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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Servo i ventilator Charles Gomersall Dept of Anaesthesia & Intensive Care The Chinese University of Hong Kong Prince of Wales Hospital Version 1.1
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Disclaimer Although considerable effort has been taken to ensure that the material in this tutorial accurately reflects the information provided by Maquet AB in its publications the author takes no responsibility for the accuracy of the information in this tutorial nor for any adverse event that occurs as a result of using this tutorial. Users are advised to consult the manual that accompanies their ventilator. Please note that this tutorial has not been endorsed by Maquet AB.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Navigation What’s different from a 300A?
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Setting the mode Changing parameters Advanced Modes Starting up User interface – a quick tour Alarms Click on “Maquet” to end the tutorial at any stage What’s different from a 300A?
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 A quick tour
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i Additional settings Additional values ! Menu touch pad
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional settings Additional values Using the menu touch pad
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional settings Additional values
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 500 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 500 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 500 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 550 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 550 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 550 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Text and alarm messages appear here
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Alarm pofile Additional settings Additional values Fixed keys
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Alarm pofile Additional settings Silence/pre-silence alarms Silences or pre- silences alarms for 2 minutes
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Alarm pofile Silence/pre-silence alarms Silences or pre- silences alarms for 2 minutes After silencing an alarm the Alarm silence symbol is shown with the remaining time 1:58
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Silence/pre-silence alarms When alarms are pre- silenced a pre-silence symbol is shown as well as the remaining mute time 0:55
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Alarm profile Press this button to: –Display upper and lower alarm limits –Adjust preset limits –Adjust the alarm sound level
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional values Alarm profile 100 % Alarm sound level 40 Upper 5.0 Lower 40.0 530 3 Pressure cm H 2 O Minute Ventilation l/min Respiratory Rate b/min End Exp. Pressure cmH 2 O Autoset CancelAccept
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Save Saves: –Current curve values –Current parameter values –Setting values 10 secs before and 10 secs after pressing key
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus 700 ml -70 70 l/min 50 cmH 2 O T Recording
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus Menu Alarm Review Options Compliance comp. Copy data Biomed Panel lock Change patient category Close
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus Menu Alarm Review Options Compliance comp. Copy data Biomed Panel lock Change patient category Close Recorded waveforms Trends
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional values Mode Volume Control Automode Admit patient NebulizerStatus Recorded waveforms 12/25/02 14:32:10 SettingsCursorClose 50 cmH 2 O -70 70 l/min 700 ml 40 cmH 2 O 0 l/min 475 ml 0.0 s
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Trends graphs 14:32 Recording saved Cursor Hours 1 Close 14:00 15:00 l/min 2 l/min 20 ml 800 0 0 0 Vee MVi MVe VTi VTe 0 10.5 10.0 300 296
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional values Mode Volume Control Automode Admit patient NebulizerStatus Recorded waveforms 12/25/02 14:32:10 SettingsCursorClose 50 cmH 2 O -70 70 l/min 700 ml 40 cmH 2 O 0 l/min 475 ml 0.0 s
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Trends graphs 14:42 Cursor Hours 1 Close 14:00 15:00 l/min 2 l/min 20 ml 800 0 0 0 Vee MVi MVe VTi VTe 0 10.5 10.0 300 296
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Trends graphs 14:42 Cursor Hours 1 Close 14:00 15:00 l/min 2 l/min 20 ml 800 0 0 0 Vee MVi MVe VTi VTe 0 10.5 10.0 300 296
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Trends graphs 14:42 Cursor Hours 1 Close 14:00 15:00 l/min 2 l/min 20 ml 800 0 0 0 Vee MVi MVe VTi VTe 0 10.5 10.0 300 296
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Trends graphs 14:32 Cursor Hours 1 Close 14:00 15:00 l/min 2 l/min 20 ml 800 0 0 0 Vee MVi MVe VTi VTe 0 10.5 10.0 300 296
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Trends graphs 14:38 Cursor Hours 1 Close 14:00 15:00 l/min 2 l/min 20 ml 800 0 0 0 Vee MVi MVe VTi VTe 0 10.5 10.0 300 296
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Trends graphs 14:32 Cursor Hours 1 Close 14:00 15:00 l/min 2 l/min 20 ml 800 0 0 0 Vee MVi MVe VTi VTe 0 10.5 10.0 300 296
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Trends graphs 14:38 Cursor Hours 1 Close 14:00 15:00 l/min 2 l/min 20 ml 800 0 0 0 Vee MVi MVe VTi VTe 0 10.5 10.0 300 296
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Trends graphs 14:38 Cursor Hours 1 Close 14:00 15:00 l/min 2 l/min 20 ml 800 0 0 0 Vee MVi MVe VTi VTe 0 10.5 10.0 300 296
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 i This function is not currently available
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIEMENS Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i Additional settings Additional values ! Main rotary dial
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional settings Additional values. Using the main rotary dial
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional settings Additional values.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional settings Additional values.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 500 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 500 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 500 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 500 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 550 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 550 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 550 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 550 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 550 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i Additional settings Additional values ! Measured values appear here
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pplat (cmH 2 O) 34 40 Additional settings Additional values Pmean 12 PEEP 6 RR (b/min) 15 30 5 O 2 (%) 42 48 36 I:E 1:2.0 MVe (l/min) 7.4 8.5 6.0 VTi 501 VTe 493
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pplat (cmH 2 O) 34 40 Additional settings Additional values Pmean 12 PEEP 6 RR (b/min) 15 30 5 O 2 (%) 42 48 36 I:E 1:2.0 MVe (l/min) 7.4 8.5 6.0 VTi 501 VTe 493
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pplat (cmH 2 O) 34 40 Additional settings Additional values Pmean 12 PEEP 6 RR (b/min) 15 30 5 O 2 (%) 42 48 36 I:E 1:2.0 MVe (l/min) 5.2 8.5 6.0 VTi 356 VTe 346 Expiratory MinuteVolume Low
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pplat (cmH 2 O) 34 40 Additional settings Additional values Pmean 12 PEEP 6 RR (b/min) 31 30 5 O 2 (%) 42 48 36 I:E 1:2.0 MVe (l/min) 8.5 6.0 VTi 292 VTe 274 Respiratory Rate: High
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pplat (cmH 2 O) 34 40 Additional settings Additional values Pmean 12 PEEP 6 RR (b/min) 31 30 5 O 2 (%) 42 48 36 I:E 1:2.0 MVe (l/min) 8.5 6.0 VTi 292 VTe 274 Respiratory Rate: High
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pplat (cmH 2 O) 34 40 Additional settings Additional values Pmean 12 PEEP 6 RR (b/min) 15 30 5 O 2 (%) 42 48 36 I:E 1:2.0 MVe (l/min) 7.4 8.5 6.0 VTi 501 VTe 493
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pplat (cmH 2 O) 34 40 Additional settings Additional values Pmean 12 PEEP 6 RR (b/min) 15 30 5 O 2 (%) 42 48 36 I:E 1:2.0 MVe (l/min) 7.4 8.5 6.0 VTi 501 VTe 493
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Next page Ppeak Pplat Pmean PEEP RR O2O2 Vee I:E MVe MVi VTi VTe 34 24 12 5 15 21 0 1:2.0 7.0 7.5 501 471
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Next page Ppeak Pplat Pmean PEEP RR O2O2 Vee I:E MVe MVi VTi VTe 34 24 12 5 15 21 0 1:2.0 7.0 7.5 501 471
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Next page E C static PEEPtot Re 24 Ri 17 C dyn 16 Tc WOB tot 922
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Next page E C static PEEPtot Re 24 Ri 17 C dyn 16 Tc WOB tot 922
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Next page E C static PEEPtot Re 24 Ri 17 C dyn 16 Tc WOB tot 922
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Alarm profile SaveTrends i Additional settings Additional values ! Special function keys
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Special function keys Start breath –Activates a set breath O 2 breaths –Changes the FiO 2 to 1.0 for one minute –Can be interrupted by re-pressing within one minute
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Special function keys Expiratory hold –Produces an expiratory pause hold for measuring total PEEP –Lasts as long as the key is pushed up to a maximum of 30 secs Inspiratory hold –Produces an inspiratory pause hold for measuring plateau pressure –Lasts as long as the key is pushed up to a maximum of 30 secs
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i Additional settings Additional values ! Direct access knobs
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Pressure Control Automode Admit patient NebulizerStatus Additional settings Additional values O 2 conc. 30 PEEP 5 Resp. rate 15 PC above PEEP 15 mmHg b/min%cm H 2 O Direct access knobs Parameter controlled by each direct access knob depends on ventilation mode selected Turn the knob to the desired value shown in the box above the knob
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Pressure Control Automode Admit patient NebulizerStatus Additional settings Additional values PEEP 5 Resp. rate 15 PC above PEEP 15 O 2 conc. 30 mmHg b/min%cm H 2 O Direct access knobs Parameter controlled by each direct access knob depends on ventilation mode selected Turn the knob to the desired value shown in the box above the knob
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode PressureControl Automode Admit patient NebulizerStatus Additional settings Additional values PEEP 5 Resp. rate 15 PC above PEEP 15 O 2 conc. 30 mmHg b/min%cm H 2 O Direct access knobs Parameter controlled by each direct access knob depends on ventilation mode selected Turn the knob to the desired value shown in the box above the knob PC above PEEP 15 mmHg
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Pressure Control Automode Admit patient NebulizerStatus Additional settings Additional values PEEP 5 Resp. rate 15 Tidal volume 500 O 2 conc. 30 ml b/min%cm H 2 O Direct access knobs If the bar in the box is white the setting is within what is generally considered safe limits PC above PEEP 15 mmHg
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Pressure Control Automode Admit patient NebulizerStatus Additional settings Additional values PEEP 5 Resp. rate 15 Tidal volume 500 O 2 conc. 30 ml b/min%cm H 2 O Direct access knobs If the bar turns yellow the setting is outside what are generally considered safe limits % PC above PEEP 31 mmHg
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Pressure Control Automode Admit patient NebulizerStatus Additional settings Additional values PEEP 5 Resp. rate 15 Tidal volume 500 O 2 conc. 30 ml b/min%cm H 2 O Direct access knobs If the bar turns red the setting is significantly outside what are generally considered safe limits An audible alarm and alarm message is given % PC above PEEP 60 mmHg
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Pressure Control Automode Admit patient NebulizerStatus Additional settings Additional values PEEP 5 Resp. rate 15 Tidal volume 500 O 2 conc. 30 ml b/min%cm H 2 O Direct access knobs When you come to a safety limit the knob is inactive for 2 seconds in order to make you aware that you have passed a safety limit % PC above PEEP 60 mmHg
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Pressure Control Automode Admit patient NebulizerStatus Additional settings Additional values O 2 conc. 30 PEEP 5 Resp. rate 15 PC above PEEP 15 mmHg b/min%cm H 2 O Direct access knobs NB When you turn a direct access knob the changes in ventilation take place from the next breath without additional confirmation
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i Additional settings Additional values ! Mains indicator
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i Additional settings Additional values ! Start/stop ventilation (standby)
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Additional settings Additional values Waveform area
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus 700 ml -70 70 l/min 50 cmH 2 O T
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus T 700 ml -70 70 l/min 50 cmH 2 O
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus T 700 ml -70 70 l/min 50 cmH 2 O
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus T 700 ml -70 70 l/min 50 cmH 2 O
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus T 700 ml -70 70 l/min 50 cmH 2 O
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Additional settings Additional values Mode Volume Control Automode Admit patient NebulizerStatus T 700 ml -70 70 l/min 50 cmH 2 O
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i Additional settings Additional values ! Patient category
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 What’s different from a Servo 300/300A?
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control Pressure support User interface Volume support Apnoea time Inspiratory rise time AutomodeSIMV
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control 300 and 300A –If patient’s breathing effort reaches 2 cm H 2 O below preset PEEP ventilator permits a higher flow –pressure is then regulated to 2 cm H 2 O above PEEP Servo i –If a pressure drop of 3 cm H 2 O is detected during inspiration the ventilator switches to pressure support, resulting in increased flow –When flow to calculated target level flow maintained until set tidal volume delivered
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume support
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Minute volume 300 or 300A –If RR < set RR (ie minute vol. < set minute vol.) –new target V T is calculated (based on preset minute volume) & used to regulate insp. pressure –Max. V T =150% of preset Servo i –Neither RR nor minute volume are set –Inspiratory pressure is regulated purely based on preset V T
94
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Inspiratory rise time 300 and 300A –Inspiratory rise time set as a % of breath cycle time, which is in turn dependent on set RR Servo i –Inspiratory rise time set as % in control and SIMV modes absolute time (s) in support modes. (NB. As a result the proportion of inspiration taken up by rise time will increase with RR)
95
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 I-E cycling 300 and 300A –I-E cycling occurs when inspiratory flow = 5% of maximum inspiratory flow Servo i –I-E cycling occurs when inspiratory flow = set % of maximum inspiratory flow –Set % = inspiratory cycle-off
96
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Apnoea back-up 300 and 300A –Apnoea > 20 secs (adults) pressure regulated volume control Servo i –Apnoea > set apnoea time Back-up mode (volume control)
97
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure support
98
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Apnoea back-up 300 and 300A –None Servo i –Apnoea > set apnoea time Back-up mode (pressure control)
99
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Inspiratory rise time 300 and 300A –Inspiratory rise time set as a % of breath cycle time, which is in turn dependent on set RR Servo i –Inspiratory rise time set as an absolute time (in seconds). –NB. As a result the proportion of inspiration taken up by rise time will increase with RR
100
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 I-E cycling 300 and 300A –I-E cycling occurs when inspiratory flow = 5% of maximum inspiratory flow Servo i –I-E cycling occurs when inspiratory flow = set % of maximum inspiratory flow –Set % = inspiratory cycle-off
101
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Inspiratory rise time
102
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Inspiratory rise time 300 and 300A –Always set as a % of cycle time Servo i –Set as a % of cycle time control modes and SIMV –Set as an absolute time in support modes
103
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Apnoea time 300 and 300A –Preset Adult 20 s Paediatric 15 s Neonate 10 s Servo i –Adjustable in volume support, pressure support/CPAP and SIMV modes –Press “Alarm profile” to set time Adult 15-45 s Infant 5-15 s
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIMV 300 and 300A –SIMV cycle = –SIMV period = Servo i –SIMV cycle = –SIMV period = set breath cycle time
105
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIMV 300 and 300A –Mandatory (SIMV) breath given at end of SIMV period if patient does not trigger ventilator during SIMV period Servo i –Mandatory (SIMV) breath given after 90% of SIMV period if patient does not trigger ventilator in initial 90% of SIMV period
106
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Automode 300A –Ventilator shifts from control to spontaneous mode if patient triggers 2 consecutive breaths Servo i –Ventilator shifts from control to spontaneous mode if patient triggers ventilator
107
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Automode 300A –Ventilator shifts from spontaneous to control mode after a set period of apnoea: Adult 12 s Paediatric 8 s Neonate 5 s Servo i –Ventilator shifts from control to spontaneous mode after trigger time- out period –Increases with each successive breath until the set trigger timeout limit is reached
108
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Setting the mode
109
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional settings Additional values
110
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%) Tidal volume 500 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. pause 10 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Volume control Automode Ti =1.33 s (33%). CancelAccept Select ventilation mode Volume control Pressure control Pressure Support/CPAP PRVC Volume Support SIMV (PRVC) Pressure Support SIMV (Press. Control) Pressure Support SIMV (Vol. Control) Pressure Support
112
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Pressure control Automode Ti =1.33 s (33%) PC above PEEP 18 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept
113
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Pressure control Automode Ti =1.33 s (33%) PC above PEEP 18 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept
114
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Pressure control Automode Ti =1.33 s (33%) PC above PEEP 18 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept
115
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Pressure control Automode Ti =1.33 s (33%) PC above PEEP 18 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept PC above PEEP 18
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 If the bar in the box is white the setting is within what is generally considered safe limits PC above PEEP 18
117
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 If the bar turns yellow the setting is outside what are generally considered safe limits PC above PEEP 31
118
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 If the bar turns red the setting is significantly outside what are generally considered safe limits PC above PEEP 60
119
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Inspiratory rise time Can be altered to increase patient comfort Some patients find sudden “bolus” of gas uncomfortable Excessively long rise time can result in receiving preset levels of ventilatory support for relatively short periods
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Inspiratory rise time Control modes and SIMV –Rise time set as a % of cycle time –SIMV Cycle time is set –Control modes Cycle time = 60/RR
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Inspiratory rise time Support modes –Rise time set as an absolute time Proportion of inspiratory time that is taken up by rise time increases as cycle time shortens (ie increased RR)
122
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Triggering
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Pressure control Automode Ti =1.33 s (33%) PC above PEEP 18 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept Trigger sensitivity. V -20 0
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Pressure control Automode Ti =1.33 s (33%) PC above PEEP 18 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept Trigger sensitivity -2 -20 0
125
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional settings Additional values Automode
126
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Automode When automode has been selected the soft key turns white
127
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Mode Volume Control Automode Volume support Admit patient NebulizerStatus O 2 conc. 30 PEEP 5 Resp. rate 15 Tidal volume 500 ml b/mincm H 2 O% Automode Volume support Control mode
128
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Mode Volume Control Automode Volume support Admit patient NebulizerStatus O 2 conc. 30 PEEP 5 Resp. rate 15 Tidal volume 500 ml b/mincm H 2 O% Automode Volume support Control mode
129
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Mode Volume Control Automode Volume support Admit patient NebulizerStatus O 2 conc. 30 PEEP 5 Resp. rate 15 Tidal volume 500 ml b/mincm H 2 O% Automode Volume support Support mode
130
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Volume Control Automode Admit patient NebulizerStatus Additional values Set ventilation mode Pressure control Automode Ti =1.33 s (33%) PC above PEEP 18 Resp. Rate 15 PEEP 5 O 2 conc. 40 I:E 1:2.0 T. Insp. rise 5 Trigger sensitivity V Basic I:ETrigger. CancelAccept Insp. cycle off 5 Trigger timeout 7 PS above PEEP 20
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Automode Automode can only be set in association with the following modes of ventilation –Volume control –Pressure regulated volume control –Pressure control
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Click on a mode to find out more about it or on the return button to return to the previous menu Modes Volume control Pressure controlPressure support/CPAP Volume support PRVCSIMV AutomodeBack up ventilation
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control volume preset assist/control ventilation ventilator delivers preset volume in preset inspiratory time with preset pause time and preset flow pattern –when triggered by the patient’s respiratory efforts –as determined by the preset ventilatory rate
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control 700 ml -70 70 l/min 50 cmH 2 O
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control Ventilator will deliver breaths to ensure preset frequency is achieved In general preset volume is delivered according to preset waveform for all breaths With the Servo i it possible for the patient to obtain a higher inspiratory flow and tidal volume from the ventilator than is pre-set
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control Flow is usually dependent on preset volume and the inspiratory time. Inspiratory time is determined by the I:E ratio and the respiratory rate If the flow does not meet patient demand the flow is automatically increased.
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control If a pressure drop of 3 cm H 2 O is detected during inspiration the ventilator switches to pressure support, resulting in increased flow When flow to calculated target level flow maintained until set tidal volume delivered
138
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control Time Flow Insp. time Pause time Exp time
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume control Time Flow Insp. time Pause time Exp time
140
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure control Pressure preset assist/control ventilation Similar to volume control except pressure is preset Inadequate flow unlikely to be a problem
141
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure control PEEP PC above PEEP Pressure Flow
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure control Theoretical decrease in risk of barotrauma Improved oxygenation due to decelerating flow pattern Risk of hypoventilation as lung compliance falls –monitor tidal and minute volumes
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure regulated volume control Preset tidal volume delivered in preset inspiratory time at preset frequency Ventilator automatically adapts inspiratory pressure control level to changes in mechanical properties of chest Inspiratory pressure constant Inspiratory flow decelerating
144
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 PRVC Pressure Flow Volume
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 PRVC Pressure Flow Volume Upper Pressure limit 5 cm H 2 O
146
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 PRVC Has the advantages of pressure control ventilation without the disadvantage of potential hypoventilation/over-ventilation as chest compliance changes
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 PRVC With automode off: –PRVC With automode on: –PRVC if patient is apnoeic –VS if patient is triggering the ventilator
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 PRVC In this mode the pressure is titrated to the tidal volume should not be used in a situation where the inspiratory tidal volume leaving the ventilator is not an accurate reflection of delivered tidal volume (eg circuit leak, uncuffed tube)
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume support Every breath is patient triggered Pressure square wave with decelerating flow Ventilator automatically titrates pressure to achieve preset tidal volume with the lowest possible pressure
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume support Pressure Flow Volume Upper Pressure limit 5 cm H 2 O 10 cm H 2 O
151
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume support Pressure Flow Volume Upper Pressure limit 5 cm H 2 O 10 cm H 2 O Maximum inspiratory flow Set % of max inspiratory flow
152
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume support If apnoea time is exceeded ventilator automatically: –Alarms and switches to Back up mode (volume control with default settings) if Automode is off Remains in Back up mode until alarm is reset
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure support/CPAP With both PS and PEEP >0 –pressure support ventilation with PEEP With PEEP = 0 –pressure support ventilation With PS = 0 –PS of 2 cmH 2 O plus PEEP
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure support inspiratory assist constant preset airway pressure supplied during inspiration
155
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure support PEEP PS above PEEP Pressure Flow Volume Maximum inspiratory flow Set % of max inspiratory flow
156
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure support PEEP PS above PEEP Pressure Flow Volume
157
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure support allows patient to control inspiratory and expiratory times, inspiratory flow and tidal volumes. This control can improve patient comfort can be combined with SIMV or CPAP or used on its own in patients whose gas exchange is improving and in whom weaning is being attempted
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure support pressure support of 3.5-14.5 cmH 2 O required to overcome the additional work of breathing due to breathing through ETT and demand valve. Patients who require pressure support of < 6 cmH 2 O can probably be extubated may unload respiratory muscles and reduce diaphragmatic fatigue
159
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pressure support disadvantages: –V T and minute ventilation variable, excessively large V T may be delivered –high initial flow and termination algorithm may be unsuitable for severe airflow obstruction
160
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Back-up ventilation Operates in association with volume support and pressure support/CPAP Does not operate when Automode is on
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Back-up ventilation Pressure support/ CPAP Pressure control Default pressure = PS or 20 cmH 2 O Default I:E ratio Default respiratory rate Default inspiratory rise time Apnoea> set apnoea time
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Back-up ventilation Volume support Volume control V T = set V T Default I:E ratio Default respiratory rate Default inspiratory rise time Apnoea> set apnoea time
163
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 patient can breathe spontaneously but also receives a set number of volume controlled mechanical breaths volume controlled breaths are synchronized with the patient’s breathing to prevent the possibility of a mechanical breath on top of a spontaneous breath remaining breaths are pressure supported SIMV (VC) & PS
164
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIMV Pressure Flow PEEP Time Pressure support above PEEP Trig Time
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIMV (VC) + PS If the patient is apnoeic the ventilator delivers volume controlled breaths at the preset SIMV rate If the patient triggers the ventilator the response of the ventilator depends on the point in the ventilator cycle at which triggering occurs
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIMV (VC) & PS Time is split up into a series of SIMV cycles duration of each SIMV cycle =
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIMV (VC) & PS Each SIMV cycle is made up of 2 parts: –SIMV period =breath cycle time –spontaneous period
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIMV period Volume controlled breath SIMV cycle Pressure supported breath TT
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Volume controlled breath 90% of SIMV period
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIMV (PC) + PS Very similar to SIMV (VC) &PS except that controlled breaths are pressure rather than volume controlled
171
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 SIMV (PRVC) + PS Very similar to SIMV (VC) &PS except that controlled breaths are PRVC breaths rather than volume controlled breaths
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Automode Active in VC, PC and PRVC modes When automode is on ventilator switches between control and spontaneous modes based on presence or absence of triggering
173
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Automode Pressure control Volume control PRVC Pressure support Volume support Apnoea Triggering Apnoea Triggering Apnoea Triggering
174
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Automode Trigger timeout –= duration of apnoea before ventilator switches from support mode to control mode –The limit increases with each successive breath until the set trigger timeout limit is reached
175
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Automode When automode has been selected the soft key turns white
176
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Mode Volume Control Automode Volume support Admit patient NebulizerStatus O 2 conc. 30 PEEP 5 Resp. rate 15 Tidal volume 500 ml b/mincm H 2 O% Automode Volume support Control mode
177
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Mode Volume Control Automode Volume support Admit patient NebulizerStatus O 2 conc. 30 PEEP 5 Resp. rate 15 Tidal volume 500 ml b/mincm H 2 O% Automode Volume support Control mode
178
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Mode Volume Control Automode Volume support Admit patient NebulizerStatus O 2 conc. 30 PEEP 5 Resp. rate 15 Tidal volume 500 ml b/mincm H 2 O% Automode Volume support Support mode
179
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Changing the parameters
180
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Pressure Control Automode Admit patient NebulizerStatus Additional settings Additional values O 2 conc. 30 PEEP 5 Resp. rate 15 PC above PEEP 15 mmHg b/min%cm H 2 O Changing parameters Direct access knobs Additional settings
181
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Mode Pressure Control Automode Admit patient NebulizerStatus Additional settings Additional values O 2 conc. 30 PEEP 5 Resp. rate 15 PC above PEEP 15 mmHg b/min%cm H 2 O Changing parameters Direct access knobs Additional settings
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Alarms This module will be available in later versions of this tutorial
183
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Starting up
184
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003
185
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pre-use check
186
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Standby Do you want to start Pre-use check? YesNo to start ventilationPress
187
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Additional settings Additional values Standby Do you want to start Pre-use check? YesNo to start ventilationPress
188
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003
189
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Pre-use check Do not use the ventilator if it does not pass the pre-use check
190
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Check batteries
191
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003
192
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Status Additional settings Additional values
193
Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Status Additional settings Additional values Status General O 2 cell Exp. cassette Modules Options Pre-use check VersionUniversal Serial no.2017 Pre-use checkPassed: 2002-02-06 14:52 Operating time167 hours Next Preventative Maintenance1423 hours Battery backup time312 min Barometric pressure1023 hPa Air Pressure 394 kPa*100 O 2 pressure401 kPa*100
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Status Additional settings Additional values Status General O 2 cell Exp. cassette Modules Options Pre-use check VersionUniversal Serial no.2017 Pre-use checkPassed: 2002-02-06 14:52 Operating time167 hours Next Preventative Maintenance1423 hours Battery backup time312 min Barometric pressure1023 hPa Air Pressure 394 kPa*100 O 2 pressure401 kPa*100
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Status Additional settings Additional values Status General O 2 cell Exp. cassette Modules Options Pre-use check Modules status Battery52 min, Slot position 1 Battery51 min, Slot position 2 Battery49 min, Slot position 3 Battery52 min, Slot position 4 Battery52 min, Slot position 5 Battery52 min, Slot position 6
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Advanced This module will be available in later versions of this tutorial
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Start breath O 2 breaths Exp. hold Insp. hold Main screen Menu Quick start Alarm profile SaveTrends i ! 12-25 15:32 Charles Gomersall 2003 Alarm messages This module will be available in a later version of this tutorial
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