MedGraphics
PLATINUM ELITE Operator Manual Rev A
Operator Manual
108 Pages
Preview
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The Medical Graphics Corporation Platinum Elite Breeze Suite Pulmonary Operator Training Manual is Part No. 142186-001 Rev. A. CAUTION: Federal law restricts this device for sale by or per order of a physician. MedGraphics® is a registered trademark of Medical Graphics Corporation. BREEZE™, BREEZESUITE™, Platinum Elite Series™, BreathPath™, and preVent™ are trademarks of Medical Graphics Corporation. Medical Graphics Corporation makes no claim for use of the product other than for those uses specified herein and disclaims any liability resulting from other uses. Observe all warnings and cautions. Copyright © Medical Graphics Corporation 2008.
All rights reserved. Unauthorized use, copying, or distribution is prohibited. Medical Graphics Corporation 350 Oak Grove Parkway St. Paul, Minnesota 55127 (651) 484-4874 (800) 950-5597 (651) 484-8941 (Fax) www,medgraphics.com
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Table of Contents Chapter I
9
SYSTEM OVERVIEW
9
1-1
The Platinum Elite System
10
1-2
Power-up/Warm-up Power-up Sequence Warm-up Power-down Sequence
10 10 10 11
1-3
Gas Pressures
11
1-4
Gases Concentrations
11
1-5
Head Assembly
12
1-6
Panels Platinum Elite – Left Panel – Gas Connections Platinum Elite – Left Panel – Adjustment Knobs
12
1-7
preVent Flow Sensor Flow Sensor/Umbilical Assembly
14 14
1-8
Testing Components Flow Sensor Barrier Filter Breath Path Patient Circuit Patient Mouthpiece Noseclips Umbilical Cable N2 Calibration Port Flow Sensor Testing Circuit Assembly with Barrier Filter
15 15 15 15 15 16 16 16 17
13
Chapter II
19
STARTING A TEST
19
2-1
Flow sensor Calibration
20
2-2
Plethysmography Calibration
22
2-3
MIP/MEP Calibration
23
2-4
Calibration Report
23
2-5
Patient Information
24
2-6
Opening an Existing Patient
26
2-7
Searching the Database
26
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Chapter III
27
TESTING
27
3-1
Slow Vital Capacity (SVC) Testing Key Terms & Definitions Physiology SVC Requirements Performing a SVC Test
28 28 29 29 30
3-2
Forced Vital Capacity (FVC) Testing Key Terms & Definitions FVC Test Requirements Flow Volume Loop Curves Performing a FVC Test
32 32 33 34 35
3-3
Maximal Voluntary Ventilation (MVV) Testing Physiology Key Terms Performing a MVV Test
38 38 38 39
3-4
Lung Diffusion (DLCO) Testing Physiology Key Terms & Definitions Gas Chromatography (GC) Test Setup/Considerations Performing a DLco Test Interpretation Collection Protocols & Discard Volumes
41 41 41 42 43 44 46 46
3-5
Functional Residual Capacity (FRC) Testing Physiology FRC Technique Washout Shape Irregularities Due to a Leak Acceptable Repeatable Maneuvers Performing a FRC Test
47 47 47 48 48 49
3-6
Single Breath Nitrogen (SBN2) Key Terms & Definitions Physiology Testing Tips Performing a SBN2 Test
50 50 51 51 52
3-7
Plethysmography Testing Airways Resistance Thoracic Gas Volume Physiology Testing Tips Performing a Combined Test Review Reporting Improper Patient Maneuvers Angle Adjustments
54 54 56 57 57 58 60 60 60 61
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3-8
Maximum Inspiratory Pressure (MIP/MEP) Testing Key Terms Performing a MIP/MEP Test
62 62 63
3-9
Bronchial Provocation (BRP) Testing
65
Protocol Selection
66
Conducting Bronchial Provocation (BRP) Testing
67
3-10
Chapter IV
68
REPORTS
68
4-1
Accessing the Switchboard
69
4-2
Printing a Report
69
4-3
Customizing Report Variables & Graphics
69
4-4
Adding Graphics to a Report Header
70
4-5
Designing a Page Header
70
4-6
Trend Plots
70
4-7
BRP Trend Plots
71
Chapter V
72
SOFTWARE CONFIGURATIONS
72
5-1
Accessing and Modifying Test Configurations
73
5-2
Setting up the Data Grid
73
5-3
Graph Properties
73
5-4
Editing Patient and Staff Members
74
5-5
Modifying PF Predicteds
74
Chapter VI
75
Quality control
75
6-1
Introduction
76
6-2
Adding a Syringe QC to the Database
76
6-3
Spirometry
76
6-4
Diffusion
76
6-5
Nitrogen Washout
77
6-6
Plethysmography
77
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Chapter VII
78
Troubleshooting
78
7-1
Cleaning & Maintenance preVent Flow sensor System Surfaces
79 79 79
7-2
Flow Issues
80
7-3
Diffusion
81
7-4
GC Column Replacement
82
7-5
Technical Support
82
Chapter VIII
83
DB TOOLS
83
8-1
Accessing DB Tools
84
8-2
Loading Shape Tables
84
8-3
Converting Old Visits
84
8-4
Purging the Database
84
8-5
Compact/Repair Database
85
8-6
Backup/Restore Database
85
8-7
Import/Export Patients
85
Chapter IX
86
Security/HIPAA
86
9-1
Security & Compliance
87
9-2
Create/Modify a User
87
9-3
Defining Roles
88
9-4
Database Security Key Terms Changing a Password
88 89 89
9-5
Audit Trail Configuration
90
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Chapter X
91
REVIEW STATION
91
10-1
Introduction
92
10-2
Patient Selection
92
10-3
PF Data
93
10-4
Options
94
Glossary of Terms
95
APPENDIX A
98
Changing out a Gas Tank
98
APPENDIX B
99
Pulmonary References
99
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CHAPTER I SYSTEM OVERVIEW
1-1
The Platinum Elite System
1-2
Power-up/Warm-up
1-3
Gas Pressures
1-4
Gas Concentrations
1-5
Head Assembly
1-6
Panels
1-7
preVent Flow Sensor
1-8
Testing Components
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1-1 The Platinum Elite System
The Platinum Elite System
1-2 Power-up/Warm-up Power-up Sequence 1. Switch the Platinum Elite system to ON. 2. Power-up the computer. 3. Click on the BREEZESUITE icon, on the computer desktop, to access the software.
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Warm-up The following warm-up conditions must exist before the tests listed can be executed:
Warm-up the Platinum Elite system for at least 30 minutes before calibration or testing.
Warm-up the vacuum pump ―Vac‖ for 2 minutes before N2 FRC or SBN2 testing. Once 2 minutes has elapsed, the timer turns green and reads, ―Ready.‖
Warm-up the Helium for 12 minutes before DLco testing. Once 12 minutes has elapsed, the timer turns green and reads, ―Ready.‖
Power-down Sequence 1. Exit the BREEZESUITE software. 2. Shut-down the computer. 3. Flip the power switch of the Platinum Elite to OFF.
1-3 Gas Pressures
Air or N2: ~20psi (door seal) Optional Oxygen and Diffusion: 135 psi
Helium: 10-25 psi
Gas tank adequate pressure: > 500psi
Oxygen is used for N2 FRC & SBN2 testing as well as oxygen analyzer calibration
Diffusion is used for DLco Calibration, Dlco Testing, door seal, calibration, firing of valves Helium is used for Dlco testing
Note: For instructions on how to change out a gas tank, refer to Appendix A.
1-4 Gases Concentrations Specific concentrations are needed for DLCO, O2 and Helium. They are as follows: Oxygen 100% - Platinum Elite Dx only Diffusion Gas Mixture: 0.5 ± 0.05% Ne
0.3 ± 0.015% CO
21 ± 0.15% O2
Remaining balance N2
Helium 100% (10 - 25 psi) – Platinum Elite DL & Dx::
99.995% He
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1-5 Head Assembly Demand Valve Sample Chamber Breath Path Patient Circuit Scissor Valves
1-6 Panels Platinum Elite Gas Connections Helium
Air (Optional)
DLco Oxygen
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Platinum Elite – Left Panel – Adjustment Knobs
Door Seal Switch
Patient Intercom Volume
Operator Intercom Volume
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1-7 preVent Flow Sensor The preVent Flow Sensor is a respiratory device used to measure inspiratory and expiratory airflow. The Flow Sensor requires calibration on a daily basis; recalibration between patients is not required.
Flow Sensor/Umbilical Assembly The following instructions demonstrate the proper method for connecting the Flow Sensor to the Umbilical Clip:
The base of the preVent Flow Sensor has a tab protruding outward and an indented notch. The base of the Umbilical Clip also has a tab protruding outward. When the two pieces are connected, the Umbilical Tab snaps into the notch of the Flow Sensor.
Ensure that the honeycomb end of the Flow Sensor is facing the patient, and that the open end connects to the Patient Circuit connection.
The flat end of the Umbilical Clip faces the patient and the tab side faces away from the patient.
The flat end of the Umbilical Clip always faces the honeycomb side of the Flow Sensor.
To connect the two units, align and insert the metal probes of the Umbilical Clip into the holes at the base of the preVent Flow Sensor. The units should snap together and form a tight fit.
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1-8 Testing Components Flow sensor The Flow Sensor is the clear component of the Flow Sensor Testing Assembly that a patient forces air though during testing to measure inspiratory and expiratory airflow.
Barrier Filter If a Barrier Filter is used, dead space and resistance must be entered into the software as follows: File>Open>Site (current)> Workstation Tab (NOT Add Workstation)
Breath Path Patient Circuit The Patient Circuit is inserted into the Head Assembly for N2 FRC, TGV, RAW, Dlco, MIP, MEP, and SBN2 testing.
The round end attaches to the Sample Chamber.
The oval end attaches to the Demand Valve.
Because this part is quite flexible, ensure that it does not become twisted upon installation. A twist may result in a leak.
Round
Oval
Patient Mouthpiece The Patient Mouthpiece is placed in the patient’s mouth while testing is being performed.
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Noseclips Noseclips are placed over the patients nose during testing to prevent leakage.
Umbilical Cable The Umbilical Cable connects to the Platinum Elite and is the means by which the testing data is transferred to the system for processing.
N2 Calibration Port Attach the Umbilical Clip in the Calibration Port (shown within the white circle) for N2 FRC calibration, or to protect the Umbilical Clip during storage.
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Flow Sensor Testing Circuit Assembly with Barrier Filter
Flow Sensor Testing Circuit
Refer to the photo above, and follow the steps below for assembling the Flow Sensor Testing Circuit (only when using a preVent Barrier Filter): 1. Gather the following parts:(Flow Sensor, preVent Barrier Filter, Patient Mouthpiece.) These parts comprise the Flow sensor Testing Circuit. 2. Firmly push the preVent Filter onto the honeycomb side of the preVent filter. 3. Firmly push the Patient Mouthpiece onto the open end of the preVent Filter. 4. Attach the Umbilical Clip to the Flow Sensor. 5. Attach the Flow Sensor Testing Circuit to the Patient Circuit positioned inside the Head Assembly.
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CHAPTER II STARTING A TEST
2-1
Flow Sensor Calibration
2-2
Plethysmography Calibration
2-3
MIP/MEP Calibration
2-4
Calibration Report
2-5
Patient Information
2-6
Opening an Existing Patient
2-7
Searching the Patient Database
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2-1 Flow Sensor Calibration
1. Click the Calibrate button, on the Breeze computer screen, to calibrate the Flow Sensor then enter the appropriate values for temperature, barometric pressure and humidity (circled at the bottom of the screen). 2. Attach a syringe to the patient end of the Prevent Flow Sensor. 3. Click the Zero Flow button, circled at the top of the screen. 4. Click Start, then withdraw and inject the syringe according to the varied rates*. Follow the computer prompts to know when to withdraw and inject. 5. Vary the speed of subsequent strokes to test the linearity of the flow system. Always provide smooth, consistent strokes. 6. Breeze confirms when the calibration is successful. 7. Do not click Reset. If calibration fails, see Note that follows.
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*Note - If the syringe sticks during calibration, execute the following steps: a. Click STOP b. Push the syringe in c.
Click START
d. Fully withdraw the syringe e. Wait for the prompt to appear, then f.
Inject the syringe
g. Click STOP h. Return to step three of the Flow Sensor Calibration process above
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