Aestiva Quick Reference Guide sw rev 3.X Dec 1999

For step-by-step instructions, refer to the Operation and Maintenance Manual. Do not use this system unless you have read each component’s Operation and Maintenance Manual. w WARNING

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Before you use the system • Complete all of the preoperative tests. • Test all other system components.

Step-by-Step Guide 1.

Make sure the breathing circuit is correctly assembled. On

2.

Set the system switch to on ( m ) to permit gas flow and to turn on the monitoring.

3.

Do the preoperative checkout. Refer to the preoperative checklist.

4.

Set the ventilation mode and controls. • Volume control mode supplies a set tidal volume. • Pressure control mode supplies a set pressure during inspiration.

Pmean

Pmax

PEEP

Pinsp

Pmax

PEEP

5.

Set the alarm limits.

6.

To start mechanical ventilation, set the Bag/Vent switch to Vent - r. • Use the volume alarm key to prevent false alarms during manual ventilation.

7.

To stop mechanical ventilation, set the or select the Bag/Vent switch to Bag auxiliary gas outlet.

R

• Use the end case key at the end of a case to prevent volume and apnea alarms and to set the pressure limit and PEEP to default values (40 cm H2O; 0 cm H2O). Mechanical ventilation must be off. Push end case. Push the knob to save.

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Checklist IMPORTANT!

Refer to the preoperative checklist: • Every day before the first patient. • Every time a different clinician uses the system.

Before Every Patient ∫

Look for damage, necessary drugs and equipment, correct breathing circuit setup, and hazardous conditions.

∫

Check vaporizer installation: • Make sure the top of each vaporizer is horizontal (not on crooked). • Make sure each vaporizer is locked and cannot be removed. • Make sure the alarms and indicators operate correctly (Tec 6 vaporizer). • Make sure you cannot turn on more than one vaporizer at the same time.

∫

Do the breathing system tests: • Make sure the one way valves and auxiliary equipment (humidifier, etc.) operate correctly. • With a circle breathing-circuit module, push the drain button for >10 sec to remove condensate. • Ventilator circuit leak test. • Bag/Manual circuit leak test. • Bag/Manual circuit APL valve test. • Circuit leak test.

∫

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Set the appropriate controls and alarm limits for the case.

Control Basics Menu 1.

Push the menu key to see the main menu.

2.

Turn the knob to select an option (highlight).

3.

Push the knob to show the next screen. • During a calibration or other procedure, the screen shows the instructions.

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Main Menu Ventilation Mode Alarm Settings Setup/Calibration Datex-Ohmeda RG Screen and Audio Normal Operation Exit to Waveform Display

Main Menu Ventilation Mode Alarm Settings Setup/Calibration Screen and Audio Normal Operation Exit to Waveform Display

3 Setup/Calibration Inspiratory Pause 25% Tl Heliox Mode Off Start O2 Sensor Cal About Ventilator... Go to Main Menu

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Control Basics Menu Map Main Menu Ventilation Mode Volume Control Alarm Settings Pressure Control Setup/Calibration Datex-Ohmeda RGM Screen and Audio Normal Operation Exit to Waveform Display

Main Menu Ventilation Mode Alarm Settings Setup/Calibration Datex-Ohmeda RGM Screen and Audio Normal Operation Exit to Waveform Display

Screen and Audio Display Brightness 9 Alarm Loudness 4 Alarm Limits Show Units of Measure Show Audi AboutTorr™ Ventilator... Off

Setup/Calibration Inspiratory Pause 25% Tl Heliox Mode Off O2 Sensor Cal Start About Ventilator...

Go to Main Menu

Go to Main Menu

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Control Basics Selection Keys The bottom of the screen shows control settings. To change a setting: 1.

Push the selection key below the setting.

Mode

Key

2.

Turn the knob to change the setting.

Knob

3.

Push the knob or the key to save the change.

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Ventilation Mode Set the mode: text above the waveform shows the ventilation mode. Volume control: supplies a set tidal volume. Pressure control: supplies a set pressure during ventilation. 1.

Push the menu key.

2.

Turn, then push the knob to select Ventilation Mode Mode.

3.

Turn, then push the knob to change the mode. You must push the knob to save the change.

1

2

3

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Main Menu Ventilation Mode Alarm Settings Setup/Calibration Datex-Ohmeda RG Screen and Audio Normal Operation Exit to Waveform Display

Main Menu Ventilation Mode Volume Control Alarm Settings Pressure Control Setup/Calibration Datex-Ohmeda RGM Screen and Audio Normal Operation Exit to Waveform Display

Start/Stop Mechanical Ventilation To Start w WARNING

Make sure the patient circuit is correctly assembled and the control settings are correct before you start or stop ventilation.

Mechanical ventilation is off when you first turn on the system.

1.

Make sure the control settings are correct.

2.

Turn off the auxiliary common gas outlet (some models).

3.

Set the Bag/Vent switch back to Vent - r. • If mechanical ventilation is not available, a message tells you what to do.

To Stop Make sure the patient circuit is correctly assembled and the control settings are correct before you start or stop ventilation.

MI

N

Make sure control settings are correct. 30

1.

70

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2.

Set the Bag/Vent switch to Bag -

Aestiva™ Quick Reference Guide

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Alarm Settings O2 and volume alarms: high and low volume and high O2 alarms can be turned off. The low O2 alarm cannot be set to less than 18%. Circuit leak audio: to prevent alarms from a known leak (e.g. an uncuffed tube), set the audio to off. Cardiac Bypass: set Cardiac Bypass to “in progress” to prevent volume and Apnea alarms when the patient is on cardio-pulmonary bypass. When Cardiac Bypass is in progress, the display shows Cardiac Bypass and Apnea Alarm Off Off. Note: mechanical ventilation must be off. 1.

Push the menu key.

2.

Turn, then push the knob to select Alarm Settings Settings.

3.

Turn, then push the knob to select an alarm limit.

4.

Turn, then push the knob to change the limit. You must push the knob to save the change.

1 Main Menu Ventilation Mode Alarm Settings Setup/Calibration Datex-Ohmeda RG Screen and Audio Normal Operation Exit to Waveform Display

2

Main Menu Ventilation Mode Alarm Settings Setup/Calibration Screen and Audio Normal Operation Exit to Waveform Display

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4 10

20

Alarm Settings 5.

The pressure limit alarm uses a selection key.

Pressure Limit

Key

Turn the Volume Alarms On or Off w WARNING

Do not turn off volume alarms with a spontaneously breathing patient. The system will not alarm for low volume.

The volume alarm key (VE/VTE) turns volume alarms on and off. When the alarms are off, the alarm limits are hidden. Use this control to prevent false alarms if you switch to manual ventilation at lower tidal volumes.

Vol Alarms On

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Troubleshooting

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w WARNING

Do not use malfunctioning equipment. Contact Datex-Ohmeda for service. Refer to the Operation Manual - Cleaning, Setup, Maintenance, and Troubleshooting for more information.

Message

Cause

Action/Concern

12 Hour Test

System in use for more than 12 hours without a power-up self test.

The system continues to operate. To do the test, move the system switch from standby to on.

Check Flow Sensors

No flow or negative flow during inspiration. Negative flow during expiration.

Are flow sensors correctly installed? Are the connectors reversed? Inspect check valves.

Low Paw

Paw does not rise at least 4 cm from the lowest pressure measured during the last 20 seconds.

Are circuit connections OK? Look at the Paw gauge on the absorber. Look for circuit disconnection.

Minimum System Failure

A severe malfunction prevents mechanical ventilation and monitoring. Other alarms may also occur.

Ventilate manually. Use a stand-alone monitor. Cycle system power (on-standby-on). If the alarm clears, restart mechanical ventilation.

Patient Circuit Leak

Exhaled volume < 50% of inspired volume for at least 30 sec.

Check breathing circuit and flow sensor connections. With an uncuffed tube or known leak, set circuit leak audio to off (alarm limits).

Unable to Drive Bellows

The drive pressure to the bellows housing > Paw.

Fill the bellows if empty. Check the patient connection.

Volume Apnea

No measured breath in last 30 seconds.

Check patient. Bag as needed. Look for disconnects. If the patient is on cardio-pulmonary bypass, select Cardiac bypass on the alarm menu.

VT compensation off

The system supplies the set breath but cannot adjust ventilation for compliance and resistance loses, etc.

Adjust VT manually and continue without compensation or change to the pressure control mode.

VT not achieved

The tidal volume measured by the inspiratory flow sensor < set value.

Adjust controls to supply adequate tidal volume.

Troubleshooting Leaks 1.

Are absorber canisters correctly installed?

2.

Is auxiliary outlet off?

Off

3.

Calibrate/replace flow sensors.

4.

Do circuit leak tests • Bag circuit • Ventilator circuit.

Aestiva™ Quick Reference Guide

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Auxiliary Outlet Switch (Option) This switch sends gas to the selected outlet when the system has an auxiliary common gas outlet. Ventilation and volume monitoring turns off when the auxiliary outlet is selected.

Gas to Breathing Circuit

Gas to Auxiliary Outlet

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Bag Arm Adjustment Only the long arm can be adjusted (option). 1.

Push in and turn.

2.

Release the arm. It stays in position.

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© 1999 Datex-Ohmeda, Inc. All rights reserved Subject to change without notice Printed in USA 12 99 1006 0400 000 C