Automatic Transport Ventilators - O
Contents
1. 24 4 1 1 Changing the Air Intake Filter To change the air intake filter undo the locking screw on the filter cover which is located on the rear panel of the unit Remove the old filter and discard following local protocols Replace the filter with a new one ensuring that the filter is properly located and then reattach the cover screwing the cover on finger tight NOTE It is recommended that the air intake filter is changed after each use of the ventilator using the 60 air oxygen mix mode to avoid using a partially occluded or contaminated filter for the next patient Fig 7 Rear Panel Layout 4 2 After Use and Monthly checking After Use After each use the ventilator should be cycled to confirm function The selectors should be rotated through all positions and all alarm functions should be checked to ensure function see section 2 3 Monthly Every month or more frequently if local protocols dictate the ventilator should be put through a checking procedure to ensure full function of all features The checking protocol detailed in section 2 3 Pre use Functional Check should be followed for this purpose Oxygen Concentration The oxygen content of the inspired gases expressed as a percentage Proximal Airway The airway pressure measured at the patient Pressure valve Patient Valve The valve which directs the flow of gas into the lungs and out of the expiratory port to atmosphere during expiration PEEP2. Gas supply low Oylinder valve not fully opened Gas supply hose kinked or cut Gas supply regulator faulty Poor patient circuit integrity loose connections or faulty patient valve Poor facemask seal Patient circuit has become disconnected Tidal volume being delivered is too low Supply pressure too low Low Input Pressure Alarm will sound Gas supply cylinder low or empty Regulator output insufficient Cylinder valve not fully open Brand of circuit used may be entraining room air through expiratory port Incorrectly selected airway pressure Airway obstructed Selected Minute Volume too high Frequency of ventilation too slow 26 Change Cylinder Open Valve fully Replace supply hose Replace pressure regulator Check all circuit connections and hose for tears holes Re position facemask Re connect circuit Adjust ventialtor settings Faulty gas supply regulator Replace cylinder Replace regulator Open valve fully Use only O Two approved circuits Select a higher pressure Correct the obstruction Change the settings selected 6 TROUBLE SHOOTING CHART NOTE If any of the remedies do not resolve the problem you are experiencing please contact your nearest Approved Service Centre SYMPTOM ATV does not function in any mode ATV does not function in automatic mode Insufficient ventilations PROBABLE CAUSE Gas supply
3. LEFT UNATTENDED THE USE OF THIS DEVICE IN AREAS WHERE THE AMBIENT AIR MAY BE HAZARDOUS OR EXPLOSIVE SHOULD BE AVOIDED AS ENTRAINMENT OF AMBIENT AIR DURING THE USE OF THE AIR MIX MODE WILL PERMIT THE PATIENT TO INHALE ATMOSPHERIC GAS ONLY THE CAREvent MRI UNIT MAY BE USED IN A MAGNETIC RESONANCE IMAGING DEPARTMENT ONLY PATIENT CIRCUITS SUPPLIED BY O TWO SYSTEMS SHOULD BE USED AS THE USE OF OTHER CIRCUITS MAY ADVERSELY AFFECT THE OUTPUT PERFORMANCE OF THEATV THE USE OF GAS PRESSURE REGULATORS THAT DO NOT MAINTAIN AMINIMUM OUTPUT PRESSURE AND FLOWRATE IN LINE WITH THE REQUIREMENTS OF THE SPECIFICATION MAY CAUSE THE DEVICE TO FAIL RESULTING IN THE PATIENT NOT BEING VENTILATED THE USE OF THIS DEVICE IN CARRING CASE OF ANY TYPE MAY WHEN USED IN THE 60 AIR MIX MODE RESULT IN AN INCREASE IN OXYGEN CONCENTRATION IF THE AIR MIX MODE IS TO BE USED IT IS RECOMMENDED THAT THE VENTILATOR BE PLACED IN ITS NORMAL OPERATING ORIENTATION AND THAT THE AIR INTAKE ON THE REAR OF THE VENTILATOR IS NOT OBSTRUCTED 2 1 3 Terms and Definitions Airway Resistance ATV CMV CPAP Demand Valve Expiratory Phase Expiratory Time Te Frequency f Inspiratory Flow Inspiratory Phase Inspiratory Time Ti Lung Compliance Maximum Patient inflation Pressure Minute Volume Vm Pressure drop across the airway per unit flow Automatic Transport Ventilator Controlled Mandatory Ventilation A positive pressure ap
4. Supply hose and Patient Circuit 2 3 Pre use Functional Checks Along with the contents of the shipping cartons you will require the following items to enable you to undertake the pre use functional check 1 Full oxygen cylinder 2 Oxygen regulator with a 60 PSI 9 16 DISS outlet The regulator must be able to output a minimum of 100 L min at no less than 40 6 PSI 2 8 Bar Calibrated Test Lung supplied with ventilator Having connected the supply hose to the regulator ensure that the ventilator Manual AUTO Selector is in the Manual position and turn on the oxygen supply Using a mild soap solution spray the input connection to the ventilator to check for leaks If any leak is present tighten the connection and re test 17 Airway Over Pressure Alarm Pressure Relief Continuous tone of a low pitch during the inspiratory phase of the ventilation that indicates that the maximum airway pressure selected has been reached inspiration p audible pulsed tone t time Fig 2 Graphic illustration of the Pressure Relief audible alarm signal Breathing System Integrity BSI Alarm Pulsed tone of a high pitch which activates if the patient circuit becomes disconnected or the airway pressure achieved does not reach 10 cmH O Alarm can be silenced for 15 seconds by depression of the BSI Alarm Mute Button See also BSI Visual Indicator p audible pulsed tone t time Fig 3 Graphic illustration of the BSI audible alarm s
5. and air ambulance settings Designed to be used by suitably trained personnel the various modes of operation of the device support the resuscitation and transportation of a wide range of patients from infants to adults who require ventilatory support The features and controls offered by the device comply with the various International Standards for Transport Ventilators The G059 models have been manufactured to comply with the latest Guidelines 2005 for CPR and ECC from the European Resuscitation Council and the American Heart Association 1 6 General Description The CAREvent ATV and MRI consist of a ruggedly constructed portable control module input hose and optional single use or reusable where available patient circuit The ergonomically designed control groupings facilitate the selection and setting of the breathing parameters The colour groupings provided on the controls adds to this ease of use concept The unique pneumatic alarm for low input pressure improves the level of safety for the patient by warning the operator of any problems of insufflcient or failed gas supply The air mix capability of the ventilator improves the operating time on bottled oxygen for long duration transports The extremely low drive gas consumption ensures full utilization of the cylinder contents Controls The controls provided are as follows Ventilation Frequency Pressure Relief Proximal Airway Pressure Minute Volume This ch
6. exhausted Gas supply not turned on fully Supply hose not connected Gas pressure regulator faulty Gas supply hose kinked or cut Manual AUTO switch in the Manual position Internally clogged orifice in the Frequency or Minute Volume controls Other control knobs may be incorrectly positioned Incorrect control setting selection Other control knobs may be incorrectly positioned Internal blockage in Minute Volume Control Pressure relief setting too low REMEDY Replace cylinder Open cylinder valve Connect supply hose to regulator outlet Replace pressure regulator Replace supply hose Switch to AUTO Switch selector knobs to a different position Check all selector knob positions Check selector positions Check selector positions Switch to another Minute Volume setting Check selector position 10 11 12 13 14 15 DO NOT DISASSEMBLE ANY PART OF THE VENTILATOR EXCEPT WHERE DESCRIBED IN THIS MANUAL AS ANY UNAUTHORIZED DISASSEMBLY WILL INVALIDATE THE WARRANT Y AFTER USE ALWAYS ENSURE THAT ALL COMPONENTS ARE CLEANED IN ACCORDANCE WITH THE INSTRUCTIONS PROVIDED IN THIS MANUAL SEE SECTION 4 ALWAYS USE THE CHECK LIST TO ENSURE THAT ALL COMPONENTS ARE REASSEMBLED CORRECTLY AND READY FOR USE IT IS RECOMMENDED THAT AN ALTERNATIVE MEANS OF VENTILATING THE PATIENT BE AVAILABLE IN CASE OF GAS SUPPLY FAILURE DURING USE THE PATIENT SHOULD NOT BE
7. the oxygen monitor is 10096 Now turn the Air Mix control to the 6096 setting and again verify using the oxygen monitor that the oxygen concentration is in the range of 54 to 66 6 Manual Ventilation With the ventilator connected to the 60 PSI source turn the Manual AUTO Selector to the AUTO position Set the frequency control to 14 BPM and the Minute Volume Selector to the 6 L position Allow the ventilator to cycle automatically for 5 breaths Depress the Manual Ventilation Button located on the front of the ventilator Hold the button in and gas will flow to the test lung for as long as the button is depressed Release the button and the automatic cycling will restart with a delay of approximately 20 seconds NOTE In the AUTOmatic mode the delay to re start following depression of the Manual Ventilation control is approximately 1 5 times the E Time for the selected frequency in the G05 model this delay is set to 20 seconds for all frequencies 7 Demand Valve Function and Automatic Circuit Shut Off With the ventilator connected to the 60 PSI source set the ventilator cycling at 12 BPM with a Minute Volume control setting of 14 L Turn the Manual AUTO Selector to AUTO and with the ventilator cycling apply a vacuum to the patient connector equivalent to a flowrate of 30 L min for a minimum of 1 second The demand valve will provide a flowrate equivalent to that demanded and the automatic cycling will cease Remove th
8. 8 1 9 Alarms and Gauges The alarm systems in the Automatic Transport Ventilator provide an audible indication of any inconsistencies in the patients breathing and warn of a loss of driving pressure from the gas supply The alarms function as follows Low Input Pressure Alarm Gas Supply A low frequency oscillating alarm occurs when the gas supply reaches the minimum safe operating pressure See also Gas Supply Status indicator HILL LL p audible pulsed tone t time Fig 1 Graphic illustration of the audible alarm signal WARNING When this alarm sounds immediately change the gas supply Once no leaks are found connect the Test Lung to the 15 22 mm patient connector on the Patient Circuit Using the selectors on the front panel select a frequency of ventilation and a flowrate Turn the Manual AUTO Control to the Auto position and the ventilator will commence cycling Testing of the Individual Features of the Ventilator The following features can be individually tested during the pre use Functional Check 1 Airway Over Pressure Alarm Pressure Gauge Function and Pressure Relief Adjustment Function 2 Low Input Pressure Alarm 3 Frequency Adjustment 4 Flow Adjustment 5 AirMix 6 Manual Ventilation 7 Demand Valve Function and Automatic Circuit Shut Off B CPAP PEEP Control 9 BSI Alarm 1 Airway Over Pressure Alarm Pressure Gauge Function and Pressure Relief Adjustment Function W
9. H 0 max 5 8 sec 0 20 cmH 0 60 OR 100 lt 6cmH 0 hPa 60 L min 18 C to 50 C O F to 122 F 40 C to 60 C 40 F to 140 F PROVIDES A VISUAL INDICATION OF GAS SUPPLY STATUS 20 60 cmH 0 19 6 TO 58 8 mBar
10. MANUFACTURERS AND DISTRIBUTORS OF CAREvent Range of Handheld Automatic Resuscitators CAREvent Range of Automatic Transport Ventilators SMART BAG MO Bag Valve Mask Resuscitators Demand Valve Resuscitators Equinox 5096 Nitrous Oxide 5096 Oxygen Oxygen Demand Valves Burn Relief Burn Kits and Dressings EasyGrip Bag Valve Mask Resuscitators CPR Bio Barrier Face Shields Revive Aid CPR Face Shields Rescue Breather CPR Pocket Ventilators Respiratory Disposable Products SQ Regulators Your Representative is O TWO MEDICAL TECHNOLOGIES INC Innovation in Resuscitation C 0120 EU Representative Marcel Houben Rue Vin ve 32 4030 LIEGE Belgique 7575 Kimbel Street Canada L5S 1C8 Tel 905 677 9410 Fax 905 677 2035 Website www otwo com E mail resuscitation otwo com For your nearest Authorized O Two Distributor In North America Toll Free 1 800 387 3405 Mississauga Ontario 13485 W MEDICAL TECHNOLOGIES INC Innovation in Resuscitation CAREvent MRI 01CV7000 USER MANUAL LJ E 01CV6000 01CV7000 Manufactured in Canada by O Two Medical Technologies Inc 17MP9654 Rev Q Sept 2008 7 CAREvent Accessories 01CV8015 CAREvent Deluxe Single Use Transport Ventilation Circuit with PEEP Port 17MP7010 Single Use PEEP Valve 17MP7327 Cs Air Intake Filter for CAREvent ATV amp MRI 01CV7025 CAREvent MRI Mounting Bracket 01CV7026 CAREvent MRI Stand and Mounting Bracke
11. Valve A device which when attached to the expiratory port of the patient valve holds a positive pressure in the patients airway at the end of the expiratory phase Positive End Expiratory Pressure Pressure Relief Valve which limits the maximum lung inflation Valve pressure by venting excess gas to atmosphere Tidal Volume Vt Volume of gas delivered to the patient during each inspiratory phase G05 Guidelines 2005 compliance Complies with the requirements of the ERC and AHA for 30 2 compression ventilation ratio 1 4 CAREvent MRI The CAREvent MRI has been designed to meet the requirements of ven tilation within the MRI environment The CAREvent MRI has been tested in a 1 5 Tesla MRI environment unshielded magnet spatial gradient of 23Mt m sec and a slew rate of 120 T m sec at an RF transmitter power of 2000 watts and a 3 0 Tesla MRI environment unshielded magnet spatial gradient of 40Mt m sec and a slew rate of 150 T m sec at an RF transmitter power of 8000 watts during a head phanton spectroscopy test scan with the device located no less than 12 inches from the mag net aperture which would be its normal use position during clinical use In addition the CAREvent MRI model can be attached to the CAREvent MRI mounting plate or attachment to a cart or wall medirail mounting bracket 1 5 General Information The CAREvent ATV and MRI are designed for use in the prehospital intrahospital interhospital
12. an one patient Single use circuits are not designed for use on more than one patient and must be discarded after each use The manufacturer recommends that circuits are used on a per patient basis and reusable circuits should be cleaned and single use circuits discarded after each use The patient valve assembly is flow direction sensitive Ensure that the patientcircuit is attached to the venti lator correctly NOTE 1 11 Control Adjustment The ventilator is equipped with a number of selectors depending on the model Each selector is actuated by the following method Fig 4 NOTE All selector positions are as viewed from the front of the ventilator 1 Ventilation Frequency BPM Located on the top right hand side of the control panel Rotary control with an anti clockwise rotation from low to high 2 Minute Volume Litres Located on the bottom right hand side of the control panel Rotary control with a clockwise rotation from high to low 3 Pressure Relief Maximum Delivered Airway Pressure cmH2O Located on the top of the control panel slightly left of center Rotary control with a clockwise rotation from low to high 4 Delivered O Concentration Located on the bottom left hand side of the control panel Rotary control with a clockwise rotation from low to high 5 Manual Ventilation Located on the lower center section of the control panel activated by depression of the button 6 Manual Auto Selec
13. art gives an easy reference to the delivered tidal volumes provided by the different combinations of frequency of respiration and minute volume 3 3 Operation in Extreme Conditions Operation of the ventilator in environmental conditions outside of those detailed in this manual may result in a reduction in the ventilator s performance In extreme cold weather a slowing down of the frequency of ventilation may be seen with a corresponding increase in the delivered tidal volume In high temperature environments the effect is not noticeable in terms of delivered ventilations but may cause excessive wear in the ventilator components over time Operation of the ventilator under supply pressures outside those detailed in this manual may result in a reduction in the ventilator s performance Input pressures below the minimum stated will cause the low input pressure alarm to function and will as the pressure falls to the point where the alarm is constant cause the ventilator to cease cycling Input pressures higher than that recommended in this manual may result in a risk of internal component failure if the pressure exceeds three times the maximum working pressure stated 4 AFTER USE CLEANING AND TESTING 4 1 Dismantling and Cleaning After use turn off the ventilator and disconnect the supply hose from the gas supply Disconnect the patient circuit from the gas outlet on the side of the ventialtor and either a discard the circuit if it is d
14. e control setting of 2 L Connect the Test Lung to the Patient Connector and turn the ventilator Manual Auto Selector to the Auto position After every 5 breaths rotate the Minute Volume counter control clockwise to the next setting and observe the increasing expansion of the Test Lung Repeat for every setting The increasing expansion of the lung indicates an increase in the delivered tidal volume as the frequency remains con stant so the delivered Minute Volume tidal volume x frequency will in crease with each increase in flowrate NOTE When testing the lower Minute Volume settings using the test lung pro vided there may be insufficient volume delivered with each breath to attain an airway pressure that will cause the BSI Alarm to be shut off Under these circum stances simply depress the BSI Mute Button to silence the alarm 5 Air Mix NOTE To fully test this function a calibrated 0 100 oxygen monitor is required not supplied 19 In the Manual mode the patient can Demand Breathe at their own rate and volume NOTE It is important to constantly observe the patient s respirations to ensure that adequate perfusion is occurring NOTE Small children may not be able to demand at a sufficient flowrate to disable the automatic cycling NOTE If used in conjunction with external chest compressions the Auto Circuit Shut Off function may be actuated should the depth of compression create sufficient tidal volume on chest re coi
15. e vacuum from the patient connector and check for the automatic cycling restart after a delay of 5 8 seconds NOTE The vacuum source can be as simple as a 500 ml calibration syringe 20 With the adjustable outlet pressure regulator set with an outlet pressure of 60 PSI set the ventilator cycling at 12 BPM with a Minute Volume control setting of 14 L As the ventilator cycles gradually reduce the outlet pressure of the regulator until you hear the Low Input Pressure Alarm activate This will be a slow mid pitched pulsed tone Continue to decrease the regulator outlet pressure and the tone will gradually slow in frequency until it becomes a continuous tone This indicates that the drive gas is now exhausted to the point where the ventilator will no longer function correctly 3 Frequency Adjustment With the ventilator connected to the 60 PSI source set the ventilator cycling at 8 BPM with a Minute Volume control setting of 14 L Connect the Test Lung to the Patient Connector and turn the ventilator Manual Auto Selector to the Auto position After every 5 breaths rotate the frequency control counter clockwise to the next setting and observe the increasing frequency of ventilation in the Test Lung Repeat for every setting If required a stopwatch may be used to check the frequency in each setting 4 Minute Volume Adjustment With the ventilator connected to the 60 PSI source set the ventilator cycling at 8 BPM with a Minute Volum
16. entilator to re cycle into an automatic ventilation mode following a delay period of approximately 20 seconds This delay allows the operator sufficient time to provide chest compressions or initiate a further manual breath should they so wish If the Manual Override Button is depressed for too long the patient is protected from high airway pressure by the Pressure Relief system In the Manual mode depressing the Manual override button will allow the operator to manually ventilate the patient at a flowrate equivalent to the Minute Volume selected Demand Breathing During automatic ventilation the Demand Breathing mode will allow the patient to commence spontaneous breathing through the ventilator while causing the automatic cycling to cease As with the Manual Override there is an increase in the expiratory time before the next automatic breath is delivered to allow the patient to continue demand breathing This system ensures that the patient receives a sufficient minute volume should their inspiratory efforts be erratic Demand Breathing is available to the patient in both the inspiratory and expiratory phases of the ventilation cycle 7 With the ventilator connected to the 60 PSI medical oxygen source set the frequency control to 8 BPM and the Minute Volume Selector set at 14 L attach the oxygen monitor to the outlet of the patient connector Turn the Air Mix control to the 100 setting and verify that the oxygen concen tration using
17. esigned for single use or b process the reusable circuit following your normal protocols Disinfect using a legally marketed commercially available hard surface disinfectant solution which is compatible with the materials in accordance to local protocols The ventilator can then be cleaned using a mild soap solution and warm water and a soft nail brush to remove ingrained contamination WARNINGS Do not immerse the ventilator in any solutions Do not use chlorine based cleaning agents If the ventilator is accidentally submerged in any liquid it should be shaken to remove as much of the liquid as possible and then the ventilator should be returned to the manufacturer for factory service 22 8 BSI Alarm With the Patient Circuit attached to the ventilator attach a test lung to the 15 22 mm adapter Set the frequency control to 14 BPM and the Minute Volume Selector to the 6 L position Turn the ventilator to AUTO and allow it to cycle for 5 breaths Remove the test lung and time the delay until the BSI alarm sounds Depress the silence button and time the delay until the alarm re starts 9 CPAP PEEP Control With the Patient Circuit attached to the ventilator attach a test lung to the 15 22 mm adapter Set the frequency control to 8 BPM and the Minute Volume Selector to the 14 L position Turn the ventilator to AUTO and allow it to cycle for 5 breaths Slowly open the CPAP PEEP control and monitor the gauge As the control is rotated t
18. he baseline pressure should increase 3 OPERATING INSTRUCTIONS 3 4 Setting of the Ventilation Parameters The setting of the ventilation parameters is dependent upon the patient s size condition and the clinical parameters required to be provided to the patient by the operator The controls should be set according to the established protocols to which the operators perform their tasks 3 2 Frequency Minute Volume Chart Fig 6 FREQUENCY OF VENTILATION BPM 40 36 32 28 24 20 18 16 14 12 10 8 050 056 063 08 10 11 13 063 069 078 089 10 13 14 083 094 43 15 17 18 19 20 22 25 28 30 38 D ul oc E zd ul 2 l o gt m Lr 2 86 1 0 1 2 1 5 88 1 0 1 2 1 4 1 8 Recommended bodyweight range 5 Kg to 180 Kg 10ml Kg 21 Delivered Oxygen Concentration 96 Manual Ventilation Manual AUTO Selector CPAP PEEP Control BSI Alarm Silence Button Visual Indicators Proximal Airway Pressure Gauge cmH O Gas Supply Status Indicator BSI Alarm Indicator Connections Connections are provided on the side of the ventilator for the Oxygen Input and the Gas Output 1 7 Principles of Operation The CAREvent ATV and MRI are time cycled Intermittent Positive Pressure devices providing a range of frequencies of ventilation and Minute Volume settings to provide a comprehensive range of delivered tidal volumes and ventilation rates The design of the micro pneumatic ci
19. ignal 10 Gas Supply Status Indicator Located on the front panel this visual indicator will show green when gas is supplied to the ventilator Used in conjunction with the Low input pressure alarm this indicator provides an additional reference for the operator as to the ventilators gas supply status BSI Alarm Visual Indicator Located on the front panel above the airway pressure gauge this visual indicator will flash red in time with the BSI Audible Alarm when the patient circuit is disconnected or insufficient airway pressure is being produced Airway Pressure Gauge Located on the front panel of the ventilator this gauge provides the operator with a visual indication of the airway pressure being reached during the ventilation cycle 1 10 Accessories Supply Hose The supply hose is a standard armoured oxygen hose with a 9 16 DISS threaded connection for the ventilator Single Use and Reusable Patient Circuits The Single Use Deluxe Transport Ventilation Circuits and Deluxe Reusable Patient Circuits are comprised of a patient valve housing and 22 mm tubing The expiratory port is configured to accept either 30 or 19 mm PEEP valves The 22 mm corrugated tubing is easily attached to the patient circuit output connector on the side of the ventilator fig 5 NOTE 1 The choice of using either a Single Use or Reusable circuit is at the discretion of the user Only patient circuits supplied by O Two Medical Technologies inc sh
20. ith the ventilator connected to the 60 PSI source set the ventilator cycling at 12 BPM with a Minute Volume control setting of 14 L Set the adjustable Airway Pressure Control to 20 cmH20 Remove the Test Lung from the Patient Connector and occlude the Patient Connector outlet This will cause the Airway Over Pressure Alarm to activate and a continuous tone will be heard during the inspiratory cycle of the ventilator To confirm the pressure relief setting observe the needle on the Airway Pressure Gauge during the inspiratory cycle and ensure that the needle reaches the 20 cmH O mark Now turn the Adjustable Airway Pressure Selector to the 60 cmH O position Repeat the test and observe that the needle reaches the 60 cmH O mark 2 Low Input Pressure Alarm NOTE To fully test this function it is necessary to have a supply regulator with an adjustable output pressure Not supplied Checking of the alarm can be undertaken by simply slowly closing the cylinder valve 18 2 2 Connection of Hoses The supply hose provided is attached to the input connection on the side of the ventilator finger tight fig 5 WARNING Using a wrench or excessive force in tightening the supply hose may damage the seal or the thread of the connection The patient circuit is attached to the gas outlet on the right hand side of the control module by simply pushing the 22 mm taper over the outlet Patient Circuit Supply Hose Fig5 Connecting the
21. l Under these circumstances a manual breath may be delivered if deemed necessary between sets of compressions Adjustable Pressure Relief This control allows the operator to vary the maximum delivered airway pressure This is achieved by diverting the excess delivered volume to atmosphere should the set airway pressure be reached Air Mix Mode To conserve oxygen during long transports or when a patient s respiratory condition demands an oxygen concentration of less than 100 the air mix mode can be selected This reduces the oxygen concentration to 6096 In this mode the ventilator entrains ambient air into the system and automatically reduces the oxygen flow to maintain a consistent tidal volume By using this mode the operating time on the cylinder supply is significantly increased NOTE Due to the design of the micro pneumatic circuit increasing pulmonary resistance has little effect on the delivered tidal volume or respiratory rate Research has shown that decreasing pulmonary compliance in the infant Minute Volume settings may give a minimal increase in the delivered oxygen concentration when used in the Air Mix mode Emergency Air Intake System for Gas Supply Failure In accordance with the International Standards for this type of device the ventilator is equipped with a failsafe Emergency Air Intake circuit which allows the spontaneously breathing patient to draw ambient air through the circuit should the gas supply fail
22. ng list to ensure that all components have been received 1 Operating Manual 2 Ventilator 3 Supply Hose 4 Single Use or Reusable Patient Circuit with Patient Valve b Calibrated Test Lung NOTE If any components are missing from the shipping carton immediately call the supplier quoting the packing slip number your original purchase order number and the description of the item which is missing 16 LOW INPUT PRESSURE ALARM AIRWAY PRESSURE ALARM BSI ALARM PRESSURE GAUGE ACCURACY INPUT CONNECTION PATIENT CONNECTION DIMENSIONS WEIGHT PATIENT VALVE DEAD SPACE AUDIBLE PULSED ALARM TO INDICATE INPUT PRESSURE IS DROPPING BELOW THE MINIMUM REQUIREMENT CANNOT BE SWITCHED OFF AUDIBLE ALARM TO INDICATE THAT THE SELECTED PEAK AIRWAY PRESSURE HAS BEEN REACHED AUDIBLE HIGH FREQUENCY PULSED ALARM INDICATING THAT THE PATIENT CIRCUIT IS DISCONNECTED OR INSUFFICIENT VENTILATION PRESSURE lt 10 cmH O HAS BEEN ATTAINED 2 FULL SCALE 9 16 DISS 15 22 mm 9 27 X 7 6 X 4 4 INCHES 236 X 194 X 112 MM 2 84 Kg Approx for ATV 3 0 Kg Approx for MRI 8 ml CYLINDER DURATION Aluminum D size cylindercontaining 415 Litres of oxygen ON 100 SETTING a 2LITREM b 14 LITRE Mv ON 60 SETTING a 2LITREMv b 14LITRE Mv 15 207 minutes 30 minutes 345 minutes 50 minutes NOTE Careful consideration should be given to the use of a reusable patient circuit on more th
23. or at its option for two years from the date of purchase at no cost to the purchaser upon the notification of the defects in writing by the purchaser and confirmation of said defect by the manufacturer All shipping costs shall be borne by the purchaser The manufacturer shall be liable under this warranty only if the Automatic Transport Ventilator and its parts have been used and serviced in the normal manner described in the instruction manual There are no other expressed or implied warranties This warranty gives no specific legal rights NOTE THIS DEVICE MUST BE SERVICED BY AN O TWO SYSTEMS AUTHORIZED SERVICE CENTER 1 2 Warnings The CAREvent ATV and MRI are intended for use by suitably trained and qualified personnel The following precautions should always be observed 1 READ THIS MANUAL PRIOR TO ATTEMPTING TO USE THE VENTILATOR 2 WHEN THE UNIT IS IN USE DO NOT SMOKE OR USE NEAR OPEN FLAME EITHER DURING USE OR WHEN CHANGING THE CYLINDER 3 WHEN NOT IN USE ALWAYS TURN OFF THE GAS SUPPLY 4 NEVER ALLOW OIL OR GREASE TO COME INTO CONTACT WITH ANY PART OF THE CYLINDER REGULATOR OR VENTILATOR 5 THIS DEVICE IS NOT DESIGNED FOR USE WITH HEATED HUMIDIFIERS 1 Low Input Pressure Alarm sounds intermittently or continuously Automatic circuit shut off not activating on demand breathing Breathing System Integrity Alarm Sounds Demand flowrate low or not functioning Airway Pressure Alarm sounds
24. ould be used 2 The use of a Bacterial Viral filter is recommended to reduce the potential for cross infection and contamination of the reusable patient circuit If used the Bacterial Viral filter must be used on a single patient basis 3 The use of a Bacterial Viral Filter in conjunction with a reusable patient circuit does not guarantee that the patient circuit will remain free of contamination 4 The use of a bacterial viral Filter on any of the CAREvent circuits will increase inspiratory resistance and if used on the distal side of the patient valve will increase deadspace 11 MRI TEST CONDITION PARAMETERS The CAREvent MRI has been tested in a 1 5 Tesla MRI environment unshielded magnet spatial gradient of lt 23Mt m sec and a slew rate of 120 T m sec at an RF transmitter power of 2000 watts and a 3 0 Tesla MRI environment unshielded magnet spatial gradient of 40Mt m sec and a slew rate of 150 T m sec at an RF transmitter power of 8000 watts during a head phanton spectroscopy test scan with the device located no less than 12 inches from the magnet aperture which would be its normal use position during clinical use NOTE When tested as indicated above the spectroscopy traces were not affected in any way by the CAREvent MRI ven tilator and the CAREvent MRI ventilator functioned to specification 2 PREPARATION FOR USE 2 1 ComponentList Having unpacked the ventilator from its shipping carton use the followi
25. plied to the lungs during all ventilation phases Continuous Positive Airway Pressure A valve that delivers gas to the patient at a flowrate equivalent to that demanded by the patient s inspiratory effort The time period from the end of the inspiratory flow to the end of the expiratory flow Duration of the expiratory phase The number of breaths in one minute also expressed as BPM The flow delivered to the patient by the ventilator during the inspiratory phase The interval from the start of the inspiratory flow to the start of the expiratory phase Duration of the inspiratory phase Volume added per unit pressure increase when gas is added to a human or artificial lung The maximum airway pressure delivered by the ventilator to the patient The total volume of gas delivered to the patient in one minute 5 MAINTENANCE SCHEDULE 5 1 Annual Preventative Maintenance Inspection It is recommended that the ventilator is returned to a service centre authorized by the manufacturer to undertake service and repair of this device for an Annual Preventative Maintenance inspection more frequently in high use areas The inspection will incorporate a full diagnostic test of all parameters When complete a certificate of compliance will be issued to cover the device for the next service period This maintenance inspection providing it is carried out by an authorized service centre will not affect the product warranty
26. rcuitry in the Automatic Transport Ventilator maintains a consistent I E ratio of 1 2 across the Minute Volume frequency combinations to optimise the exchange of gases in the alveoli This helps avoid the risk of inconsistent ventilations and protracted expiratory times that may cause additional physiological acidosis or short inspiratory times that may not allow for complete alveolar filling or may generate high airway pressures NOTE The design of these ventilators does not incorporate a negative pressure phase during either automatic or manual ventilation 1 8 Modes of Operation Automatic Ventilation Mode In the automatic mode selected by turning the Manual AUTO Selector on the ventilator control panel to AUTO the ventilator will supply the patient with positive pressure ventilations of a frequency and minute volume as selected using the Ventilation Frequency and Minute Volume Selectors on the front panel The I E ratio is maintained at a constant 1 2 to ensure that good gas exchange takes place in the lung Manual Ventilation Mode To allow the operator to control the patient s breathing manually a Manual Ventilation Override button is located on the front panel In the AUTO mode when the Manual Override Button is depressed the ventilator will cease automatic cycling and will deliver a constant flowrate equivalent to that selected on the flowrate selector for as long as the button is depressed Releasing the button will allow the v
27. t 01CV7030 CAREvent ATV amp MRI Ambulance Mounting Bracket TABLE OF CONTENTS CHAPTER TITLE INTRODUCTION Warranty Warnings Terms and Definitions CAREvent MRI General Information General Description Principles of Operation Modes of Operation Alarms and Gauges 0 Accessories 1 Control Adjustment 2 Technical Data Il ll ll ll c 1 BL nLiouoom5 ovl PREPARATION FOR USE 2 1 Component List 2 2 Connection of Hoses 2 3 Pre use Functional Check OPERATING INSTRUCTIONS 3 1 Setting of the Ventilation Parameters 3 2 Frequency Minute Volume Chart 3 3 Operation in Extreme Conditions AFTER USE CLEANING AND TESTING 4 1 Dismantling and Cleaning 4 1 1 Changing the Air Intake Filter 4 2 After Use and Monthly Checking MAINTENANCE SCHEDULE 5 1 Annual Preventative Maintenance Inspection TROUBLE SHOOTING CHART CAREvent ACCESSORIES PAGE ONOAaATKR WH a 21 21 22 22 23 23 24 25 27 1 INTRODUCTION 1 14 Warranty The CAREvenf ATV and MRI are manufactured from the finest quality materials Each individual part is subject to strict quality control tests to ensure exceptionally high standards The manufacturer warrants to the purchaser of the Automatic Transport Ventilator that its component parts are free from defects in material and workmanship for a period of two years from the date of purchase The manufacturer will replace and or repair all parts of the Automatic Transport Ventilat
28. tor Located on the front panel of the ventilator Rotary control with a clockwise rotation from Manual to Auto 12 7 CPAP PEEP Control Located on the front panel of the ventilator Rotary control with a clockwise rotation from 0 20 cmH O 8 BSI Alarm Mute Button Located on the front panel of the ventilator above the pressure gauge Acitvated by depression of the button BSI ALARM ADJUSTABLE VISUAL INDICATOR PRESSURE RELIEF CPAP PEEP BSI ALARM eee CONTROL SILENCE CONTROL j aw FREQUENCY zx u BPM a SELECTOR MANUAL 5 dns AUTOMATIC e SERIN o f SELECTOR AIR MIX GAS SUPPLY SELECTOR MANUAL STATUS VENTILATION INDICATOR BUTTON Fig 4 Front Panel Layout for ATV and MRI models 3 1 12 TECHNICAL DATA All specifications are subject to a tolerance of 10 except the I E Ratio which is subject to a tolerance of 20 and Maximum Airway Pressure 0 15 MINUTE VOLUME RANGE FREQUENCY RANGE I E RATIO INPUT PRESSURE AUTOMATIC FLOWRATE MANUAL FLOWRATE MANUAL OVERIDE DELAY TIME DEMAND BREATHING FLOWRATE DEMAND BREATHING TRIGGERING PRESSURE AUTO SHUT OFF DELAY TIME CPAP PEEP OXYGEN CONCENTRATION INSPIRATORY EXPIROTARY RESISTANCE OPERATING TEMPERATURE STORAGE TEMPERATURE GAS SUPPLY STATUS INDICATOR PRESSURE RELIEF RANGE 14 2 14 L min 8 40 BPM 1 2 45 70 PSI 8 5 Bar 6 42 L min 6 42 L min 17 23 sec 2100 L min 6 cmH 0 hPa 2 cm
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