Home

Puritan-Bennett LP6,LP10 Ventilator

1. 0 02000 19 Pressute Cycle 44 daria datan da a at 45 19 Standby E E A ae ra 19 Ventilator Parameters esan den E A AT eee 20 VOLUME or E or dele 20 Br ath Rate 00 aa 20 Inspitat ty or Tre sure 20 Breathing Effort tego neriasi i pitaa da 22 Pressure Alarms v adr cinta tt Lane en tee 22 Pressure Limit Control LP10 Only 020055 23 Power Sources ne MS NA 26 ACOPIO Aa ACEI ERR AES 26 External Battery 12 Volt DC 4 2 46 kaa ages seede 24 Using Car Date a 27 Internal Battery 12 Volt DC Dir AAA 28 Routine Safety Cheer ade 29 Monthly Safety Check nds tr es ets tt ede a 31 Tastall tron Turion cele cia AS See os 34 Mounting or Positioning aaa a ds 34 Page 111 Page iv Emergency Vehicle vauanr rv naa eee eee 35 Wheelchair vasre eder 36 Power Connections 24 dera hd set Ags eh ad hoes ead ees 37 General e055 Tage aa it ta ha 37 AC POWER AS A ea 37 External Battery 12 Volt DC arras aia ox 38 Battery Petfotmance dra el e A 39 Testing the Batteries ui ceva a a Goede gaces 40 Special precautions when using an external battery 41 Internal Battery 12 Volt DC 2 ussoeenerndkade bamse Sett 42 Patient Ventilator Circuit vaare stedet 44 Exhbalation Manifold 2 pen ES Sia Ae el ae 46 Humidification e A heh Geet cle eee 46 Short Teim casa Ft a OMe eS Ke Seba SSE SOS 46 Extended s asada ais bre eaten as bart 46 Supplemental Oxygen datas odes Kaew kA SAR eS ETR 48 Methods IN Shoe eke A 48
2. SIMV with Pressure Limit Pressure Cycle Note Warning Standby Operating Modes The ventilator functions as described under the SIMV mode The only difference is that the ventilator will limit the pressure during a delivered breath In this mode the ventilator assists or controls the patient s breathing as it does in the Assist Control mode But there s a difference If the air pressure exceeds the level set on the High Alarm Limit delivery of the breath is stopped and the high pressure alarm does not sound The high pressure alarm sounds only if the air pressure happens to exceed the High Alarm Limit by 10 cmH O hPa The high pressure alarm sounds only if the air pressure happens to exceed the limit by 10 cmH O hPa Breath Rate set at 1 5 BPM If the patient does not start a breath on his her own for 10 seconds the Apnea alarm sounds and alerts the caregiver Meanwhile the ventilator delivers breaths at 10 BPM Breath Rate set at 6 BPM or more No alarms sound if the patient fails to start a breath The ventilator con tinues to deliver breaths at the selected rate and volume In this mode when the pressure reaches the level of the High Alarm Limit the ventilator is designed to cycle into expiration without sounding an alarm It is unlikely that the pressure will exceed the set limit by 10 cmH O hPa The ventilator will not deliver breaths with the control in this mode It will however charge the int
3. Check for trach obstruction or for a condition in which the patient requires suctioning See the manifold manufacturer s instructions Reset both to the prescribed values Readjust settings to the physician s pre scription Replace filter Check for unconnected or miscon nected battery cable Check for blown fuse in the battery cable Use another external battery Reset by pushing in protruding rod Check for unconnected or miscon nected battery cable Check for blown fuse in the battery cable Use another external battery Turn it back ON Plug in the cord Use an active outlet If the problems continue provide another means of ventilation and contact your homecare dealer Page 9 Front Panel Front Panel Page 10 LPG Plus and LP 10 Clinician s Manual 10 ALARMS POWER 3 PATIENT PRESSURE Low Pressure Apnea AC Pwr Batt Charge Low Power External Battery High Pressure Setting Error Presilence Internal Battery Power Switchover s t kis Alarm Silence Reset Patient Pressure Exhalation Valve MODE LOW ALARM HIGH ALARM LIMIT Pressure Cycle MN Be 10 smv Y 70 SS A 728 x A PRESSURE ssist Control PEA 80 Al 5 Standby lt A 088 cao Y l a la 2 ST 90 VOLUME BREATH RATE LITERS BREATHS NIN vea 12 seta I Pressure Patient Air Limit Control The Front Panel of the ventilator has three sections e The upper section has small lights two touch butt
4. Routine Safety Check LP6 Plus and LP10 Clinician s Manual Routine Safety Check Note Use this information along with instructions from the patient s physi cian The procedure takes about ten minutes to complete and can be per formed by a trained caregiver Warning Disconnect the patient from the ventilator and provide another means of ventilation before starting these tests ALWAYS complete a routine safety check BEFORE connecting the patient to the ventilator 1 Check the Low Pressure Alarm ni ALARMS If the patient is not connected to the ventilator connect a patient SOUS Low Pressure Apnea circuit and test lung to the ventilator Then turn the ventilator on Low Power and switch it to an operating mode O High Pressure e Disconnect the small patient pressure tube from its port near the Setting ErroriPresilence bacteria filter Wait for two or three breaths Power Switchover e The Low Pressure Apnea light should start flashing and the audible r r alarm should sound X e Push the Alarm Silence Reset button to silence the alarm Alarm Silence Reset Reconnect the pressure tube to the ventilator The Low Pressure Apnea light should stop flashing after a breath or two PUSH 2 Check all the settings e Compare the current settings to your written record of the pre scribed settings Did e Make sure that all seven controls located behind the front panel Exhalation Tube ES door are se
5. keep the battery fully charged Some batteries need to be dis charged and recharged monthly Refer to the battery manufacturer s instructions Recharge any external battery immediately after use Use a standard battery charger The time required to recharge a battery varies Generally with a 10 amp standard charger there is a 1 1 ratio one hour of recharge for each hour of use Page 39 Power Connections LPG Plus and LP 10 Clinician s Manual Cautions Recharge an external battery immediately after use You must use an Puritan BennettPuritan Bennett approved battery charger to recharge external batteries used for extended periods of time Do not use the ventilator s internal charger to recharge deeply discharged batteries First connect the battery to the standard charger Then connect the charger to AC power NEVER connect a battery charger to an external battery while the battery is connected to the ventilator A 30 to 40 amp hour battery in good condition can power the ventilator for about 10 hours without recharging A 75 to 80 amp hour battery provides power for about 20 hours between charges Testing the Batteries Make sure that the external or internal battery is powering the ventilator before testing the battery condition To run the test press and hold the Battery Test button The needle on the Patient Pressure Meter registers the battery status in the window below A fully charged battery in good condition will regi
6. If the patient does not start a breath on his her own for 10 seconds the Apnea alarm sounds and alerts the caregiver Meanwhile the ventilator delivers breaths at 10 BPM at the selected volume Breath Rate set at 6 BPM or more No alarms sound if the patient fails to start a breath The ventilator con tinues to deliver breaths at the selected rate and volume The ventilator functions as described under the Assist Control mode The only difference is that the ventilator will limit the pressure during a delivered breath Since the pressure limit function bleeds off air to limit pressure the vol ume of air delivered will be less than the set value In this mode the patient can breathe unassisted and on his her own between ventilator delivered breaths The ventilator monitors these spontaneous breaths If the patient s effort is not strong enough to turn on the Breathing Effort light or the patient makes no effort the ventilator delivers a con trolled breath All this depends on the breath rate setting Breath Rate set at 1 5 BPM If the patient does not start a breath on their own for 20 seconds the Apnea alarm sounds and alerts the caregiver Meanwhile the ventilator delivers breaths at 10 BPM at the selected volume Breath Rate set at 6 BPM or more No alarms sound if the patient fails to start a breath The ventilator con tinues to deliver breaths at the selected rate and volume LP6 Plus and LP10 Clinician s Manual
7. Puritan Bennett recommenda tion by authorized personnel to ensure proper performance Page 59 Service Policy Page 60 The LP6 Plus and LP10 Volume Ventilators are warranted against defects in workmanship and materials The full warranty on page 64 provides details Do not make any service repairs on this equipment dur ing the stated warranty period Any unauthorized work immediately voids the warranty If you need information or assistance or if the infor mation in this manual is insufficient contact your local Puritan Bennett representative Or call Puritan Bennett Technical Services at 1 800 255 6774 Puritan Bennett does not recognize the owner of a ventilator as an autho rized service representative Puritan Bennett will not be liable for any repairs attempted by the owner Any such attempted repairs other than specified non warranty repairs voids the warranty Parts and labor costs incurred by the owner will not be reimbursed Nellcor Puritan Bennett Puritan Bennett will make available on request diagrams component parts lists descriptions calibration procedures and instructions to assist in the repair of parts classified by Puritan Bennett as repairable Before returning any device to Puritan Bennett you must get a Return Authorization Number by calling Puritan Bennett at one of the numbers given above Specifications LP6 Plus and LP10 Volume Ventilators Power Line Power Usage Maximum Nominal Exten
8. another means of ventilation Pressure Limit Control 2 Turn the Pressure Limit Control counter clockwise until it stops This reduces the pressure to near zero Note The outside ring of the knob must be pushed in before the center adjust VOLUME LITERS ment knob can be moved Terese IT 3 Set all controls to the prescribed settings 4 A guide for setting the Volume Control is a calculation based on the patient s body weight This factor should be approximately 7 ml lb 18 ml kg or 100 ml whichever is greater Example Patient weight 55 lbs set volume at 385 ml Note that the Volume Con trol setting is a prescribed setting 5 Block the Exhalation Manifold at the port that connects to the patient to observe the pressure on the Pressure Meter Warning Wash hands thoroughly Do not introduce germs or contaminants into the patient circuit while performing this task 6 Watch the needle on the Patient Pressure Meter Note the highest pressure achieved during a machine delivered breath 7 Turn the Pressure Limit Control clockwise in small increments each breath until the meter needle reaches but does not exceed the pres sure value prescribed by the physician 8 When the prescribed Pressure Limit is reached allow the machine to Pressure cycle for several breaths to verify stable operation Limit Control 9 Reconnect the patient to the ventilator Page 24 Pressure Limit Control LP10 O
9. button The needle in the Patient Pressure Meter will point to low medium or high within the lower window If the needle points to low recharge the internal battery immediately after completing the daily safety check See page 44 Perform Battery test after 3 hours of recharging Monthly Safety Check LP6 Plus and LP10 Clinician s Manual e Connect a fully charged external battery to the ventilator Verify that the External Battery light on the front panel turns on e Turn the AC power on Make sure that the green AC Power Battery Charge light located on the front panel turns on Wa rning If the ventilator does not pass the daily safety check or you cannot complete this check call your vent supplier or an Puritan Bennett Service Representative immediately Monthly Safety Check Note Use this information along with instructions from the patient s physi cian The tests take about ten minutes to complete Wa rning Disconnect the patient from the ventilator for the monthly safety check Provide another means of ventilation before starting these tests UN 1 With the ventilator turned off confirm that the pressure meter 60 pt I ao is resting at 10 1 0 cmH O hPa 2 Unplug the AC power cord Visually inspect the plug and cord for NAV damage or exposed wires which could cause a shock hazard Check the High Pressure and Low Pressure alarms Plug the ventilator into AC power Connect the patient circui
10. effort is less than the Breathing Effort control setting Patient speech or other activities lower patient airway pressure Low alarm setting is higher than Pres sure limit setting LP10 only Volume set below patient s tidal vol ume Pressure Limit level is set too low LP10 only Incorrect control settings Leaks or obstructions in the patient cir cuit Other causes LPG Plus and LP 10 Clinician s Manual Solution Alarms will stop in two seconds Alarms will stop in one second Turn vent off and set mode to Standby Wait a few seconds Return switches to prescribed settings If alarm persists provide another means of ventilation Check the patient for breathing effort Check connection of the patient circuit to the ventilator check all connections for leaks and tightness especially at the humidifier trach tube and exhalation valve Inspect and remove water from small bore tubing Uncrimp the small bore tubing Set Low Alarm control setting higher than the PEEP pressure Set Breathing Effort so the patient s breathing effort turns on the Breathing Effort light Low pressure alarm sounds whenever low pressure limit is not reached for two consecutive breaths Review the section on alarms Correct to the prescribed value Correct to the prescribed value Correct to the prescribed value Reset to prescribed values Check for leaks or crimped tubing Notify your physic
11. has an internal battery Use the internal battery for short term emergencies only for example when moving from one power source to another Make sure you recharge the internal battery immediately after each use Warning The batteries contain toxic chemicals and no attempt to remove or replace the batteries should be made by any one other than the homecare dealer or an authorized service center AC Power Plug the ventilator into an appropriate AC grounded wall outlet 110 220 The ventilator automatically operates from AC power when you plug it in and the rear panel Power switch is on Make sure that you plug the cord into a properly grounded outlet Wa rning The ventilator must be set to the proper voltage before plugging it into the AC outlet Warnings The ventilator must be properly grounded when operating on AC power If you have any doubts about the outlet s ground connec tion have a qualified electrician examine the outlets AC power sources in ambulances and aircraft are frequently unregulated As a result the ventilator may be exposed to high voltage levels that can damage it Operation of the ventilator on improper power sources voids the warranty and will seriously damage the unit Do not use a power convertor as a power source for the ventilator Page 26 Power Sources LP6 Plus and LP10 Clinician s Manual Your ventilator automatically recharges its internal battery whenever it is e plugged into an
12. ia 14 A Y FRF V r PRESSURE Assist Control 28 ssist Contro into Standby emo Oo Y J 32 JT 9 VOLUME BREATH RATI INSPIRATORY TIME BREATHING EFFORT L BREATHSIMIN SECONDS mic ce atreg 3 r al L 4 T te 2 25 y gt 2 20 1 x 3 v E 35 2 34 Pressure Patient Air Limit Control The Puritan Bennett LPG Plus and LP10 Volume Ventilators are intended for use in a non acute care institution or transport on pediatric and adult patients It is to be operated in accordance with the product labeling con tained in this instruction manual The LPG Plus and LP10 Volume Ventilators are microprocessor controlled volume ventilators They provide continuous respiratory support for patients with respiratory insufficiencies in a skilled nursing facility or hospital or during transport Because of the compact design and light weight the units are highly portable The ventilators offer a wide range of delivery volumes inspiratory times and breathing rates The physician or the respiratory therapist can set the appro priate ventilation via the controls located in the recessed front panel The magnetically latched door panel and the control knobs are designed to pre vent tampering and accidental resetting Audible and visual alarms quickly identify problems See pages 6 through 9 for a complete discussion of these alarms Page 5 Alarm Condition LPG Plus and LP 10 Clinician s
13. incorrect switch setting may damage your ventilator 14 Mounting Rails These are used to mount and connect accessories to the ventilator Page 15 Operating Controls LPG Plus and LP 10 Clinician s Manual Operating Controls Pressure Cycle 18 50 55 P 14 6 80 SIMV lt 0 85 Assist Control PRESSURE ar ALARMS 1 Standby N 4 30 20 85 d 2 VOLUME BREATH RATE INSPIRATORY TIME BREATHING EFFORT LITERS BREATHS MIN SECONDS emo Pressure Patient Air Limit Control Warning Periodically check the control settings to be sure they are at the prescribed setting Always verify that the controls are set correctly before connecting and using the ventilator Do not change them without a physician s orders 1 Mode This control selects the operating mode for the ventila tor 2 Volume This sets the amount of air the patient receives for each breath To change the setting push in the control and then turn it to the selected setting Any change made during operation results in a maximum change of 100 milliliters from breath to breath until the new volume is reached Warning For more precise accuracy in setting the volume control indica tor the use of an external volume measuring device is recom mended 3 Breath Rate This setting controls the minimum number of breaths per minute BPM delivered by the ventilator 4 Inspiratory Time This sets the time it takes fo
14. mild soap solution Discard the old filter 3 Place the new filter between the particle screens Position the new filter with the printer side toward the ventilator Make sure the black o ring is in place 4 Place the assembly into position Twist the plastic cover into place over the filter assembly Note Do NOT reuse filters Discard them after removal Ventilator Surface Frequency Clean as often as the surface becomes soiled Supplies Use a mild soap solution and a damp cloth Procedure 1 Clean with a mild soap solution and a damp cloth Squeeze the cloth thoroughly before applying it to the unit s surface Page 57 Storage of the Ventilator LPG Plus and LP 10 Clinician s Manual 2 DO NOT allow liquids to enter the ventilator Warning never allow liquids to contact internal ventilator components under any circumstances Liquid will damage the ventilator and endanger the patient We recommend using a ventilator cover to protect against liquids get ting into the ventilator Storage of the Ventilator ground reliability and prevent a ouid only be connected to a wall Before storage charge the internal battery for a minimum of 10 hours When storing the ventilator for extended periods exercise the internal battery monthly Run the ventilator on its internal battery until the low power alarm sounds Immediately switch to AC power and recharge the internal battery for at least ten hours Wrap
15. moisture exchangers HMEs and tra cheostomy tubes If the patient circuit is disconnected from the patient but still connected to these components a Low Pressure alarm may not sound Where such disconnections from a ventilator dependent patient are pos sible you must set the Low Pressure alarm to a level that permits an alarm to sound To do this simulate the disconnection if a Low Pres sure Apnea alarm does not sound after two breath cycles increase the alarm limit until an alarm sounds Parameter settings beyond the capabilities of the machine will produce a Setting Error alarm LP6 Plus and LP10 Clinician s Manual Pressure Limit Control LP10 Only Pressure Limit Control LP10 Only Pressure Limit Control Note The Pressure Limit Control is a mechanical spring loaded valve that operates independently of the ventilator s microprocessor The control is designed for optional use in the Assist Control and SIMV operating modes It allows the ventilator to function like a pressure limited time cycled ventilator Pressure limit control ventilation is intended for use with uncuffed tracheostomy tubes or in other patient circuit configura tions which ensure an intentional artificial airway leak When the Pressure Limit Control is activated the normal waveform of the LP10 I Ventilator is altered and the ventilator provides extended or plateaued pressures The figures below illustrate two printouts depicting wa
16. prevents delivery of incorrect volumes that could result in excessive pressure build up Humidification Short Term When using humidification for a short period or during transport use an artificial nose with the ventilator Connect this regenerative humidi fier to the patient circuit between the trach connector and the flextube Or follow the manufacturer s instructions Extended Use The patient s physician will usually prescribe humidification of the delivered gases Due to their popularity Puritan Bennett offers special humidifier mounting brackets The brackets include instructions for use For complete instructions on the operation cleaning and sterilization of the humidifier refer to the appropriate sections of the humidifier manu Page 46 Humidification LP6 Plus and LP10 Clinician s Manual facturet s instruction manual Warnings Always position the humidifier at a level lower than the patient The humidifier should also be at the same or lower level than the ventilator This will help prevent excessive moisture from entering the patient or ventilator Some active humidifiers do not have temperature monitoring or alarm capabilities Failure to monitor air temperature may allow inspired air to become too hot Thermal injury to the patient s air way may result Always follow the recommendations of the humid ifier manufacturer Warnings Condensation forms in the Patient Circuit over time Periodically chec
17. the AC power cord around the Cord Wrap Rear Feet Begin the wrap by placing the cord in the lower left foot Use the inner groove Continue to the upper left upper right and lower right feet Keep the first and second wraps in the inner groove At the start of the third wrap place the cord in the outer groove of the lower left foot Place the plug in the holder located at the top of the rear panel Page 58 Scheduled Maintenance The ventilator needs periodic maintenance Follow the schedule below to ensure peak performance from the ventilator Maintenance Interval Action Required Change the Inlet Air Filter As Needed See page 59 Preventive Maintenance Every twelve 12 months or 6000 Contact your dealer operating hours whichever occurs first Battery Discharge Recharge Monthly See pages 39 and 40 ALARMS POWER 2 PATIENT PRESSURE Low Pressure Apnea AC Pwr Batt Charge EE e a fT Low Power C External Battery High Pressure Setting Error Presilence Internal Battery Power Switchover sg a Alarm Silence Reset Battery Test Breatjfing Effort IF 30 OR MORE UNIT PUSH SIMULTANEOUSLY REQUIRES SERVICE You can check the total operating time on the Patient Pressure meter To do so press the Alarm Silence Reset and Battery Test buttons simultaneously When the needle points to 30 or more contact your homecare dealer for ser vice Warning The ventilator must be serviced per
18. the source of the problem You may press the Alarm Silence Reset button to silence the alarm This turns off the signal for one minute If the alarm condition is corrected during that minute the alarm light will turn off microprocessor error cannot be silenced You cannot silence an alarm before it occurs If a High Pressure or Setting Error alarm condition is corrected before you press Alarm Silence Reset the audible alarm will stop but the light will continue to flash Press Alarm Silence Reset to turn off the light If a Low Pressure Apnea Low Power or Power Switchover alarm condi tion is corrected before you press Alarm Silence Reset both the audible and visual alarms will continue You must press Alarm Silence Reset to turn off the audible alarm and the light If alarms continue to sound provide another means of ventila tion and contact your homecare dealer Page 7 Troubleshooting Guide Troubleshooting Guide Conditions All lights turn on and audi ble alarm sounds Low Pressure Apnea Alarm Pulsating audible tone with flashing light Page 8 Probable Cause Normal condition Alarms test when unit is turned on Normal manual alarm test Microprocessor error The patient is not breathing Leaks or loose connections in the patient circuit Water in small bore tubing Crimped small bore tubing PEEP pressure set higher than the Low Alarm control setting The patient s breathing
19. working properly Television sets cordless or cellular telephones microwave ovens air con ditioners food processors and other appliances can be sources of electri cal interference To avoid electrical interference between your ventilator and these appliances you must follow these instructions e Never place your ventilator near these appliances e Never plug the ventilator into the same A C electrical outlet as these appliances nor into electrical outlets on the same circuit as these appliances e Never place the cables from ventilator accessories near these appli ances Warning Electrical interference may keep your ventilator from working properly which may create a hazard to the patient Note The ventilator is exempt under Section 15 801 c 5 of the no interfer ence regulations adopted by the FCC If television interference does occur contact Technical Services at Puritan Bennett Inc or a television repair technician for suggestions Or move the television to an A C electrical outlet that does not allow interference Page 4 General Description ALARMS POWER 6 PATIENT PRESSURE Low Pressure Apnea AC PwriBatt Charge External Battery High Pressure O Low Power O Setting Error Presilence Internal Battery P 0 O O O O Power Swltchover Alarm Silence Reset Battery Test O Breathing Effort Patient Pressure Exhalation Valve LOW ALARM HIGH ALARM LIMIT Pressure Cycle Ney
20. 298 12 24 36 43 60 72 34 96 108 120 144 168 192 216 240 264 11 22 33 44 55 65 75 87 98 109 131 153 175 196 218 240 Inspiratory Time seconds Volumednspiratory Time X 60 Average Inspiratory Flow Rate I E Ratio Table Cross reference set breath rate and inspiratory time to find ratio of inspiratory time to expiratory time Breath Rate BPM 10 11 12 13 14 15 16 17 18 19 20 22 24 26 28 30 32 34 36 38 1 85 1 42 1 28 1 20 1 16 1 13 1 11 1 10 16 15 15 14 14 14 14 13 13 13 12 12119 1 17 1 15 1 14 1 1 3 1 74 1 37 1 24 1 18 1 14 1 12 1 10 1 8 H 3 15 14 14 14 13 13 13 13 12 1 2 1 1 9 1 1 7 1 1 5 113 1 1 2 1 1 1 1 24 1 16 1 12 1 9 1 7 1 6 13 13 12 1 2 1 1 9 1 1 8 1 1 6 1 1 5 1 1 3 1 1 1 1 19 1 12 1 9 17 1 6 15 1 4 13 13 13 1 2 1 2 1 1 9 1 17 1 15 1 1 4 1 1 2 1 1 1 1 1 0 13 12 1 19 1 1 5 1 1 2 1 1 0 1 2 1 1 9 1 1 4 1 1 1 Till 15 13 1 2 1 14 1 1 0 1 10 1 4 1 3 1 17 1 1 2 60 Breath Rate Inspiratory Time Inspiratory Time I E Ratio Page 21 Ventilator Parameters Page 22 Breathing Effort Warning Pressure Alarms Note Note LPG Plus and LP 10 Clinician s Manual This push to turn knob sets the patient effort needed to trigger an assisted breath It also sets the effort needed to reset the Apnea BPM rate with breath rates from 1 to 5 BPM The settings are continuous from 10 to 10 cmH O hPa with zero being atmospheric pressure When the patient s breathing effort is sufficient
21. AC outlet and e the AC Power Switch is ON 1 You can also recharge an external battery that is properly connected to your ventilator See Battery Performance on page 39 External Battery 12 Volt DC The ventilator can operate when properly connected to a 12 VDC exter nal battery If the AC power fails the ventilator will automatically switch to an attached external battery A Power Switchover alarm signals the changes from AC to DC the external battery Caution Do not use the ventilator with a 24 VDC external battery A deep cycle battery 74 amp hour in good condition can power the ventilator without recharging for about 20 hours A gel cell type battery 34 amp hour can power the unit for about 10 hours before needing a recharge Though the ventilator can recharge an external battery it is less efficient than an Puritan Bennett approved battery charger Recharge an external battery 3 hours for each hour of use For the battery test procedure see page 40 Note Do not reverse the positive and negative cables when connecting a bat tery to the ventilator If you accidentally reverse the connections a pro tective fuse in the battery cable or the ventilator s DC circuit breaker opens The cable will not provide power to the ventilator You must first correct the connections and install a correct replacement fuse in the cable Reset the DC circuit breaker on the ventilator Only then will the external battery power the ven
22. ACCESS OLE na his Banus Oe Ane Re e a hi dete FA a ve 50 Positive End Expiratory Pressure PEEP 51 Pressure Monitoring 0 eee 53 Supplemental Oxygen 0 0 0 00 eee 53 Hundido bh so de 53 Remote lata wos dyni et da 54 Printer A frasa Se ote thn Hea eat GE ae tee ROS 54 Cleaning and Maintenance ce cee cc ccc eceees 55 Patient Circuit and Humidifier ceso ia oa eee de ne 56 Inlet Air Filter sednes RA aa as 57 Ventilator Surface ts a Sea eget vb 57 Storage of the Ventilator nasa SO Pa 58 Scheduled Maintenance 0 eens 59 Service Policy cir 60 Specifications 15 A eo Gere 61 Limited Watt OR 64 Keyword Index cvirrciii dai ia ee 65 Introduction Purpose of the Manual This Clinician s Manual will help you understand the operation of the LPG Plus and LP10 Volume Ventilators It provides detailed information for physicians and other clinical personnel about the installation safe use and ver ification of the operation of the LPG Plus and LP10 Volume Ventilators It provides the caregiver guidelines for safe ventilation that are specific to the ventilator It is not a complete maintenance document Therefore it contains no disassembly repair or reassembly instructions or diagrams Carefully read and understand all instructions before using the venti lator Use the instructions contained herein in conjunction with those set by the patient s physician No instruction in this manua
23. LP6 Plus Volume Ventilator And LP10 Volume Ventilator With Pressure Limit Clinician s Manual Important Note Read this manual in its entirety P U RI TA N before using the ventilator Keep this manual for future reference B E N N E T T For more information Contact your Puritan Bennett representative for information on our full line of medical equipment and related services Or you may contact Puritan Bennett Inc directly Puritan Bennett Technical Services 1 800 255 6774 Contents Introducnon siii AS 1 P rpos of the Mangal si A SAN AAA 1 Symbols and definitions saaana a des 2 Warnings and Cautions ccc ccc cece cee ee ee ence 3 Electrical Interference vistas pci ea eee ed Le eee ews 4 General Description 0 cece cece cece eee e ee eees 5 Alarm Condition ys 9 4 AAA NESSA SE EWE VRS ESE 6 Responding to Alarms masete 6 Troubleshooting Guide AS SERGE a Ra a Peak 8 Front Panels ii A Ne ee he ae ae be Dae ae 10 Upper Section tine A has Cae ee ets 11 Lower Left Section sna oigna ee 12 Lower Right Section 0 0 00 e eee eee 13 Rear Panel vain ds O ese ae ae net 14 Operating AA Raa OG ada hee te tate eta ee ears ag 16 Operating Modes si esses a Fer Be ke Ne Ee SME STG 18 ASSiSt Controls morge A dues ert Ola eee os BS 18 Assist Control with Pressure Limit LP10 Only 18 SIMV Synchronized Intermittent Mandatory Ventilation 18 SIMV with Pressure Limit
24. Manual Alarm Condition Warnings All alarms indicate a potential risk to patient safety When an alarm sounds provide immediate attention care and support to the patient as dictated by the situation Any device is subject to unpredictable failures To ensure patient safety an appropriately trained caregiver should monitor venti lation If the patient s condition warrants the use of an indepen dent secondary alarm remote alarm or another external monitoring device the physician should prescribe it The physi cian should also determine to what level the patient may require an alternate means of ventilation Certain types of ventilators including the LP Series have a Low Inspiratory Pressure Alarm The purpose of this alarm is to alert the clinician or caregiver when the pre set alarm parameters are violated As set forth in the LP Series Clinician s and User s Manuals a number of environmental factors and circuit accesso ries components can affect the pressure in the breathing circuit These factors may prevent circuit pressure from violating the low pressure parameters even in the event of a circuit being dis connected from the patient Therefore it is important for the cli nician to consider and monitor these environmental factors when establishing pressure alarm parameters Depending on the spe cific clinical situation e g risk of disconnect perceived as high patient is ventilator dependent a secondary means of mon
25. N CONC ENTRAR TANG THERMOMETER BACTERIA F le FLO FILTER TE E EXHALATION y VALVE Es HYDROPHOBC FILTER PEEP VALVE IMV H Bag Used successfully to support the patient s spontaneous breaths associated with SIMV It also helps to stabilize and maintain PEEP Best suited for high spontaneous inspiratory flow and demands Maintains stability and ensures PEEP Requires two sources of oxygen AIR OXYGEN _ HUMIDIFIER COMPRESSOR CONCENTRATOR f THERMOMETER FLEX BACTERIA _ i TUBE FILTER ii VE o a HYDROPHOBIC pe da E P FILTER PEEP VALVE TUBING 0 Enrichment Kit Used successfully to support the patient s spontaneous breaths associated with SIMV It also helps to stabilize and maintain PEEP Oxygen delivered through the Inlet Filter for concentrations up to 100 Requires only one oxygen source Page 52 LP6 Plus and LP10 Clinician s Manual Pressure Monitoring 40 50 30 60 y Y cmH O 0 gt Supplemental Oxygen Warnings Humidification To Patient Note Accessories Use either the ventilator s pressure meter or the optional printer to mon itor proximal low and high pressure The ventilator s pressure meter pro vides a relative indication of the cycling pressures created by the volume of delivered air The optional printer on the other hand provides a precise pressure reading generated by the electronic pressure transducer You may also use a pro
26. achine hours of operation when appropriate buttons are pressed Green LED activated by adequate patient breathing effort LEDs indicate operating power source green AC Pwr Batt Charge amber External Battery flashing amber Internal Battery Flashing red LEDs Low pressure Apnea Low Power High Pressure Setting Error Power Switchover Low Pressure Apnea Low Power High Pressure Setting Error Power Switchover Loss of microprocessor control Every five minutes when powered by Internal battery each time accessory printer gen erates a report Internal to the AC Power Switch 1 for ON 0 for OFF 1 Ampere Intake for patient air Screw off cap for filter change Connection for 12 VDC battery Calibration information during service procedure Cooling vent for internal ventilator components Connection for optional alarm accessories Connector for optional printer Do not use or store in the presence of strong electromagnetic fields 5 C to 40 C 41 F to 104 E 10 to 90 RH 20 C to 50 C 5 F to 104 F 10 to 90 RH when moving the LP6 Plus or LP10 Ventilator from a non operating to an operating environment allow a minimum of one hour temperature stabilization before use Preventative maintenance must be performed by qualified personnel every twelve 12 months or 6000 operating hours whichever occurs first 9 75 X 14 5 X 13 25 24 6 X 36 8 X 33 6 cm Approximately 34 pounds 15 5 kg Maximum of 5 c
27. block the inlet filter Keep away from curtains Cord Wrap and Rear Feet There is a foot at each corner AC Power Switch Circuit Breaker This is the ON OFF switch for AC power It also has a built in circuit breaker 1 is power con Yh nected to mains and 0 is power disconnected from mains gt Communications Port A special cable fits here and leads to an optional printer Note The ventilator and printer should be turned off before connection or dis connection of the printer Serial Number Plate This has Puritan Bennett s identification number for the ventilator It also lists the unit s power requirements External 12 Volt DC Battery Connector This is where you plug in an external battery cable wn A Aa Remote Alarm Connection remote alarm optional can sum mon the caregiver when an alarm sounds Rear Carrying Handle Recess AC Plug Holder 10 Vent Warm air from the unit s circuitry leaves the ventilator and gt cool air enters through this vent This cools the ventilator Warning Do not block rear panel vent 11 Pressure Relief This prevents the air pressure from exceeding approximately 100 cmH O hPa Wa rning Do not block the pressure relief valve 12 DC Circuit Breaker This circuit breaker protects the ventilator when it is powered by an external battery 13 Voltage Select Switch This switch selects 110 or 220 volts when it is powered by an external battery Caution An
28. entilators that have been partially or completely disassembled altered subjected to misuse negligence or accident or operated other than in accordance with the instructions provided by Puritan Bennett This includes repair by unauthorized personnel This warranty represents the exclusive obligation of Puritan Bennett and the exclusive remedy of the purchaser regarding defects in the ventilator THIS WARRANTY IS GIVEN IN LIEU OF ANY EXPRESS OR IMPLIED WARRANTIES INCLUDING ANY WARRANTY OF MERCHANTABILITY OR FIT NESS FOR A PARTICULAR PURPOSE No person is authorized to modify in any manner Puritan Bennett s obligation as described above Keyword Index AC power 14 26 28 35 37 38 40 AC power switch 14 15 27 30 62 Air tube 13 34 49 Alarm lights 6 7 33 Alarm reference guide 12 Alarm silence reset 7 11 22 29 30 32 58 Assist control 17 19 22 23 30 32 61 Assisted breath 13 18 22 Audible alarm 6 8 17 18 62 Bacteria filter 45 49 Battery test 11 30 32 40 60 Battery condition 39 40 42 Breath rate 16 18 20 49 61 Breathing effort 11 17 18 22 61 62 Circuit breaker 9 15 27 39 62 Cleaning 55 58 Electrical interference 4 Exhalation manifold 9 44 46 51 External battery 9 15 19 27 28 30 36 41 61 62 Filter 49 62 Flow rate 20 High alarm 9 17 19 22 25 61 High pressure 6 7 17 19 31 62 Humidifier 46 53 56 I E ratio 20 21 Infection 54 Inlet filter 14 41 48 49 62 Inspiratory t
29. ernal or connected external battery but only when the AC Pwr Batt charge is ON with the unit plugged into a wall outlet The patient may breathe through the patient circuit in this mode External and internal batteries charge equally well in all Modes Page 19 Ventilator Parameters LPG Plus and LP 10 Clinician s Manual Ventilator Parameters Volume Set the delivered or tidal volume with the front panel Volume control VOLUME BREATH RATE BREATHS MIN INSPIRATORY TIME SECONDS 1 1 1 5 2 0 9 8 7 6 5 A AARVLONN nononono Note Page 20 This push to turn knob sets the piston excursion Its range is from 100 to 2200 ml Adjust the rate breaths per minute with the Breath Rate control Incre ments are 1 BPM for rates of 1 to 20 BPM and 2 BPM for rates of 22 to 38 BPM To find the maximum inspiratory flow rate see the upper table on the next page This control adjusts the rate at which the prescribed tidal volume is delivered to the patient s lungs Increments are 0 1 seconds for times of 0 5 to 1 0 seconds and 0 5 seconds from 1 5 to 5 5 seconds You may also select an intermediate setting of 1 2 seconds Inspiratory time and Breath Rate determine both the Expiratory time and the I E ratio The Volume and Inspiratory Time setting determine the flow rate Example 1 0 liters of vol 1 0 sec Inspiratory Time 60 LPM flow rate See the lower table on the next page Breath Rate and Insp
30. he connections a pro tective fuse in the battery cable or the ventilator s DC circuit breaker opens With an open circuit the cable will not provide power to the ven tilator You must first correct the connections and install a correct replacement fuse in the cable Reset the DC circuit breaker on the venti lator Only then will the external battery power the ventilator You may order batteries and connecting cables from Puritan Bennett These accessories come with specific instructions for connection and use The battery and case provided by Puritan Bennett have a cable with a 3 pin connector When properly used this cable connector ensures against reversing the connections between the battery and ventilator Use of other cables may damage the ventilator or make it inoperable when the cable connections are accidentally reversed As they age and due to their chemical make up batteries lose their capacity to retain an electrical charge Typically lead acid batteries lose 7 of their capacity each year For best performance follow the manu facturer s instructions The following affect the life of the battery Ambient temperature Charge level Storage conditions Time and The number of deep cycles For maximum efficiency operate or store the battery at room tempera tures It will charge and discharge most efficiently in such an environ ment To ensure maximum running time of the ventilator on any external bat tery
31. hly safety check or you cannot com plete this check refer to the Troubleshooting Guide on pages 8 through 9 and or call your homecare dealer or an Puritan Bennett Service Representative immediately With the AC power cord unplugged visually check the AC power cord for damage or exposed wires that could cause a shock hazard Page 33 Installation Caution Do not use the ventilator in a highly magnetic environment such as Magnetic Resonance Imagery MRI Doing so may damage the ventilator and affect operation Wa rning Explosion hazard if used in the presence of flammable anesthetics Mounting or Positioning Position the ventilator on a table or nightstand within six feet of an elec trical outlet Keep the rear panel free of draperies or other items that could impede the air flow to the Inlet Filter port Warning Do not block the inlet port Protect the ventilator from accidental liquid spills Never place food or liquids on top of the ventilator When used in a humid environment and when cleaning e take precautions to protect the setting switches e keep the front panel door closed and e avoid spilling or allowing liquid to enter the unit Allow for the space requirements of additional equipment e g humidi fication and supplemental oxygen When in use keep active humidifiers or the patient circuit at an elevation lower than the patient s trach Moreover keep them lower than the ventilator s Patient Ai
32. ian and your home care dealer LP6 Plus and LP10 Clinician s Manual Conditions Low Power Alarm Pulsating audible tone with flashing light High Pressure Alarm Pulsating audible tone with flashing light Setting Error Alarm Internal Battery light flashes Single tone Green AC Power light does not glow Warning Probable Cause Failure to recharge the Internal battery Water in the tubing Crimped tubing Coughing or other high flow expira tory efforts Patient inspiratory resistance or compli ance changes A sticky Pressure Limit control Airway obstruction Malfunction in the exhalation manifold Pressure Limit setting is higher than the High Alarm setting LP10 only Inappropriate setting or settings beyond the capabilities of the machine Dirty inlet filter Unit has not switched to external bat tery DC circuit breaker is open Unit is operating on internal battery AC circuit breaker is open AC power cord is not connected No power at the wall outlet Troubleshooting Guide Solution Operate the ventilator on AC power for at least three hours or place ventilator in Standby Mode while on AC power use backup ventilator Remove water from tubing Straighten crimped tubing Treat patient s cough The alarm is appropriate for these conditions Have physician determine new ventila tor settings Occlude the end of the patient circuit to free the valve
33. ill proof batteries aboard commercial air craft Follow these regulations e FA A Title 49 C F R parts 100 199 paragraphs 173 250A and 170 260D e C A B Air Transport of Restricted Articles Circular No 6D page 57 Article 1924 e J A T A Restricted Articles Regulations Article 1924 Packaging Note 802 Section VI p 149 and Section X p 207 Use the Internal 12 VDC battery for emergency use only It requires no special connections The ventilator switches to the internal battery when other power sources fail or drop below adequate levels The Power Switchover alarm signals whenever the ventilator switches from AC or an external DC battery to its internal emergency battery When powered by the internal battery the amber Internal Battery light flashes continuously In addition an audible tone sounds every five min utes When approximately five minutes of power remain a continuous audible alarm sounds Immediately switch to another power source A fully charged internal emergency battery will power the ventilator from 30 to 60 minutes depending on the operating conditions Test the charge level of the internal battery by pushing the Battery Test button Read the charge level on the Battery Condition scale of the Patient Pres sure meter ALARMS POWER 68 PATIENT PRESSURE Low Pressure Apnea C AC Pwr Batt Charge Low Power C External Battery High Pressure Nz Setting Error Presilence X I Internal Battery Power S
34. ime 16 20 21 61 Internal battery 9 19 26 28 37 41 43 61 62 Low alarm 6 8 17 22 29 61 Maintenance 54 62 Microprocessor 8 46 62 Mode 16 18 19 61 Oxygen 48 49 53 Patient circuit 8 10 13 17 29 44 49 51 55 62 Patient pressure meter 11 24 32 40 61 62 Page 65 Page 66 PEEP 22 51 52 PEEP valve 51 Power source lights 11 Pressure cycle 7 19 22 61 Pressure limit 8 17 18 23 32 61 Pressure limit control 10 13 24 25 Pressure relief 15 Pressure tube 13 Remote alarm 6 15 53 62 Safety 29 33 Serial number 15 Setting error 6 9 20 22 62 SIMV 18 22 23 61 Standby 8 19 30 43 61 Sterilize 54 Storage 41 57 62 Vent 15 62 Voltage select 37 Voltage switch 15 Volume 8 16 20 24 49 61 Warranty 26 28 64 Tyco Healthcare Group LP Nellcor Puritan Bennett Division 4280 Hacienda Drive Pleasanton CA 94588 Toll Free 1 800 635 5267 Rx ONLY 2004 Nellcor Puritan Bennett Inc All rights reserved 068772A 0504
35. ind the Guide on the inside of the Control Panel Door Control Knobs They are behind the closed Control Panel Door The patient s physician prescribes the settings for these controls See pages 16 through 22 for details Front Panel LP6 Plus and LP10 Clinician s Manual Lower Right Section Patient Air Pressure Limit Control 1 Patient Air Tube The Patient air hose connects to this tube The ventilator delivers air through this tube 2 Exhalation Valve Port The Exhalation Pressure Tube of the Patient Circuit connects to this port 3 Patient Pressure Port The Patient Pressure Tube of the Patient Circuit connects to this port 4 Pressure Limit Control LP10 Only This control sets the air pres sure limit during a forced or assisted breath For use in Assist Con trol or SIMV modes only use in other modes may not allow effective ventilation See pages 23 through 25 Page 13 Rear Panel LPG Plus and LP 10 Clinician s Manual Rear Panel External Carrying 12 Volt DC RemoteAlarm Vent AC Plug Handle Battery Connector DC Circuit Mounting Breaker Rails Communi cation Port DEL LP1 Serial Num uid only be connected toa wall b er P at e Sinan as ra Pressure Relief Cord Wrap Voltage AC Power Rear Feet Select Switch Page 14 Rear Panel LP6 Plus and LP10 Clinician s Manual 1 Inlet Filter The ventilator draws in air through this filter Wa rning Do not
36. iratory Time settings that produce an inverse E ratio cause a Setting Error alarm The ventilator will not deliver inverse I E ratios It will deliver breaths at the set inspiratory time an I E ratio of 1 1 To determine the maximum inspiratory time or BPM values use one of these formulas 30 divided by Inspiratory Time Maximum Breath Rate or 30 divided by Breath Rate Maximum Inspiratory Time Ventilator Parameters LPG Plus and LP10 Clinician s Manual Inspiratory Flow Rate Table Cross reference set volume and inspiratory time to find average flow rate liters per minute Volume liters 0 1 0 2 0 3 04 05 0 6 0 7 08 0 9 1 0 12 14 1 6 12 2 0 22 120 240 360 480 600 720 840 960 1080 120 0 100 200 300 400 600 600 700 809 90 0 1000 120 0 86 171 257 343 429 514 600 686 771 857 1029 1200 75 150 225 300 375 460 525 600 675 750 900 1050 120 0 67 133 200 267 333 400 467 533 600 667 800 932 1067 1200 60 120 180 240 300 360 420 480 540 600 F720 40 960 108 0 120 0 50 100 150 200 250 300 350 400 450 500 600 700 800 90 0 1000 1100 40 0 120 160 200 240 280 320 360 400 480 560 640 720 800 889 3 0 6 0 90 120 150 180 21 0 240 270 300 360 420 480 640 600 660 24 43 72 96 120 144168 192 216240 238336 384 432 430528 2 0 40 6 0 0 100 120 140 160 180 200 240 280 320 360 400 440 1 7 34 51 69 86 103 120 137 154 171 206 240 274 309 343 377 15 3 0 45 6 0 75 90 105 120135 150 180210 240 270 300 330 13 27 40 53 67 30 98 AOR AZO 133 160 187 021 3 240 267
37. ircuit There are other accessories available Some add oxygen or moisture to the incoming air Others set Positive End Expiratory Pressure or print a permanent record of the ventilator s operation Contact Puritan Bennett for a complete list of available accessories Adding attachments or other components to the breathing system will increase inspiratory and expiratory resistance Page 45 Exhalation Manifold LPG Plus and LP 10 Clinician s Manual Exhalation Manifold The Exhalation Manifold directs the flow of gases to and from the patient Broadly speaking this assembly consists of a manifold body a mushroom valve and a cap Refer to the manufacturer s instructions Before using it with the patient secure all connections ensure the seat ing of the mushroom valve Make sure this valve prevents the escape of any gases during inspiration and that it releases properly during exhala tion Warni ng Ensure the proper connection and operation of the exhalation man ifold daily The patient could be at risk if the manifold fails to func tion as intended Connecting patient pressure and exhalation tubes to the opposite port prevents proper patient ventilation Note To safeguard the patient upon start up the ventilator dumps the first breath through the exhalation manifold The unit s microprocessor requires one cycle to establish its reference point that is the operating mode and settings to use This operation
38. itoring ventilation e g pulse oximetry should be considered Responding to Alarms The ventilator has visual and audible alarms The audible alarm is usu ally a pulsating tone Both the ventilator and the remote alarm emit these tones Flashing or steady light s on the ventilator indicate the source of the problem 1 ALARMS Low Pressure Apnea A Pulsating Audible Alarm and Flashing Light s U Low Power O High Pressure The Low Power High Pressure Setting Error and Power Switchover setting Error Presilence alarms all use this type of alert signal O Power Switchover T M Alarm Silence Reset Page 6 LP6 Plus and LP10 Clinician s Manual 4 PUSH Note Alarm Silence Reset Note Warning Responding to Alarms A Steady Audible Alarm and Steady Lights This combination indicates a detected microprocessor error in the venti lator Single Reminder Tone A single tone sounds every five minutes when the internal battery pow ers the ventilator In Assist Control and SIMV modes the High Pressure Alarm sounds whenever the air pressure exceeds the selected high pressure limit In the Pressure Cycle mode however the High Pressure Alarm sounds only when the air pressure exceeds the selected high pressure limit by 10 cmH gt 0 hPa When an alarm sounds First attend to the patient immediately Then check the flashing or steady light s on the ventilator to identify
39. k for moisture in the Patient Circuit When present remove the moisture Before attempting to dry the circuit disconnect it from the ventilator Never subject the internal ventilator compo nents to moisture or high pressure Doing so may damage the venti lator Always drain the tubing away from the patient connection Do NOT use compressed gas to clear moisture from the pressure line when connected to the patient First disconnect the ventilator and circuit Page 47 Supplemental Oxygen LPG Plus and LP 10 Clinician s Manual Supplemental Oxygen Patient Circuit Pressure Limit Control Patient Air Oxygen Elbow Oxygen Fitting Bacteria Filter Methods At times the attending physician prescribes supplemental oxygen In such cases the ventilator has two oxygen enrichment methods 1 You can bleed oxygen into the Patient Circuit for concentra tions up to approximately 40 2 You may deliver oxygen into the rear panel Inlet Filter Port for con centrations up to 100 In hospitals oxygen comes through piped systems or high pressure tanks Liquid reservoirs oxygen concentrators or high pressure tanks are sources of oxygen in the home setting Oxygen concentration guidelines on the next page are based on 100 oxygen sources The concentrations are somewhat less when using an oxygen source below 100 Warnings To ensure the prescribed oxygen concentrations at the proximal airways measure them with a calib
40. ke this into account in all applications but especially in portable applications where another power source may not be readily available The graph displays the relative impact of deep discharge on battery life The time since recharge when a battery is being stored affects how long it can adequately power the ventilator The ventilator will switch to the internal battery and signal an alarm when the external battery s voltage drops below a preset limit The alarm indicates the ventilator can no longer operate reliably on the exter nal battery Place the battery as far away as possible from the ventilator s Inlet Filter located on the rear panel When using a tray to hold both the battery and the ventilator put a par tition between the battery and ventilator Batteries need to be discharged and recharged monthly Refer to the bat tery manufacturer s instructions Using an external battery has nothing to do with the emergency internal battery An external battery neither recharges nor maintains the charge of the internal battery NEVER place the battery above or on top of the ventilator Use sep arate batteries to power a motorized wheelchair and the ventilator Page 41 Power Connections Internal Battery 12 Volt DC 5 O O X i POWER AC Pwr Batt Charge External Battery il J Internal Battery q Page 42 LP6 Plus and LP10 Clinician s Manual You may use some gel cell sp
41. l is intended to replace accepted medical practice regarding the use of the ventilator or the care of the patient As you read this manual you will notice Cautions and Warnings in boxes on many pages Pay very special attention to these boxes They will tell you what to do and what to avoid as you use the ventilator The difference between Warnings and Cautions is A Warning contains information about possible hazards to the patient the care provider or the service technician A Caution includes information about how to avoid equipment damage The Notes and Accessories sections found at the back of this manual are for your use in applying this manual s information to a specific patient Puritan Bennett supplied accessories include information concerning their use with the ventilator Page 1 Symbols and definitions Symbols and definitions LPG Plus and LP 10 Clinician s Manual The following symbols appear on the LP6 Plus and LP10 ventilators Page 2 Power switch ON position connection to mains power Power switch OFF position disconnection from mains power Attention consult accompanying manual Alternating current Direct current Volts Amperes Standby mode of operation Canadian Standards Association Battery test switch Alarm silence switch Alarm Power Underwriters Laboratory Patient pressure External battery connection Remote alarm Battery test level Manual reset Warnings and Caution
42. lus and LP 10 Clinician s Manual If you have any questions about the power system or how the venti lator will operate contact a qualified electrician and or Puritan Ben nett If you have any doubts about the ground connection have a quali fied electrician examine the outlets If necessary have them prop erly grounded When operating on AC power the ventilator will recharge the internal battery or a properly connected external battery in any mode setting including Standby Whenever AC power is unavailable the ventilator can operate from a 12 VDC battery Use a special cable from Puritan Bennett to connect the ventilator to the battery Puritan Bennett recommends deep cycle gel cell batteries A Power Switchover alarm signals a change from AC to battery power Carefully connect the 12 VDC battery to the ventilator Follow the bat tery manufacturer s instructions Connect the red wire marked to the positive battery terminal Connect the black wire marked to the negative battery terminal Use only Puritan Bennett s cables Check to see if the ventilator s External Battery light is lit This light signals that your ventilator is properly connected and is using the exter nal battery LP6 Plus and LP10 Clinician s Manual Note Battery Performance Power Connections Do not reverse the positive and negative cables when connecting a bat tery to your ventilator If you accidentally reverse t
43. mH O E 60 LPM 0 57 ml cmH 0 for A C breaths 100 cmH gt 0 hPa approximately 20 100 LPM Measures the proximal pressure for use in pressure control and pressure monitoring Proximal Gauge pressure sensor 20 cmH gt 0 hPa to 120 cmH O hPa compensated Temperature Range 18 C to Accuracy Relative Motor Position Purpose Location Type Range Accuracy 63 C 2 5 cmH O hPa Senses the relative motion of the piston drive motor Stator of motor Hall sensor Digital NA Page 63 Limited Warranty Page 64 Puritan Bennett warrants to the owner that the LP6 and LP10 Volume Ventilator exclusive of expendable parts and other accessories shall be free from defects in material and workmanship for 24 months from the original date of sale Puritan Bennett s sole obligation with respect to any such defect is limited to the repair or at Puritan Bennett s option replacement of the ventilator Purchaser pays return freight charges This warranty is made on the condition that prompt notification of a defect is given to Puritan Bennett within the warranty period and that Puritan Bennett has the sole right to determine whether a defect exists This warranty is conditional on the performance of Preventive Mainte nance at a minimum of once every 6000 operating hours or recertifica tion every twelve 12 months whichever occurs first by service personnel qualified by Puritan Bennett The warranty does not apply to v
44. ne also beeps every five minutes Battery Test Button It has four uses When pressed the Pressure Meter displays the charge status of the battery in use internal or optional external battery Push simultaneously with the Alarm Silence Reset button for an indication of operating hours See the Scheduled Maintenance por tion of this manual page 56 Press the button to print a report from an attached printer Use this button with other controls to start the self test See page 30 Breathing Effort Light This light turns green whenever the venti lator senses the patient s effort to breathe The Breathing Effort con trol sets the sensitivity Patient Pressure Meter The meter displays three pieces of infor mation Pressure at the Exhalation Manifold The number of hours of ventilator operation The charge status of the internal or attached external battery Page 11 Front Panel Lower Left Section 1 Page 12 LP6 Plus and LP10 Clinician s Manual HIGH ALARM LIMIT Pressure Cycle a 1 NA 22 oe so I SIMV Y Y Y 70 8 k PRESSURE asosni gt A 0 ALARMS andby A f dg emhz0 O BREATHS MIN 0 VOLUME BREATH RATE INSPIRATORY TIME BREATHING EFFORT SECONDS Control Panel Door This door is latched magnetically to pro tect the controls from accidental resetting Alarm Reference Guide Consult this guide for a summary of alarms and the action you should take You will f
45. nly LP6 Plus and LP10 Clinician s Manual 10 When you first connect the patient to the ventilator the value of the limited pressure may drop See Figures Watch the needle on the Patient Pressure Meter Slight increases in the Pressure Limit setting may be required to increase the maximum pressure to the prescribed limit Allow the machine to cycle several breaths to verify stable operation 30 40 50 6 y so 40 50 60 7 10 80 10 80 0 90 0 90 de Y cmH O 100 10 Y cmH O 100 Pressure before patient Pressure after patient connection connection 11 Check to ensure that all settings are in agreement with the physi cian s prescription 12 Monitor the patient and the ventilator closely 13 Set high pressure alarm approximately 5 cmH O hPa above the pressure limit Warning The normal operation of the Pressure Limit control will not allow a High Pressure alarm to occur even when the tracheostomy tube or the patient circuit is blocked The High Pressure alarm will sound d only if the Pressure Limit valve fails to open Note Usea printer during setup and routine safety checks to confirm precise opening pressure of the Pressure Limit Control Page 25 Power Sources LPG Plus and LP 10 Clinician s Manual Power Sources When used in the hospital plug the ventilator into a convenient wall socket If you use the ventilator in a wheelchair or in a car connect it to an external 12 Volt DC battery Your ventilator
46. nt Circuit to achieve desired oxygen concentrations LPM BPM X Vy C 0 21 0 79 Where LPM 100 O Flow in Liters Minute BPM Breathing Rate in Breaths Minute VT Tidal Volume in Liters C Patient O2 Concentration desired i e 30 0 3 Oxygen bled into the circuit is additional volume Adjust for this vol ume when setting the ventilator volume Oxygen Delivery Through the Inlet Filter Method 2 for concen trations up to 100 You can achieve high oxygen concentrations at the proximal airway by delivering source oxygen directly into the air Inlet Port located on the rear panel of the ventilator Use an optional Oxygen Enrichment kit The kit contains complete instructions Page 49 Accessories LPG Plus and LP 10 Clinician s Manual Accessories A number of accessories are available for the ventilator including a remote alarm and a printer See your Puritan Bennett representative for details Caution Use Puritan Bennett approved accessories in conjunction with the ventilator The use of other accessories may prevent proper operation of the ventilator or may damage the unit Page 50 Accessories LP6 Plus and LP10 Clinician s Manual Positive End Expiratory The patient s physician may prescribe PEEP An accessory PEEP valve maintains a positive pressure in the patient s airway during exhalation Pressure PEEP This valve is attached to the Exhalation Manifold of the Patient Ci
47. o 90 cmHO hPa in increments of 5 cm H gt 0 hPa Push to turn knob to set volume continuously adjustable from 100 to 2200 ml Rotary switch to set breathing rate 120 BPM in increments of 1 BPM and 2238 BPM in increments of 2 BPM Rotary switch to set time for delivery of set volume 0 5 to 1 0 sec in increments of 0 1 sec 1 2 sec and 1 5 to 5 5 sec in increments of 0 5 sec Push to turn knob to set pressure level for detecting breathing effort continuously adjust able from 10 to 10 cmH O hPa Locking knob sets pressure limit level from 15 to 50 cmH gt 0 hPa or closes off the pressure limit feature Port for connection to the proximal pressure line of the patient circuit 22 mm tube for connection to the bacteria filter Page 61 Exhalation Valve Indicators Normal Events Patient Pressure Meter Breathing Effort Power Alarms Audible Alarms Pulsating Tone Steady Tone Reminder Tone Rear Panel Controls AC Circuit Breaker Inputs Inlet Filter External Battery Communications Port Outputs Vent Remote Alarm Communications Port Environment Operating Storage Maintenance Dimensions Weight Resistance Factor Compliance Factor Emergency Pressure Relief Flow Sensors Primary Pressure Purpose Location Type Range Page 62 Port for connection to the exhalation valve of the patient circuit Displays patient pressure 10 to 100 cmH O hPa also displays battery charge and m
48. o automati cally takes over when an external battery s power becomes inadequate A power Switchover alarm signals the change to the internal power source The ventilator operates from 30 to 60 minutes on a fully charged inter nal battery The time depends on many factors primarily the selected settings The amber Internal Battery light flashes continuously and an audible alarm sounds every five minutes when the internal battery is in use When approximately five minutes of power remain a continuous Low Power alarm sounds At this signal immediately switch to another power source Use the internal battery only for emergency power back up If the internal battery is not used exercise it every four to six weeks That is run the ventilator on its internal battery until the low power alarm sounds Immediately switch to AC power and recharge the inter nal battery With AC power ON the ventilator will recharge the internal battery in any Mode including Standby Recharge a discharged internal battery for at least three hours before turning off the ventilator This action will help prolong battery life If the patient s health or safety would be jeopardized by long term power failure a reliable back up power source is mandatory Do not regard the internal battery as a long term back up power source Recharge the Internal Battery for at least three hours immediately after use An external battery cannot recharge the internal battery
49. ompressed gas to clear moisture from the pressure line when connected to the patient First disconnect the ventilator and circuit Condensation forms in the Patient Circuit over time Periodically check for moisture in the Patient Circuit When present remove the moisture Before attempting to dry the circuit disconnect it from the ventilator Never subject the internal ventilator compo nents to moisture or high pressure Doing so may damage the venti lator and endanger the patient Warning Do NOT use compressed gas to clear moisture from the pressure line when connected to the patient First disconnect the ventilator and circuit Page 56 Inlet Air Filter LP6 Plus and LP10 Clinician s Manual Inlet Air Filter Frequency Check the filter weekly daily when the ventilator is used during trans port or outdoors Replace the filter when it becomes dirty A blocked inlet filter may cause a setting error alarm Failure to change the filter may cause serious damage to the ventilator It could also invalidate the warranty Warning Do not operate the ventilator without an inlet air filter Using the ventilator without a filter may damage the ventilator Use only fil ters supplied by Puritan Bennett Supplies The only supplies needed are replacement filters Procedure 1 Twist the plastic cover over the inlet filter 2 Remove the two particle screens that sandwich the air filter Periodi cally wash the screens in a
50. on pads and a meter e The lower left section has the operating controls The physician pre scribes their setting To prevent accidental resetting they are behind a closed panel e The lower right section has the Pressure Limit control and the con nections for the Patient Circuit ALARMS POWER PATIENT PRESSURE AC Pwr Batt Charge Low Pressure Apnea w so o ba 7 4 Low Power External Battery High Pressure Setting Error Presilence Internal Battery Power Switchover Alarm Silence Reset LP6 Plus and LP10 Clinician s Manual Upper Section o o N Front Panel Alarm Lights When flashing or continuously lit they identify a condition that demands immediate attention There is also an audi ble tone when these lights begin flashing Alarm Silence Reset Button This has five uses Push to test the alarms Push to silence alarms for 60 seconds Push to reset the alarm after correcting the problem Push simultaneously with the Battery Test Button for operating a See the Scheduled Maintenance portion of the manual page 0 Use this button with other controls to start the self test See page 30 Power Source Lights The top light is green when the ventilator is AC powered The middle light is amber when an external battery powers the ven tilator The bottom light flashes amber when the ventilator s internal bat tery is in use A single to
51. ove the alarm limit Examples of these com ponents include hydrated heat and moisture exchangers HMEs and tra cheostomy tubes If the patient circuit is disconnected from the patient but still connected to these components a Low Pressure alarm may not sound Where such disconnections from a ventilator dependent patient are pos sible you must set the Low Pressure alarm to a level that permits an alarm to sound To do this simulate the disconnection if a Low Pres sure Apnea alarm does not sound after two breath cycles increase the alarm limit until an alarm sounds 8 Pressure Limit LP10 Only This limits the maximum pressure developed for each breath For use with Assist Control or SIMV modes only use in other modes may not allow effective ventilation See Operating Modes section below for details Page 17 Operating Modes LPG Plus and LP 10 Clinician s Manual Operating Modes Assist Control Assist Control with Pressure Limit LP10 Only Note SIMV Synchronized Intermittent Mandatory Page 18 Ventilation In this mode if the breathing effort is strong enough to trigger the Breathing Effort light the ventilator assists breathing The ventilator then delivers the selected prescribed volume of air If the patient makes no effort to breathe and thus fails to activate the Breathing Effort light the ventilator takes control It delivers breaths at the selected rate Breath Rate set at 1 5 BPM
52. perly calibrated commercially available external manometer to determine precise pressure readings The ventilator has provisions for the addition of prescribed supplemental oxygen With an oxygen elbow accessory the ventilator delivers up to approximately 40 oxygen concentration With an oxygen enrichment accessory the ventilator can deliver concentrations up to 100 Instruc tions accompanying these accessories describe how they deliver supple mental oxygen Use a calibrated analyzer to measure and ensure prescribed oxygen concentrations at the proximal airway See pages 50 through 51 If you are using the 90 elbow see illustration on page 48 to deliver supplemental oxygen care should be taken to securely attach the oxygen line to the elbow s oxygen fitting If the oxygen tube becomes disconnected from the 90 elbow the drop in pres sure may not be significant enough to sound the ventilator s Low Pressure Alarm This means that the patient may not receive the prescribed levels of oxygen and the tidal volume may be decreased but you may not be alerted by the ventilator s audible alarm sys tem To prevent this you should push the oxygen line tubing as far down on the elbow s oxygen fitting as possible to reduce the possi bility of inadvertent disconnection During normal extended ventilation the physician may recommend an active humidifier Several humidification devices are compatible with the ventilator Instruc
53. r Battery Charge light will not turn on 5 Any connected accessories that signal an alarm such as a remote alarm also test their alarms If the Power Switchover alarm is on push the Alarm Silence Reset button to turn it off Push the Alarm Silence Reset button and hold for three seconds All nine or eight lights should turn on and the alarms should sound for one second The accessories also signal their alarms for one sec ond Perform a battery test If you do not have an external battery connected to the ventilator ignore the part of this test printed in italics Make sure the ventilator is operating on AC power and the green AC Power Battery Charge light is on Turn off the AC power by pushing the 0 on the AC power switch located on the back panel Make sure that the Power Switchover light starts flashing and the alarm begins to sound Push the Alarm Silence Reset button to turn it off The External Battery light should be on Press and hold the Battery Test button The needle on the Patient Pressure Meter will point to low medium or high within the lower window If the needle points to low recharge your external battery See Testing the Batter ies on page 40 Disconnect the external battery Make sure that the Power Switchover light starts flashing and the alarm sounds Push the Alarm Silence Reset button to turn them off The Internal Battery light should be flashing Press and hold the Battery Test
54. r and is the patient s link to the breaths needed Inspect it every day Make sure there are no cracks in the hose Be certain all the connections fit securely to prevent leaks Clean the Exhalation Manifold daily Replace parts regularly before they wear out Regular replacement is essential for successful ventilation See the instructions that come with the patient circuit Page 44 LP6 Plus and LP10 Clinician s Manual Warning Warning Caution Patient Ventilator Circuit Flex Tube Use this tube to connect the Patient Ventilator Circuit to a tube adaptor on your trach tube The tube s flexibility makes the circuit more comfortable Exhalation Manifold This part contains a mechanism that con trols inhalation and exhalation During inhalation the white mushroom inflates and allows air to enter the patient s lungs Dur ing exhalation the mushroom deflates and allows air to be expelled Patient Air Hose This is the large hose between the Bacteria Fil ter and the Exhalation Manifold Patient Pressure Tube included with patient air hose This small tube connects the Patient Pressure port on the ventilator to the Exhalation Manifold Exhalation Tube included with patient air hose This small tube connects the Exhalation Valve port to the Exhalation Manifold Bacteria Filter This filter cleans the incoming air before the patient inhales it Ensure the proper connection and operation of the Patient C
55. r the ventilator to deliver a breath Page 16 LP6 Plus and LP10 Clinician s Manual 5 Operating Controls Breathing Effort This adjusts the ventilator s sensitivity to the patient s breathing effort When the patient s effort reaches the set ting the Breathing Effort light turns on and the ventilator delivers a breath Push in the control knob to change the setting High Alarm Limit This sets the point at which the High Pressure alarm will sound If the pressure exceeds this limit the High Pres sure alarm sounds except in the Pressure Cycle mode Delivery of this breath stops after the pressure reaches this limit The audible alarm is automatically silenced if the following breath does not exceed the setting Often when the high alarm sounds the patient circuit has an obstruction Clearing the circuit will stop the alarm Low Alarm This establishes the pressure which must be exceeded with controlled or assisted breath The alarm sounds only when two consecutive breaths do not reach the selected limit or if the limit is reached but the pressure fails to return to a level below the limit Normally this setting is just below the pressure you need for proper ventilation If this alarm sounds look for a leak in the patient circuit A leak or disconnection of the circuit is often the cause for the alarm Note Some circuit components will prevent a Low Pressure alarm by keeping the pressure in the circuit ab
56. r tube to pre vent moisture from entering the ventilator Warning Do not subject the internal ventilator components to excessive moisture under any circumstances Doing so may damage the ven tilator and affect operation Page 34 Mounting or Positioning LP6 Plus and LP10 Clinician s Manual During transport in cars and vans securely position the ventilator and strap it down to avoid inadvertent jarring or damage Use an external 12 VDC battery to power the ventilator You may connect the ventilator to the car s battery power with an acces sory power cable equipped with a cigarette lighter plug Connect the ventilator to the cigarette lighter cable plug only after the car s motor in running Warning Do not block the alarm port Emergency Vehicle In an emergency vehicle employ a deck or mounting bracket to secure the ventilator Maintain at least four inches between the rear panel Inlet Filter and the vehicle s wall Position the ventilator to easily view all indicators with ready access to all operating controls Warning ff Ac power sources in ambulances and aircraft are frequently unregulated As a result the ventilator may be exposed to high voltage levels that can damage it Operation of the ventilator on improper power sources voids the warranty and will seriously damage the unit Before plugging the ventilator into an unknown power source check the voltage If the voltage set switch is at 110 V the
57. rated analyzer Liquid and gaseous oxygen are not flammable but can cause other materials to burn faster than normal Skin exposed to liquid oxy en may become frostbitten When using oxygen devices always ollow the manufacturer s instructions Keep oxygen warnings visi ble to the caregiver and the patient Page 48 LP6 Plus and LP10 Clinician s Manual Warnings Note Supplemental Oxygen Oxygen Delivery into the Patient Circuit Method 1 for concentra tions up to 40 First connect the Bacteria Filter to the Patient Air tube Then connect the Oxygen Elbow to the Bacteria Filter Finally attach the Patient Cir cuit to the Oxygen Elbow If you are using the 90 elbow see illustration on page 48 to deliver supplemental oxygen care should be taken to securely attach the oxygen line to the elbow s oxygen fitting If the oxygen tube becomes disconnected from the 90 elbow the drop in pres sure may not be significant enough to sound the ventilator s Low Pressure Alarm This means that the patient may not receive the prescribed levels of oxygen and the tidal volume may be decreased but you may not be alerted by the ventilator s audible alarm sys tem To prevent this you should push the oxygen line tubing as far down on the elbow s oxygen fitting as possible to reduce the possi bility of inadvertent disconnection The formula below is a guideline to the flow of 100 oxygen to be bled into the Patie
58. rcuit See Figure for proper connections Puritan Bennett supplies PEEP valves See your Puritan Bennett representative for details and model numbers You may set the trigger sensitivity up to 10 cmH O hPa with the Breathing Effort control to compensate for PEEP pressures during the patient s inspiration When used with uncuffed tracheostomy tubes or other patient cir cuits which ensure an intentional leak in the artificial airway PEEP valves will have difficulty maintaining set PEEP levels Leaks may be supported by the use of continuous flow examples of two commonly used techniques of continuous flow are dia grammed on the next page Caution Continuous flows of greater than 20 LPM may result in setting error alarms Certain patient profiles and circuit configurations may result in a setting error alarm at flows of less than 20 LPM Note PEEP when used with low tidal volumes may affect the delivered vol ume Monitor volume delivery to assure accuracy You must set the Low Alarm level above the PEEP value or the ventila tor will give constant Low Pressure Apnea alarms Warning Breathing effort control settings above zero without PEEP will cause the ventilator to autocycle i e deliver breaths based on the selected inspiratory time at a 1 1 I E ratio Page 51 Accessories LPG Plus and LP 10 Clinician s Manual IMU H BAG SYSTEM HUMIDIFIER N OXYGEN CONCENTRATOR AIR COMPRESSOR OXYGE
59. s Warnings Always follow the physician s prescription when using the venti lator Always operate and store the ventilator according to the specifi cations and instructions set forth in this manual Use only Puritan Bennett approved accessories and products with the ventilator The use of other accessories may damage the unit and endanger the patient Perform daily and monthly verification of the ventilator s opera tion as identified in this manual Always stabilize and verify ventilator performance before con necting the patient to the unit All alarms indicate a potential risk to patient safety When an alarm sounds provide immediate attention care and support to the patient as dictated by the situation The LP6 Plus and LP10 ventilators shall not be used with flam mable anesthetic agents Do not use in direct sunlight Cautions Refer any adjustments or procedures exceeding the scope of this manual to an Puritan Bennett Technical Service Representative Refer to the Puritan Bennett Service Policy on page 62 Caution Federal Law U S A restricts this device to sale or use by or on the order of a licensed physician Page 3 Electrical Interference LPG Plus and LP 10 Clinician s Manual Electrical Interference Caution Your ventilator is an electronic instrument Any electronic instru ment is subject to electrical interference Electrical interference in excess of 10 V m may keep your ventilator from
60. s the ventilator auto matically switches to the next best power source AC Power The ventilator requires 0 5 amps typical at 110 VAC If the voltage select switch is set to 110 V the supplied voltage must be between 100 and 127 VAC The ventilator requires 0 3 amps typical at 220 VAC If the voltage select switch is set to 220 V the supplied voltage must be between 220 and 240 VAC The ventilator has a hospital grade 3 pronged AC power connector Note however that the connector s hospital grading depends solely on its use in a hospital grade electrical outlet If you encounter a 2 pronged outlet replace it with a properly grounded 3 pronged outlet When traveling to another country or a region with a different power system you may encounter two problems First the nominal voltage may be different Note the ranges given above for 110 and 220 VAC respectively Warning set the Power Select Switch before plugging the ventilator into a new power system The second problem you may encounter is the plug itself It may not fit into the outlet There are two solutions First have a qualified electrician remove and replace the ventilator s plug with one designed for the local outlets Second you may use an adaptor Make certain that the adaptor has no active electronic components and that it is not a power converter Page 37 Power Connections Caution Warning External Battery 12 Volt DC Page 38 LPG P
61. sion Cord Gauge External Battery Internal Battery Type Motor Pump Front Panel Controls Alarm Silence Reset Battery Test Mode Low Alarm High Alarm Limit Volume Breath Rate Inspiratory Time Breathing Effort Pressure Limit LP10 Only Input Patient Pressure Outputs Patient Air 110 VAC range 100 127 VAC 1 Ampere or 220 VAC range 220 240 VAC 1 Ampere 50 60 Hz external voltage selector switch 630 kw hours per year 315 kw hours per year Use 3 conductor harmonized cord only up to 49 use 18 gauge cord up to 99 use 16 gauge cord up to 200 use 14 gauge cord 12 VDC 6 Amperes Approximately 20 hrs operation with 75 80 Amp hour 12 VDC deep cycle gel cell battery Approximately 10 hrs operation with 35 40 Amp hour 12 VDC deep cycle gel cell battery Approximately 1 hour operation Volume ventilator Brushless induction Piston 100 to 2200 ml tidal volume capability Push button to silence alarms during events or reset after events used with Battery Test button to read machine operating hours on Patient Pressure meter Push button to show battery charge level on the lower window of Patient Pressure meter Rotary switch to set ventilator operating mode Standby Assist Control SIMV or Pressure Cycle Rotary switch to set limit for Low Pressure alarm 2 to 32 cmH O hPa in increments of 2 cmH O hPa Rotary switch to set limit for Assist Control Pressure Cycle mode 15 t
62. ster in the Normal High range ALARMS POWER 3 PATIENT PRESSURE LowPressure Apnea AC Pwr Batt Charge PRE 7 so 2 o 90 High Pressure Low Power Xx S y a AS External Battery 10 cmH 0 100 Setting Error Presilence C D Internal Battery AY 25 Power Switchover vw A C Alarm Silence Reset Battery Test Breathing Effort PUSH SHOWS CHARGE LEVEL Notes The Battery Test meter is only a relative indicator of the remaining bat tery charge An older battery may register a high charge level but dis charge more rapidly Carefully monitor battery power sources Always have a back up power source available The total life expectancy of any battery is affected by the number of times it is deep cycled i e nearly 100 discharged Page 40 LP6 Plus and LP10 Clinician s Manual 1400 1200 Number of Cycles v a oo 3 8 8 8 8 e 8 83 8 8 o 20 40 60 80 100 120 Depth of Discharge POWER AC PwriBatt Charge External Battery NA IT Internal Battery 1 ALARMS LowPressure Apnea Low Power High Pressure Setting Error Presilence NO Power Switch 5 AA ower switchover Special precautions when using an external battery Warning Power Connections The percentage of discharge relates directly to the number of cycles the battery can deliver As a battery ages its ability to power the ventilator decreases Ta
63. supplied voltage must be between 100 127 VAC If the voltage set switch is set to 220 the supplied voltage must be between 220 and 240 VAC If the power source exceeds the proper range at any time or if the voltage cannot be verified use a 12 VDC battery rather than risk damage to the ventila tor Warnings Stabilize and verify proper ventilator performance before connect ing the patient to the ventilator Do not use a power converter as a power source for the ventilator Page 35 Mounting or Positioning LPG Plus and LP10 Clinician s Manual Wheelchair Mounting instructions vary from chair to chair Consult the wheelchair manufacturer for standard wheelchair adaptations Warning Never place an external battery above the ventilator Use separate batteries to simultaneously power an electric wheelchair and the ventilator Caution Never place a humidifier above the ventilator Here are some general guidelines to consider when using the ventilator in a wheelchair e When using a tray place a partition between the battery and ventila tor e Insert a partition in the tray mount between the ventilator and bat tery Locate this partition as far as possible from the ventilator s Inlet Filter If the ventilator and battery are in the same tray cut drain holes in the tray to prevent any leaking battery fluid from reaching the ventilator Place the battery in a plastic container to help insulate the ventilator from ba
64. t to the doctor s prescription 3 Check the Patient Circuit e Check every connection in the circuit you are using or plan to use Manto a Make sure that the tubing is routed correctly that all connections are a tight and that there are no leaks e Check every part of the circuit for cracks and water Each part must be in good condition There should be no water in any part of the circuit Flex Tube Bacteria Filter Exhalation Page 29 Routine Safety Check Pressure Cycle ooo SIMV g Assist Control O 0 Standby y 10 Note ALARMS O Low Pressure Apnea Oo Low Power O High Pressure O Setting Error Presilence p SOL power Switch po oN ower Switchover lt a 4 Alarm Silence Reset PUSH Note POWER IE ANS AC Pwr Batt Charge O External Battery O Internal Battery power O AC Pwr Batt Charge Xx p A External Battery O Internal Battery 40 50 0 60 y 20 3 0 10 80 0 90 100 cmH 0 aS Page 30 LPG Plus and LP 10 Clinician s Manual Check all the alarm signals Turn the Mode switch to Standby Wait one second and turn the Mode switch to Assist Control All nine lights on the top section of the front panel should turn on and the audible alarm should sound for two seconds If the ventilator is not plugged in or if the AC power switch is off only eight lights will turn on The AC Powe
65. t to the ventilator Use your hand to block the part of the Exhalation Manifold that con nects to the patient Make sure no air comes out e oeo y Warning f wash hands thoroughly Do not introduce germs or contaminants into the circuit while performing this test Page 31 Monthly Safety Check Note HIGH ALARM LIMIT 1 ALARMS LowPressure Apnea O Low Power SOL ni AX High Pressure Setting Error Presilence Power Switchover id A Alarm Silence Reset PUSH 1 ALARMS x pa gr S Low Pressure Apnea O Low Power O High Pressure Setting Error Presilence Power Switchover Note Pressure Cycle o SIMV 3 Assist Control O 9 D Standby gt Page 32 LP6 Plus and LP10 Clinician s Manual If you are checking an LP6 Plus ignore the steps marked with an aster isk 4 Turn the ventilator on and set the mode to Assist Control Observe the Patient Pressure Meter The maximum pressure dis played should be only a few cmH O hPa above the pressure limit prescribed by your doctor Change the High Alarm Limit switch to 15 cmH O hPa At the next attempt to deliver a breath the High Pressure light should flash and the alarm should sound The Exhalation Manifold should make a soft popping noise Air should also come out of the large opening at the top of the Exhala tion Manifold Change the High Alarm Limit control back to the setting pre scribed by
66. tation of printed reports Cleaning and Maintenance This section contains instructions for cleaning and maintaining the LPG Plus and LP10 Ventilators You must also consult such instructions for the vari ous accessories used with the ventilator Note Use the information in this and the accessories sections as well as estab lished procedure and your homecare dealer s instructions to clean your ven tilator Warnings A ventilator patient is highly susceptible to respiratory infections Dirty or infected equipment may be a source of infection Clean equipment is essential for successful ventilation Be sure to wash your hands thoroughly before and after cleaning the ventilator or accessories Do not sterilize the ventilator with ethylene oxide ETO Doing so may expose the patient to hazardous residues Caution Do not use MEK trichlorethylene or alcohol to clean the ventilator Their use may damage the unit s surface Do not sterilize the venti lator with steam This process will expose the ventilator to excessive moisture Page 55 Patient Circuit and Humidifier LPG Plus and LP 10 Clinician s Manual Patient Circuit and Humidifier To Patient Follow the cleaning instructions recommended by the humidifier manu facturer Warnings After reassembling the patient circuit check to see if the exhalation manifold is operating properly Always follow the manufacturer s instructions Do NOT use c
67. the green Breathing Effort indicator lights up Use the control settings above zero the plus set tings to compensate for Positive End Expiratory Pressure PEEP Positive Breathing Effort settings without the use of PEEP will cause the ventilator to autocycle i e deliver breaths based on the selected inspiratory time at a 1 1 ratio Low Alarm sets the low pressure limit The increments are 2 cmH O hPa for settings from 2 to 32 cmH O hPa Adjust the setting to a value just below the pressure necessary for proper patient ventilation The low pressure alarm sounds only when two consecutive breaths do not reach the selected limit or if the limit is reached but the pressure fails to return to a level below the limit You must manually reset the low pressure alarm by pushing Alarm Silence Reset The High Alarm Limit control sets the high pressure limit The high pressure alarm sounds when the limit is exceeded in the Assist Control or SIMV operating modes or when the limit is exceeded by 10 cmH gt 0 hPa in the Pressure Cycle mode The inspiratory phase stops if the high pressure limit is exceeded The audible alarm is automatically silenced if the following breath does not exceed the setting The settings are 15 to 90 cmH O hPa with increments of 5 cmH O hPa Some circuit components will prevent a Low Pressure alarm by keeping the pressure in the circuit above the alarm limit Examples of these com ponents include hydrated heat and
68. tilator Cautions Recharge an external battery immediately after use You must use an approved battery charger available from Puritan Bennett to recharge external batteries used for extended periods of time Do not use the ventilator s internal charger to recharge deeply discharged batteries Never connect a battery charger to an external battery while the bat tery is connected to the ventilator Using a Car Battery The ventilator will operate from a car battery Connect the ventilator to the car with a cigarette plug cable from Puritan Bennett Make sure the vehicle is running when the ventilator is drawing power Otherwise the ventilator may run down the car s battery Page 27 Power Sources Caution Internal Battery 12 Volt DC 14 Oo SE Swi AX Power Switchover ALARMS Low Pressure Apnea Low Power High Pressure Setting Error Presilence 5 O oO OL AS Internal Battery POWER AC Pwr Batt Charge External Battery Page 28 Warning Caution LP6 Plus and LP10 Clinician s Manual Always start the vehicle before connecting the ventilator to the car battery Starting a vehicle when the ventilator is connected may damage the ventilator and void the warranty The ventilator automatically switches to its internal battery if the AC power fails or the unit is disconnected from AC power and there is no adequate external battery connected The internal battery als
69. tions for connecting a humidifier accompany Puri tan Bennett s mounting bracket accessory See Humidification on page 48 You may use a passive in line regenerative humidifier such as an Artifi cial Nose to preserve humidification during patient transport or wheel chair transport This accessory is intended for short term use only A regenerative humidifier retains portions of the exhaled heat and humid ity to aid in conditioning subsequent inhalations Hydrated artificial noses may prevent a Low Pressure alarm by keeping the pressure in the circuit above the alarm limit If the circuit is discon nected from the patient but still connected to the artificial nose a Low Pressure alarm may not sound Page 53 Page 54 Remote Alarm Printer Where such disconnections from a ventilator dependent patient are pos sible you must set the Low Pressure alarm to a level that permits an alarm to sound To do this simulate the disconnection if a Low Pres sure Apnea alarm does not sound after two breath cycles increase the alarm limit until an alarm sounds You may connect a remote alarm to the ventilator This ventilator relays any alarm signal to locations up to 200 feet away from the ventilator Contact your Puritan Bennett representative for details The optional printer produces a permanent record of the ventilator s per formance See the manual supplied with the printer for detailed operat ing instructions and interpre
70. ttery fluid Always provide an external battery as the power source Never use the same battery to power a motorized wheelchair and the ventilator at the same time e Protect the ventilator from spills and water seepage during bad weather or other conditions when using the unit on a wheelchair e Check the air Inlet Filter frequently when using the ventilator out doors especially when the air inlet is pointed toward the ground PS e To maintain a full charge on the internal battery you must routinely a connect any ventilator mounted on a wheelchair to AC power while SN the wheelchair is not in use You must connect the ventilator to AC Aa power as soon as possible after internal battery operation no matter l how short a time the ventilator operated on internal battery Warning Always locate the external battery as far away from the ventilator as possible The distance will help prevent battery gases from drift ing toward the ventilator s air inlet Page 36 Power Connections LP6 Plus and LP10 Clinician s Manual Power Connections General Any one of three power sources can power the ventilator e External AC e External 12 VDC battery or e Internal 12 VDC battery When plugged into a functioning wall outlet with the AC power switch ON the ventilator automatically selects the AC power source It will operate indefinitely on AC All three sources may be connected to the ventilator at the same time If the AC power fail
71. veforms with and without Pressure Limit REQUITRON LP amp 71 VENTILATOR S N 5 REQUITRON LP6 19 VENTILATOR S N 5 NAMES a o ice ROOM m NAHE Pa oo Sooo eo ia ROOHs______ TIME 87 87 92 12 54 08 HOURS 1 TIME 67 07 92 12 52 29 HOURS 1 HODE ASSIST CONTROL PHR AC MODE ASSIST CONTROL PHR AC ALARHS NONE ALARMS NONE SET ACTUAL SET ACTUAL VOLUME Liters 310 312 VOLUHE Liters 316 a312 RATE BPH 30 6 29 6 RATE BPH 30 9 29 9 INSP TIME sec 1 68 1 61 INSP TIME sec 1 60 1 08 I E RATIO 1 1 86 l 1 0 1 E RATIO 1 1 1 1 5 FLOH L per min 19 19 FLOH L per min 19 19 BREATHING EFFORT cm 4 5 BREATHING EFFORT ca 4 7 HIGH ALARH ca 99 HIGH ALARH ca EL LOK ALARH ca 2 LOH ALARM cm 2 PEAK PROX PRESS car 59 9 PEAK PROX PRESS cm 27 3 MEAN PROX PRESS cm 22 8 HEAN PROX PRESS ca 18 5 HIN PROX PRESS cm 8 HIN PROX PRESS cm 6 186 158 200 LPH a 58 198 156 209 LPH 59 75 186 cm 6 25 su 75 106 ca 1890 1566 2960 cc Sen 10909 1508 2099 cc Flow i Pressure 1 7 f Volume EE Om Without Pressure Limit Note With Pressure Limit The illustrations are actual reproductions of printouts from the printer Page 23 Pressure Limit Control LP10 Only LPG Plus and LP 10 Clinician s Manual Use the following instructions to activate and adjust the Pressure Limit Control To set the Pressure Limit level on the LP10 1 Disconnect the patient from the ventilator Provide
72. witchover gt Alarm Silence Reset Battery Test Breathing Effort PUSH SHOWS CHARGE LEVEL Note The ventilator must be operating on internal battery power to obtain a reading of the internal battery s charge level Power Connections LP6 Plus and LP10 Clinician s Manual Warning To prevent shortened longevity recharge the internal battery for at least three hours after each use Always recharge the internal bat tery before turning off AC power to the ventilator Keep the internal battery fully charged at all times The ventilator charges the internal battery when it is connected to an AC power source and is in any operating mode including Standby An external battery cannot recharge the internal battery The information on external battery performance also applies to the internal battery See pages 38 through 40 Exercise the internal battery every four to six weeks That is run the ventilator on its internal battery until the low power alarm sounds Immediately switch to AC power and recharge the internal battery for at least three hours Page 43 Patient Ventilator Circuit LPG Plus and LP 10 Clinician s Manual Patient Ventilator Circuit Patient Pressure Tube Exhalation Tube Flex Tube i D J Exhalation Y SIR ZO Bacteria Filter Exhalation Tube The Patient Ventilator Circuit has a long flexible hose and several other parts shown in the diagram lt attaches to the ventilato
73. your doctor Push the Alarm Silence Reset button to turn off the High Pressure alarm Remove your thumb from the opening in the Exhalation Manifold Make sure the Low Pressure Apnea light starts flashing after two or three breaths and that the alarm sounds Push the Alarm Silence Reset button to silence the audible alarm Connect a test lung to the Exhalation Manifold The Low Pressure Apnea light should stop flashing after a breath or two Use the built in Self Test Self Test will not function properly with pressure limit in use Turn the mode switch to Standby Connect a patient circuit to the ventilator Block the end of the circuit completely Allow no air to escape Press and hold the Alarm Silence Reset and Battery Test buttons simultaneously While holding these buttons switch to the Assist Control mode Release the two buttons The ventilator will test itself Some lights will turn ON and OFF and the needle on the Patient Pressure Meter will move back and forth Monthly Safety Check LP6 Plus and LP10 Clinician s Manual e Ifthe self test is satisfactory no red alarm lights will be lit To use the ventilator turn the mode switch to Standby Then perform the Routine Safety Check e If the ventilator fails the self test one of the alarm lights will flash and an audible alarm will sound Call your homecare dealer or an Puritan Bennett Service Representative immediately Warnings 1f the ventilator fails the mont

Puritan-Bennett LP6,LP10 Ventilator

Contents

Download Pdf Manuals

Related Search

Related Contents