IPV Percussionaire User Manual
Contents
1. 10117 810972 10124 811017 ea 5 B10124 FIGURE 1 50015 1 811060 A50010 3 FIGURE 2 0088 1 Proof for Editing 07 25 08 50087 2 50503 5007 10 Phasitron Duo Proof for Editing 07 25 08 B10129 ie ade INTERNAL A50008 1 A50091 10918 A50044 FIGURE 3 FIGURE 2 Proof for Editing 07 25 08 B1096 2 B10914 B10918 50007 11 50010 5_ x 4 p A50521 acte A50016 2 50012 A50474 2 IPV CMV Interface Proof for Editing 07 25 08 SHIPPING STORAGE PROCEDURE PACKAGING AND SHIPPING When the IPV IMPULSATOR are shipped for repair or maintenance the following shipping and packaging instructions are to be followed 1 Call 800 850 7250 or 208 263 2549 for a return goods authorization number RGA Units must be identified by serial number 2 The device s must be disinfected and cleaned 3 The device s must be placed in a large plastic bag to protect from packaging and other foreign materials 4 Packaging material must be placed around all sides and top and bottom of unit in sufficient amount to protect device from damage during transportation to the designated facility 5 A packaging slip must accompany device with information including RGA Customers name and purchase order number device serial number details of work requested shipping address2. Nebulizer not aerosolizing properly Frequencies of percussions do not change as frequency control knob is rotated Proximal manometer not functioning properly or needle is not zeroed Continuous percussions without activation of remote button Remote button is sticky stuck or leaking Breathing harness connected backwards Check to see if nebulizer diffuser is in place Check yellow line while device is running for gas flow Check if unit has been abused fallen etc Check last calibration or functional check performed Check for contamination of hospital gas service Check to see that red proximal airway harness is connected to bulkhead fitting and or to proximal port on Phasitron Orifice clogged inside unit Repeated use time may cause needle on manometer to read at a higher or lower pressure when in the off position Check for external leak To determine if an external leak is present disconnect green line from unit at green bulkhead fitting Place finger over bulkhead fitting to form an airtight seal Turn unit on if percussions stop leak is external If percussions continue then unit has an internal leak Some medications Acetylcystiene abuse or time may cause this problem Disconnect harness and reconnect properly with arrows on one way valves pointing toward the breathing head Replace or snap diffuser back into place part AS50481 If there is no gas from yellow line while
3. and phone number 6 Box must be securely closed and sealed with appropriate labels on the outside of box including RGA f During shipping the unit should be kept dry and maintained at temperatures between 40 C to 40 C STORAGE The IPV IMPULSATOR should be stored a clean environment and covered when not in use Temperature should be maintained between 40 C to 40 C Humidity range is 0 95 non condensation HANDLING PROCEDURE DISPOSAL OF EQUIPMENT At the end of useful life of the IPV IMPULSATOR disposal should be in accordance with local state federal and international laws The unit may also be packaged according to instructions found within this manual and shipped to authorized maintenance centers below for disposal Percussionaire Corporation 1655 Glengary Bay Rd Sandpoint ID 83864 Phone 208 263 2549 Fax 208 263 0577
4. IMPULSATOR unit using correct color coding See Page 29 30 Long end of harness assembly should be connected to Phasitron and nebulizer using correct color coding See Page 31 green line may be left disconnected if patient is unable to depress remote switch an open green line will allow the device to cycle continuously Fill nebulizer with prescribed medications and dilute to 15 to 20 ccs Assemble Phasitron to nebulizer See Page 31 Rotate frequency control knob full counterclockwise to the easy position Rotate source pressure knob for an operating pressure of 30 35 psi IPV amp Source Operational pressure control knob is located on front of unit IMPULSATOR Source pressure control knob is located at the bottom left of unit as it is facing you NOTE The IMPULSATOR must be switched on in the rear of the unit before pressure can be adjusted Proof for Editing 07 25 08 9 Attach Phasitron to artificial airway making sure of patient comfort 50 mls of wide bore tubing may be used with a 15mm universal adapter A Initiate percussion immediately observe chest wiggle When patient is comfortable with breathing the aerosol have them if capable or the therapist depress the push button on the manual remote switch located on nebulizer See Page 32 Percussions will begin 10 Patient is instructed to inhale and exhale through the percussions this is the beginning of the active breathing cycle A
5. ESSURE TO ACHIEVE SET APPROPRIATE PIP REDUCTION REGULATOR PRESSURE REPLACE REDUCTION REGULATOR PART GUAGE MALFUCTION A50084 1 REFER TO AUTHORIZED SERVICE CENTER Proof for Editing 07 25 08 Pre Use Check The Pre use check is a brief check to confirm device is operational and ready for use it does not replace either the annual functional evaluation nor the periodic re manufacture or overhaul The functional evaluation is used to determine if units are in conformance with proper Percussionaire calibration standards Functional evaluations should be performed annually or when clinical efficacy of the device is questioned For the process of the pre use check it is assumed that the device has been calibrated to the proper standards The following is the minimum equipment needed to perform a Pre use check Stop watch or clock with a second hand Standard Breathing Circuit part 50095 1 Test Lung part B11048 1 orificed B11048 non orificed Notes 5 12 13 Proof for Editing 07 25 08 Pre Use Check for IPV IPVe1C and IPVe1 Connect standard breathing circuit 50095 1 to IPV unit Attach orificed test lung B11048 1 to Phasitron Connect IPV unit to a 5Opsi gas source Check manometer for needle at zero f not see troubleshooting Push manual inspiration button pressure rise should be gt 40 2 Turn master switch ON Adjust pressure regulator
6. GS The responsible physician should be contacted if The RCP is unable to determine appropriate care upon initial evaluation The patient demonstrates an adverse response There is failure to achieve therapeutic objectives within time frames All therapies will be administered in compliance with approved RT policies for that procedure JUSTIFICATION OF DC Patients on the IPV Protocol will be discontinued when secretion clearance is lt than 5cc per treatment for a 24hr period and post therapy chest exam demonstrates absence of retained secretions RE EVALUATION Patients will be re evaluated every 24hrs while IPV protocol and will be re evaluated 24hrs after treatment has been discontinued to assure that an acute change has not occurred SECRETION CLEARENCE PROCEDURE MD request for IPV RCP evaluator to perform assessment Determine if patient meets criteria for IPV 1 Criteria for IPV Cystic Fibrosis Bronchiectasis or cavitating lung disease with sputum production Protocol Patients with increased sputum an effective cough and or failure to clear secretions with suctioning 2 All patients who are not candidates for the IPV Protocol will proceed to the secretion Management Protocol 4 4 4 Communicate the patients plan with Nursing Initiate therapy based on assessment and protocol algorithm When the patient has been discontinued from the IPV Protocol t
7. Proof for Editing 07 25 08 a 1 i ub r d d L j i x SS 8 EL i Mem Joa on P T TN 20 s 1 T LINICAT and SERVICE Proof for Editing 07 25 08 INTRODUCTION Indications for use The Percussionaire IPV IMPULSATOR is indicated for the mobilization and raising of endobronchial secretions bronchodilation reducing mucosal edema and the resolution of diffuse patchy atelectasis in all patient populations Potential effects of IPV IMPULSATOR The IPV IMPULSATOR have inherent risks similar to all positive pressure breathing devices These risks include but are not limited to under over ventilation under over humidification pneumothorax and pneumomediastinum PIE pneumoperitoneum and hemoptysis Individuals attempting to operate the IPV IMPULSATOR must understand warnings and cautions contained in user s guide and manual to prevent bodily injury or equipment failure Cautions If IPV IMPULSATOR is used on a patient with an indwelling airway i e endotracheal or tracheotomy tube a clinician must be present so that a one to one relationship exists This device enhances secretion clearance Patients must be assessed pre and post treatment for a reduced vital capacity FRC or the need for assistance in clearing airway secretions A patient cannot breathe through an ob
8. This active breathing cycle should last at least 10 15 seconds to allow for equilibration of pressures B If applicable the patients cuff should be deflated for the facilitation of secretions into the oral airway C Observe SpO2 throughout if a drop occurs increase rate by rotating percussion knob counterclockwise toward easy 11 the patient cannot understand instructions the therapist must deliver treatment A Suction as needed 12 During the treatment which should be about 15 20 minutes in length the entire percussion frequency should be scanned easy hard in order to mobilize secretions in the different time constants of the lung A Source Pressure should be adjusted for effective internal percussions by assessing chest wiggle chest wall movement auscultation and patient comfort 13 Treatment should continue until all medication is delivered A Additional diluents may be added if necessary 14 When treatment is complete unit should be turned off bleed off internal pressure in IPV breathing head should be dismantled and stored cleaned for future use A Re inflate cuff to pre treatment level B Reassess patient this procedure may result in mobilization of copious secretions suction and evaluate A patient cannot breathe through an obstructed airway Proof for Editing 07 25 08 TROUBLESHOOTING IPV IMPULSATOR PROBLEM CHECK Breathing head Phasitron nebulizer assembly will not function
9. connection or broken fittings please refer to authorized maintenance center for calibration repair The inlet filter for the IMPULSATOR units should be checked quarterly by removing protective cap at top of unit and inspecting filters the two filters should changed as necessary Black filter Part B12450 Felt filler Part B12585 Proof for Editing 07 25 08 SPECIFICATION SHEET UNIT POWER REQUIRMENTS SAFTEY STANDARDS Impulsator F00012 VAC 115 TESTED TOUL STANDARDS 2601 AND EUROPEAN STANDARD EN60601 1 CLASSIFICATION CLASS 1 1 5 TYPE BF MAINS ISOL 5 AMP USA Ordinary Equipment 3 AMP EUR Not Suitable for use with OPER TEMP 10 40 C flammable mixtures 50 104 F Suitable for continuous operation IPV 1 Inlet to unit is a DISS FDA released for marketing IPV 2 connection working pressure at least 50psi 3 2 bars are needed IPV 1C Inlet to unit is a DISS FDA released for marketing IPV 2C connection working pressure at least 50psi 3 2 bars are needed DEVICE WIDTH HEIGHT DEPTH WEIGHT Impulsator 15 2 38 7 11 27 9 8 28 3 20 5 9 3 Proof for Editing 07 25 08 GLOSSARY OF SYMBOLS ALTERNATING CURRENT DIRECT CURRENT ATTENTION DOCUMENTS TYPE BF EQUIPMENT COMPLIANCE WITH MEDICAL DEVICE DIRECTIVE Proof for Editing 07 25 08 Proof for Editing 07 25 08 Proof for Editing 07 25 08 50007 1 ar A50010 3 Proof for Editing 07 25 08
10. f the lung A Source Pressure should be adjusted for effective internal percussions by assessing chest wiggle chest wall movement auscultation and patient comfort Treatment should continue until all medication is delivered A Additional diluents may be added if necessary B Suctioning should be as needed and at the end of treatment C Longer duration treatments may be performed by adding diluents to neb NEVER run device without nebulization When treatment is complete unit should be turned off bleed off internal pressure in IPV Breathing head and manifold should be dismantled and stored cleaned for future use A Re inflate cuff as appropriate B Adjust and observe ventilator settings as necessary C Reassess patient for airway obstruction Patient cannot be ventilated through an obstructed airway Proof for Editing 07 25 08 IPV IMPULSATOR THERAPY PROCEDURE Artificial airway Introduce yourself and explain procedure to patient Connect to proper power source A IPV 50 psi 3 2 bar gas source Make sure master switch is in off position IMPULSATOR 115Vac 60Hz USA 220Vac 50Hz Foreign sure rocker switch is in off position Patient should be in an upright comfortable position if possible A Patient should be assessed for a minimum of breath sounds heart rate respiratory rate or follow institution guidelines Short end of harness assembly should be connected to IPV
11. for a working pressure of 40psi Unit should not cycle for at least one minute f there is an intermittent cycle go to Section 9 for troubleshooting Disconnect green remote line from unit or depress remote switch on breathing head Unit should begin cycling and there should be flow to the nebulizer 17 Rotate frequency control knob through full range of motion observe that when counter clockwise easy the rate is faster and that as the control is turned clockwise the rate slows until the full clockwise hard position is reached Observe changes the proximal pressure manometer as the Percussion control knob is rotated When full counterclockwise there is peak pressure of between 0 and 40 cm H20 on the proximal pressure manometer When full clockwise there is a pressure to over 60 cm 2 on the proximal pressure manometer Rotate frequency control knob so arrow is at the 12 00 position time breaths for 15 seconds should be between 46 52 breaths 185 210 bpm I Co CON O 0 Proof for Editing 07 25 08 Pre Use Check for IPV 2C Pre Use Check list for IPV 2C effective 7 16 08 Standard IPV circuit interconnected with plug in patient outlet Do not connect GREEN tubing bayonet Rotate all Alpha control knob Arrows under their 12 00 indexes Toggle Nebulizer UP to ON Connect to 50 80 psi gas source Activate Rotate Pressure Reduction Reg knob for 40 psig Master Switch ON D CPAP
12. he entire percussion frequency should be scanned easy hard in order to mobilize secretions in the different time constants of the lung A Source Pressure should be adjusted for effective internal percussions by assessing chest wiggle chest wall movement auscultation and patient comfort Treatment should continue until all medication is delivered A Additional diluents may be added if necessary When treatment is complete unit should be turned off bleed off internal pressure in IPV Breathing head should be dismantled and stored cleaned for future use Proof for Editing 07 25 08 IPV INLINE ALOGORITHM ALIOW gt Patient being Stable Unstable is defined by hospital standards Preferable to volume delivery methods 11 Proof for Editing 07 25 08 IN LINE PROCEDURE USING CONE ADAPTER A50474 2 ARTIFICIAL AIRWAY MECHANICALLY VENTILATED Introduce yourself and explain procedure to patient Connect to appropriate power source Connect IPV in line interface part A50474 2 See Page 35 to ventilator circuit Short end of harness assembly should be connected to IPV IMPULSATOR unit using correct color coding See Page 29 30 Long end of harness assembly should be connected to Phasitron and nebulizer using correct color coding See Page 29 30 Fill nebulizer with prescribed medications and dilute to 15 to 20 ccs assemble Phasitron to nebuli
13. hey will be instructed on standard incentive spirometry RCP to re evaluate patient every 24hr while on IPV Protocol Discontinue therapy when outcomes are achieved Follow up re evaluation 24hrs post discontinued IPV Protocol to assure that an acute change has not occurred Proof for Editing 07 25 08 IPV 1C IMPULSATOR THERAPY PROCEDURE Non artificial airway Introduce yourself and explain procedure to patient Connect to proper power source IPV 50 psi 3 2 bar gas source Make sure master switch is in off position IMPULSATOR 115Vac 60Hz USA 220Vac 50Hz Foreign Make sure rocker switch Is in off position Patient should be in an upright comfortable position if possible A Patient should be assessed for a minimum of breath sounds heart rate respiratory rate or follow institution guidelines Short end of harness assembly should be connected to IPV amp IMPULSATORQ unit using correct color coding See Page 29 30 Long end of harness assembly should be connected to Phasitron and nebulizer using correct color coding See Page 29 30 Fill nebulizer with prescribed medications and dilute to 15 to 20 ccs Assemble Phasitron to nebulizer See Page 31 Rotate frequency control knob full counterclockwise to the easy position Rotate source pressure control knob for an operating pressure of 20 25 psi A IPVG amp Source Operational pressure control knob is located in
14. hysicians order EQUIPMENT IMPULSATOR IPV amp 1 C IPV amp 2 C IPV amp Breathing circuit Tissues and or basin for collecting expectorated sputum Suction equipment for patients unable to clear secretions Gloves goggles gown and mask as indicated in the Body Substance Isolation system Policy for caregiver protection Stethoscope for auscultation 50 psi 3 2 bar gas source or an approved wall outlet 115ac 60Hz USA 220ac 50Hz Foreign OVERVIEW The RCP will perform a patient assessment identify any contraindications or hazards and apply IPV protocol DESCRIPTION IPV is a form of bronchial hygiene therapy administered to the airways by a pneumatic device The patient uses a non compliant physiological interface called the Phasitron that delivers high flow mini bursts of air into the lungs at rates from 100 300 times each minute During the delivery of percussive bursts of air into the lungs a continued wedge pressure is maintained while a high velocity flow opens the airways and enhances intrabronchial secretion mobilization dense aerosol mist is delivered to the lungs during therapeutic percussion which serves to reduce the adhesive and cohesive forces of retained airway secretions During the therapeutic percussive interval there is a cyclical intrapulmonary exchange of respiratory gases which serve to flush out carbon dioxide and renew oxygen Proof for Editing 07 25 08 GUIDELINES AND WARNIN
15. index Read 4 6 cm H2O on Manometer Rotate Master Switch with ON IPV index Cycling should start Observe Manometer for cycling through 5 to 20 cm 2 Reduce Operational Pressure to 25 psig Cycling must continue With a 40 psi Operating Pressure rotate INSP FLOW INSP TIME and PERCUSSION control knob Arrows full counterclockwise Observe a Manometer Pressure Rise of over 35 cm 2 Pinch white Phasitro tubing Obstruction Alarm should sound Rotate all alpha control knob Arrows under their 12 00 indexes Depress MANUAL INSP Button Note Manometer pressure rise above 50 cm H20 Insert GREEN tubing bayonet into the REMOTE service socket Cycling should cease For patient use follow IPV 2C OPERATIONAL CHECK LIST Sed 11 12 Proof for Editing 07 25 08 Pre Use Check for IMPULSATOR Connect standard breathing circuit 50095 1 Impulsator unit Attach orificed test lung B11048 1 to Phasitron Connect IMPULSATOR to a 115 Vac 60Hz USA 220Vac 50Hz Foreign power source Check manometer for needle at zero not see troubleshooting Turn power switch on Unit should not cycle for at least one minute If there is an intermittent cycle go to section 9 for troubleshooting Adjust pressure regulator for a working pressure of 40psi Disconnect green remote line from unit or depress remote switch on breathing head Unit should begin cycling and there should be flow to
16. peratures lt 280 Fahrenheit 137 8 Celsius Standard Phasitron part A50007 A50007 1 Aerosol Generator part A50010 A50010 1 A50010 3 A50010 5 These parts can withstand temperatures lt 140 Fahrenheit 60 Celsius Phasitron Duo part A50007 10 Interface tubing assembly part A50034 Percussionaire amp units are not immersible SURFACE AREAS The IPV IMPULSATOR units should be wiped down between patient uses with an institutional approved disinfectant Disinfectant solution should not be sprayed directly onto the IPV IMPULSATOR unit The solution should be sprayed onto a cloth then the cloth used to wipe the unit down a Proof for Editing 07 25 08 Disassembly of A50095 1 Remove colored tubing A50034 from sockets No disassembly of A50034 needed Separate Phasitron assembly A50007 1 from aerosol generator assembly 50010 Unscrew Phasitron part 10914 Remove venturi assembly part 50091 including opening spring B10916 Remove Phasitron orificed diaphragm B10918 from green venturi body part A50091 Remove venturi o ring part B10968 Remove opening spring B10916 Unscrew aerosol cap part A50015 1 by holding aerosol bowl assembly part 5008 7 and rotating cap counterclockwise 4 turn B10968 10889 810120 B10914 m B10916 A50091 10918 A50007 1 A50015 1 d B11060 A50010 3 gt 50010 3 RS C P
17. ronary perfusion Lack of patient cooperation Vomiting Physiological Effects Hazards Complications Mechanical bronchodilation Recruitment of atelectatic lung Larger Vt Improved breathing pattern Decreased work of breathing Increased secretion mobilization Increased intrathoracic pressure Hyperventilation Gastric distension Decreased cardiac output Increased intracranial pressure Increased air trapping Contamination Hyper oxygenation Hemoptysis Pneumothorax Barotraumas Hypoxia Dysrythmias 9 9 9 9 9 9 9 9 9 9 9 Proof for Editing 07 25 08 DESCRIPTION OF CONTROLS IMPULSATOR Calibration Used to adjust ratio kept in 12 00 position arrow straight up for patient use Percussion Determines frequency of delivered breaths Source pressure Determines amplitude pressure rise of delivered breaths Source Pressure Power switch ON C orr Proof for Editing 07 25 08 IPV 1C Source pressure determines amplitude pressure rise of delivered breaths Percussion determines frequency of delivered breaths Manual inspiration provides for a convective breath when depressed Master switch when in ON position patient receives percussive treatment IPV 2C Source pressure determines amplitude pressure rise of delivered breaths Manual inspiration provides for a convective breath when depressed Master switch when in ON position patient receives percussive
18. roof for Editing 07 25 08 HOME CARE DISINFECTION The breathing head should be disassembled and rinsed after each treatment The Phasitron Duo was designed for ease of cleansing It is molded from LEXAN PLASTIC thus is dishwasher safe or can be cleansed with dishwashing soap and water and or typical hospital cold sterilization means DO NOT AUTOCLAVE To cleanse 1 Rotate nebulizer bowl counterclockwise to remove from top 2 Mechanically rinse in water then cleanse as desired 3 To dry place in kneeling position to allow back drainage 4 Hand flip nebulizer then set upside down to dry Phasitron Duo can also be cleaned in normal dishwasher cycle PHASITRON DUO IN KNEELING POSITION ON COUNTER Proof for Editing 07 25 08 MAINTENANCE OVERHAUL PROCEDURE Devices should be checked by an authorized maintenance center anytime clinical efficacy is not as expected If units are kept clean and water free a three year life span between mandatory overhauls is a reasonable expectation Units returned for maintenance and repair must be handled by a Percussionaire distributor and must have an RGA Authorized maintenance centers for the IPV amp IMPULSATOR units Percussionaire Corporation Bird Air lodge 1655 Glengary Bay Rd Sandpoint 10 83860 208 263 2549 ROUTINE MAINTENANCE FUNCTONAL EVALUATION A functional evaluation should be performed annually or when unit calibration is suspect n case of dis
19. side the housing behind door panel or on the front panel B IMPULSATOR Source pressure control knob is located at the bottom left of unit as it is facing you NOTE The rocker switch in the rear of the unit must be switched on before pressure can be adjusted Have patient breathe aerosol for approximately 1 to 2 minutes When patient is comfortable with breathing the aerosol have them depress the push button on the manual remote switch located the nebulizer See Page 32 Percussions will begin 11 12 13 14 16 Proof for Editing 07 25 08 Patient is instructed to inhale and exhale through the percussions this is the beginning of the active breathing cycle Objective is to perform active breathing for duration of 15 20 min treatment or for as long as possible A This active breathing cycle should last at least 10 15 seconds to allow for equilibration of pressures B The patient should be instructed to keep lips and cheeks splinted to avoid air and pressure loss If the patient cannot understand instructions the therapist must choose the correct interface to deliver the treatment Breaks between the active breathing should be as often as necessary for expectoration or therapist directed coughing The patient is instructed to continue breathing the aerosol if resting between active breathing cycles During the treatment which should be about 15 20 minutes in length t
20. structed airway If an artificial airway is in place a special gated aerosol generator must be used to relieve any transient unwanted pressure rises NOTE UNLESS OTHERWISE SPECIFIED IPV amp REFERS TO ALL Percussionaire amp Corporation Intrapulmonary Percussive Ventilation devices Proof for Editing 07 25 08 CLINICAL LIMITATIONS RESTRICTIONS Use of IPV Percussionators is limited to individuals who have received proper training in their use IF YOU HAVE NOT RECEIVED PROPER TRAINING DO NOT USE THIS EQUIPMENT The use of standard therapeutic IPV Percussionators will be restricted to a mouthpiece only Under no circumstances will a standard IPV breathing head with a gated aerosol generator be used with other than a mouthpiece with a lip seal only Whenever any patient is receiving IPV amp therapy without a mouthpiece a qualified clinician must be directly administering the protocol while employing an aerosol generator with a sleeved pressure relieving valve Impaction pressures and Frequencies Will be initiated on a conservative schedule Proof for Editing 07 25 08 PULMONARY CONSIDERATIONS FOR IPV THERAPY Absolute Contraindications Relative Contraindications Untreated tension pneumothorax History of pneumothorax Availability of a simpler more effective Pulmonary air leak treatment Recent lobotomy pneumoectomy Lack of adequate skilled supervision Pulmonary hemorrhage Cardiovascular insufficiency MI decreased co
21. the nebulizer Rotate frequency control knob through full range of motion observe that when counter clockwise easy the rate is faster and that as the control is turned clockwise the rate slows until the full clockwise hard position is reached Rotate frequency control knob so arrow is at the 12 00 position count the breaths for a 15 second period should be between 46 and 52 breaths 185 210 bpm Red Calibration knob should always have the arrow under the 12 00 index This control is only used by a certified technician when performing a full calibration Proof for Editing 07 25 08 PERCUSSIONAIRE CORPORATION CLEANING PROCEDURES These cleaning procedures supersede all others prior to January 29 2007 PERCUSSIONAIRE EQUIPMENT All new Percussionaire products are packaged clean They should not be considered Sterile or decontaminated Prior to use it is recommended that breathing circuit components be disassembled and sterilized decontaminated STERRAD 1005 Percussionaire Corporation recommends the Sterrad 1105 sterilization system Follow instructions below for how to disassemble Percussionaire breathing circuits Wash and dry all parts completely Process through Sterrad Sterilizer at a standard cycle with a 35 2 080 Mg H2O Liter concentration Reassemble circuit Other techniques The decision to use other decontamination techniques should be based on the following parameters These parts can withstand tem
22. treatment When in CPAP position delivers CPAP Rate Control determines frequency of delivered breaths IPV Source Pressure Percussion Manual Inspiration CPAP Flow Time Rate Control Inspiration Proof for Editing 07 25 08 Request for IPV RCP perform assessment See secretion clearance procedure Chronic Patient Vent Patient Bronchiectasis CF ALS SMA Dystrophy or any Disease with Sputum Production 02 Atelectasis Failure to wean Failure to clear with suctioning At risk for intubation 7 Secretions Atelectasis Ineffective cough See IPV Inline Alogorithm IPV Q4 or QID IPV Q4 or while in Acute Care Facility mouthpiece or mask D C when A ray and Physical Assessment improve Sputum 5cc per Tx for 24 hrs lf IPV is effective amp patient Has chronic problem Recommend Impulsator For home IPV Tx Proof for Editing 07 25 08 PERCUSSIONAIRE IPV PROTOCOL PURPOSE The purpose is to provide a protocol for IPV therapy that will enhance secretion removal reduce mucosal edema reduce bronchoconstriction and improve blood the gas interface by improving V Q mismatch POLICY The IPV Protocol will be initiated on patients by a written order from the physician After the physician has written an order a qualified RCP will Evaluate the patient upon receipt of the p
23. unit is functioning refer unit to authorized maintenance center Unit must be sent to authorized maintenance center Reconnect harness to proper connection Refer to authorized maintenance center Replace harness part A91005 Carefully remove gauge cover and with a small flathead screwdriver zero manometer Unit must be in the off position Examine O rings if cracked or worn replace part B10526 Examine QD fittings for cracks or breakage replace part A50036 If leak is Internal refer to authorized maintenance center See assembly drawing A50022 Unscrew part B11009 and B11017 being careful not to lose spring B10972 washer B11043 O ring B10124 Proof for Editing 07 25 08 TROUBLESHOOTING FOR IMPULSATOR PROBLEM UNIT WILL NOT START CAUSE FIX UNIT NOT CONNECTED TO AN PLUG UNIT INTO AN APPROVED POWER APPROVED POWER SOURCE SOURCE LOOSE WIRE CONNECTION OR SEND TO AN APPROVED MAINTENANCE GROUNDING CENTER FUSE NOT WORKING PROPERLY CHECK FUSE INTEGRITY AND FOR PROPER PLACEMENT OF FUSE LOCATED AT ON OFF SWITCH UNDER THE RED COVER PART 12792 USA AMP 5 PART 12791 EUR AMP 3 PROBLEM UNIT HAS DELAYED STARTUP FIX CAPACITOR FAILURE REPLACE CAPACITOR PART B12458 REFER TO AUTHORIZED SERVICE CENTER COMPRESSOR FAILURE RETURN COMPRESSOR FOR AN OVERHAUL PROBLEM UNIT FAILS TO MAINTAIN PEAK INSPIRATORY PRESSSURE CAUSE FIX WORKING PRESSURE NOT CORRECTLY SET WORKING PR
24. zer See Page 31 The following settings should be observed A Pressure Control SIMV PC and PRVC or similar B Turn off pressure support and flow by C Maintain PEEP level D Adjust Tidal Volume and Minute volume alarms as necessary E If using an older vent such as PB 7200 Other considerations may apply consult dealer Rotate frequency control knob full counterclockwise to the easy position Rotate source pressure control knob for an initial operating pressure of 20 25 psi Remove Phasitron and nebulizer unit from manifold turn unit on and observe for aerosol mist observe percussions turn unit off Reconnect Phasitron and nebulizer assembly to manifold 12 13 14 15 16 Proof for Editing 07 25 08 Turn unit on and observe chest wiggle A Patient should be assessed as necessary for BS HR RR PIP see cautions warnings B Assess for signs of air trapping Once ventilator alarms volume have been adjusted you may lower artificial airway cuff pressure If Available A Lowering of the cuff pressure facilitates secretion removal into the oral cavity were they may be suctioned This also helps in the prevention of tube obstruction in the event copious secretions are mobilized During the treatment which should be about 15 20 minutes in length the entire percussion frequency should be scanned easy hard in order to mobilize secretions in the different time constants o
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