UAM VENTILATORQUICK SET UP GUIDE

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Setting Up the Ventilator

preparing the UaM and the Ventilator

1. EnsurethatequipmentsuchastheventilatorandthepatientmonitoraresecurelyattachedtothetopshelfoftheUAM

2. Ensurethatallcablesandsamplelinesarecorrectlyattached–refertothemanualofeachindividualmanufacturer.

3. Connecttheseessentialitems: a.PatientCircuitwithYpiece. b.VentilatortoUAMusingtheventilatordrivehose. c.VentilatorpatientflowsensorbetweenthepatientYpieceandthe

bacteriafilter. d.Ventilatorpatientflowsensorsamplelinesatrearofventilator e.Patientbacterialfiltertopreventflowsensorcontamination f.Theatreanaestheticgasscavengingsystem

Ventilator ConneCtionS

1. Flowsensorconnection–Thepatientinspiredandexpiredgasismeasuredwithavariableorificeflowsensor.

a.Distaltopatient–Thecleartubeisconnectedfurthestfromthepatient. b.Proximaltopatient–bluetube.Thebluetubeisconnectedclosestto

thepatient.

note: Abreathingcircuitfiltermustbeusedtopreventcontamination.

2. Bellowsconnection–17mmmaletaperthatisattachedtotheUAManaesthesiamachineusinga15mmx1.5mblackcorrugatedbreathinghose.

3. Mainspowerinletsocket-IECpowercable.

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perforMing the pre-USe CheCkS

1. Checktheventilatorforlabelingtoindicateifthemachinehasanyfaultsorneedstobeserviced

2. Checkforvisiblesignsofdamage.3. Checkthecorrectconnectionofthepatientcircuitandanyauxiliary

equipmentsuchaspatientmonitoringequipment,gasscavengeretc.4. Performapatientcircuitleakcheck: a.Withthepatientcircuitconnectedcheckthatallconnectionsaresecure

andalltubesusedareingoodcondition. b.WiththeUAManaesthesiamachineinmanualbellowsmodeblock

thepatientYpieceandensurethatthemanualbellowsontheUAManaesthesiamachinecangenerate30cmH2Oormorepressurewhenthebellowsispusheddownwithoutthebellowsdescendingduetoaleak.

iSolating the hand BellowS

Pushthelevertothereartoisolatethehandbellowsandpullitforwardwhenthehandbellowsisinuse.

TheManualBellowsIsolatorleverisolatestheHandbellowsfromthebreathingcircuitwhentheventilatorisbeingused.

tUrning the Ventilator on

ToturntheventilatoronpresstheOn/Offpushbuttonfor1second.

Start Up Self teSt

Ifthepatientcircuitwasconnectedtoapatientoratestlung,theventilatorwillalertyoutoremovetheYpieceandpresstorepeattests.

Whentheventilatorturnsonitwillperformaseriesofself-testsandthebellowswillmoveupanddown.Thescreenwillbeblankatthistime.

note: Duringthesetests,thebreathingcircuitmustbedisconnectedfromthepatient.

MAInsInDICATOrYellow:MainsappliedGreen:VentilatorOn

On/OFFpushbutton

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patient SeleCt SCreen

Oncetheself-testsareoverthepatientselectscreenwillappear.

Thepatientselectscreenallowstheusertochoosepatientventilatorsettingsbyweight–3kg,10kg,25kg,50kg,70kgand100kgorbyselectingoneof6user-definedsettings.

Connect,pulseoximeterprobe,nIBPcuffandECGleadsforpatientmonitoring.

Patientselectscreenwithbodyweightsettingfor50Kgselected.notethattheselectedkeyisnowblackandthattheventilatorsettingsforthisweightaredisplayedonthelefthandside

Starting the Ventilator

Observethatnoalarmsareindicatedinthealarmsdialoguebox–thisindicatesthattherearenosystemerrors,includingmainspower,batteryfailures.Thealarmsaredisableduntiltheventilatorisswitchedtothe“start”screenallowingtheventilatortobeturnedonwithoutnuisancealarms.

Oncetheuserhaschosentheinitialsettingstheactualsettingscanbeadjustedasrequiredpriortostartingtoventilate.Ifthesettingsaretotheuserssatisfaction,pressingthegreen“startCase”buttonshownonthelowerlefthandsideofthedisplaywillstarttheventilator.

Patientsettingsaredisplayedinthe“sET”columnontherighthandsideverticalcolumn.Thesesettingscanbeadjustedbeforeorduringacase.Allfunctionsrequire“OK”tobepressedtoconfirmthesettingchange.IfthesettingchangeismadeandtheOKbuttonisnotpressedthescreenwilltimeoutandstayattheoriginalsetting.

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adJUSting patient SettingS

Patientsettingsaredisplayedinthe“sET”columnontherighthandsideverticalcolumn.Thesesettingscanbeadjustedbeforeorduringacase.Allfunctionsrequire“OK”tobepressedtoconfirmthesettingchange.IfthesettingchangeismadeandtheOKbuttonisnotpressedhescreenwilltimeoutandstayattheoriginalsetting.

MinUte VolUMe

Minutevolumeisadjustablebetween0.6and12litersperminute.

PresstheVmL/minkeytoopenthekeypad.Eithertogglethesetvalueupordownwiththe(+)or(-)keysortypeinthenewvaluethenpress“OK”toconfirmandthen“EXIT”orwaitforthekeypadtotimeout

note: Thecancelkeycanbeusedtoreturnthesettingtoitsoriginalvalue.

tidal VolUMe

Tidalvolumeisadjustablebetween50and1000ml.PresstheVTmlkeytocalloutthekeypad.

Eithertogglethesetvalueupordownwiththe(+)or(-)keysortypeinthenewvaluethenpress“OK”toconfirmandthen“EXIT”orwaitforthekeypadtotimeout.

note: Thecancelkeycanbeusedtoreturnthesettingtoitsoriginalvalue.

preSSUre liMit

PressureLimitisadjustablebetween10and50cmH20.

TargetPressureisadjustablebetween10and30cmH20.

Both“Limit”and“Target”pressuresareadjustable.ThedisplayedkeyinthesetcolumnisdependentonwhethertheventilatorisinVolumeorPressuremode.

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Thecalloutkeypaddefaultstotherelevantalarmleveltypeforthemodethathasbeenselected.

TheTargetPressurealarmisrelevantonlytopressuremodeandthePressureLimitonlytovolumemode.notethatthepressurelimitisautomaticallyadjustedto10CmH2Oabovepeakpressureduringventilationafter3breathstomaintainpatientsafety.

PressthePlimcmH20orthePtargcmH2Okeytocalloutthekeypad.Eithertogglethesetvalueupordownwiththe+or-keysortypeinthenewvaluethenpressOKtoconfirmandthenEXITorwaitforthekeypadtotimeout.

note: Thecancelkeycanbeusedtoreturnthesettingtoitsoriginalvalue.

BreathS per MinUte (BpM)

TheBreathsperminute,orrespiratoryrate,canbeadjustedbetween4and40breathsperminute.

Pressthe“rateBPM”keytocalloutthekeypad.Eithertogglethesetvalueupordownwiththe(+)or(-)keysortypeinthenewvaluethenpress“OK”toconfirmandthen“EXIT”orwaitforthekeypadtotimeout.

note: Thecancelkeycanbeusedtoreturnthesettingtoitsoriginalvalue.

i:e ratio

TheI:Eratiocanbeadjustedbetween1:1to1:3andanyvalueinbetween.

Pressthe“I:Eratio”keytocalloutthekeypad.Eithertogglethesetvalueupordownwiththe(+)or(-)keys,typeinthenewvalueorchooseapresetvaluedisplayedonthetoprow,thenpress“OK”toconfirmandthen“EXIT”orwaitforthekeypadtotimeout.

note: Thecancelkeycanbeusedtoreturnthesettingtoitsoriginalvalue.

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SeleCting Ventilator ModeS

Thefollowingventilationmodesareavailable:

• VolumeControlledVentilation(VCV)-deliveryofthesettidalorminutevolumeataflowdeterminedbythesetinspirationtime.Ifthesetvolumeisreachedearlyorthesetpressurelimitisexceededthentheinspirationphasewillendatthattime.

• PressureControlledVentilation(PCV)-settargetpressureisachievedasquicklyaspossibleduringinspiration.Thesettargetpressureismaintainedfortheremaininginspirationtime.

• spontaneous-patientbreatheswithnoassistancefromtheventilator.Theventilatorprovidesmeasurementofvolume,peak,andmeanairwaypressure.Anapneaalarmwillsoundifthepatientstopsbreathing.

Thesemodesareaccessedthroughthehorizontallineofselectbuttonsatthebottomofthescreenandarecolor-codedblue.

VolUMe Mode

Pressthe“Volume”modekeytoselectvolumemode.

preSSUre Mode

Pressthe“Pressure”modekeytoselectpressuremode.

SpontaneoUS Mode

Pressthe“spont”modekeytoselectspontaneousmode.Allmechanicalventilationbytheventilator’sbellowswillcease.Onlyselectthismodeifthepatientcanbreatheunaided.

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Changing Ventilation Mode when Ventilator iS CyCling

Theventilationmodecanbechangedwhilethepatientisbeingventilatedwithoutstoppingventilation.

Achangeofmodemustalwaysbeconfirmedtopreventaccidentalmodechangeduringacase.

Pressthekeyforthenewmoderequired,eg.Ifchangingfromvolumetopressure.Thenewmodeturnswhiteandawhite“ChangeMode”keyappears.

Pressthe“ChangeMode”key.Aconfirmationwindowappears.Press“OK”toconfirmchangetopressuremode.

Setting the VolUMe alarM and the apnea tiMe

ThevolumealarmcanbesetsothatthealarmistriggeredbyameasuredvalueofeitherMinuteVolumeorTidalVolumeoutsidethesetlimits.selectthedesiredalarmformatandpress“EXIT”orwaitforthekeypadtotimeout.

Theapneatimecanbeadjustedbetween1and20secondsbyusingthekeypad.

Thenpress“OK”toconfirmandthen“EXIT”orwaitforthekeypadtotimeout.

InthescreenpicturedtheTidalVolumealarmisselected,theLowAirwayPressurealarmisoffandtheapneaalarmissetto8seconds.Keysfortheselectionsmadeturnwhite.

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Setting the SCreen waVeforMS

Thetopscreenwaveformcanbechangedto:a)Flowvs.Timeb)Volumevs.Timec)Volumevs.Pressured)Flowvs.Pressure

PresstheWaveformkeyfollowedbythekeyforthetypeofwaveformyouwishtouseasthetopwaveform.

note: Thelowerwaveformisalwayspressurevs.time.

Stopping the Ventilator

Attheendofaprocedurepressingthewhite/red“EndCase”buttonshownonthelowerlefthandsidestopstheventilator.Thismustbeconfirmedbypressingthe“OK”buttononthe“EndCase”dialoguebox.

tUrning the Ventilator off

Toturntheventilatoroff,thebuttonmustbepressedfor2seconds,andthentheusermustconfirmthattheventilatorisrequiredtobeshutdownbeforeashutdownsequencewillbeinitiated.Iftheuserdoesnotconfirmtherequirementtoshutdowntheventilatorwillnotentertheshutdownsequence.

Cleaning the Ventilator

Theexternalsurfacesoftheventilatorcanbewipedwithadampclothfollowedbydryingoffpriortoclinicaluse.

note:mildantisepticsolutionsmaybeusedtocleantheventilatorbutmustbewipedoffthoroughlywithwateronadampclothpriortodrying.Caremustbetakentopreventwaterenteringthemachineduringcleaning.

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Cleaning the flow SenSor

Thepatientflowsensorcannotbeautoclavedandshouldbeusedwithapatientfiltertopreventcrosscontamination.Theflowsensorcanbegivenawashwithamilddisinfectantandwarmwateronly.Aftercleaningandairdryingitmustberecalibrated.

note: Cleaningwithalcohol-basedsolutionswilldamagetheflowsensorandresultinunreliableflowmeasurementreadings.

note:ensurethatthesampletubesareclearofwater.

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CaliBrating the patient flow SenSor

note: Thepatientflowsensorrequirescalibrationwhenbeingusedforthefirsttime,periodicallyonceaweek,ifdamageissuspected,andifsetvolumesandpressuresdifferfromthescreenreadings.

1. Disconnecttheventilatordrivehosefromtheventilatorandattachtheredplasticadaptortothe17mmbellowsdrivetaperontherearoftheventilatorbellowsassembly.

2. Connectthepatientflowsensorwiththeflowinthepatientdirection(bluelineclosesttopatient,clearlineclosesttoventilator)tofirstcalibrateintheforwarddirection.

3. Pressthe“FlowCal”button.Thenpress“CalibratePatientFlow”.Press“yes”tostartcalibrationoftheinspiredflow.

4. Whenprompted,turntheflowsensoraroundtocalibratetheexpiredflowandpressthe“continue”button.

5. Whencompletepressexit.

note:Theventilatorwillprompttheusertoputthesensorinthecorrectorientationifconnectedincorrectly

6.AftercalibrationreconnecttheflowsensortothepatientcircuitYpieceandplaceacleanpatientbacterialfilterreadyforthenextcase.reconnecttheventilatordrivehosebetweenthebellows17mmtaperandtheUAManaesthesiamachineventilatorconnector.

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@GradianHealth

Gradian Health Systems, Inc.915 BroadwaySuite 1001New York, NY 10010T +1 212 537 0340 F 212 954 5299

info@gradianhealth.org

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