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1. To pre silence the audible alarm press ALARM SILENCE RESET This will silence any audible alarms for up to sixty seconds During this period the lights on the alarm display panel will still light to indicate an alarm condition but the alarm will not sound To stop pre silencing of audible alarms press ALARM SILENCE RESET NOTE If an alarm condition occurs and has been corrected during the pre silence period pressing ALARM SILENCE RESET will reset the alarms and deactivate the indicator lights Achieva Ventilator User s Manual 7 5 This page intentionally blank SECTION Cleaning and Maintenance This section contains instructions for cleaning and maintaining your Achieva ventilator You should refer to manufacturer s instructions for specific instructions for cleaning your ventilator s accessories Warning To reduce the risk of infection be sure to wash your hands thoroughly before and after cleaning or handling the ventilator or its accessories 8 1 Cleaning the Achieva Ventilator Warning Do not spray pour or spill any liquid on the ventilator its accessories connectors switches or openings in the casing Caution e Do not use chemical agents i e alcohol MEK trichloroethylene or ethylene oxide or steam to clean the ventilator Use of chemical agents or steam may cause damage to the ventilator e Keep the front panel door closed while cleaning your ventilator Follow these instructions for c
2. Press VENTILATE Block the patient end of the patient circuit It is important that you make a tight seal and do not let any air escape This will force the air pressure to build up in the patient circuit causing a high pressure alarm At the next breath the ventilator should sound a high pressure alarm You will hear three 3 pulses of the alarm tone and will see the HIGH PRESSURE indicator light flash Unblock the end of the patient circuit Press ALARM SILENCE RESET to reset the high pressure alarm Allow the ventilator to complete two to three 2 3 breath cycles A low pressure alarm should occur You will hear five 5 pulses of the alarm tone and will see the LOW PRESSURE indicator light flash Press ALARM SILENCE RESET to reset the low pressure apnea alarm Press and hold STANDBY for three 3 seconds to put the ventilator in Standby mode This concludes the monthly safety check 5 7 This page intentionally blank SECTION Operating the Ventilator 6 1 Turning on the Ventilator Open the front door panel Press the START ENTER key You will see the current parameters displayed in the LCD screen The ventilator will be in Standby Mode Check the parameters to make sure they agree with the prescribed settings If the parameters are incorrectly set you should adjust them at this time See Adjusting Setting Parameters on page 6 1 6 2 Displaying Settings While the ventilator is in Standby Mode that is whi
3. The initial settings for these tests are Breath Rate 12 BPM breaths per minute High Pressure 80 cm H20 Low Pressure 3 cm H20 Volume 500 ml Inspiratory Time 1 0 seconds FIO 21 percent Ventilation Mode Assist Control Make sure your ventilator is set to these settings before proceeding with the alarm tests NOTE Unless otherwise stated you should put the ventilator in Standby mode before beginning each of these tests Most of these tests require that an approved patient circuit be connected to the ventilator Make sure your patient circuit is properly connected prior to conducting these tests 5 2 1 Low Pressure Test 1 Adjust the Volume setting to 500 ml Inspiratory Time to 0 4 seconds and the Low Pressure Alarm to 5 cm H30 2 Keeping the patient end of the breathing circuit open allow the ventilator to deliver three 3 consecutive breaths At the beginning of the inspiration of the third breath verify that e the LED for the low pressure alarm lights up e the LCD display indicates that a Low Pressure Alarm has occurred e the audible alarm sounds 3 Press and hold the STANDBY key for three 3 seconds The ventilator will switch to Standby mode 4 Press ALARM RESET to reset the alarm Achieva Ventilator User s Manual 5 3 Check Out 5 2 2 Apnea Test 1 Adjust the Volume setting to 500 ml Inspiratory Time to 0 5 seconds and the Breath Rate to 5 BPM Press and hold the VENTILATE k
4. lt 50 5 O2 all other O2 settings 10 of settings Supply pressures of less than 45 PSIG may result in reduced O2 performance at some settings Optimum performance is achieved at 65 PSIG O2 supply pressure It may take several minutes for the oxygen concentration to stabilize The capacity of the O2 blender is a function of tidal volume and inspiratory time which in combination influence peak flow As peak flows increases i e large tidal volumes combined with short inspiratory times the limit of the O2 flow capacity is approached The set O2 concentration cannot be delivered if the flow capacity of the O2 blender has been exceeded To ensure the prescribed oxygen concentration is delivered to the patient measure the delivered gases with a calibrated oxygen analyzer at all times Altitude 0 to 4500 meters in increments of 100 meters or 0 to 14 760 feet in increments of 328 feet Connectors Modem Jack Achieva PS or Achieva PSO gt RJ 11 phone connector to connect the optional internal modem to telephone lines Communications Port RS 232 connector for Achieva Report generator computer printer or external modem Oz Inlet Achieva PSO2 9 16 18 DISS 1240 THD External Battery Connector 3 pin male receptacle for 24 Volt DC input Power Entry Module EIA dual fuse power entry module Provides connections for hot neutral and grounded conductors The receptacle incorporates
5. 2 3 3 3 1 CPAP In CPAP the ventilator maintains a constant level of pressure in the patient s airway This can help to improve oxygenation or the level of oxygen in the patient s blood If your clinician has prescribed CPAP you should talk to him or her for a further explanation of how CPAP works 2 3 3 3 2 PS CPAP Like CPAP PS CPAP maintains a constant level of pressure in the patient s airway In addition the ventilator applies a clinician set pressure to each of the patient s breaths This has the same benefits as CPAP with the additional benefit of assisting the patient in moving air into the lungs Achieva Ventilator User s Manual SECTION Description 3 1 Your Achieva Model Number Your Achieva model number is printed on the front door panel There are certain features described in this manual that only pertain to certain models 3 2 Front Panel Figure 3 1 Front Panel E Top Panel Door Panel Display and Controls A B C Exhalation Valve Port D Patient Air Port E Patient Pressure Port Achieva Ventilator User s Manual 3 1 Description 3 2 1 Top Panel Figure 3 2 Top Panel A ALARMS INDICATOR Lights The ventilator s ALARMS INDICATOR lights will flash when an alarm condition is detected The lights are turned off only when the condition is corrected and the ALARM SILENCE RESET key is pressed The ALARMS INDICATOR has lights for the following ala
6. Power light will flash Audible Alarm Tone Three pulses This tone can be silenced for five minutes by pressing the Alarm Silence Reset switch Display screen WARNING Extremely Low Internal Battery Power Cause The ventilator is powered from the internal battery and can provide approximately 10 minutes of operation with the current settings Latching Status Latching Battery Charge Depleted Visual Indicator Low Power light will flash Audible Alarm Tone Five pulses that cannot be reset or silenced Display screen WARNING Battery charge depleted Cause The ventilator is powered from the internal battery and the internal battery s charge is depleted Latching Status Latching Achieva Ventilator User s Manual 9 Technical Reference 9 4 Troubleshooting Warning e If you suspect a problem with the ventilator or accessories attend to the patient first If necessary provide an alternate means of ventilation before attempting to troubleshoot the problem e If you cannot determine the cause of the problem contact your equipment supplier Do not use the ventilator until the problem has been corrected What you see and hear Why this might happen What you should do All lights turn on and audible The ventilator automatically self tests You do not need to do anything The alarm sounds the alarms each time it is turned on alarms should stop
7. User s Manual 2 1 2 2 Purpose of the Device 2 3 3 Modes of Ventilation The following is a general description of the various modes of ventilation available with the Achieva ventilator It is up to your clinician to determine which modes are appropriate for your patient 2 3 3 1 Assist Control A C Mode In Assist Control mode machine initiated breaths are delivered at a clinician set volume or pressure inspiratory time and rate If the patient triggers a spontaneous breath between machine breaths the ventilator will deliver a breath based on the volume or pressure settings Whether initiated by the patient or the ventilator all breaths are delivered at the same pre set volume or pressure 2 3 3 2 SIMV Mode In SIMV Synchronized Intermittent Mandatory Ventilation Mode machine initiated breaths are delivered at a clinician set volume inspiratory time and rate These mandatory breaths are synchronized with patient effort If the patient triggers a spontaneous breath between machine breaths the ventilator will deliver a spontaneous breath which can be pressure supported Spontaneous breaths in SIMV do not have a pre set volume or pressure 2 3 3 3 Spontaneous SPON Mode In Spontaneous mode breaths are delivered with a volume pressure and rate that are determined by the patient Spontaneous mode is most frequently used with either CPAP Continuous Positive Airway Pressure or a combination of PS Pressure Support CPAP
8. pressure that is currently in the patient circuit E TEST BATTERY When the TEST BATTERY key is pressed and held the PATIENT PRESSURE meter shows the charge level of the battery currently in use G ALARM SILENCE RESET The ALARM SILENCE RESET key silences the audible alarm during an alarm condition The ALARM SILENCE RESET key can be used to pre silence the audible alarm for a period of 60 seconds If an alarm condition occurs while the 60 second pre silence period is in effect or while ALARM SILENCE RESET is active the LCD will display the alarm condition but the alarm will not sound This key can also be used to reset an alarm after the alarm condition has been corrected Achieva Ventilator User s Manual 3 3 Description 3 2 2 Door Panel Display and Controls Figure 3 3 Door Panel Display and Controls C The display and control panel is located behind the ventilator s front door panel This front door panel is magnetically latched to prevent tampering and accidental resetting when closed The following is a brief explanation of what each of the controls may be used for Further information regarding how and when you should use the controls will be provided later in this manual General Controls A Standby When pressed and held for three 3 seconds the STANDBY key causes the ventilator to stop delivering air B Ventilate Pressing the VENTILATE key causes the ventilator to begin delivering air C
9. the exhalation manifold Press ALARM SILENCE RESET to cancel the test The display will indicate that the test failed Press START ENTER to repeat the test If the ventilator fails the test again connect a new patient circuit and retry If the ventilator fails after connecting a new patient circuit contact your clinician Relief Valve Test FAILED Refer to MANUAL The ventilator s relief valve is not functioning properly Press ALARM SILENCE RESET to cancel the test The display will indicate that the test failed Press START ENTER to repeat the test If the ventilator fails the test again contact your clinician Waning If the ventilator fails the User Self Test do not use it Contact your clinician Achieva Ventilator User s Manual Check Out 5 5 2 Testing the Ventilator s Alarms Before connecting to the patient conduct the following tests to make sure the ventilator s alarm functions are working properly Warning e Do not attempt to conduct ventilator alarm tests while the patient is connected to the ventilator Provide an alternate means of ventilation during testing e If the ventilator fails the alarm test or if you cannot complete the test refer to the Troubleshooting section of this manual or call your clinician the equipment supplier or Nellcor Puritan Bennett technical support While the ventilator is in Standby press START ENTER to check the ventilator s settings
10. the section on alarms There is a kink in the small bore tubing Unkink and straighten the small bore tubing PEEP pressure is set higher than the Low Alarm control setting Set Low Alarm control setting higher than the PEEP pressure There is a leak or loose connection in the large bore tubing of the patient circuit Check connection of the patient circuit to the ventilator check all connections for leaks and tightness especially at the humidifier tracheal tube and exhalation valve The patient s breathing effort is less than the Sensitivity control setting Set the sensitivity so the patient s breathing effort turns on the Assist Spontaneous light and call your clinician The ventilator s Volume setting is set below patient s tidal volume Reset the Volume to the prescribed value If values are correct call your clinician Incorrect control settings Reset all controls to the prescribed values If values are correct call physician Obstructions in the patient pressure tube Check for leaks or kinks in the patient tubing Other causes Notify your physician and your equipment supplier Low Power alarm Failure to recharge the internal battery Plug ventilator into AC power Plug ventilator into a charged external battery High Pressure Alarm Water in the tubing Remove water from tubing Crimped tubing Uncrimp tubing C
11. the Ventilator Starting Ventilation Warning You must start the ventilator and allow it to complete one full breath cycle prior to connecting the patient Do not connect the patient before this cycle completes NOTE If you are powering the ventilator with the external battery or the ventilator s internal battery the ventilator will require a warm up period approximately seven 7 seconds before starting ventilation You must wait until the ventilator s LCD displays the settings this indicates the ventilator is ready Pressing VENTILATE prior to the completion of this warm up period will cause the ventilator to power down Press VENTILATE to start ventilation You will hear the piston inside of the ventilator begin to move As ventilation begins check the following e The lights on the ventilator s display become lit and the alarm sounds If this does not occur the ventilator needs repair Do not use the ventilator contact your clinician for assistance e The pressure trigger and altitude settings agree with the prescribed settings Allow the ventilator to complete one full breath cycle before connecting the patient This cycle establishes the ventilator s reference point and is important for proper breath delivery Each time you hear the ventilator s piston begin to move it is the beginning of a breath cycle When the piston becomes silent it is the end of a breath cycle Stopping Ventilation Disconnect the ve
12. 13 low power 9 13 low pressure 9 6 oxygen 9 11 power switchover 9 12 pressure differential error 9 10 rate error 9 10 relief valve test failure 9 8 setting error 9 9 user self test error 9 7 vent inop alarm 9 11 volume error 9 9 Alerts definition 7 1 Apnea alarms 9 6 Apnea test 5 4 Arrow keys location of 3 4 Assist Control Mode 2 2 Assist Control Ventilation configuring for 4 9 Assist Spontaneous light 3 2 B Bacteria Filter 3 8 Battery depleted alarm 9 13 Breath Rate button location of 3 5 C Caution definition 1 1 Continuing Pressure test 5 5 Contraindications 1 2 D Display and Controls 3 4 E Electrical Interference 4 3 Exhalation Manifold 3 8 Exhalation Tube 3 8 Exhalation Valve Port 3 1 Exhale fail alarm 9 6 External Battery see Power Supply External battery connector location of 3 6 Index 1 F FiO2 button location of 3 5 Flex Tube 3 8 Front Panel 3 1 H Heat and moisture exchanger 3 10 High pressure alarms 9 8 High Pressure Alarms see Alarm high pressure High Pressure button location of 3 5 High Pressure test 5 5 HME see Heat and moisture exchanger Humidification devices 3 10 Humidifier positioning of 3 10 Inlet Filter location of 3 6 Inspiratory Time button location of 3 5 Intended Use 2 1 Internal Battery see Power Supply L LCD window 3 5 Leak test failure alarm 9 7 Low Power Alarm see Alarms low power Low pressure alarms 9 6 Low Pressure Alarms se
13. 8 2 Cleaning your ACCESSOSICS ccceecssseeeccceceeesteceeeeeeeessssaesseesesssssssseeeeeeeeessaeeeseseeessaaas 8 1 8 3 Recharging the Internal Battery cece cece ccssereeeeeenssaeseeeeseeeeesssaeeeeeeeeeseaaas 8 2 8 4 Cycling Internal and External Batteries le eeesseeeccceesssseeeeeeeeeeessseeeseeeeeesaaaes 8 2 8 4 1 External Battery ennn a ea e EEEE caceteedeecsteacdenssussTuunsocesdeesaenstos 8 2 8 4 2 Internal Battery si ee ee ie eee ieee dadua eink ceadabadavathosncogososbsosasnsapsesvebecessecsess 8 2 8 5 Home Maintenances 553 sss se0s pesssesdenrgsesdasielncecesccuecdeeddvecddsessoseveoevesevesesesensrinevneydiee 8 2 8 5 1 Replacing the Air Inlet Filter ee ceeccseecceeeeeeeseeeeeeeeeeesssseesseseesassaeeeeees 8 2 8 5 2 Changing the Ventilator s Fuse cece ee cceesseeeecceeeeeeessseeeseeeeeeeesssaseseseeeeesaaaes 8 3 8 6 Preventive Maintenance cs0 serscsvsssssesvsesvevesececosscecscesececsesssssssssesosssesssesssssesssatatatas 8 4 Technical Reference 9 1 Osi Ntr ductio n isnon iaaa E A Ei iE a aaa Gaa e eaaa 9 1 9 2 Ventilator Specifications sssivecssssarsosceescccsdeusdeocenssvsubsnvnabansoedbanees teteesegbeesreeceh EAEE 9 1 9 3 Alarm Conditions sunieicecccescsctesches sede tcastencbcbsecsdsede dscedscenededdcedsesshunvatessveseseosSomaeonyesennnes 9 6 9 4 TrOUDIESNOOLING A sene tees eset AG eke betes does EEK EEEE EEE area ETES SS 9 14 Warranty Information 10 1 TO 18 EiMAIRED Warran
14. AC power source to the external battery source Latching Status Non Latching AC Source to Internal Battery Alarm Visual Indicator Power Switchover light will flash Audible Alarm Tone Repeated single beep Display screen Power source is now the internal battery Cause The ventilator switches from an AC power source to the internal battery Latching Status Non Latching External Battery to Internal Battery Alarm Visual Indicator Power Switchover light will flash Audible Alarm Tone Repeated single beep Display screen Power source is now the internal battery Cause The ventilator switches from an external battery to the internal battery Latching Status Non Latching 9 12 Achieva Ventilator User s Manual Technical Reference NOTE During Low Power conditions other alarms such as Setting Error can occur when the ventilator is unable to deliver gases at the selected parameters Low Power Alarms Low Internal Battery Power Visual Indicator Low Power light will flash Audible Alarm Tone Single beep every five minutes Display screen WARNING Low Internal Battery Power Cause The ventilator is powered from the internal battery and can provide approximately 45 minutes of operation with the current settings Latching Status Non Latching Extremely Low Internal Ba ttery Power Visual Indicator Low
15. Achieva a Ventilator with Flow Acceleration Limit and Apnea Backup ee SS ee re a poan Pat Achieva Nellcor Puritan Bennett and Puritan Bennett are registered trademarks of Nellcor Puritan Bennett Incorporated For further information contact your Puritan Bennett representative or contact Nellcor Puritan Bennett directly by calling 1 800 NELLCOR Safety Information 1 1 L DEFINITIONS E E sieseietecsctats seeekceseet bocce cogs cons sossceaedert saznsanasaeese E 1 1 122 Warnings and Cautions vic 20 forced eeeebige A a aaa AETA A A 1 1 13 GONMEPAINGICATIONS 3 5 cleesdecccececeescP seen sic si ea stea shes veswonsnoecccacduacsssses veccacteacedsssdecesea ea ea 1 2 Purpose of the Device 2 1 Zs NteMn Ged WSe sie sax ce coast aes EE r estas daceteaetedededuden destuseSessdeceSuaeehierweaten seater 2 1 2 2 Role Of YOUr C1IMICIAN sseecresireirnorri irssi siisii E ENE EE E a EIEEE EEEE SIE E EEE EEIEIEE R SE SETS 2 1 2 3 How the Ventilator WOrkS eseseccccccceeeesseeeeeecccceeeaeeecesseeeeeccceeeaaaeaeeseeeeeeeeeeeaaes 2 1 2 3 1 Overview of Ventilation cccccccccsessnsessssssecccceeeeesseseeesssssescccesaeeeaeeassessesees 2 1 2 3 2 Important Term Sess esearo GS rror re rororo KES EEEE SEE EAEE ERE AEE EREE ESES 2 1 23 3 Modes of Ventilation reesen ea veh ee e a E EEE ENERE TEARS RAA 2 2 2 3 3 1 Assist Control A C MOde cccccccccsssseccceeeceeaeeseecceceeesecesuesecce
16. All three power sources can be connected to the ventilator at the same time if AC power fails the ventilator will automatically switch to the next best power source When the ventilator is plugged in to a functioning wall outlet it automatically selects the AC power source It will operate indefinitely on AC power While the ventilator is operating from AC power the AC power light on the top panel will be lit 3 4 2 External Battery An external battery should be used as a backup power source in case of AC power failure i e a power outage in your home An external battery may also be required when AC power is unavailable i e while the patient is in a wheelchair car or other vehicle While the ventilator is operating from the external battery the EXTERNAL BATTERY power light on the top panel will be lit 3 4 3 Internal Battery NOTE The internal battery will automatically charge while the ventilator is connected to an AC power source and is operating in any mode including Standby The ventilator has an internal battery that is capable of powering the ventilator for a limited time The internal battery should only be used if an AC power source or an external battery is not available You should not rely on the internal battery as the sole backup power source for your ventilator The ventilator will automatically switch to its internal battery when other power sources fail or drop below adequate levels The Power Switch over a
17. ENTILATE to begin charging the battery and resume ventilation Operate ventilator on AC power for at least 4 hours to recharge the internal battery Achieva Ventilator User s Manual Alarms and Alerts Table 7 1 Alarm and Alert Conditions Repeating burst of 3 pulses Single beep repeated every 5 minutes Single beep repeated every 30 minutes Single beep repeated every 15 minutes Single three second tone Flashing LOW POWER indicator Flashing HIGH PRESSURE indicator Flashing O3 FAIL indicator Flashing SETTING ERROR indicator Flashing LOW POWER indicator Flashing SETTING ERROR indicator Flashing SETTING ERROR indicator Flashing SETTING ERROR indicator Achieva Ventilator User s Manual The internal battery charge is extremely low approximately 10 minutes of power remaining The pressure in the patient circuit is higher than the High Pressure setting The O source or the ventilator s oxygen blender has failed Achieva PSO gt only There is a conflict with one or more of the setting values The internal battery charge is low approximately 45 minutes of power remaining The ventilator has detected an equipment failure minor fault condition The ventilator has detected an equipment failure serious fault condition during ventilation The ventilator has detected a serious fault condition while in Standby mode The ventilator is not vent
18. IMV 50ml to 1750 ml in 10 ml steps Accurate to 10 ml for 50 100 ml and 10 max 75 ml for 100 2200 ml Inspiratory Time 0 2 to 5 0 seconds in increments of 0 1 seconds Accurate to 10 Sensitivity Flow 3 to 25 LPM in 1 LPM increments Accurate to 2 0 LPM Pressure Off 1 to 15 cmH zO hPa in 1 cmH20 hPa increments Accurate to 2 5 cmH O hPa Breath Rate 1 BPM to 80 BPM in steps of 1BPM Accurate to 10 or 1 BPM which ever is greater Pressure 0 to 50 cmH O hPa in 1 cmH O hPa increments Accurate to 2 5 cmH 20 hPa of the setting once the pressure reaches the setting Pressure support settings below 3 cmH 0 hPa default to 3 cmH z0 hPa PEEP 0 and 3 to 20 cmH20 hPa in 1 cmH O hPa increments Accurate to 2 5 cmH 20 hPa Flow Acceleration OFF or ON Inspiratory flow lt 180 lpm Expiratory Trigger 15 to 55 in 10 increments Accurate to 15 at 15 5 from 25 55 Low Pressure 1 to 59 cmH20 hPa in increments of 1 cmH zO hPa Activates within 2 5 cmH O hPa High Pressure 2 to 80 cmH20 hPa in increments of 1 cmH zO hPa Activates within 2 5 cmH 0 hPa Achieva Ventilator User s Manual Technical Reference Oz Level Achieva PSO2 Only 21 to 100 for tidal volumes greater than or equal to 100 ml 21 to 70 for tidal volumes less than 100 ml in 1 increments Accuracy 50 to 90 ml 02 settings lt 70 10 02 100 to 2200 ml O2 settings
19. Menu Esc Pressing the MENU ESC key activates the menu options on the ventilator s display D Up and Down Arrow Keys The up and down arrow keys are typically used to move between values displayed in the ventilator s LCD window While a ventilator setting is flashing pressing the up and down arrow keys will increase or decrease the flashing setting s value While the ventilator s menu options are active pressing the up and down arrow keys allows you to move between menu levels If none of the ventilator s settings are flashing and the menu options are not active pressing the up or down arrow keys will cause the last alarm message to be displayed in the LCD window Achieva Ventilator User s Manual Description E Start Enter If the ventilator is in Standby pressing START ENTER will activate the display in the LCD window START ENTER is also used to accept a flashing setting value Setting Controls You can select a setting by pressing the corresponding setting control key Selecting a setting will cause the current setting value to flash in the display screen allowing the setting value to be adjusted Setting values are displayed in the LCD window Each setting value displayed in the window corresponds with the control nearest it above or below Values displayed in the top row correspond to the row of controls located directly above the LCD window Values in the bottom row correspond to the controls directly below the
20. S 5 4 5 2 4 Continuing Pressure Valley Test sesessseeessseessserreressssssereerrssseeerersssseereeeeessseee 5 5 5 2 3 High Pressure TeSt eee borreroa ELLE EKCELAS ESONI AEDES ESE anas PSP TIP eE ESEESE 5 5 5 3 Testing the Battery scv crssssschsbsestaasbssscedecdcccdeerdensedscsden ieeddecdeds Sdesassssbsoposnaboensnesoes 5 6 5 4 Monthly Safety Checkvvsscstvecessrsertetssevebavacecetecstesebeta laces dennsenterenenecedent Geendecegsegene stares 5 7 Operating the Ventilator 6 1 6 1 Turning on the Ventilator cccsssecceeeceeessseseceeeeeesssaseseeeecessasesseeeeeeeeesaaaees 6 1 6 2 Displaying Settings nene EE teas lessee deh te sunnhn Geka dedeodesdncedecedoestusedectess 6 1 6 3 Adjusting Setting Parameters herriei ccceceeeessseeceeeeeessesseseceeccssasseseeeeeeeeeaaaaees 6 1 6 4 Starting Ventilatii Nesser e eeraa ae eea e E r oE rs s ari 6 2 6 5 Stopping Ventilatii Ae sssnwssemndannsnoneeis eked ccecbetukehs so oscecncaceeececssstastsapesepyeyyeeasarees 6 2 Alarms and Alerts 7 1 7 1 Alarm Alert Condition Sirsi erisera saietera a snoeien es oii ees issis 7 2 7 2 Resetting Alai MSnase a aaiae EEE EE a E EEEE E 7 4 7 3Alarim batching eeen eaa a a e E E E N 7 4 7 4 Pre Silencing Audible AlarmMS eessssseesssesssssrreerrssssssssssrrssssssrreerrssssseressssseeeeeeesssseeeeese 7 4 Contents Cleaning and Maintenance 8 1 8 1 Cleaning the Achieva Ventilator cece cccccecensssreeccceessesseeeeeeeeeessaeeeseeeeeesaaaas 8 1
21. also help to protect the ventilator from leaking battery fluid 4 4 Achieva Ventilator User s Manual Set Up 4 4 4 Connecting the Patient Circuit Connect the patient circuit according to the circuit manufacturer s instructions Make sure that all connectors fit snugly If a connector does not fit properly contact your clinician for guidance Do not use the ventilator if any of the connections do not fit properly Figure 4 2 Achieva Ventilator with Patient Circuit Achieva Ventilator User s Manual 4 5 4 Set Up 4 5 Connecting the Ventilator to an AC power outlet The ventilator may be operated on AC power that is with the power cord plugged into a wall outlet or it can operate on its internal battery for a limited time The ventilator may also be operated on an external battery If you are using an external battery See Using an External Battery on page 4 7 Do not plug the power cord into an electrical outlet controlled by a wall switch because the power may be accidentally turned off NOTE Keep the ventilator plugged in to AC power whenever possible This allows the ventilator to charge the internal battery 1 Plug the socket end of the power cord into the power cord connector on the back of the ventilator Figure 4 3 Connecting the Power Cord 2 Plug the other end of the cord the end with three prongs into an AC power outlet The outlet must be properly grounded that is it must have three
22. and from the patient B Flex Tube The flex tube connects the patient circuit to the tracheostomy tube The flex tube is made of flexible material that makes the circuit more comfortable for the patient C Bacteria Filter The bacteria filter cleans the incoming air before it is delivered to the patient D Patient Air Tube This is the large tube between the bacteria filter and the exhalation manifold E Patient Pressure Tube This small tube connects the patient pressure port on the ventilator to the exhalation manifold F Exhalation Tube This small tube connects the exhalation valve port to the exhalation manifold Achieva Ventilator User s Manual Description 3 3 6 Supplemental Oxygen NOTE Your clinician will determine if your patient needs supplemental oxygen and will provide you with specific instructions as necessary If you are operating an Achieva model PSO ventilator your ventilator has an optional internal oxygen blender This means an external oxygen source can be connected to the oxygen input connector on the back of the ventilator Figure 3 6 Connecting Oxygen Supply Two other methods of delivering supplemental oxygen are available e Oxygen Enrichment Kit e 90 Elbow with Oxygen Fitting 3 6 1 Oxygen Enrichment Kit Your clinician may prescribe an Oxygen Enrichment Kit OEK which can be connected to the air inlet port on the back of the ventilator The OEK comes with complete instructions
23. as necessary Achieva Ventilator User s Manual Cleaning and Maintenance 8 If the filter is discolored follow these instructions to replace it 1 Twist off the retainer ring from the back panel of the ventilator 2 Replace the old air inlet filter cartridge with the new cartridge Discard the old cartridge 3 Re assemble the O ring filter and retainer ring as shown in Figure 8 1 4 Twist the retainer ring to secure it taking care not to overtighten Figure 8 1 Air Inlet Filter Assembly Flatpak Filter Model Y 6109 Retainer Ring Model Y 6109 ACH 8 5 2 Changing the Ventilator s Fuse If the ventilator is plugged in to an AC outlet but the battery charging LCD is not lit a fuse may need to be replaced The fuses for the ventilator are rated at 250 V 3 15A 5 x 20 mm slow blow To reduce the risk of electrical shock disconnect the ventilator from AC power before attempting to change the fuse To prevent fire hazard replace only with identically rated fuses Achieva Ventilator User s Manual 8 3 8 Cleaning and Maintenance Follow these steps to replace the ventilator s fuse 1 Unplug the ventilator Figure 8 2 Removing the fuse holder Fuse Holder Insert a small screwdriver under the tab on the bottom of the fuse holder Pull the screwdriver upward and outward until the fuse holder pops out slightly Pull the fuse holder out Cal ye we SS Remove the old fuses from the fuse
24. battery Connect your ventilator to AC power and contact your clinician Caution e Do not place a battery above or on top of the ventilator e Use only Puritan Bennett approved cables and batteries Follow the instructions included with your battery to connect it to your ventilator Once the battery is connected check to make sure that the ventilator s EXTERNAL BATTERY indicator light is lit This light signals that your ventilator is properly connected and is using the external battery Achieva Ventilator User s Manual 4 7 4 Set Up 4 7 Setting the Low Pressure Alarm The low pressure alarm will notify you if the air pressure in the patient circuit drops below a prescribed limit Follow these safety guidelines when setting the low pressure alarm Warning e Do not set the low pressure alarm while the ventilator is connected to the patient Provide an alternate means of ventilation e Under certain conditions the patient s breathing effort may cause continuous low pressure alarms even when the Low Pressure Alarm is carefully set If this occurs contact your clinician immediately for guidance Repeat the low pressure alarm setting procedure whenever you change replace remove or reconnect components of the patient circuit or when you change the ventilator s parameters e If you are using an HME with your ventilator you must periodically re adjust the low pressure alarm setting Contact your clinician to determine the a
25. ceeaeeseeeeaees 2 2 Za a AMV Mode panna naaa N A a a aaa a a aAa a aaa 2 2 2 3 3 3 Spontaneous SPONY MOde eee ik ttnt tten kunuku ttti Erann NEEE TE T 2 2 Description 3 1 3 1 Your Achieva Model Numbers eneee oeeie denina Ena EAN RREA EARE KONEG ESOS 3 1 3 2 Front Panekan eotea a eeaeee EEEO ERENER NARESE RESER ore PP te an EPPES DEAA RAR ES 3 1 332 1 Top Panel o ra rI a INNA ANANA PERESETENE TEETE TEELE AA AA A 3 2 3 2 2 Door Panel Display and Controls eesssssssessseressssssereessssereersssssserreeesreeersssssereee 3 4 3 3 Rearand Side PanelSiic c caccceiscscacaceessscccesscnsssestcbsecegecepuseses cues EEEE E retenata 3 6 3 4 Power SU OP Y istr Gann iret crea eresakaxakexchaxahaxaveveseteteaeteaeeegetedeenebes cheb bob cbebsbelyrateretetenetes 3 7 SAA UAG ROWE iana E E E E o08 eights ee eee 3 7 3 42 External Battery aa EE NE OAA 3 7 JAS Intermal Battery vvsievevecssaececccbccescccbccdecscevesssecevegesssevegesossesessossoevivoonaatessteaeeeeess 3 7 3 5 Patient Circuit 0 ssicscssesstacsesasesccccavcecccccscecocasteevsceesteseceesceccvsarsessvaccsvsesaccsdsssaapaozeraas 3 8 3 6 Supplemental OXVGEN eis eis sie N la oso de ode AR AA a ees 3 9 3 6 1 Oxygen Enrichment Kit 0 0 eeeeeennnnnneccececceccccccccccccceeeeeeeeeeeeeeeeeeeeeeesteeeeeeeeeeees 3 9 3 6 2 90 Elbow With Oxygen FENO x eccccccesvcccecessivasivavivavivasiveee sosesnsnsseesssnssmeees a 3 9 3 7 Humidification Devices 00 cece cc eee cc escccsscececcceeeecc
26. e The alarm will beep for one second every 30 minutes during a minor fault The alarm will beep once every fifteen minutes if the ventilator is currently ventilating and a serious fault is detected The alarm will sound for three seconds if the ventilator is not ventilating and a serious fault is detected Display screen Check Patient Circuit and Equipment Cause An Equipment failure has been detected Latching Status Non Latching Vent Inop Alarm Visual Indicator The Setting Error light will flash Audible Alarm Tone Five pulses Display screen WARNING Equipment error Refer to manual Cause An Equipment failure has been detected Latching Status Latching Oxygen Alarm PSO gt Only Oxygen Alarm Visual Indicator O Fail light will flash Audible Alarm Tone Three pulses Display screen WARNING Oxygen error Attend to patient Cause The O2 Fail alarm will sound if the ventilator does not detect a flow source at the oxygen connector Latching Status Non Latching Achieva Ventilator User s Manual 9 Technical Reference Power Switchover Alarm AC Source to External Battery Alarm Visual Indicator Power Switchover light will flash Audible Alarm Tone Repeated single beep Display screen Power source is now the external battery Cause Power is switched from the
27. e presence of flammable anesthetics continuous operation Achieva Ventilator User s Manual 9 5 9 9 3 Technical Reference Alarm Conditions Low Pressure Apnea Alarms Low Pressure Alarm Visual Indicator Low Pressure Apnea light will flash Audible Alarm Tone Five pulses Display screen WARNING Low Pressure Attend to patient Cause A low pressure alarm condition exists if the proximal pressure does not rise above the low pressure setting during the last two consecutive breath cycles The exception is in SIMV mode when the Low Pressure setting is higher than the Pressure setting Then the Low Pressure alarm will occur if the peak proximal pressure of the last two consecutive breaths never rises above the Low Pressure setting Latching Status Latching Non Latching Valley Pressure Alarm Visual Indicator Low Pressure Apnea light will flash Audible Alarm Tone Five pulses Display screen WARNING Valley Pressure Alarm Attend to patient Cause A valley pressure alarm condition exists if the proximal pressure does not drop below the low pressure setting during the last two consecutive machine breaths Latching Status Latching Non Latching Exhale Fail Alarm Visual Indicator Low Pressure Apnea light will flash Audible Alarm Tone Five pulses Display screen WARNING Exhale Fail Alarm Check exhalation valve Cause An Ex
28. e Alarm low pressure Low Pressure button location of 3 5 Low Pressure Test 5 3 M Menu Esc button location of 3 4 Mode Standby power sources and 6 2 Modes Assist Control 2 2 CPAP 2 2 mode button location of 3 5 PS CPAP 2 2 SIMV 2 2 Spontaneous 2 2 Monthly Safety Check 5 7 N Note definition 1 1 Index 2 O O2 Fail Alarm see Alarms 02 fail Overview of Ventilation 2 1 oxygen connection location of 3 6 Oxygen Enrichment Kit 3 9 Oxygen fitting 90 elbow with 3 9 Oxygen supply connecting 3 9 P Patient Air Port 3 1 Patient Air Tube 3 8 Patient Circuit 3 8 condensation and 3 10 connecting 4 5 Patient Pressure Meter 3 3 Patient Pressure Port 3 1 Patient Pressure Tube 3 8 PEEP button location of 3 5 power cord connector location of 3 6 Power Failure test 5 4 Power Supply 3 7 AC Power 3 7 battery charge testing 5 6 connecting to AC 4 6 4 7 connecting to external battery 4 7 determining source of 5 6 External Battery 3 7 external battery connector location of 3 6 indicator lights 3 2 Internal Battery 3 7 patient pressure meter and 3 3 specifications 9 1 Power Switchover Alarm see Alarms power switchover Pressure button location of 3 5 R Rear and Side Panels of ventilator 3 6 Remote Alarm 4 3 ventilator connector location of 3 6 S Sensitivity button location of 3 5 Setting Error Alarms see Alarm setting error Settings adjusting 6 1 control buttons 3 5 displaying 6 1 Specif
29. e means of ventilation if necessary e This manual tells you how to respond to the ventilator when it alarms It does NOT tell you how to respond to the patient when the ventilator alarms Your clinician will tell you how to respond to your patient in an alarm condition e Any device is subject to unpredictable failures To ensure patient safety an appropriately trained caregiver should monitor ventilation e If the patient s condition warrants the use of an independent secondary alarm or other external monitoring device the clinician should prescribe it The clinician should also determine to what level the patient may require an alternate means of ventilation in the event of ventilator failure Achieva Ventilator User s Manual 7 1 7 7 1 Alarm Alert Conditions Table 7 1 lists the alarm or alert conditions that may occur describes what you will see and hear and provides you with general instructions for addressing these alarms For detailed technical information about the different alarms and alerts see Alarm Conditions on page 9 6 Alarms and Alerts Table 7 1 Alarm and Alert Conditions Repeating burst Flashing LOW of 5 alarm pulses PRESSURE APNEA indicator Flashing SETTING ERROR indicator Flashing LOW POWER indicator 7 2 The pressure in the patient circuit has dropped below the Low Pressure setting The ventilator has detected an equipment failure The internal battery charge is deple
30. e ventilator and the proximal pressure port Block the exhalation port of the breathing circuit s exhalation valve See Figure 5 1 Press and hold the VENTILATE key for one 1 second to begin ventilation 5 Allow the ventilator to deliver four 4 consecutive breaths At the beginning of the fourth 8 breath verify that e the LED for the Low Pressure Alarm lights up e the LCD display indicates that a Valley Alarm has occurred e the audible alarm sounds Unblock the exhalation port Press and hold the STANDBY key for three 3 seconds to switch the ventilator to Standby mode Press ALARM RESET to reset the alarm 5 2 5 High Pressure Test 1 Adjust the Volume setting to 500 ml Inspiratory Time to 0 4 seconds and the Low Pressure Alarm to 50 cm H30 Press and hold the VENTILATE key for one 1 second to begin ventilation Keeping the patient end of the breathing circuit open allow the ventilator to deliver one 1 breath During the inspiratory phase of the next breath block the patient end of the breathing circuit Verify that e the LED for the high pressure alarm lights up e the LCD display indicates that a High Pressure Alarm has occurred e the audible alarm sounds 5 Unblock the exhalation port 7 Press and hold the STANDBY key for three 3 seconds to switch the ventilator to Standby mode Press ALARM RESET to reset the alarm This concludes the monthly safety check Achieva Vent
31. ed O source empty Increase O source pressure Connect an O source Replace O source Achieva Ventilator User s Manual SECTION Warranty Information 10 1 Limited Warranty Puritan Bennett Corporation warrants to the owner that the Achieva ventilators exclusive of expendable parts and other accessories shall be free from defects in material and workmanship for twenty four months from the original date of sale Puritan Bennett s sole obligation with respect to any such defect is limited to the repair or at Puritan Bennett s option replacement of the ventilator Purchaser pays return freight charges This warranty is made on the condition that prompt notification of a defect is given to Puritan Bennett within the warranty period and that Puritan Bennett has the sole right to determine whether a defect exists This warranty is conditional on the performance of Preventive Maintenance at a minimum of once every 6000 operating hours or recertification every twelve 12 months whichever occurs first by service personnel qualified by Puritan Bennett The warranty does not apply to ventilators that have been partially or completely disassembled altered subjected to misuse negligence or accident or operated other than in accordance with the instructions provided by Puritan Bennett This includes repair by trained personnel This warranty represents the exclusive obligation of Puritan Bennett and the exclusive
32. ernal Battery Use the external battery to power the ventilator until it switches to the internal battery which signals that the external battery s charge is depleted Immediately disconnect the external battery and connect the ventilator to an AC power source Follow the battery manufacturer s instructions for recharging the external battery 8 4 2 Internal Battery Use the internal battery to power the ventilator until the low power alarm sounds Immediately connect the ventilator to AC power to begin recharging the battery Keep the ventilator connected to AC power and allow the internal battery to at least twelve 12 hours Home Maintenance 8 5 1 Replacing the Air Inlet Filter The ventilator uses the model Y 1609 Inlet Filter Flatpak to filter the air that is delivered to the patient You should inspect the filter regularly to check for signs of discoloration as this indicates that it is time to replace Caution e Failing to change a dirty filter or operating the ventilator without a filter in place can cause serious damage to the ventilator e The air inlet filter is not reusable do not attempt to wash clean or reuse it If the ventilator is used indoors the air inlet filter should be checked monthly If the ventilator is used outdoors in transport or in a dusty atmosphere the filter may need to be changed more frequently If using the ventilator in these conditions you should check the filter weekly and replace
33. ey for one 1 second to begin ventilation The ventilator will deliver a mandatory breath Before the second mandatory breath is delivered verify that e the LED for the low pressure alarm lights up e the LCD display indicates that an Apnea Alarm has occurred e the audible alarm sounds Press and hold the STANDBY key for three 3 seconds The ventilator will switch to Standby mode Press ALARM RESET to reset the alarm 5 2 3 Power Failure Test NOTE If the ventilator is operating on either the external or internal battery you must plug it in to an AC power source before beginning this test Press and hold the VENTILATE key to begin ventilation Unplug the ventilator Verify that e the Power Switch over LED lights up e the LCD display indicates that the AC power source is not powering the ventilator e the LED power source indicator also indicates that the ventilator is not receiving AC power e the audible alarm sounds Press and hold the STANDBY key for three 3 seconds The ventilator will switch to Standby mode Press ALARM RESET to reset the alarm Achieva Ventilator User s Manual Check Out 5 2 4 Continuing Pressure Valley Test 1 2 Adjust the Volume setting to 200 ml and Inspiratory Time to 0 5 seconds Connect the patient end of the patient circuit to a 1 liter elastic bag Verify that the pressure tube of the patient circuit is properly connected to the appropriate fitting on both th
34. for set up and use 3 6 2 90 Elbow with Oxygen Fitting Warning If you are using the 90 elbow to deliver supplemental oxygen care should be taken to securely attach the oxygen line to the elbow s oxygen fitting If the oxygen tube becomes disconnected from the 90 elbow the drop in pressure may not be significant enough to sound the ventilator s Low Pressure Alarm This means that the patient may not receive the prescribed levels of oxygen and the tidal volume may be decreased but you may not be alerted by the ventilator s audible alarm system To prevent this you should push the oxygen line tubing as far down on the elbow s oxygen fitting as possible to reduce the possibility of inadvertent disconnection Your clinician may prescribe the use of a 90 elbow with an oxygen fitting The 90 elbow releases controlled amounts of oxygen directly into the patient circuit The elbow should be connected between the bacteria filter and the patient circuit A low pressure oxygen line can then be connected to the fitting on the elbow Your clinician will provide you with complete instructions for using the 90 elbow and the oxygen source Achieva Ventilator User s Manual 3 9 3 Description 3 7 Humidification Devices Your clinician may prescribe that the air be humidified before it is delivered to the patient Air can be humidified by passing it through an HME heat and moisture exchanger an artificial nose device used f
35. fuses in the hot and neutral lines Inlet Filter Intake for patient air Screw off cap for filter change 98 efficient at 0 3 microns Patient Pressure Port Port for connection to the proximal pressure line of the patient circuit For 3 16 I D tube Remote Alarm Connector Connector for remote alarm Nurse Call Connector Connector for Nurse Call Station Patient Air 22mm O D 15 mm I D ISO Fitting Exhalation Valve Port Port for connection to the exhalation valve of the patient circuit For 1 8 I D tube 9 4 Achieva Ventilator User s Manual Technical Reference 9 Environment Operating 5 C to 40 C 41 F to 104 F 10 to 90 RH Storage 20 C to 50 C 4 F to 140 F 10 to 90 RH When moving the ventilator from a non operating to an operating environment allow a minimum of one hour temperature stabilization before use When storing the ventilator the battery must be recharged every thirty days Storage above or below specified operating temperatures may affect battery life Miscellaneous Preventative maintenance must be performed by qualified personnel every 6000 Maintenance es operating hours or recertification every twelve 12 months whichever occurs first Dimensions 10 75 X 13 30 X 15 60 27 3 X 33 8 X 39 6 cm Weight Less than 32lbs Resistance Factor Maximum of 4 5 cmH 0 hPa 60 LPM 1 25
36. hale fail alarm condition exists when at the start of the inspiratory cycle the pressure in the patient s circuit is greater than or equal to the high pressure alarm setting Latching Status Latching Non Latching 9 6 Achieva Ventilator User s Manual Technical Reference Apnea Alarm Visual Indicator Low Pressure Apnea light will flash Audible Alarm Tone Five pulses Display screen WARNING Apnea Alarm Check SENS setting Cause An apnea alarm condition exists when there is no patient breathing effort or machine cycle for 10 seconds while in Assist Control Mode or 20 seconds in SIMV or Spontaneous modes Latching Status Latching Non Latching User Self Test Error Visual Indicator Low Pressure Apnea light will flash Audible Alarm Tone Five pulses Display screen Test ERROR Refer to USER S MANUAL Cause A user self test error condition exists if during the User Self Test the pressure in the patient circuit does not reach a sufficient level to perform the test Latching Status Non Latching Leak Test Failure Alarm Visual Indicator Low Pressure Apnea light will flash Audible Alarm Tone Five pulses Display screen Leak test FAILED Refer to USER S MANUAL Cause A leak test failure alarm condition exists when the patient circuit does not maintain the appropriate pressure or the exhalation valve fails
37. he breath is an assisted breath SIMV mode the time since the last breath is 12 greater than two times the Breath Rate setting Latching Status Non Latching Pressure Differential Error Alarm Visual Indicator The Setting Error light will flash Audible Alarm Tone Three pulses Display screen Pressure Differential Error Refer to manual Latching Status Non Latching Cause The pressure levels detected by two independent sensors differ by more than 15 cmH20 Inspiratory Error Alarm Visual Indicator The Setting Error light will flash Audible Alarm Tone Three pulses Display screen WARNING Inspiratory error Attend to patient Cause During volume breath delivery the last measured inspiratory time differed by 12 from the inspiratory setting Latching Status Non Latching Inspiratory Error Alert Visual Indicator The Setting Error light will flash Audible Alarm Tone No audible alarm tone Display screen WARNING Inspiratory error Attend to patient Cause During pressure controlled breath delivery the measured inspiratory time differed by 12 from the inspiratory setting for the last two consecutive breaths Latching Status Non Latching Achieva Ventilator User s Manual Technical Reference Equipment Alarm Visual Indicator The Setting Error light will flash Audible Alarm Ton
38. he ventilator Moisture from the humidifier may condense in the patient circuit and may drain into the ventilator e Do not place a container of liquid on or near the ventilator Liquids spilled on the ventilator may cause it to work improperly Follow these instructions to check your ability to hear the ventilator s alarm in the home 1 Before connecting to the patient place the ventilator on a flat sturdy surface in the location where it will be used most frequently Plug the ventilator into a grounded AC power outlet See Connecting the Ventilator to an AC power outlet on page 4 6 Press the START ENTER key to turn on the ventilator Press VENTILATE to start breath delivery Because the ventilator is not connected to a patient an alarm condition will sound Go to various parts of the home to make sure that you can hear the alarm You should also turn on any device that produces sounds e g radio television tools and household appliances to make sure that you can still hear the ventilator alarm over the device If you find that there are certain areas of the home or noisy activities over which you cannot hear the alarm do not leave the patient alone while you are in those areas or engaging in those activities Achieva Ventilator User s Manual Set Up 4 Remote Alarm Accessory If required a remote alarm accessory is available The remote alarm can help you to hear the ventilator s alarm from a remote locati
39. holder Figure 8 3 Fuse assembly 6 Place the new fuses into the fuse holder 7 Return the fuse holder to its original position and press it into place You should hear a click which indicates it is securely positioned 8 Reconnect the ventilator s power cord 8 4 Achieva Ventilator User s Manual Cleaning and Maintenance 8 8 6 Preventive Maintenance Preventive Maintenance must be performed by qualified personnel every 6000 operating hours or recertification every twelve 12 months whichever occurs first Warning Do not try to repair or otherwise service the ventilator yourself Doing so might endanger the patient cause damage to the ventilator and or void your warranty You can check to see how much time has elapsed since maintenance was last performed by following these instructions 1 Press the MENU ESC key 2 Press the up or down arrow key until the display screen says Ventilating hours since last maintenance XXXXX Where XXX XX is the total number of operating hours When this number nears 6000 contact a trained service representative to schedule your ventilator s service Achieva Ventilator User s Manual 8 5 This page intentionally blank SECTION Technical Reference 9 1 Introduction This section is intended for the clinician who is assisting the user in the homecare environment 9 2 Ventilator Specifications Power Power Line 100 to 240 VAC 50 to 60 Hz 2 Am
40. ications 9 1 SPON see Spontaneous Mode Standard compliance 9 5 Standby button location of 3 4 Start Enter button location of 3 5 Supplemental Oxygen 3 9 Synchronized Intermittent Mandatory Ventilation see SIMV 2 2 T Test Battery button 3 3 Top Panel description 3 2 Troubleshooting see Alarms troubleshooting U User Self Test 5 1 5 2 V Valley alarm 9 6 Valley Pressure test 5 5 Ventilate button location of 3 4 Ventilator changing settings 6 1 displaying settings 6 1 electrical interference and 4 3 placement of 4 2 placement on wheelchair 4 4 plugging into power outlet 4 6 4 7 starting ventilation 6 2 stopping ventilation 6 2 turning on 6 1 using external battery with 4 7 visual inspection of 5 7 warranty information 10 1 Volume button location of 3 5 Volume defined 2 1 W Warning definition 1 1 Warnings general 1 1 1 2 Warranty 10 1 Wheelchair 4 4 Index 3 Tyco Healthcare Group LP Nellcor Puritan Bennett Division 4280 Hacienda Drive Pleasanton CA 94588 Toll Free 1 800 NELLCOR Authorized Representative Tyco Healthcare UK LTD 154 Fareham Road Gosport PO13 OAS U K CE 0123 tyco Healthcare Puritan Bennett Rx ONLY 2003 Nellcor Puritan Bennett Inc All rights reserved 066479A 0603
41. ilating 1 Immediately connect the ventilator to adequate power supply Operate ventilator on AC power for at least 4 hours to recharge the internal battery Attend to the patient first as instructed by your clinician Check the patient circuit for kinks or obstructions Fix or replace the patient circuit if necessary Check the ventilator s settings Verify that the venti lator settings are set according to the prescription If the alarm condition persists discontinue use of the ventilator and contact your clinician for guid ance Attend to the patient first as instructed by your clinician Supply another oxygen source Monitor the deliv ered oxygen If the alarm condition persists discontinue use of the ventilator and contact your clinician for guid ance Attend to the patient first as instructed by your clinician Check the ventilator s settings Verify that the venti lator settings are set according to the prescription If the alarm condition persists discontinue use of the ventilator and contact your clinician for guid ance Immediately connect the ventilator to adequate power supply Operate ventilator on AC power for at least 4 hours to recharge the internal battery Attend to the patient first as instructed by your clinician Check the patient circuit and accessory equipment Make sure that all equipment is in good condition and properly connected Replace if necessar
42. ilator User s Manual 5 5 5 Check Out 5 3 Testing the Battery The ventilator is capable of testing the power of the battery it is currently using You can determine which power source the ventilator is using by checking the power indicator located on the top panel The indicator light will be lit to indicate which power source is currently being used NOTE The TEST BATTERY key does not operate when the ventilator is powered by AC To test the battery press and hold the TEST BATTERY key The needle on the PATIENT PRESSURE meter will indicate the battery charge status for the battery it is currently using A fully charged battery in good condition will register approximately 100 on the patient pressure meter s scale 5 4 Monthly Safety Check You should perform the following safety check before using the ventilator with the patient and monthly while the ventilator is in use to make sure that your ventilator is operating properly This safety check takes approximately ten minutes to complete Waning e Do not conduct this test while the patient is connected to the ventilator You should use an alternate means of ventilation while you are conducting this test e If the ventilator fails the monthly safety check or if you cannot complete this check refer to the Troubleshooting section of this manual or call your clinician the equipment supplier or Nellcor Puritan Bennett technical support e To reduce the risk of i
43. ilter Patient circuit Air inlet filter Means of connection to the patient i e endotracheal tube tracheostomy tube or mask Before using your ventilator inspect the device Make sure that The power cord does not have any kinks breaks or damaged insulation The connectors rubber feet filter housings etc are not loose or broken The outer casing does not have any dents or scratches which may indicate dropping or other damage All of the labels and markings on the ventilator are clear and legible Caution Contact your clinician if the Achieva ventilator is damaged Do not use a damaged ventilator NOTE Visual inspection should be performed each time the ventilator is used after storage as well as periodically during normal use If necessary wipe down your ventilator with a mild soap solution See Cleaning the Achieva Ventilator on page 8 1 Check to see if a clean air inlet filter is installed If the filter is dirty or if there is no filter in place install a new one See Replacing the Air Inlet Filter on page 8 2 Achieva Ventilator User s Manual 4 1 4 4 2 4 2 Set Up Where to Place the Ventilator Choose a place in your home to set up the ventilator according to the following safety guidelines Warning e Make sure you can hear the ventilator s alarm from all rooms in the house and when you are using appliances such as a vacuum cleaner dishwasher clothes dr
44. larm signals whenever the ventilator switches from AC or an external battery to its internal battery While the ventilator is operating from its internal battery the INTERNAL BATTERY light on the top panel will be lit As the battery nears depletion the ventilator will sound one of the following audible alarms to signal that you should provide another power source e Low Internal Battery Alarm When approximately 45 minutes of power remains the ventilator s alarm will sound a single beep every five minutes e Extremely Low Internal Battery Alarm When approximately 10 minutes of power remains the LOW POWER light flashes and the alarm sounds 3 pulses The ventilator continues to sound the alarm until an external power source is connected You can silence the alarm for five minute intervals by pressing the ALARM SILENCE RESET key Achieva Ventilator User s Manual 3 7 3 5 Description Battery Charge Depleted ventilator continues to operate When the internal battery is nearly depleted the LOW POWER light continues to flash and the alarm sounds 5 pulses The ventilator will continue to alarm until an external power source is connected You cannot silence a Battery Charge Depleted alarm until after you connect an alternate power source Patient Circuit The patient circuit consists of the parts shown in Figure 3 5 Figure 3 5 Patient Circuit A Exhalation Manifold The exhalation manifold controls the flow of air to
45. lator s low pressure alarms can operate in either a latching or non latching mode e Anon latching alarm does not require you to press ALARM SILENCE RESET to stop the audible alarm when the condition has been corrected It will automatically turn off the audible alarm but the visual indicator on the Alarms panel will still light This lets you know that an alarm event occurred and was corrected e A latching alarm will not stop the audible alarm unless the condition has been corrected AND the ALARM SILENCE RESET key has been pressed Pressing the ALARM SILENCE RESET key lets the ventilator know that you have responded to the alarm To set the latching mode of the alarms 1 Press MENU ESC 2 Press the UP or DOWN arrows until the display screen reads Press ENTER to change Alarm Latching Status 3 Press START ENTER The display will indicate the alarm s latching mode and will provide further instructions 4 Follow the displayed instructions to change the alarm s latching mode 5 After making your change press START ENTER to save or ESC to exit without saving NOTE If you exit without saving changes to the alarm latching mode will not be saved 7 4 Pre Silencing Audible Alarms There may be situations in which you wish to silence an anticipated alarm for a brief period The ventilator allows you to pre silence the audible alarms for up to sixty seconds 7 4 Achieva Ventilator User s Manual Alarms and Alerts 7
46. lay Shows current operating parameters and ventilator information Power Green LEDs indicate operating power source AC External Battery Internal Battery Battery Charging Green LED indicates the unit is charging the internal battery Assist Spontaneous Green LED indicates that the patient s effort exceeds the sensitivity setting Alarm Control Red LED flashes at 1 second intervals during a presilence condition and continuously when the non latching alarm feature is active Alarms Flashing red LEDs Low Pressure Apnea Low Power High Pressure Setting Error Power Switchover O Fail O Fail available only on Achieva PSO3 Audible Alarms One Second Beep Relief Valve Test Failure User Self Test Error Leak Test Failure Repeated Single Beep Power Switchover Repeated Three Pulses Extremely Low Internal Battery High Pressure Invalid I E Ratio High Pres lt Low Pres Volume Error Rate Error Inspiratory Error Oxygen Alarm Pressure Differential Error Repeated Five Pulses Low Pressure Valley Exhale Fail Apnea Battery Charge Depleted Vent Inop Continuous Tone Microprocessor failure Single Beep Every Five Minutes Low internal battery One Second Beep Every Thirty Minutes Minor Fault One Beep Every Fifteen Minutes Ventilator is ventilating and serious fault is detected Three Second Tone Ventilator is in standby mode and a seriou
47. le it is not ventilating you can display settings by pressing START ENTER While the ventilator is ventilating the LCD window will display the actual values of the breaths being delivered To check the settings during ventilation press START ENTER The setting values will be displayed in the LCD window for approximately four to five 4 5 breath cycles After this interval the LCD will revert to displaying actual patient values NOTE Certain settings such as low pressure and high pressure alarm settings do not have an actual value and dashes are displayed instead 6 3 Adjusting Setting Parameters Warning e Never press the START ENTER key without verifying that the settings are adjusted appropriately Using incorrect settings during ventilation can cause danger to the patient e Your clinician will provide you with the prescribed setting parameters for your patient Always follow your clinician s instructions when setting the ventilator s parameters 1 Open the front door panel Press the START ENTER key to display the current settings 2 Press the parameter key for the setting you wish to change The current setting for that parameter will begin to flash in the LCD screen 3 Use the up or down arrow key to adjust the setting s value 4 When the setting s value matches the prescribed value press START ENTER to accept the setting Achieva Ventilator User s Manual 6 1 6 6 4 6 5 6 2 Operating
48. leaning the surface of your ventilator 1 Dip a clean soft cloth into a mixture of mild soap and water 2 Squeeze the cloth thoroughly to remove excess liquid 3 Wipe the ventilator s external casing taking care not to allow excess moisture to enter openings on the ventilator s surface 4 Dry the ventilator s surface with a clean soft cloth 8 2 Cleaning your Accessories Follow your accessory manufacturer s instructions for cleaning your ventilator s accessories Achieva Ventilator User s Manual 8 1 8 8 3 8 4 8 5 8 2 Cleaning and Maintenance Recharging the Internal Battery Caution You should recharge the ventilator s internal battery after each use to retain electrical charge While connected to AC power the ventilator will automatically recharge the internal battery in any mode including Standby If you are using the external battery to power the ventilator the internal battery will only be charged while the ventilator is ventilating The battery will not be charged while the ventilator is in Standby NOTE Charging the ventilator s internal battery from the external battery will reduce the amount of charge left in the external battery Cycling Internal and External Batteries Every four to six weeks the ventilator s batteries need to be fully discharged and recharged to optimize battery performance Follow these instructions to discharge and recharge your battery 8 4 1 Ext
49. mL hPa for A C breaths Compliance Factor P 2 50 mL hPa for Pressure Support breaths Emergency Pressure Relief 90 10 cm H20 75 milliseconds under the following conditions Resistance 5 cmH20 hPa L sec Compliance 50 ml cmH20 hPa Breath Rate 20 BPM Volume 1500 ml Pressure Support 10 cmH zO hPa PEEP 5 cmH20 hPa Response time varies inversely with the displayed flow rate and directly with the selected trigger level Response time Flow average 2 0 LPM to 180 LPM The ventilator is intended to operate within its specifications if it is properly maintained and the service schedule is followed The ventilator is protected against electrostatic contact discharge of up to eight kilovolts 8 kV Electrostatic discharge greater than eight kilovolts may damage the ventilator Standard compliance The ventilator complies with the following international agency standards e IEC 601 1 Medical Electrical Equipment 1988 Part 1 General Requirements for Safety e IEC 601 1 2 Medical Electrical Equipment Part 1 General Requirements for Safety Part 2 Collateral Standard Electromagnetic Compatibility Requirements and Tests e CAN CSA C22 2 No 601 1 M90 Medical Electrical Equipment Part 1 General Requirements for Safety e UL2601 1 Medical Electrical Equipment Part I General Requirements for Safety 1994 Classified as Class I and internally powered Type BF drip proof not suitable for use in th
50. nfection be sure to wash your hands thoroughly before and after handling the ventilator or its accessories NOTE Nellcor Puritan Bennett recommends that you run the Monthly Safety Check once per month while the ventilator is in use Nellcor Puritan Bennett recognizes that the protocol for running the Monthly Safety Check varies widely among health care providers It is not possible for Nellcor Puritan Bennett to specify or require specific practices that will meet all needs or to be responsible for the effectiveness of those practices 1 Visual Inspection Inspect the device Make sure that The power cord does not have any kinks breaks or damaged insulation The connectors rubber feet filter housings etc are not loose or broken The outer casing does not have any dents or scratches which may indicate dropping or other damage All of the labels and markings on the ventilator are clear and legible 2 User Self Test See Completing the User Self Test on page 5 1 5 6 Achieva Ventilator User s Manual Check Out 3 General Alarm Test Press and hold the ALARM SILENCE RESET key for five 5 seconds You should see all of the alarm indicators light up and hear an alarm tone If not the ventilator is in need of repair Do not use the ventilator until the problem has been corrected 4 High Low Pressure Alarm Test Achieva Ventilator User s Manual Set the ventilator mode to ASSIST CONTROL A C
51. ntilator from the patient Press and hold the STANDBY key for at least three 3 seconds You will hear a beep and ventilation will stop The following text will appear in the display STANDBY Press ENTER to view parameters NOTE The ventilator can be kept in Standby mode indefinitely while connected to AC power While on Standby the ventilator charges the internal battery and the power indicators AC and Battery Charging are lit When powered from a battery the ventilator will remain in Standby for 30 seconds and then switch automatically to a low power mode Press the START ENTER key to bring the ventilator out of low power mode Achieva Ventilator User s Manual SECTION Alarms and Alerts Alarms are used to let you know when a condition exists that is dangerous for the patient and requires your immediate attention Alarms are accompanied by an audible tone Alerts let you know when a condition exists that is not a direct risk to the patient but still requires your attention The ventilator does not sound an audible tone during an alert condition This section of the manual describes what you will see and hear and steps you should take during an alarm or alert It also describes how you can use the ventilator s alarm related controls to e Adjust the alarm limits for your patient e Adjust the latching mode of the ventilator s alarms Warning e f an alarm occurs attend to the patient first Switch to an alternat
52. on Contact your clinician or a Nellcor Puritan Bennett representative for more information on purchasing and using a remote alarm If you are using a remote alarm follow the procedure above to find the best location for it 4 2 1 Electrical Interference The Achieva ventilator may be subject to electrical interference Electrical interference can come from television sets cordless or cellular telephones microwave ovens air conditioners food processors and other appliances Follow these guidelines to reduce the risk of interference e Do not place your ventilator near an appliance e Do not plug your ventilator into the electrical outlet or electrical outlet circuit that is used by an appliance e Do not place the ventilator cables near an appliance If your ventilator causes interference to other devices follow the guidelines below e Turn the antenna on the affected device e g radio television cordless phone e Move the device away from the ventilator e Connect the ventilator to an outlet which is on a different electrical circuit than the affected device e Consult the dealer or an experienced radio TV technician for help Achieva Ventilator User s Manual 4 3 4 Set Up 4 3 Mounting the Ventilator on a Wheelchair When using the ventilator on a wheelchair follow these safety guidelines Warning Position the external battery as far away from the ventilator s air inlet port as possible This will help preven
53. or short term humidification or a humidifier You should follow the device manufacturer s instructions for connecting any of these devices to the patient circuit Follow these safety guidelines for using a humidification device with your ventilator Warning e Always position a humidification device so that it is lower than the patient e Do not place a humidifier on top of or above the ventilator e Using an HME or an artificial nose may affect the ventilator s low pressure alarm setting See Setting the Low Pressure Alarm on page 4 8 e Ifa heated humidifier is used you should always monitor the temperature of delivered air Air that becomes too hot may burn the patient s airway Figure 3 7 Achieva Ventilator Connected to a Humidifier When a humidification device is used condensation may form in the patient circuit over time You should regularly check the patient circuit for signs of condensation If you notice moisture in the patient circuit you should disconnect and drain the circuit or replace it with a dry circuit Refer to the humidification device s instruction manual for operating cleaning and sterilization instructions 3 10 Achieva Ventilator User s Manual Set Up SECTION 4 1 Preparing your Ventilator The Achieva ventilator needs the following items to function properly Make sure you have these items before proceeding Power Source AC power outlet or external battery Inspiratory f
54. oughing or other high flow expiratory efforts Treat patient s cough The alarm is appropriate for these conditions Patient inspiratory resistance or compliance changes Have physician determine new ventilator settings Airway obstruction Check for tracheal obstruction or for a condition in which the patient requires sectioning Malfunction in the exhalation manifold Replace the exhalation manifold Achieva Ventilator User s Manual 9 15 Technical Reference What you see and hear Why this might happen What you should do Setting Error Alarm Inappropriate setting or settings beyond the capabilities of the machine Readjust settings to the clinician s prescription If the settings are correct and the alarm persists consult your clinician Low battery power Connect external power supply See the Alarm Section of this manual for more details Green AC Power light does not glow AC power cord is not connected Plug in the cord The ventilator has blown a fuse Replace the fuse No power to the wall outlet Switch to an active outlet Unit will not operate on external battery power Connection problem Check all connections Fuse s in battery system blown Replace blown fuse s Fuse inside vent is blown Return ventilator for service Op Fail Alarm Low O gt source pressure Ov source disconnect
55. ppropriate interval e Some patient circuit components may inhibit low pressure alarms when the low pressure limit is not carefully set Follow these instructions for setting the low pressure alarm 1 Check to make sure that the patient circuit is assembled exactly as it will be used by the patient Attach all accessories including the HME and inner cannula of the tracheostomy tube 2 Verify that all of the ventilator s parameters are set to the prescribed values Adjust them if necessary See Adjusting Setting Parameters on page 6 1 Press VENTILATE to start breath delivery Press START ENTER to display current settings Press LOW PRESSURE to select the low pressure parameter Adjust the LOW PRESSURE setting by pressing the up or down arrow on the control panel Be Or SY p IA After each adjustment allow the ventilator to complete two breath cycles It takes two breath cycles for the alarm to sound If you do not hear the low pressure alarm 5 audible pulses repeat steps 6 7 8 Stop adjusting the LOW PRESSURE setting when you hear the low pressure alarm The low pressure alarm is set 4 8 Achieva Ventilator User s Manual Set Up 4 4 8 Configuring for Assist Control Ventilation Warning e Risk of change from Assist Control Volume Ventilation to Assist Control Pressure ventilation If the ventilator is operating in Assist Control Volume ventilation and the MODE key is pressed the setting display will show As
56. ps External DC Power 11 6 to 32 0 VDC 24 VDC optimal Operating time At least 19 hours under normal load and 5 hours 30 minutes under heavy load 24 V DC or 12 V DC 32 Ah Internal Battery 24 VDC nominal Operating time At least 4 hours under normal load and 1 hour under heavy load Gel cell sealed Lead Acid backup power Lithium Battery Memory power Standard Power 90 to 200 VAC Converters Fuses 250 V 3 15A 5X20 mm slow blow Power Usage Maximum Absolute maximum is 75W Minimum 10 W Type Positive Pressure Volume ventilator Motor 3 Phase Brushless Motor Pump Piston 50ml to 2200mI tidal volume capability Protection against Type of protection Class electrical shock Degree of protection Type BF Normal Load Mode Assist Control Volume 1000 ml Breath Rate 10 BPM Inspiratory Time 1 5 sec FO 21 Sensitivity 5 LPM PEEP 0 cmH O hPa Vent pres 30 cmH O hPa Heavy Load Mode Assist Control Volume 1500 ml Breath Rate 20 BPM Inspiratory Time 1 0 sec F O2 100 Sensitivity 5 LPM PEEP 20 cmH 0O hPa Vent pres 60 cmH O0 hPa Achieva Ventilator User s Manual 9 1 9 Technical Reference Indicators Normal Events Patient Pressure Meter Displays patient pressure 10 to 100 cmH 0 hPa also displays battery charge when TEST BATTERY key is pressed Alphanumeric Disp
57. r accessories e You should always check your ventilator s breath delivery settings before using with a patient When adjusting settings special care should be taken to make sure that the new settings are set accurately Using incorrect settings during ventilation can cause danger to the patient Achieva Ventilator User s Manual 1 1 1 2 Safety Information Warning e To avoid a fire hazard keep matches lighted cigarettes and all other sources of ignition e g flammable anesthetics and or heaters away from the Achieva ventilator system and oxygen hoses e Do not use hoses that are worn frayed or contaminated by combustible materials such as grease or oils e Incase of a burning smell immediately disconnect the ventilator from the oxygen supply AC power and backup power source Caution e Do not attempt to make any repairs or otherwise service the ventilator Contact an authorized service representative for any service needs e Do not use or store this ventilator in the presence of strong electromagnetic fields such as an MRI environment Achieva Ventilator User s Manual SECTION Purpose of the Device 2 1 Intended Use This device is intended to provide ventilatory support for pediatric and adult patients who require positive pressure mechanical ventilation Patients should weight no less than 11 lbs 5 kg This device is for use in home institutional and portable settings This device is con
58. remedy of the purchaser regarding defects in the ventilator THIS WARRANTY IS GIVEN IN LIEU OF ANY EXPRESS OR IMPLIED WARRANTIES INCLUDING ANY WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE No person is authorized to modify in any manner Puritan Bennett s obligation as described above Achieva Ventilator User s Manual 10 1 This page intentionally blank Numerics 90 Elbow with Oxygen Fitting 3 90 A AC Power see Power Supply Accessories 3 8 3 10 Alarm Silence Reset button 3 3 Alarms alarm control indicator 3 2 audible alarm port location of 3 6 battery charge depleted 3 3 definition 7 1 extremely low internal battery 3 7 General alarm test 5 7 high pressure response to 7 3 indicator lights 3 2 latching mode setting 7 4 latching modes and 7 4 low internal battery 3 7 low power response to 7 2 low pressure humidification devices and 3 10 low pressure response to 7 2 low pressure setting of 4 8 O2 fail response to 7 3 power switchover 7 4 power switchover response to 7 3 pre silencing 7 4 resetting 7 4 setting error response to 7 2 7 4 setting Low Pressure alarm 4 8 technical reference 9 6 9 13 testing 5 3 5 5 troubleshooting 9 14 9 16 valley 9 6 Alarms technical reference apnea 9 6 9 7 battery depleted 9 13 equipment error 9 11 exhale fail 9 6 external battery 9 12 high pressure 9 8 inspiratory error 9 10 internal battery 9 12 leak test failure 9 7 low internal battery 9
59. res lt Low Pres setting Latching Status Non Latching Cause The low pressure limit setting is the same or higher than the high pressure setting Volume Error Alarm Visual Indicator The Setting Error light will flash Audible Alarm Tone Three pulses Display screen WARNING Volume error Attend to patient Latching Status Non Latching Cause With a volume breath the ventilator delivered a volume 12 from the set volume Volume Error Alert Visual Indicator The Setting Error light will flash Audible Alarm Tone No audible alarm tone Display screen WARNING Volume error Attend to patient Latching Status Non Latching Cause With a pressure support breath the last two breaths did not stop within three seconds or For a pressure control breath or a pressure support breath the piston reached the end of travel on the last two breaths Achieva Ventilator User s Manual 9 9 9 Technical Reference Rate Error Visual Indicator The Setting Error light will flash Audible Alarm Tone Three pulses Display screen WARNING Breath rate error Attend to patient Cause In Assist Control Mode the last measured breath rate is 12 lower than the set breath rate or If the breath is a mandatory breath SIMV mode the time since the last breath is 12 greater than the Breath Rate setting or If t
60. rm conditions e Low Pressure Apnea e High Pressure e Setting Error e Power Switch over e Low Power e O Fail Achieva PSO only These alarm conditions will be explained later in this manual For now be sure to familiarize yourself with the location of the ALARMS INDICATOR lights NOTE For the Achieva and Achieva PS models which do not have the oxygen function the O Fail alarm light position is present but it has no light or label B POWER INDICATOR Lights The ventilator s POWER INDICATOR lights indicate which electrical source the ventilator is currently using and if the internal battery is being charged The POWER INDICATOR has lights for the following power conditions e AC e External Battery e Internal Battery e Battery Charging These power conditions will be explained later in this manual For now be sure to familiarize yourself with the location of the POWER INDICATOR Lights C ALARM CONTROL Light The ALARM CONTROL light flashes when the audible alarm has been presilenced The ALARM CONTROL light will continuously light when the nonlatching alarm feature is active You will learn more about pre silencing alarms later in this manual Achieva Ventilator User s Manual Description D ASSIST SPONTANEOUS Light This indicator lights when the patient s breathing effort meets or exceeds the ventilator s sensitivity setting E PATIENT PRESSURE Meter The PATIENT PRESSURE meter shows the level of
61. s fault is detected Alarm Volume 85 db or 70 db at a distance of 1 meter 9 2 Achieva Ventilator User s Manual Technical Reference Controls Alarm Silence Reset 1 Silences audible alarms during an alarm condition 2 Silences an alarm before a known alarm condition occurs 3 Used to reset an alarm after the alarm condition has been corrected Test Battery 1 When the test battery switch is pressed the Patient Pressure Meter shows the charge level of the battery currently in use 2 Starts printer output activation Standby Used to place the ventilator in the Non ventilate State disabling the delivery of air Ventilate Enables the ventilator to deliver air to the patient Mode Causes the current ventilatory mode on the display to flash and allows the mode to be changed Setting Switches Volume Inspiratory Time Sensitivity Breath Rate Pressure PEEP Low Pressure High Pressure FIO Achieva PSO only Menu Esc Activates and deactivates the menu on the ventilator s display Start ENTER Used to accept the currently flashing parameter as the new setting Activates display Up and Down Arrow Keys Increases or decreases the parameter settings or menu levels Pressing when the sub menu is not active and a parameter has not been selected will cause the last alarm message to be displayed Settings Volume 50ml to 2200ml in 10 ml steps For S
62. sist Control Pressure using whatever the last pressure support value setting was such as the Pressure Support value set for SIMV or SPONT If the START ENTER key is pressed while this Assist Control Pressure display is present the ventilator will switch to operating in Assist Control Pressure Therefore do not press START ENTER unless you intend to change to A C Pressure ventilation and you have verified that the ventilator is set to the correct pressure e To eliminate the possibility of an accidental change in ventilator parameters by an inadvertent START ENTER entry you should set the Pressure Support values to zero 0 before placing the ventilator into the Assist Control Volume ventilation mode Follow the instructions below 1 Press the MODE key 2 Press UP or DOWN arrow key to scroll to the SPONT mode 10 BPM back up rate will be displayed Press START ENTER 3 If Pressure Support is present use the arrow keys to set it to zero 0 Press START ENTER to accept the setting 4 Press MODE 5 Press UP or DOWN arrow key to scroll to the SIMV mode Press START ENTER 6 If Pressure Support is present use the arrow keys to set it to zero 0 Press START ENTER to accept the setting 7 Press MODE 8 Press UP or DOWN arrow key to scroll to the A C mode Press START ENTER 9 Ifa pressure value is present use the arrow keys to set the pressure to zero 0 then press START ENTER Achieva Ventila
63. slots Contact your clinician or a qualified electrician if you do not have a suitable outlet When you plug in the ventilator the BATTERY CHARGING and AC POWER lights will light at the same time NOTE The power plug may not be compatible with outlets in some countries If you encounter an outlet that is not compatible contact your clinician for guidance He or she will be able to recommend a suitable adaptor or replace your plug with one that is compatible with your outlets 4 6 Achieva Ventilator User s Manual Set Up 4 Figure 4 4 Connecting to an AC Outlet 3 Verify that the BATTERY CHARGING and A C lights are lit If the BATTERY CHARGING or AC light does not light up do not use the ventilator Call your clinician immediately 4 6 Using an External Battery When AC power is unavailable the ventilator can operate from an external 12 or 24 Volt DC battery NOTE For optimal performance a 24 Volt battery is recommended Although a 12 Volt battery can be used a Setting Error alarm is more likely to occur as the 12 Volt battery discharges Follow these safety guidelines when using an external battery Warning e Position the external battery as far away from the ventilator s air inlet port as possible This will help prevent battery gases from drifting toward the ventilator s air inlet e If the EXTERNAL BATTERY indicator does not light once the battery is connected do not use the external
64. t battery gases from drifting toward the ventilator s air inlet Caution e Always provide an external battery as the power source Do not rely solely on the ventilator s internal battery to sustain ventilation e Do not use the same battery to power both the ventilator and an electric wheelchair Protect the ventilator from extreme moisture such as direct exposure to rain e Check the air inlet filter frequently while the ventilator is mounted on a wheelchair as environmental conditions may cause the air filter to become dirty more rapidly Mounting instructions may vary depending on the wheelchair model and manufacturer Consult the wheelchair supplier or manufacturer for standard wheelchair adaptations Figure 4 1 illustrates the recommended placement of the ventilator and the external battery Figure 4 1 Ventilator and Battery Placement on Wheelchair External Battery Achieva Ventilator It is a good idea to place a partition between the ventilator and the external battery This will help to protect the ventilator from battery fluid in the event of a battery leak This partition should be at least four inches away from the ventilator s air inlet filter so that it does not impede the flow of air into the ventilator If the ventilator and the battery are in the same tray holes should be cut into the tray to allow any leaking battery fluid to drain away from the ventilator Placing the battery in a plastic container may
65. ted Attend to the patient first as instructed by your clinician If the patient is not in danger continue to step 2 Check the patient circuit for kinks or loose connec tions Fix or replace the patient circuit if necessary Inspect for and remove water from small tubing Check the ventilator s settings Verify that the venti lator settings are set according to the prescription If the alarm condition persists discontinue use of the ventilator and contact your clinician for guid ance Attend to the patient first as instructed by your clinician Switch to an alternate means of ventilation Press the STANDBY key If this corrects the error resume normal ventilation If not proceed to step 4 Unplug the ventilator from AC power and wait 30 seconds Plug the ventilator into AC power and resume ventilation If the alarm has not cleared proceed to step 5 Unplug the ventilator from AC power press and hold STANDBY for 3 or more seconds Plug the ventilator into AC power and resume ventilation If the alarm has not cleared contact your clinician Disconnect the ventilator from the patient Press and hold the STANDBY key for 3 seconds Connect the ventilator to an external power sup ply e If using AC it will automatically begin to charge the internal battery Press VENTILATE to resume ventilation If using a charged external battery you must press START ENTER to restart Wait 7 seconds then press V
66. to open and reduce the pressure in the patient circuit Latching Status Non Latching Achieva Ventilator User s Manual 9 7 9 Technical Reference High Pressure Alarms High Pressure Alarm Visual Indicator High Pressure light will flash Audible Alarm Tone Display screen WARNING High Pressure Alarm Attend to patient Cause The pressure in the patient circuit exceeds the high pressure limit setting Latching Status Relief Valve Test Failure Visual Indicator High pressure light will flash Audible Alarm Tone Display screen Relief valve test FAILED Refer to USER S MANUAL Cause The relief valve failed to open while the pressure was above the relief valve threshold pressure Latching Status 9 8 Achieva Ventilator User s Manual Technical Reference Setting Error Alarms Invalid 1 E Ratio Alarm Visual Indicator The Setting Error light will flash Audible Alarm Tone Three pulses Display screen WARNING Invalid I E ratio Check settings Cause A combination of settings breath rate and inspiratory time resulting in an inspiratory time that exceeds the expiratory time Latching Status Non Latching High Pres lt Low Pres Alarm Visual Indicator The Setting Error light will flash Audible Alarm Tone Three pulses Display screen SETTING ERROR High P
67. tor User s Manual 4 9 This page intentionally blank SECTION Check Out 5 1 Completing the User Self Test Before connecting the patient it is important to test your ventilator to make sure that it is working properly It is recommended that the User Self Test be conducted e Before initial use e Once per month e Each time you remove or replace the patient circuit Warning e Do not conduct this test while the patient is connected to the ventilator Switch the patient to an alternate means of ventilation before conducting this test e To reduce the risk of infection be sure to wash your hands thoroughly before and after handling the ventilator or its accessories NOTE Nellcor Puritan Bennett recommends that you run the User Self Test before initial use once per month while the ventilator is in use and each time you remove or replace the patient circuit Nellcor Puritan Bennett recognizes that the protocol for running the User Self Test varies widely among health care providers It is not possible for Nellcor Puritan Bennett to specify or require specific practices that will meet all needs or to be responsible for the effectiveness of those practices 1 Press and hold the STANDBY key for three 3 seconds The ventilator will switch to Standby mode and will stop delivering air 2 Press the MENU ESC key The following text will appear in the display Press ENTER to begin User Self Test 3 Press the START ENTER ke
68. traindicated for use with anesthetic gases This device is intended to be used on the order and under the supervision of a physician 2 2 Role of Your Clinician In this manual the term clinician means the trained health care professional who is helping you use the Achieva ventilator in your home This may be a doctor or nurse who is treating your patient or some other trained health care professional Your clinician will e Order a ventilator for use in your home e Train you to use the ventilator e Help you to set up the ventilator e Select appropriate accessories to use with your ventilator e Show you how to respond to alarms e Answer your questions about using the ventilator e Follow up with you on a regular basis to make sure the ventilator is meeting your needs 2 3 How the Ventilator Works 2 3 1 Overview of Ventilation A ventilator like the Achieva ventilator you are about to use is a device that is designed to assist the patient by moving air into their lungs and providing adequate ventilation 2 3 2 Important Terms You should be aware of the following terms that will appear frequently throughout this manual Mode The manner or method of ventilatory support provided by the ventilator Volume The amount of air delivered to the patient with each breath Pressure A measure of the pressure required to push air into the patient s lungs Respiratory Rate The number of breaths per minute Achieva Ventilator
69. ty vec cncccncccaca ES N ces eu gies sous ARNESE EE A 10 1 This page intentionally blank SECTION Safety Information 1 1 Definitions This manual uses three indicators to highlight information of particular importance They are Warning Indicates a condition that can endanger the patient or the ventilator operator Caution Indicates a condition that can damage the equipment NOTE Indicates points of particular emphasis that make operation of the ventilator more efficient or convenient 1 2 Warnings and Cautions This section lists general warnings and cautions for your safety and that of the patient Warning e Read all of this manual before using the ventilator e Anything that damages the ventilator may cause danger to the patient e Do not use your ventilator until you have been properly trained by your clinician and have read and understand this manual e Make sure you can hear the ventilator s alarm from other areas of the house and when you are using appliances such as a vacuum cleaner dishwasher clothes dryer television or radio e Do not use the ventilator if you suspect it may not be working properly Contact your clinician to have the ventilator tested or replaced e If the patient s condition warrants the use of an independent secondary alarm or a back up means of ventilation the clinician should prescribe it e Wash your hands thoroughly before and after handling patient connectors and othe
70. ueeccuscecesecceaeceuseceuseceuseceeaneceaeeceaes 3 10 Contents Set Up 4 1 4 2 Where to Place the Ventilator ec eecsseeecceeceeesseeeeeeeeeeeessasseeeeeesssaeesseeseeeeeges 4 2 4 2 1 Electrical INtererenCe ssiesssesstssssessceccceceuecevecctecdeosvestvaaadecedessuioass EEES E EY 4 3 4 3 Mounting the Ventilator on a Wheelchair eee cece eeeeesssseeseeeeeesseneeseeeeeeeeeaes 4 4 4 4 Connecting the Patient Circuit cece cccceeeesseseeeeeeeeessssseeeeeeessseeeeeeeseeeeeaes 4 5 4 5 Connecting the Ventilator to an AC power Outlet cece ceeeeeeeeeesssreeeeeeeeeeeeees 4 6 4 6 Using an External Battery ssr eee cceesssrrcceeeeeeeeseeeseeeeseeessssseseseeesssasesseeeeeeeeeaes 4 7 4 7 Setting the Low Pressure Alarm cccssceceeeeessssseeceeecnssseeeeeeeeeeeessaseeeseeeeessaaeeseeeeeaes 4 8 4 8 Configuring for Assist Control Ventilation 0 0 eee ccceeeeeesssseseeeeesssesesseeeeeeeeeaes 4 9 Check Out 5 1 5 1 Completing the User Self Test 0 eeeeccsscecceeceeeeseeeeeeeeeeeesssaeseseeeessssaseseeeeeeeeaaees 5 1 5 2 Testing the Ventilator s Alarms cc eecessscecceeeeeeeseeeceseeseessasseceeeessssseeseeeeeaaaaees 5 3 93221 POW PreSSUMEFESU 2 5 5 a a Wei ile A cate cate cute ccherveusveusveusveusucessbebebebebebeist tens 5 3 52 2 APNOATOSt occcccccccveccsesecvesvvssvebsvensvosvoyeaytvayexartvaytyaniadedegedecegec scesseu ves vous suns ends E A 5 4 9 2 3 Power Failure TEST sosire eiA Ekia EEEE AANE EEA
71. window Figure 3 4 Setting Display and Control Correlation STANDBY VENTILATE Menu Esc Mone VOLUME INSPIRATORY TIME Fuow Sensmriviry Control Value NOTE AC 500 1 0 34 3 12 0 We 640 818 6 cet Control ae Breati PRESSURE PEEP Low His LE Rano FIO Rate SUPPORT Pressure PRESSURE START ENTER The I E Ratio and Flow settings do not have keys These controls are labeled for display purposes only PRPOZ ZF ATK TO m Achieva Ventilator User s Manual Mode Volume Inspiratory Time Flow Display only Sensitivity Breath Rate Pressure PEEP Low Pressure High Pressure I E Ratio Display only FiO Achieva PSO only 3 Description 3 3 Rear and Side Panels Oxygen Input Connection Achieva PSO only Inlet Filter Power Cord Connector External Battery Connector Side Rail Audible Alarm Port on side of ventilator DO NOT BLOCK Communications Connector Nurse Call Output Remote Alarm Connector pee Gh oa a RS Gy a gt Modem Connector Achieva PS and PSO only 3 6 Achieva Ventilator User s Manual Description 3 3 4 Power Supply Your Achieva ventilator can use any one of the following power sources e AC Power e External 12 or 24 Volt DC Battery e Internal Battery 3 4 1 AC Power NOTE e Whenever possible the ventilator should be plugged in to an AC power outlet This allows the ventilator to maintain its internal battery charge e
72. within two seconds The ventilator is responding to a You do not need to do anything The manual alarm test you are conducting alarms should stop within two seconds Microprocessor error 1 Unplug the ventilator from exter nal power 2 Press and hold STANDBY for 3 seconds or more 3 Reconnect external power If the unit is connected to AC it will automatically exit low power standby mode and begin to charge the internal battery Press VENTILATE to resume ventilation If the unit is connected to a charged external battery press the START ENTER switch to restart The internal battery will not begin to recharge until the ventilator is put into the ventilate mode Press START ENTER and check parameter settings for accuracy Press VENTILATE If alarm persists unplug the ventilator and provide another means of ventilation 9 14 Achieva Ventilator User s Manual Technical Reference What you see and hear Why this might happen What you should do Low Pressure Apnea Alarm The patient is not breathing Check the patient for breathing effort and stimulate if necessary There is water in the small bore tubing Disconnect the small bore tubing and remove the water per the manufacturer s instructions Patient speech or other activities lower patient circuit pressure Low pressure alarm sounds whenever low pressure limit is not reached for two consecutive breaths Review
73. y If the ventilator will not start ventilation continues alarming at the current rate or the rate of the alarm s beeping increases discontinue use of the ventilator and contact your clinician for guidance 7 3 7 Alarms and Alerts Table 7 1 Alarm and Alert Conditions Steady alarm The ventilator has Attend to the patient first as instructed by your tone detected a clinician microprocessor error Contact your clinician Do not use the ventilator Provide a backup means of ventilation Repeated single Flashing POWER The ventilator has Acknowledge the power switchover by pressing beep SWITCHOVER switched to another ALARM SILENCE RESET indicator power source If the ventilator has switched to its internal battery monitor ventilation or provide an alternate power source as soon as possible Flashing The ventilator has Attend to the patient first as instructed by your SETTING ERROR detected an error clinician indicator with either the Check the ventilator s settings Verify that the venti volume or inspiratory lator settings are set according to the prescription settings Alert If the alert condition persists discontinue use of the status ventilator and contact your clinician for guidance 7 2 Resetting Alarms After you have corrected the alarm condition press ALARM SILENCE RESET to reset the alarms and deactivate the indicator lights on the Alarms panel 7 3 Alarm Latching Some of the venti
74. y The following text will appear in the display Occlude patient end of breathing circuit 4 Block the part of the exhalation manifold that connects to the patient as illustrated in Figure 5 1 Make sure that you have a tight seal and do not let any air escape The following message will be displayed Press ENTER when ready to begin test Achieva Ventilator User s Manual 5 1 5 2 Figure 5 1 Check Out Blocking the Exhalation Manifold 5 Keep your seal on the exhalation manifold and press the START ENTER key The ventilator will push air into the circuit as it runs the test Once the test is completed you will see one of four messages in the display window Refer to Table 5 2 for a listing of the display messages and appropriate responses Table 5 2 User Self Test Results If the ventilator displays It Means Do this TEST PASSED ENTER repeat ESC exit The ventilator passed the User Self Test Press START ENTER if you wish to repeat the test Press MENU ESC to end the test The ventilator will switch to Standby mode Test ERROR Refer to MANUAL The test was not conducted properly Press ALARM SILENCE RESET to cancel the test The display will indicate that the test failed Check all connections in the patient circuit Press START ENTER to repeat the test Leak Test FAILED Refer to MANUAL There is a leak in the patient circuit between the patient air port and
75. yer television or radio Do not leave the patient unattended if you cannot hear the ventilator s alarm e Do not place the ventilator in a position where a child could reach it and change the controls e Do not place the ventilator in any position that might cause it to fall on the patient e Place the ventilator where the patient circuit can easily reach the patient Make sure the tubing hangs loose without strain so that the patient can move freely e Maintain at least four inches between the air inlet filter on the back of the ventilator and the wall Make sure the rear panel is not close to draperies or other items that could block the air flow into the air inlet filter e Do not place anything in front of the ventilator s alarm port on the side of the ventilator that could block or decrease the sound of the alarm e Do not place anything in front of the ventilator s patient air port on the front of the ventilator that could block or decrease the amount of air flowing from the ventilator to the patient Caution e Do not place the ventilator on or near electrical equipment such as a cellular or cordless phone television radio microwave oven or an electric heater These may affect the ventilator and cause it to work improperly e Do not expose the ventilator to extreme moisture such as direct exposure to rain Extreme moisture can cause the ventilator to fail or work improperly e Do not place a humidifier above t

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