Puritan Bennett™ 840 Ventilator User`s Pocket Guide
Contents
1. IBW kg IBW Ib ET Trach I D ET Trach LD mm low mm high 7 10 15 22 4 5 4 5 11 13 23 29 4 5 5 0 14 16 30 35 4 5 5 9 17 18 36 40 4 5 6 0 19 22 41 49 5 0 6 0 23 24 50 53 5 0 6 0 25 27 54 60 5 5 6 5 28 31 61 68 5 5 7 0 32 35 69 77 6 0 7 0 36 78 79 6 0 7 5 37 42 80 93 6 5 7 5 43 49 94 108 6 5 8 0 50 53 109 117 7 0 8 0 54 59 118 130 7 0 8 5 60 131 132 7 0 9 0 61 69 133 152 7 5 9 0 70 153 154 7 5 9 5 71 79 155 174 8 0 9 5 80 100 175 220 8 0 10 0 101 130 221 287 8 5 10 0 131 150 288 330 9 0 10 0 Puritan Bennett 840 Ventilator Pocket Guide 47 VENTILATOR SELF TESTS The Puritan Bennett 840 Ventilator has three self tests to verify microprocessor pneumatic and circuit integrity The tests include Power on self test POST A several second test that automatically checks microprocessor function when you power up the ventilator Short self test SST A short and simple sequence of tests that verify proper ventilator operation SST checks the patient circuit for leaks and measures circuit compliance Extended self test EST A more exhaustive test of ventilator integrity designed to be run by a qualified service technician Running SST Use SST to check the patient circuit for leaks and to calculate circuit compliance and resistance Always rerun SST whenever you change the circuit type or the humidification type or when you install a new or sterilized exhalation filter2. 2 Incorrectly specifying the patient circuit type or humidification type or changing either type after you ve run SST can affect the accuracy of compliance calculation and measured exhaled tidal volume You must rerun SST to change the circuit type You can change the humidification type during ventilation by touching the OTHER SCREENS then the MORE SETTINGS buttons Humidifier Volume allows you to mimimize inaccuracies due to a change in humidifier type 48 Puritan Bennett 840 Ventilator Pocket Guide r Ensure that the patient is not connected to the circuit and that the patient wye is unblocked ra dd Disconnect the ventilator from the patient before running SST Running SST while the ventilator is connected to the patient can injure the patient r Turn the power switch at the front of the ventilator to the ON position You can only run SST immediately after you turn on the ventilator r At the Ventilator Startup screen touch SST then press the TEST button on the side of the ventilator within five seconds Waiting longer than five seconds cancels SST r At the Current SST Setup screen select the patient circuit and humidification type and humidifier volume if applicable then press ACCEPT ro The ventilator automatically starts the test sequence Some tests SST flow sensor Expiratory filter and Circuit resistance require your intervention and will wait indefinitely for your response Otherw
3. this message V The delivered volume of Check patient SPONT Alarm any tube compensated Check for leaks TC breath is equal to or tube type LD greater than the inspired setting tidal volume limit Ventilator transitions to exhalation breath rate from all Check patient High respira breaths is greater than or and settings tory rate equal to the set limit Poss The inspiratory pressure Check patient High internal transducer has measured Obtain alternate ventilator a pressure of at least 100 ventilation pressure cm HO Active only Remove ventilator during volume controlled from use and breaths Ventilator contact service transitions to exhalation Reduced tidal volume likely target pressure of a Check patient tube compensated TC Check for leaks breath equals the D tube type LD limit This limit is equal setting to the setting of P rar Inspiration pressure is limited during this alarm INOPERATIVE BES is installed but not Contact service BATTERY functioning INSPIRATION IBW based inspiratory Check patient TOO LONG time for a spontaneous Check for leaks breath exceeds ventilator set limit Puritan Bennett 840 Ventilator Pocket Guide 33 TABLE 2 Alarm messages continued When you see It means Do this this message LOSS OF The ventilator power Check integrity of POWER switch is on and there is AC power and BPS insufficient power
4. YJO lqruons nb sonpeA Mop pepeuxo pue oJnsso1d sn 2 Jou sem uorepeuxq uone eyxa AA 1 uone eyxa xxx yi juaned ugerped e Sunesur Joprsuoo SY pz 5 MAI sauened oui JI e qeuonsenb are y pue S og ISS uro e uemduroo ur s4s Surqyeo1q 107e U2A JO T gt O s anqea mdur proysery qns xxx sosne 10j juaned ay pue SUHOy ABA Surgyeo1q ay uonoe1ojur Jorepnuaa juaned v xeu isi OG eut eor8o o 1s yd Jo pisno are sju ur mse ur ISAJ S T O H ut 00S gt 9 10 s T O H u 0 5 4 Sueoui 3 peKejdsip 41 e ueisisey 10 359 Tato Aq se gesso 2 5 adueljdwo gt aes no u3YM 17 Puritan Bennett 840 Ventilator Pocket Guide TABLE 1 Inspiratory pause maneuver displays continued s ndur qgeuons nb asay oqe s ny 10j ejep juoned poxojruour pue sur10JoAeA Surule 1q ay 20 s ndur rqeuons nb asay jnoqe s ny 10j ejep juored po1ojruour pue surtoJ AeA Juryjeauq ay APIO O 4q ssod eyep 1ndur o qeuonsonb mo sylns SIU 5 T O H WP OST lt lqeuons nb y os e n eA Sue1 Jo 3no sq eJep jndur ajqeuonsanb Woy Sj nsa1 5141 OH ur Tur OT gt 2 asurs jo MO 444 q JUIWDINSLIU qeuons nO
5. p Keldsip 41 e2ueisisey 10 9 3uei duio3 s nok ueuMw 19 Puritan Bennett 840 Ventilator Pocket Guide The top of the upper screen shows monitored data data outside the normal range flashes Once normal ventilation is in progress ventilator settings are displayed across the top of the lower screen Figure 8 shows how information is displayed on the GUI 12 58 28 112 18 466 685 Upper screen monitored information alarms patient data Lower screen ventilator settings Off screen keys Knob FIGURE 8 Puritan Bennett 840 Ventilator graphic user interface GUI 20 Puritan Bennett 840 Ventilator Pocket Guide ALARM SETTINGS Most alarm settings are initially set based on the patient s IBW You should review all alarm settings ro Touch the ALARM SETUP button lower screen to view the current alarm setup see Figure 9 r gt Touch the alarm you want to change r gt Turn the knob to set the value you want Proposed values are shown in red You can change several alarm settings in a batch change To cancel a highlighted change press CLEAR r Review all settings r Press ACCEPT to apply the new alarm settings Press the ALARM SETUP button to cancel all alarm changes You can touch the ALARM SETUP button at any time during ventilation to show the current limits and monitored value for each alarm If an alarm annunciates the alarm slider on the Alarm Setup sc
6. Do this result is FAILURE One or more Restart SST with a different critical problems patient circuit were detected Touch 7 RESTART SST enters a ventilator then press ACCEPT inoperative state SST from th and cannot be 5 ORE used for normal ventilation until If the failure persists contact a it passes SST qualified service technician Service required 52 Puritan Bennett 840 Ventilator Pocket Guide SAFETY MODES The Puritan Bennett 840 Ventilator offers these safety modes Safety ventilation If you attach a patient before completing setup the ventilator alarms and begins safety ventilation Safety ventilation delivers pressure control PC mandatory breaths with predetermined settings and a high pressure limit of 20 cm H O until the setup is complete Apnea ventilation The ventilator monitors the time from the start of one breath to the start of the next If that time exceeds the operator set apnea interval the ventilator begins apnea ventilation according to operator determined settings Apnea ventilation continues until the patient initiates two consecutive breaths and the exhaled volume is equal to or greater than 5096 of the delivered volume autoreset May also be manually reset by the operator Occlusion status cycling OSC The ventilator checks the patient circuit for severe occlusions during all modes of breathing to protect the patient from excessive airwa
7. LE covipiEN positive results for life The Puritan Bennett 840 Ventilator System is manufactured in accordance with Covidien proprietary information covered by one or more of the following U S Patents and foreign equivalents 4 954 799 5 161 525 5 271 389 5 301 921 5 319 540 5 339 807 5 368 019 and 5 390 666 840 Flow by DualView SandBox SmartAlert and Bi Level are trademarks of Covidien Puritan Bennett The information contained in this manual is the sole property of Covidien and may not be duplicated without permission This manual may be revised or replaced by Covidien at any time and without notice While the information set forth herein is believed to be accurate it is not a substitute for the exercise of professional judgment The ventilator should be operated and serviced only by trained professionals Covidien acknowledges sole responsibility with respect to the ventilator and its use as stated in the limited warranty provided Nothing in this publication shall limit or restrict in any way Covidien the right to revise or otherwise change or modify the equipment including its software described herein without notice In the absence of an express written agreement to the contrary Covidien has no obligation to furnish any such revisions changes or modifications to the owner or user of the equipment including its software described herein Puritan Bennett 840 Ventilator Pocket Guide TABLE OF CONTE
8. Source BPS FIGURE 1 Puritan Bennett 840 Ventilator components Puritan Bennett 840 Ventilator Pocket Guide CONNECTIONS This section tells you how to connect the Puritan Bennett 840 Ventilator to AC power air and oxygen supplies and the patient circuit Power r Plug the ventilator power cord to AC power see Figure 2 The power cord retainer protects against accidental disconnection and must always be in place during operation To avoid electrical shock hazard connect the ventilator power cord into a grounded AC power outlet Power cord Power cord retainer To AC power FIGURE 2 Connecting the ventilator power cord 4 Puritan Bennett 840 Ventilator Pocket Guide Normally the Puritan Bennett 840 Ventilator System is mains powered The mandatory 802 Backup Power Source BPS operates the ventilator when AC power drops below a minimum level The ventilator recharges the BPS during AC power operation NOTE The BPS is designed for short term use only and is not intended as a primary alternative power source The BPS is intended to power the BDU and GUI only In case of AC power loss no power is available for the compressor or humidifier If you turn on the ventilator after it has been unplugged for an extended period the LOW BATTERY alarm may become active If so recharge the BPS by leaving it connected to an operating ventilator for up to eight hours If the LOW BATTERY alarm i
9. eon E 21 Constant during rate change inspiratory time selected 25 Alarm indicators ua yes sags me rh hey 26 Alarm log uci eser ttem merge ene rere 29 Alarm message format 30 Pressure volume loop 38 Bi Level breath timing bar 43 Bi Level with pressure support 45 Inspiratory pause maneuver displays 16 Alarm messages c o ccovecviceesss vere paq heh een 31 Ideal body weight IBW and tube LD 47 Individual test results in SST 50 Overall SST res lts aaa Ee h ns 51 Maintenance summary oss aars etre eren 55 Puritan Bennett 840 Ventilator Pocket Guide INTRODUCTION This pocket guide gives you a quick overview of how to set up and use the Puritan Bennett 840 Ventilator System As you read through this pocket guide this symbol gt asks you to take an action This pocket guide is intended to supplement not replace the Puritan Bennett 840 Ventilator Operator s and Technical Reference Manual which should always be available while using the ventilator Different versions of the Puritan Bennett 840 Ventilator can have minor variations in labeling e g keyboard over lays and off screen alarm status indicators For more detailed information on any of the topics covered in this pocket guide please see the Puritan
10. the or changes in the tidal volume set limit patient s resistance or compliance The patient s exhaled Check patient and Low exhaled spontaneous tidal volume settings spontaneous is less than or equal to the tidal volume set limit Va The minute volume for Check patient and Low exhaled all breaths is less than or settings total minute equal to the set limit volume NO AIR Air supply pressure is Check patient SUPPLY less than the minimum and air source required pressure Obtain alternate for correct ventilator ventilation operation throughout its range of flows Accurate O delivery may be compromised You cannot set or disable the NO AIR SUPPLY alarm Puritan Bennett 840 Ventilator Pocket Guide 35 TABLE 2 Alarm messages continued When you see It means Do this this message NO O Oxygen supply Check patient supply pressure is less than and oxygen source the minimum required Obtain alternate pressure for correct ventilation ventilator operation throughout its range of flows Accurate O delivery may be compromised You cannot set or disable the NO O SUPPLY alarm PROCEDURE Patient attached before Provide alternate ERROR ventilator startup ventilation is complete Safety Complete ventilator ventilation is active startup procedure SEVERE Patient circuit is Check patient OCCLUSION severely occluded Obtain alternate ventilation if necessary Check p
11. the resistance across 275 AUD y your inspiratory and expiratory filters before Na every use after 15 days of continuous use in 7 77 cik policy the exhalation limb or if you suspect excess resistance SST checks the resistance of the expiratory filter Collector vial water traps and drain bag check and empty as needed Air inlet filter bowl if cracked replace bowl If any sign of moisture is visible remove ventilator from use and contact service or maintenance Clean compressor inlet filter 250 hours or more often if required Replace reusable inspiratory and expiratory Annually bacteria filters Sterilize between patients or after 100 and circuit changes or according to autoclave your institution s policy Sterilize before cycles nondestructive disposal Replace oxygen sensor and BPS internal battery Every two pack Must be replaced by a qualified service years or as technician according to instructions in the necessary Every 10 000 hours Puritan Bennett 840 Ventilator Pocket Guide 53 6135 GUNBARREL AVENUE BOULDER CO 80301 800 635 5267 COVIDIEN COVIDIEN with logo Covidien logo and positive results for life are U S and internationally registered trademarks of Covidien AG Other brands are trademarks of a Covidien company 2008 2011 Covidien All rights reserved 11 VE 0259 VE07000 WWW COVIDIEN COM
12. 442 4 pa 881 Sur q ynom Suruye nq 10 door Jet e ul Sulsu puo 9JnjsTOUI 10J xat lqe sun sr JI no ay punore jqrssod Suryjeaaq ay ur Yea e 10 o s nunuo neoje d JI si oq e qeuonsenb gt pue y 1 pu 1 suro qoud s ur Asrou f A SS X SEM ainssaid sned 1o o1e1qrmbo jou prp 58 14 pue 8011 qey Jou sr ne le d Sueoui 3 neojejd oN 444 q peKejdsip 41 e ueisisey 10 2 exueirduio5 s no uauM Puritan Bennett 840 Ventilator Pocket Guide 18 TABLE 1 Inspiratory pause maneuver displays continued jeu n p se z our Apojes oq ues epn v yl puSris p yeyur Suni juer duroo Am 10 2240 ene yi lqeuons nb e ur sypnsar 5141 O H UD 0 gt uone eux jo pua ay ye ainssaid ay pue ne zejd v jo puo v 1e o1nssad JMP IY au JUIWIDINSLIUT qeuons nO AA x 588 puo y Inun uorjeardsur padepap 1uoned ay s m qM oos o 2urn a1nsse1d ou xou suit oq uonepnuaa Tevrrou Suunp p dx jou st sri l qeuons nb pue eurrurur re SAOP pue sournqoA so1nsso1d y jeu sis 3ns STYL wrojaaem Mog renbs oq JO puo ay 1 JMOTS 2sor onsso1d ayy SURBdUI 3 yu ur rnse ur qeuons nO AA q
13. Bennett 840 Ventilator Operator s and Technical Reference Manual Also please see the Puritan Bennett 840 Ventilator Service Manual Puritan Bennett 840 Ventilator Pocket Guide THE PURITAN BENNETT 840 VENTILATOR The Puritan Bennett 840 Ventilator includes a breath deliv ery unit BDU that controls ventilation and a graphic user interface GUI that monitors and displays ventilator and monitored data see Figure 1 The ventilator supplies mandatory pressure or volume controlled or spontaneous breaths inspiratory flows of up to 200 L min with or without pressure support with a preset oxygen concentration Breaths can be pressure or flow triggered using Flow by Touch screens display monitored data separately from venti lator settings for easy assessment of your patient s condition This allows you to preview settings before applying them to your patient and the Alarm System helps you to quickly determine the urgency and root cause of alarm conditions The optional 806 Compressor provides compressed air to the BDU and can be used in place of wall or cylinder air The standard 802 Backup Power Source BPS provides DC power to the BDU and GUI in the event that AC power is lost Puritan Bennett 840 Ventilator mounting options include a cart pole mount or wall mount Puritan Bennett 840 Ventilator Pocket Guide Graphic User Interface GUI Compressor Cart Breath Delivery Unit BDU 802 Backup Power
14. EXP PAUSE key Puritan Bennett 840 Ventilator Pocket Guide 15 TABLE 1 Inspiratory pause maneuver displays sosneo SurAz pun 10 pno juaned ay pue Suryjeaaq ay uon oe19 U1 1olje mu A 1Ju ned ay 2 syru feor3oyorsAqd JO pts no are sjuouroJnseaur s ur OH W TU 005 gt D 10 O H W W 0 359 13410 q se gesso w Ja s ndur qgeuons nb asay jnoqe sanp 10j ejep juaned pue Surqjea1q v APADO e qeuonsenb 310Ja1ay are s nicA 7 pue Y eur uonnjose1 QE JO SUIT IYI MOTAq sr STUL O H UD T 0 gt uone eux pus pue nea ej d puo a1nsso1d ur o uo19grrp AJL Ga A Puritan Bennett 840 Ventilator Pocket Guide Goo o s ndur rqeuons nb asay oqe sonp 10j eyep juaned pue sur10joAeA Surtea1q ay J9YD suit oq juoura1nsvoui JO plous 1u IY Ao q st mop Juaned Ao ay I qeuons nb y UIN ut p noA uorqA uonenb 2 y o sindur ajqeuonsanb o sjurod ert mm T 0 gt Mog juaned 10 OH mamm 0 SUE9UI 3 xxxxxx H peKejdsip 41 e ueisisey 10 2 adueljdwo gt 5 no uauM 16 TABLE 1 Inspiratory pause maneuver displays continued ayer 10je1rdso1 pue urn uorjedidsur u roqs qtrssod Jy TeA1o3ur K1o3eurdxo juarornsur ue
15. NTS Introductions asno Seege 1 The Puritan Bennett 840 Ventlator srnu 2 De edad ee nat sig neta ub ento 4 Power syerske Soon RE 4 Ait and oxygen supplies aasawa oer w qis A s g 6 Patient CIECUIU sss sash Cop bene ee Wi era HN Cede buses ua ODE d 8 Patient Setups isse veo TO Daal dim a eser s Eb PO UR A 12 New patient Setup sss cere v bie A S DP ERR REOR ERR 13 EE TEE 14 Calibrating the oxygen sensor 14 Once patient setup is coniplete i C s 14 Inspiratory patise y yy y a ie echa qe eon decedat 15 Expiratory pause seerne ena en ten nce esce Bh sre ry fst 15 Alarm settings cuis cess even eer DR RER EE one Rer eda 21 Main setting chamnges SA eene rper e eR De ER EEN FUE eae 22 Mode breath type and batch multiple changes 23 Previous setup sss reis as s P sundaes olere edis 23 Humidification type humidifier volume O sensor enable disable and disconnect sensitivity 24 Constant during rate change 25 Alarm handling Ales El eege Met 26 EE 27 Alarm eset a es t re aceite dew a Ya weqaw wawan aq 27 Tarn Gs tassios te a sama ea samay a Maik chee eie 28 Alarm messages 29 cuin PR 37 Display EE 37 0000003500 37 Freezing DR see MX QU ge S RR area 39 Plot set pouasosvene EE 0 39 Once graphics are
16. SCONNECT Autoreset Normal Detection HIGH Alarm log Touch symbols Touch scroll box button to see definition and turn rotary at bottom of encoder to scroll Indicates that screen through log Af FIGURE 12 Alarm log log includes unread entries Alarm messages The upper screen displays the two highest urgency active alarms Alarms are color coded both on the Alarm Setup screen and in the alarm status section on the upper screen Red for high urgency yellow for medium and low urgency An alarm icon flashes on the MORE ALARMS button if there are other active alarms Pressing the icon displays a full screen of up to eight active alarms Each alarm message consists of a base message an analysis message supplementary information that includes any associated alarm conditions and a remedy message that suggests corrective actions see Figure 13 Puritan Bennett 840 Ventilator Pocket Guide 29 The base message The analysis message The remedy identifies the alarm gives the root cause message Touch alarm symbol ofthe alarm May also suggests how to view definition include dependent to resolve on lower screen alarms that have arisen the alarm due to the initial alarm condition Pran 28 55 f 16mm 3075 PEEP 1 955 te 1 28 Circut Type Adut 2 Humidification Type Non heated exp tube 11 33 21 Oct 1999 The tvvo highest priority active alarm messages are displayed here Touch flashi
17. ST and begin normal ventilation until the entire SST has been success Tully completed vvith the circuit to be used attached 50 Puritan Bennett 840 Ventilator Pocket Guide When all of the tests in SST are complete the SST Status screen displays all individual test results and SST outcome Table 5 summarizes overall SST outcomes and how to proceed in each case To begin normal ventilation if SST has not detected an ALERT or FAILURE touch EXIT SST then press ACCEPT The ventilator reruns POST gt The ventilator displays the Ventilator Startup screen Confirm or change the last valid settings TABLE 5 Overall SST results If the test result is It means Do this Passed All tests passed Touch one of these buttons then press ACCEPT EXIT SST To exit SST and begin normal ventilation RESTART SST To repeat SST from the beginning ALERT One or more noncritical problems were detected Follow your institution s protocol for overriding an ALERT Immediate service not required Puritan Bennett 840 Ventilator Pocket Guide Touch one of these buttons then press ACCEPT RESTART SST To repeat SST from the beginning OVERRIDE To override the alert as allowed by your institution s protocol touch EXIT SST Then press ACCEPT to begin normal ventilation 51 TABLE 5 Overall SST results continued If the test It means
18. UIT r Connect the patient circuit to the ventilator see Figure 4 From patient To patient Expiratory filter nspiratory filter Tubing Inspiratory limb of patient circuit FIGURE 4 Connecting the patient circuit 8 Puritan Bennett 840 Ventilator Pocket Guide r gt Figure 5 shows you how to install the expiratory filter and collector vial to the ventilator Attach the expiratory limb of the patient circuit to the filter s expiratory limb connection Pull latch up to install filter pull down to hold filter and collector vial in place housing area Expiratory limb connection FIGURE 5 Installing the expiratory filter and collector vial Puritan Bennett 840 Ventilator Pocket Guide gt Cap the collector vial drain port if you are not using the drain bag see Figure 6 r If you are using the drain bag install clamp on tubing Uncap collector vial drain port and install tubing to collector vial drain port Connect other end of tubing to drain bag If the ventilator is mounted on the cart place the drain bag in the cart drawer see Figure 6 The drain bag is designed to lie flat and is not designed to be suspended Place drain bag in cart drawer Tubing FIGURE 6 Using the collector vial with or without drain bag Puritan Bennett 840 Ventilator Pocket Guide ra 6 aBMBMB M cH s o X X Covidien recom
19. arm silence if active this avoids silencing an alarm condition that arises shortly after pressing ALARM RESET Pressing ALARM RESET clears any high urgency alarm that has autoreset and the steadily lit high urgency alarm indicator turns off ALARM RESET gives you a way to return the ventilator to normal operation if an alarm condition has been resolved without waiting for alarm detection algorithms to reset the alarm Alarm log To view the alarm log touch the ALARM LOG button on the upper screen The alarm log shows alarm events including time and date stamped alarms silences and resets in order of occurrence with the most recent event at the top of the list see Figure 12 The alarm log can store up to 80 of the most recent entries Completing a new patient setup clears the alarm log A question mark in a triangle appears on the ALARM LOG button if the log includes an event that hasn t been viewed yet The question mark in a triangle disappears after you ve viewed the event To scroll through the alarm log move the scroll box up or down and turn the knob to page through the alarm log An icon shows your relative position in the log 28 Puritan Bennett 840 Ventilator Pocket Guide Time Event Urgency Alarm Analysis Normal APNEA Apnea ventilation Breath interval gt apnea MEDIUM APNEA interval Normal IVre sron Detection Low IVre spont 2 of last 4 spont breathe s set limit CIRCUIT DISCONNECT CIRCUIT D
20. atient circuit for crimps blocked filter If problem persists remove ventilator from use and contact service 36 Puritan Bennett 840 Ventilator Pocket Guide GRAPHICS The graphics function displays real time patient data including Pressure time curve Flow time curve Volume time curve Pressure volume loop Display r To display the most recently selected graphics press the GRAPHICS button at the bottom of the upper screen If the pressure volume loop is selected the loop for the next full breath is displayed then updated every other breath The inspiratory area is calculated based on the area inside the loop to the left of the baseline see Figure 14 Curves pressure time flow time and volume time are drawn on the screen at the start of a breath beginning with the last 0 5 second of the previous breath Color Curves and loops are enhanced by color Inspiration is green Expiration is yellow Spontaneous breaths are orange Puritan Bennett 840 Ventilator Pocket Guide 37 15 12 18 November 199 Inspiratory area Pressure volume loop Graphics are automatically displayed when you press the EXP PAUSE or INSP PAUSE key The measured values for intrinsic and total PEEP are displayed at the end of the expiratory pause The measured values for compliance and resistance for VC with a square flow pattern are displayed at the end of an inspiratory pause During both t
21. displayed 40 RE 41 Bi Levelss s aba an i oen dice ERE i 42 Patient EE 42 Constant during rate change al sh NEEN ENEE ae 43 Using pressure support with Bi Level 44 Manual inspiration in Bi Level mode 45 Tube compensation cic s eese es re get te canes ed ben 46 Patient Sep ee M Ca Reb e aeo z 46 Ventilator self tests were exui 48 Running SST y yar drain 48 Safety modes Ped qe qa DUE es 53 Preventive maintenance CRAS 55 iii Puritan Bennett 840 Ventilator Pocket Guide FIGURES Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 TABLES Table 1 Table 2 Table 3 Table 4 Table 5 Table 6 Puritan Bennett 840 Ventilator components 3 Connecting the ventilator power cord 4 Connecting the air and oxygen supplies 6 Connecting the patient circuit 8 Installing the expiratory filter and collector yial asi stage ox een 9 Using the collector vial with or without EE 10 Ventilator startup screen 12 Puritan Bennett 840 Ventilator graphic user interface GUD 20 Alarm
22. ett 840 Ventilator Pocket Guide NOTE Expiratory sensitivity E breaths seng applies to all spontaneous Constant during rate change In Bi Level ventilation as in pressure control you can select one of three timing variables inspiratory time T LE ratio T T ratio and expiratory time T to be held constant when the frequency setting changes r Touch SETUP r Touch CONTINUE The breath timing bar appears in the lower screen see Figure 15 r gt Touch one of the lock icons to select To TT or T as the setting that remains constant when the respiratory rate changes and to determine which timing variable will be present on the timing button ro Review settings and change if necessary then press ACCEPT The value displayed is the one held constant during rate changes and becomes the only setting you can adjust directly FIGURE 15 Bi Level breath timing bar Puritan Bennett 840 Ventilator Pocket Guide 43 NOTE You can change the value of the constant setting at any time but the value does not change as a result of changing the respiratory rate setting Using pressure support with Bi Level Spontaneous breaths in Bi Level mode can be augmented with pressure support according to these rules Pressure support can assist spontaneous breaths at PEEP and PEEP and is always relative to PEEP If P upp PEEP is less than PEFP all spontaneous breaths at PEEP are augmented by the P p
23. from connections the AC supply and the BPS There may not be a visual indicator Obtain alternate for this alarm but an ventilation independent audio alarm sounds for at least 120 seconds LOW AC Mains AC power has Check integrity POWER dropped below 8096 of connection to AC of nominal voltage for power Check AC at least one second power supply Warns that AC power has dropped significantly and that a more severe power drop may be imminent The ventilator turns off the compressor if installed and otherwise operates normally LOW The BPS has less than Replace BPS or allow BATTERY approximately two it to recharge during minutes of operational normal ventilator time remaining operation 34 Puritan Bennett 840 Ventilator Pocket Guide TABLE 2 Alarm messages continued When you see It means Do this this message 1O The O measured Check patient air Low during any phase of a and oxygen supplies delivered breath cycle is 796 1296 oxygen analyzer and O 96 during the first hour of ventilator Calibrate operation or more below oxygen sensor press the O setting for at 100 O CAL 2 least 30 seconds or below min key 1896 These percentages increase by 596 for four minutes following an increase in the O setting T Vie ins The patient s exhaled Check patient Low exhaled mandatory tidal volume Check for leaks mandatory isless than or equal to
24. he expiratory pause and inspiratory pause the most recently selected graphics are displayed and frozen Graphics won t be displayed when The ventilator begins apnea ventilation or safety ventilation However you can choose to redisplay graphics by pressing the graphics button You touch the MORE PATIENT DATA ALARM LOG MORE ALARMS or OTHER SCREENS button Freezing Follow these steps to freeze graphics on the screen gt Touch FREEZE The screen flashes the message FREEZING the UNFREEZE button appears and the scaling buttons disappear Plotting continues until the screen is full r gt Once the screen is filled and frozen the other onscreen scaling buttons reappear You can now redo the plot setup and adjust the scales for the last 48 seconds of frozen data The pressure volume display shows the most recent full breath within the 48 second freeze period r Press UNFREEZE at any time to resume real time graphics display Graphics remain frozen even if you switch to another screen for example MORE ALARMS Plot setup You can choose to display one or two time curves at a time The pressure volume loop uses the entire screen so no other waveform can be displayed at the same time r gt Touch the graphics button at the lower left of the upper screen Graphics appear r Touch PLOT SETUP at the upper left of the screen Touch Plot 1 then turn the knob to select any one of the waveforms If you select p
25. ise you don t need to do anything until a test result is ALERT or FAILURE or SST is complete As each test is performed the SST Status screen shows test results see Table 4 ra dd To ensure reliable SST results DO NOT repeat an individual test with a different patient circuit if the test result is FAILURE or ALERT If you suspect a defective patient circuit restart SST from the beginning with a different patient circuit Puritan Bennett 840 Ventilator Pocket Guide 49 TABLE 4 Individual test results in SST If the test It means Do this result is Passed No problems Nothing unless prompted by found the ventilator ALERT Test results not Touch one of these buttons ideal but not then press ACCEPT 77 SE RESTART SST Repeat SST from the beginning REPEAT Repeat the test NEXT Skip to the next test FAILURE A critical Touch one of these buttons problem has been then press ACCEPT detected and SST RESTART SST cannot complete amt ke Repeat SST from the beginning ventilator passes the failed test REPEAT Repeat the test gt You can touch EXIT SST during SST to halt testing You can touch EXIT SST again to resume testing or press ACCEPT to restart the ventilator if SST has not detected an ALERT or FAILURE WARNING UY VX SV To ensure ventilation that correctly compensates for cir cuit resistance and compliance do not exit S
26. llow Indicates a change in the patient ventilator system FIGURE 11 Alarm indicators NOTE You can always change an alarm setting even when alarms are active You do not need to press ALARM RESET or wait for the alarm to autoreset 26 Puritan Bennett 840 Ventilator Pocket Guide Alarm silence Pressing ALARM SILENCE mutes the alarm sound for two minutes The key s LED lights during the silence period and turns off if the alarm is reset Every time you press ALARM SILENCE the two minute silence period restarts An on screen alarm silence notification appears on the display when alarm silence is active 2 Never leave patient unattended when ALARM SILENCE is activated ALARM RESET will cancel silence Alarm reset Pressing the off screen ALARM RESET key resets the detection algorithms of all active alarms except for these AC POWER LOSS COMPRESSOR INOPERATIVE DEVICE ALERT O SENSOR INOPERATIVE BATTERY LOW AC POWER LOW BATTERY NO AIR SUPPLY NO O SUPPLY PROCEDURE ERROR Pressing ALARM RESET has no effect on patient data If an alarm condition persists the alarm becomes active again according to the detection algorithm for that alarm For example if the APNEA alarm is active ALARM RESET resets the apnea detection algorithm to its initial state and returns the ventilator to normal ventilation Puritan Bennett 840 Ventilator Pocket Guide 27 Pressing ALARM RESET cancels al
27. mends that you use one of the identified patient circuits see the Puritan Bennett 840 Ventilator Operator s and Technical Reference Manual for patient circuit testing specifications Using a circuit with a higher resistance does not prevent ventilation but can cause an SST fault or compromise the patient s ability to breathe through the circuit NOTE To ensure optimum compliance compensation Covidien recommends that you use low compliance patient circuits For pediatric patients the compliance compensation volume limit is four times the set tidal volume in addition to the set tidal volume NOTE To ensure optimum ventilation use pediatric circuits for patients whose ideal body weight IBW is 24 kg 53 lbs or less and adult circuits for patients whose IBW is more than 24 kg Puritan Bennett 840 Ventilator Pocket Guide Once you turn on the ventilator or run SST the ventilator runs POST then displays the Ventilator Startup screen see Figure 7 on the lower screen If TC was used on the previous patient setup a note emphasizing tube type and tube LD appears below the SAME PATIENT button explanation AIC VWC s P TRIG 50kg f V Wl Pons O 16 am 363 m 21 8 2 05 100 PEER SQUARE 3 0 5 Ventilator Startup SAME Ventilate with previous settings shown above NEW Initiate new patient setup SST Perform Short Self Test SST and calibrate circuit Make a selection Ventifator Start
28. n alternate problem ventilation or contact service Puritan Bennett 840 Ventilator Pocket Guide 31 TABLE 2 Alarm messages continued When you see It means Do this this message O SENSOR Background checks O sensor is out of have detected a calibration or has problem with the O failed Press 100 sensor O CAL replace or disable the sensor cuc The measured airway Check patient High circuit pressure is equal to or patient circuit and pressure greater than the set endotracheal tube limit Reduced tidal volume likely 0 The 0 measured Check patient air High delivered during any phase of a and oxygen supplies 0 breath cycle is 7 12 oxygen analyzer during the first hour and ventilator of operation or more above the 0 setting for at least 30 seconds These percentages increase by 5 for four minutes following a decrease in the O 96 setting Va The patient s exhaled Check patient and High exhaled tidal volume for any settings Consider tidal volume breath is equal to or whether the patient s greater than the set compliance or limit resistance has changed Vas The patient s expiratory Check patient High exhaled minute volume is equal and settings total minute to or greater than the volume set limit 32 Puritan Bennett 840 Ventilator Pocket Guide TABLE 2 Alarm messages continued When you see It means Do this
29. ng MORE ALARMS but ton to vievv messages for up to six additional active alarms FIGURE 13 Alarm message format Table 2 lists possible alarm messages ra dd When more than one alarm is active and the alarm messages vary in their degree of seriousness you should assume that the most serious message is applicable 30 Puritan Bennett 840 Ventilator Pocket Guide TABLE 2 Alarm messages When you see this message It means Do this AC The power switch Prepare for power POWER LOSS is ON AC power is loss Obtain alternate not available and the ventilation Check ventilator is being integrity of powered by the backup AC power source power source BPS Contact service if necessary APNEA The set apnea interval Check patient has elapsed without the and settings ventilator patient or operator triggering a breath CIRCUIT There is a Check patient DISCONNECT disconnection in the Reconnect patient patient circuit before circuit Press the patient wye or ALARM RESET patient disconnect is detected following power restoration from an unintentional power loss with the power switch ON COMPRESSOR Compressor cannot Check patient INOPERATIVE maintain sufficient Obtain alternate supply pressure ventilation Remove ventilator from use and contact service DEVICE ALERT A background test Check patient or power on self test If prompted to do so POST has detected a obtai
30. p setting and all spontaneous breaths at PEEP are augmented by 1 5 cmH O f Per PEEP is greater than all spontaneous breaths at PEEP are augmented by the P setting and all spontaneous breaths at PEEP are augmented by P PEEP PEEP SUPP For example if PEEP 5 cm H O and PEEP 15 cmH O and P 15cm H0 SUPP All spontaneous breaths at PEEP are augmented by 15 cmH O of pressure support P upp for a total pressure of 20 cm H O SUPP All spontaneous breaths at PEEP are augmented by 5 cm H O of pressure support P upp PEEP for a total pressure of 20 cm H O see Figure 16 44 Puritan Bennett 840 Ventilator Pocket Guide PS 5 cm H O Actual Peak PS Pressure 20 cm H O T PEEPL 5 cm H O FIGURE 16 Bi Level with pressure support Manual inspiration in Bi Level mode Pressing the MANUAL INSP key during Bi Level mode causes the ventilator to Switch from PEEP to PEEP if pressed during a PEEP phase Switch from PEEP to PEEP if pressed during a PEEP phase Puritan Bennett 840 Ventilator Pocket Guide 5955 7 7 SCH 000 45 TUBE COMPENSATION Tube Compensation T C assists a patient s spontaneous breath by delivering positive pressure proportional to the inspired flow which overcomes the estimated resistance of an artificial airway TC supports all spontaneous breaths for patien
31. r screen gt For each of the current ventilator settings you want to change touch its button then turn the knob to set its value Press CLEAR to cancel a change you ve just made r Once you ve made any changes you want review the settings then press ACCEPT to apply all the new settings at the same time Touch SETUP to cancel all changes Previous setup Once ventilator settings are in effect the PREVIOUS SETUP button appears at the bottom of the lower screen when you press SETUP and allows you to restore the entire previous setup including alarm and apnea settings that was in effect immediately before you made setting changes using the Ventilator Setup screen gt To restore the previous setup touch PREVIOUS SETUP then press ACCEPT Puritan Bennett 840 Ventilator Pocket Guide 23 Humidification type humidifier volume O sensor enable disable and disconnect sensitivity Dsens To view or change gt Touch the OTHER SCREENS button then touch the MORE SETTINGS button gt Touch each setting you want to change you can change multiple settings then turn the knob to set its value To leave settings unchanged touch the OTHER SCREENS button again r Press ACCEPT to apply the new settings 24 Puritan Bennett 840 Ventilator Pocket Guide Constant during rate change If you selected pressure control PC you can select one of three timing variables inspiratory time I E ratio or expirato
32. reen will turn a color indicating the urgency of the alarm state red for high urgency yellow for medium and low urgency e Limin 100 3000 FALL 0 Tune ron V EA Vie MAND Vie SPONT Va SPONT FIGURE 9 Alarm setup Puritan Bennett 840 Ventilator Pocket Guide 21 NOTE The upper limits for the spontaneous exhaled tidal volume and mandatory exhaled tidal volume alarms are always the same Changing the upper limit of one alarm automatically changes the upper limit of the other MAIN SETTING CHANGES Main settings are the buttons displayed at the top of the lower screen and you can only change them individually Follow these steps to change main settings r Touch the setting you want to change gt Turn the knob to the set value r Press ACCEPT to apply the new setting Remember touch turn ACCEPT 22 Puritan Bennett 840 Ventilator Pocket Guide MODE BREATH TYPE AND BATCH MULTIPLE CHANGES r Touch the SETUP button on the lower screen The Current Vent Setup screen appears gt To change ventilation setup mode mandatory breath type spontaneous type or trigger type touch its button then turn the knob to set the value Proposed changes are shown in red Press CLEAR to cancel a change you ve just made r Once you ve made all the changes you want you don t have to make any changes at all touch CONTINUE Appropriate settings for the ventilation setup you ve selected appear on the lowe
33. ressure volume which uses the entire screen Plot 2 disappears gt Touch Plot 2 if applicable Turn the knob to select either of the two remaining waveforms or none If you select none only one enlarged plot with higher resolution appears r Touch CONTINUE to display the graphics you ve selected You don t have to press ACCEPT Puritan Bennett 840 Ventilator Pocket Guide 39 Once graphics are displayed Setting baseline pressure ro To move the baseline on a pressure volume loop touch the lt gt baseline pressure button then use the knob to position the e 0 0 H 0 baseline The default position of the baseline is the PEEP setting If the PEEP setting changes the baseline resets to PEEP Adjusting scales gt To adjust vertical and horizontal scales 40 touch the arrow buttons then turn the knob to select Puritan Bennett 840 Ventilator Pocket Guide THE KEY The key on the GUI displays basic operating information about the Puritan Bennett 840 Ventilator including A few basics information about screens sounds keys and symbols Ventilator alarm and apnea settings New patient setup how to configure the ventilator for a new patient How to view patient data including graphics Graphics setting up viewing and freezing waveforms and loops Alarm handling what to do in case of alarm Short self test SST Service including O sen
34. rmal ventilation begins once a patient is connected Any time before you press ACCEPT you can touch RESTART to restart setting changes Puritan Bennett 840 Ventilator Pocket Guide 13 Apnea settings Although you aren t required to change or confirm apnea settings you should verify that they are appropriate for the patient Apnea settings are automatically determined based on IBW but can be changed r If you selected NEW PATIENT the Current Apnea Settings screen appears at the end of patient setup gt If you selected SAME PATIENT touch the APNEA button at the bottom of the lower screen to view apnea settings ro If you change any apnea settings press ACCEPT to put new settings into effect Calibrating the oxygen sensor Press the 10096 O CAL 2 MIN key This causes the ventilator to deliver 10096 oxygen if available for two minutes and calibrates the oxygen sensor The ventilator s oxygen monitoring feature is always active unless you disable the oxygen sensor see the More Settings screen The oxygen sensor is always enabled when you power up the ventilator Once patient setup is complete Once the settings are accepted you can attach a patient to the ventilator Ventilation only begins when the ventilator senses that a patient is attached If you attach a patient before completing setup the ventilator begins safety ventilation and declares a PROCEDURE ERROR alarm that resets once patient setup is comple
35. ry time to be held constant when the respiratory rate setting changes r gt Touch SETUP gt Touch CONTINUE The breath timing bar appears in the lower screen see Figure 10 ro Touch one of the lock icons to select T EE or T as the setting that remains constant when the rate setting changes r Review settings and change if necessary then press ACCEPT The value displayed is the one held constant during rate changes and becomes the only setting you can adjust directly FIGURE 10 Constant during rate change inspiratory time selected NOTE You can change the value of the constant setting at any time but the value does not change as a result of changing the rate setting Puritan Bennett 840 Ventilator Pocket Guide 25 ALARM HANDLING The SmartAlert Alarm System offers prioritized alarm annunciation that distinguishes primary alarms from secondary dependent alarms that is alarms that arise due to the initial alarm condition and indicates the urgency level of each alarm An alarm log keeps a time and date stamped record of alarms alarm silences and resets in order of occurrence Alarms on the Puritan Bennett 840 Ventilator are classified as high medium or low urgency see Figure 11 High urgency alarm indicator red Immediate attention required to ensure patient safety Medium urgency alarm indicator yellow Prompt attention required Low urgency alarm indicator ye
36. s still active or if the INOPERATIVE BATTERY alarm is active the BPS battery must be replaced by a qualified service technician Puritan Bennett 840 Ventilator Pocket Guide AIR AND OXYGEN SUPPLIES r Connect air and oxygen supplies to the ventilator see Figure 3 The ventilator can use air and oxygen from cylinder or wall supplies Supply pressures must be 35 to 100 psi 241 to 690 kPa Air inlet connector Air inlet filter bowl Oxygen inlet conncer I Air hose from air supply Oxygen hose from oxygen supply FIGURE 3 Connecting the air and oxygen supplies ma OO o Connect only air to the air inlet and only oxygen to the oxygen inlet Do not attempt to switch air and oxygen or connect any other gas 6 Puritan Bennett 840 Ventilator Pocket Guide ra To ensure that a constant gas supply is available to the patient always connect at least two gas sources to the ventilator There are three gas source connections the compressor air inlet and oxygen inlet HZ To prevent damage to the ventilator ensure that the connections to the air and oxygen supplies are clean and unlubricated and that there is no water in the air or oxygen supply gas If you suspect water in the air supply gas use an external wall air water trap to prevent water damage to the ventilator and its components Puritan Bennett 840 Ventilator Pocket Guide 7 PATIENT CIRC
37. sor calibration cleaning periodic maintenance and when to call for help Puritan Bennett 840 Ventilator Pocket Guide 4 BI LEVEL Bi Level is a breath mode in which the patient has the ability to breathe spontaneously at two levels of PEEP Its pressure waveform resembles pressure controlled ventilation but differs in its ability to allow unrestricted spontaneous breathing at both the upper and lower pressure levels Therefore only a minimally necessary degree of ventilatory augmentation needs to be applied Patient setup To select Bi Level ventilation rx Touch the SETUP button on the lower screen r gt Touch the Mode button then turn the knob to select Bi Level NOTE Once you have selected Bi Level the PC mandatory breath type is selected and cannot be changed r Select PS or none as the spontaneous type or TC if this option is active select P or as your trigger type then press CONTINUE r Settings for Bi Level are displayed For each setting you want to change touch its button and turn the knob to set its value NOTE PEEP must always be set at least 5 cm H O greater than PEEP Otherwise the settings for PEEP and PEEP do not affect each other When you have finished changing settings press ACCEPT to put all settings into effect NOTE Rise time 96 determines the rise time to reach the pressure target in pressure support P or transitions from PEEP to PEEP 42 Puritan Benn
38. te Puritan Bennett 840 Ventilator Pocket Guide Inspiratory pause Pressing the INSP PAUSE key causes the ventilator to schedule an automatic pause maneuver as follows see Table 1 At the next scheduled inspiration the inspiratory and expiratory valves close to allow pressure to equilibrate between the patient and the circuit The inspiratory pause continues until a stable pressure is reached or until two seconds elapse whichever comes first The graphics screen will automatically be displayed if it is not already active The trace freezes and the values for compliance and resistance are displayed You can extend the pause beyond two seconds to a maximum of seven seconds by holding down the INSP PAUSE key Expiratory pause Pressing the EXP PAUSE key causes the ventilator to schedule an automatic expiratory pause maneuver as follows Press EXP PAUSE key to schedule automatic expiratory pause maneuver During the next exhalation the inspiratory and expiratory valves close to allow pressure to equilibrate between the circuit and the patient The expiratory pause continues until a stable pressure is reached or two seconds elapse whichever comes first The graphics screen will automatically be displayed if it is not already active The trace freezes and the values for intrinsic auto PEEP and total PEEP are displayed You can extend the pause beyond two seconds to a maximum of 20 seconds by holding down the
39. ts with an ideal body weight gt 7 0 kg 15 4 Ib and for endotracheal tracheostomy tubes with an inside diameter I D of gt 4 5 mm TC can be used within SPONT BI LEVEL or SIMV With the Bi Level option selected TC supports spontaneous breaths at both PEEP levels Patient setup To select TC option 1 Touch the VENT SETUP button on the lower screen 2 Touch the MODE button and turn the knob to select either SPONT BI LEVEL or SIMV all of which allow for TC to be selected as the spontaneous type 3 Touch the SPONTANEOUS TYPE button and turn the knob to select TC 4 Touch the CONTINUE button The settings applicable to the selected mode and for TC appear on the lower screen 5 Touch the on screen button for each setting you wish to change and then turn the knob to set the desired value see Table 3 for tube I D and IBW Proposed changes are highlighted Press the CLEAR key above the knob to cancel any changes you ve just made Flashing arrows indicate TC settings NOTE If you select an I D that does not match the IBW you must touch the OK button to continue The tube type and tube L D indicators flash if TC is a new selection 6 When you have made the settings you want press the ACCEPT key above the knob to apply the new settings or the CLEAR key to cancel the last change 46 Puritan Bennett 840 Ventilator Pocket Guide TABLE 3 Ideal body weight IBW and tube I D
40. ualified service technician must run EST The ventilator must pass EST before normal ventilation can resume SVO The safety valve allows the patient to breathe room air unassisted when the ventilator is in the SVO state The ventilator remains in the SVO state until the condition that caused the SVO state is corrected or if the ventilator declared a ventilator inoperative condition POST verifies that power levels to the ventilator are acceptable and that the major electronics systems are functioning correctly The ventilator enters the SVO state if a hardware or software failure occurs that could compromise safe ventilation both air and oxygen supplies are lost or an occlusion is detected In case of a malfunction that prevents software from opening the safety valve there is also an analog circuit that opens the safety valve if system pressure exceeds 100 to 120 cm H O 54 Puritan Bennett 840 Ventilator Pocket Guide PREVENTIVE MAINTENANCE Table 6 summarizes maintenance intervals and procedures TABLE 6 Maintenance summary Procedure Interval Check patient circuit for water buildup empty Several times Puritan Bennett 840 Ventilator Service Manual Use appropriate preventive maintenance kit preventive maintenance must be performed by a qualified service technician according to instructions in the Puritan Bennett 840 Ventilator Service Manual and clean as necessary a day or as Inspect and check
41. up BEFORE attaching Ventilator startup screen Touch SAME PATIENT then press ACCEPT to continue ventilating with the most recent settings Ventilation does not begin until a patient is connected Touch NEW PATIENT to begin ventilating with new settings NOTE If you are unsure of the meaning of any symbol for ventilator settings alarms or monitored data touch the symbol on the screen its definition will appear at the left bottom corner of the lower screen Figure 8 shows where symbol definitions appear on the GUL New patient setup gt Touch the IBW button then turn the knob to adjust the IBW Many initial settings and setting limits are automatically determined based on the IBW The proposed value is shown in red gt Touch CONTINUE this button does not appear until you touch IBW or touch RESTART to return to the Ventilator Startup screen r At the New Patient Setup screen settings for mode mandatory type for manual inspirations if the selected mode is SPONT spontaneous type if applicable and trigger type appear For any setting you want to change touch its button then turn the knob to select the value When you are finished changing settings touch CONTINUE ro At the New Patient Settings screen more settings appear Touch each setting you want to change then turn the knob to select its value To cancel a highlighted change press CLEAR r Press ACCEPT to put all settings into effect No
42. y pressures If the ventilator detects a severe occlusion it opens the safety valve and enters OSC In OSC the ventilator periodically attempts to deliver a pressure based breath while monitoring for a severe occlusion Normal ventilation resumes once the occlusion is corrected Idle mode disconnect detection Once the ventilator detects a patient circuit disconnect it enters idle mode in which the exhalation valve opens idle flow 5 L min flow at 10096 O if available begins and breath triggering is disabled The ventilator displays the length of time that the patient has been without ventilatory support Once the ventilator confirms that the disconnect has been corrected normal ventilation resumes Puritan Bennett 840 Ventilator Pocket Guide 53 The Puritan Bennett 840 Ventilator is also designed to enter emergency states ventilator inoperative and safety valve open SVO under some circumstances A ventilator inoperative condition always includes the SVO state but an SVO state does not necessarily indicate a ventilator inoperative condition Ventilator inoperative The ventilator declares a ventilator inoperative condition if a hardware failure or critical software error that could compromise safe ventilation occurs In case of a ventilator inoperative condition the ventilator enters the SVO state To correct a ventilator inoperative condition the ventilator must be turned off then powered on again at power on a q
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