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Newport Breeze E150 Troubleshooting Guide

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1. NEBULIZER OUTLET OPR150 D0208 Section 5 The Expiratory Drive Line Outlet EXP OUTLET delivers pressure to the mushroom diaphragm of the Exhalation Valve during mandatory breaths and PEEP CPAP When connected to a nebulizer which is placed inline with the ventilator circuit the NEBULIZER OUTLET allows for delivery of aerosolized medications during mechanical ventilation The nebulizer gas source is activated with the button NEB located behind the door on the lower section of the face of the ventilator Nebulization occurs during the inspiratory phase of mechanical breaths only Gas delivered through the NEBULIZER OUTLET has the same FO as the main flow of gas The NEBULIZER OUTLET delivers approximately 6 L min This flow is not part of the set FLOW It is additional to the set FLOW NOTE In VOLUME CONTROL Modes the volume of gas delivered through the NEBULIZER OUTLET is automatically added into the displayed Tidal Volume V7 In order to guarantee the delivery of medication through the NEBULIZER OUTLET when Inspiratory Times of less than 4 sec are chosen you may wish to utilize the AUXILIARY FLOWMETER in place of the built in NEBULIZER OUTLET for powering the nebulizer WARNING Flow added via external Flowmeter will cause a change in delivered V and or pressure waveform The Vy change will not be reflected on the Breeze E150 face panel Decrease mandatory flow by the L min value added via the
2. Set the MODE control to PRESSURE CONTROL A C Set the RATE control to 1 b min Rotate the TRIGGER LEVEL control until the trigger level indicator on the pressure gauge is 1 cmH20 below the baseline Squeeze the test lung lightly and release creating a negative pressure Verify that the EFFORT indicator blinks and that a mandatory positive pressure breath is delivered Set the APNEA TIME control located behind the lower front panel to 30 seconds Set the MODE control to SPONT Pressure or Volume Press the MANUAL breath button Verify that after approx 30 seconds the APNEA alarm is violated audible amp visual Set the MODE control to PRESSURE CONTROL A C Set the RATE to 15 b min While the ventilator is cycling unplug the A C power cord from the wall outlet Verify that the Battery in Use indicator lights and that the audible alarm for the battery switchover activates briefly approx 2 seconds Verify that the ventilator continues normal operation Plug the A C power cord into the wall outlet Verify that the Battery in Use indicator is no longer lit OPR150 D0208 13 MODE Control Check 14 FiO Accuracy Check Section 10 Rotate the MODE control fully clockwise Verify that the position indicator on the control knob is aligned with the A C position Rotate the MODE control fully counter clockwise Verify that the position indicator on the control knob is aligned with the A C SIGH
3. The Newport Breeze E150 accommodates the use of different types of breathing circuits which might incorporate a heated humidifier with or without heated wires and or a nebulizer Read and implement the manufacturers instructions for assembly decontamination or sterilization of such equipment If you intend to use a circuit other than the NMI permanent breathing circuit contact NMI for information regarding the need for special adapters OPR150 D0208 Auxiliary Flowmeter Optional Accessory FLOWMETER Section 4 An optional 28 psi AUXILIARY FLOWMETER is available to attach to the left side of the Breeze E150 This allows you to deliver a calibrated flow of mixed gas which is at the same FO as the FO setting on the Breeze E150 face panel The AUXILIARY FLOWMETER operates separately from all other ventilator functions The AUXILIARY FLOWMETER may be used to supply mixed gas to a resuscitation bag a continuous nebulizer etc Since the outlet supplies gas at 28 psi only the NMI flowmeter or similar flowmeter which has been calibrated at 28 psi should be attached to this outlet If a flowmeter which has been calibrated to 50 psi is used the flow which is actually delivered may be different from that which is indicated 15 L min and the main flow is set above 60 L min accuracy oe If the AUXILIARY FLOWMETER is set above of the main flow setting may be aff
4. LOW CPAP ALARM KNOB OPR150 D0208 Section 5 The HI PRESS Alarm is activated if the pressure in the patient circuit reaches the High Pressure Alarm Limit Possible causes include decreased patient compliance coughing increased resistance partial or complete blockage of the patient circuit or accidental changes of ventilator settings Inspiration is terminated Breeze E150 cycles to exhalation when the HI PRESS Alarm is violated When the alarm is no longer violated the alarm indicator latches stays lit Press the ALARM SILENCE Button to cancel latched alarm indicators The APNEA Alarm monitors patient mechanical and spontaneous breaths in all modes If the interval between ventilator initiated mandatory breaths and breaths detected by the Patient EFFORT Indicator exceeds the chosen delay time 5 60 sec for mechanically assisted modes 10 60 sec for Spontaneous mode adjusted on the front panel behind the door the alarm activates This may be caused by patient disconnect apnea decreased inspiratory effort of the patient inappropriate SPONT FLOW setting or inappropriate TRIGGER LEVEL setting Make sure that the TRIGGER LEVEL is set so the Patient EFFORT Indicator lights on each patient inspiration When the alarm is no longer violated the alarm indicator latches stays lit Press the ALARM SILENCE Button A to cancel latched alarm indicators The LOW CPAP ALARM is available i
5. a VIM A breath is delivered A mandatory breath lockout interval is activated whenever the patient triggers a PIM breath This limits the number of mandatory breaths VIM or PIM the patient receives in 60 seconds to the RATE setting b min In the diagram the lockout interval begins at the end of inspiration of the PIM B breath in the second mandatory breath interval until the start of the third interval The VIM breath is not delivered at the start of the third mandatory breath interval because a PIM breath was triggered in the last interval The patient can breathe spontaneously throughout the mandatory breath lockout interval Description of Controls Displays and Indicators 100 SIMV Window diagram Patient triggered mandatory breath Time triggered Spontaneous mandatory breath B C c Pressure Mandatory 100 breath lockout interval Mandatory breath interval Mandatory breath interval A Time triggered mandatory breath B Patient triggered mandatory breath C Spontaneous breath Scheduled mandatory breath not delivered because of the patient triggered breath in the last interval AWNRNI GhT ePSNO TLFWOs iwct hna droF OLMWTEREm su tebt ruen do ni nISVMa dnS OPTNm doset orpvodi eag for patient spontaneous breathing Preset Push PRESET in the SPONT mode to light the digital displays prior to a mode change to verify that the ventilator s controls are set at a safe level for the patien
6. electronic pressure gauge The TRIGGER LEVEL knob has two adjustment positions COARSE and FINE To adjust the trigger level in the COARSE position pull out on the TRIGGER LEVEL knob clicking it into position To adjust the trigger level in the FINE position push in on the TRIGGER LEVEL knob clicking it into position The trigger level can be adjusted from 10 to 60 cmH 0O in the COARSE position In the FINE position there is a maximum adjustment of 5 cmH O above and below the current trigger level setting Rotate clockwise to increase the effort needed to trigger a breath and counter clockwise to decrease the effort NOTE The trigger level setting is not baseline PEEP CPAP compensated WARNING Any time a change is made to the baseline the trigger level should be readjusted The electronic pressure gauge is similar in function and display as a standard pressure gauge It displays the peak pressure of the last breath baseline pressure PEEP CPAP pressure rise and fall during inspiration and exhalation patient trigger level and patient effort trigger Instead of a pointer reflecting the pressure changes each cmH O has its own Liquid Crystal Display LCD cell that illuminates non flashing green when energized Starting at the baseline pressure indicator all LCD s illuminate non flashing green up to the peak pressure inspiration then return to a dark condition as pressure returns to the baseline level exhalati
7. flowmeter in order to maintain a consistent V7 Description of Controls Displays and Indicators Pressure Relief Valve Sale M PRESSURE RELIEF VALVE Gas Ventedto the Atmosphere TORE Pressure Relief Valve Setting Breath Delivered to the Patient cm H20 Time Volume Controlled Ventilation Pressure Relief Valve Set Too Low THE ALARM SYSTEM Low Pressure Alarm LO PRESS HI PRESS J 4 LO PRESS HI PRESS emp mH 0 gt LO PRESS ALARM KNOB The Pressure RELIEF VALVE is located in the upper left corner of the rear panel of the Breeze E150 It determines the maximum pressure that can be reached in the patient circuit during spontaneous mandatory and manual ventilation This safety valve can be adjusted from 0 120 cmH 0 Clockwise rotation of the blue knurled knob increases and counterclockwise rotation decreases the maximum pressure pop off setting It is located on the inspiratory limb of the internal ventilator circuitry The Pressure RELIEF VALVE should be set above the HI PRESS Alarm setting as a safety pop off NOTE If the Pressure RELIEF VALVE is not adjusted above the pressure required to deliver set tidal volume part of the volume will be vented to the atmosphere when the relief pressure is reached The Pressure RELIEF VALVE is factory preset at 0 The LO PRESS Alarm is active
8. E150 see pg 3 2 to 3 4 For heated humidifier or heat moisture exchanger operation refer to manufacturer s instructions Plug electrical cord into a properly grounded electrical outlet Turn the power switch behind the door on the front panel to the ON position Check that all LED indicators light up and then go out after 2 seconds This ensures proper function of the microprocessor and the LEDs Attach a test lung to the breathing circuit Select the PRESSURE CONTROL A C MODE Choose FjO RATE and INSP TIME Set SPONT FLOW at min 4 L min in order to flush the breathing circuit in between mechanical breaths and stabilize baseline pressure Set the desired Peak Inspiratory Pressure PIP level by adjusting the PIP knob while observing the PEAK Pressure display Adjust the mechanical FLOW to achieve the desired pressure wave pattern OPR150 D0208 Pressure Control A C Set up cont d Pressure Control Assist Control A C Theory of Operation cmH2O OPR150 D0208 Section 6 14 Temporarily place the MODE Selector in the VOLUME CONTROL SPONT MODE Depress the MANUAL inflation button and while observing the Electronic Pressure Gauge set the Pressure RELIEF VALVE to pop off about 5 cmH O above the desired PIP level Make sure the RELIEF VALVE is set above the High Pressure alarm setting Return the MODE Selector to the PRESSURE CONTROL A C MODE 15 Connect the patient to the ve
9. Press the BASE button Verify that the PRESSURE Display shows 0 cmH50 Rotate the PEEP CPAP control until the PRESSURE Display shows 5 cmH50 Verify that the pressure gauge shows 5 cmH20 2 cmH90 9 Pressure Alarms Check amp Alarm Silence Button OPR150 D0208 Press the PEAK button noting the pressure shown in the PRESSURE Display Rotate the HI PRESS alarm control counter clockwise until the alarm display is 5 cmH gO below the PEAK pressure reading Verify that the HI PRESS alarm is violated audible amp visual Rotate the HI PRESS alarm knob to adjust the high pressure alarm setting 5 cmH90O above the peak pressure Verify that the HI PRESS alarm is no longer violated 10 3 Quick Check Procedure 9 Pressure Alarms Check amp Alarm Silence Button cont d 10 TRIGGER LEVEL Check 11 APNEA Alarm Check 12 Internal Battery Check 10 4 Rotate the LO PRESS alarm control clockwise to adjust the low pressure alarm 5 cmH20 above the peak pressure Verify that the LO PRESS alarm is violated audible amp visual Press the button Verify that the LO PRESS alarm indicator continues to blink but that the audible alarm is silenced Rotate the LO PRESS alarm control to readjust the low pressure alarm setting to 5 cmH 0 below the peak pressure Verify that the LO PRESS alarm is no longer violated Press the A button Verify that the latched alarm indicators are cancelled
10. adjusted to provide the appropriate amount of flow to meet patient spontaneous inspiratory flow demands All breaths are completely controlled by the patient with respect to RATE V Tidal Volume and Peak FLOW FO is set with the FO control the mixer and if required CPAP 0 60 cmH O may be added The spontaneous breaths are monitored by the Patient EFFORT Indicator and the APNEA alarm when the Apnea Delay is in the 10 60 sec position The TRIGGER LEVEL must be set properly for the Patient EFFORT Indicator to light recognizing the patient s spontaneous breaths The breaths are counted and the total is automatically displayed as TOTAL RATE Total Rate a full 60 second count 6 5 Clinical Application Pressure Control Assist Control A C Set up When the Low CPAP Alarm is utilized the SPONT breaths are no longer counted and displayed as TOTAL RATE Instead the LO PRESS Alarm display lights up and the LO PRESS Alarm is utilized as a Low CPAP disconnect alarm The LO PRESS Alarm should be set just below the CPAP base pressure If the proximal airway pressure drops below the LO PRESS Alarm setting for more than 4 seconds the alarm will sound Caution A Low CPAP Alarm setting of lt 2 cmH O will not detect a disconnect 10 11 12 13 Assemble ventilator Connect air and oxygen hoses to the appropriate gas sources Connect a patient circuit which includes a proximal sensing line to the Breeze
11. be impaired Periodically check and if necessary drain water from the air inlet water trap bowl to prevent Air Oxygen Mixer contamination When oxygen and or air cylinders are used as a supply source ensure that spare cylinders are available Be aware of the internal resistance of circuits and humidifiers The spontaneously breathing patient must overcome this pressure in order to open the Emergency Intake Valve in the event of a total gas supply source failure In the case of an inlet gas failure provide an alternate source of ventilation until the gas pressure is restored Always use a clean or sterile breathing circuit Periodically drain the patient breathing circuit to prevent water accumulation which can harm the patient distort waveforms increase circuit resistance to inspiration or exhalation and possibly cultivate pathogenic organisms Either place a heated humidifier filled with sterile water in line with the patient circuit or place a heat moisture exchanger in line at the proximal airway Never deliver a dry unheated gas OPR150 D0208 Section 7 Breathing Circuits Humidifiers Follow the operating and cleaning instructions in the Ventilator OPR150 D0208 Manufacturer s Operation Manual for the heated humidifier Monitor the water level in the heated humidifier chamber or solution in the nebulizer cup Contamination possibilities can be reduced by installing bacterial filters between the mainflow out
12. during mandatory volume or pressure controlled breaths Also in the SPONT MODE the APNEA DELAY may be placed in the LOW CPAP ALARM position in order to utilize the LO PRESS Alarm as a disconnect alarm The HI PRESS Alarm Limit is active in all modes In mechanical modes adjust the LO PRESS Alarm and the HI PRESS Alarm settings so that they bracket the Peak Inspiratory Pressure PIP as closely as is practical Setting the alarms within 5 cmH 0 of the Peak Inspiratory Pressure will provide the best method of detecting leaks or occlusions in the patient breathing circuit The LO PRESS Alarm is activated if the pressure in the patient circuit does not rise above the LO PRESS Alarm setting during the inspiratory time of a mandatory breath or if the LOW CPAP ALARM is activated and the CPAP pressure drops below the set LO PRESS Alarm Limit for 4 seconds This could be caused by system leaks patient disconnect improved patient compliance increased patient inspiratory flow demand or accidental changes of ventilation settings When the alarm is no longer violated the alarm indicator latches stays lit Press the ALARM SILENCE Button B to cancel latched alarm indicators OPR150 D0208 High Pressure Alarm LO PRESS HI PRESS D LO PRESS HI PRESS i emp emH 2 O_O r HI PRESS ALARM KNOB Apnea Alarm APNEA ALARM KNOB Low CPAP Alarm
13. parts which fail to meet the published specifications or which become defective during warranty period and which are upon examination by NMI found not to meet the published specifications or to be defective in materials or workmanship NMI will not be liable under this warranty unless the following provisions are strictly complied with a NMI is promptly notified in writing upon discovery of the failure of the said product or equipment to meet the published specifications or of the defects in materials or workmanship b The defective product equipment or part thereof is returned to NMI transportation charges to be paid by NMI c The defective part is received by NMI for examination no later than one 1 month following the expiration of the warranty period and provided d that examination by NMI of said product equipment or part shall disclose to NMI s satisfaction that such defect has not been caused by improper usage accident neglect alteration abuse improper installation or unauthorized repair Products equipment or parts replaced under this warranty are warranted only through the terms of the original warranty NMI neither assumes nor authorizes any other person or entity to assume for it any other warranty obligation or liability in connection with its products or equipment whatsoever and as to the fitness or usefulness of the equipment manufactured by it for any medical treatment physical condition or other purpose whatsoe
14. patient breathing circuit or using the ventilator Before patient application perform a leak test on the Breeze E150 ventilator breathing circuit and humidifier See Section 10 Quick Check Procedure Caution Federal USA law restricts the sale of this device to or on the order of a physician WARNING TO PREVENT EXPLOSION HAZARDS IN THE PRESENCE OF OXYGEN DO NOT USE ANY INSTRUMENTS OR OTHER EQUIPMENT CONTAMINATED WITH OIL OR GREASE OXYGEN VIGOROUSLY SUPPORTS COMBUSTION DO NOT USE THE BREEZE E150 VENTILATOR IN THE PRESENCE OF FLAMMABLE ANESTHETICS AS A POSSIBLE EXPLOSION HAZARD EXISTS 7 1 Warnings Precautions A C Power Source Gas Supply Sources Breathing Circuits Humidifiers Always insert the hospital grade electric power cord into the correct voltage and properly grounded receptacle Always use a 1 Ampere 250 V fuse for 100 120 Volt or 5 Ampere 250 V fuse for 220 240 Volt to replace a blown one If this problem occurs frequently contact a factory authorized representative Ensure that the air and oxygen supply source pressure lines are connected to their appropriate DISS fittings on the Air Oxygen Mixer Ensure that both supply source gases are and remain dry and clean Ensure that both supply source pressures are 50 psig 90 psig maximum 35 psig minimum or 2 45 Kg cm 6 3 Kg cm Keep the Air Oxygen Mixer bleed hole free from obstruction so that the mixer alarm function will not
15. pg 6 2 2 Select PRESSURE CONTROL SIMV MODE 3 Choose FO RATE and INSP TIME 4 The SPONT FLOW should be turned ON to provide mixed gas flow through the breathing circuit for spontaneous breathing in between mechanical breaths 5 Adjust the PIP Peak Inspiratory Pressure while observing the Electronic Pressure Gauge 6 Adjust the mechanical FLOW to achieve the desired pressure wave pattern 7 Temporarily place the MODE Selector in the VOLUME CONTROL SPONT MODE Depress the MANUAL Inflation Button and while observing the Electronic Pressure Gauge set the Pressure RELIEF VALVE to pop off about 5 cmH O above the PIP level Make sure the RELIEF VALVE is set above the High Pressure Alarm setting Return the MODE Selector to the PRESSURE CONTROL SIMV MODE 8 Connect the patient to the ventilator 9 Slowly adjust PEEP as needed 10 The TRIGGER LEVEL should be set just below baseline pressure NOTE The Patient EFFORT Indicator may not light with patient effort if airway pressure does not drop below the TRIGGER LEVEL setting This may occur if the patient s effort is inadequate SPONT FLOW is set too high or there is a significant leak around the endotracheal tube In the case where patient effort is less than 1 cmH O you may replace the Reservoir Bag with the Reservoir Bag Cap to improve the patient s ability to trigger See instructions on pg 4 1 for use of the Reservoir Bag Cap 11 Set the LO PRESS Alarm 1 2 cm
16. position Adjust the SPONT FLOW control to 10 L min Place a calibrated oxygen analyzer inline with the patient breathing Circuit Adjust the F O5 Control to 60 Verify that the oxygen analyzer displays 60 3 02 15 Proximal Line Purge Flow Test 16 Power Down Alarm 17 Emergency Intake Valve OPR150 D0208 Occlude the proximal pressure line Verify that the pressure gauge displays 30 60 cmH20 Release the line Switch power off to the ventilator Verify that a continuous audible alarm activates no visual Press the button Verify that the power down alarm is silenced Disconnect the air and oxygen supplies Verify that air can be pulled through the emergency intake valve by creating a negative effort on the inspiratory limb of the breathing circuit This can be done 1 with a bellows type test lung or 2 by inspiring through the inspiratory limb of the patient circuit Newport Medical Instruments strongly recommends that before breathing through a patient circuit you should take care to ensure the circuit is clean and sterile and that a clean and sterile bacteria filter is first placed on the circuit wye connector This concludes the Quick Check Procedure 10 5 Newport MEDICAL Breeze E150 Ventilator QUICK CHECK Pass Fail Check Off Sheet Preparation for Pre Use Tests Indicate status for each test Pre test Inspection Pas ____Fail _ Loss of Gas Alarm Pass___ Fail ___ Power Up Se
17. position Rotate the knob to achieve minimal patient effort without causing the ventilator to self trigger Although it appears you are adjusting the trigger level 1 cmH O at a time you are actually adjusting the trigger incrementally within the current cmH 0O lit LCD setting If the trigger level is adjusted equal to or greater than the baseline pressure the trigger level LCD cell will begin to flash green If the trigger level is adjusted within the LCD cells illuminated to reflect the PEEP CPAP level the LCD cell indicating the trigger level will go dark turn off If the baseline pressure is zero and the trigger level is adjusted below baseline the trigger level LCD cell will illuminate non flashing green Readjustment of the trigger level is necessary any time a change in the baseline pressure occurs The triggering or sensing of a patient effort is indicated by the EFFORT LED flashing on and off orange If you are having difficulty sensing the patient effort EFFORT LED not lighting and the trigger level is set to the least amount of effort you may want to decrease the SPONT FLOW setting You are probably using more flow than the patient needs You may also want to consider substituting the Reservoir Bag Cap in place of the Reservoir Bag Note See section titled Reservoir Bag Cap on pg 4 1 If you see the patient generate significant negative pressures beyond the set trigger level you may want
18. the average peak inspiratory pressure 11 Select a delay time for the APNEA Alarm In SIMV the patient may breathe spontaneously from the ventilator s spontaneous flow and receive a fixed number of mandatory positive pressure breaths Tidal volume of the mandatory breaths is determined by the FLOW and INSP TIME setting and is digitally displayed as Vy Tidal Volume in the Data Display Panel The number of mandatory breaths is controlled by the RATE and synchronized with the patient s breathing pattern with the TRIGGER LEVEL setting The patient s spontaneous breaths are drawn from the SPONT FLOW through the circuit and Reservoir Bag which has the same FO as the mandatory breaths NOTE For more information on SIMV see section titled SIMV WINDOW pg 5 5 There are two SPONT MODES so that the clinician will automatically know how the Breeze E150 will perform when the MANUAL Inflation is used In the Pressure Control SPONT Mode the MANUAL Inflation will be pressure controlled at the level of the PIP setting In the Volume Control SPONT MODE it will not 1 Complete steps 1 through 8 of A C pg 6 2 2 Select the SPONT MODE 3 Set FO 4 Adjust SPONT FLOW to a minimal level and allow the Reservoir Bag to fill 5 Connect the patient to the Breeze E150 OPR150 D0208 Volume or Pressure Control SPONT Set up cont d Volume or Pressure Control Spontaneous SPONT Theory of Operation OPR150 D0208 Sectio
19. 05 FLOW INSP TIME RATE Vy Tidal Volume PIP Peak Inspiratory Pressure PEEP CPAP SPONT FLOW TRIGGER LEVEL Maximum Inverse I E Pressure RELIEF VALVE Electronic Pressure Gauge Internal Battery HI PRESS LO PRESS APNEA LOW CPAP Low Battery Baa Gas Supply Source Failure Power Failure 21 1 0 3 02 3 120 L min 1 3 0 seconds 1 150 bpm 10 2000 ml 0 60 cmH 0 0 60 cmH5O 0 50 L min 10 60 cmH50 4 1 Insp Time Exp Time 0 120 cmH 0 10 120 cmH O 60 minutes 10 120 cmH50 3 99 cmH 0 5 10 15 30 60 seconds 0 60 cmH5O 15 min operating time remaining Specifications Alarm Silence INDICATORS SUMMARY OF DISPLAYS POWER REQUIREMENTS AC Power Battery Power Gas Requirements Dimension and Weight Agency Requirements 60 seconds EFFORT Inspiratory HI PRESS ALARM LO PRESS ALARM APNEA Low Battery Bl Alarm Silence Battery In Use FiO FLOW Mechanical SPONT FLOW INSP TIME RATE Mechanical TOTAL RATE Vy Tidal Volume TRIGGER LEVEL EXP TIME l E Ratio PRESSURE PEAK Pressure MEAN Pressure BASE Pressure Alarm Panel Battery In Use Low Battery Maa APNEA LO PRESS HI PRESS Alarm Silence 100 120 220 240 VAC 10 47 63 Hz 45 Watts max The sealed lead acid internal battery will power the Breeze E150 for 1 hour minimum when fully charged It features automatic recharge Oxygen 35 90 psig 60 10 no
20. H O below the Peak Inspiratory Pressure PIP Set the HI PRESS Alarm 2 3 cmH O above the Peak Inspiratory Pressure PIP 12 Adjust the SPONT FLOW to deliver an adequate amount of gas through the circuit to meet the spontaneous inspiratory demands of the patient and to refill the Reservoir Bag in between patient spontaneous breaths See Spontaneous Flow on pg 5 12 for guidelines on setting SPONT FLOW 13 Select a delay time for the APNEA Alarm OPR150 D0208 Section 6 Pressure Control SIMV Theory Of Operation Primarily this mode is used for neonatal pediatric ventilation Although the ventilatory cycle is much like that of VOLUME CONTROL SIMV Ventilation this mode differs in that each breath is limited at a particular peak pressure by the Peak Inspiratory Pressure mechanism PIP control Instead of each breath being volume limited and pressure variable it is pressure limited and volume variable This type of ventilation provides a descending ramp flow pattern PRESSURE CONTROL SIMV Ventilation combines a mandatory rate with patient spontaneous breathing The number of mandatory breaths is determined by the RATE control and synchronized with the patient s breathing pattern with the TRIGGER LEVEL setting The patient s spontaneous breaths are drawn from the SPONT FLOW through the circuit and Reservoir Bag SPONT FLOW has the same FOs as the mandatory breaths During a mandatory breath the mechanical FLOW setting deter
21. NSP TIME With the HI PRESS Alarm Limit set at 120 cmH O depress the MANUAL Inflation button observe the Electronic Pressure Gauge then rotate the blue knurled knob on the Pressure RELIEF VALVE until it is set to pop off just above the maximum acceptable peak inspiratory pressure Set a low level minimum 4 L min of SPONT FLOW Connect the patient to the Breeze E150 Set PEEP slowly Adjust SPONT FLOW to stabilize the baseline pressure Adjust the TRIGGER LEVEL just below the PEEP or baseline pressure so that the Patient EFFORT Light comes ON with each spontaneous patient inspiration Set the HI and LO PRESS Alarms to bracket the average peak inspiratory pressure Select a delay time for the APNEA Alarm OPR150 D0208 Volume Control Assist Control A C Theory of Operation Volume Control Assist Control A C Sigh Set up amp Theory of Operation Volume Control SIMV Set up OPR150 D0208 Section 6 During Assist Control A C ventilation a positive pressure breath is delivered with each patient inspiratory effort that causes airway pressure to drop below the TRIGGER LEVEL setting In Volume Control A C tidal volume V7 is determined by FLOW and INSP TIME settings If the patient does not trigger the ventilator it automatically delivers breaths according to the RATE set FO is selected with the F O control the Air Oxygen Mixer Both the Set up and Theory of Operation for A C SIGH are identical
22. Newport Medical Instruments Inc Newport Breeze E150 Ventilator Operating Instructions OPR150 Rev D O2 08 rE MEDICAL NEWPORT MEDICAL INSTRUMENTS 1620 Sunflower Ave Costa Mesa California 92626 USA 800 451 3111 1 714 427 5811 1 714 427 0489FAX Customer Service Ext 282 email Info Ventilators com www Ventilators com INTRODUCTION The Newport Breeze E150 Ventilator is intended for use by properly trained and qualified persons It is restricted for use by and upon the direction of a physician Before attempting to use this device in an actual life support situation the operating personnel must become practiced in the function and the effect of the various controls Please review this manual thoroughly and operate the device in simulated situations before dedicated use The Newport Breeze E150 Ventilator being a life support device requires the clinician to be functionally familiar with its clinical application It is recommended therefore that the initial introduction set up and in service training be performed by an authorized Newport Medical Instruments representative Table of Contents Section 1 General Description 1 1 Section 2 Specifications 2 1 Section 3 Assembly amp Set Up Procedures 3 1 Section 4 Accessories 4 1 Exhalation Valve 4 1 Reservoir Bag Cap 4 1 Heated Humidifier 4 2 Breathing Circuits 4 2 Auxiliary Flowmeter 4 3 Auxiliary Outlet Box 4 3 Section 5 Description of Controls Displays
23. and Indicators 5 1 On Off Switch 5 1 Internal Battery 5 1 Fuse Holder 5 1 Compressed Air High Pressure Hose Oxygen High Pressure Hose Air Oxygen Mixer Reservoir Bag Mode Selector Knob Volume Control Modes Pressure Control Modes SIMV Window Preset Rate Control Proximal Sensing Inlet Electronic Pressure Gauge Pressure Display Trigger Level Patient Effort Indicator Apnea Alarm Low CPAP Alarm Inspiratory Time Duoflow Spontaneous Flow Mechanical Flow Manual Inflation Expiratory Drive Line Outlet Nebulizer Outlet Pressure Relief Valve The Alarm System 1 oa oa oa onan anni ui OMOONN OOTRWBWWNMD oh oe Pas PPRPOODDDID AAAAMAAATAAAAAATAAAAAAAAAaAaaan OPR150 D0208 i Table of Contents Section 6 Section 7 Section 8 Section 9 Section 10 Section 11 Clinical Application Volume Control Assist Control A C Volume Control Assist Control Sigh Volume Control SIMV Spontaneous Pressure Control Assist Control Pressure Control SIMV Warnings Precautions Sterilzation Decontamination Maintenance Troubleshooting Quick Check Procedure Warranty 6 1 6 2 6 3 6 3 6 6 6 8 7 1 8 1 9 1 10 1 OPR150 D0208 GENERAL DESCRIPTION The Breeze Operates In Six Basic Modes Primary Controls Allow Operator To Select OPR150 D0208 GENERAL DESCRIPTION The Newport Breeze E150 is a general purpose ventilator which is used for ventilatory support of neonates pediatrics o
24. ate and effort and evaluate appropriateness of ventilator settings Reassess delay time and trigger level settings Correct leak Replace reservoir bag with reservoir bag cap Use LOW CPAP Alarm SPONT mode only instead of Apnea Alarm Monitor for Apnea with alternate device Troubleshooting Guide Newport Breeze E150 Troubleshooting Guide PROBLEM MECHANICAL SPONTANEOUS VENTILATION Reservoir bag depletes during spontaneous inhalation Desired machine tidal volume is not delivered during the selected inspiratory time PEEP CPAP pressure does not meet maximum pressure specifications with the PEEP CPAP control in the fully OPEN counterclockwise position Ventilator self triggers OPR150 D0208 POSSIBLE CAUSE Patient inspiratory flowrate demand is not met by SPONT FLOW setting Leak in the breathing circuit Reservoir bag with bleed valve is in place Leak in breathing assembly system Pressure relief valve setting is too low Volume is vented when relief valve setting is reached Leak in breathing circuit Pressure relief valve is set lower than CPAP pressure Faulty exhalation valve or exhalation valve diaphram Leaking PEEP CPAP control valve assembly TRIGGER LEVEL indicator not set properly Leak in breathing circuit TG 4 REMEDY Adjust SPONT FLOW so reservoir bag stays full during respiratory cycle Correct leak Replace with reservoir bag withou
25. ate patient manually until problem is corrected or replace the Breeze E150 with pneumatically powered and operated ventilator Prepare for hand ventilation after one hour of battery operation or replace with pneumatically powered and operated ventilator Switch ON Call factory authorized representative Troubleshooting Guide Newport Breeze E150 Troubleshooting Guide PROBLEM HIGH PRESSURE ALARM LOW PRESSURE ALARM APNEA ALARM OPR150 D0208 POSSIBLE CAUSE Increased patient and or breathing circuit resistance which causes an increase in ventilating pressure exceeding the set high alarm limits High pressure sensor was not adjusted for PEEP Leak in breathing circuit and or patient artificial airway cuff etc Inlet gas supply pressure loss No spontaneous breath detected in the time set on delay time control due to changes in patient status i e decreased respiratory rate or inspiratory effort Improper delay time or trigger level setting Leak in patient circuit disconnect Patient effort is small and reservoir bag is in place Patient effort is small and reservoir bag cap is in place TG 3 REMEDY Evaluate patient and remedy any mechanical problems Adjust indicator position a minimum of 2 3 cmH2O above peak inspiratory pressure Correct leak Reestablish gas supply sources Ventilate manually until pressure is restored Evaluate patient breathing r
26. ched of Description of Controls Displays and Indicators Spontaneous Flow a SPONT FLOW Umi in O EXP TIME lO Vr eo SPONT FLOW CONTROL Mechanical Flow as tee 68 o VW Le TOTAL RATE F O3 FLOW INSP TIME RATE 60 CE 33 L a Umin b min so FLOW CONTROL KNOB so o7 30 40 2 25 wo os 2 n 100 a 10 7 120 ot 3 0 150 Manual Inflation Eco oo PRESET MANUAL MANUAL BUTTON The SPONT FLOW is calibrated from the minimum position to 28 L min When the knob is turned fully clockwise the SPONT FLOW will deliver approximately 50 L min Set the SPONT FLOW to meet patient spontaneous inspiratory demands during spontaneous breathing in the SIMV and SPONT modes of ventilation If patient effort exceeds the set SPONT FLOW the patient may draw mixed gas from the Reservoir Bag If the Electronic Pressure Gauge displays a significant negative pressure swing during patient inspiration increase the SPONT FLOW If on exhalation the Electronic Pressure Gauge displays a significant positive pressure swing lower the SPONT FLOW setting In SIMV and SPONT Modes the SPONT FLOW should always be adjusted to meet patient spontaneous inspiratory flow demands In A C set SPONT FLOW at 4 L min and adjust as needed to stabilize PEEP CPAP Baseline levels NOTE SPONT FLOW provides a sou
27. cloth moistened with a mild medically safe detergent solution to wipe off the ventilator DO NOT gas sterilize or autoclave the Breeze E150 Do not use paper products to wipe off the face panel A Breeze E150 ventilator which does not meet manufacturer s design specifications should not be used until all necessary repairs have been made Warnings Precautions Ventilator Audible Visual Alarm Systems Pressure Relief Valve Face Panel Controls All service and repair of the Breeze E150 ventilator should be done by authorized NMI factory trained service personnel Do not operate the Breeze E150 ventilator with the case open Electrical shock hazard may be encountered When the Breeze E150 ventilator is connected to a patient constant attention by a qualified medical attendant is required Prompt attention should be given to every alarm Some alarm conditions require immediate corrective action The Alarm Silence Button on the Breeze E150 ventilator should not be used until the cause of the alarm has been determined and patient safety is determined not to be at risk Only an NMI permanent exhalation valve should be used in conjunction with the Breeze E150 ventilator The ventilator and audible visual alarm systems can only function when the ventilator power switch is in the ON position Whenever a patient is connected to a ventilator qualified personnel should be in the area at all times The use of a ventilator with inc
28. de of the ventilator Attach the end of the expiratory limb of the breathing circuit to the Exhalation Valve A chain with a small ring on the end is used to attach the Reservoir Bag Cap to the back panel of the Breeze E150 Remove a hex nut screw from the lower left rear panel of the Breeze E150 and re install it through the small ring at the end of the chain This enables the Reservoir Bag Cap to hang from the chain beside the Reservoir Bag opening NOTE The Reservoir Bag Cap is ONLY used to cap off the Reservoir Bag opening when patient triggered ventilation of very small or very weak patients Spont insp efforts of less than 1cmMH 0O is attempted For ventilation of patients with spontaneous inspiratory efforts of 1 cmH O or greater the Reservoir Bag should ALWAYS be in place and the opening should NEVER be capped off See pg 4 1 OPR150 D0208 Section 3 Extension Support Arm FE B o El O Exhalation Valve Bracket Test Lung _ gt OPR150 D0208 3 3 Exhalation Valve Standard Accessory EXHALATION VALVE Reservoir Bag Cap Standard Accessory Optional Use Only 5 RESERVOIR BAG CAP OPR150 D0208 ACCESSORIES One permanent Exhalation Valve is included with the Breeze E150 It is designed to be used for neonate pediatric and adult patients Exhaled volumes can be measured at the patient circuit wye or from the exhaust port of the Exhala
29. djust TRIGGER LEVEL indicator position Correct leak in breathing circuit Correct leak in breathing circuit Look for occlusion and fix it Call factory authorized representative Plug into approved A C receptacle Switch to ON Replace with fuse of same type and rating Call factory authorized representative Re establish functional system correct inlet gas pressures to 35 90 psi Check and replace as necessary Adjust SPONT FLOW to prevent bag from depleting during inhalation Troubleshooting Guide Newport Breeze E150 Troubleshooting Guide PROBLEM PEEP CPAP APPLICATION With PEEP CPAP control fully closed positive pressure is still displayed on pressure gauge after patient exhalation MANUAL INFLATION Cannot generate sufficient pressure insufficient chest expansion Pressure builds up too slowly Pressure builds up too fast High Pressure Alarm is activated during manual inflation OPR150 D0208 POSSIBLE CAUSE Resistance to exhalation in patient breathing circuit SPONT FLOW set too high Inadequate expiratory time Pressure manometer out of calibration Leaking PEEP CPAP control valve assembly Intubation tube size etc is too small causing expiratory resistance Pressure RELIEF VALVE setting too low Gross leak Leak in breathing circuit FLOW setting too low FLOW setting too high Inflation pressure exceeds ventilator High Pressu
30. dures Set up Procedure 10 Assemble Pole Stand a Insert a caster in each of the five base sockets b Connect two pole lengths together and insert tapered end tightly into base socket Secure pole to base with washer and nut c Mount ventilator on pole and secure by tightening the knurled knob on pole mount adapter Attach the 2 liter Reservoir Bag to the bottom opening of the Reservoir Bag Adapter Insert the Pressure Relief Valve pop off into the rear panel Connect and secure the High Pressure Air Hose to the water trap s DISS fitting on the rear of the ventilator Connect and secure the High Pressure Oxygen Hose to the DISS fitting on the back of the ventilator Insert the Extension Arm into the socket located on top of the ventilator and secure by turning the wing nut clockwise Attach the Patient Circuit Tubing Holder in the clamp at the end of the Extension Arm Attach the Exhalation Valve Bracket to the bottom of the ventilator located left front with the two thumb screws provided Snap the Exhalation Valve assembly into the black plastic clip with the inlet connector facing the front of the ventilator Attach the exhalation tubing on the Valve to the EXP OUTLET connector on side panel Connect the inspiratory limb of the patient breathing circuit to the MAINFLOW OUTLET and connect the proximal pressure sensing line of the circuit to the PROXIMAL PRESSURE INLET beneath the right si
31. e patient has complete control over each breath with respect to rate tidal volume and peak flowrate CPAP may be added Manual breaths deliver flow according to the FLOW control setting The Breeze E150 will cycle to exhalation when the MANUAL Breath button is released or after 2 seconds or if the peak inspiratory pressure of the Manual Inflation reaches the HI PRESS Alarm setting If the peak pressure reaches the Pressure RELIEF VALVE setting the peak pressure will plateau there for a maximum of 2 seconds or until the button is released In A C Assist Control a positive pressure breath is delivered with each inspiratory effort that meets the TRIGGER LEVEL by the patient The INSP TIME control determines the length of the mechanical breath and the peak gas flow delivered to the patient is at the flowrate chosen on the FLOW control Peak pressure is determined by the PIP setting Expiratory Time is digitally displayed in place of V in the Data Display Panel NOTE If the patient does not trigger the Breeze E150 automatically delivers breaths according to the RATE control setting In SIMV the patient may breathe spontaneously from the ventilators SPONT FLOW and receive a fixed number of mandatory positive pressure breaths As with A C the INSP TIME control determines the length of the mechanical breath and the peak gas flow delivered to the patient is at the flowrate chosen on the FLOW control The maximum Peak Pressure of each manda
32. e tubing to further protect the internal components of the Breeze E150 from contamination The Electronic Pressure Gauge has an operating range of 10 to 120 cmH30 and each cmH gt 0 has its own LCD Liquid Crystal Display cell The electronic pressure gauge displays the peak pressure of the last breath baseline pressure PEEP CPAP pressure rise and fall during inspiration and exhalation patient trigger level and patient effort trigger 1 Peak Pressure Indicator The LCD cell that corresponds to the peak pressure of the last breath illuminates non flashing green until the next inspiration has taken place and a new peak pressure has been established 2 Baseline Pressure Indicator All LCD cells from a baseline pressure of zero to the PEEP CPAP level illuminate non flashing green indicating the current baseline pressure 3 Inspiration and Exhalation Starting at the baseline pressure indicator all LCD cells illuminate non flashing green up to the peak pressure inspiration then return to a dark condition as pressure returns to the baseline level exhalation 4 Patient Trigger Level The patient trigger level LCD cell is illuminated non flashing green to indicate the level of effort the patient must achieve in order to trigger a breath If pressure becomes more negative than the set patient trigger level or if the patient trigger level is set higher than the baseline pressure indicator PEEP CPAP the patie
33. ected Auxiliary Electrical Outlet Box An optional AUXILIARY ELECTRICAL OUTLET BOX may be Optional Accessory er 0090 CTRICAL OUTLET BOX OPR150 D0208 attached to the back panel of the Breeze for the convenience of plugging in accessory equipment such as humidifiers and monitors consumption and current rating as the ventilator should be fer Only medical grade equipment with a similar power connected to the Auxiliary Electrical Outlet Box DESCRIPTION OF CONTROLS DISPLAYS ON OFF Switch sec bpm D LOO o H E ae or o a O m l Shoe ON OFF SWITCH Internal Battery F24 A LO PRESS HI 218 emH p t BATTERY LOW IN USE BATTERY INDICATOR INDICATOR Fuse Holder Compressed Air High Pressure Hose OPR150 D0208 AND INDICATORS The ON OFF SWITCH is located on the front of the ventilator behind the door at the base of the face panel It provides electrical power for electronically controlled ventilator functions and activates the electric power failure alarm system When the ventilator is plugged into an A C outlet the internal battery charges When switched ON a temporary audible alarm sounds and all lights on the front panel light up for two seconds This indicates a functional system self testing All electronically operated ventilator functions are deactivated w
34. ed air supply sources are clean and dry Accuracy 3 02 Nominal Supply Pressures 40 60 psig Accuracy 5 02 Operating Supply Pressures 35 90 psig The Air Oxygen Mixer is a two stage precision pressure regulation and proportioning device Itis designed to accurately mix medical air and oxygen to any selected FO between 21 and 1 0 for delivery through the ventilator to the patient Compressed air and oxygen sources are connected to the standard DISS fittings on the rear of the Air Oxygen Mixer FO accuracy is 3 02 of the control setting with gas supply pressures of 40 60 psig With gas supply pressures of 35 90 psig F O accuracy is 5 02 of the control setting If one gas supply source is lost a pneumatic crossover valve opens allowing the ventilator to continue to operate When the crossover valve opens the reed alarm on the rear of the Air Oxygen Mixer activates alerting the clinician to the gas supply pressure failure WARNING Should inlet gas supply fail immediately provide an alternate form of ventilation until the gas supply is re established Although the ventilator will continue to function if one gas supply source is lost the oxygen percentage will change WARNING In the case of total inlet gas failure the patient will receive no breaths from the ventilator The emergency intake valve inside the ventilator will allow the patient to breathe ambient air Opening pressure is approx 4 cmH90 As w
35. er chamber Routinely change the breathing circuit including patient circuit tubing exhalation valve nebulizer high volume humidifier and replace with a sterile or disinfected replacement every 24 48 hours or as required by hospital protocol Respirometers used to monitor several patients in succession should not directly touch parts of the breathing circuit Extension pieces adapters and bacteria filters should be used between the spirometer and the breathing circuit and should be changed between patients OPR150 D0208 MAINTENANCE TROUBLESHOOTING Preventative Maintenance Overhaul OPR150 D0208 To ensure patient safety NMI recommends that you visually inspect the Breeze E150 and perform the Quick Check Procedure see Section 10 prior to each time it is placed into service on a patient The Operational Verification and Calibration Procedure see Service Manual is performed with the annual Preventative Manintenance The OVP should also be performed according to hospital policy or any time the ventilator has been serviced Preventative Maintenance should be completed after every 3 000 hours of operation or earlier if the Breeze E150 fails to pass the Quick Check Procedure or a minimum of once each year The Preventative Maintenance is intended to be done in the hospital Preventative Maintenance Includes e Visually inspect the external surfaces controls attachments and accessories e Replace the Air and Oxygen mix
36. er inlet filters part MFK110A e Clean the air inlet Water Trap and replace the Jar Filter JFK100P e Remove the top cover and visually inspect the interior all tubing wires and wiring connectors screws nuts and hardware checking the general condition of all components e Perform Operational Verification on the Breeze E150 and recalibrate if necessary The Breeze E150 should be overhauled every 5 years or 15 000 hours of operation The Overhaul must be performed by a Newport Medical service technician at the NMI factory service center In addition to the items performed during Preventative Maintenance an Overhaul includes the overhaul of the Air O gt mixer and replacement of moving parts as required Contact NMI Service Department for further information on the above service 714 642 3910 or 800 451 3111 ext 500 Maintenance Troubleshooting Recommended Spare Parts Clinical Troubleshooting Reservoir Bag BAG121P Pressure Relief Valve pop off POP120A Diaphragm DIA200P Jar Filter Kit JFK100P Mixer Filter Kit MFK110A Fuses 110 V 120 V Operation 1 Amp 220 V 240 V Operation 05 Amp Fuse for power PCB 3 Amp Inside Vent 2 each 1 each 2 each 2 each 2 each FUS200P 2 each FUSO50P 2 each FUS300P 2 each It is important that both the clinician and biomedical service people have a thorough understanding of the Newport Breeze Model E150 Ventilator pneumatic electronic systems Supporting the moral obligat
37. et in the first position LOW CPAP the LO PRESS Alarm is activated to detect a drop in baseline pressure or disconnect and the TRIGGER LEVEL Sensor no longer monitors spontaneous efforts If the Baseline Pressure CPAP drops below the LO PRESS Alarm setting for more than 4 seconds the alarm sounds Inspiratory Time INSP TIME is adjustable from 0 1 to 3 0 seconds It is graduated in increments of 0 01 second from 1 to 1 second and in increments of 1 second from 1 second to 3 seconds When the selected time is reached the inspiratory phase is terminated and the Breeze E150 cycles into the expiratory phase The colon in the INSP TIME display flashes whenever an inverse I E ratio is set to be delivered The entire INSP TIME display flashes when it is set to exceed the maximum inverse I E ratio The maximum inverse I E ratio that may be delivered is 4 1 The Duoflow system allows you to control Mechanical Flow FLOW and Spontaneous Flow SPONT FLOW separately Mechanical Flow is delivered to the patient during mechanical breaths only and Spontaneous Flow is directed through the patient circuit in between mechanical breaths I S F Duoflow System Mech Spont Mech Spont Mech Breath Breathing Breath Breathing Breath Mechanical Flow Spontaneous Flow Note Your patient breathes from Mechanical Flow during a breath and from Spontaneous Flow during spontaneous breathiy Mechanical Flow goes on Spontaneous Flow is swit
38. g the previous mechanical inspiratory phase In the SPONT Mode the PEAK Pressure display is updated with each patient Trigger or at the onset of a second Manual Inflation Pressure is sensed at the airway 100 times per second negative and positive pressure are sensed Every time a patient trigger or mechanical inspiration occurs an average of Mean Pressure is calculated The MEAN Airway Pressure display is updated every patient triggered or mechanical breath It displays the average MEAN Airway Pressure of the four previous mechanical breaths or trigger conditions In all mechanical modes of ventilation the BASE Pressure reading is updated at the onset of each mechanical inspiration or every 3 seconds whichever is shorter to display the Baseline Pressure sensed during the previous expiratory phase or spontaneous breathing period In the SPONT mode the BASE Pressure reading is updated every three seconds OPR150 D0208 Trigger Level Principle of Operation TRIGGER LEVEL HD rm O EFFORT PRESSURE fead TRIGGER LEVEL KNOB Understanding the Display OPR150 D0208 Section 5 The TRIGGER LEVEL knob adjusts the amount of effort negative pressure the patient must exert to initiate trigger a breath Patient effort is displayed in cmH O and measured through the proximal pressure line with a pressure transducer inside the ventilator The patient trigger level indicator is displayed on the
39. h the ALARM SILENCE prior to an alarm infraction to pre silence the alarms prior to suctioning etc Press the Button to cancel latched alarm indicators The following non patient related alarms cannot be silenced with the Alarm Silence Button Continuous alarm indicating electrical mechanical failure Continuous alarm indicating low inlet gas pressure for either air or oxygen Quick pulse alarm indicating battery backup is weak and only approximately 15 minutes of battery power remains Alternative power supply should be found WARNING When the Low Battery alarm sounds an alternative power supply should be found The alarm indicates only approximately 15 minutes of battery power remains OPR150 D0208 OPR150 D0208 CLINICAL APPLICATION The Newport Breeze E150 is designed to ventilate neonates pediatrics and adults in all patient care areas Ventilation capabilities include Volume Control Assist Control Sigh Volume Control Assist Control Volume Control SIMV with Spontaneous Flow Spontaneous Flow Spontaneous breathing with or without CPAP Vol amp Press Pressure Control SIMV with Spontaneous Flow e Pressure Control Assist Control The Breeze E150 senses airway pressure through a proximal pressure sensing port In addition to the inspiratory and expiratory limbs the Breeze E150 patient circuit must have a third small bore line connected to the proximal wye connector This s
40. hen the power switch is in the OFF position The Breeze E150 has an internal battery which will maintain full ventilator function for approximately 60 minutes when fully charged It will automatically power the ventilator in the case of A C power disconnect or power outage An audible alarm sounds every five minutes to indicate the internal battery is in use Additionally a quick pulse alarm indicates that approximately 15 minutes of battery power remains A 1 Ampere 250 V fuse for 100 120 Volt or 5 Ampere 250 V fuse for 220 240 Volt protects the ventilator s electronic system Use only these specified fuses to replace blown fuses Consistently blown fuses may indicate that service is required Contact your NMI authorized representative The 50 psig Air High Pressure Hose is connected to the DISS air inlet on the water filter trap located on the rear of the ventilator The water filter trap should be monitored frequently for condensation and is drained by pushing UPWARD on the metal pin in the bottom of the bowl Description of Controls Displays and Indicators Oxygen High Pressure Hose Air Oxygen Mixer MODE FiO FLOW INSP TIME Ri MD exer 60 LE 33 i Umin i ir 7 TE T i20 a MV S og C AGH PRESET The 50 psig Oxygen High Pressure Hose is connected to the smaller DISS female connector on the back of the ventilator NOTE Ensure that both oxygen and compress
41. ible with plastics and anodized aluminum NOTE Ethylene oxide may cause superficial crazing of plastic components and will accelerate the aging of rubber components Caution ETHYLENE OXIDE IS TOXIC All components MUST be completely dry prior to packaging for ethylene oxide sterilization After sterilization they must be properly aerated to dissipate residual gas absorbed by the material Follow the sterilizer manufacturer s recommendations for the specific aeration periods required Sterilization Decontamination Ventilator Stand Pole Assembly General Guidelines The exterior of these surfaces may be wiped clean with a soft cloth which has been moistened with a medically appropriate germicidal agent NOTE Do not allow any liquid to enter the ventilator housing electrical or signal ports Do not spray aerosolized agents on the Breeze E150 face panel or housing Do not allow the face panel or ventilator housing to come in contact with agents that contain acetone toluene halogenated hydrocarbons or strong alkalines Do not use paper products to clean the Breeze E150 face panel The Breeze E150 is NOT AUTOCLAVABLE Only sterile fluids should be nebulized or used in a humidifier and they should be dispensed aseptically Contaminated equipment should not be allowed to touch the fluid while it is being dispensed Water that has precipitated in the tubing should be discarded and not allowed to drain back into the humidifi
42. ions of every involved professional to have a working understanding of the equipment as used in life support situations the following practical troubleshooting guidelines are provided It should be noted that this outline is not all inclusive and is only intended as a guide Further questions or problems should be addressed to the Customer Service Department of Newport Medical Instruments 714 642 3910 or 800 451 3111 ext 282 FAX 714 548 3091 Or you may write to Customer Service Department NEWPORT MEDICAL INSTRUMENTS INC Post Office Box 2600 Newport Beach CA 92658 USA OPR150 D0208 Newport Breeze E150 Troubleshooting Guide PROBLEM OXYGEN CONCENTRATION Delivered O concentration varies more than 3 from selected concentration Gas sources 40 60 psig SELF TEST All lights on front panel remain ON longer than 2 seconds ALARMS Air Oxygen mixer alarms OPR150 D0208 POSSIBLE CAUSE O analyzer not correctly calibrated Mixer contaminated with condensate Mixer knob has slipped Problem with microprocessor board Air and or Oxygen supply source difficulties Inlet gas pressures are not between 35 and 90 psig TG 1 REMEDY Calibrate according to Manufacturer s Operation Manual Call factory authorized representative Calibrate mixer knob Contact NMI service center Plug Air and O supply lines in at exactly the same time or in reverse order If using gas c
43. ith any other type of gas mixing apparatus an oxygen analyzer preferably with high and low alarm limits is recommended to ascertain that the desired FO is being delivered OPR150 D0208 Reservoir Bag RESERVOIR BAG C J Mode Selector Knob MODE FiO2 FLOW INSP TIM m a OF RESSURE CONTROL CONTROI RET PIP Un SPONT MODE SELECTOR KNOB Volume Control Modes OPR150 D0208 Section 5 A two liter bag connected to the Reservoir Bag Outlet functions as a reservoir of selected oxygen concentration for the SPONT FLOW NOTE The two liter Reservoir Bag may be replaced with a one or three liter Reservoir Bag as needed to meet patient ventilation demands You may also replace the Reservoir Bag with the Reservoir Bag Cap when necessary to enhance patient triggering in very small or weak patients Spont insp efforts less than 1 cmH20 See pg 4 1 for guidelines and warnings for use of the Reservoir Bag Cap The MODE Selector Knob allows the operator to select between the Volume Control Modes which include A C Sigh A C SIMV and SPONT and the Pressure Control Modes which include SPONT SIMV and A C WARNING Ensure the safety of your patient by checking the appropriateness of all ventilator settings prior to switching between Pressure Control and Volume Control Modes of Ventilation In A C Assist Control a positive pressure breath is de
44. let and the patient breathing circuit and between the nebulizer outlet and the nebulizer A hydrophobic filter should be used in the Proximal Pressure Sensing Line between the ventilator and the patient to prevent organisms or water from contaminating the Electronic Pressure Gauge When nebulizing substances in line with the patient circuit use a filter between the expiratory limb of the patient breathing circuit and the Exhalation Valve to protect the valve from contamination The filter should be checked for resistance and changed regularly to protect the patient from possible expiratory resistance as a result of a clogged filter Ethylene oxide is toxic All components must be completely dry prior to packaging for sterilization After sterilization is completed properly aerate to dissipate residual gas absorbed by the material Follow the sterilizer manufacturer s recommendations for the specific aeration periods required Use NMI approved patient breathing circuits If a proximal pressure sensing line is being used it must be either 1 8 or 3 16 i d for proper performance and monitoring To protect the patient from accidental exposure to high pressure adjust the Pressure Relief Valve 2 3 cmH20 higher than the High Pressure Alarm limit The ventilator functions only when the power switch is in the ON position with the A C power cord inserted into the proper receptacle or if the internal battery is in use Use a soft
45. lf Test Pass___ Fail SO Leak Check Pass Fail Pressure Gauge Pass ____ Faill LW Operational Check Volume Control Pass Fail Operational Check Pressure Control Pass Fail PEEP CPAP Pass Fail Se N a oe eS 8 P B Pressure Alarms amp Alarm Silence Button Pass Fail m gt Trigger Level Pass Fail m Apnea Alarm Pass Fail m N Internal Battery Pass Fail Mode Control Pass Fail m Ae W F O Accuracy Pass Fail m gl Proximal Line Purge Flow Pass Fail m D Power Down Alarm Pass Fail m N Emergency Intake Valve Pass Fail The ventilator is ready for operation when all tests have been performed successfully Note any comments on inspection of unit corrective action taken or recommendations for further action Completed by Facility Serial Unit hours 10 6 OPR150 D0208 11 WARRANTY Newport Medical Instruments Inc NMI warrants this product to meet the published specifications and to be free from defects in material and workmanship under normal use for a period of one 1 year from date of purchase The foregoing is in lieu of any other warranty expressed implied or statutory including without limitation any warranty or machinability warranty of fitness for any particular purpose or warranty of any kind as to design The sole liability of NMI under this warranty is limited to replacing repairing or issuing credit at the discretion of NMI for the products equipment or
46. livered in response to each patient inspiratory effort that reaches the Trigger Level Tidal Volume is determined by the FLOW and INSP TIME settings and is digitally displayed as Vy in the Data Display Panel NOTE If the patient does not trigger the Breeze E150 automatically delivers breaths according to the RATE control setting A C Sigh Assist Control plus Sigh functions much like A C with the addition of a mechanical Sigh breath equal to 1 5 times the volume of the preset tidal volume 1 5 times the inspiratory time delivered to the patient every 100 breaths In SIMV the patient may breathe spontaneously from the ventilator s spontaneous flow and receive a fixed number of mandatory positive pressure breaths Tidal volume of the mandatory breaths is determined by the FLOW and INSP TIME settings and is digitally displayed as Vy in the Data Display Panel The number of mandatory breaths is controlled by the RATE setting and synchronized with the patient s breathing pattern by the TRIGGER LEVEL setting The patient s spontaneous breaths are drawn from the SPONT FLOW through the circuit and Reservoir Bag which has the same FO as the mandatory breaths Description of Controls Displays and Indicators Pressure Control Modes NOTE For more information on SIMV see section titled SIMV WINDOW pg 5 5 In the SPONT mode the patient breathes exclusively from the spontaneous flow and Reservoir Bag at the selected FO Th
47. mall bore tubing is used to connect the PROXIMAL PRESSURE INLET on the Breeze E150 with the proximal wye connector in the circuit thereby enabling the Electronic Pressure Gauge and Pressure Display to indicate pressure sensed at the patient s airway During mechanical ventilation mandatory Tidal Volume is a product of selected FLOW L min and INSP TIME sec settings The set Tidal Volume Vp is displayed digitally in the Data Display Panel To measure the patient exhaled Tidal Volume place an uncontaminated respirometer between the patient airway connection and circuit wye Clinical Application Volume Control Assist Control A C Set up 10 11 12 13 14 15 16 17 Assemble ventilator Connect air and oxygen hoses to the appropriate gas sources Connect a patient circuit which includes a proximal sensing line to the Breeze E150 see pg 3 2 to 3 4 For heated humidifier or heat moisture exchanger operation refer to manufacturer s instructions Plug electrical cord into a properly grounded electrical outlet Turn the power switch behind the door on the front panel to the ON position Check that all LED indicators light up and then go out after 2 seconds This ensures proper function of the microprocessor and the LEDs Attach a test lung to the breathing circuit Set MODE Selector to A C Set patient parameters for F O Respiratory RATE V Tidal Volume use FLOW and I
48. minal Air 35 90 psig 50 10 nominal Height 10 inches 25 cm Depth 11 inches 28 cm Width 13 inches 33 cm Weight 30 Ibs 13 6 kg Ship Weight 64 Ibs 29 kg Designed to meet applicable requirements of CSA 22 2 IEC 601 1 IEC 601 1 2 EMC MDD Directive 93 42 EEC OPR150 D0208 Assembly OPR150 D0208 ASSEMBLY amp SET UP PROCEDURES The clinician can assemble the equipment without assistance by implementing the following instructions Remove Operating Manual and warranty card process per instructions from the shipping container Remove all parts assemblies from the container and inspect each for completeness and verify there is no shipping damage The complete assembly consists of the following parts Quantity 1 each 1 each 1 each 5 each NOTE Description Newport Breeze E150 Ventilator with watertrap for high pressure air inlet Base Pole two pieces plus nut and retaining washer Casters Pole base and casters included in standard assembly for shipments outside the U S A only 1 each 1 each 1 each 1 each 1 each 1 each 1 each 1 each 1 each 1 each Oxygen Supply High Pressure Hose 10 ft Air Supply High Pressure Hose 10 ft 2 liter Reservoir Bag Adjustable Pressure Relief Valve 0 120 cmH20 Extension Arm Patient Circuit Tubing Holder Exhalation Valve with Mounting Bracket Reservoir Bag Cap OPTIONAL USE ONLY Operating Manual Service Manual Assembly Set up Proce
49. mines the maximum flow delivered to the patient The INSP TIME control determines how long the mechanical flow will be delivered and the PIP control determines the maximum pressure that can be achieved during the mechanical breath The mechanical FLOW controls flow and therefore the pressure wave pattern for each mandatory breath All spontaneous breaths are taken from SPONT FLOW which is adjusted separately with the SPONT FLOW knob to meet the spontaneous inspiratory flow demands PIR Setting Time Longer Insp Time Time Shorter Insp Time Pressure Control Ventilation Vary Mechanical Flow and Insp Time to change waveform NOTE For more information on SIMV see section titled SIMV WINDOW pg 5 5 OPR150 D0208 6 9 General OPR150 D0208 WARNINGS PRECAUTIONS The following warnings and precautions are guidelines to assist the clinician in the safest possible operation of the Newport Breeze E150 ventilator Always observe monitor and clinically evaluate patients while they are receiving mechanical ventilation Periodically measure by using a calibrated oxygen analyzer the accuracy of the selected oxygen concentration Make sure that the Reservoir Bag refills itself between each breath during spontaneous breathing in the SPONT and SIMV Modes Adjust the SPONT FLOW to prevent the bag from depleting Always check ventilator performance before connection to the patient Always wash hands before and after touching the
50. n 6 6 Adjust the SPONT FLOW to deliver an adequate amount of gas through the circuit to meet the spontaneous inspiratory demands of the patient and to refill the Reservoir Bag in between patient inspiratory efforts See Spontaneous Flow on pg 5 12 for guidelines to setting SPONT FLOW 7 Add CPAP if desired 8 Set TRIGGER LEVEL just below baseline so that the Patient EFFORT Indicator lights with each patient inspiration NOTE If you are having difficulty sensing the patient effort EFFORT LED not lighting and the TRIGGER LEVEL is set to the least amount of effort you may want to decrease the SPONT FLOW setting If you see the patient generate significant negative pressure beyond the set TRIGGER LEVEL you may want to increase the SPONT FLOW setting 9 Select a delay time for the APNEA alarm or choose the first position Low CPAP Alarm which utilizes the LO PRESS Alarm setting as a disconnect alarm 10 The Pressure RELIEF VALVE and HI PRESS Alarm should be set as a safety precaution NOTE Although the other parameters are not used in this mode they should be set in case a manual breath or change to mechanical ventilation is indicated Depressing the PRESET button will cause the digital displays to light up indicating how each parameter is set In the SPONT MODE the patient breathes exclusively from the SPONT FLOW moving into the Reservoir Bag and through the patient circuit The SPONT FLOW should be
51. n the SPONT MODE only The APNEA ALARM DELAY knob may be placed in the first position which inactivates the APNEA ALARM and activates the LOW CPAP ALARM Set the LO PRESS Alarm just below the CPAP level the LO PRESS Alarm range changes to 0 99 cmH O instead of 3 99 cmH 0 If the pressure in the circuit as monitored through the proximal pressure sensing port drops below the LO PRESS Alarm setting for 4 seconds the LO PRESS Alarm sounds When the alarm is no longer violated the alarm indicator latches stays lit Press the ALARM SILENCE Button to cancel latched alarm indicators Caution A Low CPAP Alarm setting of lt 2 cmH 0 will not detect a disconnect Description of Controls Displays and Indicators Alarm Silence APNEA LO PRESS uipress if LO PRESS HI PRESS emhp emH 20 N ALARM SILENCE BUTTON Additional Alarms System Failure Air O Blender Low Battery Bil LO PRESS HI PRESS LO PRESS HI PRESS cmH p cmH LOW BATTERY INDICATOR The ALARM SILENCE Button B silences the audible patient related alarms for 60 seconds The alarm s red indicator light remains flashing until the cause of the alarm condition is corrected The ALARM SILENCE period 60 sec can be cancelled by pushing the B Button The audible alarm system is automatically reactivated after 60 sec You may pus
52. nt trigger LCD cell will begin to flash intermittent green until this condition no longer exists Description of Controls Displays and Indicators Pressure Display TRIGGER LEVEL lt D m O EFFORT cmH 0 PRESSURE DISPLAY PRESSURE p MEAN 5 Patient Effort With a baseline pressure of zero patient effort will be displayed in LCD cells 1 to 10 cmH50 The LCD cells equal to the effort generated by the patient will illuminate non flashing green With a PEEP CPAP level set the LCD cells illuminate non flashing green to indicate the elevated baseline pressure level The lit LCD cells displaying the PEEP CPAP level will turn off go dark as effort is generated by the patient to trigger the ventilator NOTE When the baseline pressure is elevated and the patient trigger level is set equal to the baseline level the LCD indicator for both will remain dark The PRESSURE Display provides a continuous readout of MEAN Airway Pressure MAP as monitored by the built in pressure transducer through the PROXIMAL PRESSURE INLET PEAK or BASE line Pressure readings can be displayed for 30 seconds by depressing either button The display returns to MEAN Airway Pressure after 30 seconds or when PRESET is pushed In the Mechanical Modes the PEAK Pressure display is updated at the onset of the inspiratory phase of each mechanical or manual breath It displays the maximum airway pressure sensed durin
53. ntilator 16 Slowly adjust PEEP as needed Readjust SPONT FLOW to guarantee a stable baseline 17 The TRIGGER LEVEL should be set just below baseline pressure 18 Set the LO PRESS Alarm 1 2 cmH2O below the Peak Inspiratory Pressure PIP Set the HI PRESS Alarm 2 3 cmH 0O above the PIP 19 Select a delay time for the APNEA alarm Although much like the standard ventilatory pattern of Volume Control Assist Control A C this mode differs in that each breath is limited at a particular peak pressure Instead of each breath being volume limited and pressure variable it is pressure limited and volume variable This type of ventilation provides a descending ramp flow pattern When the Peak Inspiratory Pressure set by the PIP knob is reached a pressure plateau results for the duration of the Inspiratory Time The size of the mandatory inspiration is determined by the difference in pressure between the PEEP level and the PIP level and shape of the pressure waveform created by the mechanical FLOW and INSP TIME settings The volume delivered during the plateau time varies depending on changes in patient system resistance compliance and leaks around the artificial airway This mode may be used for full ventilatory support of any patient when you wish to maximize oxygenation and at the same time control the peak ventilating pressure Clinical Application Pressure Control SIMV Set up 1 Complete steps 1 through 8 of A C
54. on All LCD cells from a baseline pressure of zero to the PEEP CPAP level will be illuminated non flashing green If the baseline pressure is zero the LCD cells equal to the effort generated by the patient will illuminate non flashing green below the baseline level The patient trigger level LCD will be illuminated non flashing green to indicate what level of effort the patient must achieve in order to trigger a breath If an LCD cell is already energized and receives another input to turn on it will go dark turn off instead For instance if PEEP is set at 5 cmH O and the patient trigger level is set at 2 cmH O LCD cells 0 1 2 4 and 5 will be illuminated LCD cell 3 will be dark turned off to indicate the 2 cmH O Trigger Level As the patient creates the 2 cmH O effort to trigger a breath LCD cells 5 and 4 will go dark until the ventilator responds with a positive pressure breath Description of Controls Displays and Indicators Setting the Trigger Level OCRAESF NI EOPISITNO Patient Effort Indicator The COARSE adjustment on the TRIGGER LEVEL knob is to bring the trigger level within 5 cmH O of the desired setting To adjust in the COARSE position pull out on the TRIGGER LEVEL knob clicking it into position Rotate the knob clockwise to increase the patient effort counter clockwise to decrease patient effort Once you are in the desired range push in on the knob clicking it into the FINE
55. orporated alarm systems or additional alarm systems does not give absolute assurance of warning for every type of ventilator breathing circuit or patient system malfunction Certain clinical as well as technical problems require immediate action In all modes of ventilation set the RELIEF VALVE above the HI PRESS Alarm setting as a secondary safety mechanism After servicing the ventilator with the face panel removed make sure to follow procedures outlined in the Service Manual for calibration and adjustment of control knobs OPR150 D0208 STERILIZATION DECONTAMINATION Patient Circuit OPR150 D0208 The Newport Breeze E150 Ventilator and the associated patient circuit are shipped in a clean but not sterile condition After each use or more often if necessary it is important to clean the exterior surface of the ventilator and the entire patient circuitry Detach the patient circuit exhalation valve and humidifier chamber from the ventilator and disassemble to expose all surfaces Thoroughly wash all equipment to be sterilized or disinfected to remove secretions and other residue Clean the patient circuit components in a medical detergent solution and thoroughly flush preferably with distilled water Sterilize patient circuit components using liquid chemicals pasteurization steam autoclave or ethylene oxide Use liquid chemical agents according to the manufacturer s recommendations Be sure that the agent is compat
56. ow and the Reservoir Bag in place If the patient IS capable of drawing a negative pressure and the Reservoir Bag has been replaced with the Cap the patient will be able to open the Emergency Intake and draw in ambient gas when their spontaneous inspiratory flowrate exceeds the set SPONT FLOW A heated humidifier or heat moisture exchanger should be used whenever continuous ventilatory support is instituted The Fisher amp Paykel heated humidifier may be ordered with the Breeze E150 For heated humidifier specifications operation and application refer to the humidifier manufacturer s operation manual For heat moisture exchanger instructions refer to manufacturer s instructions The humidifier chamber should be filled with sterile water to an appropriate level per manufacturer s instructions and the heater unit plugged into an A C outlet prior to switching ON Evaluate the humidifier s internal resistance to spontaneous inhalation In the event of a total source gas failure the patient must overcome this resistance in order to obtain ambient air through the ventilator Emergency Intake Valve Caution Remember to turn the humidifier OFF after switching the Breeze E150 OFF The Breeze E150 is guaranteed to perform within specifications when the NMI permanent breathing circuit and the NMI Exhalation Valve are utilized The NMI permanent patient breathing circuit is available in neonatal pediatric bore or adult bore
57. r adults The ventilator is provided with an Air Oxygen Mixer to control the FiO Controls are provided for the operator to select the function of the ventilator a transducer monitors peak mean and baseline pressures and alarm systems are built in to alert the clinician to violations of preset limits The Breeze E150 is classified as an electronically controlled pneumatically powered ventilator with intermittent spontaneous flow I S F It functions as a volume controlled time cycled constant flow or a pressure controlled time cycled constant flow ventilator VOLUME CONTROL A C Assist Control SIGH A C SIMV Spontaneous Intermittent Mandatory Ventilation SPONT Spontaneous PRESSURE CONTROL SPONT SIMV A C e MODE e PRESET Indicates mechanical ventilation settings while in Spont Mode e F O e RATE e INSP TIME General Description Primary Controls Allow Operator To Select e FLOW Mechanical PEEP CPAP e TRIGGER LEVEL PIP Pressure Control Vent PRESSURE PEAK MEAN BASE ALARM LOUDNESS Alarm Silence NEB Nebulizer Source ON OFF MANUAL Manual Breath ON OFF Power Pressure RELIEF VALVE Pop off APNEA ALARM DELAY or LOW CPAP HI PRESS ALARM LO PRESS ALARM SPONT FLOW OPR150 D0208 MODES CONTROLS ALARMS Audible and Visual Audible Only OPR150 D0208 SPECIFICATIONS VOLUME CONTROL A C SIGH A C SIMV SPONT PRESSURE CONTROL SPONT SIMV A C F
58. rce of gas for spontaneous breathing in the unlikely event of an electronic ventilator malfunction FLOW may be adjusted in 1 L min increments from 3 120 L min This setting determines the flowrate delivered to the patient during a mandatory or manual breath Mandatory tidal volume V7 is a product of the mechanical FLOW L min and the INSP TIME seconds In the VOLUME CONTROL MODES V7 is digitally displayed in the Data Display Panel above the FLOW and FO displays NOTE Although digital displays may be capable of indicating tidal volumes below 30 mL the accuracy is guaranteed above 30 mL only The MANUAL Button allows you to give your patient positive pressure inflations in any mode Depressing the button causes the Breeze E150 to deliver gas to the patient for a maximum of two seconds MANUAL is disabled during a mechanical inspiration The maximum number of manual inflations is 150 per minute In the PRESSURE CONTROL Modes the peak pressure of the manual inflation will be limited at the PIP level All manual inflations cycle to exhalation if the HI PRESS Alarm limit is reached or after two seconds If the peak pressure reaches the Pressure RELIEF VALVE setting the pressure will plateau In all Modes FLOW and FO of the manual inflation are delivered as set and INSP TIME and RATE are determined by the operator OPR150 D0208 Expiratory Drive Line Outlet EXP OUTLET Nebulizer Outlet
59. re limit TG 6 REMEDY Change exhalation valve or entire breathing circuit Re adjust SPONT FLOW Evaluate RATE and INSP TIME settings Contact NMI Service center Contact NMI Service center Re intubate with larger ET tube Adjust RELIEF VALVE pressure as required Correct leak and check pressure Correct leak and recheck pressure Increase as required Decrease as required Stop pressing MANUAL before pressure rises to High Pressure limit Troubleshooting Guide 10 QUICK CHECK PROCEDURE PURPOSE 1 Pre Test Inspection 2 Loss of Gas Alarm OPR150 D0208 This procedure is intended to assist a qualified operator establish a routine verification program to ensure proper operation of the Newport E150 Breeze ventilator You should perform this Quick Check each time the ventilator is prepared for clinical use Do not use the ventilator if it does not pass the Quick Check Procedure Verify that the condition of the A C power cords for the ventilator and the NMI air compressor if used are in good working condition then connect them to an A C wall receptacle Inspect the water trap connected to the air supply hose Remove any water or debris that has accumulated in the bottom of the water jar then connect the air and oxygen supply lines from the ventilator to the appropriate wall gas outlets Gas outlet pressure must be50 10 psig Connect an adult breathing circuit w proximal pre
60. setting b min into 60 Seconds results in the duration of each mandatory breath interval The 100 SIMV window allows for patient triggers throughout the entire mandatory breath interval In order to minimize problems of synchrony with spontaneous and PIM or VIM breaths the first breath the patient triggers in any mandatory breath interval is the PIM breath The patient has the rest of the interval to breathe spontaneously If the patient stops triggering breaths and one complete mandatory breath interval has elapsed without any type of breath occurring a VIM breath will be delivered The following diagram identifies the three different SIMV breath types as A B and C and the way they interact within the 100 SIMV window In the first mandatory breath interval neither a VIM or a PIM breath has occurred therefore at the beginning of the next interval a VIM A breath will be delivered During the second mandatory breath interval following the VIM A breath the patient triggers a PIM B breath remember that the first breath the patient triggers in any interval is a PIM B breath The patient may breathe spontaneously C throughout the rest of the interval In the third mandatory breath interval the normally scheduled VIM A breath is not delivered because the patient received a PIM B breath in the second interval In the fourth mandatory breath interval since one complete interval has elapsed without any type of breath occurring
61. ssure sensing line 1 8 and an adult test lung NMI LNG600P or equivalent to the ventilator Examine the test lung and patient breathing circuit to ensure there is no degrading of the material which would cause leaks Disconnect the oxygen supply Verify that the air oxygen mixer alarm is violated Reconnect the oxygen supply Verify that the alarm is silenced Disconnect the air supply Verify that the air oxygen mixer alarm is violated Reconnect the air supply Verify that the alarm is silenced 10 1 Quick Check Procedure 3 Power Up Self Tests 4 Leak Check 5 Pressure Gauge Check 6 Operational Check Volume 10 2 Press the power switch located on the front panel of the NMI air compressor if used to the ON position Verify that the Low Pressure alarm sounds and if using the C200 air compressor that the alarm indicator is lit Verify that after sufficient time less than 30 sec the needle on the pressure gauge on the compressor is in the green and that the Low Pressure alarm is no longer violated Press the power switch located behind the lower front panel of the E150 Breeze ventilator to the ON position Verify that all indicators and displays light and the audible alarm sounds Set the MODE control to either SPONT position Set the SPONT FLOW to 6 L min Rotate the PEEP knob until the pressure gauge shows approx 30 cmH50 While watching the pressure ga
62. t The PRESET condition displays Expiratory Time in the Data Display Panel when the PRESSURE CONTROL SPONT Mode is chosen and it displays Vy in the Data Display Panel when the VOLUME CONTROL SPONT Mode is chosen Cc fess PRESET BUTTON Rate Control b min The RATE control is adjustable in one breath per minute increments from 1 to 150 breaths per minute Mandatory breaths are available to the patient in all mechanical modes In the SPONT mode respiratory rate is determined by the patient INSP TIME RATE sa CE 233 sg Umin b min 0 aa Fen RATE CONTROL KNOB 5 6 OPR150 D0208 Proximal Sensing Inlet 29 1 RESERVOAR PROXIMAL PRESSURE INLET Electronic Pressure Gauge Principle of Operation Understanding the Display TRIGGER LEVEL zmo HD om O EFFORT PRESSURE fead Ca MEAN cmH ASE PEEP CPAP OPR150 D0208 Section 5 The Electronic Pressure Gauge and PRESSURE Display reveal pressure sensed through the small bore proximal pressure sensing line This small bore portion of the patient circuit attaches to the PROXIMAL PRESSURE INLET on the lower right side of the ventilator A purge flow of gas discourages water or contaminants from entering the ventilator through this port It is also advisable to install a hydrophobic bacteria filter between the PROXIMAL PRESSURE INLET and the small bor
63. t bleed valve Correct Leak Readjust relief valve 3 5 cmH20 above the High Pressure Alarm setting Correct leak Increase pressure relief valve setting by rotating clockwise Check and replace as needed Call factory authorized representative Adjust indicator position just below baseline pressure Correct Leak Troubleshooting Guide Newport Breeze E150 Troubleshooting Guide PROBLEM MECH SPONT VENTILATION Ventilator does not respond to patient inspiratory effort Low and or High Pressure Alarms are activated Ventilator does not function in any mode Ventilator stops cycling PEEP CPAP APPLICATION Airway pressure dips below selected PEEP CPAP pressure first prior to stabilizing OPR150 D0208 POSSIBLE CAUSE Patient effort too weak Incorrect TRIGGER LEVEL indicator position Airway pressure does not drop below indicator position Leak in breathing circuit Leak in breathing circuit Breathing circuit or proxline occlusion Electronic malfunction A C power cord not plugged in and internal battery is depleted ON OFF switch in OFF position Blown fuse and internal battery power supply is depleted Electronic malfunction Inlet supply gas source failure Faulty exhalation valve diaphram In SIMV or SPONT modes SPONT FLOW L min selection does not meet patient inspiratory flowrate demand TG 5 REMEDY Cap off Reservoir Bag Outlet Rea
64. tion Valve with a respirometer or an equivalent independent volume measuring device NOTE If volumes are measured at the Exhalation Valve exhaust port spontaneous flow may cause the volume measuring device to read higher volumes than are actually being delivered Accurate volumes may be measured at the proximal wye connector The Exhalation Valve assembly can be autoclaved pasteurized gas sterilized or cleaned using most cleaning disinfectant type solutions such as Cidex A Reservoir Bag Cap MAY be used to cap off the Reservoir Bag opening in special circumstances WARNING Capping off the Reservoir Bag Outlet with the Reservoir Bag Cap removes the gas reservoir from the inspiratory limb of the breathing circuit This should ONLY be done when attempting patient triggered ventilation on very small or very weak patients Spont insp efforts less than 1 cmH20 who cannot adequately lower the pressure at the proximal airway to trigger the Breeze E150 to deliver a mechanical breath with the Reservoir Bag in place SPONT FLOW is maintained at the set level Ensure that the patient is being carefully observed when the Reservoir Bag Cap is in use Accessories Heated Humidifier Optional Accessory Breathing Circuits Optional Accessory WARNING The Reservoir Bag Cap should NEVER be used in place of a Reservoir Bag if the patient is capable of drawing a negative pressure of 1 cmH O or greater with appropriately set Spontaneous Fl
65. to increase the SPONT FLOW setting NOTE If the TRIGGER LEVEL knob is in the COARSE position pulled OUT upon power ON the trigger level will be set between 10 to 60 cmH 0 depending on the rotation of the TRIGGER LEVEL knob If the knob is in the FINE position pushed IN upon power ON the trigger level will be set between 10 to 5 cmH O depending on the rotation of the TRIGGER LEVEL knob The EFFORT LED will blink orange on and off with each patient effort that meets the TRIGGER LEVEL knob setting If the EFFORT LED is not blinking with each patient effort adjustment of the TRIGGER LEVEL knob and or the SPONT FLOW level may be necessary OPR150 D0208 Apnea Alarm Low CPAP Alarm APNEA ALARM DELAY KNOB Inspiratory Time FLOW INSP TIME RATE 66 6 33 6a sec Umin b min El s 07 1 5 w os wo m 1o INSP TIME KNOB Duoflow Mechanical Flow Spontaneous Flow OPR150 D0208 Section 5 The APNEA ALARM DELAY knob is located behind the door on the lower portion of the face panel This alarm receives its input from the TRIGGER LEVEL Sensor In mechanically assisted modes the APNEA ALARM DELAY may be set for 5 indicated as LOW CPAP 10 15 30 and 60 seconds If no patient effort or mechanical breath is sensed for the set delay time the alarm sounds In the SPONT Mode the LOW CPAP ALARM is available When the knob is s
66. to those for A C except that with A C SIGH a mechanical Sigh breath equal to 1 5 times the preset tidal volume 1 5 times the Inspiratory Time is delivered to the patient every 100 breaths 1 Complete steps 1 through 8 under A C page 6 2 2 Select SIMV mode 3 Adjust the SPONT FLOW to provide flow through the ventilator circuit in between mechanical breaths 4 Choose the desired F O RATE V Flow and Inspiratory Time 5 With the HI PRESS Alarm Limit set at 120 cmH O depress the MANUAL Inflation button observe the Electronic Pressure Gauge then rotate the blue knurled knob on the Pressure RELIEF VALVE until it is set to pop off above the maximum acceptable peak inspiratory pressure 6 Connect the patient to the Breeze E150 7 Adjust the SPONT FLOW to deliver an adequate amount of gas through the circuit to meet the spontaneous inspiratory demands of the patient and to refill the Reservoir Bag in between patient inspiratory efforts See Spontaneous Flow on pg 5 12 for guidelines to setting SPONT FLOW 8 Slowly set PEEP as needed Clinical Application Volume Control SIMV Set up cont d Volume Control SIMV Theory of Operation Volume or Pressure Control Spontaneous SPONT Set up 9 Adjust the TRIGGER LEVEL just below the PEEP or baseline pressure so that the Patient EFFORT Light comes ON with each spontaneous patient inspiration 10 Set the HI PRESS and LO PRESS Alarms to bracket
67. tory breath is determined by the PIP setting Expiratory Time is displayed digitally in place of Vy in the Data Display Panel The number of mandatory breaths is determined by the RATE control and synchronized with the patient s breathing pattern by the TRIGGER LEVEL setting The patient s spontaneous breaths are drawn from the SPONT FLOW through the circuit and Reservoir Bag SPONT FLOW has the same FO as the mandatory breaths NOTE For more information on SIMV see section titled SIMV WINDOW pg 5 5 In the SPONT mode the patient breathes exclusively from the SPONT FLOW and ventilator Reservoir Bag at the selected F Oo The patient has complete control over each breath with respect to rate tidal volume and peak flowrate CPAP may be added OPR150 D0208 SIMV Window Volume or Pressure Control OPR150 D0208 Section 5 Manual breaths delivered in this mode will be pressure limited at the PIP setting and or the Pressure RELIEF VALVE The breath will cycle to exhalation when the MANUAL button is released or after 2 seconds or if the HI PRESS Alarm limit is reached There are three types of breaths available in SIMV VIM ventilator initiated mandatory PIM patient initiated mandatory and SPONT breaths The RATE control determines the total number of mandatory breaths VIM or PIM delivered each minute The total number of mandatory breaths equals the total number of mandatory breath intervals each minute Dividing the RATE
68. uge turn the SPONT FLOW control fully counter clockwise min Airway pressure should not drop more than 5 cmH20 in 5 seconds Turn the PEEP CPAP off by rotating the PEEP CPAP control fully counter clockwise Disconnect the test lung from the circuit wye connector Verify that the pressure gauge is showing 0 cmH90 Reconnect the test lung Control Set the RATE control to 30 b min the INSP TIME control to 1 00 the FLOW control to 24 L min and the MODE control to the VOLUME CONTROL SIMV position Verify that the ventilator is cycling and delivering positive pressure breaths Verify that after 1 minute the TOTAL RATE display shows 30 1 b min OPR150 D0208 Section 10 6 Operational Check Volume Control cont d Verify that the I E display shows 1 1 0 1 Verify that the V display shows 40 04 L 7 Operational Check Pressure Control 8 PEEP CPAP Check Set the MODE control to the PRESSURE CONTROL SIMV position Increase the FLOW control to 40 L min Press the BASE button and verify that the PRESSURE Display shows 0 cmH50 Press the PEAK button While monitoring the PRESSURE Display rotate the PIP knob until 20 cmH90 is displayed Looking at the pressure gauge verify that an inspiratory pressure plateau occurs at 20 cmH90 2 cmH20 Make certain that the Reservoir Bag or the blue Reservoir Cap is attached to the reservoir outlet located at the bottom right corner of the ventilator
69. ver In no event shall NMI be liable for personal injury property damage or any special or consequential damage to the buyer user or any other person whomsoever including but not limited to loss of profits loss of use of the product or equipment or for damages of any kind whatsoever based on a claim for breach of warranty other than a refund of the purchase price of any defective product or equipment Any authorization for repair or alteration by buyer must be in writing from NMI to prevent the voiding of this warranty OPR150 D0208 11 1
70. ylinders ensure that both are full valves turned fully OPEN and operating pressures are between 35 and 90 psig Ensure hose fittings are correctly inserted into hospital wall outlets Check all of the above and that inlet gas is dry If using an air compressor ensure A C power cord is plugged in and switch is in the ON position and operating in the green range Troubleshooting Guide Newport Breeze E150 Troubleshooting Guide PROBLEM ALARMS Mixer does not alarm with only one gas source being connected A C POWER FAILURE ALARM Continuous alarm sound Alarm does not sound during an electric disconnect or power failure ALARM SILENCE Standard operating alarms are not silenced when Alarm Silence button is pressed OPR150 D0208 POSSIBLE CAUSE Bleedhole obstructed Dirty inlet filters Alarm reed broken or damaged Condensate in mixer Leaking check valve Ventilator electric power cord accidentally disconnected and the internal battery is non functional Hospital electric circuit failure and the internal battery is non functional The Breeze E150 has switched over to the internal battery for 1 hour Ventilator ON OFF switch is in OFF position Alarm silence button amp is damaged TG 2 REMEDY Remove obstruction Replace filters Replace reed Call factory authorized representative Call factory authorized representative Reinsert plug Ventil

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