CareFusion AVEA User Guide Rev A

Table of contents VELA ventilator model matrix...1-2 Panels...3-8 Circuit assembly...9-12 Primary controls...13-16 Extended Functions...17-19 Operational verification testing...20-25 FiO2 Monitor Calibration...26-27 Ventilation... 28 Breath types...29-35 Ventilation modes...36-42 Apnea Backup ventilation...43-44 Noninvasive ventilation...45-46

Interfaces for NPPV...47-48 Advanced settings...49-55 Digital displays...56-60 Graphics...61-64 Loops screen...65-69 Trends screen...70-71 End-tidal capnography (EtCO2 )...72-78 Notes...79-81

The VELA® ventilator user guide is not intended as a replacement for the operator’s manual. You must become completely familiar with the VELA ventilator operator’s manual before using the VELA ventilator.

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VELA ventilator model matrix Option

VELA

VELA +

VELA Comprehensive

% O2

X

X

X

100% O 2

X

X

X

FiO 2 Monitor

X

X

X

Nebulizer

X

X

X

Inspiratory Hold

X

X

X

Expiratory Hold

X

X

X

Assist/Control

X

X

X

SIMV

X

X

X

CPAP

X

X

X

Pressure Control

X

X

X

Pressure Support

X

X

X

Basic Waveform Graphics

X

X

X

PRVC/Vsync

X

X

NPPV

X

X

Leak Compensation

X

X

Loops

X

1

Option

VELA

VELA +

Trends

X

MIP/NIF EtCO 2

VELA Comprehensive

X Option

Option

Option*

Square Waveform

X

APRV/BiPhasic

X

Assured Volume

X

*Software is activated; hardware to be purchased.

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Panels A

Front panel

B

C

D

J

A. Effort indicator PRESSURE A/C

B. Mode indicator C. Screen indicator

40

380

0

mL Vti

mL Vte

I

D. Alarm status indicator

28 cmH2O Ppeak

ALARM SILENCE

2

4

6

8

10

12

2

4

6

8

10

12

ALARM RESET

2

4

6

8

10

12

FREEZE

INSP HOLD

MANUAL BREATH

EXP HOLD

NEBULIZER

100% O2

-20 80

V (lpm)

40 0 -40 -80

21

500 750 0 -250

% FiO2

MAIN

Paw (cmH2O)

20

5

cmH2O PEEP

E. Power indicator F. Data dial

391

250

Vt (mL)

PANEL LOCK

H G

20

22

1.0

5

5

21

BPM Rate

cmH2O Insp Press

Sec Insp Time

cmH2O PEEP

LPM Flow trig

% %O2

Man Brth Silence ADV LIMITS Vol Min SETTINGS Effort

G. Message window

SETUP

ACCEPT

E

PRINT

DC AC

H. Primary controls

DC STATUS

CANCEL

F

FROM PATIENT TO PATIENT

I. Monitored parameters

PRESSURE RELIEF

J. Membrane buttons

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Rear panel A. Power switch B. Fan and fan filter C. High-pressure oxygen fitting

K

A H B

D. Low-pressure oxygen fitting

L

E. Nurse call system connection

M E

F. Ground terminal G. Future options H. Alarm speaker I. Power cord connector J. Fuses K. Parallel printer port

F

I J

N G

L. Video output port M. MIB port N. CO2 power box connector 4

C D

Membrane buttons and LEDs The VELA ventilator membrane panel differs between the International model and the U.S. model.

O2

ALARM SILENCE

ALARM RESET

FREEZE

INSP HOLD

MANUAL BREATH

EXP HOLD

NEBULIZER

100% O2

PANEL LOCK

ACCEPT

DC AC

VELA ventilator membrane panel (International)

DC STATUS

CANCEL

VELA ventilator membrane panel (United States)

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Membrane button functions Alarm Silence: Pressing this button disables the audible portion of an alarm for 60 seconds (± 1 second) or until the ALARM SILENCE button is pressed again. This button is not functional for a VENT INOP alarm. Alarm Reset: Cancels the visual indicator for alarms that are no longer active.

Freeze: The FREEZE button freezes the current screen and suspends real-time update of data until pressed again. When the screen is frozen, you can scroll through displayed waveforms, trends or loops using the Data Dial to move the cursor on screen. Inspiratory Hold: When the INSP HOLD button is pressed and held, once the preset volume of a volume breath has been delivered, the patient is not allowed to exhale for a maximum of 6 seconds. Expiratory Hold: When the EXP HOLD button is pressed and held, at the start of the next breath interval, the ventilator does not allow the patient to inspire or exhale for a maximum of 6 seconds. Manual Breath: Pressing this button during the expiration phase of a breath delivers a single mandatory breath at current ventilator settings. No breath is delivered if the button is pressed during inspiration.

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Membrane button functions (continued) Synchronized Nebulizer: When an in-line nebulizer is attached and the NEBULIZER button is pressed, the ventilator supplies nebulized gas to the patient at 6 L/min. When nebulization is active, the nebulizer flow is synchronized with the inspiratory phase of each breath and can be adjusted in increments of 1 minute for a maximum of 60 minutes. You may end the nebulization period early by pushing the NEBULIZER button again. Caution: Using the nebulizer may impact patient volumes. During volume control breaths, approximately 50 mL is added to the Tidal Volume for every 0.5 seconds of inspiratory time. If this added volume is undesirable for your patient, adjust the set Tidal Volume appropriately. This added volume also slightly increases the Peak Pressure. Properly set High-Pressure alarms help protect the patient from injury. Backpressure from a nebulizer can reduce nebulizer flow. This backpressure varies depending on the manufacturer and/or brand of nebulizer used. The user should be aware of this and take steps to account for the effect of backpressure. Neither volume nor peak pressure is affected for Pressure Control or Pressure Support breaths. Caution: Use of an external flow meter to power the nebulizer is not recommended.

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Membrane button functions (continued) O2

100% O2: When this button is pressed, the ventilator increases the oxygen concentration delivered to the patient to 100% for 3 minutes. If the 100%O 2 button is pressed again within the three-minute period, the maneuver is cancelled and the ventilator returns to the prior settings for FiO 2. Panel Lock: The PANEL LOCK button disables all front panel controls except MANUAL BREATH, 100 %O 2, ALARM RESET, ALARM SILENCE, and the PANEL LOCK button. Accept: Accepts data entered into a field on the touch-screen. Cancel: Cancels data entered into a field on the touch-screen. The ventilator continues to ventilate at current settings.

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Circuit assembly 1. Carefully seat the rim of the diaphragm on the exhalation valve, and gently press around the rim to ensure it is seated evenly as shown. Use diaphragm #10384 on models 15997, 16257, 16330 and 16186. Use diaphragm #16240 on models 16530, 16531, 16532 and 16600.

2. Line up the fins of the exhalation valve body with the openings in the exhalation valve housing.

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3. Rotate clockwise until it clicks into place.

4. Attach the flow sensor with the flow tubes in an upright position.

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5. To connect the smart connector for the variable orifice flow sensor, pull back the locking sleeve. Push the locking sleeve into the receptacle, and slide it forward to secure. To remove, repeat these steps in reverse order.

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Complete patient circuit assembly. A. Nebulizer output B. Expiratory flow sensor C. Expiratory limb of patient circuit D. Inspiratory limb of patient circuit

A B

C

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D

Primary controls Activating a primary control To activate a primary breath control, touch the touch-screen directly over the control. The control highlights (changes color), indicating it is active. To modify the settings for the highlighted control, turn the data dial below the touch-screen. Turning in a clockwise direction increases the selected value; turning counterclockwise decreases it.

Primary breath controls The primary breath controls are operator set controls, which directly affect the way a breath is delivered to your patient. They are displayed along the bottom of the touch-screen. Only the controls that are active in the currently selected mode of ventilation are displayed. Displayed control

Description

Range

bpm Rate

Breath rate in breaths per minute

2 to 80 bpm

mL Vt

Tidal volume in milliliters

50 to 2,000 mL

cmH 2 O Insp Pres

Inspiratory pressure in centimeters of water pressure

1 to 100 cmH2O

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Primary breath controls (continued) Displayed control

Description

Range

L/min Peak Flow

Peak inspiratory flow in liters per minute

10 to 140 L/min

sec Insp Time

Inspiratory time in seconds

0.30 to 10 sec

sec Insp Pause

Sets an inspiratory pause, which is in effect for each volume breath delivered

Off, 0.1 to 2.0 sec

cmH 2 O PSV

Pressure Support in centimeters of water pressure

Off, 1 to 60 cmH2O

cmH 2 O PEEP

Positive end-expiratory pressure in centimeters of water pressure

0 to 35 cmH2O

L/min Flow Trig

Sets inspiratory flow-trigger point in liters per minute

1 to 10 L/min

% %O 2

Controls the percentage of oxygen in the delivered gas

21% to 100%

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Primary breath controls (continued) Controls associated with breath type and mode Breath type

VOL

VOL

PRES

PRES

PRVC

PRVC

CPAP/

APRV/

NPPV

NPPV/

NPPV/

and mode

A/C

SIMV

A/C

SIMV

A/C

SIMV

PSV

BIPHASIC

A/C

SIMV

CPAP/PS

RATE bpm

X

X

X

X

X

X

X

X

VOLUME mL

X

X

X

X

X

X

X

X

INSP PRES cmH2O

X

X

NPPV INSP PRES cmH2O PEAK FLOW L/min

X

X

INSP TIME sec INSP PAUSE sec PSV cmH2O

X X (not in VSYNC)

X

X

X

X (not in VSYNC) X

X

X

NPPV PSV cmH2O

X

X X

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X

Primary breath controls (continued) Controls associated with breath type and mode (continued) Breath type

VOL

VOL

PRES

PRES

PRVC

PRVC

CPAP/

APRV/

NPPV

NPPV/

NPPV/

and mode

A/C

SIMV

A/C

SIMV

A/C

SIMV

PSV

BIPHASIC

A/C

SIMV

CPAP/PS

PEEP cmH2O

X

X

X

X

X

X

X

X

X

X

X

FLOW TRIG L/min

X

X

X

X

X

X

X

X

X

X

X

% OXYGEN %O 2

X

X

X

X

X

X

X

X

X

X

X

PRES HIGH cmH2O

X

TIME HIGH sec

X

TIME LOW sec

X

PRES LOW cmH2O

X

Apnea (pressure and volume settings)

X

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X

X

Extended Functions The Extended Functions screen in the Patient Screen Select dialog allows access to stored data and customization of the front panel. To access Extended Functions, touch the Screen Indicator in the top-center section of the touch-screen. The Screen Select menu appears. Press Extended Functions.

The Extended Functions menu appears.

Events

Vent Setup

Version Info

Date Time

CO2 Setup

Exit

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Extended Functions (continued) The Extended Functions menu is available from several different screens within the VELA ventilator software screens. Some of the functions accessible from this screen are for use by a trained technician when servicing the VELA ventilator.* Events

Stores data events for service evaluation and troubleshooting*

Transducer test

Allows service testing of transducer function*

Version info

Displays the software version information and the turbine and ventilator serial number

Date/time

Displays total hours of ventilator and turbine operation and the date/time configuration

Vent setup

Allows setting of these functions:

Low Min Vol

Enable or disable an Off setting for the Low Minute Volume alarm

Locks

Enable or disable the front panel lock switch

FiO 2 monitor

Turns the FiO 2 monitor on or off. Disabling results in the inability to perform FiO 2 calibration and the inability to monitor the FiO 2

Altitude units of measure

Toggles between feet and meters for the altitude setting

Altitude setting

Allows setting of altitude for accurate volume measurement

Language buttons

Select the desired language for the front panel

* Denotes function for use by trained service technician.

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