980 Series Product Training Pre-Read Overview

Table of Contents Introduction ...5 Preparing for Your Puritan Bennett™ 980 Ventilator Training Session...6 The Puritan Bennett 980 ventilator system at a glance...6 Intended uses...7 Configurations...7 Features and Benefits...8 New patient setup...8 Making changes to settings after initial setup...8 Touch-screen user interface...9 Ventilator Assurance feature...10 Unique filtration system...10 Alarm management...11 Alarm violations...11 Puritan Bennett™ PAV™*+ software...12 How PAV™*+ software works...12 Puritan Bennett™ Leak Sync software...13 Neonatal Ventilation...14 Neonatal ventilation...14 Puritan Bennett™ NeoMode 2.0 software...14 Puritan Bennett™ Proximal Flow system ...15 End-tidal CO2 monitoring...15

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Introduction The information in this pre-read guide is intended to lay the groundwork for your Puritan Bennett™ 980 ventilator training session. You may choose to read this entire overview of features and benefits before your training or focus on those sections that relate to your clinical environment. This guide is designed to help make your training session as effective as possible by familiarizing you with the Puritan Bennett 980 ventilator so you can have a more immediate impact on the treatment of your patients. As you read this booklet, a space is provided for notes or questions for the trainer. Use this guide as a quick reference before, during and after your training session. We look forward to working with you.

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Preparing for Your Puritan Bennett™ 980 Ventilator Training Session

THE PURITAN BENNETT 980 VENTILATOR SYSTEM AT A GLANCE The new Puritan Bennett 980 ventilator helps enable patients to breathe more naturally through some of the most innovative breath delivery technology available. Our simple, safe and smart design† provides more natural ventilation that may help clinicians improve patient comfort.1

Simple Our innovative user interface features a highly customizable display with intuitive screen navigation.

Safe The newly designed Puritan Bennett 980 ventilator provides a unique ventilator assurance feature and an integrated expiratory filtration system.

Smart Advanced synchrony tools help clinicians set the ventilator to adapt to their patients’ unique needs and help provide the appropriate level of support throughout the breath.

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Compared to conventional volume control mechanical ventilation.

THE PURITAN BENNETT™ 980 VENTILATOR IS INTENDED FOR: • Use in neonatal through adult populations Innovative touch screen

• Invasive and noninvasive applications

Status display

THE PURITAN BENNETT 980 VENTILATOR IS AVAILABLE IN THREE CONFIGURATIONS: • Puritan Bennett™ 980 Neonatal Ventilator-for neonatal patients only

Digital communication

Unique filtration system

• Puritan Bennett™ 980 Standard Ventilator-for pediatric and adult patients • Puritan Bennett™ 980 Universal Ventilator-for neonatal through adult patients

Hot-swappable batteries

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Simple

Features and Benefits Our innovative user interface features a highly customizable display with intuitive screen navigation. NEW PATIENT SETUP

On the patient setup screen, the gender and height you select will determine a predicted body weight (PBW), which in turn will determine a range of settings that are appropriate for use. During patient setup you may set the following: • Gender and height (or PBW)

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The touch screen automatically displays the following information, depending on the state of the ventilator:

• Primary settings, for example:

• Ventilation type (invasive and noninvasive)

– Rate

• Mode

– Inspiratory pressure

• Mandatory type

– O2%

• Spontaneous type

– Tidal volume

– PEEP

• Trigger type

• Ventilator, apnea and alarm settings • Patient data • Waveforms • Current alarm banners

If you find the default settings conflict with your institutional guidelines, you can reconfigure the institutional defaults for New Patient Setup in Service Mode.

In addition to the main patient ventilation parameter settings, the graphical user interface has a rotary encoder knob and several additional input keys.

MAKING CHANGES TO SETTINGS AFTER INITIAL SETUP

1. Display brightness key

4. Manual inspiration key

7. Expiratory pause key

2. Display lock key

5. Rotary encoder (knob)

8. Alarm reset key

3. Alarm volume key

6. Inspiratory pause key

9. Alarm silence key

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After initial setup, it is easy to make settings changes using the “touch, turn, accept” method.

TOUCH-SCREEN USER INTERFACE

The touch screen of the Puritan Bennett™ 980 ventilator is highly configurable to specific user and patient needs. The touch screen has up to five retrievable preset configurations, enabling you to choose how much or how little patient/ventilator information to display.

Intuitive icons and graphics, and large, easy-to-read text make it simple to use the touch screen while working with a patient. Setting up the ventilator for a new patient is fast and easy.2

Monitoring patient status and making changes to ventilation parameters are also fast and easy. Both the patient’s current status and long-term trending data are quickly retrievable. Patient data may be downloaded via USB ports on the back of the ventilator. All ventilation parameters are entered via the touch screen’s graphical user interface (GUI). Simple hand motions (swipe, double-tap and drag-and-drop) activate most functions on the touch screen. These gestures will be familiar to any user of a smart phone, tablet or handheld device.

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ALARM MANAGEMENT The Puritan Bennett™ 980 ventilator provides low-, medium- and high-priority alarms, each with a unique sound. If a high-priority alarm is not acknowledged within 30 seconds, the alarm volume escalates to maximum value, regardless of the user’s alarm volume setting. ALARM VIOLATIONS ARE VISUALLY INDICATED IN THREE PLACES: • The dome lamp on top of the touch screen • On alarm banners on the touch screen • On alarm settings screen on the touch screen

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Safe

Features and Benefits The newly designed Puritan Bennett™ 980 ventilator provides a unique ventilator assurance feature and an integrated expiratory filtration system. VENTILATOR ASSURANCE FEATURE

KEY BENEFITS Puritan Bennett 980 ventilator bacterial/viral filters have efficiencies of >99.999%.

Ventilator assurance is a new sophisticated safeguard system, unique to the Puritan Bennett 980 ventilator. In the event of certain system failures, the ventilator will continue to deliver ventilatory support as close to the ventilator’s settings as feasible. Most ventilators go into ventilator inoperative state under certain alert conditions. The Puritan Bennett 980 ventilator reduces the number of conditions where this could happen, which may provide a safer environment for the patient. UNIQUE FILTRATION SYSTEM The Puritan Bennett 980 ventilator has an integrated heated expiratory filtering system. An increasing number of infection control protocols cite the use of N95 or N100 respirators by clinicians to reduce the risk of exposure to airborne pathogens. Clinicians should expect the same level of protection from exhaled gases from potentially infected patients. Puritan Bennett™ filtration is designed to meet this expectation.

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Smart

Features and Benefits Advanced synchrony tools help clinicians set the ventilator to adapt to their patients’ unique needs and help provide the appropriate level of support throughout the breath. PURITAN BENNETT™ PAV™*+ SOFTWARE KEY BENEFITS • Promotes spontaneous breathing by requiring patient effort throughout the breath 3 • Automatically adjusts every five milliseconds to changes in the patient’s demand • May help improve patient comfort 1 • Helps improve patient-ventilator synchrony 4,5

The Puritan Bennett™ PAV™*+ software is a spontaneous breath type that enables the patient to dictate the breath he or she receives, and helps clinicians more clearly understand the work required by the patient to breathe. Like other spontaneous breath types, the PAV™*+ software assists patient efforts, but unlike other spontaneous breath types, the operator does not set pressure or volume. The operator sets the %Support setting (5% to 95%), tube type and tube size. The %Support setting determines the percentage of mechanical support used to offload the patient’s work of breathing. The PAV™*+ software provides ventilatory support proportional to the patient’s inspiratory effort, letting the patient determine the duration and depth of each breath. The PAV™*+ software begins to assist an inspiration when flow (generated by the patient’s inspiratory muscles) appears at the patient wye. If the patient ceases inspiration, the assist also ceases.

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HOW PAV™*+ SOFTWARE WORKS The PAV™*+ software measures the patient’s resistance (R) and compliance (C) every four to 10 breaths. It also measure flow and volume every five milliseconds. Through the use of the equation of motion, patient-generated muscular pressure (PMUS) and the actual work of breathing can be calculated in real time. It’s important to note that in mechanically ventilated patients, both R and C can vary considerably over time. The PAV™*+ software continuously and automatically measures and adjusts to these changes. This maintains the preselected percentage of assistance to the patient’s respiratory workload.

PURITAN BENNETT™ LEAK SYNC SOFTWARE The Puritan Bennett™ Leak Sync software automatically detects and compensates for leaks in the breathing circuit and patient-ventilator interface. The Leak Sync software helps reduce the guesswork in determining the appropriate settings to compensate for a leak, regardless of patient type. This unique software is designed to differentiate between flow from leaks and flow from patient respiratory effort, and then adjust quickly. The Leak Sync software also calculates the volume lost because of leaks and makes adjustments to the display of volume measurements. The Leak Sync software option compensates for leaks up to 15 L/min for neonates, 40 L/min for pediatric patients and 65 L/min for adults. A new leak or change in leak rate is typically quantified and compensated within three breaths.

KEY BENEFITS • Quickly and automatically adjusts for leaks because of patient interfaces • Helps ensure appropriate breath triggering and cycling, as well as valid patient monitoring data6,7 • Promotes synchrony during invasive and noninvasive ventilation6,7 • Reduces the occurrence of auto triggering in the presence of a leak6,7 13

Neonatal Ventilation Ventilating our most vulnerable patients

NEONATAL VENTILATION

PURITAN BENNETT™ NEOMODE 2.0 SOFTWARE

The Puritan Bennett™ 980 Neonatal and Universal ventilators with Puritan Bennett™ NeoMode 2.0 software are designed for respiratory support for newborns weighing as little as 300 g. Specific features include:

The NeoMode 2.0 software enables clinicians to set tidal volumes as low as 2 mL in increments as small as 0.1 mL across volumes ranging from 2 mL to 5 mL.

• Proximal flow sensor-Measures flows, pressures and tidal volumes right at the patient wye for neonatal applications. • C20/C-Helps clinicians potentially reduce the risk of over distention by monitoring compliance of the last 20% of each inspiration compared to the entire inspiration.8 • Configurable O2% elevation-Elevates O2%; can be configured to increase to any value between 21% and 100%. • Noninvasive (NIV) • Trending-Captures up to 72 hours and more than 57 parameters of patient data to help you review the effectiveness of treatment over time.

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KEY BENEFITS • Designed specifically for neonates with low predicted body weight • Designed to reduce nuisance alarms when nasal prongs are used

PURITAN BENNETT™ PROXIMAL FLOW SYSTEM The Puritan Bennett™ proximal flow system option measures flow, volume and pressure at the patient wye. When the ventilator has a proximal flow sensor installed, both proximal flow and proximal pressure measurements are obtained and displayed on the main screen. These values are used in the display of graphics. No calibration is required when in patient use. To ensure accurate pressure and flow measurements, the ventilator performs an autozero function to calibrate the proximal flow sensor.

KEY BENEFITS • Values from proximal flow sensor are used in the display of graphics • Proximal flow, volume and pressure data are displayed on the touch screen • Periodic expiratory phase purging occurs for accurate pressure measurements

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References 1. Grasso S, Puntillo F, Mascia L, et al. Compensation for increase in respiratory workload during mechanical ventilation. Pressure-support versus proportional-assist ventilation. Am J Respir Crit Care Med. 2000;161(3 Pt 1):819-26. 2. Internal testing Puritan Bennett™ 980 ventilator human factors testing. 3. Operations Manual Puritan Bennett™ 980 ventilator system. 4. Xirouchaki N, Kondili E, Vaporidi K, et al. Proportional assist ventilation with load-adjustable gain factors in critically ill patients: comparison with pressure support. Intensive Care Med. 2008;34(11):2026-2034. 5. Costa R, Spinazzola G, Cipriani F, et al. A physiologic comparison of proportional assist ventilation with load-adjustable gain factors (PAV+) versus pressure support ventilation (PSV). Intensive Care Med. 2011;37(9):1494-1500. 6. Oto J, Chenelle CT, Marchese AD, Kacmarek RM. A comparison of leak compensation in acute care ventilators during noninvasive and invasive ventilation: a lung model study. Respir Care. 2013;58(12):2027-2037. 7. Oto J, Chenelle CT, Marchese AD, Kacmarek RM. A comparison of leak compensation during pediatric noninvasive ventilation: a lung model study. Respir Care. 2014;59(2):241-251. 8. Fisher JB, Mammel MC, Coleman JM, Bing DR, Boros SJ. Identifying lung overdistention during mechanical ventilation by using volume-pressure loops. Pediatr Pulmonol. 1988;5(1):10-14 COVIDIEN, COVIDIEN with logo, Covidien logo and positive results for life are U.S. and internationally registered trademarks of Covidien AG. Proportional Assist and PAV are registered trademarks of The University of Manitoba, Canada. Used under license. Other brands are trademarks of a Covidien company. ©2014 Covidien. 13-VE-0047(1)

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