Dräger Medical
Savina 300 Instructions for Use Sw 5.n Edition 5
Instructions for Use
274 Pages
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DRAFT:19. December 2019 15:22
Instructions for use
Savina 300
WARNING To properly use this medical device, read and comply with these instructions for use.
Ventilator Software 5.n
Information about this document
Information about this document
Typographical conventions 1
Consecutive numbers indicate steps of action, with the numbering restarting with "1" for each new sequence of actions.
Bullet points indicate individual actions or different options for action. –
Dashes indicate the listing of data, options, or objects.
A
Letters in illustrations denote elements referred to in the text.
>
The greater-than symbol indicates the navigation path in a dialog window. Bold, italicized text indicates labels on the device and texts that are displayed on the screen.
(A) Letters in parentheses refer to elements in the related illustration.
Illustrations Illustrations of products and screen content in this document may differ from the actual products depending on configuration and design.
Use of terms Dräger uses the term "accessories" not only for accessories in the sense of IEC 60601-1, but also for consumables, removable parts, and attached parts.
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Instructions for use Savina 300 SW 5.n
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Trademarks Trademarks owned by Dräger Trademark Savina®
Trademark used under license
Trademark owner
BIPAP
Respironics
ATC® AutoFlow® LPO® Spirolog® MEDIBUS.X® The following web page provides a list of the countries in which the trademarks are registered: www.draeger.com/trademarks Trademarks owned by third-party manufacturers Trademark
Trademark owner
Dismozon®
BODE Chemie
Korsolex® neodisher MediClean®
Dr. Weigert
acryl-des®
Schülke & Mayr
Mikrozid
®
Perform® Actichlor®
Ecolab USA
Incidin® Oxycide® BruTab 6S® ®
Clorox
Dispatch
Klorsept® Descogen
Brulin Medentech
®
Antiseptica
®
Oxygenon SteriMax®
Aseptix
Cleanisept®
Dr. Schumacher
Instructions for use Savina 300 SW 5.n
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Safety information definitions WARNING A WARNING statement provides important information about a potentially hazardous situation which, if not avoided, could result in death or serious injury. CAUTION A CAUTION statement provides important information about a potentially hazardous situation which, if not avoided, may result in minor or moderate injury to the user or patient or in damage to the medical device or other property. NOTE A NOTE provides additional information intended to avoid inconvenience during operation.
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Instructions for use Savina 300 SW 5.n
Information about this document
User group requirements The term "user group" describes the personnel responsible who have been assigned by the operating organization to perform a particular task on a product.
Duties of the operating organization The operating organization must ensure the following: –
Every user group has the required qualifications (e.g., has undergone specialist training or acquired specialist knowledge through experience).
–
Every user group has been trained to perform the task.
–
Every user group has read and understood the relevant chapters in this document.
Service personnel This user group installs the product and performs the service activities. Service personnel has specialist knowledge in electrical and mechanical engineering and experience in the servicing of medical devices. Where product specific knowledge or tools are required, the service activities must be carried out by specialized service personnel. The specialized service personnel was trained by Dräger for these service activities on this product.
User groups Clinical users This user group operates the product in accordance with the intended use. Users have medical specialist knowledge in the field of ventilation. Users have knowledge of device monitoring and ventilation care. Reprocessing personnel This user group carries out the necessary activities to reprocess the product. Reprocessing personnel has specialist knowledge in the reprocessing of medical devices.
Instructions for use Savina 300 SW 5.n
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Instructions for use Savina 300 SW 5.n
Contents
Contents Information about this document...
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For your safety and that of your patients. . .
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General safety information... 10 Product-specific safety information... 13 Additional information... 16 Application... 17 Intended use... 18 Contraindications... 18 Environments of use... 18 Overview... 19 Savina 300... 20 Trolley... 24 Range of functions... 25 Abbreviations... 27 Symbols... 31 Product labels... 33 Operating concept... 35 Control and display unit... 36 Fixed function keys... 36 Screen... 37 Assembly and preparation... 41 Safety information... 42 Preparing the trolley... 42 Fitting an additional monitor... 50 Preparing the ventilator... 52 Connecting the power supply... 60 Connecting the gas supply... 62 Connecting the nurse call... 63 Using the MEDIBUS or MEDIBUS.X protocol... 65 Removing and fitting the filter cover... 67 Connecting the potential equalization cable . . . 67 Intrahospital transport of the device... 68
Instructions for use Savina 300 SW 5.n
Getting started...
69
Safety information... Switching on the ventilator... Selecting the breathing circuit and the humidification type... Checking the operational readiness... Selecting the therapy type and the application mode... Selecting the start settings for ventilation... Starting the therapy...
70 70
Operation...
72 73 79 80 82 83
Ventilation settings... 84 Adjusting the ventilation settings... 86 Non-invasive ventilation (NIV)... 89 Suction maneuver with oxygenation... 90 Medication nebulization... 92 Manual inspiration – Inspiration hold... 95 Special maneuvers... 96 O2 therapy... 97 Day/Night screen switch-over... 99 Key lock... 99 Low Pressure Oxygen (LPO)... 100 Transporting patients... 103 Interrupting the therapy – standby mode... 104 Ending operation... 105 Storing the device... 106 Alarms... 107 Display of alarms... 108 Alarm silence... 110 Dismissing alarm messages... 110 Setting the alarm limits... 111 Trends and data... 113 Opening the dialog window... 114 Displaying measured values and set values . . 114 Displaying trends... 115 Displaying the logbook... 117 Displaying waveforms and measured values on the main screen... 118
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Contents
Monitoring... 121 Information on monitoring... 122 Flow monitoring... 122 FiO2 monitoring... 124 CO2 monitoring... 126 Configuration... 133 Information on configuration... 134 Configuring the ventilation functions... 134 Configuring the start settings... 135 Configuring the device settings... 141 Configuring country-specific settings... 142 Configuring the data interface... 143 Enabling software options... 143 Scanning the QR code... 144 Troubleshooting... 145 Failure of the power supply... 146 Failure of the gas supply... 146 High ambient temperature... 146 Alarm – Cause – Remedy... 147 Reprocessing... 171 Safety information... 172 Information on reprocessing... 173 Classifications for reprocessing... 174 Before reprocessing... 174 Validated reprocessing procedures... 178 Other agents and reprocessing procedures . . . 181 After reprocessing... 184 Service... 185 Safety information... 186 Definition of service terminology... 187 Inspection... 187 Maintenance... 189 Repair... 190 Replacing the microfilter... 190 Replacing the dust filter set... 191 Replacing the O2 sensors... 192 Replacing the diaphragm of the reusable expiratory valve... 192
Disposing of the O2 sensors... 195 Disposing of the device... 195 Technical data... 197 Ambient conditions... 198 Set values... 198 Performance characteristics... 201 Displayed measured values... 203 Monitoring... 208 Operating data... 210 Alarm system of Savina 300... 216 Automatic alarm limits... 217 Device combinations... 218 EMC declaration... 219 Connections to IT networks... 221 Open-source software... 222 Principles of operation... 223 Ventilation modes... 224 Additional settings... 236 Therapy types and application modes... 244 Special maneuvers... 245 Low Pressure Oxygen (LPO)... 246 Automatic leakage compensation... 248 Measurements... 250 Pneumatic functional description... 251 Overview of the menu structure... 254 References... 258 Index... 259 Labels for options... 263 User password for Savina 300 SW 5.n... 271 Information on the user password... 271
Disposal... 193 Safety information... 194 Disposing of the packaging material... 194 Disposing of the batteries... 194 8
Instructions for use Savina 300 SW 5.n
For your safety and that of your patients
For your safety and that of your patients General safety information... 10 Strictly follow these instructions for use... 10 Service... 10 Accessories... 10 Not for use in areas of explosion hazard... 10 Connected devices... 10 Patient safety... 11 Patient monitoring... 11 Electromagnetic compatibility (EMC)... 11 Disposable products... 12 Sterile-packaged accessories... 12 Installing accessories... 12 Storing the instructions for use... 12 Product-specific safety information... 13 Functional safety... 15 Monitoring ventilation... 15 Backup ventilation with an independent manual ventilation device... 15 Additional information... 16 Training... 16 Mandatory reporting of adverse events... 16
Instructions for use Savina 300 SW 5.n
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For your safety and that of your patients
General safety information The following WARNING and CAUTION statements apply to general operation of the medical device. WARNING and CAUTION statements specific to subsystems or particular features of the medical device appear in the respective sections of these instructions for use or in the instructions for use of another product being used with this medical device.
Strictly follow these instructions for use WARNING Risk of incorrect operation and of incorrect use Any use of the medical device requires full understanding and strict observation of all sections of these instructions for use. The medical device must only be used for the purpose specified under "Intended use" on page 18 and in conjunction with appropriate patient monitoring (see page 11). Strictly observe all WARNING and CAUTION statements throughout these instructions for use and all statements on medical device labels. Failure to observe these safety information statements constitutes a use of the medical device that is inconsistent with its intended use.
Service WARNING Risk if service is not performed regularly If service is not performed regularly, malfunctions may occur, which can result in personal injury and property damage.
Accessories WARNING Risk due to incompatible accessories The use of incompatible accessories may adversely affect the functional integrity of the product. Personal injury and property damage may occur as a consequence. Use only compatible accessories. The accessories that are compatible with this product are listed in the list of accessories supplied with the product.
Not for use in areas of explosion hazard WARNING Risk of fire The medical device is not approved for use in areas where combustible or explosive gas mixtures are likely to occur.
Connected devices WARNING Risk of electric shock and of device malfunction Electrical connections to equipment not listed in these instructions for use or these assembly instructions must only be made when approved by each respective manufacturer. Before operating the medical device, strictly comply with the instructions for use of all connected devices or device combinations.
Perform the service in accordance with the chapter "Service". 10
Instructions for use Savina 300 SW 5.n
For your safety and that of your patients
Patient safety
Electromagnetic compatibility (EMC)
The design of the medical device, the accompanying documentation, and the labeling on the medical device are based on the assumption that the purchase and the use of the medical device are restricted to persons familiar with the most important inherent characteristics of the medical device.
Medical electrical equipment is subject to special precautionary measures concerning electromagnetic compatibility. During installation and before initial operation, follow the information in section: "EMC declaration" (page 219).
Instructions and WARNING and CAUTION statements are therefore largely limited to the specifics of the Dräger medical device. The instructions for use do not contain any information on the following points: –
Risks that are obvious to users
–
Consequences of obvious improper use of the medical device
–
Potentially negative effects on patients with different underlying diseases
Medical device modification or misuse can be dangerous. CAUTION Risk of patient injury Do not make therapeutic decisions based solely on individual measured values and monitoring parameters.
Patient monitoring
This device can be affected by other electrical devices. WARNING Risk due to electrostatic discharge Malfunctions that endanger the patient may occur if no protective measures against electrostatic discharge are employed in the following situations: – When touching the pins of connectors that carry the ESD warning symbol. – When establishing connections with these connectors. To prevent malfunctions, observe the following measures and train the relevant personnel: – Observe the ESD protective measures. Such measures may include wearing antistatic clothing and shoes, touching a potential equalization pin before and while making the connection, or using electrically insulating and antistatic gloves. – Observe the requirements for the electromagnetic environment. Observe the following section: "Electromagnetic environment" (page 219).
The user of the medical device is responsible for choosing a suitable patient monitoring system that provides appropriate information on medical device performance and patient condition. Patient safety can be achieved by a wide variety of means ranging from electronic surveillance of medical device performance and patient condition to direct observation of clinical signs. The responsibility for selecting the best level of patient monitoring lies solely with the user of the medical device.
Instructions for use Savina 300 SW 5.n
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For your safety and that of your patients
WARNING Risk due to electromagnetic disturbance Wireless communication devices (e.g., cellular phones) and medical electrical equipment (e.g., defibrillators, electrosurgical devices) emit electromagnetic radiation. When such devices are operated too close to this device or its cables, the functional integrity of this device may be compromised by electromagnetic disturbances. As a result, the patient could be put at risk. Maintain a distance of at least 0.3 m (1.0 ft) between this device and wireless communication devices, to ensure that the essential performance of this device is fulfilled. Maintain an adequate distance between this device and other medical electrical equipment.
Installing accessories CAUTION Risk of device failure Install accessories to the basic device in accordance with the instructions for use of the basic device. Make sure that there is a safe connection to the basic device. Strictly observe instructions for use and assembly instructions.
Storing the instructions for use CAUTION Risk of incorrect use Instructions for use must be kept accessible to the user.
Disposable products WARNING Risk of patient injury due to failure of accessories Disposable products are developed, tested and manufactured for disposable use only. Reuse, reprocessing, or sterilization can lead to a failure of accessories and cause injury to the patient. Do not reuse, reprocess, or sterilize disposable products.
Sterile-packaged accessories CAUTION Risk of medical device failure and of patient injury Do not use sterile-packaged accessories if the packaging has been opened, is damaged, or if there are other signs of non-sterility.
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Instructions for use Savina 300 SW 5.n
For your safety and that of your patients
Product-specific safety information WARNING Risk of incorrect use
WARNING Risk of patient injury
This medical device is only intended to be used by the user group "users".
Penetrating liquid may cause malfunction of the device, which may endanger the patient.
WARNING Risk of not hearing alarm signals
Do not place any containers with liquid on or above the device. During surface disinfection, make sure no liquids penetrate into the device.
If the alarm volume is too low, alarm signals may not be heard. – Set the alarm volume loud enough so that the alarm signals can be heard in the environment where the device is located. – The user must remain within hearing distance of the alarm signals. WARNING Risk due to modifications Modifications to the product may lead to malfunctions and unforeseen risks. This may result in injury to the patient or the user or in property damage. Do not modify this product. WARNING Risk of electric shock If the connectors of the interfaces and the patient are touched simultaneously, there is a risk of electric shock. Do not simultaneously touch the connectors of the interfaces and the patient.
Instructions for use Savina 300 SW 5.n
WARNING Risk of fire The flow sensor can ignite medications or other substances based on highly flammable substances. – Do not nebulize medications or other substances that are easily flammable or spray them into the device. – Do not use substances containing alcohol. – Do not allow flammable or explosive substances to enter the breathing system or the breathing circuit. WARNING Risk of failure of flow measurement Deposits that were not removed during reprocessing can damage the measuring wires in the flow sensor or cause a fire. – Before inserting the flow sensor check for visible damage, soiling, and particles. Repeat this check regularly. – Replace flow sensors when damaged, soiled, or not particle-free.
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For your safety and that of your patients
WARNING Risk of fire
WARNING Risk of fire
When using O2 pressure reducers that are not approved, excess pressure can cause a fire.
Due to oxygen enrichment in the ambient air and overheating, the medical device can ignite.
When supplying the ventilator with oxygen from a compressed gas cylinder, only use pressure reducers that comply with ISO 10524. Open pressure reducers slowly by hand. Do not use tools. WARNING Risk of fire Do not use the medical device in conjunction with flammable gases or flammable solutions that can mix with air, oxygen, nitrous oxide, or other sources of ignition since the medical device could ignite. Do not allow the medical device to come into contact with sources of ignition.
A distance of at least 10 cm (3.9 in) must be maintained between the rear of the medical device and walls or large-scale obstacles. Do not cover the rear during operation or standby mode so that air circulation is ensured. Only use the medical device in adequately ventilated rooms. CAUTION Risk of unnoticed change in the inspiratory O2 concentration If an additional flow (e.g., NO, nitrous oxide) is delivered from an external flow source, the actual O2 concentration may deviate from the displayed values.
WARNING Risk of patient injury
If required, use additional monitoring, e.g., external SpO2 monitoring.
Magnetic resonance imaging (MRI, NMR, NMI) may impair correct functioning of the medical device.
CAUTION Risk of overheating of the medical device
Do not use the medical device during magnetic resonance imaging.
Sources of heat such as direct sunlight, heat radiators or spotlights may cause the medical device to overheat.
WARNING Risk of patient injury
Keep sources of heat away from the medical device. Only use the medical device in adequately ventilated rooms.
Hyperbaric chambers may impair correct functioning of the medical device. Do not use the medical device in hyperbaric chambers. WARNING Risk of electric shock
CAUTION Risk of patient injury Positive-pressure ventilation can lead to negative effects, such as barotrauma or strain on the circulatory system. Monitor the patient's condition.
There are live components under the housing cover. Do not remove the cover. 14
Instructions for use Savina 300 SW 5.n
For your safety and that of your patients
CAUTION Risk of malfunction The touch screen has a sensitive surface. Damage to the surface results in malfunctions of the touch-sensitive controls. Never use sharp objects to operate the screen. Do not damage the surface of the screen during cleaning or transport. CAUTION Risk of electric shock
Monitoring ventilation The following parameters are monitored by the integrated monitoring: – Airway pressure – Expiratory minute volume – Respiratory rate – Apnea – Inspiratory O2 concentration – Inspiratory breathing gas temperature – Inspiratory tidal volume – End-expiratory CO2 concentration
If a faulty device without safety extra-low voltage (SELV) is connected to the medical device, there is a risk of electric shock when the housing is touched.
Changes in these parameters may be caused by: – Acute changes in the patient's condition – Incorrect settings and faulty handling – Device malfunctions – Failure of power and gas supplies
Only connect devices with safety extra-low voltage (SELV) to the connections for the serial port and the nurse call.
If the built-in monitoring fails, use substitute monitoring. During O2 therapy, the monitoring functions of the medical device are limited.
Functional safety The essential performance consists in a controlled and monitored patient ventilation with user-defined settings for the monitoring functions – minimum ventilation flow, – maximum airway pressure, – minimum and maximum O2 concentration in the breathing gas, or, if a set limit is exceeded, an appropriate alarm. The integrated monitoring also generates an alarm in the following situations: – Failure of the external power supply – Discharge of the internal battery – Failure of the O2 supply (HPO mode)
Backup ventilation with an independent manual ventilation device WARNING Risk of patient injury If a fault is evident at the medical device, its life-support functions may be affected. Ventilation of the patient using an independent ventilation device must be started without delay, if necessary with PEEP and/or an increased inspiratory O2 concentration (e.g., with the manual resuscitator MR-100).
The medical device is equipped with basic safety features to reduce the possibility of patient injury while the cause of an alarm is remedied.
Instructions for use Savina 300 SW 5.n
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For your safety and that of your patients
Additional information
Training Training for users is available from the Dräger organization responsible, see www.draeger.com.
Mandatory reporting of adverse events Serious adverse events with this product must be reported to Dräger and the responsible authorities.
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Instructions for use Savina 300 SW 5.n
Application
Application Intended use... 18 Contraindications... 18 Environments of use... 18
Instructions for use Savina 300 SW 5.n
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Application
Intended use Savina 300 is a ventilator intended for the ventilation of adults and pediatric patients. Savina 300 offers mandatory ventilation modes, ventilation modes supporting spontaneous breathing, and airway monitoring.
Contraindications When using small minute volumes, it takes longer for a modified oxygen concentration to reach the patient. For the ventilation of neonates, the use of special neonatal ventilators is therefore recommended.
Environments of use Savina 300 is intended for the following environments of use: –
In intensive care wards, in recovery rooms and generally for hospital use
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During the transfer of patients within the hospital
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Instructions for use Savina 300 SW 5.n
Overview
Overview Savina 300... 20 Ventilator with trolley... 20 Control and display unit... 20 Patient connection panel... 22 Rear... 23 Trolley... 24 Range of functions... 25 Therapy types... 25 Ventilation functions... 25 Monitoring functions... 25 Displays on the screen... 26 Additional functions... 26 Power supply... 26 Gas supply... 26 Data transfer... 26 Medication nebulization... 26 Transport of patients... 26 Abbreviations... 27 Symbols... 31 Product labels... 33
Instructions for use Savina 300 SW 5.n
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Overview
Savina 300
Ventilator with trolley
Control and display unit
A A
D
D
A Touch screen B Fixed function keys C Rotary knob
001
D Power supply display
A Control and display unit B Patient connection panel C Dräger Savina 300 trolley D Dräger Savina 300 compact trolley
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Instructions for use Savina 300 SW 5.n
003
C
B C
B