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NOTE - Frank`s Hospital Workshop

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1. 234 Chapter2 Unpacking amp Setup AVEA Ventilator Systems AVEA Troubleshooting Remove ventilator from patient with any potential problem Symptom Problem Solution s not pass EST Fails Leak cut wye not Tuly occluded Ensure circuit wya s Tully occluded Teak in patient circuit Check for leaks in circuit and reseat circuit connections to ventilator Replace circuit f necessary Fifer carriage not propery seated Remove exhalation cartridge and check condition of connections Reinstall and recheck Replace it Taek aon Replace exhalation diaphragm Wirscr pass EST Fals comicos ORE SEET COTTE 8W propa Tt Gas pressure Too ow Very IGI an gen above psig Dessus Or sensor Replace Sensor IN reading from proximal low sensor Sensor 7 Patient size incompatible See operators manual for correct sensor mode configurations Sensor not connected Ensure sensor properly connected Loose external connection Check external connection Defective sensor Replace sensor Internal fault Call Technical Service Vis Vie when operating without Normal Condition when operating No action required proximal flow sensors on test lung Normal if readings are within No action required if within ventilator accuracy specifications specifica
2. 12786 Operator s Manual vi Notices Copyright Notice Copyright 2005 VIASYS Respiratory Care Inc California This work is protected under Tite 17 ofthe U S Code and is the sole property of the Company No part of this document may be copied or otherwise reproduced or stored in any electronic information retrieval system except as specifically permitted under U S Copyright law without the prior writen consent of the Company For more information contact USA European Authorized Representative VIASYS Respiratory Care Inc VIASYS Healthcare GmbH 22745 Savi Ranch Parkway Leibnizstrasse 7 Yorba Linda Calforia 92887 4645 97204 Hoechberg Telephone 1 800 231 2466 Germany 31714 2832228 Telephone 49 931 4972 0 Fax 1714 283 8471 Fax 49 931 4972 423 www viasyshealthcare com Trademark Notices is a registered trademark of VIASYS Respiratory Care Inc in the U S and some other counties All other brand names and product names mentioned this manual are trademarks registered trademarks or rade names of their respective holders EMC Notice This equipment generates uses and can radiate radiofrequency energy If notinstalled and used in accordance with the instructions in this manual electromagnetic interference may result The equipment as been tested and found to comply with the limits set forth in ENG0601 1 2 for Medical Products These limits provide reasonable protection against electromagnetic interfere
3. 0 2 cm HzO or 45 whichever is greater hol maneuver Requires a passive patent AutoPEEP The difference between away pressure atthe end 0 50emH O 2 cmH or 45 wicheveris greater ofan expiratory hold maneuver and he away pressure at he start ofthe next scheduled breath afer he expiratory hol maneuver Requires a passive patent Auto PEEPes The diference beeen esophageal pressure Ot S0cmii0 2 cm H O or 5 whichever is greater measured atthe end of exhalation PEE Pes minus the esophageal pressure measured at he start ofa patient tiated breath sul and Be sensit ofthe vertlator s demand system The serstiviy ofthe ventis demand system is he difference between he baseline pressure PEEP nu ar he away pressure when te pabentiniiates a breath Paw soel Requires an esophageal balbon Pip Piat Trenspuimanary pressure during an inspratory 6010120 2 or 59 whichever is greater which the diference between the aiway cmo plateau pressure Pru sal and the corespondng esophageal pressure Requires an inspiratory hod and esophageal taloon Po PEEP The diference between the conesponding airway 600120 or 5 whichever greater and esophageal pressures at the end of the rpiary hold during an AutoPEEP maneuver Requires inspiratory hold and esophageal MP The maximum negate away pressure tatis 6010120 1 or SW whichever is greater achi
4. 3 IDENTIFICATION From the Setup screen press the EST button message will appear instructing you to remove the patient and block the patient wye After confirming that the patientis disconnected and the circuit wye blocked press Continue Cont The ventilator begins the EST and displays a countdown clock During the EST the ventilator will perform A Patient circuitleak test Patient circuit compliance measurement A two point calibration ofthe oxygen sensor The patent circuit compliance measurement and leak test are performed simultaneously wit the oxygen sensor calibration The maximum time for the EST is 90 seconds To restartthe EST atany time press Cancel to return to the setup screen After each testis complete the ventilator will display Passed or Failed message next to the corresponding test The SET UP ACCEPT key must be pressed in order for the AVEA to retain the circuit compliance measurement Atthis point even after power cycling of if SAME PT is selected circuit compliance measurement will Continue to be retained If NEW PT is selected the EST will be required to use this feature HUMIDIFIER REMOVE THE PATIENT BLOCK PATIENT CIRCUIT WYE EXTENDED SYSTEM TEST PASSED Circuit Compliance Test PASSED Calibration IN PROGRESS Leak Test Figure 3 8 Extended Systems Test Screens Once the testis complete press Continue to retum to the setup screen
5. Table 33 Primary Breath Controls Displayed Description Range Accuracy Control tom rate shown in Breaths 11 150bpm eo Pedati 1 bpm Rate per Minute 100120 bpm Ait mi Tisi Volume n milites 10301 250L 02 ni 10 of seing Volume 25050 ml Pediatic 20 to 300 ml Neonate emi Inspiratory Pressurein Oto 90 AGULPedatic 3 cmH 0 ors 10 whichever is greater Insp Pres _ceflimetrs of water pressure gg cmH O Neonate Lmin Peakinspiratory Flowin Lie 3t 150 Lmin Adut 10s of sting or 02 Limin 10 of Peak Flow per Minute Seting whichever is greater 0A to 300 Limin Neonate sec Inspiratory Time in Seconds 020m 5 00 sec 20056 InspTime Vi etic 015 300 sec Neonat sec Sets an inspiratory pause which 00 30sec 2005 Insp Pause wil bein effect for each Volume breath delivered CHO Pressure Supportin centimeters Oto 90 crnH O AduNPedatc s 3 cO ors 10 whichever is greater PSV ofwater pressure 0 t 80 ci Neonat Wm pressure O to 50 cmH O 4 2 emi or 5 of seting whichever is PEEP in centimeters of water pressure imn Se inspatary Tow tigger O1 1200 Lmin 10 20 Lin for PEEP lt 30 cm 20 30Lnin for PEEP gt 30 cm 2 02 10 of seting Wye ow Sensoren Convo the percentage of 21 100 2360 0 oxygen in he delvered gas In APRV BIPHASIC made Oto 90cm H 0 EE Pres High the baseine pressure achieved during Time High sec I
6. Remote Nurse Call The ventilator has a modular jack configured to interface with external systems that are either wired for normally open N 0 close on alarm or normally closed N C open on alarm signals In the active state the remote alarm can sink 1 0 A 12786 Operator s Manual Appendix B_ Specifications 5 Video Output The ventilator provides a video output connector which allows for interfacing to an externally located 256 color 800 x 600 SVGA monitor Atmospheric amp Environmental Specifications Temperature and Humidity Storage Temperature 20 to 60 C 4 1402F Humidity 000 95 RH non condensing Operating Temperature 5 to 408C 41 to 1042F Humidity Oto 95 RH non condensing Barometric Pressure 760 to 545 mmHg Physical Dimensions Overall Size Ventilator 17 W x 16 D x 10 5 H or 43 2 cm X 40 6 cm X 26 7 cm 16 25 W 2 5 0 x 13 75 H 41 3 cm X 6 4 cm X 34 9 cm Weight Ventilator w UIM no compressor lt 73 lbs 33 1 kg Ventilator w UIM and Compressor lt 80 Ibs 363 kg 12786 B 6 Appendix B Specifications AVEA Ventilator Systems Accessories Pall Microbial Filter Resistance The exhalation fiter supplied with your AVEA ventilator is manufactured by Pall Medical of Ann Arbor MI USA The published maximum resistance of this fiter is 4 20 at 100 L min for the 725 fiter Compliance The compliance for the filter is lt 0 4 0 Materials
7. Circuit Compatibility nCPAP utilizes standard two limbed neonate patient circuits and nasal prongs for the patient interface The following nasal CPAP prongs have been approved for use HUDSON Infant Nasal CPAP Cannula Sizes 0 through 4 Hudson RCI Research Triangle NC INCA Infant Nasal Cannula Sizes 7 5F 9F 105F 12F 15F CooperSurgical Inc Trumbull CONN NEOTECH Binasal Sizes 3 0 mm 3 5 mm 4 0 mm NEOTECH Products Inc Valencia CA ARGYLE Infant Nasal Cannuia Sizes Extra small Small Large Sherwood Medical St Louis MO General Specifications nCPAP Level Rame 2to 10 cmH 0 Resolution 1 emis Defaut 2emH 0 Accuracy 2cmH 0 nCPAP Flow Flow delivery is under software control and limited to a maximum of 15LPM Advanced Settings There are no advanced settings for the primary setings in Nasal CPAP 12786 5 2 Chapter Infant NCPAP AVEA Ventilator Systems Alarms The Alarms Settings Screen does nat open in Nasal CPAP Existing machine alarms and safety systems will be maintained During nCPAP support certain alarms will be suspended Alarms suspended during nCPAP Time Based Alarms Volume Based Alarms Pressure Alarms High Rate High Ve High Time Limit High Vt High Ppeak sustained LE Limit Low Vte Low PEEP Apnea Interval Low Ve Low Volume Limit Occlusion Alarms added during High nCPAP Pressure A
8. 2cmH20 or 5 whichever is greater Note Requires an inspiratory hold and an esophageal catheter 12786 Appendix Advanced Pulmonary Mechanics Monitored Parameters AVEA Ventilator Systems Transpulmonary Pressure AutoPEEP Py PEEP Transpulmonary pressure AutoPEEP the difference between the corresponding airway and esophageal pressures atthe end of the expiratory hold during an AutoPEEP maneuver PyPEEP Pan Pes atthe end of an expiratory hold Range 60 to 120 cm Resolution 1 cmH 0 Accuracy 2 cmH 0 or 5 whichever is greater Note Requires an expiratory hold and an esophageal catheter Maximum Inspiratory Pressure MIP Maximum Inspiratory Pressure the maximum negative airway pressure that is achieved by the patient during an expiratory hold maneuver Range 60 to 120 Resolution 1 cmH 0 Accuracy 2cmH20 or 5 whichever is greater Respiratory Drive Pin Respiratory Drive Pin the negative pressure that occurs 100 ms after an inspiratory effort has been detecte Pus P 1o PEEPaw Range 60 to 120 Resolution 1 cmH 0 Accuracy 2cmH20 or 5 whichever is greater 12786 Operator s Manual Appendix H Advanced Pulmonary Mechanics Monitored Parameters H 7 Ventilator Work of Breathing WOBv Ventilator Work of Breathing WOB is defined as the summation of airway pressure Paw minus the baseline pressure PEEPa t
9. Adult Circuitusing an Active Humidifier Using an active humidifer the adult patient setup as shown in figure 2 10 Attach your humidifier to the upright pole of the AVEA base Adjust the height of the humidifier and the length of the humidifier tubing so thatthe tubing is relatively straight with no occlusions imb of Patent Circuit Figure 2 10 Adult Circuit with Active Humidifier Adult Circuit without active humidifier The setup for use with a passive humidifier or HME is per figure 2 1 The inspiratory mb of the patent circuit connects directly to the gas output ofthe ventilator The passive humidification system should be placed in line in the patent circuit per the manufacturers instructions of Patient Circut Figure 2 11 Adult Patient Circuit without active humidifier 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 7 Neonatal Patient Circuit The Neonatal Patient Circuitis attached as shown in figure 2 12 Inspiratory Limb of Patient Figure 2 12 Neonatal Patient Circuit Front Panel Connections Standard Comprehensive Figure 2 13 AVEA Front Panel Configurations Standard amp Comprehensive 12786 28 Chapter2 Unpacking amp Setup AVEA Ventilator Systems Attaching Flow Sensors The AVEA can accept ei
10. Option Included Heliox Delivery Option Included 12 Chapterl Introduction AVEA Ventilator Systems Some AVEA Features Artificial Airway Compensation When Artificial Airway Compensation is turned on the ventilator automatically calculates the pressure drop across the endotracheal tube then adjusts the airway pressure to deliver the set inspiratory pressure to the distal carina end of the endotracheal tube This calculation takes into account low gas composition Heliox or Ntrogen Oxygen Fraction of Inspired Oxygen 02 tube diameter length and pharyngeal curvature based on patient size Neonatal Pediatric dui This compensation only occurs during inspiration Artificial Airway Compensation active in all Pressure Support and Flow Cycled Pressure Control Breaths WARNING Activating of Artificial Airway Compensation while ventilating patient will cause a sudden increase in the peak airway pressures and a resultant increase in tidal volume If you choose to activate Artificial Airway Compensation while the patient is attached to the ventilator you will need to exercise caution to risk of excessive tidal volume delivery Note Monitored airway pressures inspiratory wll be higher than set values when Artficial Airway Compensation is active With an inspiratory pressure setting of zero Arfiial Airway Compensation wil stil provide an elevated airway pressure which w
11. Tow plus pause time which i 5 0 seconds for adulipediatic patients and 3 0 seconds ior neonatal patens TEUMT The inspiratory expiratory ratio for a mandatory breath Notacive in APAV BIPHASIC Low exceeds 41 The Inspiratory phase ofthe breath is mode terminated LOW Fio Delivered oxygen percentage fals below the set FiOzminus NIA 6 or 18 Fn whichever is greater HIGH FO Delivered oxygen percentage fes above te set FiOz pus 6 NIA High Rc A high prot audiblehisual alam activated and CIRCUIT High DISCONNECT DISCONNECT displayed whenever the patient creut becomes disconnected Fom the ventilator or patient LOW BATTERY A high priorty audibiehisual alarm is activated and LOW BATTERY displayed whenever the intemal battery has been toa level at provides a minimum of two minutes of sae operation LOSS AC A high prorty audbevsusl alam is and LOSS AC NA 12786 6 13 Operator s Manual Chapter Alarms and indicators Message Alarm Condition Range Priority POWER POWER deplayed whenever he power swich on and AC pouer has been removed from the ventlator ie power cord isconnector loss of supply power iv igh priory aude visual alarm is acivated and LV NA High DISCONNECT DISCONNECT displayed whenever the master ventilator Becomes disconnected fom the slave ventlator during ILV TIMVALIDGASID A medium proriy be activated and NA Medium INVALID GAS LD sh
12. 3 14 Chapter3 Ventilator Operation Ventilator Systems Note ifthe ventilator is NOT connected to an oxygen supply the 02 Sensor Calibration wil immediately fail CAUTION Although failure of any of the above tests will not prevent the ventilator from functioning it should be checked to make sure itis operating correctly before use on a patient Setting the Ventilation Breath Type and Mode To access the Mode selection options press the Mode membrane button to the left of the LCD screen MODE SELECT 3 Pressure E MODE SELECT Cac Wc j we sin sv Figure 3 10 Infant Mode Select Screen The choices displayed in the Mode Select screen are a combination of breath type and ventilation delivery mode e g a Volume limited breath with Assist Control ventilation is shown as Volume A C APNEA Backup ventilation choices appear when CPAP PSV or APRV BIPHASIC mode is selected Apnea Backup is active in all Assist Control SIMV BIPHASIC and CPAP PSV modes 12786 Operator s Manual Chapter3 Ventilator Operation 3 15 Note When CPAPIPSV or APRV BIPHASIC Airway Pressure Release Ventilation selected you MUST l Setthe primary and advanced settings for CPAP PSV or APRV BIPHASIC 2 Selectthe breath type for APNEA backup mode by pressing the Apnea Settings key Setthe primary and advanced controls visible atthe bottom of the touch screen for the selecte
13. EKE SETTINGS verc Venersen vol rise Fim se eve volimi PSV PSV gee are Sov Waveform insp rise PSVTmay PSV Basow PSV rise MODE Wavetrm Vol Lmt Fi B sfow Tmax Prestig PSV Bastou PSV Prestig Bias fon Prestig Bias Pres tig Pres tig Volimt PSVTmar Flow T High Bias fou Pres tig Cycle syne Bis fou Pres t Bis fov Pres ig Fow Pres tig D Tlow Demand Demand Sc Fou Flow oy wih Vsync acted for adut pediatre patenis ory for aut and pediatric patients oniy 12786 Operator s Manual Chapter3 Ventilator Operation 3 39 Advanced Settings Characteristics and Ranges 12786 Volume Limit Vol Limit The Vol Limit setting sets the volume limit for a Pressure Limited breath When the volume delivered to the patient meets or exceeds the preset Vol Limit the inspiratory phase of he breath is terminated Range Normal 01002501 Adut 25 to 150 Pediatric 2 0 to 300 0 ml Neonate Defaults 2501 Adult 500 ml Pediatric 300 mi Neonate The Vol Limit setting sets the volume limit for a Pressure limited breath When the volume delivered to the patient meets or exceeds the preset Vol Limit the inspiratory phase of the breath is terminated Volume Linitis active for Pressure PRVC Vsync TCP L and PSV breaths only In n
14. Some alarms may be bled during a maneuver 12786 Operator s Manual Chapter 4 Monitors Displays and Maneuvers 47 Esophageal Maneuver Screen Controls PHAGEAL BALI Pediatric Size MANEUVER 573 Selecting Balloon Size and Type Upon connection of the Balloon Extension Tubing the ventilator wil display the Esophageal Balloon Size and dialogue box You must select the size and type of balloon you intend to use before you wil be able to conduct the Balloon Test Note Disconnecting the Balloon Extension Tubing wil require you to select balloon size and type and repeat the balloon test procedure In order to change balloon size or type you must disconnect and re connect the balloon extension tubing to open the Esophageal Balloon Size and Type dialogue box Selecting balloon size and type other than the one to be used can resultin failure ofthe balloon test Balloon Leak Size Test The Balloon Test verifies the integrity and size of the balloon catheter The ventilator wil display a Pass or Fail message in the message bar atthe bottom of the screen Ifthe Balloon Testis not passed all connections should be checked to assure they are secure and balloon integrity should be evaluated Note The Balloon Test must be performed without the balloon in the patient 12786 48 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Balloon Fill S
15. Te HE Trspratorfepiatory ato Rapid shal breathing index t mito Peak inspiratory pressure Peak 12786 4 22 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Display Value Mean inspiratory pressure Prea Plateau pressure Polat Postiveend expiratory pressure PEEP psig Airinetpressure Air inlet psig Oxygeninetpressure Os Inlet Percentage af oxygen Dynamic conplance mlcmH O Dynamic compliance adjusted for patent weight Respiratory system canplance Static compliance stt THmHO Respiratory system comglance adjusted for patent weight Staic complance Cstatkg FN Shalow Breathing Index wich the spontaneous breath rate per ital volume 0 Respiratory system resistance Res min Peak Inspratory fow rate PER min Peak te PEFR Cac Ratio ofthe dynamic compliance during the ast 20 of inspiration C21 to he al compliance CI Chest wal Compliance Cex the rato ofthe ital volume exhaled to the Deta Esophageal Pressure GPs Cume Lung Conplance nel he rao of he Gal volume exale to the dea trans pulmonary pressure 3 Respiratory System Resistance Ras s he tal resistance during the inspiratory phase ofa best Wm Peak Expiratory Resistance reu defined as the r
16. Ventilator Systems Apnea Ventilation in APRV BiPhasic Apnea ventilation is available in BiPhasic ifthe patient does not initiate a spontaneous effort or the ventilator does nottime cycle between pressure levels before the apnea interval has elapsed the ventlator wil alarm for apnea and begin apnea ventilation at the apnea ventilation settings A spontaneous effort from the patient or a transition in baseline pressure wil reset the apnea alarm and timer and retum the ventilator to APRV BiPhasic venation irway Pressure Release Ventilation BIPHASIC Time High Pressure High 9 o o H jo Oo Time Low Pressure Low Time Demand Breath Spontaneous Breath triggers change to Pressure High Spontaneous Breath triggers change to Pressure Low Figure 3 14 BIPHASIC Mode 12786 Operator s Manual Chapter3 Ventilator Operation 3 23 12786 Continuous Positive Airway Pressure CPAP Pressure Support Ventilation PSV O Demand Breath Figure 3 15 CPAP Wavetorm In CPAP PSV mode all breaths are patient inated demand breaths unless the MANUAL BREATH key is pressed or apnea backup ventilation is activated When the MANUAL BREATH key is pressed a single breath is delivered atthe currenty selected apnea backup control settings Pressure Supportis active in CPAP mode see Demand Breaths in this Chapter CAUTION When CPAP PSV is selected
17. WARNING Ensure that the mains power cord is unplugged before attempting to remove or replaces fuses To replace mains electrical fuses refer to figures 6 3 through 6 7 and do the folowing 1 Unplug the ventilator from the mains AC power source and unplug the power cord from the power entry module onthe rear of the ventilator 2 Using a small fat blade screwdriver pry open the cover of the power entry module Carefully ease the red fuse holder out of the power entry module 4 The fuse holder contains two identical fuses either 3 LAmp for for 100 120 volt ines or 2 0 Amp for 230240 volt lines as shown in table 6 1 5 Replace the failed fuse in the fuse holder with a fuse whose type voltage rating and current rating is identical to the fuses supplied from the factory 6 Carefully replace the red fuse holder into the power entry module Check to ensure that the correct line voltage is uppermost as you re insert the fuse holder into the power entry module 7 Close the power entry module cover and check to make sure thatthe correct voltage is displayed through the window 7 8 Chapter Maintenance and Cleaning AVEA Ventilator Systems Changing the AC Fuses Figure 6 3 Opening the power module wiha screwdriver Figure 6 5 Fuse holder showing fuse placement Figure 6 7 closed power entry module with ISV showing in the window for 100 120 volt systems Figure 6 4 Re
18. breath rate has elapsed or when the MANUAL BREATH key is pressed 12786 Operator s Manual Chapter3 Ventilator Operation 3 21 12786 Airway Pressure Release Ventilation APRV BIPHASIC Biphasic is a Time Cycled Pressure mode in which the ventlator cycles between two different baseline pressures based on time which can be synchronized with patient effort Controlled ventilation can be maintained by timed cycling the transitions between baseline pressures Additionally pressure support can be added to improve comfort for the spontaneous breathing patient In this mode the patientis allowed to breathe spontaneously at two preset pressure levels These are set using the Pres High and Pres Low controls The maximum duration ateach pressure during time cycling is set with the Time High and Time Low controls The operator can also adjust the length ofthe respective tigger Sync windows with the Time High and Time Low Sync controls which are advanced settings of Time High and Time Low The Sync windows are adjustable from 0 to 50 in 5 increments of set Time High and Time Low The ventilator synchronizes the change from Pressure Low to Pressure High with the detection of inspiratory fow or the first inspiratory effort detected within the T Low Sync window Transition from Pressure High to Pressure Low occurs with the first end of inspiration detected after the T High Sync window opens Note Time High and Time Low are maximu
19. or more charge remaining for the intemal battery Yellow Less than 80 for extemal battery 90 for the intemal battery Red less than 40 for extemal battery 30 for the intemal battery Note When approximately 2 minutes of battery charge remain the ventilator wil initiate a non cancelable alarm The ventilator should be immediately connected to an appropriate AC power source 40 indicator om ler or Se jc A Ow RED Figure 5 1 Front Panel Display Area Comprehensive model shown 12786 Operator s Manual Chapter Alarms and indicators 6 3 Messages 12786 The AVEA displays messages in one of two ways Popup message box In the Message bar atthe bottom right of touch screen Alert Messages that require an acknowledgement from the user appear in a pop up message box with an OK or Continue button When you press the acknowledgement button the message disappears and the ventilator continues normal functioning Popup Alert Messages These messages wil requie you to press a button to clear the Popup box Can t change Mode to BiPhasic when ILV is active Can t set Pres Low higher than Pres High Can t set Pres High lower than Pres Low Stored Settings and Configuration Data lost Settings Check Barometric Pressure setting Stored Settings lost Settings restored to defaults Stored Configuration D
20. oxygen supply 2 1 parallel printer port 2 13 passive humidifier or HME 2 6 patent effort 3 19 3 20 1 1 patient ID 3 12 patient select screen 3 9 patient size 1 2 patient size indicators 3 6 patient size selectscreen 3 9 patient riggered breaths 3 18 peak Expiratory rate 4 22 D 2 peak flow 3 31 peak Inspiratory flow rate 4 22 D 2 peak inspiratory pressure 4 21 D 2 PEEP 3 16 37 318 331 333 3 35 3 42 4 22 66 61 68 611 612 02 H percent leakage 421 D 1 percentage of oxygen 4 22 D 2 plateau pressure 4 22 D 2 positive end expiratory pressure 3 35 4 22 D 2 ower cord 2 26 power on indicator 6 1 power source 2 1 pres high 3 31 3 36 pres low 331 pres trig 342 pressure breaths 316 pressure high control 3 36 pressure low control 3 37 pressure regulated volume contol breaths 3 17 pressure support ventilation 3 23 Index AVEA Ventilator Systems preventive maintenance 7 3 primary breath controls 331 3 33 breath rate 3 33 fow tigger 3 36 inspiratory pause 334 inspiratory pressure 3 33 inspiratory ime 3 34 PEEP 3 35 pressure high 3 36 pressure low 337 pressure support 3 34 tidal volume 3 33 time high 3 36 time low 3 36 printing 43 protective ground connection 226 PSV 331 PSV breath 3 18 PSV control 3 34 PSV cycle 3 18 3 43 PSV rise 343 PSV 3 18 3 44 radio frequency energy vii rapid shallow breathing index 421 D
21. 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 17 WARNING Allow 90 seconds for the accumulator to purge before initiating patient ventilation with Heliox gas WARNING Connection of a gas supply at the Helium Oxygen mixture inlet that does not contain 20 oxygen can cause hypoxia or death Although an 80 20 mixture of Helium and Oxygen is marketed as medi re is not labeled for any specific medical use J grade gas the Helium Oxygen gas Attaching the Air Hose Attach the Air supply hose to the Smart connector fiting with the integral water trapfiter on the left of the back panel as shown in figure 236 The fiting shown here is DISS fitting Fittings which accept NIST and Air Liquide hoses are also available ftom VIASYS The air hose will not attach to the fiting designed for Heliox and vice versa Figure 226 Attaching the Air Hose to tho water trapiiter Note The fiting for Air wil not accept a Heliox connection and vice versa 12786 2 18 Chapter2 Unpacking amp Setup AVEA Ventilator Systems Utilities Screens Configuration Tab VOLUME gum Input Output DateTime Figure 2 27 Utilities Screen Alarm Loudness change alarm sound levels depress and hold the increase or decrease soft keys until the desired level is reached The Alarm banner wil appear during the adjustment Enable Disable 02 Alarm The High and Low oxygen
22. 2 mte 331 rear panel diagram 2 14 reference loop 45 remote nurse call system 2 24 replaceable fuses 7 6 respiratory system resistance 4 22 D 2 resume button 3 29 resume current key 3 9 safety information x save loop button 4 5 saving a loop 45 scaling histograms 425 screen select box 3 28 screens mode selection 3 14 patient select 3 9 patient size 3 9 ventilation setup 3 10 sequence in which the power sources are used 7 5 service cals 1 Setting Date 2 25 Setting the breath type and ventilation mode 3 14 Setting the Language 2 21 Setting the Time 2 25 setting up your AVEA ventilator 2 1 sigh 3 42 6 7 6 8 6 11 sigh volume breaths 3 42 SIMV mode 3 20 Smart connectors attachment 2 16 smart Heliox connectors 2 16 specifications accessories B 6 atmospheric amp environmental 8 5 data input amp output 8 3 electrical B 1 physical dimensions 5 pneumatic B 1 spontaneous breath 3 18 spontaneous breath rate 4 21 D 1 spontaneous minute volume 421 D 1 adjusted for patent weight 4 21 D 1 spontaneous tidal volume 4 21 D 1 adjusted for ideal body weight D 1 adjusted for patient weight 4 21 standby mode 3 28 static compliance 4 22 D 2 status indicators 6 1 steam sterilization 7 2 symbols synchronized intermittent mandatory venation 3 20 T tidal volume 333 time cycled pressure limited breaths 3 16 time high 331 336 control 336 time low 331 336 control 3 36 trachea
23. AC alarm activates Reconnectthe AC power cord Clear the alarm by pressing the reset button Occlude the exhalation exhaust port Verify that the High P peak alarm activates followed 5 seconds later by the activation ofthe High Ppeak Sust alarm Setthe control setting for rate to 1 bpm Verify that Apnea Interval alarm activates after the default setting of 20 seconds Retum the control seting to ts default value and clear the alarm by pressing the reset button Set the Low PEEP alam setting to value above the default control setting for PEEP on your ventilator Verify that the Low PEEP alarm activates Retum the alarm setting to ts default value and clear the alarm by pressing the reset button Set he High Ppeak alarm setting to a value below the measured peak pressure or in neonatal ventilation the default control setting for Inspiratory Pressure on your ventilator Verify that the High Ppeak alarm activates Return the alarm seting to its default value and clear the alarm by pressing the reset button Set the Low Ve alarm setting to value above the measured Ve on your ventilator Verify thatthe Low Ve alarm activates Return the alarm setting to its default value and clear the alarm by pressing the reset button Setthe High Ve alarm seting to a value below the measured Ve on your ventilator Verify that the High Ve alarm activates Return the alarm setting to its default value and clear the alarm by pressing the reset button Setthe High Vt a
24. Apnea Settings key Setthe primary and advanced controls appearing at the bottom of the touch screen for the selected apnea breath type before pressing the MODE ACCEPT button The controls for apnea backup ventilation not be visible once the MODE ACCEPT button has been pressed Only the controls that are active and required for CPAP PSV or APRV BIPHASIC will remain See figures 3 17 to 3 20 for Apnea backup settings available in each mode VOLUME A C MAIN Figure 3 17 Volume Apnea Backup Settings for BIPHASIC mode 12786 3 26 Chapter 3 Ventilator Operation AVEA Ventilator Systems VOLUME A C E o Figure 3 19 Volume Apnea Backup settings for CPAP Mode 12786 Operator s Manual Chapter 3 Ventilator Operation 3 27 12786 VOLUME A C z gx rex Confirm Apnea Settings Figure 3 20 Pressure Apnea Backup settings for CPAP mode Apnea ventilation will terminate when one of the folowing criteria are patentintiates a spontaneous breath A manual breath is delivered A timed transition between baseline pressures in BiP hasic To review the Apnea backup settings press the Mode button at any ime and select APNEA Settings Note When changing from a controlled mode of ventilation to CPAP PSV or APRV BIPHASIC the default apnea settings will be the same as those set the controlled mode Ifa New Patie
25. Checklist Troubleshootin Chapter 3 Ventilator Operation Membrane Buttons and LEDs Patient Setup Primary Breath Controls Advanced Settings Independent Lung Ventilation IV Chapter 4 Monitors Displays and Maneuvers Graphic Displays Digital Display Main Screen Displays Chapter 5 Infant NCPAP Overview Circuit Compatibility General Specifications vi AVEA Ventilator Systems 6 1 Chapter 6 Alarms and Indicators Status Indicators Messages Alarms Alarm Control Alarm Types Chapter 7 Maintenance and Cleaning Cleaning amp Sterilizatior Disposable Parts Other Access Recommended Periodic Maintenance Battery Care Fuses Appendix A Contact Ordering Information How to Call for Service Ordering Parts Appendix B Specifications Pneumatic Supply Electrical Supply Data Input Output Atmospheric amp Environmental Specifications Physical Dimensions Accessorie AppendixC Pneumatic Diagram Gas Delivery Engi AppendixD Monitor Ranges and Accuracies AppendixE Sensor Specifications amp Circuit Resistance Varflex Sensor Specifications Hot Wire Flow Sensor Specifications Circuit Resistance per EN794 Appendix Message Bar Text Appendix Adjusting Barometric Pressure for Altitude Appendix Advanced Pulmonary Mechanics Monitored Parameters Appendix Glossary Index
26. Resolution 001 Accuracy 10 Respiratory System Resistance Ras Respiratory System Resistance Ras is the total resistance during the inspiratory phase of a breath Respiratory System Resistance is the ratio of the airway pressure differential peak plateau to the inspiratory 12 ms prior to the end of inspiration Range 00 100 cmH0 L sec Resolution 02 cmHzO tisec Limitation Active for volume breaths only Note Requires an Inspiratory Hold maneuver Accuracy 10 Peak Expiratory Resistance Rezar The ventiator shall be capable of calculating and displaying the Peak Expiratory Resistance Rear which is defined as resistance atthe time ofthe Peak Expiratory Flow PEFR R Range 0 0 to 100 0 Resolution 02 cmizO tisec Accuracy 10 Imposed Resistance Rue Imposed Resistance Rue is the airway resistance between the wye of the patient circuit and the tracheal sensor Range 0 0 to 100 0 cmH0 Lisec Resolution 0 1 cmH0 Lisec 12786 Operator s Manual Appendix H Advanced Pulmonary Mechanics Monitored Parameters H 3 Note Requires an Inspiratory Hold maneuver and a tracheal catheter Accuracy 105 Lung Resistance Ruunc Lung Resistance Runc is the ratio of the tracheal pressure differential peak plateau to the inspiratory flow 12 ms prior to the end of inspiration Range 000 100 0 cmHz0 Lsec Resolution 02 cmH O L sec Note Requires an In
27. T tube the breathing circuit and the demand flow system Imposed work is assessed by integrating the change in tracheal pressure and tidal volume and normalizing the integrated value to the total inspiratory tidal volume Vs Requires the use of an optional tracheal catheter Based on the following formula av PEEPw n VT where PEEPaw aiway baseline pressure e tracheal pressure V inspired dal volume Range 0 0000 20 00 oules L Resolution 0 01 J Accuracy 105 Note Requires a tracheal catheter 12786 Operator s Manual Appendix 12786 Breath Interval Glossary Elapsed time from the start of one breath to the start of the next Preset An operator set ventilator parameter Value at which the ventilator initiates delivery of a breath Trigger as a result of measured patient effort BTPS Body Temperature at Ambient Pressure Saturated Ambient Temperature Ambient Pressure Dry Demand Flow The flow generated by the ventilator to meet the patient s flow demand in order to maintain PEEP at the preset level AC Alternating Current mains electricity Flow through the patient breathing circuit during the expiratory phase This flow is used for flow triggering bpm Breaths per minute Breath Period The length of time between machine initiated breaths Depends on the Breath Rate setting Breath Rate
28. The number of breaths delivered in a minute BTPD Body Temperature at Ambient Pressure Di Button A push button switch used to toggle a function on or of Centimeters of water pressure Any button switch or knob that allows you to modify the Santiole Ventilators behavior 2 The occurrence or activation of certain controls or Event functions of the ventilator or a patient care activity which can be stored in the trend buffer The rate at which gas is delivered Measured in liters minute L min Indicators visual element showing operational status L Liters A unit of volume LED Light Emitting Diode Limin Titers per minute A unit of Tow PER An operating state of the ventilator that determines the allowable breath types Monitored Parameter A measured value displayed in the monitor window 3 Oxygen Patient Breathing Circuit The tubing thal provides the ventilatory interface between the patient and ventilator Paw Airway Pressure Measured in Positive End Expiratory Pressure Pressure maintained in the circuit at the end of exhalation Peak Inspiratory Pressure Shows The highest circuit pressure to occur during inspiration The display is updated at the end of inspiration Ppeak is not updated for spontaneous breaths Appendix Glossary Ventilator Systems Plateau Pressure Measured duri
29. Ventilator Systems Hot Wire Flow Sensor Specifications Table E 2 Hot wire sensor specifications Pan Number use heated wire Circuit Location Wye Performance Specifications Flow Range 0 002 t 30 Lmin Vol Accuracy 10 Flow Resistance 15 20 20 L min Dead Space 08ml Freq Response 15Hz Calibration 36 point curve Linearity en Operating Temperature Sto 40C Physical Specifications Sensor length 168 Diameter Insp Vent Side 15mm OD Diameter Exp Patient Side 15 mm OD Tube length Connector Pin amp Sockettype Weight lt 0 notincluding wire Senice 25 cycles Steriizaton Steam Autoclave Materials Sensor Delin Wie Platnum Screen Stainless Steel 304 or 316 Pin Ph8z gold over nickel plated Spacer Delin Circuit Resistance per EN794 1 Itis important to check the inspiratory and expiratory resistance specification of patient circuits used with the AVEA to ensure they do not exceed the following limits when adding attachments or other components or subassemblies to the breathing circuit NOTE Refer to product labeling supplied with any accessory to be added to the breathing circuit for this information 0 6 KPA GcmHz0 at 60 L min for adult patients 0 6 KPA GcmHz0 at 30 Limin for pediatric patients 0 6 KPA GcmHz0 at 5 Lmin for neonatal patients 1278
30. and shall not apply if the equipment is used with accessories or parts not manufactured by the Company or authorized for use in writing by the Company or ifthe equipment is not maintained in accordance with the prescribed schedule of maintenance The warranty stated above shall extend for a period of TWO 2 years from date of shipment or 16 000 hours of use whichever occurs frst with the folowing exceptions 1 Components for monitoring of physical variables such as temperature pressure or flow are warranted for ninety 90 days from date of receipt 1 Elastomeric components and other parts or components subject to deterioration over which the Company has no control are warranted for sixty 60 days from date of receipt 3 Intemal batteries are warranted for ninety 90 days from the date of receipt The foregoing is in leu of any warranty expressed or implied including without imitation any warranty of merchantabiity except as to tile and can be amended only writing by a duly authorized representative of the Company 12786 Operator s Manual Contents 12786 Revision Histo Warranty Notices Safety Information Equipment Symbols Chapter 1 Introduction Some AVEA Features Chapter2 Unpacking amp Setup Ventilator Assembly amp Physical Setup Setting Up the Front of the Ventilator Front Panel Connections Setting Up the Rear of the Ventilator User Verification Test User Verification Test
31. applications Range Norma 02002500 Adult 25 500 Pediatric 2053000 ml Neonate Defaults OL Adult Omi Pediatric Om Neonate Once you setthe machine volume the ventilator calculates the decelerating inspiratory flow required to deliver the Machine Volume in the set inspiratory time When a Pressure Control breath is delivered and Peak Flaw decelerates to this calculated peak inspiratory flow ifthe Machine Volume has not been met the ventlator ill automatically transition to continuous unti the Machine Volume has been delivered Once the set Machine Volume has been delivered the ventilator wil cycle into exhalation When the Machine Volume is met or exceeded during delivery of the pressure control breath the ventilator will complete the breath as normal Pressure Control breath During this transition in the Inspiratory Time wil remain constant and the Peak Inspiratory Pressure will increase to reach the set Machine Volume The maximum Peak Inspiratory Pressure is determined by the High Peak Pressure alarm setting Note Pmaxis disabled when Machine Volume is set In the event Flow Cycling is active in Pressure Control the ventilator will not Flow Cycle unti the Machine Volume has been met Machine Volume must be setto zero to change patent sie To set Machine Volume in adult and pediatric applications with circuit compliance compensation active simply set the minimum desired tidal volume In neonata
32. appropriate balloon locaton can be confirmed by performing an occlusion technique This requires that the airway be occluded and the esophageal and alway pressures compared for similarity Afer the balloon has been inserted and tumed on the ventlator wil fil the ballon to the appropriate level and begin monitoring data The ventilator wil automatically evacuate and refil the balloon every thirty minutes to ensure accuracy of monitored values WARNING Esophageal balloon placement should only be conducted in patients under the direction of a physician who has assessed the patients for contraindications to the use of esophageal balloons WARNING Incorrect placement of an esophageal balloon can affect the accuracy of monitored values 4 10 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems MIP P1oo Maneuver Screen VOLUME A C 5 EM OM The MIP Maximum Inspiratory Pressure maneuver measures the negative defection the pressure tracing during the patients active effort to demand a breath During the maneuver the inspiratory flow valve remains dosed and no inspiratory is delivered The MIP is an indication of the maximum negative pressure that the patient can draw while an indication of the pressure drop that occurs during the fst 100 miliseconds of the breath Controls Duration The preset Duration shall determine the maximum amount of time th
33. assertion of disconnect alarms Apnea Backup Ventilation Apnea Backup Ventilation is available in Assist Control SIMV CPAP PSV and APRV BIPHASIC modes Apnea Backup in Assist Control or SIMV When in Assist Control or SIMV modes the apnea backup rate is determined by the operator set mandatory breath Rate or the Apnea Interval setting whichever provides the highest respiratory rate When the Apnea Interval sting found in the Alarm Limits window determines the backup rate the ventilator will continue to ventlate at this rate unti the apnea has been resolved All other controls for apnea ventilation in Assist Control and SIMV are set when the primary control values for these modes are selected Apnea ventilation will terminate when one of the following criteria are met The patient initiates a spontaneous breath A manual breath is delivered The mandatory respiratory rate is increased above the apnea interval setting NOTE The apnea interval timer is suspended during a Patient Circuit Disconnect Alam 12786 Operator s Manual Chapter 3 Ventilator Operation 3 25 Apnea Backup in CPAP PSV or APRV BIPHASIC When CPAP PSV or APRV BIPHASIC is selected you MUST 1 Setthe primary and advanced settings for CPAPJPSV or APRV BIPHASIC and 2 Selectthe breath type for APNEA backup mode Volume or Pressure adult and pediatric patients or Volume Pressure or TCPL in neonatal patients by pressing the
34. battery fuse D Power ON OFF Switch E Nurse call system connection F Air smart connector G Oxygen sensor 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 15 Connecting the Oxygen Sensor 02Cell e s Figure 221 Connecting the Sensor Connecting Gas Fittings 12786 The Smart Air Fitting There are two gas connections on the rear panel of the ventilator The one on the left of the panel is for attaching the Air or Heliox gas source The smart connector fiting type shown here is CGA DISS type body No 1160 for air with an integral water rap fiter To prevent the entry of moisture into the ventilator from a wall air source the extemal water trap is placed in line between the air hose and the smart air connector To attach align the connector assembly see figure 2 22 seat gently onto the fting and Smart Connector screw down the fiting colar until finger ght Similar connectors for Air with NIST and Air Liquide fittings are also available from VIASYS The oxygen sensor cell is located on the rear panel between the two gas fitings The oxygen sensor cable emerges from the rear panel directly above the sensor Carefully align and then gently push the connector onto the oxygen sensor until it seats When a good connection has been made slide the protective cover down and push over the sensor Collar Figure 2 22 Attaching the Air smart connector with water tr
35. be supported initially by the default value of 2 cm0 of continuous positive airway pressure 7 Sethe prescribed level for nC PAP Pressure and or FIO by touching the primary control tuming the Data Dial until the desired value is displayed and by either touching the primary contol again or by touching the ACCEPT membrane key adjacent to the Data Dial to activate the new setting n Operator s Manual Chapter Infant NCPAP 55 Note Low Nasal CPAP Pressure and High Nasal CPAP Pressure Alarm Thresholds are updated automatically when a new value is accepted in the nCPAP Primary Control Figure 6 nCPAP Primary Controls and Alarm Threshold Indicators CAUTION Apnea back up ventilation is suspended during nCPAP AVEA continually displays the following message during administration Figure 7 Caution Message Display Monitors 12786 In Nasal CPAP all existing monitors will be suspended except Air Inlet Pressure Air Inlet Oxygen Inlet 02 Inlet Gas Composition Monitor F10 PercentLeak The following monitors have been added for Nasal CPAP nCPAP level mean airway pressure Range Oto 120 cmh 0 Resolution 1 cmH 0 Accuracy 43 5 of reading or 2 cmH 0 whichever is greater CPAP Flow mean inspiratory fow Range 0 300 LPM Resolution 0 1 LPM Accuracy 10 5 6 Chapter Infant NCPAP AVEA Ventilator Systems Graphics All existing waves willbe maintained except for t
36. both ventilators care should be taken when setting the other independent breath controls for the slave ventilator to ensure sufficient ime is allowed for exhalation to occur CAUTION Ifthe cable connecting the master and slave ventilators becomes detached the slave ventilator wil alarm for loss of signal In this event only the master ventilator wil continue to provide venation at the current setings The slave ventilator will begin apnea ventilation after its apnea timer has elapsed at its curent apnea ventilation settings 12786 Operator s Manual 41 Chapter 4 Monitors Displays and Maneuvers Graphic Displays Grapl 5 Colors Graphic displays on may appear as red blue yellow green or purple tracings These colors may provide useful information to the operator about breath delivery and are consistent between both waveform and loop graphic displays A RED tracing indicates the inspiratory portion ofa mandatory breath YELLOW tracing indicates the inspiratory portion of an assisted or spontaneous breath patent assisted or spontaneous breaths are also denoted with a yellow demand indicator that appears in the left hand comer ofthe mode indicator BLUE tracings represent the expiratory phase of a mandatory assisted or spontaneous breath A GREEN tracing during the expiratory phase of a single breath indicates thata purge of the expiratory flow sensor or the fow sensor if attached has occured A
37. by he patent during an expiratory hold Pus Respiratory Drive Ps negatve pressure at occus 100 ms afer an inspiratory has been detected Veni Work of Breathing ROB is he summation of away pressure minus the baseline pressure mes the change in al volume to the patent during inspiration and nomalized tal inspiratory tal volume Patent Work of Breathing NOB normalized t the total inspiratory tidal volume WOB Imposed Work of Breathing WOB defned as the work performed by the patient ta breathe spontaneously rough the breathing apparatus ie the T tube the breathing crc and the demand fow system Py PEEP Transpulmoray pressure AUDPEEP PsPEEP is the diference between the corresponding away and the esophageal pressures atthe end ofthe expiratory hoki during an AutoP EEP maneuver Py Plat The ventlator is capabile of cakulating and displaying Transpulmonany pressure dwing an inspiratory hold which the diference between te away plateau pressure Pu a and the conesponding esophageal pressure Events Pressing the EVENT membrane button to the left of the touch screen opens a scrollable menu of event markers that are placed parameters To selectan eventuse data dial to scroll the event menu and highlight the desired event Press the ACCEPT button adjacent to the data dial to place the event in the tend buffer Events wil appear on the data spreadsheet in green text with an a
38. damage to the ventilator or other equipment NOTES identify supplemental information to help you better understand how the ventilator works Warnings 12786 Warnings and Cautions appear throughout this manual where they are relevant The Wamings and Cautions listed here apply generally any time you operate the ventilator The AVEA Ventilator is intended for use by a trained practitioner under the direction of a qualified physician When the ventilator is connected to a patient a trained health care professional should be in attendance at all times to reactto an alarm or other indications of a problem Alarm loudness must be set above ambient sound in order to be heard Always have an altemate means of ventilation available whenever the ventilator is in use The operator should not touch the electrical connectors ofthe ventiator or accessories and the patient simultaneously Due to possible explosion hazard the ventilator should not be used in the presence of fammable anesthetics An audible alarm indicates an anomalous condition and should never go unheeded Ant static or electrically conductive hoses or tubing should not be used within the patent circuit Ifa mechanical or electrical problem is recognized while operating the ventilator the ventilator must be removed from use and referred to qualified personnel for servicing Using an inoperative ventlator may result in patient injury When a low gas supply alarm occurs the oxygen co
39. demand or tuming the demand system back on 3 42 Chapter 3 Ventilator Operation AVEA Ventilator Systems Sigh The ventilator delivers sigh volume breaths when this setting is ON A sigh volume breath is delivered every 100 breath in place ofthe next normal volume breath Range Off On every 100 breaths Sigh Volume 15 times set tidal volume Sigh Breath Interval sec Set Normal Breath Interval x 2 Assist mode or set Normal Breath Interval SIMV mode Default of Sigh breaths are only available for Volume breaths in Assist and SIMV modes for adult and pediatric patients Bias Flow The Bias Flow control sets the background flow available between breaths Additionally this control establishes the base flow thats used for fow triggering Range 041950 Limin Defaults 20 Limin Note To ensure adequate bias flow for inspiratory triggering the bias flow setin should be at least 0 5 liters per minute greater than the tigger threshold Consult the ventilator circuit manufacturer to ensure that bias flow seting is Sufficient to prevent overheating of the ventilator circuit Pres Trig Sets the level below PEEP at which the inspiratory tigger mechanism is activated When the pressure in the patient circutfals below PEEP by the set pressure trigger level the ventilator wil cycle to inspiration Range 0 1 to 20 0 emH 0 Default 34 0 Vsync Vsync breaths are Controlled by pressure inspiratory PEEP and volu
40. inspiratory PEEP margin Cycled by time or fow breath operation is as follows When PRVC is selected decelerating flow volume controlled test breath to the set tidal volume with a 40 msec pause is delivered to the patent The demand system is active during this test breath The ventilator sets the target pressure at the end inspiratory pressure of the test breath for the first pressure control breath The next breath and all subsequent breaths are delivered as pressure control breaths The inspiratory pressure is based on the dynamic compliance ofthe previous breath and the set idal volume Inspiratory pressure is adjusted automatically by the ventilator to maintain the target volume The maximum step change between two consecutive breaths is 3 centimeters of water pressure The maximum tidal volume delivered in a single breath is determined by the Volume Limit seting The test breath sequence is initiated when any of he following occur Entering the Mode Changing the set tidal volume while in PRVC Reaching the Volume Limit setting Delivered tidal volume gt 1 5 times the set volume Flow termination ofthe test breath Exiting Standby Activation of any ofthe folowing alarms High Peak Pressure Alarm Low Peak Pressure Alarm Low PEEP Alarm Patient Circuit Disconnect Alarm Hime Limit KE Limit Note If fow cycling is active during a PRVC or Vsync breath flow cycling ofthe breath can only occur if
41. miet gas suppl pressure 080089 5 psig L4 55 bart Oz Inlet Oxygen inlet gas supply pressure 018089 5 psig 14 55 bal IMPOSITION MONITORS Delvered gercent 02 00 100 MECHANICS Dynamic Complance Com and Corn Ko 0030 Derved absolute and normalzed t patent weight mlcnit 0000500 minio ig Estat Respro Dered Stati Complance Cen absolute an nomafzed micmH 0 o Patent weight Not This requires an Inspiratory manewer mlcnit ig Mes Respiratory system resistance 0010 Note Cakulaton is performed during an Inspiratory embsO Usec PIER Peak Inspiratory few ate Oto 300 min 10 of seting or 02 Lima 10 lat patents ofsetingl whichever s greater PEFR Peak Expratory fow rate Ot 300 Lmn 10 of seting or 02 Lmin 108 lA patents whichever s greater Cew The ratio ofthe bial volume emled Deta 0m300 10 Esophageal Pressure ds Requires an micro esophageal baloon Cume The ratio ofthe tidal volume exhaled to he dela Ol 300 renspulnanary pressure The delta micro rnspulnanary pressure 5 the difference between he airway plateau pressure during an inspiratory pause and esophageal pressure at the ime the plateau pressure measured minus the erence between the away and esophageal baseine pressures Requires an inspratory hold and esophageal balon CIC The rat
42. or maintenance contact your product support representative as shown in Appendix A Contact Information A Preventive Maintenance service should be performed on your AVEA ventilator once per year Call VIASYS Respiratory Care Customer Care atthe number given Appendix to arrange for a qualified Service Technician to perform this WARNING Electric shock hazard Do not remove any of the ventilator covers or panels Refer all servi authorized VIASYS Respiratory Care service techni toan The annual maintenance wil include the following Replacement of The Air inlet Fiter The Oxygen Inlet Fitter The Compressor Inlet Fiter on compressor equipped models The Compressor Oufet iter on compressor equipped models The Exhalation Diaphragm Atthis time the following maintenance will be performed Removal amp replacement of the above items Verification thatthe following transducers are within calibration specifications Air 02 Blended Gas Expiratory Inspiratory Exhaled Flow delta Wye delta Auxiliary Esophageal Testing ofthe compressor output lon compressor equipped models Verification Testing to confirm the ventilator is functioning within optimum parameters Screen Calibration Maintenance should be performed by a trained and authorized service technician VIASYS Respiratory Care wil make availabe to qualified technicians service manuals which include such items as circuit
43. prevent the risk of excessive enclosure leakage current from external equipment attached to the RS 232 printer and video ports isolation of the protective earth paths must be provided to ensure proper connection This isolation should ensure thatthe cable shields are isolated atthe peripheral end ofthe cable Cautions The following cautions apply any time you work with the ventilator Ensure thatthe voltage selection and installed fuses are set to match the voltage of the wall outlet or damage may result A battery thats fully drained ie void of any charge may cause damage to the ventilator and should be replaced All accessory equipment thats connected to the ventilator should comply with CSA IEC601 UL260 To avoid damage to the equipment clean the air fiter regularly The following cautions apply when cleaning the ventilator or when sterilizing ventilator accessories Do notsterze the ventilator The internal components are not compatible with sterilization techniques Do notgas sterilize or steam autoclave tubing adapters or connectors in place The tubing wil over time take the shape ofthe adapter causing poor connection and possible leaks DO NOT submerge the ventilator or pour cleaning liquids over or into the ventilator 12786 Operator s Manual Equipment Symbols The following symbols may be referenced on the ventilator or in accompanying documentation 12786 Symbol Source Compliance Meaning A Sy
44. stop cycling and seta bias fow The ventilator will automaticaly detect the patient upon reconnection and resume normal ventilation The apnea interval imer is suspended during a Patient Circuit Disconnect Alarm Setting extremely small delivered tidal volumes with Circuit Compliance Compensation not active and using a proximal fow sensor may resultin assertion of Patient Circuit Disconnect Alarms 12786 Operator s Manual Chapter Alarms and indicators 6 7 Gas Supply Indicators and Alarms Loss of Air This high priority audibleisual alarm LOSS AIR is displayed and high priority tone sounds This alarm is triggered if the wall air supply to the ventilator drops below 18 0 psig 1 2 bar and the ventilator does not have a functional intemal compressor or the compressor output is insufficient to meet instrument demand The patient Continues to be ventilated by the oxygen supply only Loss of 02 This is a high priority audiblejvisual alarm LOSS Ozis displayed and a high priority tone sounds This alarm is triggered ifthe oxygen supply to the ventilator drops below 18 0 psig 1 2 bar and the control is set gt 21 The patent continues be ventilated by the air supply wall air or intemal compressor only Loss of Gas Supply This is a high priority audiblelvisual alarm LOSS GAS SUPPLY is displayed and a high priority tone sounds This alam is triggered ifthe ventilator loses all sources of gas wall air intemal
45. that Machine Volume must first be tured off before making patient size change N PanelLock LED The LOCK key disables all front panel and screen controls except MANUAL BREATH Sucion f amp O ALARM RESET ALARM SILENCE and LOCK 0 Print The PRINT key outputs the contents of the currently displayed screen to a suitably connected parallel printer P Setup Opens the ventilator Setup screen Note Pressing the Set Up button a second time before accepting Set Up will close the window and restore the previous setings The Set Up screen uses an on screen accept button To change patient size without selecting new patient requires that patient Set Up be accepted after selecting patient size Q Advanced Settings LED Opens the Advanced Settings screen for data entry or adjustment Toggles the screen on amp off Note Pressing the Freeze button while the Advanced Setting window is open will automatically close the window and freeze the graphics 12786 Operator s Manual Chapter 3 Ventilator Operation 3 7 R Mode Opens the Mode Selectscreen for data entry or adjustment toggles the screen on or off Pressing the Mode indicator at the top ofthe touch screen wil also access the screen Note Pressing the Mode button a second time before accepting the Mode wil close the window and restore the previous settings The Mode screen uses an on screen accept button Event Records an event for fu
46. the Analog Output signals Refer to Appendix B Specifications for Analog Output Pressure cmH20 mv and Volume conversions ILV connector pin configuration To connecttwo AVEA ventilators together for independent lung ventilation function the cable must be wired so thatthe ILV input the slave on one AVEA is connected to the ILV output the master on the other AVEA As shown in figure 2 27 below the ILV slave is pin 18 and the ILV master is pin 6 In addition atleast one of the analog grounds pins 5 9 10 11 12 or13 must be connected We recommend using a shielded cable 2 20 Chapter2 Unpacking amp Setup Ventilator Systems For ILV operation Connect an analog ground on Vent 1 to analog ground on vent2 See figure 2 28 Connect Pin 6 on Vent Master to pin 18 on vent 2 Slave Connect Pin 18 on Vent 1 to pin 6 on vent 2 63 9 G3 000000000009 Master Figure 2 28 Connection Pin Configuration 6 6 9 G3 6 6 6 9 amp G 8 Figure 2 2 Analog Ground Pins 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 21 12786 Note Atleastone analog ground is required for safe and accurate signal output and input One analog ground is sufficient for any and all of the other signals Selecting Language Touch the language box and use the data dial to select th
47. wil perform the EST and display a countdown clock EXTENDED SYSTEM TEST During this test the ventilator will perform Leak Test PASSED Circuit Compliance Test PASSED uit compliance measurement 02 Sensor Calibration IN PROGRESS 45sec oe Two point calibration of the oxygen sensor The patient circuit compliance measurement and leak test are performed simultaneously with the oxygen sensor calibration The maximum time for EXTENDED SYSTEM TEST the EST is 90 seconds restartthe EST at any time select the Cancel button to retum to the setup LeakTes PASSED screen Circuit Compliance Test PASSED After each testis complete the ventlato will Sensor Calibra PASSED display a Passed or Failed message nextto the corresponding test Once the testis compete press the continue button to retum to the set up screen The SET UP ACCEPT key must be pressed in order for the AVEA to retain the circuit compliance measurement At this point even after power cycling off if SAME is selected the circuit compliance measurement wil continue to be retained If NEW selected the EST willbe required to use this feature Note If you do not connect the ventilator to an oxygen supply the 02 Sensor Calibration 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 29 The Alarms Test 12786 Note To ensure proper calibration ofthe oxygen sensor yo
48. wye should be plugged to direct fow down the expiratory limb ofthe circuit Failure to do this may resultin damage to the ventilator circuit ifthe humidifier is left on Consult the circuit manufacturer to confir that 2 L min of flow is suficient to prevent overheating 12786 3 30 Chapter 3 Ventilator Operation Ventilator Systems Available Breath Types amp Modes by Patient Size Adult and Pediatric Ventilation Modes The folowing breath types amp ventilation modes are available for Adult and Pediatric patients When a mode is selected its description is displayed at the top left ofthe touch screen Table 3 1 Adult and Pediatrie Displayed Modes Displayed Mode Description Volume A C Volume breath wit Assist ventiaton Deu for du and peda patents Pressure A C Pressure beat wih Asst vera Volume Volume breath win Synchronized Intermiten Mandatory Veto and an ata level af gressure sugport Tor spontaneous breaths Pressure Pressure Breath wih Synchronized inermitert Mandatory Vertlaton SMV anda adjustable eel of oressune sugport for spontaneous breaths CPAP PSV Continuous Poste Airway Pressure Demand Breath wid Pressure Support PRVC A C Pressure Regulated Volume Contoed breath wih Assist Ventlaton PRVCSIMV Pressure Regulate Volume wth Synchronized iret Mandatory Venton SIMV and an adjustable evel of pressure support for spo
49. you must 1 Selectthe breath type for APNEA backup mode AND 1 Setthe primary controls visible at the bottom of the touch screen for the selected apnea breath type before pressing the MODE ACCEPT button The controls for the apnea breath type will not be visible once the MODE ACCEPT button has been pressed Only those controls that are active and required for CPAP PSV will remain To review the settings for Apnea backup ventilation open the mode window and select Apnea Settings Note IF PSV level insuficient to meet patient demand premature termination of the breath may occur with auto cycling In these cases the PSV level should be increased slighty 3 24 Chapter3 Ventilator Operation Ventilator Systems 1 2 on A V In figure 3 16 breath number 1 represents the fow tracing which occurs when the PSV level insufficient to meet the patient demand Breath two shows resolution after increasing the PSV level slight Pressure tracing will show a similar appearance Non Invasive Ventilation The ventiator can perform non invasive ventilation with a standard dual limb circuit Leak compensation should be tumed on when using this feature To tum leak compensation on use the touch screen control displayed in the Ventilator Set Up Screen NOTE Non invasive ventilation requires the use of a snug fiting mask with no bleed holes Excessive leaks around the mask may resultin false triggering of the ventilator or
50. 1 to 5 00 L Neonate Defaults 1 00 Liter Adults 0 50 Liter Pediatrics 0 05 Liter Neonate High Exhaled Minute Volume High V This is a medium priority udiblevsual alarm HIGH MINUTE VOLUME is displayed and medium priority tone sounds whenever the monitored exhaled minute volume is greater han the High Exhaled Minute Volume threshold seting Range Adult 0003001 Peditic 00005001 Neonate Defaults 300L Adult ediatic 500L Neonate Low Exhaled Tidal Volume Low Vi A high priority audiblekisual alam shal be activated and LOW TIDAL VOLUME shall be indicated whenever the absolute monitored exhaled tidal volume does not exceed the Low Tidal Volume alarm threshold setting for the Low Vte Sensitivity setting Range Off indicated by 0 00 to 3 00 L Adut Off indicated by 0 to 1000 mL Pediatric Off indicated by 0 0 to 3000 Neonate Resolution 0011 Adut 1ml Pediatric Neonate Accuracy 0 01 L of monitored exhaled tidal volume Adult 1 mL of monitored exhaled tidal volume Pediatric 0 1 mL of monitored exhaled tidal volume Neonate Defaults 0001 Adult Pediatric 6 10 Chapter Alarms and Indicators AVEA Ventilator Systems 0 0 mL Neonate Note The Low Exhaled Tidal Volume alarm will assert on a single occurrence of a low exhaled volume In patients who have variable tidal volumes the Low Exhaled Tidal Volume alarm may be tumed off default and the Low Exha
51. 108 freni venis asit fow sensor Xe Percent leakage The difference betweenthe Derived Derived inspired and exhaled Sal volumes in terns of diference We Minde Volume Volume ofgas entaledbytbe 009991 Derived padent during he ast minute Vekg Minute volume adjusted for patient eight 999 mig Derved Spon Ve Spontaneous minute volume owsa perves Spon Vekg Spontaneous minute volume adjusted forpatent 0o 999mikg Derived Breath Rate 0 200 bom 3 or 2 bpm whicheveris greater Spontaneous breath Tae Din 200 bom 3 or 2 bpm whicheveris greater Inspiratory ne 000109899 003 sec Te raton Tine nssistoyegratr rato 19898 Derived fom accuracies for monitored Ti Note Not active for demand breaths LOI and Te Appendix D Monitor Ranges and Accuracies AVEA Ventilator Systems Display Description Range Accuracy Rapid shalow beating index 00500 Derived fom accuracies for spontaneous iint rate and spontaneous minute volume Ppeak Peak inspiratory pressure 00100 Notacive with spontaneous breaths mid whichever greater Pmem Mean aay pressure w120 ar Demi Kr whichever is greater Polat Plateau pressure Ino plateau occurs hene 010120 35 ofreading or 2 cnt displays Kr whichever greater PEEP Postheendexpiay pressure to 60 cried 35 of wading or 2 ani whichever greater ArWet A
52. 30 Lmin L2 to 180 Lmin Dif Pres Range 2572 cmH20 257201920 Accuracy 0 012 Lmin 5 orreading 0 Lmin 5 or reading Resistance 45 cmH20 30 Lmin 2 4 emH20 60 Limin Dead Space 0 7 mlinstaled 9 6 ml installed Freq Response 17Hz 25Hz Airway Pres Range 140 to 140 20 140 t 140 cmH20 Calibration EEPROM 29 Point Cune 29 PointCune Linearity between points between points Connector ABS Operating Temperature 5 t040 5 40 C 41 to 104 F 41 t 104 F Physical Specifications Sensor Length 136 85 em 245 n 62 em Diameter Insp Vent Side 15 mm OD 15mm OD Diameter Exp Patient 15 mm OD 15mmOD Tube Length 48in 1219 cn 73 n 1854 cm Connector Bicore Proprietary Bicore Proprietary Weight 229101 02 319 0 002 Service Single Patent Use Single Patent Use Sterilzaton NA NA Material Sensor Lexan Sensor Lexan Flap Mylar Flap Mylar Tubing Tubing PVC Connector ABS Limin Dry air at 7 25 C and 14 7 psig barometric pressure Includes 1 for linearity and hysteresis with no zero drit for the pressure transducer and 2 for temperature and humidity variations The sensor must be corrected for barometric pressure and oxygen concentration Frequency Response is signal attenuation to 0707 input and assumes 100 Hz sample rate 12786 2 Appendix E Sensor Specifications amp Circuit Resistance
53. 50 Umin Neonate Default T5 cmH 0 Note The ventilator wil not allow the operator to seta Peak Inspiratory Pressure Pres or PSV PEEP or baseline pressure in APRV BiPhasic greater than 90 cmH 0 The ventilator wil deliver an on screen Pop Up Message stating that the Ppeak 90 cmH 0 The operator must change the Inspiratory Pressure and or PEEP seting to limit the P peak 1o less than or equal to 90 0 334 Chapter Ventilator Operation AVEA Ventilator Systems Peak Flow Peak is the delivered by the ventilator during the inspiratory phase of a mandatory volume or TCPL breath Range 30150 L min 1 to 75 L min Pediatric 0 4 to 30 0 Lmin Neonate Defaults 60 Lmin Adult 20Limin Pediatric 8 0 Lmin Neonate Inspiratory Time HTime The Time control sets the inspiratory time cycle variable for all mandatory pressure TCPL or PRVC breaths Range 02005005 AdulyPediatric 0 15 to 3 00 seconds Neonate Default 10 second 0 75 seconds Pediatric 035 second Neonate Note ifthe preset Time is greater than actual I Time as determined by V F and the waveform an Inspiratory Pause equal to the preset Time minus the actual Time is added to the breath Inspiratory Pause Insp Pause Sets an Inspiratory Pause which wil be in effect for each volume breath delivered A preset inspiratory pause wil be delivered with each volume breath Range 0 00 to 3 00 seconds De
54. 6 Operator s Manual Appendix E Sensor Specifications amp Circuit Resistance E3 WARNING Total resistance of the inspiratory and expiratory limbs of the breathing circuit with accessories should notexceed demH20 at 5 Li piratory flows gt 15 liters per minute are used in TCPL ventilation modes Circuit Resistance Test To measure the resistance ofthe inspiratory and expiratory limbs of the breathing circuit with accessories connect the patient breathing cicuitas described in Chapter 2 1 Select TCPL SIMV with settings Rate Inspiratory Pressure Peak Fow Inspiratory Time PEEP Fow Tigger 02 Bias Fior 5 Lmin Pressure ger 20 cm0 Select waveform Pinsp 3 With the patient wye blocked allow the baseline pressure PEEP to stabilize for 10 seconds and press the FREEZE key 4 Use the data dial to read the pressure from the Pinsp waveform The pressure must not exceed 4cmH20 at 5 L min if inspiratory flows gt 15 liters per minute are used in TCPL ventilation modes 12786 E 4 Appendix E Sensor Specifications amp Circuit Resistance AVEA Ventilator Systems This page intentionally left blank 12786 Operator s Manual F 1 Appendix AVEA Message Bar Text AVEA MESSAGE BAR TEXT CAUSE Confirm Apnea Settings Selection of CPAPIPSV or APRV on Mode Select popup when active Proximal Flow Sensor required A
55. 9 for Pediatric and Adult applications Note The settings wil be reset to default values when New Patients selected in the setup Note To achieve 100 delivered 102 during the Increase 02 maneuver set the Increase F O2 setting to its maximum of 1 WARNING Heliox delivery will be interrupted for the time that either the Suction or the Increase 0 buttons are pressed during administration of Heliox Tidal volume may be affected after the 2 minute timeout period or when the button is pressed until the accumulator has been purged G Data dial Changes the values fora selected field on the touch screen H Accept Accepts data entered into field on the touch screen 1 Cancel Cancels data entered into a field on the touch screen The ventilator will continue to ventilate at current settings J Expiratory Hold When the EXP HOLD button is pressed at the start of the next breath interval the ventilator will not allow the patient to inspire or exhale fora maximum of 20 seconds adultipediatic or 3 seconds neonate Expiratory Hold is NOT active in TCPL breaths 12786 Operator s Manual Chapter3 Ventilator Operation 35 Inspiratory Hold Manual When the INSP HOLD button is pressed once the preset of a volume control or pressure control breath has been delivered the patient will not be allowed to exhale for a maximum of 3 0 seconds 0 1 second L Nebulizer The venti
56. ACCEPT entered values for a specific field xh Symbol ratory Care Indicates PATIENT EFFORT MASYS Respiratory Care symbol Indicates MANUAL BREATH AVEA Ventilator Systems VIASYS Respiratory Care Sy MAIN SCREEN Symbol 4171EC 5102 EVENT READY VIASYS Respiratory Car Symbol MODE VIASYS Respiratory Care Sy ADVANCED SETTINGS VIASYS Respiratory Car Symbol SET UP for patent size selection MDD Directive 93H2IEEC CE Mark vol 5307 IEC 60417 ALARM RESET Symbol 5319 EC 60417 ALARM SILENCE VIASYS Respiratory Care symbol ADULT patient VIASYS Respiratory Care symbol PEDIATRIC patient VIASYS Respiratory C symbol NEONATAL Infant patient Graphical Symbolin general use internationally for 0 NOT CANCEL ie do not accept entered values VIASYS Respiratory Care symbol Select DISPLAYED SCREEN function 467 IEC 60417 FREEZE the curent display 12786 Operator s Manual 12786 VIASYS Respiratory Care symbol Enable the ALARM LIMITS screen VIASYS Respiratory Core symbol This symbol indicates CONTROL LOCK ISYS Respiratory Care syntol NEBULIZER port ASS Respiratory Care symbol Increase OXYGEN ISYS Respiratory Care symbol PRINT SCREEN VIASYS Respiratory Care symbol SUCTION por
57. ED indicator on the button illuminates and the Advanced Settings screen appears When you selecta primary control by pressing and highlighting the control at the bottom of the touch screen the available advanced setings for that selected contol appear in the advanced settings screen Primary Controls which feature an advanced setting wil display a yelow triangle to the right of the control name CmH20 Insp Pres Figure 3 28 Advanced settings indicator Note Not every primary control wil have an associated advanced setting 12786 3 38 Chapter 3 Ventilator Operation AVEA Ventilator Systems Table 3 4 Controls and Advanced Settings Associated with Breath Type amp Mode Ner vorne vous Paes PRES meae emoese APR sema TEP AC sv SMV BIPHASIC si PRIMARY CONTROLS us apea bpm Mode Mode VOLUME fare Fares Mode Mode INSP PRES apnea ne mo Mode Mode INSP TIME fee itt Mode isp Pause apnea Apnea itt Mode PSV PEEP 2 FLOW TRIG Sons PRES HIGH TIME HIGH x TRE LOW PRES LOW ADVANCED Vic Ha emi KES
58. Limin Neonate Scale Factor 10 10 mV Adut 1 Limin 25 mV Pediatric 1 Limin 50 mV Neonate Accuracy x 10 of reading or 30 mV whichever is greater Zero Offset 30 VDC atO Limin Machine When selected the ventilator provides a continuous analog voltage representative of machine delivered fow Range 0t 200 L min Adult Oto 100 Limin Oto 50 Limin Neonate B 4 Appendix B Specifications AVEA Ventilator Systems Scale Factor 1 Limin 25 Adult 1 Limin 50 mV Pediatric 1 Lmin 100 mV Neonate Accuracy 10 of reading or 30 mV whichever is greater Zero Offset None 3 Volume Range 10004001 Adult 200 to 800 mi Pediatric 100 to 400 ml Neonate Scale Factor 00 1 5 Pediatric 1ml 10m Neonate Accuracy 3108 of reading or 30 mV whichever is greater Zero Offset 1 000 VDC 4 Breath Phase The ventilator provides a continuous analog voltage representative of breath phase Inspiration 5 VDC Expiration 0VDC Digital Communication The ventilator has two RS 232 ports installed for bi directional communication of data RS 232 Chl is currently used for software updates as well as data communications to extemal systems The communications protocol is available from VIASYS Respiratory Care L2317 RS 232 Ch2 is current undefined Printer The ventilator has a standard 25 pin female Centronics parallel printer port for interfacing to an extemal printer
59. Materials used in the construction ofthe fiter have passed USP Class VI 121 C Plastic and Cytotoxicity test For further information please contact Pall Medical Water Trap Resistance The resistance ofthe intemal exhalation water trap assembly including the collection bottle is lt 0 5 at 50 L min Compliance The compliance ofthe intemal exhalation water trap assembly including the collection botte is lt 0 2 mifemHsO 12786 Operator s Manual C41 Appendix C Pneumatic Diagram Gas Delivery Engine The Gas Delivery Engine receives and conditons supplied Oxygen and Air from external andor intemal compressor sources It then mixes the gas to the concentration required and delivers the desired flow or pressure to the patient The Gas Delivery Engine begins with the Inlet Pneumatics The Inlet Pneumatics accepts clean Oz or Air it provides extra fitraon and regulates air and 0 gas before entering the Oxygen Blender The Oxygen Blender mixes the gases to the desired concentration before reaching the Flow Control Vale The Flow Control Valve controls the flow rate of the gas mixture to the patient Between the Oxygen Blender and Flow Control Valve the Accumulator System is installed to provide peak flow capacity The Flow Sensor provides information about the actual inspiratory fow for closed loop servo control The gas is then delivered to the patient through the Safety Reliet Valve and Outlet Manifold 5 X Fig
60. Operator s Manual AVEA Ventilator Systems AVEA Ventilator Systems This page intentionally left blank 12786 Operator s Manual Revision History Date Revision Pages Changes September 2005 A Al Release May 2006 11 14 21 210 Removed references to the Plus model nn Removed nor operatona fom figure 2 19 316318 321 333 Added a note regarding the setting of Peak 333 Inspiratory Pressure 53 Added Ppeak to the Ist of alert messages December 2006 c 231 Updated the Primary Controls table 236 Added NCPAP to the troubleshooting table 333 Updated the Rate specication 51057 Added the chapter infant NCP AP February 2007 D 41 Updated the igure and added a description ofthe balloon size and selection 425 Added a note regarding date and 12786 iv AVEA Ventilator Systems Warranty THE AVEA ventilator systems are warranted to be free from defects in material and workmanship and to meet the published specications for Two 2 years or 16 000 hours whichever occurs frst The liability of VIASYS Respiratory Care Inc referred to as the Company under this warranty is limited to replacing repairing or issuing credit at the discretion of the Company for parts that become defective or fail to meet published specifications during the warranty period the Company will not be liable under this w
61. PURPLE tracing indicates safety state which occurs when the safety valve is open Waveforms Three waveforms can be selected and simultaneously displayed on the MAIN screen as shown in figure 4 1 Note Waveforms are circuit compliance compensated Waveform Heading Display Flow l min Vt ml Figure 4 1 Waveform Graphs Displayed on the Main Screen 12786 42 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems When you press and highlight the waveform heading display on the touch screen a scrollable menu appears showing the choice of waveforms see figure 42 n Wavefom fet Heading P Xaxs of Figure 4 2 Waveform Selection To scroll through the waveform choices tum the data dial under the touch screen To make your selection touch the touch screen menu again or press the Accept membrane button shown here next to the data dial Figure 4 3 Data dial 12786 Operator s Manual Chapter Monitors Displays and Maneuvers 43 Each waveform is continuously updated unless the PRINT or FREEZE membrane button is pressed The PRINT button transfers data to a connected parallel printer The FREEZE button freezes the curent screen and suspends the screen update unti pressed a second tme Table 4 1 Waveform Choices Heading Display Waveform Shown may Pressure Pes i Airway Pres
62. Ratio Limit KE Limit This is a low priority audible visual alarm LIMIT is displayed and a low priority tone sounds ifthe E Ratio fora mandatory breath exceeds 4 1 The inspiratory phase of the breath is terminated when this alarm activates This alarm is not active in BIPHASIC mode 02 Alarms Low 02 Low Fi02 This high priority audiblevisual alarm LOW FiOz is displayed and a high priority tone sounds if the monitored Delivered 0 falls below the set FO minus 6 or 18 FO whichever is greater High 02 High FiO This is a high priority audibleisual alarm HIGH FiQ is displayed and a high priority tone sounds ifthe monitored Delivered 021 rises above the set FO 6 Table 5 1 Alarm Conditions Message Alarm Condition Range Priority SAFETY VALVE Safey valve 6 open m High OPEN VENTINOP Vertiator alure due to a recoverable ornanvecoverabe NA igh cordton The safety opens indicated by a SAFETY VALVE message and the patents alowed to breathe oom ait PEEP is not maintained 1086 AR Wal a drops below 180 psig L2 bar and no funcional High compressor nsaled or the compressor ouput insufficient to meet nstument demand Patent wl continue to be venilated by O supply 1055 0 Oxygen supply to the ventlator drops below 180 psig L2 bar NA High and the 0 s sett 21 Patent wil continue b be vera by the supply oniy LOSS HELIOX The alam is viggered if hellor is bei
63. Setting Pediatric Setting Neonate Setting High Rate 75 bpm 75 bpm 75 bpm High Tidal vatama S007 7000 mi 300 ml High vty Low Tidal Volume 0T TOT Som Low Vt Low Exhaled TOT EI EIS Minute Volume Low Ve High Exhaled 300 Umm 300 U oUm Minute Volume High Ve Low inspiratory Sono Suo Se Pressure Low Ppeak High inspiratory ESED O eH EELS Pressure High Ppeak Low PEEP Teno Tema Apnea Interval Z0 sec 20 sec 20 sec Auxiliary Controls adult Sting Salting Neonate Setting Manual Breath Suction Ea TER Nebulizer Inspiratory Hold Hold Expiratory Hold Exp Hold 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 33 AVEA User Verification Test Checklist 12786 Machine Serial Number Test Dat Signature of test ile TEST PASS FAIL Automated Tests Power on self test Patient circuit leak test Patient circuit compliance measurement Two point calibration of the oxygen sensor Manual Alarms Checks High Rate Alarm Low Alarm High Vte Alarm Low Ve Alarm High Ve Alarm Low Ppeak Alarm High Ppeak Alarm Low PEEP Alarm Apnea Interval Alarm Extended High Ppeak Alarm Circuit Disconnect Alarm Circuit Occlusion Alarm Loss of AC Alarm High O2 Alarm Low O2 Alarm
64. a breath is triggered by one of the folowing Patient effort activates the inspiratory tigger mechanism The breath interval as set by the RATE control mes out The operator presses the MANUAL BREATH key Initiation ofa breath by any means resets the breath interval iming mechanism Its possible for the patent to initiate every breath if hehe is breathing faster than the preset breath rate ifthe patientis not actively breathing the ventilator automatically delivers breaths atthe preset interval set breath rate p hhh TIME Mandatory Breath Breath interval expired Mandatory Breath Patient triggered REF PRESSURE Figure 3 12 Assist Control Ventilation Waveform 12786 3 20 Chapter 3 Ventilator Operation AVEA Ventilator Systems Synchronized Intermittent Mandatory Ventilation SIMV In SIMV mode the ventilator can deliver both mandatory and demand breath types Mandatory breaths are delivered when the SIMV ime window is open and one ofthe following occurs A patient effort is detected The breath interval has elapsed with no patient effort detected The MANUAL BREATH key has been pressed 10 Sec ei 10 Sec ee 10 Sec n 10 Sec ele 10 Sec ete 10 Sec Time Assist Window Open Patient triggered Volume breath Pressure supported breath eot Figure 3 13 SIMV Waveform The breath interval is established by the preset breath rate It resets as soon as the interval ime determined by the set
65. additional flow to the patient during periods of demand AVEA measures the Peak Inspiratory Pressure Ppeak 3 16 Chapter 3 Ventilator Operation AVEA Ventilator Systems every 2 miliseconds throughout the breath cycle and sets virtual Pressure Support Target of the greater of PEEP 2 cmH 0 or Ppeak 2 cmH 0 The minimum Virtual Pressure Support level is set PEEP 2 cmH0 The maximum 2 times the set PEEP Simultaneously the ventilator monitors and compares the P peak measurement to its previous value Should the Ppeak decrease by the 2 cm O the ventilator will recognize the patient demand and automaticaly switch over to deliver a Pressure Support breath at the viral Pressure Support Target This allows flow to exceed the set Peak Flow thereby meeting the patents demand Once the set tidal volume has been delivered the ventilator looks atthe inspiratory fow Ifthe Peak Inspiratory Flow greater han set peak fow the ventilator determines that the patient is continuing to demand flow and cycles the breath when inspiratory fow falls to 25 of peak inspiratory fou If he Peak inspiratory Flow is equal to the set the ventlator determines that there is no continued patient demand and ends the breath as a Volume Control breath Defauitis on Can be tumed off by accessing advanced setting of Peak Flow in Volume Controlled Ventilation 2 Pressure breaths which are Controlled by pressure inspiratory PEEP Limited by pr
66. adult patient size without first changing the mode to one available for those patients 3 10 Chapter 3 Ventilator Operation AVEA Ventilator Systems Ventilation Setup Ventilation Setup Screen T mE HUMIDIFIER E aad arem Ce ee Figure 3 6 Ventilation Setup In the Setup screen controls are available to setthe following Artificial Airway Compensation AAC Range Default OFF When Artficial Airway Compensation is tumed the ventilator automatically calculates the pressure drop across the endotracheal tube and adjusts the aintay pressure to deliver the set inspiratory pressure to the distal carina end of the endotracheal tube This calculation takes into account fow gas composition Heliox or Nirogen Oxygen Fraction of Inspired Oxygen F102 tube diameter length and pharyngeal curvature based on patient size Neonatal Pediatric Adult This compensation only occurs during inspiration Artificial Airway Compensation active in all Pressure Support and Flow Cycled Pressure Control Breaths Note Monitored airway pressures inspiratory will be higher than set values when Artficial Airway Compensation is active WARNING Activation of Artificial Airway Compensation while ventilating a patient will cause a sudden increase in the peak airway pressures and a resultant increase in tidal volume Exercise caution when activating Artificial Airway Compensation whil
67. al be indicated whenever a defective gas 1D connectors installed in ventiator When a defective Gas LD connectar is detected he qas corrections default o FANFAILURE 4 bo proriy audblevisual alarm activated and FAN NA Tow FAILURE indicated whenever te fan has Stopped rotating 12786 6 14 Chapter Alarms and Indicators AVEA Ventilator Systems This page intentionally left blank 12786 Operator s Manual 7 1 7 Maintenance and Cleaning Cleaning amp Sterilization The AVEA is designed for easy maintenance xposed parts ofthe ventilator are corrosion resistant CAUTION DO NOT submerge the ventilator or pour cleaning liquids over or into the ventilator To minimize cleaning and replacement frequency the AVEA design places the exhalation manifold fow sensor and diaphragm behind the exhalation fiter and water ap In the event that they do require cleaning use the methods given below under Cleaning of Accessories and Ventilator Parts Cleaning External Surfaces All extemal surfaces of the ventilator can be wiped clean with one of the following Isopropy Alcohol Chlorine Compounds Maximum Concentration 1 10 These compounds are ited by volume in water Cleaning Accessories and Parts 1 Using Alcohol or Chlorine compounds The following accessory can be wiped clean using the Isopropyl Alcohol or Chlorine Compounds listed above The exhalation cartridge 2 Using an Enzyme P
68. alarms can be disabled in the event of a failure ofthe oxygen sensor while the ventilator is in use To disable the alarm depress the Enable Disable 02 softkey to re enable depress the softkey again NOTE The oxygen alarms cannot be disabled while helox is in use Powering the ventilator off and back on again will automatically re enable the oxygen alam WARNING Although disabling the oxygen alarms will not effect oxygen titration an external analyzer should be placed in line in the breathing circuit until the oxygen sensor has been replaced 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 19 12786 Flow Correction Allows for fow correction to Body Temperature Pressure Saturated or ATPD Ambient Temperature Pressure Dry Default position is and should be used for all clinical applications ILV Mode To enable Independent Lung Ventilation and define the Master and Slave ventilators access the Utilities screen from the screens menu see figure 2 30 ILV requires the use of a specially configured accessory cable kit which is available from VIASYS Part Number 16246 With both ventilators tumed off connect the ILV cable PN 16124 to the analog port of each ventilator Turn on the ventilator to be designated as the Slave Adjust all primary and advances settings as desired Next power up the Master ventiator Select Master from the Utilities screen Adjust all primary and advanced s
69. an Alarm Limit To setthe limits for each alarm press the red Alarm LIMITS membrane button the right ofthe user interface marked with the icon shown here The Alarm Limits screen wil appear see figure 5 2 To setthe limits for an alarm press the touch screen immediately over the alarm control The control wil highlight change color on the screen Figure 5 2 Alarm Limits Screen ES With the control selected rotate the large data dial below the touch screen until the control reaches the setting you require To accept the new setting either press the touch screen over the control again or press the ACCEPT button Note Red indicators appearing on the primary controls display the relative alarm settings of any associated alarm Alarm Silence You can disable the audible alarm for 2 minutes 1 second by pressing the Alarm Silence key Pressing the Alarm Silence key again before the 2 minute period is up wil cancel the silence This feature is functional for all alarms with the exception ofthe Vent nop alarm which cannot be silenced E 6 6 Chapter Alarms and Indicators AVEA Ventilator Systems Note The activation of the auditory alarm silence button will not prevent the subsequent activation of auditory alarm signals for certain alarm conditions Alarm Reset The Alarm Reset button deactivates visual indicators for alarms that are no longer act
70. aneuver Screen VOLUME AIC 44 is the airway pressure at the end of exhalation immediately prior to the beginning of the next mandatory inspiration During the execution of this maneuver the ventilator will execute an expiratory hold in which both the inspiratory and expiratory valves will be closed The ventlator wil establish the AutoPEEP measurement when the system pressure reaches equilibration atthe next mandatory breath interval or 5 seconds whichever is shorter Controls Sensitivity The preset Sensitivity establishes the level that the airway pressure must drop below PEEP to abort the AutoPEEP maneuver Range 0 1 to 5 0 cmH 0 Resolution 02 cmH 0 Default 3 0 cmH 0 12786 4 18 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Start Stop The maneuver begins when the START key is actuated and the ventilator is in exhalation The maneuver will stop immediately when the STOP key is activated the maneuver is completed or a patient ffr is detected and normal ventilation will resume Note The maneuver will e aborted if a patient efforts detected and the message bar wil indicate a message stating that patent effort was detected Alarms Ali currenty available alarms shall be active during the AutoPEEP maneuver To Perform an AutoPEEP Maneuver The AutoPEEP maneuver allows the measurement of PEEP generated within the breathing system patient and circui
71. ap 2 16 Chapter 2 Unpacking amp Setup AVEA Ventilator Systems The Smart Heliox Fitting Color Gs A DISS type No 1180 smart connector iting is also available for use with an 80 20 Heliox gas mixture see figure 2 23 F ollow the instructions contained with your Heliox kitto install the tethered Heliox connector This fiting has no integral water trapfitr All AVEA Smart connectors with or without the integral water rapfiter attach in the same way Align he connector see figures 2 22 and 2 23 seat gently onto the iting and screw down the fiting collar unti finger tight Figure 2 23 Attaching the Tethered Hellox Connector The AVEA Smart connectors signal to the ventilator which type of fiting is attached and therefore which gas controls to initiate The fiting on the right ofthe panel is for attaching the Oxygen gas source The 02 fiting type is CGA DISS type No 1240 NIST or Air Liquide oxygen fitings are also available from VIASYS Attaching the Gas Hoses Oxygen Connection Attach the Oxygen hose to the fiting on the right of the back panel see figure 2 24 Figure 2 24 Connecting the 02 Hose Heliox Connection Ifyou have the upgrade for Heliox delivery attach the Heliox hose to the tethered Smart connector fiting on the left ofthe back panel as shown in figure 2 25 The air hose will not attach to fiting designed for Heliox and vice versa Figure 2 25 Connecting the Heliox Hose
72. arranty unless A the Company is promptly notified in writing by Buyer upon discovery of defects or failure to meet published specifications 8 the defective unit or part is retumed to the Company transportation charges prepaid by Buyer C the defective unt or part is received by the Company for adjustment no later than four weeks following the last day of the warranty period and D the Company s examination of such unit or part shall disclose to satisfaction that such defects or failures have not been caused by misuse neglect improper installation unauthorized repair alteration or accident Any authorization of the Company for repair or alteration by the Buyer must be in writing to prevent voiding the warranty In no event shall the Company be liable to the Buyer for loss of profits loss of use consequential damage or damages of any kind based upon a claim for breach of warranty other than the purchase price of any defective product covered hereunder The Company warranties as herein and above set forth shall not be enlarged diminished or affected by and no obligation or lability shall arise or grow out of the rendering of technical advice or service by the Company or its agents in connection with the Buyers order of the products furnished hereunder Limitation of Liabilities This warranty does not cover normal maintenance such as cleaning adjustment or lubrication and updating of equipment parts This warranty shall be void
73. at the maneuver will last Normal ventilation will be suspended for the duration of the maneuver and wil resume after the duration has timed out Range 5 0 to 30 0 seconds Defaut 10seconds 12786 Operator s Manual Chapter 4 Monitors Displays and Maneuvers 411 E Sensi The maneuver sensitvty establishes the level below PEEP that the aiway pressure must drop which determines the onset of a patient effort This allows the clinician to set the maneuver appropriate to patient abili Range 0 1 to 5 0 Resolution 02 emH 0 Default 3 0 cmH 0 Note Excessively high seting of the maneuver sensitivity affect the accuracy of timing for P100 determination Start Stop The maneuver begins when the START key is actuated The maneuver will be immediately terminated should the operator activate the STOP key and normal ventilation wil resume Note ifthe Start key is activated during a mandatory inspiratory breath the maneuver will not commence until the ventilator cycles into exhalation and the minimum expiratory me of 150 msec has elapsed Alarms All curenty available alarms shall be active during the MIP J Pio maneuver except Apnea Interval and Low PEEP To Perform a MIP P100 Maneuver The MIP P100 maneuver allows the measurement of the Maximum Inspiratory Pressure achieved by the patient during an expiratory hold maneuver The ventilator can also measure the P100 value which is the max
74. ata lost Check Barometric Pressure setting Can t change size to PED or ADULT when Mode is TCPL Can t change size to NEO when Mode is Can t change size to NEO when Mode is BIPhasic Can t change patient size when Machine Volume is active ILV is not available when Mode is BiPhasic Can t disable O2 Alarms when Heliox is in use Ppeak gt S0cmH O The Message Bar tored to default Messages not requiring acknowledgement ar response appear in the Message Bar located at the bottom right ofthe touch screen complete list of text with explanations for those messages that appear in the message bar is provided in Appendix F 6 4 Chapter Alarms and Indicators Ventilator Systems Alarms Alarm Categories ventilator alarms are grouped into three categories High priority waming This category of alarm requires immediate action high priority alarm the alarm indicator is RED and the alarm icon flashes ata rate of 2 Hz fast A high priority alarm sounds a series of five tones three low and two high repeated at intervals of 6 seconds Medium priority caution A medium priority alarm displays a yellow indicator and the alarm icon flashes at Hz slow A medium priority alarm sounds three tones all at the same pitch repeated at intervals of 20 seconds Low priority advisory A low priority alarm or advisory displays a yellow indicator and the alarm i
75. ation Range 0 50 0 Resolution 1 cmH 0 Default 0 PEEP Equilibration Time PEEP Tea The PEEP Equilbraton Time determines the amount of time allowed for equilibration of the airway pressure before slow flow commences Upon activation ofthe maneuver the ventilator wil set PEEP to the Maneuver PEEP level for the PEEP Equilration Time pror to beginning the slow flow maneuver 12786 414 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Range 0 0 to 30 0 seconds Resolution 0 1 second Default 10second Sensitivity The preset Sensitivity establishes the level below the peak airway pressure that the pressure must drop to abort the Pre maneuver Note The maneuver will be aborted if a patient efforts detected and the message bar wil indicate a message stating that patient effort was detected Range 1 50 0 Resolution 01 cmH 0 Defaut 30 0 Start Stop The maneuver shall begin when the START key is actuated The maneuver shall be immediately terminated when the STOP key is actuated a patient effort is detected or the maneuver tidal volume has been delivered and normal ventilation wil resume Upper Pnex and Lower determination Once the maneuver tidal volume has been delivered the ventilator wil into exhalation At the end of exhalation the Vol loop wil freeze automatically the upper and lower inflection points as well as the delta Pia volume wil be calcu
76. ation Circuit SmiemHZO COKE Compliance NOT actve in Compensation Neonates Circ Comp Humidification ative On ave OF ative On Patient Weight Tk Tig Tg Primary Controls Adult Setting Pediatric Setting Neonate Setting Breath TypeMode Volume AT Volume AC TCPLAC Breath Rate Rate 12 bem 72 bpm 20 om Tidal Volume 500 ml 100 mi 20 ml Volume Peak Flow B0 UR SUmm inspiratory 15 9 Pressure Insp Pres Inspiratory Pause DE CLES E Insp Pause inspiratory Time EE DEES LES Insp Time PSV PEEP 3 omid 10 Limi 10 Umi OS Umm s CUA E Advanced Settings Adult Setting Pediatric Setting Neonate Setting Vayne 0 o8 0000 NA Vsync Rise 5 5 NA Sigh CIEL Tol NA Waveform Dee 1 Dec 110957 Bias Flow ZoUmm 20 Umi ZoUmm inspiratory 30cm Pressure Trigger Pres Trig PSV Rise 5 5 5 PSV Cycle 25 25 10 12786 2 32 CChapter2_ Unpacking amp Setup AVEA Ventilator Systems Aduk Seting Pediatric Seting Neonate Set ng PSVTmax 5 0 75 sec 035 sec Machine Volume oL Omi Omi Mach Vol Volume Limit 2507 Sum EXE Vol Limit Inspiratory Rise 5 g 5 Insp Rise Flow Cycle ACH TE GT TE T High PSV Of Off NA THigh Sync GA NA TLow Sync 0 GA NA Demand Flow On On On Alarm Settings Adult
77. ator wil deliver an on screen Pop Up Message stating that the Ppeak gt 90 0 The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak to less than or equal to 90 0 2 Spontaneous breath In adult and pediatric applications a Spontaneous breath is a demand breath where the pressure level during inspiration is preset at PEEP 2 0 In neonatal applications a Spontaneous breath is a demand breath delivered only atthe preset PEEP Note IF PSV level is insufficient to meet patient demand premature termination of the breath may occur with auto cycling In these cases the PSV level should be increased sight Figure 3 11 PSV Waveform In figure 3 11breath number 1 represents the fow tracing which occurs when the PSV level is insuficient to meet the patient demand Breath two shows resolution afte increasing the PSV level slightly Pressure tracing will show a similar appearance 12786 Operator s Manual Chapter 3 Ventilator Operation 3 19 Ventilation Modes Leak Compensation The ventilator incorporates a leak compensation system This system compensates for baseline leaks at the patient interface To activate leak compensation use the touch screen control displayed the Setup screen Assist Control Ventilation A C This is the default mode for all patient types In Assist Control ventilation mode all breaths inated and delivered are mandatory breaths The initiation of
78. cal Standards to which Conformity is declared EN 794 1 EN 60601 1 EN 60601 1 2 150 13485 EU Notified Body BSI Reg No 0086 Trade names ventilator systems Manufactured by VIASYS Respiratory Care Inc 1100 Bird Center Drive Palm Springs CA 92262 8099 USA 0086 if you have a question regarding the Declaration of Conformity for this product please contact VIASYS Respiratory Care Inc atone ofthe numbers given in Appendix A 12786 Operator s Manual ix Safety Information Please review the following safety information prior to operating the ventilator Attempting to operate the ventilator without fully understanding its features and functions may resultin unsafe operating conditions Wamings and Cautions which are general to the use of the ventilator under al circumstances are included in this section Some Warnings and Cautons are also inserted within the manual where they are most meaningful Notes are also located throughout the manual to provide additional information related to specific features Ifyou have a question regarding the installation set up operation or maintenance of the ventilator contact VIASYS Respiratory Care Inc Customer Care as shown in Appendix A Contact amp Ordering Information Terms WARNINGS identfy conditions or practices that could resultin serious adverse reactions or potential safety hazards CAUTIONS identfy conditions or practices that could result in
79. catheter should be placed in the endotracheal tube and not extend beyond the p To assure proper placement measure the length of the endotracheal tube and its associated adapters Insert the tracheal catheter into the endotracheal tube to a distance not greater than this measurement WARNING Inserting the tracheal catheter beyond the tip of the endotracheal tube may cause irritation and inflammation of the trachea and airways or produce vagal responses in some patients 4 20 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Digital Displays SCREEN SELECT The Monitor Screen co io mm To access the monitor screen press the Screens membrane button to the left of the touch screen on the E E mmm UM The button is labeled with the icon shown here TEM eee Bs fiis Select MONITOR from the selection box that appears Figure 44 Screen Selection The monitor screen can display total of 15 diferent monitored values simultaneously Monitor Displays are updated at the start ofthe next inspiron or every 10 seconds whichever occurs frst Each value can be independently selected from a the available choices see table 42 Use the touch screen to select and highlight the monitor you wish to set 2 Tum the data dial beneath the touch screen to scroll through the menu choices To accept your selection either touch the highlighted display or press the accept button adjacent to the data cial see figu
80. cation for High Ppeak High Opalarm High Ppeak Sust Low Ppeak alarm Low Ve alam Loss of AC alam High Ve alarm Circuit Disconnect High Vt alarm High Rate Alarm Low O alam Apnea Interval alarm Low Vtalarm Low PEEP alarm CAUTION Although failure of any ofthe above tests will not prevent the ventilator from functioning it should be checked to make sure itis operating correctly before use on a patient The Power on Self Test POST This testis run automatically and performs the following checks Processor Self Check ROM Check Sum RAM Test The POST wil also check the audible alarms and the LEDs at which time the audible alarm sounds and the LEDs on the User Interface Module flash Normal ventilation commences at the culmination of the POST The Extended Systems Test EST The EST function accessed from the Setup screen as shown here Press the SETUP membrane button to the lower leftofthe to open this screen 12786 2 28 Chapter 2 Unpacking amp Setup Ventilator Systems SS E HUMIDIFIER AC LEAKCONP ACTIVE OF ae Pvt OFF OF mq dq if m 3 f En Press the EST touch screen icon to highlight message will appear instructing you to remove REMOVE THE PATIENT the patient and block the patient BLOCK PATIENT CIRCUIT WYE After confirming that the patent has been disconnected and the circuit wye blocked press the Continue Cont button The ventilator
81. cceptance of Volume Limit setting when Size is NEO Volume Limit is active and no Wye Flow Sensor connected Varllex or Hotwire Bias Flow insufficient to allow Flow Trigger Acceptance of Bias Flow setting or Flow Trigger setting when Flow Trigger lt Bias Flow 0 5 Heliox concentration will change Acceptance of 7502 setting when Heliox is being used Nebulizer not available Acceptance of Peak Flow setting lt 15 Ipm when Nebulizer is active or on pressing of Nebulizer membrane key when Peak Flow setting lt 15 Ipm Confirm inspiratory pressure settings Selection of Volume Limit control when Volume Limit active at default highest value for patient size Settings restored to defaults Patient Accept when New Patient selected Compliance Compensation not active for NEO Size Accept when Size is NEO and Circ Comp setting is Minimum 0 2 sec Inspiratory Time Acceptance of any combination of settings that wil produce an T Time of less than 0 2 seconds Maximum 4 1 Ratio Acceptance of any combination of settings that wil produce an Ratio of 4 1 or greater Maximum 3 sec Inspiratory Time Acceptance of any combination of settings when size is NEO that will produce an I Time of greater than 3 seconds Maximum 5 sec Inspiratory Time Acceptance of any combination of settings when size is PED or ADULT that will pr
82. ccuracy of some of th Appendix G for Barometric Pressure Altitude conversion chart struments monitoring systems See Input Output Tab VOLUME A C Configuration Input Output Analog Input Scale Analog Output Video Output urs Run Analog Input Configuration Under the heading Set Analog Input Scale there are two buttons representing two possible voltage ranges If the full scale output of the device you are interfacing with is less than 1 volt select the 0 1 volt scale button SV or less select the 0 5 volt range Select the appropriate analog scale and press the ACCEPT key to enter the configuration Analog Inputis configured on the same connector as the ILV The pin configuration for cables to use this feature is shown in figure 2 29 below Pin configuration of the connector for attachment to your other device must be supplied by the manufacturer of that device WARNING All applications using this connector require specially made cables DO NOT connect a standard 0825 cable to this receptacle This could resultin damage to the ventilator Contact VIASYS Respiratory Care technical support at the numbers given in Appendix 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 23 Analog Input Channel 1 006000606666 0000000000000 Analog Inout Channel O Figure 2 30 Analog Input connections Analog Out
83. compressor if present and wall oxygen The safety valve opens indicated by a SAFETY VALVE OPEN visual display and the patient is allowed to breathe room air Note PEEP is not maintained during a LOSS GAS SUPPLY alarm condition When the ventilator safety valve is open the ventilator graphics will indicate a safety state by displaying the color purple Loss of Heliox This is a high priority audibleisual alarm LOSS HELIOX is displayed and a high priority tone sounds The alarm is triggered if Heliox is being used and the Heliox supply to the ventilator drops below 18 0 psig 1 2 bar The patient continues to be ventiated by the oxygen supply only Pressure Alarms 12786 Low Peak Pressure This is a high priority audiblevisual alarm LOW Ppeax is displayed and a high priority tone sounds whenever the peak inspiratory pressure for a given breath is less than the preset threshold for Low Prear Range 3 t0 99 Defaults 8 0 Adult ediatric 5 0 Neonate Limitations Notactve for spontaneous breaths High Peak Pressure This is a high priority audiblevisual alarm HIGH Ppa is displayed and a high priority tone sounds whenever the preset High Prenc threshold is exceeded Inspiration is terminated and circuit pressure allowed to retum to the current set baseline pressure 5 cmHz0 Circuit pressure must retum to baseline 45 cmH20 before the next breath can be delivered Normal High Alarm Alarms i
84. con does not fash A low pror alarm sounds a single tone which is not repeated There are visual displays for all categories of alarms A text message appears in the indicator at the upper right of the touch screen The alarm icons fash unti the cause of the alarm is no longer present Bath high and medium priority alarms that have been resolved will appear as a solid yelow message indicator with no icon displayed unti the Alarm Reset button is pressed See table 5 1 for alarm messages Multiple alarms can be displayed simultaneously If 2 or more alarms are current a white triangle appears on the right of the alarm indicatoressage Touching the screen over the triangle will open a drop down box for display of up to nine alarm messages In the eventthat there are more than rine active or resolved alarms available for display he nine highest priority alarms wil be displayed close the drop down box and display single alarm message touch the tiangle again Alam messages are prioritized in order of appearance the highest priority alarm is always displayed in the tp position ofthe alarm indicator display The alarm indicator is solid green with no message when no alarms are current active Backup Alarm advisory A continuous tone alarm sounds when a ventinop occurs and the Back Up Alarm electronics detects the primary alarm is not functioning 12786 Operator s Manual Chapter Alarms and indicators 65 Alarm Controls Setting
85. d apnea breath type before pressing the MODE ACCEPT button The controls for the apnea breath type will not be visible once the MODE ACCEPT button has been pressed Only those controls that are active and required for CPAP PSV or APRV BIPHASIC will remain To review the Apnea backup settings press the Mode button at any ime and select APNEA Settings Breath Types 12786 This section contains a brief description ofthe breath types and ventilation mode combinations available for adult pediatric and neonatal patients There are two basic breath types Mandatory breaths delivered according to set ventilator parameters and Demand breaths triggered by the patient breaths are defined by four variables Trigger initiates the breath Control controls the delivery Cycle primary breath termination and Limit secondary breath termination Mandatory Breaths Mandatory breaths can be triggered by the machine the patient or the operator There are 4 mandatory breath types delivered by the AVEA 1 Volume breaths which are Controlled by flow inspiratory Limited by pre set volume or maximum inspiratory pressure Cycled by volume flow and time Note The Volume Controlled breath is the defaut breath type for adult and pediatric patients The Intra Breath Demand System in Volume Ventilation AVEA features a unique intra breath demand system in Volume Controlled ventilation designed to provide
86. data to printer has completed 12786 F2 Appendix Message Bar Text Ventilator Systems AVEA MESSAGE BAR TEXT CAUSE Printer Busy Print Screen button was pressed device has not completed sending data from previous activation Volume Limit disabled On disconnect of WFS Neo or Hotwire when Size is NEO and Volume Limit is active Proximal Flow Sensor disconnected On disconnect of WFS any ype Flow sensor is not Heliox compatie On connect of Hotwire WFS when Heliox is active Proximal Airway Line disconnected On disconnect of Proximal Pressure connection Proximal Flow Sensor conflict On simultaneous connect of Hotwire and VarFlex WES Esophageal monitoring not available On connect of Esophageal Balloon when size is NEO Tracheal monitoring not available On connect of Tracheal Catheter when size is NEO Flow Sensor Error On power up failure to validate any internal flow sensor Wye Sensor Error On connect and failure to validate any proximal flow sensor Device Error On detection of a fault Classified as Device Error see Fault Section Esophageal Balloon Leak Test Failed On failure of Esophageal Balloon leak test Stopped Patient Effort Detected Upon detecting Patient effort maneuvers which require a passive patient Proximal Flow S
87. diagrams component parts lists calibration instructions and other information to assist in repair of those parts of he ventilator designated by the manufacturer as repairable items 74 Chapter Maintenance and Cleaning AVEA Ventilator Systems WARNING Ifa mechanical or electrical problem is recognized while operating the ventilator the ventilator must be removed from use and referred to qualified personnel for servicing Using an inoperative ventilator may result in patient injury Battery Care The AVEA has an intemal Nickel Metal Hydride battery pack that will provide power backup for short periods in the event thatthe mains power supply lost see figure 6 1 Under normal operating conditions and when fully charged the intemal battery is capable of powering the ventilator alone for 1 hour or the ventilator and compressor for 30 minutes Figure 6 1 Internal Battery Pack NOTE The intemal battery is intended only for short duration backup in the event of disruptions in ine power The internal battery provides 30 minutes of battery power for the ventilator and compressor nominally The recharging for this battery can be up to 4 hours depending on the state of discharge Should you wish to perform intra faciity transport of patients you should equip your instruments with the optional extemal battery The addition of the external battery will extend the period to 2 hours for ventilator and compress
88. diblevisual alam LOW PEEP is displayed and a high priority tone sounds if the baseline pressure PEEP is less than the Low PEEP alarm threshold for a period greater tran 0 25 0 05 seconds Range Oto 60 0 Defaults 3cmH 0 Adult ediatic lado Neonate The alam is off if set to zero uit Occlusion Alarm This high priority audiblevisual alarm CIRCUIT OCCLUSION is displayed and a high priority tone sounds whenever the pressure level in the inspiratory limb of the circuit exceeds the expiratory pressure level by greater than 6 cmH 0 for more than 200msec in neonatal and pediatric applications and greater than 9 0 for more than 200msec in adult applications Inspiration is terminated and the circuit pressure is allowed to retum to the current set baseline pressure 5 0 Circuit pressure must retum to baseline 45 cmH20 before the next breath can be delivered In adult applications the circuit occlusion alarm is suspended during the first 150 msec of exhalation 12786 Operator s Manual Chapter Alarms and indicators 6 9 Volume Alarms 12786 Low Exhaled Minute Volume Low Ve This is a high priority audiblevisual alarm LOW MINUTE VOLUME is displayed and a high priority tone sounds whenever the monitored exhaled minute volume is less than the Low Exhaled Minute Volume threshold setting Range Off indicated by 0 1 to 50 L Adult Off indicated by 0 0 1 to 30 0L Pediatric Off indicated by 0 0 0
89. dule International Showing Button Icons 12786 3 2 Chapter 3 Ventilator Operation AVEA Ventilator Systems Figure 3 1b User Interface Module English Showing Button Labels The Membrane buttons are the controls which surround the Touch Screen Moving clockwise around the UIM from the top right see they are Alarm Silence LED Pressing this button wil disable the audible portion of an alarm for 2 minutes 1 second or until the Alarm Silence button is pressed again This button is not functional for a VENT INOP alarm Note Pressing the alarm silence button wil not prevent the audible alarms sounding again later for certain alarm conditions Alarm Reset Cancels the visual indicator for alarms that are no longer active 12786 Operator s Manual Chapter3 Ventilator Operation 33 C 12786 Alarm Limits Opens the alarm limits screen for data entry or adjustment Toggles the screen on and off Note Pressing the Freeze button while the Alarm Limits window is open will automatically close the window and freeze the graphics Manual Breath Pressing this button during the expiration phase of a breath delivers single mandatory breath at current ventilator settings No breath is delivered ifthe key is pressed during inspiration Note The Manual Breath button is not active in BIPHASIC Suction LED Pressing this button initiates Disconnectfor Suction
90. e bottom of the UIM Default position is off RS 232 Output Sets the RS 232 output format for digital communications via the port labeled MIB Nurse Call Connection The AVEA can be connected to a remote nurse call system via the modular connector on the rear panel shown in figure 2 20 E The jack is configured to interface with normally closed NC open on alarm or normally open NO closed on alam signals Cables for both systems are available from VIASYS Respiratory Care Ic 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 25 Date Time Tab VOLUME A C Configuration input output Y Date Tima 12786 Setting the Date Using the touch tum touch technique use the data dial to set the correct month day and year prior to use ofthe ventiator Setting the Time Using the touch tum touch technique use the data dial to set the correct me in hours and minutes prior to use of the ventiator Note After changing the date andlor time cycle the ventilator off then on and select NEW PT to ensure coordination ofthe EVENTS and TRENDS with the new datetime set 2 26 Chapter2 Unpacking amp Setup AVEA Ventilator Systems Powering up the AVEA To power up the ventilator connect the power cord to a suitable AC power supply and tum on the power switch located on the back panel ofthe ventilator as shown here oF Figure 2 4 Power Switch The power upireboat i
91. e desired language Use the Accept key to accept the change Ali text displayed on the LCD screen will automatically be translated to the set language Note For ease of use all languages appear in their native textin the text selection box on the utilities screen Low Vte Alarm Sensitivity Sets the number of consecutive breaths with an exhaled tidal volume below the Low Vte Alarm setting which are required to sound the alarm The default is 3 breaths the range is 1 5 breaths Increase Fi02 Configures the step increase used during the increase oxygen maneuver Sets the amount of oxygen the ventilator wil increase above the current set FiO2 Example Ifthe Increase FIO2 is set at 20 AND The setFiO2 is 40 WHEN The increase Fi02 Maneuver is activated the Fi02 will increase to 60 for two minutes after which it wil return to 40 The default setting for infants is 20 and 79 for Pediatric and Adult applications Note To achieve 100 delivered Fi02 during the Increase 02 maneuver set the Increase Fi02 setting to its maximum of 19 Note The settings willbe reset o default values when New Patient is selected in the set up menu Setting the Barometric Pressure Using the touch tum touch technique use the data dial to correct barometric pressure for the current altitude 2 22 Chapter 2 Unpacking amp Setup AVEA Ventilator Systems Note Failure to properly set the barometric pressure can affect a
92. e patient Delta AutoPEEPaw dAutoPEEPaw Delta AutoPEEPay GAutoPEEPau the diference between pressure at the end of an expiratory hold maneuver and the airway pressure at the start of the next scheduled breath after the expiratory hold maneuver Range 0t 50 cmH 0 Resolution 1 cmH 0 Note Requires a passive patient Accuracy 2omH20 or 5 whichever is greater 12786 Operator s Manual Appendix H Advanced Pulmonary Mechanics Monitored Parameters H 5 AutoPEEPEs AutoPEEPes is defined as the difference between esophageal pressure measured at the end of exhalation PEEPzs minus the esophageal pressure measured at the start of a patentiniiated breath Pes su and the sensitivity of the ventlato s demand system The sensitivity of the ventiator s demand system is the difference between the baseline airway pressure PEEP x and the airway pressure when the patient initiates a breath Pau AutoPEEPes PEEPes Pes sod PEEPau Pan sad Range 01 50 cmH 0 Resolution 1 cmH 0 Note Requires an esophageal balloon catheter Accuracy 2cmH20 or 5 whichever is greater Transpulmonary Pressure Plateau Py Plat The ventilator is capable of calculating and displaying the Transpulmonary pressure during an inspiratory hold which is the difference between the airway plateau pressure Puar av and the corresponding esophageal pressure Pruran Pes Range 60 to 120 cmi Resolution 1 cmH 0 Accuracy
93. e the patient is attached to the ventilator to minimize the risk of excessive tidal volume delivery Even if inspiratory pressure is set at zero Artificial Airway Compensation will stil provide an elevated airway pressure to compensate for the resistance of the endotracheal tube 12786 Operator s Manual Chapter 3 Ventilator Operation 3 11 12786 When tumed on the Artificial Airway Compensation AAC indicator will appear on the touch screen in all modes of ventilation even though Artificial Airway Compensation may not be active in the current mode i e in volume controlled breaths This is to alert you to the fact that Artificial Airway Compensation is tumed on and will become active if a Pressure Support mode or a combination mode e Volume Control SIMV is selected Tube Diameter Range 201100 mm Default 75mm Adult 55mm Pediatric 3 0mm Neonate Tube length Range 200300 Adut 200260 Pediatric 200150 Neonate Default 300cm Adult 260cm Pediatric 150cm Neonate Leak Compensation LEAK COMP Range ON OFF Default OFF During exhalation PEEP is maintained by the cooperation of the Flow Control Valve and the Exhalation Valve EXV The pressure servo is setto target pressure of PEEP and the FCV pressure servo is set pressure target of PEEP 0 4 cmHz0 The ExV servo relieves when the pressure is above its target and the FCV supplies fow when the pres
94. ed LE Ratio Calc LE based on the set breath rate set idal volume and set peak flow for Volume breaths or the set breath rate and set inspiratory for Pressure TCPL and breaths The display is located next to the Calculated Minute Volume display atthe bottom left of the Main screen 28 sec 2 GETEP Sry Range 1999109991 Limitations For Volume breaths the calculated LE Ratio shall only change ifthe set tidal volume set breath rate orsetpeak is changed For Pressure TCPL PRVC breaths the calculated Ratio shall only change ifthe set breath rate or set inspiratory is changed Note Calculated ratio is not active in BIPHASIC mode Calculated Minute Volume Calc Ve The ventilator displays the Calculated Minute Volume at the bottom left of the Main screen as follows Calc V Set tidal volume Set breath rate Limitation For Volume breaths only The Calc Ve display only changes ifthe set tidal volume or set breath rate changed Calculated Time High amp Time Low Min Max The AVEA displays the calculated minimum and maximum Time High and Time Low in APRV BiPhasic ventilation The displays located immediately under the Time High and Time Low primary controls on the main screen Pres High Pres Low Min Mix Min Note Time High and Time Low are maximum time settings for a time cycled transition Actual times may vary dep
95. ending on the patient s spontaneous breathing pattem and the Sync window setting 12786 Operator s Manual Chapter 4 Monitors Displays and Maneuvers 427 Main Screen Monitors Five monitored parameters are continuously displayed to the left ofthe graphic displays These are selected in the same way as the displays on the Monitors screen Use the touch screen to select and highlight the monitor you wish to set 1 2 Tum the data dial beneath the touch screen to scroll through the menu choices 3 Toacceptyourselection either touch the highlighted display or press the accept button adjacent to the dota dl Wege gt Selecion Mens Parameter orones Parameter XF lpm Figure 4 8 Selectable Monitored Parameters Displayed on the Main Screen Note The main screen monitored parameters may be different than the monitored parameters on the loops or trends screens 12786 4 28 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems This page intentionally left blank 12786 Operator s Manual 51 Chapter5 Infant NCPAP Overview Infant Nasal CPAP is a spontaneous mode of ventilation In this mode no mechanical positive pressure breaths are delivered and no inspiratory tiggers are required A patient spontaneously breathes at an elevated baseline pressure level called the CPAP level Note Nasal CPAP is an available option in the Infant Mode Select Screen only
96. ensor Ready 12786 Operator s Manual 6 1 Appendix G Adjusting Barometric Pressure for Altitude Table Altitude The default setting for barometric pressure on AVEA is 760 mm Hg For institutions atattudes of 1000 feet or greater barometric pressure can be set by the operator Open the screens menu by pressing the screen indicator on the touch screen or the SCREENS membrane button located to the left ofthe touch screen Select utiity from the screens menu Press the touch screen button for barometric pressure and use the data dial to change the setting Once you have reached the desired barometric pressure setting press the ACCEPT membrane button adjacent to the data dial To close the utes screen and retum to the main screen press the screen indicator again and select MAIN from the menu or press the membrane button to the left of the touch screen labeled MAIN Below is a chart of approximate Barometric Pressure at varying altitude Barometric Pre CRC Handboak of Chemisty and Phys GIStE ction 1960108 CRC Press In Boca Raton Faia 12786 G 2 Appendix G Adjusting Barometric Pressure for Altitude Ventilator Systems This page intentionally left blank 12786 Operator s Manual Hel Appendix Advanced Pulmonary Mechanics Monitored Parameters Rapid Shallow Breathing Index f VJ The ventilator is capable of displaying the calculated value for Rapid Shallow Breathi
97. eonatal applications Volume Limit requires the use of a wye flow sensor Whenever a proximal fow sensor is used Neonatal Pediatric or Adult applications the Volume Limitis actvated by the inspiratory tidal volume measured by the wye flow sensor In adult and pediatric applications where wye flow sensor is used Volume Limitis determined by the calculated inspiratory wye flow When the volume limit threshold has been reached the ventilator alarm status indicator will change to yellow and display the words Volume Limit The alarm status indicator cannot be reset until the ventilator has delivered a breath which does not meet the volume imit threshold To reset the alarm status window use the alarm reset button Note Excessive inspiratory fow rates or highly compliant ventilator circuits may allow delivery ofa tidal volume that exceeds the volume limit setting This is due to the ventlator circuit recoiling and providing additional tidal volume to the patient Delivered tidal volumes should be closely monitored to ensure Volume Limit accuracy 3 40 Chapter 3 Ventilator Operation AVEA Ventilator Systems Mac Volume Mach Vol The Machine Volume control sets the minimum tidal volume delivered from the ventilator when the control is activated in pressure control breath This control is always used with the cycling criterion in pressure control ventilation Machine volume is circuit compliance compensated in adult and pediatric
98. er of cycles 30 Vacuum Steam pre condition pulses vacuum pulses Steriizer vacuum target set to 10 26 psig Dwell at 132 138 deg C for 4 to 8 minutes duration Minimum dry 15 minutes 50 cycles maximum for the infant fow sensor and 25 cycles maximum for the water traphwater collection jar Parts not made by VIASYS Respiratory Care Bird The exhalation fiter should be sterilized per the instructions supplied by the manufacturer Pall Medical enclosed with the filter Warning Do not immerse the fiter in liquid when cleaning The AVEA is designed to accept certain non proprietary accessories If you choose to use a diferent fiter with your ventilator follow the manufacturers instructions to cleanjstelize the part Disposable Parts The following are considered disposable parts and VIASYS Respiratory Care Inc does not therefore recommend method of cleaning or sterilization Disposable variable orifice flow sensors Tracheal adapters Tracheal catheters Esophageal catheters Other Accessories For all other accessories purchased for use with your AVEA but nat supplied by VIASYS Respiratory Care Inc follow the manufacturers recommendations for clearing or sterilization 12786 Operator s Manual Chapter Maintenance and Cleaning 73 Recommended Periodic Maintenance 12786 VIASYS Respiratory Care Inc is committed to product support If you have any questions conceming your ventilators operation
99. es and press the Balloon Test softkey on the maneuver screen The ventiator wil perform a leak test by evacuating the balloon filing it to the proper specifcation measuring 12786 Operator s Manual Chapter Monitors Displays and Maneuvers 49 12786 the balloon pressure and finally evacuating the ballon A message wil appear on the message bar after the test stating Pass or Fal In the event thatthe balloon does not pass the leak test inspect the balloon for damage and replace if necessary If no damage is present on the balloon check all connectors on the ballon and extension tubing and repeat the test Note Disconnecting the ballon after passing a ballon test will require that the test be repeated Once the balloon has passed the leak test it is ready for placement in the patent Proper placement of the balloon is imperative for accurate measurements During insertion the waveform produced can provide information to confirm proper placement An approximate level of placement can be made by measuring the distance from the tip of the nose to the bottom of the earlobe and then from the earlobe to the distal ip ofthe xiphoid process 1 The esophageal pressure waveform correlates to the airway pressure in that they become positive during positive pressure breath and negative during a spontaneous breath 2 The esophageal racing may show small cardiac oscilations reflective of cardiac activiy 3 Once placed using the above criteria
100. esistance atthe tne of he Peak Expiratory Flow PEFR 3 Imposed Resistance Ror Be away resistance between the wye of the patent creuk and the rachel sens Rums Lung Resistance Rel The ato of the tracheal pressure diferental to inspiratory Tow 12 ms porta the end of spraton PER The actual peak inspiratory fow rate forthe inspiratory phase ofa breath PEFR The actual peak expiratory fou rate for he expiratory phase ofa breath Deta Airway Pressure Pao he diference between peak away pressure and baseline away Pressure Pes Deta Esophageal Pressure Pa 1s the diference beween peak esophageal pressure and baseline esophageal pressure AwoPEEP AUDPEEP is te airway pressure at te end ofan expiratory hold maneuver 12786 Operator s Manual Chapter 4 Monitors Displays and Maneuvers 4 23 Display Value Deta AutoPEEP diference between aia pressure at he end ofan expiratory hold maneuver and the airway pressure athe start of the next scheduled breath afer he expiratory hold maneuver AutoPEEPes AuxEEPis the diference between esophageal pressure measured at he end of exhalaton minus esophageal pressure measured at the start of patent ini ated breath and the of he ventas demand system Py Plat Transpulmonary pressure during an inspiratory hol me Maximum Inspiratory Pressure he maximum negative sway pressure tat is achieved
101. essure inspiratory PEEP margin Cycled by time or fw 3 Time Cycled Pressure Limited TCPL breaths available for neonatal patients only which are Controlled by inspiratory flow Limited by pressure inspiratory PEEP Cycled by time fow inspiratory or volume Volume Limit Note TCPL breath type is only available for Neonates This is the default breath type for neonate patients Note The ventilator wil not allow the operator to set a Peak Inspiratory Pressure Pres or PSV PEEP or baseline pressure in APRV BiPhasic greater than 90 0 The ventilator wil deliver an on screen Pop Up Message stating that the Ppeak gt 90 cmH 0 The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak to less than or equal to 90 0 WARNING Total resistance of the inspiratory and expiratory limbs of the breathing circuit with accessories should not exceed 4emH20 at 5 L min if flows gt 15 liters per minute are used in TCPL ventilation modes For instructions on how to perform a circuit resistance test see Appendix 12786 Operator s Manual Chapter3 Ventilator Operation 3 17 12786 4 Pressure Regulated Volume Control breaths are pressure breaths where the pressure level is automatically modulated to achieve preset volume PRVC breaths are Controlled by pressure inspiratory PEEP and volume Limited by pressure
102. eting should be atleast 0 5 liters per minute greater than the trigger threshold 02 The Oz control sets the percentage of oxygen in the delivered gas Range 218 100 Default 40 Note During Heliox administration the 02 control sets the percent of Oxygen in the delivered gas The balance ofthe delivered gas is Helium Pressure High Pres High This control is only available in APRV BIPHASIC Mode It controls the baseline pressure achieved during Time High Range 0 to 90 cmH20 Default 15 cmH20 Time High Available in BIPHASIC mode this control sets the maximum time for which the Pressure High setting is maintained Range 0 2 to 30 seconds Default 4 seconds Time Low In BIPHASIC mode this control sets the maximum time for which the Pressure Low setting is maintained Range 0 2 to 30 seconds Default 2 second 12786 Operator s Manual Chapter 3 Ventilator Operation 3 37 Pressure Low In APRV BIPHASIC Mode this control sets the baseline pressure achieved during Time Low Range 0 to 45 cmH20 Default 6 cmH20 Advanced Settings When the mode and the primary breath controls have been set you can further refine delivery of the breath by accessing the Advanced Settings Accessing the Advanced Settings To access the advanced settings group press the ADV SETTINGS membrane button located to the left ofthe touch Screen between the Mode and the Setup buttons The L
103. ettings as desired Connect the patient Note Ventilation wil not begin unti the Master ventilator has been turned on Each ventilator maintains independent settings for F102 during independent lung ventilation Close monitoring of set FiO2 on each ventilator is recommended Confirm alarm settings on each ventilator Each ventilator will alarm independenty based alarm settings established for that particular ventilator Apnea ventilation on the Slave ventilators driven by the apnea ventilation rate of the Master ventilator only Should the ventilators become disconnected during ILV only the Master ventilator will alarm for the ILV Disconnect Condition The Slave ventilator wil alarm for Apnea and begin apnea ventilation atis own active settings WARNING DO NOT attemptto connecta standard DB 25 cable to this receptacle This could cause damage to the ventilator A specially configured cable is required for ALL features associated with this connector Contact VIASYS Tech Support Setting up Independent Lung Ventilation ILV The AVEA has 25 pin receptacle on the rear panel see figure 2 20 to allow for Independent Lung Ventilation ILV with another AVEA The output for ILV provides a SVDC logic signal synchronized to the breath phase ofthe master ventilator Table 2 3 atthe end ofthis section details the relevant pins for the signals carried by this connector Note This connector also caries the Analog Input and
104. eved bythe patent during an expecta hold cmi Pun The negative pressure hat occurs 100 msaferan 6010129 inspiratory fo has been detected 12786 D 4 Appendix D Monitor Ranges and Accuracies AVEA Ventilator Systems Display Description Range Accuracy The summation of airway pressure Pua minus he 000 2000 10 baseine alway pressure PEEPan tes the ouest change i ital volume to the paient AV ding inspraton and normalized o the ttal inspiratory idal volume i Patient Work of Breathing WOS nomakzedt 000 2000 10 hetoalinspratoy tidal volume Patent wokof Joust breathing is defined as summation of to wor components wok of the lung and wok of he chest wal Requires an esophageal loon WOB The work performed by he paentto breathe 00092000 10 spontaneously rough the breathing apparatus Le eT tube he breathing icut and the demand system Requires Yacheal catheter Note Monitored values are displayed as BTPS 12786 Operator s Manual Appendix Sensor Specifications amp Circuit Resistance VarFlex Sensor Specifications Table E 1 Varllex Flow Sensor Specifications Sensor Infant 15 mm Adult 15 mm Part Number 7002500 7002300 Type Single Use Single Use Circuit Location Wye Wye Performance Specifications Flow Range 0 024 to
105. fault 0 00 second PSV Pressure Support The PSV control sets the pressure in the circuit during pressure supported breath Range 0 to 90 cmH 0 AdultPediatic Ot 80 cmH 0 Neonate Maximum Flow 200 Limin Aut 120 Lmin Pediatric 50 Lmin Neonate Default 0 Note The ventiator wil not allow the operator to seta Peak Inspiratory Pressure Insp Pres or PSV PEEP or baseline pressure in APRV BiPhasic greater than 90 0 The ventilator wil deliver an on screen Pop Up Message stating that the Ppeak 90 cmH 0 The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak to less than or equal to 90 0 12786 Operators Manual Chapter 3 Ventilator Operation 335 12786 Note In adult and pediatric ventilation a minimum of2 cmH 0 of PSV above PEEP is applied even when the control is setto zero Note IF PSV level insuficient to meet patient demand premature termination of the breath may occur with auto cycling In these cases the PSV level should be increased sight 1 2 A A V Figure 3 26 PSV Waveform In figure 3 26 breath number 1 represents the tracing which occurs when the PSV level insuffciento meet the patient demand Breath two shows resolution after increasing the PSV level slighty Pressure tracing will show a similar appearance Note Monitored airway pressures inspiratory wil be higher than set when is active With an i
106. fthe inspiratory pressure in the patient circuit exceeds the set High alarm threshold during the inspiratory phase ofa breath except during sigh breath cycles 6 8 Chapter 6 Alarms and Indicators Ventilator Systems Range 10 to 105 0 AdultPeditic 100 85 0 Neonate Defaults 40cmH O AdulfPediatic 30 0 Neonate Notactve for Sigh Breaths Sigh High Perac Alarm Alarms if the inspiratory pressure in the patient circuit exceeds the Sigh High Prexc alarm threshold during a sigh breath Range 15 x Normal High Pread up to a maximum of 105 cmH Active only for Sigh Breaths Note Maximum Circuit Pressure Limit The ventilator has an independent mechanical pressure relief valve which limits the maximum pressure at the patient to 125 Extended High Peak Pressure This high priority audiblevisual alarm EXT HIGH Preax is displayed and a high priority tone sounds ifthe High Prenc alam remains active for more than 5 seconds ie the circuit pressure does not retum to PEEP 5 0 within 5 seconds No breaths are delivered during this alarm condition The Safety and Exhalaton valves open allowing the patient o breathe from room air and the Safety Valve alarm activates Bias flow is suspended while this alarm is active PEEP may not be maintained This alarm remains active flashing unti the condition causing it has been resolved Low PEEP This is a high priority au
107. gnal synchronized to the breath phase ofthe master via a 25 pin connector on the rear of the ventilator The pin configuration for this connector is as follows PIN FUNCTION 1 Analog Input Channel O Analog Input Channel 1 18 Wh 6 vOut 2 Factory Use Only DO NOT CONNECT n Analog Output PRESSURE 5 Analog Output FLOW El Analog Output VOLUME 25 Analog Output BREATH PHASE 5910111213 Ground Analog Note Atleast one analog ground is required for safe and accurate signal output and input One analog ground is suficient for any and all ofthe other signals 12786 Operator s Manual Apper Specifications B 3 Analog Inputs The ventilator provides 2 programmable channels for analog signal inputs as shown above Each channel is scalable for the input ranges specified Ranges Ot1VDC ows voc Oto 10 voc Resoluton 025 mV for 0 to 1 VOC 137 mV for 0 to 5 VDC 25 mV for 0 to 10 VDC Analog Outputs The ventilator provides 4 signals to the analog output connector 1 Airway Pressure Paw Range 60 to 140 cmH O Scale lcmH 0 25 mV Accuracy 50 mV or 5 of reading whichever is greater Zero Offset 15 VDC at 0 cmH 0 Flow 12786 Inspiratory Expiratory When selected the ventilator provides a continuous analog voltage representative of inspiratory low minus expiratory fon Range 300 to 200 L min Adult 120 to 80 L min Pediatric 60 to 40
108. h red or yellow to indicate a high or medium priority alarm See chapter 5 Alarms and Indicators 12786 Operator s Manual Chapter3 Ventilator Operation 39 Patient Setup Patient Select Screen The Patient Select screen allows you to choose to resume ventilation ofthe current patient RESUME CURRENT or select NEW PATIENT to reconfigure ventilator setings Figure 3 4 Patient Select Screen Ifyou press the Resume Current key the ventilator begins ventilation atthe most recent patient settings The New Patient key clears loops and trend buffers and resets all settings to default values Press Patent Accept to accept your selection Patient Size Select Screen 12786 PATIENT SIZE SELECT The Patient Size Selectscreen appears as the first step of the new patient setup sequence Press the Size Accept button to accept your choices The ventilator IL PED Setup screen revealed as the Patient Size Select screen closes see Fig 35 Note The new patient size selection will not be active until the on screen SETUP ACCEPT button is pressed Figure 3 5 Patient Size Selection Screen Note The ventilator will not allow patient size changes when the active mode of ventilation is not available in the new patient size selection The ventiator will display a message instructing you to first change the ventilation mode For example in neonatal ventilation with TCPL active you cannot change to a pediatric or
109. hat you keep the ventilator plugged in to the AC power supply when notin use The 12786 Operator s Manual Chapter Maintenance and Cleaning 75 Battery Status Indicators on the front panel will enable you to monitor available charge remaining in your battery See chapter 5 Alarms amp Indicators CAUTION Should your intemal battery require replacement contact your VIASYS Respiratory Care representative Do NOT attempt to replace the battery yourself The battery should only be replaced by a qualified technician Precedence of power use The sequence in which the power sources are used by the ventilator is 1 AC 1 Extemal Battery installed intemal Battery CAUTION Do not store the ventilator in hot areas for prolonged periods of time Temperatures above 80 F 27 C can shorten battery Failing to charge the ventilator while in storage may also shorten battery CAUTION When the integrity of the extemal power earth conductor arrangement is in doubt operate the ventilator from its intemal battery or the optonal extemal battery Battery Status 12786 Battery status indicators showing the state of charge of each of the intemal and extemal batteries appear on the front panel ofthe ventlator These appear as shown in figure 5 1 Ifthe battery charge is allowed to drop below the low range of the battery monitor a battery status indicator LED may no longer be displayed The uni
110. he volume Vt wave vil be selectable with no functionality and the loops selection button will be disabled Displayed Waves NetFlow Flow Range Minimum 2 to 2 LPM Maximum 300 to 300 LPM Default 40 to 40 LPM Inspiratory Flow CPAP Flow Finsp Range Minimum 2 to 2 LPM Maximum 300 to 300 LPM Default 20 to 20 LPM Expiratory Flow Fexp Minimum 2 to 2 LPM Maximum 300 to 300 LPM Airway Pressure CPAP Level Paw Minimum 1 to 2 cmH20 Maximum 60 to 120 cmH O Default 20 to 40 cmH 0 Inspiratory Pressure PINSP Minimum 1 to 2 cmH20 Maximum 60 to 120 cmH O 12786 Operator s Manual Chapter Infant NCPAP 5 7 Messages AVEA Message Bar Text Cause Characterization is Required in Nasal CPAP Mode Key pressed when nasal CPAP characterization is in progress No Advanced Settings in Nasal CPAP Advanced Settings Screen Button was pressed No Alarm Limits in Nasal CPAP Alarm Limits Screen Button was pressed No Manual Breath in Nasal CPAP Manual Breath Button was pressed Proximal Flow Sensing in nCPAP On detection of a Proximal Flow Sensor in Nasal CPAP Mode Troubleshooting Alarm Priority Possible Causes Actions NOPAP Pressure High Limit of patient circuit Occluded expiratory filter Occlusion of expiratory imb Check expiratory limb for kinks and or water Replace expiratory f
111. high priority audible visual alarm is activated whenever the nC PAP Pressure exceeds the threshold period greater than 15 seconds Alam threshold is automatically updated on acceptance of control setting Threshold SetnCPAP level 3 cmH 0 or Pressure Limit Low nCPAP Pressure A high priority audiblevisual alarm is activated whenever the nC PAP Pressure falls below the threshold for a period greater than 15 seconds Alam threshold is automatically updated on acceptance of control setting Threshold SetnCPAP level 2 cmH 0 If nCPAP setting gt 3 0 SetnCPAP level 1 cmH0 if setting 3 cmH 0 nCPAP Pressure Limit A high priority audible visual alarm wil be activated ifthe nasal CPAP pressure exceeds 11 cmH 0 for 3 seconds Upon activation of he alarm the safety valve wil open to ambient The alarm wil deactivate and the safety valve will cose when the nCPAP pressure falls below 4 5 cmi 12786 Operator s Manual Chapters Infant NCPAP 53 Initiating Nasal CPAP 1 iniiate Nasal CPAP touch the Modes membrane button on the UIM or touch the screen area for the Current Mode Display The Mode Select box appears MODE SELECT Volume Pre Volume Pressure Sim Figure 1 Mode selection 2 Touch Nasal CPAP The folowing message appears CALIBRATION REQUIRED DISCONNECT Patient DISCONNECT Expiratory Limb of Circuit at Wye NCPAP Device Must Remain Attached at Wye and Open to Ambient Pre
112. ices A febrile patient may transfer heat via the gas column to a proximal temperature sensor which could affectthe duty cycle of the humidifier and decrease output This could cause desiccation of secretions in the Altemately in applications where a heated wire breathing circulis used this heat transfer from the patent may affect the duty cycle ofthe heated wire circuit which may resultin increased condensation in the breathing circuit The relative settings of some types of humidifiers may need to be reduced to prevent overheating of the breathing gas Note The Oxygen alarm cannat be disabled during Helix administration Do not operate nebulizer while using heliox 16 Chapterl Introduction AVEA Ventilator Systems This page intentionally left blank 12786 Operator s Manual 2 1 Chapter 2 Unpacking amp Setup Ventilator Assembly amp Physical Setup Unpacking the Ventilator The AVEA is designed for simplicity of operation and setup It requires minimal assembly on site Items Required for Ventilator Setup 12786 You will need the following to setup your AVEA ventilator Power Source The ventilator operates from a standard 100 110 220 or 240 VAC power source optional extemal 24VDC battery There is an internal battery supplied with the ventilator which wil operate the ventilator for short periods see Chapter 6 Maintenance amp Cleaning CAUTION The ventiator should be co
113. il compensate for the resistance ofthe endotracheal tube When tumed on the Arificial Airway Compensation indicator will appear in all modes of ventilation even though the function may not be active e Volume Controlled Breaths This is to alert you to the fact that Artificial Ainvay Compensation wil become active if a Pressure Support or combination mode e g Volume Control is selected Range omon Default or Available in all patent sizes Full range of Patient Size You can select a patient size of Adult Pediatric or Neonate Once the selection is made the ventilator offers only those parameters which are available for your selected patient size Non Invasive Ventilation The ventilator can perform non invasive ventilation with a standard dual limb circuit Leak compensation should be tumed on when using this feature To tum leak compensation on use the touch screen control displayed in the Ventilator Set Up Screen NOTE Non invasive ventiaton requires the use of a snug fiting mask with no bleed holes Excessive leaks around the mask may resultin false triggering of the ventilator or assertion of disconnect alarms Esinaton of inspiratory Pressure Dropin Neonatal and Pet Edaaces Tubes by Pere ent aro meram Physiological Soci 1999 12786 Operator s Manual Chapter 1 Introduction 13 Leak Compensation Leak Compensation is used to compensate for baseline leaks which may occur at the patent mask interface or ar
114. ilator operates within specification when connected to the following AC power supplies Nominal Voltage Range Frequency Range 100 vac 85 to 110 VAC 41 to 65 Hz 120VAC 102 to 132 VAC 55 0 65 Hz 230VAC 19670 253VAC 4 t65Hz 240 VAC 20470 264VAC 470 65 2 12786 2 Appendix B Specifications AVEA Ventilator Systems DC Power Supply The ventilator can also operate from a 24 VOC power source internal or extemal battery Internal Battery Maximum charge tme to achieve full charge is 4 hours Under normal operating conditions the internal battery is capable of powering the ventilator alone for 1 hour and powering the ventilator and compressor for 30 minutes when fully charged The ventiator should be connected to a main A C supply and charged for at least 4 hours prior to switching to battery power External Battery 22 0 to 26 4 VDC Under normal operating conditions charged extemal and intemal batteries combined are capable of powering the ventilator and compressor for a period of ime equal to or greater than 2 hours and the ventilator alone for a period of time equal to or greater than 7 hours With a discharged battery the ventilator should be connected to a main AC supply and charged for atleast 12 hours to insure a full charge Data Input Output Independent Lung Ventilation ILV The ventilator provides an output master and an input slave for synchronization of ventilators The output supplies a 5 VDC logi si
115. ility with simple operator interaction Ithas a flat panel color LCD with real ime graphic displays and digital monitoring capabilites a touch screen for easy interaction membrane keys and a dial for changing settings and operating parameters A precision gas delivery engine with servo controlled active inhalation and exhalation improves performance over previous generations The AVEA has been designed to function using most commonly available accessories Itis easy to clean and its design does not allow liquids to pool on the casing reducing the likelihood of fuid leakage into the body of the ventilator There are two models of AVEA Comprehensive and Standard The following table shows the standard and optional functions available with each model Functions amp Accessories Standard Comprehensive Modes Al Proximal Hot Wire Flow Sensing Synchronized Nebulizer 24 Hour Trending Intemal Battery Full Color Graphics Display Loops and Waveforms Standard Cart E Proximal Variable Orifice flow sensing Proximal Airway Pressure Monitoring Tracheal Catheter Esophageal Ballon Internal Compressor Heliox Delivery KEREKEK MA 3 x 3 Optional Functions amp Accessories Custom Cart Option Included External Battery on custom cart only Option Opton Gas Tank Holder on either cat Option Opton Intemal Compressor
116. ilter Tow NGPAP High Circuit disconnect Check circuit Pressure Circuit leak Check patient interface Patient interface leak High NCPAP High Patient circuit occlusion Check patient circuit Pressure Water in circuit Patient interaction Check nasal prongs Circuit Disconnect High Patient circuit disconnect Check patient circuit 12786 5 8 Chapter Infant NCPAP AVEA Ventilator Systems This page intentionally left blank 12786 Operator s Manual 6 1 Chapter 6 Alarms and Indicators Status Indicators The ventilator displays the following status indicators Compressor Active Ifthe internal compressor is active the Compressor Active icon shown here wil display atthe bottom of the touch screen with no accompanying tone Heliox Source Connected E If Heliox gas is connected this green icon displays in bottom right of the touch screen Mains Battery Indicators There are visual status indicators on the ventilator front pane for the mains power and the intemal and extemal batteries Figure 51 The sequence in which the power sources are used by the ventilator is Mains AC Power Extemal Battery installed Internal Battery Power On Indicator The green Power On indicator lights up whenever the power switch is on 1 and power is being supplied from any of the available power sources AC extemal battery or internal battery battery indicator while operating o
117. imes the change in tidal volume to the patent AV during inspiration and normalized to the total inspiratory tidal volume Vs Paw gt PEEPan E Paw PEEPaw AV Range 0 00 to 20 00 J oules L Resolution 0 01 oules L Accuracy 108 12786 8 Appendix Advanced Pulmonary Mechanics Monitored Parameters AVEA Ventilator Systems Patient Work of Breathing WOBp Normalized to Delivered Tidal Volume Patient Work of Breathing WOBs normalized to the total inspiratory tidal volume Patent work of breathing is defined as the summation of two work components work of the lung and work of the chest wall WOBcw where WOBuns PEEPzs Pes AV gt Pes and V gt 0 and WOBCW J PEEP gt P Work of the lung WOBuunc is calculated using esophageal pressure when the baseline esophageal pressure PEEPrs is greater than the esophageal pressure Pes indicating patient effort Work ofthe chest wall WO Ben for a spontaneously breathing patientis calculated using only the portion ofthe total tidal volume delivered due to a patient effort Ve and the chest wall compliance Cc Range 0 0000 20 00 oules L Resolution 0 01 joules 108 Note Requires an esophageal balloon catheter Imposed Work of Breathing Imposed Work of Breathing 08 is defined as the work performed by the patent to breathe spontaneously through the breathing apparatus i e the E
118. imit Vsync is only available for adult and pediatric patients Note cycling is active during a PRVC or Vsync breath flow cycling ofthe breath can only occur if the target tidal volume has been delivered This allows for expiratory synchrony while assuring delivered tidal volume Note The Peak Flow control sets the rate which is used by the ventilator for the test breath only The ventilator uses the Peak Flow setting and inspiratory Pause to determine the maximum inspiratory time during Vsync ventilation Vsync Rise With Vsync active this control sets the slope ofthe pressure rise during the volume breath Itis relative contol ranging from fast 1 to slow 9 Range 109 Default 5 PSV Rise This contol sets the slope of the pressure rise during a pressure supported breath Itis a relative control with a range from fast 1 to slow 9 Range 109 Default 5 PSV Cycle Sets the percentage of peak inspiratory flow at which the inspiratory phase of a PSV breath is terminated Range 510 45 Default 25 AdutPediatric 10 Neonate 3 44 Chapter 3 Ventilator Operation Ventilator Systems PSV Tmax Controls the maximum inspiratory ofa pressure supported breath Range 0 20 to 5 00 seconds AdulPediatric 0 15 to 3 00 Neonate Default 5 00 seconds Adult 0 75 seconds Pediatric 035 seconds Neonate Note PSV Rise PSV Cycle and PSV Tmax are active even ifthe PSV level is
119. imum inspiratory pressure achieved in the frst 100 miliseconds of the maneuver From the Maneuvers Screen select MIP P100 The MIP maneuver screen allows the operator to set Duration This is the time period that ventilation is suspended to conduct the maneuver Once the Start button is depressed normal ventilation wil be suspended until the Duration time period has elapsed or operator presses the Stop button Sensitivity This sets the sensitivity threshold that the ventilator uses to begin the timer for the P100 maneuver The default positon is three centimeters but can be adjusted by the operator to assure accuracy in patents with minimal inspiratory effort 4 12 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Note The maneuver sensitivity setting is used for the maneuver only and does nat affect trigger sensitivity Start Stop Starts and Stops the maneuver WARNING Normal ventilation is suspended for the duration of the maneuver The patient should be evaluated for contraindications prior to executing the maneuver The patient should be directly monitored by trained medical personnel during the maneuver To execute a MIP P100 maneuver set the Duration and Sensitivity controls to the desired level Press the Start soft key the maneuver screen The ventlator wil close the inspiratory and expiratory valves and begin monitoring At the completion of the maneuver the ventilator will disp
120. io ofthe dynamic complance during he last 0000500 10 20 af inspiration Cx to the total dynamic compliance 12786 Operator s Manual Appendix D Monitor Ranges and Accuracies D 3 Display Description Range Accuracy Ras The toal resistance during he nepratay phase of Oto 100 n a breath Respiratory System Resistance s he of be pressure diferenta peak plateau the inspiratory few 12 ms pror to he fd ofinspiraion Requires an inspiratory hold Roex The Peak Exgiratory Resistance rea 5 defned 000 1000 410 as the resistance at the ime ofthe Peak Expatoy cmi0 usec Flow PEFR We eaimay resistance belveen he wyeofhe 0011000 10 padent and he vacheal sensor Requires cmioiLisec inspiratory hol and Wu The ato of the tacheal pressure diferenial peak 00 1000 10 plateau to inspiratory ew 12 ms porto he cmi0Lisec end of inspiration Requires an inspiratory hold and tracheal catheter The diference between peak away pressure 120 120 2 cm HzO or 5 whicheveris greater Praca and baseine pressure PEEP al cmi da The dference between peak esophageal pressure 12010120 2 or 25 whicheveris greater and baseine esophageal pressure PEEP The away pressure athe end ofan 5
121. iratory pause 3 34 inspiratory pressure 3 33 inspiratory me 3 34 4 21 D 1 piratory ratio 4 21 0 1 inspired tidal volume 4 21 adjusted for patient weight 4 21 intemal battery 2 26 7 5 leak compensation 3 11 12786 Operator s Manual loops colors 41 comparing loops 4 5 freezing a loop 45 reference 45 reference loops 4 5 saving a loops 4 5 selection 44 loops in real time 4 4 loops screen 4 4 low priority alarm 6 4 mach vol 3 40 main screen monitors 4 27 mandatory breath 3 15 mandatory dal volume 4 21 D 1 adjusted for patient weight 4 21 D 1 mean inspiratory pressure 4 22 D 2 medium priority alam 3 8 6 4 membrane button expiratory hold 34 membrane buttons accept button 34 advanced settings 3 6 alarm imis 33 alarm reset 3 2 alarm silence 3 2 cancel 3 4 feeze 37 increase 02 33 inspiratory hold 3 5 main 38 manual breath 33 mode 3 7 nebulizer 35 panel lock 3 6 print 36 screens 38 setup 3 6 sucion 33 membrane buttons and LEDs 3 2 minute volume 4 21 0 1 adjusted for patient weight 4 21 D 1 monitor screen 4 20 monitored values 4 20 monitored values choices 4 21 multiple alarms 6 6 12786 nebulizer 29 35 neonatal patient circuit 27 new patient key 3 9 NIST fitings 215 02 percentage 3 31 optional extemal battery 2 3 ordering parts A 1 oxygen inlet pressure 4 22 D 2 oxygen sensor 2 14 cable 2 15 cell 2 15
122. ive Alarm Types Machine Alarms Safety Valve Open This is a high priority audiblevisual alarm SAFETY VALVE OPEN is displayed and a high priority tone sounds whenever the Safety Valve is open Ventilator Inoperative This is a high priority audibleisual alarm VENT INOP is displayed if the ventilator fails due to a non recoverable condition such as loss of power or supply gases A high priority tone sounds The safety valve opens indicated by a SAFETY VALVE OPEN alarm message and the patient is allowed to breathe room air Note PEEP is not maintained during a VENT INOP ora SAFETY VALVE OPEN alarm conditon When the ventilator safety valve is open the ventilator graphics wil indicate a safety state by displaying the color purple Fan Failure This is a low priority audiblehisual alarm FAN FAILURE is displayed and low priority tone sounds whenever the circulating fan at he rear ofthe ventilator cabinet stops rotating uit Disconnect Alarm This high priority audible visual alarm The ventilator wil sound a disconnect alarm when total expiratory fow inclusive of bias flow is less than 10 of total inspiratory flow inclusive of bias flow for 5 seconds Additionally in neonatal applications when a proximal flow sensor is used the circuit disconnects sounded when the Percent Leak Vte Mti is greater than 95 for three consecutive breaths Note While the circuit disconnect alarm is active the ventilator will
123. ive forall patients PES Vt Esophageal Pressure vs Volume loop This requires the use of an optional esophageal catheter and is active for adult and pediatric patients only e PTR Vt Tracheal Pressure vs Volume loop This requires the use of an optional tracheal catheter and is active for adult and pediatric patients only e Pus Vt Inspiratory Pressure vs Volume loop Pry Vt Transpulmonary vs Volume This requires the use of an optional esophageal catheter and is active for adult and pediatric patients only Note Loops are circuit compliance compensated 12786 Operator s Manual Chapter 4 Monitors Displays and Maneuvers 45 12786 Using the Freeze Button to Compare Loops You can freeze the Loops screen and selecta reference loop for Comparison When realtime data refreshing resumes by pressing the Freeze button again the selected loop will remain in the background behind the real time graphic create a reference loop refer to figure 46 47 and 4 8 and do the following Figure 4 5 Frozen Flow Volume Loop Loop off Saving a loop Press the Freeze button to freeze the loop you wish to use as reference then press the Save Loop touch screen display in the Tight hand bar beneath the frozen graphic display See figure 4 6 Figure 4 Reference Loop button OFF This pus the selected loop into memory and places a ime reference into a fel in the left hand bar beneath the graphics disp
124. l applications with proximal fow sensor in use Adjust the peak inspiratory pressure to reach the desired tidal volume SelectVdel as one ofthe monitored parameters Read the Vdel uncorrected Tidal Volume delivered from the machine during a pressure control breath Setthe Machine volume to or slightly below the Vdel measurement This wil set the machine volume to a level that wil provide more consistent tidal volume delivery in the case of slight decreases in ung compliance Note To protect against larger changes in lung compliance the machine volume should be set higher and Volume Limit should be added 12786 Operator s Manual Chapter3 Ventilator Operation 3 41 12786 Insp Rise The Inspiratory Rise setting controls the slope ofthe pressure rise during a mandatory breath This control is relative control with fast being setting of 1 and slow a setting of 9 Range 109 Default 5 The Inspiratory Rise control is not active for TCPL breaths Flow Cycle The flow cycle setting sets the percentage of the peak inspiratory flow Peak Flow at which the inspiratory phase of a Pressure Control TCPL or PRVC sync breath is terminated Range 0 Off to 45 Default 0500 Flow cycling is active for Pressure PRVCWsync or TCPL breaths only Note cycling is active during a PRVC or Vsync breath flow cycling ofthe breath can only occur if the target tidal volume has been delivered This allows f
125. l catheter 2 11 trade names vi rended data 4 25 histograms 425 spreadsheet 4 25 trends screen 4 25 variable orice sensor 2 9 12786 Operator s Manual ventilation modes 3 19 ventilator specifications B 1 ventilator synchronization 2 19 VGA output connector 2 13 visual alam display 64 volume breaths 3 15 volume limit 3 16 3 39 Vsync 3 42 pressure control breaths 3 42 volume test breath 3 42 Vsync rise 343 vt33l 12786 wamings warranty iv water collection 23 water trap 23 24 7 1 waveform 3 34 341 42 43 4 27 choices 43 waveforms colors 4 1 freeze 43 freezing 41 main screen 4 1 menu 4 2 printing 4 3 Index 8 Ventilator Systems This page intentionally left blank 12786
126. larm setting to a value below the set Vt on your ventilator Verify thatthe High Vt alarm activates Retum the alarm setting tots default value and clear the alarm by pressing the reset button Setthe Low Vt alarm setting to a value above the set Vt on your ventilator Verify that the Low Vt alarm activates Return the alarm setting to its default value and clear the alarm by pressing the reset button Setthe High Rate alam to a value below the default control setting for rate on your ventilator Verify that the alarm activates Return the alarm to is default setting and clear the alam by pressing reset button Occlude the inspiratory limb of the patient circuit Verity that the Circuit Occlusion alarm activates CAUTION Although failure of any of the above tests will not prevent the ventilator from functioning it should be checked to make sure itis operating correctly before use on a patient 12786 Operator s Manual Chapter2 Unpacking amp Setup 231 Default Settings for Adult Pediatric and Neonate The Default settings are the operational settings that take effect when you press the New Patient button on power up Ventilation Setup Adult Setting Pediatric Setting Neonate Setting ET tube Diameter 75mm 55 mm 3 0mm ET Tube Length 30em 26 om 5 Ar fical Airway OF OF Compensation Teak or or or Compens
127. lated and displayed The ventilator wil retum to normal ventilation at the curent ventilator settings The user can should they choose to do so overide the Pr values by moving the Pru indicators to a new point along the PV loop and pressing the appropriate set ey The corresponding Pre values and delta Pie volume change to represent values based on the current position of the indicators The ventilator will store up to four PV oops and their respective inflection points simultaneously Note Once the values have been redefined by he operator the original values cannot be restored 12786 Operator s Manual Chapter 4 Monitors Displays and Maneuvers 415 Alarms All curently available alarms shall be active during Pae maneuver except Apnea Interval and Time Limit To Perform a Pflex Maneuver 12786 The Pflex maneuver allows the clinician to determine opening pressures of the lung during slow flow volume controlled breath Because this maneuver is performed at a slow inspiratory fow rate the effects of respiratory system resistance are minimized Note Requires a passive patient In the eventthata patient effort detected the ventilator will abort the maneuver and deliver a patient effort detected message while simultaneously retuming to normal ventilation at the current settings From the Maneuvers Screen select fex The Pflex maneuver screen allows the operator to set Tidal Volume Vt This is the tidal vol
128. lator supplies blended gas to the nebulizer port at 10 1 5 psig 07 bar when an in line nebulizer is attached and the Nebulizer key is pressed provided thatthe calculated delivered gt 15 Limin Delivery ofthe nebulzed gas is synchronized with the inspiratory phase ofa breath and lass for 20 minutes Press the Nebulizer key a second time to end the treatment prior to the end of the 20 minute period CAUTION Use of an extemal fow source to power the nebulizer is not recommended WARNING Using the nebulizer may impact delivered tidal volumes Note Do not operate the nebulizer while using heliox 12786 3 6 Chapter 3 Ventilator Operation AVEA Ventilator Systems M Patient Size patient size is curently selected These LED indicators have no associated membrane button on the 2 e The Patient Size Indicators for Adult Pediatric and Neonate atthe bottom of the UIM show which Ts tn Note The ventilator wil not alow patient size changes when the active mode of ventilation is not available in the new patient size selection The ventlator will display a message instructing you to first change the ventilation mode For example in neonatal ventilation with TCPL active you cannot change to pediatric or adult patient size without first changing the mode to one available for those patients The ventilator wil also nat allow size changes if Machine Volume is active A message displays indicating
129. lay as shown in figure 4 7 A total of four 4 loops can be E saved atone time When the ff loop saved the oldest oop is removed Figure 4 7 Saved Loops Display Creating a reference loop Press the touch screen directly over the touch screen field in the left bar which represents the saved loop you wish to use a reference The field wil highlight see figure 4 7 Press E Ref Loop the Ref Loop ON OFF field on the righthand bar see figures zm 4 6 and 4 8 to tum the reference loop on Figure 4 8 Reference Loop When you press the Freeze button again the reference loop remains button ON visible in the background while the active display places current loops in real ime over the top oft tum off the reference loop freeze the screen again and press the Ref Loop On Off toggle button shown in figure m 4 6 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Maneuvers SOLERE The AVEA is capable of performing various respiratory mechanics maneuvers These maneuvers can be accessed from the screens menu and selecting the Maneuvers screen Depending on the model the following maneuvers may be available Esophageal MIP Pi Inflection Point Pr and AutoPEEPan Each maneuver screen includes controls monitors and waveform or loop graphics pertinent to the selected maneuver Note Maneuvers are not avaliable for Neonate patents
130. lay the and P100 values in their respective windows on the maneuver screen The and P100 wil also be available as tended data on the Trends screen The maneuver can be aborted at anytime by pressing the Stop soft key Inflection Point Prex Maneuver Screen VOLUME A C EJ CURRENT LOOP Er a85 The Infection point Pax maneuver is performed on patients during mandatory ventilation The upper and lower infection points are automatically indicated on the inspiratory portion of a Pressure Volume Paw Vol Loop 12786 Operator s Manual Chapter 4 Monitors Displays and Maneuvers 413 Note Normal ventilation shal be suspended for the duration ofthe maneuver The maneuver wil be aborted ifa patient effort is detected and the message bar wil indicate a message stating that patient effort was detected Controls Tidal Volume Volume This is the volume of gas delivered to the patient during the maneuver Range 02002501 Adult 25 to 500 mL Pediatric Resolution 0011 Adult Iml Pediatric Default 0 25L Adut 25ml Pediatric Peak Flow Sets the Peak Flow used for the maneuver Note A square wave flow pattem is used for the maneuver Range 05 t0 50LPM Resolution 0 1 LPM Default LOLPM Maneuver PEEP PEEP The Maneuver PEEP determines the baseline pressure at which the maneuver begins Note The Maneuver PEEP can be set independent of the PEEP used during normal ventil
131. led Minute Volume alarm can be used to avoid nuisance alarms High Tidal Volume High VJ This is a low priority audibleNisual alarm HIGH Vtis displayed and a low priority tone sounds ifthe absolute monitored exhaled dal volume is greater than the High Tidal Volume threshold setting Range 02003001 Adult 25 to 1000 ml Pediatric 2053000 ml Neonate Defaults 300L Adult 1000 Pediatric 300 0 mi Neonate Rate Time Alarms Apnea Interval This is a high priority audiblevisual alarm APNEA INTERVAL is displayed and a high priority tone sounds ifthe ventilator does not detect a breath initiation by any means within the preset period of time Apnea ventilation wil begin when this alarm is activated Range 610 60 seconds Default 20 seconds High Rate This is a medium priority audible visual alarm HIGH RATE is displayed and a medium priority tone sounds if the monitored total breath rate exceeds the alarm setting Range 10 200 bpm Default 75 bpm Maximum Inspiratory Time Limit Max Time This is a low priority audibleisual alarm TIME LIMIT is displayed and a low priority tone sounds ifthe inspiratory time for any breath exceeds the maximum set inspiratory time plus pause time Maximum inspiratory time is 5 0 seconds for adultpediat ic and 3 0 seconds for neonate The inspiratory phase of the breath terminated when this alarm activates 12786 Operator s Manual Chapter Alarms and indicators 6 11
132. life Replace O Sensor PEEP ico high Exhalation fiter cartridge clogged or saturated Replace cartridge Defective exhalation diaphragm Change exhalation diaphragm Unit will nat run on AC power Blown fuse on power entry module Replace fuse Power cord not connected to mains power connections Unit will nat run properly on battery Battery not sufficiently charged Internal battery may require up to 4 hours for full charge External battery may require up to 12 hours with green LED lit for full charge improper charge level indicalor Internal battery Excessively discharged battery Requires up to 4 hours for full charge Improper charge level indicalor External battery Excessively discharged battery Requires up to 12 hours for fui charge Loose connections Check connections Decreased run time on battery Battery not fully charged intemal battery may require up o 4 hours for full charge External battery may require up to 12 hours for a full charge Defective batten Gal technical Service 12786 2 36 Chapter2 Unpacking amp Setup Ventilator Systems Symptom Problem Solution s Does not run on compressor Internal fault Call Technical Service ue cyang Improper sensiivily setings Check Tow and pressure Tigger settings Creu leaks Perform EST and comedi leaks as required Bias Fl
133. low peak pressure 6 7 low PEEP 68 low priority 6 4 maximum inspiratory time 6 10 medium priority 6 4 safety valve open 6 6 ventinop 6 6 annual maintenance 7 3 apnea backup CPAP or APRV BIPHASIC 3 25 apnea back up ventiation 3 14 Artificial Airway Compensation 3 10 assemble and insert he exhalation fiter and water tap 2 3 assembly on site 2 1 assist control ventilation mode 3 19 attaching the fow sensors 2 8 attaching the patient circuit 2 6 autoclave 7 2 Backup Alarm 6 4 Barometric Pressure 2 21 6 3 base flow 342 battery cord 2 3 battery pack 74 etemal 7 4 battery replacement 7 5 battery status indicator 6 2 battery status indicators 7 5 bias fow 3 36 3 42 1 1 breath interval 3 4 3 19 3 20 3 33 breath interval timing mechanism 3 19 breath rate 3 19 320 3 33 21 4 26 6 10 6 12 D 1 breath type and delivery mode 3 14 breath types 35 320 11 breath types and modes by patient size adut and pediatric 330 breaths defined by four variables 3 15 c calculated IE Ratio 4 26 calculated minute volume 4 26 Index 4 AVEA Ventilator Systems cautions xi choice of waveforms 4 2 circuit compliance 1 3 3 11 circuit compliance compensation 1 3 3 11 Circuit Occlusion Alam 2 30 cleaning and sterilization accessories and parts 7 1 external surfaces 7 1 colors on waveform display 4 1 compliance effect ofthe circuit 1 3 3 11 compressed gas sources 2 1 connecting the 02 sens
134. m time settings for a time cycled transition Actual imes may vary depending on the patents spontaneous breathing pattem and the Sync window setting Seting the Sync to 0 cycles the transition between pressure levels on time only and will not provide synchronization with patient efforts The Manual Breath button is notactive in APRV BiPhasic The monitored PEEP in APRVIBIPHASIC is relative to the breath type In the absence of spontaneous breathing the monitored PEEP willbe the Pressure Low In the presence of spontaneous breathing the monitored PEEP wil reflect the baseline pressure over which spontaneous breathing is occured Adjustable PSV in APRV BiPhasic Biphasic features adjustable PSV The PSV is delivered above the current phase baseline pressure PSV breaths are available during Time High also by activating T High PSV an advanced setting of Time High IT High PSV is activated during Time High he ventilator will deliver the same PSV level for both Pressure Low and Pressure High Note The ventilator wil not allow the operator to set a Peak Inspiratory Pressure Insp Pres or PSV PEEP or baseline pressure in APRV BiPhasic greater than 90 cmH 0 The ventilator wil deliver an on screen Pop Up Message stating that the Ppeak gt 90 The operator must change the Inspiratory Pressure and or PEEP setting to limit the P peak 1o less than or equal to 90 cm0 3 22 Chapter3 Ventilator Operation
135. maneuver The ventilator vil Enable an Increase 02 maneuver for 2 minutes see Increase 02 below While the circuit disconnect alarm is active the ventilator will stop cycling and seta bias fow The ventilator wil automatically detect the patient upon reconnection and resume normal ventilation Silences alarms for 120 seconds Ifthe SUCTION key is pressed again during the 2 minutes that the disconnect for suction maneuver is active maneuver will be cancelled Increase 0 When this key is pressed the ventilator increases the oxygen concentration delivered to the patient for 2 minutes If the T 0 key is pressed again within this two minute period the maneuver is cancelled and the ventilator wil retum to prior setings Defaults 20 Neonatal 79 AdultPediatric AduitPediatic 79 above the set Oz Neonate 20 above the set O or 100 whichever is less configure the Increase Fi02 Access the Configuration tab on the Utilities Screen 3 4 Chapter 3 Ventilator Operation AVEA Ventilator Systems Increase 102 Configures the step increase used during the increase oxygen maneuver Sets the amount of oxygen the ventilator will increase above the curent set Fi02 Example ifthe Increase Fi02 is set at 20 AND The setFiO2 is 40 WHEN The increase Fi02 Maneuver is activated the FiO2 wil increase to 60 for two minutes after which it wil return to 40 The default setting for infants is 20 and 7
136. mbol 803 02 IEC 60878 Indicates ATTENTION consu ACCOMPANYING DOCUMENTS Symbol 45016 IEC 60417 This symbol indicates a FUSE Symbol 45034 IEC 60417 Symbol 401 36 IEC 60878 This symbol indicates INPUT Symbol 45035 EC 60417 Symbol 401 37 IEC 60878 This symbol indicates OUTPUT RE 4 o Symbol 45031 IEC 60417 This symbolindicates DIRECT CURRENT DC Symbol 45019 EC 60417 Symbol 801 20 60878 This symbol indicates protective EARTH ground y Symbol 45021 IEC 60417 Symbol e0L24IEC 60878 This symbol indicates he EQUIPOTENTIAL connection used to connect various parts of the equipment or of a system tothe same potential not necessarily being the earth ground potential e g for local bonding Symbol 5333 EC 60417 Symbol 802 03 IEC 60878 This symbol indicates TYPE B equipment which indicates equipment that provides a particular degree of protection against electric shock particularly with regards to alowable leakage current and realty of the protective earth connection Symbol 45032 EC 60417 Symbol 401 14 IEC 30878 This symbol is located on the rating plate Indicates the equipment is suitable for alternating curent Symbol 45007 IEC 60417 Symbol 801 01 IEC 60878 Indicates ON Power Symbol 45008 IEC 60417 Symbol 401 02 IEC 60878 Indicates OFF Power R Horizontal retum with line feed Indicates
137. me Limited by pressure inspiratory PEEP margin lt Cycled by time Inspiratory time in Vsync is determined indirectly by setting the peak inspiratory fow The set inspiratory is displayed in the message bar Vsync breath operation is as follows When Vsync is selected a decelerating volume test breath to the set tidal volume with a 40 msec pause delivered to the patient The ventilator sets the target pressure at the end inspiratory pressure of the test breath or the first pressure control breath The next breath and all subsequent breaths are delivered as pressure contol breaths Inspiratory pressure is adjusted automaticaly based on the dynamic compliance of the previous breath to maintain the target volume The maximum step change between two consecutive breaths is 3 centimeters of water pressure The maximum tidal volume delivered in a single breath is determined by the Volume Limit setting This test breath sequence is initiated when any of the following occur 12786 Operator s Manual Chapter 3 Ventilator Operation 3 43 12786 Entering the Mode Vsync e Changing the settidal volume while in Vsync e Reaching the Volume Limit setting e Delivered tidal volume gt 1 5 times the set volume e Flow termination ofthe test breath e Exiting Standby e Activation ofany ofthe following alarms High Peak Pressure Alarm Low Peak Alarm Low PEEP Alarm Patient Circuit Disconnect Alarm HTime Limit E L
138. me for this instrument is approximately 7 seconds WARNING A protective ground connection by way of the grounding conductor in the power cord is essential for safe operation If the protective ground is lost all conductive parts including knobs and controls which may appear to be insulated can render an electric shock To avoid electrical shock plug the power cord into a properly wired receptacle use only the power cord supplied with the ventilator and make sure the power cord is in good condition WARNING Ifthe integrity of the external power earth conductor arrangementis in doubt unplug the ventilator from the mains AC and operate it from its internal battery or the optional external battery User Verification Test WARNING The User Verification Test should always be performed off patient The User Verification Test consists of the three following sub tests and should be performed before connection to new patient The POST test The POST or Power On Self Testis transparent to the user and will only message if the ventilator encounters an error Normal ventilation commences at the culmination ofthe POST 12786 Operator s Manual Chapter2 Unpacking amp Setup 227 The Extended Systems Test EST During this test the ventilator wil perform Patient circuit leak testing Patient circuit compliance measurement Two point calibration of the oxygen sensor The Alarms Test consisting of verifi
139. moving the fuse holder BE Figure 6 6 Fuseholder label uppermost Lj for 230240VAC systems 12786 Operator s Manual 1 Appendix Contact amp Ordering Information How to Call for Service 12786 To get help on performing any ofthe preventive maintenance routines or to request service on your ventilator contact VIASYS Respiratory Care Customer Care Technical and Clinical Support Hours 6 30 AM to 4 30 PM PST Monday through Friday Phone 800 231 2466 Fax 704 283 8471 After hours service Phone 800 231 2466 from within the US and select option 2 VIASYS Respiratory Care Customer Care Helpline Hours 24 hours seven days a week Phone 800 231 2466 from within the US Online service for warranty replacements parts can be found at www viasyshealthcare comird Select Warranty Form from the choices on the left ofthe screen A2 Appendix A Contact amp Ordering Information AVEA Ventilator Systems Ordering Parts To obtain AVEA Ventilator parts contact VIASYS Respiratory Care customer service at Hours 7 00 Am to 4 30 PM PST Monday through Friday Phone 800 328 4139 760 778 7200 Fax 760 778 7274 Accessories Neonatal Kit Part Number 50 40012 00 Part Number Description Quantity Stn Neos disposable fow sensor 1 External Battery Option To add the extemal battery option t
140. n 40 vitm ELTE 75 20 50 10 E 4 1 12 10 8 6 4 3 120 1 Pmean cmH20 80 Rate bpm so oo 30 9 2 4 6 8 2 8 10 08 5 09 a 7 10 a D 6 m Figure 4 7 The Trends Window Note ifleftopen the Trends Window will update every 10 minutes Four histograms and a spreadsheet are displayed on touch screen Each histogram and column on the spreadsheet be configured from fe list of monitored parameters as well as events Touch the tile bar of any histogram or the heading of any column to open a scrollable menu Move through the list by turning the data dial Highlight the item to be displayed and press the highlighted display or the ACCEPT button above the data dial to accept the new tem for display Histograms can be scaled by touching either axis With the axis highlighted use the data dial to adjust the scale Touch the axis again or press the ACCEPT button to accept the change To look at histogram or spreadsheet tends over ime press the FREEZE button and use the data dial to move the cursor through the time fine The timeline is shown as yellow text on the spreadsheet Event markers appear in green text Note Changing the date ime back on the instruments intemal clock erases stored trend data 4 26 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Main Screen Displays Calculated Ratio The AVEA displays the calculat
141. n intemal or extemal battery battery icon wil blink in the lower right hand comer ofthe display AC Power Indicator The green AC indicator is on whenever the ventilator is connected to AC power It displays whether the power switch is on 1 or off 0 Operating On Battery Indicator When operating on battery power or External a yellow blinking battery indicator wil appear in the lower right hand comer of the LCD screen External Battery Power Indicator The EXT indicator above the battery status indicators is It whenever the external battery is providing the primary source of power forthe ventilator 12786 6 2 Chapter Alarms and Indicators AVEA Ventilator Systems Internal Battery Power Indicator The INT indicator above the battery status indicators is It whenever the intemal battery is providing the primary source of power for the ventilator Battery Status Indicators The battery status indicator shown in figure 5 1 for the INTemal or optional EXTernal battery wil iluminate incrementally depending on the available charge remaining in the battery Note Ifthe ventilator is plugged into the mains power supply and no battery status lights iluminated for the intemal battery or optional extemal battery if equipped the battery should be checked andlor replaced Replacement of the Internal battery must be done by a VIASYS trained technician Green 80 or more charge remaining for extemal battery 90
142. nAPRVIBIPHASIC mode sets 020 300 sec Time High the minimum ne for which the high pressure setings maintained sec InAPRV BIPHASIC mode sets 020 0O sec Time Low the minimum time for which he low pressure seting is maintained iO InAPRVIBIPHASIC mode Ot4ScmH O 2 emi or S of seing whichever is Pres Low conois the baseine pressure greater achieved during Time Low 12786 3 32 Chapter 3 Ventilator Operation AVEA Ventilator Systems To Activate Primary Control 8 BPm mi Rate Insp Pros control The control highlights changes color indicating that tis active activate a primary breath control press the touch screen directly over the Figure 3 24 Highlighted Control eel To modify the settings for the highlighted control tum the data dial below the touch screen see figure 3 25 Turing in a clockwise direction increases the selected value tuming counterclockwise decreases it Figure 3 25 Data dial To accept he displayed value ether press the touch screen directly over the highlighted control or press the ACCEPT membrane button to the left of the data dial The contro color wil change back to normal and the ventilator will begin operating with the new setting If you press the CANCEL button or do not actively accept the new setting within 15 seconds ventiaton will continue atthe previous settings 12786 Operator s Manual Chapter3 Ventilator Ope
143. nce when operated in the intended use environments e g hospitals described in this manual This ventilator is also designed and manufactured to comply with the folowing standards EN 60601 1 IEC 601 2 12 EN 60601 1 2 EN 794 1 CANICSA C22 2 No 601 1 M90 and UL 2601 1 MRI Notice This equipment contains electromagnetic components whose operation can be affected by intense electromagnetic files Do not operate the ventilator in a MRI environment or in the vicinity of high frequency surgical diathermy equipment defirilators or short wave therapy equipment Electromagnetic interference could disrupt he operation of the ventilator Intended Use Notice The AVEA ventilator systems are designed to provide ventilator support for the critical care management of infant pediatric or adult patients with compromised lung function They are intended to provide continuous respiratory support in an institutional health care environment e 9 a hospital They should only be operated by properly trained clinical personnel under the direction ofa physi 12786 viii AVEA Ventilator Systems Regulatory Notice Federal law restricts the sale ofthis device except by or on order of a physician Classification of Equipment Medical Equipment Class 1 type Adult ediatricnfant Lung Ventilator Declaration of Conformity Notice This medical equipment complies with the Medical Device Directive 93 42 EEC and the following Techni
144. ncentration delivered to the patent wil differ from that seton the 02 control setting A source gas failure will change the f O and may resultin patient injury The functioning ofthis equipment may be adversely affected by the operation of other equipment nearby such as high frequency surgical diathermy equipment defibrilators short wave therapy equipment walkie talkies or cellular phones Water in the air supply can cause malfunction of this equipment AVEA Ventilator Systems Do notblock or restrict the Oxygen bleed port located on the instrument back panel Equipment malfunction may result Electric shock hazard Do not remove any of the ventilator covers or panels Refer all servicing to an authorized VIASYS Respiratory Care service technician A protective ground connection by way ofthe grounding conductor in the power cord is essential for safe operation Upon loss of protective ground all conductive parts including knobs and controls that may appear to be insulated can render an electric shock To avoid electrical shock plug the power cord into a property wired receptacle use only the power cord supplied with the ventilator and make sure the power cord in good condition The AVEA is designed to ensure thatthe user and patient are not exposed to excessive leakage current per applicable standards UL2601 and IEC60601 1 However this cannot be guaranteed when extemal devices are attached to the ventilator In order to
145. ng Index f V which the spontaneous breath rate per tidal volume and is based on the following formula where f spontaneous breath rate BPM and Ve spontaneous minute ventilation in LPM Range 010 500 Resolution lbjminlL Chest wall Compliance Cew Chest wall Compliance Ccw is the ratio of the tidal volume exhaled to the Delta Esophageal Pressure dPes Coy ME dPes Range 010300 mLlcmH O Resolution 1 0 Note Requires an esophageal balloon catheter Accuracy 105 Lung Compliance Lung Compliance Cun is the ratio of the tidal volume exhaled to the delta transpulmonary pressure The delta transpulmonary pressure is the diference between the ainvay plateau pressure during an inspiratory pause and esophageal pressure at the the airway plateau pressure is measured minus the difference between the airway and esophageal baseline pressures Cun where dPurss iix Pes PEEP au Pat Range 010300 mLcmH O Resolution 1 mLicmH 0 Note Requires an Inspiratory Hold maneuver and an esophageal balloon catheter Accuracy 10 12786 H 2 Appendix Advanced Pulmonary Mechanics Monitored Parameters AVEA Ventilator Systems Compliance Ratio C20 C Compliance Ratio Czo is the ratio of the dynamic compliance during the last 20 of inspiration Cao to the total dynamic compliance C Range 0000500
146. ng an Inspiratory Hold Pplat maneuver or during zero flow in a pressure control breath Used to calculate Static Compliance Cstat PSIG Pounds per square inch gauge 1 PSIG 07bar Volume Controlled machine breath having a tidal Sigh Breath volume equal to one and a half times 150 of the current tidal volume setting WOR Patient Work of Breathing i e a measure of Patient Effort 12786 Operator s Manual Index loss of 02 67 low exhaled minute volume 6 9 access the advanced setings group 3 37 activating a primary breath contol 3 32 active humidifier 26 adult patient circuit 2 6 advanced setings 3 37 accessing the screen 3 37 advanced settings indicator 3 37 bias flow 342 fow cycle 3 41 insp rise 341 machine volume 3 40 pres trig 3 42 PSV cycle 3 43 PSV rise 343 PSV Tmax 343 sigh 3 42 volume Vsync 342 Vsync rise 3 43 waveform 3 41 air inlet pressure 4 22 D 2 air supply 2 1 alarm conditions 6 11 alarm indicator 6 4 alarm indicators 38 alarm limits 65 alarm loudness 218 alarm reset button 6 6 alarm silence 65 alarm types 66 alarms 6 6 apnea interval 6 10 extended high peak pressure 6 8 fan failure 66 high exhaled minute volume 6 9 high 02 percent 6 11 high peak pressure normal 6 7 high peak pressure sigh 6 8 high priority 6 4 high rate 6 10 high tidal volume 6 10 IE ratio 6 11 loss of air 6 7 loss of gas supply 6 7 339 12786 low 02 percent 6 11
147. ng atthe bottom ofthe front panel as shown here The fiting is marked with the icon shown here we Figure 216 Attaching nebulizer tubing Note To use the intemal nebulizer the AVEA must be connected to a high pressure air source The nebulizer is not active while the AVEA is operating on intemal compressor The ventilator incorporates an intemal pneumatic compressor which creates the drive pressure necessary to operate the nebulizer 2 10 Chapter2 Unpacking amp Setup AVEA Ventilator Systems Note The nebulizer requires an inspiratory fow rate of atleast 15 liters per minute to activate and is flow compensated to maintain set tidal volumes CAUTION When the intemal nebulizer is used the ventilator decreases the flow rate by 6 L min to compensate for the nebulizer Output However since fow from the intemal nebulizer can vary using the intemal nebulizer may impact the tidal volumes delivered to the patient Note Do notoperate the nebulizer while using Heliox Attaching a Proximal Pressure Sensor A proximal pressure sensor to monitor proximal airway pressure can be attached to the Comprehensive model of AVEA On the Comprehensive AVEA the connector is labeled as Aux as shown in igure 2 17 When active this feature will display amp alarm to proximal airway pressures A Figure 2 17 Proximal pressure sensor connection on the Comprehensive AVEA Note In applications which gene
148. ng the instructions included in the package The ventilator body is easily attached to the base by means of four thumbscrews Reference Installation Instructions L2353 for detailed directions See figure 2 1 Standard Ventilator Base Comprehensive Ventilator Base Figure 2 1 Basic and Comprehensive base attachment E CAUTION The ventilator body and UIM weigh approximately 80 Ibs 36 4 kg Employ safe lifting procedures when assembling the ventilator 12786 Operator s Manual Chapter2 Unpacking amp Setup 23 External battery option if you have purchased the optional extemal battery pack the drop Cable should be fed up the central pole of the base and out through the cord routing well shown in figure 2 2 prior tn attaching the base to the ventilator body Install your extemal batteries per the installation instructions enclosed with the cart accessories Kit P N 11372 Reference instalation Instructions L2353 for detailed directions When the cord is in place use the handles on each side of the ventilator body to maneuver and align it with the thumbscrews on the base see figure 2 1 Tighten the thumbscreus Figure 2 2 External Battery Routing Setting Up the Front of the Ventilator Assembling the Exhalation Filter and Water Trap To assemble and insert the exhalation fiter and water rap do the following Screw the supplied water collection botte into the threaded cuff of the
149. ng used and he helox NA High supply to the vento drops below 18 psig L2 br The patent continues to be ventilated by the oxygen supply any L055 GAS Alsouces of gas fali wal ak intemal compressor jf NA High SUPPLY astaled and oxygen The safety valve opens indicated by a SAFETY VALVE OPEN message and he patents alowed to breathe room air PEEP not maintained LOW Prex The peak inspiratory pressure fora breath is less Than the set 399 cmHO LOW Pax Not active for spontaneous breaths Defaut 3 cmh 0 HIGH Peak inspiratory pressure i greater than the set HIGH Normal Breath Range High Inspiration is terminated and he ciut pressure salowedto Adut retum to baselne pressure 5 LS before he next 10 105 breath is delere Default 40 cmo Peta ETE Default 40 cmo Neonate Default 30 cmo Sigh Breath Range 15 x set normal HIGH Prec Oniy active for sigh breaths 12786 6 12 Chapter Alarms and Indicators AVEA Ventilator Systems Message Alarm Condition Range Priority EXT HIGH Prex Activates whenever alarm has been active for NIA Ir more than 5 seconds Le Ifthe creu pressure tal to reum to PEEP 5 cmH within 5 seconds The safety and exhalation valves ogen and no breaths are deve The SAFETY VALVE OPEN alarm activates fow suspended whe this alam active PEEP may not be main
150. nnected to a mains AC power supply for at least 4 hours prior to switching to intemal battery power For operation on external battery the ventilator should be connected to a mains AC power supply for atleast 12 hours with green LED lotto insure a fully charged battery Pressurized Oxygen Air or Heliox Gases The compressed gas sources must provide clean dry medical grade gas ata line pressure of 20 to 80 PSIG 14 to 5 6 bar Air or Heliox Supply Pressure Range 20 to 80 psig 1 4 to 5 5 bar Supply Air 2000 80 psig 1 4 to 5 5 bar Supply Heliox 80 20 Heliox Only 3 to 10 psig 0 2 to 0 7 bar Compressor Air Temperature 5 to 40 C 41 to 104 F Minimum Flow 80 Limin at 20 psig 1 4 bar Airlnletfting CGA DISS type body No 1160 Air NIST fiting per BS 5682 1984 Air also available Heliox Inlet iting CGA DISS type body No 1180 Helix Note NIST fittings for Air and Oxygen are available from VIASYS upon request at time of order Oxygen Supply Pressure Range 20 80 psig 1 4 to 5 5 bar Supply Oxygen Temperature 5 to 408C 41 to 1048F Humidity Dew Point of gas should be 1 72C 38F below the ambient temperature minimum Minimum Flow 80 Limin at20 psig 1 4 bar Inlet F iting CGA DISS type body No 1240 NIST fiting per BS 5682 1984 02 also available 22 Chapter2 Unpacking amp Setup AVEA Ventilator Systems Assembling the Ventilator Assemble your AVEA ventiator s wheeled base usi
151. nnection is used for AVEA feature upgrades which are performed by a VIASYS certifed technician only and communications The communications protocols described in document L2317 AVEA Communications Protocol WARNING The RS 232 2 port connection is non functional Do not use SS GAComecion Comecton RS 202 1 Contos Pala RS 202 2 Figure 2 19 Connections beneath the UIM screen 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 13 Printer Connector The AVEA has a standard 25 pin female Centronics parallel printer port for interfacing to an external printer SVGA Connector A SVGA output connector is provided to enable real time display ofthe screen from a separate extemal display device such as an LCD projector or remote monitor This output can be switched on and off on the tities screen Medical Information Buss MIB Connector IEEE 1073 Medical Information Buss connection This communication portis used for all serial communication from the AVEA Please contact your VIASYS Sales Specialist for avaiable applications and kits 12786 244 Chapter2 Unpacking amp Setup Ventilator Systems Setting Up the Rear of the Ventilator 9 9 Figure 2 20 Rear panel AC power module H Oxygen hose connection connection 1 Extemal battery connector C Analog inputoutputlLV 1 Extemal
152. ns For adult and large pediatric applications Pediatric Adult Var lex flow sensor is available for use with patients whose flow requirements fall within the range of 1 2 180 Lmin Detailed information on the specifications of each flow sensor can be found in Appendix E Sensor Specifications and Circuit Resistance 12786 Operator s Manual Chapter2 Unpacking amp Setup 29 Variable Orifice Flow Sensor Plast Colar Variable Orifice sensors attach to the receptacle on the front panel of the ventilator circled in dark blue and marked with the icon shown here This is a locking connector To attach first pull back the plastic locking collar then push firmly onto the ventilator receptacle Then push the locking collar forward to lock the flow sensor in place To disconnect frst retract the plastic collar then firmly pul the connector away from the ventilator Do not pul up or dawn as this can damage the connector Figure 2 15 Variable Orifice Flow Sensor Attachment CAUTION Fully retract the plastic locking collar before attaching these connectors Failure to do this can cause damage to the connector Attaching a Nebulizer 12786 You can use in line nebulizer with the AVEA ventilator see Chapter 3 Ventilator Operation The nebulizer is Synchronized with inspiration delivers gas atthe set and is active for 20 minutes Attach the nebulizer tubing t the fiti
153. nspiratory pressure setting cof zero AAC wil stil provide an elevated airway pressure to compensate for the resistance of the endotracheal tube Positive End Expiratory Pressure PEEP PEEP is the pressure that is maintained in the patient circuit atthe end of exhalation Range 0t 50 cmH 0 Defaults 6 cmH0 Adult ediatic 3 0 Neonate Note The ventilator wil not allow the operator to seta Peak Inspiratory Pressure Insp Pres or PSV PEEP or baseline pressure BiPhasic greater than 90 cmH O The ventilator wil deliver an on screen Pop Up Message stating that the Ppeak gt 90 cmH 0 The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak 1o less than or equal to 90 cm0 3 36 Chapter 3 Ventilator Operation AVEA Ventilator Systems Inspiratory Flow Trigger Flow Trig The inspiratory tigger mechanism is activated when the Net Flow becomes greater than the Inspiratory Flow Trigger seting Net Flow is defined as Delivered Flow Exhaled Flow or Wye Inspiratory Flow when using fow sensor When the Inspiratory Flow Trigger is enabled a low level of Bias Flow is delivered to the patient circuit during the exhalation phase of the breath Range 011 20 0 Lin Defaults 10min hdultPediatic 05 Limin Neonate See Also Pressure Trigger in Advanced Settings this chapter Note To ensure adequate bias flow for inspiratory triggering the bias flow s
154. ntaneous breaths APRV Spontaneous demand breath at two baseine pressure leves or controled vento BIPHASIC sled by be Neonatal Ventilation Modes The following table shows the breath types and ventilation modes available for Neonatal patients Table 3 2 Neonatal Displayed Modes Displayed Mode Description Volume Vou breath wn Assist vention autor adut and ped pan Pressure A C Pressure breath wih Assist ventilation Volume SIMV folume breath with Synchronized Intermittent Mandatory Ventilation SIMV and an adjustable level Di pressure support for spontaneous bes Pressure SIMV Pressure Breath with Synchronized Intermittent Mandatory Ventilation SIMV and an adjustable level oforessure suppor or spontaneous breaths TCPLAK Time Cycles Pressure Limited breath wi Assist Def Tor neonatal paler TCPL SIMV Time Cycled Limited breath with SIMV and an adjustable level of pressure support for spontaneous beats CPAP PSV Continuous Paste Away Pressure Demand Breath wih Pressure Suppor Venir 12786 Operator s Manual Chapter 3 Ventilator Operation 3 31 Primary Breath Controls The Primary Breath Controls are the operator set controls which direct affect the way a breath is delivered to your patient They are displayed along the bottom ofthe AVEA LCD touch screen Only the active controls for the selected mode of ventilation will be displayed
155. nts selected the default apnea settings are the same as the factory set default settings for each ofthe controled modes Note The curent set Fi02 is delivered during Apnea ventilation 3 28 Chapter 3 Ventilator Operation AVEA Ventilator Systems Standby To initiate Standby press the Screens membrane button on the UIM identified by the icon shown here The Screen Select box wil display see figure 321 SCREEN SELECT Figure 3 21 Screen selection Press STANDBY The following message wil display ARE YOU SURE YOU WANT TO STOP VENTILATING THIS PATIENT Figure 3 22 Standby Message It you select YES the ventilator will stop ventilating the safety valve will close and the ventilator wil supply 2 Limin of gas continuously to the patient circuit and wil display the message shown in figure 322 12786 Operator s Manual Chapter3 Ventilator Operation 3 29 STANDBY NOT VENTILATING Figure 3 23 Standby Screen To resume patient ventilation press the Resume button The ventilator will restart ventilation atthe most recent setings Do notre connect the patient to ventilator unti the RESUME button has been pressed and ventilation has restarted CAUTION The 2 of bias flow which is maintained during standby intended to reduce risk of circuit overheating in the event an active humidifer is in use and lef on To ensure low through the entire ventilator circuit the patient
156. o your AVEA you wil need to order the following parts VIASYS Part Number Description Quantity am Tray Assenti 1 enr Enel Baten Wre ness 1 A AVEA Extemal Batery 2 Other Replacement Parts and Accessories VIASYS Part Number Description Ter rama Batey Fuse n n 109120 VAC Mains Power Supa Fus 0020068 230240 VAC Mains FoverSuppy Fuse 3n Gas Tank Rack Assembly 51000 40640 Fiter Caridge 12786 Operator s Manual 1 Appendix Specifications Pneumatic Supply Air or Heliox Supply Pressure Range 200 80 psig 1 4 to 5 5 bar Supply Air 20 to 80 psig 1 4 to 5 5 bar Supply Heliox 80 20 Heliox only 3 to 10 psig 0 2 to 0 7 bar Compressor Air Temperature 5 to 40 C 41 to 104 F Humidity Dew Point of gas should be 1 7 C 32F below the ambient temperature minimum Minimum Flow 80 L min at 20 psig 1 4 bar Air Inlet Fitting DISS type body No 1160 NIST fiting per BS 5682 1984 Air also available Heliox Inlet Fiting CGA DISS type body No 1180 NIST fitting per BS 5682 1984 Heliox also available Oxygen Supply Pressure Range 2000 80 psig 1 4 to 5 5 bar Supply Oxygen Temperature 5 to 40 C 41 to 104 Humidity Dew Point of gas should be 1 7 C 32F below the ambient temperature minimum Minimum Flow 80 L min at 20 psig 1 4 bar Inlet Fitting CGA DISS type body No 1240 NIST fiting per BS 5682 1984 02 also available Electrical Supply AC Power Supply The vent
157. oduce an I Time of greater than 5 seconds invalid Calibration Service State Only Validation failure while calibration dialog box is active for selected device Error saving Serial Model Number Service State Only accept of Serial Number or Model Number Change Clear Messages Service State Only Validation success while calibration dialog box is active for selected device FOV Characterization in progress Service State Only On start of Flow Control Valve characterization procedure FOV Characterization complete Service State Only On successful completion of Flow Control Valve characterization procedure FOV Characterization Tailed Service State Only Unsuccessful completion of Flow Control Valve characterization procedure Validation failure characterization and tuning data Installed Software Version Power Up Current Time Date and Runtime Hours Main key pressed DPRAM Comm Error Cir Loss of Communication with Control microprocessor Printing Print Screen button was pressed commenced sending screen data to printer Printer Out of Paper Print Screen button was pressed printer reported itis out of paper Printer Oime Print Screen button was pressed printer Is not available Printer Error Print Screen button was pressed printer reported an error condition Printer Ready Sending screen
158. or VIASYS Critical Care recommends tat when used in transport situations the expected transport time should not be greater than 50 of the usable battery ife This provides a Safety margin in the event of schedule delays or premature consumption of the battery power Should the expected transport me be delayed beyond this a dedicated transport system should be considered As with any patient transport suitable manual ventilation backup should be available CAUTION The ventilator should be connected to mains AC power supply for atleast 4 hours prior to switching to intemal battery power For operation on external battery the ventilator should be connected toa mains AC power supply for at least 12 hours to insure a fully charged battery An optional sealed lead acid extemal battery pack is also available This can signifiant extend the operating period of the ventilator when itis not connected to an AC source Under normal operating conditions fully charged external and intemal batteries combined are capable of powering the ventilator and compressor for a period equal to or greater than 2 hours and the ventilator on wall air for a period equal to or greater than 4 hours Both battery types are re chargeable and require minimal maintenance when installed Do not allow your battery to become completely discharged as this may damage the ventilator To ensure that the batteries remain charged and to prolong their ife we recommend t
159. or 2 15 contacting the manufacturer 1 control knob 4 2 4 3 420 4 27 6 5 controls associated with each breath type amp mode 3 38 cord routing 2 3 CPAPIPSV mode 3 14 318 3 23 customer service A 2 data dial 3 32 default mode for all patient types 3 19 demand breaths 318 disable the audible alarm 65 displayed value 3 32 dynamic compliance 4 22 D 2 electromagnetic components vii EMC vii Enable Disable 02 Alarms 2 18 enzyme pre soaking solution 7 1 esophageal balloon 2 11 connection 2 11 eventlog 4 24 event markers 4 23 events 424 events automatically recorded 4 24 exhalation fiter 2 3 2 4 2 5 7 1 7 2 exhaled dal volume D 1 adjusted for ideal body weight D 1 expiratory Time 4 21 D 1 expired tidal volume 4 21 adjusted for patient weight 4 21 extemal battery 2 26 7 5 extemal water trap 215 flashing alarms 6 4 flow cycle 341 flow tig 331 freezing a loop 4 5 freezing the loops screen 4 5 fuses 1 7 j gas line pressure 2 1 gas sources 21 airsupply 2 1 oxygen supply 2 1 graphs 4 3 Heliox connection 2 16 heliox delivery 14 high priority alarm 6 4 hotuire sensor 28 humidification 1 3 2 6 3 12 independent lung ventilation 2 19 3 44 indicators 6 1 extemal battery 6 1 intemal battery 6 1 mains AC 6 1 inhaled tidal volume D 1 adjusted for ideal body weight 0 1 insp pause 331 insp pres 3 31 insp rise 341 insp time 331 insp
160. or expiratory synchrony while assuring delivered tidal volume Note If Flow Cycling is active during a pressure control breath monitored airway pressures inspiratory will be higher than set when AAC is active In pediatric and adult ventilation with an inspiratory pressure setting of zero AAC wil stil provide an elevated airway pressure which will compensate for the resistance of the endotracheal tube Waveform During the delivery of a volume breath fow can be delivered in one of two user selectable waveforms square wave decelerating wave The default waveform is Decelerating Wave Square Wave Sq With this waveform selected the ventilator delivers gas at the set peak flow for the duration of the inspiration Decelerating Wave Dec With this waveform selected the ventilator delivers gas starting at the peak flow and decreasing unti the reaches 50 ofthe set peak flow Demand Flow Enables and disables the Intra Breath Demand system in volume controlled ventilation The default positon is on Note Should the patients inspiratory demand be sustained beyond the controlled inspiratory time plus the minimum expiratory time with the demand system off auo cycing or double cycling may occur This is the result of the patient demanding more flow than available resulting in a breath tigger after the minimum expiratory This may be resolved by increasing the inspiratory flow rate to meet the patents
161. orrect charge state Fuses The AVEA has the folowing replaceable fuses associated with internal DC extemal DC and AC power sources WARNING Do notremove or replace fuses or perform any maintenance tasks on the ventilator while your patientis connected Always perform these tasks off patient Battery Fuses The intemal and optional external battery fuses are 10A 250V 5 x20 mm fast blow pe be The fuse for the optional extemal batery is located on the back panel next t the extemal battery connector andis replaceable The fuse for the intemal battery located to the ght of he connection To remove pron fuses carefully unscrew with a fat blade screwdriver 9 and pull outthe fuse holder Figure 6 2 External Battery Connector amp Fuse WARNING To avoid fire hazard use only the fuse specified in the ventilators parts list or one that voltage rating and current rating to the existing fuse Mains Fuses The main AC power fuses are housed within the power entry module located on the back panel They are slow blow type Check that the correct voltage for your mains supply is showing through the window in the power entry module Table 6 1 Mains fuses Tine Voltage Fuse Amperage 2M s 12786 Operator s Manual Chapter Maintenance and Cleaning 77 12786 Replacing a Mains Electrical Fuse
162. ound the patients endotracheal tube It only provides baseline leak compensation and is notactve during breath delivery During exhalation PEEP is maintained by the cooperation ofthe Flow Control Valve and the Exhalation Valve EXV The Ex pressure servo is setto a target pressure of PEEP and the FCV pressure servo is setto a pressure target of PEEP 04 cmHiO The EXV servo relieves when the pressure is above its target and the FCV supplies flow when the pressure drops below its target up toa maximum flow rate for the patent size Range Default off Circuit Compliance Compensation When Circuit Compliance is active the volume of gas delivered during a volume controled or targeted breath is increased to include the set volume plus volume lost due to the compliance effect ofthe circuit Circuit Compliance is active for the set Tidal Volume during volume control ventilation the Target Tidal Volume in mode and for Machine Volume Itis only active in Adult and Pediatric applications Exhaled volume monitors forall modes and breath types are also adjusted for the compliance compensation volume Range 0007 5 Default 0 0 0 The ventiator automatically measures Circuit Compliance during the Extended Systems Test EST It can also be entered manually Note Although circuit compliance is displayed on the Setup screen itis not active for neonatal patients High circuit compliance with
163. ow should be set to approximately 1 5 greater than Flow Trigger setting Demand Flow med oif Turn on Demand Flow VentINOP yslem fault al Technical Service Low gas alarm on compressor Minute volume exceeds 40 Umi Reduce minute volume Loss of gas alarm Air eliox connector not properly connected insure proper connection Internal fault Call Technical Service Device Error indicator Defective sensor Replace sensor Exhalation Tow sensor nat connected Check connections Y sensor connector nof connected Check sensor Defective sensor Replace sensor Interna fault Call Technical Service Improper connection sequence External battery connection should be made with AC power disconnected CPAP Pressure Limit Occlusion of expiratory limb of patient circuit Occluded expiratory fiter Check expiratory limb for kinks Jandior water Replace expiratory iter Low NCPAP Pressure Circuit disconnect Circuit leak Patient interface leak Check circuit Check patient interface NCPAP Pressure Patient circuit occlusion Water in circuit Patient interaction Check patient circuit Check nasal prongs Circuit Disconnect Patient circuit disconnect Check patient circuit 12786 Operator s Manual 3 1 Chapter 3 Ventilator Operation Membrane Buttons and LEDs Figure 3 1a User Interface Mo
164. puts Set Analog Output Type The analog output fow signal can be selected between Wye Flow calculated fow to the patient or Machine Flow the flow measured by the inspiratory sensor within the ventilator Pressure Flow Volume Breath Phase Ji X t 6 5 0 9 O amp amp amp O O GO 6 6 OG QG 0 000 Figure 2 2 Analog Outputs Pin configuration The pin configuration for pressure flow volume and breath phase analog outputs is shown above Refer to Appendix Specifications for Analog Output Pressure cmH20 mv fow and Volume conversions 5 0 9 amp G amp amp O O 6 6 O GO 06 000 12786 2 24 Chapter 2 Unpacking amp Setup AVEA Ventilator Systems Figure 2 33 Analog Ground Pins Note Atleastone analog ground is required for safe and accurate signal output and input One analog ground is sufficient for any and all of the other signals Table 23 and Analog 1O pin configuration PIN FUNCTION Y Analog Input Channel 0 14 Analog Input Channel 1 18 ILV in 6 ILV Out 20 Factory Use Only DO NOT CONNECT 2 Analog Output PRESSURE 23 Analog Output FLOW 24 Analog Output VOLUME 25 Analog Output BREATH PHASE 5 910111213 Ground Analog see Note Video Output Enables or disables the real ime video output via the SVGA connector on th
165. rate high resistances within the breathing system monitored Proximal Airway Pressure may be higher than set Inspiratory Pressure 12786 Operator s Manual Chapter2 Unpacking amp Setup 2 11 Comprehensive Model Only Esophageal Balloon The connection intended for an esophageal balloon is circled in green at the top ofthe front panel as shown here Itis identified with the legend Pes Figure 2 18 Esophageal balloon connector Note See chapter 4 for placement technique for esophageal balloons Tracheal Catheter A tracheal catheter wil attach to the AVEA at the connection on the front panel marked as Aux The connector is shown in figure 2 18 Note See chapter 4 for placement technique for tracheal catheters 12786 2 12 Chapter2 Unpacking amp Setup AVEA Ventilator Systems Other Connections WARNING The AVEA is designed to ensure that the user and patient are not exposed to excessive leakage current per applicable standards UL2601 and IEC60601 1 However this cannot be guaranteed when external devices are attached to the ventilator To prevent the risk of excessive enclosure leakage current from extemal equipment attached to the RS 232 printer or video ports the protective earth paths must be isolated to ensure proper connection This isolation should ensure that the cable shields are isolated at the peripheral end of the cable RS 232 Connections The RS 232 1 co
166. ration 3 33 Descriptions of Primary Breath Controls Breath Rate Rate The breath rate control ses the breath interval Its function is dependent upon the selected mode of ventilation and thas different effects on the breath cycle depending on which mode is selected 12786 Range 1 to 150 bpm Neonate Pediatric 1 to 120 bpm Adut Breath Interval 60 Rate sec Defaults 12 bpm Adult Pediatric 20 bpm Neonate Tidal Volume Volume A volume breath delivers a predetermined volume of gas to the patient Tidal Volume together with the Insp Flow and Waveform settings determine how the volume breath is delivered Range 02002501 25550 mb Pediatric 200300 Neonate Defaults 0501 Adult 100 mi Pediatric 20ml Neonate Sigh 15xVolume AdultPediatric only Note When operated from the internal compressor the maximum Tidal Volume that the ventilator can achieve is 2 0 L The maximum minute volume that the ventilator is capable of delivering using wall gas supply is at least 60L and using intemal compressor is 40L Inspiratory Pressure Insp Pres During a mandatory pressure breath the ventilator controls the inspiratory pressure in the circuit For Pressure amp TCPL breaths the pressure achieved is a combination ofthe preset Insp Pres level plus PEEP Range 0 90 cmH 0 AdultP ediatric Oto 80 cmH 0 Neonate Maximum Flow gt 200 Limin lt 120Limin Pediatric lt
167. re 43 KU p 0 0 Mani ve 0 00 0 Spon Ve Figure 4 5 The Monitor Screen 12786 Operator s Manual Chapter 4 Monitors Displays and Maneuvers 421 Table 4 2 Monitored Values Menu Choices Fora full description of the Specifications peci cations and calculation of monitored displays see Appendix D Monitoring Note Depending on the model and options natal of the following displays may be available Display Value mi Expired dal volume Ve mig Expired volume adjusted for patent weight Inspired dal volume Inspired tidal volume adjusted for patient weight Milky Spontaneous tidal vole exhaled Spon vt Spontaneous Sal volume adjusted for patent weight exhaled Spon Vig Mandatory tial volume exhaled Mand Vt mig Mandatory dal vole adjusted for patent weight exhaled Mand VEKg Vdel This i he uxcoreced Hal volume measured by the nspraor Ton sensor nside he ventilator Leak Percertieatage n Minute Volume Total Ve mig Minute volume adjusted for patient weight Total Veka 1 Spontaneous minute volume Spon Ve Spontaneous minute volume adjusted for patent weight Spon Veg bpm Total Breath Rate spontaneous and mandatory Rate bpm Spontaneous breath rate Spon Rate bpm Mandatory Breath Rate Mand Rate sec rspratry ime sec Bip Tine
168. re Soaking Solution The following accessory parts are cleanable using an enzyme pre soaking solution such as Klenzymet The water trap The Infant Hot Wire flow sensor The recommended method for cleaning these parts is as follows 1 Prepare an enzyme based pre soaking solution Klenzyme made by Steris Corporation Mentor OH or equivalent in accordance with manufacturer s instructions using sterile distiled water at 20 30 C 68 86 F 2 Immerse the part to be cleaned in the prepared solution for 10 minutes Make sure that all lumens and air pockets are completely filed with the solution Agitate periodically to loosen any attached debris 3 Remove the part from the solution after 2 5 minutes and rinse immediately by immersing in at least 1 gallon of sterile distilled water at 20 30 C 68 86 F Leave the part in the rinsing bath for at least 1 minute agitating periodically to ensure thorough rinsing 4 Visually inspectthe part after removing it from the rinse to ensure that no debris remains on the part Repeat the cleaning method if necessary 12786 7 2 Chapter Maintenance and Cleaning Ventilator Systems 3 Steam Sterilization These parts can also be steam sterilized autoclave The water trap The Infant Hot Wire fow sensor Water colection jars Steam Sterilization autoclave maximum temperature 138 C 280 F minimum temperature 132 C 270 F for a maximum of 18 minutes and a minimum of 15 minutes maximum numb
169. reen Accept his selection by pressing SIZE ACCEPT Set Humidifier Active of Make any desired changes or entries to the Ventilation Setup Screen and accept these by pressing SETUP ACCEPT Press Alarm Limits button on the upper right of the user interface Verify that no alarms are active and clear the alarm indicator by pressing the alarm reset button on the upper right of the user interface Setthe 02 control to 100 Disconnect the Oxygen sensor from the back panel of the ventilator and verify that the Low Ozalarm activates Retum the Oz control setting to 21 with the sensor still disconnected from the rear panel Remove sensor from back panel Provide blow by to sensor from an extemal oxygen flow meter Verify that the High 2 30 Chapter 2 Unpacking amp Setup AVEA Ventilator Systems 10 M 15 16 18 E 0 activates Return the O to 21 reconnect the Oxygen sensor to the back panel Clear all alam messages by pressing the alarm reset button Set PEEP to 0 Set Low PEEP alarm to 0 Disconnectthe patient wye from the test lung Verify that the Low Ppeak alarm activates followed by Circuit Disconnect alarm This second alarm should activate after the default setting of 20 seconds for the apnea interval has elapsed Reconnectthe test lung to the circuit clear the alarm by pressing the reset button Disconnect the AC power cord from the wall outlet Verify that the Loss of
170. setto Zero Independent Lung Ventilation ILV Independent lung ventilation allows 2 ventilators to be synchronized to the same breath rate the rate control set on the master ventilator while all other primary and advanced controls for each ventilator can be set independently Master and slave ventilators need not operate in the same mode during ILV The AVEA offers a portto allow Independent Lung Ventiaton ILV This connection is located on the rear panel see figure 2 19 C The output provides a 5 VDC logic signal synchronized to the breath phase ofthe master ventilator ly configured accessory cable kit available from VIASYS PIN 16246 is required to implement ILV Aspe WARNING Do NOT attempt to connect a standard DB 25 cable to this receptacle This could c ventilator A specially configured cable is required for ALL features associated with VIASYS Tech Support ise damage to the connector Contact To enable Independent Lung Ventilation refer to Chapter 2 Ventilator Setup Independent Lung Ventiation LV NOTE During ILV the alarm limits for each ventilator should be set to appropriate levels for each ventilator t assure appropriate patient protection Confrm apnea timer settings and apnea ventilation settings for the Slave ventilator These setings willbe used in the event ofa loss of signal from the Master ventilator WARNING Since the master ventilator controls the breath rate for
171. sitivity Press the Start soft key on the maneuver screen The ventilator will suspend normal ventilation and begin delivering the Maneuver Tidal Volume at the set Flow The corresponding Pressure Volume curve wil be drawn by the ventilator as the volume is delivered to the patient Once complete the ventlator wil automaticaly resume normal ventilation and Freeze the graphics display The maneuver can be aborted at anytime by pressing the Stop soft key If at anytime during the maneuver the ventilator detects a patient effort the ventlator wil into exhalation and normal ventilation wil resume The measured Pfiex Lur Pflex Upr and Vdel wil be displayed if they can be determined At this point the operator can choose to accept the inflection points as determined by the ventilator or the operator can choose to set the inflection points manually set the inflection points manually simply scroll the cursor to the desired position with the Data Dial and press the Set Pfex Luror Set Pex Upr softkey The Veta will be automaticaly recalculated The measured data can be saved by pressing the Save Loop softkey Up to four loops may be saved when a fith loop is saved the oldestloop and data will be erased Note Ifthe loop and corresponding data are not saved by the operator the data willbe erased after exiting the maneuver screen 12786 Operator s Manual Chapter 4 Monitors Displays and Maneuvers 417 AutoPEEP M
172. small tidal volumes may result in extended inspiratory times This is a result ofthe delivery ofthe circuit compliance volume at he set fow rate Seting extremely small delivered tidal volumes with Circuit Compliance Compensation not active and using a proximal flow sensor may resultin assertion of Patient Circuit Disconnect Alarms Humidification 12786 You can select active or passive humidification ON active or OFF passive Active humidification assumes 99 RH passive assumes 60 RH when using an HME This feature adjusts the BTS correction factor to correct exhaled tidal volumes Range ofon Default Active ON Note Incorrect setng of the Humidification feature wil affect monitored exhaled volume accuracy 14 Chapterl Introduction AVEA Ventilator Systems Heliox Delivery Comprehensive only option on Standard Using patented Smart connector technology the Comprehensive model AVEA can deliver Heliox blended gas instead of Medical air By simply changing a connector on the back panel the ventilator identifies the gas input and adjusts to accommodate the change All volumes numeri and graphic are automaticaly compensated for accurate display The clinical benefits of helium oxygen gas are based on its sgnifcanty lower gas density when compared to nitrogen oxygen gas This lower gas density allows the same volumetric tidal volume of gas to be delivered to the patient at a signficanty lower airway pres
173. spiratory Hold maneuver and a tracheal catheter Accuracy 105 Peak Inspiratory Flow Rate PIFR The ventilator is capable of monitoring and displaying the actual peak inspiratory flow rate for the inspiratory phase of a breath Range Oto 300LPM All patients Resolution 1LPM AdultPediatric O1LPM Neonate Accuracy 10 Peak Expiratory Flow Rate PEFR The ventilator is capable of monitoring and displaying the actual peak expiratory fow rate for the expiratory phase of a breath Range Oto 300LPM All patients Resolution ILPM Adult ediatri O1LPM Neonate Accuracy 10 Dela Airway Pressure dPaw which is the difference between peak ainvay pressure Preax an and baseline pressure PEEP Pan Preax an PEEPaw Range 100 120 cmH 0 Resolution 1 cmH20 12786 Appendix Advanced Pulmonary Mechanics Monitored Parameters AVEA Ventilator Systems Accuracy 2cmH20 or 5 whichever is greater Delta Esophageal Pressure dPrs Delta Esophageal Pressure dPes is the difference between peak esophageal pressure es and baseline esophageal pressure PEE Pes Pis Premces PEEPes Range 120 to 120 emH 0 Resolution cmo Accuracy 2emH20 or 5 whichever is greater AutoPEEPaw AutoPEE Paw is the airway pressure atthe end of an expiratory hold maneuver Range 0 50 0 Resolution L cmHs0 Accuracy 2emH20 or 5 whichever is greater Note Requires a passiv
174. ss Continue Figure 2 Calibration Required Message 3 Disconnectthe Nasal CPAP device from the patient and disconnect the expiratory of the circuit at the patient wye See Figure 3 Disconnect Here ForTestng Figure 3 Disconnect Point for Calibration Do notdisconnectthe Nasal CPAP device at the wye and leave the prongs open to ambient n 5 4 Chapter 5 Infant NCPAP AVEA Ventilator Systems 4 Touch Continue the folowing message appears Characterizing Proximal Pressure 9 sec Figure 4 Calibration Progress Message f calibration is successful the following message appears CALIBRATION SUCCESSFULLY COMPLETED RECONNECT Expiratory Limb of Circuit at Wye Connect NCPAP Device to Patient Press Continue Figure 5 Calibration Successfully Completed Screen Note If the calibration test fails check the following Ensure the patient was disconnected during the calibration Ensure the circuit connections are secure Ensure there was no movement of the circuit during the calibration Ensure the prongs are open during the test Ensure the expiratory limb ofthe circuit was disconnected before starting the calibration iter crie peior checking life above remove the verla rom sence and have check qualfed technician 5 Reconnectthe expiratory limb of the circuit at the patient wye 6 Connect the Nasal CPAP device to the patientand touch Continue The patient wil
175. sterisk next to the time code see Trends discussion below 12786 in the trend buffer along with the 34 monitored Figure 4 6 The Events menu 4 24 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Selectable events include Event Abbreviation Blood Gas 86 Chest X ray CXR Diagnostic Dx Procedure Dx Feeding Feed Intubation ETT Therapeutic Rx Procedure Rx Suction n The folowing events are automatically recorded in the event log Event Abbreviation Change a primary or advanced control setting Sigs Powering the ventilator on Pon Powering the ventilator off Poff Entering Standby eSby exiting Standby Activation of the nebulizer Neb Activation ofthe expiratory hold eHold Activation of the inspiratory hold Hold A manual breath Man Activation ofthe suction button n Activation of the increase 02 button Activation of New Patient NuPt Involuntary Power Loss amp Recovery Prec 12786 Operator s Manual Chapter Monitors Displays and Maneuvers 425 Trends 12786 The monitored parameters described in the previous section are trended as one minute averaged values over a rumning 24 hour period Trend data is accessed by pressing the screen button on the membrane panel to the left of the touch screen or by pressing the screen indicator in the top center portion of the touch screen display The screen menu wil appear Press the TREND button on the screen menu to open the trends scree
176. sure Addionaly the low density properties of the gas allow itto diffuse past airway obstructions or restrictions much easier than nitrogen oxygen gas mixtures Note The Heliox smart connector is designed for use with an 80 20 Heliox tank only Orly a mixture of 20 oxygen and 80 Helium can be used as the Heliox gas supph 2 If Heliox gas is connected this green icon displays in bottom right of the touch screen To setthe Helium Oxygen mixture during administration simply setthe desired Fi02 the balance ofthe breathing gas is Helium For example A set Fi02 of 35 will deliver a 65 35 Heliox mixture to the patient WARNING Connection of a gas supply at the Helium Oxygen mixture inlet that does not contain 20 oxygen can cause hypoxia or death Although an 80 20 mixture of Helium and Oxygen is marketed as me not labeled for any specific medical use il gas the Helium Oxygen gas mixtu Note Hot wire flow sensors will not function with Heliox gas mixtures During Heliox delivery a variable orifice fow sensor should be used for monitoring delivered volumes at the proximal ainvay 12786 Operator s Manual Chapterl Introduction 15 12786 Note Heated humidifier performance should be carefully monitored during Heliox therapy Helium has significantly greater thermal conductivity compared to nitrogen oxygen gas mixtures and this could cause dificult with some heated humidification dev
177. sure at Machine Cult Pes Esophageal Pressure Tracheal Pressure Pa emt Transpuimonary Pressure Flown Flow Veni may Tidal Vole fas Epist fow fig inspiratory For Analg Based on analog Ana 1 Based on analog input scale Axis Ranges The scale vertical axis and sweep speed horizontal axis of the displayed graphs are also modifiable using the touch screen To change the displayed range press ether axis of the displayed graph to highlight The highlighted axis can then be modified using the data dial below the touch screen see figure 4 3 To accept the change touch the highlighted axis again or press Accept Time Ranges ssss 12786 6 seconds 12 seconds 30 seconds 60 seconds 44 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems Loops Accessing the Loops Screen To access the loops screen press the screens SCREEN SELECT membrane button to the left of the touch screen E the UIM The button is labeled with the icon shown here Select LOOP from the options that appear Choice of Loops TRENDS MANEUVER STANDBY Figure 44 Screen Selection The ventilator displays 2 loops in real time selected from the folowing VtFlow Flow Volume Loop Inspiratory flow Volume If proximal flow sensor is used values are based on proximal flow sensor measurements Available for all patients PAW Vt Airway Pressure Volume loop Act
178. sure drops below its target up to a maximum flow rate forthe patient size Iti not active during breath delivery Circuit Compliance When Circuit Compliance is active the volume of gas delivered during a volume controled or targeted breath is increased to include the set volume plus the volume lost due to the compliance effect ofthe circuit Exhaled volume monitors are adjusted for the compliance compensation volume in all modes of ventilation Range 0 0 to 7 5 Default 0 0 mllcmH O Circuit compliance can be measured automatically by the ventlator during an Extended Systems Test EST or entered manually Note Circuit Compliance is active for set Tidal Volume in volume control ventilation Target Tidal Volume in PRVC and Machine Volume in Adult and Pediatric applications only Although circuit compliance is displayed on the set up screen itis not active for neonatal patients 3 12 Chapter 3 Ventilator Operation AVEA Ventilator Systems Humidifier You can select active or passive humidification ON active or OFF passive Active humidification assumes 99 RH passive assumes 60 RH when using an HME This feature adjusts the BTPS correction factor to correct exhaled tidal volumes Range Active ON OFF Default Active ON Note Incorrect setting ofthe Humidifcation feature will affect monitored exhaled volume accuracy Patient Weight Patient Weight can be setin the following ranges Adut 1 to 300 Kg Pedia
179. t VIASYS Respiratory Care symbol VARIABLE ORIFICE FLOW SENSOR connecton ISYS Respiratory Care symbol HOT WIRE FLOW SENSOR connection VIASYS Respiratory Care symbol ANALOG IN OUT connection VIASYS Respiratory Care symbol Display the MAIN SCREEN VIASYS Respiratory Care syntol DO NOT BLOCK PORT VIASYS Respiratory Core symbol EXTERNAL BATTERY connection VASYS Respiratory Care symbol Indicates GAS 1D port VIASYS Respiratory Care symbol OXYGEN SENSOR connection xiv Ventilator Systems VIASYS Respiratory Care symbol OVERPRESSURE relief S5 Respiratory Care symbol REMOTE NURSE CALL connection USER INTERFACE MONITOR connection This symbol indicates an INTERNAL BATTERY FUSE VASYS Respiratory Care Symbol This symbol indicates ALARM LOUDNESS SS Respiratory Care Synbo This symbol indicates that the AVEA is being powered by the INTERNAL BATTERY only VIASYS Respiratory Care Symbol This symbol indicates thatthe HELIOX configuration is in use 12786 Operator s Manual Chapter 1 Introduction The AVEA is a fourth generation servo controlled sofware driven ventilator It has a dynamic range of breathing gas 12786 delivery that provides for neonatal through adult patients ts revolutionary user interface module UIM provides maximum flexib
180. t during an expiratory hold maneuver This maneuver requires a passive patient From the Maneuvers Screen select AutoPEEP The AutoPEEP maneuver screen allows the operator to set Sensitivity This sets the sensitivity threshold that the ventilator uses to detect patient effort during the AutoPEEP Maneuver The default position is three centimeters but can be adjusted by the operator to assure accurate sensitivity all applications Start Stop Starts and Stops the maneuver To execute an AutoPEEP maneuver the operator sets the Sensitivity appropriate for the patent and presses the Start softkey The ventilator will then cose the inspiratory and expiratory valves and allow the pressure to equilibrate between the patient and the breathing circuit At the completion of the maneuver the ventilator wil display the AutoPEEP and dAutoPEEP values in their respective windows on the maneuver screen The AUtoPEEP and dAutoPEEP wil also be available as trended data on the Trends screen The maneuver can be aborted at anytime by pressing the Stop soft key Note The AutoPEEP value will be set atthe next mandatory breath interval or 5 seconds whichever is sooner 12786 Operator s Manual Chapter Monitors Displays and Maneuvers 419 Tracheal Catheter Placement 12786 Some advanced mechanics measurements on the AVEA require the use ofa tracheal catheter To ensure accuracy of measurements and to minimize risk of adverse events the tracheal
181. t should be plugged into the AC power supply to allow the batteries t recharge When the battery voltage becomes large enough to power the battery monitor the battery status indicators will display CAUTION A battery thats fully drained Le void of any charge may cause damage to the ventilator and should be replaced Contact your VIASYS Respiratory Care Customer Care representative atthe number given in Appendix A Contact information Failure to charge Ifthe intemal batteries do not show significant re charge after being re connected to an AC power source for 4 hours contact your VIASYS Respiratory Care Customer Care representative as shown in Appendix A to arrange for replacement Total time to re charge will depend upon the extent of battery depletion and ventilator usage while charging is taking place 76 Chapter Maintenance and Cleaning AVEA Ventilator Systems Note A ventilator not in use and not connected to AC will continue to slowly discharge fully charged battery may reach a deep discharge state below 11 VDC in approximately 35 days for the intemal battery and 100 days for the extemal battery However even with a fully charged battery ifthe ventilator is unplugged from AC for more than 4 hours the intemal battery status indicator wil display red indicating a low battery conditon In this condition the ventilator should be plugged into an AC outlet for 10 12 minutes to restore the battery to the c
182. tained This alarm wil remain active uni the resolved LOWPEEP Baseline pressure Positive End Expratory Pressure is less Ow 60 cmiLO Hoh than the set LOW PEEP alarm teshold for a period greater Default than 0 25 05 seconds This alarm is OFF fett zen AduRP egiati 1 0 Neonate Monitored exhaled minute volume Ve is less than he set OFF 0 1to 50 L dut LOW V alarm threshold OFF 0 01 30L Pedatic OFF Ol 001 t 00L Neonate Default OFF Monitored exhaled minute volume Ve is greater han he set 00 15 L Adu HIGH Ve alam threshold 0003001 Pediat 0405401 Neonate Defaults 300L AduRP eat 5 00 Neonate HIGH VE The absolute monitored exhaled Ndal volume is qreater than 010 300L Adu Visual Alet the set HIGH Vtalam threshold 250 1000 mi Pedatic 201 3000 mi Neonate Defaults ROOL Adu 1000 mi Pedatic 3000 ml Neonate The absolute manitared exhaled ial volume does noterceed Offto 3 00 L AGUN Low Tidal Volume alarm vested seting 1000 mL Pediat 3000 Neonate APNEA Active in AC SIMY APRV T BIPHASIC and CPAPIPSV 6 060 seconds INTERVAL modes ifthe venator does not detecta breath within the Defaut20 seconds preset APNEA interval WIGHRATE The monitored ttal breath rate exceeds the setalrm RATE 1t 200 bpm Default 15 bem WIMEUMT The inspiratory ime fora breath exceeds Me set MAX TIME
183. tart Stop When the Start key is actuated the ventilator delivers the volume specified below into the catheter before esophageal pressure measurement commences Adult Catheter 05 to 25 mL Pediatric Catheter 05 to 1 25 mL The ventilator will evacuate and refil the balloon every 30 minutes to maintain measurement accuracy When the Stop key is actuated the ventilator evacuates the balloon prior to removal of the catheter from the patient Note Do Not inflate the balloon until after it has been placed in the patient The balloon should be evacuated prior to removal from patient Chest wall Compliance Ccw The preset Chest wall Compliance Ccu is used by the ventlator to calculate work of breathing Range 015 300 mLicmH 0 Resolution 1 mL cmH 0 Default 200 mL cmH 0 Alarms All currenty available alarms are active during the Esophageal maneuver To Perform Esophageal Maneuvers Esophageal measurements require the use of an esophageal balloon which can be purchased from VIASYS Respiratory Care Inc From the Maneuvers Screen menu select Esophageal Before placing the balloon in the patient 2 ballon test should be performed Connect the esophageal balloon extension tubing to the EPM panel on the AVEA as described in Chapter 2 Remove the new esophageal balloon from its package and connectitto the pinned connector on patient end of the extension tubing Allow the balloon to hang freely and not contact any surfac
184. the target tidal volume has been delivered This allows for expiratory synchrony while assuring delivered tidal volume Note Demand Flow is active for all mandatory breaths The maximum peak inspiratory pressure achievable by the ventilators limited by the high peak pressure alarm seting 3 18 Chapter 3 Ventilator Operation AVEA Ventilator Systems Demand Breaths All demand breaths are patienttiggered controlled by pressure and flow or cycled Demand breaths can be either pressure supported PSV or spontaneous All demand breaths are accompanied by the yellow patent demand indicator which flashes in the upper left of the screen 1 PSV Pressure Support Ventilation A PSV breath is a demand breath in which the pressure level during inspiration is a preset PSV level plus PEEP The minimum pressure support level is PEEP 2 0 in adult and pediatric applications independent of the set PSV pressure level In neonatal applications the minimum pressure support level is zero PSV breaths Controlled by pressure preset PSV level PEEP Limited by pressure preset PSV level PEEP Cycled by time PSV Tmax or ow PSV Cycle Pressure Supports active when CPAP PSV SIMV or APRVIBIPhasic modes are selected Note The ventiator wil not allow the operator to set a Peak Inspiratory Pressure Insp Pres or PSV or baseline pressure in APRV BiPhasic greater than 90 0 The ventil
185. ther a hot wire or a variable orifice proximal flow sensor These are in addition to he instruments internal inspiratory fow sensor and heated expiratory low sensor Three proximal fow sensors are available forthe AVEA The standard Hot Wire fow sensor is suitable for neonatal and pediatric applications where the peak inspiratory flow rate is less than 30 L min This flow sensor is not active in adult applications Hot Wire Flow Sensor A Hot Wire flow sensor attaches to the receptacle colar circled in light blue directiy below the variable orifice fow sensor connection front panel The receptacle is marked with the icon shown here This is a locking connector To attach first pull back the locking colar then push firmly onto the ventilator i receptacle To disconnect frst revactthe plastic colar then firmy pul the connector away from the ventilator Do not pul up or down as this can damage the ld connector Figure 2 14 Hot wire Flow Sensor Attachment Note Hot wire flow sensors will not function with Helix gas mixtures During Heliox delivery a variable orifice fow sensor should be used for monitoring delivered volumes atthe proximal airway Variable orifice fow sensors are also available on some AVEA models The neonatal Varf lex flow sensor is compatible in neonatal and pediatric applications where the peak inspiratory flow rate is less than 30L min and is not active in adult applicatio
186. tion of 10 Detective expiratory low sensor Cleanvreplace expiratory Tow Leak in patient circuit water Verify with Teak test collector or exhalation system Vie s Vi Normal if readings are within No action required i within ventilator accuracy specifications specification of 10 Detective expiratory Tow sensor Cleanvreplace expiratory Tow Leak in patient circuit water Verity with Teak test collector or exhalation system Internal fault Gall Technical Service alame waveform above below Humidifier Active omoti Set 1 Tor Active on Tor baseline on patient with internal Active off for 12786 235 Operator s Manual Chapter 2 Unpacking amp Setup Symptom Problem Solution s Normal if readings are within action required i within ventilator accuracy specifications specification lof 10 Bad expiratory flow sensor Clean or replace expiratory flow Internal fault Call Technical Service Volumes become inaccurate over lime Foreign material on flow sensor Cleanreplace sensor Internal fault Gall Technical Service Nebulizer output absent Ventilator running on compressor Connect wall ai Flow less than 15 Limin Increase flow if appropriate Triera fault Cal Technical Service FIO monitor inaccurate or reads O sensor requires calibration Perom EST sensor at end of
187. tric 1i 75 Kg Neonate 010160 Default 1Kg Patient weight s a variable determined by the clinician and is used for the purpose of displaying monitored volume per unitweight Identification Patient ID You may inputa 24 character two x 12 character alphanumeric patient identification To create a patient ID press the Touch Screen directy over the Patient IDENTIFICATION field A secondary screen appears showing the characters available for patient identification Tum the data dial at the bottom ofthe UIM see figure 3 7 to scroll through the characters Press the ACCEPT membrane key to accept each character and build your Patient ID code When the Patient ID code is complete once e again press the Touch Screen directy over the Patient IDENTIFICATION field to accept the entire Patient ID code Check the rest of the screen parameters and if you are satisfied with the setup press the SETUP ACCEPT button Figure 3 7 Data Dial Accept amp Cancel Button Note Primary breath controls active for the selected highlighted mode are visible atthe bottom of the touch screen during setup The Advanced Settings dialog box and the Alarm Limits dialog box aso be opened during setup All controls are active and may be modifed while in the Set Up screen 12786 Operator s Manual Chapter3 Ventilator Operation 3 13 12786 EST Extended Systems Test _ Ek Patient
188. ture reference Some Events are recorded automaticaly others can be lagged manually to display in this screen See Chapter 4 Monitors and Displays for a full ist of Events T Freeze 12786 The FREEZE key freezes the current screen and suspends realtime update of screen data unti pressed again While the screen is frozen a scrollable cursor appears The Data Dial can be used to scroll the cursor through data points on waveform lop or trend screens To restore the screen to active press the Freeze button a second time Figure 3 2 shows a fiow volume loop in freeze mode The cursors trace the frozen loop curve along an X Y plot ine The values along the curve of the loop are displayed as shown below mr an values at various points Dashed along the loop Cursor Line FlowNoume Loop Tracing T overlays he Y Figure 32 FlowiVolume Loop in Freeze Mode 38 Chapter3 Ventilator Operation AVEA Ventilator Systems U Screens Opens the Screen Selection box See figure 33 You can also open this by pressing the Screen indicator in the top center ofthe touch screen Note Pressing he Screens button a second time closes the window SCREEN SELECT TRENDS MANEUVER STANDBY UTILITY Figure 3 3 Screens Selection Box V Main Retums the display tothe main screen W Alarm Status LEDs The Alarm status indicators at the top right of the fas
189. u should always perform an EST prior to conducting Manual Alarms Testing WARNING User Verification Testing should always be done off patient CAUTION Following each alarm verification test ensure thatthe alarm limits are reset to the recommended levels shown in this chapter before proceeding to the nexttest Test Setup Requirements Adult Setting Pediatric Setting Neonate Setting Air Supply Pressure gt 30 psig 21b Same Same 02 Supply Pressure gt 30psig 2ibar Same Same AC Line Voltage TIS 10VAC Same Same Patient Circuit SO m Adu S m Adut Infant Compliance 20micmi20 20 micmi20 Resistance 5 2 5 perform the Alarms Test on the AVEA ventilator using default setings complete the following steps table describing the default setings for Adu Pediatric and Neonatal patient sizes is included at the end ofthe Alarms Test section Make the appropriate connections for air and 02 gas supply Connect the power cord to an appropriate AC outlet Attach an appropriate size patient circuit and test lung to the ventilator Power up the ventlator and select NEW PATIENT when the Patient Select Screen appears Accept this selection by pressing PATIENT ACCEPT This enable default settings forthe Manual Alarms Test Selectthe appropriate patient size for your test Adul Pediatric or Neonate fromthe Patient Size Select Sc
190. ume delivered to the patient during the maneuver This setting has no effect on the settings during normal ventilation and can be set to any tidal volume desired independent of the current mode of ventilation Flow This setting is adjustable from 0 5 to 5 l min and controls the inspiratory flow used to deliver the maneuver tidal volume PEEP The is the PEEP used for the Slow Flow Maneuver The operator can select any PEEP level independent of the control PEEP used during controlled ventilation PEEPTeq This control sets the equilibration atthe Maneuver PEEP after which the Slow Flow Maneuver begins Sensitivity This sets the sensitivity threshold that the ventilator uses to detect patient effort during the Slow Flow Maneuver The default position is three centimeters but can be adjusted by the operator to assure accurate sensitivity in all applications Start Stop Starts and Stops the maneuver Note All maneuver control settings are independent of control settings in normal ventilation 416 Chapter 4 Monitors Displays and Maneuvers AVEA Ventilator Systems WARNING Normal ventilation is suspended for the duration of the maneuver The patient should be evaluated for contraindications prior to executing the maneuver The patient should be directly monitored by trained medical personnel during the maneuver To execute a Pflex maneuver set the Tidal Volume Flow Maneuver PEEP PEEP Equiibration time and Sen
191. ure C1 Gas Delivery Engine 12786 c2 Appendix Pneumatic Diagram AVEA Ventilator Systems This page intentionally left blank 12786 Operator s Manual Appendix D Monitor Ranges and Accuracies 12786 DISPLAY DESCRIPTION RANGE ACCURACY VOLUME MONITORS The volume measured inspiratory pase ofthe breath s accumulated as he inspired tidal volume and the volume measured during he exhalation phase is accumulated as exhaled al volume This volume does notinciude the eheredby he Circuk Complance Compensation luncton for volume breaths TE 10 of reading dut macie 4 1 10 of reading Neonate wye ial volume adjusted for patentweght Inspired tidal volume TE 10 of reading dut macie 1l 10 of reading Neonae wye Wig spied dal volume adjusted for patentweight Ot 4 miko Spon Vt Spontaneous 48 volume TE 108 of reading Adachi 4 1 10 of reading Neonate wye Spon Vtkg Spontaneous Bal volume adjusted br patent weight Mand Mandatory tial voume Displayed asa olin OAL TE 108 reading machine average of ether breaths or one minute sensor whichever occurs fist 1 10 of reading wye Mand VEK Mandatory ital volume adjusted for patent weight Uim Derived Wiel Delvered mactine volume measured by e DI
192. water trap Figure 2 3 Attaching the Collection Bottle to the Water Trap 12786 24 Chapter2 Unpacking amp Setup Ventilator Systems Push the exhalation fiter into the water trap assembly top as shown Locating Ridge for assembly into cartridge Figure 2 4 Attaching the Exhalation Filter Align the locating ridge on the water rap assembly with the slotin the exhalation fiter cartidge see fig 2 5 Slot matches locating ridge of water trap assembly wal Figure 2 5 Exhalation Filter Cartridge Showing Locating Slot Slide the water traplexhalation iter assembly into the carridge see fig 2 6 Figure 2 6 Exhalation Filter Water Trap Assembly in Cartridge 12786 Operator s Manual Chapter2 Unpacking amp Setup 25 Rotate the metal locking lever on the lower right of the ventilator body forward toan open poston Figure 2 7 Open locking lever Insertthe completed cartridge assembly into the ventilator body as shown Make sure itis completely seated in the well Figure 2 8 Insert exhalation filter Note Placement of the exhalation fiterwater trap assembly without the exhalation fiter cartridge may cause misalignment of the fiter seal resulting in patient breathing circuit leaks Close the locking lever Figure 2 9 Close locking lever in place 12786 2 6 Chapter 2 Unpacking amp Setup AVEA Ventilator Systems Attaching the Patient Circuit

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