- Frank`s Hospital Workshop
Contents
1. FAILED LOWGAS PATIENT PROLONGED PRESSURE FLOW AUDIBLE OFF TOCYCLE SUPPLY CUIT INSP PRESS SETTINGS SENSOR Deinviesy Psv ALARM INCOMPATIBLE amp APNEA LOW BATTER Flow Cycled SIMV cS VENTILATOR RATE INSPIRATORY TIME VOLUME LIMIT Ja Monitoring Section Airway Pressure Manometer Self Test reath Rate Patient Initiated Monitor Display Windows Inspiratory Time Koy ee EN en En ESS 9 LS SS P EEP Monitoring Air O2 Monitoring toggle switch Minute Volume Inspiratory Tidal Volume _ine Power LINE POWER BATTERY low Cycled AC EAN Q ac cna SIMV IMV a cpap INSPIRATORY PEEP CPAP C PRESSURE Easy to read monitored values and indicator lights Expiratory Tidal Volume leak toggle switch BREATH RATE CD PATIENT INITIATED BEAR CUB 750esv INFANT VENTILATOR OLO PEAK INSP PRESSURE MINUTE VOLUME co et EA PE E E INSP TIDAL VOLUME CD PEEP c AIR 02 PRESSURE EXP TIDAL VOLUME LEAK TEST mi ae EA Q seanonvtine T EXPIRATORY TIME fe IE RATIO 32 LOW eee 33 HIGH ETA RATE ALARM siene Sr VISUAL RESET S LOW E VOLUME ncn HIGH PRESSURE LIMIT La Q e O O BASE FLOW INSPIRATORY FLOW MIN 27 OXYGEN ASSIST SENSITIVITY MAX ED r0 PATIENT 31 FROM PATIENT O BREATH OJ PROXIMAL PRESSURE 23 FLOW SENSOR 1 8 I D ONLY2. Controls Section Variable ventilator controls with integrated digital displays to set breath characteristics 27EEP CPAP nspiratory Pressure fentilator Rate f prato Time 3ase Flow nspiratory Flow ssist Sensitivity Manual Breath Alarms amp Limit Section Both variable and preset ventilator alarms and limits with integrated displays Variable Set Alarms Low PEEP CPAP Alarm High Breath Rate Alarm ow Minute Volume Alarm High Pressure Limit Audible Alarm Silence B Mode Selection Section The Mode Select knob allows mode selection with the turn of a knob Mode Selector Switch Flow Cycled Assist Control Assist Control SIMV IMV SIMV PSV Flow Cycled SIMV Standby CPAP Pressure Support Ventilation Pneumatics Module Percent Oxygen Control Flow Sensor Connection Proximal Pressure Monitoring Port ear Cub Ventilator Gas Flow Outlet to humidifier or patient Exhalation Valve Receives exhaled gas from patient 750PSV Battery Power TIME CYCLED PRESSURE LIMITED ce 18 Machine or assist breaths which utilize a set inspiratory flow to reach a preset inspiratory pressure Flow then decelerates and pressure is held for the set inspiratory time SIMV MODE Inspiratory Expiratory Phase in Phase gt Pressure rises until target pressure is reached and is maintained for the set inspiratory time At end
3. INE OW OR er aea cere ace E A E E A see sece esi Green Red LED Controls Modes and Waveforms BEAR CUB 750psv INFANT VENTILATOR FANES DPA ENET ORY fused PLUR Pye prsiy EEIN FOU Dreary rat MEEN ERY PRS S34 TIDAL VOL LE MAO Np OP DOAL PAUEL TUSA LULE AMG PAT GIUAI LOW PULP CPAP ECH BALATH RATI A Hihi Lind PORTA RATTAAT x LOW Minute VOLUME KGH PRESSURE Lia ee en Re J Ni H i fin K K BE mow STANDS ALAC ULIKE ESAL MG Esin N x Nad AL a g j STT SEEN AOSI GFT hehe monea Wee PSY Flow Cycted Savy ess VESTILATOA BATE SPAY D PAYOAY Tits Sen ESMAO f VOLUME LIMIT i Ji FPELOSURT y UA r A it ny ANSY d M SANOA DXSPRRATORY HOw MS ASSIST SENSITIVITY tay Low Sthson PROUIMAL Pg aE TO PATIONT PROM PATIENT This training aid has been designed to assist the clinician in the oun understanding and use of the features and options VIASYS Healthcare Critical Care Division _ available on the Bear Cub 750psv Infant Pediatric 1100 Bird Center Drive la E ventilators Palm Springs CA 92262 8099 ane Phone 760 778 7200 bom Numbers have been used for easy cross reference 800 328 4139 between faceplate information waveform Fax 760 778 7274 graphics and breath mode explanations CAUTION Prior to using this training aid read and understand the Bear Cub7 50psv Operator s Manual L1522 Rembrandtlaan 1b 3723 BG Bilthoven P O Box 299 3720 AG Biltho
4. Set Peak Inspiratory Pressure The concept of an assist window is very useful when describing the funda ene Paw inspiration breath cycles to mentals of SIMV operation exhalation and returns to baseline aa Baseline Pressure A ee Sr en ee PEEP Time w 2Sec gt 2Sec e a Time Paw l l Inspiratory Expiratory lt Phase gt SS ee ee ee Set Time Inspiratory Flow When a machine breath is due the assist window opens and waits for the patient s inspiratory Saa flow i V A effort If the ventilator does not detect an inspiratory effort a mandatory breath will be delivered at EU eoon LAS Ue the beginning of the next breath time period delivered then decelerates as pressure equilibrates in EBS OE ee the lungs o 2Sec __ _ m 2Sec _e _ l l l l l l l Paw l l l l Time B Upon sensing the patient s inpiratory effort a TCPL breath based on the preset inspiratory Pressure at the preset Inspiratory Time is delivered As soon as this breath has been triggered the assist window closes Inspiratory Expiratory As flow is delivered lung Phase Phase volume increases The P7777 7 aQ TC TCT Delivered 2506 wpe 230R breath cycles to exhalation VT Tidal Volume at the end of inspiratory time period Paw Once the TCPL breath has been d
5. decrease to 10 of the peak inspiratory flow The termination criteri on is fixed at 10 The advantages of flow cycling are improved synchrony inspiratory times that do not exceed what is necessary for complete lung inflation and lower risk of air trap ping especially at high respiratory rates inspiratory flow falls to 10 the breath will be time cycled The breath will be volume cycled if the set Volume Limit is reached first The Inspiratory Time Display will flash breath is terminated based on time rather than flow SIMV7 PSV SIMV PSV allows for a combination of mechanical and spontaneous breath types Mechanical breaths are delivered at the set ventilator rate while all other breaths are spontaneous Mechanical breaths will be time cycled at the preset Inspiratory Time or volume cycled when the Volume Limit is reached whichever occurs first All spontaneous breaths will be supported by the ventilator to the preset Inspiratory Pressure and flow cycled when the inspiratory flow falls to 10 of the peak Inspiratory flow rate These breaths may also be time cycled at the preset Inspiratory Time or volume cycle when the Volume Limit is reached whichever occurs first The Inspiratory Time Display will flash if the breath is terminated based on time rather than flow PSV When PSV is selected all spontaneous breaths will be supported to the preset Inspiratory Pressure and flow cycled when the inspiratory flow falls to 10 of th
6. e aannannnnnnnnnnnnnnnnnnnnnn 3 to 255 bpm period as set on the back of the machine then deliver 2 TCPL breaths at the set Low PEEP CPAP sssssrunrnrrrrrrrrrrssesenes 5 to 30 cmH20 ae 7 i y i Low Inspiratory Pressure 000 00s eee e eee 0 25 High Pressure Limit inspiratory time and pressure with maximum delay of 10 seconds between Low PEEP CPAP Low breaths Both visual and audible alarms will be activated PEEP CPAP Patient Circuit sce cane nace ener erecta sree a orer ete a a LED On Off The apnea alarm remains active until spontaneous breathing resumes at which Failed to Cycle 2 4 e wee eee a eee LED On Off time the apnea alarm resets When this happens the audible alarm will be re Gas Supply 2 2 eee eee eee eee eee eee ep rn rt silenced but the visual indicator will remain lit until the visual reset button is prenera CERIN ERIT ana en Lt ICED Bon pushed This alerts the clinician that an apnea event has occurred Prolonged Inspiratory Pressure 2 2 55 LED On Off FOW Sensor mara a crea veevcns tee ss ceeer ster ers te ccmeranens ea E E ee LED On Off If the ventilator recognizes a spontaneous breath before the initiation of the Low Batien P E E E E E TE LED O On second mechanical breath the above alarm conditions will occur and the second Alarm Silence m te ees ses E A e 60 sec Visual RESETE a r a oe ore E a E a reee S Push Button AEE CUT DE WO E To High Pressure Limit 0 000s 10 to 75 cmH20 E
7. e peak inspiratory flow rate These breaths can also be time cycled at the preset Inspiratory Time or volume cycled when the Volume Limit is reached whichever occurs first The Inspiratory Time Display will flash if the breath is terminated based on time rather than flow There is no mandatory breath rate in this mode WOOL LUIS Volume Limit is a feature that limits the maximum tidal volume of all breaths delivered by the ventilator It can be enabled in all modes including CPAP and PSV providing an added measure of patient safety The range is 5 to 300 mil The Volume Limit LED will display dashes if the flow sensor is absent or disabled Silent and Audible modes are available Silent Mode In this mode all breaths will be limited to the set maximum tidal volume A visu al indicator will show when breaths have been limited Audible Mode In this mode an audible tone will be delivered after 5 consecutive volume limited breaths For each subsequent volume limited breath an audible tone will be delivered ASSIST SENSITIVITY The Assist Sensitivity control determines the amount of inspiratory effort the patient must exert to trigger an Assist Control breath SIMV breath or to have spontaneous breaths counted and displayed in the breath rate window The Assist Sensitivity feature has an adjustable range of 0 2 Ipm to 5 0 L min To correctly set the Assist Sensitivity and determine if a leak is prese
8. elivered subsequent patient effort results in spontaneous breaths until the next mandatory breath is due Time c rate control setting or when the patient activates the assist trigger Provided the set assist sensitivity threshold is 1 2 2 met the patient may trigger every breath if their ventilatory demand exceeds the set venti lator rate The result is a synchronization of mechanical breaths with patient demand If the patient does not trigger a breath before the breath time period elapses the ventilator will deliver a mandatory TCPL breath according to the clinician selected inspiratory pressure ventilator rate inspiratory flow and inpiratory time All spontaneous inspiratory efforts recognized by the ventilator will be fully supported according to these preset ventilator settings 1 Mandatory TCPL Breath 2 Patient Triggered TCPL Breath FEOW CYCLE FLOW CYCLCED ASSIST CONTROLC MODE Diena a will flash if the rean is aed bacci 10 Flow Cycling on time rather than flow sec 4 6 8 Set L T 10 FLOW CYCLED SIMY MODE 20 Vt In Flow Cycled SIMV all mandatory pressure limited l breaths are delivered to the patient at the preset Inspiratory Pressure and are flow cycled when the inspiratory flow falls to 10 of the peak inspiratory flow rate 10 If the preset Inspiratory Time is reached before In any of the flow cycled modes a mandatory or patient initiated breath may be terminated by flow when the flow
9. nt turn the sensitivity knob to the right and note if a Leak Detection LED bar is present to the left of the Assist Sensitivity LED If no Leak Detection LED bar is detected the Assist Sensitivity LED should be positioned at the minimum setting If a Leak Detection LED bar is present show ing the presence of a leak set the Assist Sensitivity LED to the right of this bar Optimizing the sensitivity while compensating for leaks may prevent auto cycling CPAP While in CPAP only the base flow is active all breaths are spontaneous and unassisted When CPAP is being delivered through an artificial airway flow sen sor must be attached the sensitivity must be appropriately set in order that spontaneous breaths are counted and displayed in the Breath Rate display win dow Constant airway pressure is maintained throughout the breath cycle based on the set PEEP CPAP level Setup 1 Select CPAP mode 2 Set desired flow rate 3 Set desired PEEP CPAP level 4 Adjust the Over Pressure Relief Valve per instructions in User Manual 5 Set Inspiratory Pressure 6 Set High Pressure Limit Alarm 7 Set Low PEEP CPAP Alarm 8 Set High Breath Rate Alarm Ventilator controls must be set to appropriate settings for the patient They are active when the manual breath button is pushed or if the apnea alarm threshold is reached SETTINGS INCOMPATIBLE ALARM J ERIEO The Settings Incompatible Alarm will activate if a con
10. ting with the message E FI Error Flow Patient Initiated Indicator 000 cee eee eee LED rno i smi Minute Volume S466 e524 es err A e ee a ee ees 0 to 30 0 L min if the Inspiratory Flow setting is too high for the Volume Limit Setting TidaliVolunteingplrodlanthEx pid es ae 0 to 500 ml Volume Limit flashes E PI ZoTube Leak 1 1 eee eee eee ees 0 to 100 inspiratory TMe aeaea wise ela Sern aisu caper one ate aise mila al eee daar 0 1 to 3 10 sec The Volume Limit LED will flash alternating with the message E PI Error Expiratory Times soe oie co repens ae eve a E eee O to 99 9 sec 7 smi Aa el ee ee ere re 9 9 1 to 1 9 9 Pressure if the Inspiratory Pressure is too high for the Volume Limit Setting Beak pit SEC ea TP Pee aes ek ae cea ae ee 0 to 99 cmH20 Pressure Settings Incompatible Mean Airway Pressure T aam cence eens 0 to 75 0 cmH20 PEER a eee eee ene ieee cee eee nee eee or eee 0 to 30 0 cmH20 If the Inspiratory Pressure setting is less than the PEEP CPAP setting the AIF PrESSUTE aie aine EE a Eaa E E E EEEE ENE ANE cle O to 100 psig r O2 Pressure o ione a ee E Seer 0 to 100 psig pressure control solenoid will not cycle Only PEEP CPAP will be delivered Bioximal Airway Pressure Gauge o I ee 10 to 100 cmH20 a OA E E cect NN eect OE E E E NE EE 0 to 99 999 hours A INS IN B ANG KU JD TeSa Push button ALARMS LIMITS Should the patient become apneic the ventilator will wait for one apnea delay High Breath Rat
11. trol setting or group of ANID SD settings is incompatible with one another MAINES GVA RVNGULS RS IKES SCIFKCATIONS u Inspiratory Time and Ventilator Rate CONTROLS s Mode fra es ats ele hee wa ae alae ae re Flow Cycle AC AC If the Inspiratory Time display and Ventilator Rate display is flashing the set SIMV IMV SIMV PSV Flow Inspiratory Time is incompatible with the Ventilator rate In this situation the Cycled SIMV CPAP PSV set Inspiratory Time will change in order to maintain breath delivery at the set eraon e eee ee et ee ee sensor ng rere rate PEER eee oi eee ee ee oe E eee ee ee aS 0 to 30 cmH20 l i PIGSSUNC oe aa ae ane a a a a 72 H Base Flow and Inspiratory Flow ree aa Ta ASSISI SENSIIVIY crer 2 wre eaea Saa a E E wae E E a 0 02 to 5 0 L min The Base Flow and Inspiratory Flow displays will flash when the Base Flow has Over Pressure Relief aaannnnnnnnnnnnnnnnnnnnnnnnn 15 to 75 cmH20 been set to more that 2 times the Set Inspiratory Flow The flow control o O a a Na eet fee I Re een a ee CE 21 to 100 solenoid will not cycle and Base Flow will be utilized continuously Apnea Alarm selectable 0 00sec eee ee eens 5 10 20 or 30 sec Volume Limit flashes E FI MONITORS Breath Rate vie cae scorers are aceon E E cree eae 0 to 255 bpm The Volume Limit LED will flash alterna
12. ven The Netherlands Phone 31 30 2289 711 Fax 31 30 2286 244 VIASYS HEALTHCARE Excellence For Life www ViasysCriticalCare com CRITICAL CARE DIVISION L1586 Rev A 5 02
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