Puritan Bennett Achieva PSO2, Achieva PS, Achieva User Manual
Puritan Bennett
Achieva® Ventilators
with Flow Acceleration and Apnea Back Up
Clinician’s Manual
©Copyright 2003 Nellcor Puritan Bennett Inc., Pleasanton CA, U.S.A. All rights reserved.
Puritan Bennett is a registered trademark and Achieva is a trademark of Nellcor Puritan Bennett Inc. For more information,
contact your Puritan Bennett Representative.
Achieva Ventilator Clinician’s Manual
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Chapters ................................................................................................... 1-2
Additional information............................................................................... 1-4
Conventions.............................................................................................. 1-4
Symbols and their definitions ..................................................................... 1-5
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Features.................................................................................................... 2-1
Electromagnetic interference...................................................................... 2-2
Software Errors.......................................................................................... 2-3
General warnings and cautions ................................................................. 2-4
If the ventilator fails................................................................................... 2-4
Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Intended use ............................................................................................. 3-1
Contra-indications..................................................................................... 3-1
Front panels .............................................................................................. 3-2
Top panel.................................................................................................. 3-2
Controls and display.................................................................................. 3-5
Back and sides ........................................................................................ 3-10
Inside door label ..................................................................................... 3-12
Top label................................................................................................. 3-12
Side label................................................................................................ 3-13
Agency symbols label ............................................................................. 3-13
Back panel label...................................................................................... 3-14
Accessories.............................................................................................. 3-15
Set up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Unpacking ................................................................................................ 4-1
Inspection ................................................................................................. 4-2
Accessory checklist .................................................................................... 4-3
Power ....................................................................................................... 4-4
AC Power.................................................................................................. 4-4
External Battery 24 Volt DC ....................................................................... 4-5
External Battery 12 Volt DC ....................................................................... 4-6
Battery Performance .................................................................................. 4-7
Testing the Batteries .................................................................................. 4-8
External battery precautions....................................................................... 4-9
Internal Battery 24 Volt DC........................................................................ 4-9
Attaching the patient circuit ..................................................................... 4-12
Attaching oxygen..................................................................................... 4-15
Short term humidification ........................................................................ 4-16
Extended Use .......................................................................................... 4-17
Connecting to a nurse call system............................................................ 4-19
November 2003 i
Achieva Ventilator Clinician’s Manual
Operating the controls............................................................................. 4-21
User self test ........................................................................................... 4-23
Setting the low pressure alarm................................................................. 4-26
Operation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Starting the ventilator ................................................................................ 5-1
Stopping the ventilator .............................................................................. 5-2
Sensitivity and adjustment ......................................................................... 5-3
Display of settings ..................................................................................... 5-3
Changing modes....................................................................................... 5-3
Flow trigger............................................................................................... 5-4
Pressure trigger ......................................................................................... 5-5
Altitude setting .......................................................................................... 5-6
Assist/Control mode, volume breaths......................................................... 5-7
Limiting inspiratory flow (Flow Acceleration)............................................... 5-8
Expiratory sensitivity .................................................................................. 5-9
Assist/Control mode, pressure-controlled................................................. 5-10
SIMV mode with pressure support ............................................................ 5-11
SIMV mode with CPAP ............................................................................. 5-12
Spontaneous mode with pressure support (Flow acceleration) .................. 5-13
Spontaneous mode with CPAP (Achieva PS and Achieva PSO2) ................ 5-15
Ventilation modes and apnea .................................................................. 5-16
Monthly safety check ............................................................................... 5-17
Verifying Alarm Functions ........................................................................ 5-18
Menu selections ...................................................................................... 5-22
User self test ........................................................................................... 5-22
Ventilating hours ..................................................................................... 5-22
Pressure trigger ....................................................................................... 5-23
Date and time ......................................................................................... 5-23
What the patient and caregiver must know .............................................. 5-25
Alarms and alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
Alarm sounds ............................................................................................ 6-3
Latching and non-latching ......................................................................... 6-4
Presilence.................................................................................................. 6-5
Resetting alarms........................................................................................ 6-5
Alarm conditions ...................................................................................... 6-6
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
Troubleshooting chart................................................................................ 7-1
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1
Cleaning and sterilization.......................................................................... 8-1
Ventilator surface ...................................................................................... 8-2
ii November 2003
Achieva Ventilator Clinician’s Manual
Flatpak filter.............................................................................................. 8-2
Changing the fuse..................................................................................... 8-4
Periodic maintenance ................................................................................ 8-6
Ventilator data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Printing reports from the ventilator............................................................. A-1
Local data transfer..................................................................................... A-3
Download procedure................................................................................. A-4
Remote data transfer ................................................................................. A-6
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1
Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C-1
Bibliography..............................................................................................C-1
Organizations ...........................................................................................C-1
Theory of operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-1
Pneumatic diagram ................................................................................... D-1
Breaths and ventilation modes...................................................................D-4
Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E-1
Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .F-1
Service information ....................................................................................F-1
Limited warranty ........................................................................................F-2
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Achieva Ventilator Clinician’s Manual
iv November 2003
Achieva Ventilator Clinician’s Manual Introduction
Chapter 1: Introduction
This introduction describes the information available in this manual and lists
other sources of information about Achieva™ ventilators. It also describes the
conventions used throughout this manual.
Warning
You must read and understand all of this manual
before you try to operate Achieva ventilators.
Operating the ventilator without understanding the
information in this manual may result in unsafe
conditions or misapplication of the device.
This manual is intended for physicians, respiratory therapists, and other
clinical personnel who use Achieva ventilators. It provides detailed
information about the installation, safe use, and verification of Achieva
ventilators. Since it is not a complete maintenance document, it contains
no disassembly, repair, or reassembly instructions or diagrams.
Use the instructions contained herein in conjunction with those set by the
patient’s physician. No instruction in this manual is intended to replace
accepted medical practice regarding the use of the ventilator or the care of
the patient.
November 2003 1-1
Introduction Achieva Ventilator Clinician’s Manual
Chapters
The following is a list of the chapters in this manual, and a brief
description of each.
Overview This chapter is an overview of Achieva ventilators, and includes
a comparison of the models. It also includes general warnings and
cautions, as well as information on what to do if the ventilator fails to
operate properly.
Description This chapter gives the intended uses and contra-indications
for Achieva ventilators. It describes the features, controls, and labels on the
ventilator. Some of the accessories used with Achieva ventilators are also
described.
Setup This chapter has instructions for unpacking and setting up the
Achieva ventilators. It includes a visual inspection and user verification
test. Instructions for setting the Low Pressure alarm are also included.
Operation This chapter contains information on starting and stopping
the ventilator, as well as instructions for setting the various modes and
menu selections. It includes a monthly safety check, and a list of the
information the patient and caregiver must know to use the ventilator
safely and effectively.
Alarms Instructions on responding to ventilator alarms. A list of all
ventilator alarms is included.
Troubleshooting This chapter discusses basic troubleshooting for the
Achieva ventilators.
Maintenance This chapter has cleaning and maintenance information for
the ventilator and a maintenance schedule.
Ventilator data This chapter tells how to print a report from the
ventilator and describes the information in that report. It also describes
how to transfer information from the ventilator to a computer equipped
with Achieva Report Generator software from Puritan Bennett.
Glossary This appendix presents the definitions of terms used in this
manual.
Resources A brief bibliography and a list of organizations of interest to
clinicians, caregivers, and patients.
1-2 November 2003
Achieva Ventilator Clinician’s Manual Introduction
Theory of operation Operating theory for Achieva ventilators. It includes
a description of the modes and sample waveforms.
Specifications Complete technical specifications for Achieva ventilators.
Service Information on obtaining service for the ventilator, including the
limited warranty.
Index An alphabetical list of the topics covered in this manual.
November 2003 1-3
Introduction Achieva Ventilator Clinician’s Manual
Additional information
For additional information about Achieva ventilators, read the Achieva
Ventilators User’s Manual and the Achieva Ventilators Technical Manual. For
information on the Achieva Report Generator, see the Achieva Report
Generator User’s Guide and the Report Generator software’s on-line help
file.
Puritan Bennett publishes newsletters, conducts seminars, and supports
organizations of interest to clinicians and patients. For more information
on these sources, contact Puritan Bennett at 1-800-635-5267 or
www.puritanbennett.com.
Conventions
Throughout this manual, Warnings, Cautions, and Notes mean the
following:
Directions that warn of conditions that put the patient,
caregiver, or other individuals at risk of injury.
Directions that help you avoid damaging the ventilator or
losing data.
Directions that make it easier to use the ventilator.
Warning
Anything that damages the ventilator may cause
potential danger to the patient.
Warning
Caution
Note
1-4 November 2003
Achieva Ventilator Clinician’s Manual Introduction
Symbols and their definitions
Attention, consult accompanying manual.
!
Alternating current
Direct current
V
A
IPX1
Volts
Amperes
Standby mode of operation
Type BF equipment, degree of protection against electrical shock
Alarm
CE mark: This device complies with the requirements of Directive 93/42/EEC concerning medical devices.
Drip proof
External Battery power connector
Alarm Silence/Reset switch
Test Battery switch
MODE
MENU/ESC
V
t
T
i
f
P
PEEP
November 2003 1-5
Mode selection switch
Menu/Esc function selection switch
Volume parameter setting switch
Inspiratory Time parameter setting switch
Breath Rate parameter setting switch
Pressure Support parameter setting switch
Positive End Expiratory Pressure parameter setting switch
Introduction Achieva Ventilator Clinician’s Manual
I/E
SENS.
O2%
I/E Ratio LCD indicator
Low Pressure alarm setting switch
High Pressure alarm setting switch
Sensitivity parameter setting switch
FIO2 (oxygen) parameter setting switch
Flow LCD indicator
Start/Enter function setting switch
Ventilate function setting switch
Low Pressure/Apnea LED alarm indicator
High Pressure LED alarm indicator
Setting Error LED alarm indicator
Power Switchover LED alarm indicator
Low Power LED alarm indicator
O
Fail LED alarm indicator
2
AC (alternating current) LED power source indicator
External Battery LED power source indicator
Internal Battery LED power source indicator
Alarm Control LED indicator
Battery Charging LED indicator
Assist/Spontaneous LED indicator
Keep dry.
J
UL Mark: Classified by Underwriters Laboratories Inc. with respect to electric shock, fire and mechanical hazards only in accordance with
UL2601-1
1-6 November 2003
Achieva Ventilator Clinician’s Manual Introduction
CSA Mark: Certified by Canadian Standards Association to meet CAN/CSA C22.2 No. 601.1-M90
Fragile
Year of manufacture
Fuse rating and type
T3.15A, 250V
SN
Serial number
November 2003 1-7
Introduction Achieva Ventilator Clinician’s Manual
1-8 November 2003
Achieva Ventilator Clinician’s Manual Overview
Chapter 2: Overview
This chapter is an overview and comparison of Achieva ventilators. This chapter
includes general warnings and cautions and information on what to do if the
ventilator fails to operate properly.
Puritan Bennett Achieva ventilators provide continuous respiratory
support for pediatric to adult patients with respiratory insufficiencies or
failures, in a home, in an institution, or in portable settings. Because of
their compact design, light weight, and use of portable oxygen and power
sources, the units are highly portable.
Achieva ventilators provide the user with therapeutic support. For the
user, the portability of Achieva ventilators is an advantage over hospital
devices.
The ventilator offers a wide range of delivery volumes, inspiratory times,
and breath rates. The doctor, respiratory therapist or other care provider
can set the appropriate ventilation mode and parameters with the controls
on the front panel. The magnetically latched door panel and setting
switches are designed to prevent tampering and accidental resetting.
Features
Achieva ventilators are available in three separate models. The table on the
following page lists the features available with each model. The model you
have is displayed on the front of the ventilator.
November 2003 2-1
Overview Achieva Ventilator Clinician’s Manual
Features of Achieva Ventilators
Achieva Achieva PS Achieva
PSO
2
Modes of Ventilation
Assist/Control Yes Yes Yes
with Pressure Control Capability Yes Yes Yes
SIMV Yes Yes Yes
with CPAP Yes Yes Yes
with Pressure Support No Yes Yes
Spontaneous (Pressure Support) No Ye s Ye s
with CPAP No Yes Yes
Apnea Back Up Rate (in spontaneous mode) No Ye s Ye s
Dial-in PEEP (3-20 hPa) Yes Yes Yes
Flow Triggering Yes Yes Yes
Internal O
Access to Stored Events with the Achieva
Report Generator Software
Pediatric Capability Yes Yes Yes
Internal Battery Yes Yes Yes
External Battery Capability Yes Yes Yes
Portability Yes Yes Yes
Blender No No Yes
2
Yes Yes Yes
Electromagnetic interference
Caution
Your ventilator is an electronic instrument. Any
electronic instrument may create and is subject to
electrical interference. Electrical interference in excess
of 20 V/m may keep your ventilator from working
properly.
2-2 November 2003
Achieva Ventilator Clinician’s Manual Overview
Note
If television interference does occur, contact Technical Services at Puritan
Bennett or a television repair technician for suggestions. Or, move the
television to an electrical outlet that does not allow interference.
If another device interferes with your ventilator:
Television sets, cordless or cellular telephones, microwave ovens, air
conditioners, food processors, and other appliances can be sources of
electrical interference. To avoid electrical interference between your
ventilator and these appliances, follow these instructions:
•Do not place your ventilator near the appliances.
•Do not plug the ventilator into the same AC electrical outlet nor
into the electrical outlets on the same circuit as the appliances.
•Do not place the ventilator cables near the appliances.
If your ventilator causes interference in another
device:
If the ventilator causes interference to other devices, follow the
instructions below:
•turn the antenna on the affected device (e.g. radio, television,
cordless phone)
•move the device away from the ventilator
•connect the equipment to an outlet which is on a different circuit
from the affected device
•consult the dealer or an experienced radio/TV technician for help
Software Errors
The manufacturer has sought to minimize the risks posed by software
errors in a number of ways. The measures taken include the use of external
watchdog circuitry that verifies the operation of the software, a redundant
timebase, and multiple response circuits. Ongoing confidence testing is
also employed to limit the effect of errors.
November 2003 2-3
Overview Achieva Ventilator Clinician’s Manual
General warnings and cautions
The following warnings and cautions apply whenever the ventilator is in
use.
Warnings
Not to be used in an explosive atmosphere.
Do not use Achieva ventilators with flammable
anesthetic agents.
Anything that damages the ventilator may cause
potential danger to the patient.
Electric shock hazard. Do not operate the ventilator
without the covers and panels in place.
Do not cover or otherwise hinder the flow of air
around the ventilator.
Do not use in direct sunlight, in accordance with
EN794-2.
Use only Puritan Bennett-approved accessories
with Achieva ventilators. Use of other accessories
may be hazardous to the patient.
Cautions
Do not service Achieva ventilators. Refer all servicing
to qualified personnel.
To avoid a fire hazard, always use the same type and
rating of fuses as were originally supplied.
If the ventilator fails
The caregiver and, where appropriate, the patient must be trained to
respond to ventilator failure. Refer to the Alarms and Troubleshooting
chapters in this manual for detailed information.
2-4 November 2003
Achieva Ventilator Clinician’s Manual Overview
Warning
Any device is subject to unpredictable failures. To
ensure patient safety, an appropriately trained
caregiver must monitor ventilation. If the patient’s
condition warrants the use of an independent
secondary alarm or another external monitoring
device, the physician must prescribe it. The
physician must also determine to what level the
patient may require an alternate means of
ventilation in the event of ventilator failure.
November 2003 2-5
Overview Achieva Ventilator Clinician’s Manual
2-6 November 2003
Achieva Ventilator Clinician’s Manual Description
Chapter 3: Description
This chapter gives the intended uses and contra-indications for Achieva
ventilators. It describes the features, controls, and labels on the ventilator.
Some of the accessories used with Achieva ventilators are also described.
Intended use
This device is intended to provide ventilatory support for pediatric and
adult patients who require positive pressure mechanical ventilation
(pediatric patients should weigh no less than 5kg {11 lbs.}). This device is
for use in home, institutional, and portable settings.
Contra-indications
Achieva ventilators are not intended for the delivery of anesthetic gases.
Do not use or store in the presence of strong electromagnetic fields such as
those surrounding MRI equipment.
November 2003 3-1
Description Achieva Ventilator Clinician’s Manual
Front panels
A
B
C
G
F
E
D
A Top panel
B Controls and display
C Door label
D Patient pressure port
Top panel
A
B
E Patient air port
F Exhalation valve port
G Patient pressure meter
C
A ALARM (ALERT) LIGHTS
The ventilator’s lights will flash when an alarm condition is
D
G
F
E
3-2 November 2003
Achieva Ventilator Clinician’s Manual Description
detected. The lights are turned off when the alarm condition is
corrected and the Alarm Silence/Reset () switch is pressed.
See Chapter 6: Alarms and alerts for more details.
Achieva ventilators are equipped with the following alarm lights:
Low Pressure/Apnea ()
High Pressure ()
Setting Error ()
Power Switchover ()
Low Power ()
O2 Fail () (Only on Achieva PSO2)
Note
For the Achieva and Achieva PS models, which do not have the oxygen
function, the O2 alarm light position is present, but it has no light or
label.
B POWER LIGHTS
The power lights indicate which electrical source the ventilator is
currently using and if the internal battery is being charged. The
power lights include:
AC ()
External Battery ()
Internal Battery ()
Battery Charging ()
C Alarm Control () Light
The Alarm Control () light flashes when the audible alarm has
been presilenced. The Alarm Control
continuously when the non-latching audible alarm feature is active.
See Latching and non-latching on page 6-5.
() light will light
D Assist/Spontaneous () Light
This LED lights when the patient’s inspiratory effort is greater than
the sensitivity setting, or when the flow and pressure sensors detect
a change greater than the flow sensor or pressure trigger setting.
This is usually an indication of patient effort.
November 2003 3-3
Description Achieva Ventilator Clinician’s Manual
E The Patient Pressure Meter shows the level of pressure which is
currently in the patient circuit. When the Test Battery ( )
switch is pressed, the patient pressure meter shows the charge level
of the battery currently in use. In some fast-cycle situations the
meter reading may not reflect the actual pressure. When precise
pressure readings are required, reference the actual values on the
display screen.
F Test Battery ( )
When the Test Battery ( ) switch is pressed, the meter
shows the charge level of the battery currently in use. The test battery switch is also used to activate the ventilator’s printer output.
See Printing reports from the ventilator on page A-1.
G Alarm Silence/Reset ()
The Alarm Silence/Reset () switch silences the audible
alarm during an alarm condition. The Alarm Silence/Reset
() switch can be used to presilence the audible alarm for a
period of 60 seconds. If an alarm condition occurs while the 60 second presilence period is in effect, or while Alarm Silence/Reset is
active, the LCD will display the alarm condition. This switch can
also be used to reset an alarm after the alarm condition has been corrected.
3-4 November 2003
Achieva Ventilator Clinician’s Manual Description
Controls and display
Ventilator
Ventilation mode and
parameter controls
controls
Alphanumeric
display
Ventilation mode and
parameter controls
SIMV 1000 1.5 60
15 20 20 10 60 1:1.7 98
The control-display panel consists of:
• an alphanumeric display showing the set or current actual values of
operating parameters and ventilator information.
• push-button switches that the operator uses to make selections.
The control-display panel is located behind the ventilator’s front door
panel. After beginning a ventilating mode, the display panel shows the set
values for ten seconds and then displays the actual values for each
parameter. The set value also appears for ten seconds after the value of a
setting is changed or the Start/Enter switch is pressed. Certain
parameters, such as the low pressure and high pressure alarm settings, do
not have an actual value. For these dashes (---) are displayed instead.
Following is a description of the switches’ functions. For further details see
Operating the controls on page 4-21.
Standby ()
Use the Standby () switch to place the ventilator in the standby
mode, a state where air is not being delivered.
Ventilate ()
Use the Ventilate () switch to deliver air to the patient.
November 2003 3-5
Description Achieva Ventilator Clinician’s Manual
MENU/ESC
The MENU/ESC switch activates the menu options on the ventilator’s
display.
Up and Down arrow keys
The up and down arrow keys operate in three ways:
•When a ventilation parameter is flashing, use the up/down keys
to scroll to the required setting.
•When the MENU/ESC button has been pushed, use the up/down
keys to scroll to the required menu.
•Pressing the up/down keys when neither a menu nor a parameter
is active will cause the last alarm message to be displayed.
Start/Enter ()
When the ventilator is in Standby, pressing the Start/Enter ()
switch will activate the display. Start/Enter () switch is also
used to accept the currently flashing parameter as the new setting.
MODE
The MODE section of the display screen shows the current ventilation
mode setting. Pressing the MODE switch causes the current mode on
the display to flash and allows the ventilation mode to be changed.
Volume (V
The Volume (V
volume of air that is to be delivered to the patient’s lungs during volume breaths. Pressing the Volume
value of the volume setting to flash and allows it to be changed.
Inspiratory Time (T
The Inspiratory Time (T
length of time it takes the ventilator to deliver the volume and pres-
sure control breaths to the patient. Pressing the
switch causes the current set value of inspiratory time to flash and
allows it to be changed.
)
t
) section of the display screen shows the set or actual
t
(Vt) switch causes the current set
)
i
) section of the display screen shows the
i
Inspiratory Time (T
)
i
3-6 November 2003
Achieva Ventilator Clinician’s Manual Description
Flow ()
The Flow () section of the display shows the average air flow deliv-
ered to the patient. This calculated value is given in liters/minute.
Sensitivity (SENS.)
The Sensitivity (SENS.) section of the display screen shows the amount
of flow generated by the patient that will trigger an assisted breath.
Pressing the
sensitivity to flash and allows it to be changed.
Sensitivity (SENS.) switch causes the current set value for
Note
Sensitivity
The letters
breath cycles are initiated by the patient ( F standing for Flow, P for
Pressure) or by the ventilator ( M for Machine breath).
When using PEEP, use the pressure trigger along with sensitivity (Flow
Trigger). The pressure trigger setting can be accessed and changed as a
menu option. See Pressure trigger on page 5-5.
(F, P, or M)
F, P, or M on the alphanumeric display indicate whether
Breath Rate (f)
The Breath Rate (f) section of the display screen shows the rate at
which volume and pressure control breaths are delivered.( After entering Spontaneous mode, use the up and down arrows to select “Y” or
“N” in the alphanumeric display to activate or deactivate the auto-
matic apnea back-up rate). Pressing the Breath Rate (f) switch causes
the current set value for breath rate to flash and allows it to be
changed.
Pressure (P)
The Pressure (P) section of the display shows the pressure level maintained during either a pressure supported breath or a pressure con-
trolled breath. Pressing the Pressure (P) switch causes the current set
value for pressure to flash and allows it to be changed.
PEEP
The PEEP (Positive End Expiratory Pressure) section of the display
screen shows the pressure maintained at the end of a delivered breath.
Pressing the
allows it to be changed. You should consider setting the pressure trigger when using PEEP. This allows the patient to initiate either an
November 2003 3-7
PEEP switch causes the current PEEP setting to flash and
Description Achieva Ventilator Clinician’s Manual
assisted or supported breath. The pressure trigger will function relative to the PEEP setting baseline. When using PEEP, use the pressure
trigger along with sensitivity (Flow Trigger). The pressure trigger setting can be accessed and changed as a menu option. See Pressure trig-
ger on page 5-5.
Low Pressure ()
The Low Pressure () limit section of the display shows the mini-
mal pressure limit that must be exceeded to prevent a Low Pressure
alarm. The Low Pressure alarm sounds after two consecutive cycles
below the low pressure limit. The Low Pressure alarm sounds for a valley alarm after two consecutive breath cycles that do not fall below the
low pressure limit. See Valley Pressure Alarm on page 6-6. Pressing
the Low Pressure () switch causes the current low pressure limit
setting to flash and allows it to be changed. When adjusting the Pres-
sure (P) setting, the Low Pressure () will adjust automatically to
at least 1 cmH2O above the PEEP setting.
Note
Some circuit components will prevent a Low Pressure alarm by keeping
the pressure in the circuit above the alarm limit. Examples of these components include hydrated heat and moisture exchangers (HMEs) and tracheostomy tubes. If the patient circuit is disconnected from the patient, but
still connected to these components, a Low Pressure/Apnea () alarm
may not sound. See Setting the low pressure alarm on page 4-26.
High Pressure ()
The High Pressure () section of the display shows the highest
pressure the ventilator will allow without sounding the High Pressure
alarm. Pressing the
high pressure limit setting to flash and allows it to be changed.
I/E Ratio (I/E)
The I/E Ratio (I/E) display shows the ratio of inspiratory to expiratory time. Achieva ventilators permit a range of inspiratory times from
0.2 seconds to 5.0 seconds. The I:E ratio is calculated according to the
formula:
I:E Ratio = (1/(Breath Rate) - (Inspiratory Time)) / (Inspiratory Time)
High Pressure () switch causes the current
3-8 November 2003
Achieva Ventilator Clinician’s Manual Description
FIO
(O
%) (Only on Achieva PSO
2
2
The FIO
the FIO
(O
%) display shows the set enriched oxygen level. Pressing
2
2
(O
%) switch causes the current setting to flash and allows it
2
2
)
2
to be changed. A setting of over 21 will activate the internal O
blender.
2
Note
For the Achieva and Achieva PS models that do not have the oxygen function, the F
switch is present, but it has no label and is inoperative.
IO2
November 2003 3-9
Description Achieva Ventilator Clinician’s Manual
Back and sides
A
J
I
H
A Inlet filter
Filters air as it enters the ventilator.
G
F
E
D
C
B
B Power cord connector
C External battery connector
Used for connecting an external battery.
D Side rails
Used for mounting some accessories on the ventilator.
E Audible alarm port (on side of ventilator)
DO NOT BLOCK.
F Communications connector
This connector is used to connect a printer, external modem or a
computer (with the Achieva Report Generator software) directly to
the ventilator. Follow the accessory manufacturer’s connection
instructions for the appropriate connection procedure.
G Nurse call output
The ventilator can be connected to nurse call stations through this
output. See Connecting to a nurse call system on page 4-19.
3-10 November 2003
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