Stephan F-120 Globetrotter Paediatric Ventilator
Contents
1. PEEP Ti Total Te In ventilation mode IMV the expiration valve is closed during the set inspiration time and is opened after elapse of the set expiration time Frequency is displayed digitally Level of the respiratory flow is set on the flowmeter in relation to the lungs to be ventilated The flow is constant during inspiration and expiration phase The resulting positive insp pressure PIP can be limited by means of the inspiratory pressure valve Plateau This inspiratory pressure plateau remains constant for the duration of inspiration During this time the gas can spread in the lungs under a constant pressure The patient is able to breathe spontaneously between the respirations delivered by the apparatus IMV If the expiration time Ti is further extended the portion of spontaneous respirations increases An expiration time Te of maximum 13 seconds results in a frequency of about 4 to 5 respirations per minute The built in monitor adapts itself automatically to the change of expiration time This means however that alarm for example in case of disconnection is released then only after 15 seconds Nevertheless just for this reason an IMV ventilation with a frequency of 4 to 5 BPM should be preferred to the normal CPAP ventilation since the pressure monitor of the F 120 GT is not activated during CPAP ventilation and also no apnoea alarm will be released During controlled ventilation depressing the key for manual ventilation can prod2. component Illustration 7 6 7 6 1 7 6 2 7 6 3 7 6 4 7 6 5 7 6 6 7 6 7 Heated expiration branch of the tube system Heated inspiration branch of the tube system Connection plug of heater spiral of the expiration branch To be inserted into the provided connection socket of the patient component Connection plug of heater spiral of the inspiration branch To be inserted into the provided connection socket of the patient component Y piece connects inspiration branch and expiration branch of the tube system with the patient Tube connector for connection of ventilation tube with the Y piece With the help of it the ventilatory deadspace is significantly reduced Face mask for short term ventilation and reanimation Available in sizes 1 to 3 Reanimator F 120 GT Operating instructions Reanimator F 120 GT Operating instructions 29 8 Testing prior to operation 8 1 Monitoring After switching the reanimator on and depressing the test key all indicator elements and the performance of the expiration valve switching on five times are tested The disconnection monitor activates visually and audibly after 20 seconds a short continuous tone sounds In case of a fault the audible alarm persists and is illuminated The disconnection monitor is permanently set at 12 cmH0 this pressure value must be exceeded with every respiratory cycle performed by the apparatus otherwise alarm is released With help of the
3. Monitor Operating instructions 23 Monitor for supervision of the respiratory pressure Activated only with ventilation mode IMV MONITOR been eliminated Stenosis Visual alarm occurs if the pressure does not fall below the limit of 12 cmH20 2 2 seconds after the end of inspiration Disconnection Visual alarm ensues if the permanently installed pressure limit of 12 emH20 is not exceeded after the set expiration time maximum inspiration time 2 0 sec Failure of gas supply disconnection O Alarm Visual alarm occurs when the set values for oxygen concentrations are violated Alarm activates only when the oxygen monitor is switched on Mute Key for muting the audible alarm for 2 minutes By pressing all audible alarms are muted for 2 minutes whereby the visual alarms remain active If the alarm condition still persists after 2 minutes the audible alarm will be released again Audible and visual alarm cease only when the cause for the alarm has BAT Indication of supply voltage for 12V DC internal accumulator 12 V ext Indication of supply voltage for 12V DC external Mains Indication of supply voltage for 230V 50 Hz AC Reanimator F 120 GT Operating instructions 24 7 5 Patient component P1 Patient component with limitation of humidification of the respiratory gas inspiratory pressure expiration pressure valve and 7 5 1 Expiratory pressure valve with PEEP setting During inspirati
4. Op war TIMER HF FREQUENCY f x E ozs EXPIRATION e The O2 monitor can be switched on and off by means of the ON OFF key Hill Rom Air Shields Illustration 6 The O sensor is plugged into the gas stream at the front An upper alarm limit and a lower alarm limit can be set with the help of the coding switches The alarm limits are activated only with the x O monitor switched on In the event that the oxygen concentration level rises above or falls below the selected set points an audible and visual alarm occurs The O2 monitor has to be calibrated anew from time to time for 21 oxygen using the Cal key To do so it is necessary to place the O2 sensor in ambient air Note If it is necessary to measure the O2 concentration of the incubator you can remove the sensor from its measurement socket and close the socket with the blue replacement plug Oxygen sensor replacement plug Reanimator F 120 GT Operating instructions 19 The audible alarm of all monitor functions can be muted for 2 minutes by means of the 2 min key Prior to every putting into service a performance test has to be carried out by depressing the key AUTO TEST Hereby all luminous fields must illuminate intermittent audible alarms must sound five times and the valve must activate five times The loading capacity of the internal battery as well as the 12 V on board supply is supervised When the minimum supply is falling short ever
5. Stand by key the audible alarm of the monitor can be muted for 2 minutes The stenosis monitor is tested by means of building up of pressure If the pressure does not fall below the pressure limit of 12 cmH O 2 2 seconds after the end of inspiration visual and audible alarm ensues 8 2 Inspiratory pressure Plateau expiratory pressure PEEP The plateau regulator limiting the inspiratory pressure is tested by connecting the tube system to the Y piece The pressure gauge then must indicate the set inspiratory pressure PEEP is set on the inspiration valve by means of the control knob The tube system is occluded on the Y piece At the end of inspiration the pressure gauge must then indicate the set PEEP 8 3 Tightness Especially in the paediatrics the tightness test is of great importance With the Y piece occluded the inspiratory pressure set at min 40 cmH gt O with a flow of 5 litres per minute must exceed 30 cmH 0O in the set inspiration time of 1 0 seconds Reanimator F 120 GT Operating instructions 30 8 4 Heater and tube heating system Test of the heating system can only be performed by manual control After switching the heater on the humidifier and the tube heating system will feel warm to the touch 33 to 34 C 8 5 Oo Monitor The oxygen concentration set on the flowmeter is displayed digitally To test the visual and audible alarm the oxygen concentration is first adjusted to a value exceeding the set maxi
6. in the lungs of neonates due either to immaturity disease or failure of the respiratory system Due to the independence of any distribution voltage the Reanimator F 120 GT is designed to be operated as part of the TI 5000 Globe Trotter Neonatal Transport System The internal battery provides an operation time of at least 2 hours independent from distribution voltage at max loading capacity Caution The Reanimator F 120 GT is not designed for long term intensive care ventilation Reanimator F 120 GT Operating instructions 9 4 Specifications of the Reanimator F 120 GT Modes of operation IMV controlled ventilation CPAP spontaneous respiration Possible settings Inspiration time adjustable Expiration time adjustable O2 flow constant adjustable Air flow constant adjustable Oxygen concentration adjustable Patient component 0 25 to 2 seconds 0 25 to 30 seconds 0 to 10 l min 0 to 10 l min 21 to 100 O2 Expiratory pressure PEEP adjustable 0 to 15 cmH 0 Inspiratory pressure Plateau adjustable 15 to 60 cmH20 Heated humidification Heated tube system Power consumption Monitor Disconnection Stenosis Failure of power supply Fault of Reanimator electronics Distribution voltage Testing program AUTO TEST Mute of alarm 12 V 10 Watt 12 V 10 Watt Visual and audible alarm in case 12 cmH20 are not reached after expiration time maximum inspiration time Visual and audi
7. operating technicians The silicone ring on the connection nipple of the patient component must be checked and exchanged if defective The intake filter must be cleaned respectively exchanged Service and repairs Service and repairs must only be carried out by the F Stephan GmbH Medical Engineering Kirchstr 19 D 56412 Gackenbach or by personnel who have been trained and authorized by the F Stephan GmbH Reanimator F 120 GT Operating instructions 12 Accessories list spare parts F 120 GT Part No 1 002 61 001 1 002 61 512 1 705 50 056 1 950 60 003 1 951 60 001 1 002 61 020 1 650 40 005 1 002 61 016 1 701 60 416 Accessories Patient component P1 heated Patient hose system w y piece heated power pack Atmos suction pump O ring4x 1 5 Flat gasket humidifier bottle 300 ccm Teflon sleeve long complete for patient comp P1 P2 P3 Humidifier bottle 300 ccm Protection cap P1 P2 P3 complete Y Piece with rubber cap F120GT Ventilator Replacement Part 1 804 60 002 1 802 60 406 1 34 61 412 1 107 60 008 1 107 60 009 1 107 60 010 1 950 60 009 Set of fuses 5x20 mm Power connection cable 230 V Power connection cable 12 V Connection cable for oxygen sensor Oxygen sensor Diffuser for oxygen sensor O Ring for diffuser NeoSid Monitor Accessories disposables 1 702 60 010 1 702 60 011 1 702 60 013 1 702 60 025 1 702 60 020 1 702 60 019 1 704 60 122 1 704 60 123 1 704 80 124 Gel
8. pressure valve and can be autoclaved at up 134 C A compressor is integrated in the Reanimator F 120 GT making a self supporting supply with compressed air possible It directly and permanently supplies the F 120 GT so that no external supply with compressed air need be connected In addition to the 230 V mains supply it is possible to connect the F 120 GT to an external electric board network and to operate the Reanimator on 12V DC An internal battery provides the power supply when no mains supply respectively board network is available Switching over to the available power supply ensues automatically and is indicated Reanimator F 120 GT Operating instructions 7 Optional Monitoring The F 120 GT can be equipped with an optional Monitor NeoSid plus This monitor is able to measure heart and respiration signs of the patient during transportation The EKG and respiratory signals and are detected due to electrodes attached to the body of the patient By using the unique Massimo technology oxygen saturation of the patient is detected and controlled The large backlit display is able to show digital information as well as graphical indication by means of SpO2 EKG and respiration impedance curves Reanimator F 120 GT Operating instructions 8 3 Range of application The Reanimator F 120 GT is a ventilator for short term and emergency ventilation of premature infants neonates and infants It is used in the case of insufficiency
9. resistance caused by the development of turbulences becomes especially perceptible Flow in the trachea remains on a uniform high level only for a short period of time since the lungs with low compliance keep filling With a low offer of gas flow the set pressure limit is reached later Here the compliance of the lungs is decisive It takes a longer time until the pressure limit is reached and the flow which in this case develops less turbulence remains almost constant through a long period of the inspiration time Reanimator F 120 GT Operating instructions 13 6 Description of performance The Reanimator must be connected to the mains 230 V by means of the apparatus plug picture1 item1 and the attached connecting cable The mains switch 1 2 should always be switched on so that the internal battery can be charged during endurance Illustration 1 Additionally the F 120 Mobil can be connected to a 12V onboard supply by means of the 12V plug 1 3 with the by packed connection cable With the reception coupling and the connecting tube the F 120 Mobil must be directly connected to the oxygen supply The air pressure supply is provided by the built in compressor With the ON OFF switch the apparatus is switched on The Paediatric Reanimator F 120 GT is a time controlled and pressure limited constant flow ventilator developed for first care and emergency ventilation of babies and infants Reanimator F 120 GT Operating ins
10. 0 GT Operating instructions 26 If the patient component is removed a protective cap to prevent damages to the connections and contacts during cleaning and transportation should be used For attachment of the patient component to the Reanimator the protective cap has to be removed The Connection taper for the inspiration and expiration tubes are positioned at the left side of the patient component Between the tapers are the sockets to connect the heating of the tube system Notice Use only distilled water for the humidifier bottle Do not fill beyond the filling mark Do not fill with inflammable anaesthetic agents Test humidifier bottle for tightness after disinfection or sterilisation Reanimator F 120 GT Operating instructions 27 7 6 Patient tube system 2 7 6 Heated patient tube system consisting of the two silicone tubes with heater spiral for inspiration 7 6 2 and expiration 7 6 1 The heater spiral serves to stabilize temperature and to prevent theformation of condensate water For ventilation in the incubator only the unheated ends of the tube system are introduced in the incubator If the temperature of the incubator is lower than the nominal temperature of the respiratory gas condensate water may form in the unheated ends of the tube system The tube heating system is plugged into the patient component by inserting the plugs 7 6 3 and 7 6 4 into the sockets of the patient
11. 5 Seen DW B EE 2 Me Illustration 5 With the key for the heater 5 1 the heater cartridge 5 2 in the humidifier for respiratory gas and the heated tube 5 3 are switched on and off The fresh gas is warmed by the heater cartridge 5 2 and is conducted through the humidifying bottle 5 4 which is filled with distilled demineralised water The heated tube system maintains a constant temperature of the warmed and humidified respiratory gas and thus prevents forming of condensate water in the tube The elements of the heater cartridge and of the tube heating system are dimensioned so that a temperature of app 35 36 C results The Reanimator is provided with a monitor for supervising the respiratory pressure 5 5 and with a monitor for supervising the oxygen concentration 5 6 The pressure monitor 5 5 warns in case of failure of power supply gas supply disconnection and stenosis The failure of gas supply alarm respectively the stenosis alarm sounds if the permanently installed pressure limit is not exceeded by the respiratory pressure after the set expiration time maximum inspiration time 2 seconds Reanimator F 120 GT Operating instructions 18 Stenosis alarm activates if respiratory pressure does not fall below the permanently installed pressure limit 2 2 seconds after end of inspiration The oxygen monitor 5 6 supervises the concentration of oxygen in the respiratory gas REANIMATOR F120 CN e
12. ble alarm if respiratory pressure does not fall below 12 cmH 2O 2 2 seconds after end of inspiration time Audible alarm for 120 seconds Visual and audible alarm until fault has been eliminated Indication of the actual distribution voltage Performance test of all indicators alarms and of the valve 2 min suppression of audible alarm Reanimator F 120 GT Oxygen monitor Digital display Maximum O gt limitation adjustable Minimum O limitation adjustable Automatic calibration Indicators Respiratory pressure gauge Frequency with IMV digital Power supply Protective transformer Protective class Protective category Weight Measurements Operating instructions 10 21 to 99 O of the respiratory gas 21 to 99 Oz visual and Audible warning in case of exceeding 21 to 99 On visual and audible warning in case of falling below Only in case of saturation with compressed air 10 to 60 cmH 0 2 to 120 respirations per minute BPM 230V 50 mains 12V DC external 12V DC internal by battery Single phase separating transformer power consumption 70 VA I Type B IP20 app 18 kg L 120 x H 300 x D 210 mm Reanimator F 120 GT Operating instructions 11 5 Principle of performance The Reanimator F 120 GT primarily works time controlled and pressure limited according to the continuous flow principle The fresh gas as set on the flowmeter unit flows during inspiration an
13. d expiration To avoid unintended adjustments of the gas flow the knobs of the flow control valves are different due to the gas type and are covered by a metal frame The filling of the lungs during inspiration is accomplished by closing of the expiration valve For manual ventilation the expiration valve can be closed by hand pushing the red button of the expiratory valve If the set inspiratory pressure limit inspiratory pressure plateau is reached prior to the end of the selected inspiration time the surplus gas is evacuated via the mechanical inspiratory pressure valve A second safety valve to avoid excessive patient gas pressures is positioned at the rear of the F 120 GT It is set to 40 cmH20 at a gas flow of 5 l min Expiration is effected by opening the expiration valve Hereby the lungs evacuate due to the decrease of pressure Expiratory gas and fresh gas together are evacuated via the expiration valve From this results the following important consistency common to all constant flow appliances The set continuous gas flow bypasses even during the expiration cycle the y piece of the patient That bypass flow washes out the exhaled carbon dioxide CO2 of the patient The rate of the gas flow should be adjusted minimum to the inspiratory peak flow of the patient approx 2 5 l min Excessive gas flows will increase the work of breathing of the patient as does too low a gas flow The minute volume as set on the flowmeter unit
14. e respirator is supposed to keep operating switching over to IMV with long expiration time if necessary Reanimator F 120 GT Operating instructions 34 10 Cleaning and sterilization All components that have contact with the patient like the patient component and the patient tube system are detachable for cleaning purposes The following parts can be autoclaved at 134 C Patient component Pl complete with heater cartridge and humidifier bottle the heated tube system of the patient tube system the Y piece The following parts can be sterilized in a sterilizing solution or by means of gas sterilization the tube connector the face mask When the patient component is unscrewed from the F 120 GT for cleaning or sterilization loosening of the fastening screw the protective cap must be fastened to the patient component with the fastening screw The humidifier bottle must be unscrewed to make a separate sterilization possible The intake filter for the compressed air supply at the rear of the apparatus must be checked prior to any putting into operation In case of accumulation of dirt it must be cleaned respectively exchanged Important Especially after sterilization in a dissolvent care has to be taken that no sterilizing agent remains in the component parts All parts must be allowed to drip off and dry Reanimator F 120 GT Operating instructions 11 Inspection and maintenance Maintenance by
15. electrodes VE 240 pc s 30mm Gel electrodes for allergic persons VE 240 pc s 30mm electrodes without gel VE 240 pc s 30mm Patient cable for NeoSid Long life electrodes VE 3 pc s Adhesive rings for Long life electrodes VE 500 pc s Flexsensor for infants lt 10kg disposable Flexsensor for infants with sensitive skin lt 1kg disposable Flexsensor for paediatrics 10 50kg disposable
16. erformance test has to be carried out by activating the key AUTO TEST In doing so all luminous fields must illuminate an intermittent audible alarm must sound five times and the valve must be activated five times 9 An apparatus for manual ventilation independent from the Reanimator F 120 GT must be close at hand 10 The Reanimator F 120 GT must only be operated with the genuine by pack spare parts of STEPHAN or with those parts which are recommended by the manufacturer 11 The conveying capacity of the built in compressor changes with 12 V DC operation WARNING The Reanimator must not be used with respectively in connection with inflammable anaesthetic agents If the ambient temperature rises above 41 C the humidifier heater should be switched off The Reanimator F 120 GT is provided with an internal battery To guarantee an optimum charge of the battery the apparatus must always be connected to the current supply and mains switch on the apparatus plug must be in ON position during stand by periods With an optimum charge of the battery an operating time of at least 2 hours is secured The time to recharge the discharged battery takes at least 20 h NOTE An external 12v supply can be connected using the external dc cable Reanimator F 120 GT Operating instructions 6 2 Preface The STEPHAN Reanimator is a ventilator unit for neonatal and perinatal short term ventilation It operates time controlled flow con
17. his limit a visual and audible alarm occurs A visual and audible alarm ensues if the set limit values are exceeded or fallen below By means of the key 2 min the audible alarm can be muted for 2 minutes The visual alarm ceases only after the fault has been eliminated Reanimator F 120 GT Operating instructions 22 7 3 Control component and indicators 7 3 1 7 3 2 7 3 3 7 3 4 7 3 5 7 3 6 7 3 7 7 3 8 7 3 9 Hill Rom AirJShields A WLLL ENTALTEN Timer for setting the respiration times inspiration and expiration as well as indication of the respiratory frequency Setting of the respiration times and indication of the respiratory frequency is activated only in connection with the ventilation mode IMV 7 3 2 With ventilation under CPAP 7 3 3 the display shows three bars Key for changing to ventilation mode of controlled ventilation IMV Key for changing to ventilation mode of spontaneous ventilation CPAP ON OFF switch of Reanimator F 120 Key for switching the heater on and off humidifier of the respiratory gas tube heating system Key for starting AUTO TEST of Reanimator Hereby the performance of all input and output elements is tested Coding switch for setting the inspiration time Indication of respiratory frequency with IMV The frequency is calculated from the settings of inspiration time and expiration time Coding switch for setting the expiration time Reanimator F 120 GT 7 4
18. is the maximum quantity of fresh gas available to the patient for the period of one minute Dependent on the set respiratory cycle inspiration time expiration time respiratory time ratio the patient receives only part of the set minute volume since part of the fresh gas is lost during expiration and when the pressure plateau has been reached and consequently is no longer available to the patient From this follows that the set minute volume on the flowmeter unit must always be higher than the inspiratory minute volume that the patient is supposed to receive Reanimator F 120 GT Operating instructions 12 Dependent on the system this results according to the set flow in an increase of the end expiratory pressure indicated on the pressure gauge Due to the danger of hyperextension of the lungs of babies and infants ventilation with pressure limitation is decisive To administer a sufficient volume of gas under this limitation a constant flow is offered This may be more than the patient is able to take in Therefore different respiratory patterns may result De High gas Flow 10 Flow 10 l min l min a Low gas flow 4 Insp time Insp time Time is Time s Press 50 Press 50 cmH20 cmH20 r Pressure 4 limitation due 30 to insp valve 30 Lower insp Press due to low gas flow Insp time Insp time Time s d gt Time s With an increased offer of flow the pressure limit is reached fast here the airway
19. mum limit value and then to a value falling below the set minimum limit value In both cases visual and audible alarm must be released 8 6 Intake filter Prior to any putting the apparatus into service the intake filter should be checked and if required exchanged Reanimator F 120 GT Operating instructions 31 9 Description of modes of ventilation 9 1 Controlled ventilation IMV Inspiration and expiration times are pre selected by the user in values of seconds From this result the respiratory frequency RF 60 seconds inspiration time expiration time and the respiratory time ratio VE inspiration time expiration time The following settings are possible Inspiration time of 0 25 to 2 seconds Expiration time of 0 25 to 30 seconds From this result the possible respiratory frequencies of 2 to 120 BPM This value is displayed digitally Example Insp time 1 0 sec exp time 2 0 sec RF l min 60 sec 1 0 sec 2 0 sec 20 min 2 x Inspir 1 x Expir Inspiration expiration 1 2 I E ratio 1 2 Since the flow of gas is not interrupted during expiration the patient is able to breathe spontaneously at any time The controlled respirations released by the apparatus ensue unsynchronised i e also during spontaneous inspiration respectively expiration Premature infants and neonates easily tolerate this Reanimator F 120 GT Operating instructions 32 Pressure Limited PP PIP Paw K cmH20
20. ncrease of oxygen flow O gt concentration can be monitored on the O gt monitor Proportioning valve for setting the fresh gas flow With increase of the fresh gas flow by means of the Proportioning valve 7 1 2 oxygen concentration decreases To reach the optimum mixture of respiratory gas with a determined flow the correct setting must be found by alternating rotation of the proportioning valves Control of the O2 monitor Reanimator F 120 GT Operating instructions 21 7 2 O2 Monitor 7 2 O2 monitor for monitoring of oxygen concentration in the fresh O2Monitor gas 1 7 2 7 2 1 Digital display of O concentration lecken S R 7 2 2 Calibration key for adjusting the sensor to 21 O with FE ambient air The sensor is permanently installed in the m ___3 Reanimator During calibration the sensor must only be O2 max ee 5 saturated with compressed air I e the proportioning valve for OM 9 oxygen on the flowmeter 2 5 shown on page 14 must be a rotated to its right stop so that the supply with oxygen is cut off O2 min a 7 2 3 ON OFF switch of O monitor _ 5 ei l 7 Lee Illustration 7 2 7 2 4 Coding switch for setting the minimum oxygen concentration If the oxygen concentration falls below the selected set point an audible and visual alarm occurs 7 2 5 Coding switch for setting the maximum oxygen concentration In case of exceeding t
21. nnnnn 34 11 INSPECTION AND MAINTENANCE 222 02002uuan200000000000nnan0n0nnnnunnunnnnnnnnnnnnunnnn an nnnnnnnnnnnnnnnnnnnnnnnnnan EEN 35 12 ACCESSORIES LIST SPARE PARTS E 120 GT 22u2u00000un200000000000unannnnnunnununnnn an nnunnnnnnnn ENN 36 F120GT Ventilator Replacement Part orsssssssnsssssossnssonsnnsonsnnsnsssnssnssnnsnnsnnsnnsnnsnnsnnsnnsnnssnssnnsnnsnnsnnssnssnnsonsnnsnnnne 36 NeoSid Monitor Accessories disposables sussusssssossssnssonsnnsonsnnsnnsnnennsnnssnnsonsnnsnnsnnsnnsnnnnnnsonsnnsnnsonsnnsnnsnnsnnsnnsnnnsen 36 Reanimator F 120 GT Operating instructions 5 1 NOTICE 1 Pursuant to Medical Device Directive 93 42 the apparatus must only be operated by trained personnel Prerequisite is an exact knowledge of the operating instructions 2 The apparatus is only intended for use as specified in the operating instructions 3 The apparatus must be inspected periodically by trained personnel 4 The F STEPHAN GmbH prescribes a semi annual inspection and maintenance by an authorised service technician 5 A performance test has to be carried out prior to each putting into service 6 The F STEPHAN GmbH will not be liable for damages resulting from faulty operation due to non observance of the operating instructions or from use for which the apparatus is not earmarked 7 If possible neither antistatic nor electrically conductive tubes should be used 8 Prior to each putting into service a p
22. on the valve is closed by an electromagnet during expiration the valve is currentless open Furthermore an end expiratory pressure PEEP can be set by means of this valve This is performed mechanically by rotating the control knob in the appropriate direction Rotation to the right effects an increase of PEEP rotation to the left effects a decrease of PEEP The setting must be controlled on the pressure gauge since the scale values are only approximate values 7 5 2 Push button for manual ventilation 7 5 3 Inspiratory pressure valve Plateau for limitation of respiratory pressure The valve acts as a safety valve and limits the inspiratory pressure According to the setting of inspiration time and of flow a plateau at the level set on the valve forms Setting must be controlled on the pressure gauge 4 7 5 4 Fastening screw for fastening the complete patient Illustration 7 5 5 component of the Reanimator 7 5 5 Humidifier bottle for saturation of the warmed fresh gas with water vapour The relative humidity then amounts to approximately 85 to 95 at the outlet of the humidifier 7 5 6 Heater cartridge with bubbling tube for warming the fresh gas Hereby the fresh gas is conducted through the bubbling tube and past the heater cartridge where it is warmed and then led into the humidifier bottle Only distilled and demineralised water must be used Reanimator F 120 GT Operating instructions Reanimator F 12
23. r oise ste EE O sa esdetinsobsect lt bildeavas amp sash stediaeionsdseavdbbins 23 1 5 Patient component Ploemeur a a e sE Sae Ssa SSSss 24 7 6 Patient tub SyStem sisi esesesselesesssncsasetanaossets t de as dsconisncseosseton een tt sente denses eco 27 8 TESTING PRIOR TO OPERATION cc scccceeeeeceeenseeeeeensaeeeenseaeeeensaaeeeeensaaeeeenseaeeeensaeseenseaeeeeenseeseenas 29 SL DO 29 8 2 Inspiratory pressure Plateau expiratory pressure PEEP crssssessnssossorsnssossonsnnsonsnnsnnsnnsnnnsnssnnsonsnnsnnnne 29 8 3 Tightness is cssscvsesscs seess 29 8 4 Heater and tube heating system sorsossonsonesnssnsssssossnnsonsnnsnnsnnnnnssnssnssnnsnnsnnsnnsnnsnnssnssnnsnnsnnsnnsnnsnnssnssnssnnsonsnnssnene 30 8 5 O2 Monitor REEE AN IENE TEIE IEEE E AN 30 8 6 Intake filter degen Eed Ge Ee 30 9 DESCRIPTION OF MODES OF VENTILATION cccssseceeessseceenseseeeeeeseseeeeeseeeeesnseseeeseseeeeenenseeeenens 31 91 Controlled Ventilation IMV lt iscicisccanscsstsectcenssessboncscenssconstssoassecdisesascessasesestsuvessnessuse Siae Soei oTo aob S TaT Sae 31 Reanimator F 120 GT Operating instructions 4 9 2 Manual ventilation and imflation sccccssssccssssscssssssccsssssscsssscccessceccesssscccesseccsessnsscscseccccssnsccccsscecsessescccssnes 32 9 3 CPAP vem til ations EE 33 10 CLEANING AND STERILIZATION 222222000000n2n0000000000unnnnnnnnnnnnu nun nnnnnnnnnunn nn an nnunnnnnnnnn nn nnnnnnnnnnnnn
24. rely mechanical valve and serves to limit the respiratory pressure Limitation of inspiratory pressure If the set pressure is exceeded the inspiration valve opens inspiratory plateau and the surplus fresh gas can escape into ambient air and no longer reaches the lungs of the patient The switching cycle of the expiration valve can be set by means of coding switches for inspiration 3 3 and for expiration 3 4 The respiratory time ratio results automatically from the settings of inspiration and expiration Respiratory frequency is calculated from the set parameter and displayed digitally in the three digit display 3 5 Reanimator F 120 GT Operating instructions 16 REANIMATOR F120 FREQUENCY w s MAX 120 INSPIRATION sec EXPIRATION 1 50 01 50 Illustration 4 The keys 4 1 and 4 2 serve to change the mode of ventilation By depressing the key for CPAP 4 2 the apparatus is switched over into the spontaneous breathing mode In doing so the expiration valve is always open The patient can now breathe spontaneously using the offered flow of fresh gas Furthermore an end expiratory pressure PEEP can be adjusted by means of the expiration valve 3 1 shown on the previous page After depressing the key IMV 4 1 the ventilation mode returns to controlled ventilation Intermittent Mandatory Ventilation IMV Reanimator F 120 GT Operating instructions 17 1 6 BEZ REANIMATOR F120 E Ai
25. stant and pressure limited for controlled IMV ventilation as well as flow constant and pressure limited for CPAP ventilation and manual ventilation Inspiration time is adjustable from 0 25 to 2 seconds expiration time is adjustable from 0 25 to 30 seconds Flow is adjustable from 0 to 20 l min respiratory pressure is adjustable from 15 to 60 cmH 0 The frequency indicator digital indicates according to the setting with controlled ventilation IMV the respiratory rate of 2 to 120 breaths per minute BPM In operating mode CPAP the display shows three bars Oxygen and air are mixed in the attached twin flowmeter Oxygen concentration is adjustable from 21 to 100 O An O monitor with adjustable minimum and maximum alarm value monitors the oxygen concentration with visual and audible signals The monitor supervises visually and audibly failure of mains power and gas supply as well as disconnection and stenosis As well as the Auto Test system the electronics of the respirator are permanently supervised by a Watchdog system The apparatus is provided with a heater for warming the respiratory gas The heater consists of the heater cartridge for humidification of the respiratory gas as well as of the heated tube system to stabilise temperature and to prevent forming of condensate water The heating system can be switched on and off The patient component P 1 consists of the heated humidifier for the respiratory gas PEEP and inspiration
26. tructions 14 Illustration 2 The Reanimator F 120 GT is connected directly to the central oxygen supply or to the integrated oxygen cylinder of the incubator The high pressure gauge 2 2 informs you about the cylinder content The low pressure gauge 2 3 informs you about the oxygen pressure of the internal pressure reducer or the wall supply The built in compressor of the apparatus effects supply with compressed air The level of the fresh gas flow and the oxygen concentration are set by means of the two proportioning valves 2 4 2 5 in constant flow mode After connecting the power supply the apparatus is switched on with the ON OFF switch 2 1 After switching off the F 120 GT saves the last operation mode and starts with this mode when the Reanimator is switched on again For example if he starts in IMV mode controlled mandatory ventilation cycles are delivered to the patient in accordance with the set parameter for inspiration and expiration During inspiration the expiration valve 2 6 is closed and so the lungs of the patient are inflated By switching over into expiration this valve opens and the air can escape from the lungs Reanimator F 120 GT Operating instructions 15 REANIMATOR F120 1 TEAU Illustration 3 3 4 A positive end expiratory pressure PEEP can be set by means of the expiration valve 3 1 It acts mechanically via the set force of pressure of a spring The inspiration valve 3 2 is a pu
27. uce an artificial sigh or a prolongation of inspiration 9 2 Manual ventilation and inflation By depressing the red push button the expiration valve is closed mechanically for the duration of depression During CPAP ventilation the patient can be ventilated manually or inflated by depressing the push button Hereby the respiratory pressure as set on the inspiratory pressure valve Plateau is built up Reanimator F 120 GT Operating instructions 33 9 3 CPAP ventilation Due to the continuous flow principle a genuine CPAP ventilation is possible The PEEP mechanism in the expiration valve always maintains the set end expiratory pressure in the constantly flowing gas P cmH20 Spontaneous breathing patient CPAP _ GC Breathing With this flow of gas the patient is able to breathe spontaneously under a positive pressure This PEEP valve can be used for all modes of ventilation With sufficient spontaneous respiration the patient can breathe spontaneously in the CPAP mode of ventilation After depressing the key CPAP the expiration valve is switched currentless open and the monitor is out of operation The flow is adapted to the spontaneous respiration so that the motions of inspiration and expiration can be read off at the pressure gauge Expiratory pressure PEEP is set at the desired pressure of 1 to 10 mbar A monitor should be used to supervise apnoea and disconnection If the disconnection monitor of th
28. vc F 120 GLOBETROTTER GT PAEDIATRIC VENTILATOR Operating instructions F STEPHAN GmbH Medizintechnik D 56412 Gackenbach Kirchstr 19 Tel 06439 9125 0 Fax 06439 9125 11 info stephan gmbh com www stephan gmbh com Reanimator F 120 GT Realisation Bernd H hne Edited John Hussen F Stephan GmbH Medizintechnik Gackenbach Subject to technical changes Status February 2006 Rev 2 1 Operating instructions Reanimator F 120 GT Operating instructions 3 Content TINO TICE EE 5 2 PREFACGE EN aa nee EE EE A E 6 Optional rr 7 3 RANGE OF APPLEIGATION 2 242 ee III 8 4 SPECIFICATIONS OF THE REANIMATOR F 120 GT uuuasarH4nnnn0nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nn nnnnnn nme 9 5 PRINCIPLE OF PERFORMANCE u22402022222000022na0nonnnnnnennnnnnnnnnnnnannnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nn 11 6 DESCRIPTION OF PERFORMANCE 22uu4u42422H000nnnnnnnnnnn nn nnnnnn nn nnnnnn munnen nnnm ennn nennen nnmnnn nnmnnn nnmnnn nnmnnn 13 External Oxygen Supply Incubator cussosssonsonssonssnnsennesnsesnnensnsssssonssonssonsnnnsnnssnnsennssnnnsnnennnssnssnnennnsssnssnssanssonse 19 7 DESCRIPTION OF CONTROL ELEMENTS AND ELEMENTS ss 20 Do Mt Twink MO WMETEF EE 20 TDi O2 EE 21 7 3 Control component and indicators cussonssonsoossonssnnsensesnnennssnnssnnennnsnnnsssnsonssonssonsnnnsnnssnnssnnssnnnsnnssnnsssnssnsssnssanse 22 AE DNS VEE a ARE IEE ETE T n
29. y 30 seconds a warning tone is released It can not be suppressed and the equivalent potential indicator starts flashing As of this time 20 minutes operation time remains If the power supply falls below a critical level the apparatus is automatically shut off External Oxygen Supply Incubator It is possible to adjust an oxygen flow to the incubator or any other application where an adjustable oxygen flow is needed To do so you can open the additional oxygen valve at the front of the F 120 GT It will allow the application of oxygen flows stepwise from 0 5 l min up to 25 l min An ISO connector can be directly screwed to the outlet of the oxygen valve If the air inside of the incubator should be enriched with oxygen it is possible to measure the concentration with the oxygen monitor of the F 120 GT Oxygen valve ISO connector Oxygen valve Reanimator F 120 GT Operating instructions 20 7 Description of control elements and elements 7 1 Twin flowmeter Illustration 7 1 gt x I Vmi n IS em e 1 7 1 7 1 1 7 1 2 7 1 Twin flowmeter for mixing the respiratory gas and for setting of flow Proportioning valve for setting oxygen concentration of the respiratory gas With increased flow the oxygen Concentration increases automatically Ie in case of constant flow compressed air must be reduced Proportionally to the i
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