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PLV-100 Clinical Manual
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1. S SONSItiVity eera ki ia 5 14 16 29 39 Sensor Vent oe ceecececccccccccceceeeeeeeseususaeananaeees 16 29 SIMV Mode nananana 9 18 28 29 32 33 37 43 Specifications ee 5 8 Static Airway Pressure 0 ccccsseeesesteeeeeeeneaes 38 T Tidal Volume 00088 5 10 19 26 28 36 37 Troubleshooting Guide ccceeeeeseeeseeeeeeneees 59 U Unit Malfunction 0 0 00 ceecceeeeees reese 7 20 26 59 V Ventilator Circuits 0000 27 42 45 54 56 Ventilator Circuit Support APM cece 50 Ventilator Malfunction cccccceceees 7 20 26 59 Ventilator Monitoring eeeee 31 37 41 Ventilator Monitoring Record Sample 41 WwW Warnings ie 2 ei einai datai e i 3 Warranty 0 22 ccceeceeeeeeeneecaeeeeeeeeeeeeeteeeseneeaeees 61 62 Water Traps ierti eani arnai e ata Eai A aS 50 WEOE o aa re ER AE E A AEAT 8 Respironics PLV 100 Clinical Manual p n 35500 Rev D SECTION 15 INDEX 65 SECTION 15 INDEX F T AEA EE ANE E ETT 16 17 46 58 FICXtUDeS iaai ai aie iiti iaia 52 Front Panel Controls ccsssseseseeeeeees 5 9 15 Mode and Operation cccceeeeeeeteeeeeeeeeees 9 POWE araneae dines e aaa aaa aAa Aea ai 12 PIeSSUI siie a i iaa daa Tiai id 14 Functional Block Diagram seess 60 G Gas Sterilization cccececceeeeesseceeeeesseeeeessaaes 54 H High Pressure 0 0 2 ececc
2. Radio Frequency Interference This equipment generates and uses radio frequency energy If it is not installed and used in strict accordance with the manufacturer s instruc tions it may cause interference to radio and television reception It has been type tested and found to comply with the limits for FCC Rules which are designed to provide reasonable protection against such interference in a residential installation However there is no guarantee that interference will not occur in a particular installation If the PLV 100 is the cause of the interference this can be determined by turning the equipment off and on If this equipment does cause interference to radio or television reception the user is encouraged to try to correct the interference by one or more of the following measures 7 Assist Spontaneous LED Pressure Gives a visual indication of the patient s inspiratory effort In the Assist Control mode illumination of this LED corresponds to patient assisted ventilator delivered breaths In the SIMV mode this LED indicates patient spontaneous breaths as well as assisted breaths and registers these breaths on the BPM digital display 8 Sensitivity Control Adjustable from 3 to 6 cm H O Controls the amount of patient inspira tory effort required to trigger the ventilator in the Assist Control mode Also used as a sensor for monitoring and synchronizing spontaneous breaths in the SIMV mode The PLV 100 senses baro
3. Due to the wide variety of wave forms and voltages produced by inverters it is recommended that the PLV 100 be operated only ona 12 VDC power supply when used in mobile vehicles such as ambu lances and aircraft Do not disconnect the external battery while the unit is operating under load This may cause the unit to repeat the diagnostic start up cycle Do not operate the unit on the internal batteries in place of external batteries To decrease the chance of depleting the wheelchair battery do not use the battery as the external power source for the PLV 100 Storage of the unit with a partially discharged internal battery se verely decreases the battery life Always store the unit with the power plug connected to AC voltage or only after fully charging the internal battery from AC voltage Frequent and or prolonged use of the unit on internal battery short ens the battery life This requires close monitoring of the battery strength and may require battery replacement sooner than the normal maintenance interval Caution Federal law restricts this device to sale by or on the order of a physician Respironics PLV 100 Clinical Manual p n 35500 Rev D 2 RESPIRONICS R Radio Frequency Interference 08 57 58 Rear Panel Connections Filters and Hour Meter 020eceeees 16 17 Remote Alarm Respironics 16 17 21 49 Respiratory Rate Breath Rate 5 10 28 29 37
4. NOTE A flashing display indicates an inverse I E ratio inspiratory time is longer than expiratory time or the E ratio exceeds 1 9 9 In Assist Control mode the display reads the calculated I E ratio based on the set BPM rate In the SIMV mode the I E ratio display is blanked 5 Inspiratory Peak Flow Rate Control and Digital Display Inspiratory peak flow rate is adjustable from 10 to 120 liters per minute and is used to set the I E ratio As flow rate is increased and tidal volume and BPM rate remain constant inspiratory time decreases The PLV 100 offers a sinusoidal flow pattern on all delivered breaths The inspiratory peak flow rate display indicates the peak inspiratory flow rate delivered by the ventilator This remains constant unless the inspira tory flow parameter is changed or the flow rate is set inadequately to meet tidal volume and respiratory rate requirements See Section 9 Application Notes for further information 6 Increase Inspiratory Flow LED This LED flashes whenever set inspiratory flow rate is insufficient to meet other set parameters The flow rate automatically increases to match the set parameters See Section 9 Application Notes for further information Respironics PLV 100 Clinical Manual p n 35500 Rev D 11 SECTION 4 FRONT PANEL CONTROLS CONNECTIONS o o SECTION 13 MAINTENANCE AND TROUBLESHOOTING GUIDE AND VISUAL INDICATORS 2 J RESPIRONICS RESPIRONICS
5. PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Humidification Accessories Filters Battery Accessories Adapters and Connectors 06279 06278 06277 06273 06274 22135 22136 22149 22151 22167 22182 22154 22150 22068 22902 35220 35373 07050 07270 07280 07320 27905 SECTION 11 ACCESSORIES Artificial Nose Disposable Adult Engstrom Artificial Nose Disposable Pediatric Engstrom Artificial Nose Disposable Infant Engstrom Artificial Nose Disposable Pediatric Artificial Nose Disposable Adult Humidifier Fisher and Paykel Heater Base Model MR 410 Humidifier Fisher and Paykel Heater Base Model MR 480 Chamber Fisher and Paykel Adult Reusable Chamber Fisher and Paykel Pediatric Reusable Chamber Fisher and Paykel Home Care Reusable Chamber Fisher and Paykel Single Patient Use Wick refill for 22151 Wick refill for 22149 Bracket Cascade Heated Bracket Fisher and Paykel PLV Reusable pk of 2 PLV Reusable pk of 50 Battery Charger Pack Without Battery Cable Battery 6 With Ring Terminal Cable Battery 12 With Clips Battery Charger 10 AMP Automatic Cable Auto Lighter Endotracheal Adapters Use these adapters to connect to endotracheal or tracheostomy tubes Ta 1 TA 37 06387 elbow trach adapter 2 06395 elbow vent adapter w suction port 3 06390 elbow trach swivel adapter w suction port Respironics PLV 100 Clinical Manual p n 35500 Rev D 4
6. 7 8 9 10 1 12 13 Maintenance WARNING Do not open the case of the PLV 100 for any reason There are no user serviceable parts inside Unauthorized repairs may void the warranty or maintenance contract Refer all service a Du needs to Respironics or an authorized Service Center i Vi PATIENT AIR CONTROL coe ern A 14 Q ASSIST CONTROL Suy Nissist ourer Preventive Maintenance TIDAL VOLUME INCREASE Ressu E A pre ARWAY art The PLV 100 must have preventive maintenance performed every 8 000 ig N 3 PAP SS yo hours or 1 year The hour meter is located behind the machine air inlet amp filter located on the back of the PLV 100 This service must be performed _ ey Near opts B by Respironics or an authorized Service Center A loaner unit may be PATENTEEN provided by Respironics for use during service performed under warranty or maintenance contract ax LIFECARE LE RATIO P LV 1 oo READINGS oven 38 Electrostatic Interference Our The PLV 100 contains electrostatic discharge sensitive ESDS electronic ia AONA Gee TE components ESDS parts and assemblies may be unknowingly damaged lt ie vas cane ALARM as or degraded upon opening the case to gain access for maintenance and en oe RECHARGE amp repairs Customer or client repairs are NOT recommended Refer service ue EXTERNAL or repair to authorized service personnel only INSPIRATORY FLow DANGER RISK OF EXPLOSION IF USED NEAR FLAMMABLE ANESTHETICS
7. My a SS e CTT AMET Ayy Ny My E g My Minny Hinin BHANNAN EAM UADO AOAN A My 34906 Call button for Remote Alarm 28001 Oxygen Analyzer Alarm 28005 Oxygen Analyzer Respironics PLV 100 Clinical Manual p n 35500 Rev D 49 SECTION 11 ACCESSORIES Adapters and Connectors Continued Alarms 48 RESPIRONICS RESPIRONICS Remote Alarm Interface INTERNET alm el L Connectors and Couplers 06711 valve one way w O inlet 06348 coupler 22 mm I D Silicone 06334 connector 22 mm I D Hospital Alarm 06242 30 mm to 22 mm I D for exhalation valve Interface 06335 connector 22 mm O D 06340 connector 22 mm O D both sides 15 mm I D one side non disposable 7 06341 connector 22 mm O D both sides 15 mm I D one side disposable not shown OaRWND Pressure Alarm 23001 The Respironics Pressure Alarm is an excellent choice when an indepen dent pressure alarm is desired The Pressure Alarm reads both negative and positive pressure and has an adaptable alarm set point for either positive or negative pressure The Pressure alarm operates for at least two weeks on a 9 VDC battery and is designed for use with a 120 VAC power source Refer to the Respironics Pressure Alarm Operation Manual for details of operation and a list of accessories Respironics PLV 100 Clinical Manual p n 35500 Rev D SECTION 6 ALARM AND ALERT S
8. connection or using Respironics Auto Lighter Cable NOTE Throughout the entire Operator s Manual 120 VAC 50 60 Hz shall also imply 220 240 VAC 50 Hz or 100 VAC 50 60 Hz on international models 6 Respironics PLV 100 Clinical Manual p n 35500 Rev D 2 RESPIRONICS A ACGCESSOMIES cdiecivcidsacsptendatiaasiucaseuteatenceas 35 42 53 Adapters and Connectors 0cceeeeeee 47 48 Additional Accessories 0 000c0eeees 50 53 Alarms naana r n n a aa es 48 49 Analyzes aaia i ORAA S 49 Battery ioiii innana ini i 23 24 46 Decontamination of Accessories 54 56 Exhalation Valves cccccsssecceeeseesseeeeeeeanees 46 AIET AEREE AEE E E E OE 47 Humidificatio Menoa ai 42 47 Mouthseal Mouthpieces 51 Nasal Masks sucina nnna 51 SpotCheck Oximeter cccceeeeseeeesteeeeeees 53 Peep Vahesaar iira ia 52 Ventilator Circuits cccccccceeeeeeeeeeeeeees 42 45 Disposable Circuits ceeeee 3 43 45 Water Traps iccco deities 50 Airway Pressure ccccceeeeseeceeeeesteeeeeeesnaeeeeeeenaes 38 Airway Pressure Limit 5 15 19 30 31 38 Alarm and Alert Systems cccseeeeees 18 21 15 Second Delay LED 6 15 18 AGCCESSOMES aT E E AEA 48 49 Alarm Port ccccccccceseesseeceecesneeseeeeeeeaaeeeeeeees 13 Alarm Silence Button 000c0eceeeees 5 7 13 ADINCGE AP E E ET 7 18 Battery Alarms
9. loss of integrity of the ventilator to patient system therefore it is extremely important to set this alarm correctly Low Pressure Alarm settings more than 10 cmH O below the system pressure may prevent the unit from alarming in re sponse to circuit leaks or patient disconnects The addition of artificial noses or heat moisture exchangers to the patient circuit may prevent a Low Pressure Alarm from occurring due to the build up of secretions 10 Set Airway Pressure Limit The Airway Pressure Limit Control must be correctly set to ensure that the system pressure does not exceed a level that the clinician deter mines to be a safe maximum pressure Use the following procedure to verify the Airway Pressure Limit Be certain to assure adequate ventila tion of the patient during this procedure a Observe the peak inspiratory pressure on the manometer for several breaths b Set the Airway Pressure Limit Respironics recommends the airway pressure limit be set 10 to 20 cm H O above peak inspiratory pres sure observed on the manometer during a machine breath The clinician must determine the actual value according to the individual Clinical situation c To change the airway pressure limit turn the control clockwise to increase the level and counterclockwise to decrease the level Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Ventilator Monitoring Continued SECTION 10 VENTILATOR MONITORING
10. minute Record these values on the appropriate line Respironics PLV 100 Clinical Manual p n 35500 Rev D 37 SECTION 9 APPLICATION NOTES o Automatic Priority Sequence Patient Interfaces 36 RESPIRONICS v The PLV 100 has a sophisticated method of adjusting key parameters when the operator selected parameters do not permit operation of the unit within the limitations of the machine Combinations of set parameters that do not allow time for the piston return stroke start the priority sequence in operation as follows 1 Inspiratory Flow Rate The Inspiratory Flow Rate automatically increases The Increase Inspiratory Flow LED alerts the user that the Flow Rate has been increased This continues if necessary until the flow rate reaches its maximum level of 120 Ipm 2 Respiratory Rate If the flow rate has reached its maximum level and the return stroke time is not adequate then the set Respiratory Rate is reduced until the proper return stroke time is reached The Respiratory Rate LCD flashes the current delivered BPM to alert the user of this condition 3 Tidal Volume The Tidal Volume is given the highest priority of the three set param eters and this value does not change NOTE The priority sequence activates immediately when the setting changes are made and does not occur during the course of normal operation of the PLV 100 Vv The PLV 100 is designed to be used with a variety of patient inter fac
11. ssaaseeesssreeesrrensrrrnesrrnnresrennes 7 High Pressure ssassn 5 7 19 38 Hospital Interface seceeeeeeeeeeeeees 21 51 Increase Inspiratory Flow 6 7 11 19 36 Inverse LE Ratio mir innia i 7 19 Respironics Pressure Alarm secen 48 Low External Battery 7 13 19 23 Low Internal Battery 0 7 13 20 25 Low Pressure cccceeeeeeee 5 7 15 18 30 39 Microprocessor Failure aeea 20 26 Power Failure a a 7 20 LEIDO E REEERE PEE E A AEAT 17 21 49 Switch to Battery ccccccseeeeseeessteeeeeneeeeees 19 Ventilator Malfunction ceeeeeeeeeee enone 7 20 Analyzes scoale iina EE E dea 49 Application Notes eeeeeeeeeeeeeennnn 32 36 SIM V iii a a a i 32 OYJ rieta aia regi tet 33 H midificatio Nania a aaan 35 PreSSure LiMit ccccceseseseeeeeseesseeeeeeeaneesees 35 Assist Control Mode cccccccceseeeeeeeeeeeenes 5 9 28 ASSISUPAR e e ects 5 9 28 Assist Spontaneous LED 0cceeeees 6 14 32 Automatic Priority Sequence cceeeeeeeees 36 SECTION 15 INDEX B Battery ACCESS ONE Sinai a E 23 24 47 Charging by PLV 100 neeese 7 22 Connetti Nesin a i r a 7 22 Extena e N 6 7 12 13 19 EEN a OAC a 22 24 27 39 59 External 12 VDC Charger Options 23 External Battery LED 05 6 7 13 19 External Voltage Monitoring 6 23 39 FSG ick ei E tag chia iade
12. 00 may be operated in 3 different modes e Control Mode The unit delivers a preset tidal volume and inspiratory flow rate ata specified respiratory rate The patient is not permitted to trigger the ventilator in this mode e Assist Control Mode The PLV 100 operates as in the Control Mode however the patient may initiate a breath by beginning an inspiratory effort SIMV Mode The ventilator delivers a minimum respiratory rate at a preset tidal volume and flow rate However the patient may breathe spontane ously at a rate higher than the set level by making an inspiratory effort See Section 4 Front Panel Controls and Section 9 Application Notes for more information on the operation modes of the PLV 100 5 Adjust Tidal Volume Conirol The tidal volume is adjustable from 0 05 to 3 00 liters Set the desired volume per physician order a Turn the knob beside the Tidal Volume display clockwise to increase the amount of delivered volume counterclockwise to reduce deliv ered volume b The volume display indicates the machine set volume Some volume increase may be required to compensate for compliance of the ventilator circuit 6 Adjust BPM Respiratory Rate Control The breathing rate control scale is calibrated and marked in breaths per minute BPM The Patient BPM display indicates the sum of machine delivered breaths and patient triggered spontaneous breaths The digital display reflects the actual number of breaths d
13. 10 Low Pressure Alarm Set Point Audible Alarm NOTE Manual ventilation may be required while this check is performed Do not forget to reconnect the circuit to the individual Observe the Low Pressure Alarm Set knob and record the value in the top section on the line entitled Low Pressure Alarm Audible Alarm Respironics recommends the Low Pressure Alarm be set 5 to 10 cm H O below the Peak Airway Pressure Disconnect the circuit from the person and wait 15 to 20 seconds Place a check mark in the bottom section to document that an audible alarm sounded during the above procedure 11 Sensitivity If the ventilator is in the Control mode mark this section with N A If the ventilator is in the Assist Control or SIMV mode observe both the pressure manometer and assist spontaneous LED on the front panel Record the pressure required to either cycle the ventilator or register a breath as evidenced by the lighted LED This value is recorded as a negative number e g 1 2 etc 12 Power Source Observe the Power source LED s on the front panel to see which one is illuminated Record this information on the line entitled Power Source 13 Internal Battery Voltage Operate the unit on the internal battery by disconnecting the AC and External Battery sources Wait 2 to 3 minutes following disconnection for the most accurate value Using the Battery Test Switch read the voltage level of the Internal Battery in t
14. 120 liters per min Peak flow rate during inspiratory time Battery Test Switch Internal External Battery Main Power Switch On Off Recharge Circuit Breakers DC Circuit Breaker AC Circuit Breaker Push Pull Actuation Push Pull Actuation Airway Pressure Limit 5 to 100 5 cm H O Sensitivity 3 to at least 6 1 cm H O Low Pressure Alarm 2 to 40 2 cm H O Alarm Silence Button 30 seconds Automatic Reset Tidal Volume Digital Display Rate Patient Breaths Per Minute Digital Display I E Ratio Digital Display Inspiratory Flow Rate Digital Display Respironics PLV 100 Clinical Manual p n 35500 Rev D 5 SECTION 3 SPECIFICATIONS o RESPIRONICS Increase Inspiratory Flow Front Panel Red Indicator Light Visual Indicators 120 220 240 or 100 VAC Power Continued Green Indicator Light Battery Source Internal Battery Amber Indicator Light External Battery White Indicator Light Patient Airway Pressure Gauge 10 to 100 cm H O Assist Spontaneous Green Indicator Light 15 Second Delay Low Pressure Alarm Green Indicator Light Alarm Silenced Amber Indicator Light Power Sources Power Domestic Models Specifications 120 VAC 50 60 Hz 220 240 VAC 50 Hz or 100 VAC 50 60 Hz International Models 12 VDC Internal Battery Sealed lead acid gel 2 5 amp hrs 12 VDC External Battery 105 amp hrs marine deep cycle recommended 12 VDC Sources Automobile or boat battery by direct
15. 6 second sensitivity window This does not cause a second ventilator delivered breath For example if the rate knob is set for 4 BPM as shown above only 4 breaths are delivered by the machine V Oxygen may be added to the PLV 100 ventilator circuit using any standard low flow oxygen system such as a compensated flowmeter connected to a 50 PSI oxygen source a liquid O system or an oxygen concentrator source Oxygen may be added using an accumulator or by using a bleed in attachment to add oxygen into the hose assembly See Section 11 Accessories for adapter information Respironics PLV 100 Clinical Manual p n 35500 Rev D 33 SECTION 9 APPLICATION NOTES o Oxygen Enrichment Continued 34 RESPIRONICS Volume Adjustment The addition of oxygen into the hose assembly increases patient tidal volume Use the following formula to determine the correct volume setting for the PLV 100 Volume Vv Vt 1 FIO 79 ventilator where Vv Ventilator volume setting in cc s Vt Desired patient tidal volume in cc s FIO Fractional condition of inspired oxygen Oxygen Flow Rate Determination The following formula should be used to determine the flow rate of oxygen into the hose assembly on control mode or when the breath rate is constant If the assisted breath rate is variable or SIMV mode is used perform a closer monitoring of FIO Flow O Vt Vv R 1000 where Flow O Oxygen flow rate in liter
16. 7 SECTION 11 ACCESSORIES Exhalation Valve Options 46 RESPIRONICS v The Respironics Exhalation Valves come complete by ordering the assemblies shown Select the system that best meets your needs All tee adapters have 22 mm O D ends The expiratory outlet on the Gas Collecting Valve is 30 mm O D All valves are reusable Individual parts may be ordered separately if desired Gas Collecting PEEP Exhalation Valves Use these valves in applications where PEEP valves are used or when exhaled gas volumes are measured These reusable valves offer low resistance and are easily cleaned LIFECARE LIFECARE 2 i LIFECARE 1 2 3 4 5 Complete Exhalation Valve Assemblies 1 06710 Assy Respironics Elbow gas collecting double hose 2 06706 Assy Respironics gas collecting single hose 3 06707 Assy w PAP adapter gas collecting single hose 4 06708 Assy w ISO Tee gas collecting single hose 5 06709 Assy ISO w PAP gas collecting single hose Low Profile Exhalation Valves The Low Profile valves provide a low resistance lightweight alternative for the home or hospital when neither PEEP or exhaled gas volumes are required oO ofp oo Complete Exhalation Valve Assemblies 1 06719 Assy Low Profile Elbow double hose 2 06720 Assy Low Profile ISO Tee single hose 3 06724 Assy Low Profile with PAP Tee Respi
17. DURE a Respiratory Rate Control is available from 2 to 40 BPM in all modes of operation b Adjust rate control as prescribed by physician c The Assist Spontaneous LED indicates when the current breath is patient initiated 7 Adjust Sensitivity Control The Sensitivity Knob allows an adjustment of the machine s ability to detect a patient s inspiratory effort In the Assist Control Mode this causes the machine to begin an assisted breath In the SIMV Mode proper adjustment of the sensitivity knob enables the sensing circuit to count the patient s spontaneous breaths and synchronize them with the machine delivered breaths a To increase ventilator sensitivity turn the Sensitivity Knob clockwise If the PLV 100 begins to autocycle slowly back the Sensitivity Knob counterclockwise towards Less until the trigger light goes out b Sensitivity is adjustable from 3 to 6 cm H O c The Sensor Vent on the rear panel monitors barometric pressure and assures that the Sensitivity Control maintains its accuracy despite barometric pressure changes 8 Set Peak Inspiratory Flow Rate The Peak Inspiratory Flow Control is adaptable from 10 to 120 liters per minute and is used to determine Inspiratory Time and Inspiratory to Expiratory Time Ratio of the delivered breath a Turn the Inspiratory Flow Rate Control clockwise to increase and counterclockwise to decrease the flow rate b Assure that the patient has an ade
18. E Manual ventilation may be required while this check is performed Do not forget to reconnect the circuit to the individual Disconnect the circuit from the person and partially block air flow at the patient end of the circuit Observe the point where the needle on the manometer stops rising and the audible alarm sounds Respironics recommends the Airway Pressure Limit be set 10 to 20 cm H O above the Peak Airway Pressure Record the value in the top section on the line entitled Airway Pressure Limit Audible Alarm Place a check mark in the bottom section to document that an audible alarm sounded during the above procedure Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Operation Guidelines Continued SECTION 8 OPERATING PROCEDURE 11 Connecting the PLV 100 and Circuit to the Patient Verify and perform final adjustments on ventilator settings e g measure exhaled volume and connect the patient end of the circuit to the patient interface tracheostomy nasal mask etc NOTE It is recommended that a verification of the effectiveness of mechanical ventilation be secured by obtaining an arterial blood gas to observe the pH PaCO and PaO level within a short time following the application of all ventilators This verification may also be determined using noninvasive methods such as capnometry and oximetry It is also recommended that an accurate record of ventilator monitoring be k
19. Pressure Alarm Apnea Alarm RESPIRONICS RESPIRONICS Vv The Low Pressure Alarm is adjustable from 2 to 40 cm H O by using the front panel knob An audible alarm is activated when proximal near Additional the patient airway pressure falls below the selected low pressure alarm Accessories setting for more than 15 seconds Continued A front panel green LED located near the low pressure alarm knob labeled 15 Second Delay illuminates immediately after the pressure drops below the set point This is a normal occurrence that indicates the low pressure alarm circuit is enabled and timing It also simplifies the Low Pressure Alarm setting procedure A delay of 15 seconds is built into the Low Pressure Alarm to prevent it from sounding between breaths e During the Assist Control mode either the machine must deliver a breath every 15 seconds or the patient must trigger a machine breath within 15 seconds to prevent the alarm from sounding e During the SIMV mode the patient can breathe on their own The PLV 100 senses the negative pressure inspiratory effort and reset the Low Pressure Alarm 15 Sec Delay Thus to prevent the Low Pressure Alarm from sounding either the machine breath must come up to set point pressure or the patient must breathe on their own Additionally to ensure that an airway disconnect causes an alarm the airway pressure is compared with the Low Pressure knob set point during each ventilator deli
20. R EXHALATION VALVE ASSIST OUTLET AIRWAY PRESSURE LIMIT 50 60 40 70 30 cmH 0 O15 Seconp DELAY 1emH 0 lt 1mbar 0 1kPa 4 LIFECARE PLV 100 VN INTERNAL EXTERNAL OO READ BATTERY VOLTS INTERNAL 4 PA 4 30 SECOND ON A ALARM SILENCE 2 n A RECHARGE EXTERNAL A i A OF EXPLOSIC N UZD NEAR FLA MABLE ANESTHETICS 16 17 18 Power 16 Battery Voltage Test Switch This rocker type switch allows the user to read internal or external battery voltage levels These levels are read in the Inspiratory Flow Rate Digital Display The PLV 100 must be operating on the selected battery source to display the remaining voltage The digital display reverts to the inspiratory flow reading when the battery voltage test switch is released This value is displayed as volts remaining See Section 7 Power Supply Options for further information CAUTION When recharging the internal or external batteries wait 2 3 minutes before checking the battery voltage level Checking the level immediately after removing the charger may give a falsely high reading This is a characteristic of all rechargeable batteries Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Decontamination of Tubing and Accessories Continued SECTION 12 CLEANING AND DISINFECTION Definitions e Decontamination The reduction of microbial contamination to an acceptable level e Cleaning The process of remo
21. ROUBLESHOOTING GUIDE o Maintenance Continued 58 RESPIRONICS Radio Frequency interference continued The user should consult the dealer or an experienced radio television technician for additional suggestions if necessary The user may find the following booklet prepared by the Federal Communications Commission helpful How to Identify and Resolve Radio TV Interference Problems This booklet is available from the U S Government Printing Office Washington DC 20402 Stock No 0004 0000 00345 4 Filter Maintenance Maintenance of the filters on the rear panel is the only maintenance required to be performed by the user except ventilator circuit cleaning Check the filters twice a week and clean as necessary The filters are reusable discard only if they are worn or significantly discolored Battery Maintenance To maintain the internal batteries in the best condition possible e Store the ventilator in a cool environment when it is not being used Store the unit at or below 20 C 70 F if possible e Keep the PLV 100 plugged into AC power when not using and during storage Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Mode and Operation SECTION 4 FRONT PANEL CONTROLS CONNECTIONS AND VISUAL INDICATORS 4 E Ratio Digital Display The PLV 100 calculates and displays the inspiratory expiratory time ratio from the set BPM rate tidal volume and inspiratory flow rate settings
22. Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS RESPIRONICS Section 10 11 12 13 14 15 TABLE OF CONTENTS Introduction 2 Warnings and Cautions 3 Specifications 5 Front Panel Controls Connections and 9 Visual Indicators Rear Panel Connections Filters and Hour Meter 16 Alarm and Alert Systems 18 Power Supply Options 22 Operating Procedure 26 Application Notes 32 Ventilator Monitoring 37 Accessories 42 Cleaning and Disinfection 54 Maintenance and Troubleshooting Guide 57 Warranty and Maintenance Contract 61 Index 63 Respironics PLV 100 Clinical Manual p n 35500 Rev D SECTION 1 INTRODUCTION Introduction RESPIRONICS Vv The Portable Respironics Volume Ventilator PLV 100 is a microprocessor controlled electrically powered volume ventilator designed to provide venti latory assistance in a variety of applications The PLV 100 is designed specifically for long term use inthe home It has been clinically proven in this setting to be an efficient and reliable breathing aid The PLV 100 is an excellent choice for transport and portable application It operates from a variety of power sources and is extremely compact and lightweight The capability of the PLV 100 to ventilate a wide variety of patients makes it the choice of clinicians Adult patients are easily ventilated with this versatile device Low flow rates and low tidal
23. S Respironics PLV 100 Clinical Manual p n 35500 Rev D Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS RESPIRONICS Warnings and Cautions Warnings SECTION 2 WARNINGS AND CAUTIONS Vv Throughout this manual the following definitions apply Warning A condition that may cause injury to a patient or operator if instruc tions are not followed Caution A condition that may cause damage or shorten the service life of the PLV 100 Personnel using and operating the PLV 100 must become familiar with this instruction manual before initial setup and use Equipment that does not function correctly or alerts the user to a potential problem by sounding an alarm must not be used until the problem is corrected Use the PLV 100 only per the physician s prescription Low Pressure Alarm settings more than 10 cmH20 below the system pressure may prevent the unit from alarming in response to circuit leaks or patient disconnects The addition of artificial noses or heat moisture exchangers to the patient circuit may prevent a Low Pressure Alarm from occurring due to the build up of secretions Do not use the PLV 100 in the presence of flammable anesthetics Ensure client safety through the presence of a trained attendant and alternate emergency equipment Do not remove any covers or panels Refer all servicing to autho rized service personnel It is recommended that bacteria filters be used in t
24. Tubing and Accessories 54 RESPIRONICS Vv Clean all accessible surfaces of the PLV 100 by wiping the surfaces with nonabrasive household cleaner every 2 weeks or more often as necessary The surface may also be disinfected using a 70 isopropyl alcohol solution on a dampened cloth If a high level disinfection is required the PLV 100 may be disinfected using a glutaraldehyde solution Contact Respironics or an authorized Service Center for complete information RESPIRONICS CAUTION Do not use phenol based or quaternary ammonium compounds on the front panel of the PLV 100 as these compounds may cloud the LCD windows and manometer cover over time Do not use radiation decontamination Do not steam autoclave the PLV 100 Gas Sterilization The PLV 100 may be sterilized using Ethylene Oxide provided that humidity does not exceed 60 and the temperature does not exceed 130 F The duration of exposure in the chamber is determined by the above parameters YV The cleaning and decontamination of respiratory equipment is of great importance in the hospital and in the home Equipment infected with bacteria could infect the user s lungs To prevent this contamination simply and effectively routinely clean and disinfect the equipment on a regular basis Perform the cleaning twice a week under normal conditions Increase the frequency of cleaning as needed if signs of respiratory infection are evident Some clients
25. YSTEMS Vv Most units have the capability of connecting to the Respironics Remote Alarm The Remote Alarm provides an audible and visual alarm whenever a PLV 100 alarm condition exists An optional kit may be used to add this feature to a PLV 100 that does not support this capability See Section 11 Accessories for more information Vv The PLV 100 has the capability of connecting to most hospital call and alarm systems The user should verify whether the institution s system is a Normally OPEN or Normally CLOSED circuit A Normally Open system refers to an alarm system that must detect an open circuit in normal conditions and a closed circuit during alarm conditions A Nor mally Closed system sees a closed circuit in normal conditions and an open circuit during alarm conditions The PLV 100 may be changed to interface with either system at Respironics or an authorized Service Center Some units may require installation of the Remote Alarm Alarm Silence option to use this feature Respironics PLV 100 Clinical Manual p n 35500 Rev D 21 SECTION 7 POWER SUPPLY OPTIONS o Power Source Selection 120 VAC Source Operation 12 VDC External Battery Source Operation 22 RESPIRONICS Y The PLV 100 automatically selects the most desirable power source available Selections of power sources occur in the following order 1 120 VAC power source if connected to a wall outlet 2 External battery so
26. a heey N 17 Internal 0cc ee 6 7 20 22 24 25 27 39 Internal 12 VDC Operation cceeeee 24 INTE AIL ED voces id cease er na eiaa aa 13 Internal Voltage Monitoring seee 25 Maintenance ccccseesececceceeeseeeeeeeaneesees 4 58 Marinea a a a a a s 6 22 Operating Time cccceeesseeeeseetseeees 7 22 24 Source Indicators ccccccceeceeeeeeeeeees 6 12 13 Switch to Battery Alert 2 0 19 Test SWItCh cccccccceeeeeeeeeeeeeenees 5 12 23 25 Breath Rate Respiratory Rate 5 10 28 29 37 C Gattin Senn a i a 3 4 Circuit Breakers cccceccceeeeeeeeeees 4 5 12 13 5 Cleaning and Disinfection Procedures 54 56 Control MOde cccccececceeeeeeeeeeeeeees 5 9 28 37 Custom Nasal Masks n e 36 51 D Diagnostic Self Check c cccecssseeeeeeesnees 26 27 DIMENSIONS ana devia aah asda r ea dete wendes 8 Disinfection dianto a na adaini 54 56 Disposable Circuits cccsseceesesteeeeeeenees 3 44 E Electrostatic Interference cccccceeeeeeeeeeeees 57 External Battery See Battery External External Pressure Limiter ccccccceeeees 35 50 Respironics PLV 100 Clinical Manual p n 35500 Rev D 63 SECTION 14 WARRANTY AND MAINTENANCE CONTRACT o Warranty Continued Maintenance Contract 51035 62 RESPIRONICS Limits of Warranty This Warranty is in place of all other warranties expresse
27. and Operation 91607 Toig Tidal Volume Display Inspiratory Flow Rate amp Battery Volts Display Sensitivity L gt Sensitivity 15 Sec Delay Lights Power Indicator Lights eee Set Rate Set D gt Flow Set F_ _ _ _ Alarm Set Limit Set Battery Volts D gt Volume Set F Test Switch Mode Select Low Pressure a High Pressure Respironics PLV 100 Clinical Manual p n 35500 Rev D 1 Mode The Mode knob controls the selection of three operation modalities e Control Mode All patient breaths are delivered by the ventilator at the preset tidal volume BPM rate and inspiratory flow rate independent of patient effort e Assist Control Mode The patient s spontaneous inspiratory effort may trigger the ventilator to deliver an assisted breath at the preset tidal volume and inspira tory flow rate If the patient does not trigger an assisted breath the ventilator delivers breaths at the BPM rate set on the control knob e SIMV Mode Synchronized Intermittent Mandatory Ventilation A minimum respiratory rate is set to deliver breaths at a preset tidal volume and inspiratory flow rate On patient efforts above the minimum respiratory rate the patient breath comes through either the patient air inlet on the rear panel of the PLV 100 or an IMV H valve added to the ventilator circuit See Section 9 Application Notes for a detailed description of the SIMV mode Respironics PLV 100 C
28. being accidentally turned on and depleting the internal batteries 4 Rear Feet Cord Wraps The rear feet of the PLV 100 are designed to easily accommodate the power cord Wrap the cord in a clockwise manner The feet are also designed to allow the ventilator to be operated in a face up position for wheelchair usage without blocking the air inlet or air vent on the rear panel Avoid positioning the ventilator in a face up position on deep shag carpet or surface which might block the air vents 5 Hour Meter The real time hour meter is located behind the machine air vent filter See Section 13 Maintenance and Troubleshooting Guide for more information on the hour meter 6 Power Cord Connector This receptacle allows the use of a removable power cord If the power cord becomes loose worn or damaged it is replaceable by the customer 7 Remote or Hospital Central Alarm Connector This connector is used to interface with the Respironics Remote Alarm or most hospital central alarm systems See Section 6 Alarm and Alert Systems for more information 8 Machine Air Vent This vent allows cooling air to enter the ventilator NOTE The Machine Air Inlet houses a reusable foam filter which requires periodically cleaning by the user See Section 12 Clean ing and Disinfection for more information on filter changes Respironics PLV 100 Clinical Manual p n 35500 Rev D 17 SECTION 6 ALARM AND ALERT SYSTEMS o o Low
29. ceeecssecceeeeeseeceeeeeeseeeeeeeensaeees See Alarm and Alert Systems High Pressure Hospital Alarm Interface eeeeeeeeesteeeeeenaees 21 HOUR Meter innen Aa 16 17 57 Humidification cece eee eeeeeeeeeeeeeeees 35 40 42 47 l LE Ratio seee a n aai 5 10 11 19 38 Increase Inspiratory Flow 6 10 11 19 36 Increase Inspiratory Flow LED 6 7 10 11 19 36 Inspiratory Peak Flow Rate 5 11 29 38 Internal Battery 0 0 eee See Battery Internal ItrOGUCTION a aree eye aaa aaa aeaa a eea 2 L Low Pressure sssssssssssissnesnssesssrrtnnnnrnnnsnesreerrnnn nnen See Alarm and Alert Systems Low Pressure Respironics Pressure Alarm 48 M Machine Air Ventis a 16 17 Maintenance and Troubleshooting Guide 57 60 Maintenance Contract ccccecssceeeeteeeetteeeees 62 Manual Resuscitation BagS c ccceesereeeeee 52 RESPIRONICS Microprocessor Failure cee 20 26 59 Mode Selection ccccceeeee 5 9 28 32 33 37 Mouthpieces ccc cctit iad e ieee dhe 51 Mouthseal csececccecceesseeceeeeasseseeeseeseaeneeees 51 N NasaliMaSKkS tsidacised snc a aa tenes tee 51 O Operating Procedure ccceeeeeteeeeees 26 31 Oximeter SpotCheck 0 0 00 ceeccsceeeseeeeeeeeeeeeees 53 Oxygen AG apte rs ecscteyeteccegr in cetebeaeeceaet teyetcerprte ten ieee 44 AMALYZONS 000 ceceeeeceeceeeeeeeeeeeeneeeeeeeeneeneeeeeeneneees 49 Cat
30. check stops and the alarm sounds d A checksum test of the EPROM is performed and any error results in a 2 0 being displayed in the Tidal Volume LCD window e The audible alarm sounds to signal the end of the diagnostic check and to confirm the integrity of the alarm RESPIRONICS WARNING If any of the above mentioned checks indicate mal function DO NOT USE THIS EQUIPMENT Contact your local authorized service personnel Respironics PLV 100 Clinical Manual p n 35500 Rev D Patient Circuits Continued SECTION 11 ACCESSORIES SIMV Use the IMV manifold to provide a gas source for the spontaneous breaths in SIMV mode 1 06247 Adapter SIMV w H valve 2 Standard Circuit PLV 3 MM Humidifier ref 4 Hose 18 ref NOTE If a humidifier with restricted air flow is used it may be necessary to place the SIMV valve on the patient side of the humidifier or alter the humidifier e g take out a tower Adult Disposable Circuit 06140 This circuit is designed for use with the PLV 100 22 mm I D Respironics PLV 100 Clinical Manual p n 35500 Rev D 43 SECTION 11 ACCESSORIES Patient Circuits 42 RESPIRONICS Standard Reusable PLV Circuits Two standard PLV circuits for the PLV 100 are available 06121 circuit with gas collecting exhalation valve for use with PEEP or measuring exhaled volumes and 06125 circuit with low profi
31. cted to misuse negligence abuse or accident This Warranty does not cover damage which may occur during shipping If there is any damage in shipment please contact the carrier or individual who delivered the unit Respironics PLV 100 Clinical Manual p n 35500 Rev D 61 SECTION 13 60 Mechanical Link Electrical Link Pneumatic Link MAINTENANCE AND TROUBLESHOOTING GUIDE Cylinder Solenoid Dump RESPIRONICS o SECTION 4 FRONT PANEL CONTROLS CONNECTIONS AND VISUAL INDICATORS RESPIRONICS TIDAL VOLUME 05 TO 3 LITERS INCREASE RATE PATIENT BPM E RATIO BLINKS DURING INVERSE I E RATIO OR READINGS OVER 1 9 9 OFF DURING SIMV C INSPIRATORY FLOW RATE INCREASE 10 TO 120 LPI SENSITIVITY o PRESSURE PATIENT AIR EXHALATION on VALVE a ASSIST oume SPONTANEOUS SsIST OUTLET AIRWAY PRESSURE LIMIT 50 60 PAP 40 70 30 80 20 90 10 100 1emH 20 1mbar 0 1kPa cm H20 LOW PRESSURE ALARM SET cmH 0 O15 SECOND DELAY LIFECARE PLV 100 INTERNAL EXTERNAL BATTERY READ BATTERY VOLTS INTERNAL 30 SECOND VOLTS CAPACITY AC Rectifier Pressure Switch ALARM SILENCE High Pressure Limit EBL INCREASE INSPIRATORY FLow 50 RECHARGE RECHARGE EXTERNAL DANGER RISK OF EXPLOSION IF USED NEAR FLAMMABLE ANESTHETICS Battery Power Controller Internal External Battery Pressure Mode
32. d or implied This includes the warranties of merchantability an unwritten warranty that the product is of saleable quality and fitness This warranty is in place of all other obligations or liabilities on the part of Respironics including but not limited to contingent or consequential damages the cost of repairing or replacing other property which may be damaged if the unit does not work properly This Warranty and the rights and obligations described in it will be construed under and governed by the laws of the Commonwealth of Pennsylvania U S A Requirements for purchase A monthly maintenance contract may be purchased at any time If your equipment is placed under contract while that equipment is not still covered under warranty then that equipment must first be returned to a Respironics for inspection servicing and calibration at the owner s expense Coverage A monthly maintenance contract covers the same full line of services offered under the original warranty including preventive maintenance non routine service freight out and loaner equipment Freight Freight in is at the owner s expense Freight out is the responsibility of Respironics Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Power Specifications Continued Alarm or Alert Indicators SECTION 3 SPECIFICATIONS Battery Operation Time 12 VDC External Battery approximately 24 hrs 12 VDC Internal Battery appr
33. elivered in the Control Mode In Assist Control or SIMV the digital display reflects a BPM rate based upon the average of the last 4 breaths Respironics PLV 100 Clinical Manual p n 35500 Rev D o SECTION 10 VENTILATOR MONITORIN RESPIRONICS SAMPLE VENTILATOR MONITORING RECORD Respironics recommmends entries be made every 2 to 4 hours a a eB eme Too ee E VV VV iene VAVAVAVAVAVA eueraTio S S o a E 8 amway PRESSURE JJ 9 AIRWAY PRESSURE LIMIT e AVA a 10 LOW PRESSURE SET POINT Vi eee We ia sensmry assist 2powersource TT 13 INTERNAL BATTERY CAPACITY J 14 EXTERNAL BATTERY CAPACITY nln EEE 15 INSPIRED OXYGEN CONCENTRATION FIO ANALYZED FIO Fa Pr 16 OXYGEN SOURCE LEVEL TANK PRESSURE LIQUID O LBS MERRE 17 INSPIRED GAS TEMPERATURE en ee 18 HUMIDIFIER HEATER SETTING eo neal 19 HUMIDIFIER WATER LEVEL ee a anms 0 WY N SH N D N e eNe aS Y Ve a ser Zy VV ES T WV T Th T a W GE Respironics PLV 100 Clinical Manual p n 35500 Rev D G 41 SECTION 10 VENTILATOR MONITORING o Ventilator Monitoring Continued 40 RESPIRONICS 15 Inspired Oxygen Concentration FIO Unless the patient is receiving oxygen the inspired oxygen is room air 0 21 If the patient is on oxygen record the oxygen percentage from the O analyzer which is placed in the inspiratory line at the time of the ventilator check o
34. ept to improve the level of care for ventilator patients See Section 10 Ventilator Monitoring for a sample PLV 100 ventilator check sheet Respironics PLV 100 Clinical Manual p n 35500 Rev D 31 SECTION 9 APPLICATION NOTES o SIMV Operation 32 RESPIRONICS Y When SIMV Synchronized Intermittent Mandatory Ventilation mode is selected using the Mode Control Switch the PLV 100 synchronizes the delivered volume breath selected by the user to the patients own sponta neous breaths These spontaneous breaths may be taken through the patient air inlet on the back of the PLV 100 however the use of an IMV H valve may further reduce the effort needed to take a spontaneous breath The operator selects the tidal volume inspiratory flow rate and the ventila tor respiratory rate The PLV 100 uses the sensitivity control to detect both spontaneous patient efforts and efforts that initiate a delivered volume breath it is extremely important that this level is set correctly By synchronizing machine delivered breaths to the patient s effort stacking of breaths is prevented this works as follows e The machine operates as in Control Mode and senses spontaneous breaths adjustable for sensitivity as in the Assist Control Mode e During the six second period before a mandatory breath is scheduled to be delivered if the machine senses the beginning of a spontaneous breath it immediately delivers the next scheduled ma
35. ery is not designed to be a primary power source It should be utilized as a backup power source or when it is convenient to use the battery only as a short term power supply The Internal Battery is a sealed lead acid battery rated at 2 5 amp hours Operation of the PLV 100 on 120 VAC automatically recharges the Internal Battery There is a 3 second audible alert when the PLV 100 switches from either a 120 VAC source or a 12 VDC External Battery source to the internal battery This alerts the user to verify the internal battery voltage level to assure that a safe operating time remains Respironics PLV 100 Clinical Manual p n 35500 Rev D SECTION 11 ACCESSORIES Reusable Pediatric Circuit Low Profile 06150 Low profile exhalation valve 15mm ID tubing Pediatric Neonatal Reusable Circuits Reusable Pediatric Circuit Gas Collecting 06152 Gas collecting exhalation valve 15 mm ID tubing Reusable Neonatal Circuit Low Profile 06154 Low profile exhalation valve 10mm ID tubing Reusable Neonatal Circuit Gas Collecting 06155 Gas collecting exhalation valve 10 mm ID tubing Neonatal Disposable Circuit 06130 Non gas collecting exhalation valve 10 mm ID tubing Pediatric Disposable Circuit 06135 Non gas collecting exhalation valve 15 mm ID tubing Respironics PLV 100 Clinical Manual p n 35500 Rev D 45 SECTION 11 ACCESSORIES Patient Circuits Continued 44 RESPIRONICS Oxy
36. es The wide array of tubing configurations permit adaptation to virtually any system The PLV 100 may be used by individuals with artificial airways such as a tracheostomy or an endotracheal tube There are also many patients who use the PLV 100 with noninvasive patient interfaces These methods include nasal masks oral masks combination nasal oral interfaces and custom nasal masks Contact Respironics or an authorized Service Center for more information on positive pressure ventila tion via noninvasive means or custom nasal mask construction Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS SIMV Operation Continued Oxygen Enrichment SECTION 9 APPLICATION NOTES SIMV MODE 4 BPM ONE MINUTE BASIC TIME PERIOD 6 Second Sensitivity Period N Machine Delivered Breath a No trigger is sensed during the 6 second sensitivity period There is no change in breath delivery b End of first time period The PLV 100 delivers a mandatory breath c Patient spontaneous breath detected outside of sensitivity window d End of second time period Ventilator delivers another mandatory breath e The patient starts a spontaneous breath during the 6 second sensitiv ity period The ventilator immediately delivers a mandatory assisted breath The delivery time of the mandatory breath shifts and cancels the current six second window f The patient s spontaneous breath occurs outside of the
37. g these explanations on page 41 1 Date Fill in the date 2 Time Fill in the time of day 3 Mode Observe the mode switch in the upper left corner of the front panel Note whether the switch is in Control Assist Control or SIMV mode Record on the line entitled Mode 4 Tidal Volume Observe the volume LCD next to the volume control knob This volume does not change unless someone moves the volume control knob to increase or decrease the volume This setting should not be changed without consulting your physician If supplemental oxygen is used the displayed value may be lower than prescribed Record this volume in the top section on the line entitled Tidal Volume Use an exhaled volume monitor or respirometer to measure the actual exhaled volume Record this value on the bottom section of the line entitled Tidal Volume 5 BPM Respiratory Rate Record the set Respiratory Rate in the top section of the line entitled BPM Respiratory Rate In Control Mode this set level is also the total respiratory rate In Assist Control Mode record the set value in the top section and count the total number of breaths of the patient to find the total number of breaths Record these values on the appropriate line In SIMV Mode the set value must be counted over 1 minute by counting only the delivered volume breaths To find the total respiratory rate count the number of times the patient s chest rises and falls over one
38. ge or only after fully charging the internal battery from AC voltage Caution Frequent and or prolonged use of the unit on internal battery shortens the battery life This requires close monitoring of the battery strength and may require battery replacement sooner than the normal maintenance interval Respironics PLV 100 Clinical Manual p n 35500 Rev D 25 SECTION 8 OPERATING PROCEDURE o Diagnostic Self Check on Start Up 26 RESPIRONICS v The PLV 100 has been programmed to provide a complete check of the front panel digital displays LED s the audible alarm the operation of the pressure transducer and the EPROM Erasable Programmable Read Only Memory This 5 second diagnostic sequence of checks is routine each time the ventilator is turned ON and occurs in the following manner a All digital displays reads 8 s for 1 second This confirms the integrity of the digital readouts The E RATIO display has fixed symbols 1 these are always lit b Each front panel LED illuminates for 0 5 seconds in the following sequence Increase Inspiratory Flow Assist Spontaneous 15 Second Delay External Battery Internal Battery 120 VAC OPO Ps Con Nn This confirms the integrity of each LED c The tidal volume display reads 0 0 The 0 0 reading confirms the integrity of the pressure transducer In case of failure in the trans ducer the display shows 1 0 the diagnostic
39. gen Adapter 06260 For use with the PLV 100 Use this adapter to bleed in oxygen up to 40 e On the PLV 100 connect adapter to the patient air outlet 06260 Adapter O enrichment Circuit PLV or PVV ref Humidifier ref Hose 18 ref ROD Oxygen Accumulator 27096 For use with PLV ventilators Use to achieve up to 90 oxygen delivery 27104 Oxygen manifold 27099 Reservoir bag 06526 24 hose 27924 Oxygen plate assembly 27105 Mounting bracket ahRWNM Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Internal Battery Voltage Monitoring SECTION 7 POWER SUPPLY OPTIONS V Use the following procedure to check the Internal Battery Voltage Level 1 Disconnect AC power line if connected 2 Disconnect 12 VDC External Battery Source if connected 3 Wait 2 to 3 minutes after disconnecting any charging system 4 Press the Read Battery Volts rocker switch to the internal side 5 Hold the switch down until the ventilator cycles a breath 6 Read the voltage level on the Flow Rate Digital Display 7 Release the rocker switch WARNING Whenever using the Internal Battery Source the user needs to closely monitor the remaining voltage to eliminate the possibility of complete loss of power Caution Storage of the unit with a partially discharged internal battery severely decreases the battery life Always store the unit with the power plug connected to AC volta
40. he Peak Flow Rate LCD Record this value on the line entitled Internal Battery Voltage Be certain to recon nect the appropriate power source following this check 14 External Battery Voltage Disconnect the AC power source Wait 2 to 3 minutes following discon nection for the most accurate value Using the Battery Test Switch read the voltage level of the External Battery in the Peak Flow Rate LCD Record this value on the line entitled External Battery Voltage Be certain to reconnect the AC power source following this check Respironics PLV 100 Clinical Manual p n 35500 Rev D 39 SECTION 10 VENTILATOR MONITORING o Ventilator Monitoring Continued 38 RESPIRONICS 6 1 E Ratio Observe the values displayed on the E Ratio LCD and record this information on the line entitled I E Ratio This display is blanked out in SIMV mode and is flashing if the ratio is inverse or greater than 1 9 9 During Assist Control mode the E Ratio displays the I E Ratio based on the set parameters 7 Peak Inspiratory Flow Rate Observe the Peak Flow Rate displayed on the LCD and record this level on the appropriate line This is the flow rate on all machine delivered breaths 8 Peak Airway Pressure Observe the highest level that the manometer reaches over several breaths Record an average of this value in the section entitled Peak Airway Pressure 9 Airway Pressure Limit Audible Alarm NOT
41. he automatic 10 amp battery charger is recommended for use in all heavy duty ventilator applications requiring greater than 8 hours per day 12 VDC external battery operation This 10 amp charger quickly and efficiently recharges an external 12 VDC battery in 2 to 4 hours depending on state of discharge and re duces the possibility of deep cycle battery damage due to inadequate charge time Respironics PLV 100 Clinical Manual p n 35500 Rev D 23 SECTION 7 POWER SUPPLY OPTIONS o o External 12 VDC Connection Options 12 VDC Internal Battery Source Operation 24 RESPIRONICS RESPIRONICS Respironics Automobile Lighter Cable 27905 l This cable allows easy connection to the lighter outlet of a car or boat to Patient Circuits power the PLV 100 Continued 6 Battery Cable 07270 A 6 acid resistant battery cable is available for connecting the ventilator to an external battery This battery cable serves well for most bedside and wheelchair external battery uses It is equipped with ring terminals for securing the cable to the battery and a DC connector for attachment to the PLV 100 12 Battery Cable 07280 A 12 battery cable with clip terminals is available for connecting the PLV 100 to auto or van battery for long distance traveling v The PLV 100 has a built in 12 VDC internal battery to provide ap proximately 1 hour of continuous operation dependent on BPM rate tidal volume and pressures This batt
42. he patient circuit to ensure client safety It is recommended that an oxygen analyzer be used to verify FIO when using supplemental oxygen Periodically verify that alarms are set correctly and are operational To avoid the entrainment of battery gases into the intake ports on the rear panel do not operate the PLV 100 directly above a battery Due to the wide variety of disposable tubing the user must be certain the connection to the patient air outlet fits properly Respironics PLV 100 Clinical Manual p n 35500 Rev D 3 SECTION 2 WARNINGS AND CAUTIONS o RESPIRONICS A Do not place containers of liquids on the ventilator Do not spill Cautions liquids on the ventilator The PLV 100 must be periodically checked and maintained to ensure proper operation Do not use the PLV 100 to charge a deeply discharged external battery Connect the PLV 100 only to a grounded hospital grade outlet If either front panel circuit breaker trips reset by pushing the round circuit breaker knob in until it clicks back into position If the breakers continue to trip after resetting return the ventilator to an authorized service personnel for repair Replace the back panel shipping fuse when necessary with a 5 amp slow blow fuse type 3AG only Do not position the PLV 100 as to block the air intake ports located on the rear panel Performance may be affected at temperatures below 5 C 23 F and above 41 C 106 F
43. hpieces with the Standard flextube 22 mm or the tapered flextube 15 mm 06565 Mouthpiece Angled 15 mm 06566 Mouthpiece Angled 22 mm Respironics PLV 100 Clinical Manual p n 35500 Rev D 51 SECTION 11 ACCESSORIES Additional Accessories 50 RESPIRONICS External Pressure Limiter 06600 The Respironics External Pressure Limiter is a position independent spring loaded threshold resistor valve that is adjustable from 5 to 50 cm 2 Water Traps Both water traps shown are reusable Use the large bore water trap in the ventilator circuit and part 06718 or 06441 for the PAP line i G AS 06717 H O trap Lg Bore 22 mm 06718 H O trap PAP 4 8 mm 3 16 06441 Hydrophobic Filter On Patient Circuit Support Arm The support arm may be used with all PLV Series ventilators 27025 Circuit Support Arm 27909 Assembly Mount 06516 Circuit Hanger PLV Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS High Pressure Alarm Inverse I E Ratio Alert Increase Inspiratory Flow Alert Switch to Battery Alert Low External Battery Alarm SECTION 6 ALARM AND ALERT SYSTEMS V The High Pressure Alarm and Limit is adjustable from 5 to 100 cm H O It sounds an alarm and vents excess pressure if the system pressure exceeds the set point This alarm resets when the pressure falls below the set point The High Pressure Alarm functions independently of the PAP
44. ion Siina a Bech aa 3 34 Enrichment 00ececeeeeeees 33 34 40 41 44 SOUrCe LSVEl raae teretibersGevevssazeutends 40 41 P Patient Air Outlet ccccccceceeeeeeeeeees 14 15 27 Patient Ale AlGaAs aieeieeavin i debater dey due 16 Patient Airway Pressure Gauge 6 14 15 38 39 Patient Interfaces cccesesececcessesseeeeeeeanensees 36 PEEP Valves Reusable Disposable 52 Power Failure an inn a 7 20 22 Power Sources 12 VDC inii aa 4 13 12 VDC External 00 6 7 19 22 27 12 VDC Internal eeen 6 7 20 27 IOIA i OA EAE EA E A E 6 13 22 27 220 240 VAG aram sch etn cl oie hatin 6 GANQUAG fe ariee tier ee Oeste ec EEN 7 LED S cccicssisictav2ih can eiuai iia durisas caienass adh 12 13 39 Selectie aaaea E 22 27 Power Supply Options ceeeee 22 24 25 Power Switch cccsssssseeseeeees 5 12 13 20 27 Pressure Alarm R SDpirOnics eeeeeeeee 48 Pressure Gauge ccccccceesssteeeeesstteeeeeees 6 14 15 Pressure Limited Application 008 35 50 64 Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Front Panel Controls Front Panel Visual Indicators SECTION 3 SPECIFICATIONS Mode Selection CONTROL ASSIST CONTROL SIMV Tidal Volume 0 05 to 0 20 0 02 liters 0 20 to 3 00 liters 10 Breath Rate 2 to 36 0 5 BPM 36 to 40 2 BPM Inspiratory Flow Rate 10 to
45. ir to enter the ventilator to be delivered through the ventilator circuit to the patient NOTE The Patient Air Inlet houses a reusable foam filter which requires periodically cleaned by the user See Section 12 Clean ing and Disinfection for more information on filter changes 2 Sensor Vent The PLV 100 samples barometric pressure every minute and recalibrates the sensitivity control to zero This feature provides a more stable sensitivity set point Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Additional Accessories Continued SECTION 11 ACCESSORIES Respironics SpotCheck Oximeter 43001 The SpotCheck Oximeter is a hand held noninvasive monitor that is ideal for portable or transport applications For more information contact a Respironics representative A 9 4 SpO2 102 PULSE 0 00000000 Miscellaneous Accessories 06657 35891 35503 35505 35506 35508 35934 35972 27916 27921 Test Lung 1 Liter Foam Lined Kit Handles Complete PLV side Video Inservice PLV 100 Service Manual PLV 100 Tote Bag PLV Dust Cover PLV Faceplate Cover Assembly PLV Faceplate Cover Assembly Masked Pedestal Stand Pedestal Stand Tall For more information on any Respironics accessories please contact your Respironics deal er home care provider Respironics PLV 100 Clinical Manual p n 35500 Rev D 53 SECTION 11 ACCESSORIES Additiona
46. l Accessories Continued 52 RESPIRONICS PEEP Valves Reusable Disposable The Ambu PEEP Valve 20 is a reusable position independent spring loaded threshold resistor valve adjustable from 1 2 to 20 cm H O The PEEP valve comes standard with a 30 mm I D connector Disposable PEEP valves are also available Order part 06712 for the complete Ambu PEEP Valve 20 06712 Complete Ambu PEEP Valve 20 cm H O 06333 Connector 30 mm I D PEEP 06336 Connector 22 mm O D PEEP 06511 PEEP Disposable 30 mm I D Flextubes These flextubes may be used to decrease tension on the tracheostomy or endotracheal tubes and are reusable 06485 Fextube 5 1 2 22 mm 15 mm Tapered 06484 Flextube 2 22 mm 15 mm Tapered Min Dead Space 06495 Flextube 8 22 mm 22 mm Standard 06500 Flextube 5 1 2 22 mm 22 mm Standard Manual Resuscitation Bags 562012 BagEasy with PEEP valve amp Circle Seal Mask 6 pack 562013 BagEasy with Circle Seal Mask 6 pack 562038 BagEasy with PEEP valve amp Circle Seal Mask 12 pack 562039 BagEasy with Circle Seal Mask 12 pack 562040 BagEasy with Peep valve 12 pack 562041 BagEasy 12 pack Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Rear Panel Continued SECTION 5 REAR PANEL FILTERS CONNECTIONS AND HOUR METER 3 Battery Fuse Shipping fuse Remove the 5 amp slow blow fuse during shipping to eliminate the possibility of the unit
47. le exhalation valve These come complete with the items shown below Other configurations e g SIMV Hose Assembly O Enrichment Humidification are con structed using the Standard PLV Circuit plus additional items to complete the circuit Many variations are possible using parts listed in the section 06121 9 5 ea s4 6 LURS AS Ay I 1 IW 3 06125 5 5 ea A 6 CONS ANS a A _ 1 1 3 06530 Hose 60 Clear 22 mm I D 06706 Valve Exhalation Gas Collecting 06232 Adapter PAP Assembly 06686 Tubing 4 8 mm 3 16 I D 6 5 ft 06793 Clip Hose 06685 Tubing 3 2 mm 1 8 I D 6 5 ft 06720 Valve Exhalation Low Profile NOOR OD Humidification Use this tubing to connect the patient air outlet and the inlet port of the humidifier with the PLV 100 ventilator Other humidification accessories are offered in this section a BP BS 3 1 06525 Hose 18 Clear 22 mm I D 2 0 Standard Circuit PLV 3o eeds Humidifier ref Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Operation Guidelines SECTION 8 OPERATING PROCEDURE 1 Select Power Supply The PLV 100 may be operated from 3 different power sources e 120 VAC Power Source Use the detachable power cord and connect the unit to a grounded hospital grade outlet e 12 VDC External Battery Source Use the battery cable to connect the unit to an external battery source or use the Res
48. linical Manual p n 35500 Rev D SECTION 4 FRONT PANEL CONTROLS CONNECTIONS o AND VISUAL INDICATORS CONTROL e ASSIST CONTROL SIMV TIDAL VOLUME INCREASE 05 TO 3 LITERS Es i N RESPIRONICS SENSITIVITY PRESSURE PATIENT AIR o EXHALATION ll VALVE ga PARL SPONTANEOUS ASSIST OUTLET AIRWAY PRESSURE LIMIT 0 60 5 PAP 40 70 LOW PRESSURE ALARM SET cmH 0 Co 2 cmh o O15 sEconD DELAY 1cmH20 1mbar 0 1kPa 4 LIFECARE PLV 100 VN INTERNAL EXTERNAL OO T ep BPM wetted C24 E RATIO BLINKS DURING 4 INVERSE I E RATIO OR READINGS OVER 1 9 9 OFF DURING SIMV 4 mspiRaToR i FLOW RATE INCREASE 0 120 LPM Cas Jf a pe INCREASE 6 INSPIRATORY FLOW READ BATTERY VOLTS INTERNAL 30 SECOND ALARM SILENCE RECHARGE VOLTS CAPACITY EXTERNAL DANGER RISK OF EXPLOSION IF USED NEAR FLAMMABLE ANESTHETICS Mode and Operation Continued 2 Tidal Volume Control and Digital Display The Tidal Volume is adjustable from 0 05 to 3 0 liters by turning the knob on the front panel The actual tidal volume set is shown on the digital display adjacent to the knob This parameter remains constant unless the tidal volume setting is changed 3 Respiratory Rate Patient BPM Control and Digital Display Respiratory Rate or Patient Breaths Per Mi
49. metric pressure continually so that the sensitivity level set by the clinician remains stable e Reorientthe receiving antenna e Relocate the ventilator with respect to the receiver e Increase the distance between the ventilator and the receiver e Plug the ventilator into a different outlet so that ventilator and receiver 9 15 Second Delay LED are on different electrical branch circuits This LED is illuminated when the system pressure is below the Low Pressure Set Point The illumination indicates that the 15 second delay has begun and the pressure level set on the Low Pressure Alarm must be crossed within the 15 second delay or the alarm will sound 12 Respironics PLV 100 Clinical Manual p n 35500 Rev D Respironics PLV 100 Clinical Manual p n 35500 Rev D 57 SECTION 12 CLEANING AND DISINFECTION o Decontamination of Tubing and Accessories Continued 56 RESPIRONICS Cleaning and Disinfection Procedure continued 9 Drain all parts dry on a clean towel do not wipe dry Equipment must be completely dry before storage 10 Reassemble when equipment is dry store ready for use in a plastic bag or in a dust free area RESPIRONICS WARNING Do not reuse vinegar solution Effectiveness is significantly lessened if solution is used more than once Use all cleaning materials for a single patient s respiratory equipment only Commercially prepared quaternary ammonium compounds such as Cont
50. n materials and workmanship for a period of one year after delivery provided the unit is properly operated under conditions of normal use as described in the Clinical Manual Respironics makes replacements repairs or issue a credit for equipment or parts at Respironics option which are found to be defective The defective unit may be returned prepaid to Respironics after the customer has received approval from Respironics to return the unit Changes To Equipment Respironics its dealers and associates reserve the right to make changes in equipment built and or sold by them These changes do not obligate Respironics to make the same or similar changes to equipment previously built and or sold by them Client Safety Respironics has made every effort to make a reliable and trouble free instrument However there is always a possibility of unpredicated failure with any mechanical or electronic device Respironics cannot control the manner in which the unit is used Therefore the buyer or user alone must determine the medical and or mechanical suitability of the unit in every way and decide if other precautionary measures are needed to ensure client safety If you need safety advice Respironics is pleased to offer assistance Whatis Not Covered This Warranty does not apply to any unit or individual parts which have been repaired or altered in a way that in Respironics judgement affect its stability or reliability or which has been subje
51. ndatory breath The current six second period is canceled when patient effort is detected and results in a delivered volume breath Therefore the time interval between the machine delivered breaths changes depending upon when the patient effort is detected but the number of machine delivered breaths remains the same For example at an IMV rate of 10 and the total respiratory rate of 20 BPM the patient receives 10 delivered volume breaths The additional breaths are the patient s spontaneous tidal volume The machine does not deliver another breath until the next regularly scheduled mandatory breath The patient may continue to breathe spontaneously through the IMV valve or patient air inlet In SIMV mode the rate display indicates the sum of mandatory plus spontaneous breaths by averaging the preceding 4 breaths The ventilator deliver only as many mandatory breaths as selected by the rate knob The patient only causes the time period between mandatory breaths to change slightly Refer to the following example for further information Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Ventilator Monitoring SECTION 10 VENTILATOR MONITORING Vv Keep an accurate record of ventilator settings and other information to improve patient care and to meet documentation requirements The following procedure explains how to perform a ventilator patient system check on the PLV 100 A sample form may be found followin
52. nsate for the humidity deficit presents when artificial airways are used The addition of a humidification system may also add to patient comfort and aid in avoiding thick secretions when ventilating individuals via nasal or oral mask techniques The PLV 100 is designed to mount a humidifier in both face forward and face up positions The PLV 100 accepts a wide variety of humidification systems with a number of different mounting brackets Artificial Noses Moisture Retention Humidifiers may be used to meet humidification needs during portable ventilation application See Section 11 Accessories for specific humidification devices offered by Respironics The PLV 100 may be used as a pressure limited ventilator by adding the Respironics External Pressure Limiter 06600 to the ventilator circuit The combination of pressure limited ventilation using a volume ventilator allows the clinician the benefit of pressure ventilation without sacrificing the safety and added monitoring of a volume ventilator The External Pressure Limiter is adjustable from 5 to at least 50 cm H O For more information on the use of pressure limited ventilation contact Respironics or an authorized Service Center Respironics PLV 100 Clinical Manual p n 35500 Rev D 35
53. nute are available from 2 to 40 BPM This setting determines the actual number of ventilator delivered breaths in the Control mode This knob also controls the minimum number of ventilato r delivered breaths in the Assist Control and SIMV modes In Control mode the BPM display indicates the BPM set on the ventila tor In Assist Control mode the display indicates the sum of the controlled and assisted breaths sum of ventilator delivered breaths and patient inspiratory efforts Up date of the BPM digital display occurs by averaging the preceding 4 breaths or whenever a setting change is made 10 Respironics PLV 100 Clinical Manual p n 35500 Rev D In SIMV mode the display indicates the o SECTION 13 MAINTENANCE AND TROUBLESHOOTING GUIDE RESPIRONICS Troubleshooting Guide WARNING Whenever there is an alarm condition be certain to provide ventilation for the user unless the problem can be found and corrected immediately Symptom Probable Cause Corrective Action Unit switched ON and does not 1 All power supplies ex 1 Pluginto AC source to operate operate Continuous audible hausted and charge batteries alarm sounds 2 Circuit breaker disengaged 2 Reset circuit breakers 3 Shipping fuse disengaged 3 Engageor replace shipping or faulty fuse 1 0 or 2 0 displayed in Tidal 1 Pressure transducer failure 1 or 2 Do Not Use Unit Volume LCD window Unit does 2 Microproces
54. on the connector Rotate connector clockwise to lock 22 DC Circuit Breaker 12 V Press to reset the circuit breaker for the 12 VDC power circuit 23 AC Circuit Breaker Vi Press to reset the circuit breaker for the 120 VAC power circuit Respironics PLV 100 Clinical Manual p n 35500 Rev D 15 SECTION 5 REAR PANEL FILTERS CONNECTIONS o AND HOUR METER RESPIRONICS Made in USA US Patent 4 617 637 4 493 614 Canadian Patent 1 204 090 1 237 507 Other Patents Pending Patient Machine Air Inlet Air Vent Battery Fuse Remove fuse for safe shipment T 5 Amp Slow Blot w Model PLV 100 Decontamination Notice Do not use Serial No Catalog 35001 lal radiation or exceed 60 relative humidity 130 F temperature for gas ETO This device is intended for use only RESPIRONICS Y on or by the order of a physician and in oTa accordance with the instruction manual 120V 50 60 Hz 2A 12V 5A This unit complies with the limits for a AC Plug To assure proper ground O LISTED 7a Class B Computing Device pursuant to Subpart reliability and to prevent possible EQUIPMENT J of Part 15 of FCC Rules shock hazard this device should only be connected to a wall receptacle marked Hospital Grade g Electric shock hazard x Do not remove cover panels or end plates Rear Panel 1 Patient Air Inlet This inlet allows filtered room a
55. oximately 1 hr NOTE Operation times are decreased by conditions using increased power consumption such as extreme settings Conversely operating times increase by settings using low power consumption Battery Charging by PLV 100 Trickle charge to internal and external batteries Optional External Chargers 2 amp charger 10 amp charger Pressure Alarms Low Pressure Visual Continuous Audible High Pressure Momentary Audible Apnea Visual Continuous Audible Inverse E Ratio Visual Warning Increase Inspiratory Flow Visual Warning Battery Alarms Internal Battery Visual Continuous Audible External Battery Visual Continuous Audible Reverse Battery Connection Continuous Audible Power Alarms Power Failure Continuous Audible Power Source Change Single Audible Tone Unit Malfunction Intermittent Audible Alarm Silence Continuous Visual while activated Respironics PLV 100 Clinical Manual p n 35500 Rev D 7 SECTION 3 SPECIFICATIONS o RESPIRONICS Operating Temperature Range Temperature 5 C to 41 C 23 F to 106 F Specifications i i Dimensions Dimensions and 22 9 x 31 1 x 31 1 cm 9 x 12 25 x 12 25 Weight Weight 12 8 kg 28 2 Ib 8 Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Warranty Continued SECTION 14 WARRANTY AND MAINTENANCE CONTRACT One Year Warranty Respironics warrants the PLV 100 unit to be free from defects i
56. pironics Auto Lighter Cable e 12 VDC Internal Battery Source The PLV 100 operates for approximately one hour from a fully charged Internal Battery source if no other power source is supplied See Section 7 Power Supply Options for a detailed explanation of operation of the PLV 100 from different power sources 2 Connect Selected Ventilator Circuit a Connect the 22 mm I D tubing to the Patient Air Outlet b Connect the 4 8 mm 3 16 I D tubing to the Assist PAP connector c Connect the 3 2 mm 1 8 I D tubing to the Exhalation Valve line connector d Test for proper function of the PLV 100 using a test lung prior to connecting to a patient Verify proper rate volume delivery and integrity of the circuit WARNING Due to the wide variety of disposable tubing the user must be certain that there is a proper connection both at the ventilator and patient adapter See Section 11 Accessories for a detailed explanation of the various ventilator circuit systems available 3 Toggle Power Switch to ON The PLV 100 begins the Diagnostic Self Check and upon passing the test approximately 5 seconds the unit begins operation See the beginning of this section for a detailed explanation of the Diagnostic Self Check Respironics PLV 100 Clinical Manual p n 35500 Rev D 27 SECTION 8 OPERATING PROCEDURE o Operation Guideline Continued 28 RESPIRONICS 4 Select Operating Mode The PLV 1
57. quate expiratory time to avoid the development of auto PEEP especially in patients with COPD Consult your physician or respiratory therapist for further information c The flow setting may be adjusted while monitoring the I E ratio display When the I E ratio is at the desired value inspiratory flow rate is correct Tidal volume and BPM must be properly adjusted before setting flow rate Respironics PLV 100 Clinical Manual p n 35500 Rev D 29 SECTION 8 OPERATING PROCEDURE o Operation Guidelines Continued 30 RESPIRONICS 9 Set Low Pressure Alarm There is an automatic 15 second delay that begins following the moment that the system pressure drops below the Low Pressure Alarm set point If the delay reaches 15 seconds the audible alarm is activated a To raise the Low Pressure Alarm set point turn the Low Pressure Alarm knob clockwise To decrease the Low Pressure Alarm set point turn the Low Pressure Alarm knob counterclockwise b Pressure is monitored through the PAP proximal airway pressure line thus avoiding a back pressure created within the hose assembly and or humidifier c Respironics recommends the Low Pressure Alarm be set 5 to 10 cm H O below peak inspiratory pressure as observed on the manometer during a machine breath WARNING The Low Pressure Alarm is responsible for alerting the caregiver to patient circuit disconnection ventilator malfunction or any condition that creates a
58. r record the number of liters per minute that are being delivered to achieve the desired oxygen concentration If the FIO is incorrect increase or decrease the oxygen source to achieve the pre scribed oxygen percentage Record the oxygen percentage and liters per minute on the line entitled Inspired Oxygen Concentration 16 Oxygen Source Level Observe and record the level of the remaining oxygen source If an oxygen tank is in use this value is read in psi pounds per square inch If a 50 psi liquid oxygen system is in use this value is expressed in Ibs pounds 17 Inspired Gas Temperature Observe the temperature reading on the thermometer Record this value on the line entitled Inspired Gas Temperature If an Artificial Nose is used mark with N A 18 Humidifier Heater Setting Observe the number setting on the Humidifier Heater Record this value on the line entitled Humidifier Heater Setting This may be a reference number only and may not correspond with any actual temperature If an Artificial Nose is used mark with N A 19 Humidifier Water Level Observe the water level in the humidifier reservoir Fill if indicated and record this information on the line entitled Humidifier Water Level 20 Initials Indicate your initials on the appropriate line Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Operation Guidelines Continued SECTION 8 OPERATING PROCE
59. report doing this on regular days such as Monday and Thursday or Sunday and Wednesday This makes it easier to remain onschedule Respironics PLV 100 Clinical Manual p n 35500 Rev D Power Continued SECTION 4 FRONT PANEL CONTROLS CONNECTIONS AND VISUAL INDICATORS 17 Power Source LED s e 120 VAC LED V This green LED is illuminated when the PLV 100 is operating from an AC power source Internal Battery LED This amber LED is illuminated when the unit is operating from its internal battery This LED blinks when the internal battery charge is low e External Battery LED This white LED is illuminated when the unit is operating from an external 12 VDC source This LED blinks when the external battery source is low 18 Power Switch Switches between ON and OFF RECHARGE The internal battery and external battery if connected are charged as long as the line cord is plugged into a wall outlet regardless of the power switch position 19 Alarm Silence Button Pressing this button silences most audible alarms for 30 seconds The alarm silence function automatically resets following 30 seconds The alarms that cannot be silenced are Power failure High pressure and Microprocessor failure 20 Alarm Port Sound outlet for audible alarm 21 External Battery Receptacle Connect the auto lighter cable or external battery cable to this receptacle Align the dot guide on the front panel with the dot
60. rocessor failure Vv Failure of the following internal systems to operate properly causes the audible fast beep alarm to sound e Pressure transducer failure e Piston system failure WARNING The ventilator should not be used at any time the audible fast beep alarm is sounding Analyzers If the fast beep or other visual audible alarms continue to sound after attempting to correct the cause of the alarm refer the ventilator to autho rized service personnel for servicing Respironics PLV 100 Clinical Manual p n 35500 Rev D Remote Alarm 34003 The Respironics Remote Alarm alerts the user of an alarm condition at a distance of up to 300 feet from the ventilator An audible tone sounds and a red light flashes to indicate that an alarm condition exists Power is supplied by an internal 9 VDC alkaline battery that provides at least two weeks of continuous operation The DC converter allows the Remote Alarm can also operate on house hold current The Remote Alarm sounds if the cable connecting it to the ventilator becomes disconnected or shorted A Self Test circuit con stantly checks the internal circuitry and if an internal failure is detected the alarm sounds to alert the user that the Remote Alarm is not function ing properly The Remote Alarm can also function with a Call Button Refer to the Remote Alarm User s Manual for details of operation and accessory list MUTT yt My a
61. rol Ill are available from home care companies The cost and practicality of using these solutions for cleaning should be considered by each individual user according to specific requirements Follow manufacturer s instructions carefully A washable mini operation instruction card is available for use as a guide when disinfecting respiratory equipment For further assistance contact your local home care company representa tive or Respironics Respironics PLV 100 Clinical Manual p n 35500 Rev D Pressure Continued SECTION 4 FRONT PANEL CONTROLS CONNECTIONS AND VISUAL INDICATORS 10 Low Pressure Alarm Control This is adjustable from 2 to 40 cm H O and allows the clinician to set a customized low pressure alarm for each patient s needs Respironics recommends that this alarm be set 5 to 10 cm H O below the patient s peak pressure WARNING Low Pressure Alarm settings more than 10 cmH2O below the system pressure may prevent the unit from alarming in response to circuit leaks or patient disconnects For a detailed description of the setting and function of this alarm see Section 6 Alarm and Alert Systems 11 Pressure Gauge Proximal airway pressure displays the pressure as detected in the Proximal Airway Pressure PAP tubing The pressure range is from 10 cm H O to 100 cm H O 12 Assist PAP Proximal Airway Pressure Connector This connector accepts the 3 16 I D PAP tubing from the ventilator circui
62. ronics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS External Battery Voltage Monitoring External 12 VDC Battery Charger Options SECTION 7 POWER SUPPLY OPTIONS Vv Battery voltage reading while under load is an indication of the state of charge Pressing the Read Battery Volts rocker switch provides a voltage reading that is displayed in the Inspiratory Flow Rate window To Check the External Battery Voltage 1 Unplug the AC line cord External Battery LED illuminates 2 Wait 2 to 3 minutes after all battery charging sources are discon nected 3 Press the Read Battery Volts rocker switch to the external side 4 Hold the switch down until a breath stroke is delivered by the ventilator 5 Read remaining battery voltage in the Inspiratory Flow Rate window 6 Release the switch NOTE Whenever the PLV 100 detects a change in the power supply an audible alarm sounds for 3 seconds and then automati cally resets This alerts the user to verify the new power source level if a battery is in use In addition the audible alarm sounds if the battery voltage falls below 9 5 volts See Section 6 Alarm and Alert Systems for more information Battery Charger Pack 07050 This acid proof polypropylene carrying case comes with an automatic 2 amp charger built in voltmeter and battery cable It can accommodate an 80 amp hour deep cycle battery 10 Amp Battery Charger 07320 T
63. s per minute LPM Vt Desired patient tidal volume in cc s Vv Ventilator volume setting as determined above in cc s R Breaths per minute BPM rate WARNING It is recommended that the volume of gas delivered to a patient be periodically analyzed to ensure an accurate FIO in any oxygen enriched system This is especially important if the patient s total respiratory rate is variable NOTE In applications where the required FIO exceeds 0 40 or there are significant variations in the patient s total assisted respira tory rate clinicians may wish to consider utilizing Respironics PLV 102 The PLV 102 is the only portable volume ventilator with machine controlled FIO This system uses an oxygen proportioning valve to conserve oxygen by delivering only the precise amount necessary during each inspiration The PLV 102 is also able to account for the dilution of FIO by room air during SIMV operation and make the corresponding correction to delivered FIO Contact Respironics or an authorized Service Center for further information on delivery of oxygen in portable ventilator applications Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONICS Humidification Pressure Limited Application SECTION 9 APPLICATION NOTES Whenever the upper airways are bypassed by using a tracheostomy or endotracheal tube it is essential that a humidity system be added to the ventilator circuit to compe
64. sor failure Refer to an authorized not operate and Fast Beep Service Center audible alarm sounds 1 Check for disconnectin _ Unit passes diagnostic check 1 Low Pressure Alarm ventilator circuit or set point and begins operation Continu activated incorrectly set ous audible alarm sounds 2 Check battery voltage and 2 Low battery voltage charge if indicated 4 Unit passes diagnostic check 1 High Pressure Alarm Pressure Limit setting or and begins operation Intermit alarms with unit cycling patient may need suctioning tent audible alarm sounds 2 Check for correct setting of 2 Intermittent Low Pressure Low Pressure set point Alarm 41 Reconnect PAP line Unit is operating but no pres 1 PAP line disconnected 2 Check entire circuit for sure seen on manometer 2 Circuit disconnected disconnect Continuous audible alarm sounds t 6 External battery cable is con 1 Battery Cable Polarity is 2 Check and recharge Ex nected Continuous audible reversed ternal Battery alarm sounds 2 External Battery Low t Increase Inspiratory Flow LED is flashing Flow rate and BPM values are altered 1 Inspiratory flow rate set too low to meet rate and tidal volume selection Respironics PLV 100 Clinical Manual p n 35500 Rev D indicated See Section 9 Application Notes for information or Priority Sequence explanation 59 SECTION 13 MAINTENANCE AND T
65. system and protects the patient from potential barotrauma even if the PAP tubing is disconnected It is recommended that this Alarm and Limit be set 10 to 20 cm H O above the normal airway pressure Venting of excess pressure is not affected by the alarm silence button See Section 8 Operating Procedure for information on setting this alarm Vv This alert is a visual indication that the Inspiratory Time has exceeded the Expiratory Time The I E Ratio Digital Display flashes when this condition exists The Digital Display also flashes when the I E Ratio exceeds 1 9 9 During SIMV the I E Ratio Display is blanked to avoid erroneous feedback to the user Vv The Increase Inspiratory Flow red LED flashes if the set inspiratory flow rate is not sufficient to meet the other set parameters of tidal volume and respiratory rate The Inspiratory Peak Flow automatically increases based on the critical parameter priority sequence See Section 9 Application Notes for further information Vv The PLV 100 sounds a 3 second audible alarm when the unit automati cally switches to the internal or external battery from an AC power source This alerts the user that the PLV 100 is operating on battery power and a limited operation time remains Vv This alarm condition occurs if the voltage across the external battery while in use falls below 9 5 volts If this condition continues the PLV 100 automatically switches to the internal battery source If the Low E
66. t The proximal airway pressure and patient inspiratory efforts are sensed through this connector to trigger an assisted breath in the Assist Control Mode or to synchronize the breaths and reset the 15 second delay in the SIMV Mode 13 Exhalation Valve Tubing Connector This connector accepts the 1 8 I D tubing to provide the gas source for the exhalation valve 14 Patient Air Outlet Connector Connect the standard 22 mm I D ventilator circuit tubing or other adapt ers to this outlet The tidal volume delivered to the patient flows through this port 15 Airway Pressure Limit Control This control is adjustable from 5 to 100 cm H O and limits the pressure level in the patient ventilator system to avoid barotrauma to the user Respironics recommends that this limit be set 10 to 20 cm H O above the normal airway pressure This limit is independent of the PAP system and operates without the PAP tubing being connected Respironics PLV 100 Clinical Manual p n 35500 Rev D 13 SECTION 4 FRONT PANEL CONTROLS CONNECTIONS o AND VISUAL INDICATORS CONTROL MOD r ASSIST CONTROL e _ SIMV TIDAL VOLUME INCREASE 05 TO 3 LITERS 4 i N RATE PATIENT BPM 1 E RATIO BLINKS DURING INVERSE I E RATIO OR READINGS OVER 1 9 9 OFF DURING SIMV C INSPIRATORY FLOW RATE INCREASE 10 TO 120 LPM l G INCREASE INSPIRATORY FLow RESPIRONICS SENSITIVITY PRESSURE PATIENT AI
67. urce if connected 3 Internal battery source Vv Connect the detachable power cord securely to the receptacle on the back of the PLV 100 and connect the other end of the cord to a hospital grade grounded 120 VAC outlet The unit operates indefinitely on this power source Whenever possible leave the PLV 100 connected to the AC power source even when the unit is not in use to continue to trickle charge the Internal Battery and External Battery sources Vv Connect the battery cable to 12 VDC external battery To connect to the ventilator match the front panel dot near the receptacle with the dot on the connector Push the connector into the receptacle and twist clockwise to lock NOTE Connect the WHITE wire of battery cable to the POSITIVE battery terminal and the BLACK wire to the NEGATIVE battery terminal If these conditions are reversed an alarm will sound but no damage will occur to the PLV 100 or the external battery A fully charged 105 amp hour deep cycle marine battery provides up to 24 hours of continuous use depending on BPM rate tidal volume and pressures Use an external battery for mobility or during 120 VAC power failure situations The optional Respironics Auto Lighter Cable allows for an easy external battery interface when traveling in a car or boat If the car or boat is operating and continuing to recharge the battery the PLV 100 operates indefinitely on this power source Respironics
68. vered breath If the airway pressure does not equal or exceed the set point an alarm sounds at the end of the breath This undelayed alarm is effective only in the SIMV Mode and continues until the disconnect is corrected and the Low Pressure Set Point is reached with system pressure WARNING The user must verify the set point and function of the Low Pressure Alarm to maximize patient safety Respironics recom mends the alarm be set 5 to 10 cm H O below the peak pressure See Section 8 paragraph 9 Vv The Apnea Alarm is a function of the Low Pressure Alarm and occurs only in the SIMV mode The alarm occurs unless a The patient makes a detectable inspiratory effort or b The machine cycles to at least the Low Pressure Alarm set point See Low Pressure Alarm above for a detailed description Respironics PLV 100 Clinical Manual p n 35500 Rev D SECTION 11 ACCESSORIES Nasal Masks Custom Nasal Masks These may be used for a custom fit when leaks or user discomfort are a problem For Replacement Kits see your Respironics dealer Positive Pressure Ventilation Mouthseal Complete 06570 For use when noninvasive positive pressure by mouth is used Order part 06570 for complete mouth seal system Individual parts are listed 06365 Cushion Mouthseal 06520 Headstrap Mouthseal 06585 Mouthpiece Mouthseal 06642 Shield Mouthseal 06595 Nose Clip Mouthseal order separate Mouthpieces Use the different mout
69. ving foreign material such as blood sputum or dust from objects e Disinfection The process of killing pathogenic organisms on inanimate objects e Pathogen A microbe capable of causing disease Small Bore Tubing Do not use this procedure for small bore tubing such as the exhalation valve tubing and PAP tubing Simply wipe off the outside of this tubing with either a 70 Isopropyl Alcohol solution or mild detergent This small tubing is difficult to dry effectively inside the tubing Replace the tubing when it becomes dirty contaminated or as needed Cleaning and Disinfection Procedure 1 Disassemble all tubing and adapters 2 Wash hands thoroughly prior to cleaning equipment 3 Prepare a mild detergent solution using warm tap water and liquid dishwashing or other soap 4 Scrub all accessible surfaces thoroughly using a soft brush 5 Rinse with tap water making certain all soap residue is removed 6 Prepare a solution using one part white vinegar to three parts distilled water An average beginning quantity is 8 ounces of vinegar to 24 ounces of distilled water the actualamount varies according to individual needs Regardless of the quantity the ratio must remain at 1 3 7 Soak equipment in this solution for one hour 8 Rinse completely with warm tap water Respironics PLV 100 Clinical Manual p n 35500 Rev D 55 SECTION 12 CLEANING AND DISINFECTION o Cleaning the PLV 100 Decontamination of
70. volumes allow for effective ventilation of pediatric patients The use of the Respironics External Pressure Limiter further enhances the use of the PLV 100 for pediatrics A flow rate range up to 120 Ipm allows for ventilation of patients with increased minute volume demands or those requiring a longer expiratory time Please read this clinical manual and become familiar with the operation of the PLV 100 before using the ventilator on an individual Save the box and all packing material for safe transportation of the PLV 100 back to Respironics for preventive maintenance or service needs The PLV 100 is FDA registered UL listed FCC and CSA certified In addition the PLV 100 is approved by SEMKO Demko LGA and NATA The French Health Ministry has given the PLV 100 official homologation approval Approvals are pending from other agencies Due to our continued efforts to improve our products specifications in this manual are subject to change without notice The PLV 100 is manufactured by Respironics Inc under the following patents United States Patent 4 493 614 and 4 617 637 Canadian Patent 1 204 090 and 1 237 507 Australian Patent 586 376 Other patents pending Copyright Respironics Inc 2000 ALL RIGHTS RESERVED The information contained in the clinical manual as well as the software programs to which it relates are protected under copyright law Respironics PLV 100 Clinical Manual p n 35500 Rev D RESPIRONIC
71. xternal Battery Alarm is activated an audible alarm sounds and the External Battery LED flashes Respironics PLV 100 Clinical Manual p n 35500 Rev D 19 SECTION 6 ALARM AND ALERT SYSTEMS RESPIRONICS SECTION 11 ACCESSORIES Low Internal Battery Alarm Power Failure Alarm Microprocessor Failure Alarm Ventilator Malfunction 20 RESPIRONICS Vv This alarm condition occurs if the voltage across the internal battery drops below 9 5 volts while in use An audible alarm sounds and the Alarms Internal Battery LED flashes The machine must have an alternate power Continued source connected immediately to continue operation Vv This audible alarm is activated if the power switch is turned ON and all power sources are exhausted or disconnected This alarm cannot be silenced using the alarm silence button Vv The PLV 100 uses an internal watch dog circuit to monitor the microprocessor operation In the event of a failure the diagnostic start up cycle repeats and an audible alarm sounds continuously Under failure conditions the drive to the motor is locked out to prevent uncontrolled motion of the piston Under conditions of a stalled piston the patient may breathe unassisted through the PLV 100 ventilator through the patient air inlet on the rear panel See Section 8 Operating Procedure for a description of messages seen on the PLV 100 to specifically identify the type of microp
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