↑

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

↑f

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

TOT

↓P

PEAK

% (↓O2%) alarm . . . . . . . . . . . . . .TR 13-29

2

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

ETOT

↑V

TI

, ↑V

TI MAND

,

). . . . . . . . . . . . . .TR 13-29

↓

) alarm. .TR 13-31

V

E TOT

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

840 Ventilator System Operator’s and Technical Reference Manual 4-075609-00 Rev. G (10/06)

xvi

). . . . . . . . . . . . . . . . .TR 14-2

I END

) . . . . . . . . . . . . . . . .TR 14-3

E TOT

) . . . . . . . . . . . . . . . . . . . . .TR 14-4

) and total PEEP (PEEP

I

).TR 14-5

TOT

Contents

14.8 Mean circuit pressure (P

14.9 Peak circuit pressure (P

14.10 Plateau pressure (P

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

PL

14.11 Spontaneous minute volume (V

14.12 Static compliance and resistance (C

14.13 Total respiratory rate (f

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

MEAN

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

PEAK

E SPONT

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

TOT

) . . . . . . . . . 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

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 15-6

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

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Contents

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

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xviii

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 1-9

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 2-9

Figure 2-6. How to connect the patient circuit . . . . . . . . . . . . . . . . . OP 2-13

Figure 2-7. How to install the expiratory filter and collector vial . . . . OP 2-15

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

without the drain bag . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 2-16

Figure 2-9. How to install the flex arm. . . . . . . . . . . . . . . . . . . . . . . . OP 2-17

Figure 2-10. How to install the humidifier

(Fisher & Paykel version shown) . . . . . . . . . . . . . . . . . . . OP 2-19

Figure 2-11. How to lock and unlock the cart’s front wheels . . . . . . . . OP 2-20

Figure 3-1. Test button location . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-6

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 4-16

T

I

Figure 4-5. Alarm setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-19

Figure 4-6. New patient setup screen — NIV. . . . . . . . . . . . . . . . . . . OP 4-27

Figure 4-7. NIV ventilator settings screen . . . . . . . . . . . . . . . . . . . . . OP 4-29

Figure 4-8. New patient default alarm settings . . . . . . . . . . . . . . . . . OP 4-31

Figure 4-9. More patient data screen — NIV . . . . . . . . . . . . . . . . . . . OP 4-35

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 7-17

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

2

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xix

Figures

Figure 7-3. Dislodge the O2 sensor access cover . . . . . . . . . . . . . . . . OP 7-20

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

Figure A-1. Recommended patient circuit configurations . . . . . . . . . OP A-23

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 7-4

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 12-10

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

sensor access port . . . . . . . . . . . . . . . . . . . . . . OP 7-21

2

sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 7-22

2

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Tables

Operator’s Manual

Table 1-1. 840 Ventilator System GUI controls and indicators . . . . . . OP 1-10

Table 1-2. BDU indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 1-15

Table 1-3. 840 Ventilator System symbols and abbreviations. . . . . . . OP 1-16

Table 2-1. Patient circuit and IBW values. . . . . . . . . . . . . . . . . . . . . . OP 2-12

Table 3-1. SST test sequence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-9

Table 3-2. Individual SST test results . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-15

Table 3-3. Overall SST outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-16

Table 4-1. IBW based on patient height . . . . . . . . . . . . . . . . . . . . . . OP 4-11

Table 4-2. Patient circuit and IBW values. . . . . . . . . . . . . . . . . . . . . . OP 4-13

Table 4-3. Monitored ventilator control parameters . . . . . . . . . . . . . OP 4-14

Table 4-5. Automatic settings changes—INVASIVE to NIV . . . . . . . . . OP 4-33

Table 4-6. Automatic settings changes—NIV to INVASIVE . . . . . . . . . OP 4-34

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 7-25

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

Table A-2. Environmental requirements . . . . . . . . . . . . . . . . . . . . . . . OP A-4

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

Table A-4. Electrical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-6

Table A-5. Compliance and approvals . . . . . . . . . . . . . . . . . . . . . . . . OP A-9

Table A-6. Electromagnetic Emissions . . . . . . . . . . . . . . . . . . . . . . . . OP A-11

Table A-7. Electromagnetic Immunity . . . . . . . . . . . . . . . . . . . . . . . . OP A-12

Table A-8. Electromagnetic Immunity – conducted and radiated RF . OP A-14
Table A-9. Recommended separation distances between portable

and mobile RF communications equipment

and the 840 Ventilator System . . . . . . . . . . . . . . . . . . . . . OP A-16

Table A-10. Compliant cables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-17

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

Table A-12. Ventilator settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-25

Table A-13. Alarm settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-42

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Tables

Table A-14. Patient data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP A-47

Table A-15. Other Screens — displayed data. . . . . . . . . . . . . . . . . . . . OP A-54

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 13-27

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 4-075609-00 Rev. G (10/06)

xxii

C

HAPTER

1

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

1

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.

4-075609-00 Rev. G (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 Puritan Bennett Technical Services in the
U.S. at 1.800.255.6774. Outside of the U.S., contact your local
Puritan Bennett representative.

Ventilator System supplies mandatory or spontaneous

840

BiLevel

Ventilator System. Become familiar with

840

Ventilator System,

840

mode. A

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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

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Graphic user

interface (GUI)

Introduction

Collector

vial

Exhalation
module:

Active exhalation valve
Pressure transducer
Flow sensor

Expiratory
filter

(Expiratory

limb)

(Inspiratory
limb)

regulator

Air

supply

Oxygen

supply

Inspiratory
module:

PSOLs
Safety valve
Oxygen sensor
Pressure transducers
Flow sensors

Air

Oxygen
regulator

Inspiratory

filter

Patient

circuit

Humidification
device

8-00001

Figure 1-1. 840 Ventilator System block diagram

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Introduction

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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

2

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

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sensor is enabled and monitored oxygen

2

%.

2

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OP 1

Introduction

concentration is more than seven percent above or below the
O

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

2

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

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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.

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Introduction

1.1.7 Ventilator emergency states

Emergency states include

safety valve open (SVO)

always includes the
independent of a

The following describe the two ventilator emergency states:

•

Safety valve open (SVO)

air and oxygen supplies are lost, or an occlusion is detected, or
the ventilator enters the

The safety valve open (
room air unassisted by the ventilator. The ventilator remains
in the

SVO

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 (Vent Inop)

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

Vent I n o p

state until the condition that caused the emergency

ventilator inoperative (Vent Inop)

. When a

state. A

SVO

: The ventilator enters a

Vent Ino p

SVO

condition.

Vent Inop

) state allows the patient to breathe

SVO

condition occurs, it

state can also occur

condition.

state, the

SVO

: The ventilator declares a

SVO

SVO

and

state if both

indicator

O.

2

When a
the front face of the BDU illuminates and the ventilator enters
the

If a
ventilator from use until qualified service personnel evaluate
and correct the

If the ventilator declares a
test (POST) must first verify that power levels to the ventilator
are acceptable and that the functions of the major electronics
systems are satisfactory before normal ventilation can resume.
Qualified service personnel must repair the ventilator to
correct the problem and execute EST successfully before
normal ventilation is allowed.

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Vent Inop

state, which in turns sounds a high-urgency alarm.

SVO

Vent Inop

condition occurs, the

condition occurs, immediately remove the

Vent Ino p

condition.

Vent Inop

Vent I n o p

state, the power on self

indicator on

Introduction

1.2 Graphic user interface

This section describes the graphic user interface (GUI), the GUI
keys, the GUI indicators, and the symbols you see on the GUI.

OP 1

Upper screen:

monitored

information

(alarms,

patient data)

Lower screen:

ventilator

control

parameters

The graphic user interface (GUI) of the
comprises the

DualView

touch screens, the off-screen keys located

Ventilator System

840

below the touch screens, and a knob. Use the knob to set a given
ventilator control parameter to its desired value. Press the

ACCEPT

key—the off-screen key above and right of the knob—to enter the
selected value or parameter into memory.

Figure 1-2 identifies the components of the GUI, and the location
of information on the

Vital patient data

Alarms and ventilator status

Assorted patient data,

including graphical displays

Active alarm log, if applicable

Primary patient parameters

Setup of ventilator control
parameters, alarm limits,
breath timing parameters,
and other parameters

Symbol definitions

DualView

touch screens.

Prompt
area

Status
indicators

Off-screen
keys

CLEAR
key

ACCEPT
key

Knob

8-00025

Figure 1-2. 840 Ventilator System graphic user interface (GUI)

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1.3 User interface controls and indicators

Descriptions of the controls and indicators on the graphic user
interface are given in Table 1-1 below.

Table 1-1: 840 Ventilator System GUI controls and indicators

Control or indicator Function

Screen lock key: When the yellow light on the screen lock key

is lit, the screen or off-screen controls (including the knob and
ACCEPT key) have no effect when touched until you press
the screen lock key again. New alarms automatically unlock
the screen and controls.

The screen lock allows you to clean the touch screen and
prevents inadvertent changes to settings and displays.

Alarm volume key: Allows you to adjust the alarm volume
when you hold down this key while turning the knob. You
cannot turn off the alarm volume.

Alarm silence key: Turns off the audible alarm for two
minutes. The yellow light on the alarm silence key illuminates
during the silence period. An ALARM SILENCE IN PROGRESS
indicator displays on the lower touch screen, along with a
CANCEL button, if there is not a higher-priority alarm display
active. To exit out of the alarm silence, touch the CANCEL
button.

The system automatically exits the alarm silence when the
two-minute interval times out. High-urgency alarms such as
Device Alerts, Safety Valve Open, Occlusion, and loss of either
gas supply cancel the alarm silence.

Each time you press the alarm silence key, the silence period
resets to two minutes. Each time you press the alarm silence
key (whether or not there is an active alarm), the keypress is
recorded in the alarm log.

Introduction

Alarm reset key: Clears active alarms or resets high-urgency
alarms and cancels an active alarm silence. Each time you
press the reset key, it is recorded in the alarm log, if there is an
active alarm. You cannot reset a DEVICE ALERT alarm.

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Introduction

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Table 1-1: 840 Ventilator System GUI controls and indicators (cont)

Control or indicator Function

Information key: Displays basic operating information about

the ventilator. Press the key to display a menu of information
topics, then touch the button corresponding to the desired
topic. Browse topical information using the , ,

, and buttons located in the information header.

GO BACK

Oxygen sensor calibration key: Delivers 100% oxygen (if
available) for two minutes and calibrates the oxygen sensor.
The green light on this key illuminates and a message (100%

Cal in Progress) on the lower touch screen indicates that

O

2

100% O

delivery is active. If you press the O2 key again, the

2

system restarts the two-minute delivery interval. Press
CANCEL to stop the calibration.

Use the procedure in Appendix D.2 to test the oxygen sensor
calibration.

Manual inspiration key: In A/C, SIMV, and SPONT modes,
delivers one manual breath to the patient in accordance with
the current mandatory breath parameters. In BILEVEL mode,
transitions from Low PEEP (PEEP

) to High PEEP (PEEPH) (or

L

vice versa). To avoid breath stacking, a manual inspiration is
not delivered during inspiration or during the restricted phase
of exhalation.

You can use the MANUAL INSP key to supplement minute
volume or to assist measurement of a patient data parameter,
such as peak inspiratory pressure, or to run an INSP PAUSE
maneuver in SPONT mode.

DIAGRAM

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Introduction

Table 1-1: 840 Ventilator System GUI controls and indicators (cont)

Control or indicator Function

Expiratory pause key: Causes the ventilator to seal the

patient’s breathing circuit when the expiratory phase of a
designated breath, mandatory or spontaneous, is followed by
a time-cycled mandatory inspiration. An expiratory pause is
used to estimate PEEP

The ventilator performs two types of pause maneuver:
automatic, which you initiate by a momentary press of the

EXP PAUSE

continuous press on the key. An automatic pause performs the
maneuver until the pressure stabilizes, then takes its
measurements. The pause lasts at least 0.5 second and does
not exceed 3.0 seconds.

During a manual pause, the ventilator takes its measurements
as soon as the pressure stabilizes or the pause ends. The
ventilator continues the maneuver until you release the
PAU SE key. The pause cannot exceed 20 seconds.
Section 4.9 describes, in detail, how to use the EXP PAUSE
key.

key, and manual, which you control by a

and PEEPI (autoPEEP).

TOT

EXP

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Introduction

OP 1

Table 1-1: 840 Ventilator System GUI controls and indicators (cont)

Control or indicator Function

Inspiratory pause key: Causes the ventilator to seal the

patient’s breathing circuit at the conclusion of the gas delivery
phase of a designated, volume- or pressure-based mandatory
inspiration. This inspiratory pause maneuver provides a means
to measure the patient’s static lung-thoracic compliance

), static resistance (R

(C

STAT

The inspiratory pause maneuver maintains the inflated state
of the lungs.

The ventilator performs two types of pause maneuver:
automatic, which is initiated by the momentary press of the

INSP PAUSE

continuous press on the key.
An automatic pause performs the maneuver until the pressure

stabilizes, then the system takes its measurements. The pause
event lasts at least 0.5 second but no longer than

2.0 seconds.
In a manual pause, the maneuver continues until you release

the INSP PAUSE key, but cannot exceed 7 seconds. The
ventilator computes C
and displays the values at the end of the maneuver. P
computed and updated continuously during the plateau, and
its value is frozen at the end of the plateau. Section 4.10
describes, in detail, how to use the INSP PAUSE key.

key, and manual, which you control by a

STAT

), and plateau pressure (PPL).

STAT

and R

at the end of the plateau

STAT

is

PL

Knob: Adjusts the value of a setting. A highlighted button on
a touch screen means that the knob is linked to that setting.
Where applicable, a clockwise turn of the knob increases the
highlighted value, and a counterclockwise turn of the knob
decreases the highlighted value.

Clear: Cancels a proposed ventilator parameter value change.

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Introduction

Table 1-1: 840 Ventilator System GUI controls and indicators (cont)

Control or indicator Function

Accept: Applies and saves new ventilator parameter value(s).

Red high-urgency alarm indicator ( ! ! ! ): This alarm

indicator blinks rapidly if active; it is steadily lit if autoreset.
Yellow medium-urgency alarm indicator ( ! ! ): This alarm

indicator blinks slowly if active; it turns off if autoreset.
Yellow low-urgency alarm indicator ( ! ): This indicator is

steadily lit if active; it turns off if autoreset.
Green normal ventilator operation indicator: When

ventilation is active and no alarm states exist, this indicator is
steadily lit. This indicator is off if the ventilator is not in a
ventilation mode, for example, during service mode or short
self test (SST).

VENT

INOP

SAFETY

VALVE

OPEN

BATTERY

READY

BATTERY

ON

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Red ventilator inoperative (VENT INOP) indicator: The

ventilator cannot support ventilation and requires service. The
ventilator enters the safe state (safety ventilation) and
discontinues detection of new patient data or alarm
conditions. Qualified service personnel must repair the
ventilator to correct the problem and execute EST successfully
before normal ventilation is allowed. This indicator is
accompanied by an audio signal and cannot be reset.

Red safety valve open (SVO) indicator: The ventilator has
entered its safe state and opened its safety valve to allow the
patient to breathe unassisted from room air.

Green BPS ready indicator: The ventilator senses that the
BPS is installed, operational, and has at least two (2) minutes
of estimated run time.

Battery on power indicator: When the yellow bar to the
right of a lit BPS ready indicator is lit, the ventilator is
operating on BPS, and AC power is insufficient to support
ventilator operation. During BPS operation, power to the
compressor unit and the humidifier outlet is off.

Introduction

OP 1

Table 1-1: 840 Ventilator System GUI controls and indicators (cont)

Control or indicator Function

COMPRESSOR

READY

COMPRESSOR

ON

The indicators on the breath delivery unit are shown in Table 1-2.

VENT

INOP

SAFETY

VALV E

OPEN

Green compressor ready indicator: The compressor cable
and air supply hose are connected to the ventilator. The
compressor is up to operating pressure but not supplying gas
to the ventilator. The compressor motor turns on
intermittently to keep the compressor chamber pressurized.

Green compressor operating indicator: When lit,
compressor is supplying air to the ventilator. This indicator
does not light unless the compressor is actually supplying air
to the ventilator.

Table 1- 2: BDU in dicators

Red ventilator inoperative (VENT INOP) indicator: The

ventilator cannot support ventilation and requires service. The
ventilator enters the safe state (safety ventilation) and
discontinues detection of new patient data or alarm
conditions. Qualified service personnel must repair the
ventilator to correct the problem and execute EST successfully
before normal ventilation is allowed. This indicator is
accompanied by an audio signal and cannot be reset.

Red safety valve open (SVO) indicator: The ventilator has
entered its safe state and opened its safety valve to allow the
patient to breathe unassisted from room air.

DISPLAY

(GUI)
INOP

Red loss of GUI indicator: The ventilator has detected a
malfunction that prevents the GUI from reliably displaying or
receiving information.

1.3.1 Onscreen symbols and abbreviations

Touch an onscreen symbol to display its definition in the lower
left corner of the lower screen. Table 1-3 summarizes the symbols
and abbreviations the ventilator uses.

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OP 1

For example, if you touch:

V

MAX

21.8

The symbol definition area shows this message:

V

MAX

Table 1-3: 840 Ventilator System symbols and abbreviations

L

min

= Peak flow

Introduction

Symbol or

abbreviation

(blinking)

P

%

Definition

Additional alarms that relate to the monitored information are
active. The symbol blinks when there is not enough screen
area to display all active alarms.

The upper alarm limit

The lower alarm limit

Press to access the alarm log

Alarm log contains events that you have not yet viewed

Rise time percent

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Introduction

OP 1

Table 1-3: 840 Ventilator System symbols and abbreviations (cont)

Symbol or

abbreviation

RAMP SQUARE

Definition

Flow pattern

The value you selected for a ventilator control parameter
exceeds its recommended limit (soft bound) and requires
acknowledgement to continue

or

The value selected exceeds its allowable minimum or
maximum limit (hard bound)

Press to view more patient data

Press to view patient data graphics

Press to view additional screens

X-axis (time or pressure) adjust of patient data graphics

Y-axis (pressure, volume, or flow) adjust of patient data
graphics

Baseline pressure (PEEP) adjust

A/C Assist control ventilation mode

AV Apnea ventilation

C

STAT

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Static compliance

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Introduction

Table 1-3: 840 Ventilator System symbols and abbreviations (cont)

Symbol or

abbreviation

E

SENS

Spontaneous expiratory sensitivity percentage

Definition

EST Extended Self Test

f Respiratory rate (ventilator control parameter)

↑ f

f

TOT

TOT

Total respiratory rate (monitored)

High respiratory rate alarm

GUI Graphic user interface

HME Heat-Moisture Exchanger

I:E Inspiratory to expiratory ratio

O

2

O

2

1

O2% High delivered O2% alarm

3

O2%Low delivered O

Monitored oxygen percentage (patient data)

Oxygen percentage (ventilator control parameter)

% alarm

2

PC Pressure control (mandatory breath type)

P

↑P

2 P

3

4

P

MEAN

PEAK

PEAK

P

PEAK

P

PEAK

PEAK

Mean circuit pressure

High circuit pressure alarm

High circuit pressure alarm limit

Low circuit pressure alarm

Low circuit pressure alarm limit

Peak circuit pressure (patient data)

PEEP positive end-expiratory pressure (ventilator control

parameter)

PEEP

H

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High PEEP (ventilator control parameter, BILEVEL mode only)

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Introduction

OP 1

Table 1-3: 840 Ventilator System symbols and abbreviations (cont)

Symbol or

abbreviation

PEEP

I

PEEP

L

PEEP

TOT

PEEP

P

I

P

I END

P

PL

Intrinsic PEEP (patient data)

Low PEEP (ventilator control parameter, BILEVEL mode only)

Total PEEP (patient data)

End expiratory pressure (patient data)

Inspiratory pressure (ventilator control parameter)

End inspiratory pressure (patient data)

Plateau pressure (patient data)

Definition

POST Power on self test

PS Pressure Support (spontaneous breath type)

P

P

P

↑P

SENS

SUPP

-TRIG

VENT

Pressure sensitivity

Pressure support (ventilator control parameter)

Pressure triggering

High internal ventilator pressure alarm

R

STAT

Static resistance

SIMV Synchronous intermittent mandatory ventilation mode

SPONT Spontaneous ventilation mode

SST Short self test

T

A

T

E

T

H

T

I

1

T

I SPONT

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Apnea interval

Expiratory time

High PEEP time (BILEVEL mode only)

Inspiratory time

High spontaneous inspiration time alarm

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OP 1

T

Introduction

Table 1-3: 840 Ventilator System symbols and abbreviations (cont)

Symbol or

abbreviation

2

T

I SPONT

T

L

T

PL

V

E SET

High spontaneous inspiration time alarm limit

Low PEEP time (BILEVEL mode only)

Plateau time

Set minute volume (calculated from ventilator control

Definition

parameters)

V

E SPONT

1

V

3V

E TOT

E TO

Exhaled spontaneous minute volume

High exhaled minute volume alarm

Low exhaled minute volume alarm

VC Volume control (mandatory breath type)

V

MAX

V

SENS

V

1

V

T

TE

V

TE

Peak flow (ventilator control parameter)

Flow sensitivity

Tidal volume (ventilator control parameter)

Exhaled tidal volume

High exhaled tidal volume alarm

3

V

TE MAND

3

V

TE SPONT

1

V

TI

V

TI

Low exhaled mandatory tidal volume alarm

Low exhaled spontaneous tidal volume alarm

Inspired tidal volume

High inspired (mandatory or spontaneous) tidal volume
alarm*

V

TI MAND

1

V

TI MAND

V

TI SPONT

1

V

TI SPONT

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Inspired mandatory tidal volume

High inspired mandatory tidal volume alarm*

Inspired spontaneous tidal volume

High inspired spontaneous tidal volume alarm*

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Introduction

OP 1

Table 1-3: 840 Ventilator System symbols and abbreviations (cont)

Symbol or

abbreviation

-TRIG

V

*Refer to Section 13.10 for information regarding inspired tidal volume alarms.

Flow triggering

Definition

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1.4 Ventilator system labeling symbols

The following symbols appear on the various components of the

Ventilator System.

840

NOTE:

All labels shown are examples, and may not reflect the exact
configuration of your ventilator.

Power switch positions: ON represents the power on position
and represents the power off position. The power switch,
located on the BDU front panel, turns ON/OFF the BDU and

8-10006

8-00400

the GUI. When the power switch is in the off position, the BPS
continues to charge if AC power is present.

Refer to manual: When this symbol appears on the product, it
means refer to documentation for information.

Type B equipment, per IEC 60601-1

Introduction

8-00445

Potential equalization point (ground): Provides a means of
connection between the equipment and the potential
equalization busbar of the electrical connection. A common
grounding point for the entire ventilator.

8-00426

Indicates the degree of protection provided by enclosure
(drip-proof)

8-00432

CSA certification mark that signifies the product has been
evaluated to the applicable ANSI/Underwriters Laboratories
Inc. (UL) and CSA standards for use in the US and Canada.

SN Serial number

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Introduction

Data Key Data key connection

OP 1

BPS charging indicator: When the ventilator is operating on

mains power, the top symbol (green indicator next to gray
battery icon) on the front of the BPS indicates that the BPS is
charged, and the bottom symbol (yellow indicator next to gray
battery icon) on the front of the BPS indicates that the BPS is
charging.

8-00462

Caution

Do not remove the data key. The data key enables
software options, and stores ventilator operational
hours, compressor unit operational hours, and the
serial numbers for the BDU and GUI. The ventilator
will not operate without its factory-installed data
key.

TEST

PTS 2000

DISPLAY

(GUI)

Ventilator

circuit

breaker

Compressor &

humidifier

circuit

breaker

8-00405

Compressor outlet:

5.6 A max

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TEST button. After you touch the Short Self Test (SST)
onscreen key (available only during ventilator startup), you
must press the TEST button within 5 seconds in order to access
SST.

Puritan Bennett PTS 2000™ Performance Test System
connection, for use by qualified service personnel only.

GUI connection

Circuit breaker for ventilator power supply, located in the BDU

Ventilator circuit breaker for compressor and humidifier

Alternating current (at AC inlet and AC power indicator)

Maximum allowed output to auxiliary mains socket
(compressor electrical connection)

OP 1-23

OP 1

Introduction

BPS electrical connection

8-00413

Exhalation filter latch unlock/lock

8-00434

Exhalation filter latch open indicator: This red indicator is
located on the surface behind the closed latch, and is easily
visible when the latch is open.

GUI mounting latch unlock/lock

8-00428

Remote alarm port

IOIOI

RS-232 port

Susceptible to electrostatic discharge

Electric shock hazard

8-00443

Explosion hazard

8-00450

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 1-24

Introduction

Fire hazard

8-00417

802 BPS product information label

GUI product information label

OP 1

US/75427C

US/75422C

GUI ports label
Remote alarm and RS-232 port (9.4-inch GUI only). Refer to Appendix E for GUI remote

alarm and RS-232 port specifications.

ENGLISH/75416A

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 1-25

OP 1

Humidifier electrical label
(This label not visible unless cover plate over humidifier electrical connection is

removed.)

BDU gas inlet label

Introduction

US/75415A

US/75421A

BDU to patient label

US/75417A

Compressor gas connection label

US/75418A

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 1-26

Introduction

Compressor information label

OP 1

76505C

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 1-27

OP 1

BDU information label

Introduction

US/75423C

BDU cooling vent label

US/75414A

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 1-28

Introduction

BDU I/O disconnect label

BDU exhaust information label

OP 1

US/75419A

US/75420A

BPS electrical connection label

US/75334Lbl

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 1-29

OP 1

Compressor lint filter label

Expiratory limb connector on exhalation filter

From patient

Introduction

US/75426A

8-00423

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 1-30

C

HAPTER

2

How to set up the 840 ventilator

Chapter 2 describes how to set up the ventilator:

• How to connect the electrical supply

• How to connect the air and oxygen supplies

• How to connect the patient circuit and accessories

A Puritan Bennett Customer Service Engineer (CSE) must first
install the ventilator and run an extended self test (EST), which
calibrates the exhalation valve, flow sensors, and atmospheric
pressure transducer, before you connect a patient to the ventilator
for the first time.

Warning

• When you lift the ventilator, use assistance and
appropriate safety precautions. Figure 2-1 shows the
proper technique to lift each ventilator component.

• To avoid interrupted ventilator operation or possible
damage to the ventilator, always use the ventilator on a
level surface in its proper orientation.

• To avoid the possibility of injury to the patient and
ensure proper ventilator operation, do not attach any
device to the port labeled EXHAUST unless the device is
specifically authorized by Puritan Bennett.

• To minimize the increased risk of fire due to an oxygen­enriched environment, do not use the ventilator in a
hyperbaric chamber.

• To avoid raising the oxygen concentration of room air,
use the ventilator in an adequately ventilated room.

2

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 2-1

OP 2

Lift the BDU

from horizontal

surfaces as shown.

Use two people to lift

the compressor from

the base and the handles.

How to set up the 840 ventilator

Lift the GUI from
the base and the handle.

8-00011

Figure 2-1. How to lift the ventilator components

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-2

How to set up the 840 ventilator

Caution

• Do not connect or disconnect the ventilator’s graphic user

interface (GUI), backup power source (BPS), or compressor
while the power switch is on or the ventilator is connected to AC
power.

• All components must be securely mounted and connected by

qualified service personnel according to the appropriate
Puritan Bennett installation instructions.

• Do not obstruct the breath delivery unit (BDU), GUI, or

compressor cooling vents or fan vents.

• To avoid possible damage to ventilator components, do not use

the horizontal surfaces of the ventilator to place or stack
objects.

NOTE:

Before you use the ventilator for the first time, wipe the
ventilator exterior clean and sterilize its components
according to the instructions in Chapter 7 of this manual.
Follow your institution’s protocol for cleaning and sterilizing
the ventilator and its components.

OP 2

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 2-3

OP 2

How to set up the 840 ventilator

2.1 How to connect the electrical supply

Warning

• To minimize the risk of electrical shock, always connect
the ventilator power cord into a grounded AC power
outlet.

• In the US, always connect the ventilator to an AC
receptacle marked “Hospital Only” or “Hospital Grade”
to ensure proper grounding of the ventilator.

• The 802 BPS must always be installed. Without the BPS,
the ventilator is not protected against low or lost AC
power. Do not use the ventilator unless a BPS with at
least minimal charge is installed.

• When possible, connect the ventilator to an outlet
connected to the hospital emergency back-up power
system. Refer to Section A.4 for ventilator electrical
specifications.

Normally the
802 BPS operates the ventilator when AC power is lost or drops
below a minimum level.

A new, fully charged BPS can operate the ventilator (without the
compressor or a humidifier) for at least 30 minutes; allowing the
ventilator to be used for transport purposes within the healthcare
facility.

Warning

The 802 BPS is intended for short-term use only, and is not
intended as a primary alternative power source. The BPS is
intended to power the BDU and GUI only. In case of AC
power loss, power is not available to run either the
compressor or the humidifier.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-4

Ventilator System is mains-powered. The

840

How to set up the 840 ventilator

If you turn on the ventilator after it has been unplugged for an
extended period, the
occurs, recharge the 802 BPS by leaving it connected to a
ventilator connected to AC power for up to 8 hours (ventilator
does not need to be turned on). If, after turning the ventilator
back on, the

INOPERATIVE BATTERY

LOW BATTERY

must replace the BPS battery.

Figure 2-2 shows how to connect the power cord to AC power.
Built-in power cord retainer tabs protect against accidental
disconnection. Ensure that the power cord is securely fastened
into the AC receptacle prior to operation. To remove the cord,
squeeze the tabs on the top and bottom of the plug and pull
outward.

OP 2

LOW BATTERY

alarm is still active or if the

alarm is active, qualified service personnel

alarm may sound. If this

Power

cord

Power cord retainer tabs.

To AC power

8-00002

Squeeze tabs and pull outward to
disconnect power cord.

Figure 2-2. How to connect the ventilator power cord

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 2-5

OP 2

How to set up the 840 ventilator

Figure 2-3 shows the power switch and AC indicator. When
illuminated, the AC indicator indicates that the ventilator is
receiving AC power and that the 802 BPS will be recharged as
needed. The AC indicator is independent of the power switch, and
the power switch does not turn off AC power to the ventilator
power supply. When both the power switch and AC indicator are
on, power is available for the humidifier and compressor.

Ventilator
power supply
circuit breaker

ON

Ventilator

power switch

AC panel

AC indicator

Humidifier

and compressor

circuit breaker

Potential

equalization

(ground

point)

Compressor

connection

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

If the ventilator power supply circuit breaker (located on the
ventilator's AC panel, Figure 2-3) opens but AC power is still
present and the ventilator is operating on BPS, power is still
available to the humidifier and compressor connectors (although
ventilator software disables compressor operation).

AC power
connection

8-00045

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-6

How to set up the 840 ventilator

When the power cord is not in use, wrap the power cord around
the hook on the back of the cart for convenient storage
(Figure 2-4).

OP 2

8-00004

Figure 2-4. Power cord storage on the cart

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 2-7

OP 2

How to set up the 840 ventilator

2.2 How to connect the air and oxygen supplies

The
or wall supplies. Follow these steps to connect the air and oxygen
supplies:

1

2

Ventilator System can use air and oxygen from cylinder

840

Ensure that the supply pressures are 35 to 100 psi
(241 to 690 kPa).

Connect the supply hoses to the inlet connectors at the rear of
the ventilator (see Figure 2-5).

Warning

• Connect only air to the air inlet, and only oxygen to the
oxygen inlet. Do not attempt to switch air and oxygen or
connect any other gas.

• Always connect at least two gas sources to the ventilator
to ensure that a constant gas supply is available to the
patient. There are three gas source connections: the
compressor, air inlet, and oxygen inlet.

• Do not use conductive, high-pressure supply hoses.
Doing so may negatively affect the ventilator’s ground
isolation characteristics.

• Use only high-pressure supply hoses recommended by
Puritan Bennett. Other hoses may be restrictive and may
cause improper ventilator operation.

Caution

To prevent damage to the ventilator, ensure that the connections
to the air and oxygen supplies are clean and unlubricated, and
that there is no water in the air or oxygen supply gas.

If you suspect water in the air supply gas, use an external wall air
water trap to prevent water damage to the ventilator or its
components.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-8

How to set up the 840 ventilator

NOTE:

When you connect a pressurized air or oxygen
source, the ventilator air and oxygen regulators
have a maximum bleed rate of 3 L/min, even when
the ventilator is not in use. Always take this bleed
rate into account when calculating air and oxygen
usage.

When the air and oxygen hoses are not in use, you can wrap them
around the hook on the back of the cart for convenient storage
(Figure 2-5).

Air inlet

connector

Oxygen

inlet

connector

OP 2

Oxygen hose
(from oxygen
supply)

Air hose

(from air

supply)

8-00005

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

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 2-9

OP 2

How to set up the 840 ventilator

2.3 How to connect the patient circuit components

Warning

• To minimize the risk of bacterial contamination or
component damage, inspiratory and expiratory filters
must always be handled with care and connected to the
ventilator during use.

• To minimize the risk of patient injury, use only patient
circuits qualified for use in oxygen-enriched
environments with the 840 Ventilator System. Do not
use antistatic or electrically conductive tubing. To ensure
a leak-tight connection, only use connectors and tubes
with ISO-standard cone and socket fittings (or use
adapters to connect barbed cuff fittings to ISO-standard
fittings).

• If you use an external, pneumatically-powered nebulizer
with the 840 ventilator, it adds flow to the patient circuit
and can adversely affect spirometry, delivered O
delivered tidal volumes, and breath triggering.
Additionally, aerosolized particulates in the ventilator
circuit can lead to an increase in exhalation filter
resistance.

• Use one of the patient circuits listed in Appendix B to
ensure that the maximum pressure/flow values specified
by IEC 60601-2-12:2001 are not exceeded (see Table A-11
on page OP A-18 for patient circuit testing
specifications). Using a circuit with a higher resistance
does not prevent ventilation, but can cause a short self
test (SST) fault or compromise the patient’s ability to
breathe through the circuit.

2

%,

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-10

How to set up the 840 ventilator

NOTE:

• Puritan Bennett recommends that you run SST
(Short Self Test) every 15 days, and between
patients, and when you change the patient
circuit (particularly when you change the circuit
type, for example, from adult to pediatric or
neonatal).

• Puritan Bennett recognizes that the protocol for
running SST varies widely among health care
institutions. Puritan Bennett does not specify or
require specific practices that will meet the needs
of all institutions, nor is Puritan Bennett
responsible for the effectiveness of institutional
practices.

2.3.1 How to select and connect a patient circuit

Use low-compliance patient circuits to ensure optimum
compliance compensation, and use pediatric patient circuits
when the patient ideal body weight (IBW) is greater than 7 kg
(15 lb) but less than or equal to 24 kg (53 lb). Use the
software option and neonatal patient circuits for patients whose
IBW is less than or equal to 7 kg.

For patients whose IBW is less than or equal to 24 kg, the
compliance compensation volume limit is four times the set tidal
volume, in addition to the set tidal volume. To avoid activating a
severe occlusion alarm, only use neonatal patient circuits with the

NeoMode

Table 2-1 shows IBW values and patient circuit types. The
“Allowed but not recommended” ranges require an override.

software option.

OP 2

NeoMode

Warning

Recommended ranges exist to ensure patient safety. Only
those with the expertise to judge the appropriate
circumstances should override the recommended ranges.

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 2-11

OP 2

How to set up the 840 ventilator

Table 2-1: Patient circuit and IBW values

Recommendation Ideal body weight (IBW) in kg (lb)

Recommended Neonatal: 0.5-7.0 kg (1.1-15 lb)

Pediatric: 7.0-24 kg (15-53 lb)
Adult: 25-150 kg (55-330 lb)

Allowed but not

recommended

Neonatal: Not applicable

Pediatric: 3.5-6.5 kg (7.7-14.3 lb), and

25-35 kg (55-77 lb)

Adult: 7-24 kg (15-53 lb)

Figure 2-6 shows how to connect the patient circuit, including the
inspiratory filter, humidifier (if used), inspiratory limb, patient
wye, expiratory limb, collector vial, and expiratory filter.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-12

How to set up the 840 ventilator

(From patient)

Expiratory

filter

Expiratory limb

Patient wye

of patient circuit

Collector
vial

OP 2

(To patient)

Inspiratory
filter

Tubing

Inspiratory limb
of patient circuit

Humidifier

8-00006

Figure 2-6. How to connect the patient circuit

Warning

To ensure that all patient circuit connections are leak-tight,
always perform a circuit leak test by running SST each time
you install the expiratory filter on the ventilator.

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 2-13

OP 2

How to set up the 840 ventilator

Warning

Adding accessories to the ventilator can increase system
resistance. Ensure that any changes to the recommended
ventilator circuit configurations do not exceed the specified
values for inspiratory and expiratory resistance
(Appendix A). If you add accessories to the patient circuit,
always run SST to measure circuit compliance before you
begin ventilation of the patient.

2.3.2 How to install the expiratory filter and collector vial

Install the expiratory filter and collector vial as follows:

Place the expiratory filter latch in the up position (see

1

Figure 2-7).

Slide the expiratory filter into the housing area with the

2

expiratory limb connection facing you.

Push the expiratory filter latch down; it will position the filter

3

properly.

Attach the expiratory limb of the patient circuit to the filter’s

4

expiratory limb connection.

If you do not use a drain bag, be sure to cap the collector vial drain
port on the expiratory filter (Figure 2-8).

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-14

How to set up the 840 ventilator

Pull latch up to install
filter; push down to
hold filter and collector
vial in place

Expiratory
filter

Expiratory limb
connection
(from patient)

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

If you use a drain bag:

Install the expiratory filter. (Refer to the instructions above.)

1

Install the clamp on the drain bag tubing, making sure that

2

the clamp is closed.

Uncap collector vial drain port at the base of the collector vial.

3

Connect the collector bag tubing to the vial drain port.

4

Connect the other end of tubing to drain bag.

5

If the ventilator is mounted on the cart, place the drain bag in

6

the cart drawer (Figure 2-8).

Filter
housing

hous
area

Collector vial

OP 2

Slide the filter rim
onto these tracks

8-00018

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 2-15

OP 2

Drain bag

Tubing

Place the drain bag

in the cart drawer

Clamp

How to set up the 840 ventilator

The collector vial
drain port must
be capped if you
do not use a
drain bag

8-00007

Figure 2-8. How to use the collector vial with or without the drain bag

NOTE:

• The drain bag is designed to lie flat and should
not be suspended.

• Check the inspiratory and expiratory limbs of the
patient circuit, the collector vial, and the in-line
water traps regularly for water buildup. Under
certain conditions, they can fill quickly. Empty
and clean the collector vial and in-line water
traps as necessary.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-16

How to set up the 840 ventilator

2.3.3 How to install the flex arm

The flex arm supports the patient circuit between the ventilator
and the patient. Figure 2-9 shows how to install the flex arm onto
one of the two threaded sockets on the ventilator cart.

Flex arm

Threaded

socket

OP 2

Threaded socket
in the cart
(one of two)

8-00008

Figure 2-9. How to install the flex arm

Caution

Use only the cart handles to move the ventilator. Do not pull or
push the ventilator with the flex arm.

Flex arm replacement parts can be found in the

840 Ventilator System Service Manual

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

.

OP 2-17

OP 2

How to set up the 840 ventilator

2.3.4 How to install the humidifier

An electrical outlet for a humidifier is located on the front of the
BDU. Figure 2-10 shows how to install a Fisher & Paykel
humidifier onto the ventilator.

Warning

• When using a Fisher & Paykel humidifier with the
840 ventilator, use the appropriate Fisher & Paykel
humidifier chambers for adult, pediatric, and neonatal
patients.

• Take proper precautions to prevent water/condensate
from splashing into the patient circuit during circuit
disconnects and high peak flow rate conditions.

• To avoid possible patient injury or damage to the
ventilator system, follow your institution’s protocol for
proper patient circuit condensate management.

Caution

• Qualified service personnel must first install the humidifier
mounting hardware.

• To avoid equipment damage to the ventilator due to liquid
ingress:

- Install the plug cover when the humidifier is plugged into the

ventilator.

- Install the flat cover plate over the humidifier electrical outlet on

the front of the BDU when the humidifier is not plugged into the
ventilator.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-18

How to set up the 840 ventilator

NOTE:

• To ensure uninterrupted ventilator operation, do
not install a humidifier whose maximum current
capabilities exceed 2.3 A, with a maximum
power consumption of 270 VA.

• When you install a Fisher & Paykel humidifier,
make sure the humidifier has a right-angle
electrical plug. A short power cord is preferable.

•To ensure that ventilator occlusion detection
operates properly, do not use Puritan Bennett
Cascade humidifiers with the 840 Ventilator
System.

• If you have further questions about humidifiers
qualified for use with the 840 Ventilator System,
contact Technical Services or your local
Puritan Bennett representative.

OP 2

BDU

Plug cover

Humidifier

Mounting
bracket on
front of
ventilator

8-00138

Figure 2-10. How to install the humidifier

(Fisher & Paykel version shown)

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 2-19

OP 2

How to set up the 840 ventilator

2.3.5 How to use the ventilator cart

Figure 2-11 shows how to lock and unlock the cart’s front wheels.

Warning

To avoid interrupted ventilator operation or damage to
ventilator components, use the cart to move the ventilator.
Do not use the cables, the power cord, or patient circuit
components to push or pull the ventilator.

Press down
to lock

Press down
to unlock

8-00010

Unlocked position Locked position

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

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 2-20

C

HAPTER

3

How to run Short Self Test (SST)

Chapter 3 tells you:

• When to run SST

• Required equipment for SST

• How to set up and run SST

• The SST tests and their functions

• How to understand the results of SST

3

3.1 Introduction to SST

SST uses an internal, programmed sequence of tests to:

• Verify proper function of the flow and pressure sensors

• Check the patient circuit for gas leaks

• Measure the expiratory filter resistance

• Measure patient circuit resistance

• Measure patient circuit compliance

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 3-1

OP 3

How to run Short Self Test (SST)

SST requires approximately three minutes to complete.

Warning

• Always disconnect the ventilator from the patient before
you run SST. If you run SST while the ventilator is
connected to the patient, physical injury to the patient
may occur.

• An ALERT reported by SST indicates that the ventilator or
a related component has a defect. Repair the ventilator
or related component before you use the ventilator on a
patient, unless you can determine with certainty that the
defect cannot create a hazard for the patient, or add to
the risks that may occur from other hazards.

• When you run SST, configure the patient circuit exactly
as it will be used on the patient (for example, with same
accessories). If you add accessories to the patient circuit
after you run SST, you must rerun SST with the new
accessories installed before you begin to ventilate the
patient.

3.2 When to run SST

NOTE:

Puritan Bennett recognizes that health care institutions may
have their own ventilator protocols. However, Puritan
Bennett is not responsible for the effectiveness of any
institution’s protocols. Nor can Puritan Bennett specify, or
require, specific practices that will meet the internal needs of
every health care institution.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 3-2

How to run Short Self Test (SST)

Puritan Bennett recommends that you run SST when one or more
of the events below occurs:

• When you replace the patient circuit and the exhalation filter
after 15 days of use

• When you are ready to connect a new patient to the ventilator

• When you connect a different patient circuit to the ventilator

• When you install a new or sterilized expiratory filter

• When you change the patient circuit type

• When you change the humidification device type

• When you remove or add accessories to the patient circuit,
such as a humidifier, water trap, or drain bag

OP 3

Use SST at any time, provided that a patient is
ventilator, to:

• Check the patient circuit for gas leaks

• Calculate patient circuit compliance and resistance

• Calculate expiratory filter resistance

After SST begins, the system prompts you to prepare the ventilator
to conduct certain tests. The system waits indefinitely at a prompt
until you take action and respond appropriately.

attached to the

not

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 3-3

OP 3

How to run Short Self Test (SST)

3.3 SST components and requirements

When you conduct SST, you must have available the components
and equipment that you will use on the patient:

• Patient tubing

• Expiratory filter and collector vial

•Inspiratory filter

• Humidifier, as applicable

• Other accessories (e.g. water traps, drain bag), as applicable

Additional requirements include:

• A No. 1 rubber stopper to block the airway at the patient wye

• Two gas sources (air and oxygen) connected to the ventilator

• Each gas source pressure must be between 35-100 psi
(241 to 690 kPa)

Caution

• To prevent SST failures due to leaks, ensure that any circuit
components such as collector vial drain port cap (if not using a
drain bag), the seal between the expiratory filter and collector
vial, and water trap (if used) seals are properly installed.

• If you are using a drain bag, ensure that the tubing is properly
installed on the collector vial drain port and that the tubing is
clamped. If the drain bag tubing is not clamped during SST,
large leaks and large compliance values are possible which may
cause SST to report ALERTs or FAILURES.

Wait at least 10 minutes after you turn on the ventilator before
you run SST. The warm up time of 10 minutes will stabilize the
ventilator and ensure the accuracy of the SST tests.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 3-4

How to run Short Self Test (SST)

3.4 SST Procedure

Warning

Always disconnect the ventilator from the patient before
you run SST. If you run SST while the ventilator is
connected to the patient, physical injury to the patient may
occur.

Turn the power switch (located on the front of the BDU). The

1

system conducts the POST (power-on self test) and displays
the

Ventilator Startup

Allow the ventilator to stabilize for ten minutes with the

2

power on.

Install the patient circuit, the expiratory and inspiratory filters

3

that you will use to ventilate the patient.

Caution

The patient circuit must be unobstructed and properly connected
to the ventilator to ensure accurate circuit resistance
measurement.

OP 3

screen.

At the

4

touch screen), then press the
the BDU) within 5 seconds. (Refer to Figure 3-1 for location of

TEST

The system displays the

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

Ventilator Startup

button.)

screen, touch the SST button (lower

button (on the left side of

TEST

SST Setup

screen (lower touch screen).

OP 3-5

OP 3

How to run Short Self Test (SST)

NOTE:

You must press the TEST button within 5 seconds of touching
the SST button or SST will not start.

Tes t
button

Figure 3-1. Test button location

Caution

Do not press the test button when powering up the ventilator. This
may cause the ventilator to enter Service Mode. If you enter
Service Mode, do not attempt to run Extended Self Test (EST) with
a patient circuit. Doing so will cause EST to fail. If EST fails, the
ventilator will remain in a Vent Inop state until EST successfully
passes.

If you accidentally enter Service Mode, exit Service Mode by
touching the EXIT button on the lower GUI screen and then
pressing the ACCEPT key.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 3-6

How to run Short Self Test (SST)

OP 3

Touch the

5

PATIENT CIRCUIT

key in the lower touch screen,
then use the knob to select either Adult, Pediatric, or Neonatal
(if

Touch the

6

NeoMode

software option is installed) patient circuit.

HUMIDIFICATION TYPE

key in the lower touch
screen, then use the knob to select the humidification type
that you will use for patient ventilation.

If you will not use a humidifier, set the humidification type to

.

HME

Press

7

ACCEPT

to complete your selection of the patient circuit

and humidification types.

Warning

Incorrectly specifying the patient circuit type or changing
the patient circuit type after you have run SST can affect
the accuracy of the compliance calculation, the measured
exhaled tidal volume, and delivered/measured inspired
tidal volumes. You must rerun SST when you change the
circuit type.
Compliance calculation and tidal volume accuracy may also
be affected by incorrectly specifying or changing the
humidifier after running SST. If you change humidifiers,
ensure you change the humidification type as described in
Section 4.8. For optimum accuracy, rerun SST using the
new humidifier.

The ventilator automatically starts the test sequence. Refer to

8

Table 3-1 for details regarding each SST test step.

The SST

Flow Sensor, Expiratory Filter, Circuit Resistance

Compliance Calibration

tests require your intervention. The

, and

system will wait indefinitely for your response. Otherwise you
don’t need to do anything unless a test result is

FAILURE

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

, or SST is complete.

ALERT

or

OP 3-7

OP 3

How to run Short Self Test (SST)

As each test is performed, the

9

SST Status

screen shows test

results (see Table 3-2).

Warning

To ensure reliable SST results, do not repeat an individual
test with a different patient circuit if the test result is
FAILURE or ALERT. If you suspect a defective patient circuit,
replace the patient circuit and restart SST from the
beginning.

You can touch

10

touch

EXIT SST

EXIT SST

again to resume testing, or press

restart the ventilator (if SST has not detected an

FAILURE

).

during SST to halt testing. You can

ACCEPT

ALERT

Warning

To ensure correct compensation for circuit resistance and
compliance, do not exit SST until the entire SST is
successfully completed. Do not begin normal ventilation
until the entire SST is successfully completed with the
correct patient circuit installed.

When all of the tests in SST are complete, the

11

SST Status

displays all individual test results and SST outcome. Table 3-3
summarizes overall SST outcomes and how to proceed in each
case.

To begin normal ventilation (if SST has not detected an

12

or

FAILURE

The ventilator reruns

13

The ventilator displays the

14

with

), touch

EXIT SST

Ventilator Startup

, then press

.

POST

Ventilator Startup

ACCEPT

.

screen. Proceed

to configure the system for the patient.

to

or

screen

ALERT

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 3-8

How to run Short Self Test (SST)

Table 3-1: SST test sequence

Test step Function Comments

OP 3

SST Setup The system prompts you to

specify the patient circuit
type and humidification type
that you will use for the
patient ventilation.

1 Specify the patient circuit

type.

2 Specify the humidification

type.

You can select one of three
humidification types:

• Heated expiratory tube

• Non-heated expiratory
tube

• HME (heat-moisture
exchanger)

3 For non-HME humidifiers,

specify the dry humidifier
volume. Use the specified
volume, not the
compressible volume, of
the humidifier.

4 Press the

Warning

Select the correct
patient circuit type
and humidification
type. Otherwise,
faulty occlusion
detection and
erroneous expiratory
spirometry can result.

ACCEPT

key.

NOTE:

HUMIDIFIER VOLUME

The
HME.

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

button is not visible on the touch screen if you select

OP 3-9

OP 3

How to run Short Self Test (SST)

Table 3-1: SST test sequence (cont)

Test step Function Comments

SST Flow Sensor Test The system prompts you to

connect the patient circuit to
inspiratory filter.

Use Figure 2-6 on page OP
2-13 to connect the patient
circuit.

1 Connect the patient circuit

to the inspiratory filter—
but without the
humidifier.

2 Press

ACCEPT

the test.

NOTE:

Do not run the Flow Sensor Test with a humidifier
installed, even if you will use a humidifier when you
begin patient ventilation.

The system prompts you to
block the patient wye.

The system checks the
accuracy of the inspiratory
and expiratory flow sensors.

After the test completes, the
system prompts you to
connect the humidifier.

3 Block the wye with a

No. 1 stopper.

4 Press

If the status of the SST Flow
Sensor Test is
cannot use the
function.

ACCEPT

FAILURE

NOTE:

If you will use a humidifier during patient ventilation, connect the humidifier
to the patient circuit after the system passes the SST Flow Sensor Test. Refer to
Figure 2-6 on page OP 2-13 for connection information.

to begin

.

, you

OVERRIDE

Circuit Pressure Test The system verifies proper

function of the BDU pressure
sensors.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 3-10

If the status of the Circuit
Pressure Test is FAILURE, you

cannot use the
function.

OVERRIDE

How to run Short Self Test (SST)

Table 3-1: SST test sequence (cont)

Test step Function Comments

OP 3

Circuit Leak Test The system determines the

ability of the circuit to hold
pressure.

The system displays the drop
in circuit pressure over a
10 second interval.

Expiratory Filter
Resistance Test

The system prompts you to
detach circuit tubing from
the expiratory filter.

At the conclusion of the

Expiratory Filter Resistance
Tes t, the system displays the

pressure drop across the
expiratory filter.

ALERT

If the system reports
and you choose to override
the alert status, the result can
be improper compliance
compensation, inaccurate
tidal volume delivery, or
autotriggering during patient
ventilation.

If the test detects excessive
leaks, the system reports a

FAILURE

1 Detach the patient circuit

2 Press

If the system reports an
for the Expiratory Filter
Resistance Test and you
override the
inaccurate patient pressure
estimation can result.

The system will report a

FAILURE

exhalation compartment
occlusion or an expiratory
filter occlusion.

If you do not correctly follow
the prompts to disconnect
and connect the patient
circuit, the system will report a

FAILURE

.

from the expiratory filter.

ACCEPT

the test.

if the test detects an

.

ALERT

to begin

, an

ALERT

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 3-11

OP 3

How to run Short Self Test (SST)

Table 3-1: SST test sequence (cont)

Test step Function Comments

Expiratory Filter
Resistance Test

(cont)

Circuit Resistance The system prompts you to

The system prompts you to
reattach the patient circuit.

unblock the patient wye.

The system displays the
pressure drop across the
inspiratory and expiratory
limbs.

The reported pressure drop
includes the effect of all
devices installed on each
limb, such as filters, water
traps, or a humidifier.

3 Reattach the patient

circuit to the expiratory
filter.

4 Press

1 Remove the stopper from

2 Press

If the system reports an
for the pressure drop across
the two limbs and you
override the
inaccurate patient pressure
estimation can result.

The system reports a
if the test detects excessive
high or low limb resistance, or
if you do not follow the
prompt to unblock the wye.

ACCEPT

the next test.

the wye.

ACCEPT

the test.

ALERT

to begin

to begin

ALERT

, an

FAILURE

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 3-12

How to run Short Self Test (SST)

Table 3-1: SST test sequence (cont)

Test step Function Comments

OP 3

Compliance
Calibration

The system prompts you to
block the patient wye.

If you selected a
humidification type of either

Heated exp tube or Non­heated exp tube, the

ventilator prompts you to
indicate if there is water in
the humidifier.

The system displays the
compliance of the patient
circuit.

The system prompts you to
unblock the patient wye.

1 Block the wye with a

No. 1 stopper.

2 Press

3 Press ACCEPT to indicate

If the system reports an
for the patient circuit
compliance and you override
the
compliance compensation or
inaccurate tidal volume
delivery can result.

The system reports a
if the test detects an out-of­range compliance condition.

4 Remove the stopper from

5 Press

ACCEPT

the patient circuit
compliance test.

YES

or CLEAR to indicate

NO

, as appropriate, to
indicate whether or not
there is water in the
humidifier.

ALERT

, improper

the patient wye.

ACCEPT

complete the SST test
sequence.

to begin

ALERT

FAILURE

to

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 3-13

OP 3

3.5 SST Results

How to run Short Self Test (SST)

The

ventilator uses four status categories to characterize the

840

individual SST test results, and the overall SST outcome.

ALERT

You can override an

reported for an individual test if you

ALERT

can determine with certainty that the defect in the ventilator or
related component cannot create a hazard for the patient, or add
to the risks that may arise from other hazards.

NOTE:

If an ALERT is reported and you exit SST without overriding the
ALERT, the ventilator will enter the safety valve open (SVO)
state and cannot be used for normal ventilation until SST
passes or the ALERT is overridden.

FAILURE

When the system declares a

FAILURE

for an individual test in the
SST sequence, the ventilator enters the SVO state. When a
ventilator experiences a

FAILURE

, immediately remove the
equipment from clinical use until qualified service personnel have
completed and verified the necessary repairs.

OVERRIDDEN

OVERRIDDEN

is a final status of the overall SST outcome and
indicates that you used the override feature when the system
reported an
the test with an

PASS

condition. (The ventilator must have ended

ALERT

condition.)

ALERT

is the final status of the overall SST outcome in which no

PASS

alerts or failures were detected.

Refer to Table 3-2 and Table 3-3 to learn how to interpret and
respond to each of these SST status categories.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 3-14

How to run Short Self Test (SST)

3.5.1 How to interpret individual SST test results

SST reports a test result status for each of the individual tests. Use
Table 3-2 to interpret SST test results and to determine how to
respond.

Table 3-2: Individual SST test results

OP 3

If the test
status is:

PASSED

ALERT

FAILURE

It means: Do this:

The system did not
detect a fault for the

You do not need to do anything, unless you
are prompted by the ventilator.

individual test.

The test result is not
ideal, but is not

When the system prompts you, touch one of
these buttons, then press ACCEPT:

critical.
If SST is in progress, it

EXIT SST

halts further testing
and prompts you to
make a decision.

A critical problem has
been detected, and

RESTART SST

REPEAT

Touch one of these buttons, then press

ACCEPT:
SST cannot complete
until the ventilator

EXIT SST

passes the failed test.

RESTART SST

NEXT

Discontinue SST

Repeat SST from the
beginning

Proceed to the next test

Repeat the test

Discontinue SST

Repeat SST from the
beginning

REPEAT

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

Repeat the test

OP 3-15

OP 3

How to run Short Self Test (SST)

3.5.2 SST outcomes

When SST has completed all of the tests, use Table 3-3 to
determine how to proceed.

Table 3-3: Overall SST outcomes

If the SST
outcome is:

PASSED

ALERT

It means: Do this:

All tests passed. Touch one of these buttons, then press

ACCEPT:

Exit SST and begin normal
ventilation

Repeat SST from the
beginning

Discontinue SST

One or more faults
were detected. If you
can determine with
certainty that this

EXIT SST

RESTART SST

Touch one of these buttons, then press
ACCEPT:

EXIT SST

cannot create a
hazard for the patient,
or add to the risks
which may arise from
other hazards, you
can choose to
override the ALERT
status and authorize
ventilation.

RESTART SST

OVERRIDE

Repeat SST from the
beginning

Press ACCEPT to override
the ALERT, as allowed by
your institution’s protocol.
Touch EXIT SST, then press
ACCEPT to begin normal
ventilation.

FAILURE

One or more critical
faults were detected.
The ventilator enters
the SVO state and
cannot be used for

Restart SST with a different patient circuit.
Touch one of these buttons, then press
ACCEPT:

EXIT SST

Discontinue SST

normal ventilation
until SST passes.
Service is required.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

RESTART SST

Press ACCEPT to repeat
SST from the beginning. If
the failure persists, contact
qualified service personnel.

OP 3-16

C

HAPTER

4

How to use the 840 ventilator

Chapter 4 tells you:

• How the ventilator user interface is structured

• How to start up the ventilator for a new or previous patient

• How to change main settings

• How to change other settings

• How to set the humidification type, expiratory sensitivity, and
disconnect sensitivity

• How to enable or disable the oxygen sensor

• How to select and set the variable that remains constant when
the breath rate setting is changed

• How to set the alarm limits

• How to perform inspiratory and expiratory pause maneuvers

• How to interpret inspiratory pause maneuver displays

• How to use Non-invasive ventilation (NIV)

4

NOTE:

The DualView touch screens use light beams to
detect where you touch the screen. To avoid a

DEVICE ALERT

substances or objects on the screen.

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

alarm, do not place any foreign

OP 4-1

OP 4

4.1 Structure of user interface

The following buttons are available on the upper and lower touch
screens. These buttons appear across the bottom portion of each
of the two touch screens.

Upper screen

How to use the 840 ventilator

Display More patient
graphics

vent setup (vent
type, mode,
breath types,
trigger type,
settings)

data (e.g. O2%,

P

I END

Diagnostic
code log
(system
diagnostic,
system
information,
EST/SST
diagnostic
logs)

VENT

SETUP

)

Current/proposed
apnea setup

Alarm log Active alarms
(time, event,
urgency, alarm,
analysis)

Operational
time log
(compressor,
ventilator
hours)

Lower screen

APNEA
SETUP

Communication
setup (printer/DCI,
baud rate, data bits,
parity mode)

SST result
log

ALARM
SETUP

Current/proposed
alarm settings

Ventilator
configuration
(revisions,
serial numbers,
part numbers,
installed
options)

Time/date
change

Other screens

Test
summary
(time, date,
outcome of
SST, EST)

Other screensCurrent/proposed

More settings
(humidification type,

sensor enable/

O

2

disable, disconnect
sensitivity, humidifier
volume)

Figure 4-1. Touch screen user interface

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 4-2

How to use the 840 ventilator

4.2 Patient setup

Warning

Always complete the patient setup before you attach a
patient to the ventilator. If you attach a patient before the
setup procedure is complete, the ventilator issues a
procedure error and initiates the safety ventilation mode.

When you turn on the ventilator, the ventilator automatically
runs POST (Power On Self Test). After POST passes, the system
displays the
screen. The prompt area, located in the lower right corner of the
lower screen, contains setup instructions.

Ventilator Startup

OP 4

screen (Figure 4-2) on the lower

Figure 4-2. Ventilator Startup screen

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

OP 4-3

OP 4

How to use the 840 ventilator

4.2.1 How to ventilate with most recent control parameters

To continue ventilation with the most recent ventilator control
parameters, touch
does not begin until a patient is connected. A flashing reminder
arrow prompts you to consider the previous Tube I.D. and Tube
Type if the prior Spontaneous Type used these parameters.

Same Patient

and press

ACCEPT

. Ventilation

4.2.2 How to ventilate with new control parameters

Refer to Table A-12 in Appendix Afor the descriptions, ranges,
resolutions, accuracies, and new patient values of the available
ventilator control parameters.

ouch the

1

T

parameters for patient ventilation.

Touch the

2

to adjust the IBW. The proposed value is highlighted.

Warning

Always enter the IBW that is appropriate for the patient.
The system uses the patient’s IBW to automatically set
certain values, alarm limits, and parameter boundary limits
for several initial parameters. (The IBW values that
correlate with patient height are listed in Table 4-1.)

New Patient

(ideal body weight) button, then turn the knob

IBW

button to select new ventilator control

Touch

3

the

If you want to return to the

RESTART

The system displays the

4

following buttons, and uses the rotary knob or drop-down
menus to display the available selections.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 4-4

CONTINUE.

CONTINUE

button.

(You must touch the

button will display.)

Ventilator Startup

New Patient Settings

button first before

IBW

screen, touch the

screen with the

How to use the 840 ventilator

OP 4

Vent Type

•

INVASIVE

Determines the ventilation type

:

— conventional ventilation using either

endotracheal (ET) or tracheostomy (trach) tubes

•

non-invasive

NIV (

ventilation using full-face masks,

) —

nasal masks, infant nasal prongs, or uncuffed ET tubes
(see Section 4.12 for specific information on how to use
NIV)

Determines the type and sequence of breath delivery

Mode

:

•

(Assist/Control)

A/C

•

•

•

(Synchronous Intermittent Mandatory Ventilation)

SIMV

SPONT

BILEVEL

(Spontaneous)

(available only with

BiLevel

software option

when Vent Type is INVASIVE)

Mandatory Type:

Determines the type of mandatory breath

control

•

(Pressure Control)

PC

•

(Volume Control)

VC

• VC+ (Volume Control Plus available only with

Ventilation Plus (VV+

) software option when

Volume

Vent Type

INVASIVE)

is

(If the selected

Mode

is

SPONT

, the

Mandatory Type

applies to

manual inspirations only.)

Determines type of support for

Spontaneous Type

:

spontaneous breaths

•

(Pressure Support)

PS

•

(Tube Compensation available only with TC software

TC

option when Vent Type is INVASIVE)

•

(Volume Support available only with

VS

VV+

software

option when Vent Type is INVASIVE)

•

(Proportional Assist available only with

PA

PAV+

software option when Vent Type is INVASIVE)

•

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

NONE

OP 4-5

OP 4

How to use the 840 ventilator

(If the selected

Mode

is

A/C,

the

Spontaneous Type

button

does not appear.)

Determines the method used to detect patient

Trigger Type

:

inspiratory effort

•

•V-

(Pressure) (not available when Vent Type is NIV or

-

P

TRIG

when using the

(Flow)

TRIG

NeoMode

option)

Touch the button and turn the knob to adjust the desired
settings. When you complete your settings changes, touch

CONTINUE

The final

5

.

New Patient Settings

screen appears. Touch the button
of each parameter you want to change, then turn the knob to
select its value. To cancel this change, press the
cancel all changes and start over, touch the

CLEAR

RESTART

NOTE:

The ventilator control parameter you are setting may be
dependent upon other ventilator settings that determine its
boundaries. Refer to the prompt area on the lower GUI screen
(Figure 1-2) for more information.

Press

6

ACCEPT

to put all of your ventilation control settings
into effect. Normal ventilation begins once a patient is
connected.

The

7

Apnea Setup

screen appears. Apnea settings are
automatically determined based on IBW, circuit type, and
mandatory breath type, but you can change them. If you
change any apnea settings, press

ACCEPT

to apply.

Although you are not required to change or confirm apnea
settings, you should verify that they are appropriate for the
patient prior to ventilation.

Press the

8

ALARM SETUP

limit settings on the

button to review the current alarm

Alarm Settings

screen. Ensure that they
are appropriate for the patient. To change any limit, touch the
button and turn the knob. To cancel, touch

ALARM

. To apply the settings, press the

PROPOSED

ACCEPT

key.

key. To

button.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 4-6

How to use the 840 ventilator

You may choose to calibrate the ventilator’s oxygen sensor at

9

this point. Press the
keyboard below the touch screens.

During the oxygen sensor calibration, the ventilator delivers
100% oxygen (if available) for two minutes and calibrates the
oxygen sensor in the Breath Delivery Unit (BDU).

The ventilator always monitors the delivery of oxygen to the
patient unless you disable the oxygen sensor. Touch the

SETTINGS

button to access oxygen sensor disable or enable

functions.

After you accept the ventilation control parameters, you can

10

attach a patient to the ventilator. Ventilation only begins
when the ventilator senses that a patient is attached.

If you attach a patient before completing setup, the ventilator
initiates safety ventilation mode and annunciates a

PROCEDURE ERROR

patient setup.

Warning

Each patient circuit type is appropriate for a specified range
of IBW values. This information is summarized in Table 4-2.

The recommended ranges exist to ensure patient safety.
Only those with expertise to judge the appropriate
circumstances should override the recommended ranges.

OP 4

100% O2 / CAL 2 min

alarm that is reset once you complete the

key located on the

MORE

4.2.3 Patient data and current settings

The top of the upper screen shows vital patient data. (Out-of­range data flashes to alert you.) The current breath type is
indicated in the upper left corner:

•

= Control

C

•

=Spontaneous

S

•

= Assist

A

You can access additional patient data when you touch the

PATIENT DATA

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

button.

MORE

OP 4-7

OP 4

How to use the 840 ventilator

You can display the definitions for any symbol used in the patient
data, alarm log, or settings areas by touching the symbol. The
symbol definitions appear at the bottom of the lower touch
screen.

Current ventilator control settings are displayed across the top of
the lower touch screen (Figure 4-3). If you press the

key, the lower touch screen automatically displays the

2 min

PROGRESS
PROGRESS

indicator. If you touch the
indicator will appear if there is no other higher-

priority display active. Press the

CANCEL

Alarm Silence

button for either

100% O

key, the

/CAL

2

IN

IN

indicator to cancel the alarm silence or oxygen sensor calibration
in progress.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 4-8

How to use the 840 ventilator

Breath type
(C = Control)

OP 4

Vital patient data area

Alarm area

Patient data

(upper screen)

Subscreen area

Main ventilator
control settings

Ventilator settings

(lower screen)

3VTE MAND

2 of last 4 mand breaths ≤ set limit. Check for leaks, changes in
patient'sR&C.

11:20 25 Jun 2000

Subscreen area

Figure 4-3. Touch screen appearance during normal ventilation (shown with

alarm silence and 100% O

4-075609-00 Rev. G (10/06) 840 Ventilator System Operator’s Manual

/CAL in progress)

2

OP 4-9

OP 4

How to use the 840 ventilator

4.2.4 Ideal Body Weight (IBW)

The system initially sets most upper and lower alarm limits based
on the patient’s IBW. After you enter the IBW, you can review and
change these alarm settings, if needed. Table 4-1 below provides
the information needed to determine the patient’s IBW using the
patient’s height.

840 Ventilator System Operator’s Manual 4-075609-00 Rev. G (10/06)

OP 4-10