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